AF - 47380Date
Owner
Addre�s
I�
City of Fridley, Minn.
�
BUILDING PERMIT N•° 312 3
. � -. //.-: . � . . . . . . . . . . . . . . . . . 1��.
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�. . . . . . . � .��.�:..�.�. .�.� . . Builder ai!.���! � . �ic'r!d'�!Y. . . . . . . . .
/ n �� y. /� _ �
s . . i�. � .�. �. . .�Q�'� . Address .Of.�.Q .Q. �A�'4i! . 6r!u!� ./. . . . . s
(�
LO�CATION OF BUILD[NG
No. .�.� �.� Street .............................. Part of t . . .. ........
p ����. r �
Lot . .. .� . . . . Bloc . . . a.. . . . . . . . . . . Addition or Sub-Division . . . . .. . .. .. .
Corner Lot . . . . . . . . . . . . Inside Lot . . '�.� . . . . Setback .� `�.� . . . . Sideyard . :� .°?:'� , , , " � � ���i�j
`�!/"' '. .f.
DESCRIPTION OF BUILDING
To be Used as: � �
. g q )�1 �
. . . . . . . . . . . . . Front •J Q . . . Depth a . . . . Height �I������ Sq. F't. 9/ d'"� Cu. F't. . . . . . . . .
Fr t . . . . . . . . Depth . . . . . . Height . . . . . Sq. Ft. . . . . . . . . G�. F't. . �
� °..% . j
�*pe of Construction . . . . . . . . . . . Est. Cost. . �.1� � �{!. . . . . To be Completed . . .(�.�!??,
0.�,� �`` a '�3 �
In consideration of t'he issuance to me of a permit to construct the building desribed 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 city of Fridley.
....................................................
In consideration of the payment of a fee of $. �O.Y. .. ..� ., permit is hereby granted to ..
......................... to construct the building or addition as described above. This pexmit 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 confarm in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings with-
in the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
� .... . ... d`iiiS Inspector
NOTICE: ��
This permit does not cover the construction, installation or alteration for wiring, plumbing, gas heating,
sewer or water. Be sure to see the Building Insp�vctor for separate permits for these items.
�
•
�
City of Fridley, Minn.
BUILDING PERMIT N° 3 3 5 4
Date: . . � . /�. . ^. . . � . . �. . . . . .
� �
Owaer .'��G�?�-��'. .✓��� .. i�� . .. .. Builder . .. . . . . .. . .. .. .. .. . . .. .. .... .. .. . . ......
Address Vt .�..�.d . .� . . . .,�!� o/ �Address . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
LO�CATIQN OF BUILDIIVG
No. � j �V .A .� ��T. �!�f . . . . Part of . . . . . . . .
. . . . .�-t .�. . . Str�et . . .
Lot . . .�. . . . . . B2ock . . . . . �. . . . . . . . . Addition or Sub-Divisiox� . . yy. . . . . . . . . . . . . .. .
Corner I,at . . . . . . . . . . . . Inside Lot . . . � . . . Setback . a� . ' � Sideyard . . . �i+l. .' �! �. . . . . . . . . . .
DESCRIPT[ON OF BU[LDING
Tp,, be Used as:
C.t� � .Q-: � . . �o�,t . � `.�. neptn �. � . x�ght . /. . �l. . sQ. Ft. .�,� �cu. �. �d �"v
.................... Front ........ Depth .... Height ........ Sq. Ft. ........ C,is. Ft. .......
Type of Construction . . . . . . . . . . . . . . . . . . . �st. Co�tt. :!. � �. . . .�.�. . - . . . To be Completed . . . . . . . . . . . . . . . . . . .
f��� /6 '' 6 �. (� � /'' cf'� , 3�°-° -
.�-�. � �-r-� � ,
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In consideration of tihe issUance to me oi a permit to construct the building desribed above, I agree to do
the proposed work in accordance with the descrlption above set forth and in compliance with all provisia�s of
ordinances of the city of Fridley.
� , ✓ /, (/[R� . . . , ,f,�„�:': :�!�: G� . . . �: I: . . . . . .
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In consideration of the payment of a fee o! $. . �-.^. ., permit is hereby granted ta . .. .. .. .. . . .. . . .. . .
... .. .. .. .. .. .. .. ..... ... to construct the building or addition as described above. This permit is granted upon
the express condition that the person .to wha�n 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 oi
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of bufldings with-
in the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances. , /_
��../����/ ..ii �� . _ . - �
NOTICE:
Thfs permit does not cove� the construCtion, tnatallation or alteration fo� wlHny, plumbiny, gas heatinp,
sewer o� water. Be sure to see the Buildin� Inspector for separate permits tor these ttema
� ��7��
City of Fridley, Minn. N� 10 316
� BUILDING PERMIT
•
Date: •T,��-,_.1�9 _____r.
pwaer: _._ Ronald Harff _.._._._ Builder _..__..___ Same
Addxrss ._..�.h�..'�.Q....Ja.�kS.aY1....5.�...._.SI..F�.._..--_•-__.._...___ Address _.._._____._�a,m.e...._..__.._._..._._.._�_.
LOCATION OF BUILDING
No. ____63..�.�.__. Street ._.._ Jackson Street N.E. _ ..----__.... Part of Lot _._._._..._
Lot _._...__.�.__.._.._.__ Block _._..... $..___.__.__.._._ Addition or Sub-Division .__Christie Addition
Corner Lot _.__....._..._.._...__ Inaide Lot •---_..,X....._.._...---_.._ Setback .__.._...__........�._..._._ Sideyard __.__._..�
Sewer Elevation _._._._..._._._�_...._._.__..._.____.._.....__.__..__ Foundation Elevation ..__..._ —_._ ____
DESCRIPTION OF BUILDING
To be Used as:
..g�-�.__�.�....._._ �ont 24.'� nepw _.�2' Height .__20t.._.. Sq. Ft. .._768 c;u. Ft. �o
_.___..___.__.._...___..._......_ Front _.____._.__ Depth _._._._._._ Height �.._..____� Sq. Ft. �. Cu. F'�
Type of Construction _...___Frame ._._._._...___. Es� Cost _..----�.5850 . 00...._.._.._ To be Completed _.. S�t �_ � 969
• Paved Driveway
In consideration of the iss�ance to me of a permit to construct the building de�cribed abave, I agree to do
th� proposed work in accordance with the description above set forth and in compliance witt► all pravisiona oi
ordinanoes of the city of Fridley.
�,,.�� �__._,,�__'�
�
In co�sideration of the payaient of a fee of �__2���_..._.., permit is hereby granted to Ro.nald Harff
_ to construct the building or addition as described above. Thispe rmit is granted up�
the express�condition that thepe rson to whom it is granted and his agenta, 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 ordinsnces o�
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and. moving of buil �'
withitt the dty limits and this permit may be revoked a t any time upon violation of any of the provisi�s of sa�d
ordinances.
�'yl�r�, n��v�-�-t.�lJ guildinBInspector
HANK NNHICH-Building Offi�ial
• NOTICE:
7his p�emil dws not eowr 1h� eon�ruelioe, in�tallNton fo� wiein�. Plumbino. Yu h�aN�p, awK � wN�r. !� s� to sN
fl�� Buiidiag In��eM� for �p�nt� pMeils for fh�a ttNns.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNEfi 'S NAME ��'�•b� � J�9RFF BUILDER S�i//1 �.
ADDRESS � 3 3� r�J'� �fi► c j�'s a�✓ ADDRESS S►AM �
LOCATION OF BUILDING
NO . E� 3 3 c STRE$�1' 7'A c 11' s oy S'7 ' J� �'
LOT � BLOCK 8 ADDITION OR SUBDIVISION G h� ��d'
CORNER LOT INSID� LOT � SETBACK SIDEYARD
��...
SEWER ELEVATION TOP OF FOOTING
Applica.nt attach to this form Two Certificates of Survey of Lot and
proposed building ].ocation drawn on these Certificates.
DESCRIPTION OF BUII�DING
To Be Use�_ As :
.A�'f'AcNR / / /
�� �� C Front � 9 Depth � x Hei�ht 2�
Square feet ,� � Cubic Feet l S 3� �
Front Depth Height
Squ�re feet Cubic Feet
Type of Construction ���9��` Estimated Cost �SBSo~
To Be Completed � /�IO/1%7�'s�s
The undersigned hereby makes application for a permit for the work
herei.n apecified, agxeei.ng to do all work in strict acoordance with the
City of Fridley Ordina..nces and rulings of the Department of $uildings,
and hereby declaxes that all the facts and representations stated i.n
this application are true and correcto
DATE T- 3"� i SiGNA'I'URE ��+�-�� �
(Schedule of Fee Costs can be fourid on the Reverse Sidee)
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� y »,�nt �+-�i' rm'+it�i .-a �rc t�. n,•. .c`11 ''tp,� COME3INING Th{E _RECORD:'i OF
,d �� � " 9, F.=� �� ��4 "�'..�� '�� �1„� tti � ; . i ����' J. E. HILL C�vi�. Er���Neeh
' 7-IARVEY A. CARTY✓RiGrl'f �� �� ! j .
�al .a cb:r c°� sLL.�,�ar,� 4,;J,�:a: a c:a C�o�.ai c-'7� ' u� +
ANUF.A GOUNTY SUFtVEYa ESTA[3L19HeD 1856
-. NENNEPIN COUN'fY SURVEYS j��T� �' v�� �%�i� ����� C. F'. SATIDHO�F
MINMEAPOLIS SUR`/EYS � u - �
. . CIViL ENGiNEER �
� 8410 ?At_'s STI�EE7 REGIRTERr.D UNOEFt LAW5 UF STAiH OF �11NN�SOTA
ESTAHltSHED 1905
. .. SUNS-7 R-G073 � LfCENS[D GY GRUINANCE OF GiTY OF MINncAPOLIS
ov�xER JAMES NE"LSON
345 PLYMOUTH BU1LDItVG FEDERAL 8-87�1 Su!tvsvott
. � � ESTADLI61iED tp22
INDUSTRIAL - JUDIGI:,L
eus�Ness - ToPOCSaPr;ica� . M�T'ROPOLiTAN LAND
ciz•r LOTS - PLA7r�rvc ����fti�r ��frtifi:fltf Su4vEra-�s, E�TA9L14NE0 �n��
Tho�«�.s S. Silvis Invaice 19395
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I hereoy certify that this is a tru; ani co.r_••�ct pla� of ,: survey of �.o+., 5,
Block B, Christie A�dit�on, ��nol;a Count•y, r�innf�ti;.�a, �s surveyed b,y me this
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Date: _._,Iii1.�.-.�-r_1�.�.�.__.._.._..___...._.r..
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N° 10323
MOVER
Owner: ._Everett Shano.n____.__..._.._._...�_ � _._.. Da�e M�.Zr�..S._..�1� _�.___...._._.._._._
Address 6�.�.0....��.cks.n.n..__._.�.._._._..._.._..___...._._.___._.._ Address �_�16 Central. Av�.nue_
LOCATION OF BUILDING
No. _.��.SJ --__._... Street _.._.�.���._s..Q�,._._....________..��-----......._.--•-•••---._.._ Part of Lot _.
Lot _._.._.._...__._........_ Block _._._.._.__..__.__._.._.....___. Addition or Sub-Division ..._._.______._.
Corner Lot ...---_..._.._....__ Inside Lot _._.__._...._...___..._._. Setback ._._._---..___.___._ Sideyard
Sewer Elevatiaan
To be v�a �:
Foundation Elevation
DESCRIPTION OF BUILDING
Front ._.._..__._.. Depth ._.._......._.._ Height ___..._._..� Sq. F't. Cu. Ft _
.._.__._.__._.__..._.._.._..._..__ Front __...___....__ Depth _.____.._ fieight _..._.._..._.__ Sq. F� _ .._ Cu.. F't.
Type of Construction _._-----.....__..__._..._.�.......__.. Es� Cost ---�QQ._4Q.._.-•-----_..__....... To be C�npleted s�l?:�.3�.._..8._,....�.._._
Move Garage outside of Cit,y
In consideration of the issuance to me of a permit to cons e building described above, I to
the prop�ed work in accordance with the description above _ ai� in complianoe w�'�th al�oq sions
ordinances of the city of Fridley. � A /�/1 /l ,. /�
In caa�sfderation of the payment of a fee of �...�.�.,.��.r.._._._.., permit is hereby granted to_ Dale Movers Inc
to construct the buildittg or addition as described above. Thispe rmit is granted upo�
the express condition that the person to whom it is granted and his agents, employees and worlunen, in all wo�rk
done in, around and upon said building, or any part thereof, shall conform in all re$pects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit ma,y be revoked at any tune upom viola.tion of any of the provisio�s of said
ordinances.
�
��
' NOTICE:
7his p�nnil doa nof eowr fh� eonstrueHoa, inshllNbn for wiriny. Plumbh�W Yas ha�6��, s�w�r er wat�r. !� aun /o sN
th� euildins MspKtoe for s�p.rat� p.nnks foe N� h«ns.
�
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: APP'LIGATION FOR MOVIN.G pERMIT
_ . _ ._ FridleY�
Inspector of Buildings,
6431 Univ. Ave. N.E.
�%�� �
The undersigned hereby ma.kes application for permit to mbve building as herein specified, agreeing to do a11
work in strict a:ccordance with the City Ordinances and rulings of the Depa.rtment of Buildings, and hereby de-
clares that all the facts and representations stated in this application are true and correct.
� . . . . _ Lot Block Addition
Present Location :
, , -,
To be maved
Distance moved it.To be complet,ed abou 0 1�
Taxes paid? Eatimated cost `� oundation and alter on permit numbers
Certifica.tion as to cost :
I hereby certify that the above designated building is worth at least si 60) per ce of the cost of a simi-
lar new building.
Sign
Owner or Ageat
Approved by:
Water & Sewer Department
City Engineer
Utilities Notified:
Minneapolis Gas Co. (date) �� •
(Title)
Northern States Power Co. (date) ��
cTitle)
p �' "
Northwestern Bell Tele hone Co. (da.te)
(Title) n
In the event that the moving permit is to be a�zplied for by the owner or by any other persan than the licensed
Mover, the following letter must be campleted and signed by said maver:
Inspector of Buildings,
6431 University Ave. N.E.
Fridley, Minnesota
Please issue the bearer of this application, Mr
a permit to move building from :
to:
Date 19_
5ign�1
GENERAL INSTRUCTIONS
The following must be secured before moving permit will be issued:
him to sign my name.
� 6��
1. A building permut for new location of building to be moved. To obtain this building permit, the follawing is
required :
(a) The building to be moved must be inspecte�d far structural soundness by the building inspector. Phone this
ofiice for insp�ection. SUnset 4-7470.
(b) A survey af lot to which building is to be moved. This survey must be ma.de by a licensed surveyor.
(c) 1'he building and moving permit must be obta,ined at the same time.
2. Tax receipt showing that alI real estate taxes due have been paid. Duplicate receipts may be obtai�ed a,t Anoka
Gounty Auditor.
3. Approval from, the �idley Water and Sewer D�epa.rtment showing that bills chargeable against the property to •
be maved have been paid and water cannections have been discontinued at the curb line ar at the main. (See
reverse side of form.)
4. Approval from Fridley Directar af Public Warks office approving routing.
5. Natification to, and signature of utility companies. (See reverse side of form.)
(a) Minneagolis Gas Co., 739 Marquette Ave., Engin eering Department, Fourth F1oor.
(b) Northern States Power Co., 15 South 5th Street, Applica.tion and Extension Dep�rtment.
(c) Northwestern Bell Telephone Co., 224 South 5th Street, Business Office, First Flaor.
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11 i- 2so=e�ss �
���
sue�ecr PERM
City of Fridley 7837
AT THE TOP OF TME 7WINS g � I L D I N G P E R M I T
� REC
� �
� � •
� • COMMUNITY OEVELOPMENT OIV.
' � y - /��
r ,, --___, J��T�Q��oN SE� �9
, �"'1 C17V HALL FRIDLE� SSI�Z NUMBEp REV OATE PAGE OF APVqOVEO BY
�""�"� �'' 612-571-3450 910-F15 9/16/98 � �
J08 AODRESS 6330 Jackson St NE
t LEGAL �OT N0. BLOCK TRACT Oii AOOITION SEE ATTACMED
oescR. 5 8 Christie Addition SHEET
2 PROPERTY OWNER MAIL ADORESS 21P PMONE
Dean Johnson �'
3 CONTRACTOR MAIL ADORESS 21P VHONE LICENSE NO
Panelcraft 3118 Snelling Ave 5 Minneapolis 55406 721-6628 2179
� ARCNITECT OR DESIGNER MAIL ADDRESS ZIP PMONE LICENSE NO.
5 ENGINEER MAII AODRESS ZIP PHONE LICENSE NO
B USE OF BUIIDING
Residential
7 CLASS OF WORK
O NEW O ADDITION O ALTERATION �7 REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Reroof house & garage (195Q) Tear-off; Siding;Fascia; Trim; Windows
9 CHANGEOFUSEFROM TO
STIPULATIONS
i���sg
Reroof - Underlayment must comply with the State Building Code.
Reside - Call for building wrap inspection before covering.
Soffit/FAscia - Install soffit x��z� ventilation to meet the State Building Code.
Windows - Install smoke detectors to meet the State Building Code - in each sleeping
room and on each level of house.
TYPEOFCONST. OCCUPANCY GROUP OCCUPANCVLpAD
SEPARATE PERMITS ARE REOUIRED fOR ELECTfiICAL. PLUMBING. MEATING.
VENTILATING OR AIF CONOITIONING
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTpUCTION ZONING SO. FT CU iT.
AUTMORIZED IS NOT COMMENCED WITMIN 60 OAYS, OF IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONEO FOR A PERIOO OF 12p OAVS AT
ANV TIME AFTER WORK IS COMMENCED. NO DWLG. UN17S OFFSTREET PARKING
I HEfiEBV CERTIFV THA7 I HAVE READ AND EXAMINEO THIS APPLICATION STA�LS GApAGES
AND KNOW THE SAME Tp BE TRUE ANO CORRECT. ALL PqOVISIONS Of IAWS VA�UATION SURTAX
ANO OROINANCES GOVEFiNING TMIS TVPE OF WORK WILL BE COMP�IED
WITH WHETMER SPECIFIED MEREIN OR NOT. THE GRANTING OF A PERMIT ��� �5,437.00 �Z.72
DOES NOT PRESUME TO GIVE AUTMORITV TO VIOLATE OF CANCEL TNE pEqMITFEE SACCMAqGE
PROVISIONS Of ANV OTHER STATE Ofi LOCAL LAW REGULATING CON• @ 112 . 2S F� e SC �S .�F3
STRUCTION OR THE PERfOFMANCE Of CONSTfiUCTION `P
PLAN CNECK FEE T AL FEE
L' e SC 00 $125.40
S� ♦TUpEO�C N.AACTOQOA�UT�+O ♦G t iO�iE� EN R D THIS I R P T
� �
S�GN4TUqE O� OWNEA��� OwNEABU�tOEA� i AfE� Bl �tiSo �. � qcrE
C
NEW � ]
ADDN [ ]
ALTER [ ]
CITY OF FRIDLEY
S�1GLE FAI�IILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Effective 1 / 1 /98
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ConstructionAddress: �QJ� 3� (��Q�'1� ��,OZ- ' :��
Legal Description:
Owner Name & Address: ��°Q f� �cJ��'1 ��G'?�.� ''��� �� Tel. #
Contractor: �� l%' MN LICENSE # �,/ 7 9
Address: �/%�� //(,2 �/� �+7 � 7 �J S �/� „�j. Tel. # ��/ �li� ��
Attach to this application, a Certificate of Survey of the'
lot, with the proposed construction drawn on it to scale.
LIV�TG AREA:
GARAGE AREA:
DECK AREA:
OTHER:
DESCRIPTION OF IMPROVEMENT
Length Width Height
I.ength Width Height
Length W idth Hgt/Ground
1�s� �
Sq. Ft. •
Sq. Ft.
Sq. Ft.
� ' .
�onstruction Type:��� /' � cSG G�/ /� Estimated Cost: $ �d !� /-
%/1���2Q�CLUcS (Fee Schedu e on Back)
Driveway Curb Cut idth Needed: Ft. + 6 Ft = Ft x$ =$
DATE: APPLICANT: � Tel. # �� 2G�
CITY USE ONLY � �—,,�
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
! TOTAL
STIPULATIONS:
� 1/�?.�S`
$ s�
$ �- �
$
� �,�
$
$
$
$ _
�--�--
. = :s`
_�.s
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,000 Valuation
$1000 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 [ ]
. ,.
Z
CITY OF FRIDLEY INSPECTION DIViSION . . ��' ,
6431 University Ave NE .
Fridley, MN 55432 �. APPUCATION FOR POWER PLANTS AND HF.�ITING� COOLING, V�NTILATION,
572-3604 REfRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
;, �..�
Residential
Furnace Shet! and Duct Work; Burner -
Also Replacement Furnace �
(Side Vent • Fitf Out Back)`
Gas Piping (Needed with new furnace,
. but not replacement)
Gas Range
Gas Dryer � '
*Ai� Conditibnir�g �- Ail Sizes
Rate
$ 30.00
$ 10.00
$ 10.00
$ 10.Q0
$ 25.00
All Others/Repairs & Aiterations (LIST ON BACK)
1 Jo of Value of Appliance or Work
Commercial/Industrial
1.25q�, of Value of Appliance or Work ''
State Surcharge
TOTAL FEE
.
�i ► u _ u _ . �► , _-: ► . • • _ ► _ l ► _. • �
l _ \ .. ._ \. • . � � .�. l � � � � � � . , � _ l .`� ■ �. _ �`�
,_ � ; �::
REINSPECTIOPI FEE $47.00/Hr
*Air Conditioners can not be placed in a side yard without
written permission f�om adjoining property owner.
, ' ..t
TOTAL
��� '
$
$
�
$ a�.C�:�
$
$
$ .50
$ `�--� ' �
Effective On IVlay 10, 1999
JOB ADDRESS � O "c )� Q � 1��, C �" 1 �(') � �: �� -
OWNER �� C�� �� i`� 1 1'�� G�' �i L' �
BUILDING USED AS_ �-� �� i�� ,�� 1(��A�
ESTIMMTED COS � PERMIT N0. ���`J � `/
' : • � • ;.: �� � •: = L :
No. of Heatin Units_..� Circle One (Steam) (Hot Water) arm �r)
Trade Name P Y1 �l (�k Size No.�� � Cx ����
BTU �l,fi,� � HP EDR
Fuel Total Connected Load
Burner Trade Name_ � j Size No. �
! BTU HP EDR
;
The undersigned hereby makes appiication for a permit for the �work herein
specified agreeing to do all work in strict acco�dance with the City Codes an
rulings of the Building Division� and hereby declares that all the facts and
representations stated in this application are �true and correct.
HEATING CO ��'.��C () t�l l..�G I� -��
� F
S � DATE - ' � �
Approved By Rough•In Date Final Date 3� �9-D �
...y . - �y �.n � • _ _
_' _ "� � ,_ � _.
" -. .. ' ° ;� ; _. __
. - ' � CHIlVIlVEY AND STACB VERIFICATION -
The u�ersigned herei��.�vttifies tbat the existing chimney or�stack:
1. _ Has bcen carefully eaamin�ed .� Yes O No O
� 2. Is free from nist or.: ckteriaration .:::-�.�- :., y� O No O
3. Has no foreign objects lodged:within Yes () No ()
4. Is securely supporoed: Yes O No O
5. � Meats all curtent Codc requirements for size
a� total �Tt3's con�e:�ci � 3Ccs t) No ()
6 Has total fuating BTU's of
All other BTU's
TOTAL BTU's
7. Has a liner been provided for water heater Yes () No ()
8. Has combusiion air been provided for water heater Yes () No ()
. �
:.:�:
�,-,
�_ ��!�� �• � _�� ���
HEATING CO:
Signed By:
Date:
0
ADDRESS
PIN
LEGAL DESC
PERMIT TYPE
PROPERTY TYPE
CONSTRUCTION TYPE
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
�631572-3604 FAX: (7631571-1287
: 6330 JACKSON ST NE
: 143024410035
: CHRISTIE ADDITION
: LOT 5 BLOCK 8
: BUILDING
: RESIDENTIAL
: WINDOW/DOOR REPL
PERMIT NO.: 2004-00255 ��- � �� (
DATE ISSUED: 02/23/2004
VALUATION : $ 19,211.00
NOTE: PROVIDE SMOKE DETECTORS IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF THE DWELLING PER
SECTION 310.9.1.2 OF THE 1997 LJNIFORM BUILDING CODE WHEN ADDTIONS, ALTERATIONS OR REPAIRS IN EXCESS
OF $1,000 ARE MADE TO RESIDENTIAL DWELLINGS. CAULK AND FLASH ALL EXTERIOR OPENINGS.
REPLACE WINDOWS WITHIN EXISTING OPENINGS; RESIDE HOUSE & GARAGE
IS APPLICANT A CONTRACTOR? 1
APPLICANT
MN WINDOW & SIDING CO (20296565)
5730 DULUTH ST
GOLDEN VALLEY, MN 55422-
(763) 545-0545
OWNER
JOHNSON DEAN C
6330 JACKSON ST NE
FRIDLEY, MN 55432
BUILDING PERMIT FEE
FIRE SURCHARGE
STATE SURCHARGE, VALUE
LICENSE SURCHARGE
TOTAL
PAID WITH CHECK # 3487
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of wor�
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authority to
violat�-e�cE*1 the provisions of any other state or local law
Bldg
-Date
SEPARATE PERMITS R�OUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
321.25
19.21
9.61
5.00
355.07
NEW [ j CITY OF FRIDLEY Effective 1/1/2004
ADDN [ J 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bidg Insp
ALTER [v� SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPUCATION
Construction Address: lo.�.3b �%zc..�So» .St`'
Lega! Description: �.
Owner Name 8� Address:
6 33'v cJac�ESon 5� Tel. # 7G 3-50 �'.. -01(2 �S-'
Contractor: /YIN INi ndor.v ,� S; c�i.-�A Cofi�.�N MN LICENSE # BC -�oz94sz�
Address: 5730 �u../��h S'`f .�,�` /d�n llEt.l�Ev� . S:S'1%�- Tel. #�c5 �t5- D5�5
Attach to this application, a Certificate of Survey of the
bt, with the proposed construction drawn on it to scaie.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
jQtrrro✓It/ '� �►laaGnKn�"' �C)
Construction Type: �f �'�Q�'`�S �p �+d s%d %� r„ Estimated Cost: $ �� �I1.00
�
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
OFR'�e-
DATE: -����'y"`,-��-- APPLICANT: � M�Tel. # 7G3r$�/S�O S'i5
Call (763) 572-3604 for Permit Fees if m iling in application. Fax to 763-571-1287 if using credit card and we will call
you for card number.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
� �3a/• aS�'
$ / 0
$ , /
$
$ � �(�
$
$
Park Fee $
Sewer Main Charge $
TOTAL
i
J
$ ���f.��
CITY USE ONLY -
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1350 per SAC Unit
$5.00 (State Licensed Residentiaf Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ )
STIPULATIONS: