AF - 45353< City of FridAey, Minn.
PERMIT
---� ,
N° _ 6112,`�
Date: _...�_.�.�._ _"�"" _.L.Y � _.__.__
Owner: ���'!�...�.��:"-� ...� Builder �.._._.._. --.._.....__ r..__...._...�
-`�1����---
Address
� ���i'����
LO TION BU L I G
No. ..,1! ��� Street ' ' ...__���"�:����Part f I.ot .__...r..�_..__.�..._._ :--_.__.,_.. ,
Lot _.._:�--� .__ Block _.._.. _...._....___._____ Additian a1c Sub-Divisian _�'�t.�-`�=�`�=� ,��`—'�-`�,=C..y�
Corner Lot —_._�._..__ Inside Lot ___.�..:- Setbacl� _�____._ Sideyard _._._.:...-- .-.-._.-..--
Sewer Elevatiaa ._.._.._..r.._.._--•--._. ___.._:_ Foimiiation IIevatian ....._.. �..___.__...._....._._._..___._.._.....�
���v��:
DESCR6PTION O� BUILDING
L`x�n�� -_.__.::..:.....__ F3�Pf�2 .:..........:..:....-.. xeight ....._.::.:.._........ �g. �'�. ._._....._...._ (;u. �'t ..:
_.._...__..:...__......_......�._.____....._ g'ron ._�_.. .__ Dep3:ta _. ...... Height ' ��. Ft. ._..----._.---.... Cu. �'�.
���
Zj�e of Construction .... _... ...�� -. Est. Co��.. . ...��..�o � Co$npleteai ..---.......__.._..:_
t � ��. ..
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� -C"!� � u— �, <�=; c�J , �-; ��a_'� '-� ;
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L �/'Z,� �C=<—�r--�-�r� +c.�t--.+�c-z� r�
In consideration of the issuance to me of a permit to construct t]ie building described above, I agre� to do
the proposed work in accordance with the description above set forth and in compliance with all provisions of
ordinances of the city of Fridley. �
In co�sidera.tion of the payment of a fee of �� ., permit is hereby granted to._._..
_ 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 in all respects to the ordinances of
Frfdley, Minnesota regarding location, construction, alteration, ma.intena.nce, repair and moving of buildings
within the dty limits and this peraut may be revoked a t anyt� upon vi'�ojat�7II�pf any of the provisi�s of said
ordinances. �/ I �'} ., 1
Inspector
NOTICE:
71� p�rmff doa not eovw tlN eonsfrueliou, is�talklion fer wi�iny, �lumbiao, �as h�afi�, avw� or w�Nr. B� wn to sN
1M duildiag In��eto� for a�p�r�1� p�rmNs for fh�a i1�m.
City of Fridley, Min.n.
_. _
BUILDING PERMIT � s 1 o z
Date: ��a+?._ ""_'-��_--s�:. __.__
Owner: • _�'"I��G� Builder ._._. ... .. .._....._............_.._........._....__.._.._..._..___.
Address--. _�_ _..___.__ __ Address - --- --.._.__..�.___._...__..___...��...
` L TION BUI DING
No.��.� Street __ ' . ���--l- ����.'Fart of Lot ......____._..��..__.____.._.Y_...�..___..._�
�
Lot .—..._....�.._._.__ Block __.....�..._.__.__._.�..__� Additian or Sub-Division ....._...___.�.__.......__......_.._.�.___ _...._..____.._.._
,I� ���,i
Corner Lot �__.._..�.._ Inside Lot _._._�►'""� Setback -�;;�-�.� �__ SideYerd ---V-� -xa�—•-___..�._._.._.._.
Sewer IIevatian
Foundation Elevatian
DESC�IPTIOtV O� �UlLDING
To v : '
_ ..._.._... g'II"�n$ _.�.�._.��.. �7f:�1fiZ1 ..y�..��rc..__ �aelg�lt .�:.._4�:... 0�2$. �° $o�,�x..� L�fl. �'�� ..�.�(...i
: . .� �. .. . .._.. ront __. .. . :. Depth _.._!"� ]:3ei�ht __ .�� �. F't. _� ... :. Ctxe F't. ..��._��
Type of onstruction . ..... .:. . . ` .. Esi. C ....,����To be ComPle�ec� ...................._............_._...._..._.._
��
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 all provisions of
c�rdina.nces of the dty of Fridley.
�
In co�sideration of the payment of a fee of �.�t:. `'�rs�+""' ., permit is hereby grauted to_._._ .—
.___,..._.._..._._...__...__.:__......_�._._ 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, einployees and workmen, in all work
done in, around and upon sa.id building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota. regarding location, construction, alteration, maintenance, repair and moving of b�ildings
o�th�e city limits and this permit may be revoked at any fy�e� �pon '�'on of aay of the provisio�ns of said
1�' f
Inspector
NOTICE:
ihb p�rmN dws not eov�r Hu eoastruelkn, inMdlaeion fe� wieiey. 'Ivmbino, �u h�iNn�, srw�r or wat�r. 6� sun ro sM
th� Buildino In�p�eMr fer s�puaf� p�rmih for th�n ihnu.
APPLICATION FOR BUILDIDIG PERMIT
CITY OF FRIDLTY, MiNNESOTA
Owner' a Name �� N N JQ ' {r/�E�'N Buildex �'J✓N,Elt'
Address /1{/ j G�IQA��YA /4V NE Address
� LOCA�ION OF BUYLDING
No. �%/�,�� Street G�SRb,��/� '�v Part of .Lot .3
Lot Block Addition or Subc3ivision
/ .. /�� /
Corner Lot Inside Lot r' Setback � J� � Side-Yard �,l �t.% �,
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawu on these Certificates.
DESCRIPTION OF BUILDING
To be used as;
�ES ID�NL� Front �O 9- / Depth 3�/ Height �-a /
Sq. Ft. Cu. Ft.
Front Depth Height
Sq. Ft. Cu. Ft.
C��
Type' of� Ccrostruction Eatimated C t
To be Co�►pleted �
The undersigned hereby makes spplication for a permit for the work herein
specified, agreeing to do all'wozk in strict accordance with the City of
Fridley Ordinances and rulings of the Department of BuiZdings, and hereby
declares that all the facts and representations stated in this application
are true and correct.
DATS �=� �-� �iBIGNATURE �/`
(Schedule of Fee Coats can be �ound oa the Reverse Side).
N'
� w � • �
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.��..'.•-�.��___._
r
� o� � � APP'LlCATION: FOR M,OVIN,G P'ERMIT
/ /� y .�i��� ����
No.
/�DV� 1%� Fridley, Minn., r� � 9 19.5��
Inspector of Buildings,
6431 Univ. Ave. N.E.
The undersigned hereby makes application for permit to m�ove building as herein specified, agreeing to do a11
work in strict accordance with the City Ordinances and rulings of the Department of Buildings, and hereby de-
clares that all the facts and representatians stated in this application are true and correct.
Lot Block Addition
Present Locat�on :
�� �d �� , .C�-� , -,
To be maved to:
�, y .,3 � � �.�•-, ,
Routing :
Distance moved it.To be completed about 195�.2-�
o�
Taxes pa.id? Estimated cast $��� � F`oundation and alteration permit numbers
Certification as to cost:
I hereby certify that the above designated building is worth at lea,st sixty (60) per cent of the cost of a simi-
lar new building.
Signed �� ����� ��--'
Owner or AgeaY
Appraved by:
Utilities Notified:
Water & Sewer D�partment
City Engineer
1►Rinnea.polis Gas Co. (date
(Title)
(Title)
orthern States Power Co. (date)
_Northwestern Bell Telephane Co. (da.te)
(Title)
Signed � �'�-�
License Mover °
4 � (See reverse side for iasiructioas) � " � "� �'
►a
In the event that the moving permit is to be apglied far by the owner or by any other person than the licensed
Mover, the following letter must be complet�rl and signed by said maver:
Inspector of Buildings, � Date �g_
6431 University Ave. N.E.
Fridley, Minnesota
Please issue the bearer af tl��s application,� Mr
a permit to move building from :
to: �- to which I l�ereby authorize liim to sign my naxne.
....,,,. ��: _ .. _ _ _ _
Signed
Licenssd Mover
GENERAL INSTRUCTIONS
.�. - _ .
. __-- ___
The followfng' must be secured before maving _ perruit will be� issued :._ .__ �'
1. A building permtit for new location of building io be maved. To obtain this building permit, the fallawing is
. requa�ed:, .. . ;. ,_ . . _. _ _ . _ _ _ ._ .
(a) The building to be moved must be inspected for structural soundness by the building inspector. Phane this
office for inspection. SUnset 4-7470. '
(b) A survey of lot to which building is ta be moved. This survey must be made by a licensed surveyor.
(c) The building and moving permit must be obta.ined at the same time.
2. Tax receipt showing that all real estate taxes due have been paid. Duplicate receipts may be obtained at Anaka
County Auditor. k
3.. Approval from, the Fridley Water and Sewer Department showing that bills chargeable against the property to
be moved have been gaid and water connections have been discontinued at the curb line or at the main. (SQe
reverse side of form.)
4. Approval from Fridley Director of Public Works office approving routing.
5. Notification to, and signature of utility campaniea. (See reverse side of farm.)
(a) Minneapolis Gas Co., 739 Marquetts Ave., Engin eering Department, Fourth Flaor.
(b) Northern States Power Co., 15 South 5th Street, Application and Extensian Department.
(c) Northwestern Bell Telephone Ca., 224 South 5th Street, Business Office, First Floor.
. •.. ... .. � y � � r r -..
11 250-8-58
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• suedecr PERM IT
c�ty of Fr�a��y � i3i25
AT THE TOP OF THE TVItINS B U I L D I�� P E R M I T
. . -.� 4: �. ... . . � . .
._
COMMU�uT-Y D€Y��.OPME�vT o�v. RECEIPT NO.
�; �L _ _ 773.�
� � � #�RQTHCTIVE INSPEGTION $EG.
� � �
� � � ������ % �'C1TY HALL . FRiDLE�'- �55432 NUMBER ` .. REY. � �-DAiE�� � PAGE OF APPROVED BV
�..._.;t�.' ',� s�2-ssaaa5o
910-F15 � /
70B ADDRESS
14�3 GARDENA AV,�NUE N.E. FRIDLEY MINN�S{)�'A
tr LEGAL LOTNO. , BLOCK TRACT�RADDITION SEEATTACHED
DE�CR: 3 MELOI�AND GARLIENS SHEET
2- pRQi�R�YOWNER MAIIApORESS ZIP PHONE
DAUID REAVIS, 1.42� G�DENA AVENUE N.E., FRIDLEY, MINNESOTA
3 CONTRAC70R MAICADbRE$S Z�P PHONE LICENSE NO.
OWNER.
4 ARCHITECT OR DEStGNER MAlL ADDRESS ZIP PHONE UCENSE NO.
5 ENGiNEER MAIL ADpRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
itESIDF.�TCE
7 CLRSS_OF V1�RK
❑ NEW ❑ ADDITION ❑ ALTERATION ;� REPAIR ❑ MOVE ❑ REMOVE
B DESCRiBE9MOAK
9 CHANGE �3F USf FRCNi71 TO
STIPULATIOtJS
SEPARATE AERMITS ARE REQUIRED FOR ELECTRICAI, PLUMBING, HEATING, TYPE b� CONST. OCCUPANCY GROUP OCCUPANCY LOAD
-VEtJ7JLATtWG QR AIA CONDITIONING. g .
�THIS P��#i�4T BEGOMES NULL #ND YO1D, iF WORK OR CONSTRUCTION .ZpN�NG SQ. FT. CU. FT.
AU7li0RfZED IS NOT COMRdfNCED WiTMtM�f4 DAYS, OF}-tF CONSTRUCTIOM
OR':WOflKIS SUSPENDEQ QR Ik$ANDON�D FOA A PERtOD Of 120 DAYS AT ��,
ANY TIME AFTER �YORK IS CON►MENCEA. NO. 'DWLG: UNITS OFFSTREET PARKING
I HEFEBY CERTIFY THAT 1 HAVE RHAI} AN0 EXAM6NE� THIS APPIICATION STALLS GARAGES
AND KNQW THE SAMETO BE TfiUE AND CORRECT. ACCPROVISIONS OF LAWS yqLUATiON SURTAX
AND ORDINANGES GOVERNING THIS TYPE OF WORK W{LL BE COMPUED
WITH WHETHfR SPECIFIED 1�IEREfN OR NOT. THE faRANTING OF A PERMIT . SO
DOES NOT PRESUME TO GIVE AUTHORtTY 70 VIOLATE OR CANGEL THE pERM1T fEE • SAC CHARGE
PRQYf$tOMS OE ANY OTHER STATE OR LOCAL LAW REC�ULATING CON-
STRUCTION OA THE PERFORMANCE OF CONSTRUCTION. $S.�O
PLAN CHECKF.EE TOTALFEE
$5.50
�- SW TUREOFCONT � CTOROR THORIZEDAGENT � � (DATEI y�W�ry_pqppf��' VRLfDATE � THIS.IS YOUR PERMIT
�!" G�-c/� .,+P.CU!v: �f' ) .S AUG . ].. 19 7 5
�—SIGNpTUREOfOWNE UF.QWNER I�DERI DA EI gLCG'.�lN P��.� DATE
�r..�. .s r .. � � � � . .. . .. . ' . ... . •� t
' , . . � ' . .
� � ' '. ' • •APPLICATION rOR RLST�DL'NTIAL., ALTL'RATION,
OR AllllITION. BUILDING P�R1�1IT ,
. ' CITY OF FRIDLEY, hiiNNESOTA • ..
oWtdER's NArt� : U��� C 11 �- �v\ s BuILVER: C3w'� �t' �
. • ADDIt�S S: a�; 3� o'?t� � o'�1'd � �- ADDRES S: �
�
. . .
N0: .�i � a3 STREET: G�r d9� a r7 �, .�� �
,
i.OT : � I3LOCh : ADDITiOn : 1 ! � I a J �'► d . (�a �, a .0^/) S' ;
�
. � :
� CORNER LOT: INSIDE LOT: SETBACK: SIDiYAI'.D: '
• . !
. ,
. . � � . �
Applicant attach �o this for:r. �•�o Certificates. �f Surve .of LoC an3 _pxoposed ,. •'
bui2dino Zocation drawn on these Certificates. . �
.
. . � . ;
. ' . , . . . � "i
� . ' �
. �. . . . . • ' �
t
� �HESCRIPTION OF BUILDING - '
. .
. . i
• • :
Ta Be Used As : . � `
� • Front: Depth:' . Height: •
.• . Square Feet: Cubic.Feet:
� . Front: Depth: Height:
.. . � Squaxe Feet; Cubic Feet: � �
�� - � l 06,08
• . �}ipe of �Construction: �2� �aQ ��a Estimated Cost: � � .
To Be Completed: � � ao / %s . • . - � .
� The undexsigned hereby makes applicativn for a permit for the work herein �
specified, asreein�� to do all worlc in strict accordance with the Cit�• of
� Fi'idley Ordinances and rulinss oi the D�partment of Buildings, and her�by
� declares tliat all the iacts and representations stated in this application
axe true and corrcct. ,
• . �' lI � SICNATURE • �� � ' ��'�
• DATE: �i�
• (See I�everse Side Fox Additional Information.)'
• , �.- a o ��.e�-Y� � . • � ' . •
. ' : • , �� \� • • � .
. , , . , . .
' ...t, . ' ' • _, , - •
� " :� , �—� . _
. � � • ' • � . .
. � � � . � SUBJECT . � � PE �
City of Fridley � 1668 7
"7THE7°POFr"ET"""S gUILDING PERMlT - -
f
' ' R
� �� .
� ; v _ COMMUNI7Y DEVELOPMENT DIV. q�
r � � PqOTECTIVE 1NSPECTION SEC. �' / -
� i �
i_--- � ����1 � CITY HALL FRIDLE�'. � 55432 NUMBER REV. � DATE � PAGE OF APPROVED BV
� � / \.J
612-571-3450 910-F15 i/19/82 � �
JOB ADDRESS 1423 Gardena Avenue N.E.
1 IEGAI: LOT NO. BLOCK TRACT OR ADDITION SEE ASTACHED
DfSCR. Pt. 3 MelO�.dI1C� GdrC�ellS SHEET
2 PROPEHTY OWNER MAIL ADDRESS ZIP PHONE
Wayn,e Monson 1423 Gardena Avenue N.E. 574-1796
3 CONTRACTOR MAIL AODRESS ZIP PHONE LICENSE NO.
Haane Modernizers 4153 Miranehaha Avenue, Mpls. 721-6474
A ARCHITECT OR DESIGNER MAI� ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIt ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW ❑ ADDITION ❑ ALTERATION O REPAIR ❑ MOVE ❑ REMOVE
%
8 DESCRIBE WORK
Reside Dwellin
9 CHANGE OF USE FROM TO
STIPULATIONS
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONtNG. V1Tly'1
THIS PERM17 BECOMES NULL AND VOID 7F WORK OR CONSTRUCTION ZONING S�. FT. CU. FT.
AUTHORFZED iS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK �S SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS CQMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPUCATION 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 WIIL BE COMPLIED $2�g$r� �`1.49
WITH WHETHEfi SPECIFIED HEREIN OFi NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS STATE OR LOCAL LAW REGULATING CON- $`3H.SO
STRUCTION R THE PERFOR NCE OF. ONSTRUCTION.
PLAN CHECK FEE TOTAL FEE
$38.99
SIGNAT OF N' C70a0� T EDAGENT � �DA i � H N'PROPERiY � LlOATED THIS IS VOUR P RMIT
�
iG FO 11 � UILDERI � A 1- BLDG �N.SP �A E'
ONJt�ER:
ADDP,E55
TEL IVO:
Effective Aug. 1, 1981
CITY OF FRIDLCY
APPLIGIITI�J FOR RCSIDEf�ITI/ii_ QUILpIi�G PCiL`�iITS
(Nc��. A1 terations . Addi Lions, or Repa i r,s )
,
• STI2I3iT NO: � STItEE
F���
•�
[3UI LDER
ADDiiCSS
TEL t�0: ��1 — � � � �
Corner Lot: Insic3e Lot:
ADDITION:
SetbacY.: Sideyards :
Ap�licant attach to t}�is form two Certificates of Stirvey of lot and
proposed building location drawn on certificates to scale.
-- DESCRIPTI01� OF C01•JSTRUCTIO��
.t � Front: Depth: Neight:
L(,� �� Square. Feet: Wbic Feet:
Front: Depth:
iieight:
Sqvar.e Feet: Q�bic Teet:
Type of Cor,struction : Estimated Cost: $ [1 `� "
ib Be Cbr.�pleted: � o ��,Y4
Alt. A Alt. B
Broposed Drivc�,�ay Width if New Opening Is Desired: $� $
, . SE� REVERSE SIDE OF SHEET .
13ie un8ersigned hereby make� application for a
agreeinq to c� ,all work ir, strict accordanec wi
ruling� of �the Deiklrtment of Bui2dings, and her
repr�s�nkaticns stated in this ication e
D�iT�: `� —' �� �� a S 12F. :
StiPulations:
� �0 s�
/.�9
.� 3
� �� �
the �aork herein specified,
the Cit of Fridley Ordii�ances �nd
declares that all tl�e facts and
e,zQ�d cor ect,� _ �
SuBJECT
City of Fridley � ;� � �-
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
� � RECEIPT NO.
� �• COMMUNITY DEVELOPMENT OIV. � � �A
� `�.-------�
1 � � PROTECTIVE INSPECTION SEC.
� , C1
i � -
1 � �'��1 � CITY HALI FRIOLE� 55432 NUMBEA REV DATE PAGE OF APPROVED B�
�--"�' �'� 612-571-3450 9t0-F15 11/30/94 � �
JOB ADDRESS 1423 Gardena Avenue NE
t LEGAL �OT NO. BLOCK THACT OR ADDITION SEE ATTACHED
DESCR. Pt. Lot Meloland Gardens SHEET
2 PROPEFTY OWNER MAIL ADDRESS ZIP PHONE
Becky Buesgens 1423 Gardena Avenue NE 537-2345
3 CONTRACTOR MAIL ADDRESS Z�P PHONE UCENSE NO
Same
4 ARCHITECT OR DESIGNEA MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDiiESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION [� REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Re air roof; add vents; add insulation
9 CHANGEOFUSEFROM TO
STIPULATIONS
' TYPEOFCONST. OCCUPANCYGROUP OCCUPANCYlOAO
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTI�ATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IP 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 CERTIFV THAT I HAVE READ AND EXAMINEO THIS APPLICATION 1 STALIS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SUFTAX
AND ORDINANCES GOVEFNING 7HIS TYPE OF WORK WIIL 8E COMP�IED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMiT �ZOO �.SO
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pEFiMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATiNG CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION �LS.00 Fire SC �.ZO
PLAN CHECKFEE TOTALFEE
$15.70
` SIGNATUAEOFCON'RA TOAOAAUTHORIZEDAGENT �DATEi WHEN PFiOPERLY VALIDATED THIS IS YOUR PERMIT
�
\' �
S�GNATU:7EOF PUFOWNEABUILOE �DATE� ,�L�G n�$p OaTE
NEW
ADDN
ALTER
{]
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ConstivctionAddress:
° � �Pti�=
CITY OF FRIDLEY
SINGLE FAMILY AND DUPL�E�XES R-1 AND R-2
Building P�mit Application
W� � ���s�n >�;�.
�
�
Effective 1/i/94
Owner Name & Address: Tel. #a � � �,�
Co�ractor: ����.� �'' MN LICENSE #
Address: Tel. #
Attach to diis application, a Certificate of Survey of the
lot, with the prc�sed construction drawn on it to scale.
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
DESCRiPTIOIY OF IMPROVEMBNT
Length Width Height
Length Width Height
Length R�idth Hgt/Ground
Sq. Ft.
Sq. Ft.
Sq. Ft. � n
� 1 C� Su � � �ll�\
Corner Lot [] Ynsiide Lot [) Ft. Yd Setback Side Yard Setbacks
Type of Construction: Estimated Cost: $��D .°—G
Approa. Completion Date:
(Cost on Backj
Driveway G�rb Cut Width Neecied: Ft. + 6 Ft = Ft x$ _$
DATE: 1\ _�� �,� APPLICANT: ` �p Tel. # 53 � � ,��,�
't Fee .
' 2 �charge
�urcharge
SAC Charge
License Surc6atge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPUL.ATIONS:
� ��_ `! � �!_ _
� /_`� OC� F�e Schedule on Reve�se Side
$ , � � .QOl of Permit Valuation (1/lOth%)
a . � D �.50/51,000 Valuation
$ $800 pa' SAC Uait
$ . $5.00 (State Licensed Residential Contractors)
$ Alt. "A" or Ah. "B" Above
$ $4�?.00 Conservation Pian Review
$ Fee Deterrnined by Engineering
$ Agreement Nece,ssary [ ] Not Nec�ssary [ ]
$�..��
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DEC-17-199? 08�30 FRQM CITY OF FRIDLEY
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CHIl4�TEY A1VD STACK VEltIFICATION
T� undeisigned �enby vcri5es thaz the Guisting chi�Y or stack:
Y. Has be�n carefvUy examivaed Yes (�) No i)
2. Fs f�e from n�st or deLttioiation Y�s i) No O
3. Has no fora�gn objxts lodged within Yes O No {)
4. Is soctuclY �PPort� - Xcs {) No {)
S. Moets all ceurent Code reqturamc�ts for siu
and total B?U's connxted ' i'cs O No O
6 Has wtat heating BTU's of
All othu BTU's
TOTAL BTU's
?. Has a liner becn provided for wat�n c�atcr Yes () No ()
8. Has combustion air boe�n provided for vwdttr beater Yes () No ()
Rcmarks: �
List_ALTERATIONS ' Done:
n , n .
Fi�A'i TNG C�:
Signed By:
llatc:
z0i20'd b$88�£9
Ol J,3�QIa� �0 Jl.1I� WOa� 0�:80 L66T-LT-�3Q
,;
.. sue�etr RM ,,,A�p�:......_�,,
� City of Fridl�� 2 7 9 7 0
, , ` AT THE TOP OF TNE TWINS Bu I L D I�� P E R M I r REC O.
r
� �
COMMUMITV OEVEIOPM�N7 DIV. ��� ^
� ; V'�"'� , . . '`
r � � PROTECTIVE INSPECTION SEC. %
� .
� � �'��1 � CITY HAL,L FRIOLEw SS�� NUMBEp NEV OATE PAGE OF APPROVEO BY
�""'�' �'� 612-571-345p 910-Ft5 � �
9 25 98
�oe �ooAess 1423 Gardena Avenue NE
t LEGAL �OT NO.� BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. • �OO � Of SMEET
2 PiiOPERTY OWNER MAtL ADOR�&$ 21P PMONE
Mark Dougherty - 40
J CONTRACTOR MAII ADDRESS ZIP PHONE UCENSE NO
Boehlke Remodelin LLC 3070' N. Cleveland Av
4 ARCHITECT OR DESIGNEii MAIL ADDRESS ZIP PMONE LICENSE NO.
5 ENGINEER MAIL AOORE$S 21P PHONE UCENSE NO
6 USE OF BUIIDING
Residentia2
7 CLASS OF WORK
O NEW � ADDiTION O ALTERATIAN O REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WOfiK
Install 2nd floor bath
9 CHANGE Of USE FROM TO
STIPULATIONS
See notations on plan.
TVP OFCONST. OCCUPANCYGROUP OCCUPANCV�OAD
SEPARATE PERMITS ARE REOUIflEO FOF EIECTFICAL, PLUMBING. NEATING,
VENTI�ATING OR AIR CONDITIONING
THIS PERMIT BECOMES NULI ANO Vp10 IF WQRK OF CONS7RUCTION IONING SO. fT CU fT
AUTHOR12E0 IS NOT COMMENCEO VyITMiN 60 OAYS. OR IF CONSTRUCTION
OR WOHK IS SUSPENDED OR ABANQONEO FOR A PER100 OF 120 DAYS A7 °
ANV TIME AfTER WORK IS COMMENCEO. ' NO OW4G. UNITS OfFSTREET PARKING
I MEREBY CERTIfV TMAT I MAVE REAO ANO EXAMIN�O THIS APPLICATIQN S7ALL5 GARAGES
AND KNOW TME SAME TO BE TRUE AND COARECT. ALL PROVISIONS Of �AWS VALUATION SURTAX
ANO OiiO1NANCES GOVEqNING TMIS TVPE Of WpRK WI�� QE CpMP�IED
WITM WHETMER SPECIFIED MEREIN OF NOT. TNE GRANTING OF A PERMIT $15 000 7.SO
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOIATE OR CAMCEI TME pEqMIT fEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON•
STqUCTION OR TME PERFOflMANCE OF CONSTRUCTION 224: 75 Fire SC 15. ��
��� � lrL, � PLAN CHECK fEE TOTA� FEE
�'Se�R.I .Z S g
License S 5.0 252.2
S�GN�TUpEO�CON"NA(;TQqOpAUTMOp�ZED�GENT io� E� WMEN PROPEp4 VALIO TED T►+iS IS VOUR PEQMIT
/ /Un
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S�GNATUqE O� OWNEAi�F pWNEpBURDEA� ibAtE� .� '� Bl0 N5� � � �ic�E
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NEW [ l
ADDI�T"'° [ ]
ALTER (�(�
ConstructionAddress
CITY OF FRIDLEY
SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION a/`�
�� �/� 23 G�zr c�ena. f�v� \o
Effective 1 / 1/98
, ��
1 �
` �° �/
Legal Description: �c xnozv-r�.,
Owner Name & Address: /��v�,�, l.�c��i e r�y Tel. # S%� —�� 5lD
Contractor: �o�hl�e �e,modL/�n� GLG MNLICENSE#
Address: �07p N. �evel ,'� �(✓e QDSev�!!e, /�?� �.�'/� 3 Tel. # (�?8-D�i.S"
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:
DESCRIPTION OF IlVIPROVEMENT
Length a g Width I¢ Height �� Sq. Ft. 3 9�
Length Width Height Sq. Ft.
Leng Width H dGround Sq. Ft.
-�-�� �N� d� -x� -�'� �..
Construction Type: �oo o� l=✓'a-rn,�
Driveway Curb Cut Width Needed: Ft. + 6 Ft =
�
Estimated Cost: $ l�ve� . �
(Fee Schedule on Back)
Ft x $ _ $
DATE: o��? � APPLICANT: �� �_ ��r��✓ Tel. # �.� ���'/.S'�
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
CITY USE ONLY
$ ����s� Fee Schedule on Reverse Side
$ /.s - �(� .001 of Permit Valuation (1 / l Oth %)
$ %- S D $.50/$1,000 Valuation
$ $1000 per SAC Unit
$ .S � D O $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 [ ]
$ �s� �1
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6��� � HEATING HOUSE HEATING TEST RECORD %�,%���
N AIR CONDITIONING 7 �
AND ELECTRK. INC.
ADDRESS �f' � APT. F100 CITY �� URB
OCCIIPANT OWNER _ rC'Llt�
HEATLOSS DAT G.IN3T.
SOLD BY C INSTALLED BY �' �
Electricai Work By `� `` Gas Llno By " �`
TYPE OF HEAT QA FA _/RW STEAM_ SPACE HTR.,_ UNIT HTR.__ OTHER
GAS DESIGN CONVERSION
MAKE _ �rYCn. T MAKE OF BURNER
Modal �S-� �� J n?�E t� d Modal
Sarial _ 2 3`'1 A 1! p Z� a'Q — Max. BTU Rat{np
�NP� `'�� � �o MAICE OF FURNACE
THERMOSTAT
Valve
L'mrit -
Model
CONTROLS u
�_ H�at Plug VaM Siz� �
Dratt Hood
SIZZ.� r�� t --- NONE
Regulator
Limit Setting " Filtars Siu �` 2� Numbar _ (
Fan Setting __ �- _ Chlmnay Locat{on fnsida +� Outsida
Pllot Typa Chimn�y Const►uction
P(lotMake- � ra�- �r'
Ptlot Modsl -_- "7 )% Smolu Bomb Wiring /
Pilot T(ming Oraft Tast Tag
L. W. Cut Off Door Prossura Ughtin cInyst.
Pressun Parcant CO= /,. . Dat� Twtad { s /
-�
Input CFH �O Paroont O= .? Company Tastinp a+r-�IL Ri�
Stack Temp, //�� Parcant CO Nam� oi Tastar
Form 235
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$�55 �;Cj: �
'�� ' CHIMNEY AND STACK VERIFICATION
.,y .. »d
:.n �+„� £„;
:;,: :i� i•..
��$y verifies that the existing chimney or stack:
�»
l. Has bee �'ully examined
,� „ �#�
2. Is free fro� �ust or deterioration
�:
3. Has no foreign objects lodged within
4. Is securely supported
Yes � No ( )
Yes (� ) No ( )
Yes (�) No ( )
Yes (� ) No ( )
5. Nieets all current Code requirements for size
,_ __ _ _ _ ar�-�w:.-B�..T's . ��:e�t� _ . � - -- _ __ _ __ _ _ _ - ves ,�} No
. � - - --{ .. j- - -- — —
6 Has tatal heating BTU's of (� � i�-�
A�1:��otf��r BTU's � � e ��� �
TOTAL BTU's 1� U,(� II t�
7. Has a liner been provided for water heater Yes (� No ()
8. Has combustion air been provided for water heater Yes (� No ()
Remarks:
, � �,i � .��'t L� �-`�.-, l't.�.
� Mli�.+l4i'C Ei.EEGT., INC.
_ 1�tC�li't'A1�.J►VE. N.�.
� � aNaw� �ro s�a�
HEATING CO:
Signed By:
Date:
�, �
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sue�ecr PE .
City of Fridley � 2 8 6 51
,� 57����� TNE TW'NS g U I L D I N� P E R M I T qECEIPT NO
� ; y � COMMUMITY QEVELOP�MENT OIV.
r � � PROTECTIVE INSPECTION SEC. 7 ��
� � �"'1 � CITY HAIL FRIOLEY SS132 NUMBER AEV OATE OAGE Of APPROVED BV
�'""�"� �'' 612-571-3450 9t0-Ft5 / �
11 25 98
JOB AODRESS
1423 Gardena Avenue NE "
l0T NO. BIOCK TRACT OR ADOITION SEE ATTACHED
1 LEGAL E. LOO � Of SNEET
DESCR. �
2 PROPERTV OWNER MAIL ADORESS iIP PMONE
Mark Dau hert -
3 CONTqACTOR MAIL ADDRESS Z�P PHONE LICENSE NO
Gates Roofing 4640 Ximines Ln Pl outh 55442 -
a AfiCMITECT OR DESIGNER MAIL AODRESS ZIP PHONE LICENSE NO
5 ENGINEER MAII ADDRESS ZIP PHONE LICENSE NO
6 USE OP BUILOING
Residential
7 CLASS OF WORK � q�pAIR O MOVE . O REMOVE
O NEW O ADDITION O ALTERATION
8 DESCRIBE WOHK
Reroof house and garage (24 S) Tear-off
9 CHANGE Of USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
TVPEOFCONST. OCCUPANCYGROUP OCCUPANCVLOAD
SEPARATE PERMITS ARE REOUIREO fOR EIECTRICAL, PLUMBING. MEATING,
VENTI�ATING Oii Alq CONOITIONING �
THtS PERMIT BECOMES NULI ANO VOID IF WQRK OR CONS7RUCTION ZONiNG SO. fT CU FT
AUTMORI2ED IS NOT COMMENCED WITHIN 60 OAYS, OR IF CONSTRUCTION
OFl WORK IS SUSPENOEO OR ABANDONEO FOR A RERIOD Of 120 OAYS AT '
ANY 71ME AFTER WORK I$ COMMENCED. " NO DWLG. UNITS OfFSTREET PARKING
I MEREBY CERTIfV TMAT I HAVE READ ANO EXAMINEO THIS APPLICATION STA��S GARAGES
AND KNOW TNE SAME TO BE TRUE AND COFRECT. ALl PROVISIpNS Of LAWS VALUATION SURTAX
AND ORpINANCES GOVERNING THIS TVPE OF WOiiK WILL BE COMP�IED
WITM WHETHER SPECIfIEO HEREIN Oi: NOT. TNE GRANTING OF A PERMIT 2056 L.O3
OOES NOT PRESUME TO GIVE AUTMORITY TO VIOIATE OR CANCEL THE pEqMtT FEE SAC CHARGE
PROVISIONS Of ANV OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTI N Oi: THE PERfO MANCE OF CONS7NUCTION ]l{, F're 2
PLAN CNECK fEE TOTA� FEE
� ��= � �" •�
S�GN�tUAEO�.CON'Qa(;T UiNOQi2ED�GENt �OATE� WHEN PROPER� �A ED TMIS IS VOUF PERMIT \
I �(/' r� /
S�GN4TU(7EO�OWNEQ��FpWNEABUiIDEA� IdAiE� � BlO �NSO' � � f��/E
�
NE��- [ )
ADDN [ ]
ALTER [ J
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Effective 1/1/98
q �1
D � ��D
�- a
ConstructionAddress: �y 2 3 �11 �c�,�.-, � �Q� �
Legal Description: � l�� (-r�--►� ��
Owner Name & Address: �/%qti )C._ ��l�G,� �.�1 Tel. # �i`/- q�`�ti
Contractor: rp w� c,s 1Z e,���,,.. � MN LICENSE # (� 79 ,3
Address: �{,�.e�,U x� rv.w� L.s L�. Tel. # �,�G ���'`� 3
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
Length
Length
Length
DESCRIPTION OF IMPROVEMENT
Width
Width
Height
Height
Width Hgt/Ground
r
� t
+ � � �
Sq. Ft.
Sq. Ft.
Sq. Ft.
Construction Type: j�e.a✓ o�� � t2•� Estimated Cost: $.����' �� ��
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ =$
DATE: (-�--� -%� APPLICANT: �w�zs �Z.a,�'w'�, Tel. # ��o-�YS
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ S
$ o?. a �
$ /. 0 3
$
$ �-QO
$
$
$
$
$ 8� �
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.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 [ ]
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N� ��� CITY OF FRIDLEY �°� Effective 4/1/2004
ADDN _ �->- [] 6431 University Ave NE, Fridley, MN 5543� (763) 572-3604 Bldg Insp
ALTER [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPLICATION
Construction Address:
Legal Description:
Owner Name & Address:
�� ��
s �� ��
��
Tel. #� J S ZG�"G S�I �
Contractor: 4100 EXCELSIOR BLVD. MN LICENSE #
ST. LOUIS PARK, MN 55416 Tei. #�: ( r%- �.� ���Z�
Address: �r �pA1s�g
Attach to this application, a Certificate of Survey of the
bt, with the proposed constn�ction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LNING AREA: Length Width Height
GARAGE AREA: Length Width Height
DECK AREA: Length Width Hgt/Ground
OTHER:
�
Construction Tvae: �/�► ��
Sq. Ft.
Sq. Ft.
Sq. Ft.
ated Cost: $ �� � �
Driveway Curb Cut Width Need�d: Ft + 6 Ft = Ft x$ _$
DATE: �` S APPLICANT. Tel. # �� �7g2�
Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call
you for card number. �
CITY USE ONLY -
Permit Fee
Plan-Revi�v�
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
$ Fee Schedule on Reverse Side
$ 65% of Permit Fee
__ ___.6__ _
$ .001 of �'ermit Valuation (1/10t��%)
$ $.50/$1,000 Vaivation
$ $1350 per SAC Unit
$ $5.00 (State Licensed Residential Contractors)
$ Alt. "A" or Alt. "B" Above
$ $450.OQ Conservation Plan Reviev►�
$ Fee Determined by Engineering
$ Agreement Necessary ( ] Not Necessary [ ]
$ STIP•ULATIONS: .
4100 Excelsior Boulevard � • -
St. Louis Park, MN 554�t'A* v�1��i �� CONTRACT
OHice: 952-836-1335 ��-• �
■ Licensed
St. Paul: 651-644-0040 ■ Bonded
Fax: 612-823=1078 . - ' ■ insured
www.crawnmasonry.com C R 0 W N
MASONRY
� � �
PROPOSALSUBMITTEDTO _,. � PHONE - pA�
K. � t t. G � � � r � �x� q -- p ! - �.5_
� JOB M
7 �� �� � �
CITV, STATE and LP CODE . JOB LOCqTION
.Q �
ESTMATOR �� CELL PlqNE qTTN; �pg P�
t ` �4a- ���
WE PROPOSE hereby to fumish material and labor- complete In accordance with speoifications bebw,r fw. tlie sian d:
Payment to be � C7 O q
made as folbws: Tifi �- U(_%� �1 �Q y'%1 /1 �Q� il � ddlars fE �p ` o� ,�'�-� !
When Si rred $ C�-•- U Start $ V Beler�e to be Pad in FWI U Com efion , Owner S�, �J
- AI! matenal is guaraMeed to be as specifietl. Atl WORK to be - psthnated Start Dafe: �- !1
completed in a workmanlike manner accwrding to sfandard practices. yyeather Permitting � ����" t' � �
Specified work and quoted price subject to change upon discovery � ���
of hidden defecls. All agreements contingeM upon sUikes, accidents quthorized
w delays beyond our control. Owner to carry fire, tomado and othar � Signature _.
necessary insurance. pur workers ere fuNy covered by Workers'
Compensa6on Insurar�ce. Products a�d materials may be substituted � . .
for equivaleM products due to availability. Note: This Proposal may be
withdrawn by us if not accepted wilhin ` daye.
We hereby submk specifications and esNmates for. Page No. L of � Pages
G�cn�` �n� `-(�til.c,���rni �(� �� �,��- ��=8��n
�'�'�7 � r`T� �-.. � ; �� 7-� � n �,
C �' � � � � �'� /'� ^]?�-� � j�� I!n
�-t'Q' � � 4�- � r,.S f � !/ f} �c.L C'.e �-r��-?" C�-
/-.m�s� �fc�, � .� , a � 1�� �r,���
v 1� o��._p � t-_ C�f ��r .� , m�-?��✓
�9. c't�' r- �''� l�, r �
�� � 5 �r9s� �S ��;�� ; �ul S�r°��.
r'� �r_� ► �;.� t� I l,t.�,
. atY y�-.�
� : , ��
_ __ _ __ - - -__ _ _ ____ _
_.._ .. - . . ....-_-_, . . . �.-_ : . . .j.,.. . ---
..- .S.
NOTES: SFEREVERSESFDE�FGniFAPGR7IWTNOTICE -
All Jobs are scheduled on a weaMer-pertnitling basis. ACCe t • a
ConVact i�ludes all pertni[s and applicabie tazes. p anCe .�f. CDiiaia�►a .
Contradar ro dean up & remove all debris trom entire yard. 7ry8 eprn,e Pricee� �p��tb�$ ��� ��yy���, � ero ���
- ConVactor to mapnaHZe yard & driveway. . accepted. You ar9 aWwrized to do tl�e work as P
ConVacbr not responeible for damege W treas. buahes a Wubs �dng �rormel � mede as outlined above. � :. ��. � wiN be
masonry operaUon. n . . . �
CoMractor rwt reaponsible for sheetrxk w plastar cracka due b normd masonry Date ot P�eptanoe: � � J,(�-_�� /-� .
ope2tia�.
Contractor rrot responsible (or dust and da6ria in atdcs du . A 78te fee oi 5% w7N be imppsed p� any palence rq� paid W��hM fiy8I5) deys
Crown Masonry recommenda thet hanaovmers cover Meir�babnan�:� � of tlue dete. Owrier shei pey al Contradofs to9e�,Ylm cosis, Irxlud'mg etlm�e�+g
fees. if Owne� defauhs m
coinracwr nw res�wnsi6la ror drNeway dam�e. �"� ' ,
Contracror not respondb�e for 6nerior demaga due to cartl�on, . /
iea damminp w iCa bedaip. � [wr,r�'.1 yJ /C
Contractw 6o Wovqe mechenk's lien waivar ywn rece�t of fufl pnyment for Signature _�G���[�,��1'� �
above wak • � �
Signature
�
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