P - 48560Building
Inspections
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t)PCNING CllANGI;S 4 �,
TOTAL JOE3 VAL'
Aerniit Fee
Alnn Review
Fire Surchar�e
Surcl�nrge
License Surcht�r�e
SAC Ch�rgc
Curh Cut Escrow
Crosion Control
pnrk Fce
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BASEM�+NT ItPMt�nt:t �nrr. ��pti���•.
l. Gxivting I�loor PI�n
: PropOKed nUOr plun
3. Liv� ol�slruCtur,�� nlCRlberq (0 hQ Ll�d
I�OR NF.W C"ONSTRl1CTlUN INCLtJDING �L•'(:KS,
ADf�I'CtONS k p k 111-S�S�I�MI'1'
I. Sile i'lan/Survcy shnwing thc n�ci,ting suucwrrq
a�u1 Profx�scd pruject.
2. T�vp ;te�v ol'coi�.etruclion pluns
3• kn�rgy Culculntions
TOR WINDOWS - pROVIDF. U-VALUG AND
MANUI�ACI'URE.; S'fiC1:ER ON WINDOW.
VALUATlON, INCLUDtIYG THE COST Qr L,ABOR AND M
`(�IS��C�'H$ I997 U.a.0 FE� SCH�p���)
!) � � _
�ti.+..ur.v�v�:Y TYPE
Sec Qack Pagc for Fec Schedule
GS%afB�i(ding Permit Fce
.001 times thc total job v�luation
.0005 � Pcrmit Valuation Minimum $S,pO
$S,QO (Stute 1�icensed Rosid�ntial Contractors}
$2�30 per SAC Unit (Plans to MWCC I'or dctermination)
ft+Gft= ftx$25=�
$45p Consciv�tion AI;u� Rcvicw ��—
Fce Detrrmin�d by &nb;necring
Agrecmcnt necrssnry ( } Non Necessury ( )
Mnke chtckti u o�ble to; City of Fridlev Att��ch
1�F•IIS 1S nN nPnLICn'PlON fOR A rEliM!'I�.NOr Vnl.lb UN�rtL f�RUCfSSED J"f'u'„[�Q�,
I hereby apply for a building permit �nd 1 acknowled�,e that the informatipi� above is eompleto and nccurace; cl��t the work w;ll 6e i„
conformnnee with the ordin�nccs flnd codes of the City of f'ridlcy und with the Minnesota Construction Codes; that t understand this +s not a
p���� au� °nty a° �p��«�� tQY � p�c►ri� w rk is qo �o Start without a permit on sitc; that thi work will bc in accordancc witt► chc
�pproved p�nn in t1�e ease �\ 1 11 d�pprpval af p s,
`SIGNATUiZC OI� Al'PI,ICANT RW'I' NAMG���,��DA't'C��:� --
I APPROVAL INfiPFC'1'OR SIG ruar:
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