PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PEI MY17 N® 3076
Date: ... �...[. / j / -5'9 ................
•,.
Address .. ®..`� ? �. v .. / Y Address .. J off. O.®.. i� ./1�4r..���✓rC ..�ir0
LOCATION OF BUILDING
No. o. ".. Street . .......... Part of Lot .. {� ........ ......... .
Lot ... / � .... Block .. ....... Addition or Sub -Division OMAV, ?%
Corner Lot ............ Inside Lot .. !:�..... Setback .�A S .... Sideyard .19 + j....... .
DESCRIPTION OF BUILDING
To be Used as:
'Front
:. Height Sq. FtA /.. Cu. Ft. ........
...1%. �_ Fran P.... Depth��/ � . q�
... ......... ont Q"..7. ... Depth % . Height ........ Sq. Ft. �'� . Cu. Ft. .. .. .
Type of Construction ....... Est. Cos a ✓�•®® .. To be Completed ... ... .
3� fc 31, -
In consideration of the issuance to me of a permit to construct the building desribed above, I agree to do
the proposed work in accordance with the description above set forth d jlneompll�ance with all provisions of
ordinances of the city of Fridley.
�
In consideration of the payment of a fee of $. 0
1- !-P--,permit 0 .. is hereby granted to `-.....
......................... to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings with-
in the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances. _
Building Inspector
NOTICE;
This permit does not cover the construction, Installation or alteration for wiring, plumbing, gas heating,
sewer or water. Be sure to see the Building Inspector for separate permits for these Items.
A
Y �
53=°t,-91"051
CITY OF FRIDLEY
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
PARTIAL RATE,SCHEDULE
q
PLUMBING FIXTURE RATES: NO.
N
e
Ir%L--'-er Fixtures
ro
$3.00
e
Future Fixture Opening
x
d
$
Water
x
$2.00
$
Catch Basin
x
$5.00
$
Water Heater - to 99,000 BTU
x
O
$
100;000 BTU to 199,000 BTU
x
$10.00
$
Water Softener
Heater
$7.00
AJ
.4
x
m
$
E
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w
$
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$3.00
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4 th
(R) = Future Connection Opening
Connected with Sewer
(*) = New Fixture, Old Opening
Water
PARTIAL RATE,SCHEDULE
PLUMBING FIXTURE RATES: NO.
RATE
TOTAL
Ir%L--'-er Fixtures
x
$3.00
$
Future Fixture Opening
x
$2.00
$
New Fixture, Old Opening
x
$2.00
$
Catch Basin
x
$5.00
$
Water Heater - to 99,000 BTU
x
$5.00
$
100;000 BTU to 199,000 BTU
x
$10.00
$
Water Softener
x
$7.00
$
New Ground Run Old Building
x
$5.00
$
Electric Water Heater -
x
$5.00
$
GAS FITTING FEES:
1st 3 fixtures
x
$3.00
$
Aiditional Fixtures
x
$1.00
$
Gas Range to 199,000 BTU
x
$10.00
$
REPAIRS $ ALTERATIONS
First $100.00
each add. $100.00 or fraction
State Surcharge
TOTAL FEE
REINSPECTION FEE
f S10. 00)
$5.00
$2.00
S
$
$ .50
s 8.00
Job Address 5057 3 STREET_ NE_
s Department of Buildings
City of Fridley
Tel. #571-3450
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 Department of Buildings, and hereby declares that all
the facts and representations stated in this application are true and correc
Fridley, Mn. 11-15-76 , 19
OWNER EDWARD 0TR MBA
KIND OF BUILDING frame
USED AS res.
TO BE COMPLETED ABOUT 1 -22-76
ESTIMATED COST 10.00
OLD - NEW BUILDING PERMIT NO. PERMIT NO.
Company
Signed By
MINNEGASCO
Tel. No.
ROUGH INSP.
Date �%
FINAL INSP. 1' - 7 u ,
Date
APPROVAL FOR PERMIT
MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50
FA
SUBIECT
City of Fridley
hil
15 4 32
r
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
R IPT N0.
• COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC.
r PROTECTIVE
;,, CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
L 612-571-3450
9
9/5/79
JOB ADDRESS 5057 - 3rd Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
15
4
Carlson's Summit Manor South SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Edward Otremba 5057 - 3rd Street N.E.
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO.
Giertsen Co. 5147 Winnetka Avenue North 535-3212
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 9 REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Fire Repair
9 CHANGE OF USE FROM TO
STIPULATIONS
SF„PERATE PERMITS REQUIRED Fea
HEATING, PLUMISING AND SIGNSF_
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 I 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
$14,940
$7.47
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-
$90.00
STRU TION OR THE PERFO OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
$97.47
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI y
WHEN PROPERLY VALIDATED THIS IS YOUR PECCMIT
d
BLDG INSP IDAT
SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI f
FA
CITY OF FRIDLE Y
APPLICATION FOR RESIDENTIAL BUILDING PERMITS
• (New, Alterations, Additions, or Repairs)
OWNER:
ADDRESS:
TEL NO: —
BUILDER:
ADDRESS:
TEL NO:
Construction Location
-STREET NO: STREET: �AeL
LOT: BLOCK: "y ADDITION: j�?,fJ,@.L,$QA VS �3C-�/17/Me% ^4iJOi-
zo t -Al d
Corner Lot: Inside Lot: Setback: Sideyards:
Applicant attach to this form two Certificates of Survey of lot and
proposed building location drawn on certificates to scale.
DESCRIPTION OF CONSTRUCTION
Front: Depth: Height:
Square.Feet: Cubic Feet:
Front: Depth: Height:
Square - Feet: Cubic Feet:
V
Type of Construction: lQ��'�� �l` Estimated Cost: $ ' gqo,
9b Be Completed: C(p
Alt. A Alt. B
Proposed 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 correct.
_ e
DATE: S SIGNATURE:.
Stipulations:
9o. co
SUBJECT
PERMIT NO.
City of Fridley
-
29953'
AT THE TOP OF THE TWINS
BUILDING
PER M IT
i COMMUNITY DEVELOPMENT DIV.��
♦V ��� _
PROTECTIVE INSPECTION SEC.
1 � �
NUMBER
REV
DATE
PAGE OF
APPROVED BY
i CITY HALL FRIDLEY 55432
-__.�;"'t;•�
L 612-571-3450
910-F15
7/28/99
JOB ADDRESS 5057 3RD STREET NE
1 LEGAL
LOT NO.
BLOCKTRACT
OR ADDITION
SEE ATTACHED
DESCR.
15
4
Carlson's Summit Manor So.
Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Ed 0tremba 5567 E. Danube Rd.
571-7565
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Northern Crest, Inc. 8245 Polk St. NE Spring
-
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 O ADDITION O ALTERATION X(M REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Reroof house and garage 30 S Tear -off
9 CHANGEOFUSEFROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
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
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 WQRK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$2622
$1.31
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
83.25
Fire SC $2.62
PLAN CHECK FEE
TO L FEE
Lice S 5
92.18
rIGi qE OQACTIJOA OR OR GENT iDATEi
MEN PRWVALID71!
THI YOUR MIT
r �
F
S-GNATURE OF OWNER.IF OWNER BUILDER, iDATE,
6L G INSP
NEW[ Effective 5/10/99
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: 5057 - 3rd St. NE
Legal Description: 61p,
Owner Name & Address: Otremba 5567 E. Danube Rd Tel. # 571-7565
Contractor: Northern Crest, Inc. MN LICENSE # 20098415
Address: 8245 Polk St. NE Spring Lake Park, MN 55432 Tel. # 792-9364
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:
Construction Type: Tear off and re -shingle
house and garage - 30 square
Driveway Curb Cut Width Needed: Ft. + 6 Ft =
DATE: 7-28-99 APPLICANT: Bill Olson
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ 00
$-- 9.2. a -
Estimated Cost: $�
Ft x $
CITY USE ONLY
Tel. # 792-9364
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1050 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 [ ]
Building
1f5rV'-
BUILDING �7,0(,Permit
N .. '
Inspections
$
RESIDENTIAL APPLICATION
Received By:
763-572-3604
CITY OF FRIDLEY
Date Rec'd&/,�47
763-502-4977 FAX
EFFECTIVE 1-1-08
— - ��
,,
YOUR E-MAIL WA,pOO C
® C2 + GO47
DATE
SITE ADDRESS SO-is'
ADDRESS
,
.– � ~ st r IVF
THIS APPLICANT IS: ❑ OWNER 'CONTRACTOR
PROPERTY OWNER/
NAME: — "
TENANT
�/ _r p�
ADDRESS::- SS6 1 �- `�; fIQ UaG NCITY $Y
STATFWN ZIP
PHONE:
NAME: MKTkeyw t�
^r�
ADDRESS: l'S5-3 ^ `c91 S`F- AVe, f4' ✓ CITY I Q STATE_AWziP
CONTRACTOR
SUBMIT A COPY OF
PHONE /J&_� R �— R` FAX :5"e
YOUR STATE LICENSE
STATE LICENSE # a o01 g if EXP DATE
' 30— d OO 1 qr
PROPERTY TYPE
❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILYINEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGEISHED ❑ WINDOWS
❑ BASEMENT FINISH ❑ ROOF ❑ DRAM TILE
❑ DECK ❑ SIDING C�6THER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW HOME CONSTRUCTION ❑ ADDITION
❑ MAINTENANCE/REPAIR AEMODELING
_ k INS a SGI
DESCRIBE WORK BEING DONE: 74 kA M
SIZE OF IMPROVEMENT
LENGTH WIDTH HEIGHT
SQ FT
ROOFING
❑ HOUSE ONLY
BASEMENT REMODELING SUBMIT:
NUMBER OF SQUARES
❑ HOUSE & GARAGE
I.
Existing Floor Plan
GARAGES
❑ ATTACHED GARAGE
2.
Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3.
List of structural members to be used.
PROPOSED HEIGHT:
SIDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vinyl
❑Soffit
ADDITIONS. & PORCHES SUBMIT:
❑ Aluminum
❑Trim
1.
Site Plan/Survey showing the existing structures
❑ Other
❑ Fascia
2.
and proposed project
Two sets of construction plans
WINDOWS
3.
Energy Calculations
IN 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
TOTAL JOB VALUATION 9
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
{(USING THE 1997 UBC FEE SCHEDULE)
OO oma' OCCUPANCY TYPE
$
1f5rV'-
$
$
$
A
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)
$1825 per SAC Unit (Plans to MWCC for determination)
ft+6 ft= ft $21 =$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks payable to: City of Fridley 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 Minn ogstruc ion Cod ; 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 a or with lan in the case of all work which requires review and proval of plans.
SIGNATURE OF APPLICA IPRINT NAME (I Q SO DATE S -4-0S S
APPROVED BY
From: unknown Page: 2/3 Date: 11/12/2009 9:07:54 AM
Building
MECHANICAL
Permit No.. �
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
CITY OF FRIDLEY
Date 1 :'
763-502-4977 FAX
EFFECTrvE2-I9-M
DATE 11/122009 YOUR E-MAIL ADDRESS dave@daveshoolrkpndalr.com
SITE ADDRESS 5087 3RD ST NE
THIS APPLICANT IS: O OWNER DCONTRACTOR
PROPERTY
NAME: ED OTREMBA
ADDRESS: 5587 E DANUBE ROAD CITY FRIDLEY STATE MSP 85432
OWNER/
TENANT
PHONE: 783-571-7585
CONTRACTOR
COMPANY NAME: DAVES HEATING, AIR 8 ELECTRIC
SUBMIT A COPY OF
CONTACT PERSON: AMY MADVIG
YOUR STATE
STATE LICENSE 4 EXP BATE
LICENSE WITH
ADDRESS: 1801 37TH AVE NE Crry COLUMBIA HEIGHTS STATE MN ZIP 55421
APPLICATION
PHONE 783.7814901 FAX 783-789-8805
PERMIT TYPE
DGLE FAMILY O TWO FAMILY 0 TOWNHOUSE
TYPE OF WORK:
17 NEW ZPLACEMENT ❑ ALTERATION/REMODEL
DETAILED DESCRIPTION OF WORK REMACE EXISMNG FURNACES AND clavTrM alas WITH 2 AREFLO FURNACES AND z AIRMD CEWRAL AIRS.
FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW)
Equipment Installed MFG: MODEL: SIZE/BTU
MFG: MODEL: SIZE/BTU
MFG: MODEL: SIZEBTU
$25.00 FIREPLACE (GAS) $15.00 GAS RANGE/OVEN $10.00
NEWGASORILL$10.00
rRT101AIREXCHANOSERSIS PLACE(WOOD) $35.00
LER $35.00 ACE $35.00 _GAS UNIT HTR$10.00
MNEY LINER$10.00 AS DRYER$10.00 POOL HEATER $35.00
CT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00
Number of fixtures ® $10.00 x $10.00 = $
Number offixtures @ $1.5.00 x $15.00 - $
Number of fixWMS @ $25.00 2 X $25,00 = $ 50.00
Number of fixtures ®$35.00 2 x $35.00 - $ 70-00
state surcharge = $_ 50
MINIMUM FLEE s35.50 Total= $ 120.50
THIS IS AN APPLICATION FORA PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for a bid permit and I acknowledge that the information above is complete and accurate; that the work will be in
conformance with the din ces and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is
not a permit but only 0 appli ion for a permit and work is not to stere without a permit; that the work will be in accordance with the
approved plan in the eAre o a1 rk whic u' s eview and approval of p s.
a DATEi
SIGNATURE OF APPLIC NT PRINT N
PLEASE NOTE: SE ARATE P ARE UI ED FOR. BUILDING EI,ECTRtCAL MECHANICAL WORK
*Oty of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 763-502-4977