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P - 44906.� ��:�/� Building BUILDING Permit No.: Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'c1: , .� � 763-502-4977 FAX EFFECTIVE i-i-ZOi� DATE YOURE-MAILADDRESS 1 1�"�'� �� l%S� i C SITE ADDRESS �� Q i�- � '�i � � e .� � THIS APPLICANT IS: �OWNER ❑CONTRACTOR PROPERTY OWNER/ NAME: N��I �' �I�l rV3�. TENANT ADDRESS: ��ZD QO.�lfi0'fY� D�' �J C� CITY �V'�(��e l/ STATE'MIJ ZIP Sns�-t 3� PHONE: � S�-�"��- � �� CONTRACTOR NAME: SUBMIT A COPY OF STATE LICENSE # LEAD CERT NUMBER YOUR STATE LICENSE AND CERTIFICATE OF ADDRESS: CITY STATE ZIP INSURANCE pHONE FAX PROPERTY TYPE t�C3INGLE FAMILY/NEW CONSTRUCTION SIZE �] TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAII3 TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR �[ REMODELING DESCRIBE WORK BEING DONE: I� c � SIZE OF IMPROVEMENT GTH WIDTH HEIGHT SQ FT ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structutal members to be used PROPOSED HEIGHT: FOR NEW CONSTRUCTION INCLUDING DECKS, SIDING ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other � Fascia and proposed project. 2. Two seu of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS�Yes ❑No LOCATION OF WINDOWS FOR WINDOWS - PROVIDE U-VALUE AND OR FOR NEW OPENINGS-DESCRIBE SIZE OF MANUFACTURE STICKER ON WINDOW. OPENING CHANGES & r�- TYPE OF WINDOW TO BE INSTALLED� � b�''d�n4�1UMBER OF WINDOWS � ALL FEES ARE BASED ON VA ATION, INCLUDING THE COST OF LABOR AND MATERIALS: TOTAL JOB VALUATION Permit Fee Plan Review Fire Surcharge Surcharge License Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due $ $ $ $ $ TAE 1997 U.B.0 FEE SCHEDULE) ► OCCUPANCY See Back Page for Fee Schedule 65°/a of Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum $5.00 $5.00 (State Licensed Residential Contractors) $2230 per SAC Unit (Plans to MWCC for determination) ft+6ft= ftx$24=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks pavable 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 Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance with the approved plan in the case of all�^w� k wllic es review and approval of plan � J� `�� SIGNATURE OF APPLICANT /'/ �� PRINT NAME�� /7 ✓(/��'L DATE ��C.�t/ � l� APPROVAL INSPECTOR SIGN�TU • PLEASE NOTE: SEPARATE PERMITS ARE REQUIRED FOR PLUMBING, ELECTRICAL AND MECHANICAL WORK o nak remove unlil flnai !ns ecliane b c da officlel. ■ �■ ' ,� � ' � , ` � 1g � � s .� , � � l lY � Oualifiad � FRC MFG C�DE: SIL NFRC � CPDq 5IL—N-33 3001 Double Hung Vinyl Dual Glazed Natbne� Feneetr�bn LoE3 Argon F i 11 Ratlrg Coundl� � , ENERGY PERFORMANCE RATINGS U—Factor 5olar Heaf Gain Coefficien� � 0.30 1.�0 °0.25 (U.S,II-P) (Me�riclSI) ADDITIONAL PERFORMANCE RATINGS Visible Transmittanee 0.51 � Manufaciurer siipulates ihal these reiings cor�orm to applicable NFRC procedures for determining whole product perforrnarxe. NFRC ratings are deiermined for a fixed set of eruir�mental condiiions and a specific produd size. NFRC does noi recommend any prod�i and does noi warram the suitabiliiy of ary product for arnr specific use. Consult manufacturer's litereture for other prod�t performance infwmation. wwwrfi�ag 1 � WINDOW AND DOOR MANUFACTURERS ASSOCIATION www.wdme.com 440—H-036.16 Silver Line Windows 3000 SERIES DOUBLE HUNG Manu aclurer S!S ule4ea Cenfermence !o khe followin akandarda STAN�AR� RAT ING RRMRIWDMR/CSA 101/I.5.2/R440-08 �Lq55 LC-PG50 Sizs Tesled 38 x 57 in DP •50/-50 psf FL 8324.1 TDI—WIN-868 Glazing 2.2 mm Single S!r RN Ouker/ 2.2 mm 5ingle S{r iiN Inner Cenpliea rikh MUO UFI Bullekin 111 R0/R0 iGCC�/IGMH� 04/10 19311002.1.17 LRBEL 2010 neets�or exceeas nEC, CEC S IECC Rlr Inftltrelton Requiremenls WDMH Ha1l�eark � Cerl.ificak.ion Progrem