AF - 47335City of Fridley�, in�n
6431 Univeraity Ave. 1�.E., Mianeapolie, Minn. 55432
BUILDING PERM[T
��; _ July 1, 1971
��� Peter Schalwid �d� Tri-Co Builders Inc.
Adc7r�s Address 7561 Van Buren
�
11072 ,
,
LOCATIOIV OF BUILDING
Nq 7401 g{�t Jackson Street _ Part of Lot
y� 5 Block 1 Addition or Sub-Division MP1 nr1� Manor ��,�
�ear Lot Inside Lot x Setback . 3 �� .—... Sideyard � 5.�._'�? 7'
� ae��� 875 .60 878 .60
Top of Footing
DESCRIPTION OF BUILbING
To 1� Uaed as:
_ Dwelling ��ti 53 �� 40 g��,t 17 sq, �, 1112 �, �-t,
Front Depth Hei�ht Sq. Ft Cu. F't.
•l+ype of Consiructqon Frame �.� ��23, 000: To be Completed 10/1/71
�
Reep garage slab 18" above center line of street.
In conslderai3on of the issuance to me of a�r�mit to construct the building described above, I agree to do
�he prapose3 work in accordance with the deserYptlon abq�e se�forth and in compliance with all prcfvis�tons oE
Ord�sncea oE the dty of Fridley. �(� n �. o/
$10.31 S
In consideral3on of the paymeni of a fee of $ 5� ,�rmit is hereby granted to Tri-Go B].drs •
Inc . to construct the building or addition as descxibed above. This permit is granted upon,
�the express condition that the person to whom it 3s granted and his agents, employees and workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects •to the ordinances of
FrYcIIey, Minnesota, regarding location, construcizon, altera.tion, maintenance, repair and moviug of buildiag�
�th�e� dty li.mits and this permit ma.y be revoked a t any time upon viola.tion of any of the provisions oE 8aid
,5.. i �/�-�'_.Q, �/ ��fl Ruildiag Inspector
CLARENCE BEL�SLE
N0710E:
'1'his permit does not eove� the construetion, imtallaHon for wirfng, plum6ing, gas �ieatfeg, sewer oe water. Be wre to �e
t6e Bvilding Inspeeto� fo� aeparate permhs fo� theae hems.
��
APPLIC�TION FOR BIIILDING PERMIT
CzTY OF F$IDLEY, MINNESOTA .. � � � �
OWNER'S NAME,����- �S^�, r;Ed � G✓ ! t� BUILDER �B`' l`°� ��',�e�'+��' `�"�^C�
�Dx�s ` �n�x�ss � S'���' ��'� ,��°�-�,�
LOC9TION OF BiTILDING
No. ? � / s� ,�,�� �L' �� � �o�. � �
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LOT `")� BLOCK ADDITION OR SUBDIVISION � � A E ��' �%' � �`° � .
�
COR1�lER LOT INSIDE LOT � SE�L'BACK ��� SIDEY9RD ���- i` �
�� ELEV'ATZON ��� .(e, C� TOP OF FOOTING S%�. � O
Applicant attach �o thi,a �orm Two Certificatea of Survey of Lot and
proposed bua.ldin� location drawn on these Certificates,
DESCRIP'I'ION 0� BITIJ�DING
To Be IIsed ge:
� ��
����,,�%�� �'' �,,���� j F'ront � � Depth �� Height
Square feet � � � �� Cubic Feet �,(pD�
Front Depth Hei�ht
Square feet Cubic Feet�
Type of Cons�truction � 6` Q�. °� Eatima.ted Cost ��� a'-�%' �' �
To Be Completed ,�'� C� � `° � �' �,�
The undereigned hereby ma.kes application for a permit for the work
herein specified, agree��,g to do all work in strict accordat�ce with the
City of Fridley Ordi.nances and rulin�;a of the Department o#' $ui7.dings,
and hereby dec�.axes that all the facta and rep�esentations stated in
this appliaatios� are true a.nd correcte
�'�-
D9TE � � �� L�''�'� SiGN.ATDRE :.���--�'�-�' � . , L;
.(.Schedule of Fee Costs can be foutid on the Rever�e Sideo)
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BUILDING PERMIT�FEE SC�IILE
SECTION 2a The Inspector of Buildi.nga ahall, before is�uing permits
ior the erection of any buildi:n.g or �tructure9 0� for any addition to any
existing structure or building9 or.for any alteration or repa,irs to any
ezisting building or at�ucture9 upon applYCation therefo�e, require the
p�,yment by'the appliea,nt for �ueh permit of fee� to the amount herein
below eet iorth a.nd i.n the manner herein p�ovided to-wit:
IIniform Build' Code: Type 1, 29 & 4-$1075 for each one thousand
cubic feet, or fraction thereof9 in such cubical c.nntents. Type 3& 5-
$1050 for each one thoueand cubic feeto
For the purpose of computiug feea for building permite, the cubical
c°on'tenta of a:ny�b�ilding"��addition �o` a uni�orm het�:t9th��iugYiout `'by `� �
multiplying the ground area covered from a point aix (6) inches below
the floor line of the basement or the cellar to the average height of
the upper surface or to the avera.ge height of the roof eurface of the
main gable of a pitched roof.
For repairs or alterationa to an eacietin� atructure, the fee ahall be
at the �ate of $3.00 per each iive hundred dollara ($500.00) or
fraction thereof i:n the coet of all proposed worke
In no cas� shall the fee chax ged for axay permit ae set forth in Section
2 b� less thar�, $50000
NSSSD Connectio� Chargea based on location - 9rea 1 or 2.
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LOl' 5� BLOCK�MELODY MANOR 3RD AODiTICN
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/ 6�"'+e� c�rf� j'� /hr►t lh�s �s o frue anJ tori�cf rrp,�sen�ofQain o�'o survey �'fl �t f�ovrrderi�s qf �' aibo�er cfescrYbsd �, orxl
��� n o,l'all bu►Adm9s , fihrr� � d/ ns�bi� dxrovflrmtnft .�!'ony ,�n or �n s�rri la�rd. As surr�eyad fx�r m� f�s "' _�/
SU6Ut@6�V1! ENG/NEERIIVG, INC.
F:r►�nerrs Fr Sur-reyors
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Soils Testing �����GI1G%��J lJ��'i� Minn. 5343�
CPYiI Bnglneering �� Tele�horie 78�-6066
Mvnicipal Hegfaeari�g E.IIg.��@�j=.g 8y �uTOe�OT9 Area Code 611
Mo�rtgage Loe.n Survey Yor_�� � � �C� �Ull.L���'-r,�- ,1 {�1C
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ANcJ�CA COUN"'t"1�'
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TMis is o true and correcf represent�tien of a sur�ey of �he boundories of fhe land obove described and � the
�ocation of o1l builtlings� if au�y� thereon� :add aH. viaible encroachments� if any� from or on said land. This survey is
fnode oalr in eonRectien wifh o mortgoge Ipan eow baing p�aced on fhe property aad no liabllitr ls oanvmed
e�cept to the holder o1 sueh mortgage w enr ofher i»teresf aaqvlred by the ►eason oi such martgage. It is
�trdssstood and ograed no mo�ra+�nts have baen placed for �he purpose oi establishing Io! linea or boondory
corirers. Dated tMis,�,'%� dar oi JuTq, D. 19,�
SNBUR�AN ENGINEERING, INC.
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City of Fridley
AT THE TOP OF THE TWINS
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� • COMMUNITY DEVELOPMENT DIV.
f � �r------�
� � PROTECTIVE INSPECTION SEC.
1 S �
� �"'1 � CITY HALL FRIDLEV 55432
1��_.� � �•� g12_�0-3450
SUBJECT
BU ILDING PERMIT
NUMBER REV. DATE PAGE OF
910-F15 4/3/78 � �
JOB ADDRESS �401 Jackson Street N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION
DESCR. 5 1 elody Manor 3rd Addition
2 PROPERTY OWNER MAIL ADDRESS
Peter Scha.lvzig 7401 Jackson Street N.E.
3 CONTRACTOR MAIL ADDRESS
Velner Constxuction 4633 Maryland Anenue North
4 ARCHITECT OR DESIGNER MAIL ADDRESS
5 ENGINEER
8 USE OF BUILDING
Residential
7 CLASSOFWORK
❑ NEW
8 DESCRIBE WORK
Fire Re�
9 CHANGE OP USE FROM
MAIL ADDRESS
ZIP
21P
ZI P
❑ ADDITION ❑ ALTERATION �1 REPAIR
TO
PE
° 14615
IECEIPT NO. /
APPROVED BV
SEE ATTACHED
SHEET
PHONE LICENSE NO.
537-0714
PHONE UCENSE NO.
PHONE LICENSE NO.
❑ MOVE ❑ REMOVE
PULATIONS
Ca,ll fo.r rough-in inspection befoxe covering. Obtain a11 electrical,
pliunbing, mechanical permits necessary. Install approved partical
of combustion detector. Submit any structural change detailed
drawings for approval before instaTlation.
aE��RATE PER�AITS REQUIRED FOR WiRI�G,
MEA�'1�iC� PL.UIO�BlNG AND StGI�
TYPE OF CONST.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWIG. UNITS
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED. y�`l�j � OOO
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE
PROVISI NS OF ANY OTHER ST E OR LOCAL LAW REGULATING coN- $45.00
STRU ION OR THE PERFOR A CE F CONSTRUCTION.
� PLAN CHECK FEE
SIGNATUR F CO AC OR OR AUTHORIZED AGENT TE� W H EN �'
_ �
mnwinriiocncnwniCOntl1WNFGRIIIIOFRI IDATEI . - �B�DG WSP _.
�CCUPANCY GROUP OCCUPANI
SQ. FT. CU. FT.
OFFSTREET PARKING
STALLS GARAGES
SURTAX
$7.50
SAC CHARGE
ITOTAIFEE
$52.50
LY VALIDATED THIS IS YOUR PERMIT
/C.iC�.�'`-� ___Q� ' AATE�
A
C I TY 0f= FIZ I llLCY
' APPLIC/1TIOt� FOf2 ftL'SIUf:NTI/1L IIUILDI�JG PERMITS
' ' (I�L"W, �LTL'Rl1T10PJS, IIDll17I0(JS, OR REi'A1RS) ,
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OWI��R: r L��Z �(a � e f � , T3UILllL•'R: �— L�`��� � Ci"�-� S�
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Address: ���e �,��lc��� 1V � Address: `�k�r�,�d"�,/�rZ� /1���,"'Fi��,�fC,
. Tel. No. : �� % — 0� l �
No.: Street:
LOT:
ALOCY.: ADDITIOP7 :
COI2NER LOT: INSID� LOT: SLTBACY.: SIDL•'Y71RDS:
Applica'r,t attach 'to i:his fozm �ao Certiiicates of Survey of Lot and proposed
bui.lding locatian drawn on these Certificates. .
DESCRI PTI01'd OF BUI LDI HG
3
To I3e Use1 1�s: . �
•�' • _
f��'�'� � /2. Front: Depth: � ' Height: '
r
Square reet: Cubic Feet:
Front: � Depth: � Height:
� Square Feet: Cubic Feet: '
Type of Construction: • Estimai:ed Cost: $�� •��,
7.b Be Completed: c�� �f.>j� (� /�r%�� ,
Proposed Driveway Width If I�1ew Opening Is Desired
Alt. A Alt. B
$ $
(ST� 12�VERSE SIDE OF SHEET)
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all ���ork in strict accordance with the City of
Fxidley Ordinances and rulings of the DeoarL-ment of Buildings, and hereby
decJ.ares L-hat all the facts and representatians stated in this application
are true and corrcct. See xeverse side i acldition i fozmation.
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D11TE: � � � � SIGNATURE: .
St.�pul ations :
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BUILDI�JG PERI�IIT FE� SCHEDULE
SECTION 2. The Inspector of Buildings shall, befoge issuing permits for the erection
of any building or structure, or for any addition to any existing building or stxucture,
or for any alteration or repairs to any existing building or structure, upon application
therefore, require the payment by the applicant for such permi� of fees to the amount
herein below set forth and in the manner herein provided to-wit:
NEW CONSTRUCTION: Single Family Homes and Garages: $4.00/1,000 cubic feet.
PLAN CHECK: 25 percent of building permit fee.
DRIVEWAY DEPRESSION: (Concrete Curb Streets Only)
Alternate A: Removal and replacement of concrete curb and
gutter only; Driveway width plus 6 feet x$14.50
Alternate B: Removal and replacement of concrete curb and
gutter and install a 3 foot wide approach with
6 inch depth; Driveway width plus 6 feet x$17-20
�1DDITTONAL 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 roof.
For repai.rs 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 $7.50 plus $.50 state surcharge.
_yERiFICATION OF FOUNDATION
NOTE: Permits for construction will be issued a minimimm of 24 hours from the time
of application to allow for proper review of the proposed structure and of the
construction site.
A Certi.ficate of Suzvey of the lot, showing the location of the founda.tion once it
has been constructed will be required before proc�eding with the framing.
_CERTIFICATE OF OCCUPANCY
Application for a Certificate of Occupancy shall be made ten (10) days prior to the
use or occupancy of any structure for which a building permit has been issued; and
said structure shall not be used or occupied until a Certificate of Occupancy has
been issued.
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AIR COPdDITI�PdIBVa
`AfdD EL.ECTo�lC, WC.
ADDRESS ����/ � ��G /(�'_C4�� � �,
OCCiJPANT ���� ��
HEAT LOSS DATE WTS�. IlV�Y. �' A/'
SOLD BY � �' IFd�TALLED BY
Electrical Work �y � C jn,�. �� p��� ��
TYPE OF HEAT GA FA Z FIW STEA11eq � SPACE FRl�. � iJW94 I$�ii.� O
" �0 SUBURB
is� �9
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MAKE ��'
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INPUT � (.�. c c�; -���, �a •.► � &IDB�ICE OF FIJRWA�E
W1ode1
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THERMOSTAT ��ivtrjt�.ne�... Nead PBug bm�t SIa�O �
Valve 161WD OF LINER /,,,r c�ae wno�e
Lfmit �ra� 6dood WeguYeoe�r ••—••—
Ltmit Seriing �IB4�� �tzo f/�i!' �3 x__ / Rluenber
Fan Setttng �Bal�rto� La�9Bon Insdd� p�o�e
PIlo4 Type �h8���y �onetntetlon
Pllot Make
Pilot Model ��� �en� 1Mring ✓
R(lot Ttming Dr�iH T�a3 Teg /
L. W. Cut Oft n DCOP Pfoseur� 6lghtlng Irist.
Pressure P�rcenQ �, D�to To�t�d - � • �p �
InpuQ CFH � O- a�>, c' J Pare�nt Oo ��ropany Tastle�� >
StaekTemp. /[,l" i�e►c�ngC� __ � tUr�otToatar
Foem 235 �
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� � SuB�ECT � ,
c;ty of Frid�ey y 2 8 6 6 7
;`���:���� TME TWINS gU ILDING PERMIT
COMMUNITV DEVELOPMENT OIV. NO.
i �V - ��( D
r � � PROTECTIVE INSPECTION SEC.
1 = �
� /��'1 � CITY NALI FRIDLE� SS�32 NUMBEN REV DATE PAGE Oi APVqOVEO B�
�""� � �'� 612-571-3450 910-Ft 5
11/30/98 � �
108 ADORESS
7401 Jackson Street NE
t LEGAL �OT N0. BLOCK TiiACT OR ADDITION SEE ATTACMED
oescR. 5 1 Melod Manor 3rd Addition SNEET
2 PROPERTY OWNER MAIL ADORES$ ZIP PMONE
Pete Schalwi -21
7 CONTRACTOR MAII ADDRESS tIP PMONE LICENSE NO
Ea leview Const. Inc. 2 -
4 ApCHITECT OR DESIGNER MAIL ADDRESS 21P PMONE LICENSE NO
5 ENGINEER MAII ADDRESS ZIP PFIONE LICENSE NO
8 USE Of BUILDING
Residential
7 CLASS Of WORK � REPAIR O MOVE O REMOVE
❑ NEW O AODITION ❑ ALTERATION
8 OESCRIBE WORK
Reroof house and ara e 22 S Tear-off
9 CHANQE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
SEPARATE PERMITS AqE REOUIREO fOR ELECTiiICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GHOUP OCCUPANCV LOAp
VENTILATING OR AIR CONDITIONING.
THIS PEiiM1T BECOMES NULL ANO VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT
AUTHORIZEO IS NOT COMMENCED W.ITMIN 80 OAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANOONED fOR A PERIOD OF 1� DAYS AT
ANV TtME AFTER WORK IS COMMENCED. NO. DW�G. UNITS OfFSTREET PARKING
I MEREBY CEFTIFY TMAT I HAVE READ AND EXAMINED THIS APP�ICATION STALIS GARAGES
AND KNOW TME SAME TO BE TFUE AND CORRECT. ALL PROVISIONS OF LAW$ yp�UATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
W17M WHE7MER SPECIFIEO MEREIN OR NOT. TME GRANTING Of A PERMIT $1885 �.��F
DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OF CANCEL THE pEqMIT fEE SAC CNARGE
PROVISIONS OF ANY OTHER STATE OFi LOCAL LAW REGULATING CON-
STRUCTION OR 7NE PERFOFMANCE OF CONSTRUCTION 59.SO Fire SC �1.8$
P�AN C►1ECK FEE TOTA� FEE
j� �� License SC 5.00 67.32
�:� �GNATUP OFCON'AACTOAOp0UT�10p�2E00GENT ATE� WMEN PROPERIY VALIDATED TMIS IS VOUR PERMIT
S�GN4TUAE O� OWNEAi�� OWNEABURDEpi �DATEi BIDG �NSD � pptE
�. , 4�
NEW
ADDN
ALTER
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ConstructionAddress:
Legal Description:
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
0
Effective 1/1/98
�1`�
`p �V
�� ��
Owner Name & Address: ,___ ��g ��q�a✓iaj Tel. # 7�� � a-1 �(,p
Contractor: C� . MN LICENSE �# �� '�� p'�3 _
Address: �°l 3 `� /ly � L�� Tel. # �7��— S�YG %
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 IMPROVEMENT
Length Width Height
Length Width Height
Length Width Hgt/Ground
Sq. Ft.
Sq. Ft.
Sq. Ft.
� �� /p �� _
Construction Type: ��u�� .Q i1a� -���-e' Estimated Cost: $ l C��S
�� (Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
-�.-
DATE: i 3� �' � APPLICANT: y�-- Tel. # 75�3--�� 9
CITY USE ONLY
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ � . S'"v
$ � c���
$��
$
$ � �o
$
$
$
$
$ • ��
Fee Schedule on Reverse Side
001 of Permit Valuation (1/lOth%)
$.50/$1,000 Valuation
$1000 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
a '
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 alteration or repair to any existing building or
structure, upon application therefore, require the payment by the applicant. for such permit of fees to the amount
herein below set forth and in the manner herein provided to-wit:
TOTAL VALUE
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$100, 001 to $500, 000
$500,001 to $1,000,000
$1,000,001 and up
FEES
$21 (Minimum Fee is $21 plus surcharge)
$21 for first $500 plus $2.75 for each additional $100 or
fraction thereof, to and including $2,000
$62.25 for first $2,000 plus $12.50 for each additional $1,000
or fraction thereof, to and including $25,000
$349.75 for first $25,000 plus $9.00 for each additional $1,000
or fraction thereof, to and including $50,000
$574.75 for first $50,000 plus $6.25 for each additional
$1,000 or fraction thereof, to and including $100, 000
$887.25 for first $100,000 plus $5.00 for each additional
$1,000 or fraction thereof, to and including $500,000
$2887.25 for the first $500,000 plus $4.25 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$5012.25 for the first $1,000,000 plus $2.75 for each additional
$1, 000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50.
Alternate "B" : Removal and replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $15.75.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the locatiori of the foundation once it has it has been constructed
will be required before proceeding with the framing.
• sue�eci IT NO.
c�ty of Fridle� 32018
AT THE TOP OF TNE TWINS g� � L D I N G P E R M I T
r
IPT NO..
, � � ��
� `v _ COMMUNITY DEVEIOP�ENT OIV.
r � � PqOTEC7IVE INSPECTION SEC ���� '��0
1 . i
i.-_- w;����,,� CITY HALL FRIOLE`1 SS13Z NUMBEii pEV DATfi PAGE Of AViROVEO Y
t �� 612-571-3450 910-F15 7/20/O1 / /
JOB ADDRESS 7401 Jackson Street NL
t LEGAL LOT NO. BLOCK TfiACT OR ADOITION SEE ATTACHED
oesca. 5 1 Melody Manor 3rd Addition SMEET
2 PROPERTY OWNER MAIL ADpR�S$ 21P PHONE
Pete Schalwig 7401 Jackson Street NE 763-786-2196
3 CONTRACTOR MAIL ADDRESS ZIP PMONE LICENSE NO
Lake State Remodelers 6248 Lakeland Ave N, Brookl Park, MN 55428
a ARCHITECT OR DESIGNER MAIL AOORESS 21P PMONE LICENSE NO
763-533-1544 20047296
5 ENGINEER MAIL AODFiESS 21P PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WOFiK
O NEW �1 ADDITION O ALTERATION ❑ REPAIR p MOVE O REMOVE
8 DESCRIBE WORK
Construct a 12' x 10' Deck; Remove existing 12' x 10' Deck
9 CHAN(3E OF USE FROM TO
STIPULATIONS
See notations on plan.
' �
�fore diggi'�� ���� �°e
all utili�y I��:�tions
q,�q.�d02
R��vi���► �Y �aw
TYPE OF CONST. OCCUPANCV GROUP OCCUPANCV LOAO
SEPARA7E PEIiMITS ARE REGUIqED FOR ELECTNICAL. PIUMBING, HEATIN(i,
VENTII.ATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION 20NING SO. FT CU FT.
AUTMORIZED IS NOT COMMENCED VyITHIN 80 OAYS. OR IF CONSTRUCTION ,
OR WORK IS SUSPENOED OF ABANQON�O FOR A PERIQO OF 120 DAYS AT '`
ANY TIME AFTER WORK IS COMMENCED. " NO DWLG. UNITS OffSTREET PARKING
I HEREBV CERTIFV THAT I HAVE READ AND �XAMINED TFIIS APPUCATIQN 1 STALIS GARAGES
AND KNOW TNE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS bF LAWS yALUATION SURTAX
AND OFDINANCES GOVERNING THIS TVPE Of WORK WILL B� CpMPL1E0 @ 1 32O �.66
WITH WMETHER SPECIFIED MEREIN Ofi NOT. TME GRANTING OF A PERMIT �' �
OOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CAMCEL TME pEqMIT FEE SAC CMARGE
PROVISIONS OF ANY OTHEp STATE OR LOCAI LAW REGULATING CON- SO.95 F e SC �1.32
STRUCTIO THE PERFORMANCE OF CONSTRUCTION �
PLAN CNECK FEE O L FEE
Licens C $5. 0 �$57.93
GNATUAEOFCON'AACTQFOpAUTMOA�ZEDOGENT iDATE� HE P O Y VA TED THIS VOUR PERMIT
�-�o �/
S�GNOTUAE O� OWNEA ��� OWNEp BU�LOEp� �DA�E� . �� � G�N$P � OLTE
a
0
tvEw [ l
ADDN []
ALTER [ j
Construction Address:
Legal Description:
Owner Name 8� Address:
Contractor:
Address:
LNING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMITAPPLICATION
��� �
�--,
r ��', �l �
Effective 1 /1 /2001
(763) 572-3604 Bldg Insp
�5�3�.
����m �� Tel.# ��� �Z�C� ` �l �lf�
+t� �.� � S MN UCENSE # `�i��' � � �ei C�
� � � � �`= .� S �� � �� Tel. # `�� � �- eS.3.� ° 1.�� � �
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft
Length Width
Length f � � Width � � `
Height Sq. Ft
Hgt/Ground °7 � l� Sq. Ft / Zl� .� f=
/� �y,p � /���
Construction Type: ��� ���-� fi��1,���� ��e��titnated Cost: $
Driveway Curb Cut Width Needed:��Ft. + 6 Ft = Ft x� _$
DATE: l �f� �� d APPUCANT: ,�� L��� � �° �a�`��+t L' lzvaCG ' � �
� ��' � � '�° ` �� �'el. # `7� � - .a .i � - l S
CITY USE ONLY -
Permit_Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
Call (763) 572-3604 for Permit Fees if mailing in application
$ ��• ��� Fee Schedule on Reverse Side
$ � � � .001 of Permit Valuation (1/10th%)
$ . (�r � $.50/$1,000 Valuation
$ $1150 per SAC Unit
$ �, c�C� $5.00 (State Licensed Residential Contractors)
$ Alt. "A" or Alt. "B" Above
$ $450.00 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement Necessary [ ] Not Necessary [ ]
$ °�� �
9
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
$500,001 to $1,000,(M'i0
$1,000,001 and up
FEES
$23.50
$23.50 for first $500 plus $3.05 for each additional $100 or
fraction thereof, to and including $2,0(�
$69.25 for first $2,000 plus $14.00 for each additional $1,000
or fraction thereof, to and including $25,000
$391.25 for first $25,� plus $10.10 for each additional $1,000
or fraction thereof, to and including $50,000
$643.75 for first $50,000 plus $7.00 for each additional
$1,000 or fraction thereof, to and including $100,000
$993.75 for first $100,000 plus $5.60 for each additional
$1,000 or fraction thereof, to and including $SOO,Q00
$3,233.75 for the first $500,000 plus $4.75 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$5,608.75 for the first $1,000,000 plus $3.15 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 $15.50.
Altemate "B": Removal and replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet tunes $23.25.
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 vc�ill
be required before proceeding with the framing. New Houses Onlv
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SUBURBAN EN�i1NEERING, INC.
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THE BELOW MUST BE FILLED IN WHEIV REpLqCING FUEL BURNING APPLIANCES OR THE
,� APPLICATION WILL BE RETURNED � ,
When ' ' , the undersigned hereby verifies that the
venting has been examined and is f�ee from rust, deterioration, obstructions,
and is securely supported and firestopped where required.
The venting system is plastiGPVC and meets all current codes and manufacturer
specifications inGuding sizing, length, number of elbows and termination,
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufacturers specificabons. This does
include AGA-GAMA Category I Central Fumace Venting Tables for fan
assisted and natural draft appliances.
The '' is sized and installed to meet the current codes
and manufacturers specifications.
When required to iasta�� a►,pw �emhu tie� t� it will be sized and installed
to meet the current codes and manufacturer's specifications.
When ' ' , the undersigned hereby verifies that
it is a Iisted assembly and meets the cuRent codes and manufacturers
specifications. This does include AGA-GAMA Category I Central Fumace
Venting Tables for fan assisted and natural draft appliances.
Is the common vent and vent connectors sized and installed correctly after
an appliance has been removed from the common vent and vented
separately as per current codes
Yes ( ) No ( )
Yes ( ) No ( )
Yes ( ) No ( )
Yes( ) No( )
Yes ( ) No ( )
Yes ( ) No ( )
_ �
�.. .. - .- ... .����..
- -. ... -. ...-«. . ..��. ..
Appliance #1 Type BTU Input Fan Assisted or Nat
Appliance #2 Type _ BT� lr�; u; �an qsst�ied or Nat �
Appliance #3 Type BTU Input Fan Assisted or Nat
Total Appliances TotaB Btu Input
Common Vent Type Vent Height Diameter
.__ inches
.
Appliance #1 Vent Connector Height ft Length ,_ft Diameter __.__.in Type
Appliance #2 Vent Connector Height ft Length ft Diameter_in Type
Appliance #3 Vent Connector Height ft Length ft Diameter_in Type
HEATING CO:
Signed By:
Date :
�
_
C[lYOE
FR[DLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287
May 4, 2004
Mr. Peter Schalwig
7401 Jackson St NE
Fridley, MN 55432
Re: Fina1 Inspection at 7401 Jackson St NE, Fridley
Contractor: Northwoods Mechanical
Dear Mr. Schalwig:
A plumbing permit was issued on October 22, 2003 to install a water heater at your
address. According to Section 4715.2800 of the State Plumbing Code, a final inspection
shall be conducted on the work authorized by this pernut. As of this date the inspection
has not been requested.
The permit fee that was paid covers the inspection to make sure the work was completed
according to the Code. We will keep your permit open for another 30 da.ys and if we do
not hear from you within this time to set up the inspection, we will mark the permit "no
inspection called for by homeowner after notification" and take no fiuther action.
To set up the inspection or to have any questions answered, please contact the Building
Inspection Division at (763) 572-3604.
DJ/mh
3uilding BUILDING Pernut No.: v���� ��,. D�s
_nsper$�ns RESIDENTIAL APPLICATION R�'�� By:
763-572-3604 CITY OF FRIDLEY nate Rec'a.: il� -% ���"�
3ITE ADDRESS
iNLS APPLICANT IS: O OWNER
PROPERTY OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
WITH APPLICATTOId
PROPERTY TYPE
YOUR E-MAIL ADDRESS
�CONTRACTOR
� �-a- � m
NAIv�:
STATE LICENSE �! EE7CP DATE
ADDRESS: CITY STATE Z1P
PHONE FAX
o �rwo F,v�cn.
PERNIIT TYPE o a�nDrno�a o G�G�s►�v o wnaDOws
� BASEMENT FWISH ❑ ROOF ❑ DRAIN TILE
0 DECK 0 SIDING 0 OTHER
O SWIIvBvIIIdG POOL
TYPE OF WORK: �
O
DESCRIBE �ORK BE1NG DONE:
SIZE OF
NUNBER OF SQUARES
GARAGFS
PROPOSID STZE:
PROPOSID HEIGHT:
�9Vuly1
O Ahuninwn
❑ Other
WINDOR'S
IId EXISTTNG OPEMNGS �Yes ONo
OR FOR NEW OPEMNGS-DESCRIBE STZE OF
OPENING CHANGES &
TYPE OF WWDOW TO BE IIdSTALLID
0 REMODELII�iG
� HOUSE & GARAGE
�'ATTACHED GARAGE
❑ DETACI�D GARAGE
�Soffrt
❑ Trim
❑ Fascia
LOCATION OF WINBOWS
WIDTH HEIGHT
�ASEIvl�NT REMODELING SUBMIT:
1. Existing Floor Plan
2. . Proposed floor plan
3. List of structural membeTS to lre Used
Ft�
FOR NEW CONSTRUCTION INCLUDING DECKS,
faDDITIONS. & PORCHES SUBMTf:
1. Site Plan/Survey showing the existing sTruc4ues
and proposed project
2. Two sets of construction plans
3. Energy Calculations
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCI�DULE)
TOTAL JOS VALUATION S/`% C�' ��•� OCCUPANCY TYPE �
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Emsion Control
Park Fee
Sewer Main Charge
Total Dne
$ ,� �°) _��' See Back Page for Fee Schedule
$ 65% of Building Permit Fee
$ 1��C�, .001 tunes 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)
$ ft+6ft= ftx$21=$
$ $450 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement necessary ( ) Non Necessary ( )
to: City of Fridley Attach
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I aclmowledge 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 APPLIC /,,�L�'..� e PR1NT NAME /��� ��c/!�� %�!��.DATE � C ��
Page 2- Building Residential Application .
4,
-� �
BUII..DING PERNIIT FEE SCHEDULE
The Chief Builda.ng Official shall, before issuing permits for the erection of any building or
structure, or for any ad.dition 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:
VERIFICATION OF FOUNDATION
Permits for construction will be issued. a minimum of 24 hours from the time of applica.tion to
allow for proper review of proposed stru.cture and of the construction site.
A Certificate of Survey of the lot, showi.ng the location of the existi.ng foundation will be
required before proceeding with the framing. New Houses Onlv
City of Fridley
8uilding Inspections Department
6431 University Avenue NE
Fridley, MN 55432
763-572-3604
Fax: 763-502-4977
�
��
_
CIZYOF
FR[DLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-128'1
BUILDING PERMIT APPLICANT: PROPERTY OWNER
I, !��% �. ��✓�,��. �-%�understand that the State of Minnesota
requires that ail residential building contractors, remodelers and roofers obtain a state
license unless they qualify for a specific exemption from the licensing requirements. As
the owner of the property at ���„���� ����l .� T� , Fridley, I
am exempt from the state licensing requirement only if I am not building or improving
this property for purposes of resale. By signing this document, I attest to the fact that t
am improving this house for my own use and do not intend to sell it. I hereby claim to
be exempt from the state licensing requirements because I am not in the business of
building or remodeling on speculation or for resale and that the house for which I am
applying for this permit, isl the first residential structure I have built or improved in the
past 24 months. I also acknowledge that because I do not have a state license, I forfeit
any mechanic's lien rights to which I may otherwise have been entitled under Minn.
Stat. 514.01.
Furthermore, I acknowledge that I may be hiring independent contractors to perform
certain aspects of the construction or improvement of this house and I understand that
some of these contractors may be required to be licensed by the State of Minnesota. I
understand that unlicensed residential contracting, remodeling, and/or roofing activity is
a misdemeanor under Minnesota law, and that I would forfeit my rights to
reimbursement from the Contractor's Recovery Fund in the event that any contractors I
hire are unlicensed.
I have also been informed and acknowledge that by listing myself as the contractor for
this project, I alone will be responsible to the City of Fridley for compliance with all
applicable buifding codes and city ordinances in connection with the work being
perFormed on this property.
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