P - 45122$1�llt�tllg BU�LDIN('`.s Permit Na.:
Inspections RES�I�EIYTIAL AI'I'LI�ATIt�N R���� �� ,�
7�3-�7Z-�ca� �a ��: �
CIT� t3F F��.�"'�
���r� �. � 1� o l���. o Yt}t3R E-MI�iL ADDRESS � stherd@windcswwor ldmn . com
st�aDr��ss 54t35 west brenner pass
�s ArrLicAxr is: ❑ awrrEx aca�T�c�ra�
PROFERTY owNERt ��,p;��,: MiCI'�a�l Be��lu�d
TENANT �,Da�ss: same as site CITY sr�r� ztP
PHONE:
CONTRACTOR Nn�e:�roBuilt America
SLT�MIT A C4PY p� STATE LICENSE # BC - 2 a 3� 6$ 4 7 EXP DATE � 3 �' �
YC�U�S`�A`l'�LIC�NS� ,����s�: 221i llt P,ve E CI?�t Ntarth S� ��,�� z� 551�19
wt� A��t,teAxto�r P�r� 6 5 3- 77 a- 9 315 �� 6 51- 77 0- Q 4 9 5
PROPER�Y TYP� ❑ SINGLE FAMII.Y/NEW CONSTRUCTiC}N SfZE
O TWO FAMILYlNEW COAIS`I`RUCI'ION STORIES
P��M�i `I`��'� ❑ ADI3TfION ❑ GARAGEJ�HED C] VV1ND(aWS
❑ BASEMEN'I" FIIVLSH ❑ ROOF D DRAIN TILE
❑ B�CK Q SIDINf3 Q OTHER
❑ SWIMMING POOL
'TYPE �F W�R�: � �Ew �t ADDiTIOit[
fl MAiNTEi3Al3CEfitEPAiA L3 KEMOD'Et,iNCi
DBSCRIBEWORKBEINGDONE: Replacing 6 winclows, existing openings
SIZE t)F IMPR��itdENT LENG'�'H 1N�Il'TH ��IG�T .�t.
ROOFING G7 HpUSE ONLY
Nt1MBER OF SQUARES ❑ HOUSB & GARA(}E BASEMENT REMODELiNG SUBMifi:
�AItAG�S 0 ATTACflEf7 GARACr� 1. Fxisring Flovr Plan
PRQFOSED SLZE: �] DBTAGHED GARAGE
2. Peoposed tlaor pla�t
i'�{O('OSED F�iGH'I`; 3. Lsst of slnictsxa� m,��bers � be vse�i
�r FQR NEW GONSTRUC't'ION INC:LUDING DECKS,
❑ Vinyl �Soit'�2 ABDfTtOhI3. & P(SRCHES SUBMIT�
Q Atuminum � Trim i. Site �t�cdSurvey shewing the existing suucG►res
❑ Othes � Fascia and grapas�d }�rojact.
2. '['tvo sets of construction ptans
WINDQWS 3. Eaerg,y C$icu182ions
IN EXISTING OPENINGS LiYes d1Vo LOCATION OF WINDOWS
QR FL1A I3T�Y� QPENIT3t3S-D�SCRI�E SIZE QF
OPENING CHANGES & �
TY'PE OF WiNDOW TO BE i1V3TALLED 2313NIDER OF WINDOWS
ALL FEES ARE BASED ON VALUA'FION, INCZUDING THE COST {}F LABaR AND MA'TERIALS;
{USING THE 1947 U>B.0 FEE SCHEDULE}
TOTAi. JOB YALUATTON S 3� 72 OCCUPANCY TYPE
Per�nit Fee
Plan Review
Fire Surcharge
Surcl�arge
Licensc Surchazge
SA� �harge
Gurb C.'ttt Esccaw
Erosian Contc�l
Park Fee
Scwee M�n �hargo
$ Q��% S SS� Back Page for Fee Schaiute
� 6S% Of BUiitiiYl� Pernt'st F�
$ .401 tim�s the totat jok� valuation
$ .OQ(?5 x Per�it Vaivat[an Minimum $.SQ
$ $S.f?0 {"Siate Licensed It�iiden#ial Contractors)
$ $�G75 per SAC Ur�t (Plar�s tv N�W�i fitr det�mi�at�tm)
� ft�6�— ftx�21�$
S $45U Conservation Pian Review
$ Fee �ttermined by Engineering
$ Ag�rnern neccssary { ) Nan r�tccessary { )
�s �s ar� n�rtae.��ax �e��c �, ��z�r-r�� w��r �� �tc�e�ss�
I he�'�b}' apPly far a building permit a�t! i actcnowledge ihat #�a infor►n�tion above is camplete at�! aceurate; ti�at the work v►�!! be in
coeformaace with the ordinances and codes of H�e City of Fridley and with the Minnesota Construction Codes; ���a��a �n�s � not a
�it but cmly ��spiic�tion frn $ per�nii and ivork is nai to si�rt v►�ithbut a p�rcnit; tt�at � wcxk vrill be in ��denc:� vvitt► the epproveci
plan in the case of ali work wttich requires review and approval of plans.
SIGNATt)I2B QF APPLICANT �� �"" Fxnvr r1A1� Es ther Dahl DA.� i 2/ 10 j 1 Q