AF - 42856��**
* PIONEE�
* eng neeP
* * �*
2422 Enterprise Drive
� Mendota Hetghte, MN 55120
LAND SURVEYORS • crv� oraNm�s (812) 881-1914 FAX:681-9488
g LANO PLANNERS . U►NDSCAaE �RCHITECTS 825 Highway��10 N.E.
Blaine, MN 55434
(612) 783-1880 FAX:783-1883
Certificate of Survey for:
House Address:
1;'
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1�
House Model:
THE ROTTLUND C�MPANY
137 Christenson Court
Ashton
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CH�ISTE�lT�O1�T CO U1�T
x soo.o Denotes Exlstfng Elevatlon
oo� Qenotes Propased EleHatTon
00
—+�- Denotes Dralnoge Flow Oirectton
— Denot� Dratnoge dc Utifity Easem�t
—o-�- Denotes Monumer�t
--.— Denotes Off�et Iron Bearings shown ore assumed
PROPOSID BUII�DING ELEVATIONS
Garage Slab Etevatlon: 85Q.8 (at doar)
NOTE: Proposed buDding site gradh�g is tn aoeadm�ee �rith tAe
qrading pt�e upproved by !he city engtneer.
NOTE: Contraotor muat verify op dbnenetons k dr(�rowoy d�ign.
LOT 29 . BLOCK 1 CHRISTENSON CROSSING
ANOKA COUNTY, MINNESOTA
We hereby certify thct thia aurvey, plan or report wos prepared by me or under my direct supervision and that I a duly licenaed
Land Surveyor under the lows ot the State of Mtnnesota. Dated this Stl, day of �Jo.�Qm�e� A.D. 19�.
Stgned: PIONEER ENGI RING, P.A.
Scale: 1�= 30� BY �
.. Robert B. Sikich, L.S. Reg. No. 14891 or
3] 16190.33 Terrence E. Rothenbacher, L.S. Reg. No. 20595
SUBJECT , -
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
� � RECEIPT NO.
� i y___.__ COMMUNITY DEVELOPMENT OIV
r � � PROTECTIVE INSPECTION SEC. ���
� . �
� � /'��1 � CITY HALL FRIDLE� 55432 NUMBER REV DATE VAGE Of APPROVED BY
�"""�" �'' 612-571-3450 910-F15 11/27/96 / /
JOB ADDRESS 137 Christenson Court NE
1 LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 29 1 Christenson Crossing SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Rottlund Homes 2681 Lon Lake Rd, Roseville MN 55113 638-0500 1335
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO
Same
4 ARCHITECT OR DESIGNER MAIL ADORESS ZIP PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP pHONE LICENSENO
6 USE OF BUILDING
Townhouse & Gara e
7 CLASS OF WORK
O NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
X
8 DESCRIBE WOHK
Construct a Townhouse & Gara e 48' x 25' Town.house & 20' x 21' Gara e)
9 CHANGE OF USE FROM TO
STIPULATIONS
See notations on plan. paid Park Fee of $350.00. Paid Additional $25.00'
Park Fee on 9/18/97.
SEPARATE PERMITS REQUtR�p Fp�
WIRIi��G, HEATI�fG, PLUNi81NG A1YD St(;�$'y
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANOONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTEFi WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS yA�UATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PEFiM1T �J9,155 �39. SH
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE $900. OO SAC
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. �]62.Z,rj Fire .SC, �%9.1.5
PLAN CHECK EE TOTALFEE
� ���2��9� Li S 5. 00 $1 785 . 98 + PF
SIGNATUREOFCON'RACTOHO HORIZEDAGENT IDATE� E ERL IDATED THIS IS YOUR PERA1jT
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SiGNATUREOFOWNEA��FOWNEABUILDEAi �OATEi LDG �NSP r�p7E
NEW
ADDN
ALTER
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CITY OF FRIDI.EY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Effective 3/1/96
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ConstructionAddress: � �`% � ������� (�,�p�,°'(
Legal Description: __�l.J`� o�q; �LP�C._1'� � NIZI`��CI%�.SF�r� ��.�ll�➢C�' -
Owner Name & Address: �((� j�,� � 1��� Tel. # f��� ��j
Contractor: ``°n„'��j ��t1�j NIN LICENSE �# ) � ��
Address: o�ZD�i� �(� �+1��E. �Al�� ��V.11�� ,�. 1� , ��l � � Tel. # � �Jg- O�
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIP'rION OF IlVIPROVEMENT
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LIVING AREA: Length '- " Width o�'-�" Height �-p'� Sq. Ft, j 1 q 3�(�� ��yl�a ��
GARAGE AREA: Length �p� Width oZ I'- " Height �!-� Sq. Ft. _•�� F��, 3 Z
DECS AREA: Length Width Hgt/Ground Sq. Ft. =��'�� `��
OTHER:
-� ;/�� t�
Corner Lot [] Inside Lot (� Ft. Yd Setback Side Yard Setbacks ,
Type of Construction: _ ��D�3TI �=1 �. Estimated Cost: $ ) ( , �� � J' o /f�
Approx. Completion Date: 5 Jq -} .
(Cost on Back)
Driveway Curb Cut Width Ne.eded: Ft. + 6 Ft = Ft x$ _$
DATE: - � - APPLICANT: � 4 �i�y�,� ^ ` � Tel. # (� �J � ° (� � .
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Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
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$ . /�'
$ �- J�
$ �"O�a r'�'
$_ �i, �
$
$
$ ��, �
$
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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 Necessary [ ] Not Necessary [ ]
STIPULATIONS: -
BUII..DING PERMIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erecrion 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 phus $2.75 for each additional $100 or
fraction thereof, to and including $2,000
$62.25 for fust $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 $50,0(l0
$574.75 for first $SO,OOQ plus $6.25 for ea.ch additional
$1,000 or fraction thereof, to and including $100,000
$887.25 for first $100,000 plus $5.00 for each additional
$1;000 or fraction 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 $1,000,000
$5012.25 for the first $1,00O,OOJ plus $2.75 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete Curb Streets Only)
Alterna.te "A" : Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50.
Alternate "B": Removal and replacement of curb and gutter and install 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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CHIlVIIVEY AND STACg VERIFICATION
The undersigned hereby verifies that the existing chimney or stack:
L Has been carefiilly examined Yes () No ()
2. Is fre�e from rust or def�erioration Yes () No ()
�3. Has no foreign objects lodged within Yes O No O
4. Is securelY �PPo� Yes i) No i)
5. Meets all current C�e requirements for size
and total BTU's connected Yes () No ()
6 Has total hea.ting BTU's of
All other BTIT's
T�TAL BTiJ's
7. Has a liner been provided for water heater Yes () No ()
8. Has combustion air been provided far water heater Yes ( j Nfl ()
Remarks: .
List AL.TERA�I�NS _ Beir�g Done: .
HEATING CO:
Signed By:
Date:
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Client:
Address:
City:
Phone:
Fax:
Comment:
Rottlund Homes
2681 Long Lake Road
Roseville, Minnesota 55113
638-0500
638-0501
YOUR BUILDER FOR LIFE
Project Name:
Reference City:
Daily Temperature Range:
Latitude:
Elevation:
Winter:
Summer:
Outdoor
�Bulb
-20
95
Company:
Representative:
Address:
City:
Phone:
Fax:
Comment:
Ashton
Minneapolis, Minnesota
Medium
44 Degrees
834 Feet
Outdoor Indoor Indoor Grains
Wet Bulb $�. � Bulb Difference
N/A N/A 72 N/A
75 50% 75 36
..: .... ..., .... .:.: ........: ......._. ...... ,.. .....,.._............:....:..:�.,...:>�.>.::
Total Building Supply CFM: 556
Square feet of room area: 1,200
>:<:x �:::;.:..:;:;:::::::<::: <::;:�::;:::::<:::::;:::<:>::::.::w:�:��:<:,:::::::�:
• > � . •`• : � : ; : � ;` ; ::.: ; ; : ,` . ... ti: � : <: < � •.• • ; : : t ,? : � ,
:�:.���#�. ::�«�$?�:� ::�"«;::; �.::.::�.::z��: ;�:;<;>:::>:•::>�•::�.....,.
,:.. ..<:..,.....•>:::... �,....
Fiare Heating & Air conditioning, Inc.
Randy
9303 Plymouth Ave. N.
Golden Valley, Minnesota 55427
542-1166
542-3101
YOU CAN FEEL THE DIFFERENCE
CFM per square foot: 0.463
Square feet per ton: 836.493
Total heating required with outside air: 42,595 Btuh 42.595 MBH
Total sensible gain: 12,231 Btuh 74 %
Total latent gain: 4,304 Btuh 26 %
Total cooling required with outside air: 16,535 Btuh 1.378 Tons (based on sensible + latent)
1.435 Tons (based on 75% sensible capacity)
Calculations are based on 7th edition of ACCA Manual J.
All computed results are estimates as building use and weather may vary.
Be sure to select a unit that meets both sensible and latent loads.
�
Component . Area Sen. Lat. Sen. Total
Description Quan Loss Gain Gain Gain
4A �ndow Double Pane & Storm Clear Glass Wood Frame 123 3,859 0 2,836 2,836
8M Glass Door pouble Clear Glass Wood Frame 40 2,028 0 1,200 1,200
' 11 C Door Metal Polystyrene Core 38 1,643 0 422 422
121 Wall R-19 + 1/2" Asphlt Board(R-1.3) 960 4,857 0 1,246 1,246
131 Part R-19 + 1/2" Asphlt Board(R-1.3) 171 433 0 141 141
161 Ceiling R-44 Insulation 1,200 2.539 0 1,214 1,214
23D Slab/Warm Duct 2" Edqe Insulation(R-11) 148 12,663 0 0 0
Subtotals for structure: 2,680 28,022 0 7,059 7,059
Active People: 4 0 920 1,200 2,120
Inaetive People: 0 0 0 0 0
Appliances: 0 0 300 1,200 1,500
Lighting: p p 0
Ductwork: 0 0 0 0 0
Infiitration: Winter CFM: 54.0, Summer CFM: 36.0 201 5,465 881 792 1,673
Ventilation: Winter CFM: 90.0, Summer CFM: 90.0 0 9,108 2,203 1,980 4,183
Sensible Gain Total: 12,231
Temperature Swing Multiplier: X1 00
Building Load Totals: 42,595 4,304 12,231 16,535
Total Building Supply CFM: 556
Square feet of room area: 1,200
CFM per square foot: 0.463
Square feet per ton: 836.493
Total heating required with outside air: 42,595 Btuh 42.595 MBH
Total sensible gain: 12,231 Btuh 74 %
Total latent gain: 4,304 Btuh 26 %
Total cooling required with outside air: 16,535 Btuh 1.378 Tons (based on sensible + latent)
1.435 Tons (based on 75% sensible capacity)
Calculations are based on 7th edition of ACCA Manual J.
All computed results are estimates as building use and weather may vary.
Be sure to select a unit that meets both sensible and latent loads.
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April 15, 1997
Rottlund Homes
2681 Long Lake Rd
Roseville, MN 55113
Re: Final Inspection at 137 Christenson Court NE, Fridley, MN
Dear Sirs:
A final inspection was conducted on April 15, 1997 for the above noted townhouse. We found
that the construction of the building unit complies, to the best of our knowledge and belief, with
all the requirements of the building codes of the City and the State of Minnesota relating thereto,
and permission is hereby given for the occupancy of said unit.
If you have any questions on this matter, please feel free to contact me at 572-3602.
Sincerely,
RON
Chief
RJ/mh
_
_
CITY OF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55�32 •(61 � I 571-3450 • FAX (61?) 571-1287
July 30, 1997
Rottlund Company Inc
2681 Long Lake Rd
Roseville, MN 55113
Re: Park Fee Shortages for Issued Building Permits
Dear Sirs:
In Ghecking our files we discovered that on 10 building permits
issued in Christenson Crossing, you were charged a$350.00 park fee
instead of the required $375.00 park fee which was a stipulation of
the plat approval, resulting in a total amount due of $250.00.
The addresses involved are: 121 Christenson Court NE, 128
Christenson Court NE, 130 Christenson Court NE, 133 Christenson
Court NE, 135 Christenson Court NE, 137 Christenson Court NE, 140
Christenson Court NE, 141 Christenson Court NE, 145 Christenson
Court NE, and 147 Christenson Court NE. Each building permit has
the park fee paid noted in th� stipulation section.
We apologize for any inconvenience this error might cause and if
you have any questions concerning this matter, please feel free to
contact me at 572-3602.
Thank you for your prompt attention to this request.
Sincerely,
RON JULKO I
Building fficial
RJ/mh
sue�ECT
City of Fridley
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
� •
� �• COMMUNITY DEVELOPMENT DIV.
� LV ���.���
r � � PROTECTIVE INSPECTION SEC.
� '� �"'1 � CITV HALL FRIDLEV SS432 Nu�eeER
�""� � �'� 612-571-3450 910-F15
JOB ADDRESS
137 Christenson Ct.
t LEGAL �OT NO. BLOCK TRACT OR AODITION
DESCR. 29 1 Christenson �
2 PROPERTY OWNER MAIL ADDRES$
Curtis Britz
3 CONTRACTOF MAIL ADDRESS
Minnesota Exteriors 8600 Teff rann Ftu,�L n
4 ARCHITECT OR DESIGNER MAIL ADORESS
5 ENGINEER MAIL ADDRESS
8 USE OF BUILDING
n ._ ,. d a ,.�, a. � .. '1
REV DATE
7/16/98
ZIP
ZIP
PAGE Oi
� �
26666
�� ��
APPROVED BY
SEE ATTACMED
SHEET
PMONE
i71-1439
PHONE IICENSE NO.
� nnn�R��
PNONE LICENSE NO.
PHONE LICENSE NO
7 CLASS OF WORK
❑ NEW ❑ ADDITION 0 ALTERATION �7 REPAIR O MOVE O REMOVE
8 DESCRIBE WOFiK
9 CHAN(3E OF USE FROM
STIPULATIONS
TO
SEPARATE PERMITSAIRE fiEOUIRED FOR ELECTRICAL, PLUMBIN(i. NEATING.
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND YOID IF WORK OF CONSTRUCTION 20NING
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF �ONSTRUCTION
OR WORK IS SUSPENDEO OR ABANDONEO FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG
I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION 1
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL Pi;OVISIONS OF LAWS VALUATION
AND ORDINANCES GOVERNING THIS TVPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING Of A PERMIT �SOO
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pEqM1T FEI
PROVISIONS STATE CAL LAW REGULATIN(3 CON-
STR OR THE PERF NSTRUCTION. �Z1.00
PLAN CME(
�,//.� �1 �� Licens
TURE OF
AGENT IDATEI
iDATEi
OCCUPANCY dROUP OCCUPANCVLOAD
S�. fT. CU. FT.
OPFSTREET PARKING
STAIIS IGAFAGES
5.00
$.50
SAC CHARGE
Fire SC $.50
TOTALFEE
$ .00
% ' HIS IS�i� ER'
� '/ �
JUL-16-1998 11�08 FROM CITY OF FRIDLEY TO
�UDN [ ] � ;,, - ..: CI'I'Y. OF FRIDLEY . . . -
1LTER [� S�1ITGLE �FANiII:YtAND�DUPLEI�ES R 1 AND R 2
�,:,: � . . , . , . . . : BUILDING PERMIT APPLICATTON
-,:. . ,. . . ..:.�� :�, . .
:o�tructionAddress: � � � � �` �� � �,..�' a�� ; ,��- ' � i,e�P� �
4933669 P.02/02
�� �
����,q
,���?�- �,��� �
,egal Description: � ' `, . . . .
►wner Name & Address: ��,�.�-� �, �� a � TeI. �l �`� � - � 9, 3�
'oat�'actor, ��.�! � �a �1�.�- �-�•� ��s�e!�� �-: � • MN T�CENSE # ���� ,
,ddress: �'��-�'� �°�,�,,,��� :�. �� , ��e ����'1 Tel. !� �,� � ���5 ..
� ��" �` Attach to this applica.tion, a Certificate of Survey of the � �
lot, with the proposed construcaon drawn on it to scale.
1vII�iG ARE,A►:
�ARAG� Ait�A:
ECS AREA:
+��.
. .. . . . , ..., DESCRIPTION OF IIVIPROV�MENT ,
� .. ��wM :.• . • i.�.� • � . . . • � • �
Len$th � Width � H�ight Sq. Ft.
� . , � � . �Length �� � � ' � - � Width � Height Sq. F� �
- Length� �� � � � � Width � � � Hgt/Ground Sq. Ft.
. r
i�S$71CL10II �e: � °�'�, � �_ ESLLII1St� COSL: $ `� `� �" �
� •�`=��'` •- �- ' � ' � • " ': . (Fee Schedule on Back) . . . : �
iveway Curb C�t Width Needed: � �' • � Ft: � + 6 Ft = � x $ � _ $ �
►�: �z ���-�.� .��Piica�r: � � -��� � T�. # ����'����
� . . .. CITY USE ONLY
cmit Fe� $ ��-�� Fee Schedule oa Reverse Side
E S�r�harge $ `�� .: :: .00i of Pennit� Vaivadon (1/10th°,b}
xe S�rc�arge $- - - - �� $.50/$i,00Q Valuation
C Charge $ $1000 per SAC Unit �
:ense Surcharge $ � � � $5.00 {State Licensed Residencial Contractors)
iveway Escrow S' Alt. "A". or Ait. "B" Above
uion Con�rol $ $45Q.00 Conservatian PIan Review
�C Fee $ F� I?etermzned by Enginee�ing _
�►er Main Chazge $ Agreement Necessary [] Not Na:essary [ J
TOTAL
�ITLATIONS:
$ � ` •��
TOTAL P.02
Building
Inspections
763-572-3604
DATE
SITE ADDRESS �
THIS APPLICANT IS:
.,
PROPERTY OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
WITH APPLICATION
PROPERTY TYPE
PERMTT TYPE
TYPE OF WORK:
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
YOUR E-MAIL ADDRESS
c+ n �
❑ OWNER �e7CONTRACTOR
PHONE: �� 3- 5 7/-/�/ 3 9
NAME: M_� L�V�G� Ol�l
STATE LICENSE #
PHONE
❑ TWO FAMILY/NEW
O BASEMENT FINISH .�ROOF
❑ DECK ❑ SIDING
❑ SWA�M
DESCRIBE WORK BBING
SIZE OF INIPROVEMENT.
NvNtBEx oF sQuaxES ��
GARAGES
PROPOSED SIZE:
PROPOSED HEIGHT:
SIDING
0 Vinyl
❑ Aluminum
❑ Other
WINDOWS
IN EXISTING OPENINGS DYes �IVo
OR FOR NEW OPENMGS-DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WIlVDOW TO BE INSTALLED
O REMODELING
�HOUSE & GARAGE
❑ ATI'ACHED GARAGE
❑ DETACHED GARAGE
❑Soffit
0 Trim
0 Fascia
LOCATION OF WINDOWS
NUMBER OF
Permit No.: ` �
Received By:
Date Rec'd: � �A � ���
m �cons-l-, c o�
EXP DATE c,S c3/ 0
D ci� i l e
��3 -��s, 8 �99
STZE
STORIES
O WINDOWS
❑ DRAIN 7'ILE
0 OTFIER
?L
WIDTH HEIGHT
AT�!�iIP SS �3Z
A!ti'!�LIPSS� c��
BASEMENT REMODELING SUBMIT:
I. Existing Floor Plan
2. Proposed floor plan
3. List of swctural members w be used
Ft.
FOR NEW CONSTRUCTION INCLUDIAIG DECKS,
ADDITIONS_ & PORCHES SUBMIT:
1. Site Plan/Survey showing the existing structures
and pmposed project.
2. Two sets of consttuction plans
3. Energy Calculations
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
- TOTAL JOB VALUATION $ .� OCCUPANCY TYPE
Pertnit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
$ �. a�
$
$ .1
$ � .�Q�
� S �c�,�
$
$
�
$
$
See Back Page for Fee Schedule
65% of Building Permit Fee
.001 times the total job valuation
.0005 x Permit Valuation Minimum $.50
$5.04 (State Licensed Residential Contractors)
$1550 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$21=$
$450 Conservation Plan Review
Fee Determined by Engineering
Ageement necessary ( ) Non Necessary ( )
Make checks payable to: City of Fridley Attach
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Consiruction Codes; that I understand this is not a
permit but only an application for a permit d work is not to start without a permit; that the work will be in accordance with the approved
plan in the case of all work hich re ' s r view and a oval of plans.
SIGNATLiRE OF APPLIC PRINT NAME V������ Q� DATE 6 � �"'
Page 2- Building Residential Applica.tion
BUILDING PERNIIT FEE SCHEDULE
The Chief Building O�cial sha11, before issuing permits for the erection of any building or
structure, or for any addition to any existing building oz 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:
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 proposed structure and of the construction site.
A Certificate of Survey of the lot, showing the location of the existing foundation will be
required before proceeding with the framing. New Houses Onlv
City of Fridley
Building Inspections Department
6431 University Avenue NE
Fridley, MN 55432
763-572-3604
Fax: 763-502-4977
From: Citv of Fridlev To: 7633237595 Page: 4/5 Date: 3/4l2010 3:29:26 PM
Building MECHANICAL PermitNo.: �p�U,
IriS ections Received By: �' a
p RESIDENTIAL APPLICATION
763-572-3604 CITY OF FRIDLEY Dat - �
763-502-4977 FAX �rr•�cTiv� �-i-zo�o
UATE �'��,,. YQUR t-MAIL AllURtSS
SIT�ADDRESS � ` �i \�t��'�i�(�1 �-/�
TH1S APPLICANT IS: ❑ OWNFR �CONTRACTOR
PROPERTY NAM�: �V%� 1� lri �Y' �
OWNER/ ADllRtS5: 1�� u( \I�l�jc(� C` C1TY �VI(`, �L`-I STAT� 'G1P
TENANT PHON�: � 4' �'l 1— I�{ 3`�
CONTRACTOR COMPANY NAMt:���a/I(�`S dY�- Hf1�
SUBMIT A COPY OF CONTACT AE1tSON: !I�� �.C`� �
YOU R STATE STATE LICENSE �t EXP DATE
LICENSEW[TH ADDRESS: "1��� /�I[7�� �V1V�:.. CITY , STATt� y�'G1P�pj
APPLICATION pHONE Ll5' �'- �JZ��i SR � r•,�x'7 (Q 3- 3 2.3 --TS�iS
PERMIT TYPE ��NGL� NAMILY ❑ TWO NAMILY ❑ TOWNHQUS�
TYPE OF WORK• � NEW I.�,Z�PLAC�MENT ❑ ALT�RATIQN/R�M011�L
DET'AILED DESCRIPTION OF WORK V� G,( T W Y�.(�.(' 1 }-(,� i 1�
FL�'L�S AKL BASN:D UV $10.00 PER FIX'1'URL�, L�XCL�PT WHL�RL� VOTL�D. FIX"fURL�'S: (IVDICATL� '1'07'AL VUVIBL�R OF L�ACH BLLUW)
PROVIDL HL�AT LOSS CALC'S PL�Rl7AVUALJ 2006ASHRAL� HAVDBOOK
�quipment lnctalled MNG: ��. (_���V� M011EL: q U� � 2. Sl"LE/B7U (. �T
MNG: L.JX� V�- M011�.L: TS G� F 245� Sl'G�/HTU 'L 01/�
MFG: MODtL: SI'G�/HTU
�A/C $25.00 _NIIi�PLACE (GAS) $ I5.00 _GAS RANG FJOV tN $10.00
A1R TO A IR �XCHANGt�R $15 NIR�PLAC� (WQQD) $35.00 NtW GAS GKILL $10.00
_BOl LEK $35.00 �,FURNACE $35.00 _GAS UN IT HTR $10.00
CH1MNtY LIN�R$]0.00 GAS DRYER$10.00 PQOL H�AT�R$35.00
DU CT WOKK $10.00 GAS PIPING $10.00 V tNT1LATOR $15.00
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THIS IS AN AAPLICATION b'ORA PtWN1T-NOT VALID UNTIL PROC�SStD
I hcrcby apply for a building permit and I acknowlcdgc that thc inforruation abovc is complctc and accuratc; that thc work will bc in
conformancc with thc ordinanccs and codcs of thc City of Fridlcy and with thc Minncsota Con.struction Cod�; that I undcrstand this is
not a permit but only an application for a pernut and work is not to start without a pormit; that thc work will bc in accordancc with thc
approvcd plan in thc ca�c of all vork which r uires rcvicw and approval of plans.
SIGNATURE OF APPLICANT � ` ,� PRINT NAM� r�t��1C� l��.c_�p DATt `� '�J
APPROVAL 1NSPECTOILS SIGNATUR� DATE � ��
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City of Fridley
uildin� Iaspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 763-502-497?