PRE 2010 DOCSSUBJECT
City of Fridley
9
AT THE TOP OF THE TWINS
PERMIT.
UR
BUILDING
• COMMUNITY DEVELOPMENT DIV.
maU.
PROTECTIVE INSPECTION
�j
r SEC.
%��y
'
I CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF APPROVED BY
612-580-3450
910-F15
8/23/78
JOB ADDRESS 5831 West Moore Lake Drive N.E.
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION SEE ATTACHED
DESCR.
8
1
Donnay's Lakeview Manor Addn. SHEET
2 PROPERTY OWNER MAILADDRESS ZIP PHONE
B.. L. Altermatt 5831 West Moore Lake Drive
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO.
Lloyd's Home. Improvement Inc. 4911 - 4th Street N.E. 560-4857
4 ARCHITECT OR DESIGNER MAILADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Partial reroof of House
9 CHANGE OF USE FROM TO
STIPULATIONS
Roof can be second but not third roof. Install ridged galvanized
valleys.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SQ. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED.
$�62
$�50
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$7.50
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
3-
_
$8.00
46zlu
IGNATURE OF CONTRACTOI OR AUTHOR) D GE T (DATE)
WHEN PROP FLY VALIDATED THIS IS YOUR PERMIT
I 6 I -�3 -78
BLDG INSP DATE
SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE)
. CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PENMI TS
(NEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
OU R: L_ , BUILDER:
i
Address: L,�(���� l,�p Address:
Tel. No.
i
No. f0 s street:
LOT: BLOCK: ADDITION: �0�1 PJ (-I C/
CORNER LOT: INSIDE LOT: S13TBACK: SIDEYARDS:
Applicant attach 'to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Used As:
?WTA'L e(�6p Front:
Square Feet:
Depth: Height:
Cubic Feet:
Front: Depth: Height:
Square Feet: Cubic Feet:
Type of Construction:Estimated Cost: $ 3 ��
To Be Completed.- p Alt. A Alt. B
Pr6posed Driveway Width If New Opening Is Desired $ $
(SEE REVERSE SIDE OF SHEET)
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City of
Fridley Ordinances and rulings of the Department of Buildings, and hereby
declares that all the facts and representations stated in this application
are true and correct. See reverse side for additional information.
DATE: y o % SIGNATURE:
Stipulations:
T
SUB EC KET
City of Fridley
0RM11836 9
AT THE TOP OF THE TWINS
BUILDING PERMIT
f
R .
`L _____- COMMUNITY DEVELOPMENT DIV.
r i PROTECTIVE INSPECTION SEC.
C®°
1 1
=
1 I"'1 '- CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
j 612-571-3450
910-F15
4/8/86
JOB ADDRESS 5831 West Moore Lake Drive N.E.
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION SEE ATTACHED
DESCR.
8
1
Donnays SHEET
2 PROPERTY OWNER MAILADDRESS ZIP PHONE
Mark Ingebrigtsen 5831 West Moore Lake Drive N.E. 571-7787
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO,
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION] ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Install a Sears Free Standing Forced Air Circulating Fireplace
9 CHANGE OF USE FROM TO
STIPULATIONS Follow manufacturers installation instructions. Install fire alarms
in lowest level and in hall near bedrooms.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SQ. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
ISTALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
GOVERNING THIS TYPE OF WORK WILL BECOMPLIED
$1,500
$.75
WITH WHETHER SPECIFIED H HEREIN OR NOT. THE GRANTING OF APERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING COW
$25.50
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE TOTALFEE
LJ A
r. .25
FC Ni TO iUTHORiZE(DATEi
f
EN H S
V,{ �E
/PROPERL g. F'
n
I
SIG ATUREOFOW,' N (DAS:E)-. r
,"`'� i "ATE
NEW
[
] C--ii-ty of Fridley Effective 4/1/84
ADDh.
[
] i R-1 AND R-2 y
ALTER.
[
] Building Permit Application
Construction Address:
Legal Description:
Owner Name & Address: /�/E/P//��C!clTel . # _s7( -77S-/'
Contractor: Tel. #
Address: _
Attach to this application, a Certificate of Survey of the
lot, With the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length
Width
Height
Sq. Ft.
GARAGE AREA: Length
Width
Height
Sq. Ft.
DECK AREA: Length
Width
Hgt/Ground
q. Ft.
-SVC41
f, 1c, C 1-19
S P
OTHER:
t'
Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback
Type of Construction:
Approx. Completion Date:
Proposed Driveway Width If New Opening Is Desired:
DATE: V17176 APPLICANT.
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
f0TAL
STIPULATIONS:
CITY USE ONLY
Side Yard Setback ��ll
Estimated Cost: $ / y V
Alt. A Alt B
See Back Page for Explanation
Fee Schedule on Reverse Side -
25% of Building Permit Fee
$.50/$1,000 Valuation
$425 per SAC Unit
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
�iz"-«,OTrud( 'hi S'70-uc''1(jAj's
,tis — Fol, &*aw) to LacRs ; C.rc v� �= NK�►►�.
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
Effective On March 1, 1996
PLUMBING FIXTURE RATES:
New Fixtures
Old Opening, New Fixture
Beer Dispenser
Blow Off Basin
Catch Basin
Rain Water Leader
Sump/Receiving Tank
Water Treating Appliance
Water Heater -Electric
Water Heater - Gas**
Gas Range**
NO. RATE TOTAL
Gas Dryer**
Back Flow Preventer Required ( )Yes () No
Type _
$ 7.00
$ 4.00
$ 5.00
$ 7.00
$ 7.00
$ 7.00
$ 7.00
$10.00
$ 7.00
$10.00
$10.00
$10.00
JOB ADDRESS ya `a�J Cala/
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the city codes
and rulings of the Building Division, and hereby declares that all the facts
and representations stated in this application are true and correct.
Owner
Building Used Asc��-� C
Estimated Cost (DO - PERMIT NO.
$15.00 PLUMBING COMP
Reinspection Fee $42.00/Hr SIGNED BTEL N0. I
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5°k of Value of Fixture or Appliance
Approved By Rough -In Date Final Date
State Surcharge $ .50
MINIMUM FEE OR ANY PLUMBING/GAS PERMIT IS $20.00
TOTAL FEE $ o2d'S� PLUS THE $.50 STATE SURCHARGE
**COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. MINIMUM SIZE 9 SQ INCHES.
L�
SUBJECT
PERMIT NO.
City ®f Fridley
_. _...
22584
AT THE TOP OF THE TWINS
y 9 � I
I ®I PERMIT
BUILDING
B
r
6J�J1 L
RECEIPT NO
COMMUNITY DEVELOPMENT DIV.
_
PROTECTIVE INSPECTION SEC.
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
612-571-3450
910415
6/3/94
JoB ADDRESS 5831 West Moore Lake Drive NE
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
8
1
Donna 's Lakeview Manor SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
71-7 83
Mark/Laura In ebri tsen 5831 West Moore Lake Dr NE 571-7787-
3CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Timbercraft Remodeling 215 SW Hwy 8 e -633-8611 26214
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ADDITION ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
% R
8 DESCRIBE WORK
Construct addition to dwelling and alterations to existing
9 CHANGE OF USE FROM TO
STIPULATIONS
See notations on plan. VAR 493-18 approved for side yard setback to
1'11" (See plan), and reduce front yard setback to 31.3'.
WARNING
8efOre digging call for
all utility locations
454-0002
PERMITS REQUIRED FOR REQUIRED
IISEPARATE
BY
WIRING, HEAT!—MGI, PLUMBING AND SIGNS. LAW
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
ZONING
SQ. FT.
CU. FT.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
NO. DWLG. UNITS
OFFSTREET PARKING
ANY TIME AFTER WORK IS COMMENCED.
'HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
STALLS GARAGES
VALUATION
SURTAX
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$ 95,500
$47.75
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
PERMIT FEE
SAC CHARGE
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS F Y H STATE OR LOCAL LAW REGULATING CON-
STRUCTI R RMANCE OF CONSTRUCTION.
$ 621.50
Fire SC $95.50
PLAN CHECK FEE
TOTAL FEE
License SC $5.00
$769.75
S 1GNATURE C �RACTORORAUTNORIZEDAGENT IDeT I
RLY ALIDATED THIS IS YOUR pp�fPER IT
m�
BLDG INS P, DATE
SIGNATU E OF OWNER IIF OWNER BUILDER) IDATEI
L�
NEW I. 1 Effective 1/ 1 /94
ADDN � CITY OF FRIDLEY
ALTER ( SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Construction Address:— – `���- fit? A-A)A - V,,�,__--
Legal Description: — _-- `-� i 6'> c' U ti' C-1
S --
Owner Name & Address: �tt k Le,ctQ p,' Tel. # �57l – 79,8 7
Contractor: 01nn �wct/ ",+r IT -Ij MN LICENSE #
Address: 011 t,U - old- Hw°, AAMI BAi �-d
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length Width .Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
P
OTHER: S2 a&
� M`,l;
Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks
Type of Construction: �)-.Q j 4 Estimated Cost: $ -4-0a P-"
Approx. Completion Date: - I - q q
(Cost on Back)
Driveway Curb Cut Width Needed: Ft.4 6 t = Ft x $ _ $
DATE: 7 APPLICANT: Tel. # ( 33 4611
Permit Fee
$ 0 •
Fee Schedule on Reverse Side
Fire Surcharge
$ SD
.001 of Permit Valuation (1/10th%)
State Surcharge
$
$.50/$1,000 Valuation
SAC Charge
$
$800 per SAC Unit
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
Driveway Escrow
$
Alt. "A" or Alt. "B" Above
Erosion Control
$
$450.00 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement Necessary [ ] Not Necessary [ )
TOTAL $ `7�Sp
STIPULATIONS: 6
e=
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287
CITY COUNCIL
ACTION TAKEN NOTICE
September 29, 1993
Mark and Laura Ingebrigtsen
5831 West Moore Lake Drive N.E.
Fridley, MN 55432
Dear Mr. and Mrs. Ingebrigtsen:
On September 27, 1993, the Fridley City Council officially approved
your request for a Variance, VAR #93-18; to reduce the front yard
' setback from 35 feet to 31.3 feet; to reduce the side yard setback
/ from 5 feet to 2.3 feet; in order to allow the construction of a
double car garage on Lot 8, Block 1, DonnayIs Lakeview Manor
Addition, the same being 5831 West Moore Lake Drive N.E.
You have one year from the date of City Council action to initiate
l �,l construction. If you cannot begin construction in time, you must
4submit a letter requesting an extension at least three weeks prior
to the expiration date.
If you have any questions regarding the above action, please call
me at 572-3590.
Sincerely,
Barbara Dacy, AICP
Community Development Director
BD/dn
Please review the above, sign the statement below and return one
copy to the City of Fridley Planning Department by October 13,
1993.
Concur with action taken
i
1.1 I T Ur* rrsIULCT IN0rCIi I IV IN UIV.
6431 University'Ave NE
Fridley, MN 55432
572-3604
Lnecuve un uanuary 1, 1yy3
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARk NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS A06ype �q'(c
New Fixtures .$7.00 The undersigned hereby makes application for a permit for the work herein
Old Opening, New Fixture $ 4.00 specified agreeing to do all work in strict accordance with the city codes
Beer Dispenser $ 5.00 and rulings of the Building Division, and hereby declares that all the facts
Blow Off Basin $ 7.00 and representations stated in this application are true and correct.
Catch Basin $ 7.00 _
Rain Water Leader $ 7.00 7'15
199
Sump/Receiving Tank )_ / $ 7.00 OD
Water Treating Appliance $10.00 Owner
Water Heater —Electric $ 7.00
Water Heater — Gas $10.00 Building Used As �5, l� 1��M��U�
Gas Range $10.00 t
Gas Dryer $10.00 Estimated Cost �, 000 PERMIT NO,
Back Flow Preventer Required ( )Yes ( No
Type -$5.00 PLUMBING COMPANY Ale.
Reinspection Fee $30.00 SIGNED BY _ TEL N0. W6 -'770/
B4 L, 4, L
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1 % of Value of Fixture or Appliance
Approved Bk j Rough—In Date Final Date
State Surcharge $ .50
MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00
TOTAL FEE PLUS THE $.50 STATE SURCHARGE
SUBJECT
P
City of Fridley
'22753
AT THE TOP OF THE TWINS
BUILDING PERMIT
RECEIPT NO.
4
COMMUNITY DEVELOPMENT DIV.
_____
v e PROTECTIVE INSPECTION SEC.
r
j
e �
e � �
NUMBER
REY.
DATE
PAGE OF
APPROVED BY
i CITY HALL FRIDLEY 55432
----/`��,•�
1 J` 612-571-3450
910-F15
7/26/94
JOB ADDRESS
5831 West Moore Lake-Drivp NF.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
8
1
Donna s SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Mark Ingebri tsen 5831 West Moore Lake Dr
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Allied Fireside Corner 2700 N Fairview,1068
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
633-2561
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑x ALTERATION [IREPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Install a Majestic Built In Gas Fire lace G42HV
9 CHANGE OF USE FROM TO
STIPULATIONS
Install per manufacturer's specifications.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
ZONING
SQ. FT.
CU. FT.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
NO. DWLG. UNITS
OFFSTREET PARKING
ANY TIME AFTER WORK IS COMMENCED.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
STALLS GARAGES
VALUATION
SURTAX
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$1.00
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
PERMIT FEE
SAC CHARGE
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY O ER STATE OR LOCAL AW REGULATING CON-
$45.00
Fire SC 2.00
STRUCTION OR THE P FORMANCE OF NST CTION.
PLAN CHECK FEE
TOTALFEE
�L
icense SC 5.00
53.00
SIGNAT NiRACTORORAUTH RIZE AG NT iDAT I
PERLY VALI �YfIS IS YOUR PERMIT
BLDG INSP DATE
SIGNATURE OF OWNER 0F OWNER BUILDER) IDATEI
NEW 1 i Effective 1/1/94
ADDN [ i CITY OF FRIDLEY
ALTER [ [ SINGLE FAMILY AND DUPLEXES R-1 AND R-2 �, ��'�/l
Building Permit Application
Construction Address: -'t? 3 / -- W, !/Yip o � s' LA Kms' ,.
Legal Description:
Owner Name & Address: /[/(, A-4<, <, i 62 G, c=, a 12 Lc`T' s e. Tel. # S79 73 o a
Contractor: MN LICENSE #. /0,/,
.Address: Z 7 ® o A] 53 &Vi MAIL Tel. # -2-Cr.
j
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: LengthWidth Height Sq. Ft.
DECK AREA: Length /Width Hgt/Ground Sq. Ft.
OTHER: C�* \ 0& Q
Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks
Type of Construction: Estimated Cost: $ '�-
Approx. Completion Date:
(Cost on Back)
Driveway Curb Cut Width Needed: Ft + 6 Ft Z,Ft x $ = $
;�'2
DATE: Z6 APPLICANT: Tei. # 633 --2g�6
STIPULATIONS:
CITY USE ONLY
j
Permit Fee
$
7 � - 010
Fee Schedule on Reverse Side
Fire Surcharge
$
2-6)0
.001 of Permit Valuation (1/10th%)
State Surcharge
$
1,676
$.50/$1,000 Valuation
SAC Charge
$
$$00 per SAC Unit
License Surcharge
$
5--06
$5.00 (State Licensed Residential Contractors)
Driveway Escrow
$
Alt. "A" or Alt. "B" Above
Erosion Control
$
$450.00 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement Necessary [ ] Not Necessary [ ]
TOTAL
$
53 6 C)
STIPULATIONS:
SUBJECT
Mm
City ®f Fridley PERMIT
AT THE TOP OF THE TWINS BUILDING
r
I
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
CITY HALL FRIDLEY 55432 NUMBER
---- 612-571-3450 110-F 15
JOB ADDRESS 5831 West ore Lake-Dzi
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION
DESCR. 8 1 Donna s
2 PROPERTY OWNER MAIL ADDRESS
Mark Ingebrigtsen 5831 West Moor
3 CONTRACTOR MAIL ADDRESS
Allied Fireside Corner 2700 N
4 ARCHITECT OR DESIGNER MAIL ADDRESS
5 ENGINEER MAIL ADDRESS
6 USE OF BUILDING
Residential
REV DATE PAGE OF
7/26/94 1
IF
ZIP PHO
PER &TNO:
2 i 5 wi
RECEIPT NO.
1P G'
aPPROVEO BY
SEE ATTACHED
SHEET
ZIP PHONE
LICENSE NO.
1 1 a T1TT 551 1 3
1068
ZIP PHONE
LICENSE NO.
633-2561
ZIP PHONE
LICENSE NO.
7 CLASS OF WORK
❑ NEW ❑ ADDITION Ox ALTERATION ❑ REPAIR ❑ - MOVE O REMOVE
B DESCRIBE WORK
Install a Maiestic Built In Gas Fireplace (G42HV)
9 CHANGEOFUSEFROM TO
STIPULATIONS
Install per manufacturer's specifications.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
CU. FT.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED,
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION
1
STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$1.00
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
pERMITFEE
SAC CHARGE
PROVISIONS OF ANY O ER STATE OR LOCAL AW REGULATING CON-
$45.00
Fire SC 2.00
STRUCTION OR THE P FORMANCE OF NST CTION.
PLAN CHECK FEETOTAL
FEE
�bLicense
SC 5.00
53.00
SIGNAT NTRACTOR OR AUTH RIZE AGENT IOAT I
PER/LYVyA�LIVAI.E�S—%HIS IS YOUR RMIT
BLDG INSP r�a7E
SIGNATURE Or OWNER sir OWNER BUILDER) IDATEI
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572j,�--3604
,1t
Effective On January 1, 1993
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES � 3 �� � �� ()r° 1 VL'
JOB ADDRESS
Residential Rate TOTAL
Furnace Shelf and Duct Work, Burner –
Also Replacement Furnace $ 20.00 $_ C)
Gas Piping (Needed with new furnace) $10.00 $
Gas Range $10.00 $
Gas Dryer $ 10.00 $
*Air Conditioning – All Sizes $10.00
All Others/Repairs & Alterations (LIST ON BACK)
I% of Value of Appliance or Work
Commercial/industrial
I% of Value of Appliance or Work
State Surcharge $ .50
TOTAL FEE $
MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS ;15.00
PLUS THE 5.50 STATE SURCHARGE
REINSPECTION FEE $30.00
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes and
rulings of the Building Division, and hereby declares that all the facts and
representations stated In this application are true and rrec .
,19941
A- rn
U
BUILDING USED AS ,&—
ESTIMATED COST 5Z -5--Z. { O PERMIT NO. 2 AC S
No. of Heating Units Circle One (Steam) (Hot Water)(Warm Air)
Trade Name_ �� Size No. nix
BTU HP EDR
Fuer _Total Connected Load
Burner Trade Name
BTU HP
HEATING
Size No.
EDR
T W IMAM VR
f, .
Signed JV
WT-Jr.6J Tel No.—
he
r,
Approve Rough–In Date Final Date f
'ib -TI 7 l
FILL OUT IBAC'KS�IDE FOR STACK VERT
FiCATI� N
REPLACEMENT FURNACE
f
CHIMNEY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack:
1.
Has been carefully examined
Yes
No
2.
Is free from rust or deterioration
Yes
(1}
No
{ )
3.
Has no foreign objects lodged within
Yes
'/"
No
( )
4.
Is securely supported
Yes
6A
No
( )
S.
Meets all current Code requirements for
size and total BTU's connected
Yes
(
No
( )
6.
Has total heating BTU's of
All other BTU's
TOTAL BTU's
Remarks
AlterationsList p. Done: -
19
'. N. 1. :..Y W .1r
%1
HEATING COMPANY
Signed By
Date
A
Exp. wall
Nut exp. wall
Inl. wall
Ceding 57 J d
f loran
Total Btu.
dr—C-Room I L h J.75 Width i He' t
Windrows and Doors—Crackap and Arm
N W.nrh - NIMht Lorimar of L.t M Area
..r new. I n1 nlne Ltoht► at
Coo. Btu
Infiltration
Glass _
Exp. wall O
Net exp. wall
Int. wall
Ceding
F lour
Total Btu. !•Z
Exp, will
Net exp, wall
Int. wall
Ceiling
Floor
Total Btu.
F1.1 Room I Length Width
_Windows and Doors—Crackage and Arm
Nn. WM\h NorghYt i�.ows �I sf� aAO•M.
Inf iltratfon
Glass
Exp, wall
Net exp. wall
Int. wall
Ceiling
I F loor
Total Btu.
d
Btu
_
HEAT LOSS
CALCULATION
° 'HEMP. DIFF.
r
Customer Name
-- —
Type Construction
City
Windows Storm Sash
Dealer Name .—
Walls . Ins.
Street
_ _ _,__
Ceiling Ins.
City _.
Floor —
F1.
Room lLength �$' Width
/�
Heighj
Vh Width He
F1.1 Roor" I Ly
t
Winflows and Doors—Crackage and Area
Windows and Doors—Crackage and Area
w.eth
NO M as
M..9ht No of ; Lineal H. At"
Light: of pine L ht. OI crack p. 1t_
No.
Width Height No of Llnoot It. At"
Of no Ot M l t\ Of C/KY tA. of
Btu
Btu
—
Coef.
Coef.
Infiltration
�-i
Infiltration
Glass
_
�`
Glass
Exp. wall,
Exp, wall
Net exp. wall
Net exp. wall
Int. wall
Int. wall
Ceiling
p
3
16 _ 6)
Ceiling
F loot
F loor
Tool Btu.
Total Btu.
FI•! —c,,,,Room1LvVth U Width
5
Height,/,/,
FI.I Room yL h Width Height
_
Windows Ad
Doors—Crackage and Aim
Windows and Doors—Crackage and Area
w.ath
No 01 •M
r+•.snt No of L#01,40 ft. Atw
of •n. L t\ at crack so. it
—9 Width N�tght
NO. of Poing O/ MM
No of Wneai tt. A+ed
L b of pock . to
3
I' /
Btu
Coef.
Coef.
Btu
Infiltration
Infiltration
Glass
Glass
Exp. wall
Nut exp. wall
Inl. wall
Ceding 57 J d
f loran
Total Btu.
dr—C-Room I L h J.75 Width i He' t
Windrows and Doors—Crackap and Arm
N W.nrh - NIMht Lorimar of L.t M Area
..r new. I n1 nlne Ltoht► at
Coo. Btu
Infiltration
Glass _
Exp. wall O
Net exp. wall
Int. wall
Ceding
F lour
Total Btu. !•Z
Exp, will
Net exp, wall
Int. wall
Ceiling
Floor
Total Btu.
F1.1 Room I Length Width
_Windows and Doors—Crackage and Arm
Nn. WM\h NorghYt i�.ows �I sf� aAO•M.
Inf iltratfon
Glass
Exp, wall
Net exp. wall
Int. wall
Ceiling
I F loor
Total Btu.
d
Btu
HEAT LOSS CALCULATION ° TEMP. ®IFF.
Customer Name _ Type Construetiort
City _—_--- MFEN BLE 19�f1L^ III
1/ In x WindowsStorm Sash
Dealer Name . Walls . Ins.
AIR
Street =.,)-C®M���D. Ceiling Ins.
City COOIVIN 55433
N RAPID
Flow
Room Length Width.. Maiahr FI.I . . Z Rooml Lenwh .; Width /L> Meieht
Intlows and Doors-Crackage and Area
No W`atn nde,- et No OI I NIIwI ll. AIM
Coef. I Btu
Infiltration
Glass .
Exp. wall
Net exp. wall
Int. wall
Ceiling
F loor /GSD �I-�._? 411,
Total Btu , r ,4�11)
Windows and Doors-Crackage and Area
No W.At1, "0 No OI L~1 ft,. AIM
no .M OI eM l n1. 006,6441no, to
/ D (� �l
N..I o. of LInN. Area
040,
Loh"of areas
Coef.1
Coef.1
Coef.
Btu
Inllluatlon
Infiltration
L
4/:�Z,
Glass
Glass
Glass
r f'
Infiltration
E xp. wall
i1G t'
Exp. wall
Net exp. wall
Net exp. wall
-
Int. wall
Net exp. wall
Int wall
Ceiling
I_
Int. wall
Int. wall
F low
Ceiling
Floor
Ceiling
�a •!"
CY-
3
, 3 no
1' Ion(
Total Btu.
iF I I • S . 'f Rnem I Lenuth Width /e" Weiuht
Wlrlflnws and Doors-Crackage and Arm
N 00.111h "0.1hl No of L.neal h, AIM
•�o I.. n. nl r,.M L is of crock p. Pt
/ D (� �l
N..I o. of LInN. Area
040,
Loh"of areas
Coef.1
Coef.1
Btu
Infiltration
Btu
Infiltration
L
4/:�Z,
Glass
Glass
Exp, wall
r f'
Infiltration
E xp. wall
i1G t'
Net exp. wall
Net exp. wall
-
Int. wall
Ceiling
Int wall
Ceiling
I_
Int. wall
Ceiling
F low
Ceiling
Floor
�a •!"
Floor
Intal Btu. C�
Windows and Doors-Crackage and Area
NO
Width NO of Lln..l /t. At"
Ot M OI oM L f/ Of aack 94.11
N..I o. of LInN. Area
040,
Loh"of areas
Coef.1
Btu
Inf iltration
Coef.
Btu
Infiltration
Glass
Glass
Exp, wall
r f'
Infiltration
Exp. wall
i1G t'
Net exp. wall
Int. wall
-
Int. wall
Ceiling
Ceiling
Floor
Int. wall
F low
Ceiling
Total Btu. '7 �?
FII Rnnm I I arimh / :;, Width / --"iHaieht
Windows and Doors-Crackage and Are.
No. Width No of unset h. Ater
of n. Of M L h of etagY ag, to
Wleth N.,�tlt
of M
N..I o. of LInN. Area
040,
Loh"of areas
Coef.1
Btu
Inf iltration
Glass
Exp, wall
r f'
Infiltration
- G-•
Not exp. wan
Glass
Exp. wall
Int. wall
-
Ceiling
Floor
Int. wall
Total Btu.
FI I : Reranl l MMdh /_ Width Meiaht
Windows and Doors-Cra *ap and Area
._n._
Pan.
Wleth N.,�tlt
of M
N..I o. of LInN. Area
040,
Loh"of areas
Coo.
Btu
Infiltration
- G-•
Glass
Exp. wall
-
Not exp. wan
Int. wall
Ceiling
�a •!"
Floor
ITotal Btu. - I u' �- - v-'
SUBJECT
City of Fridley
4 6 45
AT THE TOP OF THE TWINS
BUILDING PERMIT
RECEIP
Ir
i 1- ______ COMMUNITY DEVELOPMENT DIV
L
j��
I � PROTECTIVE INSPECTION SEC.
r
l�
NUMBER
EV
DATE
PAGE OF
APPROVED By
l CITY HALL FRIDLEY 55432
"'' 612-571-3450
910-F15
77
10/10/96
JOB ADDRESS 5831 West Moore Lake Drive NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
8
1 1
1 Donnay's Lakeview Manor Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Mark Ingebrigtsen 5831 West Moore Lake Drive NE 571-7787
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Timbercraft 215 Old Hwy 8, New Brighton, MN 55112 633-8611 2624
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK ❑
❑ NEW ❑ ADDITION X ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WORK
Finish basement
9 CHANGE OF USE FROM TO
STIPULATIONS
See notations on plan.
SEPARATE PERMITS REQUIRED FOR
WIRING, HEATING, PLUMBING AND SIGNS.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SQ. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$.50
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$500
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
Fire SC $.50
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
$21.00
PLAN CHECK FEE
TOTAL FEE
$22.00
_
SIGNATURE OF CON' CTOR O MOR12E0 T
WHEN PROPERLY ALI DATED THIS IS YOUR PERMIT1/P
14;19'6
x'60
�; BL G iNSP 0ATE
SGNATUREO O ER iiF OWNER BUILDER) (DATE)
NEW [ ] Effective 3/1/96
ADDN j ] CITY OF FRIDLEY
ALTER [x] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application �®
Z
Y
ConstructionAddress:
Legal Description: 41-U/117ek ys
Owner Name & Address: �j^� - � Xe, h Tel. # ,S 7/- 7 7,? %
Contractor:' cy- MN LICENSE # 2jce" 2.1
Address: Dle<( Hwy !�- S Cu Are _ -�`y Tel. # 6 33 .�C
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IlVIPROVEMENT
LIVING AREA: Length" Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:..
Comer Lot [ ] Inside Lot W Ft. Yd Setback Side Yard Setbacks P14
Type of Construction: Estimated Cost: $ y
Approx. Completion Date: L
(Cost on Back)
rb t idth Needed:
Driveway Cuol
Ft. + 6 Ft = $ _ $
DATE:
APPLICANT:
- Tel. # , S 7l— 7 7d'�
CITY USE ONLY
Permit Fee
$ ,
Fee Schedule on Reverse Side
Fire Surcharge
$
.001 of Permit Valuation (1/10th%)
State Surcharge
$
$.50/$1,000 Valuation
SAC Charge
$
$900 per SAC Unit
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
Driveway Escrow
$
Alt. "A" or Alt. "B" Above
Erosion Control
$
$450.00 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement Necessary [ J Not Necessary [ ]
2,
TOTAL
$
STIPULATIONS:
V-A zeAENT PLAN-llc
SUBJECT
_RM IT NO.
City of Fridley?
<�_.��
4 65 9
AT THE TOP OF THE TWINS
BUILDING
P E R
M I T
RECEIPT NO.
Ir
�•
�: ------ COMMUNITY DEVELOPMENT DIV
INSPECTION SEC.
q6c?9
/PROTECTIVE
60
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
10/14/9
JOB ADDRESS 5831 West Moore Lake Drive NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.8
1
Donnays Lakeview Manor
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
Mark/Laura Ingebrigtsen 5831 West Moore Lake Drive NE
571-7787
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO
Timbercraft 215 Old Hwy 8 SW New Brighton MN 55112
633-8611 2624
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP
PHONE LICENSE NO
5 ENGINEER MAIL ADDRESS
ZIP
PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION IO_ ALTERATION ❑ REPAIR
X
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Finish basement (frame walls
9 CHANGE OF USE FROM TO
STIPULATIONS
See notations on plan.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SQ. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
STALLS
GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$7,000
$3.50
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF A Y OTHER JSTATE OR LOCAL LAW REGULATING CON-
STRUCTI T E 910ANCE OF CONSTRUCTION
$124.75
ire SC $7.00
PLAN CHECK F
AL FEE
447-4-C,4/j.00
Y7$
IGNATUREOi ON TRACTOR OR AUTHORIZED AGENT (DA/1
P
Y VA
D THIS IS YOURPERMIT
V `
OAT
$iGNATUR OF OW NERIIF OWNER BUILDER) IDATEI
NEW [ ]
ADDN [ ] CITY OF FRIDLEY
ALTER [�° ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
ConstructionAddress:
Legal Description:
Owner Name & Address: A4,111
Contractor:
Address:
Effective 3/l/96
Tel.# 571-728
MN LICENSE # '),b ,�L-
alk Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF E%IPROVENOW
LIVING AREA: Length
Width
Height
Sq. Ft.
GARAGE AREA: Length
Width
Height
Sq. Ft.
DECK AREA: Length
Wid/thHgt/G
Sq. Ft.
OTHER:
/jd
Mue '
Comer Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks
Type of Construction: `Uvo a C) 3'�Cv� Estimated Cost: $
Approx. Completion Date:
(Cost on Back)
Driveway Curb Cut Width Needed: Ft.t — Ft x $ _ $
DATE: , 0 R. `% - APPLICANT: ' Tel. # 6 - 411
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
STIPULATIONS:
CrW USE ONLY
757' Fee Schedule on Reverse Side
$ .001 of Permit Valuation (1/10th%)
$ �. $� $.50/$1,000 Valuation
$ $900 per SAC Unit
$ 6 D $5.00 (State Licensed Residential Contractors)
$ Alt. "A" or Alt. "B" Above
$ $450.00 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement Necessary [ ] Not Necessary [ ]
4
1
K
ESTIMATE #101580
TI14BERCRAFT
215 OLD HIGHWAY 8 SW
NEW BRIGHTON, MINNESOTA 55112
PHONE 612-633-8611
PETER J. MORL0WSKI
ITEM DESCRIPTION
BEDROOM
m
1 SHEETROCK WALL(S) STD
1/211
2 SHEETROCK CEILING STD
5/8"
3 SPRAY TEXTURE CEILING
SF
4 INSTLL PRE-HNG HC OAK
DR 2'-6t1
5 OAK PRINCETON CASING
1/211
6 OAK PRINCETON BASE
EA
BEDROOM CLOSET
3
1 SHEETROCK WALL(S) STD 1/2t1
2 SHEETROCK CEILING STD 5/8"
3 SPRAY TEXTURE CEILING
4 PREHUNG OAK BIFOLD DOOR 3`-011
5 OAK PRINCETON BASE
6 INSTALL CLOSET ROD & SHELF
3 BEDROOM
11
1 SHEETROCK WALL(S) STD
1/211
2 SHEETROCK CEILING STD
5/811
3 SPRAY TEXTURE CEILING
SF
4 INSTLL PRE-HNG HC OAK
DR 2'-611
5 OAK PRINCETON CASING
1/2t1
6 OAK PRINCETON BASE
EA
4 BEDROOM CLOSET
08/09/96 PAGE 1
MARE & LAURA INGEBRIGTSEN
5831 WEST MOORE LAKE DRIVE
FRIDLEY , MN 55432
PHONE H 612-571-7787
W 612-378-7300
JOB LOCATION
5831 WEST MOORE LAKE DRIVE
FRIDLEY, MN 55432
QTY UM
X 12 X 8 '6ep
2W2L ' 368 SF
�0 132 SF
Y' 132 SF
1 EA
6 LF O ,p
pJ rj 1/
X 6 X 8
2W2L 44 SF
18 SF
18 EA
18 LF
®" 6 LF
X 12 X 8
sA
2W2L
4 X 4 X 8
368 SF
132 SF
132 SF
1 EA
50 LF
46 LF
1 SHEETROCK WALL(S) STD 1/211 2W2L
128
SF
2 SHEETROCK CEILING STD 5/811
16
SF
3 SPRAY TEXTURE CEILING
16
SF
4 PREHUNG OAK BIFOLD DOOR 31-011
1
EA
5 OAK PRINCETON BASE
16
LF
6 INSTALL CLOSET ROD & SHELF
4
LF
5 HALLWAY
3 X 22 X 8
1 SHEETROCK WALL(S) STD 1/211 2W2L
400
SF
2 SHEETROCK CEILING STD 5/811
66
SF
3 SPRAY TEXTURE CEILING
66
SF
4 OAK PRINCETON CASING 1/211
125
LF
5 OAK PRINCETON BASE
50
LF
ESTIMATE #101580 08/09/96 PAGE 2
ITEM DESCRIPTION QTY UK
6 HALL CLOSET 3 X 5 X 8
1 SHEETROCK WALL(S) STD 1/2" 2W2L 128 SF
2 SHEETROCK CEILING STD 5/8" 15 SF
3 SPRAY TEXTURE CEILING 15 SF
4 PREHUNG OAK BIFOLD DOOR 3`-0" 1 EA
5 OAK PRINCETON BASE 16 LF
6 INSTALL CLOSET ROD & SHELF 5 LF
7 STORAGE 5 X 8 X 8
1 SHEETROCK WALL(S) STD 1/2" 2W2L 208 SF
2 SHEETROCK CEILING STD 5/8" 40 SF
3 SPRAY TEXTURE CEILING 40 SF
4 INSTLL PRE-HNG HC OAK DR 2'-4" 1 EA
5 OAK PRINCETON BASE 26 LF
6 INSTALL CLOSET ROD & SHELF 11 LF
8 SHOWER ROOM 4 X 8 X 8
1 SHEETROCK WALL(S) STD 1/2" 2W2L 192 SF
2 SHEETROCK CEILING STD 5/8" 32 SF
3 SPRAY TEXTURE CEILING 32 SF
4 INSTALL POCKET DOOR UNIT 1 EA
5 OAK PRINCETON CASING 1/2" 15 LF
6 OAK PRINCETON BASE g4 LF
9 BATHROOM 6 X 8 X 8
1 SHEETROCK WALL(S) STD 1/211 2W2L
/ 224 SF
2 SHEETROCK CEILING STD 5/8" 48 SF
3 SPRAY TEXTURE CEILING vo 48 SF
4 INSTLL PRE-HNG HC OAK DR 2'-4"1 EA
5 OAK PRINCETON CASING 1/2" 410 30 LF
6 OAK PRINCETON BASE 28 LF
10 GENERAL CONDITIONS V'�
1 MISC FRAMING 1 EA
s
ESTIMATE #101581
TIMBERCRAFT
215 OLD HIGHWAY 8 SW
NEW BRIGHTON, MINNESOTA 55112
PHONE 612-633-8611
PETER J. MURLOWSKI
ITEM DESCRIPTION
1
OLD FAMILY ROOM
14
1
MISC FRAMING
2
SHEETROCK WALL(S) STD
1/2"
3
SHEETROCK CEILING STD
5/8"
4
SPRAY TEXTURE CEILING
5
MOVE WATER LINES INTO
CEILING
2
COMPUTER ROOM
7
1
SHEETROCK WALL(S) STD
1/2"
2
SHEETROCK CEILING STD
5/8"
3
SPRAY TEXTURE CEILING
3
STORAGE ROOM
1
SHEETROCK WALL(S) STD
1/2"
*
MISCELLANEOUS
1
TAX
2
PERMIT
08/09/96 PAGE
MARK & LAURA INGEBRIGTSEN
5831 WEST MOORE LAKE DRIVE
FRIDLEY , MN 55432
PHONE H 612-571-7787
W 612-378-7300
JOB LOCATION.
5831 WEST MOORS LAKE DRIVE
FRIDLEY, MN 55432
x30 x8
8 11
2W2L
X 8
QTY UM
1 EA
240 SF
420 SF
420 SF
1 EA
288 SF
77 SF
77 SF
240 SF
1
SUBJECTERMI
City of Fridley
2 5 61
THE TWINS
BUILDING
PERMIT
-RECEWIPT NO.
• -------COMMUNITY DEVELOPMENT DIV.
-7� -1,4
r � � PROTECTIVE INSPECTION SEC.
l �'�•\ CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
OF
APPROVED BY
L.___� ' �•� 612-571-3450
910415
11 12 98
FPAGE
/ /
108 ADDRESS
5831 West Moore Lake Drive
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
8
1
Donna s
SHEET
2 PROPERTY OWNER MAIL ADORES$
ZIP PHONE
Mark In ebri tsen
571-7787
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Kenneth Sle ica Const.Inc. 1410 100th Ave NW #301 Coon Ra ids 55433 757-9101 2398
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW J�x ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Construct a 16' x 16' and a 10' x 6' deck
9 CHANGEOFUSEFROM TO
STIPULATIONS
See notations on plan.
�! A. .5..rt'
ljuwl'�
' u�i!!'.V
a9t -
454-0002
r%E UIRE® 13Y LA
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
VENTILATING OR AIR CONDITIONING
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT
CU FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION
STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
2913
$1.46
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON•
STRUCTI N OR THE P RF RMANCE OF CONSTRUCTION
$74.75
FiiA SC $2.91
PLAN CHECK FEE
' 11i-if?
•%®r4l
;r/FEE
.12
SiGNA ru RE OF CONTRA OR OR AUTHORIZED AGENT I ATE,
HE P
BI.JFG INSP I
THIS IS V I PERMIT
I ./
naTE
S,GNATURE 09 OWNERoF OWNER BUILDERi IDATEI
NEW [ ] Effective 1/1/98
ADDN [ J CITY OF FRIDLEY
ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 `
BUILDING PERMIT APPLICATION q
ConstructionAddress: j W e4 M Qor Q L r
Legal Description:
Owner Name & Address: , k d, L g v r
Tel. #
�1e e� II
Contractor: MN LICENSE #
Address: 10 r /00+%
®0+% v� . w' D) R . Tel. # 7 5 7 c l /0 l
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width i ( Hgt/Ground I_fj> Sq. Ft.
OTHER: 10 (�- 4*
Q Cj
Construction Type: Estimated Cost: $
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $
DATE: jl & 5 APPLICANT: XeA Q] P -- Tel. # 7S ;7-c
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
CITY USE ONLY
$ L/.7 Sr
Fee Schedule on Reverse Side
$ f
.001 of Permit Valuation (1 / 10th %)
$.50/$1,000 Valuation
$
$1000 per SAC Unit
$ ,5� 0 C)
$5.00 (State Licensed Residential Contractors)
$
Alt. "A" or Alt. "B" Above
$
$450.00 Conservation Plan Review
$
Fee Determined by Engineering
$
Agreement Necessary [ ] Not Necessary [ ]
s !Zq,12- 7 ( rl� 6,��j 1,6 7- bl-"L
0
'r
-o
JaNx
w;4l sov%Q+wles
Fps A ,
M
;' ,o, I
0
x
I
� o + c r 1�a �q rtt w��{ � P ra ✓ td
ai•c£ /4,4-y— tiAi 1S.
1) sc.%
� —yo,
,� }-a x i o
�-16._x,. �
�rl�}SC^
P Or.
-s- s
w. m
I�
CITY OF FRIDLEY INSPECTION DIV. l �,1 �� �s;�dy; Effective On January 1, 1997
6431 University Ave NE
Fridley, MN 55432. APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
JOB ADDRESS
RATE SCHEDULE
The undersigned hereby makes application for a permit for the work herein
Residential Rate
TOTAL
specified agreeing to do all work irl strict accordance with the City Codes and
Furnace Shell and Duct Work, Burner —rulings
Furnace $ 30.00
$
of the Building Division, and hereby declares that all the facts and
representations stated in this application are true and cor at.
Also Replacement
(Side Vent — Fill Out Back)
199
Gas Piping (Needed with new furnace) $10.00
$
ve rh
OWNER'• i1� Se
Gas Range $10.00
$
BUILDING USED AS
Gas Dryer $10.00
$
r
ESTIMATED COST 1 ® PERMIT NO._ /0 �2
*Alr Conditioning — All Sizes $ 25.00
$
DESCRIPTION OF FURNACE AND OR BURNER
All Others/Repairs & Alterations (UST ON BACK)
1 % of Value of Appliance or Work
$
No. of Heating Unp___.,/ Circle One (Steam) (Hot Wa r (Warm Air)
Trade Name Size No.
Commercial/Industrial
BTU HP EDR
1.25% of Value of Appliance or Work
$
Fuel Total Connected Load
State Surcharge
$ 50
Burner Trade Name Size No.
TOTAL FEE
®
BTU HP' EDR
tUSUP,SAN AIR
-!err
HEATING CO ANY NNEAPOLt3, IAN
MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
Signed By el No.
PLUS THE $.50 STATE SURCHARGE
>
REINSPECTION FEE $42.00/Hr
Approved ByRough—In Date Final Date —007
--Z —4
*Air Conditioners can not be placed in a side yard without
FILL OUT BACK SIDE FO STACK VERIFICATION ON
written permission from adjoining property owner.
REPLACEMENT FURNACE
Remarks:
List ALTERATIONS Being Done:
HEATING CO:
Signed By:
Date:
CHIlVINEY AND STACK VERIFICATION
The
undersigned hereby verifies that the existing chimney or
stack:.
1.
Has been carefully examined
Yes
O
No
(
)
2.
Is free from rust or deterioration
Yes (
);
No
(
)
-3.
Has no foreign objects lodged within
Yes
O
No
(
)
4.
Is securely supported
Yes ()
No
(
)
5.
Meets all current Code requirements for size
and total BTU's connected
Yes ()
No
(
)
6
Has total heating BTU's of
All other BTU's
TOTAL BTU's
7.
Has a liner been provided, for water heater
Yes ()
No
(
)
8.
Has combustion air been provided for water heater
Yes {)
No
(
)
Remarks:
List ALTERATIONS Being Done:
HEATING CO:
Signed By:
Date:
SUBJECT
City of Fridley
30109
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
j PROTECTIVE INSPECTION SEC
1 �
i CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
8/24/99
10B ADDRESS 5831 West Moore Lake Drive
1 LEGAL
LOT NO.
BLOCK
CT OR ADDITION
SEE ATTACHED
DESCR.
8
1
Pnays
SHEET
2 PROPERTY OWNER MAIL ADDRESS,
ZIP PHONE
Mark & Laura Ixgulkx Ingebrigtsen
571-7787
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Imperial Siding 140 Hudson Ave N Big Lake MN 55309
378-2345 8510
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION a REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Reroof house and garage (35 S Tear -off; Aluminum trim
9 CHANGEOFUSEFROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING,
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT
CU FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
ISTALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$4559
$2.28
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
RMANCE CONSTRUCTION
TR CTI�OFCON-R
$111.25
Fire C $4.56
PLAN CHECK FEE
TOTA EE
Licen C 5.0
.09
SIGNATURE ACT0 uTNORIZED AGENT IO Y
EN RO VALIDAT HIS ISUR P
6RPa�PO
BLO IN SP 4, 6.•//f1ATE
S,GNATURE OF OWNER SIF OWNER BUILOERI IDATEI
w
NEW[ ] Effective 5/10/99
ADDN [ ] CITY OF FRIDLEY
ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2
lO
BUILDING PERMIT APPLICATION �b
Construction Address:
Legal Description:
Owner Name & Address: Tel. # j,?
Contractor: _57/ MN LICENSE #
Address:�;` t �6 Tel. #W .
Attach to this application, a Certificate of Survey of the:
lot, with the proposed construction drawn on it to scale.::
DESCRIPTION OF IMPROVEMENT" -
LIVING AREA: Length Width Height Sq. Ft. _
GARAGE AREA: Length Width Height . Sq. Ft. _
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER: = _ —7T--/;, /sem–
Construction Type: ' Q E Estimated Cost: $
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: C
A APPLICANT: ,, f Tel.
TOTAL
STIPULATIONS:
CITY USE ONLY
Permit Fee
$
asf
Fee Schedule on Reverse Side
Fire Surcharge
$
%
.001 of Permit Valuation (1/10th%)
State Surcharge
$-
$.50/$1,000 Valuation
SAC Charge
$
$1050 per SAC Unit
License Surcharge
$
_`j �U
$5.00 (State Licensed Residential Contractors)
Driveway Escrow
$
Alt. "A" or Alt. "B" Above
Erosion Control
$
$450.00 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement Necessary [ ] Not Necessary [ J
TOTAL
STIPULATIONS:
2m'd -ULL01
I] AwssaoeN M I I ALMSSOOM WSLUOGJBV
MOYOY LIVId W
aAow.AL Iry Jo..V.. w
(sOP8*03 P.aalo.moa mss) w9s
run ovS jed Sly LS
uopenden MUMS
(°/aLRONL) LOWWA d P M
SPS GWaAGlt uo GIBS +8,1
lvlol
"Fv
- AINO 38n A J3
'.equmu pao.tot RoA Ate'
Ra em Pue Pno Buis" 19ZL•CL5`E9l as x6a -uowmudde a! Mmm- w 3 sooNj 3Tuumd Jai VO8 gzg f£$!.% lies
7 /V 19 •kgs .1Ntia11ddtf 7 [/ ---uva
$ a s x U = id 9+ N t M 3nO Mma Aw"Aua
44 O —vwoo Pww.wa 90-1 umpn4suoo
-WW C/ 1 // -7 -y
*W 'be PAWDI N mmw 41BUG11
7J 'bS v0*4 tw_m WBUSI
3a3®
Naw 3ova"
Iw3w SNUM
-old a3 3l uo ummp uopMouoo pesodoud eta om '301
atO 3° AGAMS 30 e3 0J a 4u0pwrdde spa o3 u=utl
# 'Ial :ssaippv
# 3SNaon NW _ _ a032eAu0'J
V .101
/ F$_S
:SmPPtl T SUMN a0UMO
:11040cns643 Pftl
:s��PAtl uoSuoO
nwuvarrddY 1MURd 3Nrenrne
xgd LSZNUS (M) Z -V GW L -V X10 G1 A1iWWJ 31J11T1e [ l a ily
aaazatjt aAPRM AUN
ZO/M'd ZSZOTLs 01 A3 URB AllJ t4MU ZT:TT £ LT-&P&J
City of Fridley
SUBJECT
IT
3454
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
'1
pT NO.
1 L
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
r
1 F i
NUMBER
REv
DATE
PAGE OF
APPROVED BY
`---. A ��"';•j CITY HALL FRIDLEY 55432
L J\ 763-571-3450
910-F15
4/21/03
JOB ADDRESS 5831 West Moore Lake Drive NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
$
. 1
I Donuay's Lakeview Manor
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
Mark/Laura Ingebrigtsen 5831 West Moore Lake Drive
NE
612-571-7787
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO
Daystar Shelter Corporation 22675 Cedar Dr NW, Bethel, MN 55005 763-753-4914
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP
PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP
PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
NEW ❑ ADDITION O ALTERATION O REPAIR
O MOVE O REMOVE
8 DESCRIBE WORK
Construct a 180 sf Gazebo on a concrete slab
9 CHANGEOFUSEFROM TO
STIPULATIONS
See notations on plan.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SQ. FT
CU FT
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED.
NO DWLG. UNITS
OFFSTREET PARKING
1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
ISTALLS
GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$4.50
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$9,000
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
l
PLAN CHECK FEE
TALFEE
®3
Licens C
$5 0
$185.75
SIGNAT RE JF CON ACTORORAUTHORIZEDAGENi IDATEI
EN RO
Y VALIDA ED THIS IS YO JR PERMIT
�; 1 -03
_
S-GNATURE OF OWNER,IF OWNER BUILDERI IDATEI
IrLbt .1
it, MATE
NEW [ ] CITY OF FRIDLEY Effective 1/1/2003
ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
ALTER [ j SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPLICATION
Construction Address: 15193I W Moore L.ak� �� ��,'��e v , MN 5-5-Y3;Z
Legal Description:
Owner Name & Address: AA,,,,d aura ?_n edr� �'IIs__en Tel. # 619-57/-7-7r-7
Contractor: Da4,5 -ar S4e l er Gordo raTion MN LICENSE #
Address: X94 7.5- `dr /I/�✓ Tel. # -763'-7!7'3
6--l-dt-L dw SY0,11
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length
Width
Height
Sq. Ft.
DECK AREA: Length
Width
Hgt/Ground
Sq. Ft.
OTHER: V concree e-
SIQb
&-z---L- /
Go22L 180 sit.
Construction Type: Coaze.bo Estimated Cost: $ 9'000
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft $ —=$
DATE: b3 APPLICANT:.�o $"k ..' V"'O P.'Y'L Swt' C#"f, Tel. # Ipi ✓' '7S3-1116=
Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-5714287 if using credit card and we will
call you for card number.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
$
CITY USE ONLY -
TOTAL $ /23-5, 7 S
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1275 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. 'B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ j
San d CL'Aio"
Lr TT co -c
1371
-7'S
10'
a
1.3
41 re&r
A
w
CROWN OF MINNESOTA INC.
1200 CENTRAL AVENUE N.E. • APLS, NN 65413
0 1 h Bloc, Nora► d &oadmW on Cff4WAW1WW
812- �1�6808
11u1,I�SotA SOMDALE STORE iN mh-Aug 20011
(T/edLovskfta Dayw `e)
18" carriage,
per rafter.,
-I Is 2x4
Idatea
corner
g' 2-5/8" Typ.
ROOF PLAN
SCALE: 3,/18" m 1'
!tout built
In 8 equal
sections bolt
together with
5/10" carriage
bolts assemble
sect. with 3"
screws
Double 2x,l
top plate
Double 2x4
rafters typicHl
18 places
1" vedar
sheathing
3" screw
thru top
plate into
each rafter
ix8 N.S. & F.S.-
nail with 7d nail
O.C. to both 20's
1" cedar decking tongue &
nail with 7d nails ® 8" O.C.
® each rafter typical 9
-0"
Btu
eve ' 1/2"x8" A.B.
with nut &
washer or 1/2"0
bolt 4" embedment
O.C. max by owner
Design Of Load v.. "
Roof Snow Load 0 psf
Wind 80 mph -exp. B
Code
All codas to be latest edition or revision
building code - State of Minnesota
Wood
-- 2x8
Facia
`�- 2x4
in Head
I �
1'
m
e�
tV
2x4 plata
5'-0° �._ u
door opening --1 a Cedar shakes WALL SECTI
or asphalt SCALE: 1 /2 1
shingles
Wall built In 8 sections
bolt together at corners
with $f 3(' carriage bolts
4 bolts per corner assemble
with 3" screws
.1 width
Idow opening
ELEVATION
VIEW
1
A. All wood construction to be in
accordance with building code
requirements and the following references
and supplements:
1. National Forest Products Association (NFPA)
2. Wesern Wood Products Association.
3. U.S. Products Standard PS 20-70
tonal-14=ber Manufactu ' On
5tabI
rovide nailing in accordance with UBC 940
e 23 -i -Q U.N.O.
. Studs, walls, blocking, nailer and
mist. lumber stud grade cedar or better.
/01,12. Rafters and double top plate: No. 2 cedar.
gin. allowable bending stress 950 psi.
�. 1" tongue and groove wall and roof
sheathing: No. 3 cedar.
W14. Use non -corrosive, non -staining rough
hardware for exterior applications.
`Vf
Wood materials built into or in contact with
exterior masonry or concrete
(slab—Qde) shall be ppwauxt ti^
When additional stud is added at center of
10 window unit and a 32" door opening is
used a single 2x4 top plate can be substituted
for the double 2x4 top plate (see wall section)
-Donot issue a building permit tor any
project using these specifications
that does not include a Daystar Gazebo Kit.
ey.amesma r now$ go or.Darae
byMaeaft pwand aaw"-
aa *d I W a sate ra0e, pdaww
awe Wv UA Vn d un aau as
Deta.S�9f98 .. w. Fav' qA
DAYSTAR'rER CORP.
UMM &UNI iEWA
8 aided wood gazebo
structure and notes
ruao ae Ima>vrmm .._
p'My "Maw • AOL Ob
N1114DERIENCINEERING CO*,91NCO
EN;GI NEERS ANDSURVEYORS
L.ANO rE1NRVEYINO,,:; SOILS TESTING
GIV.IL &o -MUNICIPAL ENGINEERING LANO PLANNING
6418 —56TH AVENUE N.
MINNEAPOLIS 22,MINN.
Oii 'r— 4014
iC le pit ii IF i it IF . !S iN l "Ve •
-'� �' 6 CY'.•-aim...: �•. 'tee..-�:sces.0.--`..va...-=c�..�.•�c�:�`.-.+._ .. w-.,.`.`. v., �-.rl•-.�- ...-e -' _ — -_ __ �..... ....-_._..._�--...._.V ��_'.i . -. �--. -.
.•r
_ � ` , •fir �=,� /F�
a��' �.4' 4 `�"r�`a•f rpt
rh ''l 4,2_1
' _ 1 ;�'I.••� p ,_ / {%.r=�`� 1/ ..+p 1_ t/ r' `.-7`p ! "Y+} ✓.t•: `,rayy. ; .� 4r4 ! F g,�. f„ _.,:,, �, ,
r �r+...• lY L / ..r � ✓ � 1 _,r • r / f 1 r/,/ 'r 41. /' �'jf s
� z: " J !., e,,��'dr�i .: ��, / �,•✓}/ j+/y% ? -,� ..v�,K,e:, f,+;_� e 2` /� �i.�Iiill
t4 r�. I/'4.'�/ / "\5/f _J , a/ -I 'F.IJ �,.J 1 Jn/'.Ir LJ ''i/ S! / (: 'JF .._ � �%, �' }��^• � •f',f�.l,, •S',p
s i� f � .. .'.� J .. •Y�. ��
. /
i
.-r. F A Q A-rLA Pot /AI +- 09z IC -v F=O Fr -1 ANI rI at sr.% It=CA 1 911 wt P �-P-TA OG G%t CT t7 A.Ttr%&§ IA1A A-7 Ck5
. h
Building
$ 1,25
BUILDING
$ JA6, 0/
Permit No:-;. l A C) `2
Inspections •
Surcharge
RESIDENTIAL APPLICATION
Received By:
763-572-3604
SAC Charge
CITY OF FRIDLEY
Curb Cut Escrow
Da ) W
763-502-4977 FAX
$
Park Fee
$
Sewer Main Charge
$
EFFECTIVE 1-1-09
$
7 Ll O
$�J�����C/
�5�.l7 %Je
DATE
YOUR E-MAIL ADDRESS
(�'Jcowq<'r,
SITE ADDRESS
^S
THIS APPLICANT IS:
VI&6WNER ❑CONTRACTOR
PROPERTY OWNER/
NAME:
ADDRESS: C, d i r CITY
i C
STATE IP
TENANT
PHONE: L U
CONTRACTOR
NAME:
SUBMIT A COPY OF
YOUR STATE LICENSE
STATE LICENSE #
EXP DATE
AND CERTIFICATE OF
ADDRESS:
CITY
STATE ZIP
INSURANCE
PHONE FAX
PROPERTY TYPE
❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILYMEW CONSTRUCTION STORIES
PERMIT TYPE
a -ADDITION ❑ GARAGE/SHED ❑ WINDOWS
❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE
❑ DECK ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW HOME CONSTRUCTION ❑ ADDITION
I-O'MAINTENANCEIREPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE: C9 G
SIZE OF IMPROVEMENT
20 LENGTH ICD WIDTH
-y
7 HEIGHT SQ FT 4 C�
ROOFING
❑ HOUSE ONLY
BASEMENT
REMODELING SUBMIT:
NUMBER OF SQUARES
❑ HOUSE & GARAGE
1. Existing Floor Plan
GARAGES
❑ ATTACHED GARAGE
2. Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3. List of structural members to be used
PROPOSED HEIGHT:
FOR NEW CONSTRUCTION INCLUDING DECKS,
SIDING— -- - - - --
El Vinyl
- - - - -- - - - - ---
❑Soffit
_
ADDITIONS. & PORCHES SUBMIT:
❑ Aluminum
❑Trim
1. Site
Plan/Survey showing the existing structures
❑ Other
[3 Fascia
and proposed project.
2. Two sets of construction plans
WINDOWS
3. Energy Calculations
M EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF. WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
SCHEDULE)
TOTAL JOB VALUATION $ (' �2J. 0 997 U.B.0 FEE OCCUPANCY TYPE
Permit Fee
$ 1,25
Plan Review
$ JA6, 0/
Fire Surcharge.
$
Surcharge
$
License Surcharge
$
SAC Charge
$
Curb Cut Escrow
$
Erosion Control
$
Park Fee
$
Sewer Main Charge
$
Total Due
$
See Back Page for Fee Schedule
65% of Building Permit Fee
.001 times the total job valuation
.0005 x Permit Valuation Minimum $.50
$5.00 (State Licensed Residential Contractors)
$2000 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$22=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks uavable to: Citv of Fridlev Attach
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a
permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance with the
approved plan in the case of al whic re es review and approval of plans. �/�� 7
SIGNATURE OF APPLICANT PRINT NAME 1/�� I ` DATE
N1101.8 Certificate
Builders Name/ Company
Date;
AAeG- %2— 26wll
Site Address: S'C.T/ /7.*&4 — --
t,.Ox
Contractor
Name:
License Number.
Location
TYFe of
Installed
Type Location Size
Insulation
R- Value
Makeup' Air
Roof/Ceiling-3
G.0'rr
Combustion Air
Walls
SW 4*27
Slab-on-GradeHAN-
Floor
Rim joist41,
P,
Interior, Exterior or Integral,
Foundation Wall
Z `' Gail-i+y
• !a
&,4Wj-.C#ft I
Interior, Exterior or Integral
Avera a U -Factor SHGC solar heatgab coefficient Passive Active
Fenestration Radon Control ❑ ❑
• 3 S Mar.
lkpe Input Rating AFUE Manufacturer Model Calculated Heat Loss
Heating System
Type Output Rating SEER Manufacturer Model COORIng Load lNeat Gain
Cooling System
W11'fA
Type Location Continuous Ventilation Total Ventilation
Mechanical Ventilation
N1101.8 Certificate
Builders Name/ Company
Location
Roof/Ceiling
Walls
Slab -on -Grade
Floor
Rim Joist
Wall
A
Date: iG- !2- Z�o9' Site Address: 5'83/ hawse— Li9�tt" e4 �--
Contractor Name: F� dL ".V//
License Number:
Type of Instal/ed type Location Size
isulation R- Value
?vim Makeud Air
Interior, Exterior or Integral
A !G
Interior, Exterior or Integral
nr SHGC irsolar hea
Air
---- Passive Active
Fenestration Radon Control
Li
• 3 S' Mint_