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City of Fridley, Minn..
BUIL�ING PERMIT
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N° 7423
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Address —___�._ Address
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LQ�ATION OF �JILDING
No. '` Street ' � �'�" / .:�.�� P ` of Lot _
r a������
Lot _ Block " Addition or Sub-Divisi� ,
Coraer I.ot� _ Ineide Lat �' Setback .��1��— Sideyard
3ewer IIevation ��—�� ` 6 (�� �opr II�ation �
DESCRIPTION OF BUILDING
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`� '� rn� � � -,�� s�i• /'��`� �-��`�'
� ��� Front ne xei t Ft. cu. FL .�
Fro ,t Depth Height �/_.._.��_ Sq. Ft Cu. Fk
Tj►pe of Conatructi �� a�.� F�t. �,..� � rl � be Completed �
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In cons�tderatlon oP the issuancae to me of a permft to conatru uilding described ab to do
th� proposed work ffi accordance with the d�script3on above ae o ia ce a'11 ona of
or�nances of the dty oP Fridley.
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In considerat[on of the payment of a fee oP $ �' , permit is her�by granted to
to conatruct the buflding or addition as descrlt�d above. This t is gisnted upon
the eupress condition that theperaon to whom ft is gi�antQd and hia agents, employees an worl�aen� fn all work.
daae fn, around and upon satd building, or anypart thereo� shall conform in all respecta to the or�lfnances of
Fridley� Minnesota reg�lP�otn,� ���alat � time nPon� �o�� � o�f an�► of �� bt� �a
within the dty ]imfts and la�
ordinanc�s. �, �, .� ,� 11
Buildia8 Inspaetor
Nonc�
7lils perm(f dees eof wrsr ths co�, �/s� vriAeB� P��+�9, 6+� b�e, � or �rdsr. B� sura te iss
t� Bui�din8 i�p�� [or pW►+b � 1or l6as (�s.
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. �PLICATION FOR BUILDING PERMi�
. ,. � C�CY 0� � FRIDLEY � MiIrAdESOTA
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LOCATION OF DI . .
No. �,,/,! • Street ��' �� � art of Lot
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Lot % ' Block�`_ Addi.e�iori, or Subdivi$ion .��
Cornes Loe ,�Inside Lot�SeCbac�k .�//�"-� 3�tde- rd ,,.�''�' - z1'
SEWLR ELEVATION FOUNDATION ELEiiATION -
Applicaat attach to.thig.form Twa Certificates of Survey of:I,ot and praposed build-
ing location, _drawn on these Certificates ..,. , �
To be
DESCRII�J.ZON OF HUILDING
ed �a:
�� �_G' � , � . . ,,�
�� //,���.�� /- F�ont � ,�"�°� ' ne�th � ��
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� Sq. .Ft. �l� ,�� Cu. Ft. . -. .
• � � .Front � Depth � Aeight
- � ' " Sq. Ft:� . Cu.-:,Ft.
..�=-' .
Tqpe of Construction .��/� �" Estimeted 1Cost /�����
,� . .
To be Completed � � ��' ' � � �
The undersigned hereby makes application fox.a permit for the work herefn specified,
agreeisg to do all work ia strict accordance��rith the Citq of Fridley Ordinances and
rulings of the Department,of Bui:ldings, and�b;ereby decl,ares that all Cha facte and
representatione etated in this applicetion �re Crue and.correct. �
DATE �I� � SIGNATURE
�Sthedule of Fee Costs cea be fouad on the Reverae Sid�).
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BUILDING PE�NIIT FEE SCHEDULE
Section 2. The Inspector of Buildin�s shall, before isauing any permit for
the erection of any bu3lding or structure, or for any addition to any �xist-
ing building or atrucCure, or for any alterations or repai�ca to any exiatiug
building or sCructure, upon application therefor, require the paymeat bq Cbe
applicant fos such permit of fees to the amount hereia below set forth and
ia the manner herein provided to-wiC;
2.1. For any such permit for the erection of any fire-proof building, other
than a garagei warehouse, factory or graia elevator, or for the erection of
any fire-proof addition� for similar occupancy, to any �xisting building
shall be at the rate of $1.40 for each one ti�ousand cubic f�et, or fracCion
thereof,.ia.such cubical coatents.
2.2. For.aay such permit for the erecCioa of an��fire-proof garage, warehouse,_
factory or grain elevator, or for the erection of aay fire-proof eddition,
for similar accupancy, ta anq esistiag building shall be at the r�te of $1.25
for eacb one thousand cubic feet, clasaified as 11fireproof" by Sectioa 502 Qf
the Minaeapolis Building Code.
flOUSES
2.3. For aany such permit for tlie erection of any aoa-Hreproof bnildiag other
than a garage, warehouse, factosq or grain elevator, or aaq aon-fireproof
addition, for similar occupancq, to aay esistiag building = permit $1.00 for
each one thousand cubic feet. .
GARAGES
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2.4. For any such permit for the erection of aaq aon-firep�coof garage, ,-
warehouae, factory or grain elevator, or for the erectioa of any non-fire�ps�oaf
additian, €or�-8imilar occupaucy, to any existing building or for each auch
.,_._. -buildiag or add3tioa - ainety cents ($0.90) for each oae thousand cubic feet
or fraetion thereof, in the cubical conteats thereof with a minia►um of $4.OQ.-
For the purpose of comput3ag fees for building permite, the c�abical coatents
of anq bui�.ding or addition to a uuiform height throughout by multiplying the
ground area covered from a point ai� (6) iachea below the floor liae of the
basement or cellar to the average beight of the upper surface or to the
average height of the rpof surface of the uiai� gable of a pitched roof.
2.5. For repairs or alterations to an exiating structuxe, the fee ahall 1��
at the rate of $3.00 per each Five Suadred Dollars ($500.00) or fraction
thereof 3n the cost of all proposed work.
2.6. In no case ahall the feQ,.charged for.aay-permi�,as set forth ia
Section 2 be less. thaa $4.00.
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Caty of Fridley, Minn.
BUILI)ING PERMIT
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Date: �:1-, � � a�� � 1 �4i i
Ocvaer: �1.��. ��°�' �c��� �a Builder �' �"
Al�dl'�8S �� 3� s���.t f�C.r�� E.��i `'� �• �i • 1-+ • iiC1i�I288 J i`:'tl2i'.
�To 925,�
LOCATION OF BUILDING
No. � � � �' Street � ' � ��� `�� `' � . �3 • r' • ____ Part of I�ot
Lot �'m _ Block a Adclition or Sub-Division i''i�� 1�s?�* Pr: nF� ��x�>a ',� �.3� .
Corner Lot _ Inside Lot x Setback ___._ Sfdeyard
Sewer IIevation — Foundation IIevation
DESCRIPTION OF BUILDING
To � v�a �:
� i= : �L �. �`'olC7� Front � �'� � Depth ��i' b Height 1 � e Sq. F� � � v Cu, F'ti _ ? , 2 �$�
Front Depth FTeight Sq. F't. Cu. Ft
1�pe oP Construction T°� .�;::: Fst. Cost —. �1, 7�s� To be Completed �ic� . 3.�'f�7
In consideration oP the 3ssuance to me oP a permit to conatruct the building described above I agree to do
tht� proposed work in accordance with the description above set forth and in compliance wlth afl pravisfons oP
ordinaaces oP the dty of Fridley.
In consfderation of the payment of a f� oP $ r•�`-� , permit fa hereby granted to �ai°'��
��'�����"�`��' � to conatruct the bufld�ng or additton as deacsYbed above. This �rmft fa granted upon
the �express oondition t the peraon to whom it is granted and hia agents, employees and worl�nen, fn all work
done in, around and u�n satd building, or anypa� thereo� shall conform in all respects tfl the ordinances oP
Fridley, Minnesota regarding lacation� conatruct�on, alteral3on, me3ntenance, repair and moving of bufldings
within the dty ]imits aad this permft may be revoked at a�y time upaa violal3on of any of the provisiona of safd
ordinanc�s.
�.�_ �; ��?+;:y E�'�:Ia�"�� '� Buildia8 �
NOTIC�
'Ihis peneh dea esf eever ths eonstroe�loe, Ieita0alten Po� �vhias, plvmbtne. 6n huHee, aw�� ee wNsr. B� sara fo a�
ths Buildio0 lespntor foe apuab parmth Po� t6as ti�na.
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APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
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OWNER' S NAME -�- C" ��) �,,��� f 1(= �� d�°a'C'i"� BUILDER ��� ��� a�•� F
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ADDRE S S �F . ) % � �. � � �' � � � ; � , .� � ADDRE S S `� �s �,�� �_-
LOCATION OF BUILDIIVG
N0. � � % / STREET ; j �, �, � � P_ �R M � r PART OF LOT _ - �
LOT �''� BLOCK ��` ADDITION OR SUBDIVISION �, a� ,�� r,'��`��`�..,t�,�4
CORNER LOT
SEWER ELEVATION
INSIDE LOT ,�� SETBACK
TOP OF FOOTING
SIDE-YARD
Applicant attach to this form two certificates of survey of lot and proposed
building location draz�m on these two certificates.
DES�IPTION OF BUILDING
To be Us ed as :
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�-�. /-` �- �: � -� Front � �a Depth :� �_Aeight � L�
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Front
Sq. Ft .
Depth
Cu. Ft.
Height
Type of Construction � ,��'�� ,�.� ;��,�` Estimated Cost � � ��� ��.��
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To Be Completed �;�—,-; �`,a`� �=� %� � �_ � �
The undersigned hereby makes application ior a permit for the work herein specified,
agreein� to do all work in strict accordance with the City of Fridley Ordinances
and ruling of the Department o£ Buildings, and hereby declares that all the facts
and representations stated in this application are true and correct.
DATE • ::���p�'� %' : �� � SIGNATUP,E _�- - � z_ ,� �;�, �.
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(Schedule of Fee Costs can be found on the Reverse Side).
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BUILDING PERMIT FEE SCHEDULE
SECTSON 2. The Inspector of Buildings shall, before issuing permits for the
erection of any building of structure, or for any addition to any existing
buildzng;or structure, 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 manner
herein provided to-wit:
Ur_iform Building Code: Type 1,2, & 4- $1.75 for each one thousand cubic feet, or
fraction thereof, in such cubical contents. Type 3& 5-$1.50 for each
one thousand cubic feet.
For the purpose of computing fees �for building permits, the cubical contents of
any building or addition to a uniform height throughout by multipluing the ground
area covered from a point six (6) inches below the floor line of the basement or
cellar to the average height of the upper surface or to the average height of the
roof surface of the main gabl� of a pitched roof.
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 permit as set forth in Section 2 be
less than $5.00.
NSSSD Connection Charges based on location- Area 1 or 2.
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' " LO? �a� BLOCK �• MEI.ODY MANOR 3R0 AODI'YION` . � , � ;y
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,� _' l hu�eby �car.�y �iat Ihis �s o h-uoe wid uo�rr�sc�, r��rresen�ot�n o� a bur'vay �'!!x b�a►n�r�es �l /Jn a4o+v aEx•r:�d /�d,ar�o� � y;
of "/j� /aco�'�n o/�o/I barkluiys , ll�erean , a�d d/ ns�ble a�a�rlimt��fs , r�'anr� ��ii ar u► swd /mid. As wrveyed d� me 11� ""' :; d�/ :, �: a
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C�ity of Fridley, Minn. � 10 7 49
BUILDING PERMIT
��; July 13, 1970
p�; Glen Frischman g�� Same
Ad�r�s 7311 �ackson Street N.E. ,�d�� Same
LOCATION OF BUILDING
No. 7311_ g�t Jackson Street N.E. Part of Lot
� 14 __ gl�k 1 Addition or 5ub-Division Melod.,y Manor 3rd
Coraer Lot — Inaide Lot � Sstback —_ Sideyard
Sewer IIevat4on ____ .� Foimdation IIevation
DESCRIPTION OF BUILDING
To be Used as:
Play �ouse FrOnt __Z___ Depth .�� Height ._6—_ Sq. Fw C�. Ft
Front Depth ITeight Sq. F't. Cu. F't.
Type of Construct3on Frame �, � � 200. _ __ To be Completed Oct �,�. 1�70_
In cansideration of the issuaace to me of a�rmft to construct the bullding described above, I agree to do
tha proposed work in accordance with the description above set and in compliance th all proviaions of
ordtaances oP the dty of Fridley.
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In Comsideration oY the pSqmeIIt of a fee Of �. 00 � permit 9s hereby �rauted to -� Fri c_hm n
to construct the buflding or additfon as described above. This �rmit ia granted upon
the express condition that the person to whom it 3s granted and hie agent�, employees and worl�en, in all work
done in, around and ugon said building, or any part thereoP, shall conform in all �respects to the ordinaac�s oE
Fridley, Mfnnesota regarding location, conatruction, altera.tion, maintenance, repair aad. moving of buflclings
within the dty limits and this permit may be revoked at any time upaa violation of any of the prov9siona oE said
or�dinancea.
��� � �,���� � �� �
� ��
NOTIC�
'I61s psrm(t d�s ao� eo�sr !hs coesl�vcNoe, hutalltlioe �o� �rhtap, pinmbine, en 6uting, sew�� o� water. B� sun to as '
tha Buildiee lespeetor for �parats p�emhs Po� �he� (�s.
� �
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APLICATION FOR RESIDENTIAL, ALTERATION,
OR AllllITiON BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME:_(_ ��Pa� %^iP �',/�/�/�h BUILDER: C�G�'�iJ'l F
ADDRES S:_ % t� f/ �l�C� Lr�r► �ADDRES S:
NO•. STREET:
LOT: BLOCK; ADDITION:
CORNER LOT: INSIDE LOT:� SETBACK: SIDEYARD;
Applic;ant attach to this form ltao Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
�ESCRIPTION OF BUILDING
To Be Used As:
�
�f� C� / /a S Front • Depth •_ � Height :
Square Feet:_� Cubic Feet:
Front; Depth; Height;
Square Feet; Cubic Feet: C
Type of Construction: �hC� ry�� Estimated Cost: $ ��C?-°�
� T , �
To Be Completed: � �� f�, �
----_
The undersigned hereby makes applicativn for a permit for the work herein
specified, agreeing to do all work in stiict accordance with the City of
Fridley Ordina.nces and rulings of the Department of Buildings, and hereby
declares that all the facts and representations stated in this application
are true and corxect.
�TE : � �•3 � d S IGNAT[TRE • �
(See Reverse Side For Additional Infoxmation.)
�� � - ;� �=� s- _ _ �
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BUILDING PERMIT FEE SCHEDULE
SECTION 2. The Inspector of Buildings shall, before issuing permits for the
erection of any building or structure, or for any addition to any existing
buildi.ng or structure, or for any alteration or repairs to a,ny existing
building or structure, upon application therefore, require the payment by the
applicant for such germit of £ees to the amount herein below set forth and in
the manner herein pxovided to-wit:
UNiFORM BUILDING CODE: �pe 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
cavered 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 suxface of the ma.in gable of a pitched roof.
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 permit as set forth in Section 2 be
lesa than $5.00.
VERIFICATION OF FOUNDATION
NOTE: i'ermits 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 Certi.ficate of Occupancy shall be made ten (10) days prior
to the use or occupancy of any strucfure for which a building permit has been
issued; a.nd said structure sh�ll not be used or occupied until a Certificate
of Occrxp�ncy has been issued. •
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SuBJECT
City of Fridley - �� � �� 4 ���
AT THE TOP OP THE TWINS g U I L D I N G P E R M I T
r
� ► RECEIPT NO.
� • COMMUNITY DEVELOPMENT DIV. ���
~ PROTECTIVE INSPECTION SEC.
� t "�",
r , ;
� ,
� � �'�'1 � CITY HALL FRIDLE� 55432 NUMBER NEV DATE vpGE OF qvvROVED Br
�""� � �'' 612-571-3450 910-Ft5 5/21/96 � �
JOB ADDRESS 7311 Jackson Street NE
t LEGAL LOT NO. BLOCK TRACT OR AODITION SEE ATTACHED
DESCR. ],({ 1 Melody Manor 3rd Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS 21P PHONE
Gary/Janet Cooper 7311 Jackson Street NE 784-2525
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO
Dahl Builders 451 Maple St, Spring Lake Park, MN 55432 784-6353 20050777
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PNONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW � ADDITION ❑ ALTERATION O REPAIR O MOVE � REMOVE
8 DESCRIBE WOf;K
Construct a 12'x 8' and 20' x 19' Addition to Dwelling
9 CHANGE OF USE FROM TO
STIPULATIONS
See notations on plan.
���� "����
8efore diBging catt �t
SEPQ eA utility Ioc�tions
R N� rE PERR�rrs R�Qu� a54-000z
�vi e.� H�riN�, P�� �� �a� REQUfREb BY 1.�1�
"�s�"� a�+� s�cN�.
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCV GROUP OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT CU. FT
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, Ofi IF CONSTRUCTION
OR WORK IS SUSPENDED OH ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CEHTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS yqLUATION SUHTAX
AND OROINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �27,550 �13.%H
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL TH� pERMIT FEE SAC CHARGE
P1iOVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING coN- �376.75 Fire SC �2%.SS
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE TOTAL FEE
License SC $5.00 $423.08
SIGNATUREOFCON'RACT OA.4UTNORIZEDAGEN IDATEI WHEN PfiOPERL ALID TED THIS IS YOUR PERMIT
���n�� , � --/���—��/L� —��
S� N REOFOWNERiiFOWNE LDERi IDATE� � BLO �NSP � DaTE
�w
ADDN
ALT'ER
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ConstructionAddress :
Legal Description:
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
�
Effective 3/1/96
Owner Name & Address: � ���, j:� �t � , ,��- �-r�__, Tel. # ��'� �- �..Sa. S"
Contractor• �/�-�,� �n� lc�l p�� � �-�,,^��� e0� � MN LICENSE # ���"�� �%�%%
Address: �/ %'}�� f �, J�- n�p�� i`e �. ��'��� Tel. # � $ � ^ � 3 S�°3
Attach to this applica.tion, a Certificate of Survey of the
lot, with the proposed const�.uction drawn on it to scale.
DESCRIPTION OF IlVIPRO`�
LIVING AREA � � � � � � �l � �O� J 7R 8'�
: Length �v Width �° i Height Sq. Ft. ��7 �,b�
r
GARAGE AREA: Length Width Height Sq. Ft.
DECB AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
Corner Lot [] Inside Lot Q�] Ft. Yd Setback Side Yard Setbacks
Type of Construction: �� S� Estimated Cost: $ � ,�
Approx. Completion Date: c� , � q y�,
(Cost on Back)
Driveway Curb G�t Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: � j�� -�` (r, APPLICANT: 1 Tel. #
Permit Fee
Fire Surcharge
State 5urcharge
SAC Charge
License Surcha.rge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Gharge
TOTAL
�.� ' , i�
$
$ �,
$
� � �C�
$
$
$
$
��-��c�
�
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,� Valuation
$900 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessar3► [ ] Not Necessary [ ]
STIPULATIONS:
-. ,
BUII.DING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for
any addition to any existing building or structure, or for any alteration or repair to any existing building or
structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount
herein below set forth and in the manner herein provided to-wit:
TOTAL VALUE
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $500,000
3,�C�,'I �
z �- �,�
j 1 �'
$500,001 to $1,000,000
$1,000,001 and up
FEES
$21 (Minimum Fee is $21 plus surcharge)
$21 for first $500 plus $2.75 for each additional$100 or
fraction thereof, to and including $2,000
$62.25 for first $2,0� plus $12.50 for each additional $1,0�
or fraction thereof, to and including $25,000
$349.75 for first $25,0{l0 plus $9.(� for each additional $1,000
or fraction thereof, to and including $50,000
$574.75 for first $SO,OQO plus $b.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,D00 or fraction thereof, to and including $500,000
$2887.25 for the first $500,000 plus $4.25 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$5012.25 for the first $1,�0,000 plus $2.75 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCRO�V
(Concrete Curb Streets Only)
Altemate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50.
Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $15.75.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed
will be required before proceeding with the framing.
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_�_ .� ...� —�__�_____� R� _
sue�ecT ERMIT NO.
c�ty of Fridley 2 7 4 6 2
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
� � R .
� 1 v�____ COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC. �/ ��
� _ , 10
l---_� �����,•, CITY HALL FRIDLE� SS032 NUMBER REV OATE VAGE OF APPROVEO BY
� 612-571-3450 s�aF�S 8 31 98 � �
JOB ADDRESS
7311 Jackson Street NE
1 LEGAL �OT NO. BLOCK TRACT OFi ADDITION SEE ATTACNED
DESCF. 1(� 1� Melod Manor 3rd Addition SHEET
2 PROPERTY OWNER MAII ADDRES$ ZIP PNONE
Jan Coo er 784-2525
3 CONTqACTOR MAIL ADDRESS IIP PHONE LICENSE NO.
Dahl Bldrs. & Remodelers
A ARCHITECT OR DESIGNER MAIL ADDRESS 21P PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS IIP PHONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION O ALTERATION � REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Reroof house and ara e 24 S Tear-off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMB�NG, FIEATIN(i, TYPE OF CONST. OCCUPANCY (3ROUP OCCUPANCV LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOIO IF WORK Oq CONSTRUCTION ZONINd 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
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE REAO AND EXAMINED THIS APPLICATION STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PpOVISIONS OF LAWS yAIUATION SURTAX
AND ORDINANCES GOVEfiNING THIS TVPE OF WORK WI�L BE COMPLIED
WITH WHETHER SPECIFIED MEREIN OR NOT. THE GiiANTING OF A pERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL TNE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTMER STATE OR LOCAI LAW REGUTATINCa CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
����� LAN CHECK FEE TOTA FEE
� L cense 5.00 2.75
SIGNATURE OF CONiRACTOR OR AUTMORIZED AGENT IDATEI N P OPE Y ALIDA D HIS IS V UR PER T
1 �
SiGNATUREOFOWNERiiFOWNFRBUILDERi IOATEI Bl �NSp p�TE
.
NEW �[ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [] SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2 � a`
BUILDING PERNIIT APPLICATION �a
l � �
ConstructionAddress: � � � ��,�'j%( ��
Legal Description:
Owner Name & Address: r���Q�./ �'/��� � �� � �//�",�(, ��� Tel. # �� -
Contractor: ,�j4�% � ��"��� �' ����L%S MN LICENSE � �/��7 %�
Address:�/ ��� Si� Tel. # ������ �
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
Length
Length
Length
DESCRIPTION OF IlVIPROVEMENT
Width
Width
Width
Height
Height
Hgt/Ground
�
Sq. Ft.
Sq. Ft.
Sq. Ft.
�rr "
Construction Type: d(� Estimated Cost: $ .�, � �� �� � /
(Fee Schedule on Back)
Driveway Curb Cut Width Needed:
DATE: � � APPLICANT:
Permit Fee $ �� - `% ^
Fire Surcharge $ � U G'
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
Ft. + 6 Ft = Ft x$ _$
Tel. �t ���—����
CITY USE ONLY
Fee Schedule on Reverse Side
001 of Permit Valuation (1/lOth%)
$ /, G� C� $.50/$1,000 Valuation
$
$
$
$
$
$
$1000 per SAC Unit
.� [�C� $5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
�
� �a 7�
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
� �
BUII.,DING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for
any addition to any existing building or structure, or for any alteration or repair to any existing building or
structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount
herein below set forth and in the manner herein provided to-wit:
TOTAL VALUE
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25,OOlto $50,000
$50,001 to $100,000
$100,001 to $500,000
$500,001 to $1,000,000
$1,000,001 and up
FEES
$21 (Minimum Fee is $21 plus surcharge)
$21 for first $500 plus $2.75 for each additional $100 or
fraction thereof, to and including $2,000
$62.25 for first $2,000 plus $12.50 for each additional $1,000
or fraction thereof, to and including $25,000
$349.75 for first $25,000 plus $9.00 for each additional $1,000
or fraction thereof, to and including $50,000
$574.75 for first $50,000 plus $6.25 for each additional
$1,000 or fraction thereof, to and including $100,000
$887.25 for first $100,000 plus $5.00 for each additional
$1,000 or fraction thereof, to and including $500,000
$2887.25 for the first $SOO,OOU plus $4.25 for each additional
$1,000 or fraction thereof, to and including $1,Q00,000
$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)
Altemate "A" : Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50.
Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $15.75.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed
will be required before proceeding with the framing.
Building
Inspections
763-572-3604
DATE�
SI7'E ADDRESS _
THIS APPLICAN7' iS:
-i❑
PROPERTY OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
WITH APPLICATION
PROPERTY TYPE
PERMIT TYPE
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
YOUR E-MAIL
❑CONTRACTOR
Permit No.:
Received By: f�i� �C° $
Date Rec'd: � "� ���+
ADDRESS: CITY STATE ZIP
PHONE:
STATE LICENSE #
EXP DATE
ADDRESS: CITY STATE ZIP
❑ SINGLE FAMILYME
� TWO FAMILY/NEW
O BASEMENT FINISH
❑ DECK
TYPE OF WORK: � ��'�'
❑ 1v�anv�
DESCRIBE WORK BEING DONE:
SIZE OF IMPROVEMENT
ROOFING
NUMBER OF SQUARES
GARAGES
PROPOSED SIZE:
PROPOSED I-IEIGHT:
SIDING
❑ Vinyl
❑ Aluminum
❑ Other
❑ ROOF
❑ SIDING
❑ SWIMM
r��.�
C�R
❑ HOUSE ONLY
O HOUSE & GARAGE
❑ ATTACHED GARAGE
❑ DETACI-�D GARAGE
�Soffit
❑ Trim
❑ Fascia
WINDOWS
IN F.JQSTING OPENINGS OYes ONo LOCATION OF WINDOWS
OR FOR NEW OPENMGS-DESCRIBE SIZE OF
OPENING CHANGES &
O DRAIN TILE
❑ OTHER
HEIGHT
BASEMENT REMODELING SUBMIT•
1. Existing Floor Plan
2. Proposed fl�r plan
3. List of strucwral members to be used
Ft.
FOR NEW CONSTRUCI'ION INCLUDING DECKS,
ADDITIONS. & PORCHES SUBMIT•
1. Site PIan/Survey showing the existing strvcwres
and praposed project
2. Two sets of construction plans
3. Energy Calculations
TYPE OF WINDOW TO BE IIVSTALLED NUMBER OF WINDOWS �
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ OCCUPANCY TYPE
Permit Fee
Plan Review
Fire Sutcharge
Surcharge
License Surcharge
SAC Chaz e
urb Cut Escrow
rosion Control
Park Fee
Sewer Main Charge
Total Due
$
$
$
$
$
$
$ �50.��
$
$
See Back Page for Fee Schedule
65% of Building Permit Fee
.001 times the total job valuarion
.0005 x Permit Valuation Minimum $.50
$5.00 (State Licensed Residential Contractors)
$1550 per SAC Unit (Plans to MWCC for determinarion) `(���
`�ft+6ft= Oo-1� 1�it�D21 =,$�r
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make c6ecks payable to: City of Fridlev Attach SNn�latinns
THIS IS AN APPLICATION FOR A PERMTf-NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I aclaiowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a
permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved
plan in the case of all work which requires review and approval of plans.
SIGNATURE OF APPLICANT PRINT NAME DATE
Page 2- Building Residential Application
.:= ��
BUILDING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or
structure, or for any a.ddition to any existing building or stxucture, 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:
VERIFICATION OF FOUNDATION
Permits for constru.ction will be issued a minimum of 24 hours from the time of application to
allow for proper review of proposed structure and of the construction site.
A Certifica.te of Survey of the lot, showing the location of the existing foundation will be
required before proceeding with the framing. New Houses Onlv
City of Fridley
Building Inspections Department
6431 University Avenue NE
Fridley, MN 55432
763-572-3604
Fax: 763-502-4977
3uilding
rnspections
763-�7� �604
;�- =
�ITE ADDRESS
fHIS APPLICANT IS:
PROPERTY OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
VdITH APPLICATTON
PROPERTY TYPE
PERMTT TYPE
TYPE OF WORK:
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
&MAIL ADDRESS
�OWNER ❑CONTRACTOR
NAME:
STATE LICENSE
FJ� DATE
Perniit No. • � �"����
Received By:
Date Rec'd: �d �R ���-�
� ��.� �--
ADDRESS: CITY STATE ZIP
PHONE FAX
❑ TV✓O FAMILYMEW CONSTRUCfION
0 ADDITION � GARAG
O BASEMENT FINISH O ROOF
O DECK ❑ SIDING
n
❑ DRAIN TILE
'�77-IER
DESCRIBE WORK BEING DONE: (�l
SIZE OF A�PROVEMENT LENGTH WIDTH HEIGHT Sq. Ft
NUMBER OF SQUARES _
GARAGFS
PROPOSED SIZE:
PROPOSED HEIGHT:
❑ HOUSE & GARAGE
O ATfACHED GARAGE
❑ DEfACi�D GARAGE
aASEMENT REMODELING SLIBMIT:
1. Existing Floor Plan
2. Proposed floor plan
3. List of struedual members to be used
SIDING FOR NEW CONSTRUCTIOAI INCLUDING DECKS,
O Vinyl OSoffrt ADDITIONS, 8e PORCI�S SUBNIIT:
❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing struc4ues
❑ Other ❑ FBscia and proposed project
�WS 2. Two sEts of c:onswction pians
IN E3QSTIIJG OPENWGS �Yes ONo IACATION OF WINDOWS 3. Energy Caiculations
OR FOR NEW OPIIJII�iGS-DESCRIBE SIZE OF
OPENWG CHANGES &
TYPE OF oVW�W TO BE INSTALLED NIJMBER OF WAIDOWS
ALL FEES ARE BASED O1V VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ OCCUPANCY TYPE
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
ClII'b CUL ESCIOW
Erosion Control
Pazk Fee
Sewer Main Chazge
Total Due
$ See Back Page for Fee Schedule
$ 65% of Building Permit Fee
$ .001 times the total job valuation
$ .0005 x Permit Valuation Minimum $.50
$ $5.00 (State Licensed Residential Contractors)
$ $1550 per SAC Unit (Plans to MWCC for determination) ,�!�L �)�
$ !� �0 �l��i „ ��? - a ,_ c aa. __ ����-� � � � �� ri� A - �A��
$ $450 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement necessary ( ) Non Necessary ( )
$ Make checks aavahle to: Citv of Ftidlev Attach Stiaulations
Tl-IIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I aclaiowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a
permit but only an application for a permit and work is noi to start without a permit; that the work will be in accordance with the approved
plan in the case of all work which requires review and,appraval of plans.
SIGNATURE OF APPLICANT .� I�iQ C�� �iRINT �►ME � DATE 0���`��
Page 2- Building Residential Applica.tion
BUILDING PERMIT FEE SCHEDULE "��'�� �
- -�,
The Chief Building Official shall, before issuing permits for the erection of any building or
structure, or for any addition to any existing building or structure, or for any alteraxion 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:
VERIFICATION OF FOUNDATION
Perm.its for construction will be issued a minimum of 24 hours from the time of application to
allow for proper re�+iew of proposed structure and of the construction site.
A Certificate of Survey of the lot, showi.ng the location of the existing founda.tion will be
requir� before proceeding with the framing. New Houses Onlv
City of Fridley
Building Inspections Department
6431 University Avenue NE
Fridley, MN 55432
763-572-3604
Fax: 763-502-4977