PRE 2010 DOCS.. 24
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
Y . L
P
OWNER'S NAME BUILDER
ADDRESS [ J 'Z ADDRESS
LOCATION OF BUILDING—,
No. .; d.-= StreeT ,,e Part of Lots
LOT BLOCK ADDITION OR SUBDIVISION
Corner'Lot Inside LOT Setback Side Yard
SEWER ELEVATION- FOUNDATION ELEVATION
Applicant attach to this form Two Certificates.'of Survey of Lot grid proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To be used as:
Front p Depth Height:
Sq. Ft. Cu. Ft.
Front Depth _ Height
". Sq. Ft. Cu. Ft.
Type' of -Construction Estimated Cost
;To be -•completed -- -
The undetsigned hereby -makes application for a permit for the work herein specified,
agreeing to do all work in.strict ,accordince.•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 3 SIGNATU'RE
(Schedule of Fee Costs can be found on the Reverse Side):.;
•
3-P.;2'96
City of Fridley, Minn. N° 8659
BUILDING PERMIT
Date: JANUARY 24, 1966
Owner: FARRELL SCROGGINS Builder SAME
Address 305 West 27th Street Address
Minneapolis, Minnesota
LOCATION OF BUILDING
No. 5612-14 c
St t 6th rStre_et N-• E, Part of Lot . S,. 13' of Lot 10, all of
Lots 11 an :bl1 & of Lo Adl
_diition or Sub -Division Hilton's Addn. to Mechanicsville
Corner I.ot Inside Lot — Setback — Sideyard
Sewer Mevation Foundation Mevation
DESCRIPTION OF BUILDING
To be Used as: REPAIR BUILDING AS TO COUNCIL ORDER - December 13, 1965
Front Depth Height Sq. Ft. Cu. Ft.
Front Depth Height _ __ Sq. Ft. Cu. Ft.
Type of Construction Est. Cost _ $3, 40 To be completed
REPAIR AS TO SPECIFICATIONS ATTACHED.
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 com ce with a'11 provisions of
ordinances of the city of Fridley. 01
In consideration of the payment of a fee of OL18.00 , permit is hereby granted to FARRIU
SCROGGINS 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 ng location, construction, alteration, maintenance, repair and moving of buildings
within � city limits ands uns permit may be revoked at any time upon violation of any of the provisions of d
ordinan
ALLEN G. JENSEN Building motor
NOTICE:
M permit does not eowr tbo coWmcd w, instaMion far wding, plumbing, go hating, awor or water. Bo aro to as
tin WMing Inspector for separate pennhs for thea home,
879.01
City of Fridley
AppOcation for Phmddng and Gas Fitting Perak
Dept. of Bldgs. Phone 880.3480
DESCRIPTION OF WORK
Number. Kind and Location of Fixtures
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO. RATE TOTAL
Number Fixtures .....
x $2.00
$
Future Fixture Opening ... ......
Y
$
New Fixture Old Opening
x $1.50
Q
Catch Basin .. ........... ..
x $3.25
$
e
•
N
WATER HTR.
GAS
ELEC.
Base
Electric Water Heater
x $2.00
$
GAS FITTING FEES:
NO. RATE TOTAL
lat 3 Fixtures ....... ..................
x $2.00
$
Additional Fixtures . .......... .......
x $ .75
$
Gas Range to 199,000 BTU ..............
1 x $5.00
$ 3.00
lot
iiwta3i
1
2nd
3rd
--
4th
° ruturo Connection Openings Connect" with
e NOW Fixture, ON OpeningsSewer
I Cesspool ❑
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO. RATE TOTAL
Number Fixtures .....
x $2.00
$
Future Fixture Opening ... ......
x $1.50
$
New Fixture Old Opening
x $1.50
$
Catch Basin .. ........... ..
x $3.25
$
Water Heater (Up to 99,000 BTU) ......
x $3.00
$
New Ground Run Old Bldg.
x $3.25
$
Electric Water Heater
x $2.00
$
GAS FITTING FEES:
NO. RATE TOTAL
lat 3 Fixtures ....... ..................
x $2.00
$
Additional Fixtures . .......... .......
x $ .75
$
Gas Range to 199,000 BTU ..............
1 x $5.00
$ 3.00
REPAIRS & ALTERATIONS—Refer to Code
Description . ............................................$
TOTAL FEE
I.eeation X12 NE. 6 street
City of Fridley:
The undersigned hereby makes application for a permit for the work herei
specified, agreeing to do all work in strict accordance with the City Ordinance
and ruling of the Department of Buildings, and hereby declares that all the fact
and representations stated in this application are true and correct.
Fridley, Minn_ AUG 2.3 1969 19,
Owner T.oi a G33ntafoon
Kind of Building Frame
Used as Rage —AUGTo be completed about G 2 9 1969
Estimated Cost, $
OldX-New. Building Permit No. Permit �aO. 1503�
signedo,, MINNEAPOLIS S CO.
t
Business Phone N G
ROUGH
FINAL
SUBJECT
P® M13O38
Cit of Fridle
y y
AT THE TOP OF THE TWINS
PERMIT
BUILDING
RECEIP
I L
I `L _ COMMUNITY DEVELOPMENT DIV.
746
r PROTECTIVE INSPECTION SEC.
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-560-3450
910-F15
JOB ADDRESS 5612 - 6TH STREET N.E., FRIDLEY MINNESOTA
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
10_11_12
2
1 HAMILTONS ADDITION TO MECHANICSVILLE SHEET
2 PROPERTY OWNER MAILADDRESS ZIP PHONE
EUGENE L. BAUCK 5612 - 6TH STREET N.E. FRIDLEY MINNESOTA
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
SAME
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
RESIDENCE
7 CLASS OF WORK
❑ NEW jj ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
CONSTRUCT DETACHED GARAGE 20 x 24 x 10
9 CHANGE OF USE FROM TO
STIPULATIONS
PROVIDE HARDTOP SURFACED DRIVEWAY
SEPERATE PERMITS AQUIREQ AOR MIRING,
HEATING, PUIMBING AND Sita! &
tom
gall
Before d��MEIEC�at GAE
�ti��PHo�IRE� U
aY .W
REav
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
F'RANIE
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
4800
4,500
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.
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$3,552
$1.78
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.
$9.00
PLAN CHECK FEE
TOTALFEE
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE)
WHEN PRO ERL ALIDATED THIS IS1YOURSPERMIT
Err
JIM 23.1975
BLDG. INSP ° DATE
SIGNATU OF OWNER IIF OWNER BUILDERI (DAT
APPLICATION FOR RESIDENTIAL., ALTERATION,
OR ADDITION.BUILDING PERMIT
'FRIDLEY, MINNESOTA
CITY OF
OWNER'S NA`1E :��. BUILDER
ADDRESS: ��_ ADDRESS:
NO:. 5-6 STREET:
LOT: /®._/ BLOCK: a7 ADDITION: &e -ea aen PUP ea 5
CORNER LOT: INSIDE LOT.: °� SETBACK:: SIDEYARD:
Applicant attach to this form Tao Certificates f Survey of Lot. and. -propose.'.
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Used As:
,Pe 54 1150'Front : v°t ® j Depth: 92Hei g_ t
h:
Square Feet: 5/86 Cubic . Feet
Front: Depth: Height:
Square Feet; Cubic Feet:
Type of Construction: a4doz Estimated Cost: $ 13ca°�
To Be Completed:
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in stxict 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:
(See Reverse Side For Additional Informs .}
ou 40
AGREEMENT
owner of the property located
at have no objection to the City allowing
the construction of a to be located at
without the required certificate of survey that the
City ordinarily requires for all new construction.
Sn t e
Address
Date
Witness
susaEcr
PERM IT.-N-a---=--
City of Fridley
.._
? 13039
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
1 . I
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
J 612-560-3450
910-F15
6-23-75
JOB ADDRESS
5614 - 6TH STREET N.E. FRIDLEY MINNESOTA
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
0-11-12
2
1 HAMILTONS ADDITION TO MECHANICSVIT•T•F SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
EUGNE L. BAUCK 5612 — 6TH STREET N.E. FRIDLEY MINNESOTA
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
SAME
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
RESIDENCE
7 CLASS OF WORK
IX NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
CONSTRUCT DETACHED GAPAGE 1
9 CHANGE OF USE FROM TO
STIPULATIONS
PROVIDE HARD SURFACED DRIVEWAY
WAR10146
fi��°ERATE PE#i�-
� tall local utilities
sefore did ng PLU
TRUNK - ELECTRIC - G*Etc. tjEAT{NGt
REQUIRED By LAW
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
FRAME
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
288
2,880
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,
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$2,131.20
$1.11
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.
$6.00
PLAN CHECK FEE
TOTALFEE
$7.11
SIGNATOR OF CONTRACTOR ORAUTHORIZED AGENT (DATE)
HEN PROPERLY V 1 D TED THI IS YOUR PERMIT
JUNE 23, 1975
BLDG. INSP a DATE
ISIGNAJWREO OWNER IIF OWNER BUILDERI (DVE)
APPLICATION FOR RESIDL'NTIAL., ALT}:RATION,
OR ADDITION.BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAM- g2 BUILDER
� /-92 6 . ADDRESS:
ADDRESS:
NO: ! e STREET: 6
LOT.: /0 -- /Z BLOCK: -:51 ADDITION: q e��
CORNER LOT: INSIDE LOT:�SETBACK: SIMARD:
Applicant attach to this form Tsao Certificates of Survey .of Lot- and:pxopose
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Us dA
y Front : /.V. Depth • .7 4✓ Height •
Square Feet • Cubic . Feet •
0
Front —Depth:
Square Feet; Cubic Feet:
Height:
Type of Construction: Estimated Cost: $ leer'
-2--r
To Be Completed:b�
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 corrccto
DATE: SIGNATURE:
(See Reverse Side For Additional -In rmation.)'
7,11
m
p
A.1 JLJA-j
p Boz
1-7,7gOdUY6
_ __ _. _ _ ._ _-_ - I \ �.
�y
�n�\\\
O
SUBJECT
of Fridley?
4 9 2 3
AT THE TOP OF THE TWINS
BUILDING PERMIT
Ir?City
RECEIPT NO.
`y -------COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC
11 ?7
r
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
3/26/97
JOB ADDRESS 5612-5614 6 Street NE
1 LEGAL
I LOT NO.BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
Pt 10 %I
2
Hamilton's Addn to Mechanicsville SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Kenneth Hafner 10239 Raven St NW, Coon Rapids, MN 55433 754-2335
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Siding Sales & Service 3555 116 In NW, Coon Rapids, MN 55433 422-8850
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
20075652
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Double Bungalow
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION Ij REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Reside Building (Vinyl 2x5 W/foamcore)
9 CHANGE OF USE FROM
TO
STIPULATIONS
Install building wrap and have inspection of same unless
manufacturer's specifications state it
is not necessary.
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
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
2
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
$3,500
$1.75
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OT R STATE OR LOCAL LAW REGULATING CON.
STRUC R THE PER MANCE OF CONSTRUCTION.
$87.25
ire SC $3.50
��
PLAN CHECK FEET
TAL FEE
e 5.0
97.50
SIGNATURE OF CON RACTOR OR AUTHORIZED AGENT IDATEI
H P FfIERLY ATED THIS IS Y UR PERMIT
r
BLDG I SP DATE
SIGNATURE OF OWNERIIF OWNER BUILDERI IDATEI
NEW [ ] Effective 1/1/97
ADDN [ ] CITY OF FRIDLEY
ALTER V] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: SG J - 541
64' St 'ki �E.- Fg Io
X132.
Legal Description: �o r P+ 10, I t PT (Z 810oc- 2 Aan iMOlS' r00pi Ty .
Owner Name & Address: �eti{a e44, 2A% n Z 3q i AVEP .S+n1 w e Tel. #
Contractor: S is1 1 Lsev`� tc MN LICENSE #
Address: -3575'5- ICS Lct Co� Y" Tel. # 2--2-
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF HUPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER: s
Construction Type: V Estimated Cost: $®a
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6.Ft = Ft x $ =. $
DATE: 3 % APPLICANT: TeL # z Z
STIPULATIONS:
s
� r
CITY USE ONLY
Permit Fee
$ cn`t7•
Fee Schedule on Reverse Side
Fire Surcharge
$ S 0
.001 of Permit Valuation .(1/10th%)
State Surcharge
$ / , `%S
$.50/$1,000 Valuation
SAC Charge
$
$950 per SAC Unit
License Surcharge
$
$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
$ S�
STIPULATIONS:
s
� r
Building
WATER OR SEWER
Permit Noai bg_ Li
Inspections
PERMIT APPLICATION
Received By:
763-572-3604
763-502-4977 fax
CITY OF FRIDLEY
Date Rec'd:
EFFECTIVE 1-I-08
APPLICATION DATE: YOUR E-MAIL ADDRESS:
THIS APPLICANT IS: CONTRA❑ OWNER
[C OR to
JOB ADDRESS:
NEW CONSTRUCTION PERMIT # (IF APPLICABLE):
H
PROPERTY
NAME r 11
OWNER/
ADDRESS: CITY: STATE: ZIP:
TENANT
PHONE:
CONTRACTOR
NAME:
SUBMIT A COPY OF
ADDRESS: CITYTAT1ZIP
YOUR STATE LICENSE
PHONE: CELL PHONE: _
AND BOND
STATE LIC: STATE BOND: EXP:
PERMIT TYPE
❑ SEWER CONNECTION PERMIT $50
❑ WATER CONNECTION PERMIT $50
WATER/SEWER LINE REPAIR PERMIT $40 WC)
❑ ADD STATE SURCHARGE $.50 f
❑ SAC CHARGE @ $1825
TOTAL
OTHER CHARGES (IF APPLICABLE) PAY TO UTILITY BILLING
NEW WATER METER COST SEE UTILITY BILLING
SPECIAL ASSESSMENTS SEE FINANCE
WATER TAP SEE ENGINEERING
NOTE: WATER METER REPAIR, INSP OR SHUT-OFF / WEEKENDS & HOLIDAYS $125 / HOUR-BILLED
THIS IS AN APPLICATION FOR A PERNIIT-NOT VALID UNTIL PROCESSED
I hereby apply for a water or sewer (new connection or repair) 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. I understand this is not a permit but
only an application for a permit work is not to start without a permit.
n �n �A �
SIGNATURE OF APP NT: 5. 7/,0MjC/v-. PRINT NAME /U l/�� ATE 1r i5yd
r
APPROVED BY: DATE l�
3
COPY GIVEN TO: ❑ UTILITY BILLING
Ci of Fridley
Y
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977