PRE 2010 DOCS•
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City of Fridley, Minn.
BUILDING PERMIT N® 6676
EWVMWV
r �
WON 0 BUILDING
No.< Street Part of.Lot
Lot ___ � __ Block ___ Addition or Sub -Division
Corner Lot _Inside Lot Setback ' ..— �ideyard —_
Sewer Elevation
Foundation Elevation
� DESCRIPTION OF BUILDING
To Used ;
Front Depth Height Sq. Ft. �� Cu. Ft—&V
Fron �,,,D�epth .Height _ _ Sq. Ft. Cu. Ft.
Type of Constructi _�== Faat.L.00001 — V--Vdr, — To be Completed
In consideration of the issuance to me of a permit to construct the building desexl e I agree to do
the proposed work in accordance with the description above set �or�a� in compli afl ons of
ordinancx� of the city of Fridley. /" / // / % % _ 3
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, re and in of buildings
owithin the rdinances. city limits and We permit may be revoked at myy upos�violaany of the provisions of said
NOTICE
VMS pennb does not cover the construction, Installation for whrin& phorbin& pat hsathrg, rower or water. Be sure to as
the BW[dh* Inspector for separate psrmita for these ham
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAMR d 1 ^ 44f _ L �� ButLDER fJ �•-�P e� �1°? E��� �%F/i�S
ADDRESS &e. ADDRESS 4200
LOCATION OF BUILDING
L/7
No. /� 7 Street .1z, n 9„ Part of Lotz_k_.V
Lot Block / Addition or Subdivision kA of P ze
Corner Lot Inside Lot Setback Side Yard �®
SEWER ELEVATION
FOUNDATION ELEVATION
Applicant attach to this form Two Certificates of Survey of .Lot and proposed build-
ing location drawn on these Certificates.
�-°� , DESCRIPTION OF BUILDING
To be used as: '. x Ati 1'' 4 -S --s_ Fr'e 4e
Front Depth
Sq. Ft. Cu. Ft.
Height
Front Depth Height
Sq. Ft. Cu. Ft.
Type of Construction 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.
DAI`E SIGNATURE
07
(Schedule of Fee Costs can be found on the Reverse Side).
Application for Power Plants and Heating. Cooling, Ventilation. ReIkigeration and
Air Conditioning Systems and Devices
', PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: RATE TOTAL
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 ............................. 5.00 $
Repairs & Alterations—up to $500.00 ................. 5.00 $
Repairs & Alterations each add. $500.00 .............. 2.50 $
STEAM or HOT 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 BTL) .......................
5.00
$�
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
$
AIR CONDITIONING
$
FAN HEATING SYSTEM See Fee Schedule
A
VENTILATING SYSTEM
$
ALTERATIONS & REPAIRS
TOTAL FEE
ROUGH
FINAL
Dept. of Bldgs. Phone SII 4-7470
Location j2z!!� t�:' ®�•�
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, Minn 19G�
Owner �Gl� 1P__ A-111
Kind of Building
Used as
To be completed about
Estimated Cost, $
Old ew. uiiding Permit No. W1 Permit No.
DESCRIPTION OF WORK
BEATING or POWER PLANTS --Steam, Hot Water(Warm Air No
Trade Name Size No -_"A4-3
Capacity Sq. Ft. E.D.R BTU H.P.
Total Connected Load— il) Kind of Fuel
BURNER — Trade NafP Size No
Capacity Sq. Ft. E.D.R BTU H.P.
(REMARKS -OVER)
Signe
.QW42 2M Business Phone No -
OF BUILDINGS
WAT LOSS CALCULATIONS DEP MIN13 APOLLS. Mll�i.
weaatamrtps
Windows a
rs—Crackage and Area
� I
Coe Bt
Width Height No. or Lineal ft.
no. e{e of pane lighW of crack
Area
aa. ft.
�o
yn.
Infiltration
Net exp. wall
Int. w4jI
C
Glace
;70Elrp.
wall
C'J
Net exp. wall
i
JUL wav
Ceiling
i
Floor
/ D
p7l
Windows and
idth
No.ar owe i
Windows and
width 1
No. of c
Windows and Doors—Crackage and Area
I
Width Height No. of Lineal ft. Area
No. of ppa of e lights of crack_ -,SQ. f
Infiltration
Glass
Exp. wall
Net exp. wall
Int. w4jI
Ceiling
^ Floor —'
wlnaOWa ana Noora—a..raczage ana nrca
Width Height No. or Lineal ft. Area
No. of Dane of pace I,ghtq,. of crack a�fL
City of Fridley
Application for Plumbing and Gas Fitting Permit
Dept. of Bldgs. Phone SII 4-7470
DESCRIPTION OF WORE Location S -i`+ , /Y
Number, Kind and Location of Fixtures
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
on
Number Fixtures ...................... x $1.50 $�
Future Fixture Opening ................ x 1.20 $
New Fixture Old Opening .............. x 1.00 $
Catch Basin ...... ..................... x 3.25 $
,ca
Water Heater (Up to 200,000 BTU) ...... x 2.00 $
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 $
REPAIRS & ALTERATIONS—Refer to Code
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 Ordinance
and ruling of the Department of Buildings, and hereby declares that all the fact
and representations stated in this application are true and correct.
Fridley, Minnon
Owners--�tro�--oma J�
Kind of Building 7
(
Used as L �
To be completed about
U Q
Estimated Cost, $ �Z 0
Old—ZIM Building Permit No 4 Permit No.
Signe
By
Business Phone No !!"/R
ROUGH '�6' �- � ^ �-3
FINAL
Description ................................................$
TOTAL FEE $ 42 2M
Imp!
�
�_
�F
Y�
o�
�pZ iTJZ
O� S�
O
<3
�g
t7
�U' e�
a
Z
�O
•
i
•
N
WATER HTR.
GAS
ELEC.
Base
1st
d`
2nd
3rd
4th
• Future Connection Openings
New Fixture, Old Openings
I Connected with
Sewer
I
II Cesspool �
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
on
Number Fixtures ...................... x $1.50 $�
Future Fixture Opening ................ x 1.20 $
New Fixture Old Opening .............. x 1.00 $
Catch Basin ...... ..................... x 3.25 $
,ca
Water Heater (Up to 200,000 BTU) ...... x 2.00 $
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 $
REPAIRS & ALTERATIONS—Refer to Code
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 Ordinance
and ruling of the Department of Buildings, and hereby declares that all the fact
and representations stated in this application are true and correct.
Fridley, Minnon
Owners--�tro�--oma J�
Kind of Building 7
(
Used as L �
To be completed about
U Q
Estimated Cost, $ �Z 0
Old—ZIM Building Permit No 4 Permit No.
Signe
By
Business Phone No !!"/R
ROUGH '�6' �- � ^ �-3
FINAL
Description ................................................$
TOTAL FEE $ 42 2M
C�
City of Fridley, Minn.
BUILDING PERMIT
Date: Sept. 29, 1969
C/,9.0 3-,&
N° 10430
Owner: Elwood Williams Builder Sussel Co.
Adm 5974 4th St. N. E. Address 1850 Como Ave.
LOCATION OF BUILDING
No. 5974 Street 4th St. N. E. Part of Lot
Lot 5 _ Block 13 Addition or Sub -Division Hyde Park Addn .
Corner Lot _____ Inside Lot — Setback --- Sideyard
Sewer Elevation __ _ _ — Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Garage Front _ 24' Depth 24' Height 10 Sq. Ft. Cu. Ft.
Front Depth Height Sq. Ft. Cu. Ft.
Type of Construction Frame Fst. Cost _ 2400.00 __ To be Completed
• Subject to final elevation as set by Engineer Dept.
Must have surfaced driveway
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 aft provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of $---9—DO , permit is hereby granted to Sussel Co.
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 violation of any of the provisions of said
ordinances.
Clarence Belisle
NOTICE:
Uk permh does not corer the condi ction, hutallation for wiring, phnnbing, gas heating, sewer or wafer. Be sora to as
the BuiM hw hnpector for separate pormhs for these home.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER Is NAME f &!v� GWiI�'d�5 BUILDER VS'A-e Cd
ADDRESS ✓� %`i�— e/ �� �� /1 �E ADDRESS /8'S�l ate
LOCATION OF BUILDING
NO. STREET y` t�i-- 141 �E 77
LOT BLOCK / 3 ADDITION OR SUBDIVISION A de
F
CORNER -LOT INSIDE LOT__.Pc,`SETBACK SIDEYAR,D
SEWER ELEVATION TOP OF FOOTING
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:
rp Front s3 ` Depth U Height
Square feet Cubic Feet
Front Depth Height
Square feet Cubic Feet
Type of Construction Estimated Cost y/®®
To Be Completed 'Po
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 V s & f SIGNATURE & -
.(Schedule of Fee Costs can be found on the Reverse Side.)
2277
LOT
NAME
SIZE
BLOCK -. -
ADDRESS -
VALUE
,_ •i
f
T. A/
�/ `nom.
ADO'N. - _ -
AREA _ -`
TYPE
I
i
A4 ge-5 A4
cz
�G7LT
L %J11 Ll C, f //C1 dN�t/.
TO 6 71l 2'T°
-
`'
1A 5 r -,Z IA- Z-7
Ill �,c� Gc�4/ vc/ IT
C17YOF
FRIDLEY
CIVIC CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MINNESOTA 55432 - PHONE (612) 571-3450
August 7, 1986
Mr. Tom Klein
5974 - 4th Street N.E.
Fridley, MLQ 55432
Re: Violation of Zoning Code - Construction on Easement
Dear Mr. Klein:
An inspection on August 6, 1986 has determined that the lean-to addition
that you have constructed onto the back of your garage is located on an
easement. Structures are not allowed to be placed on easements.
We will expect the lean-to addition to be removed from this easement by
September 5, 1986 when a reinspection will be conducted to determine
compliance.
If you have any questions on this matter, please feel free to contact me
at 571-3450.
Sincerely,
Z_
D L G. CLARK
Chief Building Official
DGC/mh
CC: Engineering Department
(MAN IF -7
["Is"
CITYOF
FRIDLEY
CIVIC CENTER • 6.131 UNIVERSITY AVE. N.E. FRIDLEY, MINNESOTA 55432 • PHONE (612) 571-3450
September 8, 1986
Mr. Tom Klein
5974 - 4th Street N.E.
Fridley, M 55432
Re: Violation of Zoning Code - Construction on Easement (SECOND NOTICE)
Dear Mr. Klein:
You were notified by letter, dated August 7, 1986, of the violation on
your property of the lean-to being constructed on an easement.
A reinspection on September 5, 1986 to determine compliance noted that the
lean-to has not been removed from this easement. This is a violation of
the City Zoning Code and must be corrected.
We will expect the lean-to to be removed by September 29, 1986 when a
reinspection will again be conducted to determine compliance. Your prompt
attention to this matter will be appreciated. If you have any questions
on this matter, please feel free to contact me at 571-3450.
Failure to correct this matter may result in this matter being turned over
to the City Prosecutor for his legal consideration.
Sincerely,
DA L G. CLARK
Chief Building Official
DGC/mh
CC: Mark Burch, Engr. Dept.
CfiYOF
FRIDLEY
CIVIC CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MINNESOTA 55432 • PHONE (612) 571-3450
October 2, 1986
Mr. Patrick J. Klein
5974 - 4th Street N. E.
Fridley, M 55432
Re: Construction of a Shed Addition, Without a Building Permit, and
Located on a Utility Easement
Dear Mr. Klein:
In August I made an inspection of your property to determine if a shed
addition had been constructed on the west side of your detached garage.
One of your brothers was home and together we looked at the
construction. It has been determined that the shed is encroaching into
the utility easement and must be removed.
TWo letters have been sent; one on August 7, 1986, the second on
September 8, 1986, however they were addressed to your father, Mr. Tbm
Klein, the former owner of the property. We apologize for that error.
9bere are both overhead wires and underground utilities located in this
easement. 'herefore, we must order you to remove the structure from
this easement. 4he present structure is approximately 3.5 feet into the
easement.
We will expect this lean-to addition to be removed from this easement by
November 3, 1986 when a reinspection will be conducted to determine
compliance.
If you have any questions on this matter, please feel free to contact me
at 571-3450.
Sincerely,
DKRRFZ G. CLARK
Chief Building Official
DGq,/ h
CC: Mr. Mark Burch
Asst. City Engineer
G7YOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287
June 4, 1991
Mr. Conway Olson
T. C. Field & Company
P.O. Box 64016
Saint Paul, Minnesota 55164
Re: General Liability Lass Notice
Date: Unknown
W Damage Because of Rain Runoff
Claimant: in
Location: 5974 4th Street Northeast
Dear Conway:
Enclosed is a claim from Mr. Paul Klein regrading damage to his property because
of improper construction, excavation, grading and drainage of the 5925 University
Avenue Northeast. Apparently, his property was flooded during a heavy rain
storm.
Please contact our Community Development Department, Ms. Barbara Dacy for
additional information regarding this claim.
If you have any questions or need additional information concerning this claim,
please contact Mr. John Flora.
very truly yours,
Shirley A. Haapala
City Clerk
Enclosures
cc: Ms. Barbara Dacy, Community Development Director ✓
Mr. Mark Winson, Assistant Public Safety Director
1 f t r 'E DATE MM/DD/YY)
F —�• Y 'i M K ,• •9„xsY3 :d £ .
AI�IIi:II.ILI �� "� F TI 4 W. -
���ut
%DMIREE ~ ��iP4v'•r•
e:4TASrIIrA«L`Y �i.4a sf�TT�..cC!T.-�.}'�.•3''�'::Y7'� ___-..._
PRODUCER 'NOTICE OF DATEMME OF OCCURRENCE I AM ;DATE OF CLAIM t - PREVIOUSLY
OCCURRENCE
NOTICE OF CLAIM. IPM! -^ - --' YI ES ! NO
-
POLICY EFF. DATE POLICY EXP. DATE POLICY TYPE RETROACTIVE DATE
OC UC RRENCE ` !
' 1/1/91 1/1/92 CLAIMS MADE
COMPANY eague Of innesotaPoucYNUMBER
Cities Insurance Trust JCMC11391
CODE SUB CODE PRODUCER PHONE (A/C, No., Ext.) REFERENCE NUMBER MISC. INFO. (Site & Location Code)
s
NAME & ADDRESS (As N appears on the policy)
INSURED'S RESIDENCE PHONE (AIC, No.) INSUREDS BUSINESS PH9NE (AIC, No., E)t.)
City of Fridley
612 1 571-3450 523•
6431 University Northeas
P SON TO CONTACT WHERE TO CONTACT
Fridley, MN5532
Shi rl ey A Haapal a, City Cl erk City Hall
or WHEN
Barbara Dacy, Community Development Dir. M -F
CONTACT'S RESIDENCE PHONE (A/C, No.) CONTACT'S BUSINESS PHONE (A/C. No.. Ext.)
r 612 1 57103450 1 523
LOCATION OF OCCURRENCE (include city & state)
AUTHORITY CONTACTED
5974 4th Street Northeast
DESCRIPTION OF OCCURRENCE (Use reverse side, N necessary)
Damage to property due to heavy rain runoff.
£'t i
COVERAGE PART OR FORMS (Insert form nos. & edition dates)
GEN. AGGR. PRODJCOMP-OPS. PERS. & ADV. INJURY OCCURRENCE I FIRE DAMAGE MEDICAL EXPENSE -- _DEDUCTIBLE TYPE
...�....-...__...._.-_..__
LIMITS �- _ __.�..._-____.
' � �...___.._
I i
i + � AMOUNT PD
UMBRELLA/EXCESS POLICY IN FORCE? ' UMBRELLA/EXCESS CARRIER UMB./XS. LIMITS i
-T-�» - - -- -- TPER
UMBRELLA EXCESS ER�
ARM
PREMISES: INSURED IS OWNER TENANT OTHER
TYPE OF PREMISES
OWNER'S NAME & ADDRESS (If not Insured) .
OWNERS PHONE: (A/C, No., Ext.)
PRODUCTS: INSURED IS ' MANUFACTURER VENDOR OTHER
TYPE OF PRODUCT
MANUFACT. PHONE: (A/C, No., Ext.) 1
MANUFACTURER'S NAME & ADDRESS Qt not Insured)
WHERE CAN PRODUCT BE SEEN?
OTHER LIABILITY INCLUDING COMPLETED OPERATIONS (Explain):
NAME & ADDRESS (injured/Owner)f
PHONE (A/C, No., Ext.)
Paul -Klein, 5974 4th Street NE, Fridley, MN 55432
1 1 1
AGE SEX I OCCUPATION EMPLOYERS NAME & ADDRESS PHONE (A/C, No., Ext.)
DESCRIBE INJURY FATALITY WHERE TAKEN WHAT WAS INJURED DOING?
DESCRIBE PROPERTY (Type, model, etc.) ESTIMATE AMOUNT WHERE CAN PROPERTY BE SEEN? WHEN?
See letter
y.
N.f
t.
NAME &ADDRESS BUSINESS PHONE (AIC, No., Ext.) i RESIDENCE PHONE (A/C, No.)
t
REMARKS
.See Mr. Klein's.letter. _.
REPORTED BY REPORTED TO SIGNATURE OF PRODUCER OR INSURED
Shirley A. Haapala City Manager
ACORD 3-S (2/88) NOTE: IMPORTANT STATE INFORMATION ON REVERSE SIDE 0 ACORD CORPORATION 1988
AUG U 6 WS1
August 6, 1991
Mr Paul Klein
5974 4th Street ATE
Fridley, MN 55432
612/571-3407
Mr William Burns
City of Fridley
City Manager
6431 University Avenue NE
Fridley, MN 55432
Re; 5925 University Avenue NE
Dear Mr Burns,
This is a very simple and straight forward claim.
Due to the improper construction, excavation, grading and drainage of the
property identified above, my property and house were flooded. This resulted
in a significant amount of damage to my garage and items stored therein.
I am enclosing copies of numerous self explanatory correspondence and
memoranda which unequivocally establishes the basis of liability for the City
of Fridley, American Family Insurance Group, Fridley Alcoholics Anonymous
Society and Stewart Homes.
American Family Insurance has responded with an inappropriate and unjustified
denial of coverage. Meanwhile, the City of Fridley has repeatedly
acknowledged this problem and resulting damage, but has failed to take any
appropriate remedial measures. My efforts to amicably resolve this matter
have proved to be futile. I have become extremely frustrated with your non-
responsiveness and blatant disregard for your obligations to remedy this
problem.
The following summarizes the extent of damage to my home, as a result of the
flooding.
ITEM REPLACEMENT COST
Carpeting: 12' x
22'
$ 150.00
12' x
20'
100.00
Carpet Pads
48.00
Sheetrock
11.85
Fire Rock
5.65
Plywood
19.26
Sak-crate
4.77
Acousti-spray
5.80
Portland cement
9.60
Mason cement
4.11
Lawn fertilizer:
starter
5.88
builder
7.98
Grass seed
27.44
Rolled roofing
9.77
Mr William Burns
City of Fridley
August 6, 1991
Page Two
ITEM
REPLACEMENT COST
Charcoal $ 3.99
Oil absorb 9.99
Labor, cleanup 200.00
TOTAL COST: ' $ 624.18
If you do not tender payment at the address found herein, before August 20,
1991, I am prepared to resolve this case in a court of law, naming each of you
as defendants. I trust a law suit will not be necessary to settle this
matter. Nevertheless, I am not willing to sit back and absorb losses
sustained through no fault of my own.
Thank you for your anticipated cooperation. I will look forward to hearing
from each of you.
Res tfully, 1547
A/d
Paul M Klein
encl:
cc: Renee Norman
American Family Insurance
Casualty Claims Analyst
PO Box 64885
St Paul, MN 55164-0885
Mr Jim Hood
Fridley Alcoholics Anonymous Society
5925 University Avenue NE
Fridley, MN 55432
Mr Skip Stewart
Stewart Homes
1790 118th Avenue NE
Blaine, MN 55404
Mr William Nee
Mayor of Fridley
Mr Mark Winson
Assistant Public Works Director
Fridley City Council
SUBJECT
PERMIT NO.
City of Fridley
6 7 5 2
r AT THE TOP OF THE TWINS
BUILDING
PERMIT
J/z
LCOMMUNITY DEVELOPMENT DIV.
I V ������,
PROTECTIVE INSPECTION SEC.
r � �
1 � �
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
LBJEA
0 1
77/22/98
JOB ADDRESS 5974 4th St NE
1 LEGAL
LOT NO. BLOCK TRACTOR ADDITION
SEE ATTACHED
DESCR.
S 1/2 of , all -5 1 Hyde Park
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Paul Klein
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Snedeker Constr Co. 18245 233 3/4 Ave Bija Lake MN 5263-3678
20039123
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 V REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
"MMM XX Reroof house and garage 22 S Tear -off; new windows
9 CHANGE OF USE FROM TO
STIPULATIONS ad
Underlment must comply with State Building Code.
Install smoke detectors to meet the State Building Code - in each sleeping
room and on each level of house.
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 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
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
$8894
$4.45
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 O TH ERFORMANCE OF CONSTRUCTION.
$149.75
Fire SC 8.89
PLAN CHECK FEE
TOTAL FEE
-
License SC $5.00
1$168.09
NATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATEI
WHEN PRO
LY VALIDATED THIS IS YOUR PERMIT
e
BLDG )NSP
r s
GATE
S.GNATURE OF OWNER OF OWNER BUILDER) IDATEI
NEW [ ]
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: -S-9 //-/ -/-/ S;— /j
Legal Description:
Owner Name & Address:
Tel. #
Effective 1/1/98
eqo
Contractor: -7';� c,- d
MN LICENSE #
ov
3
Address: , ( y.�" � � Zvi � 43 zt-1
>-4 Tel. #
'� � �lo3
-367
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:
9 o A?n o T=
h/ e- V"'
2r/__. -C
7
Construction Type: ;%-2 _ a o y /� Estimated Cost: $ 1-7
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
/
DATE: APPLICANT: Tel. #
STIPULATIONS:
CITY USE ONLY
Permit Fee
$ J� �.
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
$
$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
$ 160 0 19
STIPULATIONS:
SUBJECT
City of Fridley
2 � � 6)8�
AT THE TOP OF THE TWINS
BUILDING
PERMIT
' ,
o
DEVELOPMENT DIV.
L ------COMMUNITY
r PROTECTIVE INSPECTION SEC.
7
1
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910415
7/29/98
JOB ADDRESS �-4- -4-tirt-t- 5974 4 Street NE
I LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
S 1of 4,
11 5 13
Hyde Park
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Paul Klein
571-3407
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Exterior Innovation 2187 Overlook Dr.. Bloomington 55431
884-0814
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 N REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Reside house and garage- steel
9 CHANGE OF USE FROM TO
STIPULATIONS
Call for building wrap inspection before covering.
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 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 1 HAVE READ AND EXAMINED THIS APPLICATION
I
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
$8,000
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHE STATE OR L AL LAW REGULATING CON-
STRUCTION OR THE ERF M NCE OFC STRUCTION.
$137.25
Fire SC $8.00
PLAN CHECK FEE
TOTAL F
n
Licens 5.00
.25
SIGNATURE OF CONTRACTOR OR AUTMO IZED AGENT IDA EI
EN ROPE Y (DATE
T IS Y URMIT
PATE
SIGNATURE OF OWNER OF OWNER BUILDERI IDATEIG
INSP
NEW [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLEBUIL�DIIDNG PERMY AND I
T PAPPL CATIONND R-2 (p � & � �
ConstructionAddress: � 74 -4
Legal Description:
Owner Name & Address: �¢}1JL� i�L/� Tel. #S--7) —3-40-7
Contractor: 7` �l Off? �l�i�otir � MN LICENSE # 2��
m
Address:. Zj 9:,;�"7 C 2A)r K IQk Tel. #
i?)A) Attach to this application, a Certificate of Survey of the
31 lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF EWROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: /Width Hgt/Ground Sq. Ft.
OTHER: S J)Sit 4
Construction Type:
Estimated Cost: $ Ai �_y_)(-)-
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: APPLICANT:A A, - OeA% e Tel. # -374ri, am
STIPULATIONS:
CITY USE ONLY
l �7
Permit Fee
$
/3 / � -2S
Fee Schedule on Reverse Side
Fire Surcharge
$
P�- C0
.001 of Permit Valuation (1/10th%)
State Surcharge
$
tl UD
$.50/$1,000 Valuation
SAC Charge
$
$1000 per SAC Unit
License Surcharge
$ S_.00
$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:
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
572-36U4 VAX: (763) 571-IZ87
ADDRESS
: 5974 4TH ST NE
PIN
: 233024210117
LEGAL DESC
: BROOKVIEW TERRACE
: LOT 2 BLOCK 4
PERMIT TYPE
: BUILDING
PROPERTY TYPE
RESIDENTIAL
CONSTRUCTION TYPE
ADDITION/ALTERATION
PE ITNO: 2004-00221
DATE ISSUED: 02/18/2004
VALUATION : $ 1,000.00
NOTE: SEE NOTATIONS ON PLAN.
CALL GOPHER STATE ONE AT 651-454-0002 FOR UTILITY LOCATIONS.
PROVIDE SMOKE DETECTORS IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF THE DWELLING PER SECTION
310.9.1.2 OF THE 1997 UNIFORM BUILDING CODE WHEN ADDITIONS, ALTERATIONS OR REPAIRS IN EXCESS OF
$1,000 ARE MADE TO RESIDENTIAL DWELLINGS. BASEMENT KITCHEN
APPLICANT
PHALGOO,BOOPENDRA
5974 4TH ST NE
FRIDLEY, MN 55432
1 "R '
PHALGOO,BOOPENDRA
5974 4TH ST NE
FRIDLEY, MN 55432
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of worl
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authority to
violate or cancel the provisions of any other state or local law
regulagap—construotion or the performance of construction.
BUILDING PERMIT FEE
FIRE SURCHARGE
STATE SURCHARGE, VALUE
TOTAL
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
38.75
1.00
0.50
40.25
NEW [ ] CITY OF FRIDLEY Effective 1/1/2004
ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPLICATION
Construction Address: ��(�"
Legal Description:
�( Owner Name & Address: �o� err �,y�s/ Tel.
'x Contractor: MN LICENSE #
Address: 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: &sem a,17-
Construction Type: Estimated Cost: $
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ —=$ ,a_ -D me -9
DATE: en -/o APPLICANT: o Tel. # G1- lez- �
Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 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
TOTAL
CITY USE ONLY -
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1350 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
STIPULATIONS:
If
�tl�cr2�C
/�?ons
"Aal
'80A, -v,
. Z(Lo e
UAPP
LIL u
liw
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
(763) 572-3604, FAX (763) 571-1287
Effective On Jan 1, 2004
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
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
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
$15.00
Reinspection Fee $47.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance
State Surcharge
TOTAL
.50
JOB ADDRESS�T�C7h r�"
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.
20
Owner
Building Used As &(e6e
17l!Q1.
Estimated Cost PERMIT NO. �00 .41 _ 00-,
PLUMBING COMPANY
SIGNED BY, TEL N0.
Approved By Rough -In Date Final Date q
11,29
MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $20.00
TOTAL FEE $ PLUS THE $.50 STATE SURCHARGE
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE
THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE
APPLICATION WILL BE RETURNED
COMMON VFNT, VFNT ONN CTOR ANn COMR1ISTION AIR VFRIFICATION
When _rS In acing an Pxostang fnrance, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required. Yes () No ( )
The venting system is plastic/PVC and meets all current codes and manufacturer
specifications including sizing, length, number of elbows and termination. Yes () No ( )
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufacturer's specifications. This does
include AGA-GAMA Category I Central Furnace Venting Tables for fan
assisted and natural draft appliances. Yes () No ( )
The pxlsting .nmh istinn air is sized and installed to meet the current codes
and manufacturers specifications. Yes () No ( )
When required to ins all a now cnmhustonn air; it will be sized and installed
to meet the current codes and manufacturer's specifications. Yes () No ( )
When Mrtaffinn a naw ventina nyst m, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturers
specifications. This does include AGA-GAMA Category I Central Furnace
Venting Tables for fan assisted and natural draft appliances. Yes () No ( )
Is the common vent and vent connectors sized and installed correctly after
an appliance has been removed from the common vent and vented
separately as per current codes. Yes( )No(
)
Appliance #1 Type
BTU Input
Fan Assisted or Nat
Appliance #2 Type
BTU Input
Fan Assisted or Nat
Appliance #3 Type
BTU Input
Fan Assisted or Nat
Total Appliances
Total Btu Input
Common Vent Type
Vent Height
Diameter inches
Appliance #1 Vent Connector Height
ft Length
ft Diameter in Type
Appliance #2 Vent Connector Height
ft Length
ft Diameter in Type
Appliance #3 Vent Connector Height
ft Length
ft Diameter in Type
HEATING CO:
Signed By: Date :
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
572-3604 FAX: (763) 571-1287
ADDRESS
5974 4TH ST NE
PIN
233024210117
LEGAL DESC
BROOKVIEW TERRACE
LOT 2 BLOCK 4
PERMIT TYPE
PLUMBING
PROPERTY TYPE
: RESIDENTIAL
CONSTRUCTION TYPE
: ADDITION/ALTERATION
PERMIT NO.: 2004-00222 ��' �36
DATE ISSUED: 02/18/2004
VALUATION
NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A
BASEMENT KITCHEN SINK
# ELEC WATER HEATERS
# NEW FIXTURES (EXIST OPENINGS)
# GAS DRYERS
# OF NEW FIXTURES
APPLICANT
PHALGOO,BOOPENDRA
5974 4TH ST NE
FRIDLEY, MN 55432
OWNER
PHALGOO,BOOPENDRA
5974 4TH ST NE
FRIDLEY, MN 55432
0 VALUE OF FIXTURE/APPLIANCE
0 # GAS WATER HEATERS
0 # GAS RANGES
1 # WATER TRMT APPLIANCES
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time atter work is commenced.
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of worl
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authority to
violate or cancel the provisions of any other state or local law
reeulatine construction or the Derformance of construction.
Bldg
PLBG PERMIT MINIMUM FEE
PLBG FIXTURES (NEW OPENINGS)
PLBG FIXTURES (EXIST OPENINGS)
WATER TREATMENT APPLIANCE
WATER HEATER - ELEC
WATER HEATER - GAS
GAS RANGE FEE
GAS DRYER FEE
PLBG REPAIR/ALTERATIONS
STATE SURCHARGE, PLBG FLAT
TOTAL
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
r
0
0
0
0
20.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.50
20.50
Building
PLUMBING
Permit No.:
Inspections
RESIDENTIAL APPLICATION
Received By: /
763-572-3604
CITY OF FRIDLEY
Date R --'d: D
DATE YOUR E- ADDRESS
SITE ADDRESS _q:7q y
THIS APPLICANT IS: 0 OWNER CONTRACTOR
PROPERTY
NAME:
ADDRESS: CITY STATE ZIP
OWNER/
TENANT
PHONE:
CONTRACTOR
NAME: M, - 71b v`
STATE LICENSE # ✓C%/ 6 EXP DATE
54-• CITY S�. n ttc_t-m-G'-e. STATE 4°-�ZIP g577ro
SUBMIT A COPY OF
YOUR STATE
ADDRESS: I[ oSy 2 by-`"
LICENSE WITH
PHONE 7 - Z o 3 / FAX
APPLICATION
PERMIT TYPE
/�
o si GLE FAMILY 0 TWO FAMILY 0 TOWNHOUSE
®'REPLACEMENT
TYPE OF WORK:
0 NEW
DETAILED DESCRIPTION OF WORK F,` x k,r e-5 6^%e -to �� 2
PER MS 1613.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the
improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor )
Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor X.05 =
FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL
NUMBER OF EACH BELOW)
BATH SINK/LAV FLOOR DRAINS —SHOWER _ WATER PIPING
BATH'T'UB GAS PIPING paED cn7LrcEAm0 SWIMIyIING POOL —WATER SOFTNER ($35)
CLOTHES WASHER / KITCHEN SINK / WATER CLOSET —BACKFLOW PREV. ($15)
_
L DISHWASHER _ LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION
WATER METER _ OTHER
r +� A , (I �
ti ` N �
umber of fixtures @ $10.00_ x $1000 =
Permit Fee $
Surcharge .50
Number of fixtures @ $15.00 x $15.00 = $
Number of fixtures @ $35.00 x $35.00 = $
TOTAL DUE $
State Surcharge = $ .50
Total = $ . Jcb
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 alll work which requires review and approval of plans.
SIGNATURE OF APPLICANT /-'^� PRINT NAME % �1 1 47�'.CNe^-1 G DATE 2 -3
r�x w .e,.... .4}t �.,Rog u��t ..��
��1 T&MER ..�' ... ., .. jIt
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
572-36U4 FAX: (763) 571-1287
ADDRESS
: 5974 4 ST NE
PIN
: 233024210117
LEGAL DESC
: BROOKVIEW TERRACE
: LOT 2 BLOCK 4
PERMIT TYPE
: BUILDING
PROPERTY TYPE
: RESIDENTIAL
CONSTRUCTION TYPE
: ALTR/STRUCTURAL CHANGE
VALUATION
: $ 30,000.00
NOTE: FIRE DAMAGE REPAIR/REMODEL,NEW WINDOWS,NEW SIDING
SEPRETE PERMITS REQUIRED FOR ;ELECT, PLUMB,MECH.
CALL FOR ALL REQUIRED INSPECTIONS.
STATE LICENSED CONTRACTOR 1
PERMIT NO.: 2006-00238
DATE ISSUED: 02/08/2006
APPLICANT BUILDING PERMIT FEE 441.75
SUPERIOR CONSTRUCTION SERVICES FIRE SURCHARGE 30.00STATE SURCHARGE, BLDG VALUE 15.00
MAA 85 AVE NPLE GROVE, MN 55369 -
LICENSE SURCHARGE 5.00
M
(763) 924-9434 TOTAL 491.75
7231 PAID WITH CHECK # 16396
OWNER
PHALGOO,BOOPENDRA
5974 4TH ST NE
FRIDLEY, MN 55432
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of wort
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authority to
violate or cancel the provisions of any other state or local law
regulating construction or the performance of construction.
Applicant Date
Bldg Insp Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
building
BUILDING
Permit No. 11 — U ®c.��
Inspections
RESIDENTIAL APPLICATION
Received B
763-572-3604
CITY OF FRIDLEY
Date Recd:
DATE
YOUR E-MAIL ADDRESS
�k
SITE ADDRESS
THIS APPLICANT IS:
❑ OWNER ONTRACTOR
PROPERTY OWNER/
NAME; Q
43; I
TENANT
ADDRESS: zR 7 4 A W Al CITY( al ���STATE�J4&IP .s
PHONE:
CONTRACTOR
_ r
NAME: T
STATE LICENSE # – EXP DATE �G ,�,L
1,? g " y /lam CITY���'C�C� STATE' 'LIP���
SUBMIT A COPY OF
YOUR STATE LICENSE
ADDRESS: 1
WITH APPLICATION
PHO ) a 1— OG1 FAX
0SINOLEFAMMYINEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PROPERTY TYPE
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS
❑ BASEMENT FINISH ❑ ROOF ❑ DJa.IN TILE
VIOTHER
❑ DECK ❑ SIDING
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW ❑ ADDITION
❑ MAINTENANCEMEPAIR 0 REMODELING
DESCRIBE WORK BEING DONE: Kc Qa z,- ksen)ANc
SIZE OF IMPROVEMENT
NUMBER OF SQUARES
GARAGES
PROPOSED SIZE:
PROPOSED HEIGHT:
SIDING
❑ Vinyl
P(Aluminum
❑ Other
❑ HOUSE & GARAGE
❑ ATTACHED GARAGE
'DETACHED GARAGE
❑Soffit
❑ Trim
❑ Fascia
HEIGHT
Ft.
13ASEMENT REMODELING SUBMIT:
1. Existing Floor Plan
2. Proposed floor plan
3. List of structural members to be used
FOR NEW CONSTRUCTION INCLUDING DECKS,
ADDITIONS & PORCHES SUBMIT:
1. Site Plan/Survey showing the existing structures
and proposed project.
2. Two sets of construction plans
WINDOWS 3. Energy Calculations
IN EXISTING OPENINGS Wes ❑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:
(USING THE 1997 B.0 E SCHEDULE)
TOTAL JOB VALUATION $ 3 D d. OCCUPANCY TYPE
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Girt 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)
$1550 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$20=$
$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 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 re ices review and approval of plans.
SIGNATURE OF APPLICANT �� PRINTNAME J� �i% �C�� DATE
'AIll
00""O"" g y American Family Insurance Group
AliCRWiB—W.11 too
Randall Voelker
3920 Northwoods Drive
Arden Hills MN 55112
Phone 651.483.8271 Ext 65305
Fax 651.483.6501
Insured:
PHALGOO, BOOPENDRA
Property:
5974 4TI-I ST NE
Date of Loss:
FRIDLEY, MN 55432-5517
Home:
5974 4TI I ST NE
Price List:
FRIDLEY, MN 55432-5517
Claim Rep.:
Randall Voelker
Business: 3920 Northwoods Drive
Arden I I i I Is, MN 55112
Estimator: Randall Voelker
Business: 3920 Northwoods Drive
Arden 1-1 i I Is, MN 55112
Claim Number Policy Number
00231389872
22RH348801
Dates:
Date of Loss:
01/10/2006
Date Inspected:
01/10/2006
Price List:
MNMN=IB6A
Restos t i on/Service/Remodel
Estimate:
PHALGOO BOOPENDRA
This estimate covers
the dama-es to your house.
5-9/y vM
Type of Loss
FIRE
Date Received: 01/10/2006
Date Entered: 01/10/2006
Ho Y.((7!63) 586-6032
Cell: (763) 670-9326
Business: (651) 483-6247 x65305
Business: (651) 483-6247 x65305
Deductible
$500.00
Enclosed is my estimate for the repair of your house. Please show this estimate to the contractor of your choice. If there are
areas of concern please contact me PRIOR to beginning repairs. If you are unable to get the repairs done for the amount we
have estimated, please contact its PRIOR to hiring a contractor.
As the insured you, or your lc_,nl representative, are the only one who can authorize work on your home. The selection and
use of a particular contractor is your choice.
Policy terms require that the holder(s) of the mortgage (if applicable) be listed as a payee on a draft for structural damage.
SIDING - IF SIDING IS PART OF THIS ESTIMATE - The Xactimate unit price accounts for normal waste thus generally
the actual square footage is in t he estimate. Generally, additional waste is NOT added to the estimate.
ROOFING- IF ROOFING IS PART OF THIS ESTIMATE - Tear off includes all dumpster fees.
Your policy provides replacement cost coverage for property which was damaged in this claim. The coverage is explained in
your policy under Building Rchlacement Cost Coverage.
We are enclosing our draft for the Actual Cash Value (today's replacement cost less applicable depreciation) of the damaged
property.
N Fni�r American Family Insurance Group
d�ffU5VffWffJA1M LIFE
Randall Voelker
3920 Northwoods Drive
Arden Hills MN 55112
Phone 651.483.8271 Ext 65305
Fax 651.483.6501
Your HO -5 policy provides fill l replacement cost coverage, subject to certain provisions and limitations. One such limitation
is the damaged property must be repaired or replaced within one year of the date of loss, (refer to Gold Star Homeowners
Amendatory Endorsement 587 Ed 10/99, under CONDITIONS SECTION 1, Loss Value Determination, and paragraph d.
Procedures to Claim Replacement Coverage).
If you wish to make a claim flu- the amount we have taken as depreciation to recover the full replacement cost, you must do
THREE things:
1. You must advise its of %-our intent to make a claim under the replacement cost coverage before 180 days from the date
of loss. SEE NOTE BELOW
2. You must actually replace (purchase) the property within one year of the date of loss.
3. You must submit a final bill for repair/replacement showing the work has been completed.
The replacement cost coverage is limited to the amount it would cost today to replace with a similar item of like kind and
quality.
To claim replacement cost coverage, please send in the invoice from the contractor showing what was done and the total cost
of repairs. Please forward to our office the original invoice.
Self addressed stamped envelopes are enclosed for your convenience
You may purchase a higher quality item if you choose, but we will only pay up to the amount deferred.
MORTGAGE COMPANY- IF NAMED ON THE PAYMENT DRAFT- Under the terms of this policy, we are required to
name all parties that have an interest in the realty (usually the dwelling) on settlement drafts; generally just your lien holder
(mortgage company) and second mortgage (home equity loan usually), but there can be other parties.
(1) Please contact your ]ender and let them know that you have had a storm loss. Tell them the type of loss and the loss
amount for the realty. Thee will inform you on how to get the draft cashed. Generally it is best not to sign the draft if the
mortgage company is goin- to cndorse it and send it back. The mortgage company will have its own procedure.
ZD
(2) If you no longer have a mortgage on the property, please send us or your agent documentation from the mortgagee
showing the mortgage is canceled.
(3) If your mortgage has changed, just call the claims center and let us know what the new name is. We will cancel the
initial draft and issue a new draft with the new mortgage company (if the new mortgage company is a recognized lending
institution).
(4) If you have any quest ions, call the claims office at 651-483-8271. Make sure you have your claim number.
Thank you for insuring with American Family Insurance. Your business is appreciated.
PHALGOO_BOOPENDR;\ 02/07/2006 Page: 2
AMERICAN FAMILY American Family Insurance Group
euroa�eu�rd�r�®
Randall Voelker
3920 Northwoods Drive
Arden Hills MN 55112
Phone 651.483.8271 Ext 65305
Fax 651.483.6501
Room: Attic
PHALGOO_BOOPENDRA
240.00 SF Walls
1,270.04 SF Walls & Ceiling
106.67 SY Flooring
131.50 LF Ceil. Perimeter
Formula Peaked 40'0" x 24'0" s 110"
1,030.04 SF Ceiling
960.00 SF Floor
128.00 LF Floor Perimeter
DESCRIPTION QNTY REMOVE REPLACE TOTAL
Apply odor counteractant - liquid spray 1,990.04 SF 0.00 0.15 298.51
1/18
NO SMOKE STAINING OBSERVED TO THE RAFTERS
INSULATION REPLACED DUE TO LOSING / REPLACEING CEILINGS OF FIRST FLOOR
ROOMS AND SMOKE INFILTRATION AROUND THE ATTIC HATCH
R&R Blown -in insulation - 16" depth - R44 960.00 SF 0.91 1.05 1,881.60
Cleaning Technician - per hour- CLEAN 1.00 HR 0.00 26.53 26.53
AROUND ATTIC HATCH
PAINTING OF ATTIC HATCH IS IN THE MAIN FLOOR SCOPE
Room Totals: Attic 2,206.64
H deft RearB
�I, m
Main Level
Room: Left Rear Be
396.00 SF Walls
522.18 SF Walls & Ceiling
14.02 SY. Flooring
49.50 LF Ceil. Perimeter
Subroom 1: CLOSET
1'Z2'9"10" 102.67 SF Walls
111.88 SF Walls & Ceiling
1.02 SY Flooring
�4' 5" —
12.83 LF Ceil. Perimeter
Ceiling Height: 8'
126.18 SF Ceiling
126.18 SF Floor
49.50 LF Floor Perimeter
Ceiling Height: 8'
9.21 SF Ceiling
9.21 SF Floor
12.83 LF Floor Perimeter
PHALGOO_BOOPENDRA 02/07/2006 Page: 3
I
d
„m
skdwAShun
L'
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___ mlWd Lm.Ph
1
L�
PHALGOO_BOOPENDRA
240.00 SF Walls
1,270.04 SF Walls & Ceiling
106.67 SY Flooring
131.50 LF Ceil. Perimeter
Formula Peaked 40'0" x 24'0" s 110"
1,030.04 SF Ceiling
960.00 SF Floor
128.00 LF Floor Perimeter
DESCRIPTION QNTY REMOVE REPLACE TOTAL
Apply odor counteractant - liquid spray 1,990.04 SF 0.00 0.15 298.51
1/18
NO SMOKE STAINING OBSERVED TO THE RAFTERS
INSULATION REPLACED DUE TO LOSING / REPLACEING CEILINGS OF FIRST FLOOR
ROOMS AND SMOKE INFILTRATION AROUND THE ATTIC HATCH
R&R Blown -in insulation - 16" depth - R44 960.00 SF 0.91 1.05 1,881.60
Cleaning Technician - per hour- CLEAN 1.00 HR 0.00 26.53 26.53
AROUND ATTIC HATCH
PAINTING OF ATTIC HATCH IS IN THE MAIN FLOOR SCOPE
Room Totals: Attic 2,206.64
H deft RearB
�I, m
Main Level
Room: Left Rear Be
396.00 SF Walls
522.18 SF Walls & Ceiling
14.02 SY. Flooring
49.50 LF Ceil. Perimeter
Subroom 1: CLOSET
1'Z2'9"10" 102.67 SF Walls
111.88 SF Walls & Ceiling
1.02 SY Flooring
�4' 5" —
12.83 LF Ceil. Perimeter
Ceiling Height: 8'
126.18 SF Ceiling
126.18 SF Floor
49.50 LF Floor Perimeter
Ceiling Height: 8'
9.21 SF Ceiling
9.21 SF Floor
12.83 LF Floor Perimeter
PHALGOO_BOOPENDRA 02/07/2006 Page: 3
0� � FAQ American Family Insurance Group
mpp�,R9Baacni «£i
Randall Voelker
3920 Northwoods Drive
Arden Hills MN 55112
Phone 65 1.483.8271 Ext 65305
Fax 651.483.6501
DESCRIPTION QNTY REMOVE REPLACE TOTAL
Protect - Cover with plastic
135.39 SF
0.00
0.20
27.08
Remove 5/8" drywall - hung, taped, floated,
135.39 SF
0.35
0.00
47.39
ready for paint
Remove 1/2" drywall - hung, taped, floated,
498.67 SF
0.35
0.00
174.53
ready for paint
Visqueen vapor barrier
135.39 SF
0.00
0.29
39.26
5/8" drywall - hung, taped, floated, ready
135.39 SF
0.00
1.65
223.39
for paint
Acoustic ceiling (popcorn) texture
135.39 SF
0.00
0.68
92.07
Mask per square foot for drywall or plaster
498.67 SF
0.00
0.14
69.81
work
1/2" drywall - hung, taped, floated, ready
498.67 SF
0.00
1.53
762.97
for paint
NOTE -
WALL INSULATION NOT RECOGNIZED AS
DAMAGED AS OF INSPECTION OF 1/18
SUBJECT TO RE -INSPECTION AFTER SHEETROCK IS PULLED
Remove Baseboard - 2 1/4" INCLUDES
62.33 LF
0.35
0.00
21.82
SHOE
Seal then paint the walls twice (3 coats)
498.67 SF
0.00
0.80
398.94
Baseboard - 2 1/4"
62.33 LF
0.00
1.89
117.80
R&R Quarter round - 3/4"
62.33 LF
0.15
0.92
66.69
Stain & finish baseboard
62.33 LF
0.00
0.90
56.10
STAIN/FINISH base shoe or quarter round
62.33 LF
0.00
0.47
29.30
Clean floor
135.39 SF
0.00
0.26
35.20
Sand, stain, and finish wood floor
135.39 SF
0.00
4.07
551.04
Remove Wood window - casement, 3 - 11
2.00 EA
28.31
0.00
56.62
sf
(Material Only) Wood window - casement,
2.00 EA
0.00
210.32
420.64
3-11sf
(Install) Wood window - casement, 3 - 11
2.00 EA
0.00
54.19
108.38
sf
Casing - 2 1/4" - C:\SING I:EMOVED
27.20 LF
0.00
1.40
38.08
WITH WINDOW
Stain & finish wood window (per side)
2.00 EA
0.00
34.92
69.84
Stain & finish casing,
27.20 LF
0.00
0.90
24.48
R&R Interior door unit
1.00 EA
15.67
152.20
167.87
Stain & finish door/window trine & jamb
2.00 EA
0.00
23.37
46.74
(per side)
Stain & finish door slab only (per side)
2.00 EA
0.00
33.42
66.84
PHALGOO_BOOPENDR:\ 02/07/2006 Page:4
AMERICAN FAMILY American Family Insurance Group
Yana' ecoseress Jnr ro �e
Randall Voelker
3920 Northwoods Drive
Arden Hills MN 55112
Phone 651.483.8271 Ext 65305
Fax 651.453.6501
DESCRIPTION
CONTINUED - Left Rear Be
QNTY REMOVE REPLACE TOTAL
Door lockset - interior
1.00 EA
0.00
35.28
35.28
R&R Bifold door set - Colonist - Double-
1.00 EA
12.54
174.69
187.23
metal no casing
126.19 SF
0.35
0.00
44.17
Paint bifold door set - slab only - 2 coats
1.00 EA
0.00
28.58
28.58
(per side)
465.33 SF
0.35
0.00
162.87
R&R Closet shelf and rod package
8.60 LF
4.20
18.98
199.35
R&R Ceiling fan & light - High grade
1.00 EA
15.77
360.91
376.68
Room Totals: Left Rear Be 4,540.00
Room: Left Front B
342.67 SF Walls
456.94 SF Walls & Ceiling
12.70 SY Flooring
42.83 LF Ceil. Perimeter
Subroom 1: CLOSET
122.67 SF Walls
134.58 SF Walls & Ceiling
1.32 SY Flooring
15.33 LF Ceil. Perimeter
Ceiling Height: 8'
114.28 SF Ceiling
114.28 SF Floor
42.83 LF Floor Perimeter
Ceiling Height: 8'
11.92 SF Ceiling
11.92 SF Floor
15.33 LF Floor Perimeter
DESCRIPTION
QNTY
REMOVE
REPLACE
TOTAL
Protect - Cover witli plastic
126.19 SF
0.00
0.20
25.24
Remove 5/8" drywall - hung, taped, floated,
126.19 SF
0.35
0.00
44.17
ready for paint
Remove 1/2" drywall - hung, taped, floated,
465.33 SF
0.35
0.00
162.87
ready for paint
PHALGOO_BOOPENDRA
02/07/2006
Page: 5
�e�eeics� Farrow Aineric;m Family Insurance Group
mom
BUSINESS KAU# UK m
Randall Voelker
3920 Norihwoods Drive
Arden Hills MN 55112
Phone 651.483.8271 Ext 65305
Fax 651.483.6501
CONTINUED - Left Front B
DESCRIPTION QNTY REMOVE REPLACE TOTAL
Visqueen vapor barrier
126.19 SF
0.00
0.29
36.60
5/8" drywall - hung, taped, floated, ready
126.19 SF
0.00
1.65
208.21
for paint
Acoustic ceiling (popcorn) texture
126.19 SF
0.00
0.68
85.81
Mask per square foot for d rywalI or plaster
465.33 SF
0.00
0.14
65.15
work
1/2" drywall - hung, taped. floated, ready
465.33 SF
0.00
1.53
711.95
for paint
NOTE -
WALL INSULATION NOT RECOGNIZED AS
DAMAGED AS OF INSPECTION OF 1/18
SUBJECT TO RE -INSPECTION AFTER SHEETROCK IS PULLED
Remove Baseboard - 2 1/4" INCLUDES
58.17 LF
0.35
0.00
20.36
SHOE
Seal then paint the walls twice (3 coats)
465.33 SF
0.00
0.80
372.26
Baseboard - 2 1/4"
58.17 LF
0.00
1.89
109.94
Quarter round - 3/4"
58.17 LF
0.00
0.92
53.52
Stain & finish baseboard
58.17 LF
0.00
0.90
52.35
STAIN/FINISH base shop• or quarter round
58.17 LF
0.00
0.47
27.34
Clean floor
126.19 SF
0.00
0.26
32.81
Sand, stain, and finish wood floor
126.19 SF
0.00
4.07
513.59
Remove Wood window - easement, 3 - 11
2.00 EA
28.31
0.00
56.62
sf
(Material Only) Wood window - casement,
2.00 EA
0.00
210.32
420.64
3- 11 sf
(Install) Wood window - casement, 3 - 11
2.00 EA
0.00
54.19
108.38
sf
Casing - 2 1/4" - CASIN(I REMOVED
27.20 LF
0.00
1.40
38.08
WITH WINDOW
Stain & finish wood window (per side)
2.00 EA
0.00
34.92
69.84
Stain & finish casing
27.20 LF
0.00
0.90
24.48
R&R Interior door unit
1.00 EA
15.67
152.20
167.87
Stain & finish door/window trim & jamb
2.00 EA
0.00
23.37
46.74
(per side)
Stain & finish door slab only (per side)
2.00 EA
0.00
33.42
66.84
PHALGOO_BOOPENDRA
02/07/2006
Page:_6
jgeic �17y—r American Family Insurance Group
MMONE dUSIHESS neat to t1FE e
Randall Voelker
3920 Northwoods Drive
Arden Hills MN 55112
Phone 651.483.8271 Ext 65305
Fax 651.453.6501
DESCRIPTION
CONTINUED - Left Front B
QNTY REMOVE REPLACE TOTAL
Door lockset - interior
1.00 EA
0.00
35.28
35.28
R&R Bifold door set - Colonist - Double-
1.00 EA
12.54
174.69
187.23
metal no casing
Paint b1fold door set - shah only - 2 coats
1.00 EA
0.00
28.58
28.58
(per side)
R&R Closet shelf and rod package
4.70 LF
4.20
18.98
108.95
R&R Light fixture
1.00 EA
6.96
51.53
58.49
Room Totals: Left Front 13 3,940.19
,s fir. xmi.(
Missin" Wall:
Room: LIVING
521.24 SF Walls
781.90 SF Walls & Ceiling
28.96 SY Flooring
65.16 LF Ceil. Perimeter
Ceiling Height: 8'
260.65 SF Ceiling
260.65 SF Floor
65.16 LF Floor Perimeter
1 - 713" X 810" Opens into MCH Goes to Floor/Ceiling
EN
PHALGOO_BOOPENDRA 02/07/2006 Page: 7
eicaa FAmj7y American Family Insurance Group
�ORP�t'auStress niac rH .WE
Randall Voelker
3920 Northwoods Drive
Arden Hills MN 55112
Phone 65 1.483.8271 Ext 65305
Fax 651.483.6501
Subroom 1: Bay
�11" 10"�
91.97 SF Walls
108.15 SF Walls & Ceiling
1.80 SY Flooring
11.50 LF Ceil. Perimeter
Ceiling Height: 8'
16.18 SF Ceiling
16.18 SF Floor
11.50 LF Floor Perimeter
Missing Wall: 1- 8'1" X 810" Opens into LIVIN Goes to Floor/Ceiling
G
DESCRIPTION QNTY REMOVE REPLACE TOTAL
Protect - Cover with plastic
276.84 SF
0.00
Remove 5/8" drywall - hung, taped, floated,
276.84 SF
0.35
ready for paint
68.99
0.47
Remove 1/2" drywall - hung, taped, floated,
613.21 SF
0.35
ready for paint
836.06
Visqueen vapor barrier
276.84 SF
0.00
5/8" drywall - hung, taped, floated, ready
276.84 SF
0.00
for paint
Acoustic ceiling (popcorn) texture
276.84 SF
0.00
Mask per square foot for drywall or plaster
613.21 SF
0.00
work
1/2" drywall - hung, taped, floated, ready
613.21 SF
0.00
for paint
NOTE -
WALL INSULATION NOT RECOGNIZED AS
DAMAGED AS OF INSPECTION OF 1/18
SUBJECT TO RE -INSPECTION AFTER SHEETROCK IS PULLED
Remove Baseboard - 2 1/4" INCLUDES
76.65 LF
0.35
SHOE
Seal then paint the walls twice (3 coats)
613.21 SF
0.00
Baseboard - 2 1/4"
76.65 LF
0.00
Quarter round - 3/4"
76.65 LF
0.00
Stain & finish baseboard
76.65 LF
0.00
STAIN/FINISH base shoe or quarter round
76.65 LF
0.00
Clean floor
276.84 SF
0.00
Sand and seal wood Iloor
276.84 SF
0.00
0.20 55.37
0.00 96.89
0.00 214.62
0.29 80.28
1.65 456.79
0.68 188.25
0.14 85.85
1.53 938.21
0.00 26.83
0.80
490.57
1.89
144.87
0.92
70.52
0.90
68.99
0.47
36.03
0.26
71.98
3.02
836.06
PHALGOO_BOOPENDRA 02/07/2006 Page: 8
RICAN FAmjLY American Family Insurance Group
BQYdt�FBUSINF55 NE4[Itl LUQ®
Randall Voelker
3920 Northwoods Drive
Ardcn Hills MN 55112
Phone 651.483.8271 Ext 65305
Fax 651.483.6501
CONTINUED - LIVING
DESCRIPTION QNTY
R&R Oak iloodw -select grade - no finish
10.00 SF
PATCH
1.96
(Material Only) Carpet
282.71 SF
15 % waste added I'or Carpet.
2.48
(Material Only) Carpet pad
245.84 SF
(Install) Carpet
245.84 SF
(Install) Carpet pad
245.84 SF
1/18/06 NOTE
0.00
CARPET PRICE 01' $2.45 / SF MATERIAL
PAD PRICE OF 50.50 / SF MATERIAL
FROM ITEL REPORT C11195923
ATTACHED TO TI! IS ESTIMATE
R&R Unclerlayment - 1/2" particleboard 30.40 SF
Vinyl floor coverim, (shect goods) 33.44 SF
10 % waste added for Vinyl floor covering (sheet goods).
R&R Carpet - mctal transition strip 27.60 LF
Remove Wood window - casement, 3 - 11 2.00 EA
sf
(Material Only) Wood window - casement, 2.00 EA
3-11sf
(Install) Wood window - casement, 3 - 11 2.00 EA
sf
Casing - 2 1/4" - C:\SING REMOVED 27.20 LF
WITH WINDOW
Stain &, finish wood window (per side) 2.00 EA
Stain & finish casin_ 27.20 LF
(Material Only) Wood window - picture 1.00 EA
(fixed), 23 - 33 sf
(Install) Wood wM(low - picture (fixed), 23 1.00 EA
- 33 sf
Stain & finish wood winclow (per side) 1.00 EA
R&R Trim boarcl - I " x 10" - installed 48.00 LF
(hardwood - oak or --) SEAT AND HEAD
OF WINDOW UNIT
PHALGOO BOOI'I;NDR./\
REMOVE
REPLACE
TOTAL
1.96
9.45
114.10
0.00
2.48
701.12
0.00
0.52
127.84
0.00
0.67
164.71
0.00
0.11
27.04
1.23
1.54
84.21
0.00
3.73
124.73
0.63
2.61
89.43
28.31
0.00
56.62
0.00
210.32
420.64
0.00
54.19
108.38
0.00
1.40
38.08
0.00
34.92
69.84
0.00
0.90
24.48
0.00
375.94
375.94
0.00
44.04
44.04
0.00
34.92
34.92
0.37
7.27
366.72
02/07/2006 Page: 9
, A t!,cricnn Family Insurance Group
a. -t. --
wwwNFe'st" , �aeort .
Randall Voelker
3920 Norihwoods Drive
Ardcn Hills MN 55112
Phone 65 1.483.8271 Ext 65305
Pax 651.483.6501
DESCRIPTION
CONTINUED - LIVING
QNTY REMOVE REPLACE TOTAL
Stain & finish trim
48.00 LF
0.00
0.90
43.20
Casing - 2 1/4" AROUND WINDOW
26.00 LF
0.00
1.40
36.40
UNIT
Stain & finish casing!
26.00 LF
0.00
0.90
23.40
Remove Wood wir,!,)w - casement, 3 - 11
2.00 EA
28.31
0.00
56.62
sf
NOTE- THESE T\\'O WINDOWS ARE ON THE
NORTH SIDE OF THIS ROOM AND ARE CRACKED BY THE HEAT
(Material Only) Woocl window - casement,
2.00 EA
0.00
210.32
420.64
3-11sf
(Install) Wood window - casement, 3 - 11
2.00 EA
0.00
54.19
108.38
sf
Casing - 2 1/4" - Cl\SING REMOVED
27.20 LF
0.00
1.40
38.08
WITH WINDO\V
Stain & finish wool window (per side)
2.00 EA
0.00
34.92
69.84
Stain & finish casi111-1
27.20 LF
0.00
0.90
24.48
R&R Exterior du�,t notal - insulated -
1.00 EA
18.33
238.48
256.81
flush or panel stele
Door lockset & dca(!holt - exterior
1.00 EA
0.00
76.43
76.43
Paint door/window i rim & jamb - 2 coats
2.00 EA
0.00
18.15
36.30
(per side)
R&R Storm door assembly
1.00 EA
14.74
133.61
148.35
R&R Light fixture - I Iigh grade
1.00 EA
6.96
73.70
80.66
R&R Light fixture - I IAL,L
1.00 EA
6.96
51.53
58.49
Room'Fot:ils: LlV P,!G 8,313.03
PHALGO0_E3OOIT.','DRA 02/07/2006 Page: 10
w►Meeicat� FAMILY American Family Insurance Group
DQE®$}F 8 bt4tlX i lFf m
Randall Voellcer
3920 Northwoods Drive
Arden Hills MN 55112
Phone 651.483.8271 Ext 65305
Fax 651.183.6501
1-3'9"1 1-65"
11 /2'6" {
T
l «o
it B
Room: 1 BATH Ceiling Height: 8'
237.33 SF Walls 46.76 SF Ceiling
284.09 SF Walls & Ceiling 46.76 SF Floor
5.20 SY Flooring 29.67 LF Floor Perimeter
29.67 LF Ceil. Perimeter
Subroom 1: CLOSET Ceiling Height: 8'
80.00 SF Walls 6.22 SF Ceiling
86.22 SF Walls & Ceiling 6.22 SF Floor
0.69 SY Flooring 10.00 LF Floor Perimeter
10.00 LF Ceil. Perimeter
DESCRIPTION QNTY REMOVE REPLACE TOTAL
Protect - Cover with plastic
52.98 SF
0.00
0.20
10.60
Remove 518" drywall - hung, taped, floated,
52.98 SF
0.35
0.00
18.54
ready for paint
Remove 1/2" drywall - hung, taped, floated,
317.33 SF
0.35
0.00
111.07
ready for print
Visqueen vapor barrier
52.98 SF
0.00
0.29
15.36
5/8" drywall - hung, taped, floated, ready
52.98 SF
0.00
1.65
87.42
for paint
Mask per square foot for drywall or plaster
317.33 SF
0.00
0.14
44.43
work
Seal then paint the ceiling twice (3 coats)
52.98 SF
0.00
0.80
42.38
1/2" drywall - hung, taped, floated, ready
317.33 SF
0.00
1.53
485.51
for paint
NOTE -
WALL INSULATION NOT RECOGNIZED AS
DAMAGED AS OF INSPECTION OF 1/18
SUBJECT TO RE -INSPECTION AFTER SHEETROCK IS PULLED
R&R Fiberglass tub & shower combination
1.00 EA
69.63
705.08
774.71
R&R Shower door
1.00 EA
17.45
246.93
264.38
R&R Tub/shower faucet
1.00 EA
20.89
200.74
221.63
Toilet seat
1.00 EA
0.00
31.30
31.30
R&R Toilet - Standard grade
1.00 EA
20.89
239.25
260.14
R&R Vanity - Note: Includes: factory
3.30 LF
6.27
110.93
386.76
built, prc-finished vanity and installation
labor.
PHALGOO_BOOPENDR;�
02/07/2006
Page:. 11
RICAN F,�,,,E.Y American Family Insurance Group
Nd@ffit1F BVSQfE9S al.:[in, 1FE
Randall Voelker
3920 Nonhwoods Drive
Arden Hills MN 55112
Phone 651.483.8271 Ext 65305
Fax 651.483.6501
CONTINUED -1 BATH
DESCRI PTION QNTY
R&R Countertop - Flat laid plastic laminate
3.30 LF
- Standard grade
164.03
R&R 4" backsplash for flat laid countertop
3.30 LF
Sink - single
1.00 EA
Sink faucet - Bathroom
1.00 EA
Remove Baseboard - 2 1/4" INCLUDES
13.40 LF
SHOE
12.06
Baseboard - 2 1/4"
13.40 LF
Quarter round - 3/4"
13.40 LF
Stain & finish baseboard
13.40 LF
STAIN/FINISH base shoe or quarter round
13.40 LF
Vinyl floor covering (sheet goods)
43.98 SF
10 % waste added for Vinyl floor covering (sheet goods).
R&R Underlayment - 1/2" particle board
39.98 SF
Remove Wood window - casement, 3 - 11
1.00 EA
sf
15.05
(Material Only) Wood window - casement,
1.00 EA
3-11sf
02/07/2006
(Install) Wood window - casement, 3 - 11
1.00 EA
sf
Casing - 2 1/4" - CASING REMOVED
13.60 LF
WITH WINDOW
Stain &finish wood window (per side)
1.00 EA
Stain & finish casing
13.60 LF
R&R Interior door unit
2.00 EA
Stain & finish door/window trim & jamb
4.00 EA
(per side)
Stain & finish door slab only (per side)
4.00 EA
Door locicset - interior
2.00 EA
R&R Shelving - 24" - in place
16.00 LF
R&R Balh accessory - Sl:indard grade
3.00 EA
R&R Medicine cabinet - Standard grade
1.00 EA
PHALGOO BOOPENDR:%
REMOVE
3.61
0.75
0.00
0.00
0.35
0.00
0.00
0.00
0.00
0.00
1.23
28.31
0.00
REPLACE TOTAL
26.66 99.89
6.91
25.28
164.03
164.03
102.35
102.35
0.00
4.69
1.89
25.33
0.92
12.33
0.90
12.06
0.47
6.30
3.73
164.05
1.54 110.75
0.00 28.31
210.32 210.32
0.00
54.19
54.19
0.00
1.40
19.04
0.00
34.92
34.92
0.00
0.90
12.24
15.67
152.20
335.74
0.00
23.37
93.48
0.00
33.42
133.68
0.00
35.28
70.56
0.51
8.62
146.08
4.18
16.56
62.22
15.05
72.77
$7.82
02/07/2006
Page: 12
'A101 F'ANI ILY American Family Insurance Group
BQCHOMf BUS/NfSSNIIf 6
Randall Voelker
3920 Noi ihwoods Drive
Arden I I i I is MN 55112
Phone 65 1.483.8271 Ext 65305
Fax 651.483.6501
DESCRI PTION
CONTINUED -1 BATH
QNTY REMOVE REPLACE TOTAL
R&R Bathroom ventilat;� a fan w/light 1.00 EA 14.72 83.65 98.37
R&R Mirror - 1/4" plate class 5.20 SF 0.23 7.52 40.30
Room Totals: 1 BATH 4,908.56
F 2' 8„
r- T
c s -e t�
12'10"1
DESCRIPTION
Room: CLOSET -entry
90.96 SF Walls
98.74 SF Walls & Ceiling
0.86 SY Flooring
11.37 LF Ceil. Perimeter
QNTY REMOVE
Protect - Cover with plass is
7.78 SF
0.00
Remove 5/8" drywall - h;mg, taped, floated,
7.78 SF
0.35
ready for paint
Remove 1/2" drywall - hung, taped, floated,
90.96 SF
0.35
ready for paint
Visqueen vapor barrier
7.78 SF
0.00
5/8" drywall - hung, taped, floated, ready
7.78 SF
0.00
for paint
Acoustic ceiling (popcorn) texture
7.78 SF
0.00
Mask per square foot for drywall or plaster
90.96 SF
0.00
work
1/2" drywall - hung, tapcd, floated, ready
90.96 SF
0.00
for paint
NOTE -
WALL INSULATION NOT RECOGNIZED AS DAMAGED AS OF INSPECTION OF 1/18
SUBJECT TO RE -INSPECTION AFTER SHEETROCK IS PULLED
Remove Baseboard - 2 1/4" INCLUDES
11.37 LF
0.35
SHOE
Ceiling Height: 8'
7.78 SF Ceiling
7.78 SF Floor
11.37 LF Floor Perimeter
REPLACE TOTAL
0.20 1.56
0.00 2.72
0.00 31.84
0.29 -2.26
1.65 12.84
0.68 5.29
0.14 12.73
1.53 139.17
0.00 3.98
PHALGOO BOOPENDIZ'A 02/07/2006 Page: 13
R�'F4,7Y American Family Insurance Group
dQiO NOffiftwwa n' Al "IEE
Randall Voelker
3920 Northwoods Drive
Arden 1IiIIs NIN 55112
Phone 6� 1.483.8271 Ext 65305
Fax 65 1.-183.6501
DESCRIPTION
CONTINUED - CLOSET -entry
QNTY REMOVE REPLACE TOTAL
Seal then paint the walls iwicc (3 coats)
90.96 SF
0.00
0.80
72.77
Baseboard - 2 1/4"
11.37 LF
0.00
1.89
21.49
R&R Quarter round - 3/4"
11.37 LF
0.15
0.92
12.17
Stain & finish baseboard
11.37 LF
0.00
0.90
10.23
STAIN/FINISH base shoe or quarter round
11.37 LF
0.00
0.47
5.34
Clean floor
7.78 SF
0.00
0.26
2.02
Sand and seal wood floor FOR ODOR
7.78 SF
0.00
3.02
23.50
CONTROL
R&R Underlayment - 1/2" particle board
7.78 SF
1.23
1.54
21.55
Vinyl floor covering (sheet goods)
8.94 SF
0.00
3.73
33.35
15 % waste added for Vinyl Iloor covering (sheet
goods).
R&R Interior door unit
1.00 EA
15.67
152.20
167.87
Stain & iuiish door/whitlow trim & jamb
2.00 EA
0.00
23.37
46.74
(per side)
Stain & finish door slab only (per side)
2.00 EA
0.00
33.42
66.84
Door lockset - interior
1.00 EA
0.00
35.28
35.28
R&R Bifold door set - Colonist - Double-
1.00 EA
12.54
174.69
187.23
metal no casing
Paint bifold door set - sl:dh only - 2 coats
1.00 EA
0.00
28.58
28.58
(per side)
R&R Closet shelf and roil package
8.60 LF
4.20
18.98
199.35
Room Totals: CLOSET -entry 1,146.70
PHALGOO BOOPENDItA 02/07/2006 Page: 14
FA" pjiw American Family Insurance Group
era easaW" ,n�LF®
Randall Voelker
3920 Northwoods Drive
Arden 1-1 i I Is N1N 55112
Phone 651.483.8271 Ext 65305
Fax 651.453.6501
ear
3' 4"
2" =
1CL ET
:L. c?
I- 3' 6" -I
DESCRIPTION
Room: Center Rear
329.33 SF Walls
433.99 SF Walls & Ceiling
11.63 SY Flooring
41.17 LF Ceil. Perimeter
Subroom 1: CLOSET
Protect - Cover with plastic
R&R 5/8" drywall - hung, taped, floated,
ready for paint
Visqueen vapor barrier
Acoustic ceilin.- (popcorn) texture
Mask per square foot for drywall or plaster
work
Remove Baseboard - 2 1/4" INCLUDES
SHOE
Seal then paint the walls twice (3 coats)
Wallpaper border
Baseboard - 2 1/4"
R&R Quarter round - 3/-1"
Stain & finish baseboard
STAIN/FINISH base shoe or quarter round
Clean floor
Sand, stain, and finish wood floor
Remove Wood window - casement, 3 - 11
sf
(Material Only) Wood window - casement,
3-11sf
(Install) Wood window - casement, 3 - 11
sf
PHALGOO_BOOPEND I:: \
99.63 SF Walls
109.40 SF Walls & Ceiling
1.08 SY Flooring
12.45 LF Ceil. Perimeter
QNTY REMOVE
Ceiling Height: 8'
104.65 SF Ceiling
104.65 SF Floor
41.17 LF Floor Perimeter
Ceiling Height: 8'
9.76 SF Ceiling
9.76 SF Floor
12.45 LF Floor Perimeter
REPLACE TOTAL
114.42 SF 0.00 0.20 22.88
114.42 SF 0.35 1.65 228.84
114.42 SF
0.00
0.29
33.18
114.42 SF
0.00
0.68
77.81
428.97 SF
0.00
0.14
60.06
53.62 LF
0.35
0.00
18.77
428.97 SF
0.00
0.80
343.18
53.62 LF
0.00
2.07
110.99
53.62 LF
0.00
1.89
101.34
53.62 LF
0.15
0.92
57.37
53.62 LF
0.00
0.90
48.26
53.62 LF
0.00
0.47
25.20
114.42 SF
0.00
0.26
29.75
114.42 SF
0.00
4.07
465.69
2.00 EA
28.31
0.00
56.62
2.00 EA
0.00
210.32
420.64
2.00 EA
0.00
54.19
108.38
02/07/2006 Page: 15
eRIcaR FPM iY American Family Insurance Group
�(BffiBUststss,,,-, rx trt,� `
Randall Voclker
3920 Novi hwoods Drive
Arden I li;ls MN 55112
Phone 65 1.483.8271 Ext 65305
Fax 65 1.483.6501
CONTINUED - Center Rear
DESCRIPTION QNTY REMOVE REPLACE TOTAL
Casing - 2 1/4" - CASI \! i�FIV10VED
16.80 LF
0.00
1.40
23.52
WITH WINDOW
Stain & finish wood window (per side)
2.00 EA
0.00
34.92
69.84
Stain & finish casing
27.20 LF
0.00
0.90
24.48
R&R Interior door unit
3.00 EA
15.67
152.20
503.61
Stain & finish doorhvindow trim & jamb
6.00 EA
0.00
23.37
140.22
(per side)
Stain & Finish door slab only (per side)
6.00 EA
0.00
33.42
200.52
Door lockset - interior
3.00 EA
0.00
35.28
105.84
R&R Closet shelf and r(ul package
8.60 LF
4.20
18.98
199.35
R&R Closet rod
3.00 LF
0.43
3.17
10.80
R&R Spccial Doors - Criling access
1.00 EA
7.83
102.10
109.93
Paint door slab only - 2 coats (per side)
1.00 EA
0.00
17.75
17.75
Room Totals: Center Rcar 3,614.82
I'
�., KITCHEN
Reap
1 Nft JILA 6 ,
Missinb `,Nall:
DESCRIPTION
Protect - Cover with pl.i>. is
Room: KITCHEN
387.33 SI, Walls
542.65 SF Walls & Ceiling
17.26 SY Flooring
48.42 LF Ceil. Perimeter
Ceiling Height: 8'
155.31 SF Ceiling
155.31 SF Floor
48.42 LF Floor Perimeter
I - 713" X 8'0" Opens into LIVIN Goes to Floor/Ceiling
G
QNTY REMOVE REPLACE TOTAL
155.31 SF 0.00 0.20 31.06
PHALGOO_BOOPENI)PA 02/07/2006 Page: 16
000"' r,��;�Y Amerir:an Family Insurance Group
EMM' -
Randall `, Oclker
3920 Nci hwoods Drive
Arden I1i'Is SIN 55112
Phone 0 !.-183.8271 Ext 65305
Fax 651.-!~3.6501
CONTINUED - KITCHEN
DESCRIPTION
QNTY
REMOVE
REPLACE
TOTAL
Remove 5/8" drywall - I,, ,, , taped, floated,
155.31 SF
0.35
0.00
54.36
ready for paint
Remove 1/2" drywall - hung, taped, floated,
387.33 SF
0.35
0.00
135.57
ready for paint
Visquecn vapor barrier
155.31 SF
0.00
0.29
45.04
5/8" drywall - hung, tal)k-,1, floated, ready
155.31 SF
0.00
1.65
256.26
for paint
Seal then paint the ceill!i twice (3 coats)
155.31 SF
0.00
0.80
124.25
Mask per square foot f0 : vwall or plaster
387.33 SF
0.00
0.14
54.23
work
1/2" drywall - hung, tahc(l, floated, ready
387.33 SF
0.00
1.53
592.61
for paint
NOTE -
WALL INSULATION `J)T RECOGNIZED AS
DAMAGED AS OF INSPECTION OF 1/18
SUBJECT TO RE -INS I'I :CT1ON AFTER SHEETROCK IS PULLED
Removc Baseboard - 2 1 ',"INCLUDES
48.42 LF
0.35
0.00
16.95
SHOE
Seal then paint part of t!i walls twice (3
343.33 SF
0.00
0.80
274.66
coats)
Baseboard - 2 1/4"
48.42 LF
0.00
1.89
91.51
Quarter round - 3/4"
48.42 LF
0.00
0.92
44.55
Stain &, finish baseboatl
48.42 LF
0.00
0.90
43.58
STAIN/I` (NISI I base shoo Or quarter round
48.42 LF
0.00
0.47
22.76
Remove Wood window - (,asement, 3 - 11
3.00 EA
28.31
0.00
84.93
sf
(Material Only) Wood �\ Mdow - casement,
3.00 EA
0.00
210.32
630.96
3- 11 sl'
(Install) Wood window - ;r�cment, 3 - 11
3.00 EA
0.00
54.19
162.57
sf
Casing - ' 1/4" - CASEN(I l _VMOVED
40.80 LF
0.00
1.40
57.12
WITII WINDOW
Stain fi liaish wood wi! w (per side)
3.00 EA
0.00
34.92
104.76
Stain & Iinish casing
40.50 LF
0.00
0.90
36.72
R&R 1 nterior door unit DOOR TO
1.00 EA
15.67
152.20
167.87
BASEN I1:NT
PHALGOO_BOOPENI)!: \ 02/07/2006 Page: 17
AMER,cAM FAMILY American Family Insurance Group
Randall Voelker
3920 Norliwoods Drive
Arden l I'!,! Is 1V1N 55112
Phone 6� 1.453.8271 Ext 65305
Fax 65 1.-; 83.6501
CONTINUED - KITCHEN
DESCRIPTION QNTY REMOVE REPLACE TOTAL
Stain & finish door/winc!cw trim & jamb
2.00 EA
0.00
23.37
46.74
(per side)
Stain & finish door slab only (per side)
2.00 EA
0.00
33.42
66.84
Door lockset - interior
1.00 EA
0.00
35.28
35.28
R&R Exterior door - mci: l - insulated -
1.00 EA
18.33
238.48
256.81
flush or panel style
Door lockset & deadbolt - exterior
1.00 EA
0.00
76.43
76.43
Paint door/window trim k jamb - 2 coats
2.00 EA
0.00
18.15
36.30
(per side)
Storm door assembly
1.00 EA
0.00
133.61
133.61
R&R Cabinetry - upper i wall) units
5.50 LF
6.27
86.06
507.82
Stain & finish cabinetry - upper - inside and
5.50 LF
0.00
28.88
158.84
out
R&R Cabinet valance
2.80 LF
1.80
43.23
126.08
Stain & finish trim
5.60 LF
0.00
0.90
5.04
R&R Cabinetry - upper oval l) units
8.00 LF
6.27
86.06
738.64
SHORT MEASURES l.,,
Stain & finish cabinetry - upper - inside and
8.00 LF
0.00
28.88
231.04
out
R&R Cabinetry - full hei,,ht unit - RANGE
2.20 LF
7.54
236.36
536.58
CABINET
Stain & finish full heivht cabinetry - inside
2.20 LF
0.00
46.77
102.89
and out
R&R Cabinetry - lower (tease) units
13.00 LF
6.27
140.23
1,904.50
Stain S finish cabinetry - lower - inside and
13.00 LF
0.00
34.00
442.00
out
R&R Countertop - Flat hid plastic laminate
13.60 LF
3.61
31.15
472.74
NOTE- NO BACKSPLASH OBSERVED
R&R Underlayment - l; " p:n-ticle board
155.31 SF
1.23
1.54
430.21
Vinyl floor covering (slr -t `gods)
178.61 SF
0.00
3.73
666.22
15 % waste added for Vinyl floor covering (sheet
goods).
Sink faucet - Kitchen - I I�-h -rade
1.00 EA
0.00
178.15
178.15
R&R Sint: faucet - Kild! n - I ligh grade
1.00 EA
15.67
178.15
193.82
PHALGOO BOOPENI)PA 02/07/2006 Page: 18
AMERICA' „Y Ameri-:in F-,imily Insurance Group
muff mxreus, Zff Lift, -
IZandall Voelker
3920 N(, i: hwoods Drive
Arden I I i IIs MN 55112
Phone (o 1.453.8271 Ext 65305
Fax 651.-183.6501
DESCIZIPTIOiO
CONTINUED - KITCHEN
QNTY REMOVE REPLACE TOTAL
R&R Paneling
43.20 SF
0.25
1.82
89.42
R&R Panel cap - stain ,rade
14.40 LF
0.15
1.62
25.49
Stain & finish trim
14.40 LF
0.00
0.90
12.96
R&R I.isht fixture
2.00 EA
6.96
51.53
116.98
R&R Light fixture -1gnide
1.00 EA
6.96
73.70
80.66
Room Totals: IUTCI Il 10,704.41
Room: APPLIANCES
floa H- •`/
DESCRIPTION QNTY REMOVE REPLACE TOTAL
Dishwasher connection
1.00 EA
0.00
92.45
92.45
R&R Built-in oven
1.00 EA
22.79
788.52
811.31
R&R 1)ishwashcr
1.00 EA
22.39
396.42
418.81
R&RRrfrigerat r-22 _! CONTENT
0.00 EA
31.34
845.69
0.00
ITEM IN CONTENT Ll -,TING
R&R Range - St:indard rade
1.00 EA
16.82
358.52
375.34
R&R Range hoot] NO`•' -'VENTING TO
1.00 EA
10.52
172.63
183.15
OUTS I PE
Room Totals: APPLIAXCES
1,881.06,
Area Items Total: Main bevel
39,048.77 `
PHALGOO_BOOPENI" \ 02/07/2006 Page: 19
M. ,z IL; Anieri- tin Family Insurance Group
N�CtlQFtF sus;. ..'n UFf
Rand:i1i '•'oelker
;920 'Iiwoods Drive
Ardcli i . i its NN 55112
Phone 1.483.8271 Ext 65305
Fax 0- : -:83.0501
I---10' 6"
Missilt" `Nall
DESC; I•' ? PTI 0,",'
Room: Stairs
Stair
179.09 SF Walls
210.44 SF Walls & Ceiling
6.53 SY Flooring
26.50 LF Ceil. Perimeter
1 - 3'1" X 8'0" Opens into E
QNTY REMOVE
Ceiling Height: Stepped
31.35 SF Ceiling
58.81 SF Floor
25.87 LF Floor Perimeter
Goes to Floor/Cei I1 n `;
REPLA CE TOTAL
Clean carpet - cleanini ;Ir _ her step
11.00 EA
0.00
2.73
30.03
Clean the walls and ccl'.il g - 1 Icavy
210.44 SF
0.00
0.25
52.61
Sea] then paint the wall1 ;Ind ceiling twice
210.44 SF
0.00
0.80
168.35
(3 coats)
Mask :nod prep for paint
26.50 LF
0.00
0.79
20.94
Clean ;nul deodorize camct
58.81 SF
0.00
tt.'9
17.05
Roon, '1'I tals: `'tmrs
288.98
Area Itcn,s Tota!: Stam
288.98
Missin„ Wall
Room: KITCHEN
1 - 3'S" X 6'8"
Basement
265.22 SF Walls
337.22 SF Walls & Ceiling
8.00 SY Flooring
36.00 LF Ceil. Perimeter
Ceiling Height: 8'
72.00 SF C'c iling
72.00 SF F I oor
32.58 LF Floor Perimeter
Opens into LIVIN Goes to Floor
G
PHALG(!(�__E30 011Elv'P!:A 02!07/2006 Page: 20
AMERICAN American Family Insurance Group
NomlLjL S/fI H U£F s
Randall Voelker
3920 thwoods Drive
Arden 11 i 1Is iulN 55112
('hone 6 � 1.453.8271 Ext 65305
Fax 65 1.483.6501
DESCRIPTION QNTY REMOVE REPLACE TOTAL
Clean the walls and ceiling
337.22 SF
0.00
0.20
67.44
Clean cabinetry - upper - inside and out
7.00 LF
0.00
6.73
47.11
Clean countertop
11.00 SF
0.00
0.42
4.62
Clean sink
1.00 EA
0.00
7.20
7.20
Clean sink faucet
1.00 EA
0.00
5.34
5.34
Clean cabinetry - lower - inside and out
9.00 LF
0.00
6.73
60.57
Clean oven
1.00 EA
0.00
15.36
15.36
Clean smoke detector
1.00 EA
0.00
3.46
3.46
Clean light fixture
1.00 EA
0.00
5.88
5.88
Clean window unit (per side) 3 - 9 SF
1.00 EA
0.00
5.83
5.83
Clean floor
72.00 SF
0.00
0.26
18.72
Clean range hood
1.00 EA
0.00
9.40
9.40
Room Totals: KITCI-11--' 250.93
Missing Wall:
Missing Wall:
DESCRIPTION
Room: LIVING
1 - 310" X 618"
1 - 31$" X 618"
Clean acoustic ceiling tile
Clean the walls
R&R Exterior door - mctA - insulated -
flush or panel style
Door lockset & deadbolt - exterior
495.89 SF Walls
750.81 SF Walls & Ceiling
28.32 SY Flooring
67.33 LF Ceil. Perimeter
Ceiling Height: 8'
254.92 SF Ceiling
254.92 SF Floor
60.92 LF Floor Perimeter
Opens into HALL Goes to Floor
Opens into KITCH Goes to Floor
EN
QNTY REMOVE REPLACE TOTAL
254.92
SF
0.00
0.24
61.18
495.89
SF
0.00
0.20
99.18
1.00
EA
18.33
238.48
256.81
1.00 EA 0.00 76.43 76.43
PHALGOO_BOOPENI)RA 02/07/2006 Page: 21
ERICAV FAMILYAmerican Family Insurance Group
di7DUQl�pF41Nl.snr<N L/ff
Randall Voelker
3920 N(,rthwoods Drive
Arden Pills N1N 55112
Phone 0 1.483.8271 Ext 65305
Fax 651.-183.6501
DESCRIPTIOIe
CONTINUED - LIVING
QNTY REMOVE REPLACE TOTAL
Paint door/window trip; ,': jamb - 2 coats
2.00 EA
0.00
18.15
36.30
(per side)
R&R Storm door assembly
1.00 EA
14.74
133.61
148.35
DOOR FOUND TO BI' f IROKEN IN
POSSIGL,Y BY FIRE I)' PT OR BY VANDALS
AFTER THE FIRE
WILL ALLOW AS PA!',"r OF FIRE CLAIM
Drywall patch, ready for paint
1.00 EA
0.00
43.93
43.93
Seal then paint the surface area (2 coats)
124.20 SF
0.00
0.57
70.79
Clean and deodorize card et
240.52 SF
0.00
0.29
69.75
Clean Iloor, strip & w:ix
14.40 SF
0.00
0.55
7.92
Clean window blind - horizontal or vertical
32.40 SF
0.00
0.73
23.65
Room Totals: 1-1\7IN(; 894.29
8'4" 1
F'-7 6
All
DESCRIPTION
Room: BDRM 2-Bsmt
367.98 SF Walls
514.62 Sl- Walls & Ceiling
16.29 SY Flooring
53.33 LF Ceil. Perimeter
Subroom 1: CLOSET
97.90 SF Walls
143.86 SF Walls & Ceiling
2.67 SY Flooring
27.49 LF Ceil. Perimeter
QNTY REMOVE
Clean the walls and crilin� 658.47 SF 0.00
PHALGOO_BOOI'EN!)I' A
Ceiling Height: 6' 11"
146.64 SF Ceiling
146.64 SF Floor
53.33 LF Floor Perimeter
Ceiling Height: Sloped
45.96 SF Ceiling
24.00 SF Floor
22.00 LF Floor Perimeter
REPLACE TOTAL
0.20 131.69
02/07/2006 Page: 22
MERICAV F,-:UIILY Anieri+:an Family Insurance Group
2- -
NMH01tl;?"V , r,Ag : HUES'
Randall Voelker
3920 `;i illwoods Drive
Ai -den Is VN 55112
Phonc 1 .4�3.S271 Ext 65305
Fax 6_' I S 3.6501
DESC RI PTIO �,
CONTINUED - BDRM 2-Bsmt
QNTY REMOVE REPLACE TOTAL
Clean ,Ind deod,rize c: t 170.64 SF 0.00 0.29 49.49
Roorn l'otals: I'MRNI "snit 181.18
Room: MECHANICAL
273.68 SF Walls
396.49 SF Walls & Ceiling
13.65 S Flooring
39.67 LF Ceil. Perimeter
Ceiling Height: 6' 11"
122.81 SF Ceiling
122.81 SF Floor
39.67 LF Floor Perimeter
Missing„ Wall: I -
4'10" X 6'11"
Opens into HALL
Goes to Floor/Ceiling
DESCRIPTIO. '
QNTY
REMOVE
REPLACE
TOTAL
Clean Moor or i wl jor! "Sian
122.81 SF
0.00
0.55
67.55
Clean the walls
273.68 SF
0.00
0.20
54.74
Clean floor, strip & w:ix
122.81 SF
0.00
0.55
67.55
Clean water sollener
1.00 EA
0.00
15.64
15.64
Clean sink
1.00 EA
0.00
7.20
7.20
Clean I'urnacc - breed iir
1.00 EA
0.00
29.28
29.28
Clean water he:!tcr
1.00 EA
0.00
13.11
13.11
Room "Totals: I:CI I:`,' L 255.07
PHALGUO_BO+)PENII?I',A 02/07/2006 Page: 23
w►eseR�cu`v American Family Insurance Group
Randall Voelker
3920 N(1rthwoods Drive
Arden I I Its MN 55112
Phone 0 1.483.8271 Ext 65305
Fax 651.483.6501
i
1' 8F3'-4 " cLosl
Z 16 r
r' HALL co
F3' 3" ' 6 iv
S' ill,91.
3/4 BATH
Missing Wall:
Missing Wall:
DESCRIPTION
Room: HALL
99.13 SF Walls
128.78 SF Walls & Ceiling
3.29 SY Flooring
17.27 LF Ceil. Perimeter
Ceiling Height: 6' 11"
29.64 SF Ceiling
29.64 SF Floor
14.27 LF Floor Perimeter
1- 310" X 618" Opens into LIVIN Goes to Floor
G
1- 4110" X 6111" Opens into MECH Goes to Floor/Ceiling
ANICA
L
QNTY REMOVE REPLACE TOTAL
Clean floor or roof joist system 29.64 SF 0.00 0.55 16.30
Clean the walls 99.13 SF 0.00 0.20 19.83
Clean and deodorize carpet 29.64 SF 0.00 0.29 8.60
Room Totals: HALL 44.73
A„ Room: 3/4 BATH
� 197.82 SF Walls
249.09 SF Walls & Ceiling
314 tt
5.70 SY Floorin 28.67 LF Ceil. Perimeter
F-7' 10" -I
DESCRIPTION QNTY REMOVE
Ceiling Height: 6' 11"
51.27 SF Ceiling
51.27 SF Floor
28.67 LF Floor Perimeter
REPLACE TOTAL
Clean the walls and cei I i ng - Heavy
249.09 SF
0.00
PAINT IS A LIGHER COLOR - WILL REQUIRE
ADDITIONAL TIME TO CLEAN CORRECTLY
Clean floor, strip & wax
51.27 SF
0.00
Clean vanity - inside and out
2.70 LF
0.00
Clean sink
1.00 EA
0.00
Clean sink faucet
1.00 EA
0.00
PHALGOO_BOOPEND I: A
0.25 62.27
0.55
28.20
5.91
15.96
7.20
7.20
5.34
5.34
02/07/2006
Page: 24
p11gp1�pp p® American Family Insurance Group
euro VMMmeasr ff °
Randall voelker
3920 Noithwoods Drive
Arden 11 i I Is N N 55112
Phone 051.483.8271 Ext 65305
Fax 651.-153.6501
DESCRIPTION
CONTINUED - 3/4 BATH
QNTY REMOVE REPLACE TOTAL
Clean toilet
1.00 EA
0.00
12.07
12.07
Clean toilet seat
1.00 EA
0.00
2.61
2.61
Clean medicine cabinet
1.00 EA
0.00
7.79
7.79
Clean shower
1.00 EA
0.00
23.94
23.94
Clean shower door
1.00 EA
0.00
9.87
9.87
Clean bathroom fan
1.00 EA
0.00
15.52
15.52
Clean mirror
4.00 SF
0.00
0.40
1.60
Clean light fixture
1.00 EA
0.00
5.88
5.88
Clean door (per side)
2.00 EA
0.00
4.07
8.14
Clean door / window opening (per side)
2.00 EA
0.00
7.20
14.40
Room Totals: 3/4 BAT 11 220.79
!UL cu CC 1
DRM 1- Nsm -
C4.�
2' 4'
11 ii
itv T
Zo 1
12'z"6
DESCRIPTION
Room: BDRM 1- Bsmt
366.14 SF Walls
512.72 SF Walls & Ceiling
16.29 SY Flooring
53.07 LF Ceil. Perimeter
Subroom 1: CLOSET
117.59 SF Walls
131.31 SF Walls & Ceiling
1.52 SY Flooring
17.04 LF Ceil. Perimeter
Ceiling Height: 6'11"
146.58 SF Ceiling
146.58 SF Floor
53.07 LF Floor Perimeter
Ceiling Height: 6' 11"
13.72 SF Ceiling
13.72 SF Floor
17.04 LF Floor Perimeter
QNTY REMOVE REPLACE TOTAL
PHALGOO_BOOPENP!'.,\ 02/07/2006 Page: 25
AMERI
RAIAILY Amer;',.-an Family Insurance Groin
9UMMK==Wff4N LIFE'
Randall Voelker
3920 Norihwoods Drive
Arden 111 IIs MN 55112
Phone 0 �� 1.483.8271 Ext 65305
Fax 651.-153.6501
CONTINUED - BDRM 1- Bsmt
DESCRIPTION QNTY REMOVE REPLACE TOTAL
Clean the walls and cei! i ;g - Heavy-
644.04 SF
0.00
0.25
161.01
PAINT IS A LIGHTER COLOR- WILL
REQUIRE ADDITION:\L TIME
Clean and deodorize carpct
160.30 SF
0.00
0.29
46.49
Clean closet organizer and rod
1.00 EA
0.00
21.48
21.48
Clean door - bifold set (!)cr side)
1.00 EA
0.00
8.21
8.21
Clean light fixture
3.00 EA
0.00
5.88
17.64
Clean door (per side)
2.00 EA
0.00
4.07
8.14
Clean door / window ops ,ning (per side)
2.00 EA
0.00
7.20
14.40
Room Totals: BDRM I -I isnit 277.37
Area Items Total: Bascirncnt 2,124.36
Room: WINDOW TREATMENTS
DESCRIPTION QNTY REMOVE REPLACE TOTAL
Curtains & Drakes, Gcn ,ric Manufacturer,
1.00 EA
0.00
95.00
95.00
Lisette Arched \Vindow `sheers -54-59"
LACE PANELS - CC^: !',-.R BEDROOM
Window blind - horizon!;,l or vertical LEFT
2.00 EA
0.00
94.26
188.52
REAR BEDROO M
Window blind - horizontal or vertical
2.00 EA
0.00
94.26
188.52
Window blind - horizon :d or vertical
1.00 EA
0.00
94.26
94.26
FIRST FLOOR I3AT1 I
PHALGOO_BOOPEM? .\ 02/07/2006 Page: 26
AM
ERI Amca--an Family Insurance Group
�lRurnurc.;. --
I:andal' ",'oelker
920 ,lhwoods Drive
Ai-dcn ' IIs MN 55112
I'honc 1.483.8271 Ext 65305
Fax 6�'..-'53.6501
DESCRIPTIO''
CONTINUED - WINDOW TREATMENTS
QNTY REMOVE REPLACE TOTAL
Window blind - horizo: i or vertical -
2.00 EA
0.00
62.62
125.24
Small LIVING I:001\1 - I3AY WINDOW
Window drapery - hard are BAY
1.00 EA
0.00
80.55
80.55
WINDOW
Window blind - horizom;d or vertical
2.00 EA
0.00
94.26
188.52
LIVING ROOhI - NOP i l I END
Window blind - horizon : l or vertical -
2.00 EA
0.00
94.26
188.52
CENTER B E D P 00\ I
R&R Window dr;ihcr�, - ' ardware
1.00 EA
4.21
80.55
84.76
CENTER BEDROOM
Window blind - horizon!: I or vertical
3.00 EA
0.00
94.26
282.78
KITCHEN
Window blind - horizoii,:i l or vertical -
1.00 EA
0.00
62.62
62.62
Small DOOR TO K►Tc I I GN
Curtains & Drapcs, Gci:cvlc Manufacturer,
2.00 EA
0.00
79.99
159.98
Pinch -pleated Patio Pana!-100WxM"L
Solid -Living Room
Curtains & DraI) s, G •i, is Manufacturer,
3.00 EA
0.00
125.00
375.00
Supreme Victoi-v Valor � KITCHEN - 3
WINDOWS
Room Totals: \VINDU'. TREATMENTS 2,114.27
Room: Debris Removal
DESCRIPTION'
Dumpster load - Aphnv•.. '0 yards, 4 tons
of debris
QNTY REMOVE
3.00 EA 393.64
REPLACE TOTAL
0.(,O 1,180.92
PHALGOO_EO( FN1 ! � 02/(;7/2006 Page: 27
Anw!-; � , n Family Insurance Groul)
®rtQ 89SMW KAUHVhE
I:anclall ','oelker
920 w 1liwoods Drive
alcn ! ! ' I s N N 55112
I'honc W 1.483.8271 Ext 65305
F:ixh7' ,3.6501
CONTINUED -Debris Removal
DESCRIPTION QNTY REMOVE REPLACE TOTAL
Room Totals: I�rbris i��val
Room: Electrical
1,180.92
DESCRIPTIO.:
QNTY
REMOVE
REPLACE
TOTAL
R&R Outlet
35.00 EA
4.21
11.55
551.60
R&R 110 volt copper 1,; n,, run and box -
35.00 EA
4.48
38.17
1,492.75
rough in only
R&R Circuit breaker - I !') volt - single
12.00 EA
6.70
23.72
365.04
pole
R&R Ground FXA int. iter (GFI) outlet
6.00 EA
3.78
30.94
208.32
Room Totals: I :
AMERICAN FAP_"'LY ,�mc,` - jt! Family Insurance Group
fi= V9WSse[ar:x tut
DESCRI PT I t)
Rand.'! ' oclker
X920 hwoods Drive
Ardcn ! i '�s MN 55112
Phonc i,: !.483.8271 Ext 65305
I:ax 6: I. X'3.6501
CONTINUED - depreciation - expla
QNTY REMOVE REPLACE TOTAL
Depreciation i.v c:l)i)lir�,, Real Property Dwelling itenis based on thefollowing schedule -
Real Property
Item Class !_
': Expectancy Annual Depreciation Maximum
Appliances
Granite / Solid Surl',w-
'nnmtertop 20 years
Cooktops 1 1,
;u -s 7.14%
100%
Dishwashers
wars 10.00%
100%
Freezers Bui t In
16 years 6.25%
100%
Garbage Disp ,,,cr
10 years 10.00%
100%
Range Hood,-
vcars 5.00%
100%
Icemakcr Bulli In
16 years 6.25%
100%
Microwave S!rtce Sn
11 years 9.09% 100%
Oven/Range
years 5.88%
100%
Refrigerator Built In
17 years 5.88%
100%
Trash Compactor
10 years 10.00%
100%
Awnings k, Pati) Coy
Metal
3.33%
100°/,
Canvas
20.00%
1001;
Cabinetry
Lamin;rnc (7ol-,tenth
13 years 7.69%
100%
Granite / Solid Surl',w-
'nnmtertop 20 years
5.00% 100%
All Othcr Cahiaetry
20 years 5.00%
100%
Concrete &- Asphl ilt
Asphalt I(!
r,u-s 10.00%
100%
Concrete \V,,11
200 years 0.50%
100%
Concrete Sla:
'() years 3.3%
100%
Door
Room Totals: (! ,nreci !' - expla 0.00
Line Item Suht+)tals: I'I' ' LGOO_BOOPENDRA 49,581.65
PHALGOO_I;t;, ;'EN 02/07,2006 Page: 29
AgglicAM F,l;c`;IL). Amer r-i 'Family Insurance Group
Al77RNWHNSfxeg.�' �;[.0 'x t,r�
I:anda"
11:er
3920
�voods Drive
\rdcr''
`,!N55112
!'honc
3.8271 Ext 65305
1 --ax 6.)1
,.6501
Adjustments for Base Service Charges Adjustment
Carpenter - Finis!i, Tri: !iinet
115.72
Carpenter - Mcc! ;uric
121.24
Cleanin, Tcclm :in
53.06
Floor ClcauirL I _•chni,
62.30
Cleanin, Remc :::ition ni ian
70.54
Drywall Irstall�'�
237.12
Electrician
160.00
Flooring Instal!cr
157.08
Wood HoorinL, Installer
155.76
Hardware Irstal!cr
111.32
Heating /A.C. ',.!cchari;
157.90
Insulation Inst:i1l1•1-
130.72
Plumber
170.00
Painter
94.46
Wallpahcr I -Lir-
93.12
Total Acljustnunt, for ',' Service Charges:
1,890.34
Permit Amount:
125.00
Line Itcm Tota1�: P]1:�' '_:00_BOOPENDRA 51,596.99
Grand Tota' .',re-.!:
5,63 3.2 9 \V,,"
2,764.96 I�lo,
0.00 Lot-, i;l
1,504.96 1 loor iAi,
2,278.41 I:tci-i,,- " SII ;area
0.00 ",dacc i
0.00 tall. '_cngth
2,829.50 SF Ceiling
307.22 SY Flooring
0.00 SF Short Wall
1,947.16 Total Area
284.23 Exterior Perimeter of
Walls
0.00 Number of Squares
0.00 Total Hip Length
8,462.79 SF Walls and Ceiling
842.03 LF Floor Perimeter
864.48 LF Ceil. Perimeter
5,499.29 Interior Wall Area
0.00 Total Perimeter Length
PHALGOO_I OOPENI'P, \ 02/07/2006 Page: 30
�i�F,��71 Gt Family Insurance Group
rj
A1!!Q/AWWS,'1f11 ecaun IW
Randall ` oclker
,920 Noy 1iwoods Drive
\ rder ! I '' ; N IN 55112
Phone 153.8271 Ext 65305
;lx 6_ ,. ,.(1501
Summary for FIRE
Line Item Toial
Total
`:ie Service Charges
Permit
Mid Sales T -x 1 rc
@
6.500% x
Subtotal
Overhead
@
10.0% x
Profit
@
10.0% x
Cleaninw, ST; iv
@
6.500°/, x
Replacement Cost \'r is
Less Deprcc anon
Actual Cash Value
Less De(Iucti)le
Net Claim
Total Rccm crab(c '), -cciation
Net Claim i l' Depr ; i mm is Recovered
Randall Voelker
49,581.65
1,890.34
125.00
21,479.31 1396.16
52,993.15
52,322.22 5,232.22
52,322.22 5,232.22
2,937.49 190.94
63,648.53
(26,628.64)
37,019.89
(500.00)
36,519.89
26,628.64
63,148.53
PHALGOO_BOOi'GIyi?R 02/07/2006 Page: 31
AMeajup FAMILY American Family Insurance Group
eKaaa�a�aua,�°
Randall Welker
3920 Northwoods Drive
Ardcn Hills IVIN 55112
Phone 651.453.8271 Ext 65305
Fax 651.483.6501
zrr ,rr
BOR14 Z-Bsm[
Llai m
l
,sem ,z —Z 2%
Ma
0
"o
0
34 BA j4
iC
10' z -IT
-
PHALGOO_BOOPENDRA 02/07/2006 Page: 32
AM@RItAN FAMILY American Family Insurance Group
Mrroo��r®
.Mair
Randall Welker
3920 Northwoods Drive
Arden Hills MN 55112
Phone 651.483.8271 Ext 65305
Fax 651.483.6501
PHALGOO_BOOPENDRA 02/07/2006 Page. 33
1
LRI
mERi"� c&u F— American Family Insurance Group
am+�aee �m�r®
Randall Voelker
3920 Northwoods Drive
Arden Hills MN 55112
Phone 651.483.8271 Ext 65305
Fax 651.483.6501
Main Level
gain Lem
PHALGOO BOOPENDRA 02/07/2006 Page: 34