AF - 38050sue�ecr MIT NO.
City 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.
• COMMUNITY DEVELOPMENT DIV. ' f �.—
� � �: ----- �
r � � PROTECTIVE INSPEC710N SEC. l._�
� , �
' � �'��1 � CITY HALL FRIOLE� SS43Z NUMBER REV OATE PAGE OF AGPROVED B�
�""'� � �'' 612-571-3450 9�0-F15 8/25/97 / /
J08 ADDRESS 181 Christenson Court NE
t LEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACMEO
DESCR. 31 2 Christenson Crossing SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Th� Rottlund Co 2681 Long Lake Rd, Roseville MN 55113 638-0500
3 CONTRACTOR MAII ADDRESS Z�P PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL AODRESS 21P PHONE LICENSE NO.
5 ENGINEER MAII AODRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Townhouse & Garage
7 CIASS OP WORK
C� NEW ❑ ADDITION O ALTERATION O FIEPAIR O MOVE O REMOVE
8 �ESCRIBE WORK
Construct a 26.33' x 30.33' Townhouse & a Garage
9 CHANGE OF USE FROM TO
STIPULATIONS See notations on plan. Paid $375.00 Park Fee.
TYPEOFCONST. OCCUPANCYGROUP OCCUPANCVLOAD
SEPARATE PERMITS ARE REOUIRED FOR EIECTRICAL, PLUMBINCa, HEATING,
VENTI�ATING OR AIq CONDITIONING.
THIS PERMIT BECOMES NULI AND VOIO IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORI2ED IS N07 COMMENCED WITHIN BO DAYS, OR IF CONSTRUCTION
OR WOFiK IS SUSPENDED OR ABANOONEO FOR A PERI00 Of 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWIG. UNITS OFFSTREET PARKING
I HEREBY CERTIFV TNAT I HAVE READ ANO EXAMINED THIS APPLICATION 1 STAILS GARAGES
ANO KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS Of �AWS yq�UAT10N SURTAX
ANO OROINANCES GOVERNING THIS TYPE OF WORK WIIL BE COMPLIED See 179 Christenson ourt for Monies
WITH WHETHER SPECIFIED HEREIN Ofi NOT. TNE GFANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTtON OR THE PERFORMANCE OF CONSTRUCTION.
, PLAN CHECK FEE 707AL FEE .
.....�-- Z�r.
�GNATUAEOFCON'RA ORAUTM0�712EDAGENT IDATEI WHEN PROPERI, ALID TED THIS IS YOUR PERMIT
^ �f (�M
S�GNnTUAEOFOWNEAiiFOWNEFBU4DERi � iDATE� g� INiP �1�.TE
Prepaid Plan Check $
Fstimated Cost $
Receipt #
, C7TY OF �RIllIEY
� •• i i�!� : i i� . � .
: i �i .y. i ... •
L;�i�:ctive �i� l%96
Constnzction Address _� N'(Z iSTE►�1�1�5 �l`1��Z^T ZO�g
r?�� Description �� �_�K � CNR�S"CF1v`�O1J CR(�`�11�
Owner & P,ddress -'�[7iT w��.Q1,,Z(n$1 YT E�D � 1��utiu.E i�_Tel.# ��R-0500
CbNTRACZiOR & ADDRESS S f1 rYl E t�5 14 ►30YE. Tel .#
�rchi.tect & Address �14n'1G A� �'C'�0�/E �i�vlUT�-IU �DNnl�.a[�1,) �J'•# Z� 3 "r��
FYlgln22x & Ack3r2S3 ;��� �f�r, Z 20 �,.�IAR�CN�1 QC7 ,�► OI.IX 1'Al1.�J� SD �•# � l � ��
5'7 �07
TYPE OF Tn'I�RK � New Ll Addition ❑ Alteratian -Describe �{L� ��4JVl��
_i
�I uu�-r �� �C�„�r�mE� `���,�►
Applicant Signature `
' Tel # - �Date g-��'�
B[T.II,DIlVG DIl�15IC�TS
Length G%z �-�'� Width �j2�-d" Height��j�� Sq. Ft._$�� # of Stories_�,�
OFC. AR�',A: L�ength Width Height Sq. Ft.
WHSE ARF.�A: L�ength Width Height Sq. Ft.
0►�RR. AREA: L�ength Width Height Sq • Ft -
VAL�,TIC�T
sq. Ft. _J�,� x S_ 5�1.5� cast/sq. Ft. = valuation $���i �
sq. Ft .! Z pD x$_ 1�. 3� �ost/sq. Ft .= valuation $ z 1 q �") _$ 1
Sq. Ft. x$ Cast/Sq. Ft. = valuation $ > ��E
Building Use�E�l'i ��I�IL�tructian Z�pe - Occul�an�Y �uP �'"�
Air Conditionulg �Yes ❑ No Fire Protection Pravidsd ❑ Yes l�-No '"iA�dN�ES
Perforcnance Bond Am�unt $ ��i See Reverse for Schedule Received. L1 Yes ❑ No
Permi.t Fee $
Plan Check $
Fire Stiircharr�e $
State Surcharge $
SAC C�iarge $
Erosion Control $
Park Fee $
Spec. Assessments $
Dri.veway Escraw $
TOT�,L $
See Fee Schedule on Reverse Side
In �ccess of Prepaid Ampunt - See Reverse Side .
.001 x Pennit Valuation (1/lOth o)
$.50/$1,000 Valuation (See Sched. for > $1 Million)
$900 per SAC Unit (Plans to Nb�1CC for detenninabion)
$450.00 Conservation Plan Review
Fee Determined By Engineering
Agreement Necessary [l Not Necessary []
feet x $13.50/foot
$1 to 500
501 to 2,000
2,041 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,OQ0,001 and up
$1 to 2,000
2,001 to 25,000
25,001 to 50,000
50,041 to 100,000
100,001 to 356,000
Over $356,000
I3UILllING PERMIT FL+'� SCHEDULE
$21 (Minimum Fee is $21 plus surcharge)
$21 for lst $500 plus $2.75 for each addn'1 $100 or fraction, to and including
$2,000
$62.25 for lst $2,000 plus $12.50 for each addn'1 $1,000 or fraction, to and
including $25,000
$349.75 for lst $25,000 plus $9.00 for each addn'1 $1,000 or fraction, to and
including $50,000
$574.75 for lst $50,000 plus $6.25 for each addn'1 $1,000 or fraction, to and
including $100,000 . �
$887.25 for lst $100,000 plus $5.00 for each addn'1 $1,000 or fraction, to and
including $500,000
$2887.25 for the lst $500,000 plus $4.2S for each addn'1$1,000 or fraction, to
and including $1,000,000
$5012.25 for the lst $1,000,000 plus $2.75 for each addn'1$1,000 or fraction
PREPAID PLAN CHECI� FEE SCHEDULE
$29.25
$29.25 for Ist $2,000 plus $5.85 for each addn'1$1,000 or fraction, to and
including $25,000 •
$163.80 for lst $25,000 plus $4.225 for each addn'1$1,000 or fraction, to and
including $50,000 .
$269.43 for lst�$�0,000 plus $2.925 for each addn'1$1,000 or fraction, to and
including $100,000
$415.68 for lst $100,000 plus $2.275 for each addn'1$1,000 or fraction, to and
including $356,000
$1,000 (Balance due with issuance of building permit)
PERFORMANCE BOND POLICIES
When a building permit is issued for a commercial, industrial or a multiple dweiling residential project which requires
outside irnprovements,a Performance Bond or a Letter of Credit shall be submitted to the Ciry. The bond will cover
all outside improvements, including but not limited to landscaping, irrigation, curbing, blacktopping, screening fences,
lighting, and storm drainage systems.
�''alculation of bond amounts will be determined by the building permit values. The bond amount will be 3% of the
i�uilding permit value np to a 2 million dollar project or a$60,000 bond. Actual amounts will be rounded to the nearest
$100. The City reserves the right to require greater or lesser bond amounts based on unusual circumstances. Projects
with no outside improvements, generally will not require a bond.
Bonds must remain open untii the project is fuliy completed. AIl bonds will be held over one winter and through the
next growing season to insure the survival of all landscape installations. The City will then inspect these properties
in August of the year following the initial planting. Bonds may then be released in October of that year if all
improvements are satisfactorily completed.
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
APPLICATION FOR PLUMBING ANO GAS FITTING PERMIT
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACN FLOOR
Effedive On Januaty t, 19gg
PLUMBING FIXTURE RATES:
NO. RATE TOTAL
New Fixtures L
Oid Opening, New Fixture
Beer Dispenser
Blow Off Basin
Catch Basin
Rain Water Leader
Sump/Receiving Tank
Water Treating Appliance
Water Heater —Electric
Water Heater — Gas*• /
Geta'R"aTre,�''�- �;'iQ,P��'qc..� �
Gas Dryer**
Back Flow Preventer Required ()Yes () No
Type
$ 7.00 � �
$ 4.00
$ b.00
$ 7.00
$ 7.00
$ 7.00
$ 7.00
$10.00
$ 7.00
$10.00 /O
$� o.00 lp
$10.00
$15.00
Reinspection Fee $42.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS � D
1.596 of Value of Fixture or Appliance !/, �
State Surcharge
TOTAL FEE
$ .50
;. '�� �
JOB ADDRESS !�I �<�i�• S G= l'
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the city codes
and rulings of the Building Division, and hereby declares that all the facts
and representations stated in this application are true and correct.
Owner ' ����«�''
Building Used As
7 �� ,1998
0
Estimated Cost PERMIT NO. / ����
PLUMBING COMPANY �/�!�''�Y �ll��t b���
SIGNED BY � ��1�3� TEL N0. ��� �l�
Approved By ✓ Rough—In Date Final Date � '{
MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $20_00
PLUS THE 5.50 STATE SURCHARGE
**COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 S(1 INCHES.
,. HO S HEATING TEST RECORD "�� `����
. .� ,� ,�- , : �
ADDRE55 �/� r APT. FLOOR CITY SUBURB
OC�(iPANT �� OWNER
' HEAT LOSS ��,�- DATE HTG. INST. ��
SOLD BY __-s"� f�'`�-�'�!`� iNSTALLED BY
Eleetricol Wor By ' Gos lin• By
TYPE OF HEAT GA FA HW STEAM SPACE HTR. UN17 TR. OTHER
ESIGN CONVERSiON
MAKE MAKE OF BURNER
Mod�l Modsl
Seriol Max. BTU Rati�g —
tNPUT MAKE OF FURNACE
� Model
CONTROL S ��� I
THERMOSTA�� luy �. V.nr Size ,�
Volve KIND OF LINER SIZE t!�QNE
�,�'�`,��' ,�s s�'
Limit Droft Hood ularor �''~
Limit Ssttiny � Filters ` Size Numbsr �;/� --- ----
Fon Setting Chimney Loeation losids Outside
Pilot Typs � Chimney Construetion .
Pilot Moke
Pilot Model �'���,^^' Smoke $omb Wiring
Pilot Timing �/���'' .�/- �-' Droft _ Test Toy
L.W. Cut Off � Door Pressuro ' Lightin9 Inst.
' � �., ijr�!�Y . j+rr+aw r�
Prossure ereent COZ � Date Tested
Input CFH— Peres�t OZ Company 7esting
Stock Tsmp. Peresnt CO Name of 7estsr
Form 235 ,: r , �
�'`" �ITY bF �AIDLEY`INSPECTlON OIV.
64:l1 Universily Ave NE
Fridi�y,14�N"'�5432
572-3604
RATE SCHEDULE
Residential
`� ��v vC(f ivo On January I, I997
APPLICATION FOR POWER PUINTS AND FiEATING, COOLING, VEN7ILATION,
REFRIGERATION ANO AIR CONOITIONING SYSTEMS ANO OEVICES
Furnace Shell and Oucl Work, Burner --
Also Replacement Furnace
(Side Vent — Fill Out 8acfc)
Gas Piping �Needed wilh new lurtiacej
Gas Aange
Gas Dryer
Rale
$ 30.00
$ f0.00
$10.00
� 10.00
�, :
Igl
� i�5� S� �-
Tlte undersiflned f�ereby makes t�pplicalion for � permil for Ihe work herein
TUI�AI specilied agreeing ►o do ali work (R strict accordance wilh Ihe City Codes and
` .. rulings ot Ihe 8uliding Oivislon, and hereby declares Ihal ali the lacts and
$,�� � rep�esentations stated in Ihis application ate irue and correct. '
I°I�- g
��''l� _. t ��
OWNER ��(� 1 l L U�Il�I
�
$
/
"Air Conditioning — All Sizes $ 25.00 $ � �.�
All Othe�slRepairs & Alterations (LlST ON 6AC{�
1qo ot Value of Appliance or Wor{c $
Commercial/Industrial
1.25°/, ol Value oI Appliance or Work $
. , S7�
, � Stale Surcharge a� ,�ti
TOTAL FEE
�s.�
MINIMUM FEE FOR ANY HEATINGLOOLIN�ENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25 00
PLUS THE $.50 STATE SURCNARGE
REINSPECTION FEE $42.001Hr
*Air Cond�ioners can not be placed in a side yard wilhout
written permission Iram adjoining property owner.
�
BUILDING USEO AS
CSTIIv1ATE� COST �
PERMIT NO.���,�
DESCRIPTtON OF FURNACE ANO OR BURNEH
No. of Heating Unrts � Circle One (Steam) (Hot Waler (Warm Air
Trade ame �►�V j��/ Size No. S$1� � 1� ��
BTU fQ HP EDR
Fuel ����/ Totai Connected Load
6urner Trade Nam"e Size No,
BTU HP EDr�
F-IEATING OOMPNVY� r a-f I� d'G( �
Signed 8 el No. ���' �( Ipk�
k�
Approved By Rough-In Dale Final Oate I a
FaLI OUT BACK SIDE FOR STACK VEAIFICATION ON �� ""
aEPIACEMENT FURNACE