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PRE 2010 DOCSFridley,City of A m X? 8548 B URDING PERMIT Date: OCTOBER . 20, 1965 Owner: DONALD F. SEXTER guilder SEXTER REALTY Address 3600 France Avenue North Address Same Minneapolis 22, Minnesota LOCATION OF BUILDING No. 5730 street_ Polk Street N. E. ,____ part of Lot Lot 2 Block 2 Addition or Sub -Division . Suer Addition Corner Lot _ Inside Lot XSetback _ _ 35 Sideyard _ lot Sewer Elevation —_.. Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Dwelling Front Depth Depth 24 Height 20 Sq. Ft.1 008 CLL Ft 202160 Front Depth — Height — sq. Ft.. Cu. Ft. Type of Construction Frame Est. Cost 11 400_ To be Completed In consideration 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 o i in compliance v�th ail provisions of ordinances of the city of Fridley. t-111%�( In consideration of the payment of a fee of S 21 00 � permit is hereby granted to SEXTER REALTY to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is anted and his agents, employees and workmen, in all work done in, around and upon said building, or any n grthereof, shall conform in aII respects to the ordinances of Fridley, Minnesota regarding location, constructio , alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. ALLEN G. JENSEN Building Inspector NOTIC6a This permit don not aover the construction, hatagation hr whine, plumb:me, on heating, sewer or water. Be sun to see the Bulhling hnpester for separate permits for these liana. o . Ir APPLICATION FOR BUILDING PERMIT CITY. OF.FRIDLEY,. MINNESOTA owNER's; DONALD F.,, *8.EXTER BUILDER S E%TE; R REALTY 3600 g venue Monn JbUU France Avenue N. ADDRESS MINNEAPOLIS 22, MINNESOTA ADDRESS MINNEAPOLIS 22, MINNESOTA LOCATION OF BUILDING. NO, STREET 'Pnl k PART OF LOT LOT___2 BLOCK P ADDITION OR SUBDIVISION g p y t a r p d d l_ti n;Q GORNER LOT INSIDE LOT_SETBACK �,Ke SIDE YARD 30 SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To be used as; One family dwelling -Front 421 Depth _2_4j_Height I g,tnr Sq. Ft. 100$ ► Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. YP wood frame Estimated Cost ��® Te of Construction To be completed MaV 11 1966 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 rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct, DATE SIGNATURE (Schedule of Fee Costs can be found on the Reverse Side). J Land Planning ca�ds�yn9 *5 Teslin9 C'nal b Alunmpal 075 /illlhp5 y -14:5 4/,f 41,1yavUfwlt531, ENGINEERING, INC. a',/mr.se/a Eryineermy Engineers Sur vecrrs certificate of surveT for 7 I k SEXTER REALTY S CA t_ E' -~ 1 9 0 o OCNOTF.5 IWOw Lot 2, Block 21 Sexter Addition, //iwSdrf ce h y #W *16 /S a hw ar d. mfnd I-epresenfotra 7 ipd swvety e* bwvndories $('& 46omr ofewvhed /and, &V Or &e&o gaff lw�il9 llrrem, &dal/ risible mavQ rbmmis , ��'anrfnm wwSmid laid. As sarveyed by me lhrs _ *y 7' A.D /9�- SU8 UR8AN ENGINEERING , INC. Enfnetrs& Surreyors t . pry °'} *, — (�r� ~(:. •: � .'..1 t•.7 �?�nca ;o. �'�soJ S �3 .`vim S 1 a r 13, I b ti C 0 , .L AA�j 7 I k SEXTER REALTY S CA t_ E' -~ 1 9 0 o OCNOTF.5 IWOw Lot 2, Block 21 Sexter Addition, //iwSdrf ce h y #W *16 /S a hw ar d. mfnd I-epresenfotra 7 ipd swvety e* bwvndories $('& 46omr ofewvhed /and, &V Or &e&o gaff lw�il9 llrrem, &dal/ risible mavQ rbmmis , ��'anrfnm wwSmid laid. As sarveyed by me lhrs _ *y 7' A.D /9�- SU8 UR8AN ENGINEERING , INC. Enfnetrs& Surreyors t . pry °'} *, — (�r� ~(:. •: � .'..1 t•.7 �?�nca ;o. �'�soJ City ®f Fridley, NHnm N9 8917 BUILDING PERMIT Date: JULY 7, 1966 Owner: CHARLES JOBNSON guilder GORCO CONSTRUCTION Address 5730 POLK STREET N.E. Address 3384 Brownlow FRIDLEY, MINNESOTA 55421 St. Louis Park, Minnesota LOCATION OF BUILDING No. 5730, Street POLK STREET N.E. Part of Lot Lot .— 2 _ Block 2 Addition or Sub -Division _ _ SEXTER ADDITION Corner Lot — Inside Lot — X Setback 30' � Sideyard 10' Sewer Elevation _._ — Foundation Elevation DESCRIPTION OF BUILDING To be Used as: DET. GARAGE Front 14 Depth 20 Height 10 Sq. Ft, 280 Cu. Ft. 2,800 Front Depth Height Sq. Ft. Cu. Ft. Type of Construction _FRANC Est. Cost — $6 00, OSi _ To be Completed In consideration 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 ail provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $__4. 00 , permit is hereby granted to GORCO C.011iSTRUCTIOR CO- to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform is au respects to the ordinances of Fridley,thMinnesota reg lavation, construction, alteration, maintenance, repair and moving of buildings within e city limits an� permit may be revoked at any time upon violation of nay of the Provisions of said ordinances. CLARENCE BELISLE Building Inspector NOTICE: This pom* don no emu the condraWon, tnstdta an for Whfi , pbmhtng, on hearing, sewer or water. Be sore to we the Bonding Inspector for aparaM pwudb for than items. ititiEML1 APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME C A), / $v ( c �'L roc. S o � BUILDER GO w- c c, c L ADDRESS I a k N r ADDRESS 3 .:? S 9 i Lazo S � LOCATION OF BUILDING NO. _STREET PART OF LOT 1,60 C':�' ' '7 C4 77a/ J LOT ', BLOCK Z ADDITION OR SUBDIVISION aSe X f e m- CORNER LOT INSIDE LOT r `SETBACK , SIDE -YARD / l SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To be used as: r.D. e tom: c L C_ '1 k'_ Front/_Depth Z,:5 Height Sq. Ft. 2 1? 6 Cu.. Ft. Front Depth -- Height 5q. Ft. Type of Construction Estimated To be completed Cu. Ft. Cost The undersigned hereby makes.application for a permit for the work herein specified, agreeing to do all work in stridt accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and.hereby declares that all the facts and representations stated in this application are true and correct. DATE SIGNATURE (Schedule of Fee Costs can be found on the Reverse Side). ar' r7-9► -879001 CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. N TOTAL Number Fixtures x $3.00 o Future Fixture Opening x 0 $ Water x $2.00 $ A x $5.00 W C -! y0 $5.00 $ 100,000 BTU to 199,000 BTU x �`, $ Water Softener Heater $7.00 i New Grcurd Run Old Building x N $ F •�� s� $4 emu a 7J A C1 P7 C C y •UI � H m a aS0 . W . ° �s M 1J N o m � A .0 leC .4 q W N S A W VI w U q Q 3 C7 0 0 aS N U 1st c nn ct ry r 2nd 3rd 4th (R) = Future Connection Opening Connected with Sewer (*) = New Fixture, Old Opening Water PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures x $3.00 $ Future Fixture Opening x $2.00 $ New Fixture, Old Opening x $2.00 $ Catch Basin x $5.00 $ Water Heater - to 99,000 BTU x $5.00 $ 100,000 BTU to 199,000 BTU x $10.00 $ Water Softener x $7.00 $ New Grcurd Run Old Building x $5.00 $ Electric Slater Heater _ x $5.00 $ GAS FITTING FEES: 1st 3 fixtures x $3.00 $ Additional Fixtures x $1.00 $ Gas Range to 199,000 BTU x $1.0.00 $ REPAIRS $ ALTERATIONS First $100.00 $5.00 $ each add. $100.00 or fraction $2.00 $ State Surcharge $ .50 TOTAL FEE $ 8.00 REINSPECTIQN FEE ($10.00) Job Address -5730 POLK_ STREET NE Department of Buildings City of Fridley Tel. #571-3450 The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct Fridley, Mn. 9-20-76 , 19 OWNER B. YO JNGMARK KIND OF BUILDING frame USED AS res TO BE COMPLETED ABOUT 9-27-76 ESTIMATED COST 10.00 OLD - NEW BUILDING PERMIT NO. PERMIT NO. 2010- Compan Signed B Tel. No. MINN'F'r"- ROUGH INSP. Date FINAL INSP. Date APPROVAL FOR PERMIT MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 eZAI- A C F/ 04 / �� ��-? 2- C worr r>3 C r fes: August 8, 1978 6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 66432 Mr. Jim Jorgenson 5730 Polk Street N.E. Fridley, MN 55432 Re: Attached Garage Question Dear Jim: TELEPHONE ( 612)571-3450 Your request to attach the new garage to both the house and existing garage will require some preliminary work. First, the existing garage will have to be "under -pinned" with new frost footings (42 inches deep) around the entire perimeter. Second, the proposed garage will have to have frost footings as well. I've sketched some cross sections for your information. They are not very detailed, but your builder can refer to them when making up your plans. We will need a plot plan showing where the house is on the lot with existing and proposed garage drawn to scale. Then we will also want a footing and side section view of the old and new garage and a simple roof attachment plan. If you have any questions on this matter please contact me at 571-3450._ Sincerely, RON HOLDEN Building Inspector RH/mh ENC: 2 r 6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 66432 Mr. Jim Jorgenson 5730 Polk Street N.E. Fridley, MN 55432 Re: Attached Garage Question Dear Jim: TELEPHONE ( 612)571-3450 Your request to attach the new garage to both the house and existing garage will require some preliminary work. First, the existing garage will have to be "under -pinned" with new frost footings (42 inches deep) around the entire perimeter. Second, the proposed garage will have to have frost footings as well. I've sketched some cross sections for your information. They are not very detailed, but your builder can refer to them when making up your plans. We will need a plot plan showing where the house is on the lot with existing and proposed garage drawn to scale. Then we will also want a footing and side section view of the old and new garage and a simple roof attachment plan. If you have any questions on this matter please contact me at 571-3450._ Sincerely, RON HOLDEN Building Inspector RH/mh ENC: 2 TME CITY OF neT= DIRECTORATE OF PUBLIC WORKS MEMORANDUM FROM D.P.W. TO ACTION INFO• SUBJECT Neighborhood Rats Nasim Qureshi. City Manager_ Mrs. Nancy Jorgensen, 5730 Polk Street, 571-8328, had called the City on , June 9, 1983 regarding rats on her property. Steve Olson visited the property that morning and found one dead female rat. It apparently had died from poison applied by the next door neighbor. Steve explained the problems associated with feeding birds and dogs and the rat impact this has. He also suggested that Mrs. Jorgensen clean up her woodpile and also provided her with a poison to apply to any rat holes they may find. Mrs. Jorgensen felt that this rat problem was a migration of rats from the 1000 and 1010 Lynde Drive area. Steve responded that this was probably not an infestation or epidemic. On June 10, Steve Olson again visited the site and was told that a nest of nine baby rats were found under the wood pile and were distroyed. Three poison pockets'were left for the Jorgensens to use if any rat holes were found over the weekend. I attempted to contact Mrs. Jorgensen but was not successful. The properties at 1000 and 1010 Lynde Drive did have a rat infestation. It was probably festered by the bird and dog feeding habits of the property owners and the proximity to the old swamp area. We have been treating this area and the property owners have cleaned up their yards and stopped the feeding of birds plus obtained private exterminators to clean up their property. Investigation today indicated that this problem no longer exists, as it had in the past. JGF/mc cc: Steve Olson Address File March 13, 1985 Nancy Jorgenson 5730 Polk Street N.E. Fridley, MN 55432 Dear Ms. Jorgenson: The City of Fridley is pursuing Moore Lake Apartments regarding the replacement of the district separation fence on the North side of the apartments. Moore Lake Apartments are required to replace the fence. Presently, however, frost conditions prevent the installation of fence poles to adequate depth. To account for this, we feel we have made a reasonable request of Moore Lake by requesting that the fence be in place by June 1, 1985. To assure the completion of this request, we have incorporated this issue on our computer system. This system will automatically signal the City on June 1, 1985 that the fence should be in place. Furthermore, all future development of the apartments will be contingent on the replacement of this fence. Thank you for your patience regarding this issue. The City appreciates your efforts to maintain a healthy and pleasant environment. Should you have any questions regarding this matter, please contact me at the Civic Center, 571- 3450. Sincerely, Philip S. Dommer Planning Assistant PSD/de 3/5/19/31 11 C-85-32 SUBJECT P City of Fridley 1820'5 AT THE TOP OF THE TWINS BUILDING PERMIT r CEIPT NO COMMUNITY DEVELOPMENT DIV. yl` r � � PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 9-11-85 JOB ADDRESS 5730 Polk Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 2 Sexter Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE James and Nancy Jorgenson same 571-8328 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING resf.dential 7 CLASS OF WORK ❑ NEW Ij ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK a 10X8 treated pine deck 9 CHANGE OF USE FROM TO STIPULATIONS raise rail height to 36" TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR 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 AND EXAMINED THIS APPLICATION 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 $5500. 00 $.50 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $15.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FVTOTAL FEE $19.25 SIGNATURE FCON' CTOR AUTHORIZED AGENT IDATEI [.C7% WHEN PROPERLY VALIDATED BLDG INSF THIS IS YOUR P®JRMIT�jy�� !e ® V f SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI QA NEW [ J City of Fridley ADDN. [ ] R-1 AND R-2 j ALTER. [ ] Building Permit Application Construction Address ib .c. F2 55V3 a. Effective 4/1/84 v _ Legal Description: Owner Name a Address: j6mys i )ea.ht,,�n�2aea,cgr, Tel. # 8 Contractor:_,r�CL41A_e- Tel. # Address: Attach to this application, a Certificate of Survey of the lot, With the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length 1O Width _�_ Hgt/Ground . Sq. Ft. 00 OTHER: Corner Lot [ ] Inside Lot r pFt. Yd. Setback Side Yard Setback. Type of Construction: Estimated Cost: $ Approx. Completion Date: cj1 Alt. A _ - Alt B Proposed Driveway Width If New Opening Is Desired: $ See Back Page for Explanation DATE: S Permit Fee Plan Check State Surcharge SAC Charge Park Fee - Sewer Main Charge TOTAL STIPULATIONS: APPLICANT: Tel. # '--'7143Z7�D _ CITY USE ONLY $ e� �� Fee Schedule on Reverse Side $ _S_ 25% of Building Permit Fee $.50/$1,000 Valuation $ $425 per SAC Unit $ Fee Determined by Engineering S Agreement Necessary [ J Not Necessary [ ] e STATE OF MINNESOTA DEPARTMENT OF HUMAN SERVICES 444 LAFAYETTE ROAD ST. PAUL. MINNESOTA 55101 10-8-86 Date City of Fridley Zoning Authority 6431 University AVe. N.E. Street Address Fridley, MN 55432 City State Zip Code r-Ae- P DHS -2722 (9-85) PZ -02722-02 /0-9 ap RE: ZONING NOTIFICATION OF APPLICATION FOR LICENSURE Subject: Type of License: ame o Day Care Home pplica Family Day Care 1� �7 a 2 a:2'k . QJ=- _?P7 Group Family Day Care Street Address GJo S� 3 Licensed Capacity 0 City State Zip Code Phone No. This is to inform you that we are in receipt of an application for licensure under Minnesota Rules, parts 9502.0300 to 9502.0445 (formerly Rule 2), Family Day Care and Group Family Day Care Standards. Issuance of this license is subject to compliance with the provisions of Minnesota Statutes, Sections 245.781 to 245.812 and 252.28, subdivision 2, known as the Public Welfare Licensing Act and the rules of the Department of Human Services. You should note that under Minnesota Statutes, Section 245.812, Subvision 3, a licensed day care facility serving 12 or fewer persons shall be considered a permitted single family residential use of property for the purposes of zoning. Subdivision 4 of the same section indicates that a licensed day care facility serving from 13 through 16 persons shall be considered a permitted multi -family residential use of property for purposes of zoning. If we do not hear from you within will consider the above-mentioned your local zoning code.. Sincerely, Licensing WorIcer Street Address 30 days after receipt of this letter, we day care home to be in compliance with COMMUNITY HEALTH & SOCIAL SERVICES DEPARTMENT COUNTY OF ANOKA COURTHOUSE, FOURTH FLOOR Name o A ency Organization City State Zip Code AN EQUAL OPPORTUNITY EMPLOYER PAP F38 sueJECT city of Fridley 7�_O5 0 AT THE TOP OF THE TWINS BUILDING PERMIT r ' , R IPT N COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. 36-i r � , CITY HALL FRIDLEY 55432 NUMBER REY DATE PAGE OF APPROVED 8Y 612-571-3450 910-F15 JOB ADDRESS 5730 Polk Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 2 Sexter Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE James/Nancy Jorgenson 5730 Polk Street N.E. 571-8328 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW �] ADDITION �] ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 12' x 51 Addition; a 231 x 301 Detached Garage; a 121 x 8' Deck; Remove a 14 x 20Garage; Remove an 8' x 10' H9ek. A 9 CHANGE OF USE FROM SMARATE RER14ITS REQUIRED, FOR / HAND STIPULATIONS ° Provide smoke alarms on both levels of existing house. Provide insulation:. in attic space over heated addition with a minimum R --value of R-38. Walls around heated space must,be-2 x 6 with R-19 insulation or 2 x 4 with R-11 and a styrofoam r. Foundation walls around basement must be insulated with a �� rigid insulation with a R -value of minimum R-5. See notations on plan. s WARNING On;all new roofs or tear -offs and replacement roofs, Before digging call for State Lode requires that 2 layers of 15 lb. `tetto all utility locations mopped together, be installed to a point 24 inches 454-0002 up from exterior wall line, or the use of other REQUIRED BY LAIN approved underlayme4t membrane, 66n1` 1_ k`i S/1 `" �, • �r /n A _er e`Lr C I i�0s2C� TYPE OF CONST. OCCUPANY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SO. FT. I CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS I OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS l GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED ^. $16,600 $8,30 --h x•'73 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT / PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-- $� 8�•�� ��bb �j "� "/� STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. 79 1/t I, • PLAN CHECK FEE TOTALFEE 188.30 + lc�•�8 �TE7HI5 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI .WHEN OPERL V IS YOUR PERMIT y. )NSP DATE SIGNATURE OF OWNER OF OWNER BUILDER) IDATEI PAP F38 NIAa [ ] Effective 1/1/90 ADEN R-1 AND R-2 ALTER [,j Building Kermit Application Construction Address: 5-73o po S /U Legal Description: LJ 'j` -?, 610 C V -.�' S'��c�� (' Owner Name & Address: I-1-pMe-S 4 3 Tel. # S%/ -,Y3 Zf Contractor: fl ryt e Tel. # c'i l Address: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. �n1( JU ,' +',-' ) DESCRTPTIw OF naROVE M Rug o LIVIIJG AREA: Length Width Height Sq. Ft. GARAGE AREA: Length 2 30 Width -- Height % 0 Sq. Ft. 6 `7 DECK AREA: Length Width Hgt/Ground 3' Sq. Ft. OTHER: Re n. b U e 1q, X o ' 5;",.,Z C ,Ar %1' #1 Ac, SL jq-e&..a v -e ff ( k / ® ` D om- c (L %1/ U Corner Lot [ ] Inside Lot [ J Ft. Yd Setback Side Yard Se cJcs b Type of Construction: Wo©cQ.e Estimated Cost: $ Approx. C�letion Date: 4vN�� .'-TG�0�0&jw Proposed Driveway Width If New Opening Is Desired: Ft. $ Width + 6' See DATE: i v APPLICANT• Tel.. er MC LUSE:�/MY Permit Fee $ Mw State Surcharge $ f] SAC Charge $ k' Driveway Escrow $ Park Fee $ Sewer Main Ciarge $ TOTAL $ B 5 p ' Fee Schedule on Reverse Side $.50/$1,000 Valuation $600 per SAC Unit Alt. "A" or Alt. "B" Above 5-7/ ?3a e Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] ,ufcw rpynkcrL 13 -z UqO t�(< 1q, el?z 1q Q0 2d t 9 MAK d e „ SUBJECT P City of Fridley MOVING ®� AT THE TOP OF THE TWINS xxoWUNNG P E R AA I r 1 1r1 6 COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. i CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910415 8/15/90 JOB ADDRESS 5730 Polk. Street N.E. 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 2 Sexter Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Nancy/Jim Jorgenson 5730 Polk Street N,E, 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR �] MOVE ❑ REMOVE 8 DESCRIBE WORK Move garage from 5730 Polk Street to 5720 Polk Street N,E, 9 CHANGE OF USE FROM TO STIPULATIONS City Council approved variance for placement on August 13, 1990° TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SQ. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $400, N/A WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SACCHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $15"Q0 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE np e00 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WHE PROPERL V("TT YOUR PERMIT VI q0 G INSP HATE SIGNATUREOF OWNERIIF OWNER BUILDER) (DATE) ] Moves [ ] Job Address: legal Descri Owner & Addz Contractor: Tel. # Address: State License # � C,a. & Zi 4410 •:, 901 _ :ilra-8) .. Living Area: length Width Height Sq. Ft. Cu. Ft. r Garage Area: Length Width Height Sq. Ft. Cu. Ft. other: Length Width Hight Sq. Ft. Cu. Ft. Estimated Cost of Wrecking/Moving Approx. Ccnpletion Date l ko :4- . . .r. City Water/Sewer Mpls. Gas C.onpany Northern States Power Northwestern Bell Tel Co. 571-3450 [ ] 372-4720 [ ] 566-9120 [ ] 293-0665/293-1319 [ ] Water Bill Paid: Yes [ J Amount To Be Collected [$ ] Initials Moving Route: �( C [C 'S�Y '57 57?_0 FEES Moving: Principle Building into Fridley . . . . $ 80.00 Accessory Building into Fridley . . . . 20.00 Minim= Fee: $15.00 Through, within or out of City . . . .$ 15.00 Wrecking: For each 1,000 cubic feet or fraction .$ 1.25 For strictures which would be inpractical to cube, the fee shall be based on the total cost of wrecking at the rate of $6.00 for each $500.00 or fraction. The undersigned hereby makes application for a permit to wreck/move the building described above, agreeing to do all work in strict accordance with the City Ordinances and rulings of the Building Department, and the State Code which requires any water well on the property to be sealed by a State licensed water well driller, and hereby declares that all facts and representations stated in this application are true arra correct. PE CET FEE: STIPUTATIOM: a�9&& Vat� a-44 -97 W tfi"4wAk CITY OF FRIDLEY Effective Date May 1. 1988 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE VESIDEI�TIAL Furnace Shell and Duct Work, Burner (Also replacement furnace) Gas Piping (piping needed with new furnace) Gas Range Gas Dryer RATE TOTAL Job Address 5—? '? tZeo / J7/j — $ 20.00 $ Department of Buildings, 6431 University Ave. N.E., Fridley, MN 55432 City of Fridley $ 10.00 $ Tel. #571-3450 $ 10.00 $ 10.00 • Air Conditioning (all sizes) S 10.00 All Others/Repairs and Alterations 11 of Value of Ap liance r Work ��d.�fl� , COMMERCIAL/INDUSTRIAL 11 of Value of Appliance or Work State Surcharge Reinspection Fee ($15.00) Rough Insp. Date Final Insp. 11-49-16-6 Date Approval for Permit MINIMUM FEE FOR ANY HEATING PERMIT IS :15.00• PLUS $.50 STATE SURCHARGE *Air Conditioners can not be placed in side yard without written permission from adjoining neighbor. $ The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes $ and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. $ Fridley, Minn. Z?- OWNER ?-OWNER /-• $ KIND OF BUILDING 46zr-n-e $ .50 USED AS TO BE COMPLETED ABOUT ESTIMATED COST OLD - NEW BUILDING PERMIT NO. PERMIT NO. A0 LA -3 DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. Trade Name Size No. Capacity Sq. Ft. EDR BTU HP Total Connected Load Kind of Fuel BURNER - Trade Name Site No. Capacity Sq. Ft. EDR BTU HP Company signed Tel. No.�:4'7)3Z Fill out back side for stack verification on replacement furnaces CHIM14EY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack; 1. Has been carefully examined Yes (,) No ( ) 2. Is free from rust or deterioration Yes ( ) No ( ) 3. Has no foreign objects lodged within Yes ( ) No ( ) 4. Is securely supported Yes ( ) No ( ) 5. Meets all current Code requirements for size and total BTU connected Yes ( ) No ( ) 6. Has Total heating BTU's of All other BTU's TOTAL Rema rk s Company Signed By Da to O CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1993 6431 University Ave NE ` Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 512-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS ®` X6 �... -. RATE SCHEDULE The undersigned hereby makes application for a permit for the work herein Residential Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes and Furnace Shell and Duct Work, Burner – rulings of the Building Division, and hereby declares that all the facts and Also Replacement Fumace $ 20.00 $ ;O �0 0 representations stated in this application are true and correct, ►'���,�J ,199 Gas Piping (Needed with new furnace) $10.00 $ t OWNER,, Gas Range $ 10.00. $ BUILDING USED AS. Gas Dryer $10.00 $ ESTIMATED COST �� ;L C r" ,C, U PERMIT NO. *Air Conditioning – AD Sizes $10,00 ' $ , I L All Others/Repairs & Alterations (LIST ON BACK) DESCRIPTION OF FURNACE AND OR BURNER 1% of Value of Appliance or Work $ No, of Heating Unks___J__ Circle One (Steam) (Hot Water) arm Air) Trade Name_Size No. :55-0 Commercial/Industrial BTU L 04 C"oD HP EDR 1% of Value of Appliance or Work $ Fuel— _ Total Connected Load State Surcharge $ 50 Burner Trade Name Size No. BTU HP EDR TOTAL FEE G 3TAI M tFA7= AND AIR CGIMMMOS M 410 WEST LJ� STRE6T HEATING COMPANY par a = MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION 612-824-206 REFRIGERATIONIAIR CONDITIONING PERMIT IS X15.00 Signed By Tel No. PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $30.00 Approved'BRough–In Date Final Date *Air Conditioners can not be placed In a side yard without written permission from adjoining property owner. FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE CHIMNEY AND STACK VERIFICATION The undersigned�4ereby verifies that the existing chimney or stack: 1. :} rs Has been, kefully examined =" Yes ( i No ( ) 2. , a;4 Is,rust or deterioration a Yes ( ) No ( j `A s, 3. Has no foro;Lgn objects lodged within Yes ( ) No ( ) 4. Is secure. upported Yes ( ) No ( ) 5. Meets all 5d4#rent Code requirements for size and tbt l BTU's connected Yes ( ) No ( ) 6. Has total heating BTU's of All other BTU's TOTAL BTU's Remarks List Alterations Beincx Done: HEATING COMPANY Signed By Date r o- L., RESIDENTIAL LOAD CALCULATION Purchaser S 1 Al Sooy-/ Sales Rep 0 "or _Date Address 27 3 b F, -a NC' e Sq Ft gross wall Running walls below grade: x (Ft wall Ht)= below grade Sq Ft windows and doors below grade Net wall below (03 `1qrade �Sq Ft gross wall Running walls above grade:- — x �S �(Ft wall Ht) = � above arade(lst f (1st Floor) Running walls above grade: (2nd Floor) x (Ft wall Ht)= Ft gross wall Sq Ft gross wall Total gross Sq Ft ly�b' above grade Sq Ft windows and doors above grade Net wall above grade Windows & Doors 2S Sq Ft x HTM = BTUH Inf . (w&d x 1.3) Sq Ft x 25 'HTM = BTUH Net wall below �3 grade Sq Ft x 5 HTM = BTUH f Net wall above grade Sq Ft x (Ll- HTM = Exposed Ceiling Sq Ft x !/ HTM = BTUH Exposed Floor i2 / 5 Sq Ft x HTM = BTUH BTU TOTAL Windows & Doors Ceilings & Floors LLO I3 Is ljc� s )I - LI 2Ug 16' kz t1z /'z - n t2� 12 qy Al SUBJECT PERMIT NO. City of Fridley 2 2 6 0 5 AT THE TOP OF THE TWINS y B U I L ®I PERMIT BUILDING f LJ RE COMMUNITY DEVELOPMENT DIV.�� ~ s r � , PROTECTIVE INSPECTION SEC. NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 6/13/94 JOB ADDRESS 5730 Polk Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 2 Sexter Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE James Jorgenson 5730 Polk Street NE 571-8328 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 14', 10 sided gazebo and ground level deck 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. Provide smoke detectors adjacent to all sleeping areas.and in basement. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SO. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $3194 $1.60 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $63.00 Fire SC $3.19 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $67.79 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WHEN PRO RA VALIDATED THIS IS YOURPERMIT BLD )NSP 4ATE SIGNATURE OF OWNER OF OWNER BUILDER) IDATEI NEW Effective 1/ 1/94 ADDN (( CITY OF FRIDLEY ALTER (( SINGLE FAMILY AND DUPLEXES R -I AND R-2 Building Permit Application Construction Address: -- —� ,7 � � - ---_---__—_-- -- Legal Description: Owner Name & Address: lu k - Ir'S C' -e--JSV Tel. # %%," Contractor: 5_7 3 1 i� f- MN LICENSE # Address: A - 121 W, 5'�-f 3 -2�- Tel. # Attach to "lication, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: 4-Z /Y' S;c0ce Corner Lot f ] Inside Lot [ ] Type of Construction: Approx. Completion Date: Ft. Yd Setback Side Yard Setbacks Estimated Cost: $ q. 0 (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ DATE: APPLICANT: Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL CITY USE ONLY $ Fee Schedule on Reverse Side $ [ .001 of Permit Valuation ( /10th%) $ $.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 Determined by Engineering $ Agreement Necessary j ] Not Necessary j ] M9 Tel. # s STIPULATIONS: A� y • r�a�, L y IN- LK SUBJECT City of Fridley 25270 AT THE TOP OF THE TWINS BUILDING PERMIT r O. 1 COMMUNITY DEVELOPMENT DIV. Tr ______ r PROTECTIVE INSPECTION SEC. 3b CITY HALL FRIDLEY 55432 NUMBER REV DATEPAGE OF APPROVED BY ''j 612-571-3450 910-F15 7/14/97 I i � JOB ADDRESS 5730 Polk Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 2 Sexter Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jim Jorgenson 5730 Polk Street NE 571-1648 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Norling Exteriors Inc 341 79 Way NE, Fridley, MN 55432 784-8936 20098700 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO, 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION j7 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Soffit & Fascia 9 CHANGE OF USE FROM TO STIPULATIONS Install ventilation to meet the State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED, NO. DWLG. UNITS OFFSTREET PARKING 1 I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 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 $1,800 $.90 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $56.75 Fire SC $1.80 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE License SC $5.00 $64.45 SIGNATURE OF CONTRACTOR OR AUTHOR&tDAGENT IDATEI WHEN PROPERV9 VALIDATED THIS IS YOUR PERMIT / len SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI BLDG NSP FATE NEW [ ] ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: Legal Description: Owner Name & Address: Contractor: ko r f ,I ,, Address: .3 Y r 7 9 LIVING AREA: GARAGE AREA: DECK AREA: OTHER: 30 Apoa s /V Al'e-Vss' e Effective 1/1/97 -�kc3lbyq cs � 6p✓Tel. # ��/�/6 �� MN LICENSE # �ar' 7 ® o 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 Width Hgt/Ground Sq. Ft. Construction Type: - c 4 719� Fc-? V'cL Estimated Cost: $ Wee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ftx $ = $ DATE: 7/� �/ % 7 APPLICANT•A:!� d Tel. # TOTAL $ �r sTiPULATIONS: ©©, D 0 7,fy ,Ff 3 a CITY USE ONLY Permit Fee $ j Fee Schedule on Reverse Side Fire Surcharge $ O .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $950 per SAC Unit License Surcharge $ r(� $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ -$450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ �r sTiPULATIONS: ©©, D 0 7,fy ,Ff 3 a SUBJECT City of Fridley \ AT THE TOP OF THE TWINS BUILDING PERMIT NO. ' COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. � I = CITY HALL FRIDLEY 55432 I.J NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 7/15/97 JOB ADDRESS 5730 Polk Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 2 Sexter Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE James Jorgenson 5730 Polk Street NE 571-1648"-5'55 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ElMOVE ❑ REMOVE X 6 DESCRIBE WORK Replace all Windows 9 CHANGE OF USE FROM TO STIPULATIONS Replacement sleeping room windows must meet the State Egress Code. Install smoke detectors to meet the State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR 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 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 $69000 $3.00 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY 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. PLAN CHECK FEE TOTAL F $124.25 I NA URE OF CONTRACTOR OR AUTHORIZED AGENT IDA EI N P OP ALIDATE T IS IS YOUR PE/KNIT `BLD INSP gaTE iGNATURE OF OWNER OF OWNERBUILDE I IDATEI NEW [ ] ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddre. Legal Description: Effective 1/1/97 Uwner Name & Address: _ ,U Qen .mac L j-<) e G - iv S v,., Tel. # �' ��� /(. yF Contractor: C A,n, e `� MN LICENSE # w� t K� Address: Tel. # 7 V- 5-3 eQ Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Construction Type: R2 Q �}c� All ,,y°��,��,, s t o �t ed Cost: $ C-6 (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: J ? APPLICANT: Tel. # S-7/- l y� CITY USE ONLY Permit Fee $ �, �� Fee Schedule on Reverse Side Q ' Fire S � urcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $_ $950 per SAC Unitij 4 License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above ( �` Erosion Control $ -$450.00 Conservation Plan Review A -1 , J Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ J TOTAL STIPULATIONS: SUBJECT City of Fridley 27861 AT THE TOP OF THE TWINS BUILDING P E R M I T `y ______ COMMUNITY DEVELOPMENT DIV. SEC. r PROTECTIVE (INSPECTION ' Y NUMBER REv DATE PAGE OF APPROVED BY i CITY H 91 �"'1;•� ----�; L 612-571-3450 910415 9/18/98 JOB ADDRESS 5730 Polk St NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 2 1 Sexter Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jim & Nancy Jorgenson 55432 571-1648 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Owner Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW [jd ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Deck (201 & 24' x 161) 12" off ground - not attached to house 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. SEPARATE PERMITS ARE REOUIREO FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR 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 AND EXAMINED THIS APPLICATION 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 $750.00 $.50 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $29.25 Fire SC $.75 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL FEE $30.50 IGNA FRE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT BLDG (NSP DATE ,GNATURE OF OVVNER,,F O ER BLVADER, IOATE, NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R -Z BUILDING PERMIT APPLICATION ConstructionAddress: 5730 P o t% 57— n/ r= - Legal Legal Description: .J t Owner Name & Address: �, i�gae.., ,l o R eli s Q'/ Tel. # ✓�7/-/��� 'Y-�38c Contractor: MN LICENSE # Address: Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. CK AREA Length;20 Width / CA Hgt/Ground 6 a Sq. Ft. :� OT J v� Construction Type: (o'T�,�„/�.�r �x �f Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: /� �b APPLICANT:("�l Tel. # 571 If. Yf CITY USE ONLY Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ �2� Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1000 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 [ J SUBJECT City of Fridley 30148 AT THE TOP OF THE TWINS BUILDING PERMIT i? >r ---___ COMMUNITY DEVELOPMENT DIV. � PROTECTIVE INSPECTION SEC. F , = CITY HALL FRIDLEY 55432 NuMBER REv DATE PAGE OF APPROVED BY 612-571-3450 910415 9/1/99 10B ADDRESS 5730 Polk Street NE t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 2 2 ISexter Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jim Jorgenson 571-1648 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO .Huber Construction Co. PO Box 403 St Michael MN 55376 497-4484 20102687 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF.BUILDING Residential 7 CLASS OF WORK ADDITION 71F O NEW ❑ ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house and garage 30 S Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING, THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED, NO. DW4G. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 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 2622 $1.31 DOES NOT PRESUME TO GIVE AUTHORITY 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 $83.25 Fire SC $2.62 AIIL_- PLAN CHECK FEE TOTAL F Lice 5.00 92 0AIL111i OF CONTRACTOR OR AUTHORIZED AGENT IDATEI EN D S IS BRIT UPOPZERIDATE B0 INSR MATE S,GNATURE OF OWNER OF OWNER BUILDERS IDATEI NEP [ l . Effective 5/10/99 ADDN [ ] CITY OF FRIDLEY ALTER [ SINGLE FANIILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: 7� Legal Description: Owner Name & Address: 1 i y\ Tel. # 571 - 1 Contractor: c` �� ��,� MN LICENSE # 90 / U a� CC) B X S SC -i'" 1t�� : MO SS `%�, Tel. # `� (7 -4 -4 -t",4 - Address: Attach to .this application,. a Certificate of Survey. of the lot, with the proposed construction drawn :on it to scale. DESCRIPTION OF EM PROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Lengtk Width Hgt/Ground Sq. Ft. OTHER: 4 � /Z-oor 4�` ("13« S-� , l Li iz U aC � J Construction Type: Cry T^ Estimated Cost: Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ DATE: APPLICANT: Tel. #Loca -4,S-CJ ITY USE ONLY Permit Fee $ c9J_ �S^ Fee Schedule on Reverse Side Fire Surcharge $ Z (, � .001 of Permit Valuation (1/10th%) State Surcharge $ Z, 3 1 $.50/$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $ . 0 Q $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ STIPULATIONS: SUBJECT PE�A111 City of Fraley 3r 9 o AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. COMMUNITY DEVELOPMENT DIV. v INSPECTION SEC.�� j 0� j PROTECTIVE 1 . � CITY HALL FRIDLEY 55432 NuMBER REV DATE PAGE OF APPROVED BY L 612-571-3450 910-F15 7/10/01 JOB ADDRESS 5730 Polk Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DEscR. 2 2 Sexter Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS, ZIP PHONE Nancy/Jim Jorgenson 5730 Polk Street NE 763-571-1648 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Rite Way Waterproofing 448 Lilac St, Lino Lakes, MN 55014 651-786-0550 a ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. City License 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK 0 NEW 0 ADDITION 0 ALTERATION] REPAIR 0 MOVE 0 REMOVE 8 DESCRIBE WORK Install interior basement draintile 9 CHANGE OF USE FROM TO STIPULATIONS Electrical extension cords can not be used as part of the power source to the PUMP. ermit Inspection Cams Will Be Mailed To Homeowner 10 rust SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL. PLUMBING. HEATING. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT CU FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR 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 AND EXAMINED THIS APPLICATION 1 ISTALLS 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 $3,510 $1.75 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $97.25 Fir# SC $3.51 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK F E TOT L FEE Licens S $N /A 102.51 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT tOATE, HE PROP VALID TEHIS IS YOUR PERMIT _7-11-D BL NSD DATE S-GNATURE OF OWNEROf OWNERBUiLDERi iDATE, Prepaid Plan Check $ Estimated Cost $ CITY OF FRIDLEY Receipt # R-3, COMMERCIAL & INDUSTRIAL BUILDING PERMIT APPLICATION Construction Address 5730�� �Sre-ems' /V Legal Owner & Address CONTRACTOR & AD Architect TYPE OF WORK [] New OFC. AREA: Length WHSE AREA: Length OTHER AREA: Length Reg.# Engineer Effective 1/1/2001 (763)572-3604 Zoning Tel# (-7(p'9),5-7j—/6Y9' Tel# (&L,) :7R7c -- 0556 Reg.# BUILDING CONSTRUCTION [] Addition \Vr Alteration -Describ Width Width Width Height Sq. Ft. Height Sq. Ft. Height Sq. Ft. APPLICANT �y��„ Tel #_jag S I -7 tq_o -0 5 So Date 4p - a9 -al VALUATION Sq. Ft. most`%Sq yet �7aluatior $� ) Sq. Ft. x $- Cost/Sq:' Ft. _� Vauatioft" $ —7777 Sq. Ft. x $ Cost/Sq. Ft. = Valuation $ ) TOTAL VALUE Building Use Construction Type ;t Occupancy Group 7-0r,%444 -�" Air Conditioning []Yes []No Fire Protection Pfovided []Yes []No Performance Bond Amount $ See Reverse for Schedule Received []Yes []No PERMIT FEES Permit Fee $ 2. 9!S-- See Fee Schedule on Reverse Side Plan Check $ In Excess of Prepaid Amount - See Reverse Side Fire Surcharge $3.,5 .001 x Permit Valuation (1/10th o) State Surcharge $ �."1s $.50/$1,000 Valuation (See Sched. for > $1 Million) SAC Charge $ $1150 per SAC Unit (Plans to MWCC for.determination) Erosion Control $ 450.00 Conservation Plan Review Park Fee - 4ee Determined By Engineering Sur $ y Agreement Necessary HNot Necessary [] Driveway Escrow feet x $15.50/foot TOTAL $ "y%� ATTACH STIPULATIONS Building MECHANICAL Inspections RESIDENTIAL APPLICATION 7.63-572-3604 CITY OF FRIDLEY DATE ' ` /0- 0-7 YOUR E-MAIL ADDRESS SITE ADDRESS <7-30 Oik- -5 e° 10 THIS APPLICANT IS: i7 OWNER CONTRACTOR PROPERTY NAME: 'JA_ H a. J 0 OWNER/ ADDRESS: 5730 t2Of k- ° TENANT PHONE: r CONTRACTOR COMPANY NAME: A O tr etc t VLLQ Permit No.: Receiv ed By: Date : 0 CITY�P_ A 0/ STATE t'Ia,ZIP � Cf 01_ SUBMIT A COPY OF CONTACT PERSON: Clnfij YOUR STATE STATE LICENSE # EXP DATE LICENSE WITH ADDRESS:O B1I Xe � 9 ®D CTTY ®�1 STATE I`4� ZIP .Q1 a APPLICATION PHONE 7 6 I _ -7Stf 1 q FAX PERNIIT TYPE SINGLE FAMILY ❑TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW PREPLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK SEA Sip-t.I (2LPI o-%-L%,�k C `¢ e 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, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor } Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor X.05 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW)MODEL: `� � a� SIZEBTU o'1 `0®1� Equipment Installed MFG: ! SIZEBBTU MFG: MODEL: SIZE/BTU MODEL: A/C $25.00 —FIREPLACE (GAS) $15.00 . GAS RANGEIOVEN $10.00 _AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 NEW GAS GRILL 0.0.00 BOILER $35.00 _FURNACE $35.00 ,_GAS UNIT HTR $10.00 _CHIMNEY LINER $10.00 _GAS DRYER $10.00 PVEIQTTLATOR $15.00 OOL HEATER $35.00 DUCT WORK $10.00 _GAS PIPING $10.00 . ._...,..-. .....�:.�..�...—..<...:.-s::-r:r�.::ru�::�;sa�;;.L;wa�i,:+i�r+ai. rri '- .a.,........` 1GF8JYsy7,xl,'a3ra,tilvt1 x:+,•:ssr... Permit Fee $ o Number of fixtures @ $10.00 x $10.00 = $ Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ .S' . S c Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ 50 Total = $ THIS IS AN APPLICATION FOR A PERMIT --NOT VALID UNTIL PROCESSED I hereby apply for a building 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 application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all !wo-�rk which requires review and approval of plans. /� SIGNATURE OF APPLICANT e, ►vti(O k PRINT NAME f %k i',S 9`� d.� _DATE 5 " (0 - b City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977