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AF - 46033�. . . � City of Fridley, Minn. .� �r �� BUILDING PERMIT N� 6 4 4 9 � __ _ � � � c Dste• �.(�..� _. . __.. ____....__._.��:.,.?._._ ..._...._...�___..._._.._ Ovvner: _�,.-�•••�=.� '{ - ��l,�'��LIC�..._._ Builder _��_. ._.._ _.._ .._. .-.��-c..�.........._......._...._...___...._..._.__._.._ Adciress....._......_...._.__._.._.._______._...�..._..._._.._..._.._.._...._...__...�......_.._. Address _.._........._._.__._..._..._..._.__.._.._..........__......_.....•--�..._.._...�._.____._... • � � � LOC TI OF UILDING No. 1_.�1.�'_':�.... Street . . - ._..._.. _. - : ��"��.. ��l1...�:�:•.r.... P of Lot . ...._.....__. _....__._.. _ _.._._._ Lot ....._,��..__...._...._.. Block ._.._.._..._...�,...--•••--•-•-•---....._. Addition or Sub-Divisian �l' ._......__. _......��L�:Z��!�.�� . / r / Corner Lot ...__......_..._._.._ Inside Lot ..... �.......... Setback .---.�.a ?....----_._......_ ideyard ...........�.�__.___..._...:..__._.._..._._.._.._ Sewer Elevatian ....._..._._..._..._.._..__....._.._._.._._._---...._ ............._..._._ Foundation Elevation DESCRIPTION OF BUILDING To U : , /' /-� . � r v►�, �/ �1 _ .. ..� _ . � Front _..�.f�!..�. Depth .�..�..__. Height ....�S..l . Sq. F� ��.�.� Cu. Ft�'_�?��.C� _._......._._._.._...._._._._._........._ Front __.___..._.__ Depth _...__....... eaght ..��.._..__ Sq. F� _.___._......_. Cu. F� ___.__._._ Zj�pe of Construction� C..�..... .��.�._.__.. Est. Cost .._ �_C.:!L:�l._....'�..... To be Completed _..._.._.._.__...:._______._� In consideration of the issuance to me of a pernut to construct the building describ�d above, agree to do the proposed work in accordance with the description above set forth in compli�(ce wi p ons of ordinances of the city of Fridley. a� 6�� `� /, , .s�..._.__... � l'C� In carisf deration of the payment of a fee of ��% �.�.._.._.., permit is hereby granted to_._.._ '..._ ..._. •_..—,......__......_.._....._...:____:_..___. to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, ernployees and workmen, in all work done in, around and upon said buiiding, 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 limits and thiss permit may be revoked a t any time upoz� viol��'on of any of the provisions of said ordinances. ..-. n /1 i'' \ 8uilding Inspector NOTICE: ihb p�rmif doa nof eowr fh� eonstruefioe, in�tallafion for wieiny. Plun�bin9. 0as h�afin�, s�wK or waNr. d� wn to sN th� euildiag In�pKtor for s�p�ra» p�rmits for N�� h�ms. J -. "^ �' � �� • • . . . . . . �" App��cart�on f�or Rower Pfants and He�tutg, Cooling, Ventilot�on. Re�fr�geraMon and � Air Canditianing S ste�ms and Device�s Y PARTIAL RATE SCHEDULE nep:. of Bldgs. ph`� sy,4-��0 GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work . . . . . . . . . . . . . . . . . . . . . . . . . . 8.00 $ Replacement of Furnace . . .. . . . . . . . .. . . . . . . . .... . . . . . 5.00 $ Repairs & Alterations—up to $50Q.00 . . . : . . . . . . . . . . . . . . 5.00 $ Repairs & Alterations each add. $5p0.00 ............... 2.50 $ MECH. WARM AIR Furnace Shell & Duct Work to 12U,000 BTCT . . . . . . . . . . . . each add. 60,000 BTU ....................... Replacement oP Furnace ............................. Repairs & Alterations—up to $500.00 . . . . . . . . . . . . . . . . . Repairs & Alterations each add. $500.00 ... . . . .. . . .. .. 8.00 $ 2.00 � _,�_ 5.00 $ 5.00 $ 2.50 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines---ta 400 sq. ft. �DR Steam ...... 8.00 $ F1�xnace She11 & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $ Each add. 2Q0 sq. ft. EDR Steam . . . . . . . . . . . . . . . . . . . . . . 2.50 $ Each add. 320 sq. ft. EDR Hot Water . . . . . . . . . . . . . . . . . . 2.50 $ OIL BURNER—to 3 ga2. per hour . . . . . . . . . . . . . . . . . . . . . . . . 5.00 $ over 3 gal. per hour—See �'ee Schedule �- It� - � � City of Fridley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to da all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby deciares that all the facts and representations stated in this appIication are true and correct. Fridley, Minn_�7� �i � � '�l i� Owner � � S __ ' 195_ /Q�,--�-c[�L a��z Kind of Building I�R � m� � _ 195_. Used as U c.,�J �_� � w To be completed about Estimated Cost, $ OId—New. Building Permit N'o. � DESCRIPTION OF HEATING or POWER. PLANT5—Steam, Hot Water, Warm Air—No. GAS BURNER (up to 400,000 BTU) 7`I'ade ..............:..� 5.00 $�. Q V GAS FITTING FEES: NO RATE TOTAL lst 3 Fixtures ...................... x $1.50 $ Additional Fixtures ................. x .5U $ Gas Range to 200,OQ0 BTU . . . . . . . . . . . x 2.00 $ AIR CONDITIONING � FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM � ALTERATIONS 8c REPAIRS TOTAL FEE $ ffJ. 0 d REMARKS: Size Capacity Sq. Ft. E.D.R. BTU fi,p, Total Connected Load Kind of Fue] BURNER — Trade Capacity. Size N Sq. F`t. E.D.R. BTU H.P. � Sign � d �l I� �s � � c, By� -� - � il poST t M-t 2-se Business Phone No. m� �•� ��" City of Fridley , ` `� Application for P'lumbing Qnd Gas Fitting Permit �� Depl. of Bldgs. Phone $U 4-7�" DESCRIPTION OF WORK .�j� �� '�� Number, Kind and Lxation of Fixtures Lxation � � I f � Z F m � Y =�' Z j � 3t� � �� 3� o � Base � lst 2nd 3rd � U' WATER HTR. � Z= v� w w ? ! t �� < U Z Oy= ) U' Z 8 K~��` < a �Z Z 7 a F N GAS ELEC. ,�n � c (� m< 3 (� °� (� cS C� O 0 4th L_ ; I I I L I I I I I I__L___�_ I I I • Future Coaaection Openings Connected with * New Fixlure, Old Opesiiags I Sewer � Cesspool � PARTIAL RATE SCHEDULE PLIIMBING FIXTURE RATES: NO. RATE TOTAi. Number F`ixtures . . . . . . . . . . . . . . . . . . . . . .—L "— x $1.50 $ % . d 4 Future Fixture Opening ................ New Fixture Old Opening .............. x 1.20 x 1.00 Catch Basin . . . . . . . . . . x 3.25 Water Heater (Up ta 200,000 BTU3 . . . . . . � "� x 2.00 New Ground Run Old Bldg . . . . . . . . . . . . . x 3.25 $ $ $ � .U� $ GAS FITTING FEE3: NO. RATE TOTAL ist 3 Fixtures ..........................�— x$1.50 $ l, 3 � Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTTJ ... ... ........ REPAIRS & ALTERATIONS—Refer to Code x 2.00 � City of Fridley: The undersigned hereby makes application for a permit for the work herei: speci fie d, agreeing to do a ll wor k in strict acco r dance with t he Ci ty Or dinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are true and correct. Fridley, Minn.��?/�L t1� q , �� / � Owner ��19��LI / � � �/� S Kind of Building MA E. Used as �W LL� t N� To be completed about Estimated Cost, $ Old—New. Building Permit No. �� Permit No. � Signe � '�� //.� . � By ` - Business Phone No. M�: s a � 6 2- ROUC3H ..J ` � � � � FINAL Description ............................... $ .......... TOTAL FEE $� 0�• J� D a z sM � Application tor Power Plants and Heating. Cooling. Yentilation� Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work . . . . . . . . . . . . . . ... . . . . . . . . . . 8.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 . . . . . . . . . . . . . . . . . . 5.00 $ Repairs & Alterations each add. �500.00 . . . . . . . . . . . . . . . 2.50 $ '� MECH. WARM AIR d`_ Furnace Shell & Duct Work to 1TA,000 BTIT . . . . . . . . . . . . each add. 60,000 BT(J ... ....... . .. ..... . . .. . Replacement of Furnace ............................. Repairs & Alterations—up to $500.00 . .. . . . . . . . . . . . . . . Repairs & Alterations each add. $500.00 .............. a � 8.00 $ I L �. 2.00 � 5.00 $ 5.00 $ 2.50 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam .... . 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $ Each add. 200 sq. ft. EDR Steam . . . . . . . . . . . . . . . . . . . . . . 2.50 $ Each add. 320 sq. ft. EDR Hot Water . . . . . . . . . . . . . . . . . . 2.50 $ OIL BURNER—to 3 gal. per hour . . . . . . . . . . . . . . . . .. . . . . 5.00 $ over 3 gal, per hour—See Fee Schedule GAS BURNER <up to 400,000 BTU) . . . . . . . . . . . . . . . . . . . . . . 5.00 $ GAS FITTING PEES: NO RATE TOTAL lst 3 Fixtures ...................... x $1.50 $ Additional Fixtures . ............... x .50 $ Gas ftange to 200,000 BTU . . . . . . . . . . , x 2.00 $ AIR CONDITIONING � FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ � � `F. ALTERATIONS 8c REPAIRS TOTAL FEE ��.�_ ROUGH FINAL Depl. of Bldgs. Phone SU 4-7470 Location 7��•� � - rl � I�CL S-f � / " � � � City of Fridley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. F�idley, � Owner 0 Q Kind of Building Used as ede�"� :,dree��*�' To be completed about 19� Estimated Cost, $ / � " Old—New. Building Permit No. _ Permit No. �-��"� DESCRIPTION OF WORR HEATING or POWER PJ'�FiNTS—Steam, Hot Water, Warm Air—No. Trade Name , Size No. Capacity Sq. E't. E.D.R._�Q� BTIJ H.P. Total Connected Load ��n-►-.- a-o, 7,�-t R- �1 b lt' Kind of Fue1 � y fi �� 4 Si BURNER — Trade Name Size No. Capacity Sq. E`t. E.D.R BTLT H.p. (REMARKS-OVER) ��<z sM -. �� , � `/r _ `� ►�'��, / r r/� , . sus�ecr PE O. City of Fridley 13166 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r ; � RECEIPT NO. � ' COMMUNITY DEVELOPMENT DIV. �� ' � �: ----- � � i � PROTECTIVE INSPECTION SEC. 1 � � � � /'�'1 � CITY HALL FRIDIEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY �•"'� � ,�� 612-560-3450 910-F15 8-27-75 � � JOB ADDRESS 7463-65 ABLE STREET N.E. 1 LEGA� ��T NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 11 2 NpjGEL � S WOODLANDS SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE ALBERT C. FISHER, 5512 RIDGE PARK ROAD, EDINA 3 CONTRACTOR MAIL AODRESS ZIP pHONE LICENSE NO. MARADIATHA CONSTRi3CTION, 2403 — 54TIi AVENUE NORTI3, BROOKLYN CEI3TER 4 ARCHITECT OR DESIGNER MAIL ADDRESS 21P PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 6 USE OF BUILDING DOUBLE BUNDGALOW 7 CLASS OF WORK ❑ NEW � ADDITION ❑ ALTERAT�ON ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK 9 CHANGE QF USE FROM TO STIPULATIONS PROVIDE FiARD SURFACED DRIVEWAY ��R� � VARIANCE APPROVED COUNCIL MEETING 6-16-75 ,� ��.)tRED FOR SEPERA�E ��`�i1' �� AN� StGNS. HE,ATING� PLUM�ING w pRN�N� t��t►� gefore d�g$1°EI.ECSRIC, �►S Etc. 1E�EpNONE RE QUIR�� 8Y �-p`V� TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTI�ATING OR AlR CONDITIONING. THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION ZONING SQ. fT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT 484 4 840 ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTfiEET PARKING I HEREBY CERTIFY THAT I HAVE FEAD AND EXAMINED THIS APPLICATION STA�LS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNWG THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. � �� PLAN CHECK FEE TOTAL FEE ,.a�^�J 'C��..,-.�ya�� 1 � 10.79 S�GNATUREOFCONiRACTORORAUTHORIZEDAGENT ( TEI HEN PROPERLY IIDATED THI� IS YOUR PERMIT 8-27-75 SiGNATUREOFOWNERIIFOWNERBUILDERI IDATEI BLOG INSP � � DATE � � ,. .. . � . . n � � � _ , , . � � ' ' ' . :APpLIC/1TI0N FOR R�ST'DL'NTZn%, ALTL'ItATION,� � � • . � QR AllllITION.BUTLDING P�RI�tIT � . ' CITY OF FRIDLEY, I�IINNESOTA • � � O�dNER' S Ntll�i� : t%- �E� i � F� a � �2 BuzLV�cR : �� .e.��%� -�� /� � � ADDRESS : �� s� Z �S'�� C�� x �'�,_ �� nDi�ss : � ��' 3 S�'`� i�✓� � i✓, �5,�0�,��1 ��,e . , . � , �/ . NO : . � 7 (, � _ �7 -' STREET : �� -� � �� - I.OT : f� BLOCK : Z- ADDITIdI�T : /1/fl � � �- S (�iG� r� �j L �f �� S CORNER'LOT: � INSIDE LOT: SETF�ACK: _ SID�Y�II'.D: �pplicant a.rtac�; �o this �orm Tcao Certificates �f Su• rvey .of Lot an3 _proposed . bui2dino location c:�ajan on these Cextificates. � DESCRIPTION OF.BUILDING • . �. � Ta Be Used As: .. . . (�-�%��,� FronC: 7z- Depth: � �Z-- Hei.ght: �a • Square Feet : � � � Cubi.c . Feet : �C�i �` U Front: Depth: ' Height: � .. . Square Feet; Cubic Feet: _ ' . � 1j�pe of � Construction : C�1��' � ��fl /'1 � Estimated Cost :_� •3, � �' � . �. To Be Completed: fL'" � � - % � . . � � The undersigned hereby ma.kes applicati�n fax a permit for the work herein � ' specifieci, a;reein� to do all caorl: in stiict accordance with the City of � Fx'idley Ordinances and rulinss of the Departmen� of Buildings, and hex�by � declares thaC all tlie iacts and represenL-ations stated in thi.s application • axe txue and correct. 7 S! . �'� c��` • . � � AATE: � ` � % - SIGN11TURE • � , • � . (See �{evexse Side For Addition�l Information. )� �� `�- v,�' j�ot_-1 a �� i �`�� ' , , . .. • w . � - ' • . .. • . . sue�ecT P City of Fridley � 1916 AT THE TOP OF THE TWINS g U i L D I N G P E R M I T r ; � REC . � ; y � COMMUNITY DEVELOPMEN7 DIV. / r � � PROTECTIVE INSPECTION SEC. �� '�[ � � � i.--_�,� ��;'� CITY HALL FA1DLEv bS432 NUMBEi± REV. DATE PAGE OF APPqOVED BV i 612-571-3450 910-F15 9/10/87 / / �os aooRess '7463-65 Able Street N. E, 1 LEGAL LOT NO. BLOCK TRACT OR ADDIT�ON SEE ATTACHED DESCR. ].1 2 Nagels iPlOOdlc'�I1dS. SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE John/Kathy Baumhofer 608 Jefferson Circle, Marshall 56258 507-532-3271 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 0 ARCHITECT OR DESIGNER MAIL ADDqESS ZIP PHONE IICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP pHONE LICENSE NO. 6 USE OF BUIIDING Residential (Duplex) 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION � REPAIR O MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof Building 9 CHANGE QF USE FROM TO STIPULATIONS Roof cazi be the 2nd layer but not th.e 3rd.. Install ridged galvanized valleys. SEPARATE PERMITS ARE REQUTAED FOR ELECTAICAL, PLUMBINC�, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULI AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 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 OFFSTFEET PARKING I HEflEBY CERTIFY TFiAT I HAVE READ AND EXAMINED THIS APPLICATION 2 STAILS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WI�L BE COMPLIED $975 $. SO WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANT�NG OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING GON- 1'], SO STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $ i2LAN CHECK FEE TOTAL FEE \ $1.8. �� SIGNATURE OF ON'RACTOR OR AUTM RIZED AGENT IDATEI WHEN PROPERLY V LI ATEO THIS IS YOUR PE MIT �'� 'T �� "O � . _� ' l(l . iGNATUREOFOWNERIIFpWNE BUILDER� IDATEI BLDG �NSP aTE N� [] City of Fridley Effective �/1/86 ADDN. [ ] R-1 AND R-2 ALTER. [ ] Building Permit Application Construction Address: 7 `�f7 � - � 5 �� l S7' /t/� �rG ��S , /�� Legal Description: �o T/�' h«< Z �il/�S�'=�� Gsi ��1 �� -- Owner Name & Address : �d��'' �' ��y ��n' ��'? Tel . $ �7- � .�2-3Z7/ Contractor: S/�u� �ou•��t � Tel . � Address•_�C�� =Y�i`C2�w, �^iL�� //'�l�s�t/,�1�lJ'lr� �GZ�� 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. DESCRIPTION OF IMPROVEMENT Length Length Length �i� �Go� , Width Height Sq. Ft. Width Height Sq. Ft. Width ��i/. � _ Hgt/Ground Sq. Ft. � s' �s� �') - Corner Lot [] Inside Lot [] Ft. Yd. Setback Side Yard Setbaek �� Type of Construction: /'�"�� Estimated Cost: $ �75 Approx. Completion Date: ��T '�� 87 Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation DATE: � /U `�?�� Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge TOTAL STIPULATIONS: APPLICANT: Vi'r'`'11��"�D"t��v-- Tel . #, S�'� -J37�l9iZ CITY USE ONLY $ /�, �z� $ $ �� $ $ $ $ /� QU Fee Schedule on Reverse Side 25� of Building Permit Fee $.50/$1,000 Valuation $ 525 Per SAC Unit Fee Determined by Engineering Agreement 13ecessary L 7 Hat Necessary [] �� SUBJECT City of Fridley � � � � 2 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r ; � RECEIPT NO. � COMMUNITV DEVELOPMENT OIV. ' j L ' � r � � PROTECTIVE INSPECTION SEG � � � � � �"'1 • CITV HALL FRIOLEV SS432 NUMBER REV DATE PAGE OF APPROVED B �""'�� ,�� 612-571-3450 910-F15 5J22/96 � � �oe aooaess 7463 - 7465 Able Street NE t IEGAL �OT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 11 2 Nagels Woodlands SHEET 2 PROPERTV OWNER MAIL ADDRESS ZIP PHONE Mark Jedlenski 7463 Able Street NE 787-8412 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE IICENSE NO 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Duplex 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR O MOVE O REMOVE X 8 DESCRIBE WORK Reside Garage; Soffit & Fascia on House & Garage; Gutters; Basement Egress Window 9 CHANGEOFUSEFROM TO STIPULATIONS Egress window must meet the State Egress Code. TYPEOFCONST. OCCUPANCYGROUP OCCUPANCVLOAD SEPARATE PERMITS ARE REOUIfiED FOR ELECTRICA�, PLUMBING. HEATING, VENTILATING OR AIR CON�ITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZpNING SO. FT. GU FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANV TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFV THAT 1 HAVE READ ANO EXAMINED THIS APPL�CATION 2 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PFOVISIONS OF LAWS VAIUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED @ WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT �1� lOO y�.55 DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pEFMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- @ STFUCTION OR THE PERfORMANCE OF CONSTRUCTION. �3%.SO Fire SC y1.lO PLAN CHECK FEE TOTA� FEE $39.15 SIGNATU�7EOFCON'RACTOAORAUTHOA�ZEDAGENi IDATEI WHEN PAOP LV VALIDATED THIS IS VOUR PE/R�MIT � _ �/�J�.�� SiGNATUREOFOWNEAUFOWNERBU�LDER1 �DATE� � DG �NSP �1aiE NEW ADDN ALTER C) �l [l CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application ConstructionAddress: 1 �/ 6 3 � % `i � _S � � Effective 3/1/96 Nl � -��GJ.3 Legal Description: �vT %/ ,(�/v�_ JT � 1%I� /�'� � � %s ��✓oc��LG y, �,� Owner Name & Address: ,�''/��,�- �%��e ��,' �t��,j �� ST- Tel, #��j ��//Z Contractor: MN LICENSE # Address: LIVING A►REA: GARAGE AREA: DECK AREA: OTHER: Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRII'TION OF IlVIPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. _-- Graret�c 5iG�r�rs , 1,,,.,r` r.H�,/ c.ur So/`f,•i c,ti�/ (��c�'�,/ �,.�-r��c o��, .__\ SS G✓� 1�N Comer Lot [] Inside Lot [ j Ft. Yd Setback Side Yard Setbac�ks � �� Tyge of Construction: Estunated Cost: $ �) D o. v� Approx. Completion Date: �; 2 Z Y S 6 � - (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: � 2 �— g�' APPL,ICANT:�� i2��:�� Tel. # 7a'3-� y� Z Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY $-�� S� Fee Schedule on Reverse Side $ f /�`J .001 of Permit Valuation (1/lOth%) $ ` S �-� $.50/$1,000 Valuation $ $900 per SAC Unit $ $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ $450.D0 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] � � l �� . , -� sue�ecr PER City of Fridley 2 7 0 0 3 AT THE TOP Of TNE TWINS g U I L D I N G P E R M I: � � T NO. � • COMMUNITY OEVEIOPMENT DIV. /, /� ' j L �"�� , l l [ r � � PROTECTIVE INSPECTION SEC. � _ � � /'�'1 � CITY NALL FRIOLE� 55432 NUMBER pEV DATE PAGE Of APPROVED BY �""'�"� �'J b12-571-3450 9�0-Ft5 8/5/98 I � JOB ADDRESS 7463-7465 Able St NE t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACNED oesca. 11 2 Na els Woodlands SHEET 2 MPR�TQERTY OWNER MAIL ADORESS 21P PHONE lt � Jedlenski 7463 Able St NE 78 -8412 3 CONTRACTOR MAIL ADORESS ZIP Pl10NE LICENSE NO. Owner a ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION � REPAIR O MOVE O REMOVE 8 DESCRIBE WORK fascia & Re lace sidin N&W ides of ara e• re a e f scia & sidin N& W side of house 9 CHANGE OF USE FROM TO STIPULATIONS Call for builidng wrap inspection before covering. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. fT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANOONEO FOR A PEfiIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING , I HEREBY CERTIFV THAT I HAVE REAO AND EXAMINED THIS APPLICA710N STA�LS GAfiAGES AND KNOW THE SAME TO BE TFUE AND CORRECT. A�� PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TVPE OF WORK WI�� BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 575 . SO DOES NOT PRESUME TO GIVE AUTMOHITV TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OF THE PERFORMANCE OF CONSTRUCTION. 23 �% Fire SC . S7 PLAN CHECK iEE TOTA EE .i2 SiGNATURE O�F C TOR OR p iZEO AGENT IDATEI EN OPE LIDAT IS IS VOUR PERMIT � _�c��l�< - g' �` = � S� , '�5 > SiGNATUREOFO � RUFOWNEABUILDEAi iDATEi B�D �NSP ��tiTE ' N� [ ] ' ADDN [ ] CITY OF FRIDLEY ALTER [) SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION � ConstructionAddress: I��3 - 7`%S` /}�l� S% /1/_�. %'i, �,1� � ir, Effective 1/1/98 �oU3 a �� Legal Description: � Owner Name & Address: �'�/�,`/� t/P�%P r,,, S/�� Tel. #%�,?-� �/�l �on = MN LICENSE # � Address: � 6.� 1�.�� T� ,�. �� / S' Tel. #� Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. � LIVING AREA: GARAGE �AREA: DECK AREA: DESCRII''rION OF Il�IPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. � OTHER: �,�. • �'c�Nc� St`G/rhS i✓u/'r�'y-�.�/cs�- S.�cs vf- Jcc,rayc • r e Pl4 �-c F` ��c.rc,� d— S, �f, �s tia� r Construction Type: r S F s Estimated Cost: $ S 7� .° o � � �_�� T -�� (Fee Schedul e on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ � DATE: �� cf C� APPLICANT: �� ` Tel. #��.J �y � Z � Peranit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY , .- $ � •.� Fee Schedule on Reverse Side $ �`� .001 of Permit Valuation (1/lOth%) $ S L� $.50/$1,000 Valuation $ $1000 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 [ ] _. � ' SUB�EC� . . City of Fridley 2 8 0 7 4' AT THE TOP OF THE TWINS g � 1 L D l N C P E R M I T r ' ` R � � • � ; L �� CQMMUNITV OEVELOPMENT OIV. � r � •• •� PROTECTIVE INSPECTION SEC. /j� 61 �E� , � �'��1 • CITY HA4L FRIDLE� SSIJZ NUMBER pEV OATE PAGE OF AVPqOVEO BY �""'�"� �'' 612-571-3450 9t0-Ft5 10i2198 � � 108 ADDRESS 7463 Able Street NE t LEGAL �07 NO. BLOCK TRACT OR ADDITION SEE ATTACMEO o�scA. 11 2 Nagels Woodlands SHEET 2 PROPER7Y OWNER MAIL AODRESS 21P PMONE Mark Jedlenski 783-8412 3 CONTRACTOR MAIL ADORESS ZIP PNONE IICENSE NO Premium Roofing 6680 LUcia Lane NE Fridle MN 55432 571-3973 20097688 4 ARCNITECT OR DESIGNER MAI� ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL AODRESS 21P PNONE LICENSE NO 6 USE OF BUIL�ING Residential 7 CIASS OF WpRK ❑ NEW O AODITION ❑ ALTERATION � REPAIR � MOVE O REMOVE 8 DESCRIBE WORK Reroof house and garage (24 Sq) Tear-off 9 CHANGEOFUSEFAOM TO STIPULATIONS Underlayment must comply with the State Building Code. 7YPEOFCONST. OCCUPANCYGROUP OCCUPANCYLOAD SEPARATE PERMITS AqE REOU�NED fOR ELECTRtCAL, P�UMBING, HEA7ING. VENTI�ATING OR AIR CONOITIONING THIS PERMIT BfCOMES NUL� AND VOIO IF WORK OR CONSTRUCTION ZONING SQ. FT CU fT. AUTHOfi12E0 IS NOT COMMENCED WITHIN 60 DAYS. OR IF CONSTqUCTION OF WORK IS SUSPENDED OR ABANDONED FOFi A PER100 OF 120 OAYS AT ANV TIME AFTEi; WORK IS COMMENCED. NO DWLG. UNITS OfFSTREET PARKING I HEREBV CEFTiFV THA1 1 HAVE REAO ANO EXAMINEO THIS APPIICATION $TA�LS GAFAGES AND KNOW TME SAME TO BE TRUE ANO CORRECi. ALL PROVIS�ONS Of LAWS yq�UA710N SURTAX AND OROINANCES GOVERNING THIS TVPE OF WORK WILL 8E COMP�IED @ W11M WHETMEp SPECIFIED HEREIN OR NOT. TME GRAN7ING OF A PERMIT $2056 �p1.O3 OOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OF CANCEL TME pEqMIT fEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCA� LAW REGULATING CON- STRUCTION OR THE PERfOfiMANCE Of CONSTRUCTION �]�{.]5 Fire SC �2.�6 PLAN CHECK FEE TOTAL F /�� -�---� l�'� �� Licen $5.00 $8 . 4 $iGN4TUAE O� CON�PACTOQ OF� 4UTMOAIZEO oGEN1 �OATE� P OPERI DATED T IS VOUR PEFMIi • ��i � � S�GNATUAE O� OWNEA�� OWNEA8ui�0EQ� �D�TE� B�0 �ti5� � qcrE . r NEW ( ) Effective 1/1/98 ADDN [ ) CITY OF FRIDLEY ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 � BUILDING PERMIT APPLICATION O� �\ ConstructionAddress: �`�3 L �� Legal Description: ��'��i� �-/i�=�'C�F Owner Name & Address: _�q�'�' �]��l�LEivS,Y-� Tel. # �g�—��j� Contractor: ��E�., i��r•, (��iy� MN LICENSE # 6�:C1^f�' %��'S Address: (�SfC� LvGi�- �,v �// Tel. # _S 7/-�y3 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Length Length Length DESCRIPTION OF IMPROVEMENT W idth W idth Width � Height Sq. Ft. Height Sq. Ft. Hgt/Ground Sq. Ft. Construction Type:�F/ , Estimated Cost: $g��' �QS �, (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: IG --2-�1 �' APPLICANT: �� Tel. #�i1/`� S�G Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ '7� , S_.., $ . C� $ �. D3 $ $ � . vo $ $ $ $ % • J CITY USE ONLY Fee Schedule on Reverse Side 001 of Permit Valuation (1/lOth%) $.50/$1,000 Valuation $1000 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 [ j Not Necessary [] �� r�� PLUMBING RESIDENTIAL APPLICATION City of Fridley �ao� =03 P r i Number Rece ed y � i d NOTE: IF PROPERTY IS NOT OWNER/OCCUPIED- A LICENSED CONTRACTOR MUST OBTAIN THE PERMIT. DATE �'� �� U S YOUR E-MAIL ADDRESS SITE ADDRESS �7 S • THE APPLICANT IS: (CIRCLE ONE) OWNER O TRACTO NAME �(,U � � �CI' �Pf'1 _S �C/ PROPERTY OWNER/ qpDRESS � TENANT C{TY ��I� �U STATE �� Z1P�s� 3a PHONE# �D�v�— �`I�J7" JaO.�� NAME S UCENSE # �� ✓�� CONTRACTOR ADDRESS � L� I�b� � � CITY Q Gi��f'1 STATE ZIP �� PHONE��p�' � ��(� FAX# PERMIT TYPE �/ SINGLE FAMILY TWO FAMlLY TOWNHOUSE TYPE OF WORK ❑ NEW '� REPLACEMENT DETAILED DESCRIPTION OF WORK ___�C�, C{�- �� Q�,-�� G�YC. � FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED FIXTURES: (INDICATE TOTAL NUMBER OF EACH) BATH SINK/LAV FLOOR DRAINS SHOWER WATER PtPlNG BATH7U6 GAS PIPING (Need City License) SWIMMING POOL WATER SOFTENER ($35) CLOTHES WASHER KITCHEN SINK WATER CLOSET BACKFLOW PREV. ($15) DISHWASHER LAUNDRY TRAY _�WATER HTR ($35) FOR IRRIGATION WATER METER OTHER Permit Fee $ J�J -�� MINIMUM: $15:00 or 5% of cost of the improvement-whichever is Pian Review $ greater on work less than $300 Surcharge $ .50 TOTAL DUE $ �5� ,o Make checks payabie to: City of Fridley THIS IS AN APPLICATION FOR A PERMIT — NOT VALID UNTIL PROCESSED I hereby apply for a plumbing permit and t 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 appiication 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 pl ns. NAME OF APPLICANT _ /" �l J•� (OI LYl DATE l� -� d`D� .Please type or print SIGNATURE OF APPLICANT l�, , . . .. - ' ' ,: : � � 3 tt « : ^c Tu�'% � d �f�'f -t$ � 4`J'S . � ,�`n . Y ' 4 n�� '� � r : PLEASE`.NOTE �SEPAi�A'7'� �£i2MITS J#RE��EQUJR�D�'�1�1R''St�(F�� I #G,��.EGTRfC/,�t.�A�tD��IAE�i�A�+IIC,AL�'�NOt;K �, �` s�� a.,� _ � .�� ,.� � . - �. ° CITY OF FRIDLEY COMMUNITY DEVELOPMENT DEPARTMENT „� r� ��J 6431 UNIVESITY.AVENUE NE, FRIDLEY, MN 55432 (763) 572-3604 ;.�`J —�� - �� •�•�• Laii ur rRiuLGi r.bL/b.S Bllilding jYjEi Cj3�jNjCAY,, Permit No.:, � � Ynspections RESID�+ N�'YAL APPLICATION �I�'� B�'� 763-572-3604 CI'�'Y OF FRIDLEY D� R��'a: (r -�� DATE Jr i Z.J � O E' _ YOUR E-MAIi. MDRESS SiTE ADD�tE3S � .... . � �.�'� �.a,[ - � h 1 � r"'.�' i' TMS APPLICANT IS. O pWNER pCONTRACTOR PROPER'TY Nu�� M�� .� E s� �.. E� S�L� d�� ►nnRr:ss, '1'�i 6?� r T'-i 6 S �1 b 1� S i c.1'cY -�F�� .� L. e. �, STa7E ZiP 5 S ti Z� T�Nn,NZ' �or�:: �� z•� Z'?� - 3 0 3� CONTRACTOR COMPANY Nw1�� . . r- SUBMIT A COPY OF C�TACT P6R50N: �� r� \L . YOUR 5TAZ'E S?A?E WC�SE �r E� DATE LICENSE Wrt�i ADpRJ3�: t$1 S L. _ �-1 l t'' �S1 - S u�'Et Ad7Y�„� . rt��o...a e 1 r,S STA'IEJ�qi1P �,5 (`' ¢�� APPLICATION pH�NF; � I ? • '1 2M =ti $e`j �j FAX pERMI7 TYPE O SRJGLE FAMlLY �'N�O FAMiLY O TOWNHOUSE ��``� TXPE d�"WORK: O Tt�'�J ■ REPLACEMFM O ALTERATION/R.EMODEL bETAILED DESCRIi'ION GF WORK _��—„�s, � t-vr �s,� [.. c.. � �� o x C� �-10 U�'t 0�-c,� �-t S_ o 0 0_�, T J� 5 _.L ., g,, �'4-c..ri ��.��__ r� ��,.� l..�c, .-, � x A- c`S ��,�► -� r, � a� pER MS 16B.665 the permit fee is a minimum of 515.00 or S°/. ot the total coet up to S500.00, whichever i� �rearoer, for tbe improvemant, installation nr re�lac,e�aent of a residentiat flxture, excluding the fixtures. (This sLo�ild refleet on}y the cost of labor ) Labor cost under $300 = 515.00. I..abor cost betwe�n 5300 w 5500 = cost of )abor x.05 = fOR PROJEC'is W}��RE IABOR EXCEEDS 5500, FEES ARE BASED ON S 10.00 PER FIXTURE, EXC�P'T WF�RE N07ED. EIX7'URES: (IAIDICATE TOTAL NUMBER OF EACA BELOK� Equipme t Installed , NffG' MODEL: SIZFJBTU MFG: MODA: S1ZFIBTU MFC3: MODEL• SfZFJBTU A/C T25.00 F11tfiPLACE (GAS) S15_00 _QA5 RANQ�OV�1510.00 �nnz io r� Excrw�c� s�s �F cE �wo0�) sss.00 �w o�5 oxit,�. S�o.00 _BOIL�.R S3S.00 ✓FUlWACE 535.00 GAS UNff f1TR S 10.00 C}[1tvIIJEY LWER S10.00 �GAS DRYFR S! 0.00 _,PO�L NSATEA 535.00 _DUCi WORK S1Q00 GAS P1PiNt3 510.00 VENTII.ATOR S1S.00 PeTmit Fee S�:.°a Numbtr offucNres (r� SI0.00 x S10.00 — S Surchargc S .50 Number of fucn�res � S15.00 x 515.00 = S T'OTAL DUE S �p- 5 p Number of fixnues � 525.40 x 525.00 = S Number of fixtures Q 535.00 x 535.00 = S State Surcbarge = S .S� ToW � S!��'�� THIS IS AN .4PPLICATION FOR A PERM17-NOT VALID lyNilL PROCESSED I hereby apply for a boi?,dmg 't and I acknowkdge that the informacion above is compf�e and accurate; thia� th� work will be m eonforsnance with the ordin - s aad codes of t City Fridley and with the M'uu�esotaConatruction Codes; that•I undeistaad d►is is not a penmit but only an appli' on for a t d w is not w start witbout a permit; d�at the work p+tiU be in secordasce with the approved plan in the case of a ork which r ew and approval of s. SiGNAT1IRE OF APPLICAM PR1N7' NAME `Z�t'� A'CE City of Fridley BuNldieg Inspect�ons Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 r. � `ir. ^1C"1 LA"1 AA�7�f -- 5CF'-�1-GI�L1J 1J� 11 l,l 1 T UI" rK11JLtY �.,��/� Building 7nspections 763-572-3604 MECHAN�ICAL RESIDEN�'IAI. APPLIC,ATIQN CI'CY C�F F'RIDLEY bATE Jr 2�J ' 0 6 YOVR E-MAiL ADDItESS sT� fwpxESS _, �:. �. �` 7' :�--1 6.�_ � 6 � s r THlS APPLICANT iS; O OWNER CiCONTRACTOR x��v�a a�►:, n� R�� nvr�aaa i pA�, N� �R IL�G_ E L. Er1 \L1 _ T�NANT ��s� "1 y 6� r?'-1 6 S }�l 61 S i cxTY -�� .�� e� STatB ZIP �ar�:: b► z.� Z'� - 3 0 3� �, vi� a nR�, a va� COMPANY NAME: �Q.._ S � ti L � 'E � c`_ \ � �r� � � .,. n .► /�F � .- S[1BMIT A COPY aF CONTACT PER50N� 1� � e.. r� tL . `� YOUR STATE STA7E LiCII�SE M EXP DATE LAP'P ICAWO ADURJ3SS:__l $ l S ''i t S` .S: - S u �cAdTY.�,�r�,,_�c.,,,el �.S 5i'ATEj�,qZ,iP 55�fa�� PliOT1E 141 �• 7 Z�-1 - 1 R��j FAX rE�rr �xrE TXPE OF'WORK: O SIN(iLE FNW1,Y S'TWO FAMILY 4 rr�w . xsrrLnc�n�rr bETAILED DESCRT�'i'lON GF WORK _��c � . . � _ --� — - � '� ' • - - . , O TOWNHOUSE o �,rEw►now�nsonEL � �V � � '�� i'ER MS 16B.665 the permit f�e is a minimum of S15.00 or 5% of the tot�l coet up to 5500.00� which�ve� is great�er, �or tbe improvanent� installation or replacement of a residendal8xwre, excluding cbe fixtutes. (Tl,is s�ild retl�et anly the cost of labor ) Labor eost under $300 = S! 5.04. Labor cost barween 5300 to 5500 = cost of labor x_05 = FOR PRO]EC[S vy�B ],qBpR EXCEEDS 5500. FEES ARE BASED ON S 10.40 PER FIX7URE, FaCCEPT WFIERE NO1ED. fi�Cl'URFS: aNDYCA7'E TOTAI. NUMBER OF EAGH BELOVh £qui�t InsWied , MFG� (ypnEL,: S1Zg/gN MFG' MODEL: S1�FJBTU MFG: MODEL• SiZFJBN ac s2s.00 �t�s�CaE (�ws> sis.00 c�r►s wwG�JOV� sio.00 �AIR TO AIR EXCiiANGEFR SIS F CE (WOOD) f35.00 _NEW C3AS C3RILL 520.00 BOILBR 535.00 �l1iWACE 535.00 _,,,_GAS UMf HTR! f 0.00 CHItrflVEY LlNER S10.00 GAS DRYER SI0.00 _,POOL �A7ER 533.00 _DUCT WORK SIQ00 _GAS PIPINf3 SIU 00 _Yi]dITL,ATOR 515.00 Permit Fee S___�_Q-O° Number offucwres (q'� 510.40 x SI0.00 � S Surcharge S .50 Number of fucnues � S15.00 x 515.00 = S TQTAL DUE S 6 a•. 5 � Number of fixnues � 525.00 x 525.00 a S Numbar of fixtures @ 535.00 x 535.00 = S State S�rcbarge � $ .SO Tota] = S �r-�1 'li�S IS AN APPLICATION FUR A P$RMlT�107' VAi.ID UNi1L PROCESSED I hereby apply for a bui ' pertnit and I�knowkdge chat the informscion above is co�npfr,te aad accurate; Wac tbe work will be in conformance w�th the ordir► ces and oodes of the City of Fridley and with the Minnesota �Cona�uction Codes; that •I undelstaad dus is not a permit but onty an app cadon.for a it work is not to start without a pertnic; that the work will be in aeeordaace with the approved plan in the case of w��rhich ew m,d a�proval of plans_ SIGNATIJRE OF APPLICANP City of Frfdley Buwlding Inspect�ons Department 6431 University Avenue ATE, Fridley, MN 55432 763-572-3604 r. � `v. ^IC1 O!1^\ �A�s'7