AF - 47687BUILDING PERMIT
Village of �ridley, Min.n. N� 2 214
Date ������� ..........................
Owner.�..�. .,�.�.�+6�'� ............... Builder ...........................................
Address..� �.�� ............................. Address .........................................
Y.0��4T[ON O�' BUILDING
; .;� �' �"
No. . . � � �. . . . Street �'`.'�.t:`� r : �.���'"�''� �����i�.+iC°. Part of L .
f r ����� � . . . . � /. . . . . . . . .
Lot . . . . . . .�f. ��. . . . . . . Block . . ;F,, � . . . . . .� Addition or Sub-Division . . �� °�:'�°��,'��.� .�,�. ��. . . . . . .
�- r
Corner Lot ............ Inside Lot .��.. Setback �.����. Sideyard .�.�'�..:'�'��............
DES�CRIPT[ON OF BUILDING
To be Used as:
� � 4,
...���,,����. ..
. k,� . Front . e� �t. . Depth . � �. . . Height :'�.'`�.��': . . .
��
�
. . . . . . . . . . . . . . . . . . . . F ont . :�� . . . Depth . � �.�. . . Height ��: .��. ",' . . .
�
�e;� ;�'!��?+�7! ° �
Type of Construction �':�' .�:%�. Est Cost . � . .. .. .. .. .. .
��>�
Sq. F't. ..... ... Cu. Ft, ........
Sq. Ft. ..... .. . Cu. Ft . .......
��
To be Completed � . . �.�. �".'�.°. . ' .�
G�" �
In consfderation 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 in compliance with :all provisions of
ordinances of the village of �'ridley.
� ............. . .........
- c ation of the payment of a fee of $. :�+� ..'. , permit is hereby granted to . . �
:�T.'I. .��. ......., to construct the building or ad dition as described above. This � pernut i s g ran t e r l u p o n
the expres� 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 ordiaances of
�'ridley, Minnesota. regarding location, construction, alteration, maintenance, repair and moving of buildings with-
in the village limifs and this permft may be revoked at any time u�on violatSi�«of any of the provisions of said
drdiriances. .�°`:, . ,�' `'�
NOTICE:
_Tr:;
:�:`°:�:: Building Inspector
This permit does not cover fhe cons4ruction, installation or alteration for wiring, plumbing, gas heating,
sewer o� wate�. Be sura to see the Buiiding Inspector for separate perenits for these Items.
v'�, �
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City of Fridley, Minn. N° 8995
BUILDING PERMIT
Date: SEPTEMBER 2, 1966
Q�; FRED A. STWE $�� ROR STnCKDTT T.
Ad�r�s 6361 JEFFERSON ST. N.E. �,� GOLDEN VALLEY
FRIDLEY, MCNNESOTA 55421
LOCATION OF BUILDING
N�, 6361 g�t �FERSOIQ STREET_ 1�I.E, Part oP Lot
Lot 17 Block 5 Addii3on or Sub-Diviaion ��ST�
Coraer Lot Inside Ieot g Setback — Sideyard
Sewer IIevation — Fo�mdation IIevation
DESCRIPTION OF BUILDING
To be Used as: ADDED TO THE REAit OF PRESENT ATT. GARAGE
ADDITION TO GARAC�t 2 Z Depth 3� Height gq, �, 6, 6 00 ��
Front Depth ITeight Scl. Ft Cu. Ft
Type oP Conetructfon � F.st. Cost —�Q _ To be Completed
In conslderatlon o4 the issusnce to me of a perrmit to et building descrlbed aimve I agree to do
th� praposed work ffi accc�rdance wlth the d�acription above t fo in compliaa wi a'll r ns oP
oniiaances of the dty► oP Frldley. f
In cam�deration oP the �yment of a fee oP $ 7.00 , permit fs her8by granted to BOB STOCI�ILL
to conatruct the buil8ing or additfon es descrlbed above. Thisp�rmf t fs �ranted up�
the exPress con�iitlon that thepe�on to whom it ie greated and hfs agente, employees and worlmiea, 9n all work
doae fn, arauad aad upon eaid buil�ia8► or anypart thereoY, shall coffiorm in all respecta to the o�inaac� oP
Frldley� Minnesota reganliag locatton, conaiructlon, alteration� maiatenancQ, repair aad movin� oP buil8ia$s
�� dty ]imits aad thfs permit may be revoked at any tlane upoa vlolatton oP aay oP the provisions o� eaqd
CLARENCE BII�SLE $��S �
�'� NOTIC�
'Ihb p�nek doa ee� ee�a t6� ceesduadee, tu�laUatioe �o� wWeW P��6. Ya 6�Mtno, aw�r oe w�r. e� wn ro a�
Nn 6QiWlnB Ie�ior �er ap�rati p�mhs he d�a inm�.
��
A�PLiCATION FOR BUILDING PERI�IIT
CITX OF FRIT�LEY, MINNESOTA
OWNER'S NAME
9 -
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ADDRESS i� '� � % � � ���,�/� , -,� `/ , � � ADDRE5S
.
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LOCA�"i0N OF BUILDING
N0. (� .� (� / STREET " �/ .�`,' �,�, �• PART OF LOT
LOT BLOCR ADDI1'ION OR SUBDIVISION i'� ��r�� ,�a,/
CORNER LOT INSiDE LOT � SETBACR SIDE-YARD
SEWER ELEVATION FOUNDATION ELEVATIQI4
��
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawa on these Certificates.
DESCRIP7.ZOA OF BIIII.DING
To be usec�-as;,
1��'�� t=
��� Front Depth fleighti �,
d . Sq. Ft . � � � �. ��`l � Cu. /Ft . � � �� � � � � � ' �,
Front ' " Dept � eight
Sq. Ft. Cu. Ft.
. �
Type of Con�truction �'���'��`�-� _ Estimated Cost ;�y-� �
To be completed �,�,,-%,.�f_� �i��"�/0�' ��% ��>�-•'�T�cdJ'
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work ia strict accordance with the City of
Fridley Ordinances and rulings of the Department of Buildings, and hereby
declares that all the facts and repreaentations stated in this application
are true and correct.
DATE
(Schedule of Fee Costs can be found on the ReversQ Side).
.;
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BIIILDING PERMIT FEE SG`HEDQL$
SECTION 2. The InspecCor of Buildin�a ahall, before issu3ng any permit for
the erection of any bu�,iding� or•' st�cture,� or for any addition Co any e�tisting
building or structure, or for any alterationa or repairs to any existing
building or atsucture, upon applicatioa therafore, require the payment by the
applicant fos such permit.of•�ees to.the amount herein below eet forth and in
the manner herein provided to-wit;
2.1. For any�such permit for the erection of any fire•proof building,
othei than a garage, warehouse, factorq or"grain'e�,evator, or for the ereceion
of any fire-proof addition, far similar occupancy, to any eaisting building,
shall be at the°rate of $1:.4Q.for each one thousaad_cubic feet, or fractioa
thereof, in such cubical contents.
2.2 For any.such perm3t for the erection of any fire-proof garage,
warehouse, faetory or grain elevator, or for the erection of any fire�proof
addition, for similar occupancy, to any existing building aha11 be at the
rate.of $1.25 for each"one thoueand cubic feet, claasified as "fireproof"
bq Section 502 of the Mianeapolia Building Code.
HOIISES
2.3. For any auch permit for Che erection of any aon-fireproof
building, other thaa a garage, warehouso, factory'or grain elevator, or
any non-fireproof add3tion, for similar occupancy, to any existing building -.
permit $1.00 for each oae Chousand cubic feet.
GARAGES - � � _ .
i ' ..
2:4. For any such permit for the'erection of any aon-fireproof garage,
warehouse, factory or graia elevator, or for the ereotion of any non-fire-proof
addition,�for aimil�r occupancy, �to any�esiating building or for each suc�h
buildin� or addition - ninety cents ($0.90) for each one thous.and cubic feet
or fraction thereof, in tlie cubical conteizts thereof with the minimum of $4,00.
For the purpose of comguting feea for building permits; the cub3cal contenta
of any building or addition to a uaiform height throughout by multiplying the
ground erea covered frat� a pvint six (6) inchea below the floor line of the
basement or cellar to the average height of the upger surface or to the average
height of the roof surface of.the �in gable of a p3,tched roof.
2.5. For repairs'or alterat�.ons to an ex�isting structure, the fee ahall
be at the rate of $3.00 per each Five Huadrec� DoYlars ($500.00) or frac��.�n
thereof in tha cost of all proposed work. �� �
2.6. In no case shall the fee charged for any permit as aet fo�cth in
Section 2 be less than $4.00.
STORM REPAIR DANIAGE FEES:
Resfdential : Eatimated Cost of work up to ���'!1, �� .- S5 0^�
Estimated Coat of work ove� ','. ,.,..�;;� �`,. �:�
y .� .
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^' . ...t;,L Y�.. ?
., , ._ Estimated �.,st of �;��r:� ovc:r r_�+:+:. iJa! - $;:i%• - -
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City of Fridley � 2 9 7 09
AT THE TOP OF TNE TWINS g � I L D I N G P E R M I T
r
S : O.
� `v ___�__ COMMUNITY OE�EIOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC. 3��S
� _ �
� /"'1 � CITY MALL FRIOLE� SS13$ NUMBER pEV OATE PAGE OF APPNOVED BY
�----�' �•' 612-57t-3abo s�o-F15 6/17/99 / /
JOB ADpRESS �
6361 Jefferson Street N
t LEGAL LOT NO. BLOCK TpACT OR ADDITION SEE ATTACHED
DESCR. 17 5 Chri sti SHEET
2 PROPERTV OWNER MAIL ADOR�S$ ZIP PMONE
John & Karen Peterson
3 CONTqACTOR MAIL ADDFESS 21P PMONE UCENSE NO
S.M.A. Inc. 810 Lil c D -
4 AqCMITECT OR DESIGNER MAIL ADORESS ZIP PNONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE IICENSE NO
8 USE OF BUILDINCi
Residential
7 CLASS OF WORK
O NEW � ADDITION O ALTERATION � REPAIR O MOVE O REMOVE
B DESCRIBE WORK
Reroof house and ara e 33 S Te r- ff
9 CHANdEOfUSEFROM TO
STIPULATIONS
Underlayment mus� comply with the State Building Code.
SEPARATE PERMITS AqE REOUIRED FOR EIECTRICAL, PIUMBING, FIEATING, TYPE Of CONST. OCCUPANCY GROUP OCCUPANCV LOAD
VENTILATING OR AIR CONOITIONING.
THIS PERMIT 9ECOMES NULL ANO VOIO IF WORK OR CONSTRUCTION ZONING SC. FT CU FT
AUTHORIZED IS NOT COMMENCED Y`IITHIN 80 OAYS, OR IF CONSTpUCTION
OR WORK IS SUSPENDED OR ABANDONED POR A PERIOD OF 120 OAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTpEET PARNING
I HEREBY CERTIFY TNAT I HAVE REAO AND EXAMINEO THIS APPLICATION STA�LS GARAGES
AND KNOW TME SAME TO BE TRUE AND CORRECT. ALL PROVISIONS Of LAWS yp�UATION SURTAX
ANO ORDINANCES GOVERNING TNIS TYPE OF WORK WILL BE COMPLIED O /1 7
WITH WMETMEii SPECIFIEO MEREIN Ofi NOT. TME GRANTING OF A PERMIT $ZHZO �l.�Fl
DOES NOT PRESUME TO GIVE AUTNORITY TO VIOLATE OR CANCEL THE pE�MIT FEE SAC CMARGE
PROVISIONS OF ANY OTMER STATE OFi LOCAL LAW REGULATING CON- O
STRUCTION OR 7HE PERfORMANCE OF CONSTRUCTION �p3 e ZJ Fi re SC Z. H3
PLAN CNECK fEE TOTAL FEE
License SC 5.00 92.49
S�GN4TUAE OF CON'AACTOA Op oU1MOA�2E0 AGENt iD�tEi WMEN PAOPERLY LIOATED THIS IS YOUR PEpMIT
/ � //
$�GNaTUAE O� OWNEA��� OWNEp6URDE�1i iOAfE� BL �NSo � q�if
r�w �` [ ]
ADDN [ ]
ALTER [ ]
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
'Y
Effective 1/1/98
BUILDING PERMIT APPLICATION
' e r� b� �5
ConstructionAddress:� � � f � F ���'2.�o��J �� �l` €.
� � ��
Legal Description:
Owner Name & Address:��
'C�tractor: ��%�. � �� .
��,,,� -
Address: �/�' ,� z L �-�'C_ ��i', ��>Lc��'� ,
LIVING AREA:
GARAGE AREA:
DECK AREA:
��a�'ati'� Tel. #
�
) MN LICENSE # �a� �� �� �
�
��� � �Tel. # �o�r� ll� c� �
Attach to this application, a Certificate of �rvey of the
lot, with the proposed construction drawn o it to scale.
DESCRIPTION OF Il�RPROVEN�NT
Length Width Height
Length V6�idth Height
Length Width Hgt/Ground _
Sq. Ft.
Sq. Ft.
Sq. Ft.
01'I�R:
� C � 3� -
Construction Type: �A� O�� -� o v Estimated Cost: $
(Fee Schedul e on Back) p�, ��
c7
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
�
DATE: � � S �1� APPLICANT: �2e y! Tel. # ��� �`.�'�i � �
,�
CITY USE ONLY
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ ����
$ , �
$ �, �il
$
$ ����
$
$
$
$
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.soi$i,000 v��t�on
$1Q00 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determ
Agreement
$ `� • � � ��a �
�
. ,n
BUII.DING PERNIIT FEE SCAEDULE
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 pemut 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 ev $25,000
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $500,000
$500,001 to $1,000,000
$1,000,001 and up
FEES
$21 (Minimum Fee is $21 plus surcharge)
$21 for first $5� plus $2.75 for each additional $100 or
fraction thereof, to and including $2,OOQ -
$62.25 for frst�2,D00 plus $i2.50 for each additi�nal �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 $100,0(}0
$887.25 for first $100,000 plus $5.00 for each additional
$1,000 or fraction thereof, to and including $500,000
$2887.25 for the first $500,000 plus $4.25 for each additional
$1,000 or fraction thereof, to and including $1,000,000
$5012.25 for the first $1,000,000 plus $2.75 for each additional
$1,000 or fraction thereof
DIZIVE�AY DEPItESSION ESCR()�
(Concrete Curb Streets Only)
Altemate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet tunes $13.50.
Alternate "B" : Removal and replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $15.75 .
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the tune of application to allow for proper
review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed
will be required before praceeding with the framing.
� sue�etT � P RMIT N .
c�ty of Fridle� 3 2 0 5 s
AT TME TOP OF TME 7W INS g� � L D I N� P E R M I T
;, ,
� ` �72-3604 R � /
� • COMMUNITY OEVELOPNI�NT OIV. � / �
� ; V ������ . .
r � � PROTEC7IVE INSPECTION SEC.
� _ �"'1 � CITY NALL FRIDLEV 53132 NUMBEp 11EV D�iB v�GE OF �vvrtOVEO Br
�----� � �•� 612-571-3450 910-F15 8�8�01 / /
JOB ADORESS 6361 Jefferson Street �
1 LEGAL ��T NO. BLOCK TRACT OR ADDITION SEE ATTACHED
oesca. 17 5 Christie Addition SHEET
2 PFOPERTY OWNER MAIL AOpR�S$ 21P PMONE
Jo�n Peterson, 6361 Jefferson St., Fridley, MN 55432 763-571-6829
9 CONTRACTOR MAIL ADORESS 21P PMONE LICENSE NO
Master Remodeling, INc., 32 TOth Ave S, Hopkins, MN 55343 952-932-9311 20012916
e ARCMITECT OR DESIGNER MAIL ADDRESS i1P PMONE UCENSE NO.
5 ENGINEER MAIL ADORESS ZIP PHONE IICENSE NO
8 USE OF BUILDING
Residential
7 CIASS OF WOFK �
�] NEW O ADDITION O ALTEFiAT10N O REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Replacement windows
8 CHANOE OF USE FROM TO
STIPULATIONS �
Provide smoke detectors in all sleeping rooms and on all levels of the dwelling
per Section 310.9.1.2 of �the 1997 Uniform Building Code.
Caulking & flashing for all exterior openings.
" TVP�OFCONST. OCCUPANCY(3ROUP OCCUPANCVLOAD
SEPARATE PERMITS ARE REOUIRED FOF ELECTRICAL, PLUMBING, FIEATING,
VENTILATING OR AIR CONOITIONING
TMIS PERMIT BECOMES NULL AND VOID IF WQRK OR CpHSTRUCT10M 20NlNCi SQ. FT CU FT.
AUTHORIZED IS NOT COMMENCED V�IITMIN 80 OAYS. OR If CONSTRUCTION ,
OF WORK IS SUSPENDED OR ABANQONQO fOR A PER100 OF 120 DAYS AT "
ANY TIME AFTER WORK IS COMMENCED. ' NO. DWLG. UNITS OffSTREET PARKING
I HEREBY CEHTIFV THAT 1 NAVE FiEAO ANO E%Ay11N�0 THIS APPLICA710N STALLS GARAGES
ANO KNOW THE SAME TO BE TRUE AND CORFIECT. AlL PROVISIONS OF LAWS VALUATtON SURTAX
AND ORDINANCES GOVERNING THIS TVPE OF WORK WIIL B� COMPLIED
WITM WMETHER SPECIFIED MEREIN OR NOT. TME GRANTING OF A PERMIT �3,689.00 �1.H�F
DOES NOT PRESUME TO GIVE AUTHOFITV TO VIOLATE Oii CANCEL THE pEqM17 fEE SAC CMAAGE
PROVISIONS OF ANV OTMER STATE OR �OCAL LAW REGULATING ,CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION �97.25 . Fire SC �3. C)S
PIAN CMECK FEE TOTAL FEE
ense SC $5.00 $107.77
S�GNATUAE OF CON •AACTOa Op AUTMOA4ED AGENT iOniE� yy E PqOPERLV VALIDATED TNIS IS VOUR PERMIT
� �� q \ 7 I
SGNA7UAE O� OWNEp��� OWNEpBU4DEfii �DATEi � B ��h5 � p�tE �—
N� Il
ADDN []
ALTER [ ]
Effective 1/1/2001
CITY OF FRIDLEY (763) 572�604 Bldg Insp
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: �� � � °�c= � ¢��Z �% �A.� �. It.1 • �
Legal Description:
Owner Name & Address: �4 �K% '�L�L'7l�'ri"� Tel. # � • � gl 6�.1' �
Contractor: ���D��' �' MN LICENSE #�Oz� ! x Q/ C�
Address: Hoa�ina Miaa�a 868�i Tel. # 4c1 �. ��I l• Qi�l /
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
��c�lp�lication, 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 Width HgUGround Sq. Ft.
Construction Type:�cs�''ae c% �G� ��4J .S Estimated Cost: $ �� � Z . �
Driveway Curb Cut Width Needed: + 6 F Ft x$ _$
DATE: 2 6 v� APPLICA . �-- , Tel. # �'cJ e�• %�iLr �.� ` /
1
CITY USE ONLY -
Permit Fee
Fire Surcharge
5tate Surch�rge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
Call (763) 572-3604 for Permit Fees if mailing in application
$��� ��� Fee Schedule on Reverse Side
$ .�`� Q C� �.001 of Permit Valuation (1/10th%)
� � � ��/ $.50%$1,Q�JQ i4alu�tio�
$ $1150 per SAC Unit
$ ��$5.00 (State Licensed Residential Contractors)
$ Alt. "A" or Alt. "B" Above
$ $450.00 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement Necessary [ ] Not Necessary [ ]
$ l� 'i . '��%
�
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 $5{)0
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $500,000
$500,001 to $1,000,000
$1,000,001 and up
FEES
.'�3� ,���,���'� R� � °� ����
$23.50 ��� r�Y..n . P-> ��'a ��
d �:�,;���� �: ; " - ���
$23.50 for first $500 plus $3.�������'--�Ii=�'-�itional $100 or
fraction thereof, to and includi���$�2�;�� 3�`; �
$69.25 for first $2,Q00 plus $14.00 for each additional $1,000
- —�-��:�i��r �rrof, �-� ::iti ir��ucii�g ��,� ---
$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 $1,000,000
$5,608.75 for the first $1,000,000 plus $3.15 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
_ �oIICrete Curb-Str��ts �n�y) -
Altemate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50.
Altemate "B": Removal and replacement of curb and gutter and install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $23.25.
VERIFICATION OF FOUNDATION
Pernuts 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. New Houses Onlv