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PRE 2010 DOCSs • Village of Fridley, Minn. BUILDING PERMIT Date:.. ...................... Owner �" .tom' Address....... .. .............. 0 moo` �o .Or x Builder '.... Addres ..... �.�� '. .... L T®®IION OF BUILDING No. . � . Street .e .. — .'f ................... Part of Lot ... � . . Lot/ lock ...`.............. Addition or Sub -Division . ... ... ........... o—t Corner Lot ........... Inside Lot .......... Setback �....... SideyardQl.��. �?". DESCRIPTION OF BUILDING To be used as: AV- Front �.. Depth .� .. HeigmLM Sq. Ft,// `j Cu. Ft. ........ ..... Front B?!... Depth �. U .. Height Sq. Ft. am Cu. Ft. ........ yptruction .................. Est. Cos®./�?".� �...... 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 of the village of Fridley. �--1 LTV.-.4A- In �/ / �...!!, ermit is hereb anted to kv/ consideration of the payment of a fee of $. p y gr •••• •••••• !' ......................... to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings with- in the village limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. .. Inspector NOTICE: This permit does not cover the construction, installAtion or alteration for wiring big, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for the a items. 52-84-S915-51 Ciiy ®f Fridley ,ppiic mOr gar umbing sand Gas Fig,119 Porn, b Dept. of Bldgs. Phone 560-3450 DESCRIPTION OF WORK 5380 N E 6th St Number, Kind and Location of Fixtures Location • N f I I = 1n Z_ Sy =Z JO # p Z Z ~ Ox 1 0 ✓*Z Z 01 WATER HTR. O <O` <� '2 Z �� 004 S3 5� <3 �o tag o� * a 00 P N GAS ELEC. rn Base lst- 2nd f 3rd 4th City of Fridley: The undersigned hereby makes application for a permit for the work here! 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, Minn 6_2.7 19_ Owner Don Moldenhauer Kind of Building I �,oaneczea wzm Futuro Connection Openings Sewer ilTew Fixture, Old Openings Used as Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTUnE RATES: NO. RATE TOTAL Number Fixtures ...................... Future Fixture Opening ................ New Fixture Old Opening .... •......... . Catch Basin ... ................ ... Water Heater (Up to BTU) ...... New Ground Run Old Bldg. ............ x *= $ $21900 X. ;MX $ $1.50 x b& $ $1.50 x 3.25 $ x 3M $ $3.00 x 3.25 $ frame res To be completed about 6-7-67 _ Estimated Cost, $ 10.00 Old—New. Building Permit No Permit No. Si By Business Phone No ROUGH Electric 1r.ator Heater .52.00 FINAL GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures ......................... x $1,,f&c $ $2 000 Additional Fixtures ..nQ,nQ................. x �C $ 0117 Gas Range to ti u .............. 1 x C $ �' a REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE $ ' ly`2� �42 APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER IS NAME. (d-e?��c� �-`.� �' -BUILDER ADDRESS® _ /y� ADDRESS LOCATION OF BUILDING NO. STREET . LOT BLOCK ( �� ADDITION 0gCCa� �! O CORNER LOT G,-' INSIDE LOT SETBACK SIDEYARD 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: ` //I Front / � � Depth l® / Height , Square feet /ft Cubic Feet F�cont Depth Height Square feet Cubic Feet T l Type of Construction geo cq"�.( Estimated Cos r 4a TO Be Completedjr -�•�'��' 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. (Schedule of Fee Costs can be found on the Reverse Side.) HARIEY JA. CARTWRIGHT ANOKA OUNTY SURVEYS HENNEPINCOUNTY SURVEYS MINNEAPOLIS SURVEYS 0410 PALM STREET N W SUNSET 47655 OWNER INDUSTRIAL - JUDICIAL BUSINESS - TOPOGRAPHICAL CITYLOTS- PLATTI'N'G nn:-l. �/� 1 s Ct•� Iro ,J 1 C A E T W LAND SURVEYORS REGISTERED UNDER LAWS OF STATE OF MINNESOTA LICENSED BY ORDINANCE OF CITY OF MINNEAPOLIS 326 PLYMOUTH BUILDING FEDERAL 8-8721 HENNEPIN AT SIXTH • MINNEAPOLIS 3. MINNESOTA &urbrpor's Ifertificate COMBINING THE RECORDS OF J. E. HILL. CIVIL ENGINEER ESTABLISHED.. 1696 C. F. SANDHOFF CIVIL ENGINEER ESTABLISHED 1906 JAMES NELSON SURVEYOR ESTABLISHED 1922 METROPOLITANLAND SURVEYORS. LSTq BLISHED 1951 Invo_C^ 22101- 71 i -o. 7 r 3e.1 \D IT, 2 ; �i /34. 7/ I rer-:a�r ..,rvi-' tli%.l tris iU i:ru, an,! co: _ :ct r,pr3sor.t-tion..)f ^,sv�,-r 0- i.ot I -.n' 2, 3100._ ,,i:%':i7-torn s ._u _titian to ^chf.:iic. v - . .Ls sury:;;~j jy : n tliis ?0t -h 3-.y or July, 19 ._ . • SIG NEd - �TWRIGHT AND OL50N Ur City of Fridlay Applicaflan for Plumbing cad Gm Mng ft bt Dept. of Bldga. Phone 55t) -3M DESCRIPTION OF dlOtR-IL Number, Kind and Locet!on of Fixtures a t o f-, " I -" S I _ M ,;S o� 1 1 N J i ro N uZ S-1 o 5 f 3 7� {� W v 7< c 9 4 7 o$ • � • a WATE4 myX GAS ncc. _N Base 1st 2nd _ 3rd 4th _ • Futuro Connection Oponings Now Fixture. Old Openings PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: Sewer 0 Csaapool 0 NO. RATE TOTAL Number Fixtures ................ x $2.00 $ Future Fixture Opening ............ x $1.50 $ _. New Fixture Old Opening.......... x $1.50 Catch Basin .................... x $3.25 $ Water heater `Up to 99.000 BTU) • • • • x $3.00 $ New Ground Run Old Bldg......... x $3.25 $ Electric Water Heater .............. a $2.00 S :.AS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures x $2.00 $ . Additional Fixtures ................ x $ .75 $ Gas Range to 199.000 BTU ........... -- x $5.00 $ REPAIRS & ALTERATIONS—Rotor to Code Description ....................................."...$ TOTAL FEE a City of Fridley: The undersigned hereby makes application for a permit for the work here specified, agreeing to do all work in strict accordance with the Citi Ordinan and ruling of the Department of Buildings, and hereby declares that all the fa and representations stated in this application are true and correct Fridley, Minn 19� Owner Kind of Building'%` L� Used as To be completed about Estimated Cost, $ Co,New. Building Permit No. Permit M---7 3 Signed �`— . Business Phune No '5 ROUGH FINAL —� Z . .50 State Surcharge City of Fridley SUBJECT ;PCRMI - 1686 AT THE TOP OF THE TWINS BUILDING PERMIT 6y___ ___ COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 ; � CITY HALL FRIDLEY 55432 612-571-3450 -7 NUMBER 910-F15 REV. DATE 9/27/82 PAGE OF APPROVED BY JOB ADDRESS 5380 - 6th Street N.E. 1 LEGAL DESCR. LOT NO. 1,2 BLOCK 15 TRACT OR ADDITION SEE ATTACHED Hamilton's Addn. to Mechanicsville SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Anthony Siedlecki 5380 - 6th Street N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Milton L. Johnson Co. 2513 Central Avenue N.E. 781-9548 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 ❑ REPAIR ❑ MOVE ElREMOVE X 8 DESCRIBE WORK Reroof Dwelling 9 CHANGE OF USE FROM TO STIPULATIONS Roof can be 2nd but not third layer of roofing. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 ISTALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $3,000 $1.50 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER PkTE OAR LOCAL LAW REGULATING CON- STRU ION OR THE PERFOR AN E CONSTRUCTION. 38.50 PLAN CHECK FEE TOTALFEE �' Z 7 ` $40.00 SIGNATURE OF CONTRACTO OR THORIZED AGENT IDATEI WHEN PROPER Y VALIDATED THIS IS YOUR PERMIT BLDG INSP r) TE SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) CITY OF FRIDLEY APPLICATI -4 FOR RESID17NTIAL BUILDING PERMITS (New, Alterations, /additions, or Repairs) 01-111ER: 'ft n, TH0M-ry r 1 D J-4�Ckll_____ t� ADDRESS: T, A) TEL NO: BUILDER: Lr0 4 _ Z/A).re0 ADDRESS: ®?S 13 Ad TEL NO: � �!— • � �� b' Construction Location STRMT NO: 'S-38,0 - STREET: LOT: BLOCK: ADDITION: Corner Lot: Inside Lot: Setback.: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTIO14 OF CONSTRUCTION Front: Square.Feet: Depth: Height: Cubic Feet: Front: Depth: Height: Square - Feet: Cubic Feet: Type of Construction: T_C/k,Q-0 FF - 2®-® f - Estimated Cost: $ 3 e, To Be Completed: Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ $ SEE REVERSE SIDE OF SHEET Vne 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 truce andd�cco%rrect. DATE: I J-� I I fv- S ICNR'.CU RE : \ X W /IeSJ�{.f'.c�.� � . Stipulations; City of Fridley fP�, AT THE TOP OF THE TWINS _ `� INTER- DEPARTMENT REQUEST 1 1 ; PUBLIC WORKS DIVISION 1 1 CITY HALL FRIDLEY 58432 812-880-3450 SUBJECT SEWER STOPPAGE NUMBER REV. DATE PARE OF APPROVED III SEWER STOPPAGE ADDRESS 5380 - 6th St. N.E. DATE 11-21-89 CALL RECEIVED BY Jim Brindley & Chet Swanson AT 8:05 am (AM)(PM CREW LOCATION WHEN NOTIFIED City Garage EQUIPMENT TAKEN TO SITE Pickup truck and jetter CAUSE OF STOPPAGE Unknown TIME STOPPAGE RELIEVED 8:20 am DESCRIBE DAMAGE (IF ANY) Basement floor was completely covered with about 2 inches of water. Carpeting in one room of the basement was wet. NOTE ANY STATEMENTS MADE BY CREW OR HOMEOWNER REGARDING DAMAGE OR POSSIBLE CLAIM Homeowner was cooperative and pleased with the fast response to relieve the backup. Servicemasters was notified. CREW AND HOURS 2 men - 3/4 hour i �1 SUBJECT P City of Fridley 29197 AT THE TOP OF THE TWINS BUILDING PERMIT i � • _ COMMUNITY DEVELOPMENT DIV. IO. ^� r : PROTECTIVE INSPECTION SEC. � i �,J2 CITY12_571 NU REv DATE GEOF APPROVED By L34b0RIDLEY �.J 910-F15 /GE JOB ADDRESS 119 6 Street NE 1 LEGAL LOT N0. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 5,6 15 Hamilton's Addition to MechanicsvilleBHEET 2 PROPERTY OWNER AIL ADORES$ A. Siedlec0% ZIP PHONE �s�--S4.�e�4e�e1e.# 6 Street NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Four Season Roofing & Remodeling LLC 7930 University Avenue NE Fridley, MN 554 d ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 795-9410 20138780 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO e USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW 0 ADDITION O ALTERATION REPAIR O MOVE O REMOVE B DESCRIBE WORK Reroof House & Garage (25 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday thru Friday; 9:00 am to 9:00 pm on Saturday; No work on Sunday. Contractor changed address on permit on 4/15/99. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT CU FT AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION ] STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2,142 $1.07 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 - RUCTION OR THE PERFORMANCE OF CONSTRUCTION $74.75 Fire SC $2.14 �— _41c=j PLAN CHECK FEE TOTAL FEE [ License SC $5.00 $82.96 SSG N4TURE OFC RACTOR OR AUTNORi2E0 AGENT 90ATEj WHEN PROPERL THIS ISYS YOUR PE,%MIT q J VA�LIIOAJTED S-GNATURE OF OWNER IF OWNER BUILDER& iDATEi - a- OGJINSP T)A it NEW [ ] Effective 1/1/99 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 �' \ BUILDING PERMIT APPLICATION 11Ck A ConstructionAddress: �3� �p�h P Qf r� U Legal Description: 5-360 xc✓ c 61, Owner Name & Address: P44- S l e d I eckr Tel. # Contractor: FOE. r Sea ��. nn rf.,r owp—//AQ Cc MN LICENSE # Address: Attach 'to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Tel. #W %IJ ?q/9 LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: u Ste 4 (9-% races �5 � $ Construction Type: 4wooe ! y- eopVOEstimated Cost: $ Park Fee $ Fee Determined by Engineering Sewer Main Charge (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: 3 _ I t APPLICANT: U41Tel. L LIZ) CITY USE ONLY TOTAL $ . 96 STIPULATIONS: Permit Fee $ '`'/, Fee Schedule on Reverse Side Fire Surcharge $ J,/` .001 of Permit Valuation (1/10th%) State Surcharge $ /, 6�7 $.50/$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $ S-.66 $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 $ . 96 STIPULATIONS: c suejady MIT NO. City of Fridley 30295 AT THE TOP OF THE TWINS BUILDING PERMIT f t , RE PT NO. `� v _ COMMUNITY DEVELOPMENT DIV. -____ � PROTECTIVE INSPECTION SEC. (00 V.2 r CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F/5 9/27/99 JOB ADDRESS 5380 6th Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1,2 15 Hamilton's Addn. to Mechanicsville SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Pat Siedlecki572-8075 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Norling Exteriors Inc. 341 79th Fridley MN SS492 7R4-RQXA 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 D ADDITION ❑ ALTERATION (Ex REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reside; Soffit fascia and trim: Replace 9 , CHANGE OF USE FROM TO STIPULATIONS Call for building wrap inspection before covering. Provide soffit ventilation to meet the State Building Code. Provide smoke detectors in all sleeping rooms and on all levels of the dwelling. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING. HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION ISTALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $13,000 $6.50 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CMA E PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $223.25 Fire C T UCTION OR THE PERFORMANCE OF CONSTRUCTION $13.00 PLAN CHECK FEE TOTA F E x`27 ' Q/ei Licens $5. $ .75 SIG TUBE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI HEN O ALIDA 81.0111'INSP -4P D lS 1 O R %R r)ATE SIGNATURE OF OINNERIIF OINNERSUILDERI IDATEI c NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION A ConstructionAddress: Y 6 67 S/ Legal Description: Owner Name & Ad ress: A0 �, � ,�, Tel. # 4/07 - S'_ 2.;? Contractor: I?C7 MN LICENSE # © 6 ?,3 7 ,?d Address: o//f tV Tel. # (a,�)— -4% 293 6 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: JJ s Construction Type: �� Si�fr' - 5���`°�<`'"s'' Estimated Cost: $ OO® C® 3 4<��.e/,� /��/�«•�c7't � (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: ®a APPLICANT• rvl®� % <� Tel. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1 / 10th %) $.50/$1,000 Valuation $1000 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 [ ] FROM :Cita r{��. � I.7E��711287 I''1at-. 24 2E106 09: 2n- Hh'1 F'4 E N1 + CHANZCAL Pem-lit NoRESIDENT Received B :IAL APPLICATION y 04 CITY OF FRIDLEY Date Rec'cl: YOUR f -,-MAIL ADDRESS SITE ADDPESS THIS APPLICANT IS: ❑ OWNF R CONTRACTOR PROPERTI'-- OTVVNER/ .._ TENANT ADURFtiti' CITY STATC_ZIp _ PHONE: CONTRACTORT GQN,lI'ANY NAME; M _. SUBMTI' A URY OF CONTACT PERSON: YOUR STATE STATF, LICENSE #_._ ENT DATE L10ENS17, WITH AUURFSti: APPLICATION =�– / PLY WUA�_&. 6-1-1/1C1'1'l' 9 ' STA'('F�OVZm i FArX3 – PERMIT TYPE, EX -SINGLE FAMILY ❑ TWQ FAMILY CI TOWNTTHQl.1tiE TYPE OF WORK: ❑ NhW )fRLPLAC EMENT ❑ ALTERATION/RFM(N)F,L DF,TAILLD DESCRIPTION OF WORK PFR MS 1613.66.5 the permit fcc is a mininllurn of $1.5,00 or 5% of the total cost up to $500.00, whichever is r the, improvement, installation or replacement of a residential fixture, exchtding the fixtures. (This should reflect orgy hu c sic oflabor } Labor cost udder $300 = $ 15,00, Labor cost between $300 to $.500 –cost of labor, X'05 = FOR 13HR HCTS C14WI-HtL _)AJiC)R F..XC.ELDS $5()0, FEES ARL BASED ON $10.00 PER, NIk rURE, EXCEPT WHERE NOTED. NXTURES: (INDICATE TOTAL. NLiMl31iR. OF EACH F3H:ld)1�') FiquiP lertl h,stnliedr•>t-!'i.� l (� SIZFJBTU 00fl MNG;–C&4dMODEL: S1ZLIBTLJ . h2PCr MOD L: Si/.FJBTU _ _NIREPLACL (OAS) $15.00 _� AIR TO AIR EXCIIANC.KFR $15 PIREPLAC E (WOOD] 5.00$35,_GAS RAN(,R/OVEN $10.(10 _BOIL.F,.R $35.00 �ItZNAGE $3WO _NEW (iAS GRILL $10.00 CHIMNEYiJNER$10.00 _GUR ACF, $I(),(JO _GAS I1NITHTR $10.00 _DUCT WORK 510.00 _GAS DRYEPIPINR, _POOL HEATER $.35.00 —VENTILATOR $15.00 lENumbber of fixtures xe@b $15 00 i—i` x $150,00 $ Permit Fee g Surcharte � 00 -� TOTAL DUE $ Number of fixtures @ $25,00 __ x 9,"25.00 =,s-;3•,11 Niunber of fixtures (4) $35.00 1 x $35.[10 = $� State Surcharge = $__ 50 Total = $ THIS IS AN APPLICATION FOR A PRRMIT•NOT VALID UNTIL PROCEss D I hereby apply for a building permit and 1 acknowledge that the information above is complete and accurate; that the work will be in cnnforinance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that t 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 casUf ,p work which o t s review and approval of plans. SIGNATI!ttR OF APPLICANT'PRINT NAME Arsfil G � • le -1 v.. n•i, li 1° i. A .;. -•.. II� dfir . i1 � „ `!��iri��.,'1�i S{i"�4}�,`}�'i"it At'�'1'i'' iir'1` x•'4:.:.r t Y?:n'� ; rs,c.ra.+,,..:..:...,..,:�.,:,.�., _ .._ , .,. , ...:..._ _...... '— City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 2�� M Building Inspections 763-572-3604 763-502-4971 FAX sIT1; ADDRESS TI -M APPLICANT IS: PROPERTY ON% TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE AND CERTWICATE OF INSURANCE PROPERTY TYPE TYPE Flom: 7635448766 Page: 2/11 Date: 4/28/2010 8:29:36 AM BUILDING Permit No.�2 RESIDENTIAL APPLICATION Received By: CITY OF FRIDLEY O OWNER )RZONTRAC' NAME: ADDRESS:�o /c CiTY STATE LICENSE d ICJ k;7 F3XP DAT ADDRESS: 9641 110-`i' Ale"Ute pr ( Cr'Y vunw>: 7iCsy S-e/S/ , 91761 FAX i 00 •• Z .FAMILYINEW CONSTRUCTION FAMILYINEW CONSTRUCTION ❑ BASEMENT FINISH b7 ROOF O nECK ❑ SIDTNG O DRAIN TILE ,ItOTHER I% TEiIP--�-1-L d ATE�k1.IP _ TYPE OF WORK: S ❑ NEW HOME CONSTRUCTION 0 ADDITION LEMATNTENANCE/sEPAIR iZ REMODELING Plan Review DESCRIBE WORK BEING DONE: r�.dd< Ccs C'�/+�r'1•�_��� an '�+�"` Efi1� �a 1"/���r °� �' �f �' SiZE Qf IMPROVEMENT LENGTH J J. WIDTH S HEICr14T S FT Surcharge $ .0005 x Permit Valuation Minimum S.50 License Surcharge ROOF M 0 HOUSE, ONLY SAC Charge RASE r REMODELiNO_S.UBMIT_ NUMBER OF SQUARES O HOUSE & GARAGE $ 1. Existing Floor Pian 9ARAM ❑ ATTACHED GARAGE $450 Conservation Plan Review 2. Proposed floor plan PROPOSED SIZE: O DETACHED GARAGE Sewer Main Charge 3. List of structural members to be wed PROPOSED HEIGHT: Total Due $ Make checks payable to: City of Fridley Attach Stipulations FOR NEW CONSTRUCTION INCLUDING DECKS, WPM C] Vinyl OSoRit bmams, 1, Site P1aw/5urvey showing the existing structures 17 Alarninum 0 Trim and proposed project. O Other O Fucia 2. Two sats of construction plans WINDOWS 3, Energy Calculations TN EXISTING OPMM0S 13Ym ❑No LOCATION OF WINDOWS FOR WiNDOWS— PROVIDE•: U•VALUE AND OR FOR NEW OPENTNOS-DESCRIBE WE OF MANUFACTURE STICKF..R ON WINDOW. OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOW$ ALL FEES BASED ON VALUATION, iNCLUDING THE COST OF LABOR AND MA' X (USING THE 1997 U.B.0 FEE SCHEDULE) TION $ Permit Fez S 2 Bee Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ .001 times the total job Valuation Surcharge $ .0005 x Permit Valuation Minimum S.50 License Surcharge $ 5 $5.00 (State Licensed Residential Contractors) SAC Charge $ $2100 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $24 Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necesury ( ) Total Due $ Make checks payable to: City of Fridley Attach Stipulations THTS iS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and 1 acknowledge that the information above is complete and accurate: that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work Is not to start without a permit on site, that the work will be in accordance with the approved plan In the case of allalljw_a h requi review and approval of plans. / SiGNATi,IREOFAPPLiCANTP//� �„ �y PRINT�NAME �e _i�=/J�4P10 r _PATC FOR PL From: 7635448766 Page: 3/11 Date: 4/28/2010 8:29:37 AM LINDSTROM RESTORATION 9621 TENTH AVENUE NORTH, PLYMOUTH, MN 55441-5098 Phone (763) 544-8761, (877) 544-8761 Fax (763) 544.8766 Moro Rwdy MN 0001087, FL CCC1509130, LA 44547 Building Construction Fed TIN 41-0847540 Client: Siedlecki, Patricia Property: 5380 6th St N£ Fridley, MN 55421 Operator Info: Operator: MIKE Estimator: Bateman, Mike Business: 9621 l Oth Avenue North Plymouth, MN 55441 Reference: Company: American Family Ins, - Randy Voelkcr Business: P.O Box 22445 Robin4d2le, MN 55442 Type of Estimate: Date Entered: 2/12/2010 Date Assigned: 2/4/2010 Date Est. Cnmpleted: 2/12/2010 Date Job Completed: Price List: MNMN5B_JAN10 Restoration/Service/Remodel Estimate: SIEDLECKI-PATRICIA-J File Number: 00841.053-147 Home: (763) 572-8075 Business: (763) 544-8761 Business: (763) 951-3271 rf-C VIA�- M" - Oki gx.� �ius.` — �t2►�u_z1�1 -10 17�11G�� SIc,�J �Q�'t0 oath From: 7635448766 Page: 4/11 Date: 4/28/2010 8:29:37 AM LINDSTROM RESTORATION 9621 TENTH AVENUE NORTH, PLYMOUTH, MN 55441.5098 Phone (763) 544-8761,(877)544-8761 Fax(763)544-8766 MN 0001087, FL CGC1509130, LA 44547 Building Construction Fed TIN 41-0847540 SIEDLECKI-PATRIC]A-J Lower Level Ceiling Height: 8' DESCRIPTION QNTY QNTY UNIT COST TOTAL Mask and prep for paint - plastic, paptT, tape (per LF) 35.50 LF @ 0.45 = 15.98 Apply anti -microbial agent 48.63 SF @ 0.19- 9.24 Clean floor or roof joist system 48.63 SF @ 0.60 = 29.18 Suspended ceiling tile - 2'x 2' 48.63 SF @ 1.28- 62.25 Acoustical Treatments Installer - per hour 2.00 HR @ 64.77 = 129.54 Main Level Bathroom DESCRI)P'1'ION QNTY Ceiling Height: 81 UNIT COST TOTAL. Remove Toilet 1.00 EA ct 26.00- 26.00 (Install) Toilet 1.00 EA @ 150.00 = 150.00 (Material Only) Toilet 1.00 EA @ 248.00 - 248.00 Sink - single - Detach 0.50 EA @ 122.63 = 61.32 (Install) Sink - single - reset 1.00 EA @ 100.00 = 100.00 Remove Sink faucet - Bathroom 1.00 EA @ 26,00- 26.00 (Install) Sink faucct - Bathroom 1.00 EA @ 95.00 = 95.00 Remove Vanity 3.50 LF @ 6.28- 21.98 Vanity 3.60 LF @ Cabinet Bid Stain & finish vanity - inside and out 3.60 LF @ Cabinet Bid Remove Countertop subdeck - plywood 5.25 SF (3a 0.57 = 2.99 Countertop subdeck - plywood 5.25 SF @ 2.14- 11.24 Countertop - Tile 5.75 -SF @ 2.1.02 = 120.87 (Install) Sink faucet - Bathroom 1.00 EA @ 63.75 = 63.75 Vinyl - metal transition strip 3.00 LF @ 3.21 = 9,63 Remove Vinyl floor covering (sheet goods) 55.01 SF @ 0.77 = 42.36 Floor preparation for $heel goods 55.01 SF (]a 0.57 = 31.36 Remove Underlayment - 1/4" 5 ply 55.01 SF @ 1.22- 67.11 Underlayment - 1/411 5 ply $5.01 SF @ 2.24 = 123.22 Vinyl floor covering (sheet goods) - high grade 63.27 SF @ 3.11 - 196.77 Vinyl Floor Covering Installer - per hour 4.00 HR @ 78.13 = 312.52 Remove Bathtub enclosure - sliding glass doors I.00 EA @ 17.47 = 17.47 Bathtub enclosure - sliding glass doors 1.00 EA @ 214,82 = 214.82 Remove Tile tub surround - 60 to 75 SF 1.00 EA @ 125.21- 125.21 Tile tub surround - 60 to 75 Sr- 1.00 EA @ 1,115.72- 1,115.72 SIEDLECKi-PATRICIA•J 4/6/2010 Page:2 From: 7635448766 Page: 5/11 Date: 4/28/2010 8:29:37 AM LINDSTROM RESTORATION 9621 TENTH AVENUE NORTH, PLYMOUTH, MN 55441-5098 Phone(763)544-8761,(877)544-8761 Fox(763)544-8766 ah Roddy MN 0001087, Fl. CGC1509130, LA 44547 Building Construction Fed TIN 41.0847540 CONTINUED - Bathroom DESCRIPTION QNTY UNIT COST TOTAL I/2" Cement board 60.00 SF @ 3.74 = 224.40 Remove Soap dish 1.00 EA (a; .5-23 = 5.23 Soap dish 1.00 F_.A (a), 16.27 = 16.27 Remove Cabinetry - full height unit 3.10 LF (a), 7.54 = 23.37 Cabinetry -full height unit 3.10 LF (a Cabinet Did Stain & finish full height cabinetry - inside and out 3.10 LF @ Cabinet Bid Remove Towel bar 1.00 EA @ 5.23 = 5.23 Towel bar 1.00 EA (a,) 22.82 = 22.82 Remove Toilet paper holder 1.00 F..A (q) 4.18 = 4.18 Toilet paper holder 1.00 EA @ 22.85 = 22.85 Remove Ceramic tile 55.67 SF (M 1.50 = 83.51 Thin coat plaster (no lath) 55.00 SF @ 2.95 162.25 Ceramic tile 55.67 SF @ 11.11 = 618.49 Detach & Reset Hcat/AC register - Mechanically attached 1.00 EA @ 12.34 = 12.34 Sea] then paint the surface area (2 coats) 12.08 SF @ 0.58 = 7.01 Remove Wallpaper 135.33 SF (cr1 0.53- 71.72 Prep wall for wallpaper 135.33 SF @ 0.39 _ 52.78 Wallpaper (per roll) 7.00 RI, @) 44.82 = 313.74 Seal/prime the surface area - one coat 135.33 Sl (a7 0.33 = 44.66 Window drapery - hardware - Detach & reset 1.00 EA (§ 30.39 = 30.39 Finish Carpenter - per hour 0.50 HR (� 61.96 = 30.98 Detach & Reset Casing - 2 1/4" 17.00 LF @ 1.33- 22.61 Detach & Reset Interior door - Detach & reset - slab only 1.00 EA @ 0.00 Finish casing - I coat urethane 17.00 LF @ 0,66- 11.22 Medicine cabinet - Detach & reset 1.00 EA @ 34.32 = 34.32 Remove Shower faucet 1.00 EA @ 15.69 - 15.69 Shower faucet 1.00 EA @ia, 213.11 = 213.11 Plumber - per hour 4.00 HR (), 108-90 = 435.60 Miscellaneous DESCRIPTION QNTY UNIT COST TOTAL Taxes, insurance, permits & fees (Bid item) 1.00 EA @ Open Haul debris - per pickup truck load - including dump fees 1.00 EA (6), 135.89 = 135.89 SIEDLECKI-PATRICIA-J 4/6/2010 Page:3 From: 7635448766 Page: 6/11 Date: 4/28/2010 8:29:38 AM y UNDSTROM RESTORATION 9621 TENTH AVENUE NORTH, PLYMOUTN, MN 55441-5098 Phone (76-1)544.8761,(877)544-8761 Fax(763)544-8766 AvwysacoQy MN 0001087, FL CGC1509130, LA 44547 Building Construction Fcd TIN 41-0847540 CONTINUED - Miscellaneous DESCRIPTION QNTY UNIT COST TOTAL. Cleaning Technician - per hour 1.00 HR @ 30.07- 30.07 Cabinetry per bid 1.00 EA a) 2.470.06 = 2,470.06 Cabinetry upgrade 1.00 EA n 76.23- 76.23 Plumbing Service DESCRIPTION QNTY UNIT COST TOTAL Remove Bathtub 1.00 EA @ 250,00- 250.00 Haul old bathtub away and dispose. 3.00 HR @ Included (Material Only) Bathtub 1.00 EA @ 423.91 = 423.91 (Install) Bathtub 1.00 EA @ Included (Install) Plumber - Installation of 1ub/Sh0Wer vavle and trim 1.00 HR @ Included Grand Total Areas: 557.33 SF Walls 102.61 SF Floor 0.00 SF Long Wall 102.61 Floor Area 604.00 Exterior Wall Area 0.00 Surface Area 0.00 Total Ridge Length 102.61 SF Cciling 11.40 SY Flooring 0.00 SF Short Wall 126.75 Total Area 75.50 Exterior Perimeter of Walls 0.00 Number of Squares 0.00 Total Hip Length 659.94 SF Walls and Ceiling 69.67 LF Floor Perimeter 69,67 LF Ceil. Perimeter 557.33 interior Wall Area 0.00 Total Perimeter Length SIEDLECKI-PATRICIA-3 4/6/2010 Page:4 From: 7635448766 Page: 7/11 Date: 4/28/2010 8:29:38 AM V LINDSTROM RESTORATION 9621 TENTI-1 AVENUE NORTH, PLYMOUTH, MN 55441-5098 Phone (763) 544.8761, (877) 544-8761 Fax (763) 544-8766 Mwnys/Pmdy MN 0001087, FL CGC1509130, LA 44547 Building Construction Fed TIN 41-0847540 Summary Line Item Total 9,300.46 Mad Sales Tax Rcimb @ 7.125% x 3,046.92 217.09 Subtotal 9,517.55 Ovcnccad @ 10.0% x 9,517.55 951.76 Profit cr 10.0% x 9,517.55 951.76 Replacement Cast value $11,421.07 Less Deductible (500.00) Net Claim $10,921.07 Bateman, Mike SIEDLLCKI-PATRICIA-] 4/6/2010 Page:5 From: 7635448766 Page: 8/11 Date: 4/28/2010 8:29:38 AM LINDSTROM RESTORATION 9621 TENTH AVENUE NORTH, PLYMOUTH, MN 55441.5098 Phone(763)544.8761,(877)544-8761 Fax (763) 544-8766 Alm,l'fRwdf' MN 0001087, FL CGC1509130, LA 44547 Building Construction Fed TIN 41.0847540 Recap by Room Estimate: SIEDLECKI-PATR1C1A-.1 Area: Lower Level Bath Area Subtotal: Lower bevel Area: Main Level Bathroom Miscellaneous Plumbing Service Area Subtotal: Main Level Subtotal of Areas 246.19 2.65% 246.19 2.65% 5,668.11 60.94% 2,712.25 29.16% 673.91 7.25% 9,054-27 9735% 9,300.46 1.00.00% Total 9,300.46 100.00% SI DLEC:KI-PATRICIA-1 4/6/2010 Page:6 From: 7635448766 Page: 9/11 Date: 4/28/2010 8:29:39 AM tv LINDSTROM RESTORATION 9621 TENTH AVENUE NORTH, PLYMOUTH, MN 55441-5098 V Phone (763) 544-8761. (877) 544-8761 Fax (763) 544-8766 RRaynkcodr MN 0001087, FL CGC1509130, LA 44547 Building Construction Fed 77N 41-0847540 Recap by Category O&P Items Total Dollars % ACOUSTICAL TREATMENTS 191.79 1.68% CABJNETRY 2,591.85 22.69% CLEANING 59.25 0.52% GENERAL DEMOLITION 923,94 8,09% FLOOR COVERING - VINYL 673.50 5.90% FINISH CARPENTRY / TRIMWORK 53.59 0.47% FINISH HARDWARE 61.94 0.54% HEAT, VENT & AIR CONDITIONING 12.34 0.11% MIRRORS & SHOWER DOORS 214.82 1.88% INTERIOR LATH & PLASTER 162.25 1.42% PLUMBING 1,790.69 15.68% PAINTING 78.87 0.69% T1LE 2,079.48 18.21 WINDOW TREATMENT 30.39 0.27% WALLPAPER 366.52 3.21% WATER EXTRACTION & REMEDIATION 9,24 0,08% Subtotal 9,300.46 81.43% Mall Sales Tax Reimb (a7 7.125% 217.09 11.90% Overhead @ 10.0% 951.76 8.33% Profit`--- - n 10.0% 9SI.76 8.33% O&P Items Subtotal SIEDLECKI-PATRICIA-J 11,421.07 100.00% 4/6/2010 Page; 7 From: 7635448766 Page: 10/11 Date: 4/28/2010 8:29:39 AM O i 24 From: 7635448766 Page: 11/11 Date: 4/28/2010 8:29:39 AM 1 ?A i From: 9524473327 Page: 2/4 Date: 5/4/201011:57:16 AM FROM :DH PLUMBING FAX NO. :9524473327 May. 04 2010 11:55AM P2 Building PLUMBING Permit No.:&&0103er Inspections RESIDENTIAL APPLICATION RecoivedBy: 763-572-904 CITY OF FRIDLEY Y 0 4 N10 763-502-44977 FAX EFFECTIVE 1_1-2DIO DATE 5/4/2010 YOUR FMATL ADDRESS Kathy DHPINC@integra.net srmAL7ARIISS 5380 6th St. NE TiIIS APPLICANT IS: 0 OWNER 15M CRACTOR PROPERTY NAS; Patricia Siedlecki OWNER/ ADTYRF„SQ: 5380 6th St. NE MXFridley STAIIMN AV55421 TENANT pHom:763-572-8075 CONTRACTOR xAuc: Dana Hoagland Plumbing Inc. SUBAUL A COPY OF YWR STATE SATELICENSE # 0 6 218 OPM EXPDATE 12/31 /2010 LICEN5E,130ND AND STATFi BOND #, 66184544 EXP DACE 12/71/2010 CERTIFICATE OF AI)DRFgQ.21061 Prairie Hills Ln CrTY Prior Lake SPATE MN gIZ5.5372 INSURANCE rt•Iow, ` 952-447-3326 FAx 952-447-3327 PERK ff TYPE IYSINOLE FAMILY Q TWO FAM(LY O TOWNHOUSE TYPE OF WORK: L] NEW REPLACEMENT DSTAnzi)I)ESCRII"'l'IONOFWORK Replacinci Tub Toilet Lav Faucet &\' T&S Faucet. 77 . FEES ARE BASED ON $10.00 PER. FDCTURE+ BXCEPT WHERE NOTRD. FrATEMES: ONrACATE TOTAL NUMBER OF EACH BELOW1 I1MND4IINJ FEE .50. BATH SINKILAV FLOOR DRAINS L SH0VM WATERPERN G -I-BATKIUB _ GAS PTPTNC. (NF, FO CrrY LIC) SWIMMING POOT.. _ WATER 8001M 0357 CLOTHM WASM _KITCHEN SDX WATER CLOSET—I1AC*'LOW PREV. (515) —DISHWASHM _ LAUNDRY TRAY WATER HEATER ($35) FORIRRIGATION _ WA'= METER _OTiLEIt 0.9430-00 9 `�Ap, � •i.'4f-,. � �:= ;.. �fiC�mQ�r of�f�ures � `$15:�3t) $15.� � S. • • .. .., � • �.' •• __,_„x f •Q. .. •Y• .moi. .. ••...ice •• q (`� • J\� li�G{411ePIi @. !P?:7.LlV•. • �,d1.7J: W —.D. __ .i�t&1:4 S1urQ'tlRrge. $ •� .. .. iso Total-=$ [20.501. $35.50 THM IS AN APPIXAT(ON FOR A PHRMff-NOT VA1.I1) IINrIL PROCESSED I hereby apply for a plumbing permit and 1 acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance e of all work which requires review and approval of plains. with the approved pl=C0-V--R:%L SIONATURE OF APTMwTNAMEDana Hoagland DATF_5/4/2010 ::: tl!LEASE ..NO'ffi;• •..SEPARATE PERML I'S,•:ARE REQUMM FOR EI.l7CTit M- `NEC A W City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 J