AF - 47201City of Fridley, Minn.
�UILDING PE�.I�IIT
N° 5'795 ±
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Address Address
� �, .J� ��� LSJCATIO _� F.�BUILDII�9G
No. �� Sireet - ^�'�' s ��'�`� �'"� � . ' � Part �P T.ot
Lot —.�._� Hlo��_ Addition or Sub-Division ._�..,��`=�'-'�'� �-�"�`��° �/�'-r°�
Coraer Lot ._ �"`" Inside Lot Setback �:��� � Sideyard �� �.�
Sewer IIevation � Foundation IIevation
DESCRIPTION OF BUILDING
Tof� v�a�: .
` A ,E � . . `' ,�
.'� e �' ,e� �'. �� -t •' :. a . .
�.,�' Front " `� �p� ,'�1.� . ;!' Height �'�-�` Sq. Ft " ,�� Ft.�'' ^-,�.-� --"�'--� C�
,��..����� f' ° '� �
F�� ��o� Depth ��eight ��5q. Ft _���Cu. Ft. .���
* �.F � � ,� �..n _,-.,.: °- '. ...,..,.*
Type o Conatruction ��. �-�#;� �°-- F�t. Cost � To be Completed
In consideration of�the isauance to me of a permit to construct the building descrlbed above, I agree to do
the proposed work in acc�rdance with the description above set forth and in compliance with all provisiona oP
ordinanc� of the city of Fridley.
�
In cons4deration oP the payment of a fee of �.�.:.�� .��, permit fs hereby granted to
to constntct the building or addition as described above. This�e rmtt is granted upon
the express condition that the person to whom ft fs granted and hia agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respecta to the ordivancea of
�+'ridley, Nlinnesota regardiag locat3on, conatruction, alteration, maintenance, repair and moving oi buildings
within the dty ]imfts and this perm�tt may be revoked at any tfime upon violation of any of the provisiona of eaid
oidinancea .s�""; ,� ,�`°'`'�
8��8 �P��
NOTICE: ..
TMs permlt does ao1 eover the eonsfrudion, teatallaHon fo� vririeg, plumbing, eas heating, sewer or waier. Be sure �o aee
ths Bnildte0 Intpeetar for aeparate per�eits for f6e� items.
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APPLICATION FOR BUILDING PERNBT
CITY OF �'RIDLEY, MiNNESOTA
' G�' ���+✓.�' � Builder �i2 r—o �
Owuer a Name �'
Address Ad�ress �Z ,3 / ���(�`%���
� � LOCA ION 6F BUILDT
No. �J � �` ,� „� Street ���� � Part of Lot '
Lot�� Bloc � Addition or Subdivision �
� � � ide-Yard -� �' � � � �
Coraer Lot Ineide Lot Setback S
S�WLR EI.EVATION yv ` FOUNDATION ELEVATION �7 �
Applicant attach to ehis form Two Certificates of Surveq o¢ Lot aad proposed
building Iocation drawa on thesa Certificates.
DESCRIPTION OF BU�DING
To be used as:
Front � Depth___ �_^Height �
Sq. Ft. �_,Cu. Ft.
� %'roat Depth � �"''fiei�ht �f.-�
/Sq. Fti. _ Cu. ,FC.
Type of Conatraction
�' � Eetimated Coat �
To he Completed
�.'he undereigned her makes a plication for a permit for the work herein
specified, agreefng to do all work in strict accordaace with the City of
Fridiey Ordinances and rulings of the Department of uildinge, and hereby
declares that all the facts and representations at d in this application
are.true and corr: t.
. ,
DATE � v " �'� �✓ &ZGNATURE
(Schedule of Fee Coste can be fouad on the Ae�rerse 3idej.
_ . _ ^ ^ • -' `,_
BUILDYNG PERI+ZCT F8E SCHEBULE
Section 2. The Inapector of Buildinge ehall, before iesuing any permit for
the erection of eny buildiag or structure, or for aay addition to any exiet-
in�, bu3.lding or stt�ucture, or for any alterations or repaira to any esiating
buildiag or s�ructure, upon agplicati.oa therefor, require the payoneat by ehe
appl{cant for such perm3t of feea to the amount herein below set forth and
ia the manaer hereia provided �o-�ait: " �"
2.1. For any such permi-t far the,erec�ion of any fire-proof building, other
than a gara�e�, warehouse, factory or grain elevator� os for the erection of
any fire-proof-additioa, for similar occupancy, to any exieting bnilding
st�all be at the rate cf $1,40 fos' each one thousaad cubic feet, or fraction
thereof, in such cubic�], contea�a..
2.2. For any su��i'permit for the�erection of any fire-proof garage, warehouse,
factory or grain elevator, or for the erectioa of any fire-proo� additioa,
for similar occup�ncy, tfl any exiating build�ng sh�ll be at the rate of $1.25
for each one Chousand cubic feeC, clasaified as °ofireproof" bq Section 502 of
the Minaeapolia Building.Code.
HAUSWS
2.3. For�an'y such permit for the erection of any non-fireproof buildi�g other
than a garage, warehouse, factory or grain elevator, or any non-fireproof
edai�ioa, for sfmilar occupancy, to any existing build3ng - permit $1.00 for
each one ti�ousand:.cubic feeG.
GARAGFS
2.4. For aay:such permit for the erection of any non-fireproof garage,
werehouse;-factory or grain elevatdr, or for the erection of aay aon-fireproof
sdditioa, for similar occupancy, to anp ;esisting buildiag or for each such
� building br addiCion = ninety centis ($0.90) for eech oae thousand cu�ic feet
or fractio� thereof,. fn the cubical contents thereof w3th a minimum of $4.00.
For the purpoae of computing fees for building permita, the cubi:cal coatents
o� eny building o� additidn to�a�uniform height throughout by multiplying the
grouad area covered fram a poix�t six,(6} in�ches below the flaor line of Che
basemeat.or �cellar to the aver�ge height of the upn�r surface or to the
�vere.ge height af the,roof surface of �he maia gable of a pitched roof.
2.5. I�or repairs or alteratione to an existing structure, the fee ahall be
at �he rate of $3.00 per each Five Suadred Dollars ($500.00) or fraction
thereof in the cost of all proposed work.
2�6. In no case ahall the fee charged for any permit as set forth in
Sectirna 2 be less thaa $4.00.
� _ . - '".� i'�`� , • _ _
� c � s
y y s�a�E�T P� 12833
Cit of Fridle
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
� � CEIPT NO.
� • COMMUNITY DEVELOPMENT DIV.
v PROTECTIVE INSPECTION SEC. � /��/
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�l /"�1 � CITY HALL FRIDLEV 55432 NUMBER REV. DATE PAGE OF A�PROVED BY
L�•��� I ,•� 612'S60'3450
910-F15 2 12 74 � �
JOB ADDRESS 6749 Jackson Street N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCH. ].3 3 Meadowlands 2nd Addition SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
David Dzubay 6749 Jackson Street N.E.
3 CONTRACTOR MAIL ADDRESS Z�P PHOWE LICENSE NO.
Dempsey Construction 31st & Welcome Avenue
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WOHK
❑ NEW q� ADDITION ❑ ALTERATION O REPAIR � MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a family room addition - 14' x 18' with ba.sement
9 CHANGE OF USE FROM T�
STI PU LATION S
See markings on plan submi.tted
����R�►T� P�R��69T� � �
i—R�A,�°�9�z�, FL��'�')Qlf�"% �, �t�Ii�d�-;�� l��F' �'Eaii�l��,��,
.�f��15.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING. WOOCI Fr3IIlH
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 SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R�. ZSZ 3024
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEFiEBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION �- STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORflECT. 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 $4,410 2.21
DOES NOT PRESUME TO GIVE AUTHORITY 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. �S`16. SO
PLAN CHECKFEE TOTALFEE �
$`Z8. %�.
� '
SIGNATUREOFC RACTOROaaUiHORI D GENT (OATEI WHEN PROPER�Y WALID TED TI�-IS IS YOUR PERMIT
.:D . Jm7-//-%� i ��/02 .
�_$ M�iITUREOF OWNERIIF OWNER BUILDERI IDATEI BLDG INSP DAT
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AP�LICATION FOR RESIDENTIAL, ALTERATION;
OR ADllITiON BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER' S NAME : !, , U ��Z �- � BUILDER : E�7 °� `-O/7S / ,
ADDRESS :� �'�g f /G{- C �•S'd /'� �% � ADDRES S : �/ (�Ue. /C'C3 /� e, �� � �
N0 :.�p % STREET : C�G� C lCSO/'� ST. � C.
LOT : �� BLOCK : � ADDITION : �%G�CYO Gc� ��/'J�S ��,�
CORNER LOT: � INSIDE LOT: SETBACK: SIDEYARD:
Applica.nt attach to this form ltao Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
HESCRIPTION OF BUILDING
To Be Used As:
��.-�. �o� Aofc� Front: %� ` Depth: f�l � Height: 0�0 �
Square Feet: ,� �, ,� Cubic Feet: � ^ � t ,�'
�.
Front: Depth: Height:
Square Feet; Cubic Feet:
Type of Construction: L.��� �i��cs�-ie_ Estima.ted Cost: $%�-�d� �
c�'�� � � ,
To Be Completed: -�inoh ��s _
The undersigned hereby ma.kes applicativn for a permit for the work herein
specified, agreeing to do all work in stiict accordance with the City of
Fridley Ordinances and rulings of the Departmeat of Buildings, and hereby
declares that all the facts and representations stated in this application
are true and correct.
DATE: �°� - ��` �'S� SIGNATURE:
(See Reverse Side For Additional Inform.ation.)
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�BUILDING PERMIT FEE SCHEDULE
SECTION 2. T'he Inspector of Buildings shall, before issuing permits for the
erection of any building or structure, or for any addition to any existing
building or structuxe, or for any alteration or repairs 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 ma.nner herein provided to-wit:
1JNIFORM BUILDING CODE: Type 1, 2& 4-$2.15 for each one thousand cubic
feet, or fraction thereof, in such cubical contents. �pe 3& 5-$1.85 for
each one thousand cubic feet.
ADDITIONAL INFORMATION
• 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 roo£.
For repairs or alterations to an existing structure, the fee shall be at the
rate of $3.00 per 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 pernnit as set forth in Section 2 be
less than $5.00.
VERIFICATION OF FOUNDATION
NOTE: 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 Certified Survey of the lot, showing the location of the foundation, once it
has been constructed, will be required before proceedin� with the framing.
CERTIFICATE OF OCCUPANCY
Application for a Certifica.te 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 occup3ed until a Certificate
of Occupancy has been issued.
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SUBJECT P
c�ty of Fridley 17 9 9 7
' ` AT THE TOP OF THE TWINS g U I L D I N G P E R M I T EIPT N
�
� `v ___��_ COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC. /�/_ �7
' / cr�o
i i �
' /�"1 � CITY HALL FHIDLE� 55432 NUMBER REV. DATE PAGE OF APPROVED BV
�----� • •�� 612-571-3450 910-F15 5/22/85 / /
JOB ADDRESS 6749 Jackson Street N.E,
1 LEGAL �OT NO. BLOCK TRACT OH ADDITION SEE ATTACHED
DESCR. ],3 3 Meadowla,nds 2nd Addition SHEET
2 PROPERTY OWNER MAII ADDRESS ZIP PHONE
Alton Johnson 6749 Jacksan Street N.E. 571-Q284
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
B USE OF BUILDIN(3
Residential
7 CLASS OF WORK
❑ NEW � ADDITION ❑ ALTERATION � REPAIR ❑ MOVE O REMOVE
8 OESCRIBE WORK
Constxuct a 16� x 14� Deck
9 CHANGE OF USE FROM TO
STI PU LATIONS
'°'� �a1'�'��� �
����
-�II IocaF utifi'��es
�� ����'��'� ��� �g� .
�'I����� ����`�ly�;�� � ������€� � '������ - EL�.�TRIC - GAS Etc.
������� ��D �
;,.;,� . St��s. i2���.11R�D �Y l��
SEPARATE PEHMITS 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 CONSTHUCTION ZONINC3 SO. FT. CU. FT.
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. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE HEAD AND EXAMINED THIS APPLICATION 1 STALLS GAHAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF �AWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIEO $l� 2SO $� �
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- �22�Q�
STRUCTION 01i THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECKFEE TOTALFEE
$ 5.OQ $27,63 '
5 tvn ua oFCON Cr0 AUTH R12EDAGENT �DnrE� _ WHEN PROPERLY I ATED THIS IS VOUR PER IT
N �
�M SiG ATUREOFOWNE OWNE BUILDE i IDATE� BLDG WSP � � TE ��
�� � �
ADDN. [ ]
ALTEA. [ �
1'
City of Fridley
a-1 L/D R-2
Buildiag Permit Application
Effective 4/i/84
Construction Address: �' � �' � � � � �� 0 � � � - � � i
Legal Deacription:_ �, ��'` 13 �� �� }���� � l-�►n��s �1�`�, b�'� y� 'j�' o
Owner Nae i 7►ddress : ��Ta � '� d ��-S'fa`�1 � ��I g�� G�Sfi,Se �l �'. �f'�' =el. i � �l - b 2g �
Contraotor: ��� �' — Zel . f
,ddreaa:
Attach to this application� a Certificate of Survey of the
lot, vith Lhe proposed construction draWn on it to acale.
DESCRIPTIOIi OF DrlPBOYEl�I�T
LIVII�G AREA: Lengtta Midth Aeight Sq. Ft.
GARAGE AHEA: Length J Yidth �_ Beight Sq. FL.
DECa AilEA: Length 7� Yidth 9� Hgt/Ground �� Sq. Ft.
OTHER:
� ��-'�- �� � e� �3 stl I'� � �''°� "�. pt� �4 % e�j 21 "ZS�
Corner Lot [�] Inside Lot [] Ft. Yd. Setbaek Side Yard Setback
Type of Constructioa: 1� ���
Approx. Completion Date: � - 2g �S�
Estimated Cost: � � �'
I� �
f .,
Alt. A Alt B
Proposed Drivexay Width If Ne� Openiag Is Desired: � �
See Back Page for Explanation
DATE:� -� l � � � APPLICANT: Tel . f � �% `-� �� 7"
CITY OSE ONLY
Permit Fee � ��"�� Fee Schedule on Reverse Side
Plan Check a n� 25x of Building Permit_Fee
State Surcharge = �� =.50/a1,000 Valuation
3AC Cbarge � ;425 per SAC Unit
Park Fee a Fee Determined bq Engineering
Se�rer Msin Charge =
�� � �°1,..�`� bgreement Necessary [ J�o� Necessary [ J
�c� e
STIPOLATIONS:
�s
�
BD]I.DIIiG PBRMIT FEE SCABDIILB
The Chief Building Offieial ahall� before iasuing permita for the erection of any
building or atructure� or for aay addition to any exiating Duilding or atructure� or
for any alteration or repair to �ny existing building or atructure, upon applicatio n
therefore, require the payment Dy the applicant for aucb permit of fees to the amount
berein below aet forth and in the manner herein provided to-wit:
?otal �aluation
i1.00 to 3500.00
Feea
=10.00 (!�linimum Fee ia =15.00)
�501.00 to =2�000.00 =10.00 tor the firat =500 plus �1.50 for each
additioaal =100 or fraction thereof� to and including
=2�000.
=2,001.00 to a25�000.00 =32•50 for tbe first =2.000 plus �6.00 for each
additional �1�000 or fraction thereof, to and
including �25,000.
�25,001.00 to 550,000.00
E50,001.00 to a100,000.00
�100,001.00 and up
=170.50 for the first
additioaal E1�000 or
including �50�000.
=263.00 fo r the firat
additional � 1 � 000 or
including �100�000.
a25,000 plus �4.50 for each
fraction thereof� to and
a50,000 plus �3.00 for each
fraction thereof� Lo and
a433.00 for the first �100,000 plus ;2.50 for each
additional E1�000 or fraction thereof.
DRIOEIiAY DEPRESSION ESCRW
(Concrete Curb Streets Only)
. Alternate "A": Removal and replacement of curb and gutter only - Drive�ay r►idth 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 - Drive�ay Width plus 6 feet times �15.75
VERIFICATIOA OF FOONDATIOP
Permits for construction Will be issued a minimum of 24 hours from the time of
application to allow for proper reviev of the proposed structure and of the
constructlon site.
A Certificate of Surveq of tbe lot, ahoving the location of the foundation once it
has been oonstructed will be required before proceeding with the framing.
1��
J�'d�� °�
��� �
%�
f�
�
. ..
E
��N is o t��
B
G C C G
"Double-N��de�"
�--- G---+— F--�-- F—�-- F---�— F--�— F�—F�--G---�
("Deek Drpth" i� lM
�hoKer dhrtenslon.)
gr �%�12r�
A • s� o-
B = iz'o~
C°4'0`
D = e� o�
E= �' 6,.
F = i� a°
G = i, o�
8 � i%�'� r �
A - e• o°
B - ia' o'
C=6'0"
pa 6, o,•
E=r6•
F = z� o°
G = i' o•
��
WORKING DIMENSIONS
6-POST SUPPORT SYSTEM
.BriXl6at
A a e• o°
B=i6�o•
�' a 6' �"
p a 6• o•
E3 r6..
F = 2• o°
G = r o�•
10" x 12"
A s io�o•
B = i2'o�
C = 4'0"
D-e'o'
E = 9' 6"
F=i•4•
G a t' 04
�r'X (�ir i
A - io• o•
B = �a' ar
C= 6'0"
p . B' 0"
E = 9' 6"
F= Z�o-
�a i.o.,
10" x 16"
A - �o� o�
B - �s o4
C = 6' 0'
D a s' o°
E� .9� s�
F = r o°
G°i'o-
INSTALLATION OF "SINGLE-JOISTS"
a. The "Sl�le-Jolsts" are eut-to-length and dropped IMo the anall
Joist Hangero and aeeurely nailed in place with 8d eonmon �atranized
�roits•.
IZr �x IZr� I IZFTx
A - i2�o•
B e i2•o•
C°4'0"
p a io� a
E - �re•
F�i.4„
G � 2• o°
�' 0��
D A
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A n ir4
B . ia�o-
C. ' S' 0'
D a p' o'
E - n• s~
F-i�e•
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[ad S�,nryvq � N6'rAaesolo
�,�5&st� ENGINEERING� INC. �4��
�M� � ��, :-- En ineers � Su�ve�C/o�s —
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cert��i�a�e o� su�rve �o: �RCO, t��.
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r l�ei e6y �rf�'y .!1� fhis �s o!►�e ar�d mritcf rep�rs�ot,an o�'o su�r�y �'1Y�t �� � ee ind 1J�s ,,s'-h
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�' ��'''ci°,—`' = �� �. SUBURBAN ENGINEERlNG . INC. ,
�k���f��'���.����.l�.� �� -
_ � n.
-�_�
sua�ecr PE .
c�ty of Fridley 21 O 3 0
AT THE TOP OF THE TWINS g � I L D I N G P E R M I T
�
; ` CEIPT NO.
� • COMMUNITY DEVELOPMENT DIV. °
' j y �"��'�
r � � PROTECTIVE INSPECTION SEC. 9���
� _ �
� /"'1 � CITY HALL FRIDLE� 55432 NUMBER REY. DATE PAGE OF APPROVED BY
�'"""� � ,'� 612-571-3450 910-F15 8/27/91 � �
JOB ADDRESS 6749 Jackson Street NE
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
oesca. 13 3 Meadowlands 2nd SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PFIONE
Alton Johnson 6749 Jackson Street NE 571-0284
3 CONTRACTOR MAIL AODRESS Z�P PHONE LICENSE NO.
Rockow Exteriors 18015 Ute St NW.�, Anoka, MN 55303 753-1124
4 ARCHITECT OR DESIGNER MAIL ADORESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PNONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW � ADDITION ❑ ALTERATION � REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reside Dwelling (Steelj
9 CHANGE OF USE FROM TO
STIPULATIONS
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, �PE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTII.ATING OR AIR CONDITIONING.
THIS PEFMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION ZONINO SO. FT. CU. FT.
AUTHORI2ED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK �S SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. OWLG. UNITS OFFSTpEET PARKING
1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION �- STAILS GAHAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF IAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL 8E COMPLIED $3 e 858 $1.23
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $� � Op k'l.X.'e SC yS3 a 8G
7 UCTION OR THE PERFO�NCE F CONSTFUCTION.
� � J PLAN CHECK FEE TOT/�l FEE
' 68, 79
j SIGN T � C NTRACTOR OR AUTHORIZED AGENT IDATEI
� , - WHEN PROPE LV ED � IS YOUR P RMI�
�C ,s-
Si ATUREOiOWNEA��FOWNERBUILDER� iDATE� G�NSP r�aiE
� � �
� [ ]
�'i'� [ )
.. . ..�1-�_
�1 �Sa-iT i al I
I�l At�ID i�2
8�ilair�g P�ait 1lppiicatian
s
Effective 3,/1/91
. - _��� - ///t/,� � _ ��� . :�=1 fi �
, � � ^ � L. � _ C �-- ,
� - �� "
•.� � _ ., I� _ � � �i �� � � _
„� � �
' � �1 _ _ _ � �� ��. / � � . , y 1�����IliS:L� � - ' - �
:,•� • .1� • r_ • � - r_ - • � 1 ' • -
• - •1 . � �� c• � r •� • _ r. -
�:.='M' �' • •i` 1�11��1�':��y
i�i�ii�7 �i 7�h Wi�i111 ��]f. �• l �.•
�i'f�fl�� �i � �iLi111 �4 �• l i.•
� �i WiRi�il %'�� �• �.
0�� �� ��� o � �
•
Cbrner Iot [] Ir�i�le Iot [) Ft. Yd Se�tback Side Yazd Setbacks
Type of �iaci: Estimated Ocst: $ ��'
Approx. Qacq�leticr� Date:
Prvnosed D�iveway Width If New Openir�g Is Desired: Ft. S S
Width + 6' See Back �a e
DA'1'E. - � APPl�CAt�fr: � Tel. # ��°° ���
�TY D6�B QrII,Y
Petmit Fee $ �� . ��
Fire s1�ic�iiarge S - � �
State �t�tye � / . ,�
�� $
�iveway F�cc�w $
Park Fee $
Sewer Main C�an�e $
. �.
sizpvr��a$:
�
s ��.�cl
��_r��
1 ��� �%�'
l�ee Sd�echile an lieverse Side
.001 x Permit Valuatian (1/lOth $)
$.50/$1,000 Valuatian
$650 per SAC Unit
Alt. aA" o�'Alt. "B" Above
F1ee De�ined by �i �r; r�
� ��xY [ ] � Ne�tY [ ]
` _-� C� �- �-j S �
., ��
: �� �1�, c . � ; a:�:.-� 1�
Zlie �ief Building Officisl ehall, befm^e iesuir�q pezmits fos the erectian of any
building ar stsuct�uie, a� fc� any edditian to any esdsting buildir�g a� �t�ucture, or
for any alter3t3an a� repair ta any e�dsti�q buildirg a� etruct�n�e, �� rPPlicatiaai
tr,erefo�, z�equire the PaYme��t bY t2�e applicant fa� � peimit of fees to the amount
�IP2'E�TI �ZQii 6� f�l alY� fIl �lL' �re►ar �jn �j� tO�T�tS
'�I+ VA�JE
S1 to $500
SSOi to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $500,000
- � �.
$15 (lsiRim� Fbe is $15 Plt� �u�ci�azge)
$15 fc� fiist $500 plus $2 fc�r eaci� additianal $100 or
fractian thereof, to arrl izrluciir,g S2, aoo
$45 fo� f3='st $2, 000 plt� $9 fcr each edditior�31 $1, 000
o�' fr�Cticn thereof, to ar�d including $25, 000
5252 fa�r fii�st $25, 000 pl� $6.50 fC�' each adciitia�nal Si, 000
a� fr�ctian ti�e=eof, to ar�ci it'�luc]it�g $50, 000
$414.50 fa� fizat $50,000 plus $4.50 for each additica�al
$l, 000 0�' fraCtiCn thei'eof, to eT�d ir�cltriv�g $100, 000
$639. 50 for filst $100, 000 plus $3 . 50 fc�r e3di additianal
$1, 000 oi' fraction t2yet�of, to and incluciing $500, 000
$500,001 to $1,000,000 $2039.50 fos the fi=st $500,000 plus $3 for eacii adciitional
$1 � 000 G� fYaCtiC[1 thet�eof � to eflci 3.T1Cluditlg $1 � 000 � 000
$l, 000, 001 arxi up $3539.50 for the first S7, 000, 000 plus $2 for each �cid,itional
$1, 000 aac fiactian thei'eof
�C �SI�N S9Qi0W
(Oarr.cete C�b St=e�t8 �lY)
Alternate "A" : Re�o��l ar�d repla+oe�nct of aa3� ani gutter a�ly - DriveGray width plus
6 fee�t times $13.50.
Alternate "B" : i�ral ar�d replae�t of c� ani gatter anl ir�tall a 3 foot wide
epproach �rith 6 irrh depth -�ive�y width plus 6 feet times 515.75.
.� . �� �.• .
Piezmits for eac�.�t,ion will be 3asue�d a minim� of 24 ha�rs frcm the ti.me of
applicatian to allew foac p�vper review of the p�aQo�ed etruc4�ne ar�d of th,e
eacLStructicn site.
A OPrtifi�atre of S�rvey of the lvt, etiowir�g the laatian of the faar]atian ac�ce it has
it has been will be required before p�ooeedinq with the fta�ir�g.
sue�ecr PERMIT NO.
City of Fridley 2�. 0 4 `
AT THE TOP OF THE TWINS g � I L D I N G P E R M I T
r
� � RECEIPT NO.
COMMUNITY DEVELOPMENT DIV. �j�Q�
v PROTECTIVE INSPECTION SEC.
i L ��'-
r � " ;
� _ ,
� �'�'1 � CITY HALL FRIDLE� 55432 NUMBER REV. DATE PAGE OP APPROVED B�
�""'� � ��� 612-571-3450 910-F15 g/5/91 / /
108 ADDRESS 67,49 Ja,C�{SOri Street NE
t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. ,1.3 3 Meadowlands 2nd Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PNONE
Alton Johnson 6749 Jackson Street NE
3 CONTRACTOR MAIL ADDRESS ZIP PHONE IICENSE NO
Rockow Exteriors 18015 Ute �t NTnT, Anoka MN 55303 -
4 ARCHITECT OR DESIGNEH MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
8 USE OF BUILDING
Residentia�
7 CLASS OF WORK
❑ NEW O ADOITION ❑ ALTERATION �1 REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WOHK
Reroo� HQUSe & Gara.ge (25 Squares) Tearro��
9 CHANGE OF USE FROM TO
STI PU LATIONS
Underlayment must meet Sta.te �uilding Code.
TYPEOFCONST. OCCUPANCY(3ROUP OCCUPANCYLOAD
SEPARATE PERMITS ARE REDUIRED FOR ELECTRICAL, PLUMBING, HEATINd,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CON3TRUCTION ZONING S0. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IP 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 1 STA�LS 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 $�-�3QO yS.65
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
OVISIONS ANY OTHER TE OR LOCAL LAW REGULATING CON-
S U ION A THE PERF CE O�CONSTRUCTION. $31.00 Fire S.0 $1.30
� PLAN CHECK FEE TOTAL FEE
�,�— $ 3 . 9 5
SIGN eo ow�RACTOfiORAUTNORI2EDAGENT IDATE� WHEN ROPERLY AL A T 1 IS YOUR PERMIT
;s � (1-
SiGNATU EOFOWNER�IFOWNERBUILDERI IDATEI � BLDG SP `/L�t
� []
�� [ ]
�� [ ]
.. _ . . . � -
_� . � � «*�r�
0
It-1 l�IND R-2
Buildit�g Pe�it llpplicaticn
0
J
EffeCtfv+e 1,/],/91 •
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i�/�ri\ �i
Vi�ia«i
Cbrner Lot [] �i.ae �.a� l J
'Ij►pe oi OO�SttvCtlCr1:
Appr�x. �letic� Date:
•t"
� W1�Lil ��t �• L�.•
� ��{�1L�a �i.1�1.. �• �•
• . --_ �.:T�� 7.�- ' _�-: -r= �. _ a��
:,` �� _ �. •. I
� X � �
C1
Pt�q�osed D�iveway �lidth If New Openin3 Is Desired: Ft. $ S
�
� Width + 6 See Page
�: � � � . �. � �S 3--�`� �
�'1� D6B C�Y
Pezmit Fee $ � /. � ; ��
Fire StuYi�arqe $ / • .� C9
State S�ur�e � _ �- �
SAC �e $
D�ive�ray Esctvw $
Fark Fee $
SE;�iP.Y' M3]]'1 C�IdiqE $
. ��
S'I'IPUTATI�:
$� � � %�
i�e Sci�erh�le an I�ev�eise Side
.001 x Pexmit Valuatian (1/lOth $)
S•5o/Sl,000 Val.uatian
$650 per SAC Unit
Alt. MA" C�'Alt. �B" Above
F1ee Lie't�*�ni rr�ri � �,rri �,e.ri rrr
-� -�
� �YY [ ] � �-�Y [ ]
,, - -
.,
�
�: �l� �)�: c ;:.��y 1.; _ a.:i �� u
Zt�e �ief Buildir�g Offic3al ehall, befame issuirq peimits fos the erectic� of any
bui,ldir�g a� etz�a�e, a� fa� any ac]ditiac� tc �Y ��9 ��4 a� Btn�c4ue, or
for any alterdtian a� sepair to anY ��J ���J ��, �l ePPlicat3on
tryerefore, require the payme�t bs► t2�e applicaar,t %a eud� pe�it of fees to the am,owYt
�L�2.311 �![.,'ZQ�t � f�rl �� �1 �1e �a*ewr �jJl j�iT�C�Cl t0''W�t:
�T� VAIIJE
$1 to $500
S5oi to S2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $500,000
- � a,
S15 (Minim�n I�ae 3s S35 Plus e�i�arqe)
$15 fc� fi�st $500 plus $2 far eacii aaditiar�al S100 or
fractian tirreof, to ar�d firludirig $2,000
$45 fa� fitb't $2, 000 plus $9 fos each additiac�al $1, 000
C� fractiCn thereof, to atfd inCludin� $25, 000
$252 fcor first $25, 000 plvs $6. 50 faoe eacii adciitiac�al $1, 000
o� fracti.an ti�eteof, to and includin3 $50, 000
$414 . 50 foac first 550, 000 pltis $4 . 50 for each additioa�al
$1, 000 o�r fractian t2r=eof, to at�d ir�cluc�itr� $100, 000
$639.50 far fixst $100,000 plus $3.50 fo�' e3Ch edditiCnal
$l, 000 or fractian thereof, to er�d includir�g $500, 000
$500,001 to $1,000,000 $2039.50 for the fitst $500,000 plus $3 for eac�i add,itio�al
$1, 000 a�' fraGt.ia� theraof, to erd includirrg $l, 000, 000
$1,000,001 and up $3539.50 for the first $1,000,000 pl� $2 for eac� a+dditional
$1, 000 ar fractian t2�secf
�tIVE�IY �Pi�BIGN F8Qi0�W
(Cbc�ccet�e Q�i� Streets anlY)
Alternate "A" : R�oval ani zeplao�t of c� ar�d gutter anly - Driveway width plus
6 feet times $13.50.
Alternate "B" : Remo�ral ani zepla�t of aab ani gutter arrl install a 3 foot wide
appzoach �►ith 6 irnc �ie�fih -�'iveway width plus 6 feet times S15.75.
'I=�; �;� ". M�� `(.i� �� u,;�• M �_ �
Petmits for eeris-t�uctian will be 3ssued s minin� of 24 i�ours fr� the time of
epplicat3an tro allew fa� pa�vper zeview of the p�eno�ed etsuc4ire arid of the
�ian site.
A Oeztificate of �vey of the lvt, Btiowinq the locatim of the faa�ciatian acne it has
it has been wrLStnycted w311 be requirad before p��ooeedirig with ti�e fiaomi�.
'�- w
� v
SUBJECT
c�ty of Fridley
�
AT THE TOP OF THE TWINS g � I L D I N G P E R M I T
�enu�vo. _
2134� ,
� ` HtTit�rNU.
� ' COMMUNITY DEVELOPMENT DIV. ��� � �y
�: - �L-
� ----
r � � PROTECTIVE INSPECTION SEC.
1 i �
� /�"1 � CITY HALL FRIDLE� 55432 NUMBER REV. DATE PAGE OF APPROVED BY
�""'� � ,'� 612-571-3450 910-F15 5/20/92 / /
JOB ADDRESS 6749 Jackson Street NE
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION
DESCR. 13 3 Meadowlands 2nd Addit�,on
2 PROPERTY OWNER MAIL ADDRES$
Alton Johnson 6749 J'ackson Street NE
3 CONTRACTOR MAILADDRESS
Minn Russco 7
4 ARCHITECT OR DESIGNER
5 ENGINEER
MAIL ADDRESS
MAII AODRESS
55439
S
ZIP PHONE
ZIP PHONE
942-06�
ZIP PHONE
SEE ATTACHED
SHEET
LICENSE NO.
2173
LICENSE NO.
ZIP PHONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASSOFWORK � NEW �] ADDITION ❑ ALTERATION O REPAIR O MOVE ❑ REMOVE
8 DESCRIBE WOF;K
Construct an 18�6'� x 10� �orch Addition
8 CHANGE OF USE FROM
TO
STIPULATIONS �ee notations on plan, Smoke detectors zequixed at all sleeping rooms
if not already installed,
�������
SEPARATE PERMITS R M���G AND SIGNS.
W�RING, HE�►TING, PLU
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATIN(3,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IP WORK OR CONSTRUCTION ZOI
AUTHORI2ED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED Ofi ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO
I HEREBY CERTIFY THAT I HAVE READ ANO EXAMINED THIS APPLICATION
AND KNOW THE SAME TO BE TRUE AND CORF;ECT. ALL PROVISIONS OF LAWS VAI
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
OOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEl
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGUTATING CON-
STRUCTION OR THE P RF MANCE OF CONSTRUCTION.
� / ( �f � ��d ' �s A'� PL,
� L S� %
A U O C D� RACTOR OR AUTMORIZED AGENT IOATEi
� .� !'`'
I ......,..,�e�..�n�u.�co,mnwuCaRUIIOERi �DA7Ei . ��r
Before digging cail for
a!I utility tocations
454•Ofl02
REQUIRED BY L�W
SO.
iWLG. UNITS
�. STALLS
�TION
$4,154
T FEE
$72.00
�
SC $5.00
Gi;OUP OCCUPANCY
CU. FT.
�GARAGES
JFTAX
$2. 08
4C CHARGE
Fire SC $4.15.
�TAL FEE
$83.23
THIS IS YOUR PERMIT
�
� .� ✓ � -.� U _
NEW [ ] Effective 3/ 1192
ADDN [ ] CITY OF FRIDLEY
ALTER [ j SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Consttuction Address:
� ��'�9 5'0l� i���C
\
Legal DESCription: � v
Uwner Name & Address: {� �� �� -� 'o ��nS o.� Tel. �
Contractar: %� ��l vl , R v� S S C� MN LICENSE #� 00,21 � 3
Address: 7�/� � — (�� . S 1� � I� �i � � � C,�'� � � Tel. #
Attach to tbis applicarion, a Certificate of Survey of the
lot, with the propased construction drawn on it to scale.
p���
� AREA:
GARAGE AREA:
DECK AREA:
01'HER:
DESCRIPTION OF IMPROVEMENT
r r� �.
Length l� ` widtt► /� xeight
Length Width Height
Length Width Hgt/Ground
Sq. Ft.
Sq. Ft.
Sq. Ft.
Corner Lot [] Inside Lot j] Ft. Yd S�back _
Ty� of Consiruction: (�s-F f �g �� � °�
Approx. Completion Date:
� Side Yard S�backs
Estimated Cost: $ _ � �.; ��—
� ��%-5/��
(Cost on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft °= Ft x$ _$
DATE: -�— �� APPLICANT: ��(�� � Tel. #
Permit F� $ �� , ('' �'
Fire Surcharge $ �,1 �
State Surcharge $ �?� �`c�
SAC Charge $
License Surcharge $ �. C C''
Driveway Escrow $
Park Fee $
Sewer Main Charge $
TOTAL $ � � • � -�
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/1(?th%)
$.50/$1,�0 Valuation
$700 per SAC Unit
$5.00 (State Licensed Residential Contractors)
i��. ��° Ot �t. °B" AbOVe
Fee Determined by Engin�ring
Agreement Necessary [ J Not Necessary []
/j ��/- • �Z�-d�
STIPULATIONS: ��M►�1.2 �,Nx
1 ' F ' �.^e%a ;���
BUII.DING PERMIT FEE SCHEDULE
The Chief Building Official shall, l�fore issuing p�rmits for the erection of any building or shvcture,
or for any addition to any existing. bnilding or structure, or for any alt�eration or repair to any existing
building or shuctuTe, upon application therefore, require the payment by the applicant for such permit
of fees to the amount herein l�low set forth and in the manner herein provided to-wit:
TOTAL VALUE
$1 to $500
$501 to $2,000
$2,001 to $25,0�
$25,001 to $50,000
$�0,�1 to $100,000
$100,�1 to $5�,0�
$500,(101 to $1,0OO,OW
$1,�0,001 and up
FEES
$15 (Minimum Fee is $15 plus surcharge)
$15 for first $500 plus $2 for each additional $100 or
fiaction thereof, to and including $2,000
$45 for first $2,000 plus $9 for each additional $1,000
or fraction thereof, to and including $25,OD0
$252 for first $25,�0 plus $b.50 for each additional $1,OOU
or fraction thereof, to and including $50,000
$414.50 for first $50,000 plus $4.50 for each additional
$1,000 or fraction thereof, to and including $100,�
$639.50 for first $100,000 plus $3.50 for each additional
$1,t�0 or fraction thereof, to and including $500,000
$2039.50 for the first $500,000 plus $3 for each additional
$1,000 or fraction thereof, to and including $1,(m0,000
$3539.50 for the first $1,�,000 plus $2 for �ch additional
$1,(100 or fraction thereof
DRIYEWAY DEPRESSION ESCROW
, (Concrete G�rb Sireets Only)
Alternate "A" : Removal and replaceme� of curb and gutxer only - Driveway width plus 6 feet times
$13.50.
Alternate °B": Removal and replacement of curb and gutter and install a 3 f�t wide
approach with 6 inch depth - Driveway width plus 6 feet times $15.75.
VERIFICATION OF FOUNDATION
Permits fc�r construction will be issued a minimum of 24 hours from the time of applica.tion to allow
for proper review of the progos� s�ructure and of the construction site.
A Cerdficate of 5urvey of the lot, showing the location of the foundation once it b.as it has been
constructed will be required before proce�ding with the framing.
�
� ,� , °'r , . •
6129420644
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5 .
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d�f'l C.-�S tio w�° P'i'R'P�� ANb S�Art� Rt50�
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PanQl Weight�3.5 PSF
i � k0.76 in
S = 1$.63 in3
�/a�� o.s.a. .
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Gore Panel
Panoi Wai�ht�3.S P3F
z - 92.66 in •
8 � 29.02 3a3
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STA,YDARD ts"LOOR PA.y�L
LOAD TABLB
Spaa
6
8
12
16
e
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' 20
WORItING LOAD '
FOIi DEFLECTION (P.F.S.)
L/180 L/24 L/360 ' i
;
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66 45 ;
i
4i 31
26 16 ;
10 ;
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ea
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MATERIAL FR�PERTiL3s �
pOLYSSYRENE�COBL+a �
- �'aneila Streagth � 16-20 p.a.i.
- Chsar 5trangth (ae failure) � 11.36 p.s.i. � hereby ce
- Shesr Modulue. Gc • 280�320 p. a. i. prepered
- Modulu� of ElestiQity, E� * 180-220 p.s.i. �� p
ORiL°NTED STRAND �OARD (O.S.B.)t � �
— Modvlae of Ruptura � 8,000 p.s.i. -
— Modulu4 0! Eiastieity, E■ 1.25Q•Q00 p.a.i.�'` ,
p� �S'/e
�s so � �
.�
43 Zg i
27 17 I
19 11
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tMis plan, s ifiGat � or �poR ws9 '
w9
e rect . I n sr��J tl'�et 1 '
ulana E r nder !he Isw� '
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---------------------------------------------------------------------------------------------------------
SUBJECT P •
c�ty of Fridley 215 4 4
AT THE TOP OF THE TWINS g � I L D I N G P E R M I T
r
� ` RECEI .
� ; L ___��_ COMMUNITY DEVELOPMENT DIV. �� �
r � � PROTECTIVE INSPECTION SEC.
� _ /'�'1 � CITY HALL FRIDLE� 55432 NUMBER REV, DATE GAGE OF APPROVED BV
�'"""� � �'� 612-571-3450 9t0-F15 9/15/92 � �
J08 ADDRESS 6749 Jacks.on Street NE
1 LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 13 3 Meadowlands 2nd Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS 21P PHONE
Alton Johnson 6749 Jackson Street NE 571-0284
3 CONTRACTOii MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADORESS 21P PHONE LICENSE NO.
5 ENGINEER MAiL ADDRESS ZIP PHONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
C� NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE � REMOVE
8 DESCRIBE WORK
Construct a 10' x 14' Shed
9 CHANGEOFUSEFROM TO
STIPULATIONS
TYPE OF CONST. OCCUPANCY (3ROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTFICAL, PLUMBING, HEATING,
VENTIIATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OFi CONSTRUCTION ZONING S�. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONE� FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTEF WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICA'TION �- STAILS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS yp�UATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $687 $. .rJO
WITH WHETHER SPECIFIED HEREIN OR NOT. THE C3RANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $19. OO Fire SC $. F�
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE TOTAL FEE
$20. 19
GNATURE OF CO TRACTOH O AUTMORIZED AGENT IDATEi HE R R V LID ED THIS IS YOUR PERMIT
V � e, � �—! v � � �
Si NATURE WN IF OWNER BUILDERI 10ATEI °-' LOG �NS D! TE
r�w [ l
ADDN [ ]
ALTER [ ]
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Effective 3/1/�2
Construction Address: �.o �� 4 J l� %�' 0 l� s'l N�' ��� i J� G.� '�J� M j�s 5 S 1� 3 2.�
Lega.l Description: �- l'a� ��- � Iti(�ec�� �� 2ud ��c�i��
Owner Name & Address: ��-�'l� �-�-i A1-�' 6 I�, (0 7��1 1.(� �� 01,� ��;Tel. � 5 7/~- D 2g �
Contractor:
Address:
LI�ING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
MN LICENSE #
Tel. #
Attach to this application, a C,ertificat�e of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF II1�ROVEMENT
Length Width Height
Length Width Height
Length Width Hgt/Ground
S � � � � � � X � °� f � �.a /� �
Sq. Ft.
Sq. Ft.
Sq. Ft.
Corner I�ot ,pC� Inside Lot [ J Ft. Yd Sexback Side Yard Setbacks
Ty� of Consl�uction: F.stimat� Cost: $ ���` ��
Approx. Completion Date: _
(cost on Backj
Driveway Curb Cut Width Needed: Ft. + b Ft = Ft x$ _$ �
DATE: � ^ � 2-. APPLICANT: ��� � I� � , � i � -%� �C d l� TeI. # � %/�- n � $ �-/
Permit Fee $��d ��
Fire Surcharge $ � �"�
State Surcharge � � ��
SAC Charge $ °`°`�°
License Surcharge $ ` --
Driveway Escrow $ -""�°"
Park Fee $ -`"
Sewer Main Charge $ � �
TOTAL $ �� ° � �
STIPULATIONS:
C�TY USE ONLY
F� Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,U00 Valuation
$700 per SAC Unit
$5.00 (State Licensed Residential Contra.ctors�
Alt. "A" or Alt. "B" Above
Fee Deternnined by Engineering
Agreement Necessary [ ] Not Ne�essary [ ]
�
BUILDING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any buiiding or sbructure,
or for any addition to any existing bailding or structure, or for azry alteration or repair to any existing
building or structure, upon applica.tion therefore, require the payment by the applicant for such �rmit
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,W1 to $25,000
$25,001 to $50,000
•� °�
$50,001 to $1�,000 �
$1W,(�1. to $5�,�
$�,OOi to $1,IX?0,�
$1,000,001 and up
FEF.S
$15 (Minimum Fe,e is $15 plus surcharge)
$15 for first $500 plus $2 for each addititonal $100 or
fraction ther�f, to and including $2,000
$45 for first $2,000 plus $9 for each additional $1,000
or fraction thereof, to and including $25,000
$252 for first $25,000 plus $6.50 for each additional $1,OOQ
or fraction tbereof, to and including $50,�
�$4T4.50 for first $50,OQ0 plus $4.50 for eacb additional
$1,000 or fraction thereof, to and including $100,�
$639.50 for first $1�,(�0 plus $3.50 for e,ach additional
$1,�0 or fraction ther�f, to and including $500,000
$2039.50 for the first $S�,Q00 plus $3 for each additional
$1,000 or fra.ction thereof, to and including $1,000,000
$3539.50 for the first $1,�0,000 plus $2 for e,ach addition�l
$1,000 or fraction �thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Altsrnate "A" : Removal and replacement of curb aad gutter only - Driveway width plus 6 f�t 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 fe�t times $15.75.
VERIFICATION OF FOUNDATION
Permi�s for construction will be issu� a minimum of 24 hours from the time of application to allow
for proper revie�vv of the proposed structure and of the conshuction site.
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been
constructed will be required before proceeding with the framing.
a
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E�y-� — En9ineers � Surveyors —
certz�icate o� sutve �o: `-RCO, lu�.
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ENGINEERING, INC. "�`�°'°
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//►aieby cerfi�'y � lhis K o frue a►re mrrtcf �rprrse�ofion o�'o su�'rtt� �'1Yae bevrido�s �'!l�r abex dcwyl�d �,�
o�'Mr lacaf�a� q�'al/ br�ild�s ,lkrran , aad d/ nstb/t ax�oorhmenfs , i�'�y. �''� ar an.wid /and. As suryeyed 6r� m�e lh�s tf
� F-ebr-�o%y - A.0.1lI�. SUBURBAN ENGINEER/NG , INC.
Fsarn�+►r� c G.rri�u.rc '
. �
SUBJECT P . �
City of Fridley 2�i 2 7 9
AT THE TOP OF THE TWINS g � I L D I N G P E R M I T
r
; � RECEIPT NO.
� ; y _����_ COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC. ��� /
1 .1 i �
( 1 /"'1 � CITY NALL FRIDLE� $:f43Y NUMBER REV DA�E PAGE Of APPROVED 8Y
�----� • •�� 612-571-3460 910-Ft5 6/18/98 � �
�oe nooaess 6749 Jackson Street NE
1 LEGAL LOT NO. BLOCK TRACT OFi ADDITION SEE ATTACMED
DESCR. j3 3 Meadowlands 2nd Addition SNEET
2 PROPERTV OWNEii MAII ADDRESS 21P PNONE
Alton Johnson 6749 Jackson Street NE 571-0284
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Midwest Siding & Roofing 18979 Gladstone Blvd, Maple Grove MN 55311
4 ARCHITECTORDESIGNER MAILADORESS ZIP PFIONE LICENSENO•
416-4804 20010277
5 ENGtNEER MAIL ADDRESS ZIP PHONE LICENSE NO.
8 USE OP BUILDINCi
Residential
7 CLASS OF WORK
❑ NEW p ADDITION � ALTERATION C� REPAIR O MOVE O REMOVE
8 DESCRIBE WOFK
Reroof House & Garage (27 Sq) Tear-off
9 CHANdEOFUSEFROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
TVPE OF CONST. OCCUPANCV dROUP OCCUPANCV LOAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATIN(i,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WOqK IS SUSPENOED OR ABANDONEO FOFi A PERIOD Of 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I MEREBY CERTIFV THAT I MAVE READ AND EXAMINED TNIS APPLICATION 1 STALIS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORREC7. ALl PROVISIONS OF LAWS VALUATION SUHTAX
AND ORDINANCES GOVERNING THIS TYPE OF WOqK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEi;EIN OR NOT. TME GRANTING OF A PERMIT �2s2S1 �1. 12
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANV OTHER STATE OR LOCAL LAW REGULATING CON- @
UC N OR THE PERfOqMANCE OF CONSTRUCTION. �p%4.7.5 Fire .5�.' �2.25
PLAN CHECK FEE TOTAL FEE
/i'�� �'T �� l� License C $5. 0 $83.12
S�GNATURE OF CON7RACTOR OR AUTMOR12ED AGENT IDATEI N R P VALIDAT p TNIS 1�� PERI�1�
- t, l � �
SiGNATUREOFOWNER�iFOWNERBUILDERi �DATE� �-� 8L iNSP ryqTE
NEW [ ] Effective 1/1/98
ADDN [ J CITY OF FRIDLEY
ALTER [ J SINGLE FAMII,Y AND DUPLEXES R-1 AND R-2
BUILDING PERNIIT APPLICATION a �j ��
3�31
ConstructionAddress: (� ��/� � � �rS�a� �� ��'—
Legal Description:
Owner Name & Address: �//�u�' �Li�r��a� Tel. # � ��� ���3!
Contractor: �r �ce��.s ��• S� �. %I C� � l�o� �o� � MN LICENSE # ���/��? ��
Address:/��'��f ��a����� /���c�, i��.� A�' ��_'� � ��� 3�/ Tel. # ��C � ��� �
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale. �
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
DESCRIPTION OF IlVIPROVEMENT
Length Width Height
Length Width Height
Length Width Hgt/Ground
�A�4-P � �� �r�s � �
Sq. Ft.
Sq. Ft.
Sq. Ft.
Construction Type: � 7 � ���- � �� Estimated Cost: $ ����
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: � ��' � �
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
APPLICANT: l� l�fC ��.�� Tel. #�`I t'�`-���a?
$ �
$ �-�S`
� 1- /�
$
$ ..��
$
$
$
$
$ .� - I�
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1 / l Oth %)
$.so/$1,0� valuation
$1000 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.� Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
�. • � �°
BUII.,DING PERMIT FEE SCHEDULE
The Chief Building Official sha11, 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 $1Q0,000
$100,(?O1 to $500,000
$500,001 to $1,OOO,Q00
$1,0�,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 $50,0�
$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 $5.00 for each additional
$1,Q00 or fraction thereof, to and including $500,000
$2887.25 for the first $SQ0,000 plus $4.25 for each additional
$1, 000 or fraction thereof, to and including $1, 0�, 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.
V�RIFICATION 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 constructed
will be required before proceeding with the framing.
� r �,.�