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":. � ' � ' � ;��• . ��"'`t�3"3' .A�1�T� ��3R� �A��.. : ,' I� c��a#�n. exf ihs�N#�t�ee �d t�'�- #� �e � t:�� I?�pec�ar �#`=;� ; i � y �.� �f , �e �� , I � � � '� ��d vvti�k i� ' ��+r� � � ` �irs � � a�td �` -�a:�e prov�o�a s��'t� r��+t�f�a�tr�s � ' ' � �s b� � : �i �«tiy �ar,�t++� si�l �� •� �e � � � � �d ,��,-i� �;a'� ; � � �.r , ��ss ��?k� �� :: � , ._ �., , �.: •� � . �, , , 4 U_ , : ,. _ , � ., . . � , . ..� : � � . . . ' , ' e Y ,' 4, , � ,� . .. . ' ,. ." F . � � . ' . ..: � -' � „ : � � ' �"�.. . . . rv ... , ._. -,'� y. _.' v , , - ... .,: . � ,: . . . ,�; _ . . :. . .._. , . , �' ..x �. . _ . .. , � � . ...�� . ' . ,. �- . .g. . � �'� � �� ' � �rr� �+�rr�. � '�� r �� ' � � ,� ;�. � � i � �s�i tr� y„ f � ' ; �� .:j � �nff�t. � ° r� ;; �'p � �� } S� '�I f � � � � k 7IS - ks s^ '� � f: � 4 4 3 3 x , . � . .. �-'.�r . . _ . .. . , . ��,'' ` . . _ . .� .,_ , .. . . . . � � e ;:. . _ , , ..�:; � � �� l.�� '�.��*� ��. ` ��JI�LIQ�TG ��I'T �T° 59� : : _ a�� a��cc�raR a� ��u�� , awr��r Arch4tect Frid'_ey, 112inn., �� i��l��` I3tiIder �� , I.C?�A'yi 1�T O�' BLI�I.I7II�� , Na_�'�� Street Part of Lot Lcst ' Block Add�iion vr Sub-Dii+iaion ': ��CF��"�`��l°�T G?<' BT.J�LDING t �t t Front� Depth� �3eight�, Stories_ � 3d�er af Const��.ctio� µ ; To be used as �s� To h+e carnpleted�/ '" �r� E�titnated Cogt ��„�- ' �- + Permit fs hereby granted to t4 __±��__��^� �� ' the .buzldin� � dascribecl in the abcaue sta`temea�t. T#�s germit i� gra�ted . upan t�e express �ondition that the person to �vhom it is grazzted, and his ag'euts> �mplo��es a�c� w�rka3�� - u► �,II ; , tfle work done in, around and u�on saic� intiiciing, ar an,y part fi.he*eaf, shall eo�form iti �,11 reSpaets �o �te ordi- nances of Fridleyx Mina,, reg`arci3ng the consiruction, alt�rtst!on, maintenance, rep�,ir and mov4ng o€- b��ngs Cvithin the citq Iimits, aud this permit m�y be revoked ai any time txpon violatSon,aP any af tfce provdsions �� sa.f�i ars3in€€�nrees. �� !��._._.�speetor tif Buildfr�gs. ` AGREL1l2Ei�7T �1P� �Vi��PIV STF�TE+ I�YFNT In eonsidera`ti�n of the issue and delivex� ta r�z� hy th� In^�eeio�° s�f L��i�d�n�s a€ Fr�dley of the a,bov� pernzit, I her�k�Y .�gree to do th� prQt�c��e� �rork ?n �:e;eorc�a�ce �ith �I�.e ,`��serx}ation a.bc�ve set fartT3 and acc4rding to the grov`tsion� of t��.� oa°d'an��?ce� �f F"�i.c�?e,y; ar�d, k�eang first duiy : s�'orn, I�ereby �tate a�d sa� i,Yaat the °facts �#�iedl bJT me c� coa�ta,azz izs th�'' �.ks�ve ge�mi� are t�rue a� t��rein �tat�d: ` � . ! ;;. � �� Srtbserib�cl and: sworn to beiore me at Frfd�.ey, r��x�e�at�., `�h; `� ii�y� c►f � � A.D. 19�. > �� . , �. . : �� , t��;� , , , - �",�a�„o�,�;� ,� � �,� ,��.� � �� ,��•��'� � � +� � �� < ,;,�. � �+�el�%��8� � ��" �& �y � _ . , � �� K. ,. � � �. . � � � .;� ._ , Y:.�.. �_ . dr,} . :. .. . . , , . . F � - � fF , � � ' � City of Fridlep, �nn 6431 Univeraity Ave. 1�. E., Minneapolis, Minn. 55432 BUILDING PEl�.MIT ��: June $� 1972 �� Leslie �o Erickson B��r Same 6675 Channel Roa ,A� Address �. LOCATIOIV OF BUlLD1iNC �0 6675 s�t Channel Road p� of Lot � Part of Lo�� Addition or Sub-Divisian �uditor's Sub ��21 Corner Lot Inside Lot x Setback Sic}eyard . 8ewer Elevatian Foundation IIevation �— � �, �� , DESCRIPTION OF BUILDING To 't� vaed as: Porch �ont 16' �� 12 � Height 10' �. � 192 �� 1920 Front Depth Hei�Y►t Sc1. F� Cn. Ffi. �� Wood Frame �� 1200. To be Completed 8-15-72 . - �t considerai3on of the issuance to me of a permii to �te proposed work in accordance with the description ai� prdinances of the dty of Fridley. ,� e bnilding described above, I agree to do and in mplianc wi all provisioz�at of e � . � .f0� � � a�,► �. il � � ��.A1A / In con$ideration of the payment of a fee of $ 9. 00 �� hereby granted to Les li,e Ericks on to construct the building or addition as described above. 7'his permit is granted upon, the express condition that the person to whom it 3s granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects •to the ordivances oi i�'ricIley, M3nnesota, regarding lacation, construction, alteration, mai.ntenance, repair and moving of build3llp a� th�e� city 33mits and this permit may be revoked at any time upon violation of any of the pmvisions oi 8aid ��S � CL�SBENCE B�ZgSLE NOTICEo 'fl�is permit does not eove� 4he eonstrucHon, inatallatioa for wiafne, plumbin8, gas heafing, sewrer or water. �e wro to oes ,� ffie Building Inspeeta� fo� separate pernuts for theae items. .� APPLICATION FOR RESIDENTIAL, ALTERATION, OR AllDITION BUILDING P,ERMIT CITY OF FRIDLEY, MINNESOT � fI'�� t�e �1. Ir� �o CrY� } , ��'�'`� owivnt.'s r1at� :�2g I 1� �-� �r i � ��e,,v BUILDER: � � . ,_ ms �D�SS : (� co�s� .�� ,� ��. �D�SS : � .. NO • � S TREET : � In v► o � �A � � , , .. .,: LOT : BL�K : ADDITION :� Iitd I� 1� S[t� I� �� I a� o , CORNER LOT: INSIDE LOT:�_SETBACK: SIDEYARD: -----n--g� Applicant attach to this form �tao Certificates of Survey of Lat and proposed building location drawn on these Certificates. ➢ESCRIPTION OF BUILDING To Be Used As :�Gre�✓v�P/d 1 e 1�C�li�- � Front : � �P �� Depth • � Height • � {- . Square Feet: Cubic Feet: �� U.t,-r 0 p Front; Depth: Height: Square Feet; Cubic Feet: �pe of Construction: ►�86� �Y�rnQ� Estimated Cost: $ �, OTJ To Be Completed: L — � �tpY►,�'l� The undersigned hereby makea applicativn for a permit for the work hexein specified, agreeing to do all work in stiict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hexeby declares that all the facts and representations stated in this application are true and correct. . DATE : �aev�r � _ � �� -- S IGNAT[TRE • ^ �� (See Reverse Side For Additiona.l Informa.tion.) �, � ° ��-�' �� . .. '� �. _� �. ��°� �►' � / � 0 BUILDING PERMIT FE�E SCHEDULE SECTION 2. The Inspector of Buildings shall, before issuing p erection of any building or structure, or for any addition to building or structure, or for any alteration or repairs to a.ny building or structure, upon application therefore9 require �fln� applicant for such permit of fees to the amount h��ein be��w � the manner herein prwided to-wit: UIVIFORM BUILDING CODE : Type 1, 2& 4-$2 .15 fog eacia one iciao feet, or fraction thereof, in such cubical contentso �rpe 3& ��ch one thousand cubic feet. ADDITIONAL INFORMATION its for the ex is t ing isting y��a� �y �he ��a ��a� �� nd'cubic - $1e�5 for For the purpose of computing fees for building permits, the cub cal contents of any building or addition, is determined by multiplying the � ound area covered from a point six (6) inches below the floorc lin� of the basement �� he cellar to �.he av�r�g� heights of th� uppeg suxface or t� the average ��igl�t of th� roof suxface of the main gabl� of a pitched roof. For repairs or alterati�ns to an existing structure, the fee rate of $3.00 per each five hund�ed dollars ($500.00) or frac the cost of all proposed work. In uo case shall the fee charged for any permit as set forth in less than $5.00. VERIFICATION OF FOUNDA'I'ION 11 be at the n thereof in Section 2 be NOTE: Permits for construction will be issued a minimum of 24 ours from the time of application, to allow for proper review of the proposed structure and of the cons�ruction site. A Certified Survey of the lot, showing the location of the fo has been constructed, will be required before proceed.in� with CERTIFICATE OF OCCUPANCY ion, once it framing. Application for a Certificate of Occupancy shall be made ten (1 ) da,ys prior to the use or occupancy of any structure for which a building p it has been issued; and said structure shall not be used or accupied until Certificate of Occupancy has been isaued. a � e a [ � � � � �.I N � � , ! � c� �-~ �r. � � ' � � . °� `�� , ��J �- �_. r� �- �-�. �,� � � �, --�, c.� � � -r o c�'�___� � �� .~"`� � . � � � ---�y. t� � � � �� t� � -r� �' G � � T' � � �.� �U' '� . � �_.______. _��._.�_ _ _.___.._______.__________________^____ ...._;� � � . ____ _ ., S � �1 T � � � � ��" �� 11� �,.�'" fv � . � �� , . ---�_. . _.__._ . • � '.�� ___ _ _� ___.______w____ ,�, '� �,�� -� . r__._:� . , � �. , _ t . y.. \ •� .�-��-....�.-,l r .,-.�-_..� Th�� ;�zr¢ �� ¢<<� ��1�,� ��. . > ;=- �t, i°�'�� "' '� � ` of �he � �'LrJ �� °�a�,�. � � J `s.: V�. t ; ' /yi�� "�� e� ��` ,'��o�� '' - �� - ff. rf��°�� . � � r' ♦ � � /6�' �C� �O �(o� f""".'1 j " °`b ti�.��..�., ° �i ; E' .. -�� y - � ,�;(r . .. _ ��.�.,..►a:i af��_.�.� -�`a.1 � � � , , � ) �, ��j,, }� . �^^9 }\ z "-�.�". I i A..+�L + '-,� � ba..v ... ---P�-----� - �_____-_-=- _.$eA�� =t�'s0� �. ! � �T'r�� `✓ � � � �• , , �-;� , �^, � i`°`: � �' : a � 1\_/' / 1+ / �'.�_� / /• � �. .� a4-�'�° "'\ d'Po�r` d .i 0 �: G � �! �� ' � �- . /�' i -_ � . _' ��;,:�._ �._____ : _ ,.. . �; �°._. `� �, ..,..,—...r f� .. m ..•, • ' • • ,' " � , _. • � ' %-"� .� � f a .. Y .. - , • ' f ' ... � • `� . . � � . i t . . ' . / _.�, .. ( � � . . � ...,"'iI . � 'J / . . . . �. r _ '�`. .� d� ,r„�r.-• ......_. B i < ' • ' i t _ •� .r� f. -7- � t ! V. � • f� -_. r.,. � _.y. ' ;z�— t . : . - ♦ . , ..�. P , . .. _ ' i � . . .. ' �. '. �► ? sue�ecr PERMIT NO. City of Fridley �-- 7 4 8 2 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T -� r � ' RE � � � • COMMUNITY DEVELOPMENT DIV. , ; � ------, /�g� � r � � PROTECTIVE INSPECTION SEC. �. . , . � � � /'�"1 � CITY HALL FRIDLE� 55432 NUMBER REV. DATE PAGE OF APPROVED BY �""-'� � ,`� 612-571-3450 910-F15 5/4/84 � � JOB ADDRESS 6675 Channel Road N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED oescR. 40 (1120) 5econd Rev. Aud, Sub. #21 SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Gordon Chivatero 6675 Channel Raad N.E. 571-1337 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO. Same 4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW O ADDITION C� ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Install asphalt roo�i.ng 9 CHANGE OF USE FROM TO • STTPULATIONS Roo,f ca,n lae the 2nd layar but nat the 3xd. znstal.l ridged galvanized valleys. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR Alfi CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. 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 OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION �- STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED �`].�].OQ �.55 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $`],9.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL�g� • SS 1 SIGNAT F CON' C AUTHORIZE ENT IDATEI WHEN PROPER ALIDAT D THIS IS YOU PE MIT S� � �� a REOFOWNERIIFOWNEFBU DERI IDATEI z,,.� �.:SL�G INSP DAT NEW [ ] ADDN. [ ] pLTER. [ ] City of Fridley R-1 AND R-2 Building Permit Application Construction Address: ��%� ��`%�� /� � Legal Description: Effective 4/1/84 Property Owner/Address: .-s��' ��".�`� `-�o�° L�/�'�� Tel. #��/�3� Contraetor: ��g Tel. # Address: ��'�� Attach to this applieation, a Certificate of Survey of the lot, with the proposed construetion drawn on it to seale. DESCRIPTION OF IMPR09EMENT LI9ING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECB AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Corner Lot [] Inside Lot [] Ft. Yd. Setback Side Yard Setback Type of Construction• ��9�� '� Estimated Cost: $ !�� U Approx. Completion Date: Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: � $ See Baek Page for Explanation . �Y i'l 0 �'" APPLICANT • �s°�'��'' Tel . ��•�,�� DATE. Permit Fee Plan Check State Sureharge SAC Charge Park Fee SeWer Main Charge TOTAI. STIPULATIONS: g I�°-�� $ $ ��J $ � $ $ �9-SS- CITY IISE ONLY Fee Schedule on Reverse Side 25� of Building Permit Fee $•50/$1,000 Valuation $�125 per SAC Unit Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] �,. � � �. � [] City of Fridley Effective 4/1/64 ADDN. [ ] R-1 A9D R-2 �,Tgp, [ ] Building Permit Appliaation � Construction Addresa: ��75 G�i4ivN� L- � f�� Legal Desaription: Owner Na�e s Address: ��o�VO+�° ��I�A%�c'd 6G � cf/AHn�h6- �D_ Tel. #� 7/�� 337 Coatractor: �-� Tel. � Address: �f-=- LIYING AREA: GARAGE AREA: DE_: OTHER• Attach to this application, a Certificate of Survey of the lot, With the proposed eonstruction draWn on it to scale. DESCRIPTI011 OF II�iPaOYBMENT Length � Yidth � Height � Length Yidth Height Length iiidth Iigt/Ground Sq. Ft. � Sq. Ft. __ Sq. Ft. �U� �P , d � � �� .� '� Corner Lot [ l Znside Lot [�J Ft. Yd. Setback Side Yard Setbaek Type of Construction: ��'"'"� ��'""� Estimated Cost: � �'" Approx. Completion Date: � — �s— s � 'Z,d d Alt. A Alt B Proposed Driveway Width If NeW Openiag Is Desired: � � See Back Page for Explanation DATE: APPLICANT: Tel. # CITY IISE OpI.Y � Permit Fee � �'�� Fee Schedule on Reverse Side � Plan Check � �� +�� 25� of Building Permit Fee State Surcharge � �•� � �•50/�1,000 Valuation 3AC Charge � �425 Per SAC Unit Park Fee a Fee Determined by Engineeriag Sexer Nain Charge � r�� _ ��e�� Agreement Neeessary I] Not pecessary [] STIPULATIONS: BIIII.DIBG PBRMIT FEE SC88DIILE The Chief Building Official ahall� before iasuing permits for the erection of any building or structure, or for any addition to any euisting building or structure� or for any alteration or repair to any euisting building or structure, upon applicatio n therefore� require the payment by the applicant for such permit of fees to tbe amount herein beloW aet Porth arid in the manner herein provided to-r�it: ?otal YaluaLioa =1.00 to ;500.00 Feea �10.00 (l�Iinimum Fee is �15.00) �501.00 to a2,000.00 �10.00 Por the first �500 plus �1.50 for each additional �100 or fraction thereof, to and including �2�000. �2,001.00 to �25�000.00 �25�001.00 to �50,000.00 �32•50 for the first a2,000 plus a6.00 for each addiLional �1�000 or fraction thereof, to and including �25,000. �170.50 for the firsti $25�000 plus �4.50 for each additional �1�000 or Praction thereof, to and including �50�000. #50,001.00 to a100,000.00 �283.00 for the first �50,000 plus a3.00 for each additional �1,000 or Praetion thereof, to and including $100,000. �100,001.00 and up �433.00 for the first �100,000 plus �2.50 for each additional �1,000 or fraction tbereof. DRIYEiiAY DEPRESSION ESCROfi (Concrete Curb Streets Only) . Alternate "A": Removal and replaeement of curb and gutter only - Driveway �ridth 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 - Drivexay Width plus 6 feet times �15.75 VERIFICATIOA OF FOIINDATION Permits for construction xill be issued a minimum of 24 hours from the time of application to al1oW for proper reviev of the proposed atrueture and of the construction site. A Certificate oP Survey of tbe lot, sho�ing the loeation of the foundation onee it has been aonstructed Will be required before proceeding With the Praming. ��u� Z� G � ��e� �� p �I�•� � � _ ...r . _ _ : -.o��_� _°_ .___._,..f��,:.. � _r� ,, �-�:,--�- m° - F �'-.: ,r, ��sE ; „ - �a .." . ...- _._,w:., _ . �«-F�k�� PC x Fy,2 .�§' y�,- � f tier�� i ,�'... 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City of Fridley o� 18848� AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r S � RECEIPT NO. � `L _ COMMUNITY DEVELOPMENT DIV. �� r � � PROTECTIVE INSPECTION SEC. 1 ` � � �"�'1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY �""'� � �`� 612-571-3450 910-F15 4/1/87 / / JOB ADORESS 6675 Channel Road N. E. 1 LEGAL LOT NO. BLOCK TRACT OH ADDITION SEE ATTACHED DESCR, g� 2nd Rev. Al1C�.. Sllb. #21. SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Gordon Chivatero 6675 Channel Road N.E. 571-1337 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIC3NER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW X ADDITION ❑ ALTERATION ❑ REPAIR � MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 226 s. ft. Deck 9 CHANGEQFUSEFROM TO STIPULATIONS �A��f�� Befoee digging ca911�ca1 ��tk�� TELEPHOt�� - EtEGT�i� m CAS �� RE��1�� ; ,.. SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATINC3, TYPE 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. AUTHORI2ED IS NOT COMMEbCED 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. OWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAYE READ ANO EXAMINEO THIS APPLICATION �- STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND.ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $�-iSSO �X� `�%$ OOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE PqOVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $ZFi. rJO PLAN CHECKFEE TOTALFEE $ 6.63 $33.91 SIGNAT F CON7RACT0 U' ORIZED ENT � �DATE� � WHEN PROPERLY DATED THIS IS YOUR ERMIT � . � SiGNaTUREOFOWNERiIFOWNERBUILDERi iDA7Ei BLOG INSP � ( � nATE NEW [ ] ADDN. �,T�t. I ] Construction Address: Legal Deseription:_ Owner Name & Address: Contractor Address LIVING AREA: GARAGE AREA: DECR AREA: City of Fridleq �R-1 AND R-2 Building Permit Applicatioa � Attaeh to this applieation, a Certificate of Survey of the lot, with the proposed construetion draWn on it to scale. DESCRIPTION OF IMPROYEMENT Effective �/1/86 Tel . � �� Length Width Height Sq. Ft. Length Width Aeight Sq. Ft. Length Width Hgt/Ground Sq. F�. ,� OTHER: �'J o = ' Corner Lot [] Inside Lot [] Ft..Yd. Setback Side Yard Setbaek Type of Construction: �e� �I� �� Estimated Cost: $ '�°""` Approx. Completion Date: � � �� Alt. A Alt B Proposed Driveway Width If ATew Opening Is Desired: $ $ See Back Page for Explanation DATE: APPLICANT: Tel. # CITY USE ONLY Permit Fee $ � b.� Fee Schedule on Reverse Side Plan Check $ -�d ��v� 25� of Building Permit Fee State Surcharge $ $.50/$1,000 Valuation SAC Charge $ �525 per SAC Unit Park Fee $ Fee Determined by Engineering Sewer Main Charge $ -- Agreement Alecessary [ ] Not Idecessary [ ] TOTAI. $ STIPULATIONS: ,d �V /�6d �v� � � � .S , l � �`�,.��.:;- � c� �� , lU. Ov BUILDING PERMIT FEE SCHEDIILE The ChieF Building Official shall, before issuing permits for the erection of any building or strueture, or for any add3tion 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 applieant for sueh permit of fees to the amount herein below set forth and in the manner herein provided to-wit: Total 9aluation $1.00 to $500.00 Fees $10.00 (Minimum Fee is $15.00) $501.00 to $2,000.00 $10.00 for the first $500 plus $1.50 for each additional $100 or fraction thereof, to and ineluding $2,000. $2,001.00 to $25,000.00 $32•50 for the first $2,000 plus $6.00 for eaeh additional $1,000 or fraction thereof, to and ineluding $25,000. $25,001.00 to $50,000.00 $170.50 for the first $25,000 plus $�.50 for eaeh additional $1,000 or fraction thereof, to and ineluding $50,000. $50,001.00 to $100,000.00 $283.00 for the first $50,000 plus $3.00 for each additional $1,000 or fraetion thereof, to and including $100,000. $100,001.00 and up $433.00 for the first $100,000 plus $2.50 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 replaeement of curb and gutter and install a 3 foot wide approaeh with 6 ineh depth - Driveway width plus 6 feet times $15.75 9ERIFICATION OF FOUNDATIOH Permits for construction �till be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed strueture and of the construetion site. A CertiPicate of Survey of the lot, showing the location of the foundation onee it has been eonstrueted will be required before proceeding with the framing. m � �� NI M � 0 �� , � � L � d � t� ��', �� 4� � _/ � ��. , � � f 1 �/ 70 `. k ' OA 0 � ,� �/ = � � . .\ ^ , f �'�. ��° � . .'. ;� � se `, '�. ` 1 �_ f�� _ r � � �� . .. 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' � � , � ( � ___ _ _ . . { , _.- - __._ ; � � , � -- - - , � ,�, �'� � ____.� .__ � : : ; � : ___.�_ .��1�► ��i ______.� _ _ _ . _ � : ; � I -- --- _ _.—____ f � ; i � j : � ; '� .-------�- 3 � � � , . � � ; , _. ____.____-_____ , ; ; � 1 I ; � � �, : . . . ; �.�. � -�-`��`�L�.� , � � . sue�ee4 � p .� c�ty of Fridley 3't 9 3 � AT THE TOP OF THE TWINS �� L D I I� G P E R n/l I T � � COMMUMITY DEVELOPNI�NT OIV. �72 3604 RE�° �/p/� . . � � � � PROTECTIVE INSPECTION SEC. � r , , i---.� ��"" �'� CITY HALL fRIOLE� 54432 NuM9ER pEV D�TE vAGE oi �pvqOVED Br t 612-571-34b0 91p-F15 6/25/O1 � � 10B ADDRESS 6675 Channel Road NE - t LEGAL L07 NO. 9LOCK TRACT OR AODITION SEE ATTACHED DESCR. 1}O Second Revised Auditor's Sub. ��'21 sHEeT 2 PROPERTY OWNER MAIL ADpR�,S$ ZIP PHONE Gayle Chivatero 6675 Chattnel Road NE 763-571-1337 3 CONTRACTOR MAIL AODRESS ZIP PHONE UCENSE NO Sussel Corporation 654 Transfer Rd STE 16B, St Paul, MN 55114 651-645-0331 1934 4 ARCHITECT Oii OESIGNER MAIL AODRESS ZIP PHONE LICENSE NO. 5 ENGINEER MIAILAODFESS ZIP PHONE IICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK � NEW O ADDITION O ALTERATIpN p REPAIR O MOVE • C�3 REMOVE 8 OESCRIBE WOfiK Remove existing garage; Construct a 24' x 24' Detached Garage 9 CHANQEOFUSEFROM TO STIPULATIONS See notations on plan. Provide a hard surface driveway. Remove all demoliton debris from site. ��' SE�a��AT� �E�f�� Before diggin9 cali for REQUIRED FOR: �� utility locati�n� ��uMa�i�G� a�o��s�� E �� 45a-0002 Q RED �Y L�11A� " TYP� OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS AqE REDUIREO FOR ELECTRICAL, PLUMBING, MEATING. VENTILATING OR AIW CONDITIONING. THIS PEFMIT BECOMES NULL AND VOIp IF WQRK OR CQNSTF;UCTIOM 20NING SQ. FT CU fT. AUTHORIIED IS NOT COMMENCED VIIITHIN 80 OAYS. Ofi IF CONSTRUCTION � OR WORK IS SUSPENDED OR ABANQON�D FOR A PERIOO OF 120 OAY$ A7 ANY 71ME AFTER WORK IS COMMENCED. ' NO. DWLG. UNITS OFFSTREET PAqKING I HEREBY CERTIFY THAT I HAVE READ AND �XAMIN�O TNI$ APPUCA710N 1 STA�LS GARAGES AND KNOW TME SAME TO BE TAUE AND CORRECT. AlL PROVISIONS OF LAW$ yp�UAT10N SUiiTAX AND ORDINANCES GOVERNING TMIS TYPE OF WpRK WILL 8� COMP�IED �11,243 �S.6O WITH WHETMEii SPECIfiED NEREIN OFi NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLA7E OF CAMCEL THE pEqMIT FEE SAC CMARGE PqOVISIONS OF ANY OTHEH STATE OR LOCAL LAW REGULATING CON- STfi CTION OR TME PERFORMANCE Of CONSTRUCTION �20�.25 Fire S�'. �11.25 ^ P�AN CNECK EE TOTALFEE �� ^��/9� Lic s SC 0 231.10 S�GNATUAEOFCON'aACTOpORAUT�O 2EDeGENT IOATE� H P VA�IO D 7MIS I�rV� ��D 0 S�GNniuAE O� OwaEA ��: pWtiER gu4b.Ep� �OATE� . ' OG� �NS� ' � q`TE N� Effective 1/1/2001 ADDN [� , CITY OF FRIDLEY (763) 572-3604 Bldg Insp ALTER [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMITAPPLICATION Construction Address: �r �i 5 C1it �c.�rl �_ l �. c� Legal Description: Owner Name & Address: (r a'��_ GGii �'�,i�@,y�� S Tel. # � �(�3--.5'71-�33r] Contractor: � a-� s s� ��/� 4 MN LICENSE #��'3 � Address:� "� h � v� s�'.@ � /Z �J 1 � � S'2� � fJoc_ w � Tel. # ��'i � �6,�' a�31 LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Attach to 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 -2�' I Width .Z�O / Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. � " �l�S.(�/4�� F��4� Construction T e: D�-�' �~ a r' 'v �� yp �, Estimated Cost: �`tf��, � , � Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: �'' � �/^ �I APPLICANT: J o � dJ �-{J ��! � Tel. # �/ � �/ S�C).�'.�� CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Call (763) 572-3604 for Permit Fees if mailing in application $ �(�9, �SFee Schedule on Reverse Side $ / ,� , � 5 .001 of Permit Valuation (1/10th%) $ �� ,�C� $.50/$1,000 Valuation $ $1150 per SAC Unit $ �e� $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above E: $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [] Not Necessary [] �li�� STIPULATIONS: � �� , l� ti BiJII.DING 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 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 $100,001 to $500,000 $500,001 to $1,000,000 $1,000,001 and up 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 $14.00 for each additional $1,000 or fraction thereof, to and including $25,�0 $391.25 for first $25,� plus $10.10 for each additional $1,000 or fraction thereof, to and including $50,000 $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 $100,000 plus $5.60 for each additional $1,000 or fraction thereof, to and including $500,000 $3,233.75 for the first $500,000 plus $4.75 for each additional $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 Curb 5treets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50. 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 $23.25. VERIFICATION OF FOUNDATION Pemuts for construction will be issued a minimum of 24 hours from the time of application to allow for proper revie�v of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the framing. New Houses Oniv �� n�e�w �� C�S�� . � #1489 Ms. Gayle Chivatero �"654TRANSFER R0.0D, surr� isB � 6675 Channel �Rd. � ST.RAUL,�nN��,� �HIS J08 COPY SHALL BE -- Fridley, IVIN 55432 �Y,�ILABLE 0 P�rmiY by =� J$ H763-571-1337 651-681-2240 ��TE FOR THE FRAMING Legal Descrip4i � A[VD FINAL IN BIk� � 24x24 Det. Allbilt W/Conc. add�„ � 6/8/1 Dennis Jarnot � Value T.ype Const. ! ��'-�-"�-- ,� � � : �n /! a' �i , �� - S ; � ¢ z a � . , < < ,"T � � � � t L�+B: �__._ � � ,� i � SUSSEL : t ; � i i i , `�` �'�' ❑ Bv Owner Approx. � ' !�' �- ' � - ' '•� ! , � ��r�� ❑In ; � � � : ; .i._.`_ � � , ; ' � ; �._,. , :1 ___d_-:� I ;�.;._� _ 2-STARiING POINTS NL ' � ` _a---� ~�-`_�� (!�� ' ' � . ' � S.P.L. �` ` �'`� ��,��_�'��_�"�_��;�_"`_' =f I =- �--.i- , ` _' � ' ' � � � � , S.S.P.L. ' ' ' '��_ � T �P� ' � : , i � i , � ; -;--r-�--r--r-�- � ' , •------; AJ ey i � j t � ( � _; ' i '_ i �.! i ' �s� House ;� `° � � ' ! ; � � � ! , ` ! i i � ' � : , ��. ,_ a._,_._;__'_ ` ` } i � ! ' i F. Street t ;- i ; i� ;}``�"�-�-_.' :, s E t, � f�, Other � : '� - � , � DSquare With i � � t{`��Y"°-� � 1 n� i '–'" �'- �� i� i'`•� f ti t �.._".,` ❑Sod Rem. By i i t i i – � ❑ A.B.U. ! ; i ; ' ; r?�� f � .' " ❑ � Grade Point I, ! i r i � ��'''� "'' 2 ' �'�""'—' '�""� �^_L� �3 �. E � �-; . iocks: �v ow�er y S�sse� � I�`' ` ' ONE ROW BLOCK (4) SIDES ! �� . ❑Wtr.proof: �BY Own. �By Sus. '! � i: ! .,_.:, � ❑ Backfiili: ❑By Own. �By Sussel __�_{_ _ `� ; } { �,ABaintain 8' Tota� wa�� teiyt�t '� � OVERHEAD DOOR M.0.16'3" ''� Inciuding Blocks OR ` ' � ; � � ' ,a ; ' ; ❑ �aintain 8' Wali Height on ' � ; ; � �� ; SERVICE DOOR M.0.41 _ � ' ; Top of Blocks � ? � , , : � ' -.r-..� � ' Block Size iTop coursef � � , � � � ' � ' � � s� y ;,� „-�-�; ; � C� �,. �„ 0 ,�, ' ` ' • '^ � Wall He+ght other 2han 8' r�- , , ; � i ' r�_Y�� ' � i ; �� ' � � + + ( � { f � i j . � � } i � � ' { i ' 1 i ... Y = a �i� _�., j._.� • �-�---; O{ ; '. �.."," _._._;,`_' : { ! ' _..-�. _. � . ---�-�-.- --�--.------.__-__-;. �----7-- ---; DG ! ��i "'.-" ` �v ` � t---•--�--_ r- - h i '�� . ❑ f�. . "�_ ' h —t-....�.._ f 4 _...�._ _... i ' d � . , � Q � ! � � � � i I i s � j t . . ' i � } ' � . � � i � I . .. ' S j ._.... 9 % �—., 1 2 ---"--,.. t +��l,�1��:�_T____.:..,.i ' t---4-._ Existing garage: fVo p , - '�; � ; --•-=--'-�=-`- - ; � ,_' �-: ` I C] Qetached .0 �4ttached Yes� f ; + , ; � Size of existing: x � j � ` { i ' � � � � y ' , - Existing garage will be: ; � , ; � � � ; i ' ; � , � t ; � ; ❑ Left as is ± �" '�'' ; �`� t � � � Convested to L.S. • �y owner ' ;�, � :� : ! � ' s � C7Remov2d B�: U��vn�s C7 i '�' , ; ;,�'-� ' ;; ! �_ � � = , i-; , (� i+. ; ". . i � � . Sussel �L. < i `� ! - � � ; - _4 Junk Must B� Removed By Owra�e �;� ,� ! ; � Scakes visibl� ❑ Yes �Aio � � ' ! Survey available -[] Yes 0 i�o 1 ❑ Special inS4rucYions firom , � ! ,�,�� -- f�--�--- Cement P�Ian 5 �---�-.�-`--- ; �,_ r � � , , � , _�--7 `„f'' c� � / / �.(��`"�� ` , � ��- , ` � � � p`�' . . �'��' —�'�l�4w�J�(/_L' �V� � f �--.�_ - -� 3'( _ j A�C�� C] G�od ❑ F�ir ❑ Poor PURCHASER'S 1�111TIALS: �'°YS�� . ,� � � �,� � DIRECTION �_ `I . `�� . � . � . Ci �. � Ms. Gayle Chivatero 6675 Channel Rd. 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Z o I I O I I I�I I I I I I� � �� CJ� O O O y O v y��'' � °o °o °o 0 0 °o o °o °o °o °o °a °o : -o c � W Z � c� O � a .� m � °.: � 0 � b� �o m � � � _�_ � W a � C m a � � m' -, ��°'_ p w � ��=m - D w Z Z O �cnrm-L� D �' �0 .Z N D m 0 z O � s � -� � W N lO � � c� � m 0 D r � W 0 �'1 \ 4� v� -rl �� C 7 NQ'�� rn� C C � � � � Z N �� r N < -rte N Z� m� a -o v r n � O Z � O � 'o r C 0�0 Z G) a z v N 'fl � �,' �i � m 3 � r �' ' 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 aU current codes and manufacturer ' specifications .including sizing, length, number of elbows and termination. Yes O, No O 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 existins� 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 spec�cations. Yes ( ) No ( ) Yes ( ) No ( ) Yes()No() When installins� a new ventins� 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 Furnace Venting Tabies for fan assisted and natural draft appliances. Yes () No () Is the common vent and vent connectors sized and installed correctiy 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' Appiiance #2 Type BTU Input Fan Assisted or Nat Appiiance #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: (Describel ;� ' , HEATING Cb: ' � ' Signed By: Date : _ - C[ZYOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287 March 30, 2004 Ms. Gayle Chivatero 6675 Channel Road NE Fridley, MN 55432 Re: Final Inspection at 6675 Channel Rd NE Contractor: Norblom Plumbing Co. Dear Ms. Chivatero: A plumbing permit was issued on June 23, 2003 to install a water heater at your address. According to Section 4715.2800 of the State Plumbing Code, a final inspection shall be conducted on the work authorized by this permit. As of this date the inspection ha.s 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 permit "no inspection called for by homeowner after notification" and expire the permit. To set up the inspection or to have any questions answered, please contact the Building Inspection Division at (763) 572-3604. Sincerely, DA EN Building pector DJ/mh ADDRES5 PIN LEGAL DESC PERNIIT TYPE PROPERTY TYPE CON5TRUCTION TYPE CITY OF FRIDLEY 6431 LTNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-36U4 N'AX: : 6675 CHANNEL RD NE : 133024240022 : AUD SUB NO 021 (2ND REV) : LOT 4-O BLOCK : BUII.,DING : RESIDENTIAL : ROOFING VALUATION : $ 1,621.00 NOTE: UNDERLAYMENT AS PER STATE BUII.,DING CODE. REROOF HOUSE (14 SQ) TEAR-OFF STATE LICENSED CONTRACTOR APPLICANT WESTURN ROOFING &. SIDING (20155566) 9700 13 AVE N PLYMOUTH, MN 55441 (763) 541-0304 OWNER CHIVATERO GAYLE S 6675 CHANNEL RD NE FRIDLEY, NIN 55432 1 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this applicarion and know the same to be true and correct. All provisions of laws and ordinances governing this type of wor� will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulatin�b��l�tc1'�a o t�p��_ y/af cons ��. A�alicant ��i�� t�/ Date Bldg SEPARATE 571-1"lii"/ PE � �T NO�.: 2004-00437 �� DATE ISSUED: 04/05/2004 BUILDING PERMIT FEE FIRE SURCHARGE STATE SURCHARGE, VALUE LICENSE SURCHARGE TOTAL PAID WIT'H CHECK # 13847 `� 151��1 F _ REQUIltED FOR WORK OTI�R THAN DESCRIBED ABOVE. 60.10 1.62 0.81 5.00 67.53 NEW ADDN ALTER � � CITY OF FRIDLEY [] 6431 University Ave NE, Fridley, MN 55432 [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: � � � �l�� / �-� /�l� Effective 4/1/2004 (763) 572-3604 Bldg Insp (763) 571-1287 Fax I� � ., � �Lt �� Legal Description: Owner Name 8� Address: � � �' � �' � Tel. # ��-� � �l� ✓-�� Contractor. � -� ��'�l n MN LICENSE # �� ,� Address: � �� I ��1� �� /� ��rs � � �_/ Tel. # �f S� S%jZ` �':.��'-� Attach to this application, a Cert�cate of Sunrey of the lot, with the proposed construction drawn on it to scale. LMNG AREA: GARAGE AREA: DECK AREA: OTHER: DESCRIPTIOPI OF IMPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft Length / Width Sq. Ft. s�v� � v� / Construction Type: �� `�� Estimated Cost: $ � � �lia� � Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x$ _� �`-= �� DATE: � �✓ i� APPLIC . �� ' .� Tel. # ��,z �`�� Af�-T-'" � Call (763) 572-3604 for Permit Fees FF inailing in application. Fax to 763-571-1287 'rf using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge TOTAL $ � $ $ $ �/ $ � �D� $ $ $ $ � � Fee Schedule on Reverse Side 65% of Permit Fee .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1350 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 [ ] 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 alteradon or repair to any existing building or structure, upan 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,(�1 to $50,000 $50,001 to $100,0� $100,�1 to $500,000 $500,001 to $1,000,0� $1,�,001 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 includi.ng $25,000 $391.25 for first $25,0� plus $10.10 for each additional $1,0(� or fraction thereof, to and including $50,� $643.75 for first $50,000 plus $7.00 for ea.ch additional $1, 000 or fraction thereof, to and including $100,000 $993.75 for first $1(�,000 plus $5.60 for each additional $1,000 or fraction thereof, to and including $5(�,�0 $3,233.75 for the first $5�,000 plus $4.75 for each additional $1,000 or fraction thereof, to and including $1,0�,000 $5,608.75 for the first $1,�,000 plus $3.15 for ea.ch additional $1,000 or fraction thereof CURB CUT ESCROW (Concrete C�arb 5treets Only) Removal and replacement of curb and gutter only - driveway width plus 6 feet, times the annually determined rate 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. VERIFICATION OF FOUNDATION A Certificate of Survey of the lot, showing the location of the existing foundation will be required. before proceeding with the framing. New Houses Onlv ADDRESS PIN LEGAL DESC PERMIT TYPE PROPERTY TYPE CONSTRUCTION TYPE CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-3604 FAX: 6675 CHANNEL RD NE 133024240022 AUD SUB NO 021 (2ND REV) LOT 4-O BLOCK BUII.DING RESIDENTIAL WINDOW/DOOR REPL 571-1Zif7 �,.�. PERMIT 0.:2004-0066�' DATE LSSUED: OS/07/2Q04 VALUATION : $ 7,266.00 NOTE: PROVIDE SMOKE DETECTORS IN ALL SLEEPING ROOMS AND ON ALL LEVELS OF TI� DWELLING PER R317 OF TI� 2000 INTERNATIONAL RESIDENTIAL CODE. CAULK AND FLASH ALL EXTERIOR OPENII�IGS. REPLACE 7 WINDOWS WITHIN EXISTING OPENII�TGS. STATE LICENSED CONTRACTOR 1 APPLICANT PELLA WINDOWS & DOOR5 (20165884) 15300 25 AVE N STE 1 PLYMOUTH, MN 55447 (763)745-1487 OWNER CHIVATERO GAYLE S 6675 CHANNEL RD NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and conect. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a pernut does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construcrion. Bldg Insp BUII,DING PERMIT FEE FIltE SURCHARGE STATE5URCHARGE,VALUE LICENSE SURCHARGE TOTAL PAID WITH CHECK # 34907 SEPARATE PERMITS REQUIRED FOR WORK OTI�R THAN DESCRIBED ABOVE. 153.25 7.27 3.63 5.00 169.15 04/02/2004 FRI 13;21 FA% N�rv [ l ADDN [] ALTER [ j -�-�i ELDER JONE9 ��'a" r�ooiiooi . y � �' � .. .. �ap� C�� CITY OF FRIDLEY Effective 4/1/2004 �6431 UniversityAve NE, Fridley, MN 55432 {753� 572-3604 Bldg lesp S1NGI�E FAMILY AND DUPL�%E5 R-4 AND R 2 (763) 571-128'T Eax BUILDtNG PERMIT APPLICATION Construction Address: ��,��i� ;` � b Legal Description_ Owrner Name S� Address: ' 0�.. � Contractor. _, PELLA WINDO S& DOORS Address: 15300 - 25TH AVE. N. STE. #100 PLYMOUTH, MN 55447 763-745-1400 LICENSE # 20165884 TeI.# ��03-�7��-��.3�' MN LICENSE# Tel. # a Certificate of Sunrey of the ;truction drawn on it to scale. DESCRiPTiON OF IMPROVEMEN7 LIVING AREA: Length Width Height � sq. Ft. GARAGE AREA: Lengffi Wdth Height Sq. F� dECK AREA: Length �dth Hgt/Ground Sq. Ft OTHER: � 11n Cl C� Q � C.�11 ��li i�A A�� )�-�11� �� d� � . r �s C;�2-�,y,� ` ��O `" Construction Type: Estimated Cos� $� I��V / pciveway Gurb Cut Width Nead�d: Ft + 6 Ft = Ft x� _$ DATE: APPLICANT Tel. #��7. ( Oc l�� Call (763) 672-3604 for Permit Fee.s if mailing in applicafaon. F�x to 763-57�1-�f287 iF using credit card and we will call you for card number. Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escr�w Erosion Control Park Fee Sewer Main Charge TOTAL CI'fY USE ONLY - $ J��- �� Fee Schedu(e on REVerse Side � 65% of Permit Fee $ , a .001 of Permif Valuation (1/10th%) � �,_.!� � �.50/$1,000 Valuation � $ $1350 per SAC Unit $ S, �� - - $5.00 (Sta�Ee Licensed Residenfial Confiractors) $ AI�. "A" or Alt. "B" Above $ $450.00 Cvnservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] � /� $ STIPULATIQNS: / ADDRESS PIN LEGAL DESC PERMIT TYPE PROPERTY TYPE CONSTRUCTION TYPE CITY OF FRIDLEY 6431 iJNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-3604 FAX: : 6675 CHANNEL RD NE : 133024240022 : AUD SUB NO 021 (2ND REV) : LOT 4-O BLOCK : ELECTRICAL ; RESIDENTIAL : ADDITION/ALTERATION 571-1Zii7 PERMIT NO.: 2004-00666 DATE ISSUED: OS/07/2004 VALUATION . NOTE: ELECTRICAL PERNIIT BECOMES VOID 12 MONTHS AFTER PERMIT IS5UE DATE. � # INSPECTIONS 2 APPLICANT AMERICAN ELECTRIC 832 BELLVUE LN BROOKLYN CENTER, MN 55430 OWNER CHIVATERO GAYLE S 6675 CHANNEL RD NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. Applicant Date Bldg Insp Date ELEC PERNIIT FEE - MIl�T (RESn STATE SURCHARGE, ELEC FLAT TOTAL PAID WIT'H CHECK # 12438 SEPARATE PERMITS REQvIRED rUx wUxx u�ir�x iriaiv li��c:iuts�li a,i�v�. 40.00 0.50 40.50 �uilding In.spections 763-572-3604 DA'tE �l—�D-O sxrE nnDxFSS � THIS APPLICANT IS: PROPERTY OWNER/ TENANT � 1 l 1� E • ■F • ► ' `i �, �� G.� t . � �� :. ..�.. � =1� ` ' ;!` ` '` s�'�' `� YOUR E-MAIL ADDRESS 0 OWNER �ONTRACTOR PHONE: �'7 / —� � 3 3 rT Permit No.:N� � �(� ��' � Received By' STATE ZI1' CONTRACTOR �ptv�ANY NAME: SUgMIT A COPY OF �NTACT PERSON: ° ° , YOURSTATE STATELICENSE# �°��9 flA^ir� C� AI &� y e,� � . LICEN5E WIT'H ADDRESS: CITY STATE ZIP APPLICATION PHO� '�^,�� _ �L+�C: Io;3?__. PE� ,I,M,E O SINGLE FAMILY 0'['WO FAMILY 0 ]JEW �'�EPLACEMENT TYPE OF WORK: )ETAILED DESCRIPTION OF WORK �nS�%a L�Li ❑ TOWNHOUSE ❑ pLTERATION/REMODEL PER MS 16B.665 the permit fee is a minimum of S15.QO or.5%;o cth� ��e��$��re�� o� � r'�f� of labor ) improvement, vnstallation or replacement of a resident�al fixture, ex I g Labor cost under $300 =$15.00. Labor cost between $30Q to $S� = cost of labor x.05= FOR PROJECT'S WHERE LABOR EXEEEDS $500, FEES ARE BASID ON $10.00 PIIt FIXTU1tE, EXCEFT W�EN�TID F�CTIJR�';(�I�T� T�T`4I' NUMBER OF EACH BII�flV� %��,,/ MODEL: jL� �. � SIZEBTU �� Fq�i►Pment Installed , MFG: _��— STZFJBTIJ MFG: MODA.: • MFG: MODEL: _ SIZFJBTU FIREPLACE (GAS) $15.00 . _GAS RANGFJ.OVEN $10.00 Evc szs.00 —��,cE �w�n7 s�s:ou r�w �ns�GxII.t. �io.00 AIR TO AIIt EXCHANGEER $15 --�ACE $35.� ,_GkS C7NTT'HTR $10.00 BOII.ER $35.00 =Gps DRYER 510.00 POOL HEATER $35.00 �IvQJEy UNER $10.00 _� plp�G $10.00 �'ENT'II.ATOR 515.00 DUC'f WOWC $10.� _ . _ ...., �,�� . . . �, A _ . . _ � ,.. ..:. . .. Permit Fee $ �,� � Number of fixtures @$10.00 x$10.00 = Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DiJE $��_D Number of fixttzres @$Z5.00 x$25.00 =$ Number of fixtures @ $35.00 x $35.Q0 = $ State Surcharge = $ .50 Total = $ 'I'FIIS IS AN APPLICATION FOR A PERMIT NOT VALID UNTIL PROCESSID I hereby apply for a building permit and I aclrnowledge that the information above is complete and accurate; that the work will be in confoimance with the ordinances and codes of the City of Fridley and with the Minnesota-Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all wor w'ch requires review and approval of plans. SIGNATURE OF APPLICANT PRINI' NAME � Y1�S �G��-DATE %' I T� '� n �T C�ty �f I�'rndley �u�iding �nspec�ions �epar�ment 6431 University Avenue NE, �ridley, MN 55432 763-572-3604 FAX: 763-502-4977 �. REQUIRED INFORMATION NEEDED T� PROCESS PERlV(IT " RESIDENT[AL PED�MIT APPLICATION HVAC � ❑ NEW HOMESlADDIT(ONS ❑ EXISTING HOME ❑ MAKE-UP AIR REQUIRED FOR NEW/IXISTING HOMES 1. Combustion Air (See note below) . � Oil or solid fuel ]MC Cha�ter 7 with MN Amendments b. Natural Gas or Propane/IFGC Chapter 3 with MN Amen.dment� � 2. Make-up Air (See note below) . a. ]�IC. Chapter 5 with MN Amen.dments ' ,� 3. Venting . _ . a. Gas a�pliances ]FGC Chapter 5 with MN Amendm.ents - � b. Fu.el:oth.er than gas IMC Cha��r 8 with MN Amendments REQUIRED FEiR NEW H�MES ,� 4. Heat loss & cboling load. per raom a. R�quired: on new construction IMC 1346.0312' 5. Ventilation . � — -- a, 0�7672 _ -- ---- - 6, � Duct Design Per ]MC 1346:0603.2 a. ACCA Manual D N�"�'E: Cenierpoint �nerg� Mec�hanical Code Guidelines soit�vare may be used for cmmbustion andl anake up air ealculations