PRE 2010 DOCS•
•
BUILDING PERMIT
Village of Fridley, Minn.
Date ..524�... / .... .
7go,
Owner ..% ... `....... .. .... Builder
Address .`r:.,/ . Address
N° 2940
..r
LO ATION OF BUILDING
/ %/ 0
No. 4� . �...... Street . (�.1� . . ................ Part of Lot . .. ............ .
Lot .... .... Block ..l... ....... Addition or Sub-DivisioArU-/ �`a 6&011 ;eo— ...
Corner Lot ............ Inside Lot ... .... ..... Setback ............ Sideyard
DESCRIPTION OF BUILDING
To be Used as:
........, . ... Front c!. �.' `Depth �..�Lieight, .. ... Sq. Ft. 9 Cu. Ft.
Front .. Depth .. Height ......... Sq. Fdfn- n- . rt........ .
of Construction .............. Est. Co .1. � . vl. c ... To be Completed ' . ............. '
p
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 village of Fridley.
.... ........
In consideration of the payment of a fee of $ ermit is hereby granted to ........................
...................... to construct the buildin 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 with-
in the village limits and this permit may be revoked at aanytulrne upon violation of an of the provisions of said
ordinances.
t' ... .... Buil g In
Mector
NOTICE:
This permit does not cover the construction, installation or alteration for wiring, plumbin gas heating,
sewer or water. Be sure to see the Building Inspector for separate permits for these Item
FIRE DEPARTMENT MEMO
TO: BUILDING INSPECTION
ASSESSING
SUBJECT: FIRE DAMAGED STRUCTURE
FIRE HAS OCCURRED AT
1621 NE 662 Ave. - garage
(ADDRESS)
Oct. 19, 1978
(DATE OF FIRE
FPB -6
DATE: Oct. 19, 1978
SUBJECT
P T NO.
City of Fridley
� ® 15002
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
RECEIPT
COMMUNITY DEVELOPMENT DIV.
1 L INSPECTION
r PROTECTIVE SEC.
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-560-3450
910-F15
1/2/78
JOB ADDRESS 1621 - Ws Avenue N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
2
1
Moore Lake Park lst SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Ray Carlson 1621 - 66'h Avenue N.E.
7 -CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Daco Inc. 8701 Jafferson Street 784-3900
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
Fire Repair
9 CHANGE OF USE FROM TO
STIPULATIONS
SEPERATE PERMITS REQUIRED FOR
WIRING,
SEATING, PLUMBING AND SIGNS.
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.
$'1,O
$.50.
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
-GO
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS/Oy ANY OTHER STAT OR LOCAL L REGULATING CON-
$7.50
STRU THE PERFORM4dCONSTRUO,,71ON.
PLAN CHECK FEE
TOTALFEE
�`8.OQ
I N URE OF CONTRA O NT ATE)
WHEN PROPEFI DATEDlTHIIS IS YOUR ER IT
Yalt-')2
SDG INSP QATE
SIGNATURE OF OWNER OF OWNER BUILDERI (DATE)
• CITY OF FRIDLEY
° APPLICATION FOR RESIDENTIAL BUILDING PEMITS
(NEW, ALTERATIONS, ADDITIONS, OR REPAIRS)
OWNER: � i L G�/�/-.50.� BUILDER:
Address: � �� —�� d�� %� � Address: P701 57
Tel. No. —3210 •.
No.: 1(eA Street: zo
LOT: 5 HL&K: �^ ADDITION:
CORNER LOT: INSIDE IAT: SETBACK: SIDEYARDS:
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
To Re Used 'As:
DESCRIPTION OF BUILDING
Front: Depth: Height:
Square Feet: Cubic Feet: z
'Front: Depth: Height:
Square Feet: Cubic Feet:
Type of Construction: &
C__ .
To B C 1 d• — —
0qf5:
Estimated Cost: $ �7-D66,06
e omp ete .
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired $ $
(SEE REVERSE SIDE OF SHEET)
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. See reverse side f—or additional information.
Stipulations: C/
CK .� .
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