AF - 471501U
BUILDING PERMIT
Village of Fridley, Man.�.. N� 214 3
Date ��l.����� . . .. . . .. . . .. . . .. .. .. .. . . . . .
Owner .�:'"Ge-:�:�`.�.�':�...C��''�"�:��lf�i.. Suilder ...........................................
Address . .� .�y�:4�. . � ._. . `� . �:-:�"�:`� . Address . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . .
. �,�.
'� LOCATION OF BUILDING
No. . �.b.•f�. nT.'�r.... Street �'�-..�::{�°T.�:�:'�*':'. ... ........ .. .. ... Part of Lot . ........ ... .. .. .... .. .
Lot ................ Block ................ Addition or Sub-Division .......................................
Corner Lot ............ Inside Lot ............ Setback ............ Sideyaxd ..........................
DES�R[PT[ON OF BUILDING
To be Used as:
a
,�. . ��%��`��. . . . . . Front .�"�. . . . Depth .,r � . . . Height �� . Sq. Ft. . . . . . . . . Cu. Ft. . . . . .
..... . ............ Front ........ Depth ...... . Height ......... 5q. Ft. ........ Cu. Ft. ........
Type of Construction �.r� t�kii. �, . Es�t. Cost . . . . �".��. . �. . . . . . . To be Completed ��,��'1���'
��}'�� � �_ - ,,� �,��'.�� ,+� �7"��
��
In consideration of the i�ssuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with a11 provisions of
ordinances of the vllage of Fridley.
. r
�" In conside?,'F, �tio - the payment of a fee of $. .;,�: .. . , permit is hereby granted to �:'�: .:�.�. � .. . . .. . . .
� r�;C�-� ;�. . to construct the building or ad dition as described above. Tlus permit i5 granted upon
the express condition that the person to whom it is granted and his agents, employees and worl�nen, 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, aiteration, maintenance, repair and moving of buildings with-
in the village limits and this permit may be revoked at any time upon violatio,�Q f any of the provisions of said
ordinances. � ,�` � .? � ,,�" __-
�
� "'- :
Inspecior
NOTICE:
This permit does not cover the construction, installation or alteration for wiring, plumbing, gas heattng,
sewer or water. Be sura to see the Bullding Inspecfor for separate permits for these 94ems.
^ � �
�- �
SUBJECT � .
City of Fridley � '
ATTHETOPOFTHETWINS gUILDING PERMIT • 1490"�
�
; � RECEIPT NO.
� • COMMUNITY DEVELOPMENT DIV.
� �y-------�
r � � PROTECTIVE INSPECTION SEC.
1 = �
� /�"1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY
�""� � ,�� 812-580-3450
910-F15 9����g � �
JOB ADDRESS 5734 Jackson Street N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. % ( Donnay's Lakeview Manor SHEET
2 PROPERTYOWNER MAIIADDRESS ZIP PHONE
Ralph Rosendahl 5734 Jackson Street N.E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Gorco Construction Co. 3384 Brownlow Avenue 929-7868
4 ARCHITECT OR DESIGNER MAIL ADDRESS 21P PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
8 USE OF BUILDING
RBS ].�II't].d.�.
7 CLASS OF WORK
❑ NEW � ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WORK
Construct a 22' x 24' Gara e
9 CHANGE OF USE FROM TO '
STIPULATIONS p�yide treated plate or row of blocdcs. Provide a hard surface driveway.
SEPfRATF PERMiTS RE�UIRED FOR WIRIf�G,
HEATNVG, PLUM�ING AND SIGNS. �yA�NIHG
�efcxe digging c�ll iocaf utilities
iEtEPHONE - EtECiRIC - C�4S Etc.
REQUIRED BY LAW
TYPE OF CONST. OCCUPANCY C3ROUP OCCUPANCY LOAD
SEPAFiATE PERMITS ARE REOUIRED FOR ELEC7RICAL, PLUMBING, HEATING,
VENTI�ATING OR AIR CONDITIONING. if�00d Fr�le
THIS PERMIT BECOMES NULL AND VOID IF WORK OH CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED POR A PERIOD OF 120 DAYS AT 528 5280
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 $3� S22 �•1.91
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- 21.12
STRUCTION OR THE PERFORM OF CONSTRUCTION. $
a � /� J PLAN CHECK FEE TOTAL FEE
8 $23.03
SIGNATUREOFCONTPA ORORAUTHORIZEDAGENT ID EI y� E � PER Y VALIDATED THIS IS YOU PER IT
G _ • f /a
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SIGNATURE OF OWNER fIF OWNER BUILDERI IDATEI BLDG. INSP DAT
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Village of Fridley, Minn.
o'��� BUILDING PERMIT
Date: ..�%!���.... 3 � ...................
Owner.......................................
Address......................................
�
N° 1811
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.d� .�.�'` . . . . .!��� . .
Builder . � . .............
Address.............................................
LO T[ON4T��`�• • UILD[NG ,
No. �. � �'.'�. .� . Street . . . . . . . . . . . . a. . . . . . . . Part of Lot . . . . . . . . . . . . . . . . . . . . . .
Lot . . . . .'. . . . . . Block . . . . . . f� . . . . . . . . . Addition or Sub-Division .�p'���7��il� . . . . . . . . . . . . . . . . G��
� � �
Corner Lot ........... Inside Lot ..�� .... Setback ..��.... Sideyard ....� .......................
DESCR[PTION OF BUILDING
To be Used
� . . . . . . . . . . . . Front .�.�. � . . Depth o�.t�,J Height �. :'� . . . . Sq. F't. . . . . . . . . Cu. Ft. . . . . . . . .
..................... Front ........ Depth ........ Height ........ Sq. Ft. ........ Cu. Ft. ........
�°Ce �,'%
Type of Constru'ction . .�r. t�4� . . . . Est. Cost . � �! . . . . . . . . . . . . . . To be Completed . . . . . . . . . . . . . . . . . .
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions of
orc�inances of the village of Fridley.
" �
p,� ................ .�.............. ...............
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Tn consideration of the payment of a fee of $. ./. ,�r .:s permit is hereby granted to . Gtv 4???�. .. �
......................... to construct the building or addition as described above. This pernut is granted upon
�
the express condition that the person to whom it is granted and his agents, employees and worl�nen, 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 loca,tion, construction, alteration, maintenance, repair and moving of buildings with-
in the village limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
. . . . .�--: . ` ... . . . .- '. . . ��°� . . . . . Building Inspector
�
NOTICE: r �'
This permit does not cover the�onstruction, installation or alteration fo� wiring, plumbing, gas heating,
sewer or water. Be sure to see the Building Inspector for separate pe�mits for these items.
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C I TY �or- f(Z I U LL"Y .
_....� ., .. ,a . a.,._.... s.a.�
• APPLIC/1TIUt� FOR RL"SIUf:(JTIAL LUILDITIG PERf�iITS .
' («[:W, �LTL"R/1T1UtdS, �DllITIO(JS, OR RCPAIRS)
r ��OWl2�R:� � . �.
�aar�s 5 : � 3� . ��� a �o� _
nuzLU�}z: � Q I�,f' � ��-� ° �� .
nddress : �`�'�� vl`� i����� ��'�'► .
Tel. I1o. : �� �' �'l� ��� •
No. '� � �� Street: ���.���Jl� � � -•
. �
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LOT: / FSIACY.: !�_ ADDITIQP�: �, ���..1�, w � � �-���Ji 1�..l�,1 �CmhJp�
C0�2I1�R LOT: IIJSID� IAT: SLTB11q:: SID�YIIRDS:
Applicar.i: attach to L-his iorm ��o Certiticates of Survey of Lot and proposed
building locai:ian dra��n on these Certificates. •
DESCRI PTI01�1 OF BUI LDI �G
,
To Be llsed As: � _ �
r - l�°
�JC,� � � � Front: � `� Depth : �_� Heiqht: .
�� Square Feet: �'� O_ Cubic Feet: 3� � O
�Fxont: � Depth: . Height:� .
' Square I'eet: _ G1:tbic Feet: �
qjrpe of Construction: ��.,�•'1 �.i'��f����°i�+�.. ���ated Cost: $ �
• �8��.,�a
7b Be Completed: � Alt. A Alt. B
Pxoposed Drive��ay [9idth If 11ew Opening Is Desired __ S $ �
. �SE� REVERSE SIDE OF SHEET)
The undersigned hereby makes application for a permit £or the work lterein�
specified, agreeing to da all work in strict accardance wi�.h the.City of
Fxidley Ordinances and rulings of the Dcnari:ment oi Fuildings, and hereby
cleelares that all the facts and regresentations �tated in i:his applica�ion
axe �x'ue and correct. See xeverse side ior ac 'tional in-ozmation.
. � �
� SIGNATUF�F:
DATE: .
. ,
Stipulations: . � � '� // � `L
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BUILDI(JG PER��IIT FEt SCHEDULE
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 �lteration 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 the manner herein provided to-wit:
NEW CONSTRUCTION: Single Family Homes and Garages: $4.00/1,000 cubic fee�..
PLAN.CHECK: 25 percent of building permit fee.
DRIVEWAY DEPRESSION: (Concrete Curb Streets Only) '
Alternate A: Removal and replacement of concrete curb and
gutt�er only; Driveway width plus 6 feet x$14.50
Alternate B: Removal and replacement of concrete curb and
gutter and install a 3 foot wide approach with
6 inch depth; Driveway width plus 6 feet x$17.20
pll � : 1 �' : �l
For the purpose of computing fees for buildi.ng pernaits, the cubical cc3ntents of any
building or addition, is determined by multiplying the ground area covered from a
point six (6) inches below the floor line of the basement or the cellar to the
average heights of the upper surface or to 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 ger each five hundred 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 $7.50 plu's $.50 state surcharge. '
VERIFICATIOV OF FOUNDATION
NOT�: Permits for construction will be issued a minimum of 24 hours from the time
of application to allow for proper review of the proposed structure and of the
construction site.
A Certi.ficate of Survey of the lot, showing the location of the foundation once it
has been constructed will be required before proceeding with the framing.
� - : � � ' ' ►
Application for a Certificate of Occupancy shall be made ten (10) days prior to the
use or occupancy of any structure for which a building permit has been issued; and
sa:i.d structure shall not be used or occupied until a Certifica�e of Occupancy has
been issueda
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Octo�ier 3.�, 1988
To �lihom it IVIa�r Concern:
Et� the owners oi s744 Jackson St. N. E., Fridleg, B�innesota,
James and Bda.r�r Kostick� have no ob jections to the owners of
5734 Jackson St. N. E.� Fridley, B6innesota, Ralph and
Margie Rosendah]., havin� their whole house air conditionin�
uni� on the north end oi their house.
�� •
�`�/ /��-
e
�
e
"e
��� ��nC��6i I
�`�� � C�!�'--�' � .
CHIMtdEY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack;
1. Has been carefully examined Yes (��No ()
2. Is free from rust or deterioration Yes � No ()
,�
3. Has no foreign objects lodged within Yes �� No O
4. Is securely supported Yes �/f No ()
5. Meets all current Code requirements for size and
total BTU connected Yes ,,(/� No ()
6. Has Total heating BTU's of . �� �
All other BTU's y�, � UC�
TOTAL � D) (� l� �
Rema rk s
Com pa ny
Signed B
Da te
sue.iecT PERMI .
City of Fridley
AT TNE TOP Of THE TW�NS g � I L D I N G P E R M I T i 716
r
; � RECEIPT NO.
� ; v �_��� COMMUNITY DEVEIOPMENT OIV. ���-����
r � � PROTECTIVE INSPECTION SEC. 0���.,y9,
� . � v�tv
l--_- w;�'��,•, CITY HALL FRIDLEY SS13$ NUMBEN NEV OATE VAGE OF APPROVED BY
L �� 612-57�-3450 9�aF�s 4/2/01 / /
10B ADORESS 5734 Jackson Street NE
t LEGA� �OT NO. BIOCK TRACT OR AODITION SEE ATTACHED
oescR. 7 6 Donnay's Lakeview Manor SHEET
2 PFOPERTY OWNEFi MAIL AODRES$ ZIP PHONE
Kathy Hansen 5734 Jackson Street NE 763-571-2354
3 CONTRACTOR MAIL ADORESS 21P PHONE LICENSE NO
Prudhom Enterprises 1577 Hennessy Vista, Whi�.e Bear Lake, MN 55110 20069805
d AiiCNITECT OR OESIGNEf; MAII ADOFiES3 IIP PHONE LICENSE NO.
651-653-7740
5 ENGINEER MAII ADORESS ZIP PNONE LICENSE NO
8 USE OF BUIl01NG
Residential
7 CLASS Of WORK
O NEW ❑ ADDITION O ALTERATION f�J REPAIR O MOVE ❑ REMOVE
8 DESCRIBE WORK
Reside House & Garage
9 CHANGE OF USE FROM TO
STIPU�ATIONS
Per Section 1402, 1997 Uniform Building Code, requi�es that a weather
resistive barrier be placed over exterior she4thing to protect the interior
wail covering. Exceptions for this prov�sion would be if sheathing is an
approved weatherproof pa.nel or when the siding is an approved weather
barrier. Vinyl sidix�g is not a weatherproof covering unless the manufa.cturer
states this in their application guidelines. Cal�. for inspection of wrap
before covering.
SEPARATE PERMITS ARE 1iE0UIRED FOR ELECTfiICAL, PIUMBING, HEATIN(3, �PE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONOITIONING
THIS PERMIT BECOMES NULL ANO VOID IF WORK OR CpNSTRUCTION 20NING SO. FT CU FT.
AUTHORIZED IS NOT COMMENCED V�IITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOp A PERIOD OF 120 OAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTFEET PARKING
1 HEREBY CERTIFY THAT I MAVE FiEAO AND �XAMINEO TMIS APPLICA710N 1 STAILS GARAGES
ANO KNOW TME SAME TO 8E TRUE AND CORRECT. ALL PROVISIONS OF �AWS ypLUATION SUR7AX
ANO ORDINANCES GOVERNING TMIS TVPE OF WORK WILI BE COMP�IEO
W�TH WME7HER SPECIFIEO HEREIN OR NOT. TNE GRANTING OF A PERMIT �7sOOO �3.SO
DOES NOT PFiESUME TO GIVE AUTMORITV TO VIOLATE OR CANCEL TME pERMIT FEE SAC CMAF
PROVISIONS OF ANY OTMER STATE Oii LOCAL LAW REGULATING coN• �139.ZS Fire C�7.00
STRUCTION O E PERF qMANCE OF NSTRUC710N
PLAN CMECK TOTAL EE
Lice S $5. $ 4.75
5� u E �CON'RACTOpONAUTMOp�ZEDsGENT �O�iEr MEN PR P V ALIDAT T IS IS V �R��
$�GN4TUAEO�OWNEp��FOWNEABUILDEAi �b�rE� BL iNSP' �v/f
NEVN [ ]
ADDN [] ,
ALTER [ ]
Construction Address: _
Legal Description:
Owner Name 8 Address:
Contractor: J J�t
Address: � t
LNING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
J �teS c�� �S`
Effective 1/1/2001
(763) 572-3604 Bldg Insp
� ��
� �-�,2,/T � � s-�
� 3� J /1�fl�i� Te1. # �
S MN LICENSE # ��Q � % �
�� L� �� S�%��' Tel. # �,�� - (r �� -- ���?�
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length �� Width � Height _� �— r�q. Ft.
' !
Length �� Width � 1-I Height _�19�q. Ft.
Length Wdth Hgt/Ground Sq. Ft
j/� ��
Construction Type: � �I� �f�vS �� �f�Estimated Cost: $ �, d (�C�
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: ��� APPUCANT: �� �✓ Tel. # ��l—� � .3 °�%�
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
Call (763) 572-3604 for Permit Fees if mailing in application
$� , S� Fee Schedule on Reverse Side
$ % Ov .001 of Permit Valuation (1/10th%)
$ . !� $.50/$1,000 Valuation
$ $1150 per SAC Unit
$��. ti v $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 [ ]
� �'/• 7✓��
�
BUII..DING PERMIT FEE SCHEDULE
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 eausting 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
$23.50
$23.50 for first $500 plus $3.05 for each additional $100 or
fraction thereof, to and including $2,000
$69.25 for first $2,000 plus $14.00 for each additional $1,Q00
or fraction thereof, to and including $25,000
$391.25 for first $25,000 plus $10.10 for each additional $1,000
or fraction thereof, to and including $50,000
$643.75 for first $50,000 plus $7.00 for each additional
$1,000 or fraction thereof, to and including $100,000
$993.75 for first $100,000 plus $5.60 for each additional
$1,000 or fraction thereof, to and including $500,000
$3,233.75 for the first $500,000 plus $4.75 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$5,608.75 for the first $1,000,000 plus $3.15 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW �
(Concrete Curb Streets Only) �
Altemate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50.
Altemate "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 $23.25.
VERIFICATION OF FOUNDATION
Pemuts 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 Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will
be required before proceeding with the framing. New Houses Onlv
�_