PRE 2010 DOCSU
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City of Fridley, Minn.
BUILDING PERMITN® .7409/
Date: - 1
Owner: Buil _
Address Address
LO TI OF BUILDING
No. SILO Street Part of Lot
Lot - 5� __ Block Addition or Sub -Division,
Corner Lot Inside Lot Setback -i:%�2— /— Sideyard -14
Sewer Mevation — Foundation Elevation
DESCRIPTION OF BUILDING
TU fl
Front Depth , Height Sq. Ft. /a�� cu. rt'm C)
Front Depth Height ___ Sq. Ft. Cu. Ft.
Type of Construction ��1._ Est. _ __ To be Completed
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set ;rLmidn co pliance with all provisions of
the city of Fridley.
In consideration of the payment of a fee of permit 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 reg location, construction, alteration, maintenance, repair and moving of buildings
withianthe city limits and permit may be revoked at any time upon viola�on of any of the provisionsordinof said
Building Inspector
NOTICE:
This psemh does not corer the construction, hatallatton for whing, phunbin0, gas huflaA, aver or water. Be an to no
the Building Inspector for separate permit for these Items.
..
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S
NAME s'J ; ®�
l 9��' ., .
"�/ I.r�
'N b'l"BUILDER
ADDRESS
'' �� ; .
��; . a''6
?-
R ' ADDRESS
LOCATION OF BUILDING
No. . 1 Street Part of Lot
777 71�
Lot _. _Block Addition or Subdivision
Corner Lot Inside Lot Setback A _ Side Yard
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form.Two Certificates of Survey of Lot and proposed build-
ing location drawn4on these Certificates.
DESCRIPTION OF BUILDING
To be used as:
"Front ` �� Depth ' Height ,G
Sq.,Ft.
Front Depth Height
Sq: Ft. Cu. Ft.
Type of Construction. J^j ?!r Estimated Coat
To be Completed VC, .'
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.
DATE SIGNATURE`
(Schedule of Fee Costs can be found on the Reverse Side).
0
"-41477
City of Fridley, Minn. N° 8623
•
BUILDING PERMIT
•
•
Owner: Master i ., Builder 0--da—= P t M
LOCATION OF BUILDING
No. _ 5.L.QL_.._ Street 3rd Stl edt Naze Part of Lot
Lot — 5 _ Block 2 Addition or Sub -Division Gori son I a Sung t Nanny Snnw:e 2nd
Corner Lot _ Inside Lot % Setback _.__ Sideyard
Sewer Fdevation ___. _ _ _ Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Det- Qazagld_ Front 22 Depth 24Height 3.i$_ _ Sq. Ft. --528— Cu. Ft. -5
Front Depth Height _ . Sq. Ft. — Cu. Ft.
Type of Construction From Est. Cost 11 5 -Q -Q---..__ To be Completed — _
In consideration of the issuance to me e a permit to cons�the building l described_�I agree nt do
the proposed work in accordance with the description above o and ffi ce provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of $ 9..00 , permit is hereby granted
to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it to 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
within
n� city limits nd this permit may be revoked at any time upon violation of any of the provisions of said
NOTIC&
fhb permb dna not emu the aondruWan, Indallatlon for Wbb& phrmbino, Sao haHag, atter ar Watar. M aura to see
the BQildino InspWor for apmfe permlM for thea hams
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA.
OWNER'S NAME BUILDER
ADDRESS_ d _Jleld ADDRESS/
LOCATION OF BUILDING
No. �'f /� ; Street Part of Loth_
LOT BLOCK ADDITION OR SUBDIVISION
Corner Lot`Inside LOT Setback Side -Yard
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Two Cartifieates.of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To be 'used as:
CA -e4 Zjt3gLg Front Q R Depth_ �..y Height
T q
Sq. Ft. S_. Cu. Ft.
Front Depth Height.
Sq. Ft. Cu. Ft.
Type of Constructions Estimated Cost
To be completed
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.
DATE_ L J%- SIGNATURE �.
(Schedule of Fee Costs can be found on the Reverse Side).
1
0
d
tHe:5?'EPR MAC -IAC ->Zi .K
r
A, too.74�
vA6 LSOtotS SUMMIT I�AN0R 1hereby certify th tf ILq Ita•v y, Cala n. or report
e
was prepared by r c ()r un%I�r=rn.5f lirect super*
n PINEX 'SEC 1)No A on I T 1 ON, vision find that I im fo duly etc fiistered. Land
ANOKA COUNTYP VINNESATA' Surv(!Vor under ti vs ('9 f ` 'S„tteofMinn.
clot a.
. r�► 44-Z %
N.C. HolUM AND �-5-�' ,
"510b Hom-4ow Dawe ,
A Ik7 INC, ze.4
LAND cJUF',�J�Ygti
-
SUBJECT
PERM
City of Fridley
18481
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
IRE .
•
`...... COMMUNITY DEVELOPMENT DIV.
U.
I✓ � � PROTECTIVE INSPECTION SEC.
o -
1 �
L!
� CITY HALL FRIDLEY 55432
�.j
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
6/9/86
JOB ADDRESS 5110 = 3rd Street N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
5
2
Carlson's Summit
Manor Annex, Second Add SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
Chester Bezak same
572-1891
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO.
same
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
8 DESCRIBE WORK
Reside dwelling
9 CHANGE OF USE FROM
TO
STIPULATIONS
i
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
Wood
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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$1,500
$,75
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-
$25.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
//
�`�.� ��Y
$25,75
SIGNATURE OF CONTRACT6WOR AUTHORIZED AGENT IDATEI
WHE PROPER
11Y V I A E HIS IS YOUR PERMIT
5
���
% GNATURE OF OWNERIIF OW NER LDERI (DATE)
I SP
�aTE
NEW [ ]
ADDN. [ ]
ALTER.
Construction Address:
Legal Description
Owner Name &
Contractor:
Address:
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
City of Fridley
�R-1 AND R-2 I
Building Permit Application
D
Effective 4/1/86
1"�O1IC5
Tel. # 1'72-l�`�0
.�
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length
Width
Height
Sq.
Ft.
Length
Width
Height
Sq.
Ft.
Length
®� Width
Hgt/Ground
Sq.
Ft.
Corner Lot [ ] Inside Lot [ Ft. Yd. Setback Side Yard Setback
Type of Construction: &-DEstimated Cost: $ l�
Approx. Completion Date:
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: 1�- $ $
See Back Page for Explanation
DATE: �r �� APPLICANT: 0 Tel.el
S%�
CITY USE ONLY
Permit Fee $ cy'jI Fee Schedule on Reverse Side
Plan Check $ C--— 25% of Building Permit Fee
State Surcharge $ /►� $.50/$1,000 Valuation
SAC Charge $ $475 per SAC Unit
Park Fee $ Fee Determined by Engineering
Sewer Main Charge
Agreement Necessary [ ] Not Necessary [ ]
TOTAL $
STIPULATIONS: Isoo
�a 1cam
May 13, 1988
City of Fridley
Attention: Bill Sandin
Heating and Plumbing Inspector
6431 University Avenue N.E.
Fridley, MN 55432
Dear Bill Sandin,
In compliance with the City of Fridley ordinance, we have received
signed approval from Florian and Glynnis Novak to place a central air
conditioning unit on our property.
There are no disapprovals from 5130 3rd Street N.E., that the unit
will come within ten feet of the property line on the north side of
5110 3rd Street N.E.
Sincerely,
Chester Brozak
copies to: City of Fridley
Chester and Phyllis Brozak
Florian and Glynnis Novak
Required Signatures
11<—
Florian Novak and Glynnis Novak
ester Brozak 6fid Phyllis BrWak
t
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
Effective On January 1, 1991
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 .SAft A6 I3atou3
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
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
$5.00
Reinspection Fee $30.00
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1 % of Value of Fixture or Appliance
State Surcharge .50
TOTAL FEE $_L6___:50
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.
.19912—
BROZRK CHESTER
Owner 5110 31311 STREET t10BTiT
FR I DLEY M 0
Building Used As, H 572-1891 N
Estimated Cost -PERMIT NO.
PLUMBING COMPANY "Vi; L rr UMOR&
SIGNED BY
Approved By Rough-ln Date Final Date
MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00
PLUS THE $.50 STATE SURCHARGE
SUBJECT
P
City of Fridley
-
21735
AT THE TOP OF THE TWINS
BUILDING
PERMIT
0
COMMUNITY DEVELOPMENT DIV.
_
L PROTECTIVE INSPECTION SEC.
�`J�
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
2/11/93
JOB ADDRESS 5110 3rd Street NE
1 LEGAL
LOT NO.
BLOCK
OR ADDITION
SEE ATTACHED
DESCR.
5
2
TTRAaCT
rlson`s Summit Manor Annex 2nd Addn. SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
Chester Brozak 5110 3rd Street NE
572-1891
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO.
Builders & Remodelers 3517 Hennepin Ave S, Mpls., MN 55408
827-5481 1100
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
0 MOVE ❑ REMOVE
O
B DESCRIBE WORK
Soffit & Fascia
9 CHANGE OF USE FROM TO
STIPULATIONS
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
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 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
$7,662
$3.83
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 OTHER STATE OR LOCAL LAW REGULATING CON-
$99,00
Fire SC $7.66
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
License Sc $5.00
$115.49
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATEI
HE P PPE
(DATED THIS IS YOUR PERMIT
/L�/1�aV
BLDG IN P
+
DATE
SIGNATURE OF OWNER IIF OWNER BUILDER) IDA TEI
NEW [ J
ADDN ( ]
ALTER [ ]
Construction Address:
CITY OF FRIDLEY
SINGLE FAMILY AND DUPUXES R -I AND R-2
13uilding Permit Application
Legal Description:
Owner Name & Address:
Contractor:
Address:
5110 -3rd St NE
Chester Brozak
Builders & Remodelers, Inc.
3517 Hennepin Ave S Mpls MN 55408
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
v Aei`1trve 9i tl'tz
-*3 S>1
Tel. # 572-1891
MN LICENSE #0001100
Tel. # 827-5481
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
Length Width Hgt/Ground Sq. Ft.
Soffit & Fascia
Comer Lot [ ] Inside Lot [ ]
Type of Construction:
Approx. Completion Date: 2/12/93
Ft. Yd Setback Side Yard Setbacks
Estimated Cost: $ 7662.00
Driveway Curb Cut Width Needed:
DATE: 2/3/93
(Cost on Back)
R. + 6 Ft = Ft x $ _ $.
APPLICANT: Tel. # 827-5481
Permit Fee $ C. tO Fee Schedule on Reverse Side
Fire Surcharge $ .001 of Permit Valuation (1 / 10th %)
State Surcharge $ $.50/$1,000 Valuation
SAC Charge $ $700 per SAC Unit
License Surcharge $ 5.00 $5.W (State Licehsed Residential Contractors)
Driveway Escrow $ Alt. "A" or Alt. "B" Above
Park Fee - $ Fee Determined by Engineering
Sewer Main Charge $ Agreement Neces§lry [ ] Not Necessary [ )
TOTAL
STIPULATIONS:
$ //-5-, 4 ?
su6JEcr
PERMIT NO.
City of Fridley
(�_2895_8__�
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
sn��r
C7.P�i
I = �'•'1 CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
%j 612-571-3450
910-F15
3/l/99
JOB ADDRESS 5110 3 Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
5
2
Carlson's Summit Manor Annex 2nd Addn SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Phyllis Brozak 5110 3 Street NE
572-1891
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Lake State Remodelers Inc 6000 Bass Lake
Rd, STE 111,
Crystal, MN 55428
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO
20047291
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WORK
0 NEW 0 ADDITION 0 ALTERATION IR REPAIR 0 MOVE 0 REMOVE
8 DESCRIBE WORK
Reroof House & Garage (26 Sq) Tear-off
9 CHANGE OF USE FROM
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 BO 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
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
@ 11
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$2,228
$1 •
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OT STATE OR LOCAL LAW REGULATING CON-
Fir-/12C $2.23
STRUCT OR THE PE ANCE OF CONSTRUCTION
$74.75
PLAN CHECK FEE
F
TOTAL/FEL
Lice a
$5va�0
3.09
SIGNATURE OF CO TRACTOR OR AUTHORIZED AGENT IDATEI
EN RO
ALIDA r IS YOUR PERM4
X!
BL A'NSP
0 4W
op
6�
HATE
.,F OWNER BUILDER, IDATEI
SIGNATURE OF OWNER
NEW [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress:
Legal Description: /
Owner Name & ddress: S Tel. #
Contractor: MN LIC NSE #
Address: SL(f Tel. #
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: --% . —.
YP/c.� 1�lZ�iQ, C��!'
Construction Type: Estimated Cost: $�� �13-
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
v
DATE: APPLICANT: Tel. #
CITY USE ONLY
Permit Fee
$ S
Fee Schedule on Reverse Side
Fire Surcharge
$�
.001 of Permit Valuation (1/10th%)
State Surcharge
$
$.50/$1,000 Valuation
SAC Charge
$
$1000 per SAC Unit
License Surcharge
$ S < Uy
$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
$
STIPULATIONS: