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AF - 36376� / / � � � �"� City of Fridley, Mi�.. � � � , . � � No 641 �, Date: `" `'` �, � Oamer: Builder -..�._._...�.� AdSress Address _.._ -.-� �, LOCATI B I ING No. .�L�.�� Street - Part Lot � —=�— Bl� � Addition or Sub-Divisfon . ��9�� Corner Lot —''� Ins3de Lot S.etback ��._,_� Sideyard �� Sewer IIevatiaai ____ .� Foundation IIevation DESCRIPTION OF BUILDING To Used ' �. Front —.�� Depth Height �� Sq. F't. ��`� Cu. F't 9�� `° Front � Depth fTeight � Sq. Fk Cu. FL .;�:�____� Type of ction _._. .._...__ Est. ,��_�..�o be Completed In ca�nsideratlon of the fssuance to me of a permit to construct the building descrit�d above I agree to do � P�P� work fn accoiclance with the d�scription above set forth and in crompliance with a.�l provis�ttons of ordinanoes oP the dty oP Fridley. _�l � _ In caa�deratfon of the payaient of a fee of $�_�� , permft is hereby granted to to conatruct the building or addition as described above. This permit is granted upon the eupress condition that the person to whom it is granted and his agent�, employ�s and worl�nen, 3n all work done fn� around and upon said buflding, or any part thereof, shall conform in all respects to the ordinances of ��Y, �esota reg lacation, construction, altera.tion, maiateaanc:e, repair and moving of buflc]ings o�� dtY limfts and�th s permit may be revoked a t any time u�pon vio�p� of any of the Provisions of said Building' Inspector NOTIC� 'll� pqendi doa not cersr ths ea�rucHoe, Ins�alNtiee ier wlrte9. P��B. 6p 6�8. �wer er watsr. B� suro to ses tha Bo��die8 I�etee #o� aparaFa p�rmHs for fkas it�es. ., �� f� .�, 5�+�.,¢i /a J'a i �u� JJ � � c;�"�`� APPLICATION �'OR BUILDING PERMIT. CITY OF FRIDLEY, MTNNESQ',CA OWi�R ° S 1`]�MC BUI?.DER � �`J . �r��.�'-�.� �� ADDRESS ' ADDRESS�� • /� �' LaCATIOAT OF' BLTILDII� No • �� s�� SCreet ��c�, , Part of Lot Lot j Blo�k � Addition or Subdivision �� °y=� �`�� Corner Lot ii Inside Lot Setback ��'` Side Yard � /?' ° SEWER II.EQATION FOUNDATION �LEVATION Applicant atCach to this form Two Certificates of Surveq of Lot and proposed build- ing location dratan on these Cextificates. '. �� . , � t_ .. . DESCRiPTIOAT OF BUILDING To be used as: � �. Front Depth � Height Sq. F't. Cu. Ft. ' ; ._ Front �Depth Height Sq. Ft . � � Cu . �1?t . �ype of Construct�on �� Estimaeed Cost To be Completed The undersigned hereby makes applicat3on for a permit for the �ork_,herein specified, agreeing to do all work fn strict accordance wiCh..the Citq of Frid.ley Ordinances amd rulings of the Depa�tment of Buildings,, and herebq declares that a11 the facts and representatioas stated�ia this appl3catian are true and correct. DA�'E�� a�� = /1c�� (schedule of Fee Costs caa be found on th� R�v�rse Side). ' .� �� ' � ., • ' ^ a �� L BLTII�7.�TG PEItMIT FEE SCHEDULE �\ �ectio� 2. The InspecCor of Buildin�a shall, before isscsing any pea�raat far �he crQ�t��n of any building ox structure, or for aay addi�ion to any �x�s"- :;.�� ►ui.lding or structure, or for any alCerations or repaira �d an�* existii�g �uil�ii�� o� stcructure, upon agplicati.on therefor, xequise the paymen� �ay the apglicanC feL such permit of fees xe the amount herein below set forth and ixa tt-xe �nr.er herein provided to-wit: 2.1.. F�r any such permit for �he erectioa o,i atay fire-proof building, other t�ian a gar�ges warehouse, factory or grain elevator, or for the erection of aay fire-proof addition, for simi.iar accugancy, ta any exiating buildin� srall be at the rate of $1.40 for each one thousand cubic feet, or frac�ion ciaereof, in such cubical contents. 2,2. For any such permit for �he erection of any iire-proof garage, waxehc�aise9 factory or graia elevator, or for the erection of any fire-proof addition, ... for similar occupaacy, to'any existing building sha11 be at the r�te of $1.25 for each ona thousand cubic feet, classified as °1fireproof" by Section 502 of the P+�.nneapolie Building Cacle. ��USES 2.3. For any such permit for the erection of any non-�irepa�oof building othes than a garage, warehouse, factory or grain elevator, oa� any non-fireproof addition, for similar occupaacy, to any existing building - permit $1.00 fo� each one thousand cubic feet. GARAGES 2.�5. For any such permit for the erection of any aon-firepraof garage, warehouse, factory or grain elavator, ar for the erectioa of a�ay �on-f�e�oroc:�' addition, €or similar occupancy, to a.�ay ex3.�tiag buildiug or for each such b�iiding or addition - nine�y cents ($0.90) for each one thousand cubic fee� or fraction thereof, in the cubical caatents thereof with a minimum of �4.00. For the purpose of comgu�3ng fees for building permits, the ctabical contents of any building og addition to a uniform hei�ht throughout by multiplying t1n.e ground area covered fram a point six (63 inches below the flaor line of the basement or cellar to the average height of the upper s�face or to the average height of the roof surface of the main gable of a p3.tched roof. 2.5. For repairs or alteratious to an existcing structuse, the fee ahall be at the rate of $3.00 ger each Five I�uadred Dollars ($500.00) or fraction t�iereof in the.cost of all Froposed woxk. 2.6. Ia no case sha11 the feQ chargad for anp permit �s set forth in Section 2 be iess than $4.00. w: _. - -. � r - -� — - - _ _- - � - -- _ . r _ � � G � n � �• � o r a � : � : x° : � . m : ~ : o : � m o� �h : � • {� iA � N � � ,... H H � � � � �� M o ',� � °° � � . o • � � : o . o . o. bd : : � . . z 0 � � � � N � O Q p � 9i �G18 EA H H � � � x � � � � � m � � � x 8 � � � � o � � � � � � a�� M � � � : o � er �o � o � � ° p � ° � r�, � � : � � : � W yo°o � �' u° : OA . . . O • � : bd ; : : : : � : : ' : x 0 �a k x k� x W [�7 W ►+ �-+ i'�'' ,�I) � O � O O O ��g7 -V'� 4fl �fl :f� 69 � W Q _ O � iv� � n ` ^ � c 0 A x � \ � � 0 � � � b� � Otl � � . . , u � 1 D � r � m � � m C r m � � � vc'h Q a� � � `'� � � m GL g M � • IP W N F+ � x ,R � p' a �' � Stories � �� WATER � @ aosErs � � URINALS � nnrH o � � p a�s�� 'L7 I SINKS ��. W�, ranrs DRtNK, FOUNT. sHwas. FLOOR DRAINS CATCH � BASINS � nuTo WASHER q� GAS R• APPL c�s �� GAS j OPENINGS � � °qh8 �+ N 7� (L � � � � � 01i � 7 • 2 ! � D m A m � n p p °.a�� p �y � �j � O @ �+ � � 1-b P � m p��a � �� :� cx '.�' • ... � � O � I° �'' a. � � �'" �� `� � ��.�. � � � �� o�° `�' w m o ��'o�' fD�a� �t ��w �. �. �O �� ° �� w �Oo �wov' �• fD � � � ro � � � � � �d � A � � a� A � � M p � M � M � � � � � � � � � � `'o -�' .� � � � � a � � � g M � � � � O � � � a � A � ,� V � � ; D x a � < :� z � 8 N 00 � � w a p � f 0 Q x y z z � y ty �;j xO � H y C o x � � � � � O � � � � �� N—,' �n � o � � � m � EI1 f9 � f� b �. � � � � � Q � � r�r � y � H y a' r' w ¢ W � � � � � � � � � �� o � � � N�� o� C y . O y • �: [ : : '�'C D: �i 0 N � °o o Q � tfl {!� i� � 0 � r 4 � � I � � � � 0 0 � � n � �' � a � � ci � w � � � � t7 �o Q � � � � M � � 0 � 0 0 O O 0 � � � 0 0 � ��,. Q � H �. � � � 0 0 r bd c �0 � � °c � K I w �W �� ! � ."S' f9 o � �o ��H � fD� N • �: �: � : � • � z � ° 0 � � 0 � � � �r 0 H w w � ]' � � � w w � � ti ,ap'. a � � O 0 0 �' G y � � R° R° � ��'�� x ° � � � o Q � O � � � � y ; � ,c� . � � � � o � : : �" �' : � � • y . C7� N LV 00 00 °o 0 0 °o o° Ffl Efl d! iA -F!3 � � � x M O � I ¢ � � � � F�,• M � � � � z a � ,� m � z (� � � 0 m O � � �. g � � � � � � w � �'�'� ; � R� � � `� y � ��p �'� � m � � R� � �°� � o � n Q �� , Q� '� o� � °' b' � o �� O ; ; C O � . ; 6 Q .° : : : � 0 N C7� C7� N pD 0 0° °o °o o° �&! EA fli QI! {A � � ¢ ,7C O y o y M � � � c � 'd 'd 'C � � m tu m � � �� R° R° � �, a�.� � � � � � � � � poo�� w � � � � A� C � �' ,� • ° a � � � r��: � Q : : O � ; ' qO . , P � : . W C7� 01 pp � en o 0 0 p o o p � � � � a..a� � �� ro y�V � � y � w "'� � ,`�, ��.�. y d� `� � �, ��; o R� � p � � pa��c �E 0 ��°� '�'i w � b ��w y 'O m �� °a�"'i � ��Op e+ � �, y �� b a�� `��r�► � � N y ;�m�� Q 8 M h9 ��P'i D � --� � � m y _ m C m d » M � � � � a r A V O � � � � 0 � � � � Q � ' � � �. �_ �� a� rt � �H O � 0.:� � � �� . � 7s � � � C� .7 � rl ►� I� I I I I�� V � b ro � ��5' �� _�: � r.� k] Lond Plonn;n9 , G87'S-Nir�hwo� fGS A[E. Lond Surves/in9 Minneopa/s 2/, .�',STSt�9 EN G I NEE �t I N G� 1 N C. M�nnewta cr�i � ��;a�i s��tQ6o� . E�;�e,�� — En9ineers � Surveyo�s c esti�f scafe o� s�t.s� �.: � . � . ,�n� � � � �a �� ,: � a � a,� � . � � C� �`" AV � �!'�.�. � �. _----.=-E�`g,3_ 0 �----- �„ -- �` ' _ � ____.�L. r. �{Y .. -� � -- �� , � � � I� -� � I� � �� - �� i � ��.-�; �,r � � ��.. �� ¢- d'=3 � ��` ` ��".�� . N. i I� ° � , 9e" - ��.� � ,7'- r S r. � `;�,j�,� i 1 . _ , i . ' �� , '�. �'._ ` �1 � �., _A � � " ��_ ---� ► 3>,3 l -- �. . , � � , � R:,„J � ll 1 �� r"! a � � ��.� �f�,..� � � ■ ae � � !� � � i!'��, P+RiQ FG � C O{�1 h{ "i �i ^ {� ��'�91� E. S� T,� yfG� r � � � � �� a- /, . i ♦ +� 1 ' ' '_.� / be�rdy �. �/iot �his rs a frus od aovr�cf re�ese�oia� o�'a suwet, 9('fl� 6a�ndmyes q�fbe a�io� o(�i�'►6�ed lad, ar�d o�F'�l IxQl�ri e�'o!/ b+�blrr9s, fAri��, aad d/ ris'�6Jt aru�avdi�nd�fs, ��'any. �irsn ar ansaid /m�d As wrveyed 6� mie 1/� d� �(' ' ��s�.� A.QrL. . SU8 U28AN ENGINEEI?ING , INC. . I _�E�neers Fr sy�-re�rs _ - :� � . � � i 6r - ...�- '� s - - - - — _ ��--- —�`w� � r,.�,� � � sua�ecr PERMIT N City of Fridley o 19 9 8 8 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T i � ' ` CEIPT COMMUNITY DEVELOPMENT DIV. ' j V �� -� • 1 �, � PROTECTIVE INSPECTION SEC. ��n� i � �� L.---� ��,•� CITY HALL FRIDLEV 55432 NUMBER REV. bATE PAGE OF APPqpVED BY i� 612-571-3450 910-F15 7/11/8� / / JOB ADDRESS 6596 Channel Road N.E. 1 LEGAI LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. ]_ ]_ DOII �S 2nd Add.i.ti.on SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Loren Palmer 65�6 CT�annel Road N.E. 571--3998 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHON� LICENSE NO. 8 USE OF BUILDING Res identi.al 7 CLASS OF WORK ,p NEW ❑ ADDITION 0 ALTERATION ❑ REPAIR ❑ MOVE � REMOVE X 8 DESCRIBE WORK Con.struct a 20� x 12� Shed in Reax Yard 9 CHANGEQFUSEFROM TO S,TIPULATIONS Us.e treated. bottom plate. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, �PE 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 SUSPENOED 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 WI H WHENHER SPECIFIED H REINIOR NOTOTHE GRANTING OF AO ERMIT $800 �er3Q DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE PRpVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $Z�..OQ LAN CHECK FEE TOTAL FEE $2]... r3� SIGNATUREOFCONiRACTOROR UTHORIZEDAGENT IDATEI UV�{EN PROPEiiLY V ATED THIS IS YOUR PERMIT �► � a-- °-�' ` _ � �t iG A URE � OWNERUF NE LOE IDATEI BLOG WSP - pT NEW � �� [ ] - ALTF� { ] R-1 AND R-2 �,;�ding P�ermit Application Effective 5/1/88 • . �,.;. - • i � . � , � / � =• _ � � . .� � .� � � � .- / • - . i.- - ��• - � J I I // � � � - � / � � coritractor: 8£,��j' Tel.. # Address : 5/}�/�i� Attach to this ap�lication, a Certificate of Suivey of the 1�, �� Proposed construction drawn on it to scale. � :r. �i• •) • " 1y1�;,�j+/51�I:ti,�14 LIVIlJG AREA: T�ex�gth idth _� Heic�t Sq. Ft. QsiRAGE AREA: iength width Height Sq. Ft. DECR AREA: I�ngth Width Hgt/Growld Sq. Ft. o�x:�i1E-,O � a � /.? � � / � ��/� Corner Lot (� Inside I�t [] Ft. Yd Setback _�_� Side Yard Setbacks �/ Type of Construction: 1e/.�n � Fstimated Cost: $�� Approx. Ccmq�letion Date: Pr.'oposed Driveway Width If ldew Qpening Is Desired: ��Ft. $ $ + 6' See Hack Page DATE: � � ApPLIC�lVT: Te1. # ' O Pe.rmit Fee $ �I, �C� State Surcharge $ ,�(� SAC Charge $ Driveway Escraw $ Park Fee $ sewer r+lain c�arge $ CI'PY IISE OI�Y Fee Schedule on Reverse Side $.50/$1,000 Valuation $575 per SAC Unit Alt. "A" or Alt. "B" Abave Fee Determined bY �ginee�'irig �nt N�ssa�Y [ l � N��ary L l TO�AL �� b;��j srzx�TTOrTS: f�.SF °�'� h d3 � Ct0 �Z�� . .,.;..: � ��0,�1 �U o' ��% ` ��e Qo ��( 2 � Z/, Oo :�� r . � • �•, � �, � «:��,. � . Z�e CSzief Building Official shall, before ��G►» *� permi'ts for the er+ection of any �; � ding or structure, or for any addition 'to anY existin9 buildin4 or structure, or for any altexation or repair 't� any existincJ buildiixJ or structure� uP°n application therefore, require the payment bY the aPPlicant for such permit of fees to the an�unt herein bela�r set forth arid in the manner herein provided to-wit: TOTAL VAIUE $1 to $500 $5oi to $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 $100,001 to $500,000 a� �. $15 (Nlis�n Fee is $15 plus surcharge) $15 for fixst $500 plus $2 for each additional $100 or fraction thereof, to ar�d including $2,000 $45 for fixst $2,000 plus $9 for each additional $1,000 or fraction thereof, to and including $25,000 $252 for first $25,000 plus $6.50 for each additional $1,000 or fraction thereof, to arid including $50,000 $414.50 for first $50,000 plus $4.50 for each additional $1,000 or fraction thereof, to arid includirig $100,000 $639.50 for first $100,000 plus $3.50 for each additional $1,000 or fraction thereof, to arxl including $500,000 $500,001 to $1,000,000 $2039.50 for the first $500,000 plus $3 for each additional $1,000 or fraction thereof, to arxl includirig $1,000,000 $1,000,001 and up $3539.50 for the first $1,000,000 plus $2 for each additional $1,000 or fraction thereof DRIVE'W'�iY DEPRESBION ffiC� (Cor�rete Curb Streets OnlY) Alternate "A" : Remaval arxi replac�aent of curb arid gutter only - Driveway width plus 6 feet ti�es $13.50. Alternate "B" : Removal arid replaoe�ent of curb and gutter ar►d install a 3 foot wide appraach with 6 inch depth - Driveway width plus 6 feet time.s $15.75. 'l�; �� v; � �1� • � ;��_��it,a 4��1i Permits for construction will be issued a m?n��+ of 24 hours from the time of application to alla� for p'ro�er revieRa of the proposed structure and of the construction site. A Certificate of Survey of the lot, shaw�ng the location of the %undation orx�e it has it has been construct-.ed wi11 be required before proc;eeding with the framing. �, .,, �, o � � ��: P 3' = d z a �' ✓ a" t � r ,y' m 3� 'sa 't ''� � k _ �;c � d � '� ,',�,, f, ;n �'�e n¢ ,n� � a�;}f: i '�'.'�3k b '�'� �,��p$ ,.� P� 2:; ''� E� T y';'va h¢� �`?ii ='�t ��"� � .. � . � . � . ��e� �`�_ �� ,�� ,��. . . � 1 c�v�,;,� �� Soils Tssfeit� C►vr/ b M�n'iripvl E�� , - 6�1S-N�„� �rs ,v�. � M�bs v. � I � � � � � 4Lo. A'�"�la / .fl�isef4-606� — En9i�eers � �urve�c ors — �:�°�'�i,��• ��' •s D. L.. ANDERSi!N 1' ��4�la,. N Sr.� C� �'=3 a ��_ , r i i V ' � s �r- �o � t�" , ��N _`..__ AVENUE -- 118,3 � --- I-'` � � � � �. � - � �z d - � � I �v , '0�5 � �. , � Iro �.�� 1.�- y �� I -� �= �. � �� .�;� � L o"t' t� P �. � G K 1 �. ��_ y,.� .. ._.,_,_ _.:_ r= , s � � ---- � ;. � _.- '� . -- I 33,3 l -- -., -^. � �� y� ! � �►� �', Q � `` � • � � , � � , � �9 .� . d" l.LJ � r Z � Q ��- s � v .`. �r°� !t ' . �-- . ,�� ,�.� �) � �, �DOi��S 2.N—° AC�Dt�00i� A�10 ec A C o L7 N 4 Y.� P/� � 1�1 A1 � 50 T A e��y �y �� o� oa� aarrtc� ��ofia�r� y('o srre�t, q�'� ia+n�dor�s �'!Lr ��t dsc,+'r6er� �,md � � �� ' �s, . �md �tI � a�naaJmrenfs , i�my. }Ga�i er n.� �Sid. �!s sr�r�e�ed � nae �°s� dx� A.Q �. SUBURBA�/ EAIGlNEEQ/NG, /AfC. � �s� fr S�rrryrirJ �� 6 •� �L /%✓ `r'� i- ,., -- i� _ _�,_ �___. _ __�_--__= --��,. _•�__---- --- _ . - — ,.. _ . . - - SuBdECT City of Fridley AT THE TOP OF THE TWINS g U I L D I N G P E R M I T � i � ; �L _ COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. � j , � �"'1 � CITY HALL FRIDLE� 55432 NUMBER �""""� � ,`' 612-571-3450 siaFiS JOB ADDRESS 6596 Ghannel Rd. 1 LEGAL LOT N0. BLOCK TRACT OR ADDITION DESCR. � � Don's 2nd A 2 PROPERTY OWNER MAIL ADDRESS Pa�� 6596 Channel Rd 3 CONTRACTOR MAILADDRESS Bo' S Cons��+�ction 18 �nc� A�� S n�l� 4 ARCHITECT OR DESIGNER MAIL ADORESS 5 ENGINEER MAILADDRESS 8 USE OF BUILDINCi Residential 7 CLASS OF WORK REV DATE PAGE OF 7/2/98 / / 'P'ERMIT NO. 2643� RECEIPT NO. 3� �/ AVPROVED BY SEE ATTACHED SHEET Z�P PNONE �� _n .an ZIP PHONE LICENSE NO. 70A-503� 20�.40�6�6 ZIP PHONE LICENSE NO. ZIP PHONE LICENSE NO. ❑ NEW 0 ADDITION � ALTERATION ❑ REPAIR p MOVE ❑ REMOVE B DESCRIBE WORK Tear off and reroof house and aaracre 9 CHAN(iE OF USE FROM STIPULATIONS TO Underlayment must comply wi.th State Building Code SEPARATE PERMITS ARE REDUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION 20NIN(i AUTHORIZED IS 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 I HEREBY CEiiTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIEO WITH WHETHER SPECIFIED MEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERMIT FEE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTI OR THE ERFORMANCE OF CONSTRUCTION PLAN CHECK FEE ,� _ `7`�- �.�e SI NATURE Oi TOR OR AUTMORI D AGENT IDATEi N P � SiGNATURE OF OWNEA�IF OWNER BUILDERI . IDATEI oi .�rco OCCUPANCY GROUP OCCUPANCV LOAD SO. FT. CU. FT. OFFSTREET PARKING STALLS _IGARAGES $5. TOTAL $61.50 �w [ ] ADDN [ ] ALTER [ ] ConstructionAddress : Legal Description: _ Effective 111/98 CITY.OF FRIDLEY SINGLE FANIILY -AND DUPLEXES R-1 AND R 2 �, ��J �i� I BUILDING PERMIT APPLICATION a j� � ��, - - ��'� c�a �� l �� ,�1�. Owner Name & Address: ��,,�,,,,, P� � v�.� ep" Tel. # �7� �1 �- % Contractor: , 7 S ('�., ��r�c `� �`wt MN LICENSE # �O l �� ',6 Address: �� l�s �;�.,�e� �� S, UJ/�,rD �5 �� 5��% Tel. # ��5�3 � ' � 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: 01'HER: DESCRIPTION OF IlVIPROVEMENT Length Width Length Width Length Width 0 Height Height ^ Sq. Ft. Sq. Ft. Sq. Ft. V ° Construction Type: �� ' 1 Estimated Cost: $ =�`� � � �,�� 00 (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: Permit Fee r, — . � �- �� APPLICANT: - �c� �S�c_ h� Tel. # ��°- �� Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: � �G $ l •�7 $ ,�3 $ $ � � C�C� $ $ $ $ $ �. 5�� CITY USE ONLY Fee Schedule on Reverse Side .�1 of Pernut Valuation (1/lOth%) $.50/$1,0� Valuation $1000 per SAC Unit $5,{3U (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.� Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] a, e � s . BUII.DING PERMIT FEE SCHEDULE The Chief Building Off'icial shall, before issuing permits for the erection of any building or structure, or for o any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: TOTAL VALUE $1 to $500 $501 to $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,OQ0 $100,001 to $SOO,OQO $5(}0,001 to $1,�0,000 $1,000,�1 and up FEES $21 (Minimum Fee is $21 plus surcharge) $21 for first $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 $62.25 for first $2,000 plus $12.50 for each additional $1,000 or fraction thereof, to and including $25,000 $349.75 for first $25,000 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,000 $574.75 for°first $50,�0 plus $6.25 for each additional $1,000 or fraction thereof, to and including $100,000 $887.25 for first $100,000 plus $5.00 for each additional $1,000 or fraction thereof, to and including $500,000 $2887.25 for the first $500,000 plus $4.25 for each additional $1,000 or fraction thereof, to and including $1,000,000 $5012:25 for the first $1,000,000 plus $2.75 for each additional $1, �0 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate A: Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50. n n Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet tunes $15.75. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the locadon of the foundation once it has it has been constructed will be required before proceeding with the framing. �. City of Fridley AT THE TOP OF THE TWINS i� � � i VV � COMMUNITY DEVELOPMENT OIV. r � � PROTECTIVE INSPECTION SEC. i . , l �� l_'__� ��.�• �.1 CITY 81 2 612-571-34 lOB ADDRESS 6596 Channel Rd NE t LEGAL �OTNO. BLdCK TRAC1 DESCR. j 1 DC 2 PROPERTY OWNER MAIL ADDRESS Loren Palmer 3 CONTRACTOR MAIL ADDRES3 Owner SAme 4 ARCHITECT OR DESIGNER MAII ADDRESS 5 ENGINEER MAIL ADDRESS B USE OF BUILDING sue�ett PERM 7812 �U ILDING PERMIT s�aF�s OR ADOITION n's 2nd PT NO. G l�� 11EV OATE PAGE Oi APVqOVEO Br e�iti�AR / / SEE ATTACHED _ SHEET 21P PHONE 55432 571-0240 Z�P PHONE LICENSE NO ZIP PHONE LICENSE NO Z�P PHONE LICENSE NO Residential � 7 CCASS OF WORK O NEW 0 ADDITION O ALTERATION p REPAIR O MOVE ❑ REMOVE 8 DESCRIBE W K Sof f 3��5�ascia 9 CHANGE OF USE FROM STIPULATIONS TO Install soffit ventilation to meet the State Building Code. SEPARATE PERMITS AqE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE O VENTILATING OF AIR CONDITIONING. THIS PEHMIT BECOMES NULL AND VOID IF WORK Oii CONSTRUCTION ZONINt AUTHORIZED IS N07 COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDEO OR ABANOONEO fOR A PER100 OF 1� DAYS AT ANV TIME AFTER WORK IS COMMENCEO. NO. D1 I HEREBY CER7IFV 7MAT I HAVE READ AND EXAMINEO THIS APPLICATION ANO KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS yp�UAl AND ORDINANCES GOVERNING THIS TVPE OF WORK WI�L BE COMP�IED WITM WHETNER SPECIFIED HEREIN Op NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTMORITY TO VIOIATE OR CANCEL TMH pEpMIT PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON• STRUCTION OF TNE PERFORMANCE OF CONSTRUCTION S�GN4TUAE OF CON'RACTOp OA AUTHOA4ED OGENT 1DATE� ��GNATUAE O� OWNBWaF pyyNEpBURDENi , � iS�iF� - R� OCCUi SO.FT UNITS STALLS $1,900.00 $62.25 OF OCCUPANCV�OAD CU. FT. :ET PAqKING GAqAGES $.95 ,RGE e SC $1.90 EE $65.10 / ��i / r NEW ADDN ALTER [] [l [l ConstructionAddress: Legal Description: Owner Name & Address: Contractor: Address: LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Effective 1/1/98 CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 � BUILDING PERMIT APPLICATION � �� c� - �� ' � � Tel. # MN LICENSE # Tel. # 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 IlVIPROVEMENT Width Height Sq. Ft. Width Height Sq. Ft. Width Hgt/Ground Sq. Ft. ��; s� �� Construction Type: Estimated Cost: $ �� (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ . ✓�� DATE: -� ` � APPLICANT: p 1. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge �� $ $ $ $ $ $ $ $ $ • �° z_ %ar�� , i STIPULATIONS: 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 [ ] BUII..DING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for: such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: TOTAL VALUE $1 to $500 $501 to $2,OOU $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 $100,�1 to $5(�0,000 $500,001 to $1,000,000 $1,000,001 and up FEES $21 (Minimum Fee is $21 plus surcharge) $21 for first $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 $62.25 for first $2,000 plus $12.50 for each additional $1,000 or fraction thereof, to and including $25,000 $349.75 for first $25,000 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,000 $574.75 for first $50,000 plus $6.25 for each additional $1,000 or fraction thereof, to and including $100,000 $887.25 for first $100,000 plus $5.00 for each additional $1,000 or fraction thereof, to and including $500,000 $2887.25 for the first $SOO,OQO plus $4.25 for each additional $1, 000 or fraction thereof, to and including $1, 000, 000 � $5012.25 for the first $1,000,000 plus $2.75 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50. Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. � A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the framing. � -