AF - 38060SUBJECT PEp
City of Fridley E, 4 6
AT THE TOP OF THE TWINS g � I L D I N G P E R M I T
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; ` IPT NO.
� `y ______ COMMUNITV DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC. ���,�
i �
� � ,
( � ����1 � CITY HALL FRIDLE� 55�32 NUMBER REV DATE . PAGE Oi APPROVEO 8Y
�'""�' �'' 612-571-3450 910-F15 10/29/97 � �
JOB ADDRESS 6403 Christenson Lane NE
t LEGAL �OT NO. BLOCK TRACT Oii AOOITION SEE ATTACHED
DESCR. l}9 1 Christenson Crossing sweer
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
The Rottlund Company Inc 2681 Long Lake Rd, Roseville, MN 55113 638-0500
3 CONTqACTOR MAIL ADDRESS ZIP PHONE UCEkSE NO.
Same 1335
4 ARCHITECT OR OESIGNER MAlL AODAESS ZIP PNONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE IiCENSE NO.
6 USE OF BUILDING
Residential Townhouse & Garage
7 CLASS OF WORK
C� NEW ❑ ADDITlOM O ALTERATlON O REPAIR O MOVE O REMOVE
8 DESCF;IBE WORK
Construct a 48' x 25' Townhouse & a 21' x 20' Garage
9 CHANGE OF USE FROM TO
STIPULA710NS
See notations on plan. Paid Park Fee of $375.00.
' �������
6efore di�ging call fot
�EPA�?'A"i� PE'!'�D11T5 REQpI�' � ai� ut��ity Iocations
WiR1NG. HERTING, PLUMBiNG AND S(G E UIRtD BY LAi�V
� RQ
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV IOAD
SEPARATE PERMITS ARE REOU�RED fOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONOITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK Ofi CONSTRUCTION ZONING SO. FT. CU. fT.
AUTHOR�2E0 IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WOF;K IS SUSPENDED OR ABANDONEO FOR A PERIOD OF 120 OAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. OWLG. UNITS OFfSTREET PARKING
I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GAI;AGES
AND KNOW THE SAME 70 BE TRUE AND CORREC7. ALL PROVISIONS OF LAWS yq�VATION SUR7AX Fire SC
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIEO
WITH WHETHER SPECIFIED HEREIN ON NOT. THE GRANTING OF A PERMIT �79,990 $40.00 ](�.(�C�
DOES NOT PRESUME TO GlVE AUTHORITY TO VIOLATE OR CANCEL TNE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CO -
STRUCTION OR THE PERfORMANCE OF CONSTRUCTION. �%C)2.2.'r) $950.00
��,..�.--.. / Q, PLAN CHECK FEE TOTAL FEE
�_. �g License SC $5. 1,837.24 + PF
UAE OF CON'i7 R AUTMOAl2ED AGENT IOATEI OP VALI AT D THIS IS VOUR PERMIT
Y ' /G/ �� l ' �/
..
S�GNnTUAE OF p R i�F OWN BU4DERi �DATEi 8�D �NSo ��atE
N E�V
A.�LN
ALTER
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ConstructionAddress:
CITY OF FRIDLEY
SINGLE FAMILY A,ND DUPLEXES R-1 AND R-2
BUILDING PERMIT A.PPLICATION
)�
Effective 1 / 1 /97
p �� �� �-%
.l�
Legal Description: _ G%l�jf�r-'r���p�/ ���`��� ��;pG�C / , Lor �9
Owner Name & Address: ' � �,
� i-IE �iTl � c�,i� (�ti ►��.� �ll I N�. Tel. #�_���Q ���}O
Contractor: S�m� MN LICENSE # I���
Address: ��og l 1 1.1C� �►LG "1�r�,q'�,,_ '1�.�.v� LI.E , Nli�i 5�11�_Tel. #!� �$ � 0 7L0
LIVING 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.
DESCRIP'I'ION OF IMPROVEMENT
� �� �� Hei ht ► � "
Length _ �8-D Width �5'%D_ g � 'a,
Length �l = 0 N Width aFJ'-p '� Height �
�ng� Width Hgt/Ground
� �y
y � �
11�y ° � _.
t�
Sq. Ft. �
Sq. Ft. �
Sq. Ft. �� Vy �
---�� �1
� � O.O
Constniction Type: �
Estimated Cost: $ � 3D, 0
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$
—�
DATE: _�.�� APPLICANT: r-�-_..�1 1. Tel. # 13�� DS�3�
v
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
$ 7G2 . ZS
� �9, 9 9
� o.oa
� �' �+. ar
$ S, ov
$
$
$ 7 ' : oc�
$
$�'� /� .
CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/lOth%)
$.50/$1,000 Valuation
$950 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 [ )
r
Sheet1
EXTERIOR ENVELOPE THERMAL TRANSMITTANCE WORK:5HEET
ROTTI.UND CO. INC. PRODUCT: ASHTON
DEVELOPIVIENT: •��-��CI�itL�TENSON CROSSING CITY: FRIDLEY
SITE ADDRESS: 6403 CHRISTENSON LANE DATE: 10-21-97
ASSEMBLY AREA (Sq Ft) U-FACTOR U-FACTOR X AREA
CEILING/ROOF
EXPOSED WALL
INSULATED AREA 1924.57 0.047 90.45
FRAMING AREA 339.63 0.107 36.34
WINDOWS 162.00 0.500 81.00
DOORS 37.80 0.350 13.23
RIM JOIST 0.00 0.024 0.00
FIREPLACE WALL 0.00 0 0.00
ABOVE GRADE FOUNDATION WALL 0.00 0.084 0.00
FOUNDATION WINDOWS 0.00 0.00
FLOOR OVER UNHEATED SPACES (U = 0.04) 0.00 0.00
OTHER 0.00 0.00
TOTALS E 2464.00 F 221.03
AVERAGE U-FACTOR: F / E = G G 0.090
REQUIRED U-FACTOR (from Energy Code) (U = 0.110) H 0. 210
If C is greater than D, or G is greater than H, revise the design as necessary to meet the envelope criteria
of the Energy Code.
1) U-Factor for skylights and windows must be determined by the Nadonal Fenestradon Rating Council Standard 100-91 or
ASHRAE 1993 Handbook of �ndamentals, Chapter 27, table 5.
2) Thermal Transmittance of opaque components (including integrally insulated masonry and metal stud framing)
use part 7670.0450, subpart 4.
� Page 1
'U'-V��U� C,��CU��4T(01�5
�OOF/CL�. AT INSULATION
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COMPONENTS
EXTERIOR �lfR FILM
BLOIUN-IN II�SUL.
I/2" �YP. BD.
INTERIO� �41R FILM
!_�. AT INSULATIO�1
0
�
�
0
0
TOTAL:
COMPON�ENTS
EXTEf�fOR �fR FILM
BLOUJ�I-IN I1�SUL.
2X� BOTT. CHORD
i/2" GYP. BD.
INTER�OR AIR FILM
TOTAL:
R-V�LUES
0.17
��.0
0.�5
O.G1
R=�5.23
u=o.o22
R-VALUES
O.I�(
2�.6
5.0
0.�5
0.61
R=35.83
u=o.o2-�
�oi�o=n
L�'b=�{
89'O
��'O
L8'9
Z'I
0'O
�. I' Q
s�n���-�
L�o�o=n
��iz=�
89'O
5�'O
O'bl
Z�I
O�O
Ll"O
s�n�b�-�
��t�101 ' °
!��l1� �lb' �101��1N1
"a9 "dJ��J „Z/I
an1S 9XZ
�NIH1'd3HS „Z/I
�JNICfIS
W�I� �I'v` �OI�J�1X�
S1N�NOdWO�
� 7'd l 01
�
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�
0
0
0
�
�
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0
��
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�JNIW'd�� l�i ��'dm �101��1X�
W�I� �I'd JOI��1N1
"CI8 "dJ�� „Z/I
N011�1�C1SN1 „Z/I �
�NIHl'd�HS „Z/I
�JNI(JIS
W71� �I� �IOI��1X�
S1N�NOdWO�
�
�
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Q
0
0
NOI1�i-1nSNI 1'd "1"1'dm �101�{�1��
sNO�1��n���� �n���-,n,
'U'-y�LUE C��CU�.�T(0�15
A60VE C�R,4DE FOUNDATION
GP.ADE
0
0
�
0
COMPONENTS
EXTERIOR A(R FILM
2" RIGID INSUL.
�" BLOCK
INTEf�IOR AIR F(LM
TOTAL:
f�-VALUES
o.�-,
10.0
I.OI
0.68
R=11.q2
U=0.08 r
f p ,^' .
� HOUSE HEATtNG TEST RECORD ��`f��'��L-
,i .,t '. :� : _ ,�..__ ; �/�
ADDRE$S ' APT. FLOOR CITY 1G_.—SUBURB
OCCUPANT OWNER
. _....
HEAT LOSS �_DAT -1iTG. INST. `' �-" -' '
SOLD BY ���a � - � INSTAL�ED BY '
El�chieol Work By Gas lin� Br .G�
TYPE OF HEAT . GA FA HW STEAM SPACE HTR. UNIT HTR, OTHER
G',S DESiGN CONVERSION
KE MAKE OF BURNER
•! Model
�!� � � � � �
;oi" Max. BTU Roti�g ,
PUT MAKE OF FURNACE
' Mbdel
CONTROLS �/ :
ERMOSTA7 '� eot Plvy �. > Vsnt Siza
Valvs , KIND OF LINER SIZE NO E�__
Limit D�aft Hood / R�yvleror
Limit S�ttiny Filters Si:e/ Number � �
Fan Settiny � Chimnsy Location�' Insid* Outsid•
Pilot Typ� ��,,���. - Chimney Construetion '
Pilot Maks ��%��G1iG�-'`
Pilot Model �L �.�+ Smoke ,Bomb _
Pilot Timing "� �/�?-��-�'� Draft
L.W. Cut Off �� Door Pressurs _
�
Pressure _� �'' � Psresnt CO2 Date 7ssted _
tnput CFH� Pe►esnt 0� Company Testing
IM'"
' Stack 7emp. Perc�et CO � Name of Testsr _
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!i'/,�/"'d/,'"//f�lr'% Ai`
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.%�fj% /�' ( � r"� r
Form 235 ir
..r u�:: . ._.. _ ,... ,.�n. _.,. , ... w...t ., �...t.,�„�. ...�. ,.�,., ....,r�. ..,.�,,.........,,.�..,,,.i'�4, �,a,.,..,..iac:.s.�.�.r...al.:S,�a. .,.,�.�r..�.u.�.E..+„a?:.;i,.»s.,s..3e.�ae,...1„w..dca.,.��::x�,w..,iw..,..,�..�..... SW.r _�ac�.sm.,sar�,...,,�, .. .. ...�
��[ !�j .
,, �:IIY OFFRIDIEY INSPECtION OIV.
� 643 f University Ave NE
Fridley, MN 55432 .
512-360Q
RATE SCHEDUIE
�Co�. �� .
Ef(ecliveOn January f, 1997
APPLfCA710N FOR POUVER PU�NTS AND HF�ITING, COOI,ING, VENTtI.ATiON,
REFAlGERATION ANO AIR CON(?IT(ONING SYSTEMS ANO OEVI ES
JOB ADDRESS 6 3 S (f � 1--� .ei
Residential
Furnace Shell and Duct lA�o�C, Surner -
Also fteplacement Furnace
(Side Vent - Fill Out @ack)
Gas Piping (Needed wilh new furnace)
Gas Aange
Gas Dryer
*Air Conditioning - Ail Slzes
All OtherslRepairs 8� AlteraUons (LIST ON BACIQ
1% of Value of Appliance or Work
Commercial/Indust�ia!
1.28% ot Vatue o( Appliance or Wo�k
3
Rate
$ 30.00
$ 10.00
The undersigned hereby makes appiicaiion for a permit for ihe work herein
TOTAI. specitied agreeing to do all work ir� slrict accordance with it�e City Codes and
$_���' rulings ol the Buildirtg �iylslon, and hereby declares tt�ai all the facts and
representalions stated in this application e true a d arrect.
� � Q � � U • � � ,_. ? 997
owrv�R � �i b � � U,YL�',�
$ 1Q00 $
BUIIDING USED AS
$ t0,00 $
� ESTIMATE� COST � D D. O� PERMIT N0. %a ��
$ 25.00 $ �� .
� DESCRIPTIO OF FURNACE AND OR BURNER
� No. o( Heating Unrts� Circle One (Steam) (Hot Waier) arm Ai
T�ade ame C� j Siie No. �j � p �- �'�
BTU G HP �D�
$ --- � F�� (,L� GlS i'atal Connecfed Load
Siate Surcharge
TOTAI FE�
$ .50 Surner Trade Name
j �! �� BTU �
�✓ J
MlMIMUM FEE FOR ANY HEATING(COOI.lNGNENTIIATION
REFRIGERATION/AIR CONDITIONiNG P�RMIT IS $25 00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $42.00/Hr
�Air Condrtioners can not be p(aced in a side yard wiihout
wtitten permission (rom adjoining property owne�.
Size No,
HP
EDr�
HEATING OOMPANY F(� �"j n G
�
Signed 8 � Tel No. �o�—%�� JO
' Approved By Rough-In Date fina! Oale `��`"�
FILI OUT BACK SIDE Fa STACK VEAIFlCATIOiV ON ��
aEPIACEMENT FURNq
_" " «r;:� - _ . . .. , - -
' Client:
Address:
City:
! Phone:
Fa�c:
� Comment:
Rottlund Homes
2681 Long Lake Road
Roseville, Minnesota 55113
638-0500
638-0501
YOUR BUILDER FOR LIFE
Company:
Representative:
Address:
City:
Phone:
Fax:
Comment:
Project Name: Ashton
Reference City: Minneapolis, Minnesota
Daily Temperature Range: Medium
Latitude: 44 Degrees
Elevation: 834 Feet
Outdoor Outdoor Indoor Indoor Grains
�/ Bulb Wet Bu(b fl�(,b,�, � Bulb Difference
Winter: -20 N/A N/A 72 N/A
Summer: 95 75 50% 75 36
Total Building Supply CFM: 556 r
Square feet of room area: 1,200
Flare Heating & Air conditioning, Inc.
Randy
9303 Piymouth Ave. N.
Golden Valley, Minnesota 55427
542-1166
542-3101
YOU CAN FEEL THE DIFFERENCE
CFM per square foor 0.483
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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�
�
��
Component Area Sen. Lat. Sen. Total
Description Quan Loss Gain Gain Gain
4A Window Doubfe Pane & Storm Clear Giass 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 Duct2" Edge 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
Inactive People: 0 0 0 0 0
Appliances: 0 0 300 1,200 1,500
Lighting: 0 0 0
Ductwork: 0 0 0 0 0
Infiltration: 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 Swinq 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
� �ik \�.CQ� �'4 �' �✓, t � . . A .� K^, �� 1 n'\ .�' -0
a>,� •s x; .bf. ��.' k '� � ' �
k
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 + tatent)
1.435 Tons (based on 75% sensible capacity)
�,�, ��. ..� �,, � , � � �
� .. �� �, '�' .� �„ ��i ',`''�'� a'�;+;`�'3'c, ��•�,� � i "' i �,. �� �\�C. �,�. �� "�`�,2�':\\� ti,,`�� \ �,\ �, \
t � K � � :.:+�v i : � , r i� , '�,'�,�� � �+� {���+i.'�, 42 �l .� �' , � ���`.� � \ �� \�"��. �,`''��,� t� .
�<.��az, '��.`...� � c`a ��� ��������� `*\�����. ` �����Y a�`,�z *.�����
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.
� . �; �- . . _ . _ _ _ _.
0
• �r
C(TY OF FRtDLEY INSPECTION DtV.
6431 University Ave NE
Fridley, MN 55432
572-3604
APPUCATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
Effedive On January 1, 1997
PLUMBING FIXTURE RATES: NO. RATE TOTAL
New Fixtures C�� $ 7.00 C� „(jb
Old Opening, New Fixture $ 4.00
Beer Dispenser $ 5:00
Blow Off Basin $ 7.00
Catch Basin $ 7.00
Rain Water Leader $ 7.00
Sump/Receiving Tank $ 7.00
Water Treating Appliance $10.00
Water Heater —Electric $ 7.00
Water Heater — Gas** I $10.00 i0, �Tj
Gas Range** � $10.00 � p • � �
G�s_B�yet** � � $10.00
Back Flow Preventer Required OYes O No
Type $15.00
Reinspection Fee $42.00/Hr
ALL OTHERS AND/OR REPAIRS AND AITERATIOMS
1.596 of Value of Fixture or Appliance
State Surcharge
TOTAL FEE
$ .50
$ l� ,S�
JOB ADDRESS ��� 3 �� �Fi�-Sdti � �
The undersigned hereby makes application tor a perm+t for the work herein
specified agreeing to do all work in strid 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.
�— �� , 1998
Owner /`��Pk��( �o�*-"�S
Building Used
Estimated Cost
PLUMBING COMPANY
SIGNED BY
s/e/�/
PERMIT NO. / �C� f�(c,
�'r�-1� �� �,� ,..�
Approved By�_ Rough-ln Date
TEL N0. '���"�1��
Final Date —��
MIT IS 520.00 i/-�
**COMBUS110N AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SC� INCHES.
_
_
C�TY OF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN SS43? •(612) 571-3450 • FAX (612) 571-1287
February 4, 1998
Rottlund Homes
2681 Long Lake Rd
Roseville, MN 55113
Re: Final Inspection at 6403 Christenson Lane NE, Fridley, MN
Dear Sirs:
A final inspection was conducted on February 4, 1998 for the above noted townhouse. ' We
foun d t h a t t h e c o n s tr u c t i o n o f t h e buildin g com plies, to the best of our knowledge and belief,
with att 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 building.
If you have any questions on this matter, please feel free to contact me at 572-3603.
Sincerely,
c��
BARR RIESCH
Building Inspector
BR/mh
�>
Building
Inspections
763-572-3604
763-502-4977 FAX
DATE � `
SITE ADDRESS _� 7 V v
THIS APPLICANT IS:
PROPERTY OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
PROPERTY TYPE
PERMIT TYPE
TYPE OF WORK:
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
�n �� E��Iv,�AI�ADDRESS
�-'1.L.t_tS 1 � .
O OWNER �CONTRACTOR
NAME:
ADDRESS: CITY "
PHONE:
NAME: — f
ADDRESS:
PHONE ' o� �0 FAX
STATE LICENSE # �P � s
❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE_
O TWO FAMILY/NEW CONSTRUCTION STORi]
❑ BASEMENT FINISH �+OOF
❑ DECK ❑ SIDING
❑ SWINIlN
❑ NEW HOME CONSTRUCTION
❑ MAINT�IVANCE/REPAIR ,
DESCRIBE WORK BEING DONE;
SIZE OF IMPROVEMENT
N�ER�OF SQUARES � J � � (
A1tA E �
PROPOSED SIZE:
PROPOSED HEIGHT:
V►�yl
❑ iw�,�►� �tl�
O Other
WINDOWS
IN EX[STING OPENINGS I�Yes ONo
OR FOR NEW OPENINGS-DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED
FEES
'OTAL JOB VALU
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
NG POOL
O ADDT!'ION
O HOUSE ONLY
❑ HOUSE 8c GARAGE
� ATTACHED GARAGE
O DETACHED GARAGE
0
EXP DATE
❑ DRAIN TILE
O OTHER
.
Permit No.:
Received By• ' '
D���' 12OOB
STATE "� yv ziYyy
i
STATE ZIP,
o G _
� -�3 I - m
Cti�Y
QA3EMENT REMODELING SUBMIT'
i . Existing Floor Plan
2, proposed floor plan
3. List of structural members to be used
FOR NEW CONSTRUCTION INCLUDING DECKS,
ADDITIONS & PORCHE�SLJBI�T:
OSoffit l, Site plan/Survey showing the existing structures
❑ Trim and proposed project.
❑ F�� 2. Two sets of construction plans
3. Eoer� Calculations
LOCAT[ON OF WINDOWS
ON VALUATION,1
(USING THE l
�t OF WINDOWS I
LUDING THE COST OF LABOR AND MA
�n ccs e.��,,DULE)
O�b . °° ��I ✓ OCCUPANCY 'i'Yr�
�, See Back Page for Fee Schedule
$ 65% of Building Petmit Fee
$ ,'1 .001 times the total job valuation
$ , .0005 x Permit Valuation Minimum $.50
$ ��_ $5.00 (State Licensed Residenrial Contractors)
$ $1825 per SAC Unit (Plans to MWCC for determination)
$ ft+6R= ftx$21=$ '
$ $450 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement necessary ( ) Non Necessary ( )
e .. Make checks aavable to: City of Fridley Attac
T S IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a buiiding permit and I ac wledge that i ion above is complete and accurau; that the work will be in confomeance with the ordinances and codes
of the Cily of Fridley and with the Minneso onstructio ' t I understand this is not a permit but o y an application for a pertnit and work is not to start without a
permit on site; that the work will be in wi e roved lan in the case of alt work which requi Leview and app val of plans. /
SIGNATURE F APPL A _
PRINT NAME /"v w / �- � �� DATE � � ` '
. 1` fi ,. A. _ DAT� � i�
APPROVED BY