AF - 40887FIRE DEPARTMENT MEMO
TO• �BUILDING INSP
ASSESSING �
SUBJECT: �FIRE DAMAGED STRUCTURE DATE: Dec. 3�, 1y�2
FIRE.HAS 4CCURRED AT
�: .
• 6�1� E. �iver Rd.
ADDRESS .
D�c. 29, 1��2
DATE OF FIRE
�/ '
�!
SUBJECT PER
c�ty of Fridley 16 9 7 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. / fS
1 `y _ _ 9 � �r '
r � � PROTECTIVE INSPECTION SEC.
' i '
� ��"1 � CITY HALL FRIDLEv 55432 NUMBER REV. DATE PAGE OF APPROVED BV
�""'"� � ,�� 612-571-3450 910-F15 4/11/83 / /
JOB ADORESS 6819 East Ri.ver Road N.E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. $ ], �'(�13T1eS lst Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
David Petrosavage 6819 East River Road N.E. 572-0352
3- CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
Bri.taho�nes � 7128 Chicago Avenue 5outh 861-6150
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION O; REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Correct Fire Dam e to Dwellin
9 CHANGEOFUSEFROM TO
SjIPULATIONS
�E�UtRED
F OR ����`
SEPERATE PER� ��� ANp SIGN�•
HEATING. PLU�B
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PEFMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I 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 �r48.o� �`2Li.00
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- y�`2'7��00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECKFEE TOTALFEE
$298. 00
ATUREOFCON7RACTOR U HORIZEDAGENT IDATEI WHEN PROPERLY V LIDATED THIS IS YOUR P RMIT
C� Qr �
SIGNA URE F WN �IF NERBUILD RI IDA EI BLDG INSP � �AT
CITY Of fRIDLCY Effective �ug. �, i9ai
APPLICAT10t� FOf� RCSIDLNTIII� BUlLD1i�G PLRt�fITS
(NH,�. Alterations. Additions. or Repairs)
OWNER: ,�
ADOP.FSS: ���(% j��, ���T �
�i
�� �o: .��7 � v � -� 5 � �
BUI LDER : ,��Y�/ r��7 � � �� 5
AODRCSS: �/� ���e�� _,
e
�� f�o: �� �— � i�-��
Construction Location
• bTRIST, N0: 6TItEET:
ypT= � BI,p(1C: _�_� ADDITION s �! s�1� �/� s � S�_ _/� N�
Corner Lot: __ Insii3e Lot: � 6etback: Sid�yazds:
Ap?13cant attach to tl�is iozm two Certificates of Stirvey of lot ana
pzcposea buflding locaticn drawn on certificates to scale.
DESCRIPTIOi�! OF C01•�STP.UCTIOt�
,�
` Frcnt: Depths Height:
bquare Feets Qibic Feet:
Front: Depth: Hefght:
Squase FePt: Wbic Feet:
• � (' � P +� c i
. •
Zype of Corstzuction a � � � � Estfa�eted Cost: S
Rb Be CDr.�pleted: �
' 7►lt. A Al t. B
Propesed Drivc�+�ay iiidth If New Openinq Is Des3seds S� S
SEE Rs.VERSE SIDE OF SHEET �
Zi�e un8essigned hereby ma1;c� epgiication for a permit icz the ��ork herein specified,
agreeing to do ,all vork ir� stzict eccoza�ce Nith the City of Frialey Ordinances e�id
ruli»gs of the Delk�rbnc�t of Dufldings, and hereby declares that all t]�e facts and
repres�t�tiens stated iri this application are true and correct.
D��TE: � SIGNATi7R�:
Stipulationsa
��
,
•, �
�r,���� �,,►.
� �� �I�
�
� ��p .00
BUILDING PERMIT FEE 6CHEDULE
The Inspector oi buildings shall, befoze issuing permits for the
•r�etion of any building oz stzuctnze, os ioz any addition to any
•xistiAg buildiA� or strueture, or for any altezation or sepairs
to any •:istinq Duilainq os stzucture, npon application therefoze,
s�quize the paymeat Dy the applicant foz such permit o! �ees to the
aaouat �ezeia belov set ioztb and in the �anaez bezein psovided to-vit:
TOT11L V11II)11TICN
i1.00 m i500.00
5501 t� =2,000
SZ,001 b� 525,000
S�S,001 to 550.000
SSC,001 to 5100,000
S100.001 ar� up
!E£S
i10.00 !linimu� Fee 515.00 plus surcharge
510.00 !or the first 5500 plus S1.50 foz each
a8ditional 5100 oz fzaction thereof, to and
includinq 52,000
532.S0 ioz the fiztt 52,000 plus 56.00 for each
additional S1.000 or fzaction th ereof, to ana
including 525,000
5170.50 foz the fizst 525,000 plus S4.50 foz
each aaclitional 51,000 oz fraction th�eof, to
and iacluding 650,000
i?83.00 tor the fizst 55�, 000 plus
each additicnal S1,000 or fraction
ana incivai� Sioo, o00
5443.00 foz t�e fizst 5100, 000 plus
each additional S1,00G or fraction
P7.AA1 Cl�QC: 25 percent of building permit fee
53, oo foz
thezeof, to
S2. 50 foz
thezeof
DRIVfl�AY DEPRESSION ESCZtdW: Conczete Q�rb Streets Only
]�lteznate `l1"a R�oov�al ar�d zeplacem�t of curb ar�d gutter only ,
Driveu�ay width plus 6 feet s�13.50
111ternate 'B"s Renoval ar�d replace�es►t of curb and quttez and install a 3 foot
wide approach with 8 inrh depth
Drivevay width plus 6 feet z 515.75
VERIFICATION OF FOUNDATION
Peza�ita for constivctioi► vill be issued a mini�mim� of 24 hcurs fzom the time of
application to allow for propez zevieW of the proposed structuze and of the
constzu ction site.
A Cert3ficate of �xvey of the lot, �hvwing the location of the foundation once it
has been oonstructed vill be required before proceedi� with the frami,r�g.
3 � °�
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.� HEAT LOSS CALCULATION ° TEMP. DIFF. ��'��fL1�� �i
<= �'- . i
Cu:tomer Name TYp� Conjtruction '
Cny Wir�dows Storm Sath
Dal� Name - WaUs . Int.
Str�t -- Ceiling In�.
City Floor ' '
FI.� Room j Length � Width Hei t �- FI.� Room � Length Width H�
Win�dows and Doors-Crackage and Area Windows and Doors-Cnck
pe �nd Arq .
No. wp M Heiqnt No. of Lfnul ft. ArM No WIAib Md�M � No. of LInMI It, ArN
M�n� of n��� L h�r o� rnek q. h. ot et rh L b ot ene � p. k. � �
`� --�- --- a
Iniiltration �
G lass
Exp. wall' C)
Net exp. wall a
Int, wall •
Ceiling .
Floor
Total Btu.
�-FI.�L,�����, Room�Length �� Width
Windows and Dcwrs-Crackageand Arp
No. W'��� M��qnt No. of Llnwl ft. A�w
of o�M � Ot D�M L1Oht� 01 C►KY p. �t.
Infiltration
G lass
EYp. wall
Net exp. wall
Int. wall
Ceiling �
F loor
Tota1 Btu.
) - F I.I ,��,� Room
Wmrk�ws an�f Door!
Nn W�A�� M�p�ht
n� n�rr� 1 nl n�no
Inf iltrat�on
G Iau
Exp. wall
Net txp. watl
Int. wall
Ceil�rg
Flonr
Towl Btu.
and Ara
Btu
��j Infiltration
/UQ Glass
Exp. wall
t�'�� Net sxp, watl
Int. wall
Ceiling
F loor
7Sn Total Btu.
h� �_ FI.I , i9'/L/ _ Room
Windows and Doon
No. w�dM NN/Nt
O} �M 01 �M
8tu
) HeigF+t �
a3��
L/J`� � cd
�-�
!� 4� �S
M. Btu
Infiltration
G lass
Exp. wstl
Net exp, wall
Int. wall
Ceiling
Floor
Total Btu.
� FI.I �j �- Rooml
Windows ae� Doors•
� N�. �b.� �.�.
1 nf iltration
G laa
Exp. wall
Net exp, wall
I�t. wall
Ceiling
Floor
ToUI Btu.
Width
•nd Ara
and /►na
8tu
��
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�_
�_
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Btu
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- HEAT IOSS CALCULATION ° TEMP. DiFF. � ��
_��
�� .
Customer Name Typ� Comt►uetion
C� Windows Storm Snh
�al� Name - Wall� _ Irq.
SbNt ---- Ceiling Iru.
City — Floor �
-FI.� RoomjLength Width J
Win�iows and Doors-Crackage and Ares
No Wp th Ne�pnt No. 01 Linpl ft. ArN
nl •n� a1 p�n� Li �ts of eryek p. /i.
Z �
Ca
Infiltration a� �
G lass
Exp. wall'
Net exp. wall
Int. wall •
Ceiling
F loor
Btu
Total Btu. � �
f-F�.I Room � Length p Width 7 Hai t�
Win�ws and Doors-Cracksge snd Arp •
No. W�dtn H��ynt No. of Lirwllt. Aru
of n� ot n� L Atf 01 c��C4 q. h. � 3 Y�
a3��
------
Zi�37
Coef. etu
Infiltration
Glaa "
Exp. wall
Net exp. wall ,�l (e .� �G
Int. wall
Ceiling
F loor
Total Btu.
FI.I Room�Length � Width
WmAc�ws and Doors-Crackage and Arp
N� Wufrh H�u�h� NO. o/ Lnw11t. A/p
nt n+�r � ot panc L b o/ n�tk p. I[.
Iniiltration
G �au
Exp. wall
Net txp. wall
Int. wsll
Ceil�ng
Floiu
ToWlBtu. _
BiU �
FI,� Room�Lenqth Wi
Windows and Doors-Cnckpe and Arq
No. WItltH M�lOht NO. W �InMI N. /
o� � ol na L n et ene11 � r
Infiltration
Glass
Exp. wall
Net exp. wall
Int. wsll
Ceili�g
F Ioor
i,l Totel Btu.
FI.� Room�L h Width
Windows and Doon-Cnckage snd Ara
No. w�Oth M�I�ht No. of LInMI h. A�
ct �ra o1 n� L Nb of enaY p. ft.
Infiltration
Glass
Exp. wsll r
Net ezp, wsll z �
Int. wall
Ceiling
F loor
Total Btu.
FI.� Room�Laqth Width
Windows a� Doors-Gadupt md Ana
- N� w�a.� M•;N,e No. w LUwI h. Am
e1 rr ef n� L b of p�ek p. H.
Infiltration •
G Isss
Exp. wall
Nec exp. well
Int. walt
Ceiling
Floor
Total 8tu.
Btu
8tu
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Building BUILDING P�t No.: � �'
� ,���
Inspectioas RESIDENTIAL APPLICATIUN R�ry� �'�
763-57�-3604 CIT'� UF FRIDLEY D$�d��� n� 2
nA� 09/26/09 Y���,�� estherd�probuiltam.com
srrE,�D�s 6819 E River Road
THIS APPLIGANT IS: ❑ OWNER �COAITRACCaR
PRUPERTY OWNER! �: paul Johnson
TENANT ,���s: same as site crrY s�rA� z�
�:
CONTRAG"f�R ��; proB il ric
SUBMPP A COPY UF STATE�.[c�vs�� BC-20356847 �►aA� 03 10
YOUR STATE LICENSE Aon�ss: 2211 1 t Ave �� North 3� �A� ��53.8 9
w�i APPLICATION PHOATE 551- 770 - 9315 F,� 651- 77 0- 04 95 +
PROPERTY TYPE O SINGLE FANIILY/NEW COAi3TRUCFIOAI S1ZE
❑ TWO FAM[LY/NBVV CONSTRUCTION 3'fp12iFS
PERMIT TYPE a Runrno�v o G,�c.�rs�n o wu�mows
❑ Bas�rr r�nsx ❑ itooF a nxa�r �n.�
❑ u� a sronac o o�x
a swn�mvG raoot.
TYPE OF WORK: ��v ❑ a.nnrrioN
❑ �nu�r�rr�ivc�rAm a �on�uv�
DESCRIBE WORK BEING DONE: Replacing 3 window,
SIZE OF IlViFROVEMENT LENGTH WIDTH HEIGHT . Ft.
$� � HOUSB OiVLY
I�IUMBF1t OF S�JARES O IiOUSE & GARAGE
1. E�ing Floor Platt
� o Arracr�nc��ucac�� 2- �� �, ��
PROP'OSED SIZE: O DETACI�J GARAGE 3. L.i� of struct�al atembets � 1� �d
PR(fPOSED fffiGHT:
SIDD�IG FOR NEW CON3TRL�L�70N INCLi7DIAtti DF:C�CS,
CI V�nyl {]So�'tt S. & PORCHES SI3BMiT, j,
� At� � Trim i. Sibe PlanlSmroey s�vmg ti�e exisbing struch�r�y
O Ot�r ❑ Fasc� m� � P�.I�
��,S 2. Tv�s s�s ofco�ian p�ns
IN El�STII3G OPENIIdGS 01'es �fo LOCA'iTON UF WiN�iVS 3• E� Calculatianq
QR F4R NEW OPENIl�TCi3-DESCRiBE SIZE QF
OPFIVIlNC3 CHANt3F.S &
TYPE OF WIl3DOW TO BB INSTALLID NUMBER OF WIfTDOWS 3
ALL FEFBS ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND A�ATERIALS:
Fermit F�
Ptan Review
Fire Surcharge
Sw�c�acge
License Surcharge
SAC �ge
C�rb C:ut Esctow
Erc�sion Couh+ol
P�rk F�
Sewc� Maia G'h�rge
(USING THE 1997 U.B.0 FEE SCHEDULE)
ALUATION $ � 0� 9 �CUPANC'
� ���l� S� Back Page for F� Ss�ule
$ 65% of Buildin� P�tnit Fee
$ r'� .�1 rimes the toial jo6 valuation
$ .�OS x Permit Valuation Minimum $SO
$ � �5.� (State Li� Reside�al Co�ttracto�s)
� $1675 per SAC Unit (Plans to MWCC for detertni�tion)
$ ft+6f�= 8x$21=$
$ $45Q Ca�on P� Review
$ F� De�ermin�ti bY E�g
$ Agreeme�t necessary ( } Nan Nec�ssary ( }
TH[S IS AN APPLiCA110N FOR A PERMIT 1VOT VALID UNTIL PROCE95PD
I Hereby appiy far a building �it and I acknowledge that die infurmation above is cumpiete �nd aQe�u�ate; that the work wiil be in
confo�noe � tl�e ordinances � c�s of the City of Fredley and w�ith the M'�� C.�vction Cad�; tl�t I�ad ffiis is n� a
petmit but onty an appiication for a ' and wo�c is nat to sta�t wilitout a pe�mi� that t$te work wiii be in acaordattce w�t the approv�
plan in fhe case of atI work whirdi approval of p
s�v�►rUxE o� .aPrr.�c,a�rr w;���/f ��' t� P. �n�rr�� �'�5r Dahl nA,� 0 9/ 2 6/ 0 9