AF - 36624�
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�� �'��`� City of Fridley, Minn.
BUILDING PERMIT
�� o� � �
N° 6661
. .� �
Date: _.._ _ .. �.____... `4 -�---_._... _._..�_..._.._..._..
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Owner: . . - ...:_ �,! _ .__ _.� .. ._... .1.�.2�'�uilder .. . ....._ ._....::.. �j.��.........._..---�---�----....._..__..--
Address....._......._...._.._........._..._____..__...._..._..._ ................_...._...._..._......._.._ Address _..._..---.._..._.__....._..........._---....._........----._...--�---
LO T�N � O UI DI
No. ..[J/ .. �� Street �.. .. ....._.���r--�C��.�� ..... -�-- - " �'P Lot --�--�-�•-----� -•
�1� �," ..._ ..........--- ............._.......__.._............
� `�� � �
Lot ....._.. ....__..........._ Block ._.._..._... .. Addition or Sub- ivision
,�,�.........--�•---•--. � . ...... y�.�(�-�_.�:�=--._. .._.... .:. _
s`- / /
Corner Lot ------------.--.._........ Inside Lot .....- ............._..-.------.---.-- Setback ._.....L..�_. 1..
�-�----• --�•--�--- Sideyard ............ .. _ � �...__....._....---.__.._
Sewer Elevation _..._......._...._......._.--.---....._----.•---.-•----••----_...._ ............._......_ Foundation Elevation ...-•---..__...-------_...._...---_...•._._..--.....----...-•-•--.•----..�
DESCRIPTION OF BUILDING
To as:
L. _. ..._ ,C._ Fiont _.� Depth ..��..�..._. Height ...���.. Sq. F� �/..�-" Cu. FL l�r.���
.._._._........._._ ..._...._.....-----........ ,�.._._.........._.__ Depth .....__....... eight •-----..���, .-- Sq. Ft. ....._ ................. Cu. F� ....._.....__.----
Type of ConstructionV�!��1,�'!�i.J.k.�_.. Est. Cos �.��..�._..�.`.r:.r To be Completed ..........----....._....._. _____�_
In consideration of the issuance to me of a permit to construc �1the building describ ve, I agree to do
the proposed work in accordance with the description above se/�Eq�h � i�t c°m 1��, all p�r . �ions of
ordinances of the city of Fridley. /�/ /, i% / � //
In consideration of the payment of a fee of $._�. ��......._.., permit is hereby gra�ited 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 lceation, construction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at any tiyae�ugqn�v�3a�o� of any of the provisions of said
ordinancea. / 1///// 1
Building Inspector
• NOTICE:
Thh p�rmit do�s not eov�� the eonslru�iion, in�atlafion io� wieina. Plumbino. �as 6�afiny, s�w�r or wNsr. B� wn to »�
th� Building Intp�eMr for s�p�rat� p�rmks for th� ihms.
__ . W .. -p,�--
. '; , . ,. _
SUBJECT P .
City of Fridley , 12954
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
; � R .
� • COMMUNITY DEVELOPMENT DIV.
' j y �-"'-�
r � � PROTECTIVE INSPECTION SE�. 7��, /
,
' -�'�/'-�1, � CITY HALL FRIDLEV SS432 NUMBER REV. DATE PAGE OF APPROVED BY
� "' �� 612-560-3450
910-F15 5/21/75 � �
JOB ADDRESS
6606 Brookview Drive N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. '� 2 Brookview 2nd Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Orville Jacobson 6606 Brookview Drive N.E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Owner & Sussel Gara es
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZtP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
S lCl Il'tl
7 CLASS OF WORK
�1 NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 24' x 24' Garage
9 CHANGE OF USE FROM TO
STIPU�ATIONS provide a hard surface driveway. The single car garage not be used
for a commercial enterprise and that it be placed on a proper foundation.
Both accessory buildings match the appearance of the house. Both garages
meet all the Code requirements.
SEPERATE PERMITS REQUIRED FQR WIRING,
HEATING, PLUMBING AN� SfGNS.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OA AIR CONDITIONING. WOOCZ FY'dlCl(.'
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 R-1 SZS SZHO
ANY TIME AFTER WORK IS COMMENCED. N0. 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 4 262 2 1.3
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE
PROVISIONS OF ANY OTHER STATE OR IOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. ].1
PLAN CHECK FEE TOTAL FEE
$13.13 ,,
SiGNn7U /�OFCONraaCrOaOa rHOai2EDnGEN7 iDniEi \ WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
�b` . t.(. .. ' � '!'/ ^y�,./`�` �C.J `/w�..'V(..J i� �e� / `��i�
iGNATU EOFpWNER1IFOWN BUILDERI IDA EI BLDG i!+SP �IATE
APPLICATION FOR RESIDENTIAL., ALTERATION, I
OR AllDITION.BUILDING PERI�IIT
CITY OF FRIDLEY, MINNESOTA
OWNER' S NAME : l�',� `,.1� :, � ��a,n��%��'-zv �iUILDEFc: ,''-G-c;7Z�� � �� �.� � ��
✓ .�
ADDRES S : �l p � /���:�_��. � �.�.� ,� ;��. ADDRES S :
% � �
NO•. ,/.,.1 a f, STREET:�i',����-n;%i,�.cz-� l�:'i .
LOT : � BLOCK: _� ADDITION ; ,/-j� � � = _ ,. � �� �
�+•�" _.��t[(.�� �'i%�C'�'rl�-C
CORNER LOT: INSIDE LOT: �_SETBACK: SIDEYARD:
Applicant attach �o this fcrm �ao Certificates of Survey of Lot an3 prcposed
building location drawn on these Certificates.
�ESCRIPTION OF BUILDING
To Be Used As:
� ' . �ti Front : � �Depth : :� y Height • /G
,
Square Feet: Cubic Feet:
Front: Depth; Height:
Square Feet; Cubic Feet:
Type of Construction: ,�_,�_�.r,�, ��,,��,� Estima.ted Cost: $ <� � � � ��
To Ee Completed: � �
____�
The undersigned hereby makes applicativn for a permit for the work herein
specified, agreeing to do all work in stiict 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 corxect.
DATE : / `" , ,<<� / � ,S SIGNAT[JRE : f _ 1��, �i��,vv��� ����-��
//� -
(See I�everse Side For Additional Information.)
i1�-' � ,������. � .
�/l� ;, ��aan S�RF�4c�c� �n�u�w+� By su�,� 1,�4�y
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BUILDING PEI2MIT FEE SCHEllULE
SECTION 2. The Inspector of Buildings shall, before issuing permits for the
erection of any building or structure, or for any addition to any existing
building or structure, or for any alteration or repairs to any existing
building or structure, upon application therefore, require the payment by the
applicant for such permit of fees to the amount herein below set forth and in s
the manner herein provided to-wit:
UNIFORM BUILDING CODE: Type 1, 2& 4-$2.15 for each one thousand cubic
feet, or fraction thereof, in such cubical contents. Type 3& 5-$1.85 ior
each one thousand cubic feet.
ADDITIONAL INFORMATION
For the purpose of computing fees for building permits, the cubical contents
of any building or addition, is determined by multiplying the ground area
covered from a point six (6) �nches below the floor line of the basement
ox the cellar to the average heights of the up�er surface or i:o the average�
height of the roof surface of the main gable of a pitched roof.
For repairs or alterations to an existing structure, the fee shall be at the
rate of $3.00 per each five nundred dollars ($500.00) or fraction thereof in
the cost of all proposed work.
In no case shall the fee charged for any permit as set forth in Section 2 be
less than $5.00.
VERIFICATION OF FOUNDATION
NOTE: Permits for construction will be issued a minimum of 24 hours from the
time of application, to allow for proper review of the proposed structure and
of the construction site.
A Certified Survey of the lot, showing the location oi the foundation, once it
has been constructed, will be required before proceeding with the framing.
CERTIFICATE OF OCCUPANCY
Application for a Certificate of Occupancy shall be made ten (10) days prior
to the use or occupancy of any structure for which a building permit has been
issued; and said structure shall not be used or occupied until a Certificate
of Occupa.ncy has been issued.
�i �
1 r���` �
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWP�R' S NANIR /��k !�` l L � F - � � , '��`,� �j �-(/Ll =: �� iv BUILI�ER
ADDRESS �?(��'D �f?��i`(i'K�i � % f�) ��L�bDRESS
LOCATION OF BUILDING
No. (����•�;�" Street ����;'��F��✓�,�'t'<'��� Part of Lot
, /I,'_`��
Lot � Block �� Addition or Subdivision�,�, �����•k� /�-�,;, �,
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;
��f-�f�'��'a�=, Front ��� �C� �� Depth Height
Sq. Ft. Cu, Ft.
Front Depth Height
Sq. Ft . Cu . Ft .
Type of Construction ���,t��F 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 a11 the facts and
representations stated in this application are true and correct.
DATE
S iC>NATUItE
(cchedule of Fee Costs can be found on th� Pe�s�se Side).
.... � i _ ...
BUILDING PEItMIT FEE SCHEDULE
SPc.tion 2. The Inspector of Buildings sh�ll, before iasuing any perm�t for
�he erection of any building or structure, or for any addition to any exist-
in� bui�.ding or structure, or for any alterations or repairs to any existing
building or structure, upon application therefor, require the payment bq the
applicant for such permit of fees to the amount herein below set forth and
in the manner herein provided to-wit;
2.1. For any such permit for the erect,ion of any fire-proof buildin�, other
than a garage� warehouse, factory or grain elevator, or for the erection of
any fire-proof addition, for similar occupancy, to any existing building,
shall be at the rate of $i.40 for each one thousand cubic feet, or fraction
rt±ereof, in such cubical contents.
2.2. For any such permit for the erection of any fire-proof garage, warehouse,
factory or grain elevator, or for the erection of any fire-proof additioa,
for similar occupancy, to any existing building shall be at the rate of $1.25
for each one thousand cubic feet, classified as "fireproof" by Section 502 of
t:�e l:inneapolis Building Code.
EUUSES
2.3. For any such permit for the erection of any non-fireproof buildiag other
than a garage, warehouse, factory or grain elevator, or any non-fireproof
addition, for similar occupancy, to any existing building - permit $1.00 for
each one thousand cubic feet.
GARAGES
2.<<. For any such permit for the erection of any non-firepreof �arage,
w�rehouse, factory or grain elevator, or for the erection of any non-fir.eproof
addir.t�u,, for similar occupancy, to any existing building or for each such
t�u�lding or addition - ninety cents ($0.90) for each one thousand cubic feFt
or fraction thereof, in the cubical contents thereof with a minimum of $4.00.
For the purpose of computing £ees for building permits, the cubical contents
of any building or addition to a uniform height thzoughout by multiplying the
g�ound area covered from a point six (6) inches below the floor line of the
basement or cellar to the average height of the upper surface or to the
average height of the roof surface of the main gable of a pitched roof.
2.5. For repairs or alCerations to an existing structure, the fee shall be
at the rate of $3.00 per each Five Hundred Dollars ($500.00) or fraction
thereof in the cost of all propuaed work.
2.6. In no case shall the faP chargPd for a,1y perut9t as set forth in
Section 2 be less than $�i.00.
r- � , ..
.� . _ i � . . . _
SUBJECT P
CitY of Fridle MOVING
AT THE TOP OF THE TNlINS� O 1295
; ` BU ILDING PERMIT
ECE .
� • COMMUNITY DEVELOPMENT DIV.
' ; a: — � ��9�
r � PROTECTIVE INSPECTION SEC. 1
1
1 -�,��'-�1` � CITY HALL FRIDLEV 55432 NUMBER REV. DATE PAGE OF APPROVED BY
� "' �� 612-560-3450
910-F15 5/21 75 � �
JOB ADDRESS 6606 Brookview Drive N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. '] 2 Brookview Second SHEET
2 PROPERTYOWNER MAILADDFESS ZIP PHONE
Orville Jacobson 6606 Brookview Drive N.E.
3 CONTFACTOR MAIL ADDRESS Z�P 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
CI NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑x MOVE ❑ REMOVE
8 DESCRIBE WORK
Move garage from present location to be set back further on the lot
9 CHANGEOFUSEFROM TO
STIPULATIONS
See stipulations on Building Permit #12,954
SEPERAtE �ERMITS REQUtRED FOR WtRING,
H�ATING, PLUMBING AND S1GNS.
TYPEOFCONST. OCCUPANCYGROUP OCCUPANCYLOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING. WOOC� FY
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
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEFMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECKFEE TOTALFEE
SIGNATUREOFCONTRACTO ORAUTHOR12EDAGENT �onTe� WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
� i �a i'" � w _ � i�'a. / � � -Q � �� F�C 2.��J � �7 ! ''le�.
SiGNATUREOFOWNERUf NERBUILDERI iD EI BLDG iNSP DATE
�—City of Fridley
i f AT TIIE TOP OM TNE TWINY
� ,
� e L
Ir j t,"^�'-� COMM�iN�TY pEVE1,.0/MENT OIV.
� � P�QTECTrvR iM�CT1pN 0[rT,
I � i ' CITV NAI.L fRIpLtY Fi�MQ
/'--1 i
! �----�,� �.a s��-ew-3.sa
Yzoperty Owner �
/r � tzL'v�.
resent Lot D Bloc c No
Legal �
To Be
Moved To �
Mover
� �,�-�J
Expecte Time xn ox 'I'�ru Fx�I
Routing
tuBJECT
MOVI�`�G P�RMIT APP�ICATIOiJ
iv-rci � v
Addxeas
�
act or x.t
�
� /�-a�c,u-c<
, ress
Estimat
Approved By:
Utilities Notified: Stat� whe�her notif�.ed and date
2/15/73 I 1 1
os
Minneapolis Gas Company
Engineering pepartmenk `���'
372-4850
N�rthern States Power Compar�y
Customer Business Off�ce ?�`'`�
330-.�540
Northwestern Be11 Teleph4ne Cq. •
Business Offic� �='�'>?X-�
332-4112
Approved By Wa�er & Sewer Departmen�:
All Bill� Are Paid
Yermit No.� f
Receipt No.
�800____
one
--Zicense-ZVo. �
Servicea Are Disconnected
' The unders�gn�d hexeby malces appli.cation for � permit ts� move� tl�e building
�des�ribed above, a$re��.n& ta do ���, work in strict ac�ordance with tha City
�QXdin�nces and x'uling& pf ��� Depa�rGment of �uildinga, and hereby declares that
�11 �acts and xepxeaenCations &tated �.n thi.e appli.cation ar� fixue and corxect.
� ��
� � j - ��
�� ��
i � � (j a Co�ntractar ,i
i �'
.I• .
.�
h� �i i���5 . I
f� �� �ate � ;
� - - ---- - ;� _ - -- — - -- -- ---� __-- __ _ __ _.. .. .'
FIRE DEPARTMENT MEMO �'��7��
____
T0: BUILDING INSPECTION �
ASSESSING
.
�
SUBJECT: FIRE DAMAGED STRUCTURE DATE: July 24, 1987
FIRE HAS OCCURRED AT
6606 Brookview Drive.
DDRESS
July 24, 1987
D TE F RE
�
FD-7
City of Fridley
AT THE TOP OF THE TWINS
r
� �
� �
� ; y __.__ COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC.
1 �
i
`._--����"'1�'� CITY HALL FRIDLEv 55432
i 612-571-3450
SUBJECT
BUILDING PERMIT/
NUMBER REV. DATE PAGE OF
910-F15 10/8/87 � �
JOB ADDRESS 6606 Brookview Drive N.E.
1 LEGAL LOT N0. BLOCK TRACT OR ADDITION
DESCR. 7 2 Brookview 2nd Addition
2 PROPERTY OWNER MAIL ADDRESS ZIP
Orville Jacobson 6606 Brookview Drive N.E.
3 CONTRACTOR MAIL ADDRESS ZIP
Kaymar Enterprises Inc. P.O. Box 425, Bemidji, MN 56601
4 ARCHITECT OR DESIGNER MAIL ADDRESS Z�P
5 ENGINEER
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW
B OESCRIBE WORK
Repair of Fire
9 CHANGE OF USE FROM
STIPULATIONS
MAIL ADDRESS
❑ ADDITION O ALTERATION
TO
ZIP
�l REPAIR
°/_19235
R E C ETPfi N6�
a�s3i
APPROVED BV
SEEATTACHED
SHEET
PHONE
571-3524
PHONE LICENSE NO.
751-8929
PHONE LICENSE NO.
PHONE UCENSENO
❑ MOVE O REMOVE
Install products of combustion fire alarms on all levels including
basement. New window in dormer must meet egress requirements is
serving a bedroom.
SEr,�n�11�� f-'�;�1�.��T� i?��Jl�ED FOR
Wlh°�f(�, h�Aji�,��, f'L�NIBING AND SIGNS.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONS7. 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
ANV 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 $6rSOO S3.2S
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHAFGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
S TION OR THE PERFORMANC OF CONSTRUCTION. $GZ . SO
PLAN CHECKFEE TOTALFEE
��� - � �.� � � iy��r s65.�5
SIGNAT OFCON RACTORORAU7HOR12EDAGENT io Ei � WHEN PROPERLY V DATED THIS IS YOUR PERMIT
SiGNnTUREOF OWNERiIF OWNER BUiLDER� �DATEi ��� � ���� �/r `
__ _ _ . BLDG iNSP � �rc i
NEW [ ]
ADDN. [ ]
pLTER. [ ]
Construction Address:
City of Fridley
� R-1 AND R-�
Building Permit Application
0
Effective �/1/86
i'/�l .Ul t-
Legal Deseription:
Owner Name & Address: d��/1�� g ��'Zyl- ������� Tel. � s��".3SL�
Contractor: Kaymar Enterprises n Tel. � 218-751-8929
Address• P• 0. Box 425� Bemid�i, M[�11 56601
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale. �
t�v �s � ��'�'�` p � �
DESCRIPTION OF IMPROYEMENT S
LIVING AREA: Length
GARAGE AREA: Length
DECR AREA• L th
OTHER : I� � � �-- � r�"i � /`
Corner Lot [ ] Inside Lot [ ]
L ���,i .✓��r (r��e�
Width Height S�. Ft.
Width Height Sq. Ft.
Width Hgt/Ground Sq. Ft. �
u n �� �� Jo �� r f� r`� G� '_ C� `' L��, �- __ X�� l
Ft. Yd. Setback Side Yard Setback
Type of Construction: fire damagQ Estimated Cost: $ ���nn.n� _
Approx. Completion Date: September 30, 1987
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: N/A $ $
�See Baek Page for Explanation
" �. G�ou�a,..,.
. h /t/: (�/�/,�L-r�Or�i \�cY>
DATE. a-� /�l APPLICANT: Tel. � ��l " �yL�
CITY IISE ONLY
Permit Fee $ ��W Fee Schedule on Reverse Side
Plan Check $ �"� 25� of Building Permit Fee
State Surcharge $ aJ $•50/$1,000 Valuation
SAC Charge $ $ 525 per SAC Unit
Park Fee $ Fee Determined by Engineering
�500 �
��`� (��� 3''J.Ov
v" � �...���
�"��
Sewer Main Charge $
� S�'� Agreement Necessary [] Not Necessary []
TOTAL ��$
STIPULATIONS: �•�
�
L�K/1J�'"' , .
' / � � �
/
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� ti�it�) I.ut.�oow W O�H r+tiC►s6 N�IUW'. �G2�s �i�i,f�u�nM R�ur't
S�:Rv�•:i� A 3'i� �w
i� �M3"
BUILDING PERMIT FEE SCHEDOLE
The Chief Building Official shall, before issuing permits for the erection of any
building or structure, or for any addition to any existing building or structure, or
for any alteration or repair to any existing building or structure, upon applicatio n
therefore, require the payment by the applicant for such permit of fees to the amount
herein below set forth and in the manner herein provided to-wit:
Total Valuation
$1.00 to $500.00
$501.00 to $2,000.00
$2,001.00 to $25,000.00
$25,001.00 to $50,000.00
$50,001.00 to $100,000.00
$100,001.00 and up
Fees
$10.00 (Minimum Fee is $15.00)
$10.00 for the first $500 plus $1.50 for each
additional $100 or fraction thereof, to and including
$2,000.
$32•50 for the first $2,000 plus $6.00 for each
additional $1,000 or fraction thereof, to and
ineluding $25,000.
$170.50 for the first
additional $1,000 or
ineluding $50,000.
$283.00 for the first
additional $1,000 or
including $100,000.
$25,000 plus $4.50 for each
fraction thereof, to and
$50,000 plus $3.00 for each
fraction thereof, to and
$�33•00 for the first $100,000 plus $2.50 for each
additional $1,000 or fraction thereof.
DRIVEWAY DEPRESSION ESCROSi
(Concrete Curb Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus
6 feet times $13•50
Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $15.75
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 2u hours from the time of
application to allow for proper review of the proposed structure and of the
construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it
has been eonstructed will be required before proceeding with the framing.
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sue�ecr P
c�ty of Fridley �;- � � � 2
AT THE TOP Of THE TWINS g U I L D I N G P E R M I T
r —
; � RECEIPT NO.
� COMMUNITV DEVELOPMENT DIV.
� � v � PROTECTIVE INSPECTION SEC
r , ��% �- 'Z
( ' ����1 � CITY HALL FRIDLEV 55432 NUMBER REV DATE PAGE OF APPROVED BV
�----�'� �'� 612-571-3450 910-F15 3/21/97 � �
JOB ADDRESS 6606 Brookview Drive NE
1 LEGAL LOT NO. BLOCK TRAGT OR ADDITION SEE ATTACHED
DESCR. ] 2 Brookview 2nd Addition SHEET
2 PROPERTV OWNER MAII ADDRES$ ZIP PHONE
Orville Jacobson 6606 Brookview Drive NE 571-3524
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO
Builders & Remodelers 3517 Hennepin Ave S, M ls., MN 55408 827-5481 1100
4 ARCHITECT OR DESIGNER MAIL ADORESS 21P PHONE LICENSE NO
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR O MOVE O REMOVE
X
8 DESCRIBE WORK
Replace 9 Windows
9 CHANGEOFUSEFROM TO
STIPULATIONS
Replacement bedroom windows must meet the State Egress Code.
Install smoke detectors to meet the State Building Code.
TYPEOFCONST OCCUPANCYGROUP OCCUPANCVLOAD
SEPARATE PERMiTS ARE REQUIRED FOR ELECTRICAI, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZpNING SO. PT CU FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OH WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 OAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO DWLG. UNITS OFFSTREET PARKING
1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STA�LS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VA�UATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED �5�779 �Z.H9
WITN WHE7HER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- � 112. 2S Fire SC �S .%H
STRUCTION OR E PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE TOTAL FEE
�. � ��`� License S $5.00 $ 92
SiGNnruaEOFCON'�nCiOROanuTr+OAiZeon NT� IDATE� E OPERLV ALIDATED T YOUA PERMIT
�-�% �%
S�GNATUREOFOWNEa�IFOWNERBUILDEAi IOATEi " B �NSP nF1E
NEW [ �
ADDN [ ]
ALTER [ ]
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: ����b( �� ao /Tv� c�✓ �i� �r°��N
Legal Description:
Effective 1/ 1/97
Owner Name & Address: o.� v; //c ,/� � 0 6 sv.� S',d�h" _ Tel. #��/ 3�� Z y
Contractor:/�,�� ,`/�.r -� /c'�,�.t�� �P�s �c MN LICENSE# Q�OI/CU
Address: 3s/ 7/�e.�.,-�o,n �L-� S /`7.�/s Tel. # gz 7,:.SSY�j
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Construction Type:
DESCRIPTION OF IlVIPROVEMENT
Length
Length
I.ength
lQ ���
� �y� �'��<�? �l l �C�
Driveway C�.ub C�t Width Needed:
Width
Width
Width
�
(n y)U� c ,
Ft. + 6 Ft =
0
Height
Height
G��,
_ Sq. Ft. _
_ Sq. Ft. _
Sq. Ft.
��o�� �� �
Estimated Cost: $ �% �% �
(Fee Schedule on Back)
Ft x $ = $
DATE: 3 2 APPLICANT: � i'/�,.,,� �;� Tel. #�z � 5���
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
� l ��. �s
� � . '7�
$ �.
$
$ .���d
$
$
$
$
� ��.� . -
CITY USE ONLY
Fee Schedule on Reverse Side
.00l of Permit Valuation (1/lOth%)
$.50/$1,000 Valuation
$950 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Deternuned by Engineering
Agreement Necessary [ ] Not Necessary [ ]
. .-
. BUILDING PERMIT FEE SCHEDULL
The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for
any addition to any existing building or structure, or for any alteration or repair to any existing building or
structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount
herein below set forth and in the manner herein provided to-wit:
� TOTAL VALUE
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$100, 001 to $500, 000
$500,001 to $1,000,000
$1, 000,001 and up
FEES _ • :�. _, . <,
$21 (Minimum Fee is $21 plus surcharge)
$21 for first $500 plus $2.75 for each additional $100 or
fraction thereof, to and including $2,000
$62.25 for first $2,000 plus $12.50 for each additional $1,000
or fraction thereof, to and including $25,000
$349.75 for fust $25,000 plus $9.00 for each additional $1,000
or fraction thereof, to and including $50,000
$574.75 for first $50,000 plus $6.25 for each additional
$1,000 or fraction thereof, to and including $1Q0,000
$887.25 for first $100,000 plus $5.00 for each additional
$1,000 or fraction thereof,.to and including $500,000
$2887.25 for the first $500,000 plus $4.25 for each addidonal
$1,000 or fraction thereof, to and including $1,000,000
$5012.25 for the first $1,000,000 plus $2.75 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50_
Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $15.75.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minunum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed
���iil be required before proceeding with the framing.
s�s�ecT PEFdAbI� NQ.
c�ty of Fridley ., ,;,;3 �
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T ��/�
r
� � RECEI�Tl�6
� COMMUNITY DEVELOPMENT DIV
' � ti.- -
r � � PROTECTIVE INSPECTION SEC ���i ���
i . �
� � �'�'1 � CITY HALL FRIDLE� 55432 NUMBER REV DATE PAGE OF qPpROVED Bv
�""'"��� ,'' 612-571-3450 9�0-F15 7/14/97 � �
J08 ADDRESS 6606 Brookview Drive NE
i LEGAL LOT N0. BLOCK TRAC1 OR ADDITION SEE ATTACHED
DESCR. % 2 Brookview 2nd Addition SHEET
2 PROPERTV OWNER MAIL ADDRESS ZIP PHONE
Orville Jacobson 6606 Brookview Drive NE 571-3524
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO
Builders & Remodelers 3517 Hennepin Ave S, Mpls., MN 55408 827-5481 1100
4 ARCHITECT OR DESIGNER MAIL ADORESS ZIP PHONE LICENSE NO
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CIASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION fKJ REPAIR � MOVE ❑ REMOVE
8 DESCRIBE WORK
Reside House, Soffit & Fascia; Storm Door; 2 Door Canopies
9 CHANGEOFUSEFROM TO
STIPULATIONS
Canopies must be supported by frost footings. Provide smoke detectors
to meet the State Building Code.
TYPEOPCONST. OCCUPANCVGROUP OCCUPANCVLOAD
SEPARATE PERMiTS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED Ofi ABANDONED FOfi A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFV THAT 1 HAVE READ AND EXAMINED THIS APPLICATION 1 STAILS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND OROINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED �iS,975 ��.9H
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pEiiM1T FEE SAC CMARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW FEGULATING CON- �23� � 25 Fire SC �p iS . 9H
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
���� G/� PLAN CHECK FEE TOTAI FEE
�_�y_p� License SC $5.00 $266.21
� S�GNATUFlEOFCON�RACTOROFlAUTHOA�ZEDAGENT 1DATEI WHEN PROPER ALIDATED THIS IS YOUJR PERMIT )//
� � / �/ �^ / /
S�GNATURE OF pWNEP i�F OWNER BU�LDE�71 IDATE� BlD �NSP natE
NEW
ADDN
ALTER
[l
[ l
L l
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BU[LDING PERMIT APPLICATIOIV
ConstructionAddress CG a� �,2 0 o,t �„r w ��
Legal Description:
Owner Name & Address: o it �i c. �� J,4 � d� f o,,�
Contractor: ��,
Address
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
�
uE, S
Effective 1/1/97
� �i.� �r�'a-'3
Tel. # ,r7/ - 3,,-� y
MN LICENSE # //o 0
U�� Tel. # �.z �_,s'y��
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
Length
Length
L.ength
DESCRIPTION OF IMPROVEMENT
Width
Width
Width
Height
Height
Hgt/Ground
Sq. Ft.
Sq. Ft.
Sq. Ft.
S/D/�G .S'l••f CA/�/NC, JT•ar .00eh
Construction Type:� �,,,�n z,000,,.. CANO/YJ Fstimated Cost: $ �,s, ��,T�
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft �x $ _$
DATE: �-, y_ 9� APPLICANT: /�,�j� i%j� --� Tel. # d'� 7-.rY�/
0
Permit Fee
Fue Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park I'ee
Sewer Main Charge
TO"I�A L
S"T[Pt JL��"1'IONS:
CITY USE ONLY ��fUS�
�I � l�y
$_ � � �% . �� Fee Schedule on Reverse Side ��
$ � S� d.001 of Pe ' � �/,� S
� , rmit Valuation (1/lOth%) �� - ��
� � �- �� $. 50/$1, 000 Valuation �"' � �
� $950 per SAC Unit � � �
� �
� � � �� �� $5.00 (State Licensed Residential Contractors) � )�
$ Alt. "A" or Alt. "B" Above �' c`,/' '
�
$ $450.00 Conservation Plan Review �U• �
$ Fee Determined by Engineerin�
� �
� Agreement Necessary [ ] Not Necessary ( ]
�_ ���Q�o��
(3UILDING PERM[T FEE SCHEDC,'[.,E
"1'he Chief I3uilding Officia( shall, before issuing pern�its for the erection of any building or structure, or far
any addition to any cxistiii� building or structure, or for any alteration or repair to any ezisting buildin� or
st�ucrure, upon application tlierefore, require the payment by the applicant for such permit of fees to the amount
herein below set forth and in the manner herein provided to-wit:
TOTAL VALUE
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000
FEES
$21 (Minimum Fee is $21 plus surcharge)
.
$21 for first $500 plus $2.75 for each additional $100 or
fraction thereof, to and including $2,000
$62.25 for first $2,000 plus $12.50 for each additional $1,000
or fraction thereof, to and including $25,000
$349.75 for first $25,000 plus $9.00 for each additional $1,000
or fraction thereof, to and including $50,000
$50,001 to $100,000 $574.75 for first $50,000 plus $6.25 for each additional
$1,000 or fraction thereaf, to and including $1Q0,000
$100,001 to $500,000
$500,001 to $1,000,000
$1,000,001 and up
$887.25 for fust $IOO,OOU plus $5.00 for each additional
$1,OOO�or fraction thereof,�to and including $500,000
�
$2887.25 for the fust $500,000 plus $4.25 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$5012.25 for the first $1,000,000 plus $2.75 for each additional
$1, 000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - Drive�vay width plus 6 feet times $13.>0.
Alternate "B": Removal and replacement of curb and gutter and install a� foot wide
approacti with 6 inch depth - Driveway width plus 6 feet tirnes $15.75.
VERIFICATION OF FOUNDATION
Permits for cons[ruction wi(I be issued a minimum of 24 hours from the time of ap�lication to allow tor pro,�er
rc��iew of the proposed structure and of the construction site.
�'� �e�-tif�i�ate ot Survey of tlte lot, shc����iag the location of'the foundation �>nce it has it has he�r� constr�.ic�_-�.:
�i-i'; h;� rcyuirccl l�cf�c�r� r�r�jc�cciin�� t��irt.1 ihe ;ramin�=.
�
Building IVj�i C�ANICA�, Permit No.� �-�X.�� 1�
Inspections R.�.SI�EI�ITIAL APPLICA�'�QN Received By:
763-�72-3604 ��[�y �]F FR:�DLEY Date Rec'd� � � ���'
DATE �.-- I�" �� YOUR E-MAIL ADDRESS
3ITE ADDRESS L b � b ��- G � Ic. e...a 7R. � � n=t �J � c oJ S 3�-
THIS APPLICANT IS; � OWNER �CONTR.ACTOR
PROPERTY
OWNER/
TENANT
NAME: t G G-w_ f� J'�' ie_ o- S LJ ..�, �r-
ADDRESS: � l0 0 1a J4' �' .�S,o•n, CITY � rC �� 1 e S7'ATE r� � ZIP 5 S�3-�
PHONE: i� 3- 5? l- 13 a ��
CONTRACTOR � COMPANY
k. T'l t � o, (
SUBMIT A COPY OF CONTACT PERSON� Ch'� � s �-�
YOUR STATE STATE LICENSE � EXP DATE
LICENSE WITH p]�DRESS: ��1 ola 1��-4n �1h • CITY � R� � �'•=- STATE � N ZIP `�,�3�-
APPLICATION PHO� �� 3_��`_i ' a � j j FAX
PEI2NIIT TYPE
TYPE OF WORK:
�( SINGLE FA1vIILY ❑ TWO FAMILY
❑ �W p REPLACEMEN7'
❑ TOWNHOUSE
j�ALTERATI ON/REMODEL
DETAILED DESCRIPTION OF WORK r► S�-� � i o. � c�n D�' �4 « s� i c �c s T✓� S-t h= �'
PER MS 16B.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.OS =
FOR PROJECTS WHER-E LABOR EXCEEDS $500, FEES A.RE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOT'ED. FiX'TURES: (INDICATE TOTAL
NUMBER OF EACH BELOV�
EquipmentInstalicd . MFG: �J}�c- MODEL: LNECDl1 ?D R�! SIZE/BTU 30. oU•J
MFG: MODEL: SIZEBTU --`
MFG; MODEL: StZE/BTU
A/C $25.00 a' FIREPLACE (GAS) $15.00 _GAS RANGFJOVEN $10.00
AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 ,_NEW GAS GRILL 510.00
BOILER $35.00 _FURNACE 535.00 _GAS UMI' HTR $10.00
CHIMNEY LINER $10.00 GAS DRYER $10.00 _POOL HEATER $35.00
— GAS PIPING $10.00 VENTILATOR $15.00
DUCT W ORK $10.00 _ _ . . . .. . ,; __ , -.— _,::._.._.�__:.:.. .....,.;..:w x .,. �:,.,.�, �.ns�srinw'�n'r n
Permit Fee
Surcharge
TOTAL DUE
...�:,,.,a:. .,:...,., ,.., .:,..,_ .. ..... . .. ...:.. . _
$�, o u Number of fixtures @$10.00 x$10.00 =
$ .50 Number of fixtures @ $15.00 � x �15.00 = $ ►5. �
$ � s �_ Number of fixtures @$25.00 x$25.00 =$
Number of fixtures @ $35.00 x $35.00 = $
State Surcharge = $ 50
Tota1 = $�
THIS IS AN APPLICATION FOR A PERM�T-NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota �Construction Codes; that I understand this is
not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the
approved plan in the case of all work which requires review and approval of plans.
SIGNATURE OF APPLICANT ��-�l � a�� �k'I PR.IN� NAME riS �DATE p�- I� ��7
City of Fridley
Building inspections �epartrnent
6431 University Avenue NE, Fridley, MN 55432
763-�72-3604
r. n v• �� ;_Sfl�_d977
�
REQUIRED INFORMATION NEEDED TO PROCESS PERMIi
RESIDENTIAL PERMIT APPLiCATION HVAC
❑ NEW HOMESIADDITIONS ❑ EXlSTlNG HOME ❑ MAKE-UP AlR
REQUIRED FOR NEW/EXISTING HOMES
l. Combustion Air (See note below)
� Oil or solid fuel ]MC Chapter 7 with MN Amendments
b. NatZU'a.l Gas or Propane/IFGC Chapter 3 with � Amendments �
2. Make-up Air (See note below)
a. IMC Chapter 5 with MN Arnendments
3. V enting
a. Gas appliances IFGC Chapter S with MN Amendments
b. Fuel other than gas 1MC Chapter 8 with MN Amendments
REQUIRED FOR NEW HOMES
4. Heat loss & cooling load per room
� Required on new cons�uction JMC 1346.0312
5. V entilation
� per MN Energy Code 7670 or 7672
6. Duct Design Per IMC 1346.0603.2
a. ACCA Mauual D
1�T0'I'�: Centerpoin.t Energy Mechanical Code Guidelines soffware may be used for
combustion and make up air calculations