AF - 42918FROM :� I OMEE�2 EhJG I h� I hIG, PA PHDNE N0. : 612 783 1�3
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Certfiit�ate of Survey for:
House Address:
House �od�e1:. H��� .
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2� �e t1t��Or�N 65120
(Bt2; B81-1814 FA)I:881-9488
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{�t�) 783�-188� FAX:'76.�-1883
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� r�a.�tes ora�,aga de utmty '��e�i . ' • ' •
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We trer�y certify thvt ihl� 8urvey. P�d^ �°r ��P� �� P��� by ms o�' under my direo! �ton and thnt 1 o duly II� �
LAnd S�eyvr under tbe latrq oi �the St,ot�e oi Ylrtne9ot0. Dotsd' .tfiis �. d�Y °f ������ �-- 19`�- --- �,
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- --- -- , _ ____ __ __�. _ Stqned: Pt GaN1�NG. P.A.
I� B�"'� �.
� � ' � ° ��. ' . . . ` Rob�rt 8. Siltkf+. L.S. Rag. Na 1�1891 or
' 7arenca� E. �tothanboc�er� I..Sr R+g. No. 24595
� 923 16190.37 TRB . . - --- ----
�
sue�ecT P T O.
City of Fridley 2 5� 8 �
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T '
�
RECEIPT NO.
� � COMMUNITV OEVELOPMENT DIV.
, . ����� �
� ; �r------�
r � � PROTECTIVE INSPECTION SEC.
i �1 �
�.--_� � "','� CITV NALL FRIDLE� S�43Z NUMBER REV DATE PAGE OF APPROVEO BY
612-571-3450 910-F15 4/1/98 / /
JOB ADDRESS 6408 Christenson Lane NE
t LEGAI LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 32 1 Christenson Crossin SFIEET
2 PROPERTYOWNEF MAILADORES$ 21P PFIONE
Rottlund Com an Inc 2681 Lon Lake Rd Roseville MN 55113 638-0500 1335
3 CONTRACTOR MAIL ADDRESS Z�P PNONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS 21P PFIONE LICENSE NO.
8 USE OF BUILDING
Residential Townhouse
7 CLASS OF WORK
O NEW ❑ ADDITION O ALTERATION ❑ REPAIR ❑ MOVE O REMOVE
X
8 DESCRIBE WOHK
Construct a 42'6" x 25' Townhouse & a 22' x 20' Gara e
9 CHANOE pF USE FROM TO
STIPULATIONS
See notations on plan. Paid park fee of $375.00.
��iT� p�r�s R�Qur�a fva
11VIR1l�G, �E�Ttl�dG, PLUMBING AND SlGl�d�,
,,
TYPE Of CONST. OCCUPANCY dfiOUP OCCUPANCY LOAD
SEPARATE PEFMITS ARE REOUIRED FOR EIECTFtCAL, PLUMBIN(i, HEATIN(i,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION 20NIN(i SO. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENOED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WOHK IS COMMENCED. NO. OWLG. UNITS OFFSTREET PARKING
1 MEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALl PROVISIONS OF LAWS VALUATION SURTAX Fire SC
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIEO
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �118s322 �59.16
DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OF CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. ��82.25 � OOO
PLAN CHECK FEE TO L FEE
� 9� Lice SC $ 00 2,164. 73 + PF
�'31 UREOFC �RA RORAUTMOR12EDAGENT 1 ATEI E PpO VALI T THIS IS Y UR P'RM
♦
� �
SiGNATURE OF OWNEF i�f OWNER BUILDERI iDATEi • BL G�NSP rya7E
�1
NEW
ADL'I�T
ALTER
�
C]
ConstructionAddress:
CITY OF FRIDLEY �
SINGLE FAMII,Y A1vD DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
�
Effecti�e 111/97 ��
�'%u�y 5�
��� ��� 1
� �� 1 ��
�
Legal Description: �L�i?/S�l� �,�%/(� , LO K l f_O,r.. ��
Owner Name & Address: I UE �-ri l � w3j� ��,, �t/ I N�.,. Tel. # l�Q�.�pp _
Con�ractor: SP►tYl�. MNLICENSE# I ?5�
Address: ,��0$1 �� ,q.�� -�,�� ��v � L�E . M I�i 5113 Tel. #� (� �$ -- p �p
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIYING AREA: �
GARA,GE �REA:
DECK A.REA:
OTHER:
DESCRIPTION OF IlVIPROVEMENT
Length Z /fv �� Width ��C��� Height �!o /`j '_
Length 2�°O" Width ZC� `-O �° Height /�'
�n� Width Hgt/Ground
/��
Sq. Ft. _1� y� ,
sq. Ft. �,� i �: r�
Sq. Ft. ' �g�� y�,
Constniction Type• ��5/ T/A2; .S/ �la G .$ looZ S�s'
� A2 Lce1 Fstimated Cost• `� �, L� � `�
(Fee Schedule on Back)
Driveway Ci�rb C�t Width Needed: Ft. + 6 Ft = Ft x$ —$
DATE: � - / � -9g APPLICANT: � (�G{E �� Tel. #� lv 3g - f7.S� Z
CITY USE ONLY
Permit Fee $ 9�2-Z� Fee Schedule on Reverse Side
.�ire Surcharge $ , �2. .001 of Permit Valuation (1/lOth%)
��ate Surcharge $ $.50/$1,000 Valuation
���
���C Charge $� C� �950 per SAC Unit
�icense Surcharge
!�riveway Fscrow
:rosion Control
'ark Fee
$_ S'� � $5.00 (State Licensed Residential Contractors)
$ Alt. "A" or Alt. "B" Above
$ •$450.00 Conservation Plan Review .q�
$ �7 �, � � Fee Determined by Engineering � °�6'�
�ewer Main Charge $
TOTAL
�TIPULATIONS:
Agreement Necessary [ ] Not Necessary [ ]
$ .3
�5,3�� %�
I3UII,DI\'G I',EE2�I�IIT FEE SCfiEDUI,[:
F
1'lie Chief Building Official sliall, before issuing perniits for the erectio�z of any building or structure, or fi�r
an}' addition to any existing building or stn�cture,� or for any alteration or repair to any existing building or
structure, upon application therefore, requtce 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 �
��01 to $2,000
�2,0�1 to $25,000
�25,001 to $50,000
�50,001 to $100,OQ0
$1QO,OQ1 to $500,0(10
$500,001 to $1,000,000
-,
$1,000,001 and up
FEES
$21 (Minimum Fee is $21 plus surcharge)
$21 for first $500 plus $2.75 for each additional $100 or
fraction thereof, to and including $2,000
$62.25 for first $2,000 plus $12.50 for each additional $1,000
or fraction thereof, to an�i including $25,000 � ...:t.
$349.75 for first $25,000 plus $9.00 for each additional $1,OOOy
or fraction thereof, to and including $50,000
$574.75 for. first $50,000 plus $6.25 for each additional
$1,OOU or fraction thereof, to and including $140,000
$887.25 for first $100,000 plus $5.00 for each additional
$1,OOO�or fraction thereof,.to.and including $SOO,OQO ,
$2887.25 for the first $500,000 plus $4.25 for each addidonal
$1,000 or fraction thereof, to. and including $1,000,000 �•
$5012.25 for the first $1,000,000 plus $2.75 for each additional
$1,000 or fraction thereof
DRIVEWAY DEPRESSION ESCROW
(Concrete G�rb Streets Only)
Alternate "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 FOUNDATIOi�T
.
Perniics for construction wilI be issued a minimum of 24 hours from the time of application to allow for pro�er
re��ie«• of the proposed structure and of the construction site.
�� �::e�•tiiicate of Survey vf thc lot, sho�Wing the location of the foundatio�� r�nce it has it has been constructc:!
«'+:: �"� rcquireJ hefc�re �r��cecdin� �vith tlie framin,.
� � �1 l
�'�` HOUSE HEATING TEST RECORD �����`�
a {-�
ADDRESSt � }�°=� ���^p,y� f'� ������`)�� . e �`'p,� �'� �.,� APT. FLOOR CITY �_SUBURB
OCCUPANT f � `�"��� °'' � OWNER
HEAT LOSS DATE��HTG. INST. � T�."�� �� ,� f.
SOLD BY =_� ' "�' �'" INSTALLED BY '��r � �"' �`--"`'
Elechicol Work Bp " ��� r�� Gas lins Br `�� °,"'
TYPE OF HEAT GA FA �, ?` HW STEAM SPACE HTR. UNIT HTR. OTHER
��rj45,DE SIGN CON V E RSION
� �`�,,�.�� ,��' ,^ ,9 f%
MAKE MAKE OF BURNER
Mod�l �' �a y��0� Model
e ,�� � �, , _ � �- �> ,� " �; .
Serial ":"'%� %�;'�T �` f Max. BTU Roting _ �+
INPUT "�°��`; " MAKE OF FURNACE ,� '�
� , �F ;
� .(� Modsl '�
� �` ,,
� j' °>°'"� CONTROL S �,r'f'� ' � �
THERMOSTAT � �'' H�o)�up �� Vent Si:e � ��'
� �.,w�
Volve '`� °�`"� a-•^ KIND OF LINER SIZE SaN�E ,
Limit ,°"9 4� Oroft Hood ��,_r.Rsyuluror .�;, s�°�,��f� ° i<'^�_
Limit SsHiny
Fon Setting _
Pilot Type _
Pilot Make _
Fi Itsrs
Chimnsr Locafion
Chimney ConstruNion
Pilot Model ''� � _.�� Smoke Bomb _
Pilot Timing `a �����'�-�-�"�'' Drcft
L.W. Cut OfF ��� Door Pressuro_
��,�;
Preasuro ��� �9 ��� E�`� g=' Peresnf C0� �`�� Dote Tested —
s � `, � �
Input CFH— �'�� � +�' Peresnt p2�-`;�� -�� `�% Company Testing
SPmck Temp. ��"� � Peresnt CO �� �. Nams oF Tsatsr _
Form 235
fy
Insidi Outsids
Wiring
.Tsst Tag � .,'�-
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CHIlVINEY AND STACK VERIFICATION ,
The undersigned hereby verifies that the existing chimney or stack:
1. Has been carefully examined Yes () No ()
2. Is free from rust or deterioration Yes () No ()
3. Has no foreign objects lodged within Yes () No ()
4. Is securely supported Yes O No O
5. Meets ali current Code requirements for size_ °
and total BTiJ's connected , Yes () Na ()
6 Has �total heating BTU's of
All other BTU's
TOTAL BTU's
7. Has a liner been provided for water heater Yes () No ()
8. Has combustion air been provided for water heater Yes () No ()
Remarks:
List ALTERATIONS Bein Done: - -
HEATING CO:
Signed By: ..
Date: -
r.�� �A
n�+�� � v Iv
� • @..'J.�� �,�'•fi;'�.�'�F' � �'`r`>•'•`u`���'C^Q �.r::�� � •Q. rra.�b�'.`,` �`h ..� `�+~ '� ;'`v,�.Z� h.�`�.`'t`a`.�'�:�;��\�. ::i
��� ♦ �; � �S""������'V�� � 2�� ':'�VY. : �s:< ..��, 'a� �5 ` g. • • � . • ��. t ��. '�� a �.• �'�•�; o: r�,���•
�fii"•� V
Client:
Address:
Cily:
Phone:
Fax:
Comment:
Rottiund Hames
2681 Long Lake Road
Roseville, Minnesota 55113
638-0500
638-0501
YOUR BUILDER FOR LIFE
Project Name:
Reference Ciiy:
Daily Temperature Range:
Latitude:
Eleva�on:
Outdoor
D� Bu�b
Winter: -20
Summer: 95
Medium
44 Degrees
834 Feet
Outdoor Indoor
}OCei6Lla. H�1.Hum.
N/A N/A
75 50%
Company:
Representative:
Address:
Cit�r:
Phone:
Fa�c:
Comment:
Is. Minnesota
Indaor Grains
D� Bulb Difference
72 N/A
75 36
Flare Heating 8 Air conditioning, inc.
Randy
9303 Piymouth Ave. N.
Golden Valley. Minnesota 55427
542-1166
542-3101
YOU CAN FEEL THE DIFFEREIdCE
��h�;-,av_���j��,r.'. '2`�',��•'�:`'�,^C y �a', '°�,`5�`a�"�'��c��'1.:�;'•;'<,^�:�''">� ",�3.\"�. \ ��``;-•-� ��_ .�•t �, �: ���`,��,.�'ti�>'�'c'.�' -` ..Q . -
��•,� :- +� w�, � � � ` �.. ,,� ..�.��'`�u .. r� �•. _ .
3 . ,�",L�'�C'�. �"��,� ��\� �'�5�� � *� ��c .�," �.', ti:'+:•'.��'. t
.;u�, r`-�t���.*�`.'.:, �,"�����;���������,�'^�`'�'�.+�,'��'����::, i����'�'`�,���h 1��a�����`�;�ti��\� ��.���,k���������
,� � ���`�1`2�� �'�4' ."�.+'.- �. �ak� a A r��- �:`C^Z:a\.>:• �.� x ti�."�4��.`��3� �_���.. . �.:,�. t6\i�'�.,1'a�.��...��, �, !�ti a..1�.. �,� .
Total Building Supply CFM: 664
Square feet of room area: 2,054
CFM per square foot: 0.323
Square feet per ton: 1,197.276
.��c:a•. � �xa�.y�.,.;,,,. .:�a,-� .,�.,..c�r.��...�".. ..�,;�,*v�:..�: .r�q;,�:q . '•'C'>
,�:+,��,��: 2��<e:c��.:cs:;-�.V.. :ra�c�.��:: ��,�c.��- ti�' °.xz�� •��t'�� .ac;.'o\°t2i>�fl: i,e, ,� ."t'fi?::.:.,._�\" '��;'�F ,o'�.. \i c�?� � '�„
:y�.'tiY.:'o..� ,�. �:�.>. 'l'�.`C� . . �. . �� :'� :a. .;.�..���^"`:x�. �:'`::,£c�i:�C>\a;?:\x:o�.. �. .u�. ,\:s3�;t'�: . ��� :.' "':�\?,.: �:>L�c..� . . �i,,.. ��, '�":�. . �
.��; �::�a,:�.:�`.\�:,:�.�:�:�r:l?�'�ia,�.' "`^. �.., • ..1•'�,;,�',;1.. :`e>>: ,�.. , .,.,�;:?'��,�i,�\a:V.� :.\_,\1�..'��F'�>. 1�.*; 1�:.'2a"� ���..'��'�, �a. . o ,,�.` , �
a :. . �- ; � + ; ; ? ; � :..: : ,: ;. a ,: . ,,. �., ..�'�'�:. '�:;; `'� `�. � _ .���%:�'�. <: ��{ �>�: �` :���s� .��-, ,��c. �.. . �n*lfi.��.. �.�.. c�; �?�. ��, . ,. `.�.'� ;�:'.a. ti�w'�C \:"�.�. '��� :. �.. ,
�; . �, u ``'�'�;, �.ti; . .��, . �.'�.,, �.. c \ .,�,,� � ,.� � �C . � ; .��. � \. '.�'.'�{ �,. �� ;� `� , �
°���.`.�'�:�?a`:�:�:..:��-�:,�.:.a\���'�����.5�����.a;C���:��;u.���s��.�;. `ti...,�'�;.�w��,���.:���s:��'�:�'�`.<u.�.�`�,r:�,�ci..,'`�'��.��'�����?c�����>�a �x. ���`.�.�.
Total hea�ng �equired with outside sir: 41,498 Btuh 41.498 MBH
Total sensible gain: " 14,608 Btuh 74 %
Total latent gain: 5�147 Btuh 26 %
Total cooiing requfred with outside air: 19,755 Btuh 1.646 Tons (based on sensible + latent)
� � � �.7� 6 i ons (based on �5°� sensible capaciiy)
�� `�FY ":n e�.\ea> � v�;:1ti:':.sa�av:e.e.;uc.:,.�\cyax.'.., . ,�:� a't.�+,:''S�`'y.`' ':'C�� ^'�C:fS`;'+:� • {�. �t� :.S•"'�a'U`�::;:��� '���` :i�:.. �' {Q�`w4.: � 'a,"C;y'i;:.���?2?i:�.\��{� "•.,�,.,:,x _�`..
�.� ,� ..,* �� ..1\ . C,�r_''�i;`�.�����:a.• 'C�� ti;.. � �"'" 4 +�.;�.� �� ti�, ♦. +�•,. � � �� .,
:1..,�'�•` '�:..ti�;�S.���;��'��� ,. .�\",.�'+ �t'�+xc,v��a�..\l� � ;�., z;�:3�x.�,,,'"\,,���.a:v. '_�;• '�"��,�.�a<.�c ?�ti,.�C'?c<:''a..\,ti
����i, � .�' � b � �a. �c.y ,•��'� . ;� \. s ' �u, , � �k . .'* � �'��''=� �-t.`:�, ��,.��°�`c.�'���: �b�,.,� �'�} � �;��' �¢'�'l :. A'�,,� .
$'� �, �., ��,\��, ��iY. .t'+z� � � `�. ;�� "\ „ � ,���;���� ^Z'`..��?r\��,±Ys�. `�'���,`�.f`�*+�i�� �
. a'\�"�\k�.��.��;�������;o\'�'.��.',.+�'c� '�`a�?:�.\�:.?.`.;��;;.'�}�>�','�*�\��:�fi;����������\� �' � � a �-. �� �,..v'��'.�;.,. �, r ,R,.: �.*o-'..
�i. . t.v.�=. u.V.-.4.;ia\4.A \,.
Calcuiafions are based on 7th edition of ACCA Manual J.
All computed results are estimates as bullding use and weather may vary.
Be sure to select a unit that meets both sensible and latent loads.
Component Area Sen. Lat. Sen. Total
Description Quan Loss Gain Gain Gain
4A Window Double Pane � Storm Clear Glass Woad Frame 169 5,929 0 5,389 5.389
11 C Door Metal Polysiyrene Core 40 1.730 0 444 444
121 Wall R-19 + 1/2" Asphlt Board(R-1.3) 1�495 7�564 Q 1.940 1,940
15B Wall 2-5' Below Grade 8/12" BIk+R-5 530 3,608 0 0 0
16H Ceiling R-381nsulatian 1.027 2,457 0 1,175 1,175
21 A Basemt Floor 2' or More Below Grade 1,027 2.268 0 0 0
Subtotals for structure: 4.308 23,556 0 6.948 8,948
Active People: 4 0 920 1,200 2,120
Inactive Peo.ple: 0 0 0 0 0
Appliances: 0 0 600 1,200 1,800
Lighting: 0 0 0
Duciwork: 0 0 4 0 0
Infiltration: Winter CFM: 87.3. Summer CFM: 58.2 229 8,834 1�424 1,280 2,704
Ventilation: Winter CFM: 90.0, Summer CFM: 90.0 0 9.108 2�203 1.980 4,183
Sensible Galn Total: 14.6a8
Temperature Swring Multiplier: X1 •00 _
Building Load Totals: 41 �498 5,147 14�6Q8 19.755
w �1,.
.'a,�'��.��w� � �. � �, �c ,� �. ,� - �� � �, � �'��,� �• c � �,�- � '�a. �-�`.�.� .
� '% }���x�, ��a`��a��C����1����������� ���A ; �,"'� ���;;t�����������3��i�?����?;V����������$���x#rkx'� ,'�,'� ���,�,� ,?K,`���� J
n..._. _ . � . _ ... .... . ... . .. . _ _. _,_ _ ... __°_..__ . , - -- — --°-�- �t �.. a. `\. , �5+.
U, a. , �.
fotal Building Suppfy CFM: fi64 CFM per square foot: 0.323
Square�feet of room area: 2,054 Square feet per ton: 1,197.276
'�;����� �- "2� � �'St � � ���v � w,,,� �. � �� .X �, s �1•.�xl � '�{ �,� : a, '�t �'�;�"�:
�;rt�\�.'f,?��y����\'�{ \��. A � � � k �..� � .. �. ���+�^�^y�`p� • � +. ' � � �t��+�'�� y ?�,
��'�.nM'�:2a2'.�caR,�NrA�JZP.�`52iV.."�{ .����'���v�.���,���, � .{nC'h.i < �..`�.'�.`�'c\��C.��.��.'�Y+ �v.\,:�{C* ��;. * � i?:�����i�����`„��, n*:<�� �.. �,+,,.� . �* K r,
Total heating ►equired with outside air: 41,498 Btuh 41.498 MBH
Total sensible gain: 14�608 Btuh 74 %
Total latent gain: 5.147 Btuh 26 %
Total cooling required with outside air: 19,755 Btuh 1.646 Tons (based on sensible + latent)
1.716 Tons (based on 75% sensible capacity)
,'��`��. ��,,�.'�' �,. `� �'�*�. z�z� �� � ',1,�� �� b .,k�t;��;�;� . ��3s,�, '�w� �����.�v��� ��` ������'�
���.��N.: � � �\ �����'� ��,�;� �.° "`:, �Y'z��•� ��. ���. >.�. • : . ;" ��,��`;u���'' ",�`�� �` a�� �" �.
.Q.. `���'. �� �x�-:�.�i'±a
Calculations are based on 7th edition of ACCA Manual J.
All computed results are estimates as building use and wea�er may vary.
Be sure to select a unit that meets both senslble and latent loads.
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C�TYOF
FRIDLEY
FRIDLEY MU1vICIPAL CENTER • 643 I UNNERSITY AVE. N.E. FRIDLEY, MN 55432 •(612) 571-3450 • FAX (612) 57 I-1287
July 13, 1998
Rottlund Homes
2681 Long Lake Rd
Roseville, MN 55113
Re: Final Inspection at 6408 Christenson Lane NE, Fridley, MN
Dear Sirs:
A final inspection was conducted on July 13, 1998 for the above noted townhouse. We found
that the construction of the building complies, to the bsst 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 building.
If you have any questions on ttus matter, please feel free to contact me at 572-3602.
Sincerely,
RON JU
Building
RJ/mh
Building
Inspections
763-572-3604
763-502-4977 FAX
DA� D I ('@
SITE ADDRESS �
7'HIS APPLICANT IS:
PROPERTY O�
TENANT
CONTRACTOR
SUBNIIT A COPY OF
YOUR STATE LICENSE
PROPERTY TYPE
PERMIT TYPE
TYPE OF WORK:
■ • :� �
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
PHONE �.�
STATE LICENSE fJ
�
0
ADDRESS
FAX �Z f� "S �
EXP DATE
O SINGLE FANIILY/NEW CONSTRUCTION SIZE
O TWO FANIILY/NEW CONSTRUCfION STORIES
❑ ADDITION O GARAGF/SHED � WIlVDOWS
❑ BASEMENT FINISH ��%�OOF ❑ DRAIN TILE
O DECK �9�ING ❑ OTHER
❑ SWIlVIIVIING POOL
❑ NEW HOME CONSTRUCTION O ADDI1'ION
O MAINTENANCFIREPAIR O REMODELING
DESCRIBE WORK BEING DONE:_
SIZE OF IMPROVEMENT
ROOFING
NUMBER OF SQUARFS
GARAGES
PROPOSED SIZE:
PROPOSED HEIGHT: _
j'%'�N,� �1����,r �'.I'+, _
❑ Other
wnvnows
IN EXISIING OPENINGS �Yes ONo
OR FOR NEW OPENINGS-DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED �.
.�
TOTAL JOB VALU
Permit Fee
Plan Review
Fire Surchazge
Surcharge
License Surcharge
SAC Chazge
Curb Cut Escrow
Erosion Control
Park Fe�
Sewer Main Charge
Total Dne
❑ HOUSE ONLY
❑ HOUSE 8c GARAGE
❑ ATTACHED GARAGE
O DETACHED GARAGE
Permit No.
Received
Da�
�7.t'�3`�" �1
� � �:
����
F7'
BASEMENT REMODELING SUBMIT:
1. Existing Floor Plan
2. Proposed floor plan
3. List of structural members to be used
FOR NEW CONSTRUCTION INCLUDING DECKS,
❑Soffit ADDITIONS. 8c PORCHES SUBMIT;
❑ T� 1. Site Plan/Survey showing the existing structures
O Fascia a"d P�Po� PT�.I�
2. Two setv of consuuction plans
3. Energy Calculadons
LOCATION OF WINDOWS
ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1 7 UBC FEE SCHEDULE)
[ON $ ` o� � � � � OCCUPANCY TYPE
$ `"� o� See Back Page for Fee Schedule
$ 65% of Building Permit Fee
$ � .001 times the total job valuation
$ > .0005 x Pemut Valuation Minunum $.50
$ �. ��? $5.00 (State Licensed Residential Contractors)
$ "'� $1825 per SAC Unit (Plans to MWCC for determination)
$ ft+6ft= ftx$21=$ '
$ $450 Conservarion Elan Review
$ Fee Determined by Engineering
$ Agreement ne�essary ( ) Non Necessary ( )
� R�'� �@ Make checks aayable 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 ac owledge that e i 'on above is complete and accurate; that the work will be in confonnance with the ordinances and codes
of the Ciry of Fridley and with the Minn Construction • I understaztd this is not a petmit but ly an application for a pertnit and work is not W start wi out a
permit on site; that the work will be in with the a ved lan in the case af all work which req review and approval pl s.
SIGNATURE A IC � , RINT NAME P� f a a- ����DATE I
APPROVED BY DAT \
Building
Inspections
763-572-3604
763-502-4977 FAX
DATE Q � `� v �%�
SITE ADDRESS �
THIS APPLICANT IS:
PROPERTY OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
PROPERTY TYPE
PERMIT TYPE
TYPE OF WORK:
DESCRIBE WORK BEING DC
S1ZE OF IMPROVEMENT
ROOFING
NUMBER OF SQUARES _
GARAGES
PROPOSED SiZE:
PROPOSED HEIGHT:
SIDING
�' Vinyl
� Aluminum
❑ Other
❑ OWNER
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
EFFECTIVE 1-1-08
YOUR E-MAIL ADDRESS
� �
.��.
. �
' � ��i����a�Lr�I ,��i�� � ,��Vt��i'
�
'��' �f ■I�
• . — i . •,
STATE LICENSE
0 SINGLE FAMILYMEW CONSTRUCTION
❑ TWO FAMILY/NEW CONSTRUCTION
❑ ADDITION � GARA
❑ BASEMENT FINISH ❑ ROOF
❑ DECK �:SIDIN
❑ NEW HOME CONSTRUCTION
❑ MAINTENANCFJREPAIR
WINDOWS
IN EXISTING OPENINGS OYes ❑No
OR FOR NEW OPENINGS-DESCRIBE SIZE OF
OPEMNG CHANGES &
TYPE OF WWDOW TO BE INSTALLED
C
CITY�
,�� 3 ,
EXP DATE
Permit No.: � `�� � �
Received By: -��
Dat�. �'d��� � 8 2��8
STATE ZIP_
i
� � �/i STATE �%�%GIP,
- Z i��'
�/oq
SIZE
STORIES
:/SHED ❑ WINDOWS
❑ DRAIN TILE
� ❑ OTHER
NG POOL
❑ ADDI1'ION
❑ REMODELING
WIDTH HEIGHT
❑ HOUSE ONLY
❑ HOUSE & GARAGE
❑ ATTACHED GARAGE
❑ DETACHED GARAGE
��
BASEMENT REMODELING SUBMIT:
1. Existing Floor Ptan
2. Proposed floor plan
3. List of structural members to be used
FOR NEW CONSTRUCTION INCLUDING DECKS,
❑Soffit ADDITIONS. & PORCHES SUBMIT:
� Trim 1. Site Plan/Survey showing the existing structures
❑ Fascia and proposed project.
2. Two sets of conswction plans
3. Energy Calculations
LOCATION OF WINDOWS
NUMBER OF
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 UBC FEE SCHEDULE) '
TOTAL JOB VALUATION $��O , Q� OCCUPANCY TYPE
Permit Fee
Plan Review
Fire Surcharge
Surchazge
License Surcharge
SAC Chazge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
$ •_
$ ,�DC�
$ � Sia
$
$
$
$
$
Q
$
See Back Page for Fee Schedule
65% of Building Permit Fee
.001 times the total job valuation
.0005 x Permit Valuation Minimum $.50
$5.00 (State Licensed Residential Contractors)
$1825 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$21=$
$450 Conservation Plan Review
Fee Detetmined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks pavable to: City of Fridlev Attach
THIS IS AN APPLICATfON FOR A PERMIT-NOT VAL[D UNTIL PROCESSED
I hereby apply for a building permit and I ac wledge that the info ' n 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 Minnes nstruction Codes• I understand this is not a permit but only an application for a permit and work is not to start with ut a
permit on site; that ffie work will be in acco an with�he app pl in the case of all work which requir eview an� approval plan
SIGNATURE OF APPLICANT " r✓ PRINT NAME �� � 0� j,� I C� ���C� �DATE '�
APPROVED BY � � DATE '
Page 2- Building Residential Application
BUILDING PERNIIT FEE SCHEDULE
The Chief Building Official shall, before issuing permits for the erection 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:
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
Bui�ding Inspections Department
6431 University Avenue NE
Fridley, MN 55432 '
763-572-3604
Faz: 763-502-4977