AF - 45069City of Fridley, Minn.
BUILDING PERMIT
Date: _.._... September .3, 1970 __..�._.��.��...���
_�
� �.
pwner; _�Charles. E._..Johnanson ._..___T__ Builder _..__Charles .Ew__Johanson..._. _._.W.�___.�__
Address .....58 0.- 6 9 th ._Av enue_.1`?.. E�......_.._...._..--.--.._..._.._ Address _._ S ame _.__._.._...._.._._..._._._._.._..M_._..._.M.._...__y.
LOCATION OF BUILDING
No. _.._....7..6.�:L...----- Street _.._..._........Al.$�.kI�.x --.1L.E.._._._....--.---......_....---•-------_. Part of Lot ._._.._.._..___..�.__.._.._.._.._..
Lot ....._.._3...._.._...._.__ Block _..._....._.__8.__.._..___._._.._._. Addition or Sub-Divisian ....._Pearson's Craigwa�Estates 2nd
Corner Lot .---_.._...._..._......._ Inside Lot
Sewer Elevation
Setback .__.._..__ ............._.._....... Sideyard
__......_ Founda.tion Elevation ....._...._.__
DESCRIPTION OF BUILDING
To be Used as: 26&89&45
Dwellin�._.._......_..__ F'ront _31&26 Depth •••-._..........._. Height ..��........._. Sq. Ft. _1976 Cu. Ft _37,648
C�axa,�e..._......._.._-•_--__.__._ Front .._26.......__ Depth _..._.23.--- Height ....._....1Q.__ Sq. F� ._.._5.9$. G�. F'� _5.�.$.Q._
Type of Construction ...___..E�ama_._......._..._.__.. Es� C�t ..�3..4,.4QQ.. QQ....._........ To be Completed __._. �_� 11 /Z.l.
Verify Basement Location by Survey, Provide Hardsurfaced Driveway.
-. �.
In consideration of the issuance to me of a permit to cons ct building
th� proposed work in accordance with the description above se��and y� co
ordinances of the city of Fridley. � //
I agree to do
provisions of
Ea co�sfderation of the payment of a fee of $......_._.._ZQ.._QQ.._.., permit is l�e�by grauted to_.Seh��..�I4�3�Slson
_.._._.._.._.....,._�...._...__. to construct the building or addition as described above. This permit is granted upo�
the express condition that the person to whom it is granted and his agents, employees and workmen, in all work
done in, around and upon said buildin�, or any part thereof, shall conform in all respects to the ordinancee� o�
Fridiey, Minnesota regarding lceation, construction, alteration, maintenance, repair and moving of buildings
within the city limits and tlus permit may be revoked a t any time upon violation of of t1Le provisio�s of said
ordinancea
��° f ' —.., ' etoz
CLARENCE BELISLE �
NOTICE:
ifiis p�rmit doa not eowr fhe wnstrueNoe, ins�ailation foe wiriny, plumbine, gas h�atin�, s�w�r or wat�r. M wn to tN
th� Buildiag In�pKtor for a�p�rah p�rmils for fh�a h�na,
' . . �
.
L J
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
y ARLES E. JOHANS4N 1�, CNARLES E. JOHANSON INC.
OWNF,�'t ' S N � 9��i-ratk2Rtke�- n� � BUI LDER ..
Fridtey. Minnesoi�a- a5�3� Fridley, Mi�nesota 55432
ADDRESS ADDRESS
LOCATION OF BUILDING
,•, /
NO.��STREEI' �`,� � �%� .�s .�� r l�„o.
� LOT .3 BLOCK ��� ADDITION OR
CORNEft LOT INSIDE LOT SETBACK
ION �
SIDEYARD
SENIEft ELEVATION TOP OF FOOTING p�� ��.,,. � z., �,._, �-, a-►�.1
�����
Applicar�t attach to this form Two Certiiicates of Survey of Lqt and
proposed building location drawn on these Certificates.
DESCRIPTION OF BUII�DING
To Be Used As: _,
� �! �L , .�
w Front �.� Depth � q�-� 5 Height ��-
�'o�- � r�e
Square feet ��`�/ J� !r 'C"ubic Feet ,� � � � �'
� � �_Front �� Depth oZ 3 Height � � 6
Square �eet S/ � Cubic Feet
0g/
Type of Cons'truction ������yyt-G� Estimated Cost 3� odo/
To Be Completed 3�i �j/
--r,
The undersig.ned hexeby makes application for a permit for the work
herein specified, agreeing to do all work in s�rict accordance with the
City of Fridley prdina.nces and rulings of the Department of Buildings,
and hereby declax�es that all the facts and representations stated i.n
this application are true a.nd correcto
DATE ��_��`� �'�„C%`7o , SiGNATURE �
(Schedule of Fee Costs can be fourid on the Reverse Side
- j~ v �` : � �
� . ; ���v
{� . ,' .. /r ;� n, + � � _.+ f4' ± / , ` •,ri��.
D
�-.*''`--'` .
- . --J
.«y - . !
.
��� Peranit for i-Ll�IV1�ING AND GAS F1�� TING
N.B. When work covered by this permit is ready, the Plumbing Ordinance requirea that request for
inspection shall be phoned in to the plumbing Inspector, 560-3450 giving number of thia permit.,
� W Q
.SfAT128 t�- O z F m
< .! d' Q 7
3 0 � m �
Basement �!
lst �
2nd
3rd
4th
Plumber. Kind csnd Location of Fixtures
2 Y = � Z Z
N Z QY �
Q
m a 3� o a
�
� �
/
O` I U m I Q�( F ii I C1 ¢ I ta9 a I GASE � ELEC.
Connected with Sewer-Cesspool Gas Piping ior Openings
Permission is hereby granted!�-!}'�! n'��� �� to do the plumbing and
gas fitting in the building described in the statement hereto attached, upo 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
Inspector.
Finallnspection Date
N° 52i8
S�f6 ��
�Permit `
F� � a�.dn �
City of Fridley /`�O�%�/yi,�� /a _, 19.2Q
Owner i��i /t Jr-�[�, �G_��Q_.6zC..�
Location
Kind of Building � �-�� �
.
Used as
To be Completed , 19�
Estimated Cost $
Ol -New Building Permit No. %����5 �
Date
0
Inspector. Inspector of Buildings.
a z 1 M-6-69- V
- . ,, _._ .....
. _
, ,� -
land Planning sfLC'^�t�l(•fi j1 � 6875 Highwny No.65 N.E.
" Land S�rveying � � � � �: Minneapolis�
(( ll dI1PPl tj�f ,: ll.C. M���. ss43�
Soils Testing � � ,
Civil Engineering Telephone 784-6066
Munici�u! Engineeri�g Eng"llleel'S ' HG SL1Y'VeyOY'S Area Code 612
. _ _ � _ I� � �i �
- �.. ���-�l���� , �
e of ��rve for. U��K �.��
Certificat Y
,� . � � �
�o� �; ��oc t�. g , ,,--. �
p�.r�n_So� 5 c2��Gv�'�Y � .
; _ -
�cT/�,`T �� 2nv ��171T�a�'4---- _.__ :_ _ +� ,.\ \
. , . • . AtroKA ,c.oVn1T1'� MtNr�1, n�. l �� . . ..
O
, . . . . � `� .. : , O . \` , R .. .
. _ ��`. �. � / .� �X p��L< - �� Q � � �. � . . . . .
k�� �} ' � r,✓�,.. � � � \ XL \ {i �C/ \ � �
� � �� ., D` / c� (� \
� `�� a � <,y , �. � �d` j � �
� �' ' ✓ , , y j i�. �
� s \ e\c � � � /
� - y
v w, j•. � r� 'r ' V L- '�
�"-' t ,ti c ,-` n �Y � � �q �` .` ;� ,
. . � p'-' . .�`�'. `�, - 0 � . T [i � . : . .
J 'L�>>}`-'�(.'/ � s�i� ` /S �
�'�' h� •�`• � y �7 P �
�,� ` y�c lf� 7 y4� _ ij
.\ � \ � . /y - � .
\ ��,�,� ,� �
� �A ` '� / �_ — -g�_'"' \ _ i/
►/� % :., � .� -_,
�1 ,
� .
su
� �a
�_ .
. �
> , �
� ��
� I � �.
�-
i�
.�
, .
��
s
_c
v� �
= -�� � ���
;`ti �� ��� .
;����
,,�`Q
' " . . , r . . . . . , .
1 tiereby certiiy that this is a true and correct representation of a s�rvey of 1he boundaries of the obove
des<ribed land and of the locatian of all buitdinys� fhereon, and all visibte encroachments� if ony� from o� on
said lund. As surveyed by me this �2�day of t.J1.1I A•�• 19�• .
. . �----
��(�:LC �"` = 30{ SUBURBAN :EidGtNEERING, INC.
.,
" . •� UeNaT"CS �2oN Engineers Surveyors
. • ►sy ;+ _ ( f �'y_�'L � r-�e.,,_t.,_� ` . �
-f-R----�-�
S iG, � ��� i ' .
� rl 1 / i �
�
�i1y of Fridley
APP�icu�ion 1� Plu�g and Csas Fitli�q hn�it
Dept. of Bldqs. Pho�u 5�0-3450
DESCRIPTION OF WORH �/
Ydumb�r, Kind and Location o! Fixlures Loeafi°�- i� 7� �
t � � • •
H N WATER MI1.
��$j 3 ��5Q '3�` 3� 3�r =� � $z b<z o� }� 'z
3 Q � S F i I �n I 3 � O��. �,� O j V ��; �� p� V$ � N GAS FLEC.
Base J
Ist
2nd
3rd
4th _
• Fu:tu:� Cona�elSoa Op�ainqs
* I�I�w Fixtur�. Old Op�»ia�s
PARTIAL RATE SCHEDULE
City of �idley:
The undersigned hereby makes application for a permit for thc Roak herei
specified, agreeing to do all work in strict accordance with the CiO� Otdinance
and ruling of the Department of Buildinga, and hereby declares that alt the tact
and representations stated in t2�is application are jrue ,and correct
1
Owner L-
.
Kind ot Building � � �'�
���_ � Used as
�v�� n
P%QMSING FIXTURE RATE3: NO. R1►TE TOTAL
Number Fixtures . . . . . . . . . . . . . . . . i �' x 52.00 S .�`�
Future Ftixture Qpening . . . . . . . . . . . _� x E1.50 $_'� ='_Si__.
New Fixture Old Opening . . . . . . . . . . . x a1.50 �____
Catch Basin . . . . . . . . . . . . . . . . . . . . x a3.25 3
Water Heater (Up to 99,000 BTU) .•.. 1- X�3,pp $ 3., u`U
New Ground Run Old Bldg. . . . . . . . , x a3.25 $
El�ctsic Watu ii�at�r . . . . . . . . . . . . . . s :2.00 =
GAS FITTING FEEB: NO. RATE TOTAL
ist3Fixtutes •••••••••••••••. • V xS2.00 ; ��.,�
�
Additlonal i�ctures . . . . . . . .... . . . . . x ; .76 i
Gas Ran�e to 195,000 BTU ..,.. ...... x E5.0� i
REPAIRS Ac ]1LTEAATIOIfb—R�f�s to Cod�
Description . . . . . . . . . . .. . . . . .. . . ... , . . . . ... . . .. . ... . ... . _
TO'PAI. FEE • � v
To be completed about
19,
Estimated Cost, a
�� Old--�Tew. Buiiding Permit No. Perm't � �°
�-�, �'
Signed � � ..ti �� � "i,� 1 "� -
g�, ` �� .�S/=c,a.- � _
BusinessPhune No. �� `�•�` ��7y��
ROUGH
FINAL �' �' � � ��
Application tor Power Plants and Heafing. Cooling, Ventilation. Refrigersrtion and
Air Conditioning Systems ond Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: RATE TOTAL
Furnace Shell & Duct Work . . . . . . . . . . . . . . . .. . . . . . . . . . . $10.00 �
Replacement of Furnace ............................. 6.00 �
Repairs & Alterations—up to $500.Q0 . . . . . . . . . . . . . . . . . . 6.00 $
Repairs & Alterations each add. $500.00 . . . . . . . . . . . . . . . 3.00 $
MECH. WARM AIR D � �
Furnace Shell & Duct Work to 17A,000 BTIJ . . . . . . . . . . . . $10.00 $�
�^ r
each add. 60,Q00 BTU . . .. . ..... .. ... ... .. .. . 3.00 � ��
Replacement of Eiirnace . . . .. . . . . . . . . . . . . . .. . .. . . . . . . 6.00 $
Repairs & Alterations—up to $500.Q0 . . . . . . . . . . . . . . . . . 6.00 $
Repairs & Alterations each a d. 500.00 . . . . . . . . . . 3.00 $
'ZG-��. �.� _.�i; r: �v�.. e: , �`' d r.�
Lj" -C� sc�, Y
3TEAM or HOT WA1'ER SYSTEM U
Furnace Shell & Lines—ta 400 sq. ft. FDR Steam ..... $10.00 $
Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 10.00 $
Each add. 200 sq. ft. EDR Steam . . . . . . . . . . . . . . . . . . . . . 3.00 $
Each add. 320 sq. ft. EDR Hot Water . . . . . . . . . . . . . . . . . . 3.00 $
OIL BURNER—to 3 gal. per hour . . . . . . . . . . . . . . 6.00 $
over 3 gal. per hour—See Fee Schedule
GAS BURNER (up to 199,000 BTU) . . . . . $ �� � ���
............ 5.00 �
over 199,000 BTU See Fee Schedule
GAS FITTING FEES: NO RATE TOTAL
lst 3 Fixtures . . . . . . . . . . . x$ 2.00 $ � � f�
Additionai Fixtures . ............... x .75 $
Gas Range to 199,000 ... x$ 5.00 $
AIR CONDITIONING
FAN HEATING SYSTEM
VENTILATING SYSTEM
ALTERATIONS 8i REPAIRS
ROUGH
FINAL S" �� � / /
�
See Fee Schedule
$ /� /���g
TOTAL FEE ���
Dept. of Bldgs. Phone 560-3450
/�� � ��
.
�
City of Fridley:
The undersigned hereby makes application for a permit for the work hereir.
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 fact�
and representations stated in this application are true and correct.
�� s
�idley, Minn. /o` � C� , 19 � �
f�'l� , i° , / ii �
Owner
Kind of Building _�
Used as
,
y• c
To be completed about ��� � � � ��
Estimated Cost, $ �L �v 6 -�l
Old—New. Building Permit No. Permit No._� � 0
DESCRIPTION OF WORK
HEATING or POWER PLANTS—Steam, Hot Water, Wazm Air—No.
r �� �
Trade Name /'.' 'y �' �`•%' ~ Size No. oc. �
!,
Capacity Sq. . E.D.R. BTU H.P.
Total Connected Load � �/ � ��� Kind of E�el
BURNER — Trade Name '-v` ti'�"� ' -� `�� s ° { Size No. ' � � �
Capacity Sq. Ft. E.D.R BTil H.p.
(REMARKS—OVER)
�4E
Signe��J�f ��.C%. �i�"j'1�_t.�f' �/%/t���lYt%��•
1
gy_ � -��i -� 6! c �'� ��i�`•t.-s.'/
Business Phone No-�p. �/ '�` ''� tT �
o��
PERMIT for Power Ptants and Heating, Cool-
ing. Ventilation. Refrigeration and Air
Conditioning Systems and Devices
D�SCRIPTION OF WORK
No. of � Heating Plants to e inst ltered—repaired
Make � , Size �'�d a 4 0 C, ;
Oil �red ; Coal fired ; Gas rcred �; Gas Authorization No.
Remarks -�!��'L.C�' ,P p � ��i r �.(� p` �i.n� C��.i 0-'��2� � ��"Cli�2.
2�.�r� .� .b �� . .t,�� �//4�,f.t,G'� � ,. (,-5 �.o� �i!�i,��1 �r �i1 / �, � o.Q_
Approaed by
Final Inspcction Date , 19_
Inspector
S' ys`�-s�
P�t N° -- 48�0
Fee $ �� : vd -
OfFce of the Inspector of Buiidings
City of Fridley
City of Fridley, Minn.,���'- ��� , 19�
Owner �� � �Cl-�L.�d��'l.�
Location �� `�� .�—
Kind of Building����'�� �
How Occupied
Work to be Commenced ,19_
To be Completed �-e-L` • / ,19.�
Estimated Cost, $ 1��•va
�ld-New, Building Permit
Permission is hereby granted to� 7�1C�� p�„� Q o� y��T.l�'� t-�,,� to install—erect—use the material and deaices 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 tlae City of Fridley
relating to or governing the work to be done and the operation of the deaices herein named, and to the specifications t forth in the approved application for this
permit on f�le in the office of the Inspector of Buildings.
� � ��.�✓vt � � L�Z� , Inspector of Buildings
�<2 sMii-��v
. SUBJECT PE
City of Fridley J
�
ATTHETOPOFTHETWINS gUILDING PERMIT • ��O
� � CEIPT NO.
� i L_.���_ COMMUNITY DEVE�OPMENT DIV. �
r � � PROTECTIVE INSPECTION SEC.
� ,
l-_-- � �/"'1,'� CITY HALL FRIDLE� 55432 NUMBEfl REV. DATE PAGE OF APPROVED �BY
Z � � 612-560-3450
910-F15 5/12j77 � �
JOB ADDRESS 7641 Alden Way N. E.
1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 3 8 Pearson's Craigway 2nd Addn. SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Mr. & Mrs. George Sundem 7641 Alden Way N.E.
3 CONTRACTOR MAIL ADDRESS Z�P PHONE WCENSE NO.
Quality Pools 420 Sibley Street, Sava e, 55378 890-6712
4 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 ❑ MOVE O REMOVE
X
8 DESCRIBE WORK
Construct a 32' x 16' In Ground Pool
9 CHANGE QF USE FROM TO
STIPULATIONS See stipulations on letter dated May 12, 1977 from Environmental Officer
IRED FQ'R 1NtRING, eef�e ��H%
SEPERATE P'ERMITS R�Q� TfLEpy� fB�`ing �aN"��
N�.ATING, PI.Ul�BING AND StGNS. . R�Q N�'-EtECTR��,� t�ti�s
UI�� p BY r�.
��
SEPARATE 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 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 OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VAIUATION SURTAX
AND OROINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT S8�dOO $4.00
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF ST CTION. $4H .00 NONE
\lJ � PLAN CHECK FEE TOTAL FEE
/k/___ I( �Lt � ° ��- � �i � �J 2 . � �
SIGNATURE OF ON'f7ACTOR OR AUTHORI2ED A IDATEI EN PROPERLY VA ATED THIS IS YOUR PERM.IT .
.: �
.
` F 5-,62 -'�7
SIGNATUREOFOWNERIIFOWNERBUILDERI - IDA fl BLDG WSP DATE
��_
CITY OF Ff�IDLEY
APPLI(:ATIOiV F�fZ RESIJEC�TIAL BUILDING PERt�IITS
{i�Ew, �LTERATIONS, ADDITIO(�S, OR REPAIRS)
OWNER: ///� z
�ddress:
r� �
�.���, ,
No . �� ��
. �
LOT: �
CORNER LOT:
, �
� BUILDER: --�� �` - �;�r
C•(�l�d`dxess : � ' "��j,(,d��
/ �
t�:�c-�._.. - Tel. No. SQ�� ���� -
Street:
BLOCK: �_ ADDITION:
INSIDE LOT: ;/ SLTBACK:
�f''54�1
S IDEYt1kUS :
Applicant attach to this farm 7t,ro Certificates of Survey uf Lot and proposed
building loca�ion drawn on these Certificates.
DESCRIPTIUN OF BUILDING
To Be Used As : �/(J � ����
/ /L' �r //
�ljM ctc�`C�� Fror.t: _�,;�,1�/� Depth: ��/.� Height:
Square �eet: Cubic Feet:
Front:
Square Feet:
Deptn:
Cubic Feet:
Height:
Type of ConstrucUyon: _'cl/I!�QETE_ Estimated Cost: $���-1
To Be Completed: _i�,yJpjv� Alt. A Al.t. B
Proposed Driveway Width If New Opening Is Desired $ $
(SEE REVERSE SIDE OF SHEET)
The undersigned hereby makes application for a permit for tne work herein
specified, agreeing to do all work in strict accordance with the City of
Fridley Ordinances and rulings of tne Department ot Buildings, and hereby
declares that alI the facts and representations stated in ttiis application
are true and correct. See reverse side for addii.ional information.
�a
AATE: �=/G'-- %% 5IGNkTURE: �
Stipulations:
��
�lo��
�'�.vv
s,��� �s. U
�,(S�
�l� � ���U
�
,z :
�_--
�
.�'r ,��Ly
,t;.
�.
��t' ,
f ���� ��
,. �
.��
��
��� ��_
�s• � m.:
�;: ,��r
y� : _
�,{:
;*`�
� . ,.� '
May 12. 1977
C���`Y �� �R��C.a�..EY
6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432
Quality Pools
420 Sibley Street
5avage, NIn. 55318
Re: Swiu�ming Pool Construction at 7641 Alden �9ay N.E.
Dear Sirs:
TELEPHONE ( 612)571-3450
This letter is to make clear this departments requirements for the swimming
pool construction at the above address.
1. As indicated, two (2) skimmers approved by the National Sanitation
Foundation will be provided.
2. As indicated, four (4) inlets of approved design for fresh and/or
repurified water will be provided.
3. As indicated, a main drain of approved construction will be provided.
4. The filter and pump shall be approved by the N.S.F'. and be of
sufficient capacity to provide a minimur.► turnover of at least two (2)
times in 24 hours. This department recor.miends a turnover rate of
6-8 hours.
5. A deck of at least three (3) f eet wide, measured from the pool water's
edge, shall be provided which extends completely around all private
residential pools. Above qround private residential pools may be
provided with deeking of a minimum size of 4 feet by 4 feet at pool.
entry points and provided that such decking has the approval of the
City.
6. The diving area will be acceptable provided there is no overhead
obstruction.
7. Fencing or other effective means including but not li.mited to walls
or buildings, acceptable to the City, shall be provided to positively
control ail access to public and private residential swimming pools.
Fencing shall meet the following criteria: �
(a) The fencing shall prevent the entrance of children and be without
hand or foot holds that would enable a person to climb �over it.
(b) The fencing shall be at least 6 feet high and entrances shall be
equipped with self-closing and self-latching gates capable of
being locked.
(c) Self-closing and self-latching devices shall be placed at the top
of the gate or otherwise inaccessible to small children.
(d) The opening between the bottom of the fence and the ground or
other suriace shall be not raore than four inches.
8. An automatic chlorinator should be provided with a suitable test kit.
9. All electrical and plumbing install�tions shali be inspected and
approved by the City Inspect�.c�n . De�partment .
Quality Pools
May 12, 1977 Page 2
10. All electrical lines must be 10-20 feet or more away from the pool
surface.
11. The pool.fill spout must.be air gapped or protected by a vacuum
bzeaker.
12. Suitable safety equipment to include but not li.mited to a ring buoy
and rope that is l� times the pool diameter, and shepherds crook pole
must be provided and maintained with the pooi at all times.
Furthermore, these and any other requirements must meet the provisions of
the Fridley City Code, Section 115, Swimming Pools. The building permit
is approved contingent on final inspections and approval by the City.
If any questions or problems arise fran this letter, plaase feel free to
contact me at 571-3450, ext. 170. ,
5incerely,
'/�_//%�-...,,-� �
• .,�....�.�. •,•
r � • •
. -. � -
SSOJmh
CC: Mr. & Mrs. George E. Sunden
7641 Alden Way P7.E.
,
� 4 . r
:i
\
i�
i
Land Plonning /A /t� �y
�iLi>�;LG�Li'%L 6875 Highwoy Mo.65 N.E.
tond Surveyiny �v • • Minneopolis�
so;+s r@s�cng (�'ylf�'ljlP.. P�ZYG�I !j (YIC. .M��,.. ssaa�
CeriF Engineering Talephone 784-6046
Muni<ippi Engineering EI1�IT38@TS 8L .SL1PV@y0I'6 A�aQ Cada 613-
Mortgage Loan Survey for L�E� i� L�S �. �U H�� �j� �`� �, �
�
. . . . . � � � . . . � . � � . .
a f- �tv
� � �
:
� \
�/h,
\
V
/
�
�`'_o�
� �
/
, \
� ' �
� ?
� i ��-
� �-�.._.
V
.\ l
�o, _ _ �-..�-"
?c
�
e
`y
L
1�
/ ��/
\ n .
` V
�
0
/ / � � � � . '�,
c �^. _h �� � � �.+ i'
_ � `N, � _ -� _ ��.
- � `�
j ..-.r �j �
L.__�.J_i .�.1 ,� t�7��� ��
r� �
4-�� .� i � � �� i� � [ �., c�;� t � �.�/���
_ � �i-�TC S 1 No � � � ! `T" I �� �..I
,t,,, uwra ,_�_�'•: Y
a
' ,��
��
. This is n true and correct represenrotion of a survey of the boundories of the lond above described and of rh+
locafion of ali buildings� if any� thereon� p�d all visible encroochmenfs� if any� from or o� suid lond. TF+�s sv�v�y"
made only in connection with a morfgoge loan now being pldted on the property and no linbil�ry �s o:•M�"�d .�
except to the holder of such martgage or anY other interest ucquired b ihe reason of sucb mor��o9 �,:r�"
� understood and agreed no mooumenfs huve been plpced fo� the p�rpose of establish�ng io' �'°�� � `
corr.�rs. Datrd fhis �«^ day oi �}LL}�:'.�;.� y A-..D. 191�J. ,. � ��..��...' -. .
. ,� -�+a�ll�iBdN -El.�G�wa�.ca•""� � - �.
. L32� �� � . .. 's.�: ._�-
�c� r m __
�
_a . _._
___.. , ,
- ...._....._ . �� Y �-. . . . � . . .
... .. .._._ .. _.. .:. - - �.. -
. .-.._.. . _..__ � � � • :�' ' . 'ti . _ ;�
� � . ' � � � � ..
.. .. _ _... � � . - ,
_._ .
. ._' ..T� _ .. . �. . - � -
- _ _ _. . _. e , .
, . ,. .._ - _. ,
. , _.
_ _ . r r: �. -
. _ , ,
. ; _ �' E> ,-, .. ., , . : __ �8 �
. � . , . ' ... . . . ' 1 t �• .
;��_�-�- _ _ - . _ . � 33' � - A -.. � -. � `' - , , u
_, �
� , -.:n:.,
: •�� ; -
� _ , -. .,: - �., ,
_ . _, ,
120 . , _ _. O_ --- _
G,.4�A�GE ' µ , . .
( . _— �
' � fe ; _
. ; -- —
.. .
�
( ,....____._. _ , , -
s_. _ _.__ .
i
I
--_ _ _ _
-- LdT � iuE ___
�
t
_�
�
t
/6x32
PvoL
_ _ 33� _
�
�s,__ _ _ : ____
.
� `
�` �. ;
+� ���
..",
�\� ,` '� �"
. z�
.��� �
; � "��
w,
�'� .#;`.
sF`�'� z �
�i�
� ��_,� ;
t � � �
' " ;
�• �
� ��
�... r ..
May 12, 1977
Quality Pools
420 Sibley Street
Savage, �In. 55318
�
C� i � �� ���'��..��
6431 UNIVERSITY AVENUE h.E., FRIDLEY, MINNESOTA 55432
Re: Swiraming Pool Construction at 7641 Alden Way N.E.
Dear Sirs:
TELEPHONE ( 612)571-3450
This letter is to make clear this departments requirer.�ents for the swimming
pool construction at the above address.
1. As indicated, two (2) skimmers approved by the Nation,al Sanitation
Foundation will be provided.
2. As indicated, four (4) inlets of approved design for fresh and/or
repurif ied water will be provided. .
3. As indicated, a main drain of approved construction will be provided.
4. The f ilter and pump shall be approved by the N.S.F. and be of
sufficient capacity to provide a minimur.i turnover of at least two (2}
times in 24 hours. This department recommends a turnover rate of
6-8 hours.
5. A deck of at least three (3) f eet wide, measured from the pool water's
edge, shall be provided which extends completely around all private
residential pools. Above ground private residential pools may be
provided with deckinq of a minimum size of 4 feet by 4 feet at pool
entry points and provided that such decking has the approval of the
City.
6. The cliving area will be acceptable provided there is no overhead
obstruction.
7. Fencing or other effective means including but not limited to walls
or buildings, acceptable to the City, shall be provided to positively
control all access to public and private residential swimming pools.
Fencing shall meet the following criteria:
(a) The fencing shall prevent the entrance of children and be without
hand or foot holds that would enable a person to climb over it.
(b) The fencing shall be at least 6 feet high and entrances shall be
equipped with self-closing and self-latching gates capable of
being locl:ed.
(c) Self-closing and self-latching devices shall be placed at the top
of the gate or otherwise inaccessible to small children.
(d) The opening between the bottom of the fence and the ground or
other sur�ace shall be not niore than four inches.
8. An automatic chlorinator should be provided with a suitable test kit.
9. All electrical and plumbing installations shall be inspected and
approved by the City Inspection Department.
� a'�
� w ,
Quality Pools
` May 12, 1977
Page 2
10. All electrical lines must be 10-20 feet or more away from the pool
surface.
11. The pool fill spout must.be air gapped or protected by a vacuum
breaker.
12. Suitable safe�y equipment to include but not limited to a ring buoy
and rope that is l� times the pool diameter, and shepherds crook pole
must be provided and maintained with the pool at all times.
Furthermore, these and any other requirements must meet the provisions of
the Fridley City Code, Section 115, Swimming Pools. The building permit
is a�proved contingent on final inspections and approval by the City.
If any que4tions or problems arise fraa this letter, please.feel free to
contact me at 571-3450, ext. 170.
Sincerely,
+/�
�/�,/.�. �► �
•.a.�.�,.�.� ..
�x - � •
. . • -
SJO/mh
CC: P4r. & Mrs. George E. Sunden
7641 Alden Way N.E. � �
�,� y/ '�'? � �-s��/, � I � �y� �/ap
� ) � ' l � / �f/� �
/����l1`�
� �
r
�
v
:E�,-
,� _ '�„�
�. _
�R� ,:,�-,--
��ica`it �oo�d
�
QUAL/TY CONCRETE POOL CONSTRUCTION
�a:
��� �� _ .����
�� :�;- =
420 SIBLEY STREET • SAVAGE, MINNESOTA 55378 • PHONE: (612) 890-6712
Mr. & Mrs. George E. Sundem
7641 NE Alden Way
Fridley, �iinnesota
POOL DATAt
�rea: 512 sq. ft.
�erimeter: 96 linneal ft.
.�ffepth: 4�'to 8' 6"
�pacity: 2,�,000 gals.
��
, y"�
i�
CONCRETE SHEZL=
✓Re-enforcement of 3/8 re-rod placed 12"
�-an center. Tough shell with 6" bottom and
.�8"' side walls, 4,000 PSI concrete.
FILTER DATA =
Filter Media s High rate sand -�� `�
Filter Rate: �r. �0 pm c�� a�--� --PF 3s, So� !�
�urnover Capacitya �hrs.
FILTER E6iUIPMENT:
Filter tr. 60 fiber lass 'gh rate sand �
1 h.p. with strainer yt�� �- rt,l�
250,000 BTU gas heater
� 2 skimmers with equalizers -� �" r��
Main drain with relief valve
4 cyclolac adjustable inlets
pvc. solvent weld piping with bronze valves
�DECK E UIPMENTs
Fi" fiberglass di�ing board with stand
3 step stainless steel ladder
Maintenance kits 2 telescopic poles� 30" vacuum
hose and head, wall brush, hand skimmer.
Test Kits 4 in 1 gardex
Safety Lines 3/4" line with �"x9" floats
Under Water Light: 500 watt, with wet niche and
deck box
' ��ua�it �oo�
�
, QUALITY CONCRETE POOL CONSTRUCTlON
420 SIBLEY STREET • SAVAGE, MINNESOTA 55378 � PHONE: (612) 890-6712
��o��,���"'LO G,r°�'�^�� ;;..t �`"�tyc�+�,
7
`. m.. _.. d� S"O �
� ~��'" �� ��'� �
�/i, ° `��'�° � ��
��`r-F; TE�
�� ��f � �"'� � 1'�.
�������
� —
......_�..,.. ,:..._ �
_._. �.. __ . ....,.... _ �., f . _.-�� s. .. __._e ,....,, -.....4.�...�
�� �Ts
.,�....._ ._ .�.�.� _w`._� _ � �' ._.___._, .._.... � '
� �_�..____... -_
¢
;
�
;
�
t
�� J
�\
. ____ ��� � �
2 � /
��` �;
1• �� UL �
1 �` �
� � ��'
����
�r�'�r° S .�'�
� �"e�'",F�,e' ,�
�
�l%�"' �n � �
s ,��� ,
. �� ,
� � M,a�N ,dk,�la!
i
9
..��� _.r.4,�- o
i
;_
i
i
�
�
E
I
� jO�
,
, 3�
;
�,�;,�
�
;
;;
�:
�� � , �
�._ �
...__ _ _._�� _ _-._ �.�__ .
— - ----
4
!I� �
(�' � s
_ ... ,.._.,�,____—�.:..�
� _
v
_ _ _ .
,,//�o a..f'�
� ____ ._._ __.___ ____--
%1 ����D��� � � � G3�
.�,'1,
��
,.
�
�
.
.
l�'
. �� y� _ .
�- x � .
�� � .
�_ � �
�
It makes good sense:
Teledyne Laars' Mark V gives you more
of what you bought your pool for!
More fun. More relaxation. Of course, a pool heater is
Most of all, more swirnming. And, essential if you plan to have one
isn't that what a pool is all about? of the popular
After all, your pool is an whirlpool `spas' �
� investment in good adjacent to your �
�� "�1'�` health and family main pool, or if �*'� �
� "�,;; enjoyment—an you wish to use `�`
� � oasis away from the pool for �,�f *�;
`""' �� crowded beaches, many kinds of physical therapy.
�� congested highways Mark V makes it easy to maintain
and the problems of everyday the desired temperature in either
living. When you dive in your pool with just a flick of the ther-
pool at the end of a hard day, you mostat dial to the "SPA" setting.
leave your cares behind without Or, if you prefer, a separate
ever leavmg your home. Spa-Temp Control is available as
In these days of gasoline an optional
shortages, pollution and concern accessory. By the
about the environment, it's nice to way, a whirlpool isn't
realize that owning a pool makes merely therapeutic—
good sense in conserving energy ` it's delightful
and our natural resources. �- - ==�- relaxation for the
In a very real sense, our Mark whole family and will greatly
V pool heater makes it all increase the use and enjoyment
possible. It keeps your pool water you receive from your pool.
warm and Truly, a Mark V heater
swimmable more completes your pool. Gives you
�, hours each day, what you bought your pool for. It
��, �w:v�" more months each does its job quietly, efficiently,
�^� �„, m� ' year. The fact is economically. And, of course,
'' ' ' "� that an unheated automatically.
pool is just a big tub of cold water We've designed the Mark V to
most of the year. Not much fun to make sure that it exceeds the
come home to, or to stay home efficiency requirements for its
with except in the hottest months. American Gas Association
But a Mark V makes the swimming pool
difference! It can take the edge heater rating. It's
off those cool evenings in late built to be stingy in
spring and early fall when you'd using fuel (both
like to take a refreshing dip. natural gas and
A morning swim is an propane models are
exhilarating way to start the day, available), and to maintain its
provided it's not too exhilarating. efficiency over its years of
Mark V can smooth the way by operation without wasting fuel or
keeping your pool comfortably increasing your fuel costs.
swimmable with just a minimum And we've built the Mark V to
amount of heating. be dependable—to perform for
years with minimum maintenance
and upkeep. For many years
Teledyne Laars has been the
world's largest-selling pool heater
manufacturer—and the main
� �� � reasons are quality and
, value! Most of the quality
features described on the
�� page opposite were
� '� pioneered by Teledyne
�'-` Laars, and many are still
exclusively available on the
beautiful Mark V. Each new
heater is thoroughly tested before
it leaves the factory to make sure
it's right.
And standing behind each
Mark V is �,� -�e�
Teledyne Laars' `"""�
written warranty
(one year on
controls, copper --- --�-
tubes and "��'���'ir►�`1
firebox; five years on all other
components)—plus excellent
afteysale service. You can be sure
of finding competent service
- - technicians and
genuine factory parts
�' - if you need them.
x: � �
� �= It's no wonder more
4�, . `4 quality pool builders
�'� � �¢�� and supply stores sell
and recommend Teledyne Laars
pool heaters than any other brand.
So choose the Mark V for your
pool with confidence and pleasure.
Choose the Low Profile Mark V
for outdoor installation, or the
Stacktop model for indoor use
(with approved draft hood). The
two models are identical except
for the tops, (which are inter-
changeable, in case you later
need to switch).
There's a Mark V for every
pool size and location, in both
natural gas and propane models
(see selection tables on back).
Teledyne Laars' Mark V—the
sensible way to heat your pool.
--�' -� �-`:--'°-°,1 —
..--��"'�:� �-u°'�`.�-�-� :-�r � �i
�, „ � � i
� �>�, �.� � � �
,�. �� s J
�
,
/ � .:_ ,
y:,�.
� � _ ����I „^,
�,� I �
' �...
�` ��_
�.
...�
a--�—
��'
�—
� _
� ���T
��. �
�,, �
� ��<:
�
i
Select your Mark V
First, calculate the square footage of your pool. Next, determine the required temperature rise (that is, the
difference between the average air temp and the desired pool water temp during the coldest month of
pool use). Next, refer to one of the tables at the bottom of this page. Use the Fasr HE,nriNG table if you wish
to bring your pool up to swimming temperature in 24 to 36 hours. Use the TEMPERaTURE Ma�NTENANCE table
only if you'll be content to wait 48 hours or longer. The sizing tables list the maximum square footage for
each heater model to accomplish a given temperature rise.
Mark V Low Profile (outdoor only)
BTU/hr.
Input Model No. Width
175,000 DM-175 18
250,000 DM-250 22Yz
325,000 DM-325 263/<
400,000 DM-400 313/a
Mark V Stacktop (indoor or outdoor)
BTU/hr.
Input Model No. Width
125,000 DM-125 15
175,000 DM-175 18
250,000 DM-250 22�/2
325,000 DM-325 263/a
400.000 DM-400 313/a
Fast Heating Tabli
DESIRED
TEMPERATURE
RISE
15°
20°
25°
30°
35°
S
(Indoor
Draft Hood)
S
(Indoor
Draft Hood)
20'h
203/a
28 Yz
29'/z
30 3/a
HEATER MODEL NUMBER:
125 175 250 325
Maximum Square Footage of Pool
345 476 690 880
255 358 510 675
205 287 410 555
172 240 343 443
147 205 293 380
V
(Diam)
V
(Diam)
5
6
7
8
9
Shipping
Weight
217
250
277
308
Shipping
Weight
200
217
250
277
308
— �— w --�- s � �— 2s+i2 -
z�4--I �
393/a 14�/e---� �
C
v
— y� �«g� � 26Yz
2�i
343/a 14�/e
2a�<
�
s
Temperature Maintenance Table
DESIRED HEATER MODEL NUMBER:
400 TEMPERATURE �25 175 250 325
RISE Maximum Square Footage of Pool
1070 15° 620 855 1239 1580
800 20° 456 642 912 1210
642 25° 368 515 737 995
533 30° 308 430 616 794
460 35° 263 367 526 683
i
400
1920
1435
1151
955
826
1. Heating tables are based on 3Yz mph average wind and average pool depth of 5.5 feet. 2. Ali models certified by American Gas Associa-
tion as gas-fired Swimming Pool Heater for natural gas or propane gas for outdoor instailation and for indoor installation. All models con-
structed for 125 psi working pressure. 3. Reduce input ratings by 4% for each 1000 feet above sea level. 4. Teledyne Laars maintains a
policy of continuous improvement. We therefore reserve theright to change specifications without notice.
, / _
TELEDYNE LAARS
North Hollywood, California 91605 LITHO IN U.S.A. OO 1975 TELEDYNE LAARS SD-215
�
F
bv(.
'1 b"4,:� , , �
�
'
� � �.. � �R� ,
�—."�`_ ,r-�'� � w
* ; � �
„ _' „
" •�� �e.. �o� . �� ,.i tt ' � ��
���� �� ,. S..y � . � �I �,;...�
� �� ��
r
! j • t�
���. �� "..� ' ��SP
Y
� `��
— ._
PAC•FAB ��� �� SAND FILTER
The SEAMLESS
stainless steel pool
filter that ends service
and maintenance
problems !
One-piece construction offers you
peace of mind with SUPERFLOW!
All SUPERFLOW sand filter mod-
els offer these worry-free features:
Welds, the most common source
of corrosion failure in tanks, have
been all but eliminated. (Only one
model has a weld — the PF 100).
All parts other than the tank are
made of high-impact resistant and
corrosion resistant thermop/astic.
All internal piping subassemblies
have fhreaded connections for easy
maintenance and service.
Pressure gauge is at the top of the
tank where iYs protected from
"water hammer."
Manual as weli as automatic air
relief valves permit fast bleeding
during start-up. Takes only seconds
Quick, easy service — 2 basic
valves fit all tank sizes.
Long filter cycles for ecortomt'�af—
operation.
Easy backwash.
10-year warranty.
There's no substitute for SUPER-
FLOW . . an't enjoy your
po i you have.ta- out
our filter!
own above is a 50-gallon-per�
min tank. Available in two othe
sizes — nd 100 GPM. Includec
as standard e nt option
either an economical "push-pull"
backwash valve or a versatile and
� �� �
� Products that make swimming
;a �
�'� pools more fun ... less work!
r.
Form 14.1/74
A I I i1 III :�,.
�! 1�
...�� .-
:
� .�E
��.�
��
. .^.
� W - I^
, ,,,«,°=,
� ��...��,
�
easy-to-operate five-position
multiport valve.
Unique overdrain keeps filtering
sand bed flat and level. Water is
evenly distributed over entire
surface.
Lateral filter elements have
threaded connections . . . even a
single lateral can be replaced
easily.
� pacif ic fabrication, inc.
SUBSIDIARY OF STRUCTURAL FIBERS, INC.
PAC�FFi� EL MONTE, CALIF. 91731 •(213) 442-7795
SANFORD, N.C. 27330 • (919) 775-5526
8752 Goldbach, Postfach 1208, West Gennany • Tel. 06021-51630
r�f� " �
' � F�' ti ��
� �
�/� _G�_ i�'�
Qc 1974 Structurat Fibers
Printed in U.S.A.
�
r�
L�
�I
�
�
Sta-Rite "CK" Series pumps are first line
quality pumps ... yet are competitively
priced. Built of rugged cast iron, pumps
are designed with integral hair-lint trap and
pump body ... complete with strainer
basket.
"CK" Series pumps are truly self-priming
... after priming chamber is filled with
water repriming is not required, under most
operating conditions . . . "diffuser" design
will handle more air than ordinary pumps.
Easiest of all swimming pool pumps to
instail ... no separate trap to bolt on ...
top discharge makes plumbing more con-
venient.
Easiest of all swimming pool pumps to
service ... simply remove four bolts and
entire pump is open for inspection ... no
need to disturb plumbing.
"CK" pumps are a compact, heavy duty,
competitively priced series especially for
residential swimming pool installations.
H
w
w
�
z
�
a
w
_
J
Q
O
H
_
STA=RITE
"CK" Series Self-Prir�ing
Swimming Pool Pumps
�I� �j" l�( �. U �
l V `
20 40 60 80 100 120
U. S. GALLONS PER MINUTE
���� �'�� �.. =.,. �." ����+°��C����:::
•
STie►-RITE INDUSTRIES, INC.
WATER EQUIPMENT DIVISION
DELAVAN, WISCONSIN
• Chamblee, Ga. • Kaufman, Texas
• Orlando, Fla. • Los Angeles, Calif.
Listed
518R
�/z Thru 1 H.P. Only
Compare These Duality Features
U.L. listed ... the first U.L. Listed cast iron
swimming pool pumps ... assures maximum
electrical safety plus dependable "set and
forgeY' performance obtained through tough
testing in sun, rain and wind.
New Weather-Proof Motor . . . protects
against excessive moisture and contaminants
. resists high temperatures, runs cooler
for prolonged life under high ambient con-
ditions. New grounding lug for maximum
consumer protection in the pool area.
Mechanical Seal . . . Drip-proof, corrosion
resistant seal, is same �sed in other Sta-
Rite swimming pool pumps. Never needs
adjustment.
Special Impeller ... Precision impeller has
unusually smooth water passages, which
means higher efficiency.
Built-In Suction Trap ... Suction trap is
included. In comparing with competitive
models, cost of separate suction trap they
may require should be considered.
Strainer Basket . . Rugged 4" rust-proof
basket is same as furnished with other Sta-
Rite pool pumps with 4" suction traps.
Rugged Construction . . One piece cast
iron case includes pump body, suction trap,
and pump base. Seal plate and diffuser are
made of special rugged material. "CK" Series
pumps have 1�/z" suction opening, 1�/z" top
discharge, and tapped hole for gauge con-
nection.
Easy To Service ... for routine maintenance
motor can easily be removed—without dis-
turbing piping or mounting—allowing ready
access to p�mp parts. Service of most elec-
trical parts can be accomplished simply by
removing protective motor canopy.
"����'
5 2
EFFECTIVE SUPERSEDES '
� OCT. 1, 1975 OCT. 15, 1974 :
w
�. — ---.....�.,�__<. ..._,�
"CK" Series Swimming Pool Pumps
Distributed By:
PRINTED IN U.S.A.
CIN OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
�
�
Effedive On January 1, 1997
APPLICATION FOR PLUMBING AND GAS FITT1Nr PERMIT
MARK NUMBER OF FIX'i'URES TO BE INSTALLED ON EACH FLOOR � •
PLUMBING FIXTURE RATES:
NO. RATE TOTAL
New Fixtures
Old Opening, New Fixture
Beer Dispenser
Blow Off Basin
Catch Basin
Rain Water Leader
Sump/Receiving Tank
Water Treating Appliance
Water Heater –Electric
Water Heater – Gas*' �
Gas Range**
Gas Dryer•*
Back Flow Preventer Required ()Yes () No
Type
$ 7.00
$ 4.00
$ 5.00
$ 7.00
$ 7.00
$ 7.00
$ 7.00
$10.00
$ 7.00
$10.00
$10.00
$10.00
$15.00
ReinspecYon Fee $42.00/Hr
ALL OTHERS AND/OR REPAIRS ANO ALTERATIONS
1.596 of Value of Fixture or Appliance Q. do
State Surcharge $ .50
• . TOTAL FEE $�d
JOB ADDRESS 7�� f ,��(�G'%/� � �j�� ��
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strid accordance with the city codes
and rulings of the Building Division, and hereby declares that all the facts
andrepresentations stated in this application are true and correct.
_, 1998
Owner _ �C//UsLJ��� 9,�-�/PCglc ���% � �6�%
Building Used As �CS�fU����--�
• Estimated Cost PERMIT NO. ! �� `� ' �
PLUMBING
SIGNED BY
Approved By
�
� � �f � � � r /I i �
�
_ �
.___ �—" - �..� 1 � � � <
Rough–In Date Final Date � �
��
PLUS THE 5.50 STATE SURCHARGE
"�COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6–A. MINIMUM SIZE 9 S� INCHES.
C �C�:L�
sue�ecr RMIT NO. ,
City of Fridley 3 3 5 6 9
AT THE TOP OF THE TWINS g U I L D i N G P E R M I T
f
� ` RECEIPT NO.
� • COMMUNITV OEVEIOPMENT DIV. y��� ^
r � V � PROTECTIVE INSPECTION SEC. ���� ��
( � �'��1 � CITY NALI FRIDLEV SS13� NUMBER pEV DATE PAGE OF APPROVEU BY
�'""'��� ��' 763-571-3450 9/0-F15 6/2/03 / /
JOB ADOAESS 7641 Alden Way NE
1 LEGAL LOT N0. BLOCK TRACT OR ADOITION SEE ATTACHEO
oescR. 3 8 Pearson's Craigway Estates 2nd SHEET
2 PFOPERTY OWNER MAIL ADORESS ZIP PMONE
Marcy Hamberg 7641 Aiden Way NE 763-571-8716
3 CONTRACTOR MAII ADDRESS ZIP PMONE IICENSE NO
Sela Roofing & RemodeZing Inc 4100 Excelsior Blvd, St Lou�s Park, MN 55416
4 AFCHITECT OR DESIGNER MAIL AODiiESS Z�P PHONE �ICENSE NO.
612-823-8046 1050
5 ENGINEER MAII ADDiiESS Z17 PHONE LICENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW O AODITION O ALTERATION l� REPAIR O MOVE O REMOVE
8 DESCRIBE WORK
Rebuild chimney from roof up to meet code
9 CHANGEOFUSEFROM TO
STIPULATIONS
TYPEOFCONST OCCUPANCVGROUP OCCUPANCVLOAD
SEPARATE PERMITS ARE REOUIRED FOR ELEC7RICAL, PLUMBtNG. HEATING,
VENTILATING OR AIR CONOITIONING
TNIS PERMIT BECOMES NULL ANO VOID IF WORK OFi CONSTRUCTION ZONING SO. FT CU FT
AUTMpRIZEO IS NOT COMMENCED WITHIN 60 DAVS. OR IF CONSTFUCTION
OR WORK IS SUSPENpED OR ABANDONED FOA A PERI00 OF 120 OAYS AT
ANV TIME AFTER WORK IS COMMENCED. NO. DWIG. UNITS OFfSTi:EET PARKING
I MEREBV CERTIfV THAT I HAVE READ ANO E%AMINEO THIS APPLICATION 1 S1All5 GARAGES
AND KNOW TNE SAME TO BE TRUE ANO CORRECT. A�L PROVISIONS Of �AWS VALUATION SURTAIf
ANO ORDINANCES GOVERNING THIS TVPE OF WORK WILI BE COMPLIEO @
WITM WMETHER SPECIFIED HEREIN Ofi NOT THE GRANTING OF A PERMIT �3,163 y�1.SH
DOES NOT PRESUME TO GIVE AUTMORITV TO VIOIATE OR CANCEL THE pEqMIT fEE SAC CHARGE
PFOVISIONS OF ANY OTMER STATE OR LOCAL LAW REGULATING CON-
ST CTI OR THE PERFO CE OF CONSTRUCTION �9% .25 Fire SC. �3. 16
PLAN CHECK FEE TpT � FEE
4 �'_�._ v�
Lic�ns $5 106.99
S�GN4TUAEO ON'PS(;TOQOpAUTNQFizEO• iD�iE� N HOPE VALID T THIS IS VOUR PEp=1�
- S
S�GN<TU�7EO�OwaEQ��GOWNEpBWIOER� �D�iE� B�D �tiSo � �i�rE
NEW
ADDN
ALTER
[ j CITY OF FRIDLEY Effective 1/1/2003
[] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
[] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPLICATION
�ILD�
Construction Address:
�
s��
Legal Description:
Owner Name & Address: ��1 �t � I� � �^-�be,� G ° Tel. # ^163 - S'►1 -'�� 16
Contractor: SELA ROOFINA�t ��;ra.A,_REMADELINC. �Nr MN LICENSE #
Address: 4100 EXCEL����pp �(CELSIOR BLVD. Tel. #�612) -ja3-�`��16
. ,
Atfacf� to ��is a�I�dAS�a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
DESCRIPTION OF tMPROVEMENT
Length Width
Length Width
Height
Height
Sq. Ft.
Sq. Ft.
���✓
�i�� �-
Construction Type: C ��� �", ��� r����'`� r Estimated Cost: $ 3� 6 3,° a -
Driveway Curb Cut Width Needed: + 6 Ft = Ft $ _$
DATE: �UN 0 2 2003 APPLICANT: �� � Tel. # G I Z'�Z �' Y�0 �-i 6
Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will
call you for card number.
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
$ �S�
$ .3 l
$ �� ��
$
$ . C� �
$
$
$
$
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1275 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 [ ]
TOTAL $ ! ��� STIPLI ATIONS:
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
. ,..,
�,
PERMIT O.: 2004-01415 �
DATE ISSUED: 08/26/2004
(763) 572-3604 FAX: (763) 571-1287
ADDRESS : 7641 ALDEN WAY NE
PIN : 103024120070
LEGAL DESC : PEARSONS CRAIGWAY ESTATES 2
: LOT 3 BLOCK 8
PERMIT TYPE : BUILDING
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : RESIDING
VALUATION : $ 6,000.00
NOTE: PER R703, 2000 INTERNATIONAL RESIDENTIAL CODE, REQUIRES THAT A WEATHER RESISTIVE BARRIER BE
PLACED OVER EXTERIOR SHEATHING TO PROTECT THE INTERIOR WALL COVERING. EXCEPTIONS FOR THIS
PROVISION WOULD BE IF SHEATHING IS AN APPROVED WEATHERPROOF PANEL OR WHEN THE SIDING IS AN
APPROVED WEATHER BARRIER. VINYL SIDING IS NOT A WEATHERPROOF COVERING UNLESS THE
MANUFACTURER STATES THIS IN THEIR APPLICATION GUIDELINES. CALL FOR INSPECTION OF WRAP BEFORE
COVERING OR TAKE PICTURES. RESIDE HOUSE & GARAGE; REPLACE WINDOWS WITHIN EXISTING OPENINGS.
STATE LICENSED CONTRACTOR 1
APPLICANT BUILDING PERMIT FEE 125.25
GRAYHAWK BUILDERS (20174611) FIRE SURCHARGE 6.00
3020 CENTERVILLE RD STATE SURCHARGE, VALUE 3.00
LITTLE CANADA, MN 55117 LICENSE SURCHARGE 5.00
TOTAL 139.25
PAID WITH CHECK # 13752
OWNER
HAMBERG KURT P& MARCY J
7641 ALDEN WAY NE
FRIDLEY, MN 55432
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void ifwork or construction permit tnspection Car�s
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days �i" Be Mailed
at any time after work is commenced. �o Homeowner To Post
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
provisions of laws and ordinances governing 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 provisions of any pther sta or local law
regulating constructio the perfo ance o onstructio
Applicant Date
Bldg Ins D �'-' =��
SEPARATE PERM S REQ YRED FOR WORK OTH�R THAN DESCRIBED ABOVE.
dEV1f [ �
��or� t )
�LTER j �
�onstruction Address=
�� � � o
CRY OF FRtDi..EY
SiI+iGLE FAMtLY AND DUPLEXES R-1 AND R-2
9U1l.DIttIG PERMtT APPLtCAT10N
�nc�t� �-c�� �1fs�
EffECSive 1/'3/2t107
{763) 572-3604 6ldg insp
.
_egai Descnptifln_
�wner Name c� �0.ddress '�G �' Tel. # �Q�� � `8� �
�ontracto� ^ MN LICENSE # �C���' �i�0 I
,.�a.e��.�� n 1 �\ Q/i _ 1 J T21. #,�� U�±�D �
Attach to this applicatian, a Certificate of Survey of the .
iot, with the proposed caristruction dravm on it to scale.
DESCRlPTlON OF 1MPR01/'EM�NT
UYlNG AREA: Length Width Height Sq. �t
GARAGE AREA: L�ngth Width Height ___„_,_._� Sq- Ft __
DECK AREA: Length V�,dth Hgt/Ground Sq. Ft
OTHER:
/� �
�onstrudion Type: c.� 1 � 1y1�_5 Estimated Cost $� vl
�,.,,eway Curb Cut W+dth Needed: ____Ft + 6 Ft = Ft x� _$ --
OATE: �
APP�IGANT: T�i. #�� � � ��
:iTY USE ONLY -
Permit Fee
�ire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Etosion Cont�ol
Park Fee
Sewer Main Charge
TOTAL
c-'�' 1�1TtONS:
Cafl (T63) 572-3604 tor Penr�it Fees if mailing in appticafian
�_ %�� �� Fee Scheduie on Reverse Side
g � n� .00'I o# Pe+rmit Vatuation t'11'lUth°�Q}
$ �� -QQ $_50/$�,000 Valuatio�
$ $1150 per SAC Unit �
� !� �v $5.00 {State Ucensed Residentiaf Contractors)
$ Att ,.A" or Ait, '�B° Above
$ $450.00 Conservation Ptan Review
$ Fee Determined by Engineenng
� Agteement NecessacY j 1 Nvt Necessary 4]
� �3y.as
;
i
O
�
� �
�
N��-U`7-2805 14�48 CITY OF FRIDLEI'
Building
��� Zz��pectians
'Zb3-572-3604
DA'rE �7 c� '�/
SITr' ADpRES5 �
TFiIS APPLICAN7IS:
OWNER/
TENANT
CONTRACTOR
SUBNIIT A COPY OF
YOUR STATE
LICENSE Wii'�X
APPLICATiON'
PERM�'T TXPE
TYP� o� Wartx:
:LV��HANICA.�
�.ESII)ENTIAI., .A.�'�'LICAT�O�V'
�CiT'X' U�' FRID�E"Y
❑ OWNER
YOUR FrMATL ADDRESS
� � %�u r
pt�or�:� -�7/-8%/(0
COMPANY NAME:
CONTACT PERSON:
STA7'$ L10EN5E #
PHOTIE ��/ -%� rS� - �o� � % , FAX
l�(,�SINGLE FAMIL`Y ❑ 'I`W O PAMILY
p NEW � REPLACEMEN�i
Ia�TAILED DESCRIPTION OF WORK
P . t�2i1�4
Permit No. • 0`�7 c%
Rece�ved By:
�a� R��.p�.�.__R._.�..�.
$TA7E�,ZI�
FXP AATE
' CITY�a r`i�'i 5'i' • l�uw ( 5iAib��,ZIP�SIO �/
I7 TOWNIiOUSE
�nLTERA7'lbi�/REMOAEI.
l�.c e
' PER MS 16B.665 the perm�i fee is a minimum of SX5.00 or 5°1. of the total cost up to 5500.00, whiChtvGt is greater, for tho
improvement, installation br rzplacement of a xesider�tial fixtnre, excluding the fixtures. (This should reflect only the cost of labor }
Labor cpst under $300 =$15,00_ X.abor cost betweez� $300 ro $500 = cost of labor x.OS s
FOR PROJEGTS W}1L'}i� LA.SOR E3CCEEDS S500, F�)�S ARE BASED ON a 10,60 PE,R FIXfURE, EXCfiPT WM�iC� NOTEI,?. k7XTURES' (lNDIGATE TOTAL
NUMBER OF FACH BELpV� � / �
Equ'tpmcnt Instal3ed , MFCr: aZ !�`'�7" MODEL�,,,,�5� n /� .i�L S1Z'UBTU
MFG: MODEL: SIZFJBTU
Mi�G: MpDEL: SIZEBTIJ
A!C S25.Q0
� A1R TO AIR EXCHANG�R $15
�90ILER S35.00
�CTii1vW�Y I,�13ER $10.00
��ucT wa�uc s�o.00
Permit Fae
Starcharge
TOT,A,�. DUE
�FIR�PY,P,CE (GAS) $25.00 GAS RANG�JOVEN 510.00
FIREPL.ACE (WOOD) 535.00 NEV�1 GAS �Wx.L 510.00
FURNACE 535.00 �GAS i3NTf l�LTR 510.00
�GAS DTtYER SI0,00 POOL i�AT�t 535.00
�_GAS PTPING S 10.00 VEN7[LATOR 515.00 _-- -- ___
$�[,�, o� Idwonber of ilxtures � S I 0.00 x 510.00 a S
� _.�� N'umber �f iixt�r�s rz � 15.00 _[,__ x $I5.0� _ $ /S �
S_„_,[,�.�'� Number of 5�xtiures �$ $25.00 x 525.00 �$
Number of ftxiures (�; $35.04 x 535.00 =�
Stau Surcharge = $_ _ _ _ ____ _ 50
Total = $ b • � o
i�S IS AN APPLICATIbN FOIt 1# P$R1vflT NOT VALID 1JN'�'1L PROCE.SSID
; hereby apply for a build'vng permit and I acJu�ow[edge t1�at the informAtio�1 above is complete a�ptd aeewra.te; that the work will be in
conformance wittl the ordinances and codes of the City of Fridley and with the Minnesota�Construction Codes; that I understand this is
not a penmit but only an applicatio�o for a perrnit and work is not to start without a permit; that the work will be in accflrdance wit}a the
approved plan in the case of aU wark which r uires review and approti�al of plans.
SIGNATURE OF APPLIC ' �• ��J __PR1T'T N da�?,�'1 DATE � :� ' ��
�ltj' O� �' l'���E�
S�ilding Inspect�ons Department
6431 Un�versity Avenue NE, Frid�ey, MN 55432
7�3-5'72-3604
I3uildir�g
Inspections
763-572-3604
763-502-4977 FAX
DATE n u r-r (,
SiTE ADDRESS �
TEIIS APPLICANT IS:
PROPERTY OWNER/
TENANT ADDRESS: '%Lc �i { I�' � t� Yl �Ai LlU 1V E CITYJ Fr � d I�_� STATE��ZIP ~�%
�-} � PHONE: "7Io ,�� 5 7 t' Yi � I(a C� I I�I'i :°7 Iv 3- 2 Z C� '� Z. 3 I � Ku,r`��
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
EFFECTIVE 7-1-2010
YOUR E-MAIL ADDRESS
OWNER ❑CONTRACTOR
Permit N
Received By:'�
Date Rec'd: �
�
!�
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
AND CERTIFICATE OF
INSURANCE
PROPERTY TYPE
STATE LICENSE #
ADDRESS:
PHONE
�SINGLE FAMILY
❑ TWO FAMILY/NEW CONSTRUCTION
PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED
❑ BASEMENT FINISH ❑ ROOF
❑ DECK ❑ SIDING
❑ SWIMMING POOL
TYPE OF WORK: I❑ NEW HOME CONSTRUCTION ❑ ADDITION
❑ MAINTENANCE/REPAIR '`�REMODEL:
EXP DATE
CITY_
FAX
ZE L'{U8 5 ci -�
'ORIES�
❑ WIIQDOWS
❑ DRAIN TILE
❑ OTHER
DL'SCRIBEWORKBEINGDONE: ['r,t,l�- ['AV1� (��'YY)pc��.I j'Y�0.S'f"c't`� bQ;�=S�� Yl.tt.`i�'1C11S_
SIZE OF
TOOFING Sam2. �VZ:'�;�.
NUMBER OF SQUARES
GAItAGES
PROPOti�L' SiZE:
PROPOSE�? i ii:IGHT:
SIDING
❑ Vinyl
❑ Aluminum
❑ Other
LENGTH WI
❑ HOUSE ONLY
❑ HOUSE & GARAGE
❑ ATTACHED GARA'JE
❑ DETACHEG GP.R '.+;E
ATE Z[P.
FT
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. & PORCHES SUBMIT:
❑ Trim 1. Site Plan/Survey showing the existing structures
❑ Fascia and proposed project.
2. Two sets of conswction plans
WINDOWS 3. Energy CalculaUons
IN EXISTING OPENINGS OYes ❑No LOCATION OF WINDOWS FOR WINDOWS — PROVIDE U-VALUE AND
OR FOR NEW OPEN[NGS-DESCRIBE SIZE OF MANUFACTURE ST[CKER 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�HE 1997 U.B.0 FEE SCHEDULE)
7 OTAL JOB VALUATION $ �Ud OCCUPANCY TYPE
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
$
$
$
$
$
$
$
$
See Back Page for Fee Schedule
65% of Building Permit Fee
.001 times the total job valuation
.0005 x Permit Valuation Minimum $5.00
$5.00 (State Licensed Residential Contractors)
$2100 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 payable 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
confonnance 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 o ll work whic req i s rev� and approval of plans. j
S[GrdATUREOF APPLICANT �� j,v� EL/���PRINT NAME rYiLL�"�"�l �. ��Lt,4� t°�i�� DATE 7/���
APFROVAL INSPEC'TOR SIGNATURE i , i �
�
i�:�7
1 1i
�
�
� � � DO WE ,
7 NEED TO �.
MOVE THE
TOILET � «
�v�
LIGHT S
FAN SW
v��N ts„
--�t� �WG �� t� � 5- 9
�` ` -�-d � r�'�
DOOR
LIGHT
SHOWER THRESHOLD KNEE WALL - 3-6 HIGH
o ^��
i ^
�--
� T
�� ��
SEAT
FAN
LIGHT SCONCE LIGHT LIGHT
zx cezs
2X VANITY
LIGHT SW
� ���� � ���� a �
-�'�-- �t Q� z l � �I►�:
�
<r�� � � �
3-9 O3-5
3-0 CLOSET
LIGHT
��� � ��s' (EXISTING)
�.
��� ��� /� BI-FOLD //�
DOORS
SCONCE LIGHT SW ,a
CLOSET LITE SW a
�
3
� �� �
r o ,� �r
i t � �
M C� � tf)
�f�c�Q6 SE�
to .-+
i �
� I
�
�(Z� � ��
CLOSET
AREA
�
�
i
N
� 8-�
�
�
�
N
�-�i
. �
�`
TZ-Z
�
�
�� z
T-i
_ -_ _ �_ �
� ' �
� w � , � .-�- � � �
� 2 � ... � , U,, �
� `� �.�. '� ' � �
� � � � �
, � � —� . , �� N
I�7a Z I �
, o � 2 ? --
-� � � � �
� ,p�H f_ � , o !�F
W �,, �– ...
-� o W �. � —�
(� U FC � Ci �
� � �
' J .-J �
w � � �r �
..�
I � �
TT-8
�'I'IKM ,L3T � JNI'II3� Y10233 I�MO4 Sd02t 'I'IFIM
-- -- -...-- -- - - -- - - -.._..__.. 9-8
3
�
w
H
H
a
H
W
�
O
� a
U
3
�
H
x
c7
H
a
�
E-•
H
-7.
�
�
'I'I�iM
��Z ��
� �� � w
� H
a
�`��
�,L��'�
C
�.
V�
�
�
0
O
0
H
O x
�
H
a
[�FI3
M
1
(�l
0
a
0
x
�
W
a
x
H
x
w
�
0
x
�
� �
� i
N N
�'�
L-£
�
�
�
�
�
`-�!
�
:II1�
H 6-8 !
�
�
DO WE
NEED TO
MOVE THE
TOILET
IDRAIN???
� LIGHT �
FAN SW
LIGHT
SHOWER THRESHOLD KNEE WALL - 3-6 HIGH
0
i
N
O SEAT
FAN
5-9
DOOR
3-9
3-5
3-0
LIGHT
SCONCE LTGHT LIGHT
2X GFIs
2X VANZTY
LIGHT SW
CLOSET
LIGHT
(EXISTING)
BI-F4LD
DOORS ,
SCONCE LIGHT SW ,a
CLOSET LITE SW �
3 CLOSET
AREA
� � � � r+� � � � �
0 - 0 i ° ' �' � `° ,_�.,
M c � � 0� 1
�
��9P�S�.� �/z�%o
�
�
�
i
N
T- 8'�
�
�
i
N
�
Buildirig PLUMB�G Permit No.:' L1 �
Inspections RESIDENTIAL APPLICATION Re ��
763-572-3604 D����: .
CITY UF FRIDLEY .
763-502-4977 FAX gpFECTNE 7-1-2010
�A� S J� I� 0 YOUR E-IuiAiL ADDRESS
SITE ADDRESS � ` � � � �"
Tf�S APPLICANT 15: ❑ OWNER �CONTRACTOR
PROPERTY
OwN[�R/
TENANT
COI�ITRACTOR
SUBM7T A COPY �F
YOURSTATE
LICENSE, BOND AND
CERTIFICATE OF
INSURANCE
P6RMIT TYPE
TYPE OF WOAK:
PHONE: `'JL 2 � S 71 -�'� � V �
NAME:
STATE LICENSE #J Terry Overacker Plumbing, fnc.
STATE BOND # 502 E Main Street
Anoka, MN 55303
ADDRE55: License� 061945PM
PHONE 763-572�8880
❑ SINGLE FAMILY
❑ NEW
�
� TWO FAMII.Y
Q REPLACEMEl�iT
O TOWNHOU3E
� S�a-
EXP DATE
EXP DATE
STATE ZIP
1
FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURPS: (LNDICATE TdTAL NUNIDER OF EACH BELOV1�. MIIYIMUM FEE
S35.S0. �� p�p��
BATH SINK/LAV FLOORDRAINS SHOWER
r gpTHTf,jg � GAS PIPING (NEED CTiY LIG'� � S WIMMiNG POOL WATER SOFTNER ($35)
�CLOTHESWASHER iK]TC1{ENSINK WATERCLOSET _�AO �OG PREN•(S15}
DISHWASHER �LAUNDRY TRAY WATER HEATER ($35)
— ! \VATER METER � 4�
THiS IS AN APPLICATION FOR A PERMIT-NOT VALID UN'CiL PROCES9ED
I heceby apply for a plurnbing perm�t and I acknowledge that the information above is complete and accurate; that the work will be in
coafortaance with the ordinances and codes of tl�e City of Fridley and with the Minnesota Constsuctian Codes; that I uncierstand this is
not a permit but oaly aa application for a pemut and work is not to start without a permit on site; that the work will be in accordance
with the approved plan ia the case o all work which requires review and approval of plans. �� B�/�n�TE ��i gf�v
SlGNATURE OF APPLiCAI3T �����*� —pRINT N?.ME
eauRnvas. TNSPF.CTORS SIGNATl3RE�� � �-,.�ee�n��i rc�
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridiey, MN 55432
7b3-572-3d04
FAX: 763-502-497?
� . -I .-. ... .-. .-. 4 �. . . - __..
Wd L£�9Z 6 O lOZ/6ll8 �a1�4 Z/Z�:a��d . ^ 6888 ZLS £9L � ��o�� . .. . � ^ . � � T � ^ � '