AF - 47132Village of Fridley, Mi.nn.
BUILDING PERMIT �°• 19 8 8
Date : . . c�. ��``��' �" '�. �� :°'°'.:� �� . . €:j°. .� . . . . . . .
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Owner ...............,....................... Builder ..."....... � r�...:.. ...... ...........
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Address...................................... Address .............. ... ...... .. .....
�' LOCAT[ON O�LDING
No. `.�i�.,��'..+�.�.'�.� . Street ' � .:: i�-rr",�..�::'"°..'�`�.`�.`� . Part of Lot ........... ............. .....
Lot .. .�/!. . . . . . Block . . . .��. . Addition or Sub-Division ;�:�l::.'.�`!�� :�2�'��i:.. I'�.�°.��'� :`�:'�......
. . � �
Corner Lot . .. ... .. .. . Inside Lot ... .. ... Setback �'�..��%. Sideyard a`.� � : t'+�"::°�:' .............
DESCF2IPTION OF BUILDING
To be lised as:
/�,;�,•�'.e,'.�r� ¢ p��:'. . . . . . Front . ;�e'� . . . Depth � g.�. � Heightt'�: � :�.�2 Sq. Ft. . . . . Cu. F� . . . . . . . .
.... ...... ........... Front .. .... Depth ...... Height .. .. Sq. F't. ....: Cu. F�. .
_ Type of Construction .,.. n,� p:�.:�:. .. Est. Cost,�rd �a �"...�.�.. .... To be Completed„�i"�:..`�"��':�:�`�.� �
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In consideration of the issuance to me of a permit to construct the building deseribed above, I sgree to do
the proposed work in accordance with the description above set forth and m compliance with all `provisions of
ordinances of the village of Fridley.
Tn consideration of the payment of a fee of $.,,/.�.�:`�'..., per�sit is hereby granted to/' �'���":�:��`�'"� ....
� , .
�' �.�°�.:r "�'d". �'�'.'` .`�:�'1: to construct the huildittg or addition as described above. TYiis permit is gra�► .uPon
the expFess conditian that the person to whom it is granted and his agents, employee�s and worlanen, in all work
done in, around and ugoia said building, or any �rt thereof, shail canform in all respects to the ordinances of
F'ridley, Minnesota. regarding location, consfruction, alteration, maintenanee, repafr and moving of buildings with-
in the village limits and this permit may be revoked at any t9xne upon violation of any of the provisions of said
ordinances.
a �
... �.'(,� f- � f .. ��:�:� :�.-.�`e �. Bwtlding Inspector
_ �.
NOTICE: _
7his permit does noi cover the. construction, installation or alterati4n for wir[ng, plumbing, gas heating,
sewer or water. Be sure to see� Butlding Inspector for separate Aermits fo�r�iese items.
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Date:
Owaer:
Address
City of Fridley, Minn.
BUILDING PERMIT
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�-..?..�.,� "''s Address _ --•�•��.L�_...�_�.__i /Y.. °,� � _ ..r °'''' �� � .� �..
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� LOC//�TION OF Bl�i DING
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No. .,�..... { :::.�._ Street ��; -''� '� � .._�� ._.L'.__.... Part of Lot _.__.._._.._.._.__—�,,�
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I.flt .:..---.` �--...._.....::. Block ry-•--- --����� - -........ Addition or 5ub-Division . y�:%�'-�:�'.��!~-� � •- ''�=.� --- � �''�
-- -
CornerLot ....._......-�-- .._...._........ Inside Lot ..- - � .. . ............_. ...... Setback .-----..........-�--•----•---.._...._._ `Sideyard --------.........--•------..._... -� -----...._........__.._...
Sewer IIevation
Foundation IIevation
DESCRIPTION OF BUILDIIdG
�o ue �Use� �s:,. �
� � � r � � �, �,�t �x f�' ,�.�: , � �r '��`'" �� � ,.�,�'
- - � �= . Front / --- .--- De th .... �:. . Height _ <_:..._.. S
� � --- � fF - A , ,�•---- 9. Ft � =--- --:.,d*�_ Cu. Ft. .-----:� -• _-'•
..._.......---------__.�.... _. N .._............_.. Depth .............: ° _.. Height ... .... . Sq. Ft ....._................. Cu. F't. _....................-
............. F'�TOnt,,�. � �„ �* ��
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Type of Construction .-- ,}- --....... �:_..:;�•"' `._. Est. ost,,�'1. ��� .,�.,� --.--..... To be Completed .----_.......-----..._......._..---------
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Ia 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 compHance with all provisions of
ordinancea oP the city of Frldley. #
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In consideration of the payment oP a fee of .r:r �...'.'�:� �'...�, '
$ -- pernut is herebY 6�anted to.-----••---------••-•---------.._..--•�-------�---
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_____...._.._...__._._..._____._..__....__ to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the dty limits and this germit may be revoked at any time upon violation of ,any of the provisions of said
ordinances. „ �.
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NOTICE:
Thls permh does nof cover the wnstruefion, insfallefion for wiring, plumbing, eaa heatin8, sewer o� wafer. Be sure to see
fhe Building Inspedor for separate permits fo� these hema.
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' � �PPLICATI�N FOR BIIILDING P�T
CITY OF FRZDLEY, MINNESOTA
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Qwners Name ��� . , der
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Addres8 . _ �.��� ' ��� 'Address
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� LOCgTION OF BUILDING .
No. °��� � Stree� �'�`L'`�`� ' a Part of Lot
Lot �e Block �. Aclditicn or. Sub,Div. ��'' � ��`,����`
- �
Corner Lot___�_Inside. I,ot � Se't Ba.c1t Side-Yard
SEWER ELEVATION FOUIdDATION ELEVATIOAI
Applicant.,attach to th3a £orm Certificate of Surve� of Lot and proposed build3ng
location. ._
- �' DESCRiPTION OF BUILDING
To be used ass � �
. �
�ront Depth_,_,�
Sq. Ft: � � ��� Cu. F�•.����.,_.�_—
,, .. .
sieht �
' P'ront Depth Hei�ht
Sq. Ft. G�.t. Ft, � .
.. . � / � z � .
Type .o£ �Construction � _ " ted Gost ����� �'' ; �
/'� �� _ .
To 'be
. The undersigned hereby makes°�application for a permit`ftir the work herein specified,
agreeing to do all work in strict accordance with the City Ordinances and ruling of
the Depas�tment of Build3ngs, and hereby decleres that all the facts and representa-
tions atated 3n thi.s applic�tion are true and corre t.
DATE �-� SIGNATtktE
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• ( 5chedule of Fee costa can be found on the Reverse Side,)
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BIIILDING PERMIT FEE SCflEDULE
Section 2. The Inspeator of Buildings shall, before issuing ang perm�.t
for the ereotion of ang bu3.lding or structure, or for any addition to
any existing building or structure, or for any alterations or repairs
to any ex3.sting bu31c1ing or struature, upon application therefor� require
the payment by the applica.nt for such permit of fees to th� amount herein
below set Porth and in the manner herein provided to-wit:
2.1. For any such perm3.t for the erection of an� fire-prooP building� oth�r
tharY a garage, warshouse, factor� or grain eleva.tor, or for the erection of
ang f`ireproof add3tion, for similar occupancy, to any existii�g �ntilding
shall bQ at the rate of �1.�.0 for each one thousand cubic feet, or fraction
thereof� in such cubica.7. cont�n;,s.
2.2. For an�► auch perm3t for the erection of any fireproof gara�e, wsre-
house, factory or gra3n e1ev�.tor, or for the erection of e.ny £ireproof
addition, for similar occup�..ncy, to ang existing building �hall '� at tbe
rate of �1.25 for ea,ch one thou;and cubic feet, classified as "Pireprao�'n
b�r Section 502 of the Minneapolis Building Code.
HOIISES
2,3. For any suah perm3.t for the erection of an
o-�her than a garage, warehouse, factory or gra�.n
fi.reproof addition, for similar occupancy� to an
<'ermit �1.� for each one thousand cubic feet.
GARAGES
y non-fireproof building
elevator, or a,ny non-
y exi�st3.ng building.
2,/�. For any such permit for the erection of a.n,�► non-fireproaf �ara�e,
waxehouse, factory or gra3n elevator, or for the erection of any nor�
fireproof addit3on, for similar occupancy, to any existing buildin� or
for each such bui].ding or addition. Ninety Cents for each one thousand
cubic feet or fraction thereof, in the cub3cal contents thereof with e.
minimum of $4.00.
For the p":'pose of computing fees for build3ng permita the cubica]. contents
of eny bui.ld3ng or addition to a un3form.height throughout by mu].tiplying
the ground area covered i°rom �. point s3x (6) inches below the floor line oP
the basement or cellar to the average height of the upper surface or to the
average height of the roof sur�ace of the main gable of a pitched roof.
2.5. For repairs or alterations to an exiating �tructure, the fee she]1 be
at the rate of �3.00 for esch Five Hundred Dollars ($500.00), or fraction
thereof in the coat of all proposed work.
206. In no case shall the fee chaxged for any permi.t ss set forth 3.n
Section 2 be less than �4.00.
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SUBJECT
City of Fridley 16 2 7 6
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
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� �v �___� COMMUNITY DEVELOPMENT DIV.
r j � PROTECTIVE INSPECTION SEC. ����
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`---- A �����,,� CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY
L J� 612-571-3450 910-F15 7/7/81 � �
JOB ADDRESS 5705 Jackson S'�C�'t N. E.
7 LEGAL �OT NO. BLOCK TRACT OR ADDITION
DESCR. ]_], 5 Donnay's Lakenie�r Manor SHEETTACHED
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Wallace Challstro� 5705 Jackson Street N.E. 571-6763
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
6 USE OF BUILDING
ReS]S�P.Il'tld�.
7 CLASS OF WORK
❑ NEW ❑ ADDITION � ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof dwelling
8 CHANGE OF USE FROM TO
STIPULATIONS
This roof can be the 2nd but not the 3rd roof. Install ridged
galvanized valleys.
SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING, TMPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING. ASPY13�.'t
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. fT. CU. FT.
AUTHORI2ED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENOED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PAFiKING
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 yS],�200 �`.CO
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO' VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- �S`9.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECKFEE TOTALFEE
$9.60
�SIGN TUREOFCONTRACTORORAUT ORIZEDAGENT �DATE� WHEN PROPERL VALIDATEO THIS IS YOUR PERMIT
_ ��� �� -�����, 7 �,��=� ° � � � �
SiGNATUFEOFOWNERUFOWNERBUIL R� �DATE� �BIDG WSP q E
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cz�Y or �r��o��Y � •
kPPLICATIO;d FOfZ Rl:SIDLi�ITIN_ QU1LDItlG PERI�IITS
(tJe►�r, A1 Ler�ations, Additions,� or Repairs)
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� Ot�JtJER: $�' I� �- �-1'� C �- �� �-- �� �¢ L � � ��[3UI LDER : , . � �' =�`°� .
ADDRESS: -� "' v a ,.��Uc sU �v 5'�2 /1DDRESS: - ,
TEL t�0: J�� � �? � � TEL td0: •
� . Construction Location ' �
• STItiS's�' 1�I0: �% C� �' STREET: J a4 � i� 5 a/t-' J`j (�� k .
LOT: / � - BLOQC: � ADDITION : ��'' e.• ,� ' �d c 'S � f 1 ��- c 1 � �
/ l� �� �l)N������`
Corner Lot: Insic3e Lot: � SetbacY.s Sideyards:
-.___._�. .
Ap�licant attach to this form two Certificates of Survey of lot and
. proposed building �ocation dracan on certificates to scale. �
� DESCRIPTIOir' OF COPISTP.UCTIOPd - �
� �L,C� � Front: - Depth: Height:
Square. �'eet: C�ibic Feet:
, �ront: Depth: � Height:
Square• Feet: � Cubic I'eet:
Type of Construction : ��� ��r� �) � j Estimated Cost:
� /�'�c,
Zb Be Q�npleted: • �
� ` • - � Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired: $' $
, . . . SE� REVERSE SIDE OF SHEET
76ie undexsigned hereby ma};e� applic�ttivn for a permit for the �:�ork� herein specified,
agreeing to c?o ,all work iri str�ct accordance t•�ith t2ie City of �'ridley Ordiiiances and
ruling� of L•11e Del��zrtmen� of Buildings., and hereby declares that all the iacts and
zepresenE.ltions stated in this application are true and correct.
D.iTE: � .�, 1 � � � �% ^ SICNATUF.E: �f C� t� C� � � �` C�c�_ �`„c_ l.'�t�3z�
S�ipulations: • ��
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:,IsC'�ZOI•� 2. • 7.'1�Z 7n�.:��ectar. of: 13uS.lc?in�J:; ::h:►1.�., b�tozc: i;,uz�ig Z�cnniL•;; tor �lic crcct-S.on
vf: ��ny l�ui.l.�l.in�� c�r :tt:�-uct:ur:c, o�: �a�: an�� acicti.t:3��n !:o euly cr.i:;L-i.nc� Luilclincj oz ::�xucL•w:r_,
. ci�- f:a�' r,iiy aJ.tc�r��Cic,n or, r.cl,��ir.:; to •any c.:a.::t:S.�i�� l�ui.).di.�i<:J or st•1:ucturc,. u��c.n nr�l�li.c:at.i.oi�
�i:lir_1:�for.c, r.cqu.iic t:li� pti}�mci►L• 1�y U�e appl.i.cant: tor. :,ucl� ��cr.mS.L• ol.� f'ces to tlie �nounti
hcr4in bcJ.o�•� sol for.th ���d i.�i thc manncr. hcrcin provxclGC1 t�-�.�a.t: •
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I�J},1•1 COIa�`I'I:UC'rIO2J: Si�zc��.c l:'amil.y Ilomc:� and Gar.ac{cs: ;:4.00/].,0�� cu2�i.c te.ar.
}�LTsF@ C;Ii1:Cl;: 25 per.ccr�t: aL- 1�ui.�cli�lcJ pe�-miL ice.
Ultl���1:111' llEl'P1:SSxOi•I: (Cpncretc, Gtiirb �Lrcei:s On1y) ' �"
' A].L-ern�-�t:e n: ltc:inoval and replacement of concrete curb and
qutL-er only; Uriveway ��idth plus 6 feet x$13. �0
AltcrnaL•a B: }2emoval and replacem�•nt of concrete curb and
.� • gutter and in�tall, a 3 foot v�icie approach c.�ith �'
' ,- 6 a.nch depth; Driveway �•�ic:th �plus 6 feet x-515, 7�
• . �pDI i"l ON/1L I��FOR`�1/1T I OP!
Tor the purl�se of compuL-ing i'ees for. vuilding permits,. the cubical contents of any
i�uild�.ng or addition, i.s dei:er_mined by rnultiplyirig L-he ground area covered fro� a
p�a.nt si �(6) inches belo:� the iloor )_ine oi tlle basement or th� cellar to 'thc
average heights of thc •upper surface or to the average height of the roof surtace
oi L-he nain gable of a pitched rooi. �,
For reFai.rs or alteratioas to an existing stnxcture, the fee shall� be at the xate
..of �3.00 �ier. each five hundred dollars -($500.00) or fraction thereof in the cost
of all proposed wor.k. . e '
in •no case sha�.l the fce charged fdr any ppxmit as set iorth i.n Section 2 be less •
than $7.50 plus $.50 state swrcharge. � . � ' �
� � . VERIFIC.,�TIO�! QF F�U��DlIlIOf�
NOTE: Permits �or construction a�ill be issued a minimiIIn af 24 hours from t1�e time
of application to all.ow for pro�er re��ie�� of the pro�sed structurc and oi the � .
construction site. �
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A Certificate�of Survey of the lot, sho�.*ing the locztion of the foundation once it
has been cons�nicted �.*ill be required before proceeding ��ith the irarrtinq.
,�FRT I F I G�1TE QF �CGUP/1hC1`
'?�pp].ication for a Certificate oi Oceupancy shall kie madn ten (10) days prior to the
u. e or oecugancy ot any sti-ucture for �ahich a L�uilding perr,►it 12as been issu�d; and
s3.ic1 struc�ture siiall. �iot be used az- oaeupied t•siL-il a Certi�ic�te of Occui�anc}• has
bcen xssued. � �
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sue��C� IT NO.
City of Fridley 2 g 749
AT TME TOP OP TME TWINS g u � L D I N G P E R M I T
; , �7_2-�6��
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� • NITY DEVELOPMENT Dw
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r � � PROTECTIVE INSPECTION SEC
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i--_-�; "' ��� CITY NALL FRIDLEV SS132 NUMBEi1
t 612-571-3a50 s�aF�S
JOB ADDiiESS
5705 Jackson Street NE
1 IEGAL LOT NO. BLOCK TRACT OR AODITION
DESCR. 1� 5 Donna 's Lak
2 PROPERTY OWNER MAIL ADORE,S$
Beatrice Peterson
4 AqCHITECT OR DESIGNER
5 ENGINEER
8 USE Of BUILDING
Residential
7 CLASS Of WORK
8 OESCRIBE WORK
9 CHANGE Of USE fROM
STIPULATIONS
MAIL ADORESS
08 83rd Ave N
MAIL ADDRESS
MAII ADDRE$S
11EV
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O�TE P�GE OF APVROVED Br
12/14/98 / /
21P
PHONE
SEE ATTACHED
SNEET
LICENSE NO
»�qsn
UCENSE NO
LICENSE NO
O NEW O ADDITION O ALTERATION � REPAIR ❑ MOVE O REMOVE
Underlayment must comply with the State Building Code.
SEPARATE PERMITS ARE REOUIRED FOF ELECTf11CAL, PLUMBING, HEATING, ' rrc vr vuna� u�;Wri
VENTILATING OH AIq CONDITIONING
THIS PERMIT BECOMES NULL AND VOIO IF WORK OF CONSTRUCTION 20NING SO. FT
AUTMORIIEO IS NOT COMMENCED V�!ITHIN 80 DAYS, OF IF CONS7RUCTION
OR WORK IS SUSPENDED OR ABANOONE� FOR A PERIOD OF 120 OAYS AT
ANY 71ME AF7ER WOqK IS COMMENCED. NO DWLG. UN17S
I HEREBY CERTIFY THAT I HAVE READ ANO EXAMINED TNIS APP�ICA710N STALLS
AND KNOW THE SAME TO BE TRUE AND CORFIECT. ALL PROVISIONS OF �AWS yALUATION
AND ORDINANCES GOVERNING THIS TVPE OF WORK WILL BE COMPLIEO
WITH WHE7MER SPECIFIED MEREIN OA NOT. TME GRANTING OF A PERMIT �17�9
DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLA7E OF CAMCEL TME pERMIT FEE
PqOVISIONS OF ANV OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OFi TNE PERFOFMANCE Of CONSTRUCTION $56.75
S�GNATUfiE O� CON'aACTOp OA AUTNpa12E0 oGENT
IDATE�
�� VWNCNtlVIIUCMI IDATEI I B�
GROUP OCCUPANCrLOAD
CU FT
OFFSTREET PAqKING
GARAGES
SUR7AX
$.90
SAC CNARGE
Fir SC $1.80
TO A� EE
/+. 45
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�ec 14 98 12:06p
NEW
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CorisocuctionAdd�sg: �
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�gal D�scription:
0� N�tntc 8c A �
Cormacior: �i��, ) L�
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LN�1TG AR�q;
��AGE AREA:
DEC$ �p:
or�;
566-7183
p�P � ���
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SIIYGLE g �Y �� �N•EY
AM,LtY AND DIIPI.E� R_a q� R z
SU,tL,piNG PF�qF� APPLICaTION
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Eff�ccive I/i�gg
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Tel. � �7 J �
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AVach �o this apptication, a Certificat� of Su -S Z 2S:
��, �h � pt+�� co�tion drdwn on i�t to �s�ate.
�C�iPTION OF IMp�p�T
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Ie�
Ix �-"
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wid�h �,� Heiahc
Width =, �. �t.
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w�dcn �� H�,�� -.--�
Sq. Fc.
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Co�ccion Tj►pe; �,�,,�
Esci�ted Cost: g,� � ��
Drivewa rFee Schedu,Te ox� Beck� � r�� 9
y Curb Cuc vV'dct` Ne�: .-._Fc- + 6 Fc =�Fr x$ .
DATE: - � $
�.IC/k�Pis
Tel. �
�ennit Fe�
F'� Sv�+eharge
stace snrcharge
�C C�e
�en�se St�tgt
��'�Y Escraw
��t Concc+ol
�rtt Fee
�et Main Ch�ge
rOTAL
�'11Y-ai�[qNS:
C�Y E ON
$ ��. %� Fee Scltednle on Reve
$ �� � rse Sid�
.001 af Per�it Valuation (1/IUti►%)
$ a l a $.�/,��,(� `/�lt8[lOit '
$ S10D0 ptr SAC Unic
� ° a ss.00 csca� �
$ � Residentf�l Goruractors)
A[t. "A" or Alt. °B" qbove
$ � $430.� Ca
$ n�rvation Pian Reviewr
� Fee Decermir�d by �g��
A��� N��Y ( l Mot Neces�y � i
s.� ,y/�'