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AF - 43929C C� � � � � a�� l� Date: Ovnner i � City of Fridley, Mi.n.n. �� BUILDING PERMIT No s s 61: _..._.�' ��' _��.. �__ . .__ _..._ .._ . _._ _._ _ __._ .__ � � ; : . ..� _. _ :_. . ._ .�.�.i��uilder _ . ....._ _..:..._. _... .... ..., .. .........._......._.._..__..._..__ Address.._._......._�.._._........._..._.__._.._..__.._..._ .._...__..........._..._...__....._.._. Address LO T�N `O I DI No. _([l... . S�'S��:. Street _ -• •._.� .. .. .�/.':_t�.��. ..... ,...� #� Lot ............... __..._......___._..__......._.w.._.._. Lot .....__ ...__....._.....__ Block •••---......... . ...._ _. _ : .. .._._.._..._._: � .__.. ._ _ �.....� Addition or Sub- ivi�si� i��:!`'� Corner Lot ...__..--•......._....... Inside Lot ....._............_..._ .............. Setback .�'�_.._�.�....----•-•_--•-.--. Sideyard _.........._l..._.:�._.........___.__._...._.._ Sewer Elevatian Foundation Elevation DESCRIPTION OF BUILDING To as: __ _ ..... .,L.. Front _..o.f..Z,L. Depth .,�.�..._. Height ...��.. Sq. F� �.a�!�` Cu. Ft �� _.____....__ ...._..._.......__...._ _____.......__ Depth _...__...... eight ....._.. . .. Sq. Ft. •----_....._..._.. Cu. F� _-•-••-.._._— ��%, �� Type of ConstructionVk�r�..�.�._.?�;�'y�'.,�"�.'".. Est. Cos �•(.�,�..'�.`."`.r To be Completed In consideration of the issuance to me of a pernut to construc e building th� proposed work in accordance with the description above set �', co ordinances oP the city of Fridley. �� /��. � �� z In ca�sfderatfon of the payment of a fee of �.__ __�_.., permit is hereby I agree to do prFwisions of to_____.� _ _.._ .. to construct the building or addition as described above. This permit is granted upon ...___._._....___.._.._...----......_._. _.___. the expr�s 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 buildinga within the dty limits and this permit may be revoked at any tiyae.,ugqn, �1� of any of the provisions of said ordinances. / I// '// Building Inspector • NOTICE: ih& p�neit doa noi eov�e !hs eonslrueHoe, insh11N1on fo� wirin�, Phnnbing. gas h�afia�, snw�r or waNr. 8� wn to sM th� Buildiag Intp�efor for ap�raN p�rmih for th� if�ms. SUBJECT P 12954�� Gity of Fridley 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. r � -----, %'�� / / � ~ � PROTECTIVE INSPECTION SEC. � � � � /'��1 � CITY HALL � FRIDLEY 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 211C1 AC1C�1't10I1 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Orville Jacobson 6606 Brookview Drive N.E. 3 CONTRACTOR MAIL ADDFiESS ZIP PHONE LICENSE NO. Owner & Sussel Ga.ra es 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 6 USE OF BUILDING S� 7 CLASS OF WORK �l NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 24' x 24' Garage 9 CHANGE QF USE FROM TO STIPULATIONS provide a hard surface driveway. The sinqle car garage not be used for a commercial enterprise and tha.t it be placed on a proper foundation. Both accessory buiZdings match the appearance of the house. Both garages meet all the Code requirements. SEPERATE PERMITS REQUIRED FOR WtRING, HEA�'iNG, PLUMBING AN€� SfGNS. TYPEOFCONST. OCCUPANCY GROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. WOOCl F1'3ICLe 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�l SZH SZSO 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 PROVISlONS 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 L� 2 2 2 13 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECKFEE TOTA�FEE $13.13 �,� SIGNATU OFCON�aqC70ROR THORIZEDAGENT IDn7Ei WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT �� ' 4 l.�-�X1L�c.J S -� ! -7S`"t„ , iGNATUREOFOWNERIIFOWN BUILDERI � IDA I BLDG INSP DATE APPLICATION FOR RESIDENTIAL., ALTERATION, � OR AllDITION. BUII,DING PERI�4IT CITY OF FRIDLEY, MINNESOTA � OWNER' S NAME • �� i? -�,�,,o--f�y-�.� F�U ILDEFc : _i `C-�%72� � � � � ` , � �.� -� ADDRESS : �lQ , ��i�,, , ,rrtz,�� Ay//. ADDRES.r, : � r�� NO • . � l a �L_ S TREET : �� : 5 ��-..e,�- �7 . - • � LOT : ,�_ BLOCK:_ � ADDITION :_,� �,..�r.�� ,vs�J�-� �� CORNER LOT: INSIDE ZOT:�_SETBACK: SIDEYARD: Applicant attavY: �o this form Ztao Certificates o.f Survey of L�t and prcposed building location drawn on these Certificates. r HESCRIPTION OF BUILDING To Be Used As: � Front : �� _Depth : a S/ Height : /O � Square Feet: Cubic.Feet: Front: Depth: Height: Square Feet; Cubic Feet: �rpe of Construction: ��`, �� Estimated Cost: �.�� d To Be Completed: �� The undersigned hereby ma.kes 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 hexeby declares that all the facts and representations stated in this application are true and correct. DATE : . � � cz- / � S SIGNATURE • `"' � '�' (See $everse Side For Additional Information.) � �a � �.��z � • � s��,� I, �4�4 � / � � iia a n 5� R F�4c � � �n � u �'�+wt � �� , _ �` . � �• �d �� oK C�GD�t.�11 /� � � '; _ ,� APPLICATION FOR BUILDING PERMIT CIZ�'Y OF ,F$IDLEY, MINNESbTA owr��'s N�?�i�lfl��_��_,'��lN`�G/� BuiL��at ADDRESS �ij �Cj DO C?.�'�(J �C�i'C��(J �� _�jbDRESS LOCATION OF BUILDING No. (,�•vc% Street ��(;,y��//,�!/�JQ�, Part of Lot Lot �� Block �_Addition or Subdivision�,�+� �: f��,�," �� Corner Lot Inside Lot Setback Side-Yard SEWER ELEVATION FOUNDATIdN ELEVATION Applicant attach to this form Two Certificate8 of Survey of Lot and proposed build- ing location drawn on these Certificates. DESCRIPTION OF BUILDING To be used as: C.�f,�-�c��,�_.....- Front �� O �' DepCh - Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft .: Cu . Ft . Type of Construction ��,t�,t,�� Estimated Cost ��G'C� � To be Compl.eted 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 a1.1 the facts and representations stated in this application are true and correct. DA�'E S ZGNATITRE (schedule of Fee Costs can be found on th� �e��se Side). �_ ... � � � , . � SUBJECT P CitY of Fridle �ov�c AT THE TOP OF THE TWINS� O 1295 ; ` BU ILDING PERMIT E�E . � ; L _ COMMUNITY DEVELOPMENT DIV. �� / r � � PROTECTIVE INSPECTION SEG � / / ` � �/'��; � CITY HALL FRIDLEY 55432 NUMBER REV. DATE � PAGE OF APPROVED BY `""'�' '� 612-560-3450 910-F15 5 21 75 � � �oe ,aooRess 66Q6 Brookview Drive N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. '] 2 Brookview Second s"EET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Orville Jacobson 66Q6 Brookview Drive N.E. 3 CONTRACTOR MAI� ADDRESS Z�P PHONE LICENSE NO. Same 4 ARCHITECTOR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR � MOVE ❑ REMOVE 8 DESCRIBE WORK Move garage from present location to be set back further on the lot 9 CHANGE QF USE FROM TO STIPULATIONS S� stipulations on Building Permit #12,954 SEPERAtE �ER1�11?S :REQU1RLn F"OR 1�It�21NG, HEATING, PLUMBING ANf� SIGNS. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR EtECTRICAL, PLUMBING, IiEAT1NG, VENTILATING OR AIR CONDITIONING. Od r 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 pERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL lAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. P�AN CHECK FEE TOTAL FEE � SIGNATUREOFCONTRACTO ORAUTHORIZEDAGENT IDATEI WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT I r i%1 / �/?/Z.2� �.�%(�-.v2.� � o? 1- %e�.• SiGNATUREOFOWNERIIF NEFBUILDERI�� ID EI gLDG INSP DATE � City of Fridley i � qT TNE TOP O� 7NE TWfNY ; r , j i L �r � t,"^-" � tGMMt�N�TV pEVE1.0�MENT DIV. t � `f PIIUTE4TIVR M�MiCT10N f�K. I � ' �-^t i ptY NAI.I FQIOL:Y if�� 1 �-----�•' `.� N�-ew-�.su _ ___. _.._ i Pxoperty Qwner rresenL Lot Lega�. To Be M�ved To Mover , Expecte T me Rout�ng �. �v o � iUBJEGT MOVI��G P�RMIT APPLICATIOiJ L�^rGl i u Addre�s act ox Xt �.ho-�/s�,�-c� re�ss —"�lEs t i.mat Permit No.� i Receipt No. p�TE 'NF Of Ov :, ev - Z 15/73 1 1 800 one �-` � -t �,��-' � �` %/ ' 3 S � ,� s� ...�1s'� �e_r�_ _ ane --- icense—lQo.—" ost Approved By: Utilities Ncatifi.ed; Stat� whe�her r►p�i.fi.etl and date � Minneapolis Gas �om�any Engineering 1'?epartmen� :.�,i 2.�� 372-�+�50 Northern Sta�es Power Crampamy Customer Business Office ��`� ` 330- 55�+0 Noxthwesterr� Be1]. Telephe�r�e Ca. • �Business Off�.ee ��?',1;1z-� , 332-l+112 Approved By Water & Sewer Depaxttnen�: All �i�.ls Are ]?aid Sez�rice� Ax'e Disconnected _. The undex�sigr�Qd her�:by ma�Ces applicatian fox � permi� to mave the ui ing described above, a$�e�ain� ta do ��, wvrk in st�:ict �c�ordanc� w�tt� the City Q�dinan�es and rul�nga o� th� Depa�r�men� of �uildin$s, and hersby declaxes that a11� �acts and repxeaert�katior►� ata�ed �.n this apQlicativn ax� �rue and eorrect. �.� j - �' �' U � Co�txactor �r � �, .I- � + �� , � .�� ,� f7s .,'� Dat� , SUBJECT City of Fridley AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r � � � � � • COMMUNITY DEVELOPMENT DIV. ' � ti: ------� r � � PROTECTIVE INSPECTION SEC. � � � � � �"'� � CITY HALL FRIDLEv 55432 NUMBER HEV DATE �.---�: ,.J 612-571-3450 910-F15 10/8/87 JOB AODRESS 6606 Brookview Drive N.E. 1 LEGAL LOT NO. BLOCK TRACT OA ADDITION DESCR. '] 2 Brookview 2nd Addition 2 PROPERTY OWNER MAIL ADDRESS ZIP Orville Jacobson 6606 Brookview Drive N.E, PAGE OF � � 3 CONTRACTOR MAIL ADDRESS Z�P Kaymar Enterprises Tnc. P.O. Box 425, Bemidji, MN 56601 d ARCHITECT OR DESIGNER MAIL ADDRESS Z�P 5 ENGINEER 6 USE OF BUILDING Residential 7 CLAS5 OF WORK � NEW MAIL ADDRESS ❑ ADDITION ❑ ALTERATION FIRE DEPARTMENT MEMO T0: BUILDING INSPECTION ASSESSING . ' SUBJECT: FIRE DAMAGED STRUCTURE FIRE HAS OCCURRED AT 6606 Brookview Drive. DDRESS July 24, 1987 D E F RE FD-7 _ _ � _ 6 w-o-o __ � _ ___ __ _,�. _ . _ SiGNAT A€-OF CON RACTOA OA AU7HOA�ZEO AGENT ID EI . I SiGNATURE OF OW NER �1F OWNER BUILDEA� IDATE� ZIP �J REPAIR v 1923.5 REC . ac�s 3i APPROVED BV SEE ATTACHED SHEET 571-3524 PHONE LICENSE NO. 751-8929 PHONE UCENSE NO. PHONE IICENSE NO. ❑ MOVE ❑ REMOVE � �� 7�� DATE: July 24, 1987 � N� [] City of Fridley Effective 4/1/86 ADDN. [ ] �R-1 AND R-2 ALTER. � 7 Building Permit Application Construction Address: C� �'h'l./�l t- Legal Description: Owner Name & Address : � �✓ � � C g ��"'Z �=1- � �� o I� Tel . � s �� "' .� �L'"� Contractor: Kaymar Enterpris s n � Tel. # 218-751-8929 Address: P 0 Box 425, Bemidji MN 56601 Attach to this application, a Certificate of Survey of the lot, with the proposed construetion drawn on it to scale. � �ds � d��" p � � DESCRIPTION OF IMPROYEMENT Ll��l �✓�M (r"�R� LIVING AREA: Length Width Height S�. Ft. GARAGE AREA: DECR AREA• OTHER : r � 'Q- Length Width Height Sq. Ft. h Corner Lot [ ] Inside Lot [ ] Width Hgt/Ground Sq. Ft. u !n f�J�o 2�(1 �' � �o ' % `' �� , � t- _ �' � � Ft. Yd. Setback Side Yard Setback Type of Construction: fire damagQ Estimated Cost: $_�_ �nn.�� --- � Approx. Completion Date: September 30, 1987 Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: N/A $ $ �See Back Page for Explanation " �e. C�ou.,�-�•+,. �z(Y� DATE: �3 /�l APPLICANT: �✓= ��%t�� Tel. � ��l "" �yL� CITY IISE ONLY Permit Fee $ �� Fee Schedule on Reverse Side Plan Check $ '�'�'� 25� of Building Permit Fee State Surcharge $ v� $•50/$1,000 Valuation SAC Charge $ $ 525 per SAC Unit Park Fee $ Fee Determined by Engineering �d o � �.� �� .Ov � Sewer Main Charge $ � ��'� Agreement Necessary [ ] Not Necessary [ ] TOTAL �� . STIPULATIONS: O V• � ' � � � � / / ' d� �.u�.�aow I� OonH r+ti�s� m.ic.�w�. �G�t� S�i�„4o �n � RN� �� ' � g��,� � �'�� »� 0 0 s y x,� a � , j , } '� 5 "� R - * '"'� �, .yy' d t _ .' � e� � .� �' ;� � � 5�' ��;�R �t , a? � t<,�� . . �c �. � 4 � ,'t { � *��. � . i� �� v �, : �-�' � . � T`" � x. >" � � i __ - � ` :i� $ .. � � !F . . . �'si f � �� .. . . � - �� " � f i� i � � �� i �i - `t � + 1 ` � � � O :� ( — • , � � ' f i . � . . .. � .. � s. � ♦ � � � i >`J � � . , {q .' 3�.. � i . �. . • �t t 1 i � � ; � � ._ � � �� w ;i' ' '� � � �� F� , �� , �M � .� � 1� , ' _ � � � � � � ! , � � � � � �� .� : j j,. j a � � •� '� .,,, ', �► :� 3 l �'' �� +� � �"� ' S � + � ;� �< i � �'"r � f � � :� '� � .� � � ; ; _�� . ��_, � � r 1 ; " � i� -�,: �� .. . :; � �'' . _ � , - . . ;�- � � � � ' . , � +,�'`�'.` � � ,� � 4 � � � `�°� � ' �. . . ... � , .. , .� �-l.� � I � r � � � � � '� ' � �� . � - :: � �?P�` s:�ylWr � ��.1�. ... � `� J� � +� � . .. i '�'r .,F. �'�' - "'r$"� "�' ��+ � � '�f:.v�A� � � � k �� =f. �' ��i � �. } 'k . 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"7"`�, ' _ 1 , �!� � � __.. �__ � , +� ; ; . . ! .:�. .. � f . � � t i � 4 J � ' • • , , � ' _ : .. � � - r - _ � , � { �� ` { �� J � � ;� � � � .. . � . : : . ., . _ T , � ; . . : �.r ,� . � � _ . � v ; y� .9' � '� O �' �1 — � ` I �1 i i -�f . �� . i ,� r ; ;� ��u ,� 1� � ' :�l I�� , � . �. SuBJECT . City of Fridley � q. �� 2 AT THE TOP OF THE TWINS B U I L D I N G P E R M I T f ; � RECEIPT NO. � COMMUNITY DEVELOPMENT DIV. � ��,------ � Y r � � PROTECTIVE INSPECTION SEC. � � � i � i ' � /'��1 � CiTY HAIL FRIDLE� 55432 NUMBER REV OATE PAGE OF APPROVEO BV �'"'"�� ,�� 612-571-3450 910-F15 3/21/97 � � J08 ADDRESS 6606 Brookview Drive NE 1 LEGAI LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHEO DESCR. ] 2 Brookview 2nd Addition SHEET 2 PROPERTV OWNEF MAIL ADDRESS Z�P PHONE Orville Jacobson 6606 Brookview Drive NE 571-3524 3 CONTRACTOR MAI� ADDRESS Z�P PHONE UCENSE NO Builders & Remodelers 3517 Hennepin Ave S, Mpls., MN 55408 827-5481 1100 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAtL ADDFESS ZIP PHONE IICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION C7 ALTERATION ❑ REPAIR O MOVE O REMOVE X 8 DESCRIBE WORK Replace 9 Windows 9 CHANGE OF USE FROM TO STIPULA710NS Replacement bedroom windows must meet the State Egress Code. Install smoke detectors to meet the State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD SEPARATE PERMITS ARE fiEOUIREO FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULI AND VOID IF WORK OR CONSTRUCT�ON ZONING SO. FT. CU. fT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBI( CERTIFV THAT I HAVE READ ANO EXAMINED TFiIS APPLICAT{ON 1 STA�LS GAFAGES AND KNOW THE SAME TO BE TRUE AND CORqECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TVPE OF WORK WILL BE COMPLIED �S 77(� �Z.H9 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 IOCAL LAW REGULATING CON- � 112. 2S Fire SC �.5 .%H STRUCTION OR E PERFORMANCE OF CONSTRUCTION PLAN CHECKFEE TOTA�FEE ��-��`�� License S $5.00 $ 92 SIGNATU�7EOFCON'RACT0:70RAUTNORIZEDA ENf-- � iDniEi E OPERLY ALIDATED T VOUR PERMIT . �- �� l�� SiGNATURE OF pWNEP UF OWNER BUILDERI IDATEi "" �B �NSa Da1E NEW [ ] ADDN [ ] ALTER [ ] CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: �7��b�, �i�--oo /Tv� c�✓ �i� �i°��y Legal Description: Effective 1 / 1 /97 Owner Name & Address: �,�vi /l �� '� � sv� S��h" Tel. #:��-- �3_5 Z y Contractoz: �c- ��%-� -r �.� d� l�s � � MN LICENSE # a�0 !l� 6 Address: 3S'/ 7/�e.�.,--�o.� �--� � /`7d�s Tel. # 8"Z 7�:S—Y�'l/ Attach to this application, a Certif'icate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: GARAGE AREA: DECK AREA: OTHER: DESCRIPTION OF IlVIPROVEMENT Length Length Lengrth la �,..�, Width w��n Width � Height Height Sq. Ft. Sq. Ft. _ Sq. Ft. �D�«?.� - � �-V� �',()C��l l � '1�;y)��.c_ ; a� Construction Type: Estimated Cost: $ ,j _% �% " . (Fee Schedule on Back) Driveway C�rb Cut Width Needed: Ft. + 6 �t =: Ft x $ ' - . ._ $ , : DATE: ,3 2 APPLICANT: _ °�`%,,,� ��-� Tel. # �Z 7 ��'� Permit Fee Fire 5urcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: � 1 l�. �� .�� $ �� $ $ .��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 Determined by Engineering : Agreement Necessary [ ] Not Necessary [ ] y � K SuBJECT c�ty of Fridley � � AT THE TOP OF THE TWINS B U I L D I N G P E R M I T �� r ; � RECEI � COMMUNITY DEVELOPMENT DIV. e� �% ' j V �-��-, 'VY/ �C/ r � � PROTECTIVE INSPECTION SEC. 1 � � ' � �'��1 � CITY HALL FRIDLE� 55432 NUMBER RE� DATE PAGE Of APPROVED BY �'""�� ,'' 612-571-3450 910-Ft5 7/14/97 � � JOB ADDRESS 6606 Brookview Drive NE t LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 7 2 Brookview 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Orville Jacobson 6606 Brookview Drive NE 571-3524 3 CONTRACTOR MAILADDRESS ZIP PHONE UCENSENO. Builders & Remodelers 3517 Hennepin Ave S, Mpls., MN 55408 827-5481 1100 4 ARCHITECT OR DESIGNEF MAIL ADDRESS ZIP PMONE LICENSE NO. 5 ENGINEER MAIL ADORESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK O NEW ❑ ADDITION O ALTEFiATION �7 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. TYPE OF CONST. OGCUPANCY GROUP OCCUPANCV LOAD SEPARATE PERMITS ARE REOU�RED fOR ELECTf71CAL, PLUMBING, HEATING, VENTI�ATING OR AIR CONDITIONING. THI5 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. N0. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALIS GARAGES AND KNOW THE SAME TO BE TFUE AND COFiRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERfJING THIS TYPE OF WORK WI�L BE COMPLIED $15,975 �%.9H WITH WHETHER 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 IOCAL LAW REGULATING CON- $23J.ZS Fire SC �LS.98 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. � w�E� L�� n PLAN CHECK PEE TOTAL FEE 1;�,� ; 7_� y_ p � License SC $5 . 00 $266. 21 ' S�GNA�UREOf CON�FACTOAOA.AUTHOR�ZEDAGENT IDATEI WHEN PAOPER ALIDATED THIS IS YOUR PERMIT � � ��/ �^ � S�GNATUAEOFOWNEa�iFOWNERBUILDEAI IDA7E� BlD INSP ��4TE NEW ADDN ALTER [l [ l [) CITY OF FRIDLEY SINGLE FAMILY A.ND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: _ CG o G �rio o,� �� g w , fl� Legal Description: � Effective 1 / 1 /97 �j� ��a-73 Owner Name & Address: o ic �i c�� J,a c d�.r o..� Tel. # s-�/ _ 3,�-,� y Contractor: Address LIVING AREA: GARAGE AREA: DECK AREA: OTHER: vE MN LICENSE # ��o 0 �Tel. # �,2 7-,�Y�l Attach to this application, a Cer`tificate of Survey of the lot, with the proposed construction drawn on it to scale. Length Length Length DESCRIPTION OF IlVIPROVEMENT Width Height Width Height Width Hgt/Ground 3`��^J �. ,y'y� F C A/A/N �, JTe ia�.. .voe h Sq. Ft. Sq, Ft. Sq. Ft. Construction Type: r��•�n ,Z ,,,a,� �,��o�rs Estunated Cost: $ /,f 9�,T-°= ( .F.ee Schedul e on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE• �-/ Y- 9� A.PPLICANT: /�,�,��/%�.a.�� Tel. #�'� �-.r-Y�/ Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Pee Sewer Main Charge TOTA L. ST[PULi1`I'IONS: CITY USE ONLY �l A u S'� �� $_ � � �% . � Fee 5chedule on Reverse Side �� $ / S � a .00l of Pe � � G% rmit Valuation (1/lOth%) �y�� $ l,�c� $.50/$1,000 Valuation �`"` � � $ $950 er SAC Unit "� � n P � I✓ $ � •� �� $5.00 (State Licensed Residential Contractors) )� � Alt. "A" or Alt. "B" Above �' U' ' ��r � $ $450.00 Conservation Plan Review �U� v` � � $ Fee Detertnined by Engineering � Agreement Necessary j] Not Necessary [] � �� .� Building M%CI�ANICAL Permit No.� ?—�� 1`� Inspections R�+ SIDENTIAL APPLICA7CIQN Receive d By: 7. 63-�72-3604 F FR[�LEY Date Rec'd�- �� `' CITY O DATE �-- I�"' �-1 YOUR E-MAIL ADDRESS SITE ADDRESS l. �O �� - o �`�� z•,� ��. � %�t �� o� 3 Z. THIS APPLICANT IS: � OWNER �CONTRACTOR � PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOURSTATE LICENSE WITH APPLICATION PERNIIT TYPE TYPE OF WORK: NAME: C c�-w_ P S'� R.0. S �j �-�. ✓- ADDRESS: �� 0(o J� �cs-S �o�,.,r-�L, CITY '�R t� 1� STATE�� ZIP 5 S�3.L PHONE: i� 3- 5�7 l- I� O �� COMPANY NAME: f�Cl v Z r CONTACT PERSON: Ch Y i s STATE LICENSE # r'tc�a ( EXP DATE ADDRESS: ��1 3a i''�a-4^ JE. CITY Ii2� A le-'-� STATE�N ZIP `�5S y3�- PHONE i� 3-�7 ti`'i ' 3( i`� FAX � SINGLE FAMILY O TWO FAMILY ❑ �W ❑ REPLACEMENT ❑ TOWNHOUSE �ALTERATION/ftEMODEL DETAILED DESCRIPTION OF WORK ��► s{-�-� i c� � c s^ 0�' �4- «s �� c ��s =� �� 2"� PER MS 16B.665 the permit fee is a minimum of 515.00 or 5% of the total cost up to $500.00, whicbever is greater, for ths 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 WHERE LABOR EXCEEDS $500, FEES ARE BASED ON 510.00 PER FIXTURE, E7CCEPT Wi�ERE NOTED. FiXTiJRES: (II�tDICATE TOTAL NUMBER OF EACH BELOV� EquipmentInstailed , MFG: AJ�'�G MODEL: LN�CD1130 R►� SIZEIBTU� DU� ��-,; MODEL: S��T� MFG: MODEL: SfZFJBTU A/C $25.00 ,�FIREPLACE (GAS) $15.00 GAS RANGFJOVEN $10.00 _A!R TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 ,_NEW GAS GRILL $10.00 BOILER $35.00 _FURNACE $35.00 _GAS ITNIT HTR S 10.00 CHIMNEY LMER $10.00 _GAS DRYER $10.00 _POOL HEATER $35.00 — GAS PIPING $]0.00 VENTII.ATOR SI5.00 DUCT WORK $10.00 — � ..__.. .,._, . ....�.:� ,.....�_�;..;;r...��;.�,av.,-.,.;r,;�,:�,-.rr+ri�rc� tni'r�ii�°ii�Crxi t1r,�.r,r�;�n.�v:r�c��u,:�::.��;.J.�.a�,,.., ..........� „ � ::,,: , ,. ; . ..� .... . ... ... .. _ _ Permit Fee $�. o� Number of fixtures @$10.00 x$10.00 = Surcharge $ .50 Number of fixtures (a3 $15.00 � x $15.00 = $ I�.� TOTAL DLJE $ t 5 .� Number of fixtures @$25.00 x$25.00 =$ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ 50 Tota] _ $� THIS I3 AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accwate; 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 � ��O 0�+r PKINT NaME r�S � DATE a- I3 v7 City of Fridley Building Inspections �epartment 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 r � v. �� ;_�m_4977