AF - 47670City of Fridley, Minn.
BUILDING PERMIT
�v� soo2
_.�'�--�-�-_� '
Date: _. �
Owner: �� Builder �_..____..._—___..._.._..��
Addresa .....__.____._____.___. ' ._..._..__.__..._..__..._._.._.._._ ' Addresa _..__ _�_ ..._
-�...... �I�G�'�+/�aT�,QN� �L NG
No. �I�_ ._. street �A �. ����..-� P of Lot .�.._._.
Lot _.._..� ._:� Block W..`�..:.._._.�:_.._.� Addition or Sub-Di `orL _ /
< �� . ;
Corner Lot ___.._.�!!inside Lot ...._._'..__.._...._..__._._.. Setback .� .. Sideyard' _.� ��.��.._
�. ._._.__....
Sewer Elevatiort __..____.._._.___._.._.._..��....�.�_.._..___.._._ Foundation IIevatio�
^ DESCRIPTION OP BUILDING
To Used a • r � �„
�Front ��. Depth � ight �.._.. Sq. Ft Cu. Ft
Froi _ Depth _._ • ' E�eight � Sq. F� !' Cu. I�'t. -
_.
T�e of truction _._..._ .. Es� Gost �.. __....._ o be Completed _:�..
In consideration of the issuance to me of a perinit to construct the building described above, I a8ree to do
th� propoaed work in accordance with the d�scription above set forth and in compliance with all pravisfons of
ordinsnc�s of the city of Fridley.
�
In co�sideration of the payment of a fee oP �...�._+�!!"�' �.., permit is hereby granted to—
to c�struct the building or addition as described above. This permit is granted up�
the express condition that the person to whom it is 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 ordinances of
Fridley, Niinnesota regarding location, construction, alteration, maintenance, repa.ir and moving of buildings
within the city limits and this pexnnit may be revoked at aqy time upo� violat,i�n of aqy of the provisioais of said
ordinancea ..*�. /"'"l
B��S �P��
NOTICE:
ihis p�m�ir dws not eowr tla eonsnueNoe, in�ll�1[on for wGiny. Phaebin�, oa hNNn�, s�w�r er wN�r. 6� suN fo sN
th� EuiWiae Intp�elor for s�p�r�N pamits for tMa ifans.
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APPLICATION FOR BUiLDING PERMIT
CITY 4F FRIDLEX, MINNL�7ESOTA �
^ �
/�/� ,
Owner's Name , �-���- ��l���Cl�,.�� Builder ��1�-e� �z�----.�
,
Rddress Address� l `� �'�� �^�,
IACATION OF BUILDING . .
� -�_.
No. � ,�� / Street �_ �, � > '�,_Part of Lot
, �,�
/ i c i� Z'e-�-!�`� d- ��_ �-�.s�
Lot -� Block _,__ �,/ / �����Addition or Subdivisio �,_„_,
Corner Lot v`' 2naide Lot Setback�Side-Yard ��
SEVJER ELEVATION ,S� '�� � � . FOUNDATION ELEVATTON � �' �
Applicant attacii to thia form Certificate of 3urvey of Zot and �
�ti�•-�
proposec� buildir�g location. � ��
�.�.:�.�� e .
DESCRIPTION OF BUILDING
w . �i.,<-�L.t
To e used as o��'-r.� �� . ! e�- �
R
ront Depth ��Height r�`- �
Sq. Ft. ���� Cu. Ft. �. �i�� c�
Front � „_Depth � eight �
Sq . Ft . _ � ,�,7 C� Cu . Ft .
Type of Construction '.=�� �'t-4-� Eatimated Cost
,
To be Completed � �"��
The undersigned hereby makes apglication for a permit for the work
herein specitied, agreeing to do all work in strict aceordance with
the City of Fridley Ordinances and ruling o� the Department of 8uild-
ings, and hereby declares that all the facts and representations
stated in this pplication are true and correct.
, ;
DATE � ti � ` -,,�� SIGNATURE � � ;/-��'r`-'`--� C!� -� - _
.._,__� -,..,...._.--- _.._._....�_
(Schedule of Fee Costs can be found on the Reverse Sidej.
� . � ' ~
� �
Application �or Power Plam�s and Heerting� Cooling, Ventilation, Re�frigerafiion and
Air Conditioning Systems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: RATE TOTAL
Furnace Shell & Duct Work . . . . . . . . . . . . . . ... . . . . . . . . . . 8.00 �
Replacement of Furnace ............................. 5.00 �
Repairs & Alterations—up to $500.00 . . . . . . . . . . . . . . . . . . 5.00 $
Repairs & Alterations each add. �500.00 . . . . ... . . . . . . . . . 2.50 $
MECH. WARM AIR
Furnace Shell & I?uct Work to 120,000 BTU . . . . . . . . . . . .
each add. 60,000 BTU . . . . . . .. . . . . . .. . . . . . . . .
Replacement of Eiirnace .; ...........................
Repairs & Alterations—up: to $500.00 . . . . . . . . . . . . . . . . .
Repairs & Alterations eaeh add. $500.00 . . . . . . . . . . . . . .
STEAM or HOT WATER SYSTEM
Furnace Shell & Lines—to 400 sq. ft. EDR Steam .... .
Fumace Shell & Line—to 640 sq. ft. EDR Iiot Water ...
Each add. 200 sq. ft. EDA Steam . . . . . . . . . . . . . . . . . . . . .
Each add. 320 sq. ft. EDR Hot Water . . . . . . . . . . . . . . . . . .
8.00 $ �� �
2.00 ;
5.00 $
5.Q0 $
2.50 $
8.00 $
8.00 $
2.50 $
2.50 $
G�IL BURNER—to 3 gal. per hour . . . . . . . . . . . . . . . . . . . . . . . 5.00 $
over 3 gal. per hour—See Fee Schedule
GtiAS BURNER (up to 400,000 BTU) . . . . . . . . . . . . . . . . . . . . . . . 5.00 $�
GAS FITTING FEES: NO RATE TOTAL
lst 3 Fixtures ......................�_ x $1.50 $�
Additional Fixtures ................. x .50 $
Gas Range to 200,000 BTU . . . . . . . . . . . x 2.00 $
AIR CONDITIONING
FAN HEATING SYSTEM
VENTILATING SY$TEM
ALTERATION3 & REPAIRS
ROUGH
FINAL
;
v
3ee Fee Schadule
Y r• .. �
TOTAL FEE �_.�' X' �
Dept. oi Bldgs. Phone SU ;-7470
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City of Fridley:
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City Ordinances
and ruling of the Department of Buildings, and hereby declares that all the facts
and representations stated in this application are true and correct.
� Fridley, Minn. , 19 � L
�
Owner _
Kind of
Used as
To be co
Estimated Cost, $
Old� Building Permit No. (� U O�—�Permit No. �- ��
DESCRIPTION OF WORK
HEATING or POWER PL.ANTS-�team, Hot Water, Warm Air—No._'�__
�
Trade Name Size No.,��,lo�
Capacity Sq. F't. E.D.R.�,����v� BTiJ H.P.
Total Connected Load�_ � Y Kittd of �e
�
BURNER — Trade Nam Size No_� ��� a
Capacity Sq. Ft. E.D.R �v BTLT H.P.
� � , � � . SUBURBAN HEATING & SHEET MtTAI
CENTER QRIVE �4 E
,,. �419 _ .
,� .� K�. g�e MIYNF.I�POI.IS 2I. MINN►
�
sy
� 4: sM Business Phone No- �G � l �
(REMARKS-OVER)
�
D�T6 � . . a z t . - .�
HEAT LOSS CALCULATIONS DEPARTMENT
Weatherstrips A.S.H.V.E. Construction 11'
Guide
Windows Doors Reference Out. Wall Int. Wall Ceiling
—No ( No 151�5� v
Fl.� " Room � Length �� Width ,jt Height �
mdows d Doors—Crackage and Area
�Vtdth Height No. ol Llneal It. Area
Na. o[ pane o[ Dane lighta of crack sq. It.
� � D
� � / �
�3'0" � , 3 ,
Coef. Btu
1n61tration 7,p
Glaaa p��
Exp. wall
Net exp. wall p l� p p
lnt. wall
Ceiling � Q
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. L.eader area Z
Fl oom � Lengthy� � Width �3 / Height� �
indows and Doors—Crackage and Area
Wtdth Helght No. o[ Lineal ft. Ares .
No. of pane ot pane IiQhts oI crack sa. tt.
?� 7� yo v L .
-z, /3. 3 %
`�� �� , �9
Coef. Btu
Infiltration �� �,p 2/ �
Glasa 1,, y �/
Exp. wall
Net cxp. wall � /.d
Int, wall
Ceiling 4 �
Floor
Total Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. l.eader area
FI. oom � Length �/ Width ��� Hei
Windows and Doors—Crackage and Area
Wldth Helght No. ot Lineal ft. Area
No. of Dane ot Dane Ifghts ot crack sq. tt.
/ �. . C�J Z � �i � /
Infiltration � ,�
Glasa �j
Exp. wall �p
Net exp. wall , �
Int. wall
Ceiling �'
F�oor
Tbtal Btu.
Required sq. ft. E.D.R. or sq. ins. W.A. Leader area
� i�S� �
OF BUILDINGS FRIDLEY, MINN.
o. Iasulation
Roof F1oor i d How A li
Fl.� Room Lengt �p� idth 11
indows and Doors—Crackage and Area
Wldth Helght No. ot Llneal tt. Area
No. ot pane ot pane �Ights ot crack p. [t.
� /
Coef.
Infiitration i yC�
Glasa 3J
Eap. wall
Net eap. wall ,— O
Int. wall
Ceiling / D
Floor
Totai Btu.
Required aq. ft. E.D.R. or aq. ina. R/.A. l.eader area
FI.I Room ( Length � Width �
Windows and Doots—Crackagt and Ana
Wldth Helght No. o! Llneal It. Area
No. o[ pane of pane I!`ht� ot crack ep. tt.
2 /-
� -z -
f.
In6ltration i '?io
Glaas ` '
F.�cp. wall �pp
� Net e:p. wall
Int. wali
� Ceiling
Floor
T Total Btu.
l4
Required aq. k. E.D.R. or aq. ina. W.A. L.eader area
FI.� Room I Length / Wid
indowa and Doors—Crackage aad Area
Width Helsht No. ot Llne�l ft. Ares
No. ot pane at Daae Ilght� o(,crack p. tt.
Btu �
',� In6ltration
� Glaas
Exp. wall
� Nec exp. wall
Int. wal)
Ceiling
Fioo�
Total Btu.
�6tG'/
Btu
���
�_��
��i/���
►�rur ., ..
��
�i�"�
ft. E.D.R. or aq. ins. WA. l.eader area �f.
� ,
City of Fridley
Application for P'#umbing and Gas �tting Per�nit
' Dept. of $ldgs. Phone $U 4-7
DESCRIPTION OF WORK � �
Number. Kind and Locatian of Fixfures I.ocatio
; V I � I� � I m� �; � la � I ; Iu. �+U �+< 3�U`' q�(79 < IU' O� I I N I GASTER ELEC.
� � �
Base /i
lst ,
2nd
3rd
4th
• Fuiure Coaaectfoa Openings Comsected with
* New Fixlure, Old Openiags � s��er �
ca�p�i p
PARTIAL RATE SCHEDULE
PI.IIMBING FIXTURE RATES: NO. RATE T�TAL
Number Fixtures . . . . . . . . . . . . � x $1.50 $ / G •
� �
Future Fixture Opening . . ... . ... .. . ... .`�_ x 1.20 $_�U
New Fixture Old Opening . . . . . . . . . . . . . . x 1.00 $
Catch Basin .... .............. x 3.25 $
Water Heater (Up to 200,000 BTiJ) . . . . . .--� x 2.00 $� . G �%
New Ground Run Old Bldg . . . . . . . . . . . . . x 3.25 $
GAS FITTING FEES: NO. RAT'E TOTAL
lst 3 Fixtures .......................... :� x $1.50 $�_�
Additional Fixtures ..... ............. .. x .50 �
Gas Range to 200,000 BTLT . . . . . . . . . . . . . . x 2.00 �
REPAIRS 8c ALTERATIONS—Refer to Code
Description ................................................$
TOTAL �'EE � � �
City of Fridley:
�
The undersigned hereby makes application for a permit for the work herei
specified, agreeing to do all work in strict accordance with the City Ordinance
and ruling of the Department of Buildings, and hereby declares that all the facl
and representations stated in this applicatio are true and correct.
Fridley, Minn. � , 19�L.:�
Owner �
Kind of $uilding
Used as
To be completed about
Estima Cost, $
Old e ding Permit
ROUC3H v � _ � �
FINAL
az sM
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City of Fridley, Minn. N° '7 "116
BUILDING PERMIT � �
! ����
n$te: _.._ June 1�, 1965
owner: _ Kenneth N�clellan Bu�aer i• �. S�t�elson Const.
�
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Adclress C` � t.4 .�.�i�.�tC11 .�'e ._.. Address ��I!: �T . �.�..__—
LOCATION OF BUILDING
No. _.. b�4L..— street � Kenna,ston Drive DT. E. .___.�_.� Part o! Lot
Lot ._._..__�___..___ Biock 2 Additiari or Sub-Divisi� . M_+68+d01�t1.aAd8� 2Ad. Add•
Coraer Lot — Inside Lot ._.._. Setba.ek _._._. Sideyard �
Sewer IIevatian ________ � Foundatioa IIevatiaa
DESCRIPTION OF BUILDING
To be Used as:
��g F'ront Depth Height ..� Sq. F�
.� Front Depth I�eight _.__ Sq. F't.
Zj�pe of Constniction ��� F�� C�t _�a.�.��.._..___._ To be C�pleted
Cu. F't
Cu. Ft
StOrm damag6 repair
In consideratlon o! the isauance to me of a permit to ca�struct the bed abav agree to do
the p�opoaed work in acxordance with the d�scription above set forth pliance with pro�via�ions of
ordinancea o! the dty o! Fridley.
Ea caoaiderati� at the paymeat ot a fee of � 10.40 , p�t is hereby granted to L• �1. 8smttelsoA Cor�at.
to construct the building or additioa� as descrlbed above. This perniit is granted upon
the expresa coa�ditioa� that the person to whom it fs greated and his agents, employees and worknien, in all work
done in„ around aad upon said building, or any �art thereof, shall conforra ixi all respects to the ordinances o�
Frldle3►, Minnesota regardin� location, construct�on, alterati�, maintenance� repair and maving of buil�
wlthin the dty limits and ttus pera�fit may be revoked at ar�y time upon violation of any of the provisians o� sa�d
orrlinanc�ee.
Allen Jenee� B� �
NOTIC�
71ds p�net� dwt �ot eewr 16� �r�sN�, t�uhllMiea fer wlri�y. P�wb�� Ya hwltn�, sNww er waNr. M sen fo sN
flN duiWi� Inp«Is� fer s�pwlr p�r�6� fer fh�n iNms.
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� � APP'LI�ATION FOit BtTiLDING PSRI�IIT
_ ,,- .. . .. } .. , . . ,�; ,. ,_. -.�
, � ' CITY OF'. Fit31iLEY, . MINNg3`tY�A . ' _
. OW�iISR' g� NA1�B __�'i�et.h i[�,�til�iit. ' BtriL�?8R' � b:i '`W. FS�uat�d� f1O31['"Q�11 s'�'
.. . . . . . . , �.,:, . rw`...�, . . . . • - . . . _ - i i i ,;i .�...._. ,.�i , i.� �rr-----
ADD�SS -8?49 K�nnasto� Drive ADDRESS ?840 R'Ri�t� R�ad �
. • - . _. , .. �- � . �._
, - - L�dA�.`'i0�fi� OF � EOiLDIt��' . . . . •: . .
, . . � . . . , ;a �r -, a .:,
No. 67�49 Kd�a:����t Ih�1�F�St�e�t �� `. .` : Pit�t'bf'r�€iE�`.
—:.-..� , ,�.----
- _ .__ .�.,
i.l3T, , �- , $LibCK , �� : ADDtTiON OR SUgD�VISION ,��,�-�,s��..-.�
• �Co�ner'Lot � X � xnsid� �,0��,_;_r,,.,Setbaak ; F Side=Y� . ' ... . .'� . G�-�•�.�
' • -_ , , - . . . . . . ,. ._
SEWBR 'ELSVATION . . ''�FOUNDA+l''Id�Q $f�VX'1'tQl� - � ,
, � . .. .. � � . *.- ._ .r .
Applicant attach�to this form Two Certificates of Suzvey of Lot and pro�osed
building location drawn on these Certificates. `:f'�-'=
_ � • . �b8§CRIL�'TION' OF BU$DINCr . ;' . c
. . ' . . � , , . _ . . . . . . . . � . . . . � . . . � . _. .. ..Y'j . ..
. To be nae� as : �� To��tio ' �i)a�wtage : � � ; � _ . :, � ' .',:>.
� . ,_ .,_ ,�;_f _. ,. ... � _. ,_
ih►elli]�g Front Dept �_, Seight
_ Sq. Ft. - Cu. Ft,
,._ . . _ . - .r.
_ �. _ , .. . ;
' Pra�t � , fi t�� Y : = �'Hef `� � �' =t � �' �
, . . - . , � . � _.,�,—..�......,. .. � . . . . _
� , . , •. - :.
, , : s Ft_ , _ .,: . ;. . r.�,� ��:; _ a s'r.;.c�
�. .- . .
�z
_
. . _, ,. . t , ..
. . , _.,; ;... . , .
, . : .. ._ � � - --.. _ ,::. . _..;
� Tppe oi Caaetruction �'�e Tor�ado Damage gstimated Cost �5�68�•DO(�Po$al)
-, -� � ...� � T .��...� �
. .. . . . . . � . . . . , . . . - . . . . ,. . . . , , , .. . �•. _.. d•.,'i
To b�e ccmp�eted �!1 9t�om� a!i POaaible _ . :.� 1 �: ",
' . � ' , . .. . � . . . . , . . ' . . � � . � � , . _ . • . .� . . . . � 1 ' . . . . .r .
Owner doing, oio�i gla:� �a�ad pai�ting repai�a. " -`: _` �' ::
The undersigned hereby n�kes application�• for a peradi�t 'for the �ork �hei�e#t�`��b`pecified,
agreeing to do all work in strict accordance with the City of Fridleq.Ordinances
and rulings � of �tiie Departiment `of " Buil'd'trigs, 'aKUd �he�b ' dec ��ea that. °.�2� the facts
and - representations etated � ifi this app licati � re '` e� d os'rect� �'=� ''
Re�ove and �eplaae sidi.ng, Rsplaee o r� �` li �i�e��wal.l.
In�tall new veata ridge
r.
DATB � � , S�G1�ATt�RE .:
, . , .. , . �... _
(Schedule of �'ee Coats can be found on the Reverse Side),
� .. . . � •
sue�eci PE
City of Fridley ~
AT THE TOP OF TME TWINS g �� L D I N� P E R M I T 2 814 6
r
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� � COMMUNITY QEVELOPMENT DIV. / _ I ` �
� •
r� � v � PROTECTIVE INSPECTION SEC. �J 7/
, ,
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� � /"'1 � CITY MALI FRIOLE� 5S1$2 NUMBER AEV OATE PAGE Of •PPROVEO BY
�----�•� ,'� 612-571-3450 910-Ft5 � �
10 7 98
lOB ADORESS
6749 Kennaston Drive NE "
t LEGAL �OT NO. BLOCK TRACT OR ApDITION SEE ATTACMED
oesca. 5 2 Meadowlands 2nd • n SNEE7
2 PNOPERTY OWNER MA�L ADORES$ Z�P PMONE
Ted Christenson -
3 CONTRACTOR MAIL ADORESS ZIP PMONE LICENSE NO
Exterior Desi n Service -
� ARCHITECT OR DESIGNER MAIL AOORESS ZIP PMONE LlCENSE NO.
5 ENGINEER MAIL AODRESS ZIP PHONE LICENSE NO
8 USE OF BUIIDING
Residential
� CLASS OF WORK
O NEW O ADDITION 0 ALTERATION � REPAIR O MOVE O REMOVE
8 OESCRIBE WORK
Reroof house and ara e 25 S Tear-off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
TVP df CONST. OCCUPANCY GROUP OCCUPANCV IOAO
SEPARATE PERMITS ARE REOUIRED FOR EIECTRICAL. P�UMBING. MEATING.
VENTI�ATING OR AIR CONpITIONING
TMIS PERMIT BECOMES NUIL AND VOID IF WORK OR CONS7RUCTION ZONING SQ. FT CU FT
AUTMOR12E0 IS NOT COMMENCEO WITH�N 60 DAYS. Oii IF CONSTRUCTION $
OR WOi;K tS SUSPENOED OR ABANDONEO FOR A PER100 Of 12p OAYS A7
ANY TIME AfTER WORK IS COMMENCED. ° NO OWIG. UNITS OfFSTREET PAFKING
I HEREBV CERTIFV THAT I NAVE REAO ANp EXAMINEO THIS APPLICATION S7ALlS GARAGES
AND KNOW 7ME SAME TO BE TRUE AND COEiRECt. ALL PROVISlQNS OF LAWS yAlUA110N SUi;TAx
AND ORDINANCES GOVERNING TMIS TVPE OF WORK Wll� BE COMP�IED
WITM WHETMER SPECIFIEO MEREIN Ofi NOT. TME GRANIING OF A PERMIT 2142 1.07
DOES NOT PRESUME TO GIVE AUTMORITV 70 VIOLATE OR CANCEL TNE pEqMITFEE SACCMARGE
PROVISIONS OF ANY OTHEFi STATE OR LOCA� �AW REGULATING CON-
STqUCTI OR TME PERf MANCE OF CONSTRUCTION %I{. ]rj Fli2 SC L. L�F
� PI,AN CHECK FEE TOT FEE
Licen S 5. 2.96
� S�GN tuAE O� C N'Q TOp OA AUTHOAl2ED �GENT iOATE� EN OP VALIOA THIS I$ V�R P�qM �
�
l
S�GNaTUWE O� OwNEQ��� OwNEaBWIDEp� �O�TE� . � Bl0 � �ti5� � - � � ���tt
� �
NEW [ ]
ADDN [ ]
ALTER [ ]
ConstructionAddress :
CITY OF FRIDLEY
SINGLE FAlV1ILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
,
t" te u J.s �O y �^
Effective 1/1/98
l��
� �1
��
Legal Descriptio�: � �
Owner Name. & Address: ��� �� �-;s j�rtisoti Tel. #.S`7a1 �- 93�7
____ ._._ ..
Contractor: ���}; or %��t:� Sr,. �- ; c c MN LICENSE #
Address: � 3 �/ /y%y ie � �'D� �!/i�. � � �ir �y f/L�hi Tel. # .Sr7/ —3 a � �
LNING 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.
Length
Length
Length
DESCRIPTION OF IMPROVEMENT
Width Height
Width Height
Width , H�VGi
0
Sq. Ft.
Sq. Ft.
Sq. Ft.
� i
Construction Type: �k Estimated Cost: $ ����
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: /p— 7 � �
APPLICANT: , Tel. #c��/ --„� e� �
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
` Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ ,s
$ _/
$ /. D �
$
$ `C� O
$
$
$
$
$ ��- o
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,000 Valuation
$1000 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
sue�etr , P � �,�
City of Fridley 3 i 964
A T T M E T O P O F T M E T WI N S g� J I L D I N� P E R M i T
r
' ` RECEIPT NO.
� � �
� �
COMMUNITY DEYEIOP��µT OIY. ��+ �AO py� � �� /�
r � y � PROTEC7IVE INSPECTION SEC. �� y T �
_�
�
� ,
� � �"'1 � CITY MALL FRIOLE� 55132 NUMBEA pEv D�TE o�GE O� APnROVED Bv
�-�"'�"� �'' 612-571-3¢50 siaF�s 7/9/O1 � �
10B ADDRESS 6749 Kennaston Drive NE .
t LEGAL LOT NO. BLOCK TiiACT OR ADOITION SEE ATTACHEO
oescR. 5 2 Meadowlancls 2nd Addition SHEET
2 PiiOPERTY OWNEF MAIL AOOqES$ zIP PMONE
Ted/Krista Christensen 6749 Kennaston Drive NE 763-572-9387
3 CONTRACTOR MAIL ADORESS ZIP PNONE LICENSE NO
Window Star Home Improvements 12322 Business Park Blvd, Champlin MN 55316
♦ ARCHITECT OR DESIGNER MAIL AODRESS ZIP PMONE UCENSE NO.
763-712-8881 20228319
5 ENGINEER MAIL AOORESS 21P PHONE UCENSE NO
6 USE OF BUILDING '
Residential
7 CLASS OF WORK
p NEW O ADDITION �] ALTERATION O REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Install E ress Window
9 CHANGE Of USE FHOM TO
STiPULATiONS
Window must meet the State Egress Code.
Provide smoke detectors in all sleeping rooms and on all levels of the
dweiling per Section 310.9.1.2 0€ the 1997 Uniform Building Code. Caulk
and flash all exterior openings.
tYPEOFCONST. OCCUPANCYGROUP OCCUPANCV�OAD
SEPAfiATE PERMITS ARE REOUIREO FOFi ELECTii1CA�, PLUMBING, HEATING.
VENTI�ATING OR AIR CONOITIONING
TMIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION jONING SO. fT CU FT.
AUTHORI2ED IS NOT COMMENCED Y�1ITHIN fi0 DAVS, OR IF CONS?qUCTION �
OR WORK IS SUSPENDEO OR A9ANOONEO FOF A PERIOD OF 120 OAYS A7
ANY TIME AFTER WORK IS COMMENCED. " NO DWIG. UNITS OfFSTREET PARKING
I HEREBV CERTIfV THAT 1 MAVE READ ANO EXAMIN�O TMIS APP�ICATION 1 STA��S GARAGES
ANO KNOW TNE SAME TO 8E TRUE AN� CORRECi. ALL PFOWSIQNS i�f LAWS yp�UAT10N SUliTAX
AND ORDINANCES GOVERNING THIS 7YPE OF WORK WILl B� COMP�IEO @ @
WITM WHETMER SPECIFIED HEREIN OA NOT. TME GRANTING OF A PERMIT W2�OOO y+1.00
DOES NOT PRESUME TO GIVE AUTHORlTY TO VIOLATE OR CANCEI TME pEqMl7 FEE SAC CMARGE
PAOVISIONS OF AN� TE OR IOCAL LAW REGUTATING CON- G
STRUCTION OR TN ERfORM CE OF CON TRUCTION �y9.25 Fire SC �Z.00
��AN CMECK fEE TOTA FEE
--�' ?-4'-d �
Lice C $5.0 7.25
S�GN QE O� CONCFA(;iQq rr+OQ�2E0 �GEH� iO�iE� EN OPE AUOAT TMIS IS YOUF P MIT
- -D
S�GaaiUAE O� OwaEp��f OWNEQBURDEAi �DAiE� ' BL ���NS� ' � ����E
JUN-04-2001 13�34 FROM CITY OF FP.IDLEY TO 712^00^^03 P.02/03
NEW � j
ADpN [ ]
ALTER [ ]
` Effective 1/1/2001
ClTY OF'FRIDLEY (763) 572�604 Bldg (nsp
S�NGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Constnaction Address: ��7�-1 g I'�-ev�n� s�-c�-. � � N�=
Legai Description:
OwnerName &Address: r�e.d � K�r��� Chf � S+.e�s�� r�,.# ��3-s�a- 93��
Contra�tor: ��. 5�a � }-{ oVre _Lr�.-p�p�,, r,.,.,,.�, ^ MN LICENSE # � d �� �3 � �
Address: ! a3 �� �3�Si noss 1��,-�t �31 v � ��. +,-, ✓�,.v �r Tel. # ���3-"� ia -8 b'a'l
LIVING AREA;
GARAGE AREA:
DECK AREA:
Attach to this application, a Certficate of Survey of the
lot, with the proposed construction drawn on it to scale_
DESCRIPTION OF IMPROVEMENT
Length Width Height � Sq. Ft.
Length Width Height Sq, Ft.
l.ength � Wdth HgtiGround Sq. Ft
OTHER:
���� �
� o
Construction Ty�e: �� S 4 l( � r�ss �,,� ,.� d� w Estimated Cost: � ��
Dnveway Curb Cut VVdth Needed: Ft. + 6 Ft � Ft x$ _$
DATE: � �—v � APpLICANT: Te1. # �6 �' ��d �-d' �'� �
CI7Y USE ON�Y -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
rorA�
Cail (763) 572�604 for Pennit Fees if mailing in application
�
$ �� a Fee Schedule on Reverse Side
$ �°–° .001 of Permit Valuation (1/1pth%)
$— _1 � $.50/$1,000 Valuation
$ $1150 per SAC Unit
$_. S`� $5.00 (State Licensed Residential Contractors)
$ �Alt. "A" or Alt. "B" Above
$ $450.00 Conservation Plan Review
$_ Fee Determined by Engineering
$ Agreement Necessary ( I Not Necessary []
$ T7 �
STIPULA710NS: �i�t� d . ��0• !i � 1/
/99� � � c. ��� ����.��---��.�
�"�J,��fd,�'�.,,, ��+%/I�1�
.
sue�eci IT NO�-
City of Fridley 3 20 8 3
AT THE TOP OF TME TWINS g �� L D I�! G P E R M I T
r
� ` REC IPT NO.
.
COMMUNITY DEVELOPNIENT DIV. ����Q�O� �✓7�Y�`� y%
i ♦V������ � 7 � J
r � � PROTECTIYE tNSPECTION SEC.
� �
� � �"'1 � CITY MALL FRIOLEV SSIJ2 NuMBEA REV O�TE P�GE OF AvvqpvED Sr
����'�`� �'' 612-57�-3a50 s�aF�S 8115/O1 � /
10B AODRESS 6749 Kennaston Drive 13E �
1 LEGAL �OT NO. BLOCK TRACT Op ADDITION SHE ATIACMEO
DESCR. S 2 Meadowlands 2nd Addition SHEET
2 PROPERTY OWNER MAIL ADORES$ 21P PMONE
Ted/Krista Christenson 6749 Kennaston Drive NE 763-572-9387
3 CONTRACTOR MAIL AODRESS ZIP PMONE LICENSE NO
Window Star Home Improvements 12322 Business Park Blvd, Champlin, MN 55316
� ARCHITECT OR OESIGNER MAIL ADDRESS ' ZIP PNONE UCENSE NO.
763-712-Q223 20228319
5 ENGINEER MAIL ADORESS 2�P PHONE IICENSE NO
6 USE OF BUILDING
Residential ,
7 CLASS OF WORK
O NEW ❑ ADDITION O ALTERATION �1 FiEPAIR O MOVE ❑ REMOVE
8 DESCRIBE WORK
Replace windows within existing openings
9 CHANGEOFUSEfROM TO
STIPULATIONS
Provide smoke detectors in all sleeping rooms and on all levels of the
dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. Caulk
and flash ail exterior openings.
TVP OFCONST. OCCUPANCYGROUP OCCUPANCV�OAO
SEPARA7E PERMITS AHE REOUIREO FOR EIECTRICAL. PLUMBING, HEATING.
VENTILATING OR AIR CONDI710NING
THIS PEFiM1T BECOMES NUIL AND VOIO IF WORK OA CONS7RUCTION ZONING SO. FT CU FT.
AUTMORIZEO IS NOT COMMENCED V�1ITMIN 60 OAYS. OR If CONSTRUCTION �
OR WORK IS SUSPENDED OR ABANOONEO FOR A PER100 Of �QO DAY� A?
ANV TIME AFTER WOfiK IS COMMENCEO. ' NO DWLG. UN17S OFfSTREET PARKING
1 HEREBY CERTIFV THAT I HAVE READ ANO EXAMIN�O THIS APPUCATION 1 57A�LS GARAGES
AND KNOW TME SAME TO BE TRUE ANO CORfiECT. ALL PRO��SIONS OF LAWS VA�UATION SURTAX
AND OROINANCES GOVERNING THIS TVPE Of WOAK WILL 9E CpMP�lEO
WiTM WHETHER SPECIFIED HEpE1N OR NOT. THE GRANTING OF A PERMIT $7 , 252 $3 . E�3
DOES NOT PRES TO GIVE AU7HOR�TY TO VIOLATE OR CANCEI THE pEqMIT FEE SAC CNARGE
PqOVISIONS ANY OTHEq STA7E OR IOCAL LAW REGUTATING CON-
STRUCTIO R TH ERiORMA F CONSTRUCTIO $153.25 Fire SC �7.25
PLAN CHECKFEE TOTA EE
Lice�.se $5.00 9.13
$�GN1iUpE O� N"QA(;TOA OA �UTNOp�1ED �GENt IOA1E� N iiOPE � ALIpATED S IS VOUR PEiiMIT
� -/S-�/
�_ S�GNaivaE O� OwtiEp��F QWNEA BU�IOEAi �OATEi . � � Bl � �NS� ' � � � ����E
� ,
JUN-04-2001 13-34 FP.OM CITY OF FP.IDLEY TO
NEVI/ ( j
ADqN � ] � , C{TY OF'FRiDLEY
A�TER [] SaNGLE FAMILY AND DUPLEXES R-1 AND R-2
6UILDING PERMIT APPLICATION
712^0^0^03 P.02/03
Effective 1/1/2001
(763) 572�3604 Bidg (nsp
Construction Address: 67� � � e�nn a 5�u�-� 1� r' �'�. �� � /1�,t�
Legal Description:
OwnerNameB►AddressT�d� K�� �� Ch�r�S�Anso,r. Te1.# �6`3-r�a-43J�'7
Co�tractpr: 1,.� �tido,,.� 5#-er h-( o,�c .i�r�".e r�,�.,� s ., __ MN I�ICENSE# o�oa��'3I �
Address: (�a,a. �3�s,ncss ,fJa�l�f 13j�d. C.l�� 1,:, /1�..U�r31 6. Tel.#?�`�-'�Id-oaa'3
LIVING AREq;
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 IMPROVEMEN7
Length Vlydth Height Sq. Ft.
Length Wdth Height Sq, Ft.
length Width Mgt/Ground Sq. Ft
Construction Type: �� �� l,� �-. d�ws o 0
Estimated Cost_ $ � 5 ��
Dnveway Curb Cut Width Needed: Ft. + 6 Ft � Ft x$ _$
DATE: _�Z, I�..j_ APpLICANT: c Tel. # 76�-� �a-��
CI7Y USE ONLY -
Permit F�e
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULAI'IONS_
Call (763) 572-3604 for Permit Fees if mailing in application
$ �s.3 •�S� Fee Schedule on Reverse Side
$ . �S .001 of Permit Valuation (1/10th%)
$ $.50/$1,000 Valuation
$ $1150 per SAC Unit
$ -Ob _$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 [ j
$ 1� ,�