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City of Fridley SUBJECT
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
i `
; `L __�___ COMMUNITY DEVELOPMENT DIV.
� j � PROTECTIVE INSPECTION SEC.
� ` �
1
`+___� �'�'�,� CITY HALL FRIDLEV 55432 NUMBER REV. DATE
L 812-560-3450
910-F15 ,
JOB ADDRESS 6676 Channel Road N.E. `
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION
DESCR. 2 ], Steiger Terrace
2 PROPERTYOWNER MAILADDRESS
James L. Roehler 6676 Channel Road N.E.
3 CONTRACTOR MAILADDRESS
Same
4 ARCHITECTORDESIGNER MAILADDRESS
5 ENGINEER MAIL ADDRESS
B USE OF BUILDING
� ���
�R NO.
. 12072
ECEIPT NO. /
PAGE OF IAPPqOVED BY
r3 / /
SEE ATTACHED
SHEET
cir PHONE UCENSE NO.
ZIP PHONE LICENSE NO.
Z�P PHONE LICENSE NO.
Dwelling
7 CLASS OF WORK
0 NEW ❑ ADDITION �1 ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
S OESCRIBE WORK
Addition to Dwg. 18' x 24'
9 CHANGE qF USE FROM
STI PU LATION S
TO
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CO
VENTILATING OR AIR CONDITIONING. WOOCZ �
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG.
I HEREBY CERT
�ANCY GROUP OCCUPANCY LOAD
CU. FT.
1118. 8572
OFFSTREET PARKING
IFY THAT 1 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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $9' OOO. OO $/a.. 5O
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OFi CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOGAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. � .��.F) . OO
PLAN CHECKFEE TOTALFEE
� �����7� 20.0
'NATUREOFCONTRACTORORAUTHORIZEDAGENT �DATEI r�``f/yHEN PROPERLY VALID1jT T IS IS OUR PERMIT
SIGNATURE OF OWNER IIF OWNER BUILDEflI (DATEI �� � � � � � � � `
BLDG.INSP pA7E 4��
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�►�.�� �#.�c# ���+� _�,o Certificates o£ Sutvey o� Lq� a�t,d prope��e�d
�,��� �.�ativ�n d� � #�ese Certificates*
�
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»1��e��P�rzQ� o� �u��,��t��
,�,�'�� �ii.3 � �3 D�+#i : � � �fgt�t : � � `�fit1 �` � %..
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� 1 �R"sT
�q� � ��`R'lwMMa �. � '{� /' y /� � � "�... �/ � � .
1�1 r �Y� 1 �w /
i� �+��Z►�d hese�y �lc�s a�l�,c�ti� for, a pe�.tt ia� the w�►�k 1��reia3
#���� a��ea� �+ da a�.t �� iu stt�.at aacoardance witt� ths !�,�► �f
�,tdl� �i��ru�s �d sul�� �►f $�e De#►art�e� qf Bui,3�d�.��, � �exeby
�1�+e.� � all � i��cts �d, ��reseata.�3.��s ��ated � t��.s ap�►Ii�catia�t
� � a� apxrecfi� .
�,�s,� '/O,�'D� °- ��._.� �I�NAT[Tl�E: L��;� �� ��> ,
��+e� ��re S�ti�r �og Add��oaai Info iBA,. �
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��U���IN� P�RMIT F�� �GH��U�E
����A�T �. �.'h� Inepecta� P� $u�ldings sk►all, befox� i.esui�g permit� for �he
������on o� a,ny building Ax structure, ou for any addition to any �i�t�.�
'���.�.d� ox stxuCture, or fo7� any alteratian� o� �e�airs �o any ex��tir�g
��,���:� o�e st�,tc�uxe, upon �ppli�&ation th�ref��e, xequi.xe the p��nae�� by t9hs
�,���,1��� �p� sucl� p�r�n�� p� �ees �o the a$tocint herein below aet fArtln �.rt�l �.r►
��� �e� he��r��� p��vided � t��wwi� �
UU�T��'0� �UZLI�TNG CODE= 1�Pe Is 2&�-$2•�5 �or each �arae thousartd cubic
�e��� �►s� f7s'ac�tion th�lreo�, 3.n �u�� cubical coaCents. �pe 3& 5 a$1.$� �o�'
�ae�► An.Q C�vusand �cb�.c �etet, .
��p�T�UI�IAL ��iFl)�MAT�ON
Fa� �t+� pu�[���e of �ca�pu��.m$ �eea for building pennite, the cubical cantents
o� a�y building oz additian, i� detexmined by mu1��.ply�.n� �he �xound area
�y�,� �enn � poi��: ��s (�i) in�hes below �he f�.ca�r �ine c�� the basement
� t�,� ����.a� �a ��e average lneights of the uppex surface or to the averag� �
��ki� �� ��'��� ���ace a� Che u�a.iA �ab�� Q� � Pitched xoof,
?� �i� o� a�����t�.o�s 1� aa existing s�tu�ep �a� f�e shal�. lae �� ���
��,�� o� $�,fl0 #+e�c' �+� ��ve h��sed dollax� ($�OOoQU) � £�t�.� �h��so� �.r�
3�e ca�� o� a�.�. p�apcased wc�xka
7� � ca�+ s�ia�l i�i� f�s �+�d fo�r �r pe�it as ae� �o� �.0 S���.az� 2 b�:
� �� $�.�.
�
V�����a�'�'iC#N �� ���NAATI(3N
�p�� I'�ts �Qx a�s#�t+��t�.o�n wi��. be �.��ued a �in�.mum e�� �4 �ctuxs ��am �a
.� o! ��p�icat#.o�, �a a��at� �ox Pra�ex �:eview of �lie p�rApo�ad s�7�u�#�re �ud
�g �e �ts��'u��ion �i�e.
' � ���,�i� �� v� �li,� �.��,,, �� � teseat� e�� It%� �auuc�tir�t, �x�� ��
�,� �s�t.�edA wii� #�+ ��uir+�d bef��e t�ruc.eedi�►� w�.�h � fr�ni�g.
,
C�1��'�F���'�� t�� t���PAN�Y
,��l�,e���.�a� f� ��e�-t�����a�ta �� Qae�tpar�cy �hal� bs mae#a te� (34) +�ay� px�ox
�+� fih� ��e c�ar �ccup�y Q� ��tr�c�e fax whi�h a� bu�.�.d�.n$ �esx�3.0 has baen
issu�d; � s��� si�tt�� �hal� �ot b� used �� occt�p�ed ust�.l a��xt�.fi.cate
+af 4��upaa�cy ha� be� �Sau�ad�
.
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SUBJECT
City of Fridley
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
� �
•
COMMUNITY DEYELOPMENT DIV.
r j y � PROTECTIVE INSPECTION SEC.
i� � �
--N� ��"" �,� CITY HALL FRIDLEY 55432 NUMeER REV.
� 812-560-3450
910-F15
JOB ADDRESS 6676 C�annel Road N. E.
t LEGAL LOT NO. BLOCK TRACT OR ADDITION
DESCR. 2 1 Steiger Terrace
2 PROPERTYOWNER MAILADDflESS
Monte Greeurood. 6676 Channel Road N.E.
3 CONTRACTOR MAILADDRESS
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS
5 ENGINEER MAIL ADDRESS
DATE PAGE OF
5/24/78 / /
PERMIT
�. 1472�
RECEIPT NO.
/'7 02 �j
APPROVED BY
SEE ATTACHED
SHEET
ZIP PHONE
Z�P PHONE LICENSE NO.
ZIP PHONE LICENSE NO.
Z�P PHONE LICENSE NO.
6 USE OF BUILDING
Resideriti.al
7 CLASS OF WOflK
O NEW O� ADDITION � ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Cbnstruct a 18� x 12' Deck
9 CHANGE OF USE FROM
STI PU LATIONS
TO
Provide. 42"' frost footings min.imum.
5E�'`eRaTE P'ERA�tTS R�EQUIRED ��?R INIRiN
MEA�'1i�G. PLUMBtNG ,�I�D StGMS. �
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST.
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING
AUTHOFIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION �.
AND KNOW THESAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED.
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 5�95
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. � y�%. SO
WARHING
�efore di�gin� call local. utifft���
TELEPNONE - ELECTRtC - GAS Etc,
REC�UIRED BY LAW
PANCYGROUP �OCCUPANCYLOA�
CU. FT
OFFSTREET PARKING
STALLS GARAGES
SURTAX
$. 50
SAC CHARGE
r�arv �nt�Krtt TOTALFEE
$ 8. ��
Na7uREOF ACTORORAUTHORIZEDAGENT �D�A7E� HEN PROP RLY VALIDATED THIS IS YOUR PERMIT
� '[?',��� s � G� < �', _
�--, �� �=a�l- ;
IATURE ,_ WNERIIPOWNERBUILDERI �DATEI n�nr. inico ...__
,� . , .. ,. _�.
• � CITY 01= l=1tIl)LCY , � .
' /tPl'LIC�TIU1� f'Oft (Z�SIll(=fdTI/1L LUJLDI('iG f'Clt('IIT� .
' (�VL"W, �LTL"R/1TIU(JS, �L�llITI01J�, O(2 RCPI�IIiS) ,
. • � .
oi;i��R: � (T-I�T� C�1 R.�� c�1 � � � . nuzz.ur•.�t: � �� � � '
� ��. '
1�cldr..css : (� ��i�L � hc3dress : .
2e1. lJo . : �
i�To. .
Street:
I.OT: �� I3TACY.: �_ I�DDIT70P�: �����
CO1t1�iLR LOT: IILSID� IIJT: �� S;:TPACY.: SIUL•'YnRDS:
A,pplica'r,L- at-tach 'to this foxm ��uo Certiiic�te� of Survey of Lot and proposcd
bui.lding locaL-ion dra�rm on these Certiticates. .
DESCRI PTI Oi'd OF BUI LDI i�G . "
, . .
To T3c Used As s
. o
,����� • �'zont: J � Depth : _� � � Iiei.gl�t: �
,
Square Feet: Cubic Feet:
rront: � Depth: � Height:
� Square I'eet: Cubic reet: '
' • (� o0
Tj�pe •o� Const-xuction: Estimaied Cost: $ � % �
7�b T3e Coinplei:ed:
Alt. A Alt. B
Pxvposed llriv��.ay i•�idL-h Zf i1et,� Opening Is Desirer3 $ $
(S�� 12�VEFSE SI'DE OF SHEET)
The undersigned he�'ek�y ma}:�s applicaL•ion for a permit for the k�or�: herein
specified, agr�cing Y.o do all ccork in sirict acc��:dance �,rith the City of
Fxidle�� Ordzii.,��ccs and ruli.ngs of the Dc��:��i:ract�t ot }3uildings, and Ilereby
dec�.ares i:�st all the facts and reprGSe»L-ations stated in i:his a�.��licai:i�t�
are txue .'�r►d orrect. See xeverse sidc for acic3iL-iona ini'orni�i�ioii.
. �. z; 7� ��
DItT�: � / v SIGI�ATURL•': �.��—��� �
St�.pul.;t•io»s:
v ��� �� � � ��
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BUILDI(�G PERf�1I1' FEi. SCiiEDULE . .
S�CTION 2. The Inspector of Buildings shall, before issuing pexmits for the erection
of a�ty bvilding or structure, or for any ac�ditio:� 'to any existing building or structure,
o�' for any altez'ation or rQpairs to any existinq bui.lding or structure, upon "application
therefore, require Uie payment by the applicant for such permit of.fees to the amount
herein below set forth and in the manner herein providea to-wit:
AIEi�J CONSTFUCTION: Single Famil� Homes and Garages: $4.00/1,000 cubic feet..
PT�T�N CIiL•'CK: 25 percent �f building �ermit fee.
DRZVEWAY DEPRESSION: (Concrete G�rb Streets Only)
Alternate A: Removal and replacement of concrete curb and
gutter only; Dri.veway width plus 6 feet x$14.50
Alternate B: Removal and replacement of concrete curb and
gutter and install a 3 foot wide approach with
6 inch depth; Driveway width plus 6 feet x S��•20
� 1 1 � : _ \ �' ' � �
For. the purpose of cor.iputing fees for building permits, the cubical contents of any
building or addition, is determined by multi_plying the ground area covered from a
point six (6) inches belov� th� floor line of the basement or th� cellar to the
average heights of the upp�r surf ace or to the average height of the roof surface
af the main gable of a pitched roof.
F�r repairs or alterations to an existinq structure, the fee shall be at tl-�e rate
of $3.00 j�er each five hundred dollars ($500.00) or fraction thereof in the cos�
of all proposed �vork.
In no case shall the fee charged for any pernit as set forth in Section 2 be less
than $;.SO plus $.50 state surcharge.
VERIFICATIO� OF FOUNDATION
NCTE: Permits for corL�tructian will be issued a minimum of 24 hours from �he time
of applic�.tion to allow for proper review of the proposed structure and of the
cans�:ru�tion site.
A C.ertificate of Survey of the lot, showing the location of the foundation once i.t
laas beer constructed ��ill be required before proceedir.g with the frami.ng.
CrRTIFICATE OF OCCUPANCY
Application for a Certificate of Occupancy shall be made ten (10) days prior to the
use or occupancy of any structure for which a buildizig permit has been issued; and
• said structure shall not be used or occupied until a Certificate of Occupancy has
been issued.
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sus�ecT PE NO.
City of Fridley 1612 9
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r • -
� �
� � CEIPT NO.
� �� _ COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC. �� �
� .
t '
l-___ ������;,, CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BV
j� � � 612-571-3450
910-F15 4�22�8� � �
�oB AooRess 6676 Channel Road N.E.
t LEGAL LOT NO. BLOCK TRACT OR ADDITION
DESCR. 2 1 Steige X�X Terrace SHEETTACHED
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Catherine Greenwood 6676 Channel Road N.E. 571-7965
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO.
Kilgore Siding Company 460 Mississippi N.E. 571-9715
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS 21P PHONE LICENSENO.
6 USE OF BUILDING
res '
7 CLASS OF WORK
❑ NEW � ADDITION ❑ ALTERATION C� REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
new siding on garage
9 CHANGE QF USE FROM TO
STIPULATIONS
SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP- OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING. WOO�
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZpNING SQ. FT. CU. FT.
AUTHOFiIZED IS NOT COMMENCED WITHIN BO 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 � 5OO �, J8
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 LOCAL LAW REGULATING CON- 9, OO
STRUC�OR THE PE RMANC F CO RUCTION.
� �` !^ PLAN CHECK FEE TOTAL FEE
�� ��J 9 . 78
SIGN TUREOFCONTRACTORORAUTHORIZEDAGE IDATE) EN PROPE Y ALI TED THIS IS YOUR,� MIT .
� /l
p.. _i . !�� . ��.
SIGNATUREOFOWNERIIFOWNERBUIL�ERi IDATEI BLDG iNSP f7ATE
. . � . -�
� CITY (IF FitIDLCY • � �
Af'PLTCII'I'IO;J FOIt P.I�STUEi�1TIlli_ QUILDIi1G PCRt�iI7S � •
� (tJcti��, A1 tcr.�i;ians, Additions, or Repairsj
I ��01ltdER: �'� E3UIL.pER: � � �
ADORESS: � -7� � � ��� nodr�css: UG� � ' �� �,
� � `
TCL �t0: � �%� �' � �% �.� TEL IdO: �S �F r � �C�
� Constr
� �
STIiI�T NO: l � STREET:
ction Location
i . �
�� �� � �
I,C?T: �,,,�p, BLOCK: _ ,� _ ADDITION: '1.r � ,OL �.
Corner Lot: Inside Lot: SetbacY.: ideyards:
Ap�licant attach to this form tsro Certificates o£ St�rvey of lot and
proposed building �.ocation drawn on certiiicates to scale. .
DESCRIPTIOid OF C�EISTRUCTIOPd •
� � - . .
t �dl� �aront: Depth: Height:
Squa�e.Feet: Cubic Feet:
. Fron�: Depth: Heigh�:
. Square• Feet: � G'�ibic Feet:
�.'ype of Construction: Es�.imaLed Cost: $ '� .
Zb Be Oor,cpleted:
` , . � Alt. A Alt. B
Proposed Drive��ay Width If New Opening Is Des.ised: $� $
. ., S�� R�VERSE SIDE OF SHEET ,
TIie undexsigned hereb�� make� appl5.cation for a permit for the t:�ork' herein specified,
agrceing to c� ,all work in stra.et accordance �•�ith the City of I'ridley Ordinances and
ruliiigs of L•l1e DG'2�1I:1:ttlCilt of Buildings, and hez:eby decJ.ares that ail tlie facts and
re�resen t,ztioi�� stated an t.his applicatian are true and orrec �
D.1TF: � ,� SIGNIITUF.F: ��` °J � •
Stik�ulations : � �
� � Qa
< <�� .
�- �. ?8
. �
ra. �
;
;,
Bur�nir�c t>c-r,r�i�r r-�:�� sc:�ir:nut_E�� ` .
.r,l:r'i'ZOl•� 2. �'19�Z� 7n�.c��eci:c�r.' of: l?u�.lc?it��J:; :;}i:iJ.�,, bntor.c: i.:.;�;«ittg pc�init:; �or Ghe crr.cL•i.on
vt r�»y l�u�.J.cl.in�j ar :,i::.-uct:urc, or. fa�: uiiy adcli.i:a��n +.:o a�fy cr,ic�3.»c} Ltiildi�tg �r st;zuctur.c,
. iu� i.'a�- ar,y tiJ.�cratir,n or. r.cl,ai.r.:� L•o •any cxa. .t:in��{ 3n�i.).di.�r� oz sL•1:ucture, UZ��n nY>p1i.c:aL•.i.an
�ilicr.�ior.c, r.c:quS.re t�J�c pr,l►mc�►C }�X tlie �-�pp].i.c:ant: f:or. sucl� ��er.mi.t• of.� ice, ta iltic arnount
hcx4in bcl.a�•i sc:L �'or.t•h �uld S.�i �ltc manr�ez hcrcin p�:avi.clecl L•o-wit: •
pd1�1? COI��`!'I:UC'�IOt�; SingJ.e L•`amil.y Iloiacs and Ga�-�zges: ;4.00/7,000 cuUxc �ec:�. .
P7,Atd CiII:Cl;: 25 l�r.xcent: of bui.�.cling �.�er.miti t'ee.
URxVF.�•:RY llEl'P1:SSi0I•I: (Cqncretc, G'�itb �i:rcets Only) � �"
• A].tern��i:e A: Itcmoval and replacement of concrete cuzb and
guLL•er only; l�riveway �•ridth plus 6 Feet x$13.�0
1�l.�crnate I3: F.crmoval and re���acem�•nt of concrete curb and
. gutter and iiistall a 3 foot ��ic�e approach �,�ith ''
' .• 6 znch depth; Driver�ay �•�idth �plus G feet x-$15� 75
• . AI�DI i I 0�/1L I t�FOR��1AT I ON
Tor the �url�se of computing fees far building permit5,. L-he cubica3� contents of any
build�.nc� or addi�ion, i.s dei�er.mi.ried by rnultipt}�ing L-he qround area covered irorn a
p�i.nt sir. (6) inches below L-he: iloor ].9_ne oi the basement or th� cellar to 'the
averdge heights of the •upper sur_face or to the average hei.ght of the roof suriace
oi the raain gable of a pi.tched rooi. • �_
Fox reFai.rs or a].terations i:o an existing stnicture, the fee sha11 be at f.he rate
of $3 . QO �er. each fivc hundred do].lars °($500.00) c►r fraction tlieriof i.n the cost
oi all proposed wor.Y. , . '
zn •no c.ase sha�.l the fee charged fc�r any percnit as set iozth i.n Section 2 be less �
than $7.50 plus $.50 state surcharge. " '
• � , _ VER1' F I C�TIO�! OF F�Ut�Dl1TI0(�
NOTE: Permits for COriS;trL1Ci:10ri Wl�.�. }�@ i.ssued a minimum af 24 hours from the time
af apnlication to aJ.low for pro,�er revie�v of t}ie proposed st�ucture and o� the .
�onstruction site. '
.� _
A C�rtificate � of Survey of the lot, shoc,ring the location of the founda�i.on o�ice it I
has been cons4nicted <<till be required k�efore proceeding c�ith the iraminq. '
�RTIF GA7E OF OCGUP/1(��Ci_ � '
' 1+g��.ication for a Certificate of Occupancy sh�l]. be mad�� ten (ZO) dlys prior to the
u�:e ox occu�+:�ncy oi any stz�cture for sahich a L�uilcling permit has been i.ssued; and
saacl s�LUCt;t�re slial]. iiot l�e used or. occupied L;ntil a Cer��.ficate o.f Occul�ancy has
been �ssued.
�
0
0
� �
y' � iP "i. ��
;
� �
c;ty of F��a�,��
AT THE TOP OF TME TWINS
;,
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COMMUNITY DEVELQPNIENT OIV.
r � � PROTECTIVE INSPECTION SEC.
l1 = ,
� f"° �� CITY HALL FRIOLEY SS�32
L
�UILDIPJG PERIVIIT
���°����
REV OATfi P�GE
�'�' � �' 612-571-3460 910-F15 7/23/O1 �
IOB ADDRESS 6676 Channel Road NE .
t LEGAL �OT N0. 9LOCK TRACT OR ADDITION
oescR. 2 1 Steiger Terrace
2 PROPERTY OWNER MAIL ADOR�S$
Charles Huber 6676 Channel Road NE
3 CON7RACTOR � MAIL ADDRESS
Same
4 AfiCHITECT OR DESIGNER MAIL AODflESS
5 ENGINEER p1AiLA0DRESS
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW O ADDITION
8 DESCRIBE WORK
Reroof Garage (12 Sq) Tear-off
8 CHAN�3E OF USE FROM
STIPULATIONS
ZIP
❑ ALTERATION � REPAIR
SEPARA7E PERMITS ARE REOUIREO FOR ELECTRICAL, PLUMBING, HEATINO, r�PC vF Go
VEN7ILATING OR Alq CONOITIONING.
THIS PERMIT BECOMES NULL ANQ VOIO IF WORK OR CONSTRUCTIOM YONING
AUTHORI2ED IS NOT COMMENCED Y�!ITNIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANQON�D FOR A PEHIOD OF 120 DAYS A7 "
ANY TIME AFTEq WOpK IS COMMENCED. ` NO DW4G.
I HEREBY CERTIFV 7NAT I HAYE READ AND EXAMIN�D THI$ APP�ICA710N 1
AND KNOW THE SAME TO BE 7flUE AND CORRECT. ALL PROVISIpNS OF LAW$ VALUATION
AND ORDINANCES GOVERNING THIS TYPE OF WpqK WILL �� COMP4�E0 @
WITM WHE7HER SPECIFIEO HERE�N OFi NOT. TME GRANTING OF A PERMIT y�1s227
OOES NOT PRESUME TO GIVE AUTNORITY TO VIOLATE OR CANCEL TME pERMIT FEE
PqOVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR TNE PERfORMANCE OF CONSTRUCTION ��►].9Q
OF CON' CT O THOaIZEO AGENT 1DaTE�
�� OWN i� WNEA�U4D,EA� IOATE� '
E9
f
SO.
STALIS
32022
REF IPT N
����
APPqOVED 8Y
J
SEE ATTACHED
SHEET
PMONE
763-571-5024
PHONE LICENSE NO
PHONE LICENSE NO.
PHONE LICENSE NO
O MOVE : ❑ REMOVE
CYGROUP OCCUPANCVLOAD
CU FT
OFFSTREET PARKING
GARAGES
SUqTAI(
$.61
SAC CHARGE
Fire SC $1.23
/ TOTAL F
$49 74
N� � � Effec6ve 1/1/2001
ADDN [] , CITY OF FRIDLEY (763) 572-3604 Bldg Insp
ALTER [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address:
Legal Description: _
Owner Name 8� Addre
LNING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Attach to this application, a�ertificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft.
Length Width Height Sq. Ft
Length Width Hnt/C�mi inrl e.. ��
Construction Type: Estimated Cost: $_ �o� %
Driveway Curb Cut Width Needed: Ft. + 6� Ft x$ _$
DATE: ����"�� � APPLICANT:
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
Call (763) 572-3604 for Permit Fees if mailing in application
�
Te�. # � ��'-�S 7l J �a `�
$ ��. ,�Fee Schedule on Reverse Side
$ %� .001 of Permit Valuation (1/10th%)
�_ - �ol $.50!$1,000 Valuation
$ $1150 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 [ ]
$ �
F
BUII.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,�1 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 $25,000
$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 $50,000 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 fraction thereof, to and including $500,000
$3,233.75 for the first $SOO,OOQ plus $4.75 for each additional
$1,000 or fraction thereof, to and including $1,000,0�
$5,608.75 for the first $1,OOO,Q00 plus $3.15 for each additional
$1, 000 or fraction thereof
DRNEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Alternate "A" : Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15 .50.
Altemate "B": R�oval and replacement of curb and gutter and install a 3 foot wide
ap�roach with 6 inch depth - Driveway width plus 6 feet times $23.25.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will
be required before proceeding with the framing. New Houses Onlv
Q,
- .,.
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, NIN 55432
-�;
PE N0.:2004-01061 �
DATE ISSiTED: 07/07/2004
(763) 572-3604 FAX: (763) 571-1287
ADDRESS : 6676 CHANNEL RD NE
PIN : 133024240089
LEGAL DESC : STEIGER TERRACE
: LOT 2 BLOCK 1
PERMIT TYPE : BUILDING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ROOFING
VALUATION : $ 1,852.00
NOTE: UNDERLAYMENT AS PER STATE BUILDING CODE. REROOF HOUSE (16 SQ) TEAR-OFF.
APPLICANT BUII..DING PERNIIT FEE 66.20
HiJBER CHARLES J& LINDA L FIRE SURCHARGE 1.85
6676 CHANNEL RD NE STATE SURCHARGE, VALLTE 0.93
FRIDLEY, MN 55432 TOTAL 68.98
PAID WIT'H CHECK # 8595
OWNER
HUBER CHARLES J& LINDA L
6676 CHANNEL RD NE
FRIDLEY, MN 55432
AGREEMENT AND SWORN STATEMENT
This permit becomes nu11 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 other state r local law
regulating c �uc '$n or the pe L nce of co
A'PPli Date
Bldg InsP 1. Da � �
SEPARATE PERMITS QUIRED FOR WORK OTI�R THAN DESCRIBED ABOVR.
NEW
ADDN
ALTER
/� � ��� o
[] CITY OF FRIDLEY "� Effectnre 4/1/2004
[] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
[] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPLICATION
Construction Address: (.�' �
Legal Description:
Owner Name & Address:
� �� �
�
� �� �
7'e�. # 7� � r��� ` - V �� � •
Contractor: MN LICENSE #
Address: Tel. #
LMNG AREA:
GARAGE AREA:
DECK AREA:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
- � UO �/°�'O(� /
Length Width Height Sq. Ft
Length
Length
Width
Width
Height
Hgt/Ground
Sq. Ft.
Sq. Ft
,� , , ,
OTHER: 1� !✓' �.C� �o �S
�
rr� �
Construction Type: -� 0 i� Estimated Cost: $ �J
Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x$ _$
DATE: APPLICANT: Tel. # �' �l J��
Call (763) 572-3604 for Permit Fees if mailing in application. a�c to 763-571-1287 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 Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
CITY USE ONLY -
$� -a o� Fee Schedule on Reverse Side
$ 65% of Permit Fee
$ _ �5� .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 [ ]
$ �o • �� STIPULATIONS:
BUILDING PERMTf FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any
addition to any exisring building or structure, or for any alteration or repair to any existing building or
structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount
herein below set forth and in the manner herein provided to-wit:
TOTAL VALUE
$1 to $5�
$501 to $2,000
$2,001 to $25,000
$25,�1 to $50,000
$50,001 to $100,000
$100,001 to $5�,000
$500,001 to $1,000,000
$1,000,001 and up
FEES
$23.50
$23.50 for first $5� plus $3.05 for each additional$100 or
fra.ction thereof, to and including $2,0�
$69.25 for first $2,� 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 $50,0�
$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,�0 or fraction thereof, to and including $500,000
$3,233.75 for the first $500,�0 plus $4.75 for each additional
$1,0� 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
CiTgg CUT ESCROW
(Concrete Curb Streets Only)
Removal and replacement of curb and gutter only - driveway width plus 6 feet, times the annually determined
rate
Permits for construcdon will be issued a minimum of 24 hours from the time of applica.tion 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
pr�ce�ing with the framing. New Houses Onlv