AF - 47364•
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L�
Date:
�.,,�
i f Fri Min.n. �
ty o dley,
BUILDING PERMIT N� 6 5 9�
_ �-._� �-.� ..�____._ __._.__ °��9°�"�
.
..... �..e�..._.�1..�-,r.� Builder _.._.. _.._. .. .. .._.__..._.._...._.._....._.._..
Address._.__._..__._.___._....______._.....,...____._...___.____.._.___.._._ Address
/ � L TION F B ILDING
No. !��._,��..� _. Street _._... ... .. . _.. .�. .. :,. f�,..�..t..... Part of Lo ...._..�r ...� _.__ _.__...._ ......._
Lot _.._....�i . .Ns......___ Block ._._..--� .._._._._._._ Addition or Sub-Divisi� _.... � -- -__._ _.��
-- � /
Corner Lat .___.__._...�_ Inside Lot ._._._. �� --_._. Setback ._...�,�...---__._._ Sideyard _...�� _�..�..:_.__..._
Sewer Elevatio� __......_..___.._.. ._.._.__._.._ _......______ Foundation Elevatian
DESCRIPTION OF BUILDING
� v�ea /'
. . ... Front _�� Depth ...�(�._. Height ...�aQ Sq. F� ..l�Z...�Cu. Ft �!'.`_..9.�G.d
__ f�µ ..t...__ Front _��.�..�_ Depth _.�. . H'eight ...,�.�.� Sq. Ft. ._.c.�.LL.Q. Cu. F� ���
_.__.
Type of Constructiott—�.. . ._ ._._ .__ Est. Cos �.�,. ..�.�' �.�...�....."fio be Coznpleted __._. .
In consideration of the issuance to me of a permit to
the proposed work fn accordance with the description ab�
ordix►anoes of the city of F`ridley. /
in
described
�� . permit is hereby granted to.�
In co�isideration of the payment of a fee o_ `�...._. ,
to do
�ns of
to c:onstruct the buildix� or addition as described above. This permit is gi'anted up�
the express condition that the person to whom it is granted and his agents, employees and workmen, in all wark
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinanceg o�
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of bufldi�►ga
within the city limits and this permit may be revoked at ar�y ttimeme upo� viola.tion of any of the provisio�s of said
ordinances.
. Buildin8 Inspecto�
NOTICE:
iUis p�emie doa not eowr th� eon�rue�ioe, Inuall�Non fe� wlr�. P�+�o. Y+� �0. �wva or wa�. d� wn to a�
fM 6uiWing le�p�cfo� for a�p�raN pwe�ils fo� f6a� i1Nns.
, , ,
R�
J N.,�. .�jy _�.� '� �.."',i _ k.?'� `^i � '�. ' 1.`[ $ P� .�Y.
,7�: .+�, �<«i-s :,i't, a,� ;,VR;' '»'4,�, '>
Y,. � a ....�., i' ":� '� 'i� �. " . r � .:�.` ,/` c., . .. ,�.
� PARTtAI R�TE SC��aiiLE
aaavtrt waaa�t �rx: as�s zo�r�►r..
�n sh�ii a� �c wo� . . . . . . . aio.00 i�
Replacement of Ptiarnace 6.00 $
a
Rcpai*s & Aitcratioas--up to f50d.00 . g pp �
Repairs dc AlteraUons each add, t500.00 . 3 W =
w�cx. w�c xnt
�are sbeti a� Durt w�� co iw,000 B'rv
tath add. 60.000 BTU . . . .. . . . .
AepLcetnent of F1�rnace
Reflairs & Alterations—vp to 5500.U0
Aepairs &� Alterations each add. i�0•00
..aio 00 �
3.W ;
6.00 !
6.00 =
3.0o i
STEAM o: HO? W1►TEA SYS?EB[
Fl�rr:ace Shell Sc Lines—to 400 sq. tt. F.DR Steam �IQ.4p S.
F�srnace Shell & LinP—to 640 aq, ft. EDR fiot Water 20.00 s.
Each add 200 aQ. tt. EDR Steam 3.()p =
Each add. 320 sq. ft. EDR Hot Water 3.00 s
OIL BIIRKER—to 3 gaL per hour 6,00 S.
over 3 gal. per houc--See Pee Schedule
GAS 3IIR1fER (uD to I99.000 BTU1 6.0� _
over 199.000 B'T[I Sa� F« seh�du]•
G118 FI1'TING FEF.�: I10 R11TE TO?1►L
lst 3 Flxtures x� 200 S
Additlonal Flxttues x .76 =-- -
Gas Range tv 199.00� si 6.0� S
��Qx a2-�q��j„�yQ1� State Surcharge .50
CG� �' - f
!]U� STiT�t � � TN Se3�duL
v�rn�.ar�c s�rsr�r �
u.'RRATiolts t REPAIlt3� 20'i'�I. lE1L �
sovax
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Cfty ot �Y�'idley: •
The undersigned hereby makes application for a permit foa the wor3c Aereir
specified. agreeing to do ati work in striet accordance with the Ci4y Ordfmancef
and niling of the Departm�nt of Buildinas, and hereby declsres that aID the faci�
and representatiuns statcd in this application are true and correct.
Fridley, Minn . ��i,( �1- �!1 � 1� J�
�Jsed ac .�y�11C.!/_-[.�L� � -
To i�e completed about,� L����7`�"" _
Estimated Cos� 3 �
Old Nerv. Building Pernvt No. __.__ P�rmit No.
—`-�� `�
,.�„. .. �_ �L;
i�ATTNG or FOWER PZ.ANT3--.Steam, Rot Waler, Warm Air—No
7'rade Name Size No
Capacity---- — S9. Ft. E.D.A B1V H.P
TotaI Connected i.amd 1Cind et 1ruN
BURNER — 'Ilrade Nam@ Siu No
Capacib 84. !'t. L�.D-R B'!'�T �
(NfMAlti�01RR�
i
.,_� /i✓ _ �� / .�� �:� il
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��_ �ll11AI� � ' .[��
".� � _I,I
y y SUBJECT OR i3006
Cit of Fridle
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T •
r
; � RECEIPT N0.
� ; L __�_�_ COMMUNI7Y DEVELOPMENT DIV. �^
r � PROTECTIVE INSPECTION SEC. �
i �
1 �
14 � /"�1 � CITY HA�L FRIDLEV 55432 NUMBER REV. DATE PAGE OF � APPROVED BV
`•"'�' ��� 612-560-3450
910-F15 6/9/75 � �
JOB ADDRESS
6295 Jackson 5treet N.E.
1 LEGAL LOT N0. BLOCK TRACT OR ADDITION SEE ATTACHED
oesca. 16,17 5 Florence Park Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Norman Young 6295 Jackson Street N.E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE IICENSE NO.
rnest ren Box 53A Ro ers Minnesota
4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO.
same
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
residential
7 CLASS OF WOFK
❑ NEW �7 ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
construct a fire lace(basement)
9 CHANGE OF USE FROM TO
STIPULATIONS
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING. bY'1C�C
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAVS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PEfiIOD 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 S1�2OO .6O
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-
STRU TION OR THE PERF NCE OF CONSTRUCTION. �S`% . ZO
PLAN CHECK FEE TOTAL FEE
�� r � l S %.80
SIGNATUREOFCONiRACTO AUTHOR12EDAGENT IDATEI WHEN PROP L I A D HIS IS YOU,}i P MIT
C/ � �/
J
SiGNATURE OF OWNEfi11F OWNER BUILOERI IDATEI BLDG. WSP ATE
• -� . •APPLICATION FOR R�SID�NTIAL., ALTERATION,
OR AllllITION.BUILDING FERMIT
CITY OF FRIDLEY, b1INNESOTA �
. , _ . ,. .
OWNER' S NAME :_ e K � BUILDER :��^ � e.r° � � .e.
/�� •
aDD�ss : ��a2 l � �,9�` �S Q�' ADDRESS : Qo x s" .3 �09 P �.r /,�/l�-�.�.,
. _ _ .f
N0: . ���5 STREET : �A C�.f' O�y' �
_ ..� . .� ��., }
LOT c l�� % BLOCK: ADDITIOIv': �/� '� p^' � P �i�h i� .v ,
_ • �
CORNER LOT: INSIDE I.OT:�_,,,SETBACK: SIDEYARD: t
;,
• . . �
,.
, ,.
. �
Applicant attach to �his: far.r. �.tao Cer�ificates of SurveY -of Lat an3.,gropose,'.
building location drawn on these Certificates. ��
i
-!
. . . - �
. �
• DESCRIPTION OF BUILDING � '
. !
Ta Be Used As : , / ;
�/h� b/ �,� -P .
, / ,
Front: Depth: Height:
- Square Feet: Cubic.Feet:
� Front: Depth: Height:
Squaxe Feet; Cubic Feet:
Z�rPe of Construction: coNjtv� Estimated Cost: $ �,Z �D� O�
,
To Be , C.omgleted ���� " � S . . .
Tfie undersigned hereby makes application for a permit far the work herein
specified, agreeing to do all work in stiict accordance with the City of -
Fridley Ordinances arid rulings of the Department of Buildings, and haxeby ,
declares that all the facts and representations stated in this application
� � are true and correct.
. ,r �j � . �
DiATE : ,,,� / s SIGNAT[JRE . �
(See I;everse Side For Additional Information.)� �
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,� � 6��,��-�
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,.
SuB�ECi
City of Fridley
AT THE TOP OF THE TWINS g � I L D I N G P E R M I T
r
� .
� �
� • COMMUNITY OEVELOPMENT DIV.
r � L •� PR07EC71VE INSPEC7ION SEC.
� �
� L �"'1 � CITY HALL FRIOLE� 55�32 NUMBER AEV DATE
�'""�� �'� 612-571-3450 910-F15 7/10/98
JOB ADDRESS 6295 Jackson Street NE
t LEGAL �OT NO. BtOCK TRACT OR ADDITION
DESCR. ].(), Pt 17 5 Florence Park Addn to Fridley
2 PROPERTY OWNER MAIL ADORESS Z�P
B1air Sjostrom 6295 Jackson Street NE
3 CONTRACTOH MAIL ADDRESS ZIP
Same
4 ARCHITECT OR DESIGNEf; MAIL ADORESS ZIP
5 ENGINEER MAII ADDRESS Z�P
6 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW ❑ ADDITION O ALTERATION f� REPAIR
8 DESCRIBE WOFiK
Reroof House & Garage (20 Sq) Tear-off
9 CHANGEOFUSEFROM TO
�
26546
RECEIPT NO.
�/��
OF APPROVED BY
�
SEE AT7ACHED
SHEET
PHONE
574-00 9
PMONE LICENSE NO.
PHONE LICENSE NO.
PMONE IICENSE NO.
O MOVE O REMOVE
I STIPULATIONS
Underlayment must comply with the State Building Code.
TYPE OF CONST.
SEPARATE PERMITS ARE REQUIFiED FOR EIECTRICAL, PLUMBING, NEATING,
VENTI�ATING OR AIR CONDITIONING.
?HIS PERMI7 BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING
AU7HpRIZED IS NOT COMMENCED WITHIN 60 OAYS, OR IF CONSTRUCTION
OR WORK IS SUSRENDEO OR ABANDONED FOFi A PERI00 Of 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. OWLG. UNI
I HEREBY CERTIFY THAT 1 HAVE FiEAD AND EXAMINED THIS APPLICATION 1
AND KNOW THE S/YME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION
ANO OROINANCES GOVERNING THIS TYPE OF WOFlK WILL BE COMPLIEO
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GFANTING Of q PERMIT �1,668
OOES NOT PRESIfME TO GIVE AUTHORITY TO YIOLA7E OR CANCEL THE pERMITfEE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. �S�F.00
A
A BWLDEA�
D AGENT iDATEi
SO.FT
STALLS
CU. FT.
f PARKING
GAf1AGES
$.83
�AC CMARGE
Fire SC $1.66
O/T �� FEE
�$56.49
; THIS I$,.Y�UR P�,M�
�r �
NEW [ l
ADDN [ ] CITY OF FRIDLEY . .
ALTER [] SINGLE FAMILY -AND DUPLEXES R-1 AND R-2
y, ,
BUILDING PERMIT APPLICATION
ConstructionAddr�ss: + C�� t `_�
Legal Description:
Owner Name &
Contractor:
Address:
LIVING AREA:
GARAGE AREA
DECB AREA:
OTI�R:
Construction Type:.
�riveway Curb
DATE: �
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main CharQr
TOTAL
STIPULATIONS:
r
(rC.1
�
Tel. #
Effective 1!1/98
��c�
, �.� � �. .
MN LICENSE #
Tel.1f �
Y c����
�"' Attach to this application, a Certificate of Survey of the '
lot, with the proposed construction drawn on it to scale.
°. , . . : DESCRIPTION OF IlVIPROVEMENT ,.
Length . Width �� �<Height Sq. Ft.
,_ Length . Width Height Sq. Ft: :
Length ' Width � Hgt/Ground /S�q. Ft.
- ... n t � • .. l / w /' /
� v v / p •.
Estimated Cost: $ l � �C� �
� � (Fee Schedul e, on Back)
Width Needed: Ft. + 6 Ft = Ft x$ _$
� APPLICANT: . Tel. # �/ �w'`=��
_ CITY USE ONLY
$ J''7. �(, Fee Schedule on Reverse Side
$ � �n �° .001 of Permit Valuation (1/lOth%)
$ � $.SO/$1,000 Valuation
$ $1000 per SAC Unit �
$ $5,00 (State Licensed Residendal Contractors)
$ Alt. "A" or Alt. "B" Above
$ $450.00 Conservation Plan Review
$ Fee Determined by Engineering �
$ Agreement Necessary [ ] Not Necessary [ ]
$ ���
.., `
sue�ecT PER
City of Fridley 313 51
.
AT THE TOP OF THE TWINS g � I L D I N G P E R M i T
„
� � R .
� ; v__ COMMUNITY OEVEIOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC. ��� �
1 � � �J
� � �"'1 . CITY MA�L fR10lE� 55�32 NUMBEA pEV O�iE P�GE Oc �6vnOVEO Br
�----�: �.' 612-571-3450 9iQ-Ft5 8/28/00 � �
JOB ADDRESS 6295 Jackson Street NE
t LEGAI LOT N0. BLOCK TRACT Ofi ADOITiON SEE ATTACMED
DESCR. 16,17 5 Florence Park Addn to Fridley ShIEET
2 PROPERTY OWNER MAIL ADORESS 21P PMONE
Blair/Deborah Sjostrom 6295 Jackson Street NE 574-0029
3 CONTqACTOR MAIL ADDRES$ ZIP PHONE LICENSE NO
F& S Remodeling Service 24329 Seelye Brook Dr, St Francis MN 55070 5989
� ARCNITECT OR DESIGNER MAIL AOOFiESS ZIP PMONE �ICENSE NO.
763-753-0231
5 ENGINEER MAIL AODRESS ZIP PHONE UCENSE NO
6 USE Of BUII�ING
Residential
7 CIASS OF WORK
O NEW � ADDITION O ALTERATION �] REPA�R ❑ MOVE O REMOVE
8 DESCRIBE WORK
Reside House & Garage
9 CHANGEOFUSEfROM TO
STIPULATIONS
Per Section 1402, 1997 Uniform Building Code, requires that a weather
resistive barrier be placed over exterior sheathing to protect the interior
wall covering. Exceptions for this provision would be if sheathing is an
approved weatherproof panel or when the siding is an approved weather
barrier. Vinyl siding is not a weatherproof covering unless the manufacturer
states this in their application guidelines. Call for inspection of wrap
be£ore covering.
TVPE Of CONST. OCCUPANCV GROUP OCCUPANCV �OAD
SEPARATE PERMITS ARE REOUIRED FOR EIECTRICAL, PLUMBING. HEATING,
VENTILATING OR AIR CONOITIONING
THIS PERMI7 BECOMES NUII AND VOlO IF WORK Op CONS7RUCT10N ZONING SO. FT CU f7.
AUTMORIZED IS NOT COMMENCEO V�1ITHtN 60 DAYS. OR IF CONSTRUCTION
AR WORK IS SUSPENDED OR ABANDONEO FOii A PERIOD OF 120 OAYS AT
ANV TIME AFTER WORK IS COMMENCEO. NO DW4G. UNIT$ OfFSTREET PARKING
I HEREBY CEFITIFV THAT I HAVE READ ANO EXAMINEO TMIS APPLICATION 1 STALLS GARAGES
AND KNOW TME SAME TO BE TRUE ANO CORRECi. ALL PROVISIONS Of LAWS VA�UATION SURTAX
ANO ORDINANCES GOVERNING THIS TYPE Of WORK WI�L 8E COMP�IEO r
WITM WHETMER SPECIFIED MEREIN OR NOT. TME GRANTING OF A PERMIT �8aOOO ��F.00
OOES NOT PRESUME TO GIVE AUTMORITV TO VIOIATE OFi CANCEL TME pERMIT fEE SAC CNAFGE
PROVISIONS OF ANY OTHEFi STATE OR LOCAL LAW REGULATtNG coN- �153.25 Fire SC �H.00
CTION OR THE PERFOfiM NCE OF CONST TION
PLAN CNECK F TO AL FEE
� ��`d � Licen S $5 . 170.25
SiGN�TUQE OF �ON' A, Op T1�Op�2E0 �GENT � �OATEi ME PRO� ALIO T THIS IS V UA PEpMiT
� s �
S�GNaTUAE O� OWNEQ��� OWNEA 9UI�OEp� iDAiE� B� �p p, � ���TE
NEW [ ]
ADDN []
ALTER [ ]
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Effective 1/1/2000
(763) 572-3604 Bldg Insp
� �
���j�3�
Construction Address: � � �.�Sa �(.� �,7 7. /t.%� �
Legal Description: J��(,4 (!P� ��'� �Rp�/� S� p,5%R� yyl
Owner Name & Address: _ -�/� � � Tel. # J''�� `t � v �9
Contractor: %` s�� �'� ���- n ' C� 9'
D l2 U I �° � MN UCENSE #
Address: S€ L �3�. �2. S i�R�l� f�` if>f.t, y,5 �7 U Tel. #� 63' 7.7 �J`"15�.3 /
LIVING AREA:
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 Sq. Ft.
GARAGE AREA: Length Width Height
DECK AREA:
OTHER:
Length Width Hgt/Ground
Sq. Ft.
Sq. Ft.
�
Construction Type: � s����� Estimated Cost: $ l� � C� �
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: ��d��l-t� t� APPLICANT: ��1�-l'� 1d. �CX,[ fCC� � Tel. #%� 3��S�`� �J i
CITY USE ONLY - Call (763j 572-3604 for Permit Fees if mailing in application
Permit Fee $ ��.3. �5�� Fee Schedule on Reverse Side
Fire Surcharge $ c�• DO .001 of Permit Valuation (1/10th%)
State Surcharge $ �DD $.50/$1,000 Valuation
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ $1100 per SAC Unit
$ ���d $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 [ j
$ �%l�'�,��
., _ � -