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AF - 47396� � BUILDING PERMIT C, J Village of Fridley, Min.n. N� 2 R 7 7 Date . ��Y� . .%Q� .%4� . . . . . . . . . . . . . . . . . Owner . �J.ld.�.�R . .� C�J�. . . . . . . . . . . . . . . . . . Builder . . . ,�Qiyh..�. . . . . . . . . . . . . . . . . . . . . . . . . . . Address . �p.7.I.� . . . . f �X�I_" _ _ ____' "' . . . . . . . . . .. . . . Address. . . . �7 8S. .. �c 1C.J`. . . . . .. . . . . . . ... ��J L CATiON OF BUILDWG No. ,��.... Street . . ..... . .......................... Part of Lot ........ .......... Lo� . ./8�. !9. . . . . Block . . . . . . �� . . . . .. . Addition or Sub-Division . . . . .��V.2 �i�C.�. . . �%}.�1.�. . . . . � � Corner Lot ............ Inside Lot .....�!�... Setback . 3 S...... Sideyard ....�� ................... T e Used as: DES�RIPTION OF BUILDING �o? I / Front� N. Depth �� . !. EIeight [w�"�. . Front �� . . . Depth .00V. . . Height .��G. .�. � Sq. Ft. /.Q�.' . Sq. Ft. ��:. Cu. Ft. ........ Cu. Ft. ........ Type of Construction . . ��fl N1 �. . Est. Cost . . �!� � .�Q J. . . . . . . . . . . . To be Completed .`Plr�. . . . . . . . . . . . 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 all provisions of ordinances of the village of Fridley. � �. . •.;,�qpnsideration of the payment of a fee of $!�a t�. , pernut is hereby granted to .. /i,L,W-'. ....... ... :CrK4�.t�L.. ...., to construct the building or ad dition as described above. This pernut is granted upon the express condition thst 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 hall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alter ion, ainte e, repair and moving of buildings with- in the village limits and this permit may be revoked at a y tim upo ion of any of the provisions of said ordinances. /r _ /% m �'ilding Inspector NOTICE: � This permit does not cover the construction, installation or alteratio or wiring, plumbing, gas heating, � sewer or water. Be sure to see the Buildin Ins ector for se arate \ � g p p permits for these items. 'V �. sue�ecr P 7 N O. City of Fridley � 13513 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r � � RECEIPT NO. i tV ��..��, COMMUNITY DEVELOPMENT DIY. r � � PROTECTIVE INSPECTION SEC. � . � �� /��'1 � CITY HALL FRIDLEV 55432 NUMBER REV. DATE PAGE OF APPROVED BY ""� � ,'� 612-560-3450 910-F15 � � JOB ADDRESS 6411 Jacksan Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED oescR. 18,19 4 Florence Park SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Lorraine Uteiss 6411 J'ackson Street N.E. 3 CONTRACTOR MAIL ADDRESS Z!P PHONE LICENSE NO. Richard Hastings Co. 6331 Riverview Terrace 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PNONE UCENSENO. 6 USE OF BUILDING Residential 7 CLASS OF WORK O NEW ❑ ADDITION C� ALTERATION � REPAIR ❑ MOVE � REMOVE 8 OESCRIBE WORK Reroof and cover trim 9 CHANGE OF USE FROM TO STIPULATIONS SEPARA'fE PERMITS ARE REQUIRED FOR ELECTR�CAI, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD VENTILATING OR AIR CONOITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF COkSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSiREET PARKING I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION �- S7ALLS GARAGES AND KNOW THE SAME TO BE TFUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPI.IED �S`2�LiOO �..ZO WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE PROVlSIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- �`].rj.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE � $16.20 ,� SIGNATURE FCONiRACTORORAUTHORIZEp GENT IDntEi � WHEN PROPERLY VALIDATED TFi#S IS YOUR PERMIT � J � �.� � _� G�c.�.�.� �'—�� - �.� � SIGNATUREOFOWNERIIFOWNEFBUI�DERI IDATEI BLDG.INSP DA7E � , ApPLICATION FOR RESIDL'NTTAL, AL'TERATION, OR AllllITION BUILDING PLRA7IT CITY OF FRIDLEY, MINNESOTA 0 � OWNER' S NAME : 1 �• t''b l i�2 � 1 r,�,,, �: ; BUILDER: � i i• 4;. � �%/ %� � �r, AnDxESS :_ /. �/// /� � • � s� , _ � / ��' �ADDxESS : l � � / ', �� =n�'�' � c , ._.,._._. , NO : .��i�/ � STREET : � 1 G��' /"�%, f% �-J ' ~ � � /�� LOT:_� ,�7 $LOCK: � ADDITiON:_ �-/n✓�'�s �; � � � ,i� CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD: Applicant attaeh to this form �tao Certificatcs of Survey of Lot and proposed building location drawn on these Certificates. To Be Used As: DESCRIPTION OF BUILDING Front: Depth: Height: � Square Feets Cubic Feet: • Fxont: Depth: Height: Square Feet; Cubic Feet: Type of Construction: ��=,r, t�-� �� c�� -�� ;�,Tstiunated Cost:_ $��j;,�� e� To Be Completed: A<.t� � ;�.,� - . . f The undersigned hereby makes applicatinn for a pexmit for the work herein� speci£ied, agreeing to do all work in stizct accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declaxes that all the facts and representations stated in this application are true and correct. • � DATE: SIGNAT[TRE • � ,,-, � (See Reverse Side For Additional Information.) � �`��: �� , .� i- � . - � 1��-�' � � � . ---,+' • � , . r � 'i . . - ;�� ' `-,� SUBJECT • c�ty of Fria�ey 26356 ' , AT THE TOP OF THE TWINS g U I L D I N G P E R M I T O r � � � • COMMUNITY OEVELOPMENT DIV. r � v � pROTECTIVE INSPECTION SEC. �� '�'1 � CITY HALL FRIDIEr 55�32 NUMBEF REV DATE pAGE OF APPROVED BY �""�' �'' 612-571-3450 9t0-F15 6/25/98 / / JOB ADDRESS 6411 Jackson Street NE t LEGAL �OT NO. BLOCK TRAC? OF ADDITION SEE ATTACMED DESCR. 18,19 4 Florence Park SHEET 2 PROPERTY OWNEfl MAIL AODRESS Z�P PHONE Weiss 6411 Jackson Street NE 3 CONTRACTOR MAIL ADDRESS ZIP PMONE LICENSE NO. Exterior Design Service H1�XZX%�i 6391 Monroe St NE, Fridley, MN 55432 571-2380 4 ARCHITECT OR DESIGNER MAIL ADORESS ZIP PMONE UCENSENO. 3237 5 ENGINEER MAII ADDflESS ZIP PMONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK O NEW ❑ ADDITION ❑ ALTERATION � REPAIR O MOVE O REMOVE B DESCRIBE WORK Reroof House & Garage (18 Sq) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. TYPEOfCONST. OCCUPANCV GROUP OCCUPANCVLOAD SEPARATE PERMlTS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEAtING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTtON ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED W1THIh 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONEO fOR A PERIOD OF 120 DAVS AT ANV TIME AFTER WOFK IS COMMENCED. NO. OWLG. UNITS OFfSTREET PARKING I HEREBY CERTIFV THAT I HAVE READ ANO EXAMINEO THIS APPLICATION 1 STALIS GARAGES ANO KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTA% AND OHpINANCES GOVERNING THIS TYPE OF WORK WI�L BE COMPLIED $1 SOL �.75 WITH WHETHER SPECIFIED MEREIN OR NOT. THE GRANTING OF A PERMIT � DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE PAOVISVONS OF ANY OTHEfi STATE OR LOCAL LAW REGUTATING CON• �S 1. 25 Fire SC � 1. SO STRUCT N OR THE PE ORMANCE OF CONSTRUCTION � ��,�� PLAN CHECK FEE TOTAL FEE License SC $5.00 $58.50 S�GNATUA OFCON�R TOAORAUTNOQ�ZEDAGENT �DnTEi WHEN PROPERI LIDATED THIS IS ^YOUR PERMIT V V V' S�GNATURE OF OwNEa �iF OWNEA BUI�DENi �OATEI w g�• �N$v btiTE NEW - �DDN ALTER I�.- ConstructionAddress: CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Effective 1/1/98 ��,�-� �',' � Legal Description: Owner Name Address: ��¢'�� Tel. # Contractor: MN LICENSE # Zs� 3 7 Address: d'ttach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. Tel. # DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height GARAGE AREA: Length Width Height DECK AREA: Length Width __� Hgt/Ground _ Sq. Ft. Sq. Ft. Sq. Ft. OTHER: { li • ``'�Q Y � - f`OD 20 Construction Type: Estimated Cost: $ � f S�O (� (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: �'`� � �PI Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge S'/ � 2 S� $�� $ � . �o $ %5� $ $ � oc� $ $ $ $ CITY USE ONLY Fee Schedule on Reverse Side Tel. # -S �/ �' � 3 �O` .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 [ ] TOTAL $ , � ,s'�o . STIPULATIONS: �. .. �uildill� �nspections %6J-�%�-.�i7�4 763-�02-4977 FA.s DATE t0 J�L S�l a SITL ADDRE55 � THIS APPLICANT IS: �� z�'�',—, Permit No �� . �� T�' � "' � ,+ �P� ;' �� '�' �� Y�e�� . ;.., � �....r r s. �. � rj �.. _ .:�1 �,�� .�� e ec�� EFFECTI V � ? - � 9-09 YOUR L-MA1L �DDRL-S5 A�� ❑ OWNEP. 7PROPERTY �(pML: N�NWI.LUVI �WNER/ ADDRES : byt� � TENANT PxoNE: �'(ia✓' CONTR.ACTOR NAME:�� SUBMIT A COPY OF gTATE LICENSE# YOUR STA'TL — LICENSE, BOND AND STATE BOND #�� C�RTIFICATE OF ADDRESS: � !U INSURANCE . PERNIIT TYPE �rYrE oF woRx: PHONE � 3'�1,i � --T— �INGLE FAMII.Y � NEW DETAILED DESCRIPTION OF WORK � ❑ TWO FAMILY �tEPL?.c'EMENT CITY�� EXP DATL- �EXP DATE _CITY I'��i'rM�_ _ FAX ❑ TOWNHOUSE � 2 FEES ARE BASID ON $10.00 PER FIXTURE, EXCEPT VVHERE NOTED. FIXTURES: (IldDICATE TOTAL MJMBER OF EACH BELOVi�. MINIMUM FEE $35.50. • BATH SINK/LAV FLOORDRAINS SHOWER • _WATERPIPIN(� BATHTUH GASPIPING(NEEDQTYLIG� SWINA�VGPOOL WATERSOFINER($3� CLOTHES WASHER KITCF�N SINK WATERCLOSET _BACKFLOW PREV. ($l� DLSHWASHER _ LAUNDRY TRAY �WATER HEATER (335) FORIRRIGATlON — _ WATER METER _ OTF�R THIS IS AN APPLICATION POR A PERMIT-NOT VALID UNTIL PROCESSLD I hereby apply for a pluinbing permit and I acicnowledge that the information above is complete and accurate; that the worlt will be in conformance with the ardinances and codes of the City of Fridley and with the Minnesota ConstrucYion Codes; that I understand this is not a permit Uut only an application for a pertnit and worlc is not to start without a permit on site; that the worlc will be in accordance with the approved plan in ti�e cas of all worlc which requires review and approval of plans. S1G�f1TUPSOPAPPLICANT-----G��K1, PRINTNANI� NI�K (�l��.�/� DATL- � Z /v PC��SE i��UTE`. S�P.�Ri1T�'['ERN[IT_S. ,�R� R�nUIRCD F(�R 13TII'LDiNG; �I;L:C'PRIC��L. A,i�fD .N.[E.C.C�:�NtCA"L WC7RI�. �i� �� Frid�e� �aanflc��mg I�as��iions I�e��r�ae�.� 6�� J. Universiry Avenue NC. �ridley, N1I�f ��3? 76�-�7''-360� F��:: 7b3-�02-�977 .. ................_. .�