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AF - 47492City of Fridley, Minn. BUILDING PERMIT N� " 5 g s 1 Date: �� "�', "", ,� .,'�"�°: Owaer: ��t��F�� Builder r'� Address �� Address _.. � CATION P BUiLDING No. � fi Street �— �-�'�� .��._,�:... Part of t � Lot _ Blo �— Addition or Sub-Division _�" � Coraer Lot Inaide Lot Setback �� eyard �� Sewer IIevation �..._.._. Foundation IIeva�lon DESCRIPTION OF BUILDING To vsea `� � � �,e� . k "� � F'ront � Depfih �� HeiP,ht � Scl• F�q�� Cu. ,;r� � �De� � --�+-�� sq. �t. cu. � t. Type oE Constructio °' Est,� � To be Completed In consideration of the issuance to me of a permit to construct the building descxibed above, I agree to do the proposed work in accorrlance with the descript3on above set forth and in compliance with all provTsions of ordinances of the dty of Fridley. � In consideration of the gayment of a Pee o4 $.� � , permit is hereby gra.nted to— to construct the build3ng or addition as descrlbed above. Thispermi t is granted upon the express condition that the person to whom it is granted and his agents, employees anc� worlmien, in all work done in, around and upon said building, or any part thereof, shall conform in all respect� to the ordinances oP Fridley, Minnesota regarding location, construction, altera.tion, maintenance, repair and moving of buildings �� dty limits and thia permit ma.y be revoked at a�y ��n violatio�pf any of the provIsions of said � Buildin8 Inspector NOTICk� This permH does not eover the enestroetfon, installatton fo� wGieg, plumbtng, ges heaHne, se�ere� or watae. Be suro 1e see t6s Building lospector for aepuate parmHs Por thw� itema. _ - �' 4 � � ._ — . �_-, �� . - - _ - APPLICATIO�T FOIa BUI�DTNG PERMST CTTY 0�' �RID�EX, NLT�SOTA O4i111eY � S Address Addres LOC�PiTION OF HUII►DING L y,��a'�'��-� � , No. �� 3treet �_�Part o� Lot Lot � �lock / Aolditioa or Subdivision ��-�"� ------_ Co�ne�c Lot �nside Lot �� Setback 3S +Side-Yard � v`�!-r' SEWEi'� ELEVATION FOUNDATIOIV ELEVATTOYIT Applicant attach to this form Certi�icate of Survey of Lot and �roposec� building loca�ion. DE�CRIPTI4N OF BUILDTNG io be used asa � � � � ,�� «�, �'ront�Depth i�eight 3�s Ff.• \.�ie �• Front________,pep•� He3ght Sq. �t. Cu, Ft. Type o:� Construc�cion Est3mated Cos� , . To be Completed The undersigned hereby makes application gor a permit for �he work here�.n spec3fiecl, ag�eeing to do all work in atrict accora�ance with t�he City of Fridley Ordinances and ruling o� the Deparicament of Huild- ings, and herehy declares that all the facts and represen�tations s�cated in this apg�lication are true and corroct. DATE �' �`' � � �'`� SIGNATUTiE c �'°-� (Schedule of Fee Costs can be found on the Revesse Side). � � HUILD�NG PE�iMIT t� EE SCHEDULE Sec�ion 2. The I�spector of Buildin�s sha11, be�o�ce issuing any per��i�: for the erec•�ion of any building or structure, or for any addition to any ox�s��n� building or ��ruc�ure, or for any alterations or repa�rs fio any �xis�ing buildinc� or�s�ruc�ure, upon appl3.cation �:h�re�or, r�quire �he payntent by the a�plican�c cor such pera�it of fees to the amount herein below set �orth and 1n the manner herein ��ovided to wits � . 2.1. For any auch pe�m�.t for the erect�.on o�E any fire-p�oo:� building, oi:her than a galcago, war�house, factory or grain elevator, or �os �he erec�ion of any i�a.'e-p;�oo� addition, gor similar occupancy, to any exis�t�.ng building s�a].1 be at the rate of- $1.40 £or each ono thousand cu�ic :�eet, or frac��.on thereo�E, in such cubical conten�s. 2.2. For any such pernn3�t �or the erec�tion of any fire-proof garage, warehouse, factory o� grain eleva�tor, or �or the erection or ar►y ccire- proof addit�on, �o� s�nilar occupancy, �co any existing bu�1.d�.ng shall �e at the ra�a oi $�.,25 �or each one thousand cubic feet, classia�ieci as "iireproo�" by Sect�.on 502 of the M�.nneapolis Building Code. FiOUSES 2.3. For any such permi� for the e�cec�3on of any non-��.reproof build- �.ng o�her �than a garag�, warehouse, �ac�ory or grain eleva�or, or any non-sire�roo�E addi�ion, �or similar occupancy, to a�y exis��.ng building Pe�znit $1.00 for each ono thousand cubic feet. C�AGES 2.0�. For any such �e�,r�i� for tl�e escectio� oi any noa-fireproof garage, warehouse, ractogy or g�ain eleea�or, or for the erection of a.ny non-gireproof addition, fos similalc occupancy, to any_existing building or �or each such building or additione NinOty Cen�s for each one it�ousand cubic feet or fraction �he�eof, ir► the cubical conten�s thereof wi�ch a m3.naLaiu�► o� $4v00 0 For ihe g�ur�ose o� computing �ees for 1aui1d3.nq pesm3.te the cubical con- ten�s of any builc�3.ng or addition to a unirorm height throughou� 1ay multiplying the g�cound area covered �ro�n a g�oint six (6) in�es �ae].aw the fcloor liao or the basement vr ce11a� to the average height oiE the up�er surface or fio che average heigh� of the roofc surface of the main . gaZole ot a pj tcl�ed roo�. � 2.5, For repa�rs oY alterations to an ex3st3.ng -structure, the �ee shall be at.the ra�ce o� $3.00 per each Five Hundr�d Dollars ($500.00� or iraction ghereo:c in �ttze cos� o� all proposed work. , 2.6. �a no ��se shall the fee charged for any permit as aet forth in Seetion 2 be less tIr'`� $4.00. � - •>_ - � ..�.k� s i'`'�+'�`•�.�°�`q"a _ � e i�jr'� �� tFi'4'••��''� �.�.�t`v' £>�� '� t � ` ' dt �i. . � ''� �' � Y� r a..�- � ka� �'��. �.;;< :. . . � x�� '�` � `�''�a �``, � J�� 'r t� �'"� [?� �,'w."'� � 4 �. . � �`t � _. , � , . . ; ;� : e y r v � � A� . y,. .. : ., r.f.. v , , . r, � . : ,, . ey� : . _ , ..��, � � . . t. s+ . . � , . - . . . . � � , � r- -ar 9-:- ��. � ' � . . . � . �.�' �;�. t _ � . . . . . . ' � � �' �'p � � . - _ _ 9,.s �Y. .� � . . �. � �. . . . ��' � ,. f.ar►r�PAor� 1� /I�MdI� *� N.� �'" �� z Lmd �v�+rrfar� Mii�hs 1►, ��` �� 4` � s°'� �IyGr#I��ER#�I�r, ��1C�. . �fo 7 ' Civ;� b �rpvl .��[�6i � , � . _ {'� �� y � �� -- Er�9�neers � �Su�vec�ars — � .. � . � .�. { ��l�'�i�t.i'� !� �� s N � M DEVEt,O�PMENT f�, ., �l�� ;° t �� . �: - ,} �; . ��,, � � � � ,� - T �: N �,_' I ^ _ � �{ .; /34. 9 7 � � � __._ ?— � � � � :; � � � � u � i � `�\� � � � r� F-- --� � � � � ��,�� t � � � `� ti� Z ,� ' � � � O y M .'y' .._ �� h f 0 0 t ,A . 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'i , �.� � _. � �W � � ��„ : �, � ,s �4 �c `��,°'R'+.,� _ _* ,�" ��S�s,';�5 ..2�ts"l�i .. .. , .} �� ,;,.� .�,. ., r �-,_ ... � MY,R�"; �.�,`��a�i.�� .... � �. �_ .� .w`�rv`#� , , ` � , ��.°,F ds._.�.,.s 'a'...,.. .,?w ...h. � 3 s � O � r°. F�� N � � � � � � p � , O c,i x � � "� � � � � r � ox y � �- G � x x � � � � O � � � Z �� H � w� � �n � � � � �� m � �n . ,� � �n .. w a `� y y ►+ � W x ��' p � ►r� ,,., k L*J o '�1 � N N � � 0 o ' O y • o � aya : : Q : : � � � x „ „ �a o N � 0 0 � � t� tn rn � ' o �� r � C�7 � I � � � � 0 Y N � .�ai � � � � 0 � 0 0 0 O 0 � � 0 0 � `\ ,� 0 O r � � � < �' y O w w w� � � H � y x o � � o � � � . A � �. �: �C. � F� • R • � 0 0 � O A�i M C7 � �y w FJ � � � � � � � � � o � � �� P � � � � � ¢ � � w l� � � � o � z 0 � ` � � ro � �' � � x° M 0 � �' �- � � r � p' 0 ,ar'�'. a ` c o °o k � � � � � � � � �1�< o � � � � � � ; r ,y . : � � C . . F . . . . • F . . � . . ° . . P _• •� � � � � � N � ° x ; � H . p o Ro � � � ' � fA � � � i � : ,� � � a � �� i� i� i � i � � N � � en en c o 0 0 0 0 tn �s t�s ts� � � �. � � � � � A � � o � � � � m � 0 � � O a' � � � � � � � � b � � i' � � � �� m�� `�� w "' o' �° p o � � d � � o � n Q w � fD o 0 � '� : o�' v� � � � o a � : � � v' � � • °o � ° : : Q .° ; : : � N�.�N� o °o °o °o °o va �s a+ � � 1Z �►` .� R� p, � � � � �• , � �7 .� � � � b � � �, w �� . � � � � � � 0 0 � ?� � � � � � m � � � � • M w � � � a �» • • � . . c�i� ,°o : : o $ . . o . . 8 : : : a ��,�,�� , ea o 0 0 0 0 0 0 � O t" Rp. A+ � � �� o b �� H �N � w ��,�� , � ��•� � � � � , �b o ��o� � � p�� 0 � ��y � � � � �'j' ��ro o�� a�� G. �a�°p � �°�o � y �Y N �, �. � � � � �'� � �.� ��a" ��y �� o a r• � � m � A I� � � � � � � � —I m y _ m C � m d '�tl » M � � M � a � � V O �-� :r .n . � � �� d $ � ,A. ._ �o �y a ' o.:� � � e. �, � � �� 3 70 � . 0. � � , �'� � �, � nt.� > 9 l"' _ HEAT LOSS CALCULATIONS<f'/ � `�� pEPARTMENT Weatherstrips �•S.H.V.E, Construction 1 Guide m ws oo s Reference Out. Wall Int. Wall Geilin Yes o I Ye ,: 0 19— '� `• , ` � Room � Length j_ Width / Height � Windows d Doors—Crackage and Area �Vldth Halght Na. ot Lfneal f, Area No. ot pana o[ pane Ilghte of crack � e9• Pt. � '�0 0 � L �� D � � �v�: /�ot. [r / , q Coef. Btu Infiltration � �' f � Glass � �f �� -� Eap. wall � -- Net egp. wall /Q / � Int. wall Ceiling � � Floor �� 7'otal Btu. Requir E.D.R. or sq. ins. W.A. Geader area F7. Room � Length �-, Width�c�� Height ° Wind ws and Doors—Crackage and A�ea Wldth Aelght No. ot Liaeal ft, Ares No. oY pa e o[ p e 1lghte ot crack eq. tt. / � � � �� / .e� Coef. Bcu Infiltratioa ��' � �' Glasa �� Exp. wall /� v Net exp. wall � �°Ur' � Int. wall Ceiling /� � �� Floor � Total Btu. Requir s. . D.R. or aq. ins. W.A. Leader area Fl. � Room � Length Widt Height / Windows and Doors—Crackage and Area Width Helght No. of Ltneal tt. Ares No. of Dane ot pane lighte ot crack eq. ft. � �� G �7.7 i�_�P' lnhltration � / C,laaa e Exp. wall Net eap. wall i Int. wall Ceiling � Floor / Total Btu. • Required sq. ft. E.D.R. or sq. ias. W.A. I.eader area � � '� �� 7—,� . �; �°��.�r�� OF B�JILDINGS MINNEAPOLIS, MINN. �o. Insulation Roof Floor Kind How Applied FI. Room Length / — Width,� Windows and Doors—Crackage and Area Wldth Height No. ot Llneal it. Area No. of Dgne o[ Dane Ifghte � o! crack eq. tt. � � /� � Lg , � �' . � Infiltration �885 � Exp. wall �` - " Net esp. wall Int. wall Ceiling � �-f"- Floor �� J � � �� Total Btu. Required sq. t. E.D.R. or sq. ins. W.A. Leader area FI. Room ( Length /� Width /�� Height / Windows and Doors—Crackage and Area Width Helght No. of Lfneal tt. Area No. of pane of pane llghte oL crack eq. ft. � Coef. Bm InSltration � Glass � �' Eap. wall �� Net esp. wall //,j j�jn Int. wall Ceiling Floor �' Total Btu. Required sq. k. E.D.R. or sq. ins. W.A. Leader area Fl. Room I Length ` .Width Windows and Doore—Crackage and Area Width Helght No. ot Lineal ft. Area No. of pane ot Dane tighte of crack ea. tt. � i�" /' .� ( Inhltration /�.�`j' _ Glass Esp. wall _ Net eap. wall Int. wall ' Ceiling Floor Total Btu. f, ��.12equired sq. ft. E.D.R. or sq, ins. W.A. Leader area I ieiaht�Y/ f.� Btu � d y � � r o `� p �'� : y . x :Y . � . h . O : a . m r7 . � : � • \ � � ;� � � �+ � �a � w � � p �� 5► � � m � • O • O � . o.. Q : : 0 � � � N ►�+ � O Q Q � � H O � � � � � � � � � m � � Z x 8 � � � � � � � � � � � � a��'� �� , " : o � � �a p' ,� � � ��: ��.: � W _°o : � � : � o . � . O4 � . . . . : � • � . • 9 ` Q �E k k k DC �4 G7 N W f+ f+ � � C�71 p C�i� O O p � �? Efl iA �{a H! l�' y . ,� y p � � � c 0 � x � i � � � � � � � N � � r � m � � _ m °c r m a � w � �,' bd � � �' � � � � (�. N � O � e m �° � �� ...�1 � : ■..■, : s ��►!1 � . ■■.�, ,� �, ■��, : ��i► �� o m ❑ M � I � o � � � cr a a. � � � � � � � � � � � � I� I�4 r WATER QOSETS �� enrH �� e�siNs SINKS W�, �� DRtNK. FOUNT. SITYi/R5. FLOOR D�tAINS �Ta BASINS nuro w�a GAS APPL GAS RANGE GAS OPENINGS � � Z ! � � � � �� ,�� '� p � �� ' � � o �� o � � � � O y LL � � � � � � � � �� o�y�� p m o '� p, 0 p � a° H ��w � ��. a o��" �� oo a' � � ro 3 r� �r°• �' � � ;a � �� A � � p• '�i N � � p � M o �� a � � � �i � � � � � 0' � Q � � �� r� d O. � � Q m � � � M � � � � ro �cr � � A � a � p �� 0 �t � � = � City of Fridley, Minn. BUILDING PERMIT Da�: OCTOBER 20, 1965 N° 8546 � l � �/ p�r; LII�A1�ID E. OLSOl� $��, GORCO CONSTRIICTION CQNIl'ANY ,�� _5860 Jefferson St. ft. E. A�e 3384 Brownlow Fridley 21, Nlinnes ots�. St . Louis Park, Minnes ota LOCATION OF �UILDING No 5860 g�t JEFFERSON STREET N.E• _,_,,,, Part of Lot Lot � _ Hlock x Adait�on or 9ub-Divflefon ...�LYNDALE BUIZDERS, 7TH ADDITTON Corner I�t � Inside Lot Setback ____ Sideyard 3ewer IIevatioa _____ � Foundatfon IIevation DESCRIPTION OF BUILDING To be Used ea: DET. GARAGE ��t 22 Depth 22 Height 10 �. � 484 �� 4, 840 Front Depth I�efght Sq. F't. Cti. F't. 7�j►pe of Construetlon � F�t Cost _.... $1,350 To be Completed Ia consideration oP the fesuaace to me of a permit to conatruct the buiiding described above I agree to do the proposed work 9n acc�rdance with the d�ecription above set Qfor_th and in��e wit�► asl provisfons of or8inaac�s oE the city of Fridley. �J�� . In ca�deration of the payment oP a Pee oP ;� 5. 00 , peraift fe hereby granted to ��GO �STRUCTION CO - �o �� bufldfng or adalition as descrii�ed above. T�fspe rmft is granted t�n tlie exPreas condition that theperaon to whom it fe greated and his agents, employees and worlmien, fa all wark done fn, araund end upon safd build9ag, or any part thereof, ahall conPorm in all respects tfl the ordinsaces oE FridleY, Minnesota regardin��g locat4on, conatruction, alteration, maintensace, repa3r aad mov7ng of bufl�� w1�� dty limfts and tb9s permit may be revoked at any time upon violatfon of aay of the provis�tans oP said AT T.FN G. J'ENSEN 8��8 �� ^ NOflC@e 16h p�emh dea ee� eewr �la eee�naNa�e, �.nt�ton �e. wt�, �n�md�a on e..�a ar.r e� wwr. B� am fo a� �In enildloo imp�der h* apuab � h� f�na kw. APP`LICATION FOR BOILDING PERMIT CITY OF FRIDLEY, MINIVESOTA owx�'s � ,1 �. �,� �,�. � �_ �0 L S' 6 /V BUTLDER �� i c � �, � �,r r � a ADDRESS �,�� (6. �� f' Fe itso /!' �' r /4/, � ADDRESS � � � fr � �'' e � �: � N � . _ . • ;� i'. L� es..c e 3' P h Fi Y. . LOCATION OF BUILDING N0. ,S°�' �� STREET ��,F'f'� ft�S s �y S' T, �/� PART OF LOT LOT BLOCK ADDITION OR SUBDZqISION CORNER L0� �`INSID,E LOT SET�ACR SIDEyYARD SEWER ELE9ATION FOUNI�ATION ELEVATIQN ' Applicant attach to this form Two CertificaCes•of Surveq of Lot and proposed buildiag location drawn on these Certificates. DESCRIPTIOIQ OF BIIILDING To be used as; �� e� e� G� 4 e°� �+ ire � Front�Depth �� Height Sq. Ft. - ��. % Cu. Ft. Front _ , Depth fleight Sq. Ft. Cu. Ft. Type of Construction�eO ��,p �' �� a� e Estimated Coat `��'� �� To be completed ,� .� e p /� � The unders3gned herebq makea application for a permit for the work herein specified, agreeing to do all work fn strict accordance with the City of Fridley Ordinances and ruliags of ehe Department of Buildings, and hereby declares that all the'facts and representations stated in this application are true and correct, ' DATE i e� -, �� °� �% f S SIGNATURE � (Schedule of Fee Coste can be found on the Reverse Side). �. � � � /�1 � _ � ., ....9 - . --- - � � BUH�DII�G � PERMIT FEE $GHEDIILB SECTION 2. The Inapector of �$ui.lding� ��ii�ll, befoi�e isauing any permit for the erection of any buildiag or structure, or for any addition to any existing buildin� or structure, or for any:alterationa or repairs to any existing building or structure, upon applic��or2�therefore, require the payment by the applicant for auch permit of fees to the amount Yterein_below set forth and in the mauner hereia provided to-wit; �•• 2` 1. For anq auch permit for'the erection of any fire-proof building, othei than a garage, warehouse, factory or grain elevator, or for the erecCion o€ an�y fire-proof'additioni tor similar occupancy, to aay esisting building, shall be at the rate of $1,.40.for each one thousand cubic feet, or�fracti.on thereof, in such cubical contents. �� . f. 2.2 For�any such permit for the erection of'any fire-proof garage, warehouse, factory or grain elevator,, or for the erection of�any fire»proof addition, fo� s3milar occupancy, to any esisting building ahall be at the rate vf $1..25 for each one thousand cubic�feet, classified ae "fireproof" bq Sect�.oa 502 of the M�Lnneapoli$ Building Qode. . HOIISES 2.3. For any such permit for the erection of any non-fireproof building, other than a garage, warehouse, factory or grain elevator, or any non-fireproof addition, for �imilar occupaacy, to any esisting bu,i.lding - perm�L.t $1.00 for each one thousand cubic feet, GARA�ES 2.4. For aay such pezmit�f�r tha erectiQn of any non-fireproof garage, warehouae, factorq or grain.elevator, or for.the erection of any non-fire-proof addition, for similar occupancy, to any e$isting buildiag or fo� each'such " bu3.lding or addition - ninety ceats ($0.90) for each one thous.and cubic feet or fraction thereof, in the cub�.cal contents thereof with the min�mum o£ $4.00. For the purgose of computing fees for building permita, the cubical contenta of any building or addition to a uniform height throughout by multiplqing the ground area covered from a poinC aix (6) inchea below the fl"oor line of the basement or cel�.ar to the ave�age h2ight of Che ugper snrface or to the average height of the roof surface of the main gable of a pitched roof. 2,5* For repairs or alteratione to an existing atructure, the fee shall �_ be at the rate of $3.00 per each Five Bundred Dollare ($500.00) or fraciion thereof in the cost of all proposed work. 2.6. In no case ehall the fee charged for any permit as aet forth in Section 2 be less than $4.00. STORM REPAIR DAMAGE FEES: Resfdentialt Estimated Cost of �ork-�p to S�CO3.40 -$5.�0 Estimated C�st of w�t� e�,er +( 4 J�..�.-�JJ -$�L,s�O � Commer�ial; Estima.t�Cost �f w��l� u� ta ��!��?z�.'0 _$�''�'�� ` _.,,.,.�,�.._.._ �0 �� = �- == Esti�•rit. Cost of wur& o�,�er $SG�.+.t7U -$�.,. SUBJECT PE ' City of Fridley A,, 2 2 6 6 0�: AT THE TOP OF THE TWINS B U I L D I N G P E R M I T --" ' r ; ` RECEIPT NO. � ' COMMUNITY DEVEIOPMENT DIV. � � C � j V �'��'� r � � PROTECTIVE INSPECTION SEC. l l� ` � -__.� �/'�',,� CITY HALL FRIDLEV 55432 NUMBER REV OATE PAGE OF APPROVED BY L 612-571-3450 910-F15 6/30/94 � � 10B ADDRESS 5860 Jefferson St NE 1 LEGAL LOT NO, BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. �F 1 Lyndale Builders 7 Addn SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Charles Shields 58f:0 Jefferson St NE 572-8022 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PNONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK O NEW ❑ ADDITION � ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE X 8 DESCRIBE WORK Reroof Dwelling (16 Squares) 2nd Layer 9 CHANGE OF USE FROM TO STIPULATIONS Roofing can be the 2nd layer but not the 3rd. TYPEOFCONST. OCCUPANCYGROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBIN(i, HEATING, VENTILATING OF; AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONIN(i S0. FT. CU. FT. AUTHORI2ED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OH ABANDONE� 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 EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO 8E TRUE AND CORRECT. ALL PROVISIONS OF LAWS yALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILI BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �880 �.SO DOES NOT PRESUME TO GIVE AUTHORITY TO VIOIATE OR CANCEL THE pERMITFEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. �L3.00 Fire SC .SS PLAN CHECK FEE TOTAL FEE 24.38 I�AT AE OF CON i RAC R OR A �i0 IZED AGENT IDATEI E RO RL ALIDATED THIS IS YOUFi PERMIT ` .� / ` / '.�G-G�f . -{� , SiGNATUREOFOWNE OW RBUILDER� IDATEI �"BLDG � r1ATE N.�W . j j � . Effective I/ 1/94 � ADDN : ( �. � � � � CITY�•OF FRIDLEX. � � � . � ' . ' ALTER ( � SiNGLE FAMILY /�ND DUPLEXES R-I AND R-2 � • � Building Per•mit Application � � . Constructic�n Adcl�ess : _ -� � �j Z' � 2�� i SO i'1 S, �_-- .-� �._L�l.- �e• �------------ ------ Legal Description: _ _ � � � Owner Name 8c Address: ��e �� Tel. !#��_�Q a. � Contractcir: � e L -� � � � � � MN LICENSE�# Address: � . � � . . . . . Tel. # � � . . . LIVING AREA= . GARAGE AREA= DECK AREA: � ' . �OTHER: Attach to this application, a Certificate of Survey of the lot, with the prc�posed construction drawn on� it to scale. . � . DES�RIPTION•�OF �IMPROVEMENT. �. : . . • . . • . : . � •• . � . � .; " Length � � Width � Height � Sq. Ft. : Length � Width � Height � Sq. �,Ft. _ � �� Length � • �' Width' Hgt/Ground. Sq. Ft: � . '� � �. • �,,,,� _ .i . r al .,,,.. � ' r �1 �-...,,n��,,,. � � Corner Lot { ] Inside Lot [ ] T� O� COIIStrUChOII: Approx. Completion Date: _ - . • �, � . � , � • . v , � Ft. Yd Setback � . Side Yard Setbacks � � � �,,-, �� C-, r°, � G�'� �� COSrt: � �: „"___. �� L �_ �- ` � �_'�'� � .� (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft $ _$ DATE: r-a °' ��APPLICANT: � Tel. # Permit Fee Fire Surcharge Staie Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ �� . `' �' � � �� <. -�� -� $ $ $ $ $ $ � .�' -�` CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/lOth%) $.50/$1,000 Valuation $800 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Deternrined by Engineering Agreement Necessary [ ] Not Necessary [ ] y -- SUBJECT P , City of Fridley ,� �� :� AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r � � RECEIPT • COMMUNITY DEVELOPMENT DIV. � 1 V �� D��D�� r � � PROTECTIVE INSPECTION SEC. � � � v � ( � �'��1 � CITY HALL FRIDLE� 55032 NUMBER REV DATE PAGE OF APPRpVEO BY �"""� � �'' 612-571-3450 910-F15 10/5/94 / / JOB ADDRESS 5860 Jefferson Street NE 1 LEGAL �OT NO. BLOCK TRACT OF ADDITION SEE ATTACHED DESCR. L► 1 Lyndale Builders 7 Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Shields 5860 Jefferson St NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION C� REPAIR p MOVE O REMOVE 8 DESCRIBE WORK Reroof Garage (8 Sq) 2nd Layer 9 CHANGE OF USE FROM TO STIPULATIONS Roofing can be the Znd layer but not the 3rd. TYPEOFCONST. OCCUPANCYGROUP OCCUPANCVLOAD SEPARATE PEFMITS ARE REQUIRED FOR ELECTHICAL, PLUMBING, HEATING, VENTI�ATfNG OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT AUTHORIZED IS NOT COMMENCED WITHIN BO DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WOFK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING 1 HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS ypLUATION SUHTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $440 �.SO DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- @ STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. �piS.00 Fire SC �.44 PLAN CHECK fEE TOTAL FEE $15.94 GN u oFCON7RACT0 uT R�2EDaGErvi IDATE� WHEN PROPERL VAU�TED THIS IS YOUR PERMIT �� , � /�' ��Y SiGNATURE OF OWNER iiG OWNEA BUILDEF7i IDATEi BLD �NS f�p7E 1� NEW ADDN ALTER Il [l [J Construction Address: Legal Description: Owner Name & Address: Contcactor: Address: CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Buildiag Permit Application v � Tel. # MN LICENSE # Attach to this application, a Certifit;ate of Survey of the 1ot, with the proposed consttvction drawn on it to scale. DESCRIPTIOAT OF IMPROVEMENT Tel. # Effective 1/i/94 LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length �Vidth Height Sq. F� DECK AREA: Let Width Hgt/Ground . Sq. Ft. OTHER: iz ��- - cg � �N-� �_� Corner Lot [� Tnside Lot [ J Ft. Yd Setback Side Yazd Setbacks Type of Construction: �stimated Cost: $ y(,� Approx. Completion Date: ____ _ (Cost on Back) Driveway Curb Cut Width Needed: Ft Ft = F x$ =$ DATE: �' D� �% APPLICANT: � Tel. # Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge. � 13riveway Esc;row Erosion Control Park Fee Sewer Main Charge TOTAL CITY USE OI�TLY $ %� . C�4 Fee Schedule on Reverse Side $ � .001 0� Perenit Valuation (1/lOth%) $ , �U $:50/$1,�0 Valuation $ $800 p�er SAC Unit $ $5.00 (Staxe Licensed Residentia.l Contractors) $ Alt. "A" or Alt. "g" Above $ $450.00 Conservation Plan Review - $ �ee Determined by Engineering $ Agreement Necessary ( ] Not Necessary [ ] $ i�=� STIPUI.A"i'IOIVS: � �- � 0 BUiLUING PERMIT FEE SCHEDULE "I'tic Ciiief i3ui(ding Ofticial st�a(l, t�efore issuing permits for the erection of any building or sfructure, or f�r any addition to any cxisting building or structure, or for any alteration or repair to any existing building or stlucture, u�n application therefoce, require the payment by the applicant for such �ermit c�f� fc:cs to thc acnount hercin f�elow sct ti�rti� and in thc manner hereia providcxi to-wiL- , `I'01'AL VALUE $1 to $500 $501 to $Z,000 $2,001 to $25,0(?0 $25;001 to $50,000 $50,(IOZ.� ,to $100,000 $100,001 to $SOO,OQO $500,001 to $1,000,000� . $1,OOQ,0p1 and up r-r_r:s $IS (Minimum Fee is $IS plus surcharge) $15 for fust $Spp plus $2 for each additioaai $100 or fraceion thereof, to and including $2,00p � -$45 for fiist $2,ppp p(� $9 for each additional $1;000 - or fraction thereof, to and including $25,000 � . $252 for fust $ZS,ppp pl�s $(_SO far each additional $1;000 or fraction th�eof, t,o. and inclading $50,000 -. $414_SO for first $SO,ppp plus $4.Sp for each additionai .$1,000 or fraditon thereof, to and including $100,000 $63950 for f�ust -$100,000 pius- $3_SO for each additional� � $1,000 or fradion l�eof, to and including -$500,000 . $2(i39.50 for die fust $Spp,ppp pius $3 for each add'ztionat $1,000 or fradion thereof, to and includ.ing $1,000,000 $3539_SO for �e fiist $I,OU0,000 plus $Z for each addiiionai $1,OOQ or fraction �thereof - DRIVEWAY DEPRESSION ESCROW (Conccete C�u-b Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13_S0. Alternate "f3"_ Removal and replacement of curf� and gutter and install a 3 foot widc � ,� approach with 6 inch depth - Driveway width plus 6 fe�t times � 15_75_ VLRIF[Cq"I'(ON Or FOU[YDAT[Ot�! PermiLs for const�uction witl be issued a mini.mum oE 24 hours from the time of ap�{ication to allow for pro�cr rcvicw ot tlie proposul Structurc and of the construction site_ A Ccrtitic:atc oi� Survcy of tlie tot, showing thc location of thc founciatio� once it has ii has l�ccn consU-uc(cci will hc rcyuireel bctore �rocculi�#; with the frarnin�_ � � Sua�etr p c;ty of Fr�a�ey 27811 AT THE TOP OF TME TWINS g U I L D I N G P E R M I T i� � � . COMMUNITY DEVEIOPMENT DIV. r � y � � PROTECTIVE INSPECTION SEC /�� . � � i ,"' : ///�� l--_•� � �', CIT��I�I��SS��2 NUMBEp NEV OAiE PAGE Of APP OVED BY � v 1 7i�i— 5 s�aF�s 9 16 98 / / J08 ADDRESS 5860 Jefferson St NE • t LEGAL LOT NO. BIOCK TRACT Ofi ADDITION SEE ATTACMEO oesca. 4 1 Lyndale Builders 7th Addition SMEET 2 PROPERTY OWNEfi MAIL ADDRES$ ZIP PNONE Charles Shields 572-8022 3 CONTRACTOR MAIL ADDRESS 21P PNONE LICENSE NO Giertsen Co 860 Decatur Ave N Golden Valle 55 2 e ARCNITECT OR DESIGNER MAIL AOORESS 21P PMONE LICENSE NO 5 ENGINEER MAIL AODFESS ZIP PMONE LICENSE NO 8 USE OF BUILOING Residential 7 CLASS OF WORK O NEW O AODITION O ALTERATION � REPAIR O MOVE O REMOVE 8 OESCRIBE WOqK Reroof house & garage (20SQ) Tear-off; Reside house & garage (lOSQ) 9 CHANGE OF USE FROM TO STIPULATIONS Reroof - Underlayment must comply with the State Building Code. Reside - Call for building wrap inspection before covering. SEPARATE PEpMITS ARE REOUIRED FOR EIECTRICAL, PLUMBING, NEATING. TYPE Of CONST. OCCUPANCY GROUP OCCUPANCV LOAD VENTI�ATING OR AIR CONOITIONING THIS PERMIT BECOMES NULI ANO VOIO IF WORK OR CONSTpUCTION 20NING SO. FT CU FT. AUTHORIZED IS NOT COMMENCED WITNIN 80 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANOONEO fOR A PERIOD OF 120 DAYS AT ANY TIME AfTER WOqK IS COMMENCED. NO DWLG. UNITS OFfSTREET PAqKING I HEREBV CERTIFV 7NAT I MAVE READ ANO EXAMINEO TMIS APPLICATION S7ALL5 GARAGES AND KNOW THE SAME TO BE TRUE AND COpREC7. ALL PROVISIONS Of LAWS VA�UATION SURTAX ANO ORDINANCES GOVERNING THIS TYPE Of WORK WILL BE COMPLIED WITM WHETMER SPECIFIEO HEREIN OR NOT. THE GRANTING OF A PERMIT 4 114.00 �Z.OS OOES NOT PRESUME TO GIVE AUTHORI7Y TO VIOLATE OFi CANCEL THE pEqM1T fEE SAC CMARGE PROVISIONS Of ANY OTHEfi STATE OR LOCAL LAW REGULATING CON- STRUCTION O E P RFOFiMANCE OF CONSTRUCTION 99 . 7.5 F e.5�,' �4. i l �/�`� PLAN CMECK FEE TOTA EE i � e s 5.0 $110.91 S�GN AEO�CON'RACTOAOpAUTMONi2EDOGENT 10AiE� EN O VALIOA D MIS IS VpUR PERMI S�GHniUAEO�OwtiEA��OWNEpBU40Ep� �D�iE� BLD �h5o � ` I�qarE � a NEw ADDN ALTER [] [l [l ConstructionAddress: CITY OF FRIDLEY SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION �� a� Effective 1/1/98 �\ �� Legal Description: Owner Name & Address: G�� 5��.oS Tel. #��Z � z s- Contractor: � ��T.S°� � �v MN LICENSE # /� �9�� Address: �� . �.��o � a, �,� �� ti� Tel. # S � � --i�� Attach to this application, a Certificate of Survey of th��°2 % lot, with the proposed construction drawn on it to scale. LIVING AREA: GARAGE AREA: DECK AREA: DESCRIPTION OF IMPROVEMENT Length Width Height Length Width Height Length Width Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft. OTHER: � - t�' - l��"� L�I—r'-�' �� D ° �� - �onstruction Type: f� /I� � � � � -s �� Estimated Cost: $ '`� �l (Fee Schedule on Back) Driveway Curb C�t Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: ��—��6 APPLICANT: Tel. � ��1`�� e�� Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL . STIPULATIONS: CITY USE ONLY $ `°/ 9- %S Fee Schedule on Reverse Side $ '� � � .001 of Permit Valuation (1/lOth%) $ � OS� $.50/$1,000 Valuation $ $1000 per SAC Unit $ � � �d $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 � 9� BUII.,DING PERNIIT 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,Q01 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 $1,0{� 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 $15.75. VERIFICATION OF FOUNDATION Permits for construction will be issued a minirnum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. � A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the framing. .r _ � � G � I � � Z nn N Y�+ �0 �� z� � P- � -i' � �`�' P � '0 < a � � � oa � 7 d � � a � � � , � ' �' n. � O, i � ' 3 � on ; O � � ± � i � , �, �� n � o� �' t � 1 A I �� rn � -v m n � 0 Z T rn m fiN (71 O O � _ 0 � � X � 6� � s � 1 � � a � � N C m• ? o� � � � o . � 0 � V � � ' l►� � � � � � � a � � v � o O 3 � 0 3 � � c � C G �p 0 3 m ro � � � � o � � �� vs-"- 3 .� fn U1 � c� �JI � O o � c O � b m -+ n .� a � _ O cp � � � o � � � 5 � � o 3 a � � a o � � a C m .�.. � t?r�i 9�/ s` > > � p \ tv' � 5,., O 3m p. ''�� 71 5� � �� o � �~ m y A �� ,°o m o � � , m 3 � � � y a O. tD 'i f�D � �i C � .��Q� a O � a � 3' °= s tD fD a � ;� _ - ��°� o;QO � a °�°i °-' 3 _m n �.00 � � �: ;� � -1" � � � a a 3 � � a e ,.. �a-"o = � n � � a g � Q 1 � � � {� � W � � F �. :. �i �,�70 .. � m � s r. ; � � � cs - � ^ � � o � x y� a - � c� m � � C � � � a c� m � � S '� v, 0 � ° � b � a O � � Ool s• � � L7 m !O z t�D � � N � � o�n tD G� o> fA � b a�n � m < c 3 O1 � 0 -Q � � � � � N N N �-�► �A - -�- _� _ Q °o 0 0 °a � � � � � � ��$ �y � v O W Y � Z� a � �.c3D c'a I � � o m � _ �O o � 3� � D ,. � � � � � � a O v m � a R m � � � d o `� d 3 > 1 � 'Ty ' m a 0 � � � � � 0 °� c � � � � � � � � � y VJ � 3 � m � � T L�. � Q � C � � 1 n "� A o � � � � � fD � � W � �- 0 0 � � L 8 m � � 3 � � � C a l 0 . ....�. �.,,., � � rn � a A Ct1 � f' � � � � O °a � � � � j < � � �' m � v � � � r '' v N N z � � V � � -o rn � O � �� r _ � rn � -ai z zo m� z -v v o � � � m ` � W Q � � z � Q v � � N � �' O y, Z a v � L� _ _ � � � � m � 0 � n �� Z O ,�.,, v _ 2 rn � rn m � � � m � � � � O { eo � � �0 ' d �H101 — -�. - �$ � 4 �1 e �F ers [�n � ��-� � le � FBLL IN COMIPLETEi.I( �OR F'iEPLAC�111EfdT FUEL �URNING APPLIAi10E PE9iMIT5 COWIMON VENT, VEN�'CONNEC'TOR AND COMBUSTiON AIR !/ERIFICATION When �alacina an existinc� fumace, the undersigned hereby verifies that the venting has been examined and is free irom nast, deterioraticn, obstructions, � and is �curely supparted and firestopped where required. Yes No () The vendng system is plastirJPVC and meets all curr�nt oodes and manufacturer specificatians including si�ng, length, r►um�c af elbaws and termi�ation. Yes� The tindersigned also verifies that the replac�ment unit � a listed assembly � and meets the current codes and manufac�ers sp�cfficatians. This �lces - --� — - include AGA-GAMA Category 1 Central Fumace Venfi�ng Tables for fan , " assisted and natural draft epptiances. Yes � No ( ) No ( ) -=� The �xistina combustion air is sized and instailed to meet the cuRent codes and manufaciurers specltications. Yes , No (} When required to i�ll a new combustion air. i� will be sized and inst�tled to meet t11e current cod� and m�uufia�urer's specifications. Yes� No () When fr�stallin� a new ver�tinp svstem, th� undersigned hereby verifies that � ls a listed assembly and neeets the current cades and mariufacturers specific�tions. This does ir�dude AGA-GAMA Category I Cer�al Fumac� Venting Tables for fan assisted and naturel draft applianc�s. Y No (} Is the c�mmon verrt and vent wnnectors sized and installed �mectly after an appli�ance has been removed from the common vent and vented separately as per tx�rront oodes. Yes� No ( ) Appliance'T1i�e ancd S�e/Common Vent and Vent Connector iriformation � �� Appliance #'I Type fiv �"� BTU Input �m� Fan Assisted � Appllance #2 Type r, �, BTU 1 t�put r N Appliance #3 Type BTU lnput Fan Assi ed or Nat Total Appliances Tt�al Btu Input BD Common Vent Type �.�! �t�✓'f VeM Height � Diameter �� inches Appfiance #1 Vent Connector Height ,�ft Length 3 ft�ame#a' �in Type 6,' 1� Appliance #2 Verrt Connector Helght ft Length � ft Diameter in Type Appliance #3 Vent Connector F�eight ft Length ft Diameter in Type ALTE�tAT10NS: (Deseri�► 'hf�� 5 � v �-- HEAYING co: River City Sheet Metai, r��. �g�vr'aipi s� � � ap � S Signed By: Date : _ 9 (763) 754-2199 Fax (763) 75a�-�'��