AF - 37008sue�ecr PER
City of Fridley 1711
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
� � RE EIPT NO.
COMMUNITY DEVELOPMENT DIV. N/
i bL �_���_, � � J
r � � PROTECTIVE INSPECTION SEC.
�
� i �
� /��'1 � CITY HALL FRIDLEY SS432 NUMBER REV. DATE PAGE OP APPROVED BV
�'""'� � ,�J 612-571-3450 910-F15
5/6/83 � �
JOB ADDRESS 6774 Channel Road N.E:
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. j�t. 2L.� Brookview Additi.on SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Jay Johnson 6774 Channel Road N.E. 572-0345
3 CONTRACTOR MAIL ADDRESS 21P PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
8 USE OF BUILDING
R�S].C�P11't7.d�.
7 CLASS OF WORK
O NEW ❑ ADDITION ❑ ALTERATION � REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WOflK
Replace Sidi.ng
8 CHANGE QF USE FROM TO
STIPULATIONS
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, 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.
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 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 yALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED �`$OO �. SO
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFOFMANCE OF CONSTRUCTION. $�-S.00
PLAN CHECK FEE TOTAL FEE
$15.50
SIGNATUREOFCON'RACTO �IAUTHOR12EDAGENT IDa7E� WHEN PROPERLY LIDATED THIS IS YOUR PERMIT
�
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SI A U EOFOWNE F WNERBUILDERI tDA 1 BLDG iNSP ATE
C1TY Of fRIDLCY �ifeetive �yg. 1, 1961
APPLICATlai FO(t RtSIOCNTIII� 8U]LDIi�G PIRir1lTS
(Nc,,r. Alterations. Additions. or Repai�s)
ONf�ER: �q y .�HNSON
—
ADDP.ESS: ��/ CyRn/�/E� iPn �
—
BUILDER: _ a,�y .ToN.�s�,r
—
ADDRLSS: _ 677�,/ Ch//�iv.�,��
TEl 110: _.S ��- o.3y.s ' TEl N0: _..,f7�t - o,3'Y t
. _
_._
, Constrvction Locetion
-____._
• iTR�T NO s, b 7 7 y _ 6T�tF.i'r: CfIAN'�✓EL Qvq �,
._.__
Lo�r: �T a� _____ si.00c: _______ Aoai rso�t s�iPooK vi E tr1 ���� ri� �
Cozner Lot: � Inciile Lot: `_ k���}a ^__ Sideyatbs:
J1p�lieant attech te tl�is iosu bvo Certificates of Svzvey of lot ar�d
pzoposed builcling Iocatian drawn on ceztificstes to scale.
�ESCRIPT10�t OF COIJSTP,UCTJ01�
�� �._� Frant: DePt?►s Neigbt:
� � aquare Foets Q�bic Feet:
, Ftont: DePth: Bei9ht:
Square Feet: Oubfc Peet:
. `
'1�►pc of Gbr.atruction: ��v� ��'� � , •
. f� Estis�ated Cost: i�00. eo _
� e� o�r.�plcted: �a�../��g3,,._�__
" 7�1t. !► A1 t. B
pzoposed Drivc�+ay f►idt?� if Nev Openir�g Ie Desised: _�` _�_
• • • 6E� RiVER;E SID� OF SHEET
. , .
�i�e undessioned 1�ereby �nal;es applieation foz a permit icz the ��rk herein apecified,
agreein9 to cb ,all work i�, 6trict •ccozdsr�ee with the City of Fridley Ozdivances end
�1��9� of �� �el�►�st�++c�t of Duildingt, and !►�seby dec]ares t?�r�t all t]ie facts ana
zeprescs�t�tiens stated Sr� t?�is application are true and co:rect.
a�rF: 5 '� - �3 sicN�►ru�:
_ ._
Stipulations:
� ��aa
�
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SUILDING pERMIT !EE SCHED�LE
The Inspectoz ot bnildinqs shall, Detore 3ssuing pezmits ioz the
•s�ctioa ot •ny Duildinq oz strnetvze, or ios •ny aaditioa to any
•:1atiAQ buildi�q or stz�ietnze, or ior any •ltesation'bs"'sepaizs.
to any •:istinq Dnileinq os •tznctnze, npon •pplieation theseioze,
s�quize the payaent by tAe applieant toz such pezmit'�ot iees to the
a�ouat a�zeta belov set�ioztA and in t?�e s�nner ?�ezeiA p:oviaed to-vit:
xnu, vi►wA�a�
=1.00 !a iS�0.00
�SO1 � �2/�0�
i2.001 !� i25• 000
i25,00i co iso,00�
0
sgs
i10.00 !lini�� Fee 515.00 plus surc?arge
:30.00 !or the tint 5500 plus 51.50 foz each
•aaitionai =100 oz traction thezeof, , to ar�d
sMiva�� :2,oao .
�32.50 ioz the iirct 52,000 plus 56.00 foz each
additional S1.000 oz izaction therecf, to and
tr�eluding i25, 000
=170.50 toz the iizst S25,000 plus 50.50 for
eacA additional 51,000 or fzaction the�eof, to
ar�d ineluQing t50, 000
i50, 001 ta =1D0, 000 :?83.00 to= the iisst i50, 000 plus S3. oo foz
each additional 51,000 oz iracti�n tAereof, tc
ana �neivai� sioo, o00
i]00,001 ar�d up id43.00 foz the first 5100,00� plus S2.50 ioz
each ad8itional 51,000 oz tzaction thezeof
PLW �OC: 2S pezcerit of Du3lding permit iee
DRIVDiAY D�EPRESSION ES(R�W: Conczete Wzb 5treets �ly
1►lternate 'A": ReJacv`al ar�d zeplac�oent of cvrb er�d qutter �nly ,
Drivevay vidth plus 6 feet :�13.S0 . . �
�-���ternate '8': Refloval and zep2sce�er�t oi cvzb ana gutter and ir,stall a 3 foot
vide approach vith 6 inth depth
Drive�:ay vidth plus 6 teet x i15.�5 �
VERIFICATION OF FOUNDATION
Pera�ita tor constsuctiat� vill be issued a feini�+►�n ot 24 hours from the time of
application to allov foz proper zeview oi the proposed itsucture and of the
constrv ction site.
I1 �eztiiicate of �:vey of the lot, showinq the Ioeation of the founclation once it
bas been oonstrvcted rill De zequired befoze �roceed_ ir� vith the traroir��.
.�__
0
sus�ECT PER
City of Fridley ° 17 0 9 7�
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
i �
� �
i bV �
COMMUNITY DEVELOPMENT DIV. � � �� �
r j � PROTECTIVE INSPECTION SEC.
� . ,
i-___ A�����,,J CITY HALL FRIDLE� $5432 NUMBER REV. DATE PAGE OF APPROVED BY
i � � 612-571-3450 910-F15
8/17/83 � �
JOB ADDRESS 6774 Channel R,oad N. E.
1 LEGA� LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 24 B.rookview Addition SHEET
2 PROPERTYOWNER MAILADDRESS ZIP PHONE
Jay/Dawn Johnson 6774 Channel Road N.E. 572-0345
3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO.
Saine
4 ARCHITECT OR DESIGNER MAIL ADDRESS 21P PHONE LICENSE NO.
5 ENQINEER MAILADDRESS ZIP PHONE LICENSENO.
8 USE OF BUILDING
� �d
7 CLASS OF WORK
O NEW � ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 OESCRIBE WOHK
9 CHANGEOFUSEFROM TO
STIPULATIONS
Reroo� can be 2nd layer but not 3rd. In�tall ridged galvanized
valleys.
TYPE OF CONST. OCCUPANCY GFiOUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBINO, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING S�. FT. CU. FT.
AUTHORI2ED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I 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 $`3OO y�`. SO
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- y�15.O0
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE TOTAL FEE
$15.50
SI ATUREOFCONTRACTORORAUTHOR12EDAGENT �DnTEi -- Ht�N PROPEFi LIDATED THIS IS YOUR PERMIT
� �� � �
SIGNATUREOFOWN IFOWNERBUILDER� IOATEI BLDG��NSP �A E
�
CITY Of F(tIDLCY
: Effective Auq. l, 1981
APPLIGATIO:� FOft RCSIDL"f�TIll� QU1LDIitG PERi�iITS
(Nc►��, Alter.�tions, Additions, or Repairs)
OtJNER: ���( o'°�wd,��J �p�t��Cj`1�-� '[3UILDER: �
no�r�ESS: ��"7y �����,1 'i?� nonr�css:
TEL A0: _ S 7�- C� 3 y� TEL f10:
Construction Location
ST7tI•TT NO: 7�-i ST32EF.T: c�'\c�l��el �L�Q(,�
9 �
i,o1�: � �-% sLOC�c: AnniTioN: ��'�%(�/��v _ s�iDh
Corner Lot: � Insicie Lot: Setback: Sideyards:
Applicant attach to tliis form two Certificates of S�rvey of lot and
proposed building location drawn on certificates to scale.
DESCRIPTIO�� OF COi•JSTRUCTIOW
P S Front: Depth: Height:
� Squanc Feet: C�ibic Fcet:
_ Front : Depth : Heiglit:
Squar.e Fe�t: Gvbic Feet:
Type of Con.truction: '���,���@_ %S�J��%�
. �
Zb Be Oor.�pleted:
Esiimated Cost: $ ,30Q, 0�
Alt. A Alt. 8
Proposed Drivevay width If New Opening Is Desired: $" $
. . S�� PEVER�E SIDE OF SFIEET
ZSie undessigned hereby ma1;c� applicaticn for a penait fcr the ♦:�ork herein specified,
agreeing to do ,all work ir� strict accordancc rrith the City of Pridle}� Ordi�iances and
rulings of tlie Delk�rt�nei�� of Buildings, and hereby c]eclares thzt all the facts and
represr�tati�ns stated � this applica�ion ase true and correct.
D1:TE: �� 6� Sa�iA��'.�u.:
Stil�ulations :
� �� �
. j—v
C�� �
�.: _
•1_.. . � ' c yu - . _ .
The ChieP Building OPficial 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 repairs to anq existing building or
structure, upon application therefore, require the payment by the
applicant for sueh permit oP Pees to the amount herein below set forth and
in the manaer�herein provided to-wit:
_ _.�
#1.00 to �500.00
Fees
�10.00 (Minimum $15.00)
�501 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 to $25,000
$32•50 for the first $2,000 plus $6.00
for each additional $1,000 or fraction
thereof, to and including $25,000
�25,001 to �50,000 �170.50 for the first $25, 000 plus
�u.50 for each additional $1,000 or
fraction thereof, to and including
$50,000
$50,001 to $100,000
�100,001 and up
$283.00 for the Pirst $50,000 plus
�3.00 Por eaeh additional $1,000 or
fraetioa thereof, to and including
$100,000
$433.00 for the first $100,000 plus
$2.50 for each additional $1,000 or
fraction thereoP
Plan Cheak: 25 percent of building permit fee.
Driveway Depressioa EsaroW: Concrete curb streets only.
Alternate "A": Removal and replaaement oP eurb and gutter only -
Drivewaq Width plus 6 feet times �13.50
Alteraate "B": Removal and replacement oP curb and gutter and
install a 3 foot wide approach s�ith 6 inch depth - Driveway width
plus 6 feet times $15.75
- .� �� '. �._ .,
Permits for cansfi�raaction vill be issued a minimum of 24 hours from the
time of applieation to a1Tot�r for praper review of the proposed structure
aad of the construction site.
A CertiPicate of Survey of the lot, sho�ing the location of the Poundation
once it has been eonstructed Will be required before Dz�oceedina with the
framing.
�- - � �.
SUBJECT
c�ty of Fridley
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
� �
� �
� `L _ __ COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC.
� _ �"'� � CITY HALL FRIDLE� 85432 NUMBER REV
�""'� � ,'� 612-571-3450 910-F15
JOB ADDRESS 6774 Channel Road N.E.
1 LEGAL �OT NO. BLOCK TRACT OR ADDITION
DESCR. Pt. 24 Brookview Addition
2 PROPERTYOWNER MAIIADDRESS
Randy Young 6774 Channel Road N.E.
3 CONTRACTOfi MAIL ADDRESS
5 ame
4 ARCHITECT OR DESIGNER MAIL ADDRESS
5 ENGINEER
8 USE OF BUILDING
Residential
7 CLASS OF WORK
MAIL
DATE
9/12/90
PERMIT .
20567
3� ��
PAGE OF APPROVED BY
� �
SEE ATTACHED
SMEET
21P PHONE
571-7827
ZIP PHONE UCENSE NO.
ZiP PHONE LICENSE NO.
PHONE LICENSE NO.
❑ NEW �] ADDITION ❑ ALTERATION O REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Construct a 14� x 10'' Deck.; two 4e.x 5� Decks.
9 CHANCiE OF USE FROM
TO
STI PU LATION S
See notations on plan, Deck 14ust b,e. at lea.st 40.� �eet �xom ths cux'b.
��pqRqTF
�i��, y� F�M�r
T ���' p`U �p��R
M��� q�'��R
�� S��NS
' TYPE OF
SEPARATE PERMITS ARE HEQUIRED FOR ELECTRICAL, PLUMBING, HEATIN(3,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING
AUTHOF;I2ED IS NOT COMMENCED WITHIN 80 OAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
��� .�,�� r•
� �•� `�i � ��
8ei�re �r�n�;.,g �u1r �.
all r,ii;;�y l��ai fl� for
REQ���E -�c�� �S
� �Y �A�°
SQ
ANY TIME AFTER WOHK IS COMMENCED. NO. DWLG. UNITS
I HEREBY CERTIFY THAT I HAVE READ ANO EXAMINED THIS APPLICATION 1 STALLS
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LRWS VALUATION
AND ORDINANCES GOYERNING THIS TYPE OF WORK WILL BE COMPLIED $1309.
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING Of A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pEiiMIT FEE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING coN- $33.00.
STRUCTION OR THE PERFORMANCE OP CONSTRUCTION.
�AN C1iECK FEE
ire SC $1,31
OF
AGENT .IDATEi
(3ROUP OCCUPANCYLOAD
CU. FT.
OFFSTREET PARKING
GARAGES
SURTAX
� $.65
�L FEE
$34.96
IS,IS YOUR
N�1 [ ] Effective 8/16/90
� [ ] R-1 AND R-2
AL'PF1t [ ] Huildi� P�ermit Applicatioai
Q
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Attach to this a�lication, a Cert.ificate of Survey of the
lot, with the propased �cti� drawn art it to scale.
7�IVII�1G AREA: Length
C�,RAGE AREA: I�ength
��" �
�
�
. :� «- . • .� . �
Width
Width
Width �
Height
Height
�/� �
, �
tbrner Iot Inside L�t [] . Yd Setback 111ets �� ��"` " 3ide
�I'j7p2 Of CO � G"t1011: ESt]i[13t.� C06t1
Approx. �pletion Date: �� ��,%�
Sq. Ft.
Sq. Ft.
SCj. F't. °� (J ' / c9 �i'i L—
i� i , , /
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/ . - ._
� _ S�= � �
+ � /
Proposerl Driv�way Width If New Opening Is Desired: Ft. $ $
Width + 6' See Back Page
n�: — - �r�c�ar: AT ��rrC � • # � %/- ���'I
, �„
P�mit Fee $ ��. �C?
Fire SurGharge $ l,� /
State Surch�-�ge $ ��
SAC C�arge $
Driveway Escrdw $
Park Fee $
Sewer Main C1�aYge $
. ��
����_�� � •,�-
S �� i�La
CI'PY II8E �Y
Fee Schedule on Revetse Side
.001 x Permit valuatioai (1/loth �)
S.so/Sl,000 valuation
$600 per SAC Unit
Alt. "A" or Alt. "B" Abave
Fee Determirted bY F�git�eerir�g
Agremnent NeoessaYy [ ] Nat Ne�ssary . [ ]
:+��� � �,. ��+;�v�4 �+�+� _-a�:i:��_�1 _
The Qzief Building Official shall, before ��-�+» *� permits for the erection of ariy
building or structure, or for any addition t.o ariy exi �; *+� building or structure, or
for any alteration or repair to any existirig building or structure, upon application
therefore, requir+e the payment by the applicant for such m�+;t of fees to the an�t
herein belvw set forth and in the maru�r hexein provided to-wit:
� �AL �TAI�JE
$1 to $500
$501 to $2,000
$2,001 t.o $25,000
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $500,000
E � �+a±�
$15 (Minitmun Fee is $15 plus surcharge)
$15 for fiYSt $500 plus $2 for each additional $100 or
fraction ther�of, to and including $2,000
$45 for first $2,000 plus $9 for each additional $1,000
or fraction thereof, to and including $25,000
$252 for first $25,000 plus $6.50 for each additional $1,000
or fraction thereof, t,o and isicludirig $50, 000
$414.50 for first $50,000 plus $4.50 for each additianal
$1,000 or fraction thereof, to and includirig $100,000
$639.50 for first $100,000 plus $3.50 for each additional
$1,000 or fraction thereof, to and includirig $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 ir�luding $1,000,000
$1,000,001 arid up $3539.50 for the first $1,000,000 plus $2 for each additional.
$1, 000 or fractiari thereof
DRIVE�iY DEPRE•9SI�T FSC[i�W
(Concrete Curb Stxeets On1Y)
Alternate "A": Remaval and replacement of curb and gutter only - Driveway width plus
6 feet times $13.50.
Alternate "B" : Removal arid replace�nent of curb ar�d gutter ar�d install a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $15.75.
►'/�; �� �: M �J� • � a� �1�i�; M �;,
P�mits for construction will be issued a minim�aa of 24 haurs frcan the time of
application to allow for praper review of the praposed stYUCture and of the
aonstYUCtion site. �
A Certificate of S�.iYVey of the lot, showing the location of the foundation onc:e it has
it has been constructeci will be required before proc�eding with the fYaming.
i.
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sue�ecr MIT NO.
c;ty of Fridley � 3� � � ,� - �
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
; � R NO.
� • COMMUNITY DEVELOPMENT DIV.
� ; V ����� ,
r � � PROTECTIVE INSPECTION SEC. %`//S
T/rs
' ' �"�1 � CITY HALL FRIDLE� SSO.3Z NUMBER (7EV DATE PAGE OF APPROVEO BY
�"""'�' �'' 612-571-3450 910-F15
10/31/94 � �
J08 ADDRESS
6774 Channel Road NE
t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. Pt 24 Brookview Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Lyn.da Young 6774 Channel Road NE 571-7827
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO
J& J Total Construction 6870 164 Ln NW Ramse MN 753-6558 9227
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WOFiK
❑ NEW ❑ ADDITION ❑ ALTERATION � REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
REpair roofing and sidin
9 CHANGE OF USE FROM TO
STIPULATIONS
Install smoke detectors as per UBC 1210 adjacent to all sleeping
areas and in basement.
SEPARATE PERMITS RE��1�;i�fl 'FOR
WIRING, HEATING, PLU147B1�1� ��li� S�%�
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TVPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OF AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID �F WORK OR CONSTRUCTION ZONING SQ. FT CU. fT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WOFiK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STAILS 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 HEHEIN OR NOT. THE GRANTING OF A PERMIT W iS � OOO �7. SO
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHAFGE
PROVISIONS OF ANY OTNER STATE OR LOCAL LAW REGULATING CON- @
STRUCTION OF THE PERFORMANCE OF CONSTRUCTION. �LC)Z.00 Fire SC �p1S.00
PLAN CNECK FEE T07AL FEE
$5.00 $189.50
SIGNATUAEOFCON�AACTOAOAAU7MOA�IEDAGENT IOATEi WHEN PfiOPE VA DATED THIS IS VOUF PERMIT
� °� /�- -�Z�
SiGNATURE OF OWNEFl UF OWNER BU�LOEA1 �DATE� BL G�NSP �iuTE
♦
NEW
ADDN
ALTER
��
[l
Il
CITY OF 1�RIDLEY
SiNGLE FAMILY AND DUPLEXES R-1 AND R-Z
Buildiag Permit Application
Effective 1/i/94
�����
ConstructionAddress: �77�/ ��i�a✓�e � �'a A-d
Legal Description:
Owner Name 8c Address: � Y�Q �; o�,v 9 Te1. �,��'%l — 7�� `� ,
Contractor: �'� q--� I a�� l� a A0S iR �� 7'�a v� MN LICENSE # g�7� 7
Addre.cs: �� i o f 6 y�' �c.�, y�- /�.�r s e� Tel. # 7.�.� '�.�.��
Attach to this application, a Cerdficate of Smvey of the
lot, with the p�osed constivcti� drawn on it to scale.
DESCRII'TION OF IMPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. F�
DECB AREA: Length Width Hgt/Grround �. Ft.
oTHER: �06 ��.✓ 9 �� o %� � yr�►,�vo•� �-��do�i�
--, ,
Comcr Lot [� Inside Lot [] FL Yd 5etback Side Yard Setbacks
Type of Construction: �ted Cost: $��; ���° m�
:Approx. Compietion Date:
(Cost oa Beck) � _ `;'.
Driveway Curb Cirt Width Ne�ied: Ft + 6 Ft = Ft x$ —$
�
DATE: �o- 3 i - � `/ APPLICANT: �a2�� �� Tel. # �.��-- 6 �f �`'
Petmit Fee
Fire Surcharge
State Surcharge
SAC Charge
License S'�n�charge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
� % ���. OC�
$ ��� �C�
$ t � �G�
,
$
$ �. c� cc�
$
��!_�. '� � L _
Fee Schedale a� Reverse Side
..001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$800 per SAC IJnit '
.. ,
$5.00 (Sta�e License+d R�identiai Contracr,ors)
Alt. "A" or Alt "B" Abave
$ $450.00 C�nssivati.on Plan Review
$ Fee Determined by Engineering
$
$ �C, ��
Agreem�t N�y I l Not Nec�sa�y [ l
I3UiLD[NG PERMIT FEE SCHEDULE
1'hc Chicf f3uilding Offcial shall, t�efore issuing �mits for the erecbion of any building or structure,
ar for any addition to any cxisting building or structure, or for any altecaUon or repair to any existing
buiiding or slructure, upon application therefore, roquire ttte payment by the applicant for such permit
of fcc.t to the amount hercin, t�e(ow sct fc�rth and in the manner hereia provided to-wit:
TOTAL VALUE
$ I to $500
$501 to $2,000
$2,001 to $25,000
$25;001 to $_50,000 - .
$50,001 to $100,000
$l0U,Q01 to $500,000
FCES
$15 (Minimum Fee is $i5 plus surcharge)
� 15 for fust $Spp plus $2 for eacL additionai $100 or
fraction thereof, to and including $2,000 �
$45 for fitst $2,Opp plus $9 for each additioual $1;00(3
or tr�idion thfxeof, to and inclu�ng $25,000 •
$252 for first� $ZS,ppp plus $6.50 for eacii additionaI $1;000
or fracbion th�eof, to. and including $50,{)00 •-
$41450 for first $SO,Opp plus $¢.Sp for eacii additional
$1,000 or fi�c�ion the,reof, to -and induding $100,000
�. -$639.50 for f�rst �$100,OQ0 pins- �3.50 for each additional. '
. �1,000 or i'radion diereo� to . aad includ�g $500,000 .
$SOO,OOi t,o :$I,U00,�0 r _,_�_ : _ . ,_.. ,_.. � , .
_ . <. $203950::.for' die S�rst � $�0,000 = plus � $3 for eai'� �'addifron.al
�1,000 or � fiadion ti��eof, to: and iacludiag S1,OOO,ODO
$1,00�,001 and up _ _ _ _ . -- - : $353950 for the f� $1,OQ0,000 P1us $2 for each additional
$1,OQ0 or fradion thereof -
,
DRIYEWAY DEPRESSION ESCROW � .,
. � {Concrete Gtirb ';�reets Only) � .
Alternate "A": Removal and replacement �'of curb and gutter on�y �_ Dr�veway width pius 6 feet times
- $I3_SQ ,
Alternate "B": Removal and rep(acement of curb aud'' gutt� aiad inshaQ a 3 foof wide.
approach with 6 inch depth - Driyeyvay width pius 6 feet times $15_75_
VERIF[CAT[ON OF FOUNDAT[ON
Permits for conslruction will be issued a minimum of 24 hours from the time of a{�p(ication to allow
for proper review of the proposed stnicture and of the constniction site_
A Certificate of Sucvey of the lot, showing the location of the found.ation once it has it has t�ecn
constructeci will be reyuirecl before proceeding �,ith the framing_
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NOTE: ��1 through ��8 required when using a side vent furnace.
CHIMNEY ANi) STACK VERIFICATION
The undersigned hereby verities that the existing chimney or stack:
1. Has been carefully examined Yes () No ()
2. Is free from rust or deterioration
3. Has no foreign objects lodged within
4, Is securely supported
5. Meets all current Code requirements for size
and tatal BTU's connecte�
6 Has total i�eating BTIJ's of
?.
S.
All other BTLT's
TOTAL BTU's
Has a liner been grovid� for water heater
Has combustion air been provided for water heater
itemarks:
; '_�_ � : � � � ��,,-
HEATING CO:
Signed By:
Date:
Yes t ) No E )
Yes ( } No � )
Yes ( ) No ( )
Yes ( ) No ( }
Yes()No()
Yes()No()
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SUBJECT P
c�ty oi Fridley
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T �� ���
r
� �� RECEIPT NO.
� ty �'���'
COMMUNITY DEVELOPMENT DIV �Z�
r � � PROTECTIVE INSPECTION SEC
l� _ �
-•-. A;/"','� CITY HALL FRIDLE� 55432 NUMBER REV OATE PAGE Of APPROVED BV
L J\ 612-571-3450 910-F15 7/18/96 � �
JOB ADDRESS 6774 Channel Road NE
1 LEGAL LOT NO. BLOCK TFiACT OR ADDITION SEE ATTACHED
DESCR. Pt. 24 Brookview Addition SHEET
2 PROPERTY OWNER MAII ADDFiESS ZIP PHONE
Linda Young 6774 Chanttel Road NE 571-7827
3 CONTRACTOR MAIL ADDRESS 21P PHONE LICENSE NO
Randy Beers Construction 4208 6 St NE, Columbia Hei hts MN 55421 860-7076
4 ARCHITECT OR DESIGNER MAIL ADORESS ZIP PHONE LICENSE NO.
6551
5 ENGINEER MAIL ADDRESS 21P PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION � REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Reroof & Reside Garage
9 CHANGE OF USE FROM TO
STIPULATIONS
TYPEOFCONST. OCCUPANCYGROUP OCCUPANCVLOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIFi CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZpNING SO. FT CU. FT
AUTHORI2ED �S NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STAILS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORREC7. ALL PROVISIONS OF LAWS yAIUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED MEREIN OR NOT. THE GRANTING OF A PERMIT $1,350 �.68
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- @
STRUCTION OR THE PERFOFiMANCE OF CONSTRUCTION. �p45.75 Fire .SC. �1.35
PLAN CHECK FEE TOTq� FEE
License SC $5.00 $52.78
SiGNATUfiE C N�RACTORORAUTHORIZEDAGENT ionrEi WHEN PfiOP Y VALIDATED THIS IS VOUF PERMIT
- � � � ` `�-
S�GNATUREOFOWNEA�IFOWNERBUiLDER1 IDATE� 8 DG �NSP qaTE
�
NEW � ]
ADDN [ ]
ALTER []
ConstructionAddress:
Legal Description:
CITY OF FRIDLEY
5INGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
��
Effective 3/1/96
, �
�3 z�
Owner Name & Address: �_tN � � '�t`p' � o� Tel. # �'�l— �� �
Contractor: f�n.► Q`� ��Q$ n��,u c,�� �� MN I,ICENSE �# (9��
Address : �„ ��^ 5-� I`9 - � Cf� ,�-(-�5 � D�� ���� l Tel. # �i � f� ' �D %�
Attach to this application, a Certificate of Survey of tlie
lot, with the proposed construction drawn on it to scale.
DESCRII'TION OF IlVIPROVEMENT
LIVING AREA: I.ength
GARAGE AREA: Length ��
DECK AREA: ng�
OTHER: � � �
�-e� - _
Corner Lot [] Inside Lot ] Ft. Y etback
Type of Construction:
Approx. Completion Date:
Width Height Sq. Ft.
Width �_ Height Sq. Ft.
Widt�h Hgt/Ground Sq. Ft.
� � � �, v � � s��; �
S' � - U �
� S' e Yard Setbacks
Estimated Cost: $� , ��Q . D
(Cost on Back)
Driveway Curb C�t Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: � � � APPLiCANT: ��A� � � i�; E� Tel. # �(qp—%0 � ,
Permit Fee
Fire Surcharge
Sta.te Surcharge
5AC Cha.rge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPLTLATIONS:
$ S ��.�
$ �. .� �
$ � ��
$
$ S-�C.�
$
$
$
$
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CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%}
$.50/$1,000 Valuation
$900 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 1Vecessary [ ] Not Necessary [ ]
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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
$100,001 to $500,000
$500,001 to $1,000,000
$1,000,001 and up
FEES
$21 (Minimum Fee is $21 plus surcharge)
$21 for first $500 plus $2.75 for each additional $100 or
fraction thereof, to and including $2,OQ0
$62.25 for first $2,000 plus $12.50 for each additional $1,000
or fraction thereof, to and including $25,000
$349.75 for first $25,000 plus $9.00 for each additional$1,000
or fraction thereof, to and including $SO,Q�
$574.75 for first $50,000 plus $6.25 for each additional
$1,0� or fraction thereof, to. and including $100,000
$887.25 for first $100,000 plus $5.00 for each additional
$1,000 or fraetion thereof, to and including $500,000
$2887.25 for the first $500,000 plus $4.25 for each additional
$1,000 or fraction thereof, to and including $1,OQ0,000
$5012.25 for the first $1,0�,000 plus $2.75 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete G�rb Streets Only)
Alternate "A" : Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50.
Alternaxe "B": Removal and replacement of curb and gutter and insta.11 a 3 foot wide
approach with 6 inch depth - Driveway width plus 6 feet times $15.75.
VERIFICATION OF FOUNDATION
Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper
review of the proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed
will be required before proceeding with the framing.
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CHIlVIlVEY AND STACg VERIFICATION
The undersigned hereby verifies that the �existing chimney or stack:
L Has been carefully examined Yes (�) No O
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2. Is free from n�st or deterioration Yes () No ()
3. Has no foreign objec.ts lodged within Y� () No ()
4. Is securely supported Yes () Na ()
5. Meets all ciutent Code requirements for size
and total BTU's connected Yes () No i)
6 Has total heating BTiJ's of
All other BTiJ's
TOTAL BTU's
7. Has a liner been provided for water heater Yes () No ()
8. Has combustion air been pmvided for water heater Yes () No ()
Remarks: .
List ALTERATIONS Being Done:
HEATING CO:
Signed By: _ ^
Date:
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