AF - 36494� �
Ci of Fridle Minn.. ��� 7 2
t3' y,
6431 University Ave. 1�. E., Minneapolis, Minn. 5
� � 1 � � � �
�g�; A�,gi,at 1 ,� 1 A72
��; Helen Argue B�d� Style-Rite Builders
�d�� 6648 Chaun,el Road Addx,ess 4517 Minnatonka B1vd.
LOCATION OF BUILDING
No 6648 S�t Channel 8oad N;E, p� of I.ot
yot 28 81ock Addit3on or Sub-Divisian Brookview �Sddition .
Corne7� Lot Inside Lot Setback ..._..�. Sideyard
$ewer IIevatian Foundation IIevation
DESCRIPTION AF BUILbING
To 'be vsed as:
Residing Front Depth Height � Sq. F't. _ Cu. Ft
«
Froni Depth Hei�ht Scl. k't. ..,.. Cu. F't.
Type of Construction Steel ��� 2, 000.00 To be Completed 9,�1%72
Cau1k the butt end�
In considerai3on of the issuance to me of a p�rmit to consfxuct the building described above, I agree to do
'�he proposed work 9n accordance with the dest�llption above set forth and in compliance with all provisions oE
Ordinances +DP the dty of Fridleq. �� �
1000 State S�'chaxge
In consideration of the payment of a fee of $ ZZ • 00 St le Rite BuiAders
, permii is hereby graated to_...�' _'
to construct the building or addition as described above. This permit is granted uposi
the express condition that the person to whom 3t is granted and his agents, employees and worl�nen, in all work
dOne in, around and upoa said building, or any part thereof, shall conform in all respects •'Eo the ordinances oi
�'rYdley, Minnesota regarding location, construction, alteration, maintenaace, repair and moving of build3ng8
o� � aity limits and this permit ma.y be revoked at any time upon viola.tion of any of the provisions oE said
C/E� �C%�� ��ilding Inspector
CLARENCE Belisle
NOTICE: .
This psrmit doeac not eove� 4he eonsiruetfon, installat3oo ¢o� wirina, plumbin�, ges 6eating, sewer oe watee. Be aure 90 ses
t6s Building laspecfo� for separate permifs far theae items.
AP.PLICATIO� �OR RESIDENTIA�, A�T�FtATION,
OR AllllITION BUILD�NG p��IT
CITY OF FR�ALEY, MINN�SOTA
ow�! s AlKL�a i �/ � lo� l�• � •'s �(� DuiLn� i �'[ � �(� �fry=! 6rs �' (� !/ r —T•e
�. e n ea V �1 I[
�D�.ss : � � �� e ����a� c-�v ��S : �a�;,� ���� �� ��
Np:,.. l, �° `�� STREEET• ��l��� ��r
..._._—
Jf,02' ; �� BLOCK t ADDITION S ��` � t G`t ler'e� ���`„�� ^,
CORNER LOT: INSIDE LOT: SETBACR: SIDEX�;�
�pplicaat attach to thia form 1�o Certificates of SurveSr of Lot amd pxo�AS�e,d
buildiag location drawn an these Certificates.
HESCRIPTION OF BUILDING
�o �e IIsed As:
�' �(�'e- ��� Front: Depth: Height: _
Square Feet: Cubic Feet:
' Front: Depth: Height:
Square Feet; Cubic Feet:
'�pe qf Construction: �� f'°"C��= r�ri���- Estimated Cost: $ � � �o � �
a �aaise ��e��pa
�'a �e Campleted: � �����c ��i�'�
The undersigned hereby makes applicativn for a pes�nit for tt�e _w6��'14 ��7�+��1
�pec��ied, agreeiag to do all work ia ettict accordance w�.tit� the C�,�y +p�
F�c�,dle3r Ordinances and rulings of the Department of Buildings, aad '�a�c�bT
d�cl��es that all the facte aad representations stated in thie agp�.�,����,�
a7re ts�ue and correct.
�li�F ; �� � °� SIGNATURE : �/� ��i�----�—�-
(�e� lteverse Side For Additioaal Information.)
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$UILDING PERMIT FEE SCHEDULE
$EC�ON 2. The Tnspector of Build3.ngs shall, before issuing permit� for thg
exection of any bui�ding or structure, or for a.ny addition �o any exi.sti,n�
building or structure, or for any alteration or repairs ta any ex�.stiag
bui.ldiag ox structure, upon application therefore, require the payflne�� by �h�
applicant fox such permit of fees to the amount herein below set faxtli aucd �.A
�he maaner herein prwided to-wi�:
UNZFORM BUILDING CODE: �pe 1, 2& 4-$2.15 £or each one thoueand cub�,c
�p�1t, ox fraction thereof, in such cubical contents. 1�►pe 3� 5-�1..$5 �9r
each one thousaad cubic feet.
ADDITIONAL INFORMATION
Fer the purpoae �f computing feee for building permite, the cubical contents
o£ any buildi�g or additian, ie determined by multiplying the ground area
�overed from a point six (6) inches below the floor line of the basement
or the cellar to the �verage heights o€ the upper surface or to the average-
height of the roof aurface of the main gable of a pitched roof.
�'or repairs or alterations to an existing atructure, the fee shall be at the
rate of $3.00 per each five hundred dollars ($500.00) or fraction thereof in
tlne cost of all proposed work.
Iu no case shall the fee charged for any permit as set forth in SecGia� � be
lesa than $5.00.
VTRIFICATION OF FOUNDATION
1�pTE; Permits for eonatruction will be isaued a mininaim of 24 hours frotp the,
�ime of application, to allow for proper revieTa of the proposed structuze asid
o£' the conatruction site.
A Ceztified Su=vey of the lot, ehowing the location of the foundat�,Ax�A Q��� �,�
1�as been constsvcted, will be required befo�e proceeding with the f�Caat��,
CERTIFICATE OF OCCUPANCY
Applicatioa for a Certificate.of Occupaacy ahall be msde ten (10) days p�1c��
tp the uee or occup�ncy of any etructure for which a building permi� ha� ��sA
iseued; and said structure ahall not be used or occup�ted until a Certificat�
o� Occupancy has been isaued.
��
� -�
SUBJECT PE
City of Fridley _ y 16 0 0 5
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T �
r
; � EIPT N
COMMUNITY DEVELOPMENT DIV.
� � � � PROTECTIVE INSPECTION SEC. �,� � ]
� i �
� � �
( � /'�'1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BV
�"'""� � ,�� 612-571-3450 910-F15 / /
11 12 80
JOB ADDRESS 6648 Cha.nnel Road N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. ZS BYOOISV3.-E3W AC�C�.l'tlOri SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Mrs. Argue 6648 Channel Road N.E. 571-9436 � o_��-j
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO.
E* E Construction 1623 � First Avenue, Anoka, N�i 55303 421-0389
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW l� ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 12' x 20` Breezewa Addition between house and ara e
9 CHANGE pF USE FROM TO
STIPULATIONS
No firm connection to house urith roof for breezeway. Reinforce
rafters 9n garage if necessaxy.
�,�P��AY� p���6T� R��t91��D ��R �IR1�JGe
HEATtfdC�, PL�19���1�� ��� �9����
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING,
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 HEFiEBY 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
ANO ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $�-►85Q $.92
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE
PROVISIONS OF A OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR T PERFORMANCE CONSTRUCTION. $�-2.0�
PLAN CHECK FEE TOT�j,�F2EE9�
� �fi � �`P � s
SIGNATUR CONTRA TOROR �UTHORIZEDAGENT 1 TE� WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
_ - ��� �- �,Q� $o
SiGNATUREOFOWNERtIFOWNEABUILDER� IDATEI BLDG iNSP f7A E
0
CITY OF �itTDf_CY -
!�f'f't_I(;/1'(IU'd f�Dit !;!� y1Ui�i�aTIP,�_ QUIL(lIt;r P�rufTTS
(tJe��l, A1 �erati�ns, l�dditioiis, or Repairs)
al•JIdER: � � vL �
11DaRESS : ���_____C�t�� �. r' .�(
7CL �0: �4�7 i_ ��.3�
L'UILp�R: ,� ��. C.'cn s�
nonr�css: /� a 3 �0,�2� �
TEL tJO: �',yc'_� / ' � � 8' �
� Consi:ruc�ion Locat�on '
sTZU��r No: ���� s��r•.T: �_��rr,�'�,���. �v� �
Lo�.�: 2 �6 - $r,oac: �nzTZO�v: ,,�Q do . . ' �
�_�.,�..��c.2
Corner Lot: Insicle Lot: � Setback: Sideyards:
Ap�licant attach to t2iis form two Certi�icates of Survey of lot and
prop�sed building location drawn on certiiicates to scale. . •
DESCRIPTIQfv OF COi�lSTP.UCTIOPd • -
����� � �^ � �P� = T�.c� Gd - Height: � .
� Front: �-
Squa�e �'eet: ,�? �f � Aibie :Feet: ,.
. Fron�: DePth: Height:
Squar.e• Feete Cubic Feet: -
� �� �� - �
Type of Construction: se� �j� � -��� Esi:imated Cost: $ 1�.$`O
� - .t� � . .
�.b Be O�r,�pleted: %� ^ /-- &'!� . �, . .
` . _ � Alt. A A1.t. B
Propased Drive�•ray Svidth i� New Opening Is Desired: $' $
� . � .. SE� Rc^.VERSE S�DE OF SFiEET
�.Rie undersianed hereby makes a�pl9.catian for a permit fcr the �nr3:� herei.n specified,
agreeinq to c'.Q ,all worl: in strict accardance �•�ith the City of I'ridley Ordin�nces and �
xuling� of the Departmeiit of Buildings, and he�eby declares that all tlie facts and
xepre�en�.,-�tians stated in tizis applicatian are tru and correc�.
/ .
D�1T�: _ �(% Q �/ �"d SIGNATURE: �- S-e
5tipulations:
$ o
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R�
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v1: ��t�y )�u:i.).cZ.i.r,�J az :;i::.-ut;t:ure, or. tr.,�: t,»y tidcli.Li��n !:o �uiy cr.i�L•iuc� J,uilclincj �i :;Lnic�Ur.c,
. cir. !:c>r ar�y a.1.�c,r�Cion or. r.cl,air.:� L•o �any c;:a.::Li�i�� )�ui.l.di,�r.J or SL1:l.iCtllY'C� u}���i ar���li.<:ati.on
�t}ir.r.�f.or.c, r.cciu.ir.c t�]�� pa}►mc��L• 1�y tl�c .�r�pl.i.c�ai�t: for. such ��er.mi.t• af' i'ec, ta tl�e �naun�
hrxu.it► bcl.c��•i �r.l tor.tli �uicl i.�i 1:lic i��anricz hc�:c�.n p�:ovi.dc:cl i:�-t•::�t:
13i:1•I CUIJ��1'];UC'L'30i�: Sing).c l.'ami7.y ilom.es and Gar.�ZC�cs: ;�.ao/�,o�o C��.� tec:t.. .
rLTi 7 CII):C1:: 25 ��c:zcer►t;. of hu�.lcl�_nc1 }�e�7nii� fee. �
llRI:��1:ldAY llL•'1'P:r:5SI01•;: (C�ncrcL•c, Cu�U �L-reets Only) ` �'
' A].tern�-�t:e A: ltc:�noval and rej�laccmen� oi- concrete curb and
` qutL•er only; uriv�way V1CIt}1 p].us 6�ee� x��:�,$.75
11].tcrnatc B: Rem�val and replacemcnt of concrete curb and
• guttcr and inst�ll. a 3�fooL- ��icie aPproach �aith -°
' ,� 6 vich depth; Drivcway �•ric:th �plus G feet x$17.85 �
. � . annl�-ior`nt� 1��r-o���nTro_. r�.
For the purlx,se oi co�npuL-i.ng fees for_ building permits,� L-he cubical. contents o£ any
� buil.d�.ng or a.ddi�ion, i� detcr.mi.ned by multiplyir�g i:he ground area coverecl from a
���.nt six (5) inches belor� ihc' �loor ]_ine oi t.lie basemen� or tha cellar to tiic
average iieights of the �upper surface or to i.he average iieight o£ the roof. surf-�,ce
of i:he raain gable of a pitched zoof . �
Fox xeFaixs or al.terations to an existing stnzcturet the fee shall� be at the xate
. of $3.00 per, each Eive hundred do3lars °($500.00} ar fraction L-lieieof in the cost
oi �11 proposc�d wor.k. . . ,
in �no c.ase sha�.l_ t�?�� ��e charg�� ��r any pennit �� set .-toxth i.n Sectiun 2 be l�ss -
th�n $?.50 pl.us $.50 stai.e surcharg�. � • �
� V�RTFICATIO�! aF r-ouc�n�riora � �
2�OTE: P�rmits �or cons.L-xucL-ion will bc: issLted a minimum c,f 24 hours £rom tlze time
oi a�plication to a].low for proper re�rieto of the pro�osed structure and oi ihe .
construction site. �
; ,
I► Ceri.ificate � of Surve�► of the lot, shoc.*inq the location of tiie faundation OI1CG' it
has been coi�stnicted �.�all be required bef.ore proceeding with �he iraminq. �
.�RTIFIC(`-,TE 0� OC�UPAti�CY . .'
11pp�.i.cation �or a Certificate of Occupancy sha11 be mad:� ten (ZO) days priox to the
u; e or accur3ncy oi an}► stiucture foz �ahich a builcling permit l:as been �ssued; and
saAd s�ructurc : iial]. iiot be tLSCd or. accupied t:ritil a Cezi:�.iicate or Occui�.zncy has
bcen xssucd.
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sue�ecT PE
City of Fridley 219�"" �
' , AT THE TOP OF THE TWINS g U I L D I N G P E R M I T T NO.
�
� � COMMUNITY DEVELOPMENT OIV. „ ]
; �,: ------. �3 � ��'
r i � PROTECTIVE INSPECTION SEC. /
1 i i
� /��'i � CITY HALL FRIDLEY 55432 NUMBER HEV. DATE PAGE OF APPROYED BV
�----�• •'� 612-571-3450 910-Ft5 /26/93 � �
JOB ADDRESS 6648 Channel Road NE
t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
oesca. Lot 28 (P cel 1380Z Brookview Addition SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Kyle Young 6648 Channel Road NE 572-2632
3 CONTRACTOF MAIL ADDRESS Z�P PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS Z�P PHONE LICENSENO.
6 USE OF BUILDING
Resi denti�l
7 CLASS OF WORK
❑ NEW O ADDITION ❑ ALTERATION � REPAIR ❑ MOVE O REMOVE
8 OESCRIBE WORK
Reroo� Hause (8 Squares� Teax•-o�f
9 CHANGE OF USE FROM TO
STIPULATIONS
Undexlay�ent znust comply Hrith th.e State Building Code. Provide adequate
attic ventilation, Provide sn�oke detectc�rs as per UBC 1210 adjacent to all sleeping
a�eas and in basement',
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBItdG, HEATING,
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 SUSPEPIDED OR ABANDONEO 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 ANO EXAMINED THIS APPLICATION �- STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS yqLUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $�OO $. SO
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $23. OO Fire SC $, 9O
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE TOTAL FEE
$24�40
SIGNATUREOFCONTRACTOROPAUTMORIZEDAGENT IDATEI WHE RLY LIDATED THIS IS YOUR PERMIT
� 2�-��
SiGNATUREOFOWNERqFOWNERBUILDERI IDATEI - •^BLDG NSP Ol+TE
NEW [ ]
ADDN [ �
�-'� f ]
Consaruccti�on A�ress:
Le,gal Description: _
CITY OF FRiDLEY
SINGLE FAMII.Y AND �DUPI�EXES R-1 AND R-2
Building Permit Application
G���,��/ �� /��
Effective 5/26l93
�
4arner Name & Address: �yl � �CJ� �oc��� �/Q �2 �' y� �. �� . Tel. � ����.
Contractor: ,� C. /� � �� ��� /�' MN LICENSE #
--,
A�dx'e�s:
At�ch to t��is application, a Certificate of Suivey of the
lot, with the propas� t;onstruction drawn on it to scaie.
DESCRIR"fiUAT OF IMPRUVEMENT
Tel. #�
LIYING AREA: Ix,ngth Width Height Sq. Ft
GARAGE AREA: Length Wic�h Heigbt �. Ft.
DECK AREA: T.e�gth Width Iigt/Ground �cl- �t-
OTH7ER: %- r O i� 9� �� �Cmm�'' .�.
Corne,r Lot [ l Insi'cie Lot [] Ft. Yd Ssiback
Type o€ t;onistructian: °
Apgrox. coa�le�ion Uate:
Drivewa}� Curb Cufi VVi�h Needed: F�. + 6 Ft =
Side Yard Setbacks.
Estimated Ccut: S .� S� > %�' /
�G�� �-
{Cost � Back}
�t x $ _ $
DATE: � � � ���J APPLICANT: �! ` - .f'- Tel. #
Permit F�
Fir� Surc�arge
State Surcharge
5AC Chazge
License Surcharge
Driveway Fscrow
Er�ion Contml
Park Fee
Sewer Maia Charge
TUTAL
� � �
$ e QD
$ �50
�
$
S
�
$
$
� �4���
E� Ii�l! ���.�:����I_�►'�
Fee Schaluie on Reverse Side
.001 of Permit Valuation (1/li�h%)
�.501$i,000 Valuation
$750 par SAC IInit
$5.00 (State Lice�used Residential Contractors)
Alt. °A" or Alt. 'B° Abrnre
Conservatian Plan Review $45U.�
Fee Determiaed by Engineering
Agreement Necessary [ ] Not N�:essary [ ]
STIPULATiONS:
i
BUII.DIN(i� PERNIIT 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 bnilding or sbrucda�, or for aity altera.tion or repair to any existing
building or structure, u�n application therefore, require the payjme�nt 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 $S00
$501 to �$2,000
$2,001 to $25,000
$25;001 to $50,000
$50,001 to $1�,�
$100,001 to $500,000
$500,�1 to $1,000,000
$i,�,001 and up
FEFS
$15 (Minimum Fee is $15 plus sm�charge)
$15 for first $500 plus $2 for each additional $100 or
fraction ther�f, to and including $2,000
$45 for first $2,000 plus $9 for each additional $1;000
or fraction thereaf, to and including $25,000
� $252 for first� $2.5,�0 Plt�s $6.50 for each additional $1,000
� or fraction thereof, to and including $50,000 -
$414.50 for first $50,0� plus $4.50 for each additional
$1,(m0 or fraction the�eof, to .aad including $100,fl�
0
$639.50 for first $100,000 plus $3.50 for each additional
$1,000 or fiaction th�reof, to and including $500,(m0
$203g.50 for the first $500,000 pins $3 for each additronal
$1,U00 or fracrion thereof, to aad including $1,(�}0,000
$3539.50 for the first $1,�,000 plus $2 for �ch additional
$1,000 or fraction �thereof {
DRIVEWAY DEPRESSION ESCROW
(Concrete Cbrb Stre�is On1Y)
Alterna% "A°: Removal and replaceme� of curb and gutter only - Driveway width plus 6 feet times
$i3.50.
Alternate "B" : Removat 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 propos� structure and of the conslruction site.
A Certifica.te of Survey of the lot, showiag the l�on of the foundation once it has it has been
constructed wiil be r�uired before proce�ding with the framing.
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COMMON VENT VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When realacinq an existinq furance, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstrucfions,
and is securely suppo�ted and firestopped where required. Yes No ()
The venting system is.pla�fc/°PVC and meets a11 current codes and manufacturer �
specifications including sizing, length, number of eibows and termination. Yes () No {) �
The undersigned,also verifies that the replacement unit is a listed assembiy
and meets the current codes and manufacturer's specifications. This does�
include AGA-GAMA Category I Centrai Fumace V�nting Tabies for fan ,�
assisted and natural draft appiiances.
The existinQ combustion air is sized and instaAecY to mee# the currerrt codes
and manufacturer's specifications.
- - - - - -
When required to install a new combustion air it will be sized and installed
To meet the current codes and manufacture�s specifications.
When instapina a new ventinq svstem, the undersigned hereby verifies that
it is a listed assembly and meets the carrent codes and manufacturer's
specifications. This does include AGA-GAMA Category I Centrai Fumace
Venting Tables for fan assisted and natural draft appliances.
ls the common vent and vent connectors sized and installed correctiy after
an appliance has 6een removed from the common vent and vented
separately as per current codes.
Y�s ( No ( ) -
I
Y�s ( No ( )
+- --
I -
Yes No ( )
�
; �
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�
Ye's ( No ( )
Yes o ( )
Aapliance Tvae and Size/Common Verrt and Vent Connector IrrFonnation
Appiiance #'1 Typ� �� BT..0 input ;� � F Assist o Nat!
App iiance # 2 Type ,� ;�.r �_ B'�'� Input ,�'� Fa s a
Appliance #3 Type t BTU Input _ Fan Assist a;_
Totai Appliances _, Totai Btu Input ;
�/ � .� ri �
' Common Vent Type � Vent Height J Diameter �� i�ches
� �
Appliance #1 Vent Connector Height �_ft Length �ft Diameter � in Type �'�' �
Appliance #2 Vent Connector Height � ft Length �ft Diameter in Type �
Appliance #3 Vent Connector Height ft Length ft Diameter in Type
ALTERATI�NS: (Describel ; `
HEATING CO:
Signed By:
�
�° % � i ���
�
%' ' i `��
�
ly
�
sue�ecr P
City of Fridley 2 9 2
AT THE TOP OF THE TWINS g � I L D I N G P E R M I T
r
; � O.
� i y_�__� COMMUNITY OEVELOPMENT DIV. '���
r � � PROTECTIVE INSPECTION SEC. ����
� � �"'� � CITY HALL f RIDLE� SS1$P NUMBER pEV OATE PAGE OF APPROVED BY�
�"""� � ��' 763-571-3450 910-F 15 12 / 11 / 0 2 / /
JOB ADDRESS 6648 Channel Road NE
1 LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. Z8 Par el 1380 Brookview Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS 21P PHONE
David Garner (Renter) Berta Letran (Owner) 10400 Ho.�lywood Blvd N6J, CR 55433
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO
David Schweich Construetion Inc 21716 Kenrick Ave, Lakeville MN 55044
4 ARCHITECT OR DESIGNER MAIL AODRESS ZIP PNONE LICENSE NO.
952-489-3222 20262629
S ENGINEER MAII ADDRESS ZIP PHONE LICENSE NO
8 USE OF BUILDING
Residential
7 CLASS OF WOqK
❑ NEW O ADOITION C� ALTERATION O REPAIR D MOVE O REMOVE
8 DESCRIBE WORK
Install an egress c�indow
9 CHANOEOFUSEFROM TO
STIPULATIONS
Provide smoke detectors in a31 sleepir_g rooms and on al? leve�s of the dwe�ling
per Saction 310.9.1.2 0€ the 1997 Uniform Bui?ding Code. Caulk and flash a�l
exterior openings.
SEPARATE PERMITS ARE fiEOUIRED FOR ELECTRICAL, PLUMBING. HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV 1,0A0
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONS7RUCTION 20NING SQ. fT CU FT
AUTHORIZEO �S NOT COMMENCED WITHIN 80 DAYS. OR IF CONSTRUCTION
OR WORK IS SUSPENDEO OR ABANDONED FOfi A PERIOD OF 120 DAYS AT
ANY TIME AfTER WORK IS COMMENCED NO DWLG. UNITS OFFSTREET PARKING
I NEREBY CERTIFY THAT I NAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GAHAGES
AND KNOW TME SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE Of WORK W�LL BE COMPLIED @
WITH WMETHER SPECIFIEO MEREIN OF NOT. THE GRANTING OF A PERMIT `I'1 s 7SO �.87
DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR OCAL LAW REGULATING coN- �63. ZS Fira SC �1 .7S
STRUCTION O THE PERFORM CE OF C STFUCTION
PLAN CHECK fEE TOTAL FEE
Li ense SC $5.00 $70.77
Si ATUAEOFCON7i7ACTOAOA4UTHOAIZEOOGENT iDATEi WH N ROPERLV VALIDATEO THIS ISrV UR PE �
�
� Jl.
S�GNaiUqE O� OwaEp ��F OWNEA BWLDEA� �DAiE� G�NSo O� E
� �
NEW -- - - ( ] - � � CITY OF FRIDLEY Effective 1/1/2002
ADaN . [ ]._... . .. _ . � _. . _ .. _� _ 6431 University Ave NE, Fridley, MN 55432 (763) 572�604 Bidg i�sp
ALTER [] SINGLE FAMILYANQ�DUPLEXES R-1 AND R-2
BUILDING PERMITAPPLICATION
Construction Address:
Legal Description:
Owner Name 8 Address:
Contractor.
LMNG AREA:
GARAGE AREA:
OECK AREA:
OTHER:
�% )
I�( �/n/ ,QJ�O� ��
7�' �� DZ> � �-�'� � Le�/J � 2�'
� l^ � �C��(J 1��� Tel. # �-� � ` Z5� � � �
��%'�� � ✓/�� MN LICENSE# �C���,iL �Z
� -re�. # ��� �y �� > �,�ezZ�
�—�N�� � G dt -�v � �
Attach o this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft
Length Width Height Sq. Ft
Length Width Hgt/Ground Sq. Ft
Canstruction Type: Estimated Cost: $ ��� � � p
Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x� _$
DATE: � l� � Z APPUCANT: U�l� J i� �,.5�, !til�,�%%��C� � Tel. # �I ��- " 7�" �)i
Call (763) 572�604 for Pertnit Fees if mailing in application or Fau to 763-571-1Z87 if using credit card and we wili
call you for card number.
CITY USE ONLY -
�
Permit Fee $ .�S Fee Schedule on Reverse Side
Fire Surcharge $ , .001 of Permit Valuation (1/10th%)
State Surcharge $ $.50/$1,000 Valuation
SAC Charge $ $1200 per SAC Unit
License Surcharge $ � D(� $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 [ J Not Necessary []
TOTAL $ � � STIPULATIONS:
�- - �_
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 $5(�
$501 to $2,(�0
$2,001 to $25,�0
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $500,000
$5�,001 to $1,000,0�
FEES
$23.50
$23.50 for first $500 plus $3.05 for each additional$100 or
fraction thereof, to and including $2,000
$69.25 for first $2,000 plus $14.� for each additional$1,0�
or fraction thereof, to and including $25,�0
$391.25 for first $25,(�0 plus $10.10 for each additional$1,000
or fraction thereof, to and including $50,�
$643.75 for first $50,000 plus $7.00 for each additional
$1,000 or fraction thereof, to and including $100,000
$993.75 for first $1�,(�0 plus $5.60 for each additional
$1,000 or fraction thereof, to and including $SQ0,000
$3,233.75 for the first $500,0� plus $4.75 for each additional
$1,000 or fraction thereof, to and including $1,0(�,000
$1,t�0,�1 and up $5,608.75 for the first $1,Q00,� plus $3.15 for ea.ch additional
$1, 000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $17.00.
Permits for construction will be issued a minimum of 24 hours from the time of application to a11ow for proper
review of the proposed structure and of the construction site.
VERIFICATION OF FOUNDATION
A Certificate of 5urvey of the lot, showing the location of the existing foundation will be required before
proceeding with the framing. New Houses Onlv
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