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AF - 47166RJ+' , /�'i City of Fridley, Minn. BiT�DING PERMIT Date: . . �". . .� . ! . . . . .� . . . . . . . . . own��r ......... ........................... Addre�ss ...................................... �\I �N° 3540 _�`��' s,�a� � ... ... . . .............. • . .. Address .. � ................................. LO�CATI OF BUILDING No. . � /. �. .�. . Street . . . . . .. . . . . . . . .. . . . . . . . Part of Lot . . . . . .. . . . . . . . . . . . . . . . . . . . . . . Lot .. �.. .. ... Biock . ...�....... Addition or Sub-Dfvision � . . . .�.,� Coraer I.ot . . . . . . . . . . . . Inside Lot ��. . . . � t ey� . . ....... Setback �.e. Sfd ��.: � � ................ DESCRIPTION OF BU[LDING To be Used as: P ee �� °�,��... �om . .�:� n� a�:=°� �x��t �.C,.: � sq. �. %�:,� cw. �-t. ��:�� .................... Front ........ Depth ........ Height ........ Sq. F't. ........ G�. F't Z�►pe of Construction . . . . . . . . . . . . . . . . . . . �st. Cost. /. o�` �.�: �. .�'�. . . . . To be Completed . . . . . . . . . . . . . . . . . . . In consideration of t'he issuance to me of a permit to the proposed work in accordance with the descrlpticn ordinances of the dty �oP Fridley. /& � desribed above, I agree to do compliance with all prov3sions 'of ...................................:.. � In consideral3on of the payment of a fee of $.��, �:, permit is hereby granted to ................... ... .. .. .................. to construct the building or addition as described above. Tbis permit ia granted upon the express condii3on that the persoa, to whom ft ia granted and hta agents, employees and worl�en, in all work dane in, around and upon said building, or any part thereof, ahall congorm in all respects to the ordinances up Fridley, Minnesota regarding loca.tion, construciat�n, altera,tion, maintenance, repa3r and moving of buildings with- in the dty limits and this permit ma.y be revoked at any time upon violation of any of the provisfons op said ordinances. r , ,; : �� i_ f'i L'/:% �" � i. �< icf�.a�.� NOTICE: This permit doea not aover the const�uaRlon, Inatallat�lon o� alteration for wirin8, ptumbing, gas heating, sewe� o� water. Be aure to sea the Building Inap�r fo� separate permiia for these tiema - w Y-,,t a •• MINDER ENGINEERINCi► C�.,INC. ENGI NEERS AND SURVEYORS �wNO auaveY�NO Bo�L� TESTIND GIVIL d, MNNIGIDAL ENOINEERINp LANO PLANNINl9 �J� 7 � � � �,P�°�� ! I r�� 1 vl � i Iv�n\ I i+ ;d �� iy �� I� I �_C �� I� �- I� �� i � (' -- ' 64t8-5(dT" AVENUE N. I�AIt�INEAPOL15 2l', MINN. KE T- 3(037 �C � a�� a � n �c� � �� IF !� � ��►�� ' a� �,� �. f . � ��,.r'� n , �� / :� L �� ; .- ic.� � i � ��-- 35 � �f�/" , ��7 . : � '_ � v�� /� � � � �� ci �t �i c _ It _ 1 �; i --- _1 ��/a� C ei 7 � �,� m � ��`�'�- —10� � i m Ivor' I n S I I iran �—LJ �--t—_I �� v / � ` _l iJ ) �� l� � :�� : � �! ;; �'s I l i� �1 i i� li � SC..:�)�; ; �,��aP !— GT `_.C' � �i.. C.:� 'a i.�., C' ' �� J'w/ ��s' 16. Y � Lo �+�3r I M f� rF J.i 6v d WE HERE9Y CERTIFY THA7 THIS IS A TRUE ANO CORREGT REPRESENTATlO1J OF A SURYEY OF THE BOUNpAR1ES OF THE �fWD AgOYE OESCRI[iED AND OF THE LOCATION OF ALL BUII�tNGS, IF ANY, TNEREON , AND ALl VI516LE ENCROACHM�NTS, �F �w,r, FROM ORON SAID LAND. �pER ENGINEERING CO., INC. DATED TNIS OnY OF O•: tOi"C L' P.O.HS �? ✓ EN6INEERS AND SURv6YOR5 "T rJ• f � �I , ,,J ._-� � � _.�-, � ,. ,�; , ° � � , . �;,.:� v �:= �--.� r r � � City of Fridley, Minn. �UILDING PE�T No r 5 2 3'7 �. Date: --�_� � '"" �� WII@P: � r�,�.''�� l�.r..+f-i,�� „e: Rui �P � _ _ f � �J,r, r Address Address _�� -- "� LOC�TION OF ��I�B�9G No. �� Street �' =`� �.�..��--.t,�'t'�� Part of Lot _ L.ot .._ __ Block '� � Addition or Sub-Division �_� Coraer Lot _ Insfde Lot —�' �tback � : :�`��Sideyard --_�_�.� Sewer Elevation _____._.. Fo�dation IIevation `_ DESCRIPTION OP �UiLDING To� le U�d ac• �� -- �, �ont �-:�; Depth �-_ �� Height �� Sq. Ft. . �� Cu. Ft -�,G-,a--�°l,,,�' Front � Depth Heiglit Sq. Ft .� Cu, Ft ___. Type of Construction �''...�!��.'.�.;� F�t.`�..�,"'�,i._.�...� `_ '.�..�""�'v"'°'t'o be Completed In consideration oF tiie issuance to me oE a permit to construct the building described above, I agree to do the propased work in accordance with the description above set forth and in compliance with all provisions of ordinances oE the dty of Fridley. �r� ,�>, �:' �'�` ' In consideration of the payment of a fee oP $ r`l� '� �� "� ., percnit is hereby granted to..� � to construct the building or addition as desca°ibed above. This permit is grant,ed ugon tlne express condition that the person to whom it 3s 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 ordinanees of Fridley, Minnesota regazding location, construction, alteration, maintenance, repa3r and moving oi bwlldings ��. city ]imits and this permit may be revoked at any time...µpon violatiQn-�f any of the provisions of e�id �� , � Building Inspector NOTICE: � Thts pereilt does nof cover fhe eonstruttton, leitallallon for wirine, plumbfeg, gas heaNng, aewe� or weter. Be �re to aee fhe Butidieg leapeetor fa� asperato permNs for these Itsms. - � 4 r"`� . `. �-.�. � s: „ r �, �IPPLIC�TION FOR BIIILDING PERI►�T CITY OF FRID?�Y, MINAIESOTA � � _ � - �� :. ..�� r' �i/� �i�� . _ � �ddreee No. i�CATION OF BUILDIIdG of Lot Lot B1ock Addition or Su�ivision Corner Lot �_,Inside Lot Set�ck Side-Yerd S� FIYVATIQN FOIII�IDATION ELEVATION �pplicant e.ttach to this form Gertificate of Survey of Lot and proposed bu3lding loce.tion. To be used as: DE.SCRIPTION OF BIITLDING � Depth � � Aefeht - � � �. Ft. �-( �/ � Cu. Ft.��/ 0�� Front_ Depth Height Sq. Ft. Cu. Ft. Type of Construcstion �/��.e-- Fet3mated Cost�_ To be Completed 3 b ,� � The undersigned hereby makes applicat3.on for a permit for the mork herein spec3fied, a.greein� to do all work in �trict accordance with the City Ordinances and ruling of the Degartment of Bui].d3nge, and hereby declarea tha.t all the facts aad representatione stated in this applicat3on are true and correct. DATE ��"— � � ^ l� � SIGN�� (A 3chedule of Fee Costs can be found on the Reverse Side.) � � ^ . � BIIILDING PERMIT FEE SCI�DULE Se�ction 2. The Inspector of Bu�t].d3rigs shall, before � issuing anx permit for the erection of any build�.ng or structure, or for any additfon to any existing bu3.].d- 3.ng or stsucture, or for any elterations or repa3rs to eny exist3n� buildiag or st,ructure, upon application therefor, require the paarment by the applicant for auch perm3t of fees to the emount here3n be].ow set forth and in the m8nner herein pruvided to-wit: 2.1. For any such pex°mit for the erection of a.ny fise-proof building, other than a garage, warehouse, factor� or grain e].eeator, or for the erect3on of any fire- proof add3tion, for similar occupanc�, to any existing building shall be at the rate of �]..I3A for eaeh one thous�nd cubic feet, or fraction thereof� 3.n such c�b3ca]. contents. � 2.2. For any such permit for the erect3on of axiy fireproof garage, w�rehouse, factory or grain elevator, or for the erection of any fireproof addition, for sim3lar occupanc3r, to any exieting building sha11 be at the rate of �11.25 for ee,ch one thousand cub3c feet, cl�ssified as "fireproof'� by Section 502 of the Minneapolis Building Gode. HOUSE3 2.3. For any such permit for the erection of any non-fireproof build3.ng other than a�arage, warehouse, fe.ctflry or grain elevator, or any norr-fireproof addition, for sim3lar occupaneg, to any existing building. Permit �7..00 for ea.ch one thousand cubia feet. GARAGES 2.L�. For any such perm3.t for the erection of an�r nor�f�.reproof garage, warehouse, factory or grain elevator, or for the erection cf.ang non:fireproof addition, for aimilar occupancy, to any exiating bui.lding or for each such building or addition. Ninety Centa for ea.ch one thousand cubic feet or fraction thereof, in the cubical con�ents thereof with a minimum of �4.00. For the purpoee of computing feea for building permits the cubical contenta of any build3ng or addition to a un3form height throughout by multiplying the ground area covered from a point six (6) inches below the floor line of the basement or cellar to the average height of the upper surface or to the average height o� the roof surface of the main ga.ble of a p3tched roof. � 2.5. For repaira or alterations to an ex3.eting structure, the fee shell be et the rs�te of $3.00 for each Five Hundred Dollsrs ($5�0.00), or fraction thereof in the cost of all p:roposed work. � 2.6. In no case shall the %e charged for any permit as set forth 3.�n Section 2�e leas than �4•00• �� !":s� � � r �..� ��3�' BLflt� F- _ i ....................... ....�. .... ... .. ...... c� ; �� X.�� _�p �� . � '°�e' �„�.� 4� ee � i q ,��.�. � �s - �+ ��: d � � �— � � .. � ! ; �� .� � 0 � � � � `�,! ��- �-��-�-�� Sy� �':� � "� � � � , d'�� '�° �., -�?�.�.r�-� � QALII�'I�i � TYPE .` ,�`��, .... � t . a �" r�� ¢ ��'�~ �� ' � �' �� a, ,��` °. FR ,�� r��- G�A ` � � � , �,: l.�c�� ` F �► `� F ,,-� I ,f ,� ,� d�"�,*�r,+��,;�r� p �,��-�i� � J � � ' �t,J�`,.:F.i.r:3a�-s9�� d � � � �� : �—��- � �_a---- y� ��. ,� °� �,��.� �� t� .�; .....� ..................... ........�.................. ..........................�.... � �� "� 4 � 7i.^ � � r � � _ � � � City of Fridley, Minn_ BUILDING PERMIT ��; JUNE 18, 1965 � �s� � i .— N° '7947 �r: GORDON D. BEl�'N'E� �� HQRT•�' J HANSON' Addr+e� 6710 ,Tackson St, ft. E. A� 6819 Beard Avenue N'orth Minneapolis, Minnesota 55429 LOCATION OF BUILDING N� 6710 S�t ,?ackson St. N'. E. Part of Lot Lot �' Bl�k 5 Adaiit�ton or Sub-Division Brookview Terrace Coraer Lot Inaide Lot Setback Sideyard 3ewer Elevati� Foimdation IIeval3on To be Used as: Front Front Type oP Corrstructfon DESCRIPTION OF BUILDING Depth Height Sq. Fk Depth I�efght Sq. Ft r�� r$ 2, 075 . 00 To be Completed Cu. I�'L Ga. F't NEW GARAGE (REPLACING) STORM DAMAGE REPAIR Ia consideral3on oP tl�e issuance to me of a permft to construct the building described above I agree to do the proposed work in accrordance with the d�scription above set forth and in compliance with afl provisions of ordinences � the dLy of Fr1d1eY• . �s a In camsideration ot the Pa3►a►ent of a fee of $ 1 �• �� , permit 9s hereby �raated ta HARLAN J. H1�NSON' to co�truct the b ufld3ng or additfon e� described above. Thi��rm� t ia granted upon the egpress condition that the peraon to whom ft 9a grented and his ab�nts. emp1oYees an� worl�en, ffi all work done fn, around and upon said building, or anypa� thereo� ahall oonPorm in all reapects to the ordinancee of FridleY. Minnesota location, conatruct�on, alteration� maiatenaace, repair aad maving of bufldiuga wiwo�� dty limit$ and permit may be revoked at any time upon violation of a�► of the provfaions of said ALLEN G. JEN'SEN Suildin� Inspector NOTI� '161� pqemM doa eot ee+ror ths eoedroa8oe, tnalalHtioe tor �rfeing, pium6tne, oa ��°e �► � pP�+ W*� Mr tha� h�ma. 6�� arne or water. B� sun fo as API�LICATIOR FOR $IIILDING PERM'tT CIT'Y 0�' FRIDLEY, MIIVNESO�A nrt�Ya�n ''`,� °� '1 �J�}� L+rf %�f ,� F vaarraA � S IYL�l7� ._��` ��w1 /'f:.'� � A:- - ,� � o lr i6c � DU ■ ..�f+il A n,F-;�,.,,o �-. Am �. e. ' • x ,F /i �P. �, ,.��, U�..�. ADDRES9 � `� /� ° �� /� � � �� '-�'- �� ADL`RESS ,�-��'� � ° �� - a �r� � °�� h� � r�`' ! , �'� ��,.�T ° � 4 �,� ." � LOCATION OF BUILDING =�iO-R. Stx�eet Part of LoC . _..�._.....� L� K ADDITION OR SUBDIVIStON Corner Lo�`�Y�Bi�� LaT SetbBCk Side�Yard �� SL�WER ELEVATION � FOFJNDATION ELEVt�TION;,_.,_,_ „_, Applicant attach to this form Two Certificates of Survey of LoC and proposed bu3lding location drawn on these CertiEicates. DESCRIPTIOIQ OF BIIII.DING To be used as; ��. l�titi ��/� G� iC�� ,��. � �aP�B�I k�'=I'�Orit � � �'� ` �� - � �Pt$ �_ 2 �� Heighf �' ��r1. �� !(� �'Qe�� .�r � �� Sq. Ft. ��,� Cu. Ft. _r d��c ��d�� '.� � �&�� .�, � Front DepCh Height ----�--- � � �'��. � � �'�- �� -� � � � � Sq. Ft. Cu. Ft. T�►pe of Coa�tructioa ��'�/� � E�timated Cost ��' %�� a�—'� To be coaipleted �" ,�,, ` �`n � �,� ,°, q'he uadersigned hereby makes application for a permit for the work herein epecified, agreeing to do all work 3.n strict accordance with the City of Fridley prdinances and rulings of the Department of Buildings, and hereby declares that all the fact� aad repres�ntaCfons stated in this application are true and correct. �« r � -'�_; � '� � , : '� SIGNATURE � � � �.�-�� t��,._� �� q — (3chedule of Fee Co�ts can be found on the Reverse Side). �� /"°� �"� -.� •�� .-��'� _ � �- � - r � ,- � BViLDI�iG PERMIT F_�..SGHF.II�E " SE�. The Inepector of Bui�.dings shall. before issuiag any �rmit for the erection of any building or atructure, or for any addition to any existing build- ing or structure, or for any aLterations or repairs to any exietiag building or structura, ugon application therefore, requi.re the paymeat bq the applicaat for such permit of fees to the amouat herein below set foreh and ia the_maaser hereia_.. provided to-wit; 2.1. For any such .germit for the erection�of any fire�proof build3n�, other than a garage, warehouse, factory or grain elevator, or for the erection cf any fire•proof add3tion, for eim�l..lar occupancy, to auy existing building, shall be at the sate of $1.40 for each one thousand cubic feet, or fraction thereof� in such cubical contenta. 2.2. For �uy su�h permit ior the erectioin of any fire-proof garage, warehcuse, factory or grain elevator, or for tha erection of any f3re-proof addition, for similar occupaacy, to aay existing building shall be at the rate of $1.25 for e�.ch ane �housand cubic feet, classified as "fireproof" bq Sectioa 50� of the Minrieapolis Building Coc�e. " SOIISES . . . .. 2.3. For any such germit for the erection af any non•firepreof building, other than a garage, warehouse, factory or grain elevator, or aay non•firepreof addition, for eimilar occupancy, to any existing building - germie $1.00 for each one thousand cubic feet. GARAGES 2� 4. For any auch permit for the erectioa of anq aon-fireproof garage, warehouse, factory or grain elevator, or for the erection of aay non•fireproof addi.tion, for aimilar occupancy, to any esisting building or for each such buildin� or addiCion - ninety cente ($0.90) for each one thousand cubic feet or fraction Cheaeof, in the cub3cal conteats t�ereof with the minimum of $4.00. Fos the purpose of computing fees for buildin� permits, the cubical coatents of anq buildfng or addition to a uniform beight throughout bq mulCiplying the ground area cavared from a point aix (6) inches below the floor liae of the basement or cel�.ar to the average height of the uppez surface or to the average height of the roof su.rface of the maia gable of a pitch�d roof. 2` For repairs or alterations to aa ex3sting structure, the fee sball be at the rate of $3.00 per.each Five Hundred Dollars ($SQ0.00) or fraction thereof in the c0et of all propoaed work. 2_ 6. In no case shall the fee charged for ang permit as aet forth in Section 2 be la�s than $4.00. q � n ^ � ie l: r � , K'µ ' SUBJECT PE City of Fridley' 99 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T • r � � EIPT NO. � ; L__�_ COMMUNITY DEVELOP I ENT DIV. r � � PROTECTIVE INSPECTI N SEC. �� yd� 1 . i 'I 00 , � �'��1 � CITY HALL FRIDLEYII 5S43Q NUMBER REV. DATE PAGE OF APPROVED BY �._«� � LJ si2-56o-3a5o i 910-F15 10/3/78 � � JOB ADDRESS 6710 Jackson Stre�t N. E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 4 5 Brookview Terrace SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Gordon Bennett 6710 Jackson Streei N.E. 3 CONTRACTOF MAIL ADDRESS ZIP PHONE LICENSE NO. saffi� 4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑� ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK 9 CHANOE pF USE FROM S�TIPULATIONS TO SEPER.ATE PER�dITS REQI�IRED F�,� � HEAT6NG, PLUI��d9�� ;I�.� S6��e I, SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R 1. ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINE4 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. $c,�OO.00 y�` .'JrO WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEfiMITFEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- -STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. ' $7• SO � PLAN CHECK FEE TOTAL FEE $8.00 SiGNn7U D o0 aA OHAUTHORI2EDAGENT �DATE� HEN PROP RLY VA�IDATED THIS IS YOUFi PERMIT � ; , ��.�_°�� 1 �aA.� /� �-7�g SIGNAT E F OWNERUF OWNER BUILDERI IDATEI i nr. itisa ....� 0 0 . ; CITY or- r-iziv�cY . ' APPLIC�TIOPi FOft RL'�Tllf:NTI/1L I3U]LD1P�G PEIt1�1ITS . ' (I�L"W, IILTL"R/1T10PJS, IIDUITIOIJ�, OR RCPAIRS� � �CO�Ooa% �f'� '� � OWti�R: �=i(JAl�'iT i3UILULR: ' Address: �c��1sD°+�� 5T. d6_� f3��L�JS: • � Tel . tJo . : No.: �' 5�reet: , LOT: BLOCY.: �� RDDITIOP7 : /?j,��s r� c� I�� E12 f�' �CB � CORI�IER LOT: INSID� IAT: � SLTBAC}:: SID�YARDS: ApplicanL- attach 'L-a L-his form �lao Ccrt-iiicates of Survey of Lot and proposed building locatian dra4�n on these Certificates. . DESCRI PTI01'J OF BUI LDI I�G To Be used As: , 0 �%'HrNrs�/ � n�"T,G �TFront: Depth : • � � ' Height: " Square Feet: Cubic Feet: • •� Front: � Depth: � Neiqht: � Square Feet: Cubic Feet: ' �.ype of Construction: Estamated Cost: $ %�� , � 7.10 Be Completed: /� °/,3- '� � Alt. A Alt. B Proposed Drivecvay WidL-h If i�ew Opening Is Desired $ $ (SE� 2Z�VERSE SIDE OF SHEET) The undersigned hereb}� makes application for a pe-mit for the wark lierein specified, agreeing to do all <<ork in strict acc�rdance with the City of Fra.dley Ordinances and rulings of the Denartment oi Buildings, and hereby declares ihat all the facts and representations stated in i:his application are tr.ue and correct. See reverse side f di 'ona information. . � D11TE: �� -„j - � 1s SIGNATUP.E: Stipulations : � � �� . , �--� � �, �Jv . _ . � BUILDI(�G PER��IIT FEt� SCHEDULE SECTION 2. The Inspector of Buildings shall, before issuing permits for the erection of any building or stxucture, or for any addition to any exis ting building or structure, or for any alteration or repairs to any existing huilding or structure, upon application therefore, require the payment by the�applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: NEW CONSTRUCTION: Single Family Homes and Garages: $4.00/1,000 cubic feet. PLAN CHECK: 25 percent of building permit fee. DRIVEWAY DEPRESSION: (Concrete Curb Streets Only) ' Alternate A: Rennoval and replacement of concrete curb and gutter only; Driveway width plus 6 feet x$14.50 Alternate B: R�emoval and replacement of concrete curb and gutter and install a 3 foot wide approach with 6 inch depth; Driveway width plus 6 feet x$1�•20 p11 � : 1 �' : �1 For the purpose of computing fees for building permits, the cubical contents of any building or addition, is determined by multiplying the ground area covered from a point six (6) inches below the floor line of the basement or the cellar to the average heights of the upper surface or to the average height of the roof surface of the main gable of a pitched roof. For repairs or alterations to an existing structure, the fee shall be at the rate of $3.00 �ier each five hundred dollars�($500.00) or fraction thereof in the cost of all proposed work. In�no case shall the fee charged for any permit as set forth in Section 2 be less than $7.50 p].us $.50� state surcharge. ° � ! , / / , / j ' � NOTE: Permits for construction will be issued a mini.miun of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has been constructed will be required before proceeding with the framing. ; + � � ':\ Application for a Certificate of Occupancy shall be made ten (10) days prior to the use or occupancy of any structure for which a building permit has been issued; and said structure shall not be used or occupied until a Certificate of Occupancy has been issuedo �. V. _ � c� _ _ �e SuB�ECT c�ty of Frid�ey AT THE TOP OF TME 7WINS g U I L D I N G P E R M i T ;, ,� ; �v _ COMMUNITY OEVELOPMENT DIV. r j � PROTEG7IVE INSPECTION SEC. � i � �l �"'1 � CITY MALL FFiIOLE� '351�2 NUMBEN L.��: �.1 612-571-3450 gt0-F15 JOB ADORESS 6710 Jackson Street NE 1 LEGAL �OT NO. BLOCK TRACT OR AOOITION DESCR. ({ 5 Brookview Te: 2 PROPERTY OWNER MAIL ADDRES$ Lawrence J. Mrozla 3 CONTRACTOR MAILADORESS Owner a ARCNITECT Oq OESIGNER MAIL ADDRESS 5 ENGINEER MAIL ADDiiESS 8 USE Of BUILOING Residential 7 CLASS OF WORK REV wi� PAGE Oi 10/20/98 / / RMI% ?8326 �� C3 APPROVED BY SEE ATTACHEO SHEET PFIONE 502-�0378 PHONE LICENSE NO PMONE LICENSE NO PHONE LICENSE NO ❑ NEW ❑ ADDITION � ALTERATION � REPAIR ❑ MOVE O REMOVE B DESCRIBE WORK Reroof house and garage (22 Sq) Tear-off 9 CHAN(3E OF USE FROM STIPULATIONS TO Underlayment must comply with the State Building Code. SEPARATE PEFMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, NEATING, TYPE OF CO VENTILATING OR AIR CON01710NING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION 20NING AUTHOR12ED IS NOT COMMENCED WITNIN 80 DAYS, OR IF CONS7RUCTION OR WOfiK IS SUSPENDED OR ABANDONED fpq q pEpIOD OF 120 OAYS AT ANV 71ME AFTER WORK IS COMMENCED. NO OWLG. I HEREBY CERTIfY THAT 1 MAVE READ ANO EXAMINEO THIS APPLICATION ANO KNOW TME SAME TO BE TRUE AND CORRECT. ALL PROVISIONS Of LAWS yp�UATION AND ORDINANCES GOVERNING THIS TYPE OF WOFK WI�� BE COMP�IED WITM WMETHER SPECIFIEO MEREIN OR NOT. THE GRANTING OF A pERM1T 1885 DOES NOT pRESUME TO GIVE AUTMORITY TO VIOlA7E OR CANCEI 7ME pERMIT FEE PROVISIONS OF ANY 07MER STATE OR LOCA� LAW qEGUTATING CON• STRUCTION OR TNE PERFpqMANCE OF CONSTRUCTION ��n �� S�GN4TU�7E O� CON'HACTOA OF 4UTNONIjED 4GENT IDI�1E� � t8_�� GN4TUAE O� OWNEAi�f OWNEA BWIDE �OATE� � -�-�..��...v. anvur VC:GUPANCY LOAD SO. fT CU FT OFFSTREET PAqKING S7A��g GARAGES SURTAX SA CC ARGE Fire 1.88 TOTA� EE ALIOAT IS IS YD�q pERMiT / � i �i�iF ., . s �. NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [] SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2 � a.� � BUILDING PERMIT APPLICATION � � ��G� o e �� , ConstructionAddress: � � � J � �-�S� `'� � � ( N � �r l °� l �/ /� � � Legal Description: Owner Name & Address: � a W►'e+� �Q � /�. ra Z� � Tel. # S� Z- 0 3�$ Contractor: S e� f �� rf �� 5 MN LICENSE # —� Address: LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Construction Type: Tel. # — 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 Sq. Ft. �e '� %a o� �io ceS ¢ �w � ��ir'O� 9'� — oZo�--- � Q. -}-ec� r-a'Ff Driveway Curb Cut Width Needed: Ft. + 6 Ft = Estimated Cost: $ /l vU� S (Fee Schedule on Back) Ft x $ _ $ DATE: j�� Z� � 9� APPLICANT: Tel. �{ 5 o Z- 0 3�i` � Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY $ �g � �Fee Schedule on Reverse Side $ � v � .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 [ ] $ �.� .�� BUII..DING PERMIT FEE SCHEDULE The Chief Building O�cial 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 alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: TOTAL VALUE $1 to $500 $501 to $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 $100,001 to $500,000 $500,001 to $1,000,000 $1,000,001 and up FEES $21 (Minimum Fee is $21 plus surcharge) $21 for first $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 $62.25 for first $2,000 plus $12.50 for each additional $1,000 or fraction thereof, to and including $25,000 $349.75 for first $25,000 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,000 $574.75 for first $50,000 plus $6.25 for each additional $1,000 or fraction thereof, to and including $100,000 $887.25 for first $100,000 plus $S.QO for each additional $1,000 or fraction thereof, to and including $500,000 $2887.25 for the first $500,000 plus $4.25 for each additional $1,000 or fraction thereof, to and including $1,000,000 $5012.25 for the first $1,000,000 plus $2.75 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 $13.50. 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 $15.75. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for 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 has it has been �onstructed will be required before proceeding with the framing. From: Building Inspections 763-572-3604 763-502-4977 FAX DA'I'� '0=7 U " SIT� ADDR�SS THIS APPLICANT 1S: OWNEIt/ TENANT of Fndley io: 8��3t314�1 h�age: d/0 uate: �� :41:r1 rm MECHANICAL Perm.it 1vo.� RESIDENT.LAL APPLICATI(�N ��i°ed By: DOWNF:It CIT� OF FRIDLEY I Da��. L•VVL•/'�TIVL•N �nnn -(;D YOUR CONTRACTOR �pqNY NAM�: SUBMIT A COPY OF cor,T��HEA7ING B AIR CONDITIONING LLC YOUR STATE sTnrt L�c�NS��910 Wentworth Ave. So tiJtP DATL� LICENSE WITH A„D,�ss: Minnea�,olis, MN 55420 C1TY S'fAT� 'LiP APPLI TIOA) pRpN� _-�9�J2� SS� ��O NAX _ PERMIT TYPE �PE oF wox�c: �SINGLE NAMILY �'fW0 NAMILY ❑ N�W �RR�ALAC�MM�NT DETAILED DSSCRIPT[ON OF WORK O TOWNHOUS� � ALT�RATION/R�MOD�L rL�LS Aft1C BAStLD O� $10.00 PLR F1XTUl L�XCLPT WHL�ItE VOTED. b7XTU�LB: L�DICAT}+�' T AL �U1�IBL�RON LACH SLLOV1n �quipment lnatalled MNG: M011BL: U'lv �� p�]1� SI'LH/H1'U �� Ml'Ci: LE'� MODEL:�� S1'L�/HTI.I�� T°�1 �AlC $25.00 AlR TO AIR �?CCHANG�R $15 �1301Lk:R $35.00 CHIMNEY L1NBR$10.00 DUCT WORK $10.00 MMG: MQDtiL: N1RN.PLAC� (GAS) $15.00 F1R�PLAC� (WOQD) $35.00 ,�NU RNACE $35.00 GAS DRY h:R $10.00 (3A5 PIPING $10.00 Sl'LkJHTU _GAS RANdk�JOV�N $10.00 N�W GAS CiRILL $10.00 CiAS UNIT HTR $10.00 PQQL HEATBR $35.00 Y�NTILA'fOR $1 S.OU THIS lS AN AFPLICATIAN NORA Pl�RM1T-NOT YAL1D UNTIL PRCIC�55�D 1 horoby apply for a building pcnnit and I acknowlod�c that thc information abovo is complcto and accure�to; ttiat thc work will bo in conformancc� with thc ordinanc�s and cadcs of thc City of Fridlcy and with thc Minncaota Conshuction Codcs; that [ undcrstand this is not a permit but only an application far a permit and work is nat to start without a permir that thc work will � in accordancx with thc appnovcd plan in thc ceRC of al� work which rc�uirc� rcvicw and approval of plans. SIGNATUR� ON City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3b04 FAX:763-502-4977 � ♦