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PRE 2010 DOCSAzVs- (city ®f Fridley, 31hm N° 10 369 BUILDING PERMIT Date: Aug. 13, 1969 Owner: T. A rSensUlt Builder Rodney Billman, Inc . Address Address 151 Silver Lake Road New Brighton, Minnesota LOCATION OF BUILDING No. 1560 get Trollhagen Drive _,_„ part of Lot Lot _._.4Block 4 Addition or Sub -Division . Innsbruck 5th Addn . Corner Lot — Inside Lot — x Setback -- Sideyard Sewer Elevation &Ux 974.37 _ 977.37 Top of Footing DESCRIPTION OF BUILDING To be Used as: Dwelling Front 65 Depth 26'/28' Height Split Sq. Ft. 1752 Cu. Ft. -34,554 Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Frame Est. Cost $32,000.00 _ To be Completed SEWER LOCATION - 23' West of Manhole WATER LOCATION - 34' West of Manhole NOTE PILASTER In consideration of the issuance to me of a permit to cons the building described above, I agree to do the proposed work in accordance with the description above set 4#th and inance with all pr ons of ordinances of the city of Fridley. 6r ,� Sewer Connec In consideration of the payment of a fee of $..._� 5 ' OOpesmit is hereby granted to thRodney Billman, Inc. to construct the building or addition as described above. This permit is granted upon e express condition that the person to whom it is granted asci his agents, employees and workmen, in all work. done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and. moving of buildings within the city ]imus and this permit may be revoked at any tune upon violation of any of the Provisions of said ordinances. P NOTICE: This permit does not cover the construction, installation for whing, phmhtng, gas heathen sewer or water. Be sure to see the Building hnpector for separate permits for Chess Nems. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME OW ! �����BUILDEA ADDRESS ADDRESS /._I2��,.��r LOCATION OF BUILDING tW9A4,,-- NO o r STREET ,( 1 LOT BLOCK ADDITION OR CORNER LOT INSIDE LOT SETBACK SIDEYARD SEWER ELEVATION TOP OF FOOTING Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: Front `� Depth Ito }-Z Height Square feet li Cubic Feet Front Depth Height Square feet Cubic Feet Type of Construction 7 , estimated Cost,$3�,,, To Be Completed The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations atted in this application are true and correct°�ti—,r��.e DATE / SIGNATURE (Schedule of Fee Costs can be found on the Re e e Side.) .. , A BUILDING PERMIT * FEE SCBmUI,E SECTION 20 -The Inspector of Buildings shall, before issuing permits for the erection of any building or structure, or for any addition to any existing structure or building, or.for any alteration or repairs 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 mam. er herein provided to -wit: Uniform Building Code. Type 1, 2, & 4 - $1075 for each one thousand cubic feet, or fraction thereof, in such cubical contents. Type 3 & 5 - $1-50 for each one thousand cubic feet. For the purpose of computing fees for building permits, the cubical contents of unn form hei i:t"th-Mz-g1roUt-by_.­ _. multiplying the ground area covered from a point six (6) inches below the floor line of the basement or the cellar to the average height of the upper surface or to the average height of the roof surface of the main gable of a pitched roof. For repairs or alterations to an existing structure, the fee shall be at the rate of $3.00 per each five hundred dollars ($500000) or fraction thereof in the cost of all proposed work. In no case shall the fee charged for any permit as set forth in Section 2 be less than $50000 NSSSD Connection Charges based on location - Area 1 or 2e Original . PERMIT for Power ants and Heating, Cool- ing, Ventilation, Refrigeration and Air Conditioning Systems and Devices DESCRIPTION OF WORK No. of 1 Heating Plants 2 to be ' talled'altered—repaired Make AA -4 , Size Oil fired ; Coal fired ; Gas fired ; Gas Authorization No. Remarks Aa -gyp W _- a-'C_A� Approved by Final Inspection Date , 19_ Inspector Permit N® Fee $ 460 5 oc C% d-�� Office of the Inspector al' Buildings City of Fridley City of Fridley,, Minn., ) 0 Owner Location Kind of Builth»,g �7i���2�✓ How Occupied Work to be Commenced—,19— To ommenced ,19_ To be Completed ,19_ Estimated Cost, Old -New, Building Permit No.I� t0 Permission is hereby granted to � `"�"�`"'`� ' to install--erect—use the material and devices described in the above statement. This permit is granted upon the express condition that the person to whom it is granted, and his agents, employees and workmen, in all the work done and materials used under this permit, and in the operation of the devices herein mentioned shall conform in all respects to the ordinances of the City of Fridley relating to or governing the work to be done and the operation of the devices herein named, and to the specifications set forth in the approved application for this permit on file in the office of the Inspector of Buildings. k)j ' Inspector of Buildings 42 2M 99-67 V Original Permit for rLUMBING AND GAS FITTING N.B. When work covered by this permit is ready, the Plumbing Ordinance requires that request for inspection shall be phoned in to the plumbing Inspector, 560-3480 giving number of this permit, DESCRIMON OF WORK }} Number, Sind and Location of Fixtures W W A W G' W S m W WATER HTR. Stories rW-o zZ o o°QZ fm -� mx°� oda a J C 4 7 a Z a K O x .! K a s O f a OAS EIEC. 3 0 I m F m 'm 3 r o u y w p o m Basement �t 1st 2nd 3rd 4th Connected with Sewer -C ool Gas Piping for Openings Permission is hereby granted to do the plumbing and gas fitting in the building described in the statement hereto attached, upon the express condition that the person to whom this permit is granted, and his agents, employees and workmen, in the plumbing or gas fitting of said building shall conform in all respects to ordinances of the City of Fridley, and this permit may be revoked at any time upon the violation of any of the provisions of said ordinances. By Order Of The Inspector Of Buildings Roughing in Inspection Date Inspector. Final Inspection Date Inspector. 42 IM -."9-v N? 5005 L(J�-?� ermit FPee $ ?f . City of Fridley I` ,19-�ky s Kind of Building� Used as To be Completed //- / - ( 5? 119— Estimated Cost $ Old -New. Building Permit a4:: Inspector of Buildings. 97 -�! �—�►160�. !+f•P�IC:.T10P1 FOR PLut•IDIt4G A14 GAs FITTING Pc. tc•SIr -�. � ._-.. P i. • 1 9 ii •? a ,7 v �1 J ..� i y 4tatec a• � b r � t� .. +7 1 «� S .. p� � t" �• Ilea CEt � 1 1 1 t•.t•rte :..rnectloa G►.anir } : .:.e:tsd with Stwer 1 r.c- t lat..ta, 01 optr,;r...3 .. Water i S 11111uG ftES: :at 1 tiawtta x 51.00 5 wt.l:at.rnal flaturaa `T--" x 51.00 i '•'° d.. /• w 199,00u bIU x 510,C0 1'Allot L ALitKA11uNS t i..t n1JU. 04 as--� &ZJ. yl,;,.Jli .:C tCiC6:;f1 SZ,CO 5 Staco S,. r.:r,ar,e S 5:, 8.00 Job Address 1560 Trollhagell Drive Dcparunr:r,t at City at rr:di.y Tel. k571-JI450 Tha ��ndornlgn\d e:y r.»kea appli:_t:,:^ -r e mc:t t;.r the wG tk Lerch,epaclfledaSracf:fJ tD da' n:! work ir5tr:a tt.cr3er.»a WILL U.\ City C-L:Ua and rulings ct tt,e !�,:::arurcnt of Bai:31r. s, s UIQ faclu mid iatud Irthsitrrt[ 'c is[el ti 4t At .:Caticr. sr3 trio and c.,If•n:, t r:.11i y, ::r.. 51-5-8-0 1 9 OWNER ARSENAULT - KIND OF UUILLI:;.; frame USCD AS T TO BE CVt'tPUTUD !'5..: t 5-12-80 P ESTIMAt'LO CUS': -50000 OLD - qCH Q ILG1:1.i I ilutl: rtry MIP NEC -ASC (I S1;nr.1 Ey .; ROUGH INSP. Da La FINAL. 111SP,P Dato MIPHUVAL ►Gh i-Liu-tif MII1IHUr1 1'Cl' t\.q !�r'i PLU!.u.1,.; .Ir IS S1.:J FLUS :..0 �;/.TC 6UkC)tA1,fC n%'•'I.� tiu. RATE TOTAL' latuCay i x $2.00 $ f.t. t..[iia, G1J Ope:.1:., x 2. GO ----• 5 st_t. caatu X $5.00 5 aata& to y;.cQOG bTU x 55.00 $ -� 1—.JJO Lm W 1S G:.O is:t; i x $10.00 5 aat•r s..f tenat —^ x 57.00 5 4910 vt—nd Rir, Old x 55.00 5 "C -LAX.; N1teC Ilaalat x $5.00 $ S 11111uG ftES: :at 1 tiawtta x 51.00 5 wt.l:at.rnal flaturaa `T--" x 51.00 i '•'° d.. /• w 199,00u bIU x 510,C0 1'Allot L ALitKA11uNS t i..t n1JU. 04 as--� &ZJ. yl,;,.Jli .:C tCiC6:;f1 SZ,CO 5 Staco S,. r.:r,ar,e S 5:, 8.00 Job Address 1560 Trollhagell Drive Dcparunr:r,t at City at rr:di.y Tel. k571-JI450 Tha ��ndornlgn\d e:y r.»kea appli:_t:,:^ -r e mc:t t;.r the wG tk Lerch,epaclfledaSracf:fJ tD da' n:! work ir5tr:a tt.cr3er.»a WILL U.\ City C-L:Ua and rulings ct tt,e !�,:::arurcnt of Bai:31r. s, s UIQ faclu mid iatud Irthsitrrt[ 'c is[el ti 4t At .:Caticr. sr3 trio and c.,If•n:, t r:.11i y, ::r.. 51-5-8-0 1 9 OWNER ARSENAULT - KIND OF UUILLI:;.; frame USCD AS T TO BE CVt'tPUTUD !'5..: t 5-12-80 P ESTIMAt'LO CUS': -50000 OLD - qCH Q ILG1:1.i I ilutl: rtry MIP NEC -ASC (I S1;nr.1 Ey .; ROUGH INSP. Da La FINAL. 111SP,P Dato MIPHUVAL ►Gh i-Liu-tif MII1IHUr1 1'Cl' t\.q !�r'i PLU!.u.1,.; .Ir IS S1.:J FLUS :..0 �;/.TC 6UkC)tA1,fC P, ,,TTY OrFRIDLEY INSPECTION DIViSION 6431 University Ave NE Fridley, MN +55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent - Fill Out Back) Gas'Piping (Needed with new furnace, but not replacement) Gas Range Gas Dryer *Air Conditioning - All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work L) C) �3 1 305 o - )e/> Effective On May 10, 1999 JOB ADDRESS I I %61-1 1 off) OWNER (2 M ��� A 1 5P -Vi -L- Rate TOTAL BUILDING USED AS Ji C'S i r� l� . $ 30.00 $ / ESTIMATED COST 0 00 PERMIT NO. $ 10.00 $ DESCRIPTION OF FURNACE AND OR BURNER $ 10.00 $ —" No. of Heating Units I Circle One (Steam) (Hot Water) arm Ai $ 10.00 $ Trade Name L v v% vi o,_- Size No. �a*=�'A (2,3/ r c t BTU I or, c o c, HP EDR $ 25.00 $'7P --or Fuel �✓erF��a Total Connected Load JV 60 s' State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. $ .50 6 Burner Trade Name Size No. BTU HP EDR 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 an rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are -true and correct. HEATIN COCell/)�/91,"-� Sign l 3.z ��-� ���' DATE Rough -In Date 9 01 List jj ALTERATIONS Being Done: HEATING CO: Signed By: Date: CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: L 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 No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes (-No ( ) 6 Has total heating BTU's of .0 All other BTU's AL Poo TOTAL BTU's 4P on 0 7. Has a liner been provided for water heater Yes (,,<I No ( ) 8. Has combustion air been provided for water heater Yes (0 No ( ) List jj ALTERATIONS Being Done: HEATING CO: Signed By: Date: HEM' LOSS CALCULNTlONS Wcatllcrsttip>s ' ! A.S.l AN _�_ Construction N Guide Windows Mors Deference 7 illi. Udall Ilii. Wall Ceiling Yes—No— ycs _jiJo- 19____ I It� oot.J . J " ' ' idll_.-a I Leight FI. n l.englle -_„_.�" Windows and Foots—Crackaga and Arca tivldtii 11016ht Nu. of i.Inonl It. 7. r, No. of Pa no of pane Ilvhle of crack ` 5 Coef. Btu Infiltration Glass ---- Exp. wall Net exp. wall - Int. wall Floor----- Ceil. Total Btu.-- Required ft. E.D.R. or Vi. ills. VJ:A. Idcader area H.1 Roo tn �Lengtla Width I lciglat Windows alld Doors--Crackage and Ate& width Iloight B1 No. of l.faoal ft. Aran tio• o�,anm o�Pana-IOf,CrnU}Y - 2L. (..)' Coef. Btu Infiltration Glass Exp ll Net cxP. wall Int. wall _._........_....._. - ___ Floor _ ------ _ --- — Ceil. �_.—_—____.--------- Total Bt". __ _------------ Iiequitcd sy, ft. I;.D.p. or sq. ins. NY.A. Lcadcr �zlca ---- _ -_ = __Width_ FI. llao►la ILengtlt� Ffefgllt Windows and Dools—Crackag_e and Atca width )1,1,1,t too. of Fnea—It t. Arca No. of Dano o[ Vane 118h1a of craclt — -- Coef. R,__ _Witt_ Infiltration Glass Exn walla s _s _'.:_,��. _4'�1_`_..A: ,Net exp -- Int. wall Floor Total Btu. - - -- - -" - Insulation 0. __— hoof floor K--- I -low Applied Doom Length. Width Sleight hLL. ` Willdaws and Doors--Crackage and Area lvldth aht It or o� r, a_„ �k 04.* Lineal Et- Area No. of patio of ot____can__..° --' —" Coef. Ilifiltration ___._---- Class Exp. wall Net exp. wall Inc. wall Floor C ilc Total Btu.. FPenuired sq. ft. E.D.R. or aq. ins. W.A. Leader area F1.1 Room I Length Width Windows and Doom--Crackage, and Area %vI,I am DIoICht pet �® or CrLineaait- ok @r ft. of ane ..........—..- No. of p, Ano ...<...- Infiltration Glas--------- ExpExp' wall all Net exp. - p' wall lilt. wall __- Floor r Ceil. 'r_r.,i ftt,r 12equired sq. ft. E D•D• or sq. ins. W.A. Leader area Doom I Length Width Windows and Door s--Crackagc and Arca Tto. Width of pane atotaht o_ f.pano 0. 01 llahto Lineal ft. of crack Area a4. ft. _- -- '-- C Infiltration Glass Glass---------------- - Exp. ti�ull Net ext). wall Int. wall Floor - Cc:l: __Total Btu___^__ _ lYcga:ired scl. _ _ _ 1t. E.f).R..or sq. ins. W.A. Header area Sleigh: v 00,1 ►399-®eF-?- ',�.I` HOUSE HEATING TEST RECORD ADDRESS —APT. APT. FLOOR OCCUPANT OWNER HEAT LOSS DATE HTG. INST. SOLD BY e ��INSTALLED BY Electrical Wwk By 10Ape `' °� Gas Lino By TYPE OF HEAT GA FA HW STEAM _SPACE HTR. UNIT GAS DESIGN MAKE MAKE OF BURNER Mod.I S' `'le® — Model. Serial, Max. BTU Rating INPUT �a e��� �� �� MAKE OF FURNACE Model CITY SUBURB OTHER CONTROLS THERMOSTAT L Heat Plug Vent Size Valeo _0. zlaz 444=0 ___ KIND OF LINER f�� AzCC 00! SIZEd1l NONE Limit ® Draft Hood _._ Req later Limit Setting _� _ Filters Size Imbe► Fan Setting Chimney Locatlon Inside Outside Pilot Type Chimney Construction „_�„ IDs✓ - Pilot Make Pilot Model i Smoke Bomb Wiring Pilot Timing Draft Test Tog—� L.W. Cut Off Dow Pressure ASift A-- Lighting Inst. Pressure Percent y �� r Percent CO --4/1� Date Tasted 0 r Input CFH_ e 0 Percent 02 711 Company Testing %` � Stock Temp. ® Percent CO 14 'L If 4- Name of Testes i CITY OF FRIDLEY INSPECTION DIVISION Effective On January 1, 2000 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS 0 RATE SCHEDULE OWNER Residential Rate TOTAL Furnace Shell and Duct Work, Burner - BUILDING USED AS si'deic Also Replacement Furnace $ 30.00 $ (Side Vent - Fill Out Back) ESTIMATED COST rGbo-� PERMIT N0. Gas Piping (Needed with new furnace, $ 10.00 $ but not replacement) DESCRIPTION OF FURNACE AND OR BURNER Gas Range $ 10.00 $ / fNoyofd Heating nits Circle One (Steam) (Hot Water) (Warm Air) Gas Dryer 10.00 Y S S Trade Name o Size No. �fll kL BTU_ 3Y HP EDR *�ir Conditioning - All Sizes $ 25.00 $ Fuel N. 6n Total Connected Load All Others/Repairs & Alterations (LIST ON BACK) Burner Trade Name Size No. 1% of Value of Appliance or Work $ BTU HP EDR Commercial/Industrial 1.2517o of Value of Appliance or Work $ 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 an State Surcharge $ .50 rulings of the Building Division, and hereby declares that all the facts and representatior ' this application are true and correct. TOTAL FEE $ �s��o d1aFLOW 4 um" #21WHIN DATE / _ 27001 WwAm MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION HEATING CO Ro%11111i OW REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE Signed TEL # REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without Approved By Rough -In Date Final Date /®0 written permission from adjoining property owner. COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacina an existing furance, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes () No ( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes () No ( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes( ) No( ) When required to install a new combustion air, it will be sized and installed To meet the current codes and manufacturer's specifications. Yes () No ( ) When installing a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category 1 Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes( ) No ( ) Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan A _ i ., eO ergljt Total Appliances Total Btu Input `'` "`j Common Vent Type Vent Height Diam4 ry1% T®r 4 inches se Appliance #1 Vent Connector Height ft Length ft Diameter Tpe pe Appliance #2 Vent Connector Height ft Length ft Diameter i Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) HEATING CO: Signed By: Date iUB.;Etr PE NO. City of Fridley 32651 AT THE TOP OF THE TWINS BUILDING PERMIT COMMUNITY DEVELOPMENT DIV. j e PROTECTIVE INSPECTION SEC.4� 1 . i?19 NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910415 5/30/02 JOB ADDRESS 1560 Trollhagen Drive NE I LEGAL LOT NO. 13LOCK TRACT OR ADDITION SEE ATTACHED DEscR. 4 4 1 Innsbruck 5th Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Tom Arsenault 1560 Trollhagen Drive NE 763-571-4705 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Home Enhancers Inc 8609 Lyndale Ave S #201, Bloomington, MN 55420 952-884-6106 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 1949 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO B USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 16' x 16' Porch Addition 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. WABefore SEPA RAS I REWIRED digging call for F00.--ass utility locations lik''yF4TING 450002 Osft R U I R E Y LAVA S-EPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. ' NO. DWLG. UNITS OFFSTREET PARKING 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $7.27 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $14,530 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROW OTHER STATE OR LOCAL LAW REGULATING CON- ST TION OR THE $251.25 Fie SC $14.53 ERFORM CE OF CONSTRUCTION PLAN CHECK FEE T AL FEE 3o oL e SC k5/00 $278.05 S,GNATUREOFCONTAACTORORAUTHORQEDAGENT iDATE, HE FPRO CY VA ED THIS IS OUR PERMIT S"GNATURE OF OW NER",F OWNER BUILDER, ,DATE, " . SL ,NS DATE NEW ( CITY OF FRIDLEY Effective 1/1/2002 ADDN 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg IMP ALTER ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ��- s �'� Construction Address: � � 771Z 0 L L l��-G',� D ani Iii Legal Description: Owner Name & Address: �1-1,7 Tel. # 76 3-'S'7/ -W o._i Contractor. MN LICENSE # Address: A60 ° Z!i so, 4 Zo/ Tel. # sSl{zv Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LMNG AREA: Length Width _�_ Height fSq. Ft Z 57-- x�S6 -%�i GARAGE AREA: Length Width Height Sq. Ft DECK AREA: Length Width Hgt/Ground Sq. Ft OTHER: 6"30. 5 Construction Type: PO �t U4 m Sb'0®Al Estimated Cost: $ " U Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $ DATE: S a �/ 2- APPLICA . - 1(--- Tel. # 9SZy x/06 Call (763) 572-3604 for Permit Fees if mailing in application or Fax to 763-571-1287 if using credit card and we will call you for card number. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL CITY USE ONLY - $ 6-- $ ,� • X73 $ 7f $ 0? ! 8,OE Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1200 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 [ ] STIPULATIONS: BUILDING PERMIT 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: TOTAL VALUE $1 to $500 $501 to $2,000 $2,001 to $25,000 $25;001 to $50,000 $50,001 to $100,000 $100,001 to $500,000 $500,001 to $1,000,000 FEES $23.50 $23.50 for first $500 plus $3.05 for each additional $100 or fraction thereof, to and including $2,000 $69.25 for first $2,000 plus $14.00 for each additional $1,000 or fraction thereof, to and including $25,000 $391.25 for first $25,000 plus $10.10 for each additional $1,000 or fraction thereof, to and including $50,000 $643.75 for first $50,000 plus $7.00 for each additional $1,000 or fraction thereof, to and including $100,000 $993.75 for first $100,000 plus $5.60 for each additional $1,000 or fraction thereof, to and including $500,000 $3,233.75 for the first $500,000 plus $4.75 for each additional $1,000 or fraction thereof, to and including $1,000,000 $1,000,001 and up $5,608.75 for the first $1,000,000 plus $3.15 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW, (Concrete Curb Streets Only) Removal and replacement of curb and gutter only Driveway width plus 6 feet times $17.00. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once itlias it has been constructed will be required before proceeding with the framing. New Houses Only �,v ✓ r Nr ..... ms *'c a a^,^' iMAr` a \ t �.-, �ae-r+r�� 1{1 ' Landr� sr ENGINEERING": INC. —�- En�►ineers E Survec�ors ----�- cea t Cate of SUNFour. �O% r 0 1 ROLL HAGEN OQ•1VE J: k• � �e 1 Af+•26 A. r 7 ter,vd��:g kT t 10 , w r d e 41 ov t t .. ih •r ✓ �; a 2 ¢ 4k ;�..�ar w . rk ° O+ E i'+i'OT L.'1 1QU1`� 4 ( F iii r "'y t 7h�Fo,f �■..b'7ES MI`iWAC7E ANO L.y.\ILVTY E.A-SIC 4E.NT\' ^ff v v ,P Tx ea 'mA,'♦�,�r ' As vy�y��j,�� lAJi�6iO�� t, A lvfas� �a E 5 t �a'" t r 'i" t��,.", '.- - a, � +� 3 �' } � .$t^ � e✓y-� ��`r�tY-k •t�4(� I � � �� a *40,• Y ',. r �'t we �n. r\�.jd; •4 q, `Y ali',j�',ya.,V°t`'y `1 5'M1rr S-13-202 2:19PM FROM HOME ENHANCERS 884 9652 P.2 EX'T'ERIOR ENVELOPE ENERGY CODE COMPUTATION WORKSHEET To Determine Compliance with the Minnesota Energy Code (Section 5g2 of the State Amended 1989 Model Energy Code) Project Site X. EXPOSED WALL CALCULATIONS I� C. Opaque Wall 1. Masonry/Concrete a. b. C. 2. Foundation Wall (Above —-Grade) a. b. 3. Wood Frame Wall a. Insulated Area b. Framing Area (Ave. 15% at 16" oc) C. Framing Area (Ave. 10% at 24" oc) 4. Peripheral Floor Edge/Rim Joist a. b. Glazing 1. Windows a. b. 2. Doors Doors 1. Wood a. Solid b. With storm door 2. Metal 3. Overhead 4. Other D. TO'T'AL WALL AREA, sq.ft .............................. AREA. x x x "U" VALUE AREA x "U" x E. TOTAL OF AREA x"U"...................................................................................................... Ii. ROOF/CEILING CALCULATIONS A. Roof/Ceiling Insulated Area _ 3 I x a E. Roof/Ceiling Framing (Ave. 15% at 16" oc) x = C. goof/Ceiling Framing (Ave. 10% at 24" oc) x D. Skylight x = E. TOTAL ROOF/CEELING AREA sq ft.........« .............. F. TOTAL OF AREA x"U"................................................».........................................................•........ 5�5' S-13-202 2:21PM FROM HOME ENHANCERS 884. 9662 P.1 III. BUILDING ENVELOPE REQUIREMENTS TOTAL AREA REQUIRED "U" ALLOWABLE (Fro�m/ I.D. & II.E) (From V.) (Area x "U") A. Exposed Wall: x 5 '�,/�Z-1IL B. Roof/Ceiling: x C. TOTAL ALLOWABLE BUILDING ENVELOPE (Total of A & B above) .................: � IV. ACTUAL BUILDING ENVELOPE ACTUAL (Area x "U") A. Exposed Wall (From I.E.) .5-57, B. hoof/Ceiling (From II.F) f7i C. TOTAL AAL, BUILDING ENVELOPE (Total of A & B) ..................................... 1,0,q7 *(Meets code requirements if less than III. C) V. REQUIRED "U" VALUES MALU ROOF CEIIM Detached one and two family dwellings .11 .026 * Multi-FanWy Residential Buildings (3 stories or less in height) .238 .026 * All Other construction Types (3 stories or less) .238 .06 * All Other Construction Types (More than 3 stories) .28 .06 *Based on 8007 heating degree days (Mpls ISt Paul) Adjust "U" Values accordingly for other lowdons I hereby certify that I have completed the above information and that it complies with the Minnesota State Energy Code Nd -,c BCSD 4-93 CC/SM/6574 S'// : 3/o S-13-202 2:23PM FROM HOME ENHANCERS 884 9662 +I WALL FRAY--: NG SECTION:. 17tericr alr filn a„inC;tes. sof 0 ( �� •--rte.'. Ex;,ricr air 11m E WAL! SECTIGII (INSULATED) ------ ;l Inzaricr air -film Vq _..�; L to Exderfar eir flln TOTAL R � •�iD�r U T/.+ TOTAL R U -1/R ,p , U n h e a z.1 SIs: Minicar. R 6.2 7'. , r I � � � • �— a.•em -J9s • • Q 1 • . RIM JOIST SECTICN: ;1 Interior air film 0.68 \0 Exterior air 0.1 film TOTAL R , 3 FOUNDATION _ INSULArNON REQUI'-cD: ' Min. R•5 on entire Well OR U Min. R-10 down to frost depth FOUNDATION SECTION: '1 Interior air film 0.6$ ti Exterior air fila 0.17 /-e f TOTAL R a U = 1/R = Si. AS ON GPADE U n h e a z.1 SIs: Minicar. R 6.2 7'. , r I � � � • �— a.•em -J9s • • Q 1 • . S-13-202 2:25PM FROM HOME ENHANCERS 884 9652 Pet 0j L Loa 3441\ VENTED CONSTRUCTION R W - L:.°= CEILING SECTION (INSULATED) : 1 Interior air -film 0.r.1 3 O.o� Exterior air If ilm (S-,! If) TOTAL R = �ie1 y U - 1/R = _A C=1LInG FRAMING SET 10-11: 1 Interior air file. 0.61 2 ,a. 95 4 Interior ~air Film tsei 1 i 0.61 5 cies soft ..ccei TO -,AL R U - 1/R CEILING SECTION (INSULATED) 1' Interior a_ i r f i lrn 0.61 1t Exterior air film (sill) 0.51 TOT AL R = U CEILING, FRAMING SECTION: i• Interior a1 r film 0.61 2 3 4 Exterior air film still) 0. I 5 Inches soft wood TOTAL. R = U = 1/R = I _Inside atr film 0.61 2 3 5 Outside air film 0.17 TOTAL R = Il = IA . Page 5 su6JEcr - MIT N O."' 7 -" City of Fridley 3303 � AT THE TOP OF THE TWINS BUILDING PERMIT r COMMUNITY DEVELOPMENT DIV. SEC. 1 PROTECTIVE INSPECTION NUMBER REV DATE PAGE OF APPROVED er CITY HALL FRIDLEY 55432 763-571-3450 910-F15 9/4/02 JOB ADDRESS 1560 Trollhagen Drive NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 4 4 1 Innsbruck 5th Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Thomas & Mary Anne Arsenault 1560 Trollhagen Drive NE 763-571-4705 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ADDITION ❑ ALTERATION ❑ REPAIR O MOVE O REMOVE 8 DESCRIBE WORK Construct a 16' x 12' Deck 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. WARIVIN(; Before dig9in all Utili 9 call f®r t y to q'EQ454.0002 til LAW SEPARATE PERMITS ARE REOUIREO FOR ELECTRICAL, PLUMBING, HEATING. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO OWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 ISTALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $2,112 $1.05 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL FEE $86.4 RE OF CO CT AvR AUTV RIZ D AGENT pD DATED THIS YOUR PERMIT VPA Q C'L�\// ��ENPERL ©� SIGNATURE OF OWNERof OWNER BUILDER, iDATE, - OATE NEW [ ] CITY OF FRIDLEY ADDN [ J 6431 University Ave NE, Fridley, MN 55432 ALTER (] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: Legal Description: (..a Tv"4Ll ka`e ff,ective 1/1/2002 172-3604 Bldg Insp �, A Owner Name & Address: ��.gs� Noiy Ay rQ A V 3 [ "� Tel. # 7 <- 3 - S I —4? o S Contractor. S'- � -�-- MN LICENSE # Address: Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft GARAGE AREA: Length Width Height Sq. Ft DECK AREA: Length j c.. t Width ('a- : Hgt/Ground 4 D I� Sq. Ft i'( 7), OTHER: Construction Type: Estimated Cost: $� ice° Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ _ $ DATE: �-� a APPLICANT:' re Tei. # -7 (- 3 -S2±--42 G Cali (763) 572-3604 for Permit Fees if mailing in application or Fax to 763-571-1287 if using credit card and we will call you for card number. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL CITY USE ONLY - Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1200 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by*Engineedng Agreement Necessary [ ] Not Necessary [ ] STIPULATIONS: BUILDING PERMIT 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: TOTAL VALUE $1 to $500 $501 to $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 $100,001 to $500,000 $500,001 to $1,000,000 FEES $23.50 $23.50 for first $500 plus $3.05 for each additional $100 or fraction thereof, to and including $2,000 $69.25 for first $2,000 plus $14.00 for each additional $1,000 or fraction thereof, to and including $25,000 $391.25 for first $25,000 plus $10.10 for each additional $1,000 or fraction thereof, to and including $50,000 $643.75 for first $50,000 plus $7.00 for each additional $1,000 or fraction thereof, to and including $100,000 $993.75 for first $100,000 plus $5.60 for each additional $1,000 or fraction thereof, to and including $500,000 $3,233.75 for the first $500,000 plus $4.75 for each additional $1,000 or fraction thereof, to and including $1,000,000 $1,000,001 and up $5,608.75 for the first $1,000,000 plus $3.15 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $17.00. Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. VERIFICATION OF FOUNDATION A Certificate of Survey of the lot, showing the location of the existing foundation will be required before proceeding with the framing. New Houses Only S.." �.�� .i.. .. - .... ... ,• �'i +SO'''S ^'i'-�t'* Tytt f"' ^'W - ' y.raV 1%Yy �SS. J�• /�� [vAo�PRann� �8lS-N.� jV�• ' [ad Sw•pc�ir� � ala ... `, :'' ''� So,/3><s, ENGINEERING, INC. - E� -- Enineers Sur ve ors ---- • caPte of a uvve. ifo:. Zednew-alliqlaces't3�a� �' . P •� TROLL HAGEN 6 4 ' 'L3 •—� zo N l ,• ti. i • a. �wt� rr'� v�3S �i ',+�,t}tai . • ' �•� �.,, ;':, s s ` `� P }`r .. 1..0'f � 4'., Bt»ocK 4, lAll►�sfAucK• 5't�i Aoo�r;�oN:. �:, �,�.;�,:��"a `�i��� , ri!r Fz�.�y,j :'' • .-•�'00E OaY'C'S MON r t �-L84'1f! :�• ��r' � s, �� ' •„�,,, 'OIL WC)TE,S DRAINAGE ANO UTI E..SCME•,NTS r` , .. ! � , , v t J. X• 1 s 1r day t IT ,! E a YAt�+ , !a♦ 6 �fl i -. , , v ,, .. ... . � r f•4,• S d } ? Yt+ r r a ' ed! 6 irr's, #ieiVN O ddil WSW-- axr4o=h a+AJ lrrr f ar d, AdA And As R i y SUDS URBAN. °; f t Y. i • N d aao�a4 `,��a� d sc-clle: 1 ,*d0 aao� a o Building PLUM ING Permit No.: S� Inspections RESIDENTIAL APPLICATION Received By: 7637572-3604 CITY OF FRIDLEY Da : E DATE 5- YOUR &MAIL ADDRESS SITE ADDRESS io THIS APPLICANT IS: O OWNER CONTRACTOR PROPERTYl� NAME: CQ OWNER) , L� ADDRESS: N39bo-R.'A CITY STATE�'I/�GIP TENANT PHONE: CONTRACTOR NAME: Champion STATE LICENSE # 651-365-1340 EXP DATE SUBMIT A COPY OF YOUR STATE ADDRESS: 3670 Dodd Rd. #100 CITY STATE ZIP_ WITH EwjimLICENSE PHONE FAX APPLICATION PERMIT TYPE 'SINGLE FAMILY ®TWO FAMILY O TOWNHOUSE c TYPE OF WORK: ® NEW REPLACEMENT DETAILED DESCRIPTION OF WORK PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of.labor ) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x.05 = FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FDXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) BATH SINK/I.AV DRAINS SHOWER —WATER PIPING _ _FLOOR GAS PIPING MD c rryzxmw) T_ SWIMMING POOL _ WATER SOFTNER ($35) —BATHTUB _ CLOTHES WASHER KITCHEN SINK WATER CLOSET _ BACKFLOW PREV. ($15) _ _ _ LAUNDRY TRAY WATER HEATER ($35) FOR IRRIGATION —DISHWASHER WATER METER OTHER Q . "W"4001 Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ Surcharge .56 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ .50 Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ .50 Total = $ 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; that the work will be in accordance with the approved plan in the case of all work which requires review and approval of p f �y 2S DATE` r SIGNATURE OF APPLICANT PRINT NAME City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 V A V. 1/417 G/V1 An'77 0I Building BUILDING Permit Fee Permit No.: - Inspections Plan Review RESIDENTIAL APPLICATION Received By: 763-572-3604 $ CITY OF FRIDLEY Surcharge DateM: S E P 0 201 763-502-4977 FAX License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $2100 per SAC Unit (Plans to MWCC for determination) EFFECTIVE 1-1-2010 $ ft + 6 ft = ft x $24 = $ DATE YOUR E-MAIL ADDRESS $450 Conservation Plan Review SITE ADDRESS $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) THIS APPLICANT IS: ❑ OWNER ❑CONTRACTOR Make checks payable to: City of Fridley Attach Stipulations PROPERTY OWNER/ NAME: TOM ��-S� t��,A I+ - ADDRESS: 1 �i(40 }G' d�L �.T" CITY�tfL-em STATE%M%,N ZIP t-IZ1 TENANT PHONE: CONTRACTOR NAME: uA,o ek SUBMIT A COPY OF YOUR STATE LICENSE STATE LICENSE # EXP DATE AND CERTIFICATE OF ADDRESS: 16Vf,"vCVe®v.+ Ovo Y\ CITyrrLA ' �,STATEPI�k ZIP. INSURANCE PHONE I.eil- -� Z e7 '-6146 FAX PROPERTY TYPE ❑ SINGLE FAMILYINEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCEIREPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING g� Q HOUSE ONLY NUMBER OF SQUAREST ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: I. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: FOR NEW CONSTRUCTION INCLUDING DECKS, SIDING ADDITIONS. & PORCHES SUBMIT: ❑ Vinyl ❑Soffit showing the existing structu 1. Site Plan/Survey showres ❑ Aluminum ❑ Trim TrimFasci and proposed project. ❑ Other ❑ 2. Two sets 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 & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ OCCUPANCY TYPE Permit Fee $ See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ .001 times the total job valuation Surcharge $ .0005 x Permit Valuation Minimum $.50 License Surcharge $ $5.00 (State Licensed Residential Contractors) SAC Charge $ $2100 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $24 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ , Make checks payable to: City of Fridley Attach Stipulations 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 oAall 1work1which requires review and approval of plans. SIGNATURE OF APPLICANT \ 1 PRINT NAME SOi k _L41r-30m1 DATE