AF - 47175Caty of Fridley, 1Vlinn.
BIJTI�DING PE�VIIT N� 5� 5 8
Date: �"""��_ �
,'3 ^ -
, ��
Owner: Builder +��..e�` �'
Addr�ecss Address
LOC TION OF 1 ING
No. ��j2��� Street � Part of Lot
Lot -� _ Bl Ad�ttion or Su'b-D4yi�� .� �
Coraer Lot Inside Lot �"�""� Setback � Sideyard ��
Sewer IIevation ° Foundation IIevation
�, DESCRIPTION OF BUILDING
T „ Used �
� P ��'+�'— g .a�_ q. ��`,� F'��
Front _� De th Hei ht . S Ft, Cu.
Front �!� Depth �,�� HeiP,ht �.. Sq. Ft. .�� Cu. Ft. :���
Type o c13on Fast. Cost � To be Completed
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the descript3on above set forth and in compliance with all provisions oP
pr8inances oP the cfty of Fridley. � '
In consideraiion oP the payment oE a fee of $,��� , permit fs hereby granted to
to construct the building or addition as described abuve. This permit is granted upon
the express conalition that the person to whom it is granted and his agents, employees and worl�nen, in all work
done in, around end upon said building, or any part thereo% shall conform in all respects tp the ordinances of
k'ridley, Minnesota regarding locatton, construction, alteration, maintenance, repair and movfng of buildia'ga
��� dtY limits and this permit may be revoked at any 't�e upon�violafi�"on�of aay of the provisions oE said
BtSlding 7napector
NOTIC�
T6b permi� does net eover t6s caest►ueHon, Inshllaiton for wlrtng. Plumbfng, gas 6eaHeg, sewee or wafer. Be are to me
ths Butldtee lespeefo� for aeparate peraifs io� 16�e ttems.
/'� 4 ^
� -� <- .�. _ - -
_ _ �, �__ -- �
APBLICATI011i FOR BUSLDiNG PERI�lIT
CITY D�' F1tT�J.�EY, N[�NNE�4TA
LOCATI011T OF BUITaDiNG
No. � ` �
of
zoi I .� � �, .�`
Hlock_„� � �Addit3on or Subdivis�.on,�,+�
� ��
Corne�c�Lot Tnside Lot Setbac��Side-Yard �
SETnTER Ei1EVATION �� FCIUNDZ�TSON ELEVATION
1
�pplicarlt attach to thie �orm Certiricate of Surv�y o�E Lot and
proposea buildin� locat:ton.
DE�CRIPTYON OF BZJILDTNG
To �e used aso
7 �
�'ront��!�Depth ,� � Heigh� `��
eS�s �'tr• �• �.•
i .
Front—.l-�"`DBP�ch,��I�eight � �'�
_. .`.--
Type of Construci�
�o be
Sq• Ft• Cu. Ft.
stimated Cos�
�he uriders3gned her�y mak�s appl�.cation �or a permit �or the wo�k
he+�ei� apeci�Cied, agree�.ng to do a11 work in strict accordance with
the C�.ty of Fricllay Ordinances and ruling o� the D�par�nent o� 8uild-
ings, and hereby declares that a11 the fac�cs and represenicatioas
stated in this apg�li ation sre true and correct.
DA►TE � �?sJ ,� � �
..__, �,__SIC�1A1 .� �
(scheaule o£ Fee cos�e car� be found on the Rev�rse �iaej.
s�
� � ,
�UiLD�TG PE1�NlIT Zs`EE SQ�EDULE
Secrion 2. The Tnspector o� Buildin�s sha11., be�oge issu�.ng any
perm3.i: for the erec•�ion os any 1ou11ding or s�ructure, or for any
addit�.on to any c�x�s�jng �uilding or sicruc'�ure, or for ar�y aitera'cions
or repaira �o any oscis�t�.ng bui.ld�.ng or si:ruc�u�e, upon applica�ion
�h��e�or, requige �he payment by trhe a�plicant �or such pe�mit of
fees �to the aYaount here3.n below set �orth and �n iche manner h.�rein
pgovided to-w3.to
2.1. �'or any such p�rmit �Eor the erection o�E any �ire-p�oo:� building�
o�lner than a garage, waac�house, factory or graln eleva�tor, or gor the
e:rec�ion o�c any ��s:e-p�coo� addition, �or sim�.lar occupancy, �o an�i
e�e�.s�ing building shall he at the rate o� $1.40 for each one thousand
cu'�ic �eet, or �ractaon thereof, in such cubical conten�s.
2 e 2. �c ox any such permi� �or �che erec�ion or an�r fire-proof garage,
warehouse� cactory or grain eleva�or, �r �or �e erection oi ar,y fire-
proo� adc�ition, iox simj.laac occupancy, 'co any exis�ing bui lding shall
be at the ra�ta oy $1.25 for each one thousarid cubic feet, classi�ied
as "fiseproo�° by Sect�on 502 0� the �l�.nneapoli� Building Code.
fiOUSES
2.3. For any such perm3.� for the erec�ion of any non�fi�eep�coof builcl-
�.ng oilzer than a garage, warehouse, �ac�ory or gra�.,n elevator, or any
aon-sixep�coof add�.�ion, £or similar occupancy, to a�y exis�tinq buildingo
Peacnnit $1.00 for each on� thousand cubic �eet.
GP�AGES
�.__,
2s�. For any such �e�rait ior �he erec��ton oi any nan-�ireproo�
garage, warehouse, yac�o�y or gra�.n eleva�or, or for the erec�t�.on of
a�y non-fireproo� add3.ti.o�, �or si�nl�.ar occu�ancy, to any ex3sting .
build�.ng or �ox each such louilding or add3.t3one Ninaty Cen�s �or each
one �ousand cubic �eet or fraction �hereo�, 3n the cu�ica]. conten�s
�hereo� wi�h a ma.n�m�n of $4o00a
For �he purpose oc cora�u�ting fees for building pernai�ts the cubical con-
te��s o� any build�ng or addition �o a un�.fo�m height throughou� by
multiplying �the grou�nd as.�ea covered yrom a point six (6) inches below
�the floor line o� the basement or cellax �o �che avegage height oiE the
uppe� surface or �o 'che average heigh� os the roog surface of the tnain
ga'�le of a p�.tched root. -
2� For repairs or alterat3one to an exis�ting structure, �the cee
shal� be at the raie of $3.00 per each Five Hundr�d Dollars ($500.00�
or iYSC'F�lOYl �hereos in �the cos� o� a11 pro�osed wor� e
2� �n a�o case shall �he fee charged �or any permit as sot �orth in
Section 2 be less tl��} $4.00. r"�
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HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS FRIDLEY, MINN.
Weatherstrips A.S.H.V.E, Copstruction No. lnaulation
Guide
Windows Doors Reference Out. Wall Int. Wall Ceiling Roof F7oor How Applied
No I e No 1 ' � � fJ' -3 -- _� '= �
: - .�
FL� ' Room � Lengt Width � Height / Fl.� Room Length � Width Z/ Height ,�
Windows a Doors—Crackage and Area Windows and Doors—Crackage and Area
�Vldth Helght No. ot Llneai It. Area Wldth Helg6t No. ot Llneal tt Atea
No ot Dane ot vane Iighte ot crack eq. ft. No. ot pane ot Dane tlghte of crack ea.
��/ i � ,
� �/J� i 't/�Gi�� / L.�� ��. � "f�h
In6ltratioa �
Glass � �
I Exp. wall
Net exp. wall � �
` int. wall
Ceiling � �
Floor
Total Btu.
Required sq. ft. E.D.R. or aq. ins. W.A. Leader area �
F1 oom � Length 2 y/ Width / Hei;
Windows and Daors—Crackage and Area
Wld'th Hefght No. ot Llneal ft. Area
No. ot Dane ot pa�e IiQhte ot crack sa. tt.
G/ c
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/ 1. -� � Ga f//_ //i/ � /1% 7 i6 �
BcU �
�� �/ Infiltratioa
?;� Glaaa
�`'� Fap. wall
� Net eap. wall
Inc. wall
��� Ceiling
�� Floor
i
�_ Total Btu.
COtf. Bhl
Infiltration � � �
Glasa � �2
Exp. wall
Net eap. wall �y `� y�
Int. wall
Ceiling
Floor �
Total Btu. �
Required sq. ft. E.D.R. or aq. ins. W.A. I.eader area
F7• Room �LenBth ,� � Width L/ Height
Windows and Doors—Crac�age and Area
Wldth Helg6t No. ot Llneal [t. Ares
No. of pane ot Dene Ilg6ts ot crack eQ. tt.
� � � � / /
��' ,3 � �% Z,
Inhltration � �
Glaas
F�cp. wall `
Net exp. wall �
Int. wall
Ceiling
Floor
Tocal Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
i
Coef.� Btu
Required sq. k. E.D.R. or aq. ins. WA. l,eader area
� FI. Room I Length �/ Width /
� Vf/indows and Doora--Crackage and Area
Wldth Selght No. ot Llneal 1t. Area
No. o[ pane ot pane Ifghts ot crack eQ, [t
_ .� � / .li �
�
Infiltration
Giass
Eap. wall
Net eap. wall
Int. waU
Ceiling
Floor
Total Btu.
�
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Required aq. k. E.D.R. or aq. ins. W.A. L,eader area
f FI.� Room I
� Windowe and Doors—C
Width Hefght N
No. ot cane o[ o�nw u
Btu
�Infiltration
' � Glaas
3�� Eip. wali
Net eap. wall
Int. wall
��_ Ceiling
Floor
�� ' Total Btu.
� w�a� �
and Area
neal tt. Ares
aq. ft. E.D.R. or aq. ins. QIA. Leader area
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sue�ecr � PER
CitY of Fridle �
AT THE TOP OF THE TWINSy gU I L D I N G P E R M I ° ��O
� � RECEIPT NO
� ; y ____ COMMUNITY DEVELOPMENT DIV. �
r � PROTECTIVE INSPECTION SE0.
� ,
� _ �
�' r���� � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OP APPROVED BV
----� ' ••' ei z-ssaaaso
910-F15 4/18/77fd � �
JOB ADDRESS 6729 Jackson Street N. E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. ],]. 3 Meadowlands Second SHEET
2 PROPERTYOWNER MAILADDRESS 21P PHONE
Steven A. Holter 6729 Jackson Street N.E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
� NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 10' x 9' Shed
SEPERA'i'� PERMITS REQUIRE�f F�t liI�R1HG.
9 CHANGE OF USE FROM 1Jc�'��, p��} � �� �,
r��.
STIPULATIONS Shed must be pernLanently tied down.
SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING, �PE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTIIATING OR AIR CONDITIONING. Me'�3�.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPEWDED OR ABANDONED FOR A PERIOD 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 $200.00 �`.SO
DOES NOT PRESUME TO GIVE AUTHOFiITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. � yS`%. SO
PLAN CHECK FEE TOTAL FEE
�`8. �0
SIGN REOFCONTRACTO RAUTHORIZEDAGENT (DATEI WHEN PqOPERLY VALIDATED THIS IS YOUR PERMIT
�/� 7� _/8 -7 ���
p^ �yNATURE OF OWNERIIF OWNER BUILDERI IDATE) BLDG INSP pqTE
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PERMITS
�NEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
OWNER: 070 � Uc/I° �• OG' c%�,� BUILDER: ��;��; ���'
Address : �/ �,� � �%i��,('�S��o ' �'. d�-� Address :
Tel. No.
� `r �`
No. :_ � .� .-� ✓ Street: �%�1��5�.'���' �?-� /���
�
LOT: ,o BLOCK: ��� ADDITION: /.�: ��7.°j-�; ;',!'.�?� ;��� �S S� e- 6
�,�f ���--c=
CORNER LOT: INSIDE IAT: [�' SETBACK: SIDEYARDS:
Applicant atta.ch to this form Ztnro Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Used As:
ti�.'���� Front: ,�G' ° Depth: � � Heigh�:
Square Feet: • `�e`'� Cubic Feet: � ��=��'
Front: Depth: Height:
Square Feet: Cubic Feet:
4'ype of Construction: �=� T��,! Estimated Cost: $,���G-�. ��
7.b Be Completed:
Alt. A Alt. B
Proposed Driveway Width If New Openinq Is Desired $ $
(SEE REVERSE SIDE OF SHEET)
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City of
Fridley Ordinances and rulings of the Department of Buildings, and hereby
declares that all the facts and representations stated in this application
are true and correct. See reverse side for additional information.
DATE: �/�!%� .�� SIGNATURE: ''-���..�..°, .��«�-� .,-
--�- _
Stipulations:
�� ��
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, �
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BUILDI(JG PER��IIT FEt SCHEDULE
shall, before issuing Pern►its for the erection
existing building or Stru°ture'
SECTION 2• The Inspector of Buildings addition to any u on application
of any building or structure, or for any�isting building or Stru�t�'e' p
or for any alteration or repairs to any licant for such permit of fees to the ���t
thereforQ, require the payment by �e app
herein below set forth and in the manner herein provided to-wit:
Homes and Garages= $4•00/1,000 cubic fee�.
�W CONSTRUCTION: Single Family e�t fee.
pLAN CHECK: 25 percent of building P
AN
oval and replacemexit of coiuse6 fee tX al • 75
DRIVEWAY DEPRESSION: (Concrete Curb Streets On y
Alternate A= �tter only; Driveway width p
oval and replacement of concrete curb and
p,7�.ternate B: � roach witY►
gutter and install a 3 W a� pauSa6Pfeet x$15.40
6 inch depth: Driveway
� ADDITIONA� I IO
fees for building permi�� the cubical contents of any
For the PurP°Se of computing ��,tiplying t�e ground area covered from a
building or addition, is detern►ined by
inches below the floor line of �he basement or the cellar to e
point si.x (6) er surface or to the averaqe height of the roof surface
- average heights of the upp
of the main g�le of a pitched roof .
For repairs
or alterations to an existing structur��► fraction thereo el ttheecoste
of $3.00 per each five hundred dollars ($500.00
of all proposed work.
. hall the fee charged for anY P�lt as set forth in Section 2 be less
In no case s
t� $7.50 plus $.50 state svrcharge.
IC 0 F F I0
for construction will be issued a m�oi��d stn��t� 5and of�the �e
NOTE: Pe�l� ro r review of the p P�
of application to allow for p Pe
construction site.
of the lot, showing the location of the foundation once it
p Certificate of SurveY ired before proceeding with the framing-
has been constructed will be requ
� IFIC 0 P Cl
shall be made ten (10) daYs Prior to the
ancy �it has been issued; and
Application for a Certifs�ructureoforpwhich a building Pe
use or occuPancy of anY ied until a Certificate of OccupancY has
Saic1 structure shall not be used or occup
been issued.
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City of Fridley 15 5 0 0
, ` AT THE TOP OF THE TWINS g U I L D I N G P E R M I T R EIPT NO.
r
� `L ____ COMMUNITY DEVELOPMENT DIV. �
r j � PROTECTIVE INSPECTION SEC.
� . ,
i
L-__. � �����,', CITY HALL FRIDLEY 55432 NUMBEP REV. DATE PAGE OF qPPROVED BY
L J\ 612-571-3450 910-F15 10/1/79 / /
JOB ADDRESS 6729 Jac.kson Street N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 1], 3 Meado�nrlands 2nd Addition SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
5teven A. Aolter 6729 Jackson Street N.E. 574-0807
3 CONTRACTOR MAILADDRESS 21P PHONE LICENSENO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
8 USE OF BUILDING
Resident;�ai
7 CLASS OF WORK
O NEW � ADDITION � ALTERATION � REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 14" x 22� Gara e Add3tion
9 CHANGE OF USE FROM TO
STIPULATIONS provide a hard surface driveway. Provide frost footings .
SEPERA'tE PERMIi'S REQtifREO F�R WtR1�G, _..
tt`EAi1MG, Pl.UNI�ING ANO SiG�iS, WARNIN�� �
8efore dtg�ing c�111�a1 utllit���
'�EIEPHONE •EI.ECti�IC o �d�� �t�s
R���l�h'�� �°�' t��►'+�I
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING. WOOCI FiaIIlE
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZpNING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN BO DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD 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 $2578 $�-. 2g
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. S12e32
PLAN CHECK FEE TOTAL FEE
� 13 e 61
SIGNAT flEOFCONTRACTORORAUTNOR�ZEDAGENT .(DATEI WHEN PROPERLY VALI ATED THIS IS YOUR PERMIT
•���✓ �O-/-%� 1� [
NATURE OF OWNER UF OWNEA BUILDERI ' IOATEI - BLDG INSP 4 TE
. • , • ,
• CI?Y OF. FRIDLEY • � . - •
�
� , � APPLICATION FOR RESIDENTIAL QUILDIP�G PERMITS � � � �. r
� " � � (Wew, Alter���ions, Additions, or Repairs) � ,
_ . .
' � 04�`�ER: �� �,��� o�' r -�� G%E � BUI LOER : . . ����� � .
ADDRESS: G� � `�' ���/1 � �� ADpRESS: • . ' .
TEL N0: _ � �,�=t�� �� TEL N0: ' �
' • � ' � Construction Location . ..
• s�T No : � � .�� s�rx�r: ,� � ���c��,0 ���''c r .a. . , •
LOT: •BLOCEC : ADDITION :
Corner Lot: ' Insicle Lot: Setback: Sideyards: •
Applicant atta.ch to this form two Certi.ficates of Survey of lot and
e � proposed building location drawn on certificates to scale. �- �.
� � DESCRIPTIOW OF CONSTRUCTION • . � � ..
� �p A2_I�o� �1dJ�IJ. Front: � �7 � DePth:. 0�2 � Height: /Q f .
� • . - Squa�e. Feet: Gtiibic Feet: _ .
_ Front: � Depth: � Hea.ght:
� � Square• Feet: Cubic Feet:
TyPe o� Constructio� : (��jOD ��� (� � , � � Esti.mated cost: S ��%C�
. Rb Be Cbmpleted: ° . � � . . . � � . . �,
' . . . � Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired: $' $ �
� � -. , , • . � . SEE REVERSE SIDE OF SHEET
_ .7�e undersigned hereby makes applicata.on for a permit for the work� hesein specified,
agreeing to do all work in strict accordance with the City of IYidley Ordinances and
rulings of the Department of Buildings, and hereby declares that all the facts and �
representations stated in this application are true and correct.
DATE: ��� �7% SIGNATUI2E: � .
Stipulations: • �
�
� . 02 � � ✓ � /��t � 2°�6 F���'c�. � .
. . �� � PR� .
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. uu, �v, rvc f�Ear��T r-EC SCHCDULE' . ,.
8J3CTION 2. T)�Q Inra�,�ector �oL 13uilclinq� uha7.l, hc�orc is .uing pennits for the erecL•ion �
oL• any buil.a�.nc� ar :�L•ruct:ure, or �or any addi.t•a.an to any exi�L•inc� building or strucL•ure,
. ciz tor any .zlteratia� or Xepair:s , to •any exi.�ting }�ui.lding or st•ructurc, upan anp�.ication
•.'L•hexeL•orc, requirc l:hc PaymenL by tlie applS.cant far. such permiL of fees to the amount
. hcrein be].ow seL- forth and in L-}�c manncr herein providcd L-o-wiL•: . •
' � ' • • : '
N1sVJ CONSTRUCTION: Single 1'ami].y IIomes and Garages: $�.00/1,000 cubi.c ieet. �.
PIJ►N CiiLCY.; 25 percent ot- bui.lding permit tee. ' ''
D122V�(rJAY D�PRL•'SSIOiJ: (Concrete, Curb Streets Only) � �' •
' Alternate A: xemoval and replacement of concrete curb and '
gutter only; Driveway width plus 6 feet x Y15,75
�• . l�ltcrnate B: Remova]. and replacement of concrete curb and I'
.• � , gutter and ins�all a 3 foot wide approach with "
.•• : . 6 inch depth; Driveway width ��lus G teet x$17.85 �
- •� . . . � _ADDITI�N/1L IN�OR�IATION '
Tor the purpose of computing fees ior building permits, the cubical contenL-s of any
builda.ng or addition, is dcL-ermined by multiplying ihe ground area covered irom a
point sir. (6) inches below t:he floor line of the basement or th� cellar to the
average heights of the upper surface or to the average height of the roof �uriace
of the raain gable of a pitehed roofe � -
. .
For repaixs or alterations to an existing si:ructure, the fee shall be at the rate
. of $3.00 per each five hundred dollars -($500.00) or fraction ttiereof in the cost
of all proposed work. _ . . °
In•no case sha].1 the fee charged for any pezmit as set forih in Section 2 be less•
•than $7.50 plus $.50 state surcllarge. , . � • '
' . . _ .. . .... . _ . . . _ ..- VERIFICATIO��F FOUNDATIOfV . .. _' . .. .. . .. .. .
�NOTE: Permits for cons truction ��ill be issued a minimtun of 24 hours from the time
oi application to allow for proper reviecv of the proposed structure and of the
construction si te. ° �
?1 Certificate of Survey of the lot, showing the location oi the foundation once i�
has been constructed will be required before proceeding with the framing.
' � � � � _GERT I F I C/�TE OF OCCUPANCY � . '
' Application for a Certificate ot Oceupancy shall be made ten (10) days prior fio the
use or occupancy of any structure for �aiiich a buildi�ig permit has been issued; and
said structure shall no� be used or OCCL1p7.@C� until a Ceriiticate of Occupancy has
been issued.
. ' • • • • � • �
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usuRSwN
�NOIN6�RINa
('md & Mun�npul Enguieenng �.4od Test�ng � Land Surueytng � Land P(muung
Main Oftice 571 6086
6875 Highway No. 65 N E.
Minrreapolis, Mmrtespta 5543Y
South Office 890-6510
1101 Clitf Road
BurnsvJle, Minrresota 55337
Mort�age Loan Survey for ��WA�p T�• gl.l L!�
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This is a true and correcf representation of o su�vey of the boundarie of �he land obove , dsscribed arui of tha
lotafion of all bufldings� if ony� fheraon� and oll visible encroochmenfs� if y� from or on said laed. This aurvey Is
made onlr in connestioe wifh o�norfguge loan rtow being ploced on t proparty and ne IiobilHr is assumed
e:cept to ♦he holdm of such mortguga or onr ofher interest ocquirod y t ��asot�'' f sueh mort�age, H is
undersfood ond agrsed �,qmonu�no�ts have been I ced for �he iur e estob�d`sh ng lot lietes or boundary
cornen. Doted this�day of +a.L.�" A.D. 1V� _ ,+ �' _
SUBUR,BA lill� ING IN�
���'l��-
Not Pu6lished: All Rights Reserved
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Surv�y0rs
t > � �-;1 �,�' ' �...r :a�"z4,.
��
SUBJECT
City of Fridley
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
� �
� �
( �L _ COMMUNITY DEVELOPMENT DIV.
r j � PROTECTIVE INSPECTION SEC.
l-_--� ��"� �,� CITY HALL FRIDLE� 55432 NUMBER REV DATE
i 612-571-3450
910-F15 6/8/89
JOB ADDRESS 6729 �?ackson Street N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION
DESCR. ],]. 3 Mea,dornrrlands 2nd Addition
2 PROPERTY OWNER MAIL ADDRESS Z�
Steve Holter 6723 J'ackson Str�t N. E.
3 CONTRACTOR
PAGE OF
� /
��
PERMIT
_ 17541 ;
O.
l � ��y
APPROVED BY
SEE ATTACHED
SHEET
MAIL ADDRESS ZIP PHONE LICENSE NO.
Pati.o Enclosure Inc. � 3537 Hillsboro 2�,venue North 546-3322
4 AqCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
8 USE OF BUILDING
Resid�ntial
7 CLASS OF WORK
8 DESCRIBE WORK
❑ NEW ❑ ADDITION
B
15' x 2Q.' 3 Season Pe
9 CHANGE pF USE FROM
STIPULATIONS
VVA�NING
Before �j��i�g cail locai utilities
fE�Ep�01�� � ELECTRIC - GAS ftc.
REG2�I��ED BY LAYV
❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
& Patio Door
TO
SEPERATE PERMIiS REQUtRED FOft �YIR�NG,
H�,ATING. PLUMBI�� ,��yp SIG�$�
SEPARATE PERMITS ARE FEOUIRED FOR ELECTRICAL, PLUMBING, HEATING, nPE OF CONST
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UN
I HEFEBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION ],
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $5,250
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE
P OVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
S R CTION OR THE P RFORM NCE OF CONSTRUCTION. $SF). �JO
PLAN CHECK FE
^�- `��' $14.13
SI NA RE OF CO i RACTO OR AUTNORIZED AGENT �DATEI VVHEN �.
�DATE�
OGCUPANCYGROUP OCCUPANCYLOAD
SQ. FT. CU. FT.
OFFSTREET PARKING
STALLS GARAGES
SURTAX
$2.63
SAC CHARGE
TOTALFEE
$73 .26
RLY VALIDATED THIS IS YOUR PERMIT
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FI�/DI� �,- ��`'� '�f f, _ r � DATE:. �,c,yy
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p� [] City of Fridley Effective 4/1/8�
ADDN. L 7 R-1 AND R-2
pI,Tgp. [ ] Building Permit Application
Construation Address : � % °� � � �'% � � � �� �
Legal Desaription:
Owner N�e & Address : � %eu-� �e� /7�t �' � ! �� �'9 �� �0 � ' Tel . #
Contractor : �fi Ti <� £",t� c,�,c-� Lfr�t �'itr � ° � � Tel . # S�� ` 33 �2
Address: �S 3� �-/i //S �c.'�t�v 64r�z /t, ,
Attach to this application, a Certifieate oP Survey of the
. lot, with the proposed construction drawn on it to scale.
DESCaIPTIOA OF IMPaOVEMENT
LI9ING AREA: Leagth Width Height Sq. Ft.
GARAGE AREA: Length Width fleight Sq. Ft.
DECS AREA: Length W.idth Hgt/Ground Sq. Ft.
ar�a: �► � � ��� ������-- � � �=°'��r� z'�ei� �
+� e o� X�• W'y z��.�1 t 5 Z. �
Corner Lot [ Inside Lot [] Ft. Yd. Setback Side Yard Setbaek
Type of Construction: � S�l��v%� ���'�1� Estimated Cost: $ ���
Approx. Completion Date: �cl/v � 2� f��� SZ�
Alt. A Alt B
Proposed DriveWay Width If New Opening Is Desired: $ $
See Baek Page for Explanation
DATE: ��'°� ` Sy APPLICANT: � Tel . # � � �� ��z �
CIT7[ IISE ONLY
Permit Fee $ �+� Fee Schedule on Reverse Side
Plan Check $ • 25� of Building Permit Fee
State Surcharge $ �� � � $•50/$1,000 Valuation
SAC Charge $ " $425 per SAC Unit
Park Fee $ ��' Fee Determined bq Engineering
Ser�er Main Charge $ '��'
Agreement Alecessary [ ] Not Necessary [ ]
TOTAL i �
STIPULATIONS:
, e
e
BIIII.DIHG PERMIT FEE SCHBDIILE
The Chief Building OfPicial shall� before issuing permits for the erection of atty
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 applieant for sueh permit of fees to the amount
herein beloW set forth and in the manner herein provided to-Wit:
Total 9aluation
a�.00 to �500.00
Fees '
,.
$10.00 (Minimum Fee is �15.00) �
�501.00 to $2,000.00 $10.00 for th� first $500 plus $1.50 for each
additional �10i! or fraetion thereof, to and including
�2,000.
$2,001.00 to $25,000.00 $32•50 for the first $2,000 plus $6.00 for each
additional $1,000 or fraetion thereof, to and
including $25,000.
$25,001.00 to �50,000.00 $170.50 for the first $25,000 plus $4.50 for each
additional $1,000 or fraction thereof, to and
including $50,000.
$50,001.00 to $100,000.00 $283.00 for the first $50,000 plus $3.00 for each
additional $1,000 or fraction thereof, to and
including $100,000.
$100,001.00 and up
$433.00 for the first $100,000 plus $2.50 for eaeh
additional $1,000 or fraetion thereof.
DRIYEfiAY DEPRESSION ESCaW
(Conerete Curb Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - Driveway �ridth plus
6 feet times $13•50
Alternate "B": Removal and replaeement 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 FOIINDATION
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
construetion site. �
A CertiPicate oP Survey of the lot, showing the location of the foundation onee it
has been aonstructed will be required before proceeding with the framing.
� ��
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ZONING - NOTIFICATION OF INTENT
Foster Family Homes
Day Care Homes
� ' ; �� i/�
Municipa
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ess
� .„
cal 5ub �vision
, ,
`,aY��i�,,
FROM: ANOKA COUNTY COMMUNITY HEALTH & SOCIAL SERVICE
ANOKA COUNTY COURTHOUSE
ANOKA, MINNESOTA 55303
APPLICANT: _ �G�-�, c���1°I D� ��ir
�
• � �y'
,
Ip
' ? '��°7
�
P1
(Number of Natural Children under 18 in Home: 0 1� 4 5 )
� (Circle Number) j
(Number of Foster Children included in License: O�Z 3 4 5 6 7 )
( cle Number)
(Number of Natural Preschool Children in Home: 0 1 2 3 4 5 )
4 (Circle Number) )
l )
(Number of Day Care Children included in License: 0 1 2 3 4 5 )
(Ci rcle Number�)
DATE OF NOTIFICATION: �-- -��--��
`�+� G� C�i�la'c` , ��. �.�� � �'� -7� �S�
`
0
acCxss 169 (l0/80)
,\ \ _
SUBJECT
City of Fridley ="°
AT THE TOP OF THE TWINS g U I L D I N G P E R M i�
r
� �
� • COMMUNITY DEVELOPMENT DIV.
� �v------�
r � � PROTECTIVE INSPECTION SEC.
' i '
� /'�'1 � CITY HALL FRIDLE� 55432 NUMBER HEV. DATE PAGE Of
�"'""� � ,'� 612-5� 1-3450 910-F15 4/1/�2 � �
J08 ADDRESS 6729 Jackson Street NE
1 LEGAL �OT NO. BLOCK TRACT OR ADDITION
DESCR. 11 3 Meado�tlands 2nd Addition
2 PROPERTY OWNER MAIL ADDRESS Z�P
Steven Holter 6729. J`ackson S'tx'eet NE
3 CONTRACTOR MAIL AODRESS Z�P
Axneberg Constxuction Co 25.75 Di.a,nne �t� No St P�,ul, MN 5510g
4 ARCHITECT OR DESIGNER MAIL ADDRESS Z�P
5 ENGINEER MAIL ADDHESS ZIP
21250�
�s�c�E�ztv�' �
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APPROVEO BV
SEE ATTACHED
SNEET
574--Q807
PHONE LICENSE NO.
777-6948 528(
PHONE LICENSE NO.
PHONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASSOFWORK � NEw p ADDITiON ❑ ALTERATION �df.7 REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Replace Screened�-in Porch Roo� (Tisater. D�1a,�e)
9 CHANGE OF USE FROM
STIPULATIONS
See not�,tibns can plan,
TO
�
SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBIIdG, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTfiUCTION ZONING SQ. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IP CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERI00 OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION �- STALLS
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION
AND ORDINA CES GOVERNI THIS TYPE OF WbRK WILL BE COMPLIED $r� OQO
WITH WHET Fi SPECIFIED EREIN OR NOT. THE GRANTING OF A PERMIT �
DOES NO RESUME TO E AUTHO ITY TO VIOLATE OR CANCEL THE pERM1T PEE
PROVISI N OF ANY O STATE LOCAL LAW REGULATING CON• ��� $72�QO
T UC O OR THE P FO MANCE CONSTRUCTION.
j PLAN CHECK FEE
'` L/ - � '% Z License SC $5.00
SIGN TU E OF ON i RACTOR OR AUTMOR E AGENT IDATEI HE PRO ER Y V�
�_
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-.--. -'.._.. __ ,........,..� ..,.�.,�o e� ��� ncm �DATE� BLDG INSP
LOAD
FT.
�GARAGES
URTAX
$2.50
AC CHARGE
Fixe SC $5,00,
OTAL FEE
$84.5Q
I THIS IS YOU PEAMIT
�,
;.�n.:.:v.A;v::.b.1:i.�:Ri.�i�� .i.!.>.y:5ti. :i:wt:.h:.:.:�:c:�:.::::tirih:::.:.:.:..� w �.:i . . , bu. . ..... .. . ... ... . .. . .... .. . . . ... . . . ..... ..... . ......... . . . . .. ..... . ... .. ... . ....... . .. ....... , ..., ,�.,. . . . . ....
NEW [ ] Effective 3/1J92
ADDN [ ] CITY OF FRIDI.EY
ALTER [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Peimit Application
� �
COnStrildlOn Addl'�S,S: :D �02 � ��-C-,�Sa�t/ � % - ✓��: � � ��cY
Legal Description: �
Owner Name & Address: ��v��v /��T��2 Tel. � �`��- ���`7
COOtraCtot': f��C=rJC�'-�`'��C� � r�a;-v �z�; zd� �� . MN LICENSE #�a�S� 8�
Addtess: c����� �i��.v� ��- �� , �T� �� /� ��-,. , TeI. # � "7 ? -�gYB
At#ach to this application, a Certificate of Suivey of the
lot, wit6 the proposed cons�uction drawn on it to scale.
LIVING AREA:
GARAGE AREA:
DECg AREA:
OTHEii:
DESCRIPTION OF IIVIPROVEMENT
Length Width Height
Leng�th Width Height
Leng� Width H,�t/Ground
a--
Sq. Ft
Sq. F�
Sq. Ft.
���
Corner Lot [ J inside - Lot j J Ft Yd S�back Side Yard S�backs
Type of Constiucti+�n: !�� �'s¢r�S �fi -�c��� Est�mat,ed Cost: $ ��� —
Approx. Completion Date: � - `�'-9� .
(Cost on Backj
Driveway, Curb Cut Width Ne�ed: F� + 6 Ft = Ft x$ _$
- - �i �� � - - �'�7-���r�
DATE: '� � � APPLICANT: ����%�----- TeI. #
Permit Fee $ �/� � �
Fire Surchazge $ � OZ�
State Surcharge $ �. ��
SAC Charge $
License Surcharge $ �• GfJ'
Driveway Escrow $
Park Fee $
Sewer Main Charge $
TOTAL $ � � � �
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50J$1,000 Vaivation
$700 per SAC Unit
$5.00. (State Licensed Residemial Contractors)
Alt. "A" or Alt "B" Above
Fee Deternuned by Engin�ring
Agreement Nec�ssary I l Not Necessary [ l
STIPULATIONS: _ g
BUII,DIN(i PERMIT � FEE SCHEDULE
The Cluef Building O�icial shall, before issuing permits for the �ction of any buiiding or sbructure,
or for any addition to a�► existing building or strucd�e, or f� any alteration or repair to any existing
building or st�ucture, upon aPPlication therefore, require die paymem by the applicant for such p�rmit
of fees to the amount herein below set forth and in the manner herein provided- to-wit:
TOTAL VALUE
$i to $500
$SOl to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,0�
$100,001 to $500,000
$500,001 to $1,000,0�
i��
$15 (Minimum Fee is $15 plus surcharge)
$15 for first $500 pins $2 for each additional $100 or
fiaction thereof, to and including $2,000
$45 for fir� $2,000 plos $9 for each additional $1,OQ0
or fr�iction thereof, to and including $25,0(�
$252 for first $25,OD0 plus $6.50 for each additional $1;�0
or fraction thereof, to and iacluding $50,000
$414.50 for first $50,000 plus $4:50 for each additional
$1,000 or fraction thereof, to and including $100,000
$639.50 for first $1(�,OOQ plus $3.50 for each additional
$1,000 or fractioa thereof, to aad including $500,000
$2039.50 for the first $500,�0 plus $3 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$1,OOU,001 and �p--� _ __ ._�--._�6�3539.50 for the first $1,000,000 plus $2 for �ch additional
$1,000 or fraction �thereof
DRIVEWAY DEPRESSION ESCROW
(Conctete Curb Slreets Only)
Alternate "A" : Removal and replacemem 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 coashuuction will be i�ued a minimum of 24 hours from the time of application to allow
for proper review of the proposed structure and of the constivction site.
A Certificate of Survey of the lot, showing the la;ation of the foundation once it has it has been
consbiucted will be required before proceeding with the fcaming.
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� MATTSON/MACDONALD INC.
9TFIUCTUFRAL ENOINEERS �
' 1422 W. LAKE STREET
MINNEAPOLIS, MINNESOTA 66406 (B,'� Qj 627 7625
�
May 7, 1987 � �,� �S - � . i; . '= '
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• '� F
Panelcrait Inc.
3I 18 SneUing Avenue South ,`
MInneapoUs� Mlnnesota SS406 -
� ;:
REa INSULATED ROOF PANEL '-4t ' ''
Gentlemen:
I have revtewed the load carryIng capacIty of the 3" insulated rooi panel. -: ,
I have completed calculations for a panel constructed as followss �
032" 3003-H14 Aluminum Alloy facing on each sIde oi 3" thidc 2 potu�d per cubic
foot polystyrene foam.
3" x 1.961b/ft Aluminum beam 6061-T6 AUoy spaced at 4'-0" � cente�.
Based on my calculations I ilnd that thls panel can span 12'-0" when subjected to a snow
load oi 40 p.s.f. The span under thls loading Is 1lmited by a deflectlon of L/180 =.80". ..
Ii there are any questions plea� do not hesitate to contact me.
.
Yours truly, • � ,
MATTSON/MACDONALD� INC. , � ,:; .
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Davld H. Macdonald, P.E. 2 I� ' r: `
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MATT80N/MACDONALD INC.
BTRUGTUAAL ENOIIVE@RB
1422 W. LAKE STREET °' � � "
MINNEAPOLIS, MINNESOTA 86409 (612) 627,-7926
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STRUCTURAL CALCULATIONS FOR
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3" lnwlated Rooi Panel A,;:;; ,; :
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I h�reby certlfy that these calculatlons a►ere �•
prepared by me or under �" my � direct
supervislon and that t am a duly regIstered
• PcotessIonal Engineer unde�.the laws oi the '
State of Mlnnesota. '
J. � i
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David H. Macdonald, Reg. No..1Q751.:
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� Date ��
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Prepared for: � � � �
Panelcraft Inc.
MInneapolIs, Minn4sota SS406 � �, =' , a
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� �
P�epated by: � ' � ;�
Mattson/Macdonald, Inc. `
Structural EngInee�s
1422 West Lake Street ' �
MinneapolIs, Minnesota 33405- ' , ;
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sue�ecT P MIT NO.
City of Fridley � 0 0
AT THE TOP OF THE TWINS B U I L D I N G P E R M I T .�--_
r
; � RECEIPT NO.
� ; y ______ COMMUNITY DEVELOPMENT DIV. r�7 g
r � � PROTECTIVE INSPECTION SEC. / C�'•' ��
I 1 �
� � /"'1 � CITV HALL FRIDLEV 55432 NUMBER REV DATE PAGE OF APPROVED BV
ti.__.11.' '•� 612-571-3450 910-F15 4/20/93 � �
108 ADDRESS 6729 Jackson Street NE
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. �-�. 3 iKeadowlands 2nd addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Steve Iiolter 6729 J'ackson Street NE 574�0807
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNEH MAIL ADORESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS Z�P PHONE LICENSENO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION O ALTERATION � REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
rnstall �o��i.t & �'as.cia
9 CHANGEOFUSEFROM TO
STIPULATIONS
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, �PE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PEFiM1T BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORI2ED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION �' STA�LS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TVPE OF WOFK WILL BE COMPLIED y�`].�ZOO $ F2O
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT °
DOES NOT PRESUME TO GIVE AUTHOFlITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGUTATING CON- $29�00 Fire �C $Za2O
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECKFEE TOTALFEE
�30e8V.
S�Grv TUAEOFCONTRACTOAORAUTHOA�2EDAGENT iOATEi WHE P PE Y V�A ATED THIS IS YOUR PEAMIT
��� �� �J �� - � � 2����
= �
Y��S�GNOTU EO�(.�WNEA�iFOWNEABUILDEF7i IDATE� BLDG �NSP � pbTE
NEVfi [ l
ADDN [ ]
ALTER [ ]
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Effective 1/1/93
�j 232
Construction Address: 6 ��' � � .�;''ef-y' C..�; .� t�' � �SG?� � ,� % �.�� �
�,
Legal Description: `
F
Owner Name & Address: ���� ' a,r!c=°�' � f � 5�,�;�r� � Tel. # S%�-�o �'U -�
Contiactor:
Address:
LIVING AREA:
GARAGE AREA:.
DECI� AREA:
OTHER:
MN LICENSE #
Tel. �
Atxa�h to this application, a Certificate of Survey of the
lot, v�+ith the proposed constructioa drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height
I.ength � Width Height
Length Width . HgtlGround _
Sq. Ft.
Sq. Ft.
Sq. Ft.
Comer Lot [) Inside Lot [] Ft. Yd Setback Side Yard Setbacks
� s
Type of Construction:�'��"��,%f�'°�!�,��'�'..�'�' Estimated Cost: $ j��� , �'�
`
Approx. Completion Date: ��� G;i'�1'��
(Cost on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
�
DATE: ,fP .�' APPL][CANT: �:.��� J.:::,''"`�,�i==f�e✓ Tel. # v���l/�U �
..�
Permit Fee $ � � d �
Fire Surcharge $ f . �C�
State Surcharge $ � �C-�
SAC Charge $
License Surcharge $
Driveway Escrow $
Park Fee $
Sewer Main Charge $
TOTAL
STIPULATIONS:
$ ��� �O
CITY USE C1NLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/51,� Valuaxion
$750 per SAC Unit
$5.00 (Sta.te Licensed Residential Contractors)
Alt "A" or Alt. "B" Above .
Fee Aetermined by Engineering
Agreement Necessary ( ] Not� Neces.Sary [ )
.�
..� -�
BUII.DING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erectioa of any building or structure,
or for any addition to any existing bnilding or structore, � or for azty alteration or repair to any existing
building or stivcture, upon application the,�efore, require the pay�nent by the applicant for such permit
of fee.s to the amouat herein below s� forth and in the m�nner herein provided to-wit
TOTAL VALUE
$1 to . $S(TO .
$SOl to �$2,0(�
$2,001 to $25,000
$?.5;001 to $50,000 '
$50,001 to $100,0(�
$100,001� to $500,000
$500,001 to $1,000,000 �
$1,004,001 and up
FEES
$15 (Minimum Fee is $15 plus svrcharge)
$15 for first $SQO plos $2 for each additionat $100 or
fraction the�eof, �to and including $2,000 �
$45 for fust $2,000 plus $9 for �ach addilional $1;000
or fra,ction thereof, to and including $25,000 -
$252 for �first $25,�0 p��s $6.50 for each additional $1;000
or fraction thereof, to and idcluding $50,000
$4�14.50 for first $50,004 plus $4.50 for each additional
$1,000 or fra.ction th�eof, to .aad including $100,000
$639.50 for first $1�,OQ0 plus $3.50 for each additi.onal
$1,000 or fraction th��eof, to and including -$500,(�0
$2039.50 for the first $S�,OQO plus $3 for each add.itional
$1,000 or fraction thereof, to and iacluding $1,OQ0,000
$3539.50 for the first $1,(�00,000 plus $2 for each additional
$1,OU0 or fraction �thereof �
DR�VEWAY DEPRESSION ESCROW
(Concrete � Curb Streets Only)
Altemate "A" : Removal aad repla.cement 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 $15.75.
VERIFICATION OF FOU�iDATION
Permits for construction will � issued a minimum of 24 hours from the time of appGcation to allow
for proper review of the pro�sed structure and of the coastruction site. .
A Certificate of Survey of the lot, showing the lorttion of the foundation oace it has it has been
coastructed will be required before proceeding with the fiaming. .
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CHIMNEY 2lND BTACK V$RIFICATION
The undersigned hereby eerifies that the existing chimney or stack:
1. Has been carefully examined Yes (� No (�
2.. Is free from rust or deterioration .� Yes (� No ()
3. Has no foreign objects lodqed within Yes (� No ()
4. Is securely supported Yes (�j No ()
5. Meets ail current Code requirements for
size and total BTU's connected
6. Has total heating BTU's of ��, � o t�
Al l other BTII' s � ��� f3' O�
TOTAL BTII' s % � �� �
Remarks
List Alterations Beinq Done:
HEATIIdG COMPANY ��1���
S igned By ��� �
Date � ���'��� .
Yes (f� No ( j
/�
�
0
su6��tt P .
City of Fridley 3 i 6� 3
AT TME TOP OF TNE TWINS � � r L D I N G P E R M I T
r
� .
� � •
� `L __���_ COMMUNITY DEYELOPMENT DIV. ,�.��
r � � PROTECTIVE INSPECTION SEC.
i . .
1 � /�"1 � CITY MALL FRIOLE� SS�32 NUMBEP pEV DATE PAGE OF AVVROVED BY
�----� • •,� 612-571-3450 9t0-F15 12/20/00 / /
JOB AOpRESS 6729 Jackson Street NE
1 LEGAL �OT NO. BLOCK TRACT OR AODITION SEE ATTACMED
DESCR. 11 3 Meadowlands 2nd Addition SMEET
2 PROPERTY OWNER MAIL ADDRQS$ 21p PNONE
Jed Marck 6729 Jackson Street NE 438-3187
3 CONTiiACTOR MAII ADORESS Z�P PMONE LICENSE NO
Roberts Residential Remodel 16320 Kenrick Loo Lakeville, MN 55044 469-3900
4 ARCNITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
6885
5 ENGINEER MAIL AODRESS 21P PFIONE LICENSE NO
8 USE Of BUILDING
Residential
7 CLASS OF WORK
O NEW O AODITION � ALTERATION ❑ REPAIR O MOVE O REMOVE
8 DESCRIBE WOfiK
Basement Remodeling
9 CHANOE OF USE FROM TO
STIPULATIONS
See notations on plan.
SEPARAT� P�RR��T�
REQUIRED FORe
PLUM�I�GG AN� SI�� � .
tYPEOFCONST. OCCUPANCYGROUP OCCUPANCVLOAD
SEPARA7E PERMITS ARE FiEOUIRED FOR ELECTRICAL, PIUMBING. HEATING.
VENTILATING OR AIR CONDITIONiNG
TMIS PERMIT BECOMES NUIL AND VOIO IF WORK OR CONSTRUCTION 20NING SO. FT CU fT.
AUTHORIIED IS NOT COMMENCED V�IITHIN 80 DAYS. OF IF CONSTRUCTION
OR WORK IS SUSPENOED OR ABANDONEO FOR A PER100 OF 120 OAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO DWI.G. UNITS OfFSTREET PARKING
1 MEREBY CERTIfV THAT I MAVE REAO ANO EXAMINEO THIS APPLICA710N 1 STALLS GARAGES
AND KNOW THE SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS OF LAWS yp�UATION SUFTAX
AND ORDINANCES GOVERNING TMIS TVPE OF WORK WILL BE COMPLIEO
WITH WHETMER SPECIFIEO HEREIN Oii NOT. TME GRANTING Of A PERMIT �20�000 �IO.00
DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OR CANCEL TNE pEqMIT FEE SAC CMARGE
PROVISIONS OF ANY OTHER STA7E OR IOCAL LAW REGULATING CON-
OR RMANCE OF CONSTRUCTION $321 . ZS F e SC �LO .00
P�AN CMECK E TAL PEE
Lice e SC 00 $356.25
5� NATUpEOFCON•AACT(SAQ_ TMOp� DAGENt �DAiE� N Pq LV VA TED TMIS IS VOUR PE IT
`� � 6
S�GNA�UAE O� OWNEA��f pWNEp BU�LDEN� �D�rE� B �NS ���tF
DEC-14-00 12:47 PM R08ERTS RESIDENTIAL 6124693939
NEW "ADDN CITY OF FRIDLEY
ALTER ( J SlN�LE FAMILY AND DUPLEXES R-1 AND R Z
BUILDING PERMITAPPUCATION
P. 04
Effectlue 1/9/2000
(763) 672�604 BIdB Insp
Construction Address: L
Legal Description:
Owner Name & Add�ess:
� Tel. # -
Contraclor: '
� �- �n s MN LICENSE # L
�eitirsoe• 1 i �e .. � � i .
//�.�.��? ��/�� �c'�('�^� � �C���
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T@�. # QC
�°' �y Attach to this applfc�tion, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LMNQ AREA: Length Width , � � , �
--�- `` .� � , Height ` ,P, Sq. Ft � - �
OARAt�E AREA: Length �` �dth �,� Height � S, Ft
DECK AREA; �A�gth �` y�dth Q
_`� HgtlGround _` gq, p�
OTHER:
Construction Type: A �F�q,,;{ EsUmated Cost: $
�" ��� /�c�T' QCi OMd �°S�/�Y/�Q��'c� �'�
D�iveway Curb Cut V�idih Needed: Ft. + 8 Ft = Ft x$ = g
DAYE: APPLICANT�� �v1.� ,� ` .
�� Te�.# 3 �9 -2�8� c��
��'b1AS't�.T�.�� �OPCIL.�J
�
�ITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License 5urcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TorA�
STIPULATIONS:
Call (783) 57Z-3604 for permlt �ees 11 malline In appllcatlon
�
$ �l o� Fee Schedule on Reverse Side
$ �� � � .Q01 of Permit Valuation (1/10th%)
$ � �� $,501$1,000 Valuatlon
$ $1100 per SAC Unit
$ �_ � $5.00 (State Licensed Residential Contractors)
$ Alt, "A" or Alt. "B" Above
$ $450.00 Conservation Plan Review
$ . Fee Determined by Englnee�ing
� Agrevment Necessary ( ] Not Necessary [ ]
$ � � �J�
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COM�IION 1/6NT. VENT CONNEGTOEt AWD COMBUSTIOM AIR VERifly CAYIOloI
When Eeqlacin� an existin� ftarance, the unclersigtted hereby ve 't'�i'ieg titat ihe
venting has b�n examinea a�d is free frorn rust, deterioration, obsgructions,
and is secureiy supported and fire�opped where �equired. Yes ( j No ()
7�he venting system is plas�clPVC and meets a41 euRent codes and manufacturer
speclticaticns including sizing. tength, nurnber of eibows and termination. Yes () No ( a
The w�dersigried also vetities t��at the repiacement unit is a listea4 assembPy
and me�s the cuRertt coc�s and manutac�urer's speaiica4ions. Tttis does
inch�de A�A-GAMA Catego►y 1 Centr'al Fumace \Oenting Tabtes for fan
ass�ted and r►atucal draft appliances.
'P'he e�clstit� combustian air is sized and installec! to meet the current codes
and m�nufaacturer's spepfications.
Whe� required to install a new comP�ustian air. it wil! be sized and ins�aped
% meet the aarrent codes and manufacturers specifi�a�ons.
Yes()No()
Yes()No(�
°!es ( ) n�o ( )
When instailin� a new veMina svstem� the u�ersigned hereby verif�es that
d is a listed assembiy and meeM the cuRent codes and man�,factu�e�s
specificatlorts. 1'his dces i»dude AGA GAMA Category t Centra! Fumacs
Venting Tabies for fan assisted and natura! draft app6an�s_ Yes () No ()
Is ft�e common vcnt and verd aonnedots siz�d artd instatled wrrectly after
an appliarzce has be�n'removed from the ;ammon vent ar�d vented
separately as per cuRent codes. Yes () No ()
App[ianee Tn�e and SizelCoe�nrnon Vent aetd i/ent Con�eator l��arrr�tioes
Ap�lPance #�i Type _„______� �TU Inpu� Fan Assisied ar Nat
A�Gance #2 Ty� � �TU lr�puF Fan Assisted or lVai �
Appliance #3 Type BTU lnpc�4 F�n Assts%d or Nat
Total Apppancss To4af �tu Input _____�_
Common iJerit Type _,,, Vee�f Helght Diameter inches
Applfanc� #1 Vet�t Cortne�to� H�ight ft Len�h � Diame@�r in Type
Apptiance #2 Vent Connector H�sgpt# �t Lertgth 4i Diameter,�,ir� Typs
Appliar�e �f3 Vent Conneotor Height �t Leng�h � Diameter in Type
A!1'�RATIONS: fDesc�ibe) ,�,
HEATING
S1gr�ed By:
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CITYOF
FRIDLEY
FRIDLEY MUIVICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287
March 8, 2002
Jed Marek
6729 Jackson St NE
Fridley, MN 55432
Re: Fnal Inspections at 6729 Jackson St NE
Contractors: Dave's Heating & Air Conditioning
Fgnar Plumbing Co.
Dear Mr. Marek:
A mechanical permit was issued on ]uly 18, 2001, to install an air conditioner, and a plumbing
permit was issued on January 5, 2001, to install a fresh air extension in the basement at your
address. According to both the 1991 Uniform Mechanical Code and Section 4715.2800 of the State
Plumbing Code, final inspections shall be conducted on the work authorized by these permits. As
of this date, no final inspections have been called for.
The permit fees that were paid cover the inspections to make sure the work was completed
according to the Codes. We will keep your permits open for another 30 days and if we do not hear
from you within this time to set up the inspections, we will mark the permits "no inspection called
for" and take no further action.
To set up an inspection or to have any questions answered, please contact the Building Inspection
Divi_s on at (763) 572-3604.
Inspector