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PRE 2010 DOCSCity of Fridley, Minn.. BUILDING PERMIT L6f) Date: Owner: der, Address Address -- C F BUILDING +`� Part f Lot No. Street . — - 047 A Lot _�_� ___ _Black _ Addition or Sub= 0 Corner Lot Inside Lot Setback r,*_` _ Sideyard Sewer Elevation _... Found Elevation DESCRIPTION OF BUILDING To be Used s:F CAI Front Depth Height Sq. Ft. 91 cu. Ft. Fa . 't Depth Height � �_ _ Sq. Ft. Cu. Ft. Type of Construction Fant. Cdst 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 forth and in compliance with all provisions of ordinances oY the city of Fridley. otrz 4-F 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 regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon violatiom)of any of tl provisions of said Ordinances. Building Inspector NOTICEr. This penult does not cover the construction, installation for whine, plumbing, gas heating, sewer or water. Be sure to sae the Building Inspector for separate permits for these items. - � d APPLICATION FOR BUILDING PERMIT CITY OF FRIDISY, MINNESOTA 0 -mer Is NameArvid E. Carlson n,`I�r c�Bu3lder Arvid E. Carlson & Snn- 2nc_ Address 3200 France Avenue South Address 3200 France Avenue South _ LOCATION OF BUILDING No. 5201 Street 3rd Street N. E. That Part of Lot 5, lying So of the 1o, 87' thereof as measured along the West line thereof, lot 6 & the 1tio, 35' of lot 7 as measu along the Went 7inra Addition or Subdivision thereof, except that part thereof lying within the right of way of Stat Trunk Hwy 56 in Corner Lot Inside Lot %X Setback gy Side-Yar� UI -1011 & &21-1011 SEWER ELEVATION 80 below basemen floor FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING To be used as: Apartment Building Front 77 Depth ati Height 23 Sq. Ft. 2772 Cu. Ft. 76,000 Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Frame & Brick Veneer Estimated Cost $60,000.00 To be Completed August 1961 The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that1 the facts and representations stated in this application are true and correct. (A Schedule of Fee Costs can be found on the Reverse Side.) * Block 1' Carlson's Summit Manor Annex, Anoka County, Minnesota Approv .d Buildin inspector r. Application for Power Plants and: Heating, Cooling, Ventilation. .Refrigeration �d Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone SII. 4-7470 GRAVITY WARM AIR: RATE TOTAL, 1. Furnace Shell & Duct Work .......................... 8.00 $ Replacement of Furnace 5.00 $ Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ each add. 60,000 BTU ........................ 2.00 $ Replacement of Furnace ............................. 00 $ Repairs & Alterations up to $500.00 .... ............ 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ STEAM or OT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. IDR Steam....... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $ Each add. 200 sq. ft. EDR Steam ...................... 2.50 Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ OIL BURNER—to 3 gal. per hour ........................ 5.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ • a GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x $1.50 $—% • �o Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE $ ROUGH FINAL Location City of Fridley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Fridley, Mnn_ ��i�I E .Z T y 19 44-1 Owner i Kind of Building Used as To be completed about Estimated Cost, $ —5 X— d • Old—New. Building Permit NoZ permit N DESCRIPTION OF WORK BEATING or POWER PLANTS—Steam,of Wate Warm Air—No Trade Name ! ���,� Size No Capacity Sq. Ft. E-D.R #1100'C&eBTU H.P. Total Con4ected Load ri &ro-4r Kind of Fuel BURNER — Trade Name A • S AA/' Size No- ® a,7 Capacity. Sq. Ft. E.D.R- .3 � � � BTU H.P. Signa ��•®tsl� By Jt�-�%J9e�a� <2 2M 7-59 Business Phone No- (REMARKS—OVER)�� n City of Fridley Application for Plumbing and Gas Fitting Permit DESCRIPTION OF WORK Number. Kind and Location of Fixtures q Gl 4f;il � �� � Z � 3� z o� 8QZ K< �'o lJ °C 3 J ` U o' R N WATER HTR. GAS ELEG Base 3 1st,/ 2nd 7 _ 3rd 4th • Future Connection Openings New .fixture, Old Openings Connected with Sewer E] Cesspool E] PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: O. RATE / TOTAL Number Fixtures ...................... x $1.50 $ C` G Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ...... ..................... x 3.25 $ Water Heater (Up to 200,000 BTU) ......—�_ x 2.00 $ L U New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL-- 1st 3 Fixtures .......................... x $1.50 Additional Fixtures .................... / x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ ' REIT VES & ALTERATIONS—Refer to Code 'Description ...........$ L I--- \ TOTAL FEE O Dept. of Bldgs. Phone SU 4-7470 Location -5- )- O / 3-121W �� • C• City of Fridley: The undersigned hereby makes application for a permit for the work herei; specified, agreeing to do all work in strict accordance with the City Ordinancs and ruling of the Department of Buildings, and hereby declares that all the facl and representations stated in this application are true and correct. Fridley, NCnn 6 190 r ®� Owner Kind of Building l r Used as To be completed about Estimated Cost, $ Old Ne Building Permit No !y / Permit No. Signed ��t/La .i?i� By Business ROUGH � I ^ l® FINAL CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1991 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT 572-3604 MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR PLUMBING FIXTURE RATES: NO. Water Closet Urinal Bath Tub Shower Wash Drink. Floor Sink Tray Fount. Drain Catch Basin Auto. Gas Washer Appl. Gas Range Misc. Water Heater Fixt. Gas Elec Stories Basemen 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 Floor 1 CAZOSP-tra ►, - C.D M Rain Water Leader $ 7.00 .� 2.9C S7" E' -�7/ ' Z) Z4 Sump/Receiving Tank $ 7.00 Floor 2 Water Treating Appliance $10.00 Owner O 1!-75 Water Heater -Electric $ 7.00 73-7,7f G� Water Heater - Gas f Floor 3 Building Used As Gas Range Gas Dryer $10.00 $10.00 I , Estimated Cost 6b` - PERMIT NO. Back Flow Preventer Required ( )Yes () No PLUMBING COMPANY 21��- 61& � �w` LL,/A e d.'NC. Floor 4 $5.00 ,D Reinspection Fee $30.00 SIGNED BY TEL NO. 5 36-coZ7 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS .2:4-2 J J" -.5 I IC -)Jt 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 CAZOSP-tra ►, - C.D M Rain Water Leader $ 7.00 .� 2.9C S7" E' -�7/ ' Z) Z4 Sump/Receiving Tank $ 7.00 !3 + CZ S � �-�'�� Water Treating Appliance $10.00 Owner O 1!-75 Water Heater -Electric $ 7.00 73-7,7f G� Water Heater - Gas f $10.00 Building Used As Gas Range Gas Dryer $10.00 $10.00 I , Estimated Cost 6b` - PERMIT NO. Back Flow Preventer Required ( )Yes () No PLUMBING COMPANY 21��- 61& � �w` LL,/A e d.'NC. Type $5.00 ,D Reinspection Fee $30.00 SIGNED BY TEL NO. 5 36-coZ7 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1 m/o of Value of Fixture or Appliance Final Date �— F Approved By Rough- n Date State Surcharge .50 �� MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 TOTAL FEE $ I� ' PLUS THE $.50 STATE SURCHARGE La SUBJECT P City of Fridley 2403 4 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. • COMMUNITY DEVELOPMENT DIV. _ a. PROTECTIVE INSPECTION SEC. r NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 3/27/96 JOB ADDRESS 5201 3 Street: 5290 3 Street NE; 5291 3 Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. See F les I SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Bi os Investment 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. G W Cook Construction 3133 Nicollet Ave. Xpla,MN 55404 822-1326 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING A artments 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE R 8 DESCRIBE WORK Roof overlay on all three buildings 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 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 $20,850 $10.43 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- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTALFEE $331.03 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IOATEI EN P RLY A TED THIS IS ,OUR PERMIT S Ll /} AY/ SiGNATUREOF OWNER OF OWNER BUILDERI IOATEI LDG INSP La Prepaid Plan Check $ Effective 3/1/96 Estimated Cost $ p � C rfY OF I+RIDIEY Receipt # R3, CMSIF1tML & P"BIRiAL BUILDING PI+W APPIIMION Construction Address Legal Description Owner & Address CCNTRACIOR & ADDRESS Architect & Address Engineer & Address TYPE OF WORK [] NeX [] Addition [] Alteration -Describe Applicant Signature Length OFC. AREA: Length WHSE AREA: Length OTHER AREA: Length Sq. Ft. x $ Sq. Ft. x $ Sq. Ft. x $ Width Reg.# Reg.# Tel Date B�T�DING DIl��ICflVS Height Sq. Ft. Width Width Width # of Stories Height Sq. Ft. Height Sq. Ft. Height Sq. Ft. VALY=CN Cost/Sq. Ft. = Valuation Cost/Sq. Ft. = Valuation Cost/Sq. Ft. = Valuation Building Use Construction Type Occupancy Group Air Conditioning [] Yes [] No Fire Protection Provided [] Yes [] No Performance Bond Amount $ See Reverse for Schedule Received []Yes []No Permit Fee Plan Check imp" 070, MA Fire Surcharge $ /C), State Surcharge $ SAC Change $ Erosion Control $ Park Fee $ Spec. Assessments $ Driveway Escrow $ 707AL See Fee Schedule on Reverse Side In Excess of Prepaid Amount - See Reverse Side .001 x Permit Valuation (1/10th a) $.50/$1,000 Valuation (See Sched. for > $1 Million) $900 per SAC Unit (Plans to MWCC for determination) $450.00 Conservation Plan Review Fee Determined By Engineering Agreement Necessary [] Not Necessary [] feet x $13.50/foot RDER [7pAT,E� nEPaRr� Nr r a . THIS DOCUMENT GOOD FOR PURCHASES UNDER $1,000.00 ONLY F 45769 THIS NUMBER MUST APPEAR ON ALL CORRESPONDENCE w . _ SENT TO US SUPPLIER "." ,: PAYAI�, VOUCHER e....,,, ADDRESS y BY SIGNING THIS DOCUMENT BELOW I HEREDO AUTHORIZE PAYMENT AND THAT THE GOODS AND SERVICES HAVE BEEN RECEIVED OR RENDERED AND ALL CITY GUIDELINES HAVE BEEN FOLLOWED IN THE PROCUREMENT OF THE BELOW STATED ITEMS. TOTAL I� kf REED NOT TO DISCRIMINATE IN HIRING PRACTICES ON THE BASIS OF RACE; SEX, COLOR, CREED, MARITAL STATUS, RELIGION, AND HAS AGREED TO TAKE AFFIRMATIVE ACTION TO RECRUIT MINORITIES AND WOMEN INTO EMPLOYMENT. IT ENCOURAGES ENCIES WITH WHOM IT PURCHASES PRODUCTS OR SERVICES TO DO UKEVItISE. 'WHITE, VENDOR -YELLOW, PURCHASING — PINK, ACCOUNTING — GOLDEN ROD, DEPT. HD. PURL ASE ORDER I DATE - �- DEPART T fir , F 45769 P CHASED BY THIS NUMBER MUST APPEAR ON ALL CORRESPONDENCE SENT TO US THIS DOCUMENT GOOD FOR PURCHASES UNDER $1,000.00 ONLY SUPPLIER �. JiC° Z•i t 677W _ ADDRESS CITY OF 7 - FRI D LEY PHONE NO. 972 8431 UNIV. AVE. N.E. FRIDLEY, MN 55432-4384 CONTACT �� 812-57-3450 PR/NTEDONRECYCLED PAPER PAYMENT VOUCHER BY SIGNING THIS DOCUMENT BELOW I HEREDO AUTHORIZE PAYMENT AND THAT THE GOODS AND SERVICES HAVE BEEN RECEIVED OR RENDERED AND ALL CITY GUIDELINES HAVE BEEN FOLLOWED IN THE PROCUREMENT OF THE BELOW STATED ITEMS. IVSD PAYMENT AUTHOR BY IF r ACCOUNT OTY. UNIT PLEASE ENTER OUR ORDER FOR THE FOLLOWING NIT PRICE AMOUNT Q1` ®^- a® go, TOTAL THIS AGENCY HAS AGREED NOT TO DISCRIMINATE IN HIRING PRACTICES ON THE BASIS OF RACE, SEX, COLOR, CREED, MARITAL STATUS, RELIGION, OR NATIONAL ORIGIN AND HAS AGREED TO TAKE AFFIRMATIVE ACTION TO RECRUIT MINORITIES AND WOMEN INTO EMPLOYMENT. IT ENCOURAGES FIRMS AND OTHER AGENCIES WITH WHOM IT PURCHASES PRODUCTS OR SERVICES TO DO LIKEWISE. WHITE, VENDOR - YELLOW, PURCHASING - PINK, ACCOUNTING - GOLDEN ROD, DEPT. HD. SUBJECT PERMIT NO. City of Fridley 24026 AT THE TOP OF THE TWINS BUILDING PERMIT f RECEIPT NO. ' COMMUNITY DEVELOPMENT DIV. _ >V PROTECTIVE INSPECTION SEC. r NUMBER REV DATE PAGE OF APP IED BV CITY HALL FRIDLEY 55432 612-571-3450 910-F15 JOB ADDRESS I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK 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 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 GRANG OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLAT O CANCEL THE PERMIT FEE SAC CHARGE PROVISIO OF ANY OTHER STATE OR L C LAW R GU ATING CON- PERFORMA OFC S RUCTI N. 0 PLAN CHECK FEE TOTAL FEE �THE �a i RE OFCONTRAC R RAUTHORIZEO E T IDATEi WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT SIGNATURE OF OWNER,1F OWNER BUILDERi iDATEi BLDG iNSP GATE Print Key Output Page 1 5763SS1 MIN0 940909 FRIDLEY 03/27/96 08:27:26 Display Device . . . . . : DSP11 User . . . . . . . . . . . COLE CR400103 City of Fridley 3/27/96 Payment Inquiry 8:27:16 Operator ID : COLE Date: 3/21/96 Number: 00 Receipt number: 0001186 Post date 3/22/96 Payment entry date : 3/21/96 Customer Location Amount Type Sry Lien Number Check No Tdr 299.75 BP CK 20.85 FS...................................... Payment Description 10.43 SU . : View information, press Enter. Description : G.W. COOK CONSTRUCTION a BP # 24026 -::4 C'�1 . FOR 5201,5290,5291 904VERSR*- . Total 331.03 Total tender 331.03 F12--Cancel FS=Comments F12=Cancel F14=Batch in:....................................: From: City of Fridley To: 7634752566 Page: 212 Date: 7/20/2007 92:28:38 PM Building PLUMBING Permit No. Inspections COMMERCIAL APPLICATION Received By. 763-572-3604 22007 CITY OF FRIDLEYR:. DATE_ -7-Un%-7 YOUR E-MAIL ADDRESS SITE ADDRESS /- TENANT f�— i L _ SUITE NO. PROPERTY NAME: ADDRESS: CITY STATE ZIP OWNER/ TENANT PHONE: CONTRACTOR Nom: STATE LICENSrE,�# L106Lf - PM EXP DATE X31-0.7 SUBMIT A COPY OF YOUR STATE ADDRESS: 3 "1 �!7 !\ i IMS twve_� I CITY I STATE LICENSE WITH PHONE -76 -(7S-=- ®?A 4& FAX— APPLICATION PERMIT TYPE ❑ INSTITUTIONAL MULTI -FAMILY ❑ SWINGGNG POOL ❑ TOWNHOUSE ❑ COMAIERCIALIMUSTRIAL ❑ OTHER TYPE OF WORK: MW ❑ REPLACEMENT ❑ ALTERATION/REMODEL �+ DETAILED DESCRIPTION OF WORK lW,ge S)�Sj� CLOTHES WASHER _ FLOOR DRAINS _ RPZ VALVE _ URINAL _ _ DISHWASHER _ GAS PIPING _, BACKFLOW PREV. _ WATER HEATER —DRINKING FOUNTAIN _ GREASE TRAP _ ROOF DRAINS _ WATER METER —FAUCET _ KITCHEN SINK _ SHOWER _ WATER PIPING FLAPAMABLE WASTE TANK _ LAUNDRY TRAY _ SLOP SINK — WATER SOFTENER LAVATORY _ SWIMMING POOL _ WATER CLOSET .............................................................:::..............................................................................................::::::::::............... Total Job $ ® All fees are based on valuation, including thecost of labor and materials. Valuation Permit Fee $ '35-613 (1.25% of Job Valuation / Minimum fee: $35) Surcharge $ _ Valuation X.0005 Total Due $� Make Checks Payable to: City of Fridley THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all work which requires review and approval of plans. NAME OF APPLICANT — NI DATE � �--[ 4on�a SIGNATURE OF APPLICANT :ARE:1 I�:t�z:s;I3cfie<ab .................................................................................Q................................................,............. . City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 CITY OF FRIDLEY FIRE DEPARTMENT FIRE MARSHAL'S OFFICE DEPARTMENT OF FIRE PREVENTION NOTICE OF BUILDING FIRE To: Building Inspection Assessing Water Billing City Manager From: Ralph Messer, Fire Marshal Date: December 10, 2007 Subject: Fire Damaged Building Location of Fire: 5201 3rd Street, N.E., Apt 302 Date of Fire: December 8, 2007; 0703 hours Other pertinent details: This fire is believed to have started in a bedroom in Apartment 302. The fire was confined to that unit. There is water damage to the unit directly below the fire unit. Although this is an 11 unit building, the only tenants displaced by the fire were in Apartment 302. Also, there were no injuries to civilians or firefighters. Columbia Heights and St. Anthony Fire Departments assisted us in extinguishing this fire. The fire is under investigation by the Fire Department. If you have questions concerning this fire, please contact me at x3621. Building BUILDING Permit Nc�— `Y I$spections COMMERCIAL/INDUSTRIAL Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: 1e ©& 763-502-4977 FAXEFFECTIVE 1-1-08 DATE cr)l E-MAIL ADDRESS SITE ADDRESS jYOUR 3 CJ TENANT NAME: SUITE NUMBER Z PROPERTY OWNER NAME: S A <C)19 4 5 ADDRESS: /�Ci % �( ( S'– CITY S L STATV�MXIP S � PHONE: bra ,� 8 G � d? ARCHITECT NAME: ADDRESS: CITY STATE ZIP CONTRACTOR NAME:__G L .J 0 .1 w N S L,c YX o ADDRESS:62 S 2- 2 0- r_/_ 14Aj 0 *u -,_ CITY A4/L S STATE vim,, ZIP 5�_'-% VA R Ak Proposal (7K Proposal N0.16- r " r-� G.W. Cook Construction General Contractors • Commercial/Industrial Roofing 2922 Oakland Avenue South Office (612) 8221326 Fax (612) 822-0239 Minneapolis, MN 55407 Mobile (612) 940-5187 PROPOSAL SUBMITTEDTO „ ! L= PHONE 5 7- 6 STREET/ JOB NAME j,_),Any S7 c2 671 r Cn'Y, STATE & ZIP CODE'2 JOB LOCATION "1 WE PROPOSE TO FURNISH ALL LABOR, MATERIALS ANd EQUIPMENT NECESSARY TO COMPLETE THE WORK AS FOLLOWS: y F�, �.._J..%`.. ��'.ft::li`^� ',�._.. %:.JR-...C_2.-�-�.4� ..A_.,,v"'e�' �'�p�..��;b„Y..�'`--"`�'�..� �'.•".`-...""�V ^ Jfi?...� WE AGREE TO DO ABOVE DESCRIBED WORK FOR THE SUM OF $ _ '*^ TO BE PAID AS FOLLOWS CONTRACTOR TO CARRY WORKER'S COMPENSATION AND PUBLIC LIABILITY INSURANCE ON ABOVE WORK. VERBAL AGREEMENTS NOT BINDING - ALL ADDITIONAL WORK AND AGREEMENTS MUST BE SHOWN IN WRITING. ALL ORDERS ACCEPTED BY US WITH THE / UNDERSTANDING -THAT WE ARE NOT;TO BE HELD LIABILE FOR CAUSES BEHOND OUR CONTROL, THIS PROPOSAL SUBJECT TO ACCEPTANCE WITHIN 30 DAYS. 1,5% PER MONTH CHARGED ON ACCOUNTS OVER 30 DAYS. T O D SIGNATURE We are required by law to provide you with the following notice regarding the rights of persons furnishing labor and materials. (A) Persons or companies furnishing labor or materials for the improvement of real property may enforce a lien upon the improved land if they are not paid for their contributions, even if such parties have no direct contractual relationship with the owner. (B) Minnesota law permits the owner to withhold from his contractor so much of the contract price as may be necessary to meet the demands of all other lien claimants, pay directly such liens and deduct the cost thereof from the contract price, or withhold amounts from his contractor until the expiration of 120 days from the completion of such improvement unless the contractor fumishes to the owner waivers of claims for mechanics' liens signed by persons who furnished any labor or material for the improvement and who provided the owner with timely notice. I HAVE READ THE ABOVE AND ACCEPTED THE TERMS AND CONDITIONS OF THIS CONTRACT. SIGNATURE DATE Building BUILDING Permit Noed 01�z? Inspections COMMERCIALANDUSTRIAL Received By: 763-572-3604 FAX CITY OF FRIDLEY 763-502-4977 EFFECTIVE 1-1-08 DATE Z— /-% — YOUR E-MAIL ADDRESS SITE ADDRESS r -27 TENANT NAME: SUITE NUMBER PROPERTY OWNER NAME: /e;:Ot VIC ADDRESS: /0--, Ox Z6-7 `7 CITY 5 L/f STATE ZIP 55$ 2,49 PHONE: cI 15-? 47 3 51- 93 2_2 ARCHITECT NAME: ADDRESS: CITY STATE ZIP CONTRACTOR NAME: V ADDRESS: E�gekei.P u- .�, CITY 4' STATE �J ZIP lJ [t2 * NOTE: CITY LICENSE REQUIRED FOR COMMERCIAL, PHONE: 76 2 ?l7 SWG CELL: 7G 3 3 Y 13 � FAX: INDUSTRIAL AND CITY LICENSE # : J����a [ �X EXP: MULTI FAMILY PROPERTY TYPE 0 TOWNHOUSE 0, COMMERCIALANDUSTRIAL 0 INSTITUTIONAL 0 MULTI -FAMILY PERMIT TYPE 0 ADDITION 0 NEW CONSTRUCTION 0 OTHER REMODEL 0 ROOF 0 SWIMMING POOL PLEASE SUBMIT: 1.4 SETS OF DRAWINGS 5. CONTRACTORS LICENSE OR 6. SPECIAL INSPECTION 2. SURVEY/SITE PLAN LICENSE APPLICATSCHEDULE 3. LANDSCAPE PLANS ti[ W,17. PERFORMANCE BOND 4. ENERGY CALCS A Z 4-11, AMOUNT $ lzft BUILDING TO BE USED AS: OFFICE SF VMS. sF OTHER SF TOTAL SIZE: STORIES FIRE PROTECTION (Y/N) AC(Y/N) DETAILED DESCRIPTION OF WORK ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 UBC FEE SCHEDULE) Sq. ft. x $ Cost/sq. ft. = Valuation $ Sq. ft. x $ Cost/sq. ft. = Valuation $ Sq. ft. J x $ Cost/sq. ft. = Valuation $ TOTAL JOB VALUATION: $ d USE OCCUPANCY TYPE Permit Fee Plan Review Fire Surcharge Surcharge SAC Charge Erosion Control Park Fee Special Assessments See Back Page for Fee Schedule 65% of Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum $.50 $1825 per SAC Unit (Plans to MWCC for determination) $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Curb Cut Escrow $ ft + 6 ft = ft x $21 = $ Total Due $ Make checks payable to: City of Fridley Attach Stipulations 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 wxLwith the Minnesota Construction Codes; that W nderstand 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 wor ill be in accordancgwith the approved afI �.Cn the case o I work which requires review and approval of plans. SIGNATURE OF APPROVED BY PRINT NAME DATE DA