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AF - 47156� �� /'"�1- Village of Fridley, Minn. ` � ING PERMIT �°• 181 S � �� ' Date: ..��. '�r>...�� .... .��.'!. �- __�� f �� ,�'�,., ,�,� Owner ....................................... Builder ... ..... �C�C'T°s�r'�s. .. . . Address................. .................. Address ......��rzyl��............................ CATIO F BUILD[NG � No. .�.R'�. ��. Street .. .�. r�. . . .. .. .. .. . Part of Lot . .. .. . . . . . . . .. .. .. . �G4�`�� . s2'�`.'°� . . � ` Lot . . . . (�. . . . . . . . Block . . . . .�.�. . . . . . . . . . . . Addition or Sub-Division �' • . • • . Corner Lot . . . . . . . . . . . Inside Lot . . . � . . Setback . . � . :°�� . . Sideyard . . . . . �� . . . . . . . . . . . . . . . . . . . . �� t � �� ^ �� DESCRIPTION OF BU[LDING To be tised as: �.�.-s4r��E�� . . . . Front . 3. � . . Dept�._ .�-�. . !� � Height . . � `! . . Sq. Ft. . . . . . . . . Cu. Ft . . . . . . . . . . . . . . . . . . .� . . . . . Front . . . . . . . . Depth . . . . . . . . Height . . . . . Sq. Ft. . . . . . . Cu. Ft . . . . . . . . Type of Construction �� . . . . . . Est. Cost . . . ( �n.-: ��- . . . To be Completed . . . . . . . . . . . . . . . . . . In consideration of the issuanee 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 ordinances of the village of Fridley. � d� Tn consideration of the payment of a fee of $. .�.�.:'� permit is hereby granted to .. G�?�lir+r�ie�.�`�'�o��' . . . . . . . . . . .. .. . . . . . . . . . . . . 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 worl�nen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances oP P'ridley, Minnesota. regarding location, 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: This permit does not sewer or water. Be sure see the �on, installation or alteration for wiring, plumbing, gas heating� Inspector for separate permits for these items. � YI . �,,� ti �. , �. � � � , � � � M� � � � � � � r o � �� w � � O � � � � � � � � �� w �. e � � W : � � : �'v-�� : f� � � . , � � �� : o � : � � : � ~ 0 1� �, �N ^ . 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' � �: � 3. � � �o. � � � V � Q •i �� : � • � .�d N ',b,� ae .w � •n � :W ;� o .a1y+ /j/j�'� iy � � i ��—, � : . y � � D ' � � . � � �• c� S fl1 � � � N � • es+ O O p '� fA � fD ' � � � . � � � � � r � � � a �' p p'� � °�' x `� � � � w x� 8 � J E -��i �o � n � � � A � � m� y: M � C � � � "..�` ~ H o �° •°� � °' � � �c � � zt , �Q � � � � � � .. {D� � ` ci ii �' .,�,� y i• Q m : �i' 0 0 : $ � ; -� 25 a .� °• � � : . : �o � 2. ,"�, : �C ' : . � : a � o� . . ., °° : . . �, . . . :: : . . . � . . . . : . . . • . • • • • • • i • : �. . . _ : : . : . : : : : 0 0 fl K IQ M k x k x �e k �i � }�t0a � N ,+�a �a �°a d: � ,t�� 70 $ � : � ,;.� g �i � � � � S a ta r►• � N tn ew u► �w eA w � O i I O �+ I � C'� � , � � ) 0 Q � � 0 a � a c a � � � � D � � r � —��1 fi1 cn C) 2 m v � T I ...., . , .■.■, � : ...., � � �� ' ; �� : ...�, ��^ �� 0�, M � ❑ � o e .. „ � � � �. � � � �A a . � S 0 � � � N N t � • � M � a � � � WATI� �: uaiwiu �wn+ n� �� s��+ics w� rawrs �� GAS OPENItiK',S . • z .• N � a � � n �q ��b � o.a� a ; � �� a � � � �� y .. • oA5". Fz,. � �g� o ��o � �� N � �.� �� R � � ~ O � � � � b � d � � b Q _ � � o��? � o � �� m � ��R �. .- � a�� A� �� r�. o "�� . � r A � m h A 0 s�� Z Z m Gl r L x � ?S � �� 5 .�i a� � 61 . � �°n o� � �� x � � � . � ra � �"a�. .�� W 1 C�D � � � � � � � '� � - M �E , � E' � � �� x o � � ~ �� . � C�7 . � W p . � � 0 � � � �, � m � SUBJECT . City of Fridley 17 2 9 9 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r ; � ECEIPT NO. � • COMMUNITY DEVELOPMENT DIV. i 1 V � - // / r � • � PROTECTIVE INSPECTION SEC. 1 . � 1 � /��'1 � CITY HALL FRIDLEV 55432 NUMBER REV. DATE PAGE OF APPROVED BY �'"'"'� � �� 612-571-3450 910-F15 / / 10/19/83 JOB ADDRESS 5744 Jacks.on S'�P.e't N. E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. ( 6 Donnay's Lakeview Manor SHEET 2 PROPERTYOWNER MAILADDRESS V Z�P PHONE Dave Seott 5744 Ja,cckson Street N.E. S%�� 571-8454 3 CONTRACTOR MAILADDRESS Z�P PHONE LICENSENO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS � ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 6 USE OF BUILDING Residential 7 CLASS OF WORK 0 NEW ❑ ADDITION 0 ALTERATION O REPAIR ❑ MOVE ❑ REMOVE % B DESCRIBE WORK Construct a 22' x 20` Ga,ra e 9 CHANGE OF USE FROM TO STIPULATIONS Gara,ge to be 4� �est ��cam side lot line. Agreement signed by neighbor. Provide a hard �xface d��,bewa�.. ��`�� u'��C�t�es F�R t�ilRl�s� �a\\�� Gp,SEt�' SEPERATE PERY+�iTS �E�UiRE� a��`��EC�R` � �p,�N �dEATtNG, PLUNI�ING AN� �1�I� 8Q�0�e pNE� �E��eN v�RE� � ��a TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. WOOCI FxdIRC.' 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 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 SUFiTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $4,699 $2.35 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- rjO. SO STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $ PLAN CHECK FEE TOTAL FEE $52.85 StGMA7� E.OFCONiRACTOROR THORI2EDAGENT IDATEt *� �,1-IEN PROPERLY VA ATED THIS IS YOUR PERMIT � C� c.m° ° �1 % / �� ! SIGNA REOFOWNEHtIFOWNERBU�IDER� IDATEI BLDG �NSP ATE CITY Of fItIOLCY . Effective Auq. l, 1981 /�PPLICATla1 FO(t RCS10C��T11'w t3U1LQlitG PE�u'•iITS (Nch�, Alteratians. Additions, or Repairs) 0�� t�E R: � �q–v `C� �C C?? � AD�RESS: �t � � TEL k0: — L -S . . QUILDER: �%/l � �� ADa'2CSS: TEL 120: Construction Location STTtIST NO: . `'1 SZ`liEF.T: _ � %' yp7�; % BLOC9C: _� 11DAITIO;i: �S Corner Lot: Insicie Lot: _ Setback: Sideyards: Ap�licv�t attach to tl�is form tti►ro Certificates of SLrvey of lot and p:oposed building locatian drawn on certificates to scdle. DESCRIPTIO�� OF COilST�;UC7IOt� �_ Fzont: ��- - Depth: �` � Heiqht: � Squarc i'eet: G1�bic. Fcet: , Front: Depth: Heigl�t: Square Fc�t: Lvbic Teet: _ . C�:,�� ,��, � . � � ,��qr oz� ',7�pe of Cor,:.truction : Estimated Cost: S Zb Bc mr.�plcted: �l/ '� `� — b � `� � � ` �� Alt. A Alt. B Proposed Drive�aay Hidth If Ne+�► Opening Is Desired: $ S , S�� PZVF.R;L' SIDL OF SiIF.�T . 7iie undcr sioncd hereb:� m31;�� appliclticn for a perr�it fcz the �:ork hc= ein specif icd, agreein� to �.all �ork ir� striet accozc3arice yith the Ci�y of I'ridle�� Ozdi»ances e�id zulin�� of tlie De2�.�rtmcnt. of Dui:c]ings, and hescby declares that all tl�c facts and reprec��t,itiens stated in this applic.�tion are true an�correct. � c.��: /� ` % � � �� sic�nzv� : �tii�ulations : $��,�,� �. .3 S� . ��-�s � � , ,. „ ,t � � - r�� - - The ChieP Building Official aball, before issuing permits for the erectioa cf any Duilding or atructure� or tor any addition to any ezisting building or atructure or for any aiteratioa or repairs to any existing Duildiag or atructure, upon applicatioa therefore,�require the payment by the spplicaat for auch pe�►it of lees to the amount herein belox aet forLh and in tbe manner Dereia provided to-trit: Sotal Valuation =1.00 to =500.00 =501 to =2�000.00 =2,001 to =25�000 Fees =10.00 (Ninimum �15.00) =10.00 for the first i5oo plus a1.50 for each additional �100 or fractioa thereof� to and including �2�000 S32•50 for tbe first �2,000 plus a6.00 tor each additional a1,000 or fraction thereof, to and including �25,000 =25�001 to i50�OOQ =170.50 for the firat =25 � 000 plus =�•50 for each additional �1.000 or _ Practioa thereof, to and including =50�000 =50�001 to =100�000 =283.00 for the first �50, 000 plus �3.00 for each additional �1�000 or fraction thereof, to and including =100,000 =100,001 and up =433.00 for tbe first �100�000 plus =2.50 for each additional �1,000 or fraction thereoP plan Cbeck: 25 percent of building permit tee. Drivevay Depression Escrov: Concrete curb atreets oaly. Alternate "A": Removal and replacemeat of curb and gutter only - Drivexay vidth plus 6 feet times =13•50 Alternate "B": Removal aad replacement oP curb and gutter and :install a 3 foot Wide approach vith 6 inch depth - DriveWay width plus 6 feet times =15.75 .� � �. �. .. Permita for eonstruction will De iasued a minimum of 24 hours from the time of application Lo allo� for proper reviev of the proposed atructure aad ot Lbe construction aite. • Certificate of Survey of tbe lot� abowing the 2ocation o! the toundation once it bas been constructed will be requfred before�roceedina With the framiag. R _w � ► �, � [7 � - � AGREEMENT . I, �� /, i,��v' , owner of the property locatecY-�_`,��,� j� �� , have no objection to the City allowing the construction of ,� ��°'�� _, to be located at �� r�� C�� 3�`: without the required certificate of survey that the Cit,y ordinarily requires for all new construction. • . � ' -�---- - - _ ,_.. _ Witnes �. 0 r �� / ''��° � /� :� � � - � �� - � �..:� _�� .� �� - - _�- Address � P � �� Date 0 T � • P° � 1 . / � . / I ."- -' ._ .- _ , . �- � - .. _ ._._- _,.._--�--" t / �� ! �� - _ _ t� �� . s��c� �� s �� S � �o - - ___-_--- �f, d �� , �� \ �� ,, � �� 1 � � � ____ _: _ ._._� _ _� _ . -_�= -_ �_-� = - _ _ , �� 3 .. . � � � L. _ � � �� . -�, � � � _� _ _ -- --� � � � � , _ � - _�fi�� - ��_ � � `� � ,� � ..� �.. _ __, � .`� �� Q �� --� _ � � ��0 � t � � � . �.� � . � � , � � � � � �� o � � � ,,. .� � � �. � - �. . `i ---.� - _ sus�ecr PERMI City of Fridley 17 3 4 5 AT THE TOP OF THE TWINS B U I L D I N G P E R M I T � r � � REC . � `v _.__�_ COMMUNITY DEVELOPMENT DIV. r j � PROTECTIVE INSPECTION SEC. /�� y � 1 = � � /""L � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY �'"'"� � ,�� 612-571-3450 910-F15 11/29/83 � � 108 ADDRESS 5744 Jackson Street N. E. LOT NO. BLOCK TRACT OR ADDITION 1 LEGAL SEEATTACHED DESCR. G 6 Donnay � s Lakeview Manor SHEET 2 PROPERTYOWNER MAILADDRESS ' yZo Z1P PHONE Dave Scott 5744 �'ackson Street N.E. S� �� 780-1071 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. B USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION C� ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Insta.11 a woodbu�ning stove 9 CHANOE QF USE FROM TO STIPULATIONS SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PEFMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONEO FOR A PERIOD OF 120 DAYS AT ANY TIME AFTEH 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 yALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT ��200 y�. SO DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE PFOVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. yS�.S. OO PLAN CHECKFEE TOTALFEE $15e50 S�GN REOFCONTRACTO RAUTHORIZED GENT �DaTE� - WHEN PROPERIY V LIDAT THIS IS YOUR P RMIT � ci � " \ � e�- SIGNATUREOFOWNERIIFOWNERBUIL IDATEI BLDG iNSP �PTE CITY OT fItIOLCY HPPLIGATIa� f0(t �CS10Ci��TII'w t3UlLQ1t:G PLiL'•iltS (I�ch�. Atterations. Additions, or Rcpairs) ON�NER: � ��/;� S CIZ� ADDf;ESS: �'� � a�SO h TEL k0: % �O ��07 I 0 Effective Aug. l. 1981 �t3UI LDER : IM � !�S . /IDa'tCSS: SGCtM'� TEL I10: Construction Location STItIST NO: STItEF.T: L07': � HLOCK: _� ]1DAITIO:i : � � � � � � S Corner Lot: Insidc Lots . Sctback: Sideyards: �_ Ap�lic�-u�t attach to tl�is fo�cm t�.�o Certificates of S1�rvey of lot and p_oposed building location dr�wn on certificates to scdle. DESCRIPTIO�� OF COi;STF�JCTION Front: Depth: Heiqht: Squarc Peet: CUUic.Fcet: Front : Depth : H eigl�t: Square Fe�t: C1�bic Teet: _ '.��pe of Cor.struction : � ��wV h �t Y . Rb Be Obr.�pleted: �� / /S ��( � , ' ��_ Est3mated Cost: S� 0 O, O�r Alt. A Al t. B proposed Drivc��ay kidth If New Opening Is Desired: S S , S�� PiVF.R;L' SIDL OF SiIE�T , 9iie undersiened hereby mal;c� applic�ticn for a perait fcz the �:vrk he:ein specified, agzeein3 to ao .all �ork ir� strict accozdance �ith the Ci�y of 1'ridle�• Ozdi»ances aiid sulin�� of tlie Deik�rtm��t. of Dui2dings, and heseby declares that all tl�e tacts and represc��itiens stated 3n this applic.:tion are true and�orrect. � c. �: I� l� g� Y 3. sic�anzvr. : Stii�ulations : � p � �C� � �� / �. ��' � / � �y�� : �„ �=��n The Chief Suilding Otticial ahall� Defore iasuing permits for the erection of any building or atructure� or for any addition to aay ezisting buildiag or atructure or for any alteratioa or repairs to any ezisting buildiag or atructure� upoa application therelore� require tbe paymeat Dy tbe applicaat for auch permit of tees to tbe amount herein Delov aet forLb and in tbe manaer herein provided to-vit: � =1.00 to =500.00 �501 to �2,000.00 =2�00� to 325�000 =25�001 to �50�000 Fees =10.00 (Mlinimum �15.00) =10.00 for the first =500 plus �1.50 for each additioaal =100 or fraction Lhereof� Lo and including a2,000 =32•50 for the first �2,000 plus �6.00 for each additional �1,000 or fraetion thereof, to and iacluding �25�000 =170.50 for tbe firat =25,000 plus =4.50 for each additional �1,000 or fraction thereof, to end including =50�000 �50,001 to =100.000 =283.00 Por the first a50, 000 plus �3.00 for each additional �1,000 or fraction thereof� to and including =100�000 =100�001 aAd up =433.00 for tbe first �100,000 plus =2•50 for each additional �1,000 or fraction thereof Plan Check: 25 percent of building permit fee. Driveway Depressioa Escrov: Concrete curb atreets oaly. Alternate 'A": Removal and replacement of curb and gutter only - DriveWay vidth plus 6 feet times =13•50 Alternate "B": Removal and replacement of curb and gutter and ;install a 3 Poot Wide approach vith 6 inch depth - Driveway width plus 6 feet times =15.75 9erification Of Fcuadation Per�ita for construction Mill be iasued a miaimum of 2� ho»rs from the time of application to alloW Por proper review of tbe proposed structure aad af tbe construction aite. A Certificate of Survey �oP tbe lot, ahowing the location of the touadation once it bas Deen constructed xill be requfred �efore croceedinpr trith the framiag. °-� a � . � w rt � M x � � � � o � x � � � w � K O p. � � K � n � � m o '� � M o a �r � u. a.� �. ro ° � � � w "' � � � � � m F,, ro K � a � � a � n E te � � rr m ro� f�11 H �� o h1 H� �� n x �� czi ro � � H � � cn 0 0 H !n Q r � ro o a � � � I� � � v i ; O � � n � � c`ti t�' ty' N ro � o r c � � � � ro ro N w w rt � � 0 C w � � m ro v a rr N b a � � � � n � N � cao r� ,� �° 5' ,� z czi � � � " .N N � � a �_� � S ro 1D a � W � o . � . � rt � A M � � � n � ' � b7 R M � � � M � w � ao w � c�'o � � c� m w x � a�yyy 0 M C O b� � � V 1 F' �' Z r Q O � n � � I� � � A cy' . � � � � • m ro � n 0 a � � m � r � 0 0 �rt a rt m � y a � � w � � � � � 0 v, u' O O n � r ev � � H a r � � � � e M N ro �'O � n � H 0 rs � � . h�+ W r ti ao O f� O °� a cm rt G (�D � c� ro w MM � �b � p �� N ►-• a a w m� m n r°t rt o� x� � F+ 0 0 0 c� c� c� � � � m m To m n r�t o � �rowro �� w n c`�o � w � � � � o r Mr � � �* w a p � � � �� W X :°. v. � � � � F+ I-' F+ N ;U o a o o �� 0 0 0 o tyai 0 0 0 0 � � � � � � �' � N 0 0 0 O O �J O O Q � � o � C i � � ° � g � ° a o � � H y � 4�] c�i � ro °r� �S � a H -C/b �•. N Q„ O v �p �} +� � �. � n � 0o fo Cf) W �`o O \ (O o —� Q v cA � � � � ��p H H z O t� � � ?-• �i � � n � H O � � n a�� "' ro a a z �A � ro � �o w a�p.� � WN � JM ht a� a a r�n m "�tl o ri4t w u�i µ° � f�0 M W m O� G A ' � `� x ~ � � �ro°ry w � � � ; o �' ar � � � m�or�, w A � � �,' rt i"' � r f� w � o �d �A � � �' a a •n M a � �' ��G d C F+� r � eS- ��am m r- (n m � � o �C ?�1� ' "'°rt� c z M ;� rn n a n � z O � � � `7 N W'G m � W � fD W M �"� W � � � H � 00 � � � � � L4�+C] � � W l!� . � f7' 'G k' N � f1 F~+ p� M I � � � � � � � . � � c-� z � m y � v r c� D � 0 z � 0 � 0 � m � ar� � D O ai z cy a ►- z � G .. o x Z �o-. iii �-�i Z Cn G7 � � N ��7 C") 3 O N � G � m m < � n � m � y -� 0 z . � m � .� c� m � D � O z n z C V qi � Cf`t 1 � 00 � � CHIMWEY AND STAC� VERIFICATION The undersigned hereby verifies that the existing chimney or stack; 1. Has been carefully examined Yes (� 2. Is free from rust or deterioration Yes (�) 3. Has no foreign objects lodged within Yes (�() 4. Is securely supported Yes (�(} 5. Meets all current Code requirements for size and _� - _ tots�l �TU �ornP&�ed- 6. Has To ta l hea ti ng BTU' s of ,�/ 4D0 All other BTU's TOTAL Rema rk s /// . i � �' �i d� �' No ( ) No ( ) No ( ) No ( ) Ye s - �; � N� � � — Com pa ny C� v�� t' c�. i�° P�✓I �• Signed By Da te �� ' � 1 sue�ecr P IT N O. City of Fridley 2 0 7 9�� AT THE TOP OF THE TWINS g � I L D I N G P E R M I T r r � ` RECEIPT NO � ; y _ COMMUNITY DEVELOPMENT DIV. t � � PROTECTIVE INSPECTION SEC. O� � y � _ � � /"'1 � CITY HALL PHIDLEV 55432 NUMBER NEV DATE PAGE OF APPROVED BY �""'� � �� 612-571-3450 910-F15 4/30/91 � � J08 ADDRESS 5744 Jackson 5treet NE t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. Fi 6 Donnay �s I�a,ke�iew Manar SHEET 2 PROPEFTY OWNER MAIL ADDRESS 21P PFIONE Ja�es/Mary Kostick 5744 Jackson Street NE 572-2582 3 CONTRACTOR MAILADDRESS Z�P' PHONE LICENSENO. 5ame 4 ARCHITECT OR OESIGNEF MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS Z�P PNONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK O NEW I� ADDITION ❑ ALTERATION � REPAIR O MOVE ❑ fiEMOVE 8 DESCRIBE WORK Construct a 14' x 14' Addition a,nd a 14 e�c 10" Deck 9 CHANGE OF USE FROM TO STIPULATIONS See not�tions on lan, aicle p ya,rd variance to �. �eet approved by Appeals Commission on 4/16/91� I�AR�11N� 8��' di;g��ng caN for at� � �uRl�� Io�tions `��@0� �� SEPARAT� PERMITS REQUIRED F�R IN`^ING, HEATING, PLU��61�1�a As�D ;iIGCJS. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OFi CONSTRUCTION ZONINO SQ. FT. CU. FT. AUTHORI2ED IS NOT COMMENCED WITHIN 80 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 HEFEBY CERTIFY THAT I HAVE READ ANO EXAMINED THIS APPLICATION �- STALLS GAHAGES 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 $�-�-� 75'O $5 • 88 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- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $13 rJ. QO �.�''].�E SC �`I.�. a 75 PLAN CHECK FEE TOTAL FEE $152, 63 SIG�� UREOFCONiRAC ORAUTyO DA ENT , IDA,E� yy EN PRO ERL D T HIS IS YO R PERM(I�T� �� - • / � 6 :�°� ,��, � �° / -se- e� iGNATUREOFOWNERiIFOW E BUILD�R� IDATE BLDG �NSP npTE s� E��i a .. �+- [l [�l [] R-1 AI�ID 1�2 Huilding Fiermit Applicatiaai G�strvctiaai Addres.s: �7 /�/' ../� <��a�� 5��.�.� �� Effective 1/1/91 I,e9a1 Descr,r'iptiaais �� '��,� � � s�. <.�° �:�..i ��.��'o� �� i f �.�L. � C' � (� Owi�er I�k�e & Aaa,-��; _ ,l�.n-a,aS = 0"��2� � .,��::� ��'� �,�� 'Pel. �� i� ,. � # .5��- �.��-wi< ��: �:.� � .�� . .,;,. r.� •r• r.- • •��+• .�s«- . ��._ . �•��,� v�6 � �� . # � Attach to this applicat3aaz, a Certificate of S�vey of the lat, with the prcypo�ed ooa�tn�ctiaaz drawn aai it to scale. D�8(�'I�T �' Il�VH�Ji' Le�h width � xeight l�� °°sq. Ft. f/�O IP��1 W1C1�1 He1C�lt $C;. F''t. I�xygth wiatli Ir)' xgt/Gro�urid sq. Ft. /� %` � / �/� �' �V % ��j ��c�� _d (! i � �1 <�e � m � �� Z ( I i �� Corner Iot [] Inside Lat [] Ft. Yd Setback Side �Sa �s Z�pe of Cbnstruction: FstimatQd Qost: $ � �' � - ' �' � Approx. C7aatq�letion Date: ✓ 0 � / - � / Proposed Driveway Width If Ne�a Is Desir�ecl: Ft. $ $ + 6' See Back Page I�ATE: �0 / APPZSC'ANI': 'Pe1. # S%Z- a.S�� CITY T� �Y i P�ermit Fee $ � '�� Fire Surcharge $ , 7 , State Surrharge $ r SAC Charge $ Driveway Esc�vw $ Park Fee $ Sewer Main Q�aYge $ . �. s-ri�c�s: S�o� �� s � � F� . �f�(�.e P�� pP��c� C`_`� Qer �� .� �1 � l �� r �20�► �v ' �v �i l Fee Sch,edule aai R�verse Side .001 x Permit Valuatiaa'i (1/lOth $) $.50/$l, 000 Valuatio�'i � $650 per SAC Unit Alt. "A" Or Alt. "B" Above Fee D@t�Y�*+� by �i rw�ri rrr � � �ar�"t Neoe.ssazY [ ] Not Neoes-�'Y [ ] /i,'7�o ,� �, dou - yJs � �0�`� �� / 3�'0tJ �Z. � a� �, �� ) �� /'� � ��° �:+�1� � �y i:,�� `�+` r�.:i:�� e Qzief Buildir�g Official shall, before ?ss�*� permits for the erectia�n of any buildin� or sttwcture, ar far� atzy aaditi.aai to atiy p� G* i m buildinq or stYUCture, or for atiy alteratian or repair to a� existiryg buildinq or st�ruc�ture� upon apPlication therefore, require the payment by the applicant for � permit of fees tc the amaunt herein below set forth at�d it1 the �anr,ar �jn p� to-wit: �L V�IIIJE $1 to $500 $501 to $2,000 $2,001 to $25,000 $25,001 t�o $50,000 $50,001 to $100,000 $100,001 to $500,000 �� $15 (Minimffi Fee is $15 plua su�dlarge) $15 for fiYSt $500 plus $2 for eac�h addi.tional $100 or fractia� th�ereof, to at�d includir�g $2, 000 $45 for first $2,000 plus $9 for each additional $1,000 or fractiCd"1 theTeof, to at�d iTicludirig $25, 000 $252 for first $25,000 plus $6.50 for each additional. $1,000 or fractia�l thereof, to ar�d includirig $50, 000 $414.50 for first $50,000 plus $4.50 for each additional. $l, 000 ar fractioa�► ther�eof, to ar�d incltxiir�g $100, 000 $639.50 for fixst $100,000 plus $3.50 for each additional $1, aoo or fractia�► thereot, to ana includir�g S5oo, o00 $500,001 to $1,000,000 $2039.50 for the first $500,000 plus $3 for each additional $1, 000 or fTdctiCa'1 th�ereCf, to aryci including $l, 000, 000 $1, 000, 001 ar�d up $3539. 50 for the first $1, 000, 000 plus $2 for each aclditional $1, 000 or fracti� ti�ereof �tI�Y �BI�T ffiQmW (Doa�crete Gtitb Streets On1Y) Alternate ��p,n : R�oval a�i replaoe�oent of c�rb ar�d gutter o�ly - Driveway width plus 6 feet times $13.50. � Alternate "B" : Re�oval ar�d replave�ent of curb ar�d gutter atri install a 3 foot wide approach with 6 irx3z depth - Driveway width plus 6 feet times $15.75. ,��; .� �� .: . � -.�� .. .; Piermits for �stn�,ctiaai will be issued a minita� of 24 hairs f�n the time of applicatian to allvw for proper review of the proposed stn�c4ir+e ar�d of the cor�truct3on site. A Oertificate of S�nvey of the lat, stivwing the locatioai of the fau�dation o�e it has it has be�n co�s�ucted will be required before proc�eedir�g with tl�e fi'dming• , � � Q � � �',. /� � C �1 �J � I ti7 .. -. - -1----_ ~, Q -- _--''- . - � .� {� �:_ ,-� ' \ . � � �_ � � f1 ` � �n � I -- - - `'� \ — � •'T1 d -�.. y G�. � _ ' ,, - � � ' .� � . `i)� � ��., r `•,`� I � - :i � --�_� �__` IF _ t_.____,_ � __ �i J L ' � � i � I � la. � 3 � =,i �� _ I � � � � � a; �� -� � ° � . � � � �' ' , �� ti 'd � 1 — ty`, � � `4 � � v r I � � � �1 � � s L �� Q � � .� �� J 1 � 1 e- i � ( � I '•l� ;��.� � '�.,\ ;� �O � � � � �o � cS�- � `� � � � �° �' � • � "� �' � �' - _ � � � �^ � � � �C, �^ _ �.� J �_ � " � � �} ��y d ' R � `� `� � C7 �''Z.0 � � � �- -- � � � �� 9�.� ° - __�`_� � ��, � � �, ,� i � ✓y� � --___'_. ♦ 'J � - \\` -_ � \ • � . `V V � � � ` � � - 9� '. , � � ,; ' `� '� __ . =�'_o�. � `�' _�. � \ _ �;_, . . � _ � ._,. ` I `� �� n a � � � i � o � � S 1, �. � - - - W � v ! � � \ 4`( V ,S u V � - � � � d � V � � ^ � � Y� �~ O ( ,' � ' �, � ,f . � '� • \ V � ` . ! � J 1 � � � � �'• . I v . �—__ -` ' - --_- i ,', . ,! � '� `� -•_. � ._ ' V : � c � N � � Z � � O / � �� -- °� -�, c� �� p �� ^ � � �� p � � �G � � � � P � 1 --' � � � � � � d � � fi � s -, o n Z � � � � ��.;� , ,�»� B �1 � � �'�� 9 �� /Z, �� o 5► i. 0� �C `?� . . .. -- —_ --- ,.i:a i I ; � f� I .� 7Q �'.l C�n' i�� v7 ��fl 9 '� � 2� ,�� ,.t a�d�-� . s3�fr� ��t��' � .?�:(.�'-� Q�� ,�,�o�Y?r4��X3 , � ��ea . .�� , �T u 1u.�n-. .___....__ � ,,. -----'� ; ��' 1l�/ �y�,�cT :�.� � o}t , c�� rY 1 fY„��l CJ _�i �, , �� S �; f,�G�d .� � �, r�" � � � �. �� I-� .�:: ._..._..___.. � _��r �� k� �� ; r�h� � `~. �� ,��(l.�l � ' ��`-a�;i � 1 '�° � f � �*�•' � �,;d� �� ,, ��S � �,�, .� �� / y' ov1�� JJ C, � c��l�v3 �?`(11 ��- �J N ��L� �c�9 CY � '� „�I � �i/ X Z° �I—`� � ��, ----�.�.... --Y—� � � � ��.�� •� � ��7� 9�r � � a T �� a _� . _ __ . ,. _ ., . .. ._. . .. ��i�� _ ��,�'-jb SS�7� �h' �----- 0 9 � / Ms�-� � � f� s�,� -- ��'� � � �� h� -� a�� 2 y � ��a o o � j.� ;� �q � �� - _ -- -- ---- _ _� . l nD�.' I . �� ; ��'3� ,, .� � ��-.. . � �� x �v� r f ' = D � �` 7 � 0 � q� � o N (p � y O � 3 � a o o� ?: v � �� -� a 0 �� N � � � w 1 1 a � � � 0 c ... � m � n m � m Z � � C � z n m � m Z � -9 m n � Z TI m m � w 0 0 0 m a a � 0 m a 00 � � � 0 c co � I 3 v � � � � � v N m � 1 V� i � � � � � � a � � � m O U` �' t � `1 � � _ D � Z � n � o `� a m r tn � m � m m � � � � (� o C � � � � a m Z � � 2 'O � m z 0 m' v � 0 0 ,1 D \ � � O O � ° � � M � �� C � � � D rn �� ' � � � � N 3��a g,.. a �� 1 � 0 O o �� o� � �� . � O . Z � D nT . v � � � -��i � o m C a o m �, w � � � m � � c � � _ � � n N � c� � m � m � a v� � o m � a� m " �,oz /� � • 0 m m � � � a .; v � n � 0 Z O C � z n m Z v � � C � z m � s D n 0 � 0 � � � a � � H � � H v � 1 � � N � � � cc � � � � j J �..► 0 0 0 0 0 0 0 0 0 � � � m � � -�i v n � � �� m � � Z O �, � � � C r v Z G) C � m v �, G� N � � z m � G � � � � � � � � � � Q 0 0 � � Z � a y C y o � a � m �: p� EJ) — ci ? � � m � .�+ a � v � � m� 0 � o� � , � � i � � � o � o m � � n r q �c� �-� m�'�� 'o>> fl' ? � �' cao n � N � � o �, � n v, � n a - � m .,-n► � �. � a na � c° �' � � � ��,fDQ m ~�� y � O � � W a � 0 � a � � y � i v � v�� y. � O 0 3 a � � � =. � � � o y �' � � � m � 1 1 � m C' � :+ R� `� � -� � a � o 7 n � �' � m 1 .. � t�A � O � � � � co 1 a m � c� _ v c m � � a � v � �� v � � C7t � � C7 V =. A rvaw� � � �� C 0 � < � Z N � N ,� v r N m � zZ m� � � � Z v < �� p r � n ma n O -� Z O �t Z O D � z � vp v_� �m c� 7° O� z vZ -� N oD zZ �° 2 � � � Z � � ZO v r vz �� nm mZ � � � z � � � •�_,+ � O � � � C � ...i � co � a��Q �g pa�bzg 1CIZKd1nt0, 9i�IIS�i�H :aQOQ u�rag suoi�8se}T�ai �siZ sx.zeutag s � llss ZKSOs S � f1.ZS .zaLl�o tt�i 3o s� nyg b�ti�Eat� TE�o�. sEg • 9 () oH () sa� pa��ac[ao� s��g TE�o� p�te azts .zo3 s�uau[a�inba.z apo� �ua.z.zna ttE s�aaL1 • g ( ) oH ( ) sax pa�.zoddns �Cta.znoas sI • � () oH () sa� uiq�Trr pabpot s��aCqo ubiaio3 ou sEH '� () oH () sa� uo��E.zoT.za�ap .zo �snz iuo.z3 aa.z,� sI • Z () oH ( j sax pauiu�[Exa dZTn3a.zEa uaaq s�H ' T :X�E�s .zo �tau�tttua bui�stxa au� �2u� sai3i�an �iqa.zau paubzs�apun aus Hois�r�i�ix$e x��rss a�ia� � sue�etr IT NO. City of Fridley 29538 AT THE TOP OF TME TWINS g � I L D I N G P E R M I T r � � RECEIPT NO. � `y �_��_ COMMUNITY DEVELOPMENT DIV. r � � PAOTEC7IVE INSPECTION SEC. � �/ � 1 . , � _ �'�'1 � CITY NALL FRIDLE� SS132 NUMBEA NEV DATE PAGE OF AVPROVED B� �.---�: �.' 612-57t-3450 910-Ft5 5/24/99 / / 10B ADDRESS 5744 Jackson Street NE 1 LEGAI �OT NO. BLOCK TRACT OR ADDITION SEE ATTACMED DESCR. 6 6 Donna 's Lakeview Manor SNEET 2 PROPERTY OWNER MAIL ADORES$ ZIP PNONE Jim Kostik � CONTRACTOR MAIL AODRESS 21P PNONE LICENSE NO ualit Contractin 11380 W Ri d Cham li 5531 4 ARCNITECT OR DESIGNER MAIL ADORESS 21P PNONE LICENSE NO. S ENGINEER MAIL AODRESS 21P pHONE LICENSE NO 8 USE OF BUILOING Residential 7 CLASS OF WOqK O NEW O ADDITION ❑ ALTERATION � REPAIR O MOVE O REMOVE B DESCRIBE WORK Reroof house and ara e 2b Tear- f 9 CHANGEOFUSEFROM TO STIPULATIONS Underl ayment must comply wi th the Stat e Bui l di ng Code. SEPARATE PERMITS ARE REOUIRED FOR EIECTRICAL, PLUMBING, HEATING, TYPE OF CONST OCCUPANCV GROUP OCCUPANCV LQAD VENTI�ATING OR AIR CONDITIONING TMIS PEFMIT BECOMES NULL ANO VOIO IF WORK OR CONSTRUCTION IONING SC. FT CU FT. AUTHOR12E0 IS NOT COMMENCED WITHIN 80 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED Ofi ABANDONEO FOR A PERIOD OF 120 DAVS AT ANY TIME AFTER WORK IS COMMENCED NO OWLG. UNITS OfFSTREET PARKING 1 MEiiEBY CERTIFY THAT I MAVE REAO ANO EXAMINEO TMIS APPLICA71pN STA�LS GARAGES ANO KNOW TME SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAW$ yALUATION SUR7AX AND ORDINANCES GOVERNING THIS TYPE Of WORK WILL BE COMPLIED q WITM WMETMER SPECIFIED MEREIN OR NOT. TNE GRANTING OF A pERM1T $2142 y. O% DOES NOT PRES ME TO GIVE AUTHOiiITY TO VIOLA7E OR CANCEL TME pEFMl7 FEE SAC CMARGE PROVISIONS ANY OTM 7ATE OR LOCAL LAW REGULATING CON- STRUC 1 Oq TM P � OF �83 . 25 F� e SC 2. 14 PLAN CMECK FEE T T � FEE � ns SC .00 1.46 S�GNATUpE O� CON'AACTOA OA AUTHOp�LEO eGENT �DAiE� ME P V VA�I A D�TMIS IS V �IT �� S�GN4TUAE O� OWNEA�� OWNEpBU4DEAi �O�TE� � B G�h5 pd E �w [ ] ADDN ALTER Eff�tive 5/10/99 [ ] CITY OF FRIDLEY [] SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2 BUII,DING PERMIT APPLICATION 1��a� �� 0 �� Construction Address: � 7 T� � G�e I�s�'�-� S�' Legal Description: Owner Name & Address: � r� �S� r f� , Tel. �# Contractor: � ( c ^F � ��csu�e � �. NIN LICENSE # /�j �,S' P Address: � C.c� , e�(> 2�' Tel. #�Z 7— 7%� 3 s Attach to this application, a Certificate of Survey o the lot, with the proposed construction drawn on it to scale. LIVING AREA: GARAGE AREA: DECK AREA: OTHER: DESCRIPTION OF IMPROVEMENT Length Width Length Width Length Width Height Height Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft. � ��,�� -v Construction Type: � `� (` `�� Estimated Cost: $ Driveway C�rb Cut Width Ne.eded: Ft. + 6 Ft = Ft x$ _$ . DATE: � � APPLICANT: i° � ' l�' � ��a `'� Tel. � �Z � —7 7,� � CITY USE ONLY Permit Fee $�,o�s� Fee Schedule on Reverse Side Fire Surcharge ot'• �'� $_�� .001 of Permit Valuation (1/lOth%) State Surcharge f p� $ $.50/$1,000 Valuadon SAC Charge $ �� $1050 per SAC Unit License Surcharge $ t��C� $5.00 (State Licensed Residential Contractors) Driveway Fscrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [] Not Nec,��azy [] TOTAL STIPULATIONS: $ • 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 a�teration or repair to any existing building or structure, upon application therefore, require the payment by the �pplicant for such permit of fees to the amount herein below set forth and in the manner herein provided to-wrt: TOTAL VALUE $1 to $500 $501 to $2,000 $2,�1 to $25,000 $25,(�1 to $50,000 $SO,QOl to $100,000 $100,001 to $500,000 $500,001 to $1,Q00,000 $1,Ot?0,001 and up �� $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 $1,000 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 $1,0�,000 $5,608.75 for the first $1,OOO,a}0 plus $3.15 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 �15.50. 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 $23.25. VERTFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the tune of applicataon to allow fo� 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 bas it 1� b�n �o��tt� will be required before proceeding with the framing.