AF - 47368Date
Owner
Addres
�
BUILDING PERMIT
�
Village of Fridley, Minn. N° � 2 917
C
. ' . . ..�. /..��":� ...... .. .. .. ...
.... .. ........ ..�/ .-'��+��'G�. Builder ................ ..........................
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s.. . . ... . . .. . . . . .... Address .........................................
LOCATION OF BUILDWG
No. 1p. � �. � . . . . . Street . f.��.���.�,�,��'.!! . . . � v �' . . . . . . Part of Lot . . . . . . . . . . . . . . . . . . .
G�,(% - � •r
Lot .....�....... Block ......t% ........ Addition or Sub-Division ... ... ... ..... .. .............
?J r r
Corner Lot . .. .`�. . . Inside Lot ... . . .. .. .. . Setback ...J.l� ... . .. Sideyard .��!��!�,j. %Q. �h"'�'1°"
�i
DES�RIPTION OF BU{LDING
To be Used as:
. . ./�LGG"c.��'j`'e�. . . Front . . . . . . . . Dept.h . . . . . . . . Lieight . . . . . . . Sq. Ft. . . . . . . . . Cu. Ft. . . . . . . . .
...............'/... Front ��.� Dept � � Height ?�' !.� . Sq. F't. .�� �Cu. F't. ........
�'1. � �ZF (/
Type of Constructio�����i. • r�' • . . . . st. Cost . . . . ./,,�} .�. � d . . . To be Completed . . .�. . . . . . . . . .
/
In consideration ef the issuance to me of a permit to construct the buiiding described above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions oP
ordinances of the village of Fridley.
Tn consideration of th2 payment of a fee of $. .,�.: ��iernut is hereby granted to ........... � �
. . • . • . . . . . . . . . . . . . . . . . . to canstruct the building or ad dition 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 anfl upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Nliruiesota 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'ap,y of the provisions of said
ordinances. � , % �,
m�
NOTICE:
This permit does not cover the construction, installation or alteration for �
sewer or water. Be sure to see the Buiiding Inspector for separate permits for
Inspector
gas heating,
SUBJECT P .
City of Fridley _ 17 412
AT THE TOP OF THE TWINS g U I L D I N G P E R MJ T
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� • COMMUNITY DEVELOPMENT DIV. �
' j y _ �' �
� � � PROTECTIVE INSPECTION SEG �
1 � �
� � ����1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY
` ���'�./ �.J
612-571-3450 910-F15 2/21/84 � �
JOB ADDRESS 6300 Jackson Street N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
pESCR. 8 8 Q1Y'1S'tl@ Addition SHEET
2 PROPERTY OWNER MAIL AODRESS ZIP PHONE
H. H. Egler 6300 Jackson Street N.E. 574-0855
3 CONTRACTOR MAILADDFESS Z�P PHONE IICENSENO.
Miltan L. .Tohnson Co. 2513 Central Avenue N.E. 781-9548
4 ARCHITECT OR 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 O REMOVE
8 OESCRIBE WORK
Install aluminum siding and re-roof s,tructure
9 CHANGE OF USE FROM TO
STIPULATIONS
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 6U RAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD Of 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWIG. UNITS OFFSTREET PARKINCa
1 HEREBV CER?IFV THAT I HAVE FiEAD AND EXAMINED THIS APPLICATION 1 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 Ofi NOT. THE GRANTING OF A PERMIT S8�OOO =i.00
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE
PROVISIONS OF ANY OTHER S O CAL LAW REGULATING CON-
STRUCTION OR THE PERFORM NC O C NSTRUCTION. $74. SO
PLAN CHECK FEE TOTAL FEE
� �/ � $78.50
sGNaTUaE FCON�RACTORO r+ F4 RIZEDAGEN� fDA e� WHEN PROPER VALIDATED THIS IS YOUR PERMIT
.. - ° �` � �t
SiGNATUREOFOWNER�IFOWNEROU�LDERi �DATE� BLDG WSP PTE �
�
CITY OI' FItIOLCY
kPPIICATIQ� FOit RCSIOCiiTl/`�� OUiLDIf;G Pc('�iITS
(t�c�•�. Alterations, Additions, or Repairs)
o�;r�Ftt: N � /-� , � �C ER
ADJRESS: �0300 ✓AC�Css.•���`•NC..
TELRO: 57�-085�
Effective Aug. 1, 1981
�t3UI LDER : � i L j'-D �J � . �o-y,use .� �,
ADDit[ss: o?s�,3 C. �ti i�•Q ��� E
TEL 120: �8/ �'� y �
Construction Location
STJiI�T RO: �� � O STTtEF.T: � G� S Q..1 �%,��
L07': `� BLOC7C: � 11DAITIO;i: �
Corncr Lot: Insic]c Lot: ,. Setback: Sideyards:
Ap��lic.v�t attach to tl�is form tw�o Ce=tificates of S1�rvcy of lot and
p_opo:.ed building lecation drawn on certifi�cates to scale.
OESCRIPTl4�� OF CO��STF:UCTION
_ Front: Depth: Height:
Squarc Feet: C1�bic Feet:
Front:
Depth : Heigl�t:
Square Fe�t: Cl�bic I'eet:
'.7�pe of Co:,�truction :�JlU M��a: N `�" ►�l O o
R� Be Cbr.�pleted: � � cp G�,�%
7•-----
Estimated Cost: S�� O 40 ��
Alt. A Alt. B
Propos�d Dzivc�+�ay Hidth If New Opening Is Desired: $ $
. . S�� P.F.VF:ILL' SIDE OF StIEET
ZSie un8ersioned hereb:� m�1;c� APplic�zticn for � pes-rzit fcr the �:ork heYein spccified,
agreein� to clo .all �:ork ir, strict accordance �ith the Ciiy of Fridle}• Ozdii�ances a�ici
ruli�i�� of tlie Department. of Bui2dings, and hereby decl�res that all tl�c facL� and
represc�t.itiens stated in this applic�:tion are true and eozrp,ct,�
DT.T�: a'.Z /- 6 j�' SI(�1)1TU �:
�til�ulations :
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sus�ecr P
City of Fridley 27931
AT TNE TOP OF THE TWINS g � I L D I N G P E R M I T
�
� �
, � �o�
i •
COMMUNITY DEVELOPMENT OIV.
� LV��
f � � PROTECTIVE INSPECTION SEC.
� �
� � �"'1 � CI7Y HALL FRIDLE� SSIJ2 NUMBER nEv O�7E P�GE OF AVPROVED OY
�----� • •'' b12-571-3450 9t0-F15 9/22/98 / /
JOB ADDRESS 6300 Jackson St
t IEGAI ��T N0. BLOCK TRACT OR ADOITION SE£ ATTACNED
DESCF. $ 8 Christie Addition S►IEET
2 PROPEaTY OWNEA MAIL AQDR�SS ZIP PMONE
Joan Egler 574-0855
3 CONTqACTOF MAIL ADORESS ZIP PMONE IICENSE NO
Paulson Construction Inc PO Box 247 Anoka 55303 427-0033 6329
l ARCMITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAII, ADDRESS 21P PMONE LICENSE NO
B USE OF BUIIDING
Residential
7 CLASS Of WOHK
O NEW ❑ ADDITION D ALTERATION � REPAIR O MOVE O REMOVE
8 OESCRIBE WORK
Reroof house & garage (22SQ) Tear-off; Replace entire garage roof
9 CHANGEOFUSEFROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
TYPEOfCONST. OCCUPANCVGROUP OCCUPANCV�pAO
SEPARATE PERMITS ARE REOUIRED fOR ELECTRICAL, PLUMBING, MEATING.
VENTILATING OR AIR CONOITIONING.
THIS PERMIT BECOMES NULL ANO VOIO IF WORK OR CONSTRUCTION IONING SQ. fT CU FT
AUTHORIZEO IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENOED OR ABANDONEU fOR A PERIOD OF 12p DAYS AT
ANV TIME AFTER WORK IS COMMENCED. NO DWIG. UNITS OffSTREET PARKiNG
i HEREBY CERTIfV THAT I MAVE READ AND E7(AM�NEO TMIS APPLICATION 1 STALLS GARAGES
AND KNOW THE SAME TO BE TRUE ANO CORRECT. ALl PROVISIONS OF LAWS VALUATION � SUR7AX, 2� 4O
AND ORDINANCES GOVERNING THIS TYPE QF WORK WI�� BE COMP�{ED �{HOO �
WITH WNETHER SPECIFIED MEREIN OR NOT. 7ME GRANTING Of A PERMIT
DOES NOT PRESUME TO GIVE AUTMORITY TO VIOIATE OF CANCEI THE pERMl1 FEE SAC CMARGE
PROVtS S Of ANY OTHER STATE OR IOCAL LAW REGUTATING coN- $99.75 Fire SC �1F.8O
TRUC I OR T E PERf ANCE O CONSTRUCTION
PIAN CNECK f EE TOTAI FEE
License SC $5 0 $111.95
S�cwru O�CON'AACTpFpR�U�MOa�ZEO�GENT iOarE, WMEN�PEpL��TED THIS IS YOUR PE�T
i
�- S�GN4tUQE O� O�NNEp ��� OwNEp Bui�DEAi �D�TEi� B�0 �NS� � ��<<E
NEW
ADDN
ALTER
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CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Effective 1/1/98
����3�
ConstructionAddress: � �d � �G� ��'d ti ��
Legal Description: � 7�//�g'S.S
Owner Name & Address: c�C9ct r� �q �-e,� Tel. # G
Contractor: �� �S � „� �.� ,U ���` �� � MN LICENSE # ��3� %
Address: � � , /,��� ,� 02 �/ `? /�� Tel. # �la �o0 3 �
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Construction Type:_
Attach to this application, a Certiiicate of 5urvey of the
lot, with the proposed construction drawn on it to scale.
Length
Length
���� �I
Driveway Curb Cut Width Needed:
DESCRIPTION OF IlVIPROVEMENT
Width
Width
(Fee Sc
Ft. + 6 Ft = Ft x$ _$
Height
Height
H�t/Ground
Sq. Ft.
Sq. Ft.
SQ. Ft.
DATE: �l 2-s-(�I k APPLICANT: Tel. # L�.2 ?D� � 3
Permit Fee i% �S $
Fire Surcharge �� $
State Surcharge o� ��$
SAC Charge $
License Surcharg���$
Driveway Escrow $
Erosion Control $
Park Fee $
Sewer Main Charge $
TOTAL � �l� �S $
STIPULATIONS:
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,000 Valuation
$1000 per SAC Unit
$5.� (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [] Not Necessary [ J
SuB�ECT
City of Fridley
AT THE TOP OF TME TWINS g � I L D I N G P E R M I T
r
� •
� �
� • COMMUNITY DEVELOPMENT DIV.
f � ~ � PROTECTIVE INSPECTION SEC.
, . .
.
� � �"'1 � CITY NALL FRIDLE� SS132 NUMBEN nEV D�TE
�"'"��� �'' 612-571-3450 9t0-Ft5 5/6/99
10B ADDRESS 6300 Jackson Street NE
1 IEGAL �07 N0. BLOCK TRACT OR AOOITION
oescR. 8 8 Christie Addition
2 PROPERTY OWNER MAIL AODRESS Z�P
Joan Engler 6300 Jackson Street NE
3 CONTiiACTOR
Northland S
a ARCNITECT OR DESIGNER
5 ENGINEER
8 USE OF BU1lDING
Residential
7 CIASS Of WORK
❑ NEW
MAIL ADORESS Z�p
& Insulation 18461 Cedar Dr, Cedar, Ml�
MAI� AODRESS Z�p
MAIL ADDFiESS
O ADOITION O ALTERATION
8 OESCRIBE WORK
Reside House & Garage
9 CHANGE OF USE FROM
STIPULATIONS
TO
OX REPAIR
ERMIT NO. '�
29413
as,z�
PAGE O� APVROVEO !r
� �
SEE ATTACMED
SNEET
PMONE
574-0855
PMONE LICENSE NO
Call for building wrap inspection before covering.
PHONE LICENSE NO.
4158
PNONE LICENSE NO
O MOVE O REMOVE
CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday thru Friday; 9:00 am to
9:00 pm on Saturday; No work on Sunday.
TYPE OF CONST.
SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING. MEATING.
VENTI�ATING OR AIR CONOITIONING
TMIS PERMIT BECOMES NULL AND VOID If WORK OR CONSTRUCTION 20NING
AUTMORIZED IS NOT COMMENCEO WITHIN 60 OAYS. OR If CONSTqUCTION
OR WORK IS SUSPENDED OR ABANOONE� fOR A PERIOD OF 120 DAYS AT
ANV TIME AfTER WORK IS COMMENCED. NO DWLG. UN17S
1 NEREBV CERTIFV THAT I MAVE REAO AND EXAMINED TNIS APPLICATION 1
AND KNOW TME SAME TO BE TRUE AND CORRECT. ALl PROVISIONS Of LAWS VALUATION
AND ORDINANCES GOVERNING TMIS TVPE OF WORK WILL BE COMPLIED $8 3OO
WITM WMETHER SPECIf1E0 MEREIN OR NOT. TME GRANTING OF A PERMIT �
OOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OFi CANCEL TME pEqMIT FEE
PROVISIONS OF ANY OTMER ST 7E OR COCAL LAW REGULA7ING CON-
S R THE PERf NCE OF CONSTRUCTION $149.75
PLAN CHECK f EE
Licen C
NAIUQE OF C N"AA ,TQA OA AUTMOQ�ZED �GENT IDATE� MEN PR<
S�GN4TUQEOFOWNEA��FpWNEpBU�LDEp� ���TE� r G �NS�
OCCUPANCV GROUP OCCUPANCV
SO. FT CU FT.
OFFSTREET PARK�NG
STA�LS GARAGES
SURTAX
$4.15
Fir SC $8.30
OT EE
$167.20
TNIS IS VOUF1 P MIT
r �.�.�
�
fltif
NEW [ ]
ADDN
ALTER
Effective 5/10/99
[ ] CITY OF FRIDLEY
[] SINGLE FAMII,Y AND DUPLEXES R-1 AND R-2
BUII.,DING PERNIIT APPLICATION
f �-�,
Construction Address: � � ;� G�(.Q /�C p iC/ =-� / /��
Legal Description:
_ ���
� ��
� �
Owner Name & Address: ��4¢� ��L G E S� Tel. # �%'� " � � �'�
Contractor: ����;��� r ��P MN LICENSE # �/J`��
� �
Address: /���� l ���.y � ����, ��i,�• �,�/� Tel. # �i3 �Sl�
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTI�R:
Construction Type:
Length
Length
DESCRIP'I'ION OF IlVIPROVEMENT
�Sr
Width
Width
Width
Height �
Height
Hgt/Ground
Sq. Ft.
Sq. Ft.
Sq. Ft.
Estimated Cost: $ (y3��%
Driveway Curb Cut Width Needed: Ft. + 6'Ft = Ft x$ _$ �
DATE: � APPLICANT: � Tel. # �3 �
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Pazk Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ /�9, ��
$ C�•3d
$ ��s"
$
$ `-� • DU
$
$
$
$
$�,�� e
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,000 Valuation
$1050 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 [ ]
Building
Inspections
763-572-3604
763-502-4977 FAX
DATE f "- �CJ '-
SITE ADDRESS �
THIS APPLICANT IS:
PROPERTY OWNER/ NAME:
TENANT . ��.,.
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
EFFECTIVE 1-1-08
?6 3 —
YOUR E-MAIL ADDRESS
,.o o�' .t� �
CITY
Received By:
Date Rec'd:� ' �(�
ATE ZIP �5 N 3 �
CONTRACTOR ADDRESS: �SJ a o� �-..r�. �(J CITY STATE �IP J�_ SY��
SUBMIT A COPY OF pHONE � �` 7 7`'f.S F,4X 76 .3 -�T �' 2.S ''f S
YOUR STATE LICENSE STATE LICENSE #���0 lJ�00 l7 EXP DATE �' 3/'/O
PROPERTY TYPE
PERMIT TYPE
TYPE OF WORK:
$"SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILYMEW CONSTRUCTION STORIES
❑ ADDIT[ON ❑ GARAGE/SHED INDOWS
❑ BASEMENT FIN[SH ❑ ROOF DRAIN TILE
❑ DECK ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
❑ NEW HOME CONSTRUCTION ❑ ADDITION
❑ MA[NTENANCElREPAIR .� R6MODELING
DESCRIBE WORK BETNG DONE:
SIZE OF IMPROVEMENT
.O�-wvc A�+,
�
LENGTH
�
HEIGHT
ROfjFING ❑ HOUSE ONLY
NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT:
1. Existing Floor Plan
GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan
PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used
PROPOSEA HEIGHT:
SIDING FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT:
� Aluminum ❑ Trim 1. Site Pian/Survey showing the existing structures
❑ Other ❑ Fascia and proposed project.
2. Two sets of construction ptans
WINDOWS 3. Energy Caiculations
IN EXISTING OPENINGS �es �No IACATION OF WINDOWS
OR FOR NEW OPENINGS-DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WMDOW TO BE INSTALLED �- NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
�LJSING THE 1997 UBC FEE SCHEDULE)
TOTAL JOB VALUATION $ � � OCCUPANCY TYPE _____
Permit Fee
Plan Review
Fire Surcharge
Surcharge
, License Surcharge
� SAC Charge
Cwb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
��
�
��
�
�
�
�
�
�
�
�r'/ji
See Back Page for Fee Schedule
65% of Building Permit Fee
.001 times the totai job valuation
.0005 x Permit Valuation Minimum $.50
$5.00 (State Licensed Residential Contractors)
$1825 per SAC Unit (Plans to MWCC for determination)
$+6ft= ftx$21=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks payable to: City of Fridley Attach
THIS IS 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 accurate; that the work will be in conformance with the ordinances and codes
of the City of Fridley and with the Minn truction Codes; that 1 de tand this is not a permit but only an application for a permit and work is not to start without a
permit on site; that the work will be in a ordance e ap ove 1' ase of all work which requires review and approval of plans.
SIGNATURE OF APPLICAN PRINT NAME �D �'E R� y' a K� DATE�"a�'49
APPROVED BY
DATE