PRE 2010 DOCSCity of Fridley, Minn..
BUILDING PERMIT N® (4:6:3:7)
Date:
.,.,1- 'r Builder _
Owner•
Address Address
LO '
street � NyBUILDING
a,r..__.._....,...._... Part o
5
Lot ---•-----------....-... Block _...___...._._.._.....--_..__-. Addition or Sub -Division ---
Corner Lot ..._ . ............................ Inside Lot ........... .......... Setback �„d"� .`.' ._..... , S eyard ...:. S .... ........_........................----.._.._..
Sewer Elevation ........... ................... ...... ._................ _.................... .._.. Founiation Elevation ...... _.................
DESCRIPTION OF BUILDING
To Used W: y -,._. ... ....._
Front .dp.-._.: Depth .: _._ Height''
" ... .fir" ..... ... a c�'' -._. ._.. Sq. Ft. Cu.� �'t..:�-•�r-�'_
_....-.-•---------� Front ..................... Depth ..................... ght .. . _ Sq. Ft. ............_...._.. Cu. Ft. ....................
Type of Construction . : - ..!.�*i l Est. Cost..........To be Completed . .... .......... ......................... -........
CA UILo
THIS PERMIT t ��'
IT DO�_S NOT AUTHOR;ZE VIOLAT-
ION OF ANY Ftl{v— I—E LA;.,Ip COVENANTS AND
BUILDING RESTRICTIONS.
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
ordinances of the city of Fridley.
In consideration
of the payment of a fee of $....W...._........_._....., 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
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at any time_ upon violatiog of any of the provisions of said
ordinances.
Building Inspector
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see
the Building Inspector for separate permits for these Items.
City of Fridley, Minn.
BUILDING PERMIT
Date: JUNE 18, 1965
No '7948
Owner: WALLACE GREGERSON Builder H1ARLAN J. HANSON
Address 6040 .. 3rd St. N. E. Address 6819 Beard Avenue North
Fridley 21, Minnesota Minneapolis, Minnesota
LOCATION OF BUILDING
No. 6040 Street 3rd Street N E part of Lot
Lot 8 _ Block 6 Addition or Sub -Division Hyde park
Corner Lot _ Inside Lot Setback Sideyard
Sewer Elevation Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Front Depth Height Sq. Ft.
Type of Construction
Front Depth Height Sq. Ft.
Est. Cost _$800.00 To be Completed
• REPAIRS DUE TO STORM DAMAGE
0
Cu. Ft.
Cu. Ft.
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 ;Jl provisions of
ordinaaoes of the city of Fridley. ,
✓cam r€�
In consideration of the payment of a fee of $-5-- —00 , permit is hereby granted to
HARLAN J. HANSON 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
Fridley, Minnesota glocation, construction, alteration, maintenance, repair and moving of buildings
ordlnaace��. city limita� permit may be revoked at any time upon violation of any of the provisions of said
ALLEN G. JENSEN
Building Inspector
NOTICE:
TIS permh dos not eorw tho comet ucdon, InhWen ter wkhgb plumbing, gas hedh% s wa or water. Be an to m
tbo sunding mopedw for sepm to ponm6s for those item.
APPLICATION FOR BUILDING PERMIT
CITY OF FR.IDLEY., MINNESOTA
LOCATION OF BUILDING
No. _A1)._, Streeter S'l = art of Lot
Lot Block_ Addition or Sub�Di .
Corner Lot Inside Lot ,Set Back Side -Yard
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
DESCR,IIPjTION OF BUILDING
To be used as:
�.._..�-.Front ..,� ..Depth Height
Sq. Ft. Cu. Ft..
Front Depth Height
Sq. Ft. cu. Pt
Type of ConstruetioEstimated Cost
To be
The undersigned hereby makes application for a permit for the work herein specified,
agreeing to do all work in strict accordance with the City Ordinances and ruling of
the Department of Buildings, and hereby declares that all..the facts and representa-
tions stated in this application are true and correct.
DATE j SIGNATURE
(A Schedule of Fee costs can be found on the Reverse Side.)
e
m
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER' SNA1►� , f1 - "-6�e.,� d�,,. BUILDER
ADDRESS 3,eo ADDRESS
LOCATION OF BUILDING
Nat Street Part of Lot
LOT�--_-_JaLOCK ADDITION OR SUBDIVISION
Corner Lot Inside LOT Setback Side -Yard
.SEWER ELEVATION FOUNDATION ELEVATION..
r
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
To be used as;
DESCRIPTION OF BUILDING
Front Depth Height
Sq. Ft. Cu. Ft.
Front Depth Height
Sq. Ftp Cu. Ft.
iL ac' Y/�� u l� ��//f lnr j 01 L
Type of Construction .__. � ��,� �CT 4- Estimated Cost keel o
To be completed
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).
SUBJECT
PERM
City of Fridley
19512
AT THE TOP OF THE TWINS
g U I L D I N G.
P E R
M I T
_
r
R CEIPT NO.
16 • COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
1
1 i
`
1 '1 CITY HALL FRIDLEY 55432
NUMBER
REV,
DATE
PAGE OF
APPROVED BY
.j 612-571-3450
910-F15
6/6/88
JOB ADDRESS 6040 - 3rd Street N.E.
I LEGAL
LOT NO.BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
Sly 7, 8
6
Hyde Park
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
Wallace Gregers.on 6040 - 3rd Street N.E.
571-2823
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO.
Normandale Services Route #1, Isanti, MN 55040
338-1511
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
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Install aluminum.soffit & Fascia
9 CHANGE OF USE FROM TO
STIPULATIONS
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
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 1 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
$1,000
$.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
SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$25.00
STRUCTI OR THE PEBFORVANCE OF CONSTRUCTION.
�'
PLAN CHECK FEE
TOTAL FEE
►
$25.50
SIGNATURE O F CONT C OR AVORIZED AGENT I TE)
WHEN PROPERLY V (DATED THIS IS YOUR ER ,IT
r,
•
BLDG WSP
G/
FIATE
SIGNATURE OF OWNER I IF OWNER BUILDER) IDATE I
NEW [ ]
ADDN [ ]
City of Fridley
R-1 AMID R-2
ALTER (+f Building Permit Application
Construction Address: 3 V S/. "V 1 '
Effective 5/1/88
legal Description: '
Owner Name & Address Q if e Tel. # S -7
Oontr actor : a Ir v. i .'rTel. 3 3 9-- / Sr(
Address • P�L ( T's" v\, �` , t SE 6 Yb
Attach to this application, a Certificate of Survey of the
lot, with the proposoed construction drawn on it to scale.
0
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sg. Ft. '
DECK ARFA: Length Width Hgt/Ground Sq. Ft.
tw VI/1 A b �� �'
Cbrner Lot [ ] Inside Lot [ ] Ft. Yd Setback
Type of Oonstruction:
Approx. Completion Date:
Side Yard Setbacks
mu
Estimated Cost: .Zoo 0 '-
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired: 5 5 -
Width + 6' See Back Page
DATE : APPLIC M: Tel.
MY USE OHI.
P+etIDit Fee 5 nom, i
State Surcharge S
SAC Charge 5
Driveway Escrow 5
Park Flee 5
Sewer !lain Charge
TOTAL 5 ':YS
SPIPUIATIONS:
Free Schedule on Reverse Side
$.50/51,000 Valuation
$550 per SAC Unit
Alt. "A' or Alt. 'B" Above
Fee Determined by Engineering
Agreement Necessary [ ] Not Neoessary [ ]
/moo. oo
moo® o
'S'4a ndsla(j
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
5.,2-3604
RATE SCHEDULE
Effective On August 1, 1995
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
JOB ADDRESS ��— c� ` t
v L
Residential
Furnace Shell and Duct Work, Burner —
Also Replacement Furnace
(Side Vent — Fill Out Back)
Gas Piping (Needed with new furnace)
Gas Range
Gas Dryer
*Air Conditioning — All Sizes
All Others/Repairs & Alterations (UST ON BACK)
1 % of Value of Appliance or Work
Commercial/Industrial
1.25% of Value of Appliance or Work
The undersigned hereby makes application for a permit for the work herein
Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes and
10C) representations
of the Building Division, and -hereby declares that all the facts and
$ 30.00 $ , representations stated in this application are true and ccorreect.
,1995
$ 10.00
OWNER l�
$10.00 $
BUILDING USED AS
$1000 $ r� ESTIMATED COST 'Co PERMIT NO. 4-e /
$ 25.00 $
DESCRIPTION OF FURNACE AND OR BURNER
$ No. of Heating Units 1 Circle One (Steam) (Hot Water) arm Air)
Trade Name Size No. I'�
gTU [dQ��j HP EDR
$ Fuel tJ P, i OLD Total Connected Load
State Surcharge
TOTAL FEE
$ .50 Burner Trade Name Size No.
� Bim} HP EDR
$ I I u ah-),Lp ,� — +N_1_ 1c).00se-er 6i4l�� -
HEATING COMPANY
RMINIMUM, FEE" FOR EFRIGERATION A ANY HEATING/CO OUNGNENTILATION
I IR CONDITIONING PERMIT IS $25.00 Signed By Tel No.
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $42.Hr Approved By Rough—In Date Final Date
. 00 /
*Air Conditioners can not be placed in a side yard without FILL OUT BACK SIDE F R STACK VERIFICATION ON
written permission from adjoining property owner. REPLACEMENT FURNACE
S
CHIMNEY 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's connected
Yes No ( )
6 Has total heating BTU's of 7 , 000
All other BTU's (i✓. l y S��
TOTAL BTU's
7. Has a liner been provided for water heater
Yes (� ) No ( )
8. Has combustion air been provided for water heater
Yes ) No ( )
Remarks:
List ALTERATIONS Being Done:
HEATING CO:
Signed By:
Date:
SUBJECT
City of Fridley
2 7 2 2
AT THE TOP OF THE TWINS
BUILDING P E R
M I T
r
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
r 1 PROTECTIVE INSPECTION SEC.
3Y
i
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
''j 612-571-3450
910-F15
18/17/98
JOB ADDRESS 6040 3rd Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
8 Sl / 2 7
6
1HYde Park
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Lorraine Gre erson
786-0386
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO.
Four Seasons Roofing & Remodeling L
-
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZI
PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP
PHONE LICENSE NO,
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW O ADDITION O ALTERATION XX REPAIR
O MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof house and garage (21 Sq) 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 JS NOT COMMENCED WITHIN 80 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
'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
1751
.87
DOES NOT PR UME TO GIV T IORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS ANY OTH A E OR LOCAL LAW REGULATING CON-
STRUCTION THE P�F,6!6>& OF CONSTRUCTION.$56.75
Fire SC $1.75
Cj
PLAN CHECK FEE
TOTAL FEE
License $5.00
$64.3
IGNATURE OF CO a RA R OR AUTHORI ED AGENT IDATEI
NOPE IDATED
00,
B G INSP 1
T IS Y UR P IT
4 DAT
SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI
Effective 1/1/98
CITY OF FRIDLEY
SINGLE FAMILY -AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
_,,'._`LruCtionAddress:, kgQq6 -A I=d St-_ N ,E
5c.5cription:
r v—&4 ri a- r-n@,r—rso-"
Mame Address: La Tel. #
to kle
MN LICENSE
Tel. #jq5_,F<114o
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF 1A1PROVEMENT
k.X 'Ud"'A:
Length
eng
.'Width
Height
Sq. Ft.
:_-'1.63E AkEi
Length
Width
Height
Sq. Ft.
AREA:
Length
Width
Hgt/Ground
Sq. Ft.
IILR:
IWOm t) \1 .0
-cy- Roev k4e,
'SOI /)
Ti�Kns lv!�.s
Type:j2 .0 Estimated Cost: $
a)F
(Fee Schedule on Back)..
Cull Cut Width Needed: Ft. + 6 17t7 $
P.4rz: gf APPLICANT: Tel. #1
Fee
Surcharge
SAC' Charge
Li-,_--ense Surcharge
Escrow
c),ion Control
tvlaiii Charge
f0TAL
STiPULATIONS:
q67�N
,3450.00 Coiiservation Plan Review
Fde Determined by Engineering
Agre*einent Necessary Not Necessary
CITY USE ONLY
,� %;
Fee Schedule on Reverse Side
of Permit Valuation (1/10th%)
$
$ 50/$1,000 Valuation
$
per SAC Unit
.$1000
(State Licensed Residential Contractors)..,:,
.�$5.00
Alt.'"A" or'Alt.'"B" Above
,3450.00 Coiiservation Plan Review
Fde Determined by Engineering
Agre*einent Necessary Not Necessary
Building
BUILDING
Permit No.:.a
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
CITY OF FRIDLEY
Daj�PW 2009
763-502-4977 FAX
EFFECTIVE 1-1-09
DATE r
YO E- IL ADDRESS
+ C Q
CQ
SITE ADDRESS t7 N i iM JAS
THIS APPLICANT IS:
OWNER ❑CONTRACTOR
PROPERTY OWNER/
NAME: O
TENANT
ADDRESS: 0V cto C CITY �
STATE ZIP S�
PHONE: -.I/0011:1
CONTRACTOR
NAME: 150
SUBMIT A COPY OF
YOUR STATE LICENSE
STATE LICENSE # EXP DATE
AND CERTIFICATE OF
ADDRESS: CITY
STATE ZIP
INSURANCE
PHONE FAX
PROPERTY TYPE
,IXSINGLE FAMILYNEW-CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES_
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED lial WINDOWS
❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE
❑ DECK .BRIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW HOME CONSTRUCTION ❑ ADDITION
4!1 MAINTENANCE/REPAIR ❑ REMO ELING
DESCRIBE WORK BEING DONE: Ini J l'K iY-I1'W
SIZE OF IMPROVEMENT
LENGT WIDTH A(p HEIGHT S FT
ROOFING
❑ HOUSE ONLY
BASEMENT REMODELING SUBMIT:
NUMBER OF SQUARES
❑ HOUSE & GARAGE
1. Existing Floor Plan
GARAGES
❑ ATTACHED GARAGE
2. Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3. List of structural members to be used
PROPOSED HEIGHT:
FOR NEW CONSTRUCTION INCLUDING DECKS,
IDING-- -- _ - - -
inyl
- - --- -- - ---
❑Soffit
ADDITIONS. & PORCHES SUBMIT:
❑ Aluminum
❑Trim
1. Site Plan/Survey showing the existing structures
13 Other
13 Fascia
and proposed project.
2. Two sets of construction plans
WINDOWS
❑Yes OrNo LOCATION OF WINDOWS
3. Energy Calculations
IN EXISTING OPENINGS
OR FOR NEW OPENINGS-DESCRIBE SIZE OF 3 (e x- q 'k
OPENING CHANGES & f
TYPE OF. WINDOW TO BE INSTALLED\
NUMBER OF WINDOWS10
ALL FEES ARE BASED bN VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ -:�,OO U
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
OCCUPANCY '1'YFE
See Back Page for Fee Schedule
65% of Building Permit Fee
.001 times the total job valuation
.0005 x Permit Valuation Minimum $.50
$5.00 (State Licensed Residential Contractors)
$2000 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$22=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks savable to: Citv of Fridley Attach
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 on site; that the work will be in accordance with the
approved plan in the case of all hich requt��view and approval of plan����� �
SIGNATURE OF APPLIC _ PRINT NAME %� d DATE