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AF - 36502,.�: �``� � Village of Fridley, Minn. BUI�DING PERMIT ' Date: . .��.� �. . � �. f � �,�"�, , ;� , . . . . . Owner � y . . . . '":� - t�� -�,•' � " �.,.p ;>�'�wr,,.�,,, Builder . Address �/y �. J. �%. ` . . . . . . . . . . . . . . . . . . . . . . � Address W ;^ �T° 1056 � �`�;� :............................. ............................................. �..00ATION�'`,OF B.�JJILDWG No. � �r, .rr �,.� . Street . . . .� . .-��"�,^`';"�;°�f' . �✓ .� � • ... . .: Part�,q,f,�Lot .. ...... .. ..... . Lot .... ,�:. '�r:.. Block .................. Additio ..... „�,� n or Sub-Division � . : .� +�- ,�..�, � � • . ..�...... .. Corner Lot ........... Inside Lot ....�.":�.... Setback .:.��.'� y .�s!� ,/'y'"' �*�*,..s�.. •.. Side ard To be Used as: ,i�y Ca.e.s. � °,r:c��r„.� A t . ... . . .al-� DESCRIPTION OF BUILDING �;� �° � - Froni ........ Depth ...:!�:.� Height . ''� . •�°'`��q. Ft. ..,�fir.�:i Cu. F� ........ ..... ............. Front ........ Depth .... Height ........ Sq. Ft. ........ Cu. Ft .. ;� ,� ........ Type of Construction . ;� . .�: . ;-^�. : :-:�;- , Est. Cost . . � �'„�. :d!'�, .. , , , , To be Completed .v�.�. "'�,"'�� , ��'� � 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 F'ridley, . .�. ^� .f:�� . . . . E ''.��r: ?`:�'�: . . . . . . a � � . . .. :'1f'4s=:+:"i ,.,1.. . 7n consideration of the payment of a fee of $..�j'j !�?!? permit is hereby granted to ��"�°.`-�:°i,. :,..,, �. ; � . .. ••�^��Lw:-::*... to construct the building or addition as described above. This ermit is P granted upon the e�ress condition that the person to whom it is granted and his agents, employees and worl�en, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of F"ridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings with- ° in the viIlage limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. �' ,� s ; . . . ;-:�:�: . . . s..� ' : .'�: : ;~r-a:�,.,..$1u1d'uig InspeCtoT NOTICE: This permit does not cover the construction, instaitation or alteration for wiring, plumbing, gas heating, sewer or water. Be sure to �fihe Building Inspector for separate permits f�c, these items. __ _,� � � � s R ni � � y � � �� 0 ��o �� o � ...-�.+- � _ � � � � /� � � � � 4 � t --- - - � �, 3 � Q �� !� � � � � � � � � �.. �W� � p � .. �+. �„� b � �� o ��: �� : : �� : ' : � � .; � : �. °° � ° :. 5�� $ M fA � 0 yy � 0 t" ° � �� C � w �: � � Q a � �s � � � o � � � A A G � CTi � '°1 \ �z � 0 . fe o 0 0 b m 1 �O' � a ,� �� I � � � 0 � � � � a6� \ � � b � � � � O r � �� N � W W � � '� g� �o �~ � : � � �: � s iA � � � O � � � �� a a � � o N p � A "� 04�� ,� �°�� x�� . : : � � : � �i �' . . o � . . � : : � : : � . . � W Ci0 Q O ��gs � � � � � � � � � '� � � � � � �� ' �°�� & � : � � � ; w o : : � � � ; ' � � : : : � ii �y °� .�� n A �. � �, � � m b � g �, i � � o �o � � V � � �+ . . . . � ��o s$s�$ M� �, - �- � �� • � I� � �m� ��y�� ~� 0 0 ,��, �� , � Q � : ��:: v � : : _ � ;..: : � ' � � � ��o s$sg� � I �� I � �,� � ' � �� ' �� o�cr'�' .. �� , . ��.o � on�� 0 _—�E ��__�M��~ � � _ -. m W " �p-- <c.. �� Co ` �� o�'�� y � � A� � �0,� � �C � O ��;�y � � �� ; � a� �� *y �� S�q �1 �.. t��p. � 4P '° � � I �� A � �* r � fl7 � m c � � M � � HO SE HEAT G ST RECORD ADDRESS � OCCUPANT APT. FLOOR CITY �_SUBUR � I HEAT LOSS DATE HTG. INST. I�/�� ER SOLD BY AS C0. METER BADG # Electrleal Work By INSTALLED BY TYPE OF HEAT Gq FA �s Line By STEAM SPACE HTR. UNIT HTR. � AS DESIGN OTHER MAICE CONVERSION Model � MAKE OF BURNER Serial Modei INPUT P�1ax• BTU Rating P�AKE OF FURNACE _ THERMO Valve � Ltmit . Limit 5etting Fan Setting ! Pilot Type _ Pflot Moke _ ug —_/ - Z, � A�odel /� Vant Size ---- -- KIND OF LINER SIZE �raft Hood � NE�_ Regularor � � � Filters Size= ��.0 Y � , �' -------� �,umber_ Chimney Location Inside Outside Chimney Ccns#ruction V ' � Pilot Model ' Pilot Timing Smoke 8omb� �Qfj '"' L•W. Cut Off ��-- �aft �_ Door Pressure _ Prossure • pereent CO2 � Q Input CFH Date Tested �! Pereent Q2 Compcny Testing Staek Temp. � Pereent CO Form 235 Name of Tester _ � N ro t7 n ,3 _ O � r. :o 1 ' � 4 H v+ o � 7 R r m N 7 = ia � � � n � m C7 -o � -� � [l y .- � ro � r x �i � � - r 4 �- � {. jy • N 1-� ft 4 D 4 N � C o n � tr L. n• �+ •. c n n .+ c n '" � u, �n c� a rc n G ev n � �s n � � r+ Cr7l n r.i � � n �s .-. p Uj r- •� r.- p O �-- 6 Z 6 an 7 O n �,� tn O Z tn X n G r eo 7 �- O L O to p r+ ^1 'q - o s`' m v x '-' � •-• o b m c��c �n o r n 7_ X a n o n r n .., y c n r- m o� � m e, .+ .-+ r o C-- �i � n r+ �' m w n n�i x 0 o ry � o � ��c m �T'� rc � n Ly r o m� C 0 w c ►'n � o n a o 7� O � 't L/7 �- r R O 'D [7 o �a -- d a o o� 0 M o " . - .. .n �o � v, --D "' O ° r"'s c � =D > > Y � ►s Z CD �� - 1-�`� +D O 7 � ri7 ---1 rt tn H - s„ _ c • o o .o � .—. � o � � o y� -- � p _ m C � y -� - C � _ -i m [.n Ci - � n Z C o rn x x x x.x x x r. x x x x � � sn v, r v, �n .n Kn <n r v, v, v, sn �n _ n� cn o r�-_ v� cs� � o cn in r,� ro� .� 0 0 0 0 0 0 0 0 0\o 0 0 0 0 -3 o D o 0 0 0 0 0 0 0 0 0 0 0 � V� t! �n �N �N N N � N Y/1 N Vf in iIf N Vl N �"� 0 � . ' 9 O ° :r - r H z 3 ' c '� m rn _ � O rL K ro r C m Z n R� I�] � H H H � . U � O �D c� � cn O H � � C � 3�` � _ � "O ro � O < � � 0 � `O ro � v H m �3 ID I � M H � H N -o O c � S H N ro b O �.s v ni r I S[oi1a� n � w `. jo �' a a r* . C e a • Closet9 Z��m = c �I ' - Urfnals. - � n r m � . � o (• IIath Zubs n - m - � ( Bd53119 n o R � n~. o Sinics 7 . � � � Wash ,2Yays � n � � I Drinking `a � � • Fountai.ns � � I .Shovess I I ( '£loor Drai A 0 � Catth � I I � I Hasins " ( ( I �- I Rvtomatic R � Washer = f I �` � � I t �Gas -Apnl_ � � - I { Hisc_ £i5c� � �n I I Gas Range m m 1R� S tY rS Ot�1PS - . . 1 I m d i� m rr ( I I I � � n � O P7 �3 c � O �-• tn O [n rc i � M ID O v n t � Cl7 � O �7 H A N "�J C 1 [+7 O ` o � C � m � r ►+ rc-� v°� a o [' H � �-+ o, v � � � Z S' (Q � Q � F . [� '3 � � H � y r sa � y 0 CO � . S � - � � o N fD fi ' � � D � '2 � ''C � 'O o � U ;y !� y � z � O Z z � \� rr p+ m H I7 0 4 _ �•p m rm o o O� m�3 r rr 'D U o � - �c � �-n K h- m �t 7 a � ro =o a n r r- = �+ r+, � a r F-- m 7 J l.7 rt c a p,a r�� m �p D 1 n rt [n v m m n � r m - � m .� a o in r rb °'r�nrKO :a oco tt W � '� TD p � � 6 G � � A. I- n m �n � a O� C � b O rT � �" .., o m o m � O � � r. m [b tT a P R O `� .r�- 3 m 3 O O �' D' � -=.-F m R � �n m �y .•r� ID O O C r U � X '7 m p. n CD 'a �'°� r. o L r }' m aY� � � � r d tn A+ a 7 r- rr n s � � K h . rt �O Y- O _ 7 N n � �. r � R _ 6� m M p� m O O � n n T d n o a Oo f- � 't ( F- m o. 'D N n •i a � N v m � n � r+v o H - M 'C m i" � O R \Q � d L " w r-- 'w a n rt o n r a' n O pr �'1 ff K rr N ?' 7� c „- C _ i f G ~ . D R (� S F-� p+ D P rT M -. �p � r+ `C %C I G V [7 ? ' �r O � r n K „p+ m � n ry n SUBJECT City of Fridley AT THE TOP OF THE TWINS B U I L D I N G P E R M I T r � � i �• COMMUNITY DEVELOPMENT DIV. r � �' � PROTECTIVE INSPECTION SEC. � 'i �---� � CITY HALL FRIDLEY 55432 NuMeER REV �"""'�'� �'� 612-571-3450 910-F15 JOB ADDRESS 6670 Channel Road N.E. t LEGAL LOT NO. BIOCK TRACT OR ADDITION DESCR. 2 % Brookuiew Addition 2 PROPERTYOWNER MAILADDRES$ 6670 Channel Road N.E. Joyce/Sig Aa.nestad 3 CONTRACTOR MAIL ADDRESS Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS 5 ENGINEER MA�� DATE 6/22/90 21P ZIP ZIP ZIP PAGE OF � � ' � � • � � � 7f� APPROVED BV SEE ATTACHED SHEET PHONE 571-0164 PHONE LICENSE NO. PHONE LICENSE NO. PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK � NEW � ADDITION 0 ALTERATION C� REPAIR � MOVE ❑ REMOVE 8 DESCRIBE WOFiK Rexoo� House (17 Squares) 9 CHAN(iE OF USE FROM STIPULATIONS TO On ell new roofs or tear-offs antl replacement roofs, State Code requires that 2 layers of 15 ib. felt, mopped together, be in�talled to a point 24 inches up from exte�ior wall line, or the use of other approved underlayment membrane. TYPE OF CON57. SEPARATE PERMITS ARE REQUIREO FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZpNING AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONEO FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNI 1 HEREBY CERTIFY 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 COMPLIED $9OO WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $23.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. OCCUPANCY GROUP OCCUPANCYLOA SQ. FT. CU. FT. OFFSTREET PARKING STALLS GARAGES SURTAX $.50 y23e`J� oF C NiRaCTO, ORAUTHORIZ� EN7 �tDArEi WHEN PROPERIY V DATED THI IS YOUR PERMIT .e .,�.,w�eo.ir rnN� C RIIII nFR� DAT� ��BLDG �NSP _ � nA� � � � EffeCtive 1/1/90 ApDN [ ] R-1 AND R-2 AT,Z�t [ ] Buildirig P�nnit Application .. w . � .;. - IP.�CJal Lk'SC71j7�1Ori: «� � & ��: �"o�ac� �S�G �a��S�-�r� �. # 5 � ��o� �y contr��tor: S �- � z+e�. # Adaress: '-- I�IPa1G AR�: GP,Ti�yGE AR�,: DFJCR AR�+,: OTi�R: Attaah to this application, a Cextificate of Survey of the lot, with the pr�posed construction drawn on it to scale. DESCTiIP7.'I@T OF II�E'�� Length Width Height Sq. Ft. Lerigth Width i%ight Sq. Ft. Ie.ngtii" � -� Width Hgt/G�o�uid Sq. Ft. Corner LAt [] Inside L�t [] Ft. Yd Setback Side Yard Setbacks Type of Construction: S� �j� QS2� Estimated Cost: $ Qi�1C) Approx. Ccanpletion Date: Proposed Driveway Width If New Opening Is Desired: Ft. $ $ Width + 6' See Back Page DA'I'E: C� �� (� APPLICAl�T: �1 • # Permit Fee $ o� �.- 0 U State Surcharge $ � � SAC C�arge $ Driveway Escrow $ Park Fee $ Sewer Main Charge $ TOTAL $ �`�",� . �� CITY OSE OTII,Y Fee Schedule on Reverse Side $.50/$1,000 Valuation $600 per SAC Unit Alt. "A" or Alt. "B" Above Fee Detexmi.ned by IIlgine�sinc! Agre�nt Necessary [ ] Not Necc�ssary [ ] :+1 A � � ' :rl'i �� ' :ii' ; �:I:N�.1 'Ihe Chief Building Official shall, before issuing permits for the erection of ariy i�a,i 1 a�J or stnicture, or for any addition to any existing buildinq or structure� or for ariy alteration or repair to any existinq ��;1 d�q or structure, upon ap�lication therefore, require the p,ayment b�, the applicant for such �r++;t of fees to the amount herein below set forth and in the manner herein provided to-wit: Z�0►I'AL VALUE $1 to $500 $501 to $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 $100,001 to $500,000 ��. $15 (Miniim,nn Fee is $15 plus surcharqe) $15 for fiYSt $500 plus $2 for eac�h additional $100 or fraction thereof, to and including $2,000 $45 for first $2,000 plus $9 for each additional $1,000 or fraction thereof, to arid including $25,000 $252 for first $25,000 plus $6.50 for each a�ditional $1,000 or fraction thereof, to arid iricl� $50, 000 $414.50 for first $50,000 plus $4.50 for each ac�ditional $1, 000 or fraction the.reof, to arid iricludis�g $100, 000 $639.50 for first $100,000 plus $3.50 for each additional $1,000 or fraction thereof, to and includitiq $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 and includ.ing $1,000,000 $1,000,001 arid up $3539.50 for the first $1,000,000 plus $2 for each additional $1,000 or fraction thereof DRIVEW�iY DEPRESSION ESCiiOW (Concrete Curb Streets On1Y) Alt�xnate ��A��; Remaval ar�d replacement of curb and gutter only - Driveway width plus 6 feet tilnes $13.50. A]-tex�ate "B" : Removal and replace�merit of curb arid gutter ar�d install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet tin�es $15.75. ' �' ■ v• �� • � • �i i� � •;�1 P�mits for construction will be issued a min�rman of 24 hours frcen the time of applic�tion to allaw for praper review of the Pro�os� structure and of the construction site. A Certificate of Suzvey of the lot, sho�aing the location of the f�ation onoe it has it has been aonstructed wi11 be required before proc�eairiq with the framux�. � * _ D rr � 3 0 � 3 m a � � 3' � � � y. � O y � n � �' O � � � o- a� 0 �• � �• a� 0� n lD � Q' O � � °' � a o � � � �`�° a � s 0 c .-r n v � < m a. � � 0 c � � � v � m � m z � � m c� � 0 Z '�'I m m {i9 � V O 0 \ _ -� I� _n � � � � � N I � � _ a � Z � c� O D � m � o � D D r m � m � s � m Ul � � 0 � o n �-+ _ �� O o� �D o ? � �� <°1 �� n► �h � c� � m Q, o � c � � D N. -� =' � -o Q° � �' �' D �, � � n � � (D O ._+; o ��N O � � r � � � 0 Z �� n N� � � � . � � � � � � � N � v � � 3 -. � � � m � p � a � o n, � °�'. � o°'v �'. y W � � h _, � n. � � � o � o-� a o- � °°`< � � � � ��n'—�, y j. O N � � N '� � �� (j� �. N "0 � �. ,� �. cu =+. � � � �, =� � � A � ma�-h � � ° o c � � � � 1 � � � � y (np � fl.s� � A p� �r O � � -w � p� � O fD = �- �, .n.r '�' CD S CD C7 � A � O v► O � � Q 3 fD � Q y f�D � �. � cW � m --I � a fD Z n, m 2 � N m Z O � � D C� O � a � 7� � � N� � N � N � 0 N � � � �� N � N � y :� �O � � N � � �, N � � � � � � m c� � d p- � < � m � � � � � a � � �o-_n,�Q -c � � � � � ��-..'°'� � � W� o � � t7 � � "'�` v v � � � � n � N � � � � � � N � i--� r (N cn o 0 o O 0 0 0 0 0 � O O O O O � � � � � � -� 0 a r �-Wi�o � C °� ' — Q' o m �, Z = � � � �' m r'• 7 OR � N _ O � C? N n n � o p > > � � m � ^ � n- (n N r rv °� o.r"Z3 v �o� 2 0 N � N v � � � D v m � � D � m � C7 O � � -o m � � � z 0 �"?++_ �% -�.- , W C r 0 z � c N m 0 0 Z � � � m N C�i 2 m v C r m � O W D � I� � � � V cn -n rn C� N O. W '""� �� O� j O ��•� Z m � �� o W C -< N m Z z� m� m n � � z � G N a � � z � r �� O mZ �O �� O� Z� Z� v� a� �z ZN � Z .� v o= zm Z -a�l � Z �n m� N O �Z Z� v< vm mZ <� C� N � � Z � m � <' N � � L v � C N �G r N O O O COMMON VENT VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existins� furance, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes () No () The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes () No () The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. The existina combustion air is sized and installed to meet the current 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 manufacturer's specifications. Yes ( ) No ( ) Yes ( ) No ( ) Yes ( ) No ( ) When installina a new ventin4 svstem, the undersigned hereby verifies that it is a listed assembly and meets the cuRent codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. Yes () No () Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes () No () Appliance Tvpe and Size/Common Vent and Vent Connector Information Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches 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 ALTERATIONS• (Describe) HEATING CO: Signed By: Date : n � W C _-I Z D � � _ D r r W m 'D � O v m v v m z c � n � m � � Z � �° D D Z v a W r m rn ,D c� O � Z m z � z O O Z W n � � � m O D r � m m � • ♦ � °: m � c �- v cc m D � -� �m � o � 'NO � �p � � O N � '7'1 o Z c�n �� O� c � o o m= � �� a v � — Cn � A � �v r � m � 0 Z � �� a�i, cni W m� m ,� �- v, v, m m m�� fD °' � � o � � 2 2 � � � pp � 0 � 'n � N � N fD � N .-.. N .0 �. � �� N .�-« .�-« N � t-�i N� � tD � � � � f� �p � �• r.. � t�i� � �p fD � � � (G ' � N . ul m � ' `° � � D � � � � � � � � � m� A c�i � c _ �D m m o. .-. m � v z � i�9 Ut co O � r C � W Z �ii � � C � m � � I I I I I I I I I "' � O I I E�A �� EA bA tfl iA {fl 69 EA � O O O v O V�l V�1 Cn A�I m 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 o p o 0 0 0 0 0 0 � O � � � D v� � m ao � � � r � c, � o � �' � W a � W � � n m � y a �O y , .� � ,,, � 0 c m � � v �: � � � d � � � m r 'o m � 3 =i �+,. � � � N �� Q � n. a m � � � m 2 � � � � � a � � y � � .��. °� m c° � � � �� a N W p (3p � � n, a o. ,� � o ,� a �° °� � � � °�' ,� �. O � 7: p1, �., y m ? � � -o � N -o �• a � � ��, g � 'm � �, � � a o � a � � � c�i � � � � � � u��i �• �` fl- r► � o �s � ' rt (� _ N � n � '� �`A� O O � -w p. (D H N fD �� W � � � � � � � � o 0 0 0 0 � �, A W N -� ? m c �. � o� :;:::::: '::::�:�> D .�:: ;0 ? � � z � C � � W m ��' �y�::>:::<::� .�::..:..:.;_:: � ��<::::<::: O :::::: 'n .�:. � ' X � � C `` �' m � :�t:l:::>t�' O �:::::: ^� pp !�:;:�.....�..�`.....�......: m .''::.` Z '»'•`• �:::::>:: Cn :o�::�. a ?• O r m v �:>� ��>�:' z �k<:>' ::. �!x<:s . :: �17 �:>: �• :: D :>::: C� C '''>'' 2 pCj .. C r �no0 �' o m � , G� � NpCj N � _ m� cfDi m � COMMON VENT. VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existina furance, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes () No () The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes () No () The undersigned also verifies that the replacement unit is a listed assembly and meets the cuITent codes and manufacturers specfications. This does include AGA-GAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. The existing combustion air is sized and installed to meet the current 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 manufacturer's specifications. Yes ( ) No ( ) Yes ( ) No ( ) Yes ( ) No ( ) When installina a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufaeturer's specifications. This does include AGA-GAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. Yes () No () Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes () No () Aaaliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches 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 ALTERATIONS• (Describe) HEATING CO: Signed By: Date : City of Fridley AT TNE TOP OF THE TWiNS i � � � COMMUNITY OEVELOPMENT DIY. i LV ��'��'� . r j � PROTECTIYE INSPECTION SEC. i.__•� ��"' �.� CITY HALL FRIDLE� SS132 i 612-571-3450 �oe aopaESS 6670 Channel Road NE t LEGAL ��TNO. DESCR. Z] 2 PROPEfiTYOWNER Joyce Aanestad 3 CONTRACTOR Same 4 ARCHITECTpRDESIGNER 5 ENGIN 8 USE OF BUILDING Residential 7 CLASS OF WORK �U ILDING PERMIT NUM�EP REV OATE PAGE Oi s�aF�s 10/25/00 / / CT OR ADDiTION Brookview Addition 6670 Channel Road NE ADORESS MAIL ADQRESS ZIP ZI �] NEW �] ADDITION � ALTERATION O REPAIR 8 DESCRIBE WORK Construct a 32° x 24� Living Area Addition and a 38` x 26' Garage 9 CHAN(3E OF USE FROM TO 3 i 522 v�� E�T N� / b PROVEO B• SEE ATTACHED SHEET PFIONE 763-571-0164 PHONE LICENSE NO LICENSE NO. PHONE LICENSE NO O MOVE ❑ REMOVE STIPULATIONS ' See nota.tions on: plan. Install a hard surface driveway. Install soffit ventilation to meet the State Building Code. IInderlayment must comply wi�h the State Building Code on roofing. Call for building wrap before covering with siding. Permlt lnsp�ction Cards Will R� E�ail�d To Hom��vn�r To P�rt � �� efore diggeng cail for �II utility locations , 4540002 REQU��D �Y �.AVV SEPARA7E PERMITS ARE RE�UIqEO FOR ELECTRICAL, PLUMBING, HEATING, 77PE OF GONS VEN7�LATING OR AIR CONOITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CpNSTRUCTION yONING AUTHORIZEO IS NOT COMMENCED Y�(ITMIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONE� FOR A PERIOD OF 120 DAYS AT ANY TIME AFTEfi WORK IS COMMENCED. NO. DW4G. U I HEFiEBY CERTIFV 7HAT I HAVE READ ANO EXAMINED THIS APPLICA710N 1 AND KNOW TME SAME TO BE TRUE ANO CORREC7. ALL PqOVISIONS OF LAWS VALUATION AND ORDINANCES GOVERNING TMIS TYPE OF WORK WILL BE COMPL�ED @ WITH WHETHER SPECIFIED MEREIN OR NOT. TME GRANTING OF A PERMIT `Y79,059 DOES N07 PRESUME TO GIVE AUTMORITY TO VIOLATE OR CANCEL TME pEFMIT FEE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR TME PERFOFiMANCE Of CONSTRUCTION $846 . JS TUaE O� CON'RACTOp OA AU 0 eGENT IOA E� �a oa �D�TE r 3 SQ. STALLS V a� GrtOUP OCCUPANCY LOAD CU fT. OFFSTREET PARKING GAqAGES SUFTAX � $39.50 F re SC $79.05 A� FEE $965.30 D 7HIS IS YOUR PERMIT �� °'o�� NEVV [ ] ADDN � ALTER [ ] Construction Address: � � Legal Description: � c,-�; CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION �� Effective 1/1/2000 (763) 572,3604 Bldg Insp Owner Name & Address: _ J C�i CQ- �'(�1,, � �°p� Tel. # �� J 'rJ� � -� � �p � Contractor: � ( � MN LICENSE # Address: ` S c>..y(v� Tel. # ��'1tiJ� LNING AREA: GARAGE AREA: DECK AREA: �ttach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length 3� W�(� � Height Sq. Ft. Length 3$ Wd{� Z(n Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. OTHER: ��d� �Y S—� � S� �o Construction Type: � Estimated Cost: $ �, �� Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ -$ DATE: � ��2-� �� APPLICANT: � ' J� � Tel. # b -5-i �' 4 6 °� -7 - � CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application Permit Fee $ �l o��Fee Schedule on Reverse Side Fire Surch�rge $__ �•D� .001 of Permit Valuation (1/10th%) State Surcharge $_ , ��j $.50/$1,000 Valuation SAC Charge $ $1100 per SAC Uni# 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 [ (y — �� JJ�-�- Gv, c.� I�� TOTAL $ ^7 � ' �� i.� � d7 e �� D ✓ � � 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 $500 $501 to $2,000 $2,001 to $25,000 $25,001 to�� $50,000 $50,001 to $100,000 $100,Q01 to $500,000 $500,001 to $1,000,000 $1,000,041 and up FEES $23.50 $23.50 for first $5� plus $3.05 for each additional $100 or fraction thereof, to and including $2,000 $69.25 for first $2,000 plus $14.00 for each additional $1,000 or fraction thereof, to and including $25,000 $391.25 for first $25,000 plus $10.10 for each additional $1,000 or fraction thereof, to and including $50,000 $643.75 for iust $50,0� plus $7.00 for each additional $1,000 or fraction thereof, to and including $100,000 $993.75 for first $100,�0 plus $5.60 for each additional $1,000 or fraction thereof, to and including $500,000 $3,233.75 for the first $5�,000 plus $4.75 for each addirional $1,000 or fraction thereof, to and including $1,000,000 $5,608.75 for the first $1,000,000 plus $3.15 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete C�rb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50. Altema.te "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 $23.25. VERIFICATION OF FOUNDATION Permits for construction will be issued a minunum 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. New Houses Onlv � Job Site address: �� -��d�`�� G�� ° � "`�CA'�'EGORY 1" ALTERN�TE -FOR 41�TE � TW(, FAMIL� DWELLINGS Inspection Divisiore 763-572-3604 dYSTRUCTIONS: This alternative may be used for one- and two-family dwellings built to meet the Category 1 requiregaa�� ' �Iinnesota Rules, Chapter 7670. Complete Paru a, B, and C. Clearlv mark plans tivith: insularion R-�•alues; window and skylighY L= values; size and type of equipment; equipment conu-ols: and location of vapor retarder and w�indwash barrien. �Iore detailed iz�tormation can be found in the :6linnesora Ener�.• Code summary sheets available 6rom the �tinnesota Deparnnent of Commerce. Part A. BUILDING ENVELOPE Check proposed envelope joint sealing opdoa � ��Prescriptive (cauiking, gaskeu, etc.►' �� Performance (test perf76"0.0•l70 subp. 7.—C.) ; Check thermal energ}+ calculation opaon used � �••Cookbook" (completz worksheet below) ❑�[nCheck method (attach report) ,_ ` ❑ Performance (attach C-value calcularians) 0 Systems analysis methad (attach analysis) i MINNESOTA ENERGY CODE - WH/CH RULES MAY l USE ? Part B. DEPRESSURIZATION PROTECTION ` � � �, -� . Check oprion used: �J Fuel burning equipment (complece schedules below) O No fuel burning equipment - I�iSTRUCTIONS EXB��QST / �UP�AIIi SCH£Dk3I.��-`;� Step 1. Complete the Combustion Equipment Schedule belon•. Only equipmeat Exfiau�i devices ove=3tf0:c�'m Flow � with a Y(Yes) may be selected under the "Category 1" alternate. c%i� Step 2. Complete EYhausd.�lake-up �lir Schedule on the ri�ht if direct or power =cf�{ vented or solid fuel a�nospheric vent space hearing equipment is selected '.cfiri; Part C�. V�NTILATION VENTILATION QUANTITY _ . (Mechanical ventilation must be provided per the Iargei qaantity calcnlated below) � j�� ' cnbic feet s 0.00583 Iminute =�°� �; cfm ( �d g 15 cfm/bedroom) �+ 15 cfffi _: �� cfm '� . .. , _: volume of habitable rooms number of bedrooms .� _ .. " - VENTIIIATION FAN`SCHEDIILE Check method(s) proposed � �- Exhaust only � Balanced (heat recovery ventilator, air exchanger, etc.) � Fan description or location � ��.�,�; �� TOTALS .= ' VENfILATION Intake cfm cfm cfm cfm cfm AS DESIGNED Exhaust �`��' cfm cfrn cfm cfm cfm Statement of Compliance: The proposed building design represented in these documents is consistent with the building p1_ans, specifications, and other calcularions submitted with the permit application. The proposed building has been designed to meet the requirements of the Minnesota Energ}+ Code. Applicant (print name) Signature Date Telephone number Part C2. VENTILATION (Snbmit Part Cz npon completion of system verificationj�) �---------------------------------------------------------------------- Job Site Address: Permit Number Compliance Statement: Installed ventilation stem is in compliance with Energy Code and is sized to provide the design air flow. �� .ar�� °'1� �� 3 � � —6 � � Applicant (print name) Signature , Date Telephone number n O � W C � � O Z D � � � r W m � � O v m v � m � c � n � m � O z � A D D Z � D W r m rn D � O � O Z < m z � z � O z W n � � v m �o a r � m m � � �� m � c i� � � � m � v °< � n W � D � �rr,m 5' � O� fD O�,=n v � � c � 'n o z m -^ v c �� o rn= � D' -o v � °� D � uv D � m � O z � ,< � N N m m m � v nni �� m v c� v 3� �° n' � '� -n � �i '� � -� � C � O � ,D �1 � � � � � N N � � � W N �. C -, .� � � °� � � � � < � � N. a, �° v�i c � � co �' � � c�o Z m � m y � �. � �, � n v -� � � y � �. � �1 � � � � c > .o � m� Q. � m � � z � � r C W Z G� � � C � m � � m � �I I I I�I I I I I�� cn o 0 0 � o y �:� �t �n � v rn 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 � � o O ,� ' D O O , O r : !�, cn `� v � r Z C m � v 00 W Z � � n O � a .� � 0 c � � � m m � �� ? Z v ° .�+� � m � � � 1 � � ! � �� ' � .�• m 3 °: n. � N � W � � Q e v m � � -� � W �q n � � �' C � (� a �' a � � v n a � m v 2 m c � .� � Q n f�/1 � N N � ��. o � �' o. �o N c� o m v Q: a o. a c° d � � O � n�i < � � vi; �. N n � _ � -o � N -o -� � � • . a � � �. � m o � m �' �. d ,C' a ° N Q p� N .»� (p � �p N N N fD � , � � � v�i -+: r' �. A°� r► � o O S S � � m �"'s m °� � �D � — � � � � m � �- � -" �. fD � N f� �� N lO � O � � v � m � � � � C� � w o: � � K � W � < .�.� rn Z m � � ��i+ � v N D �`m Z Z m� -o m n -i O Z v < a � � r � � O Z � O � '� r C o�o z 6+ a z v a N � � Z � � rn 3 � � � N O � � m � N O O � COMMON VENT VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacina an existing furance, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes� No () The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes () No () The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. The existing combustion air is sized and installed to meet the current codes and manufa�turer's specifications. When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes( ) No( ) Yes()No() Yes ( ) No ( ) When installing a new ventin� svstem, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. Yes () No () Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes () No () Appliance Tvpe and Size/Common Vent and Vent Connector Information Appliance #1 Type BTU Input ' Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches 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 ALTERATIONS• (Describe) HEATING CO: Signed By: Date : za � � C� O � � 0 �rn c -cni c O � z -� D � m � � < r- �m -�1 �I C� z � O Z Z < � D �� o � � a � o N• � y. fD O N � n � �' O � � � 0 � � a�`o �� a _' � � A CD a Q o �� -o a> � y. � Q � 0 � � -. � � . � 3 0 c � � m z � -v rn n � O z � rn m � � v 0 0 � 2 � �m3 'N�? � rn�3 ��rn oOm ay°� -��a N n � �Zm v __�� aoZ mz� �n O -p O m �z 3� � � < ym �Z N � �' a �O Z � �'? _ � � m -D_t � � Z a G� � � O � 0 C �Q � � � � (hD � � C/� I" rn � C _n � m -zi n� '�' O � VJ Z � z J m n � � ..0 G � � � � � � m � T' � ►-� o � 3 � fD �� 1 � � N Q� C O � � � c�' � A co O 0 �- O � � D m r � -n c rn � m � � N � � O � � � O � � N � � c. � �' � j n � m � � � � h O p., � � '"f Lv N j � � �. cn � �. c� �, c. � Q ,� oq � �=9� n- °° a �•oo� ,+<_•°' � S t/r � =) �• � y � � � � - � �' � �' Q � h � � �. N � � � h � � � j m a c�i -� � � p O c �, � � � � � � y n N � � � Q rt � f� � � .-+ O r+ � -w � � � O � _ �- .-+ �. 3 m � N C� �D � `< o N o � � n- m N L��., N C�D � �. � �D o� O o � < �D � al N � rn m O � D �� -� N �� D m � o � � o �_ N �� -� 0 z W D C7 � .., D -�' C'� 0 a �' � D N m N � � N 0 N � Efl �6A C1't O °o °o t-� tia 69 �W C '� I� c� � N a m Z � � 2 'D m 0 � N� m Z -nao-+z m C � ° Q' o m �, � _ � � 9 �' c� =� � 0 � Ci = y � 2 O � C� � n n � O Q > > � fp (D .n-t- ^ CD ' � a �� r N � Qmz.� � � o ,� _ O � m �.�i � a � c� � n -n � N 4f O � C. � � r, � o� c� � �,�� (�p rt a N � N A � d � z � m m .t' CfpD '�'+- t�D � � � � � � 1 � � � 0 — C N .+ � � `� � c m � pp m a � .� � � � ""' v v � W � � � � � � m � �6�9 � 0 0 0 �bA i�H � w 0 0 °o °o �* c� � � � (�LI --i Q o D r m � =I D � m 0 C� O � -� � m � � z . � � �� W C r � Z � c � rn � 0 Z a -� m � f') _ m � C r m �� V) rn � �� W �. W ;,�. t--� N� � �� tiu � < � a,zm � � � �� m W D '� N m Z Z � m� m n -� 0 z � < � D � � z � r � c� � �m'1 -D-1 ��' �o �� Z °�a°,�. � O � � � �� O� O 2� � ' v � '% a D �� Z � 0 N� � Z �- .� q .� ` Z m 4'� � � Z � �°� � y � �� 0 -< - � � m0 3r N Z �v< ,�:pZ � < '� � mn N � n Z � � -� � m A � G CD � � � IU � G � � � N 0 0 � �r ,;� COMMON VENT. VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When reqlacina an existin� furance, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes (i� No () The venting system is plastic/PVC and meets all cuRent codes and manufacturer spec�cations including sizing, length, number of elbows and termination. Yes'�,� No () The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. The existina com_bustion air is sized and installed to meet the current 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 manufacturer's specifications. Yes� No ( ) Yes�' No ( ) Ye�� No ( ) When installina a new venting svstem, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. Yes� ) No () �� Is the common vent and vent connectors sized and installed coRectly after an appliance has been removed from the common vent and vented separately as per current codes. Yes ��No () Appliance Tvpe and Size/Gommon Vsnt and Vent Connector Information Appliance #1 Type �-P.�� BTU Input �`OC�O Fan Assisted or Nat Appliance #2 Type �t �-� BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches 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 ALTERATIONS• (Describe) HEATING CO: Signed By: �� Date : 5�� / 0 � �� v � � . � � ed ��,�` � � r�¢� _ 6;, s y m C S,� C'°�� -�-„� ��,� �ii S d� � �,S "� �.�' � �� :°�- � ,��` � �� ?� �, , '� / 1d�� ° �� r �R ,< r � x C) i��,5 �,M � � � � t � �. , . �i � . "4 � 1 � � , '-�' j� �' �Ii ■�'�. ■1� - � � :� N�� 1 - --� e � � �7 � � �►�� Q � � a c �'�n � �' � � � � G A � �,,� �. ,� � �.: � � � � ��;�� . �, c o- � �.�z� �3 C `� 6 y. � � h R� �y _ _ CITYOF FR[DLEY FRIDLEY MUrTICIPAL CENTER • 6431 UrTIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287 May 6, 2002 Joyce Aanestad 6670 Channel Road NE Fridley MN 55432 Re: Paved Driveways Dear Ms. Aanestad: In 1997, the City Council adopted an ordinance declaring gravel driveways a public nuisance. They were declared a public nuisance for a number of �easons, such as: they can cause erosion, contaminate soil with oil and other vehicles fluids, and deposit soil and gravel in the City's storm sewers and detention ponds. When gravel driveways were declared a public nuisance, the City Council gave property owners five years to have their gravel driveways paved. The five-year deadline is quickly approaching, which means all gravel driveways within the City of Fridley must be paved with approved concrete or asphalt by December 31, 2002. If on December 31, 2002, your driveway hasn't been paved a citation will be issued and filed at the Anoka County Courthouse. A misdemeanor citation is a criminal offense and is punishable by up to 90 days in jail and/or a$700 fine. If you've already paved your driveways, Thank you! Please call me at 763-572-3595, so I can update our files. For your convenience, a brochure on the City's loan program has been enclosed. You can use this loan program to acquire financing for your driveway improvement project. Please call Jim Hesnik at 612-335-2651, if you have any questions regarding this program. Thank you for your cooperation! As you successfully complete your driveway improvement project, please call me at 763-572-3595, so I can do an inspection of your properly and update our files. If you have any other questions, please feel free to call me at the above number. Sincerely, Stacy Str mberg Planner C-02-53 _ _ C[ZYOF FR[DLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287 July 2, 2002 Joyce Aanestad 6670 Channel Road NE Fridley MN 55432 Subject: Paved Driveway Reminder Dear Ms. Aanestad: This letter is a friendly reminder that all driveways within the City of Fridley need to be paved by December 31, 2002*. As you are aware, the City Council adopted an ordinance declaring gravei driveways a public nuisance. They were declared a public nuisance for a number of reasons, such as: they can cause erosion, contaminate soil with oil and other vehicles fluids, and deposit soil and gravel in the City's storm sewers and detention ponds. When gravel driveways were declared a public nuisance, the City Council gave property owners five years to have their gravel driveways paved. The five-year deadline is quickly approaching, which means all gravel driveways within the City of Fridley must be paved with approved concrete or asphalt by December 31, 2002*. If you've already paved your driveways, thank you! Please call me at 763-572-3595, so I can update our files. For your convenience, a brochure on the City's loan program has been enclosed. You can use this loan program to acquire financing for your driveway improvement project. Please call Jim Hesnik at 612-335-2651, if you have any questions regarding this program. Thank you for your cooperation! As you successfully complete your driveway improvement project, please call me at 763-572-3595, so I can do an inspection of your property and update our files. If you have any other questions, please feel free to call me at the above number. Sincerely, Stacy S mberg Planner *If on December 31, 2002, your driveway hasn't been paved a citation will be issued and filed at the Anoka County Courthouse. A misdemeanor citation is a criminal offense and is punishable by up to 90 days in jail and/or a$700 fine. C-02-83 _ _ CIIYOF FR(DLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287 February 7, 2003 Ms. Barb Aanestad 6670 Channel Rd NE Fridley, MN 55432 Re: Final Inspection at 6670 Channel Road NE Contractor: Homeowner Dear Ms. Aanestad: Plumbing and Mechanical permits were issued on May 9, 2001 for fixtures and a new furnace at your address. According to Section 4715.2800 of the State Plumbing Code and the 1991 Uniform Mechanical Code, a final inspection shall be conducted on the work authorized by these pemuts. As of this date final inspections have not been requested. The permit fee that was paid covers the inspection to make sure the work was completed according to the Codes. We will keep your pernut open for another 30 days and if we do not hear from you within this time to set up the inspection, we will mark the pemut "no inspection called for by homeowner after notification" and take no further action. To set up the inspection or to have any questions answered, please conta.ct the Building Inspection Division at (763) 572-3604. DJ/mh sue�ec. P N O. City of Fridley 32 9 3� AT THE TOP OF TME TWINS g U I L D I N G P E R M I T � ; � O. � ; y _ �� COMMUNITY DEVELOPMENT DIV. �� r i � PROTECTIVE INSPECTION SEC. � .1 � � 1 /"'1 � CITY HALL FRIDLE� SS�1�2 NUMBER REV DATE PAGE Oi APPROVED BY �'"""� � ��' 763-571-3450 910-F15 7/26/02 / / JOB AODRESS 6670 Channel Road NE 1 LEGAL ��T NO. BLOCK TRACT OR AODITION SEE ATTACHED DESCR. 2] Parc 1 1340 Brookview Addition SNEET 2 PROPERTY OWNER MAIL AODRESS 21P PHONE Joyce Aanestad 6670 Channel Road NE 763-571-0164 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO 4 ARCHITECT OR DESIGNER MAIL ADORESS ZIP PHONE LICENSE NO. 5 ENGINEER MAII ADDRESS IIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CIASS OF WOfiK ❑ NEW � ADDITION O ALTERATION O REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Construct a 14' x 32' and a 24' x 7° Deck 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plax�. Footings poured before inspection. e .� - � R � � � ,.,_ �efor� cligging call foP all utility location� 45A�-0002 �� TYPEOFCONST. OCCUPANCYGROUP OCCUPANCVLOAD SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. fT CU FT AUTHOiiIZED IS NOT COMMENCED WITHIN BO DAYS, OH IF CONSTqUCTION OF WOqK IS SUSPENDED OR ABANDONED FOii A PERIOO OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED NO DWLG. UNITS OFFSTREET PARKING I MEREBY CERTIFV 7HAT I MAVE READ AND EXAMINEO THIS APPLICA710N 1 STALIS GARAGES ANO KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS yq�UATION SURTAX AND ORDINANCES GOVERNING THIS TVPE OF WORK WILL BE COMPLIED @ WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT `Y7fOS�F $3.S1F DOES NOT PRESUME TO GIVE AUTHOR�7Y TO VIOLATE OR CANCEL TME pEqMIT FEE SAC CHARGE PROVISIONS OF ANV OTHER STATE OR LOCA� �AW REGULATING CON- STRUCTION OR TME PERFORMANCE OF CONSTRUCTION $153. ZS Fire SC � J.O8 PLAN CMECKFEE TOTALFEE 63.87 S�GNATU�7E CON7pACTOA Op AUTNOA4E0 AGE r iDniE� EN FOP ALIDATE TMIS IS VOUA PEpMIT `� �Z �� -- . � S�GN4TU�7EO�OWNEA�� OWNEABUILOEp� IDA i B�D �NS� rFiE NE1N [ ] ADDN ( ] a�.rER II Cohstruction Address: Legal Description: CITY OF FRIDLEY 6431 Universiiy Ave NE, Fridiey, MN 55432 SINGLE FAMILY AND DUPLEXES R-9 AND R 2 BUILDING PERMIT APPLICATION � C�I�c� r� n� Effective 1/1/2002 (763) 572-3604 Bldg Insp �- r�� y � Owner Name � Address:��i C � �ol.l�ii,�.s,,`(' CR.C� Tel. # � � � � � �"� o � � Contractor. � r�yVl� MN LICENSE # Address Tel. # LMNG AREA: GARAGE AREA: DECK AREA: o-rHeR: Attach to this application, a Certificate of Survey of the lat, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft Length Wdth Height Sq. Ft Length� Width �Z HgUGround Z-�'} Sq. Ft �� Z 7 , t��a � �n �� l� k'�1l sd � Construction Type: Estimated Cost: $ � �� Driveway Curb Cut Width Needed: Fi + 6 Ft = Ft x$ _$ DATE: APPLICANT: Tel. # Call (763) 572�604 for Permit Fees if mailing in appiication or Fax to 763-571-1287 if using cred'at card and we wiil call you for card number. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL CITY USE ONLY - $ ✓"j 3-�� Fee Schedule on Reverse Side $ �o C�� .001 of Permit Valuation (1/10th%) $ �• 5S' $.50/$1,000 Valuation $ $1200 per SAC Unit $ $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Ait. "B" Above $ $450.00 Conservation Plan Review $ . Fee Determined by�Engineering $ Agreement Necessary [] Not Necessary [ j �s i � STIPULATIONS: 0 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 e�sting building or structure, upon applicaxion 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 tawit: TOTAL VALUE $1 to $5(m $501 to $2,000 $2,�1 to $25,000 $25,001 to $50,000 $50,001 to $100,(l00 $1�,001 to $500,000 $500,001 to $1,000,0� FEES $23.50 $23.50 for first $500 plus $3.05 for each additional $100 or fraction thereof, w and including $2,000 $69.25 for first $Z,�O plus $14.00 for each additional $1,0� or fraction thereof, to and including $25,000 $391.25 for first $25,000 plus $10.10 for each additional $1,000 or fraction thereof, to and including $50,000 $643.75 for first $50,0(� plus $7.00 for each additional $1,0(� or fraction thereof, to and including $100,000 $993.75 for first $100,000 plus $5.60 for each additional $1,000 or fra.ction thereof, to and including $500,000 $3,233.75 for the first $5�,� plus $4.75 for each additional $1,000 or fraction thereof, to and including $1,OOQ,000 $1,OQ0,001 and up $5,608.75 for the first $1,(�0,000 plus $3.15 for each additional $1,000 or fraction thereof DRIVEWAY DEPRE5SION.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 he 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. • VERIFICATION OF FOUNDATION A Cert�cate of Survey of the lot, showing the location of the existing founda.�ion v✓ill be required befor� proceeding with the framing. New Houses Oniv � �. - : �. ,'�. ♦ _ _ . .__– - ---- - �–�—� - � • 1 1 ' I 1 1 � ( . 1 1 ' .a '. �'' �8 . 1 � ��i ' i ,30' , , � � ` � � las. � v° , . : , . , . ,. �.e;;,. - , � : ... � .. . . � . y .. . t. • �� •. � ' , . . . �a,'.i 1 r ,`�i!'r i�a„, ♦ �7�1ST�MlN�rv� ; i� ' � 1 1 � a �, t !. 1 1 � �� - ' - . ' � ` � t . t.__. . � � � -7 �� .._ �:, �-�� - ��z � iY t z � � . __ . ,� �c't� � � ;+�J� '�� C�°�i�� , f ►�C%� j{-� �2 S 1 Z� '' � C- i y V� i�L �� r f� �� -� _ �._ _..._..__ . . _ _ �'�P �d�it.1 G�� PC � i .� � �� z L � S �r� � j �,! � = C� IC �� 'eS' � �� S Pr� � . ��G LVi � y - ' �= ��e�� ;.� i ��i Sc.� � S�i' ? F��r'� � C-��:4,� c,�►��v �:S_�---� , ..., - � ,` E�'t!�'� S ��ZC �' D�t ill �� 2�C � G� ` S J _ .. ._ �.�__.__.__ - -�- �.. . �` . _ _..._ -- - _ _ _ ._. _ .. . . _ . � � i S r S�� c 4 S_�� t' �, ZV C�- = '�. ic ��' S ��;� �'� C, . _ ___ _�.�� ':_1"�'.��OS =._� .__ ��r�i�' ._��(' _ 1��-r�l� � ��P� Z` o�f�-' ��cyb _.__.-� ..._--- _ _ _ . . .. �''C��LL j�L i� j�{�i" �' �� f�'i �r� = �/ Z �' i�l � G�=1f ;, .. -___.�.. $� _, -----_..._ _.. _ --- - �`�`�`�k i,� — ---- - - -- _ . . . _ ._ _ -_ _._ _ _. , ... .: r ti-- _._.. .._.._�_...____. _ ...._..._� _ -a. ___.._. _ _ ;f�,~__ .. _ _- ---_.. . ------_?i.'_��' ..._ _ . _ _ . __ � . � i� _ ' ... �' � � � � -- - . ��--- �� / PLAP! APPf�t)V`�n SUBJi:;,.T �n ; �:_�� tP1ti� ::�T,��`�� P'� �^ ;,�e�: (`�(� \ fii_ l.aJ Ll� �.�1� . d 1 �� . _ _. ^r.�. _ _._ .. . _ ___ 1..�..�.,_ -� p � f � ... _ � .�� f � _ � _., _ . _ � � �'� i � — V .... . _. i ` � . . _ . � ..... _... i � �' � �� ..� . ... 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S.. -. _. .. i—�.�. � .... . ...._. ......_.�,_...�.'_"__'__'..._�...._._._ ...... .... ......�_..._-._�. ��.' ... .... ... -"�"...�... .-. ....-..�.. •� � � � � � � O � `°_.. _. ___. _ _. ._ ... _ . .. .._. . _. �i _..____.�.... _1_ r-.-.__�, . � . . �� a ,� � � ... . _ . ..�. r� � .��____ ______ ___ _ __ ._ _ . �. _ � . ._..,� ._ _ � ,� � ��, � �'�-�'�N `�'�� ._,_.°�V _ I�.. _.. � . ��.y1��._.. _. . ... � � � . ..__._._ �.�--- -......_.,_.. .. , _ ._. _.... ..__ `- .___ . _.._.. . � ._ ... _ . . .. .�. _ � � � � , � . `, � � . _ .__� _._.____.._ �___ �.____� . __ . � _.-_ ._�_ _ _._ _� _ �` .. __._ �.__.. �_ �_. ��. _. � r � � � � � -_. � .�_.,__�_._�__._^..�.�._ .__� �'�'__. ..;.._. _.�....__ � . _. � ._.�_.__ _1- � ; '� �' � �- ' � � � . . � � + ___ � ._.____.._..__._._.__..� _._____.___._._ . .... __ ! ... d �,, �... _.. � �, ..� �, � � � � �. � ' �,.� � �.. .�._.___._ __ _ ._ ._�.,,...__.. � �, � �. .�� .-:__._��_ ____ .. _ . �. � � ► � �. �, ._ . _ _.. � x � � ��.��...___ ._. _. _ _ __ _ _. _ _._ I ` � - . X . �, . --,_____. _ ___ _ _ ___ .__ � � �____._.___. ._�__°�.,,. . _ .__..__ ---- ._ ._. � __ ._ _. , ��4 �� J S ! 01 X,z , � 1- . ��.. -_ .._ . �--� � �- . � �� _- .____� � . .�� . _� __�, . E�gi�eering WATER AND SEWER Permit No.: 763-572-3551 pERMIT APPLICATION Received By: 763-571-1287 fax CITY OF FRIDLEY D�� EFFECTIVE 6/9/09 APPLICTATION DATE: ``" l 3�� YOUR E-MAIL ADDRESS: _, THIS APPLICANT IS: ❑ OWNE �OATTRACTOR(� - � JOB ADDRESS: �� 10 ��.NO ti �.,� t`a`- �1 � C a � NEW CONSTRUCTION PERMIT�! (IF APPLICABLE): PROPERTY N�: (Z,� .= ��' OWNER/ ADDRESS: O �. CITI� �Cti l�i �+� � STATE ZIP TENANT PHONE: �I�� °.�1? l^' P� [ L�f CONTRACTOR N�: `�"O �S � �' °k�t✓�°�l� . SUBMIT A COPY OF �DRESS: (.� 0 !`o n�..P �' � CITX Lo r+—°� � ` STATE��IP. YOUR STATE LICENSE WITH PHONE �I/�� °-� CELL PHONE: Co� ��:��° �oiZB � APPLICATION STATE LIC # � STATE BOND: F�' DATE: �/�-3, 0�� g L Narrative/written descriptions � �i�1. n l�. � �.� dlc. " a. e� I r � � 2. Please aitach sketch showing curb line, utility tine, building, etc. with distances. PERMTT TYPE ❑ SEWER CONNECTION PERMIT $50 ❑ WATER CONNECTTON PERNIIT $50 ❑ WATER LINE REPAIR $40 � SEWER LINE REPAIR $40 '� O • � � ❑ ADD STATE SURCHARGE $.50 ❑ SAC CHARGE @ $2000 = � �Os � 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 / wEExENDS & xoLIDAYS $125/HOUR-BILLED TFiIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED . I hereby apply for a water or sewer (new connection or repair) permit and I aclrnowledge that the informarion above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley. I understand this is not a pernut but only an application for a pe ' and work is not to start without a permit. SIGNATURE OF APPLICANT PRINT IdAME: �� uN� DATE: J'°�l 3�' �� APPROVED BY: � �`�l DATE: I�^ I 3-d q COPY GIVEN TO: o u�riLrrY Bu�Lnv (only if new meter) ❑ PUBLIC WORKS � ENGINEERING City of Fridley Engineering Department 6431 Uruversity Avenue NE, Fridley, MN 55432 763-572-3551 FAX: 763-571-1287 �'�'1'� � � /2°�' �� -�/ � / � M i ` ( �#� el' I y. +�'� �.e - i� 1 � i .. �..�$ .Y �,� (' _ - • �� , .. � . 1 � \ �� av X _ 3 � i .�. � 1 I i . M : � �� ° - ', ; : � �, +" ! h .: _; ., ,-�e . X J :�: '� p' f : �. . , , � . , �� ..- - , _ �,i , �. ' . . - - "- �:." . .' , ' ,. �, ` � ,. ,' ' . . ' ' C ' �� '':.: '. � :. _ � � � � 4 . . .� . . � , .a , _.. ., - � _ 4 , _ . _ , . ' . ` .. . � + 'l , . + � . . -. . � , r i , � - ' . ' � F + _ '�.: � .. � . :� . ..��r..� , , . . I� � ^ �� ," ✓ � , I j� . �+' � _ : � �. �� A�� . �:' a ,is�'. S� � � �i�� , i i f '� ° .��:. _ � � � K � � g �� I � iY � l I t ' , ` c :.'. ,... , � � , n . .,. . � , ' , ;;. } ., . , , ',.. , , , . '. 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