Permits - Permit# 01-39 - 4317 Channel Road - 1/1/2001CITY OF SPRING PARK(
4349 WARREN AVENUE
SPRING PARK(, MN 55384
952-471-9051 FAX 952-471-9160
BUILDING PERMIT APPLICATION
Building Permit Application Requirements:
1. Application to be filled out & signed
2. Mechanical Permit Application & Calculation filled out
3. Energy Calculations filled out
4. Furnish a Certificate of Survey - See Attached
5. Furnish 3 sets of Construction Plans
a)1 set for City flies
b) 1 set for builder to use on site
c) 1 set for City Building Inspector
Construction Plans should include:
1. First floor plan
2. Footing & foundation plan
3. Elevations of all sides
4. Wall sections & cross sections
5. Details - stairs & any special connections
ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL BE STARTED
Date Received
Date Approved
Permit No.
Fees To Be Charged:
Permit /// --2,5'
State Surcharge .So
Plan Review
SAC Charge
Availability Chrg
TOTAL
THE APPLICANT IS (CIRCLE ONE) `- — OWNER
gOR_ w , CONTRACTOR
JOB SITE ADDRESS H 2-5C _ YWhR`� , �11X� 9 ' /� % - .2
NAME OF OWNER .�C�l(1�1� k'erxoi-e-e HOME PHONE%2►'9 •100I + WORD( PHONE
MAILING ADDRESS CITY ZIP 5S M9
CONTRACTOR
MAILING ADDRESS
STATE LICENSE NO. _
ARCHITECTIENGINEER _
MAILING ADDRESS
NAME
Renewal By Andersen
350-73rd Ave. NE
Fridley, MN 55432
763-502-4777
#MN20130983
CITY
REGISTRATION NO.
MOBILE PHONE
ZIP
PHONE
ZIP
TYPE OF WORK: NEW ADDITION ACCESSORY STRUCTURE MOVE DEMO
REMODELIALTERATION RENOVATE LAND ALTERATION
PROPOSED WORK (Describe In Detail) -1�t D\
ZONING DISTRICT
STORIES SQ FEET OR EACH FLOOR NO. OF BEDROOMS GARAGE STALLS
ATTACHED OR DETACHED BLDG. SIZE: LENGTH WIDTH HEIGHT
ESTIMATED CONSTRUCTION VALUATION (excluding land) $ -J • q W��
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BUILDING PERMIT APPLICATION
. PAGE 2
HARDCOVER CALCULATION WORKSHEET
A. House 'X =
S.F.
Length width
X =
S.F.
B. Garage X =
S.F.
C. Driveway X =
S.F.
X =
S.F.
D. Sidewalk X =
S.F.
X =
S.F.
E. Patio/Deck X =
S.F.
F. Other X = _
S.F.
1. TOTAL HARDCOVER
S.F.
2. TOTAL PROPERTY AREA
S.F.
1 DIVIDED BY 2 X 100 =
%
I hereby apply for a building permit and I acknowledge that the Inforrnation above is complete and accurate; that the work will be in conformance
with the ordinances and codes of the City and with the State Building Code; that I understand this is not a permit and work Is not to start without
a permit; and that the work will be in accordance with the approved plan.
APPLICANT'S SIGNATURE �.
�
iS 4CI 'O I
S i� DATE
INSPECTION REQUIRED: WORK REQUIRING SEPARATE PERMITS:
Footing before a pour Plumbing
Framing rough -in Mechanical
Insulation Well
Wallboard before taping Grading & filling
FINAL before occupancy Sewer
Water
WORK BEYOND OR WITHOUT A REQUIRED
INSPECTION WILL BE SUBJECT TO PENALTY Electrical from State
24 HOUR NOTICE REQUIRED CALL 952-249-4600
ZONING CERTIFICATE
I do hereby certify to the Orono Building Official that the following described work has been reviewed for
compliance with the Zoning Requirements of the City of Spring Park and will be approved for construction upon
approval of the construction plans by the Building Official.
Name Date
BUILDING CODE PLAN REVIEW
Name Date
.... -�Ider Jones
Building Permit Service, Inc.
1120 East 80th Street
Bloomington, NIN 55420
Phone: (952) 345-6047
Fax: (952) 854-4909
To whom it may concern:
We at Elder -Jones Building Permit Service, Inc. are acting as an agent for Renewal By
Anderson. If there are any questions, or if the permit has to be picked up in person, please give
us a call at the number above. If the permit can be mailed back to us, we have enclosed a
self-addressed envelope for your convenience.
Thank you,
Kara Benson ext. 147
Elder -Jones Building Permit Service, Inc.
1120 East 80th Street ' Bloomington, Minnesota 55420-1498
952-854-2854 1 FAX: 952-854-4909
Form No. 259 Valuation $ 4430
Election Systems and Software 1-800-800-8225
Permit $ 111.25
State $ 2.50
.to taf ... $.i13.76
NII...01-39........
fttt of Minnesota, q i ty .... of .. Spr i nq Park ...........
County of ... Hennepin Office of Bui1din� InspectorBut"Ibing Vertnit
IN CONSIDERATION OF The statements and representations made by ......................
................... Renewgl..b.y Anders.eR..............................................................
in application therefor duly filed in this office, which application is hereby made a part hereof', PERMISSION IS HEREBY
GRANTED To said .... ,Renewal By Andersen ........ as owner
to ...replace. Ai.ndows, in. kitchen. &. d.i.ni.ng, rm, pe.r .appl icati.on .a building described as follows: kind of construction
(build, erect, install, add to, alter, repair, move, wreck, as the case may het
....................................................................................................
front or width in feet ................ : side or length in feet ................ ; height in feet ................ ;
number of stories ............... : contents ............... cubic; feet; ............... square feet, upon that
tract of land described as follows: Lot ................ Block ................ ; plat or addition ................
4317 Channel Road 19-117-23-12-0033
....................................................................................................
which tract is of the size and area specified in said application.
This permit is granted upon the express conditions that said owner and h .i.s.. contractors, agents, workers and
employees, shall comply in all respects with the ordinances of the .. City .............. of ..Spring.Par.k....... ;
that it does not cover the use of public property, such as streets, sidewalks, allevs, etc., for which special permits must
be secured; and that it does not cover the following: ..... None .of .the fQl.l.owi_n9 ........... . . .
(Flecirical work, plinnhing. heating, plastering, etc., if' such there he.)
for which special permits must be secured.
Given under the hand of the Bu.i.ld.in.g..In.s.pec.tor of said ..Ci.ty ............... and its corporate seal and
attested by its ....Clerk .............. this ... 24th ................ clay of . Octpber )'ear2001
Attest:
William .D..Weeks
........ .... .................�
...C.lerk................
........Lyl.e Oman
... V. () ....................
...l3ui1ding.JnSDeGtPr...