AF - 47767�
�; �,
City of Fridley, Minn.
BUII,DING PERMIT
Date: . . .°. : . . . � . .�. . � .-.1 . . . . . . . . . . . . . . .
N° 3844
Owner . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Builder . . . . e�G1��1�' . . /��! :� : : ":':� . . . . . . . . . . .
Addr�s ...................................... Address ..............�.�....................
LO�ATIQ�1i OF BUILDING
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No. 4� P. .��. . Street . . . . . � . . .4 . ��: .� . Part Lot . .. .. .. .. .. . . . . .. � %
.. . �
Lot ....�...... Brack .. ..��.. Addition or Sub-Dfvision .!*�.4�.'r."N.��.. .......
r ` o �.
Corner Lot ............ Inside Lot .x......... Setback,,�.�... Sideyard �o. �� ................
DES�R[PTION OF BU[LDING
T be Us e� r .,
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� . . . . . . Front '��.� 1?epth f� 7.'� Height /. .7. .°`� Sq. F't. /. .4'. � ���' �
fi . . � Cu. Ft
�� . . . . Frpat � � Q.�.� Depth � � 1 �'Hdght l.�P. :� Sq. F't. ��� G�. Ft. ����
�+pe of Construction .................., F.st Cost..................... To be Completed ...................
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In consideration of ffie iss�ance to_ me oP a�rmit to construct
the praposed work in accordance with the deacrlption ahove sej�s!
ordinances of the ciLy of Fridley. (
��
In consideration of the payment of a fee of $�� �.'°.�. .�,
uilding degribed above, I agree to do
r
i in compHance wfth all pro of
.
. .�.s. .. . . .. ...
is hereby granted to ...................
. . . .. . . .... . . .. .. . . . .. . . . to construct the bwllding or �.ddftion as described above. This permit is granted upon
the express condiiion that the person to whom ft ie granted and hia agents, employees and worlrmen, fn all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances o4
Fridley. Minnesota. regarding location, construction, alteration, maintenance, repair and moving of buildings with-
in the dty ]�fts and this permit may be revoked at any time upon violation of any of the provisiona of sa3d
ordinances. �
NOTICE:
1
.... Building Inapector
This permlt does not cover the const�uotlon, InsEat(atlon o� alteration fo� wlring, plumbing, gas heating,
sewe� o� water. Be sure to see the Building inepector fo� separate pe�mita fo� thmse itama
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MINDERENGINEER.INC� �O.,INC.
ENGI NEERS AND SURVEYORS
LAND BURV@YINO ' 801L3 TESTINO
GIVIL d, MUNIGIOAL ENOINEEQINGi LANO Pt_ANNIN6
6418-56T" AVENUE N.
MINNEAPOL►5 27, MtNN.
KE 7- 3�37
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WE HEREBY CERTIFY TNAT TN15 IS P► TRUE AN� CORREGT REPRESENTATION OF A SURYEY OF THE BOUNOARIES OF TME
LAND ABOYE DESCRIBED ANO OF7HE LoCATION OF ALL BUILDlNGS, IF ANY, THEREON , AND ALL VISl6l.E ENCROACHMENTS,
,F �,r, FROM ORON SAtO LAND. MINDER ENGtNEERING CO., INC.
DATE�TXIg pNYOF M�Y A.0.�95 �
� EN6�t�il AND SURvflYORS
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natg; Jul� 13, 1965
,•.•.� - ; �: ; � r : �— �i
Ca.ty of Fridley, Minn.
BUILDING PERMIT
Builder �ON IP1C .
�����
N° 8180
Ag� 6$21 Jefferson St. __ Ad� ?Ol Co]a�mbia Blvd.
Fridley 2I, Minnesota Miru�.eapolis, N�innesota
LOCATION OP BUILDING
Na ���- Street Jef'ferson St. Part of Lot
Lot 1 Bl�k 5 Addition or Sub-Divisian 1�C. `.i.� �T 6
Corner Lot Inside Lot Setback Sfdeyard
Sewer IIevation � Fo�mdation IIevation
To be vsed as:
DESCRIPTION OF BUILDIIdG
Front Depth � 73eight Sq. Ft Cu. Ft
Front Depth I�eight Sq. Ft Cu. Ft
Type of Construction Fast. Cost 19��0•(� _- To be Completed
REBIIIIZD DDE TO S�OBM DAt�1GE
In consideration oP the issuance to me of a permit to c
ths ProPosed work in acc�rdance with the drescription ab e set
ordlnant�es oP the dty of FrYdley. �
Ipa �� �
In con�deraiion of the payment of a fee of �; 1�•� , p�rmit fs herebY graated 'to �C�3.paR,D �AR�N
to canstr�uct the buflding or addition as d�cribed above. This �ermi� is granted upon
the eapress c�ndition that the n to whom it 4a granted and hia agenta, employees and worl�nen, fn all arork
flo�e fn, ara�md and upon building, or anypart thereof, shall conPorm in aII respecffi to the orainaaces aF
FricIIey� Minnesota location, construction, alteration, maiatenance, r+epair and a►ov9ag of bwtldin�s
within the dLy limit$� permit may be revoked at any tiaae upon violation of aTMy of the proviaiona of eaid
a�dinaat�ea.
,�EAT G. d�bTSEN BuildinS inspector
NOTICEs
ihis psimh deu aof ee�rsr ths cee�leucHon, tmfalWion hr trirtny, plumbtee. an 6adeo, sevru or rvatar. 8� sun ro a�
ths Buildin� In�etar tor apuw p�emds for fMa (�ms.
^
" . - . . � ... , .—
AP1'��CATION FOR $VtLDING PERMIT
CITY OF FRIDLEY, MINN$SOTA
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ow�x's
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. . LOT ,/ �,LUCR . -� � ADDIT�ON
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Corner Lot�_��side �,OT�, ., Setbeck Side-�Yard
Part of Lot
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. . �S�1ER �i.EVAZ'TON , FQUNDATIDN ELEVi�TfOI�, �, - ,� _
Applicant attach to ehis form Two CerCificates of Survey of LoC and proposed
_ buildiag location drawn on these Certificates.
DESCRIPTIOAI OF BIIIIrDING
To be u d as • �
� r %
^ Front � ��'�% DePt .� Height � �
. Sq. Ft. �CO Cu. Ft.
Frant�� —p Depth�� ,��� Height � r �
� Sq. Ft. �� � Cu. FC.
�{ ��p
Type of Coastruction "�jJj�,9j�j Estimated Cest .��,��� !�°"�
//� �
To be complQeed_ � ���������
q'he tu►dessigned her�by makes application for a permit for the work herein specified,
agreeing to do all work 3n strict accordaace with the Citp of Fridleq Ordinances
and.rulings of the Department of Buildinga, and herebq declares that all the facts
and repres�ntationa stated in this application are true and corre �
HA SIGNATURE
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(Schedule of Fee Costs can be found on the Reverse Side). �
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HDILDII�IG PERMCT F� :.SCIiED�BI.E
SEGTION 2. The Iaspector of Buildings eha].l. before issuing any peranit for the
erection of any buildin� or atructure, or for any addition to anq euistin� build•
ing or structure, or for any alterations or repairs to anq eaieting building or
structura, upon application therefore, require the payment by the applicant for
sucb permit of fees to the amouat herein below set £oreh asd in the.maaIIer°harein..
provided to-�nLt;
2,_ 1. For any such permit for the erection of any fire-+praaf building,
other than a garege, warehouse, faceory.or�grain elevator, or for Che erection
of aay fire-proof additioa, for similar occupancy, to any exieting building,
shall be at the rate of $1.40 for each one thousand cubic feet, or fractiou
tbereof� in such cubical contents.
2.2. For aaq euch permit for the ere�tion of $ny fire-proof garage,
_ Wareh ae, factory or grain elevator, or for the erection of any fire-pxoof
addition, for similar occupancy, to any existing buildiag shall be at the rate
of $1.25 for each ane thousand cubic feet,.claesified as "fireproof" bq
Section 502 of the Minaeapblis Building (Sode.
SOOSLS
2.3. For any such permit for the erectfon of any noa-�irepraof ba3lding,
other than a garage, warehouse, factory or grain elevator, or any non-fireproof
addition, for similar occupaacy, to any exieting buildiag - permit $1.00 for esch
one thousand cubic feet. .
GEIRAG''S
2 4_ For any auch perm�tt for the erection of anq noa-fireproof garage,
warehouse, factory or grain elevator, ar for the erection of anq non-fireproof
addiCion, for s�imilar occupancy, to any existing building or for each such
building or addiCion - ninety cente ($0.90) for each oue thovsand cubic feet
or fraction thereof, ia the cubical content� t�ereof with the miaimum of $4.00.
For the purpo�e of computing fees for buildin� permits, the cubical coateats
of anq building or addition to a uniForm heig&t thraughout bq multipiying the
ground area covered from a po3ne six (6) inches below the floor line of the
basement or cellar to the aver�ge height of the upper surface or to the average
height of the roof surface of the main �able af a pitched roof.
2.5. For regairs or alteratiane to ati exieting st�ructure, the fee shall
be a the rate of $3.00 per.each Five Hundred Dollars ($SOO.OQ) or fractioa
thereof in the cest of all propoaed work.
2•6. In no case sha11 the fee charged ior any peranit as set fart� in
Section 2 be le�s ehan $4.00. . .
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CHIM��EY AND STACK VERIFICATION
The undersi.gned hereby veri.fies that the existing chimney or stack; �
1. 'Has .been. careful ly examined. � Yes (, )
2. Is free fran rust or deterioration -� Yes ()
3. Has no foreign objects lodged within Yes ()
4. Is securely supported . Yes ()
5. Meets all current Code requirements for size and .
total BTU connected � Yes ( )
6. Has To ta 1 hea ti ng BTU' s of
All other BTU's
TOTAL
Rema rk s
No ( )
� � )
No ( )
No ( )
No()
.
Campany
Signed By
Da te
0
SUBJECT
City of Fridley
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
i �
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� `L � COMMUNITY DEVELOPMENT OIV.
r � � PFOTECTIVE INSPECTION SEC.
i . �
� _ /"'1 � CITY HAIL FRIDLE� SS432 .NUMBER REV OATE PAGE OF
�.__.11.' �•� 612-571-3450 9t0-F15 7/22/98 / /
JOB ADORESS
6821 Jefferson St. NE
t LEGAL �OT NO. BLOCK TRACT OR AODITION
DESCR. 1 5 Rice Creek Terrace, Plat 6
2 PROPERTY OWNER MAIL ADDRES$ Z�P
Luis Giron 6821 Jefferson St N
3 CONTRACTOR MAIL ADORESS Z�P
Owner
4 ARCHITECT OR DESIGNER MAIL AOORESS ZIP
5 ENGINEER MAII ADDRESS Z�P
8 USE OF BUILDING
Residential
7 CLASS OF WORK
2��
RE EI� NO..
AVPROVED B
SEE ATTACHED
SHEET
PNONE
572-1780
PMONE LICENSE NO.
PFIONE IICENSE NO.
PHONE LICENSE NO.
❑ NEW ❑ ADDITION ❑ ALTERATION � REPAIR ❑ MOVE O REMOVE
B DESCHIBE WOHK
e (26 Sq) Tear-off
9 CHAN(iE OF USE f ROM TO
STIPULATIONS
Underlayment must comply with StateBuilding Code.
SEPARATE PERMITS ARE FE�UIRED FOR ELECTRICAL, PLUMBING, MEATING, ��� �
VENTILATING OFi AIR CONDITIONING.
THIS PERMIT BECOMES NUIL AND VOID IF WORK OR CONSTRUCTION 20NIN(i
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERI00 OF 120 OAYS AT
ANY TIME AFTER WORK IS COMMENCE0. NO. DWLG.
I HERE9Y CERTIFV THAT I HAVE FiEAD AND EXAMINED THIS APPLICATION 1
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION
AND OFiDINANCES GOVERNING THIS TVPE OF WOFiK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �2168
DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OR CANCEL THE pEqM1T FEE
PROVISIONS OF ANY OTNER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. �%�F. %S
NATUHE OFLONiAACTOR OR AUTNORIZED AGENT
/ 1 1 \ ..
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IDATEi 7J
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Sa.
STALLS
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LOAD
CU. FT.
GAfiAGES
�1.�8
iAC CMARGE
ire SC $2.16
OTAL FEE
$77.99
I THIS IS VOUR PERMIT
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1�TEW
ADDN
ALTER
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CITY OF �'RIDLEY
SINGLE FAMII,Y AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress:l.�� (� \ �
W ��, � ,��
Effective 1/1/98
B� /
�/n� �`
\ C`` �
Legal Description: �
Owner Name & Address: S � d 1. #�`� Z—� 7�
�•
Contractor: �q�� `� �: r` MN LICENSE #
Address: Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale. �
LIVING AREA:
GARAGE �AREA:
DECK AREA:
OTHER:
DESCRIP'rION OF IMPROVEMENT
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
Length Width Hgt/Ground Sq. Ft.
Construction Type: Estimated Cost: $ �� C-� �� �
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + Ft = Ft x$ _$
DATE: �' �' / �i APPLIC Tel. # -- �
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
,
CITY USE ONLY
/� ^
$ /�� 5 Fee Schedule on Reverse Side
$ . �� .001 of Permit Valuation (1/lOth%)
$ < U ° $.50/$1,000 Valuatioa
$ $1000 per SAC Unit
$ $5.00 (State I.icensed Residential Contractors)
$ Alt. "A" or Alt. "B" Above
$ $450.00 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement Necessary [ ] Not Necessary [ ]
$ �7•�
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pa��n�3suo� uaaq s�q �i s� �i a�uo uoi�Epuno� a� 3o uot���oi a� �atn�ous `�oi a�3 30 �aninS �o alE�t�t�a� �
•a�is uoi��ru�suo� aq� 3o puE ain��nAs pasodoid a�;o n�atnai
iadoid io� nsoi� o� uot���tjdd� 3o au� aql Lno� sino� },Z 3o umuicuirII � panssi aq fins uoq�n�isao� io3 s�tuuad
1�IOI.L�Ql�f103 30 1�i0I,L��L�I2i�A
'SL'SI$ saunl �aa� 9 snid q�PIM �EmanuQ - qldap u�ut 9 qlin�► ���oidd�
apinn l003 � E n�s�n pnE ia11n� pn� qm� 30 luatua��idai p� �notuag :,,gu a��ua��
•ps•£j$ saunl �aa3 9 snid qipi� ��nc�anuQ -�juo ia�ln� pu� qin� �o luaiva�Eidai pue jEnotuag :ud„ a��ua�jd
(�iQO siaaAs qin� a�ai�uo�)
A102I�5� I�tOISSS�?Id�Q ��'A��AI?IQ
�oaia� notl��i; io ppp`i$
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