AF - 47394�
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City of Fridley, Minn.
BUIIIDING PERMIT �•° 3 3 91 �-�
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Date: . . . l . . . . . �. .�. . . . .J.'.`.- �. . . . . . . .. .
Owner....................................... Builder .. � `�..�. ...... ... . ..............
Address...................................... Address .............................................
ATIO�IV OF BUILD[NG
No. .� �.,% �y �. ! . Street . . . . . . . . . . . . . . . . . -�'`! : . . . �'C Part of qt . . . . . . . . . . . . . . . . . . . . . . . . . . .
Lot l.�P.'.�l. ... Btock .. ...�.�. ... Addition or Sub-Division .�l.�'�./�...'�^...'r/.. ��?. �i..........
Corner Lot ..%l........ Inside Lot � . Setback � .�0..`..b. Sideyard ....1� :. � ............
DESCR[PTION OF BU[LDING
To be Used as:
. ... Front
.Y.Y. . : o �� �� . � Height � 1.' � sQ. Ft. �1:�. �~ c�. Ft. �.� 9Y3� ��� °i�
P
. . . . . . . . . . . �om . f.�r: "� ��n Q7. !Y �ieight .,l A-. .D sQ. �. �,3.(� c�. �. ,3 .(a O �" "'°
Zj�pe of Construction �� . . . . . �a� � �� . 7. . �. :�'S'. To be Completed . . . . . . . . . . . . . . . . . . .
In consideration of L'he issuance to me o! a permit to construct the building desribed above, I agree to do
the proposed work in accordance with the descrlption above set fo and in compliance with all provisiona of
ordinances of the city of Fridley.
.x... �?,......� ,. ..�.�w.... ...............
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In consideration of the payment of a fee o! $.ol. .,7. . . . . . , permit is hereby granted to . . . . . . . . . . . . . . . . . . .
......................... to construct the building or addition as described above. This pertnit is granted upon
the e�ress condition that the pexson to whom it is granted and his agents, employees and worlunen� in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
J Fi�idley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings with-
in the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
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���,.. .��� ... .. .. . Building Ixispector
NOTICE:
This permit does not cover the constructfon, inatallation or alteratlon for wiriny, plumbiny, �as haatin�,
sewer or water. Be sure to see the Building Inspe�tbr for separate permits for these itema
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City of Fridley, Minn. N° '7808
BUILDING PERMIT � 7v
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June 9, 1965
Date:
p�.; Robert Ritter B,,;l�r _ Ted Murr Contractor �
A� _ 61�.01 Jackson Street N. E._ A�S _ 2001 Wentworth Ave. So. St. Paul�
LOCATION OF BUILDING
xo. 61t...�1 .� street Ja�ksail S�reet N. E. ._._____._... Part o! Lot
Lot 16��__ Block _ �+ ____. Additiari or Sub-Divisi� _TFlOI'eACB PST�i
Corner Lot � __._ Inside Lot ._._. S.etback .�.._.____..�—._ Sideyard
Sewer IIevatioa �____ ._—� Foundation IIevation
DESCRIPTION OF BUILDING
To be vsed as:
--_ Fra�t � Depth Height Sq. F'G .��
�.._._.—.. �t Depth Height ._._ Sq. Ft.
Type of Construction � . _.. Es� Cost �Sl.(�___._.___._ To be C�pleted
Cu. b't
Gu, FL
Storm dama�e repair
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Ea cansideration of the isauance to me of a permit to construct the building described above I agree bo do
th� propoaed work in acc�ordance with the d�scription above set forth and in compliance with a�l p�avisiions o�
ordinances a! the dty of Fridley. ���_� i��Zc,�cit- /
In caosideral3� of the payment of a fee oi � 5-� ,�nntt � hereby �tea to Ted N�r�' Cost.
to c�onstruct the building or addition as descrfbed above. This peraiit is -granted upon
the express oondition that the person to whom it is granted aud tus agents, employees and worlunen� in all work
d�e in, around and upari said building, or aqy �art thereof, shall oonform in all respects to the ordinances o�
Fridley, Minnesota regarding locatio�, constructiart, alterati�, maintenance, repair and maving of bufldin�
ano��� dty limits and this perrmit may be revodced at any time upo� violation of any of the �'ovisions oi said
Al1en Jenaea � �
NOTICE:
1Ns p�endt dou nw eov�r f6� eonaroeNoe, Is�fallNios /or vrtrYw. P��W Y�s I� aw«� or wat�r. !� su� to �
tIN luildh�y 4ap�eler foe s�ah p�rwils fer fMa Rann.
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APYLICATION FO�R BtiILDING PERMIT
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' • CI�"Y'OF FRIDh:EY, MINNE901�A ,. . . _
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OWNBR' S � NAI�ffi : Q���Z�, ' -. �2� _ : ., i1TL�BR � , .
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, A�DDRBSS � �o / � � ADDRESS . �oo / " , /fi�'''�
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. . _ .tocATia,ri :og sv�tcn�tivc . .. :r , a.
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; No. - �p � �#'� . ' . - � ' Str�et ��4�-.l.ri�r�....!. =parti� o!� Lof'�''
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� LOT / /� � � ,� BLOC�t� ADDITION R SUBDIVxSION�� p_.�-� �,. �♦l+�
i��+'�� ��, �+�+�r.��. -. w :�^ �
. ._ . . . . . � . . . . . . .. . .. . , �..�. . . . . . . . .. . ��
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Co�ner � Lot � �Inside LOT " S�tbaaTc ` . �id'e-�ard
. -^---- r--�---- . . . . , . .. . . . . .., . . ,.
SEWER E#.EVATIi'�1� : ` ' ` ' � �' � 'FOUNDATIO�t ELI:VATION : ` - . . `: :� �
. �; . . _ � .. _ � .... _.....___
Applicant attach to this form Two Certificates of Surrey of Lot aad propo��,d,
building locatioa drawn on rheae Certificates+ •---------
fic� be t��ed �as ; �
, D�3CRt�'T'tOt�T �P''�BV�DING " °
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_... � . . .. . . .? : jF:
Front Dept ^r_._____ Height
_u �..
Sq. Ft, Cu. Ft,
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Frrnat -' . ; .. • Depth.,���+H�i$ht:,� � _ . . ..
. � . .. . � .. . � � . . . . . . . �. . � � . � . .. . . � ��+if:`4
, ' . : . Sq.` Ft. .... . . Cct: #�t.�' .. . . �.�._�;
� . ..: - . , � � . .:,�,. �: ��
.Type of Crna�truction � ,� Cost � s� �
_ .. , • ..... , � � „ . .r � Setimsted
.: ... .. . �+. . ;.� ' ' :•. __ : ._ , . _
.To .be c leted ���_� ' �
°'°�p =__._,���� ;µ�� � _..�,!'_����L_..,�-,�,.2�;�� , .,,.,.,. �
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The undersigned' hereby `makea`-appif�atiori fbr a'perarit 'for"�th'e�'ao�lt� bere�ti� sp�cified,
agreeing to do ali wortc in strict accordance with the Citq of Fridley O�Cd�.nances
. . . .
� and ruling6 0� the Departmerit o�.Buildi,ngs-,•and"hereby declareg that a�l� the,.facta
and representationa stated in�this, appl3cat�aia��are'tru2 and cbrr�crt.''� '' "
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DATB ,3 � d -'-, fi.• ,s!" ' SIGNA�'tJItt� ' . .. . �:.
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(Schedule of Fee Coats can be found on the Reverse Side). ��`f F?�
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CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1991
6431 University Ave NE � � � ��
Fridley, MN 55432 APPLICATION FOR POWER PI.ANTS AND HEATING� COOLING, VENTILATION,
572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
JOB ADDRESS � �� � �GLC�SO/V' ��� I��•
RATE SCHEDULE
Residernial
Furnace Shell and Duct Work, Burner -
Also Reptacement Fumace
Gas Piping (Needed with new furnace)
Gas Range
Gas Dryer
Rate TOT/#L
S 20.00 $ o�G�, CTC►
� 10.00 $�0. �
$10.00 $
$ 10.00 $
"Air Condittoning - Atf Sizes $10.00 $ fQ� �
All OtherslRepairs & Alterations (LIST ON BACK)
19k of Value of Appliance or Work $
CommerdaUlndustri�ai
19�0 of Valus of Appliance or Work
State Surcharge
TOTAL FEE
S
� •50
a�! ,�b
MINIMUM FEE FOR ANY HEATING/COOLINfaNENTILATION
REFRIGERATION/AIR CONDlTIONlNG PERMlT IS $15.00
PLUS THE �.50 STATE SURCHARGE
REINSPECTtON FEE 530.00
*Air Conditioners can not be placed in a side yard without
written permission f�om adjoining property owner.
The undersigned hereby makes application for a permit for the work
herein specified aareeing to do all work in strict accordance with the
city codes and ruling of the Building Division, and hereby declares
that aN the tacts and representatians stated in this application are
true and cor�ect. .,�Y'1-1 � � ,1991
,v �v
BUILDING USED AS__Y�a!�'-f'��-�'/
ESTIMATED COST � �� � �� PERMIT N0. �� �� /
DESCRIPTION OF FURNACE AND OR BURNER
No. of Heating}�n-it�s-_.,C— Circ:le One (Steam) (Hot Water) (Warm Air)
Trade Name �"1nU�C SizB No.
BTU li)�C'G�C� HP_ EDR
Fuei Total Connected Load
Burner Trade Name Size No.
BTU ' HP EDR
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HEATING
�-,�`i� C_ � /� � •
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Signed By el No. � 7a `� �� l��
� �Appr4ved By �_ Rough-In Date Final Date
(J�Sc�'l�
FILL OUT BACK SIDE FOR STACK VERIFICATION ON
REPLACEMENT FURNACE
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aa . i �� � :__� � - _ s_ '�. �. � •
.�._._ .... _L.
The undersigned hereby verifies that the existing chimney or stack:
1. Has been carefully examined Yes Q�) No O
2. Is free from rust or deterioration Yes (� No O
3. Has no foreign objects lodged within Yes (� No ()
4. Is securely supported Yes (� No O
5. Meets all current Code requirements for
size and total BTiJ's connected Yes �'� No O
6. Has total heating BTU's of %(�� �L�
Al l other � BTU' s � 7 Q�
ToT� BTV � S 1 ��Tl��
Remarks << �
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List Alterations Beina Done:
HEATING COMPANY
Signed By
Date
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SuB�ECT NO.
City of Fridley 2 9 0 4 3
AT TNE TOP OF TME TWINS g U I L D I N G P E R M I T
r
; � RECEIPT NO.
� `L _ COMMUNITV DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC. /�,'3� 9
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i._-.�; �'�' �'� CITY MALL FRIOLEV 55�32 NUtaBEN pEV O�TE P�GE O: AGPROVEO !Y
L 612-571-3450 910-F15 3/22/99 / /
lOe aDDRESS 6401 Jackson St NE
t LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACMED
oesca. 16,17 4 FZorence Park SMEET
2 PROPERTY OWNER MAII ADORESS ZIP PMONE
Joe Dougherty 6401 Jackson Street NE 571-7638
3 CONTqACTOR MAII ADORESS ZIP PMONE LICENSE NO
Kastle Co 809 E 48 St, Minnea olis, MN 55417 869-3020 20029530
a ARCHITECT OR OESIGNER MAIL AODAESS ZIP PNONE LICENSE NO.
5 ENGINEER MAII ADORESS ZIP PHONE IICENSE NO
6 USE OF BUIIDING
Residential
7 CIASS OF WORK
O NEW ❑ ADDl7101V O ALTERATlON � REPAIR O MOVE D REMOVE
8 DESCRIBE WORK
Reroof House & Garage (25 Sq) Tear-off
9 CHANGEOFUSEfROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday thru Friday; 9:00 am to
9:00 pm on Saturday; No work on Sunday.
tYPE Of CONST. OCCUPANCY GROUP OCCUPANCV LOAO
SEPARA7E PEAMItS AAE REOUIRED FOR ELECTR7CAL, P�UMBING. HEATING,
VENTI�ATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NUII AND VOIO If WOiiK OR CONSTRUCTION 20NING Sa. fT CU FT.
AUTHORIZED IS NOT COMMENCEO WITNIN 60 OAYS. OF IF CONSTRUCTION
OR WORK IS SUSPENOEO OR ABANOONEO FOR A PER100 Of 120 pAVS AT
ANY TIME AfTER WORK IS COMMENCED. NO DWIG. UNITS OFFSTREET PARKING
I HEfiEBY CEFTIFY THAT 1 HAVE FEAO ANO EXAMfNEO TMIS APPIICATION 1 S7ALL5 GARAGES
AND KNOW TME SAME TO 8E TRUE AND CORRECT. ALL PROVISIONS Of LAWS yALUATION SURTAX
ANO ORDINANCES GOVEFNING TNIS TVPE OF WORK WILL BE COMP�IED
WITH WHETMER SPECIf1E0 MEREIN OA NOT. THE GRAN7ING OF A PERMIT �2� 1�F2. �1.07
DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE O:i CANCEL THE pEqMIT FEE SAG CMARGE
PROVISIONS OF ANY OTHER S?ATE OR LOCAI lAW REGUTATING CON- $74�75 Fire SC �2.1�i
STRUCTI OA TME P RMANCE OF CONSTRUCTION
c� PLAN CHECK fEE TOTAI fEE
� O'� 2 License SC $5.00 $82.96
N U%1E O� CON'R�CTOp OA AUT D�GENT �o�TE� � WMEN PROPERIY VALIDATEO THiS iS VOUR PEpMiT
S�GNAIUQE O� OWNEQ��f O�NNEpBU�IDEA� �OATE� OG �NSO f�61E
NEW [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY \�
ALTER j] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 �� r�
BUILDING PERMIT APPLICATION �U�,� �,"\
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ConstructionAddress: ��i � / .�C��i`� S�,-� 5%` � ��
Legal Description:
Owner Name & Address:
Contract�
Address:
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
� Tel. # S�/ - 7�3 �
MN LICENSE # aC..t�?9" 53d
Tel. # �j % ���
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
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DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
Length Width Hgt/Ground Sq. Ft.
� = ��.��z��o
Construction Type: %�O � � �/� �' Estimated Cost: $ �%g�
(Fee Schedule on Bac�k)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: /D- $'`�! $�
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
APPLICANT: lia 5�/� Tel. #$�i q' 3 B� O
CITIF USE ONLY
`� � e��
$ _ Fee Schedule on Reverse Side
$ �_ �y .001 of Permit Valuation (1/lOth%)
$_ � , c� $.50/$1,000 Valuation
$ $1000 per SAC Unit
$ �� pQ $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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