AF - 47517•
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Date:
Owner:
Addi�ess
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City of Fridley, Minn. N°• � 2 0 3
BUILDING PERMIT
Spril 26, 1967
Homedale Builders
-••-._.�...__._.._..._._. _.._..___.�._..__.. Builder _..___.__.._. .--•--...___..._._.._._._.._._......_..._.._.._._.._.�.._—.
Addres$ .....__ 5217._Wa�zata _Blv_d.. ._._�._
LOCATION OF BUILDING
7599 Jackson St. N. E.
No. .._._.._._.----•--•--_..... Street _.._-----__.._--_-_-•-•._..._.__�_..._.._..__.---._......._.__.._------_ Part of Lot ._..._.�_.._.._........_.._.._—_._....
Lot _.__._$ .._...._._.__ Block ._.._._1....____..___.__._...._._. Addition or Sub-Division ....._.._Melod.y Manor 4th Addn.
x �
Corner Lot _.__......_.._._.._ Inside Lot ....._....._...........__--------. Setback .._. 35...._.._.__..._.._. Sideyard ......_...__....___..�_.._.�._..__..
Sewer Eievatian ._.._..._._ 884._ 57.------._.._____.._ .............-- -.- 887 .57
-. --------.._._. ____._.._....�__—_.__.—.
Top of Footing
To be Used as:
Dwelling Fr�nt
•-._._._.__._.._.�..._.._.__..__ Front
Frame
Type of Construction _..._..._.._.._..
DESCRIPTION OF BUILDING
._.__46_.__ Depth 24/28_ Height .....20
_.....__.._.__ Depth _.___......._._.. Height _..._..._.
..__.__.__._.._.. Es� Cost ._._$18,500.._........._
� � 1152� � � ry23,040
Sq. Ft. _.._..._....__. Cu. F'� _
To be Completed _.._ �� 15 / 67
SEWER LOCATION- 71' ftorth of Ma.nhole
WATER LOCATION- 81' North of Ma.n.hole
In consideration of the issuance to me of a permit to cons c building described above, I agree to do
th� proposed work in accordance with the description ab and in com ' ce with a11 Provisfons
ordixianc�es of the city of Fridley.
1 0.00 N.S.S.S.D. y
In co�sidera.tfon oP the payment of a fee of $._.__34;.00 � Homedale
. permit is hereby granted to.._._
Builders to constxuct the buil '
duig or addition as described above. This permit is granted upo�
the express condition �that the person to whom it is 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 orclinances oR
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at aqy time upon violation of any of the provisions o� sa�d
ordinances.
CLARENCE BELISLE g�� ���
NOTICE:
'Ihis p�neif dws not eow� tM eonqeueHon, ins�allaHon fo� wirin�. piumbin�. Oy laafi�, tww� or wN�r. B� sun te s»
fh� BuiWing Insp�c�e� h� aparat� p�nehs for fh�s� iNms.
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APPLICATION FOR BUILDING PERMIT
� CI1'Y :OF . FRID�EY, :MINNBSOTA ,
OWNER' S NAt� , � _ BUILDER :
ADDRESS AIfbRLSS��
L TIOAi OF BOILDII�G �
N0. i�'% ��� STREE'P PART OF LOT �
LCr.� B�.00K � ADDIZTON OR SUBDIVISION '� ""� �
CORNER LOT INSIDE LOT !� SETBACK ���� SID&-YARD
SEWER ELEVATIO'N
i
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Applicant attach to this form Two Certificate �f` Survey
building location drawn on these Certificates.
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CVC��I/ � / � d�t . %%'liCt i 2 d � � -t ..�. '
�' DBSCRIPTION OF BUiLDING
Ia�7
Lot and proposed
To be used as; � �
4 '`T � Depth-�f�2��`�Height .%Y�
Front
Sq. Ft . /���� Cu. Ft .��Q .�`d
_ %�/d ��/ °�'_� Front Dept ,_,Height
Sq. Ft. Cu. Ft.
Type of Constructi� .��„�!�/y��- , Estimated Cost f���
.
To be completed
�� �
The undereigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City of
Fridley"Ordinances and rul3ngs of the pepartme�t.of Buildings, and hereby
declares that alI the facta snd repreeeatations stated in this application
are true and correct.
DATE � (� SIGNATURE
(Schedule of Fee Costs can be found on the Reversa Side)
� r ty �.-_- .
� 'C,� t �,"�. � � i c f C �c.. c c�` � 'i S . � /".� , a�,°O : /t/ �, � � � ,
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Application for Power Plants and Heating, Cooling. Yentitation. Re�igerration and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: RATE TOTAL
Furnace Shell & Duct Work . . . . . . . . . . . . . . ... . . . . . . . . . . 8.00 �
Replacement of Furnace ............................. 5.00 �
Repairs & Alterations—up to $500.00 . . . . . . . . . . . . . . . . . . 5.00 $
Repairs & Alterations each add. �500.00 . . . . . . . . . . . . . .. 2.5U $
MECH. WARM AIR
Furnace Shell & I?uct Work to 120,OOQ BTIJ . . . . . . . . . . . ,
each add. 60,000 BTiJ . ... ......... ... ... . .. .
Replacement of Furnace .............................
Repairs & Alterations—up to $500.00 .................
Repairs & Alterations each add. $500.00 . ... ... .. . . . ..
� �d ✓
� $
2.00 �
5.00 $
5.00 $
2.50 $
STEAM or HOT WA1'ER SYSTEM
Furnace Shell & Lines—ta 400 sq, ft. EDR Steam ...... 8.00 $
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $
Each add. 200 sq. ft. EDR Steam . . . . . . . . . . . . . . . . . . . . . . 2.50 $
Each add. 320 sq. ft. EDR Hot Water . . . . . . . . . . . . . . . . . . 2.50 $
OIL BURNER—to 3 gal. per hour . . . . . . . . . . . . . . . . . . . . . . . 5.00 $
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 400,000 BTU) . . . . . . . . . . . .. . . . . . . . . . . 5.00 $ ✓
GAS FITTING FEES: NO 2�QATE TOTAL
lst 3 Fixtures . . . . . . . x $�ia(} $ "�
Additional Fixtures ................. x .50 $
Gas Range to 200,000 BTU . . . . . . . . . . . x 2.00 $
AIR CONDITIONING �,
FAN HEATING SYSTEM See Fee Schedule
VENTILATING $YSTEM ;
ALTERATIONS 8c REPAIRS TOTAL FEE �����
ROUGH
FINAL
Dep4. of Bldgs. Phone 560-3450
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City of Fridley: �'
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City Ordinances
and ruling of the Department of Buildings, and hereby declares that all the facts
and representations stated in this application are true and correct.
Owner
Kind of Building _
Used as ,%1'X-�A.0
To be completed about
Estimated Cost, $�
Permit No. ��D � Pezmit No� (J G�
DESCRIPTION OF WORK
HEATING or R team, Hot Wa Warm �. �
Trade Name � �_�,E-���������� �t.,� Size No. L, �i�/ � f_
Capacity Sq. E't. E.D.R .�� ��� BTLJ H.P.
Total Connected Load ��• ,'�% 6� Kind of Fue `' ����� -'
BURNER — Trade Name Size No.
Capacity.
(REMARKS-pYER)
��<z
Sq. F't. E.D.R BTLT H.P.
RAY N. WELTER HEAT{Nt; Cp7
ign 4637 CHICAGO AVE.
SMINNEA►POL19 7. MINN O /+�
B4' _ -C'��� �C L "
Business Phone No- �2f r" L��° �
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! ' City of Fridley
App�iccrrion for Ph�mbing and Gas Fitting Pern�it
Dept. of Bldgs. Phone 560-3450
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures
Cf I� I� � I � I ? I3 � lo � I; lo o Ic� ��< 3 I� d I� �a �u O
Base
lst ( �
2nd
3rd
4th _
• Future Connsction Openings
* New Fixlure, Old Openiags
PARTIAL RATE SCHEDULE
WATER HTR.
• t
F N GAS ELEC.
Sewes �
cesspoot n
PLUMBING FIBTURE RATES: NiO. RATE TOTAL
Number Fixtures ....... �
. . . . . . . . . . . . . —�---_ x $2.00 $ �
Future Fixture Opening ................ x $1.50 $
New Fixture Old Opening . . . . . . . . . . . . . . x $1.50 $
Catch Basin . . . . . . . . . . . . . . . . . . . . . . . . . . . x $325 $
Water Heater (Up to 99,000 BTCT) ..... .� x$3.00 $ 3�
New Ground Run Old Bldg. . . . . . . . . . . . . x $3.25 $
Electric Water Heater s $2.00 $
GAS FITTING FEES: NO. RATE TOTAL
lst 3 Fixtures $ � • �
.......................... x �2.00
Additional FYxtures . . . . . . . . . . . . . . . . . . . . x $ .75 $
Gas RanBe to 199>000 BTLJ . . . . . . . . . . . . . .
REPAIRS & ALTERATIONS—Refer to Code
x $5.00 �
Description ................................................$
TOTAL F'EE # ` —
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City of Fridiey:
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The undersigned hereby makes application for a permit for the work herei
specified, agreeing to do all work in strict accordance with the City Ordinance
and ruling of the Department of Buildings, and hereby declares that all the facl
and representations stated in this application are tr and rect.
� �'ridley, Minn _ _ �---'.�'��e�� , 19_
Owner �L���� �
Kirid of Building �
Used as
To be completed about
_ �'fi
Estimated Cost, $ °�''`
� a � � � G'
Old—New. Building Permit No. Permit No.
S,gne l.�7'/'�/�11���v/1P���l�j
By
Business Phone No. 'Z �
ROUGH �i�" Z 2 " � �I
FINAL
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City of Fridley, Minn.
BUILDING PERMIT
Date: _._.... �une__23� 1967 ...�___._._.._...�.._._.._.__
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N� 9333
pwner; _.Homedale Blders �___ __ A. B. C. Blacktop Co.
. Builder _._..__._.._ ._.._._._....__....____�_.._...._... .._._
Address _-.�.���.._.�.�Z.�Wa.,yzata_Blvd.__.._.._...____ Address .�1308 Ma.in St.... N-_.E. _
LOCATION OF BUILDING
No. _._.7.5.�.2._�.. Street ._._.._........ J a cks on __St..�.. N�. E�...._..._...-----._._.... Part of Lot ._____—
Lot ._._8____._..._ Block _._.__1..--_-------_- -- Melod Ma.nor 4th
- -• ----__ Addition or Sub-Division --------_._..._.._�.�...._._._._._
Corner Lot �_._......_..__ Inside Lot ...._.._._..----....___._.._. Setback _._...._.__._...—.___._ Sideyard ...__._._..._..
Sewer Elevati� _._.._..._._.._._____...._.._.___.._...�____.._.___._ Foundation Elevation _.�._�.._ ._...
To be vsed as:
DESCRIPTION OF BUILDING
Front �.._..._.� DePth _.._.._._..._ Height .__..._.___. Sq. F't. ..._.. Cu. FL
_._.._......_...�_.._..._._........_. Front _..._______ Depth _._._.�.._ I�eight _.._...._......_ Sq. E't. __.. Cu. 1�`t.
Type of Construction Aspha�t . Drive __. �t. Cost _....��.83•_25._....______.._ To ibe Completed __ July 7� 1967
In consideration of the issuance to me of a permit to consiruct the building described above, I agree to cio
th� proposed work in accordance with the description above ,�et f� in compliance with all pro�viaions of
ordinances of the dty of FridleY• 7
In coa�sideration of the payment of a fee of �..._. 5• 00 _, permit is hereby granted to A,y,�,,, C.
$lackto Co. duig or addition as described above. This rmit is granted upott
_Q... __....__._.___. to construct the bufl ' pe
the express condition that the person to whora it is granted and his agents, employees and workmen, in all wark.
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordit►auoes oR
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buil
within the dty limits and this permit xnay be revoked at ar�y time upon violation of any of the provisions of d
ordivances.
M �N :� '1 . � ���•
NOTICE:
TMs p�rmit doa not eowr th� eonpruelba, tnshllaNen fo� wieina, pluadiia9, yn MNin�. aw�r er wN�r. d� ain fe �
th� euildiog Insp�efor fe� s�p��ah p�rmifs fo� fh�a h�ms.
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APFLICATIDN FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER' S NAME f� o m c= D/-1 L L-� /�_��,� F R BUILDER �- %�- C�/� L� e�To�° �c3
ADDRESS l�' T? CIi'3'l L3� L L�T ADDRESS %3a$"- �%1l9/ ru ST, lU �.
LOCATION OF BUILDING
N0. �� � 9� STREET ��}�-f�S 0 n/ Si� PtJ �� PART OF� LOT _
LOT P BLOCK / ADDTTION OR SUBDIVISION �Z-�-�� 9���z�'� •`�l ��
CORNER LOT INSIDE LOT ' SETBACK
SEWER-ELEVATION
TOP OF FOOTING
SIDE-YARD
Applicant attach to this form two c.ertificates of survey of lot and proposed
building location drawn on these two certificates.
To be Used as:
DESCIPTIDN OF BUILDING
-`Front Depth
Sq. Ft.
Front
Height
Cu. Ft.
Depth Height_
Sq. Ft Cu. Ft. _ _
Type of Construction /*S ff�-L'T �J R�v��v Estimated Cost �g3 ��'�
�T�
To Be Completed ` c.� �.
The undersigned hereby makes application for a permit for the work herein specified,
agreeing to do all work in str�ct accordance with the City of Fridley Qrdinances
and ruling of the Department of Buildings, and hereby declares that all the facts
and representations stated in this application are true and correct.
DATE � ,,c�z /� SIGNATURE �� � � - CP• •�',. `-0'
(Schedu e of Fee Costs can be found on the Reverse Side).
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HOUSE HEATING TEST RECORD
ADDRESS ��,�� �Q�'c��'�-�'-.'-' ��� APT. .,F��� O�R Ci S B RB
OCCUPANT OWNER _..,�'4� � �
HEAT LOSS DATE HTG. tNST. GAS C0. METER BAD
SOLD BY INSTALLED BY ����� �
Electrieol Work By Gas Lins By
TYPE OF HEAT GA FA HW S7EAM SPACE HTR. UNiT HTR. OTHER
G ES �� j�--� � CONVERSION
MAKE ,��-m �.Y��C-'--�'-�� - MAKE OF BURNER
Mod�i / �S" „�/' " Z.-- Modei
Sxial r,',�������rL,� �"�--��'�- Mox. 8TU Rating
iNPUT LL�S�f / MAKE OF FURNACE
Mod�l
QNTROLS 1/
THERMOSTAT �p� Haot Plug V�nt 5ize
Vaive ��l_.e7 r�� ,J� KIND OF LINER ZE NONE
Limit �� 3�17'�-'�-�� Droft Hood Reyulomr
Limit S�fting �� Filters Sise Number
Fan Setting ��_-"� Chimnsy Location inside �Outside
Pilot Type Chimnsy Construetion
Pilot Make � �
Pilot Modei ' Smoke Bomb W�►��9
Pilot Timing �'�-> Draft �� �" Test Toy
L.W. Cut Off �/ Door Preasure Lightin9 (nst.
Prossure - 2! �� �P—�jree �t Q � `� Dote Tssted "" "'"
Input CFH ��- �_ F�iF��t d� Company Testing �f�^�
� �'- � Name of Tester
St�ack Temp. •� r Perce�t CO af? R-✓� 4"
Fwm 235
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City of Fridley, Minn.
BUILDING PERMIT
August 12, 1968
Date: _._.._._..._..__._.__�.._.�
Owner: � Anton A. Didling �� ��A.�� Builder _Same`
7599 Jackson St. N. E. Same
Address_..._.__._.._...._._.._.�__._._,...._.__._..__.__.._....____..._----.._ Address �
�� �s �
�� 9883
LOCATION OF BUILDING
No. _---.....7599....._. Street _._..._� Jackson...St.. N.._�_...._..._...-.---_..._......._._. Part of Lot _.__.._.__._._..._.._.�....�......_
Lot ._.._.8.__.._.....__._.__ Block _..___..._l._._..._..._.._......_._. Addition or Sub-Division -.---..._.._._� Sahffer's_. Sub .�`1 _...�._._..
Corner Lot .____..._..._.._.._ Inside Lot _.••--•---_.._.._...-----._ Setback .__.._...-••--_._�_._..__ Sideyard __._�.._.._ �
Sewer Elevatia�
Founda,tion Elevation
DESCRIPTION OF BUI6DING
To be Used as:
__...._..._..ga.�. P.Qrt....... Front _ 14 �..._. Depth ....._3 ��_ Height .__l.� �..._. Sq. F't. Cu. FL ____
_._.._.__..____._._.._.___._._ �ont __...__..._.__ Depth _.___._.__ Height ._..__.___.__ Sq. Ft. _..__....� G�1. Ft _
Type of Construction _.___._Frame.._.._._.......___ Es� Cost .._._..�350.00__..._........ To be Completed ._.._. M .r
In consideration of the issuance to me of a pexmit to cons e building
the proposed work in accordance with the description above forth �gd in ca
ordinances of the city of Fridley. �,,,r-�L- /
to do
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Ea cu�sideration of the payment of a fee of �....._ 5.00 _.__.., permit is hereby granted to._.._�ton
v
Didling to construct the building or addition as described above. This permit is granted upaa
the �express condition that thepe rson to whom it is 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 respecta to the ordinances a�
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city ]imits and this permit may be revoked at aqy time upon violation of any of the provisiona of said
ordinances.
Official
Buiiding �
Breher
NOTICE:
1Ms p�nnit do�s not eow� th� wns�eudioe. ie�tall�tion fo� wie�y, Plumbtay. yas laatiay, s�w�e or wat�r. !� sun to sN
fh� BuiWiag In�p�ero� for s�rat� p�rmhs for 1h�a iMms.
APPLICAT:tt�1 FOII HUZLD;.1�� PEilMI�
CL�TY OE '�;�. ; �$0�A
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OWNER'S �1�►ldl��� �,,:$tIXLI�� " .
ADD1t�SS� ' ,.._�.l� _. ;. f.�AD➢RF,�S,�i�sN� =.._...�, ._._:..:_..._..
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• � �" Loc�tort � suu:� . _ . . � . . �
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1.a .7 .�..r.: ...�.�.�.� � _...� �
LbT__„___,��� BI.00�t � �,,,_,�„_ ADDYTION OR �tIJBDIYI�I�. �
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.CORYi�R LOT ' _ �.�:IN3��B � L•OT�,�';;SETB�A�K�-:.,,�,r;�S�$YAAU,;,;,,r„�,. y,
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SEWF,R ETsEVAxI� T(2P OF F00'f�I� �
.�....r_.
APPli�eat ,at�ac�i- to this #o�tn 1�vo .Ce�ti€icat�a�,o.f S�rve�t. of bot sud *ropoeed
building 2ot��ioa' dri41� oa� thesa� Cer'E�:�f�aa'tes�. .: �,;� .-� �+ •
� . • • . • .+.. . ;.• ., fs,..i .
.. ' . . � . wa- �y � �{�y �w . r'� . . . . � . .
. . � . . . . • ' �iilV WLii ���V`�'T.'M'}� � _M��N�' .. . �- . ' . � . . ' ' '
.. - � ' , .. . � ' . . �� . . . � . � - � .. ' .. . _ . . . l. .s . . • . � ' .. .
To Be Used Aa .� - ' ' ' ' . •r . . • ,.
� � � . .�.: :
� bY'� F.roaatt � `� Depth� --.�•v .r ��i,g�t � "
. . � —�-�--. ..�..�.���r. - ..._..........:,.�.
. . ' . i .. . . . . . � � , . ' . ' 4 • . . � .. •
, . " .. . ., , Sqcu�re feeC .: : ' : � . Cub� �wet�.. � - — _..._..
. £ .. `:l.� �_ , _
, �'�la� • D�pth ���'�:.,t, ;
, . . ..., • , . _. .,�• �� � . • . r. , . . • .. �� .
Square feet Ct�bic ,l��t � .
� .�.:;:.._.__ _ _ __..
?� +�!' C�etsCru�C� � �� •�stianate�• Qt»t - �� ��` , ..
_.�._ �.
To Be Completed_�,,,� _�����
The undersigned hereby makes application fox �. perauLt fo�t the �ork herein
specified, agreeing to do all work in strict accordaace with Che Citq of
Fridiey Ord�.aances aad rulin�s of the Aepartment of Buildings, and hereby
declares thaC all the facts aad representations stated in thia 4pplicatiott
are true and correct. �
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DATE �� " � oG .- �p��SIC�NATiTRE „Q.,,,_ _ .
(Schedule of Fee Costs ceA be found on tbe Reverse Sidej.
������5�� �
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� BUILDII�G PERMiT FEE SCHEDt3L8
.. . ... .._ ,., -
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. SECTION�2. ` �3`he Ins ect�or �f��Bis�lt�iri`��
p �s° sh�li, be'�c3r+� i�Auing `permiC� for
the er�cti+�n of +�ny building or structure; or ���or �tny additicm to any
existing str�cture or building, or fer ariy alt�ration �ar �ep�.irs� to any
exi�ting building oY s�tu�ture, upon application th�refore, require the
the payment by the applicant''f�ir such permft of f�es to the amount herein
below set £orth and�.' ia the �anner herin prpvided to-wie; �� _- •�� --- --
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U�iifo�m�uildin� Cade: Type I, Z, b 4- $1.75 for each csne thousend cubic
feeC, �r fraction thereof, ia euch ctr�b�ical contents. Type 3� 5- $1.50 for
each oue thouaaad cubic feet. �� •-. . . •
' . .. � ' � . '. . . 3 .. � . . .
/1 . , . . . .. .
F�r the ��►us�c�ae ef camp�iting fe�s •for-bt���ld�ng�`permi[s, ��e cubi�el
contents e# any build�ix�g -;or addition t� a u�iforai heigtit" thxaighaut by
multipiying the ground area covered fr�m•a pQi�t six�(6}.;,�inches below the floc-
line •f 3�t�e base'ment :ar, tfie::celiar ts the average height of � the upper surface
or t� the average height ef the roof gurface'�f the��in �able.of a
pitched roof. � . . •
.- •
, � .. . .�
Fer repairs or aLteratidas` to ari�existing`atructuse, the fee shall be at the
rate of $3.0� per each five hundred dollars ($500.�0) or fraction thereof
i�.the cost �f all�proposed work. �
. . . . ... . .;
In no case ehall ehe Eee'�charged for•-axiy�permit as aet .forth ia Section 2 be
less than $S:oO.... � .
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NSSSD�,:C�aaeeXion Charges based oa.ic�atl�n- A�ea 1 or 2.
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sue�ecr PE NO.
City of Fridley ° 1410
AT THE TOP OF THE TWINS g U I L D I N G P E R M
r
� � RECEIPT NO.
( 1 L�����_ COMMUNITY DEVEIOPMENT DIY.
r � � PROTECTIVE INSPEC710N SEC.
1 . �
i____ � �/'��1,,� CITY HALL FRIDLEY 55432 NUMBER REV, DATE PAGE OF APPflOVED BY
Z � � 612-560-3450
910-F15 5/26/77 � /
10B ADDRESS 7599 Jackson Street N. E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATT�ICHED
DESCR. S 1 Melody Manor 4th Addition sHeer
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Rr�y Warner 7599 Jackson Street N.E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAII ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAII ADORESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW C� ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRBE WORK
Construct a 20' x 24' Ga.rage (attached to house)
n+��aiE • 1
�.EC�tKrc.
9 CHANGE QF USE FROM T� ��^�D �Y �w
STIPULATIONS provide a hard surface driveway. Provide visual access to existing
pier footings or install complete new frost footing.
SEPE�tATE P'ERMitS REQUIREO F�[i WtRtNG,
NEaTIr�,.. Pt�UNA�ING •�1tvo � S16NS.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY �OAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING. WOOC� Frame
THIS PERMIT BECOMES NULL AND VOID IF WORK OR COfVSTRUCTiON ZONING SQ. FT. CU. FT.
AUTHORIZEO IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OFi ABANDONED FOR A PERIOD OF 120 DAYS AT R—]. 4SO �iHOO
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE fiEAD AND EXAMINED THIS APPLICATION 1 STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPI.IED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRAiVTIIYG OF A PERMIT S3� 5S2 ��..%S
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $�.9. ZO
PLAN CHECKFEE TOTALFEE
$20.98
SIGNATUREOFCONTRAC70RORAUTHORIZEDAGENT Ion7E� WHEN PR PERLY VALIDATED THIS IS YOUR PERMIT
� s � � - � � � � � ab -��
� SiGNATURE O NER UF OWNER BUILDERI IDATEI „ � BLDG �NSP —_ DATE r—�
CITY OF FRIDLEY �
APPLICATION FOR RcSIBEf�fTIWL Bl1It_DING PERt�{ITS
�NEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
OWfdER: �m � �� �Q �(I {z' l� �UILDER: ��� F
Address :%J q� ���C l�CS� N S�• Address :
Tel . No . ' 7 � �"' � 3 �8
No. :�,�'�' � Street: ��q c kSa N ST_ �
LOT: � BLOCK: �_ ADDITION: �I�Z��d y /�%��JDR y�/i� 14DQ_
CORNER LOT: IN5IDE IAT: 5;TBACK: SIDEYARDS:
Applica.nt attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates. �
r
DESCRIPTION OF BUILDING
To Be Used As:
�' E� (� J'4 � �' Front: � p f Depth: .� � ( Height: �O ' .
f'7'.U[JYV . rv �� Square Feet: �O Cubic Feet: �j�
Front: Depth: Height:
Square Feet: Cubic Feet:
Type of Construction: [p��op f i?<A I'�1 � Estimated Cost: $ 3 SSZ
Zb Be CompZeted: `p � �p N��y�s
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired $ $
(SEE REVERSE SIDE OF SHEET)
The unclersigned hereby makes application tor a permit for the work herein
specified, agreeing to do all work in strict accordance with the City of
Fridley Ordinances and rulings of the Department of Buildings, and hereby
declares that all the facts and representations stated in this application
are true and correct. See reverse side for additional information.
DATE: �^ � � — 7 , SIGNATURE: L� �
Stipulations: � �j � �7` �
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9- � ° ��,�..c, v,� a�c� j ,,�, ,�. �;y�,,,�,�
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� � - oUENOTES ti20N '^—�D�NdT�S dRA�N1>GE .4tV� UT��1TY EASEMENT
� ���` $� �LbCK �. S�.'S���DY %/';ANOR 4jH ADO1TtON _
A1�fOKA CEKlNTY
��i�'rGy �er'��°y ��iirs rs a fi�e a�d tarrtrf r��sonfofrian �('a su-rey �'�fir ba.+d�rirs �'�r �bsrr a�su+ied lw�d,wad
: c�'1� bac4i� a�'�rlt drNklrys . lbrr-tur , wad ar'1 �srbtt t►K naorJ�rrrrlfs . �!',nay ,�i�arn ar �rt ss+d knd. A� surrr�rd b�r r mt ihts� —' d�
g(' .�5���.c �_D r�s..
' SUB URBAN ENGlNEEQING , INC.
��s 6- sur-.jeyors f,
t�_ `f`` �.j -°i �� _ .�
_
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AGREEMENT
I, :
, owner ot the property located
at p .
•�-. have no objection to the City allowa.nq
the construction of a�`�e�'�n AR F ta be located at �]�' �' 9
G�ISO,CJ S'�` without the required certificate of s�vey that the
City ordinarily requires for all new construetion.
�
Signat�re
- � . . . . � � � � 6 � � . . �
Addr s �
� � S 7
� �� n � Da�e
4 '� Ct% a
Witness
,.
3uiiding
'=nspections
763-572-3604
)ATE � � L��,c�
�ITE ADDRESS —7 S�� �;
i'HtS APPLICANT IS:
PROPERTY OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
WITH APPLICATION
PROPERTY TYPE
PERMIT TYPE
TYPE OF WORK:
BUILDING 3d /� I Permit No.
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
Received By:
Date Rec'd:
YOUR E-MAIL ADDRESS �mC[:+�,Y �fX (.'V CQ�'�V ILl�YY1C�Y� �(�i�fY1
�L� C_1�SF'�'1 JtYt CT� Nb
�.OWNER
E� �.\1 �S1?--
[]CONTRACTOR
�
ADDRESS:��Q� ,��'n �* CITY �'`�l�'�1 STA
PHONE:�ta� - �b`:. - � 1 �'J'�ai
NAME:
STATE LICENSE #
EXP DATE
ADDRESS: ' CITY STATE ZiP,
PHONE FAX — - --
D BASE2v�NT FIIdISH
0 DECK
DESCRIBE WORK BEING
SIZE OF IMPROVEMENT
7
❑ DRAM TILE
❑ OTHER
WIDTH HEIGHT
Ft
ROOFING , �,f(s-� O HOUSE ONLY
NUMBER OF SQUARES � �iOUSE & GARAGE BASE1v�NT REMODELING SUB1vIIT:
GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan
PROPOSED SIZE: O DETACI-�D GARAGE 2• ProPosed floor plan
PROPOSED HEIGHT: , 3. List of structural members to be used
gm FOR NEW CONSTRUCTION INCLUDING DECKS,
Vinyl �Soffit ' A9DITIONS. & PORCI�S SUBMIT:
❑ Aluminum ❑ Trim ' 1. Site P1arJSurvey showing the existing strucdues
� Otha O Fascia and proposed Project.
WWDOWS 2. Two sets of consWction plans
IN EXISTING OPENIIJGS OYes ONo LOCATION OF WMDOV✓S 3. Energy Calculations
OR FOR NEW OPEMNGS-DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WIIdIDUW TO BE INSTALLEb NUMBER qF WINDOR'S
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING 1997 U�C FEE SCHEDULE)
TOTAL JOB VALUATION $���D , y' OCCUPANCY TYPE
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Controi
Park Fee
Sewer Main Charge.
Tota! Due
$� j 7 See Back Page for Fee Schedule
$ 6S% of Building Permit Fee
$ j 1f .001 times the total job valuation
$ '7. dv .0405 x Permit Valuation Minimum $.50
$ ^ $5.00 (State Licensed Residential Contractors)
$ $I550 per SAC Unit (Plans to MWCC for determination)
$ ft+6ft= ftx$21=$
$ $450 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement necessary ( ) Non Necessary ( )
$��"'�,'_ �� Make checks payable to: City of Fridley Attac
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a huilding permit and I acla►owledge 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 w rk which require view and approval of plans.
SIGNATURE OF APPLICANT �C�� PRIN't NAME Me1�S�'� C�►'�A� DATE g Ia 1 ac