AF - 47602�
•
.
City of Fridley, Minn.
BUILDING PERMIT
� �- %���'
N° 7347
nate: _�.w' �_ � �
i y
Owner: . .. Builder _ . . .._..._._.._...__...._..._____ _
Address_._..___.._. ._._.._.__.___.._.....�.._.._._.._ Address .�_____.._......._.__.�_� _.�.._.�.._._..___________
No. �..��_..... Street
Lot ...�C.� �..� Bloclt
L���
_._.._.._._. Addition or
Corner Lot ___....__..._..__ Inside Lot ._.._.'_`��_ Setback .. � Sideyard _._.�...�__� �
. . .��...�..- _._.__._
Sewer IIevatiari ..�.�.. a 7 � . 3 .� __._.__.__._....._____._ evation ...._ � ,3 O � 3 .(,
T�p o� /=a�T/A/C. �
Lot
T Uaed �
- - • Frant
DESCRIPTION OF BUILDING
�,�2.._.. DePth �� Height �_.. Scl• F��.� Cu. F�/G��'""'.
_._. _._._......_.._. _._ ._._.._..__.. I�pth _..__._ H ght ...__o� Sq. Fk _.M__...._.. Gti1. P't. _
7.j�pe of Construction ����J�i�,Q,,,._.�_ Es� C ..,�.C�.. i�...'� To be Coanpleted _..._..
In consideration of the issuanoe to me of a permit to construct the building described above, I agree to do
th� proposed work in accordance with the description above set forth in compliance with all pro�vistona of
c�rdinanoes of the city of Frfdley. � �/
��._
!
In co�sideration of the payment of a fee of �.�_-_-_-____., permit is hereby granted to
to co�struct the building or addition as described above. Thia permit is granted upou
the �express condition that the person to whom ft is granted and his agents, employees and workmen, in all work
dane in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances o�
Fridley, Mimnesota regarding location, construction, alterahon, maintenance, repair and mavin8 of bufldin�s
within the dty limfts and this permit aiay be revoked at any time upoa violation of aay of the provisions of said
.,,a;,,�,...�
NOTICE:
Yhb p�nnk doa net �owr 11� eonproeHon, in�hllNkn he wirta�. Phnnbino. Yas 6�aNn�, a�w�r er wabr. M �w+ to a»
fh� BuiWiuO Intp�cMe fer s�puaN p�naits for fh�a il�nn.
sue�ecr PERM .
c�ty of Fridley 14098, ��
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T ' -
r
� � CEIPT NO. .
� • COMMUNITY DEVELOPMENT DIV.
� ; .: ------� 2
r � � PROTECTIVE INSPECTION SEC. Q/�
1 . i 0
1
�4 � /'�'1 � CITY HALL FRIDLE�. 55432 NUMBER REV. DATE � PAGE OF APPHOVED BY
""'� � ,�� 612-560-3450
910-F15 5/20/77 � �
JOB ADDRESS 641 Janesville Street N. E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 1��11 p R].VP.rVl@W Heights SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Richard Jackson 641 Janesville Street N.E.
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Sussel Co. 1850 C7omo Avenue, St. Paul, Mn. 645-0331
4 ARCHITECT OR DESIGNER MAII ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADORESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential -
7 CLASS OF WORK
�l NEW ❑ ADDITION ❑ ALTERATION O REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 16' x 22' Garage
9 CHANGE OF USE FROM � TO
STIPULATIONS provide a hard surface driveway.
WARHIl�6
8efore �igging ca11 loca( utiiities
5EP'FRIt1� i�RMt'TS REQUIRED �'QR WIi2tNG, fE�E�onE • EtECTRIC -GAS Et+c..
HEATIi�, PLUMBING AND SIGNS. � R�QUIRED BY lA1N
TYPE OF CONST. OCCUPANCY GKOUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING. WQOC�{ FrdICLE
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
ALTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENOED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R 1 352 3520
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT 1 HAVE READ 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 COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTiNG OF A PERMIT $2� 6O4 S�-•3O
DOES NOT PRESUME TO GIVE AUTHO TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIO S OF ANY HER STATE OCAL LAW REGULATING CON-
RUCTIO OR THE FORMAN E O NSTRUCT N. �`�.4.OS
r PLAN CHECK FEE TOTAL FEE
�!i $15.38
s uaEOFCO � ACTORORAUT EDaGEnIT ID Ei WHEN PR PERLY VALIDATED THIS IS YOUR PERMIT
: �� s�a��
SiGNATUREOFOWNEFIIFOWNEFBUILDERI IDATEI BLDG iNSP � � � DATE
CITY OF FRIDLEY
APPLICATION 1=0R RESIDENTIAL BUILDING PERt�1ITS
�f�IEW, ALTERATIONS, AllDITIONS, OR REPAIRS)
I �}AC,i�[,si>,J BUILDER: �� S -g� �`'
0(nITdER: ��.G�.+47L1s�
Address : � �/-° �AA1ES(1 / LZE Address : Cp,�a �cJ� �l �• �i4ti l+
Te 1. No .: (e�S -- �`3 3 �
No. : (��-�- � Street : ��J E S C� � L.�.0
LQ�': _ I Q"' I I BLOCK: � ADDITION: ���VtR1�Ib1.� ��1ref��
CORNER LOT: INSIDE LOT: �_ SLTBACK: SIDEYARDS:
Applicant attach to thi.s form Ztao Certificates of Survey of Lot and proposecl
building locatian drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Used As:
� � 1
C,p�Z� Front: _ �� Depth: Z 2.. Height: � C�
Square Feet: � Cubic Feet: ��oZ�
Front: Depth: Height:
5quare Feet: Cubic Feet:
Type of Construction: �9 O � � ,�y�,� Estimated Cost: $ Z(�Q ��—
7.b Be Completed: �J d��•4� q �-- Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired $ $
(SEE REVERSE SIDE OF SHEET)
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City of
Fridley Ordinances and rul�ngs 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 additiona info ati •
DATE: �"20 "'� � SIGNATURE: '
Stipulations: •
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SUSSELfiARA6ES SUSSELICOMPANV, INC
1" x 8" Ridgeboard
�\\ 2 X�
— — Rdf��rs
� �
\ � \/ 2„X6„
,/ Cross Ties
ROOF: GABLE REVERSE GABLE- HIP
u
EAVE OVERHANG: ( �
RAKE OVERHANG: �
240# SEAL DOWN SHINGLES WITH PLYWOOD
ROOF SHEATHING AND 15# FELT
Plywood Sheathing
� _ .
1" x 6" W-Bracing —� � 2"" x 4" Double �
when applicable Top Plate
per Minn. State Code
NOTE:
3) On 18' and narrower garages, eliminate the W-tiracing and collar
ties. �
4i Roof approved by Minn. State Building Dept. as meeting Minn.
State Code Requirements of 30# snow load. Refer to State
Building Code Letter Number 35.
5) Hip roofs consist of 2" x 6" rafters, 2" x 6" cross ties 48" O.C.,
2" x 8" hip rafters and no plywood gussets are used.
RAFTERS: 2" x 6" 16" O.C. '�� �
STUDS: 2" x 4" 16" O.0 24" O.C.
WALLSHEATHING: t Z.`� C,►2�L,tT�
SIDING: iZl� N. i3- L✓��
OVERHEAD DOOR HEADER: Double 2" x 12" steel
plate. wtTl��u�T
Slab on grade construction approved per Minnesota State Code. Refer
to State Building Code Letter Number 11.
`SLAB: 4" WITH MESH 6" x 6" #10 Gauge
r,
240# Seal Down Shingles
�
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45° � "'
� 4" (• -�
Trim
Fascia .
1" x 4" Sub
Fascia
Soffit
3/4" Cove
2" x 4" Studs
Siding
YZ" x 7" Anchor Bolt
per U.B.C.
2" x 4" Treated Bottom Plate
Grade Line
%�� � ��/�//�/
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SUSSEI6ARA6ES SUSSELICOMPANY, INC
Permit by �'S�� �-� `-^--
Legal Description
Loi � � ' �" 1
Blk T
Add'n Lv �ltC'
Value
Type Const. ��'
S� B:
�BySUSSEL
��r/ Owner Approx.
❑in
2-STARTINGS POINTS ONLY
Z j S.P.L.
S. S. P. L.
� ` R.P.L.
Al ley
House
F. Stree
_. Other
�quare
Rods
WORK �=;')RDER � � � -
HOME PHONE� s_�1_CL��
NAME / f;i, t� ,�/'� L�-Sc`,7t� BUS. PHONE.` �� °J( 2-�
JOBADDRESS�'',�`� `��'�'/��G��Cf[-� /L1��
BLDG CODE AREA �Y�% �� ' ✓
SALESMA�/Y �C� CONTRACT DATE�'� IZE � Z
FOR OFFICE USE ONLY
CONTRACTOR ���f �'� JOB #
�
�--�--- 16 ' 3�
. i :
�
_ � �
�� � ' .
/1J IYTiJII ... . . . � - . .. ..
��Sod Rem. - By.�t"3y[3._
g5-Bag Mix
,�^�.6-Bag Mix
O Tamping
�Alo Tampi '
;�`A. B. U. ���J�S �
rade Point
-�_ .
Conduit
ocks By wn �By Sussel
C`�—Maintai'""n 8` T�otaW�aU '' 2Z+
cks
amtain Height on ' ' '
---�of.r�f�Bf�eeks
rit�`�"�— _
7�O.y, Dr Offset � I �
�:D. Location
Windows� ��f _ . � ` �
�
❑ Att Gar Roof Tie-in
Orawn on attached pictures , ; .
Existing garage: rvo S
❑ Detached ❑Attached Yes ❑ _ _;�. � � �� �.- � � �
S�ze of existing: — x � � �
Existing garage will be:
� Left as is � �� .
� Converted to L.S. - By owner `��
O Removed By: Owner ❑
Sussel (")
IJunk Must Be Removed By ner .
�p � uss
r ow - trees, bushes, eta
�how approx. dist..garage to
ouse and all prop. lines
Stakes visible - � Yesi � No
Survey available - O Yes o
�Special instr�ctio�s fr
owner: ',l� �5., L� �
P . �
H��'gr
5
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P RCHASER' NITIALS:
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_ . DIRECTION -
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g7 -8!� -879�1
CITY OF FRIDLEY
�• ' APPLICATIO� FOR PWhiDING kND GAS FlTTING PERM(T
A ' ro � � � � � � � 4(ater
a � ,� � o, ���� u� Q �; m ti pa, w � Heater
C .f� �1 N .G G� Ol fC 1{
p � 0 ..�i � ..1 p � � 7 0 S � v� ��u,� �n � uu1 vl �
a'i 4 a a � '� '� u o.c .-� ro ro p ro ro
�n � A a. u� e+� U W R 3 t� � � O �as 31ec
lst e � ,
2nd � . �
3rd �
4 :h
(R) 4 Eliture Connection Opening Coi�nected with Sewer
(') o New Pixture, Old Opening Water
PARTIAL RATE SCHEDULE '
PLU�l9INC FIXTUR� RATES� N0, RATE
1tu�ber Fixtures x S3.p0
FUtura F:xture Opening x $2.00
hev Flxture, Old Opening x $2,00
Catch Basin ' x $5,00
Hater Heater - to 99,000 BT(1 ' x $5.00
100,000 B1'U to 199,000 BTU x 510,00
Nater Soltener x 57.00
Nev Ground Fv n Old euildinq x $5�00
Eleccric NateK Heater x $5.00
G�S FITTI�G FEES; �
lst 3 fixwres • x $3,00
Additionnl,Fixture9 x 51,00
W s Ranga to 199,000 BTU x$�:0.0�
REPAIRS F� ALTERATIONS
First $100.00 $5.0�
each add. 5100,00 or tractSon $2.00
Statq Surcharga
' TOTAL t'CE
� .}
TOTAL
$
S !^
S
S
$
S
S
$
S
$
S '
$ .
S
$
$ .50
S 8•�
�ob Address 61►1 Jamesvill� PiE
Department oE euildings _
City of [•'ridley
Tel. H571-3950
The�undoref.gned hcrehy mdkee application for a permit for th� �rork herein
epecified agreeing to do all work in strict accordance With thi3 City Codas
and rulings oP the Deparcment of Buildings, and hereby declarea thnt a11
tlio facl� nnd repro�ontncions st�tod in Chie a��>llcution aro trvo and corroct
Fridley, Mn. 8-16-79 , 19
OWNGR SK�F'+�
KIND OF DUILDING ' frame
useo as res.
TO BE COMPLETED ABOUT 8��3 �? 9 �
ESTIb1ATED COST �;�O�O�
OLD - NEW BUILDING PERt1IT N0. PER111T N0. �.�
,
Company ��r.{' �
Signed Hy M�NN�GASCO
Tel. No.
ROUGH ItJSP.
Da ta
FINAL INSP.
Date .
APPROVAL FOR PEf2l�fIT ��
MINIMUDt FEE FOR hNY PLUI4BINC PERMTT IS S7.50 pLUS $.SO SThTE 6URCf1AftGE
A«
1�
REINSPECTIOtJ FEE
C� rY �r r,s i UI-CY
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFF�IGERATION AND
f AIR CONDITIONING SYSTEMS AND DEVICES
PARTIAL RATE SCNEDULE �
Gf2AVTTY 41'ARM AII2: RATE TOTAL Job Address � �� G���
Furnaca Shell & Dact Work $12.Q0 $
* Replacesnent of FUrnace 7. 00 $
Repairs & niterations-up to $500.00 �•OQ $ Aepartment af auildinga
Repairs & Alterations each add. $500.00 4•00 $ City of Fridley
Tel. #571-3450
MECHANICAL WARM AIR:
EUrnace Shell & Duct Work to 100,000 BTU
each add. 50,000 BTU
* Replacement of Furnace
Repairs & Alterations-up to $500.00
Repairs & Alterations each add. $500.00
STEAbi OR HOT WATER SYSTkM:
8oiler & I,ine� up to 100,000 STU
each addn. 50,000 BTU
Boiler only up to 100,000 IITU
each addn: 50,000 BTU
OIL BURNER- to 3 gal. per hour
each add. 3 gal. per hour
$12.00
4.00
7.00
7.00
4.00
$
$
S�
$
$ ---
,512.00 $
4.00 $
7. 00 $
6.00 $
S1o.00
lO.OQ
GAS BURNER- from 100,000 BTU to 199,999 BTU $10.00
(over 199,999 BTU see Fee Schedule)
GAS FITTING FEES:
lst 3 Fixturas x$ 3.OQ
Additional Fixtures x $ 1.Op
Gas Range to 199,OQ0 8�'U _� X$1Q.00
AIR CONAITIONING
FAN HEATING SYSTEMS g�e Fee 9ehedule
VENTILATING SYSTEMS
ALT�RATIONS $ R�PAIRS
State Surchaxge
TOTAi, FEE
liQUGH INSP.
Ddte
FINAI, INSP. / - Z .�.�' �i �"'
Date
APPROVAL FOR PERMIT �l�-��-�
REINSPEC�ION F£E
(.$10. 00)
S
$
$ !D, �ls�
S
$ .�. O v
$
$
$
S
$
g �o
S�D . J'T�
MINIMUM FEE FOR ANY HEATING PERMIT IS $7,50 pLUS $.50 STATE SURQiARGB
*Attached stack verificati,on porm
a
The undersigned hereby makes application for a permit for the work here.in
specified agreeing to do a'.1 work in strict accordance with the City Codes
and rulings of the Departmennt of Buildings, and hereby declares that all the
facts and representations :;tated in this application are true and correct.
ley, Mi.nn. / � — � / , 19��J
OWNER
KIND OF fil�;�LpING .-�.� �L(L.�
� � �
US�D AS
TO BE COMPI,�T£A AHOUT O%� -.� G� •- � i�
�1 O�
ESTIMATED COST ��Q�/ �
O�, NEW BUILDING PERMIT N0. PERMIT NO. �(�!,�°j
DESCRIPTION OF FURNACE/BURNER
EATI ox� PON)�A LANTS, Steam, Iiot Water, axtn Ai No. /
Trade Name Size No. L[% il �[� ��O �/�' /�
Capacity Sq. Ft. EAR BTU �!J ,r�Z. HP �
Total Connaated Ivad �� loO8"C Kind of Fuel �f'
BURNER - Trade Name Size No.
CdpaOlty ��_Sq. Ft. EDR BTU HP
ComP�Y �-�
3lqned By __
Tel. No. �.� %- d �i ��
�d / � / - s� a- .,-z1 �. �2�
"s �i�_
CTTY OF FRIDLEY
.
APPLICATION FOR HEATING REPLACEMENT
. .
. CHIMNEY AND STACK VERIFICATION
THIS FORM MUST ACCOMPAP�Y STANDARD APPLICATION FOR HFATING PERMIT FORM.
�
LOCATION cp �� bi ��I � OATE /a — /7 ��7� �
� � �� � b,
OWNER AODRESS � .
The ur+dersigned hereby verifies that the existing chimney or stack:
1. Has been carefully examined ��
2. Is fr�e from rust or deterioration � f
3. No foreign objects are lodaed within `-
4. That it i s securely supported `~
.
5. That it meets all current Code requirements �.
for size and total BTU cannected
5. Total Heating STU ��; U ��
All Other BTU y�U, U v d �
--�—
TOTAL 1� U; d U l% �
REMARKS / "(/ A��
. ,
SIGNED ' �z.c�-r
� L�censee
by v-Q> ,
Addres s � /� / -• 5� � -n.s� ��r �%,
�Telephone � � � �i� S /
k1EATING PERMIT # �
Fridley. City License �
, .�..�. _ �
sue�ecr PERMIT.f„y,Q,,,,,�
City of Fridley � 1785
AT THE TOP OF 7HE TWINS g U I L D I N G P E R M I T
r
� .
� �
� • COMMUNITY DEVELOPMENT OIV.
' � y__'___',
r � � PROTECTIVE INSPECTION SEC. /S��
� � /'�'1 � GTY HALL FRIDLE� 55432 NUMBEF REV. DATE PAGE UF APPROVEO BV �
�"""��� ,�' 612-571-3450 9t0-Ft5 2/4/85 � �
JOB ADDRESS � 641 Janesville Street N. E.
1 LEGAL �OT NO. BLOGK TRACT OR ADDITION SEE ATTACHED
oescR. 10,11 P Riverview Heights SHEET
2 PROPERTY OWNEF MAIL ADDRESS ZIP PHONE
Steve Phifer 641 Janesville Street N.E. 780-0825
3 CONTRACTOfi MAIL ADDRESS ZIP PHONE IICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAI� ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE IICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW O ADDITION ❑ ALTERATION ❑ REPAIR � MOVE ❑ REMOVE
X
B DESCFIBE WORK
Install a wood st,ove in the basement (Sierra Tuxbo Burn T-2000, Sierra Mfg.)
(ICBO #3942)
9 CHANGEOFUSEFROM TO
STIPULATIONS
Install fire alarms in basement and by bedrocgns upstairs.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROLP OCCUPANCV IOAD
VEN71LAT1NG OR AIR CONDITIONiNG.
THIS PERMIT BECOMES NULL ANQ VOID IF WORK OR CONSTRUCT�ON ZONING SO. FT. CU. FT.
AUTHORI2ED IS NOT COMMENCED WITHIN 60 DAYS, OR If CONSTRUCTION
OH WOFK IS SUSPENDED OW ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ ANO EXAMINEO THIS APPLICATION �- STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORREC7. ALL PiiOVISIONS OF LAWS VAlUAT10N SURTAX
AND ORDINANCES GOVEFNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $�-�OQQ �. SO
DOES NOT PRESUME TO GIYE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
S7RUCTION OR THE PERFORMANCE OF CONSTRUCTION. 517. 5O
PLAN CHECK FEE TOTAL FEE
tiS`�.8. Q�
siG uRE oF corvTRACTOR OA AU o o A eNr IDaTEi WHEN PROPER� VALIDATED THIS 1S VOUR PERMIT
�fl-�S � -
GNA QWNEFi11F W R IL RI IDATEf �, BLDG �NSP �/ TE
NEW [ ]
ADDN. [ ]
AI,TER. [ ]
Construation Address:
Legal Description:_
Owner Name & Address:
City oP Fridley Effective 4/1/84
�R-1 AIiD R-2
Building Permit Application
y 1 J�uGS ��� �v� �.� ���� �� Y
1 I • - � � t�-i
-�e�e '�h��e�r �4 � JR��sv�u.� N• � . sei. � �So o8zs
Contraetor: ____-- Tel. � , __ —_
Addreaa:
Attach to this application, a Certifieate of Survey of the
t, With the proposed construction drar�n on it to scale.
�C�� O # �'�� DBSCRIPTIOA OF IMPROYENENT
. Length Width Height Sq. Ft.
GARAGE AREA: Length Yidth Height Sq. Ft.
DECb AREA: Length iiidth Hgt/Ground Sq. Ft. _
�-
OTHER: � �a� l� -�o�-e �� ���mew�'
� i � -!z �' A � �.c 2 .6 � �c.� � �U T - �c�c� b � �--�� �i'- /�i0
Corner Lot [] Inside Lot [] Ft. Yd. Setback Side Yard Setback �_
Type of Conatruction: Estimated Cost: a�Jd ��'��i'� �
Approx. Completion Date:
Alt. A Alti B
Proposed Drivexay Yidth If NeW Opening Is Desired: # �
See Back Page for Explanation
D�TE: ! � ��
Permit Fee
Plan Check
State Sureharge
3AC Charge
Park Fee
Se�rer Nain Charge
zora�.
STIPULATIOHS:
��1 ���`
� � ��
APPLICANT: Tel . i���- � 0 2'S
CITY IISE OIiLY
� J/-��-� Fee Schedule on Reverse Side
� 25x of Building Permit Fee
� �� �.50/�1,000 Valuation
a � a�25 per s�c u�t '
� Fee Determined bq Engineering
� —
Agreement Necessary [ j Not�Necessary [ ]
a ����
,�� ��;.
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City of Fridley 31082
AT TME TOP OF THE TWINS g U I L D I N G P E R M i T
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; � RECEIPT NO.
� ; y �_��� COMMUNITY DEVELOPMENT DIV.
f � � PROTECTIVE INSPECTION SEC. ��
� ,
i---•�'��'�' �•� CITY NALI FRIDLE� 55�32 NuMBER pEV O�TE P�GE OF �VPpOvEO !r
i 612-571-3450 910-Ft5 6/22/00 / /
JOB ADDiiESS �1 Janesville Street
1 IEGA� �OT NO. BLOCK TRACT OR AOOITION SEE ATTACNEO
oescR. 10,11 P Riverview Heights s►+e¢r
2 PROPERTY OWNER MAIL AOORESS IIP PMONE
Kris Sylvester 641 Janesville St. NE 780-8492
3 CON7iiACTOR MAIL ADDRESS ZIP PHONE UCENSE NO
New Haven Construction 4208 83rd Ave No. Brookl n Park, MN 55443 566-5225
� ARCMITECT OR DESIGNER MAIL AODRESS ZIP PMONE LICENSE NO.
20077950
5 ENGINEER MAII AODi;ESS ZIP PNONE IICENSE NO
6 USE OF BUIIDING
Residential "
7 CLASS OF WORK
O NEW ❑ ADDITION O ALTERATION �1 REPAIR O MOVE O REMOVE
B OESCRIBE WORK
Reroof with tear off 23 squares - house and garage
9 CMANGEOFUSEFROM TO
STIPULATIONS
Underlayment must comply with the State �a�#ag Building Code.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV lOAO
SEPARATE PERMITS ARE iiEQU1RED FOq EIECTRICAL, PIUMB�NG, FIEATING,
VENTILATING OR Alq CONOITIONING.
THIS PERMIT BECOMES NUII ANO VOID IF WORK Oq CONSTRUCTION 20NING SO. FT CU FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS. Oq IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED fOR A PERI00 OF 120 OAVS AT
ANV TIME AFTER WORK IS COMMENCED. NO DWLG. UNI7S OfFSTREET PARKING
I MEREBV CERTIFV TMAT I MAVE REAO ANO EXAMINEO TNIS APPLICATION 1 STALLS GAfiAGES
ANO KNOW TME SAME TO BE TRUE ANO CORRECT. ALl PROVISIONS Of LAWS VALUATION SURTAI(
AND ORpINANCES GOVERNING 7HIS TYPE Of WORK WILL BE COMPLIED
WITM WHE7MER SPECIFIED HEREIN Oii N07. TME GRANTING OF A PERMIT �Z�OIO.00 I..O1
OOES NOT PRESUME TO GIVE AUTMORITY TO VIOIATE OR CANCEL TME pEpMl? FEE $83 � 25 SAC CMAqGE
PROVISION$ OF ANY OTMER STA7E OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERfORM E OF NSTRUCTION ,-i Fire SC Z.O1
r^ �� ^ PLAN CNECK FEE TOTAL FEE
�J
- c nse SC 5.00 91.27
S�Gti�ru OFCON• A(;TO Op�uT Op�2E0�GEtii �o�rE� M PROPEpLV VALIOATED THIS IS OU PEAMI
$�GN4TUAE O� OWNEA��f OWNEpBU4DEA� �DATEi 10 �NSD f��
NEW [ j Effective 1/1/2000
ADDN [] CITY OF FRIDLEY (763) 572-3604 Bldg Insp
ALTER [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: ��'�-I � � �•�.�.,� S' c� < < � � �
Legal Description:
Owner Name & Address: _ �c � 5 �v �c>�S Ir< Tel. # %�U - ��92
Contractor. N�� `7�i� �c�ryl �,-�: MN LICENSE#�GY�7�i�c�
Address: � ZO� B 3-•-` �L� �� =��� Tel. #.��Cv - S2 2 S
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.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
Length �Af'i %l�round Sq. Ft.
Construction T � D�iC F-� c�( . � v C�
YPe� � Estimated Cost: $
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: lCJ'- Z 2'C�-� APPLICANT: Tel. #� ��2�-�
CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application
Permit Fee $� 3.�. Sf Fee Schedule on Reverse Side
Fire Surcharge $ �.� � .001 of Permit Valuation (1/10th%)
State Surcharge $ �- d 1 $.50/$1,000 Valuation
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ $1100 per SAC Unit
$ S - °� $5.00 (State Licensed Residential Contractors)
$ Alt. "A" or Aft. "B" Above
$ $450.00 Conservation Plan Review
$.
$
$ �•�
Fee Determined by Engineering
Agreement Necessary [] Not Necessary [ J