AF - 47673,�
T'i
.� -� 9.�
BUII.DING PERMIT
�\
Village of Fridley, Mi.n.n. N� 2�� n
Date lD.��� .�"�?.� ....................... .
Owner /� . . . . . . . . .�!v . . . . . . . . . . . . . . . . Builder �' .°�l!�Q. . . . . . . . . . . . . . . . . . . . . . . . .
e
Address � ��..�.�.. ���la�.� .. Address .........................................
O�CATION OF BUILDINC�
No. .�`�f ...... Street ............................... Part of Lot .......................
/�� , �
Loic . . .�� . ,.r� fiV K Block . . . . . t f .� . . . . . Addition o r Sub-Division 6�f . . , . , t�. �''�� • : f" • , , , , , , , ,
�-;
i E �
Corner Lot . . . .. . . . . . . . Inside Lot . . r�. . . . . . . Setback � �1� Sideyard 1�.. ���f�.� . . . . . . . . . . . . .
To be Used as:
�(�dr.r�'���. . . .
DES�RIPTION OF BUILDING
Front .��.. Depth �::�... :ieight �Ra�� ....
.................... Front ........ Depth ........ Height .........
Type of Construction�/� ..�� . . . Fst Co�l:����. .� . . . . . . . .
Sq. Ft. ��.. Cu. Ft. ........
Sq. Ft. ........ Cu. Ft. ... .....
To be Completed ?�. ���r�.
� ;.
F•
r
/ �
. f
In consideratio� of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and ' compliance with all provisions of
6rdinance� of t�e village of F'ridley.
.. .. }� .. ...�: ..'.�c� ........' a
I conside•ration of the payment of a fee of $ ��. . . . , permit is hereby granted to . . .�'o.?�'i�� . . . . . . . . .
`.......... to construct the building or ac3 dition as described above. This permit is granted upon
the express condition that the person to whom it is granted and his agents, employees and worl�nen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Nlinnesota regarding location, construction, alteration, maintenance, repair and moving of buildings with-
in the village limits and this permit may be revoked at any time upon 'olation of any of the provisions of said
ordinances.
�
� ... .. . .. Building Inspector
NOTICE:
This permit does not cover the constructlon, installation o� alteration for w(ring, plumbing, gas heattng,
sewe� or water. Be sure to eee the Building Inspector for separate permits fo� these Items.
�%_
� '�� - • J 1,. � �. /
t . .. 3� �... . /.
l/
r `
r '° t�' -
/`
/` �r'-
's
_ _ ______...__�
�7 / ` _. ..
—L '" i
��� '� ���� � � � 1
�
.�! ` >' i
_ _..��. -€ `�' i
�
i
�
;
; _. __ _ _ _ ____: _ ....._..�. ___ __ __,_ ._._.--_.._..,,
.�_r._. _..
i � � ") '
E � _. t. � �� � L:
;, �.. � i
� � ! �
� � M � h
i
i
1
1
� L. .... ...., _t .........-«_..._..,........_.w..=.�..s...._....�,�...�..m_.��
'J
i�
t
`�
/?;
,;
_._._.__. . . _,__ � _ __ � _
. � :i
; ; ,
. - :
� � �f: � _ � , '• � .t° � : _ �.. , �, .. ,.. _..._..
i �
r , `,; f^,
/ ��� '�� � �
i
!
_ . �... __.�...�i
��
City of Fridley, Minn.
BUILDING PERMIT
.:- � � �'
� " 1 " � J � Jm�n;._/ � ��rwY s /.at � . ��..,.d ��..
` � �
�v� szoi�
CATION ING
No. �:� Sir�et ( � �! Part o! Lot
Lot ._._ _.__ Bla Addition or Sub-Diviaion .r�
Corner Lot _ Inside Lot ___..,�"'""�� �rtback � Sideyard ,�.—
�
Sewer Elevation � _.._ Fo dation IIevatiaa
DESCRIPTION OF BUILDING
To vs as:
���F'ront � Depth .�,'f�� Height .,�� 5�• F�. p�� Cu. Ft r���
!�� H'ei ht Sq. Ft. Gw. Ft
Front Depth
Type of Construction �'`�-�"'r" F�t Co �.������...�` � To be Completed
Ea consideration oP the issuance to me of a permft to construct the building described above, I agree to do
th� proposed work fn acc�rdance with the description above set forth and in compliance with all provisions of
ordinancea of the dty of F'rfdley.
�
In consfderatfon oP the payment of a fee oP $��- , permit is hereby granted to
to construct the building or addition as desccibed above. Thia permit is granted upon
the exPress condition that the person to whom it is granted and his agent�, employees and worl�nen, in all work
done 3n, around and upon said buildittg, or any part thereof, shall conform in all reapects to tlae ordinances oP
Fridley, Minnesota regarding local3on, conatruction, alteration, maintenance, repair and moving of bufldiuga
within the dty limits and thts permit may be revoked at any time upon violation of any of the provisiona oi said
ordiaancea .+�'='1 �.+� �-"' '�►
Bufiding Inspector
NOTICE:
ihb psemt! d�s eet cavsr t6s eoest�veNee, iestallaHea }e� �ay,'IumbteW �a huHn�, aw�e er wf�r. B� wn to se�
�h� &rilding le:p�ttae for �p�rab p�rmhs Por fha� Inms.
,�-� � �
Y
City of Fridley, Minn. N° '7607
,�,
BUILDING PERMIT � z � � ��
Date: - June 1 �, 196�
��: H�.ehP ��r G13saa Rea7.tg & Home Bldtrs.
�� �� J�fferson St. N. E. A� 519 loth st. N. W. New �righton,
M�ie�ota
LOCATION OF BUILDING
No. 634i Sts�t deffersoa Street 1V. E. p� of Lot
� 15 g�� 5 Adaition or sub-Divisian ��tie Additiou
Coraer Lot _ Inside Lot Setback Sideyard
Sewer IIevation Foundation IIevation
To be Used as:
Front
Front
Type of Constructfon
DESCRIPTION OF BUILDING
Depth Height Scl. FL
Depth fTeight Sq. Ft
.r F�t. Cost .�� 500.�_ To be Completed
Cu. FL
Cu. Ft
Storm Damage Repa3r
In conslderatton of the iesuaace to me oP a permit to canstruct building descrlbed above I agree to do
tha proposed work in accordance with the description above set f ia compliancae wi a'll pravisions of
orriiaanaea of the dty of FricIIey.
�
In co�aideratlon of the payment of a Pee of $�� , pe�wit fs hereby granted to�este2' Cr7.3,88=1
to construct the buflafng or addition as descrlbed abave. This permit is granted u�
the expr�s conditian that theperson to whom it ia gi�anted and his ageats, employeea an� worlmnen, 9n all work
done in, around aad upon said building, or anypart thereof, st►all conform 9n all raepects to the ordinanc� oP
FridleY, M9nnesata regarding la�ttion� conatruct�Ton, alteration, maintenaace, repair and m�v3ng of buildiuge
wlthin the dtq ]imfts and thia pernoft may be revoked at any tirne upon violat4on oP a�► of the P�v9siona of said
ordinancea.
Allen Je�en 8�� �
NOTICEs
71ds � dea no� emnr t6s eoeshvcH�, ledat�On fer 'rrirtn6. P���9. 6a kuNea, swu er w�tsr. B� aro ts �
dn Boqdie8 I�er hr ap�rair p�rmib Poe th�a ihms.
���'���
�
APPL�t;ATIOR F08 ` �iTi'GDING T
` . _ , . � ' +CIT7f OF' �R�I�:EY� Mi�E�E3'TA � ' - - •
. . _ . . ... . ,._�;.. � . . .
OWNER { S NAt+� , :, �' . �'` _ B'U�L�EI�:�����*�-� �� ������`' �� ��
. . : r-----•�" ' �-�- 4
��. . . .. . . ... M . .
ADDRESS � � ADDRESS l �- � '�`� `�r�`e�"`�` as
_ . � : .. .. _ � L� � ;�
e, t. , .
..: . : .. < _ .,. .
, s�
, — �
� < . � �
. : . .. . , � ;, ... .
. ` ° LOCA�'ION'OF BUILDING .' � . -
No. � � � ��� � • ' ,.$tteet - � . a�� of Lo �,_
_ , _ .� . ,_
LOT . BLOCR ,�ADDITION S SInI�
Corner Lot ' Iriefde`L� � SeCii�C�C � ' � 3ide�Yard ' . �
- �_: . _.__.__ .
SEWER `ffi.EVATYOIV FCIUNDATib� ELEVATION' , ,
Applicant attach to this form Two Certificates of Survey of Lot and propos_ed
building location drawn on these Certificates. �-' ',
_ , • � � ' � DESCRI ON �OF�:BI�II.DIrTG ,
, . . � � . . .
To be :u�ed as; �` . . �
��, , .. . _ . 1,
Front Dept `�_ eight
_ ,54. Ft. Cu. Ft.
.� .. , . , , �.;�'roat ' , ` �
. . D�pth Height ..�
, , _. _ � ,, . . .
.. . . . . : . .. Sq: �t: " . :. _ . . ., � Ci�: gC. _ �:.
�. . _.._ ,. �. .. _. • �
Type of Con�tructiop _ Eseimated Cost �,�� •
� . . . . . . . • . . .. ., , + ; •a , � � - _r� *.
To be cc�mplet�d . :! : � � . . , . . _ .
:
. � . . . . . , �, � : .�.
. • _ .. �;_. . .. _ . �. � . . __
The undersiga�d' 6erebji' malc�s° application �£or a' pesmit �far the wotk here3ir specified,
agreeing ta do all work in strict accordance with the City of,Fridleq Ord�nances
and irul�%iige ibf' the Degai"tnrient df ``Bu�.ldiugs;�' `ani�' hereb'y �declares Chat al'-1 the. facte
aaig' repree�nt�tiarie stated ia `tliis applicaC9.on are� true and corr�ct. �
(Schedule of Fe Costs can be found aa
?���-� _ � �
�
the
./` ,
� ; � ;. ' �
. �� ��� � �
� ; f, r�
, ; ,; �_
,` � �
`;�
':�,
' . .
, i � , BOILDING PERI�T FEE SCHEDT�LE
SECTION 2. The Inspector of Buildings shall, before issuing any germit for the
erection of any building or structure, or for any additioa to anq esisting build-
ing or structure, or for any alteratians or repairs to aaq exietiag building or
structure, upon application �herefore, require the payment by the appl�.can� for
� such permit of fees to the amo�mt herein 6elow aet forth aad in the manner herein
provided Co-�rJ.t:
2.1. For any such permit for the erection of any fire-proof building,
other than a garage, warehouse, factory or,grain elevator, or for the erection
of any £ire-proof addition, for similar occupaacq, to any existing building,
shall be st the rate of $1.40 for each oae thousand cubic feet, or fractioa
thereof, in such cubicai coiitents. _
2` 2. - For any such permit for the erectio� of any £ire-proof garage,
Warehouae, factory or grain elevator, or for the erection of any fire-proo€
addition, for simiiar accupancy, to anq esisting building aha11 be at the rate
of $1.25 for each one thousand cubic feet, claesified as "fireproof" by
• Sectioa 502 of the Minneapolis Bulldin$ Code.
HOUSES
2.3. For any.such permit for the erection of auy non•fireproof building,
other thaa e garage, warehouse, factory or grain elevator, or any non-fireproof
addition, for similar occupancy, to any exiating building - p�rmit $1.00 for each
one thousand cubic feet.
GARAGES
_..._._._
2� 4. For any such permit for the erection of anq aon-fireproof garage,
warehouse, factory or grain elevator, or for, the erection of any non-fireproof
additian, for similar occupancy, to a� esisting building or for each auch
building or addiCion - nineCq cents ($0.90) for each one thousand cubic feet
or fraction thereof, in the cubical conCenes thereof with the miaimum of $4.00.
For the purpvse oE camputing fees for buiiding permits, the cubical contenCs
of any building or addiCion to a uniform height throughout by multiplying the
- graund area covered from a point aix (6) inches below the floor line of the
basement or cellar to the average he3ght of the upper surface or to the average
height of the roof surface.of the maia gable of a pitcbed roof.
;2.5. For regairs or alteratioas to an existing structure, the fee ehall
be at the rate of $3..00 per each Five Hundred Dollars ($500.00) or fr$ction
thereof in the coet of all proposed work.
2.6. In ao case shall the fee charged for any permit as aet forth in
Section 2°ba less than $4.00: '
� ` 4°"`A - 4 L ..v ^
/ \ ' \
sue�ee� RMIT NO.
City of Fridley 3 0 007
AT TNE TOP OF THE TWINS g � I L D I N G P E R M I T
�
; � RECEIPT NO.
� `L __���_ COMMUNITY OEVELOPMENT DIV. �/�
r � � PpOTECTIVE INSPECTION SEC.
�
� _ /'�'1 � CITY FIALL FRIOLEr SS132 NUMBEi1 RFV DATE PAGE OF APVqOVED BY
ti.__.1�-� '•� 612-571-3a5o s�aF�s 8/5/99 / /
J08 ADDRESS
6341 Jefferson Street
t LEGA� L07 NO. BLOCK TiiACT Oii ADOITION SEE ATTACMED
oescR. 15 5 Christie Additi SNEET
2 PROPERTY OWNER MAIL ADDRES$ ZIP PHONE
Jose h Ne sha -
� CONTRACTOR MAIL ADORESS Z�P PMONE LICENSE NO
Precision Roofin 200 -
4 ARCMITECT OR DESIGNER MAIL AOORESS 21P PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS 21P PMONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WOqK
❑ NEW O ADDITION O ALTERATION � FiEPAIR O MOVE O REMOVE
B DESCRIBE WOFK
Reroof house and garage 25 S Tear-off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
TYpE OF CONST OCCUPANCV GROUP OCCUPANCY LOAD
SEPARATE PERMITS AqE REOUIREO FOR ELECTRICAL. PIUMBING, MEATING,
VENTILATING OR AIR CONOITIONING.
THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION 20NING SO. FT CU FT
AUTMOR12E0 IS NOT COMMENCED WITMIN 80 DAYS, OR IF CONSTRUCTION
OR WOfiK IS SUSPENDED OR ABANDONEO FOR A PERI00 OF 120 OAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO DWLG. UNITS OFFSTREET PARKING
I NEREBV CERTIFV THAT I MAVE READ ANO ExAMINEO THIS APPLICA710N STAlLS GARAGES
AND KNOW TME SAME TO BE TRUE ANO CORRECT. ALl PROVISIONS OF LAWS VAlUAT10N SURTAX
AND ORDINANCES GOVERNING THIS TVPE OF WORK WILL BE COMPLIED 21HS
WITM WHETMEii SPECIFIED HEREIN Oii NOT. TNE GRANTING OF A PERMIT � �1.09
DOES NOT PRESUME TO GIVE UTMORI TO VIOIATE OR CANCEL TME pEFMl7 fEE SAC CMARGE
VISI S OF ANY OTNER TE O CAL LAW REGUTATING CON-
STqUC N OR T E PERFOfiMA E NSTRUC710N �83. 25 Fire SC a�2 .�.9
�r �� PLAN CNECK fEE TOT EE
� Licen $S. 0 $ .53
GNATUAEOFCON:AA iOpO 4u Opi2EDSGEHi i0• E� ME PROO A�IpAT MIS IS yQ0�1 P�T
vr
S�GNnTUAE O� OWNEp��� OWNEA BWlOEp� �D�rE� BL G�ti5� r�<<E
�� � _
ADDN
ALTER
Effective 5/10/99
I l CITY OF FRIDLEY.
[] SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2
BUII.,DING PERMIT APPLICATION
Construction Address: �i �� f � e�j—�r S0 r� �� G►,� �
Legal Description:
��� �
ti`°" � /
Owner Name & Address : "j�F� S� � ,��� � Tel . # � 7 / — � � 1 �1
Contractor: _ �' � e ; S, �,� � � .�',-,,,, � MN LICENSE # Zc�� y' Z Z �
Address: 2.�� t��s�l— �-f�• ��� � �� � �JC�;��z � ��i� e Tel. # �y'`���`�
r „
LIVING AREA:
GAI�AGE AREA:
DECB AREA:
OTI�R:
Attach to this a.gplication, a Cer�ificate �f _��rve�C of the
lot, with the propQSed construction. drawn on it to scale.
Length
Length
�
Length
DESCRIPTiUN' OF IlVIPR0�7EMEN'�
Width
�Vidth
WidtYi
r
Height
Height
Hgt/Ground
�� d
Sq. Ft.
Sq. Ft.
Sq. Ft.
�' � ��
Construction Tyge: � �, � � � Estimated Cost: $ ��-� � � �� � �
�- - -
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: ��I �Ci APPLICANT: 1 Tel. # .�a � ^ � �7S �'
� ��'
Penmit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
G =' �
� � .�. �? S
$ � ��
$ / C, �r
$
$ �-`��
$
$
$
$
� �j �J
CITY USE ONLY
Fee Schedule on Reverse Side
.QOl of Permit Valuation (1/lOth%)
$.50/$1,0� Valuation
$1050 per SAC Unit
$5.00 (State Licensed Residential -.Con�:ractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
BUII.DING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any
addition to any existing building or structure, or for any alteration or repair to any existing building or structure,
upon applica.tion 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 $StlO
$501 to $2,000
$2,001 to $25,000
$25,001 to $SO,Q00
$50,001 to $100,040
$100,001 to $500,000
$500,001 to $1,OOO,U00
$1,000,001 and up
FEES
$23.50
$23.50 for first $500 plus $3.45 �or each additional $1(� or
fraction thereof, to and including $2,Q00
$69.25 for first $2,OQ0 plus $14.00 for each additional $1�,000
or fraction thereof, to and including $25,000
$391.25 for first $25,0� 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 $500,000
$3,233.75 for the first $500,000 plus $4.75 for each additional
$1,000 or fraction thereof, to and including $1,0OO,OQO
$5,608.75 for the first $1,000,(�0 plus $3.15 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete C�rb Streets Only)
Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50.
Alternate "B": Removal and replacement of curb and gutt�r and 3nstall a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $23.25.
VERIFICATION OF FOlTNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will
be required before proceeding with the framing.
Building
Inspections �
763-572-3604
763-502-4977 FAX
DATE � '°
SITE ADDRESS
THIS APPLICANT IS:
PROPERTY
OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE
LICENSE. BOND AND
CERTIFICATE OF
INSURANCE
PERMTT TYPE
TYPE OF WORK:
��.��B�G
�SIDEl�TIAL� APPLICA'I'I�l�T
CITY OF FI�I.�E�
EFFECI'IVE i-I-OS
YOUR E-MAIL ADDRESS
� ��
I�OWNER OCONTRACTOR
NAME: ��r��� a � i�I
AnD�ss: fv I 3�,�
PHONE: ��� ,� i . �
NAME:
STATE LICENSE #
S7'ATE BOND # _
�-�5'9
Permit �� '� �
Received By:
Date Rec'd:/! �l �
EXP DATE
EXP DATE
:4TE�ZiP�
.
ADDRESS: CITY STATE ZIP,
PHONE
J�.SINGLE FAMILY
O NEW
DETAILED DESCRIPTION OF 9dORK
O TWO FAMILY
I�12EPLACEMENT
FAX
O TOWNHOUSE
PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the
improvement, insta.11ation or replacement of a residential fixture, excluding the fixtures. (1'his should reflect onty the cost of labor )
Labor cost under $300 =$15.00. Labor cost between $300 to $500 = cost of labor x.OS = plus .50 surcharge
OR
FOR PROJECTS VdHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL
NUR2BER OF EACH BELOV�. MINIMUM FEL $15.50.
� BATH SWK/LAV _FLOOR DRAIAiS _ SHOWER _ WATER PIPING
�gpTH1'�JB • GAS PIPING (NEED CITY LIC) _ SWIMMING POOL _ WATER SOFINER ($35)
CLOTHES WASHER KITCHEN SIIJK WATER CLOSET BACKFLOW PREV. ($15)
DISHWASHER LAUNDRY TRAY WATER HEATER ($35) FOR IRR1GATi0N
— WATER METER _ OTNER
Pernut Fee
TOTAL DUE
$15
$ �� ' Number of fixtures @ $10.00 x $10.00 = $
.50 Number of�xtures @ $15.00 x $I5.00 = $
$ ��y�j OR Number of fixtures @ $35.00 x $35.00 = $
' State Surchazge = $ .50
MIMMLJM $15.50 Tota1= $
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I he�'eby apply for a plumbing permit and I acknowledge 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 appGcation fo a permit and work is not to start without a permit on site; that the work will be in accordance
with the approved plan in the � or ich requires review and approval of plans.
SIGNATURE OF APPLICANT •�� '� PRMT NAME �I �Y ���I�'� DATE l� l o�
APPROVED BY
City of I+'ridley
�uilding Inspections Departnnent
6431 Uxuversity Avenue NE, Fridley, MN 55432
753-572-3604
FAX: 763-502-4977
DATE d�