AF - 43614sue�ecr PERMIT
City of Fridley 15 7 6 8
�,
AT THE TOP OP THE TWINS g U I L D I N G P E R M I T �
, � RECEIPT NO.
� • COMMUNITY DEVELOPMENT DIV.
� � y PROTECTIVE INSPECTION SEC. �
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� /'��1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BV
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612-571-3450 910-F15 6/9/80 / /
JOB ADDRESS g437 Balcer Avenue N.E.
LOT NO. BLOCK TRACT OR ADDITION
1 LEGAL SEE ATTACHED
oESCa. 14 1 Moore Lake Highlands sHeeT
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Thomas Williams 6437 Baker Avenue N.E. 571-2858
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
5ame
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE UCENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDiTION �] ALTERATION ❑ REPAtR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Reroof structure
9 CHANGEQFUSEFROM TO
STIPULATIONS
l�of can be 2nd but not 3rd roof. Install ridged galvanized valleys.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VAIUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED �`]_ � OOO $. SO
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $7.SO
PLAN CHECKFEE TOTALFEE
$8.��
SIGNATUREOFCONTRACTOROFlAUTHORIZEDAGENT IDATEI WHEN PROPERLY V IDATED THIS IS YOUR PERMIT
� 6 -� - �� � ,.�� �Q �.A) � -� �'a
SiGNA7URE0 OWNER�I WN UILDERi �DATEI BLDG WSP Da7E
ci�rY ar- r►;z��cY � •
AI'('LTCl1'f10,J (+OR RCSIOi:Pd'r111!_ G�JILUihlG I'ERMITS
' (f1ev�, Alter��tions, AcldiLions, ot� Repairs)
�
(it�d(dGft: ��E1��v�u�__`� �.���c.�r(1S _ f3UILQER: � �"-�� �
ADDRESS: �,2��� ���Qr )� i��.�., �DDItESS: •
TCL �l0: �j �� � — �.� �� � 7EL (d0: '
Construction Location
.
s-rrir�� No :��'�.� s�r�r:T: K�� v
LO'P: 1y � BLOC't'.: _�� ADDITZON : LC�iC �2. � ��� Ia-�� S ..
Corner Lot: Insic3e Lot,: � Setback: Sidey�rds:
Ap�,�].i.c�zt: attach to this form t�cao Certi�icates a� Survey of lot and '
proposed building location drawn on certificates i.o scale.
' `-- �+�_
DESCRIPTIO(d OF CONSTRUCTIO(�
�'�-��� I'zont:
Squa�e.reeL-:
IMpth :
Clibic Feet:
H eight :
I?ront : Dept.h : H eight:
Square� Feei:: Cubic Feei::
�T��e of Coi�struc�ion: y„� � r �v�.a+�:�LT� �stimated Cost: $� ("�C) ,�T
�.b Be CbmUleted: l� �,___�._U�Y1� . �� �� ��
A1�. A Alt. �
Propased Driveway �4idth If New OpenirLg Is Desired: $� $ -
SEg REV�RS� SIDE OF SHEET .
�"iie undei-signed hereby makes applicat�ion for a permii. for the ti�ork herein speci�ied,
ac�reeitig to clo all �vork in str.ict accc>rdance with ttie City of ]�ridley OrdiTiances and
xuliysqs of the Depari�neiit of T3u.ildinc3s, and her.eby declares that all i:he fac�s and
representations stated iri tiiis applica�ion are true and cozrect.
A�1T�: �l ��._.(�(L� �.� ��'1 � SiGNATUF.� :
Sti��ulations :
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sue�ecT PERMI .
City of Fridley 180�b
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
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� ; L_ COMMUNITY DEVELOPMENT DIV. � 0�
r � � PROTECTIVE INSPECTION SEC. t
� . �
i
i---. A;/"'1,'j CITY HALL FRIOLE� 55432 NUMBER REV. OATE 11 PAGE OF APPROVED 8V
�' '� 612-571-3450 910-Ft5 6/�$/85 � /
JOB ADDRESS 6437 Baker Avenue N. E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 14 1 Moore Lake Highlands SHEET
2 PROPERTY OWNEFi MAIL ADDRESS ZtP PHONE
David Johnson 6437 Baker Avenue N.E.
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
Berg & Associates 3140 Harbor Lane, Plytqouth 559-0272
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS 21P PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW � ADDITION ❑ ALTERATION ❑ REPAIR O MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 12' x 24` Living �,re.a'A,ddition and a 20' x 24� G�rage Addition
9 CHANGE OF USE FROM TO
STIPULATIONS
Provide a hard surface driveway.�
���� B �������
efa�e ��g�« f��
��,�,����'� pERM,TS rEt�p � ��r! �fl�
r��q tING pL� FQU�R�D F �oruE - FtFCT,��� ��� �r��
' ����� AN �R ��Q UIR;� fl B Y �f�
D S�GNS. �A 1N
SEPARATE PERMITS ARE REOUIRED FOFi ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCV GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING. WOQC� FZ'�@
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZpNING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OFi 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 ANO EXAMINED THIS APPLICATION 1 STA�LS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND OROINANCES GOVERNING THIS TYPE OF WORK WILI BE COMPLIED $].H�HSO y�g.43
WITH WHET SPECIFIED HEFiE1N OR NO7. THE GRANTING OF A PERMIT
DOES NO - PR SUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISI NS ANY OTHER STATE R LOCAL LAW REGULATING corv- $134 . SO None
STR C ON THE PERF MANCE F CONSTRUCTION.
° /� �,,r PLAN CHECK FEE TOTAL FEE
(�'{/Vi $ 33 _ 63 $177 . 56
� NATUREOfCONT ACTOAORAUTHOR12EDAGENT ionrEi • . WHEN PROP�RIY VAL TEO THIS IS VOUR PERMIT
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S�GNA7UFlEOFOWNERIIFOWNEABUILDEA� IDATEI LDG iNSP TE
pEf�r [] City of Fridley Effeetive u/1/8�
ADDN. � �R-1 AND R-2
AL,TER. [ ] Building Permit Application
Construction Addr�ss: ��q'�� ��.F�i�i..
Legal Description:
Owner Name & Address: y�%�� ���'J Tel. #
Contractor: ��2(fl `�' ��YS 1 �P1�t'► z�S Tel .# 5�'�2%�
Address• � � qt� ��R260T� � • ��Y''���"'
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
6 DESCRIPTIOK 0� IMPROYEMENT _
LIDING AREA: Length �2 _ Width 2 Height �� Sq. Ft. 2�
GARAGE AREA: Length �0 Width ��{ Height �� Sq. Ft. �_
DECR AREA: Length Width Hgt/Ground Sq. Ft.
OTHER : � � �
�x �!� ��,�5�.� -� '�gx �P�I-I � 2 �2��i2.3'L 2 ig,��3.s- ,
Corner Lot [] Idside Lot [�j Ft. Yd. Setback Side Yard Setbaek
Type of Construction: ��'�Z � Estimated Cost: $ «. b �"� ��
Approx. Completion Date:
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: $ $
See Back Page for Explanation
,p � G
DATE: C�'_�"( � o� APPLI ^ Tel. #�_ I^ �°Z� �
CITY IISE ONLY
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
$ I��i .�
$ 3`�.�3
$ a• ��.._
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TOTAL $ _=s_���
3 oa
STIPULATIONS : � ` a, �' k�
�?,��- oY� `
Fee Schedule on Reverse Side
25� of Building Permit Fee
$.50/$1,000 Valuation
$425 per SAC Unit
Fee Determined by Engineering
Agreement Necessary [ J Not Necessary []
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PLYMOUTFi, MN 5544.1
(612) 559-0272
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3140 HARBOR LANE
PLYMOUTH, MN 5544�1
(612)559-0272
DE61GN/BUfLD, INC.
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C�TYOF
FRi DLEY
CIVIC CENTER • 643t UNIVERSITV AVE N E. FRIDLEY. MINNESOTA 55432 • PHONE (6121 571-3450
September 27, 1985
Berg & Associates
3140 Harbor Lane
Plymouth, MN 55441
Re: Construc tion of Garage Addition at 6437 Baker Avenue N.E., Fridley
Dear Sirs:
A final inspection was made on September 25, 1985 of the garage addition
that you constructed at the above noted address. The construction can not
be finaled out until the fire wall between the house and garage is secured.
We will expect this correction to be completed by October 14, 1985 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,
DARREL G. CLARK
Chief Building Official
DGC/mh
CC: Mr. David Johnson
6437 Baker Avenue N.E.
.
sue�ecT P MI .
City of Fridley o 18450
AT THE TOP OF THE TWINS B U I L D I N G P E R M I T
r
; � R O.
� ' L _____ COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC. �� � O
� �
i
�.--- �,�����;,� CITY HALL � FRIOLE� 55432 NUMBER REV. OATE PAGE OF APPROVED BY
1� 612-571-3450 910-F15 5/23/86 / /
JOB ADDRESS
6437 Baker Avenue N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 1L� 1 Moore Lake Highlands SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
David Johnson 6437 Baker Avenue N.E. 571-6278
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
ReSlC�P.rit].d�.
7 CLASS OF WORK
❑ NEW � ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 OESCRIBE WORK
Construct a 15' x 15� Deck
9 CHANGE QF USE FROM TO
STIPULATIONS
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 Ofi CONSTHUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITH4N 60 DAYS, OR 1F 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 HEFEBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES
ANO KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVEANING THIS TYPE OF WORK WILI BE COMPLIED �•1�300 $.6S
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- y�`22�00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECKFEE TOTALFEE
$ 5.50 $28.15
SIGNATUAEOFCONiRAC O RAUTHOAIZEDAGENT IDATEi WHEN PqOPERLY VA TED THIS I VOUR PERMIT
��� FO� OWNERBUILDERI IDATE� BLOG �NSP - �
� TE
NEW [ l City of Fridley Effective 4/1/86
ADDN. [] L R-1 AND R-2
ALTER. [ ] Building Permit Application
Construction Address: ��f�? ��►��✓' �T�c- %�
Legal Description:
Owner Name & Address: �p�+� � d" S�sa�. l� S��ks--� 6`t37 tSq�G- A•� NE Tel. # s�� -6778'
Contractor• Tel. �
.
Address•
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.
DECR AREA: Length _,.J S� Width J S� Hgt/Ground /-�'i` Sq. Ft. �„2S
OTHER:
2.2�'� ��1�0 S=2a Zd ���'30 1'L.51.3ti '� i'3ou
Corner Lot [] Inside Lot [] Ft. Yd. Setback Side Yard Setbae�
Type of Construction• wo Estimated Cost: $.�� ��
Approx. Completion Date: ��3d��
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: $ $
See Back Page for Explanation
DATE:
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
APPLICANT : IJa v�vC � �a � "' 1 "� Tel . � S` 7/ "G Z %�'
CITY IISE ONLY
� "2,2, 04
� ,sd
$ `
$ ��
� '',...
$ ��
$ +t,/
Fee Schedule on�Reverse Side
25� of Building Permit Fee
$.50/$1,000 Valuation
�475 per SAC Unit
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
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DESIGN/BU(LD, INC.
�
3140 HARBOR LANE
PLYMOUTH, MN 5544.1
(612) 559-0272
sue�ecT PE .
City of Fridley � 20273
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
; � RE O.
� ' y__ COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC. '3,�J�p y�
1 i
1 � /'��1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY
�""'�� ,�' 612-571-3450 910-F15 3/3Q/�0 / /
JOB ADDRESS 6437 Baker Avenue N,E,
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 14 �- Moore L�ke High3ands SNEET
2 PROPERTY OWNER MAIL ADDRESS 21P PHONE
David Johnson 6437 B:aker Avenue N.E, 571--6278
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION C�} ALTERATION ❑ REPAIR O MOVE ❑ REMOVE
S DESCRBE WOFiK
Remodel Basement
9 CHANGE OF USE FROM TO
STIPULATIONS
See notations on plan�
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIF CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCEO 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. AI.L PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES QOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $SOQ $ s 5Q
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAI LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $I.rJeOO
PLAN CHECKFEE TOTALFEE
$15.5Q
SiGNATURE OF CONTRACTOR OR A THORIZED AGENT IDATEI WHE PROPE Y I AT THIS IS YOUR PERMIT
� �.J�� � 3 �3 ��9d � � �Cj
SiGNATUF7EOFOWNERiIF NERBUILDERI �DATEI WSP ���
NEW [ ] EffeG�tive 1/1/90
�N j ] R-1 AND R-2�
AL'I'ER �q Building Permit Application
oonstrvcti� Aaare.ss: � y 3 � r3G ke�- f�-� �_
�31 �2SCY'l�lOri: �vT � � i5� ��- r 1�Y1�ur� �c, �� �'7�r�� �a�aC S
owner xame & Address : Oa V, �( Sa �� s ��. G' w 3 7 �'S.� k� �- /�.� a-r Te1. # s- ��-� z 7�
coritractor: Tel. #
Address:
Attach to this ap�lication, a Cextificate of Survey of the
lot, with the propo�ed canstruction drawn on it to scale.
.. «• .; . � � �• •.. � � ��
LNII�IG AREA: Length Width Height Sq. Ft.
CAR�,�GE AREA: Length Width Height Sq. Ft.
D�CR A�A: Length Width Hgt/Grrnuxl Sq. Ft.
O�I�It: R{,�.,��t( L 5��,,�� ���w- <_f 6<s��«�- tZ' x rz' -� �/ss, ft-
Corner Lot [] Inside Lot [) Ft. Yd Setback Side Yard Setbaaks
Zj�pe of Construction: Estimated Cost: $ S7JG. dc�
Approx. Ocet�letion Drate: `�u ( 3/ l� yC'
Proposed Driv�way Width If New Opening Is Desired: Ft. $ $
�/- i�� �=�---Width + 6' See Back Page
nA�: 3 3��9e ��c.�ar: � �'n- Tel. # s-�/ -62 7��
Permit Fee $ � j►�(}
State S�.ircharge $ � SQ
SAC C�arge $
Driveway Escrow $
Park Fee $
sewer Main Charge $
ft�v�
��Mi���i: �ti- ����
$�,% �. � V
CITY U3E �II,Y
Fee Schedule on REVers� Side
$.50/$1,000 Valuation
$600 per SAC Unit
Alt. "A" or Alt. "B" Akx�ve
Fee Det.ermined by �gineerincl
A�t Necessary [ ] Not NeoessaYy [ ]
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PURCHASE ORDER DATE DEPARTME
!o � 9 a 1.�� .,vs . F 2 2 3 5 6
PURCHASED BY THIS NUMBER MUST APPEAR
ON ALLCORRESPONDENCE
SENT TO US
-
_
C�TY OF
FRIDLEY
6431 UNN. AVE. N.E.
FRIDLEV, MN 55432-4384
612-57t-3450
�
0
THIS DOCUMENT GOOD FOR PURCHASES UNDER 51,000.00 ONLY
SUPPLIER � � I� � D -.IO i/1l.% �D �
ADDRESS �J /� / IEJ���/C r`7VC�
�/� i 1� L.�`r-c�/ ,� �7ti1 .�"5��3�
PHONE M0.
CONTACT
0
ENTER OUR ORDER FOR THE
0
PAYMENT VOUCHER
BY SI6NING THIS DOCUMENT BELOW I HEREDO AUTHORIZE
PAYMENT AND THAT THE GOODS ANO SERVICES HAVE BEEN
RECEIVED OR RENDERED AND ALL CITY GUIDELINES HAVE
BEEN FOLLOWED tN THE PROCUREMENT OF THE BELOW
STATED ITEMS.
TOTAL
THIS AGENCY HAS AGREED NOT TO DISCRIMINATE IN HIRING PRACTICES ON THE BASIS OF RACE, SEX, COLOR, CREED, MARITAL STATUS, RELIGION,
OR NATIONAL ORIGIN AND HAS AGREED TO TAKE AFFIRMATIVE ACTION TQ RECRUIT MINORITIES AND WOMEN INTO EMPLOYMENT. IT ENCOURAGES
FlRMS AND OTHER AGENCIES WITH WHOM IT PURCHASES PRODUCTS OR SERVICES TO DO LIKEWISE.
EXEMPT FROM SALES TAX AS A POLITICAL SUBDIVISON OF THE STATE OF MINNESOTA CITY OF FRIDLEY NO. 8030301
WHITE, VENDOR - YELLOW, PURCHASING - PINK, ACCOUNTING - GOLDEN ROD, DEPT. HD.
sue�ecr , ..B-Ef�isA1I�
City of Fridley 2 5 3 3 5
AT THE TOP OF TNE TWINS g U I L D I N G P E R M 1 T
f
� ` IPT NO.
� • COMMUNITY OEVELOPMENT DIV.
� �y'_"._ ,
f � � PROTECTIVE INSPECTION SEC. �.
i �
i � '
1 � /'��1 � CITY HALL FRIOIE� 55�32 NUMBER REV OATE PAGE Oi APPROVEO BY
�"""�' �'' 612-571-3450 9t0-F15 7/31/97 � �
JOB ADDRESS 6437 Baker Avenue NE
t IEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. Z�F 1 Moore Lake Highlands SMEET
2 PROPERTV OWNER MAIL AODRESS ZIP PNONE
David Johnson 6437 Baker Avenue NE
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Andover Exteriors 2780 S Coon Creek Drive, Andover MN 55304 754-0443
d ARCHITECT OR DESIGNER MAIL AODRESS ZIP PHONE LICENSE NO.
20052503
5 ENGINEER MAI� ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION C� REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WOHK
Reside Dwelling; Soffit & Fascia
9 CHANGE OF USE FROM TO
STIPULATIONS Install building wrap and have inspection of same unless
manufacturer`s specifications state it is not required. Install soffit
ventilation to meet the State Building Code.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, NEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. fT. CU. fT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTFUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANV TIME AFTER WORK IS. COMMEMCED. NO. OWLG. UNITS OFFSTREET PARKING
I HEREBY CEFTIfV THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 S7A�LS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS Of LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK W�LI BE COMPIIED $8�000 ��F.00
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTMORITV TO VIOLATE OR CANCEI THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTFiiR STATE OR L AL I.AW REGULATING CON- $137.25 Fire SC �H.00
STRUCTION OR THE PERFORMANCE OF NSTRUCTION.
' 1 PLAN CNECK FEE TOTAL FEE
� License SC $5.00 $154.25
� S�GNATU�7E OF CON FACTOA 0�7 AU�HOA�ZED AGENT iDATEi WNEN PROPERLV LID TED THIS IS VOUR PERMIT
. . - 7 3� 9�
SiGNATUREOF OWNERUF OWNE�:BU�IDEF�I IOATEI ` BLD �NSP pqTE
NEW
ADDN
ALTER
I1
[7
� l
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: �� 7
Legal Description:
��� ,�ve
Effective 1/1/97
Owner Name & Address: 1%,,, J d- 5��. ��i1� ti SG � Tel. #
Contractor: ��, �v� -�,� — ,� .� ,. � 'v � 5 MN LICENSE # �Qb .���D�
Address: �7gv S', CG- C/. ,C%�� ..�%�DL%� d� Tel. # 7S�/- o�-!c/3
�
Attach to this application, a Certificat� o�� rvey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
DESCRIPTION OF IlVIPROVEMENT
�ng� � Width
Length Width
�ng� Width
5�..� � � So ,��;� .�
�,� y L_
Height
Height
Hgt/Ground
Sq. Ft.
Sq. Ft.
Sq. Ft.
Construction Type: �i'J � Estirnated Cost: $ �, o��U
(F'ee Schedule on Back)
Driveway Curb Cirt Width Needed: Ft. + 6 Ft = Ft �x $ _$
, 1
DATE: �� % � 7 APPLICANT: r-----�- Tel. # �Z � ` �� %
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPUL�1"1'[ONS:
$ �1-�'1- �S
� o.OD
$ . D C>
$
$ �.CJ�J
$
$
$
$
� /'� - �S
CTTY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,000 Valuation
$950 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Ah�ve
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ) Not Necessary [ ]
sue�ecT IT N O.
City of Fridley 2 �2 g
AT THE TOP OF THE TWINS g � I L D I N G P E R M I T
f
� ` RECEIPT NO.
COMMUNITY OEVEIOPMENT OIV. �
r � L � PROTECTIVE INSPECTION SEC. �� �
� �
� _ �
' �'��1 � CITY HALL FRIOLEV 55�32 NUMBER REV DATE PAGE OF AVPROVED BV
�'.---�•� �•' 612-571-3450 9�0-F�5 8/19/98 � �
JOB ADDRESS
6437 Baker Avenue NE
1 LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 1(f 1 Moore Lake Hi hl n SHEET
2 PROPERTY OWNER MAIL AODRESS 21P PHONE
David Johnson -
3 CONTRACTOR MAIL ADDRESS ZIP PHONE �ICENSE NO.
Midwest Roofing & Siding 18979 Gladstone Blvd. Maple Grove 55311 416-4804 20010277
a ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS 21P PNONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WOf;K
O NEW O AODITION ❑ ALTERATION C�}X REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Reroof house and ara e 27 S Tear-off
9 CHANGE OP USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
CALL FOR ICE & WATER AND FINAL INSPECTIONS.
TYPE OF CONST. OCCUPANCV GROUP OCCUPANCV LOAD
SEPAAATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION ZONING SO. FT. CU. fT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONEO FOR A PERI00 OF 120 OAYS AT
ANY 71ME AF7ER WORK IS COMMEMCED. NO. OWLG. UNITS OFFS7FEET PARKING
I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GAFAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF �AWS yALUATION SURTAX
AND ORDINANCES GOVERNING THIS TVPE OF WORK WILL 8E COMPLIED
WITH WHETHER SPECIf1E0 HEREIN OR N07. THE GRAN7ING OF A PERMIT $2251 1.IZ
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS Of ANY OTHER STATE OR IOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. �7�F.JS Fire SC Z.ZS
PLAN CHECK FEE TOTA� FEE
License SC 5.00 83.12
S�GNAIURE OF CON'RACTOA OA AUTHOA�ZED AGENT IDATEi HEN PROPER� LIDATED THIS IS YOUR PERMI
SiGNATUREOFOWNEAUfOWNERBUI�DEA� IDATE� BLD ����NSP ' q4i
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