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AF - 36112Date: •�•�a Addre�s r`, City of Fridley, Minn. �� BLTILDING PERMIT N° 3_4 3 6 � y � � ��.��`f .,�........ � ................... ...... �� ............ � ........... . Builder .... ...�.� .................................. ....(�.��.�. . . .. ... Address ............. ............... LO�CATIQ�V OF BUILDINC No. l�i.� �� Street .......... . ..� !��.. Part of Lot . ................. ........... Lot . ..�: .-�.�.. . BYock ... .... .. .. ....... Addition or Sub-Dfvision �.��,�:..•eb�s�':.. �. / Corner Lot ............ Inside Lot x......... Setback ............ Sideyazd ......... ................... DESCRIPTION OF BUILDING To be Used as: � ` � . . . . . . . oat :"?•�• � DePth .�'�. . � . � Height . ��. .�. � 5q. Fk .�.°�.� � Cu. ��1. � � .................... Frot►t ........ Depth ........ Height ........ Sq. Ft. ........ Cu. Fk ........ Type of Construction .......:........... �st. Cost..�.� �..�..... To be Completed ................... ° iI� j d� � _ �� ,� , �� ,r6 i _._ , . i y I _ � � � � �� r i�� 9 s.t�� F/, K � � /�'" Coc� �� ^ � ,� --� � � In consideration of L'he fssuance to me of a permft to construct the building desribed above, I agree to do the proposed work in accordance with the descrlption above set forth. and in compliance wfth all provisions of ordinances of the dty of Fridley. .� . . -�� :�........ . ................. � In considera.tion of the payment of a fce oP .. ��., permit is her�by granted to ................... ... .. .. .. .. .. .. .. ..... .. . to construct the building or addition as descrlhed above. This permit ia granted upon the express condition that the person to whom it is granted and hia agenta, employees and worlunen, fn all work done in, around and upon said building, or any part thereaf, shall conform in a11 respects to the ordinances of Fridley, Minnesota, regarding location, con�truction, alterat[on, maintenance, repair and moving of bufldings with- in the dty limits and thfs permit ma.y be revoked at any time upon viola.tion of any of the provisions of said ordinances. � � . :�: . . l. `.'�!�/��'"l1y ./. . . . . .�,uilding Insspector NOTICE: // ' Thls pe�mit does not cover the const�uotion, lnstallatlon or altera4lon fo� wl�ing, plumb(ng, gaa heating, , sewer o� water. Be sure to see the Bulldine Inspeator for sepa�ate parmits fo� th�a Itema +r� >.. City of Fridley, M,� BUILDING PEI�MIT 4� w�� N° 5158 Date: ----V�-- �.� –�---�� . ,, �,� � � �. Y . . . � . . . .. � �� ' � � �a �VVl1� '� $1131�P �, l, Address Address`� } — CAT � UILDING No. � Sireet � �� " Part of Lat ��A � Lot __ Block ' Addition or Sub-Division �.._._.... Corner Lot ..._ ..�.... Inaide Lot Setback _ Sideyard Sewer IIeva.tion .,. Foundation IIevaf3on DESCRIPTION OF BUILDING To as• ,...._ ,,� - 5 Front � Depth ,,�"'"�"' Height L� Sq. F't. ��er' Cu. Ft, �;�--'r---� ' • t Depth .:_.�.�t Hei ht �� Sq. Ft. Cu. Ft r Type of 'Construction ��,,,.�,�6e�t.–�._. Es� Cos�t �.�� "�."�"'"_' To � Compieted � � �� In consideration of the issuance to me of a permit to construct the buiiding described above, I agree to do the proposed. work in aceordance with the description above set forth and in compliance with all provisions oE prdinances of the dty of Frldley. `� r- Ea conaideraiion of the payment oE a fee of $.�.,. , permit is hereby granfied to to consiruct the building or addition as described above. TY�ispe rmit is gTanted upon �the express conditton that the person to whom it is granted and his agents, employees and workmen, in. all work done in, around and u�on said building, or any part thereof� SYlA�I COIlPO1Z11 lII 8.II T�3p@Ct8 LO 'F$@ O�inanran Ag Fridley, Minnesota regardfng loca.tion, construction, alteration, maintenance, repair and moving of buildings 1�vithin the dty ]imits and thia permit may be-r,evoked �t any time upon vio�f any of the provisions of said oTdinBnc�s. _„�.-_,, Btiilding Inspector NOTICE: Tlils permit does not cover t6e wnsteudYoa, InstallaHon for wiriae, plumbing, gas heating, sewer or water. Be sure to see the Buildieg Inspee�or for separata permhs fo� fheae itean. � � P �~ �_ _,t � e� 4 �` --..r �--s ,. _ =.: - _ - - _ _ __ _ . � a�zc��rio� r� sunnnvc � crr� oF �xmr�z, r�so2� .- � � Owrier's Name "'`� ��X^�'� Bu3lder �• �%�� ~l/�L 1f✓ C��f � �o�, � ._..__. . lddress �o �o ��C,'P.�,�¢.Q at'il/$. �s Addresa /�2 S'/ ��E"�(/'�4 . �-t� � r �� LOCATION OF BUILDING No. �� h' Street,� �, Part of Lot Lot Block Addition or Subdieision Carner Lot _____,___Inside I�o� Setback Side-Yard SEWER ELEVATTOPI FOIINDATIflAT ELEV�TION �pplicant attach to this form Cert3f3.cate of Survey of Lot and proposed building lacs.tion. DESCRIPTION OF' BUILDIPJG «� o r�c 2 6 � ' � �"°"'- ,s�',�'�� ,�4 � � To be used e.s : � �" � + r FTOiIt_,_� Dep'th H83.gh.t Sq, Ft. Cu. Ft. F'ront epth Height � Sq. Ft. Gu. Ft. �y Type of Conatruot3on "� � Estime.ted Coat 1� � To be Comple'ted 4.�l.�� dc.�"—�-� � Y The undersigned hereby makes application for a;permit for the work herein specified� agreeing to da all work in �trict accordance with the City Ordinences and ruling of the Department of Buildin�s, and herebg declares tha.t all the facsts and representations statad in thi.s appl3.ca.tion are true and correct. �' � DA�E � T--4 / STGN,ATURE (A Schedule of Fee Coats can be Found on the Reverse Side.) � � _ � � � ,, �, ( ,1 1 ' �' �M �# 'C3i1 1 ;'" 5ection a. T'�e Ins�etor of Buildings shall, 'before issu3ng an�r permit for the erection of any building or structure, or for any addit3on to an� exist3ng build- ing or structvre, or for eny elterations or repairs to an,y existing bu�.].di.ng or structure, upon appl3.cation therefor, require the payment by the applic.ant for such permi.t of fees to the amount herein below set forth and in the mar�aer herein provided to-wit: 2.1. For ar�r such pex°mit for the erection of a�y fire-proof bu3lding, other thea a garage, warehouse, factory or grain elevatflr, or for the erect3on of a.ny fire- proof addition, for s3.m31ar occupanc�, to any ex3sting building shall be at the rate of �'l.L,A for ea,eh one thousand cubic feet, or fraction thereof, in such cubical contents. . 2.2. For an�r such perm3t for the erection of any fireproof garage, warehouse, factory or grain elevator, or for the erection of any fireproaf addit�ton, for aim37.ar occupancy, to any exlst3ng building sha11 be at the rate of �1.25:;for ea�h one thoueand cubic feet, classified as ��fireproof" by Section 502 0£ the� M�rinea.pol3s Builclittg Code. . HOUSE.S 2.3. For eny auch permit for the than a garage, warehou�e� facto addi'tion, for s3m3ia.r occupancy, each one thousand cubic feet. GARA S erection of a,ny non-firepr�of building t�ther r� or grain elevator, or any norr-f3reproo� to an�r existing building. Permit �..00 for 2,1�, For any suCh,perm3.� for the erect3.on of any nor��i.��proof garage, we�ehouse, fa�tory or g�°a.in �ievatot', or for the erection of g,ny nori�►�i.:r�'eproof addiiio�, s` for s3milar occupancy, to any existing building or for each such building or addition. Ninety Cents for ea,ch one thousand cubic feet or fraction thereo�, in the cubica]. con�ents thereof with �. minimum of �4.00. For the purpoae of computing fees for building permits the cubica7. contenta of any building or addition to a uniForm height throughou� by multipl�ring the ground area covered from a point aix (6) inches below the floor line of the basement or cellar to the average height of the upper surface or to the average height of the roaf stu'face of the main ga,ble of a pitched roof. 2.5. For repairs or alterations to an existing structure, the fee she11 be at the rate of $3.00 for each Five Hundred Do].lars (�500.00), or fraction thereof in the cost of a,ll propoaed work. 2.6. In no case shall the fee charged for any permit as set forth in Section 2 be leas tha.n �L�.00. i'�'� �� w-v � _ � d N y � To'. y p M : y . 7i : � ' M . N : o � a . m r1 . � : � • � � G� 9 � � 3 �S �y �• H � � � � � p ►�! �� O • o � ; o . o . o . � : : � . . I I I � k id N tv r�+ � °o q o � � H ►�3 � t� � � � w m � Z x $ � � � � � � y �, � � � � � � � �� ! y : O � � � � ,� � � o a � � : � a N ; � �• : en W _°o� : �' 04 : 0.'�4 � � . . . � : . . . : � : � : : �` � o �4 k SC k �! i4 � � h,� c� w f+ r r c�i o c�ii o o O ,.'b.� r� t� �a t� v> bI W y H a �� D � r � � m N n _ m C r m „ �i��l - : ....' �� L .��1 � � .■�■, �� ' ■�■1 • � ■...' �� m o m ►��+ M ','� o O � Q � O �x [ � � a' A' �., p x m F�' � � °'b � � a � � � � � r�. � a � d �' a� � � g � `E � � � O F � � � � � ��• C4 p � O � _ l� � � _ . �� WATER c�osers URINAlS enrH �� awsiHs SINKS WASH rru�rs DRINK. FOUNT. sHwas. FL�R DRAINS CATCH BASINS nuro wasHen GAS APPL GAS RANGE GAS OPENINGS � s z r �> In D A m n p aa� � c�o � � °N, � �'a� � �o�� d �� , p � v, ,�.� o � � � O y GL fD � � �� c+ ��. !A � � � � � � � � O`A �Su p � o � p,' o p � �, o M y A7 � � � � �� o��: ��° �� m ��o � �' �� 3 ^� � � � � tj tn m a� a� �x �M ag �� , e '0 � �i � � � ^ � 0 � � {0 � � � d a � � � � � � M 00 � � �. ro � 0 m 'v b A � �C V O � � � �, City of Fridley, Minn_ BUILDING PERMIT Date: JUNL 6, 1966 Ovvaer: �RAZD D. WESTLU1aD Builder SAl� Ad�s 6617 Central Avenue N. E. Addrese Fridley, Minnesota 55432 �� v� ss71 LOCATION OF BUILDING No. 6684 Str+eet CENTRAL AV�'NUE N.E. Part of Lot 4 Lot — 81�k Addition or Sub-Division �1 R�� - SUB _ 2�. , Coraer I�t _ Ins�ide Lot Sewer IIevation Setback Sideyard w Foundation IIevation DESCRIPTION OF BUILDING To be Used as: REPAIItS & ALTERATIONS TO DWELLING � Front __�.$__ Depth � Height � 5q. FL �..,2�k8 C'�. Ft � Front Depth Height Sq. F't Cu, FL Type of Construc�tion - Frame Fst Cost _.. 18 700 To be Completed Ea c�onaideratton of the issuaacae to me of a permit to construct the bwilding described aimve I agiee to do th� proposed work 9n accardance with the d�acription above set forth and 3n c�mpliance wlth afl provlsfons of ordiaances of the dtq of FricIIey. � � / � In cwz�deratton oP the paqmeat oP a Pee of � 13 .0� � permit is hereby granted to GERALA �ST�� to construct the buflding or addition as described above. Thfs rmit is graatsd up� the eapress condittott that the�pereon to whom it is granted aad hfs agenta, employees an�worl�s►en, 9n all work done in, around and upon eaid building, or anypart thereoP, shall cunPorm in all respecta to the ordinaace� � FridleY� Minnesota re�aiadin_g locatioa�� conatructton, alteration, maintenance, repair and mavlag oP buildfuga within the dty ]imits aad thfa permit may be revoked at any time upon violation of aay of the Provieions of ea�d ordinancea WTT T•TAM T3. SANDIN ��8 � NOTiC� tlWs p�rmtr aoa eoe aowr f6. eauhoaHon, tmt,nnton �er �, plumblaa o.. h.�tieo, .� or wah.. s. wn to a. 16� BttiWieo I�eEor te� aparaN p�rmti� Por f6a� N�nu. � , e � APPLICATION FOR BUTLDiNG P$RMIT CITY OF FRYIiLEY, MINNESOTA OWNER�S NAME �� s / � / �� G �/`� f ; � ? .. . ADDRESS �� ia� i "� ��' n ?�Q ,� �l l�< IV• � � ADDRESS " - LOCA�.'ION.OF.BUILDING � . • : . ' � � / N0. �� 6�' `� , STREET �'"Fr �� , I .. 6RT OF LOT � . P � . ��c., , c LOT BLOCR AbDITION OR SITBDZVISIO .r �L�' .� � 7�"��.e.. �� . / � � . � �Z- � � • �„� i ' ' CORN�R LOT INSIDE LQ'f SETSACR SID ARD '�� °� ��-s' SEWER ELEVA�.`ION � �'QUNDATION �%EVATIOIQ °� ""'t� �� t�-� � ApplicanC attach to this form Two Certificates of Suz`vey of Lot an rp�apoaed ''Z building locati.on drawa on these Certificates. DESCRIPTIOIQ OF BUYLDING To be used` as ; , � l�dl� ' ' '. . • � _ �. , FronC ��Depth ��0'.3�� Height 0 , Sq. Ft. /�v�-�� Cu. Ft. ��' �� •Froat Depth Height Sq. Ft. ' Cu. �'t. � Tqpe of Construction �rc� ra?c�" Eetimated Coat w� ,� .; � � ��`� :�� To be completed_ � � The undersigned hereby makes application for a permit for the work herein specified, agreeing to do al�, work in strict accordance with the City of Fridley Ordinances and�rulings of the Department of Buildings, and heieby declares that a11 the�facts and repr�esentationa stated in this application are true aad correct, DATE �'� �"" � � SIGN�TURE � . ��.� �-esa��-�.� (Schedule of Fee Costs can be found on the Reverse Sidej. �� , � -- - 0 � � � U / +' . U i � . .iit'. . . ' ' �"i� ..... BIIII�DING PERMIT FEE SGgIEDUL$ SECTION 2. The Inapector a£ Build3tig�s shall, before issuing anq permit for �he erection of any building.or st�ucture, or for any addition to anp euisting � building or �tructure, or for any a,�'�terations or repaira to any existing building or structure, upon applicgt��a therefore, require the.•paymeat by the applicant for such permit of fees�-�o-the amount herein below set forth and in the manner herein provided to-wit; 2„r.l, For anq such permit for the erection of any fire-proo.f building, other th�n a garage, warehouee, factory or grain elevator,. or for the erection of any fire-proof additioa, for similar occupancy, to any existing building, shall be at the rate of $1.40 for each one thousand cubic feet, or fraction thereof, in such cubical contents. 2.2 Fos any such permit for the erection of any fire-proof �arage, warehouse, factorp or grain elevator, or for the erection of any fire�proof addition, for similar occupancy, to any esistin� building ahall be at the rate of $1.25 for each one thousand cubic feet, classified as "fireproof" by Section 5.02 of the Minneapolie Buildiag Code. flOIISES 2.3. For any such perm3t for the erection of any non-fireproof building, other than a garage, warehouse, factory or �rain elevator, or any non-Eireproof addition, for:similar occupancy, to.any existing building - permit $1.00 for each one thousaad cubic feet. GARAGES 2�4. For�any such permit far the�erec�tion of any non•fireproof gara$e, warehouae, factory or graia elevator, or for�the erectior► of any non-fire-proof addition, for simiiar'occupancy, to any extstYng building or for each such building or addition - ninety cents ($0.90) for each�one thousand cubic feet or fracCioa thereof, in the cuiiical conCenta thereof with the minimum o£ $4.00. For�the purpose of computing fees for building perm3ts, the cubical contents of any buildia� or addition to a uniform hei,gHt throughout by multipl,ying the ground area co�ered`fram a point �ix (6) inchea below the floor line of the basement or cellar to the average h2�tght of the upper auicface or to the average height of the roof surface of the main gable of a pitched roaf. � 2.5. Eor repairs or alterations to an existing structure, the fee sha11 be at the rate of $3.00 per each Five Hundred Dollare ($500.00) or frac�3an thereof in the cost of all proposed work. 2.6. In no case shall the fee charged for any permit as sat forth in Section 2 be lesa than $4.00. STORM REPAIR DAMAGE FEES: Residential: Estimated Cost of work up to S��Oo�� -�5.�a Estimated Cost of woY:t c-�rr �:g �..�� - Y:;,��0 Co�►ercial• Estimated �t of �W�n�. `� ; `�°^ ''(� � ^, ^,°� � �S. tU. f+" L J �.� J c. e V�'J �.. C.' .� " - � � Estimated �_ et of b�ork o'v�� $��i.:�.:.Ji1 - ��.L_ '`_'e' • . _ �f/cr� , ��"`. ,r•,r' /. ..:� ��'�A�Qvi,v',•A�t�/�',� ��°`il..a,�', � .�.r '��7� �. L'�. PAc�06�➢O�DGF9 CO. ( �� ' 1953 UNIVERSITY AVENUE, ST. PAUL 55104 TELEPHONES ( 646-6858 SCALE: 1 INCH FEET 742 BUILDERS EXCHANGE BLDG.. MINNEAPOLIS 55402 �333_8476 ��+ �� f� �� `� '� '` .' o� P�o�c�-rv or-- �a�n/��7" °, ��`��6�� C��r�`.�°��i�%��.�''r ��r-/,�.,� �/ � DESCRIBED AS FOLLOWS��' �� v�i�%r' '`�r�� 1��.«'e��..�. =!I !J�"� a'f C�/ ^'I��i'" lGI�O�"1'��"�°� i � /' 1 � � 1,6,/ �+/' � � , d � ! � �� f d� � /�iG�11'�: �, /S' !rC s� � � .� °='� .f e�'!/BSIt�i7 D /�Ul7�i.9�ii�'..,� �vl -�/Y/J/e�/`1 /�Q'. �% S`�j' CG �! D /1. `f.C�� /� ��(� L bs" . . 6 ` i � 6 . , � � � � •I �� I �' _ .�.. �� .,..e _ ��}� V �! `i, �( �� ' h ' \\( P� \ �I � � 1 �� { I � t �F i t � CEftTIFI�ATE OF' LOCATION OF BUILDING CER.TIFICATE OF SURVEI' Y hereby certiiy that on `�� C—�' 19 �'-'�� I hereby certify that on —__i�J-- I made a survey of the location of the building(s) on the T surveyed the property described above and that the above above described property and that the location of said building(s) is eorrectiy sho�vn_.on tt},e.,above plat. �, P1at is a correct representation of said survey. �.% �co-.i'9� /.adj> � /''1 �%' 1 f',r-"�,' �,.�" ""r%'°,�`sr �- c Y" " E. B. NfCDONOUGH, �REGISTERED SURVEYOR. No. 1990 PAULJ.CRANE. " " No.4449 JOHN J. RYAN. " " No. 4489 Form No. 133 2M McClain Hedman Schuldt Co. . _ . _ " %�� _ /� __ > S c. '>` -. r a r - --- - � M V � �! � w � o � p � • M : x : � . m ; M . 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FLOOR DRAINS UTCFi BASINS � nuro w�n GA$ MPL G1S RANGE �u OPENINGS � a • z s � � D m A m n p a � o � � �'� � � � Q' � � $ �a� '7�' w � � o K � �' t3 f°w 8 a ° Gi � �R'`° � � � �� vi R' °�1 � O c�o �� °�y i� �, � g � y��. �, o � � �° � � �i �- ° � � v � � I � � � ��`� � �� > � � �, bd w � b ��'� �. � � =.m � � � py' �m i� � � � o � ��.�p a �, \j.. �+ t�pi .0.�! y �q� � O' f�j � L-h � � � ��. o��r� � � (`TD 'O'J er � � A � A7 �� ► Oo � � Dy�' r+ �D �. I �� ' 3 `� r• �� C.' � �� H a M A � � � p � M � �, �i � ,�a " -� _. �i .'� � � -• � � � � Q �—'rd �+ � � � b � � o ,� � a �� `=- � • l�v � b �p ;_�°�, ; �, m A � � . � � � � �m.. � � �_ ; � `d ��-� � � � a � N � � :°. O � x � r t� � � y x x � ��C� x x x � m � 4� O FP � � Z �� 7 $ � o � �E m � �.� �. s i� \'\ \ �� . � � r , 0 4 � , � �� ►_ � m M �1 �'¢�y z '�1 �"' �a ,n g '� d ks � M►�i C � � � M��q'� O � � NCD O ��N 'g� o� � � : �� m y : : � 5 . . ►y . : : : y : . ' . p' ' : . �• : I I I m � � � � x . �,��o : O Oai O � O �� c� 0 � r � o t� ~ 0 I � � � � � Z w � � � � N � � o � � 0 � � � � m z 0 � �D ', � O r � � �i C � � I w � � w � �� '3• y O .� y O V� y m m . A �. � : � E: �o � �� ,r�¢'. a o °o � � �� x� eO+ A � � � ; r� �� C! ~ �° x �o m `� � R° � �� O 0 � ',� �' � � � � r r O O O O O �n tn tie tis tn � � � z G� M � � � 0 � � � � O � � � °x M � � O tL � � � � m � 0 � � ,� � � � �� Fi° Fi° �D A1 � � � � � o � � � m R, 0 0 � � � �� Q & � � � � �y a. � ' ° �„ � : G .. o . � �i o : : ° 0 a : : : � � � w � � w o °o �' o � o <n v► en vn �s O � y O N � � � a a. � o � � i1' `� � � ro � y a�-� � � � �� + w �g � m � z O \! Iv � � � i� � b � � � S ��"�� y � � � � � � � � � � o ~ � �« ^�y= ro � Re y ^ � M 00 � � I � � c � � ° a � � � a �' . _ w . . e�i� Q : : 0 0 . . o . . � : : : . . .� �° W Ci O� O y 0 o g g L'1 �» sw e�► O t" � �� a,a� � y �� O � ��'� � y � V w w"'�`D � O f�D CJ � d dua °� � �, �� o ��o � � p�� ¢ �oo�¢7� � ��yi�i d �� •� n �" �'�V' a =' " s m �a'ots '"r �, O fD ►t � �� ro � a � �, � �� f�Dy �� -�"'- Q O �, ro �, x Id � Q�•� � �' P m � � � �� A � D r � � m H _ m C m d � � � `� x � m 73 w � � �. � � � O � �� 0 � � � � d �_ � � H y � � � � 3 0 � 0.� °� <� �� 0 D � :�. � �• � 7 � • t' �i sus�ecr PE O. City of Fridley 1710 2 , ` AT THE TOP OF THE TWINS g U I L D I N G P E R M I T RE r � • COMMUNITY DEVELOPMENT DIV. � ' j � �-��-, �� / r � � PROTECTIVE INSPECTION SEC. 1 � � � /��'1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY �""-"� � ,�� 612-571-3450 910-F15 5/2/83 � � JOB ADDRESS 6684 Central Avenue N.E. t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 4S 2nd Aud. S13I�. #2�. SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE John Perry 6684 Central Avenue N.E. 571-7918 3 CONTHACTOR MAIL ADDRESS 21P PHONE LICENSE NO. 5ame 4 ARCHITECTORDESIGNER MAILADORESS ZIP PHONE LICENSENO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING RE S � C�P17.'f1 �1.�. 7 CLASS OF WORK O NEW 0 ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK 9 CHANGE QF USE FROM TO STIPULATIONS ° Roof can be 2nd layer but not 3rd. Install ridged galvanized valleys. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. ASPhd�-t 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 TPUE AND CORRECT. ALL PROVISIONS OF �AWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $6OO .,5. 'rJO 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 CONSTRUCTION. S�-S.00 PLAN CHECKFEE TOTALFEE $15. 50 IGNA F ONiRaC70 O t HOC� �' WHEN PROPER VALIDAT D THIS IS YOUR PERMIT 2 � � SfGNATURE OF OWNEF iIF OWNER BUILOERt 1 ATEt BLDG INSP � TE CITY OF fRIDLtY Effective Auq. 1, 19B1 APPLIC11Tla� FOfi RESIDCNTI/l� BU]LD1ffG PiRi�IIJTS �N�, A1 terations. Addi Lions. or Rcp� i rs ) ONNER: �(� r�l 1 e�Z-� ADDP.ESS: �n Cq �� C-�.�.`�'��( �-vQ /V � TEL M0: _ � 7� 7�% ll1 BUI IDiR : _ ��r,. �,. ADDRLSS: TEL N0: . . Construction Location • STRIST NO s CJ 6 TI2E�'T: ��`°l � 1 f l�C� .'V � �rOT: _ �`!� HLODCt `_.__ �IDAITIOI�Is - �N'�J � �..� o� / Corner Lot: Insiile L�t: `_ 6etbacY.: ____`__ Sideyards: Jlp�licant attach to tl�is fo� b+o Certificates of Svrvey cf lot ar�d pzoposed building locatian drawn on certificates to scale. DESCRIPTIOit OF C01•JSTP.UCTI01� �______ Front: � Depth: Heiqht: ��(� �� Square FaeL: C�bic Feet: , Fzont: Depth: Height: Square Fe�t: A�bic Peet: Zype ei Oerstzuction: Estimated Cost: S 1� d� 9b 8e Cbr.�plcted: /?/� � j� � � � '� . - ._-....�.� 7►lt. A 7►lt. B proposed Drivc�+�ay iiidth Ii Ne�r Opening Is Desired: �' g ._---_-___ �_ _ . . 6E� RiVER,E SIDE OF SHEET si�e undessi ned here ma);c� a lict�tion for a • s b'Y " PP � permit icz the ��erk hereir► specffied, egzeeirx� to do ,all werk ir, strict accordsnce With the City of Fridle�� OzBi»ances tnd sulinqs of the Del�.�ztmc�t of Duildings, and heseby declazes thr►t all t]�e fact� ond represr�tatieas stated fn t?�is application are true and ect. 1��7'Es � �- SIGNATUJ�: Stipulstio�ss � � � � `� `� � S • S'� HUILDING pERMIT FEE SCHEDULE ?he tnspectos ot buildinqs shall, befoze issuinq pezmits ioz the �r�cti.oa of any building os •tsuctuze, oz ioz any additior, to any �:isting buildinq or strueture, or ioz any alteration or sepaizs to any •sistinq Duildinq oz structuze, npon applicaticn lhezefose, requize thc paysent by the applieant f os such permit ot te�s to the asount btzeia belov •et iozth and in the sannez hezeia provided to-wita '1'0�171I. V�1ITION :i.00 m sSOO.Oo tsoi �o s2,00c� 52,001 t�c �25,000 i25,001 to 550.000 �so,00i to Sloo,000 Ti�S i20.00 !linim� Fee 515.00 plus surchazge =10.00 for the iirst 5500 plus 51.50 ioz each additional 5100 oz fraction thereof, to and inclndirg 52,000 i32.S0 foz the first 52,000 plus Sb.00 for each additional 51.000 oz fraction th�seof, to and including 525,000 5170.50 for the fizst S25,OOG plus 54.50 foz each additional 51,000 oz fraction thes eof, to ana incivaia9 Sso,000 t?�3.0o ior the fizst SSO, o0o pius S3, oo for each additional 51,000 oz izacticn thezeof, to and including 5100.000 s100, 001 and up 5443.00 foz the fizst 5100, 000 plus S2. SO foz each additional S1,000 or fzaction thezeof PLaW (�iEOCa 25 pezce�t of building permit iee DRIVii�tAY DEFRESSION ES(�tOW: Concrtte Q�zb 5treets �ly Alteznate 'A": Rerflov�al and zeplaceJO�t of cuzb and qutter only , Driveway vidth plus 6 feet z s13. SO 111terr�ate •8": Refloval and replacw��t of cvzb ar,a qutter ana install a 3 foot vide sppzosch vith 6 inch depth Dzivevay width plus 6 ieet x 515.75 VERIFICATION OF FOUNDATION Permits foz constzuctior► vill be issued a minim�n of 24 hours fzan tr,e time of application to allow for proper zevie�+ of the proposed structure and of the constrv ction site. 11 Certificate of �rvey of the lot, sha.+ing the location of the four�ciation once it has been vonstructed vill be tequired before proceeaing vith the frainit�g. -��--.� � SueJECi PEFi'AiPtTN�. City of Fridley � � �, � � 4 ' AT THE TOP OF THE TWINS g U I L D I N G P E R M I� �� ---__ ' ; � RECEIPT NO. � • COMMUNITY DEVELOPMENT DW � ��: '--��-� r � � PROTECTIVE INSPECTION SEC � 7� � � � � /'�'1 � CITY HALL FRIDLE� 55432 NUMBER pEV DATE PAGE OF APPROVED BY �---'� � �'� 612-571-3450 910-F15 6J19/96 / / JOB ADDRESS 6684 Central Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHEO DESCR. L}S Revised Auditor�s Sub. ��21 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE John Perry 6684 Central Avenue NE 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO R P Vogel Co Inc 2426 E 26 St, M ls., MN 55406 729-6653 2485 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILAODRESS Z�P PHONE LICENSENO 8., USE OF BUILDING Residential 7 CLASS OF WORK O NEW ❑ AODITION ❑ ALTERATION ❑ REPAIR O MOVE ❑ REMOVE X 8 DESCFIBE WORK Tear-off, replace plywood, and reroof sereen porch with do�able covering roofing 9 CHANGE OF USE FROM TO STIPULATIONS TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED 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 ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED NO. OWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOYERNING THIS TYPE OF WOFK WI�L BE COMPLIED WITH WHETHEii SPECIFIED HEREIN OR NOT. TNE GRANTING OF A PERMIT �isZOO �.GO DOES NOT PRESUME TO GIVE AUTHORITV TO VIOLATE OR CANCEL THE pEfiMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- TRUCTION OR THE PERFORMANCE OF CONSTRUCTION. ��FO. ZS Fire SC � I. LO PLAN CHECK FEE TOTAL FEE � �� / �' �6 License SC $5.00 $47.05 NATUAEOFCON'RACTOAORAUTHOAIZEDAGENT ionrEi WHEN PFiOP Y VALIDATED THIS IS Y UR PERMIT ��s °�� , . SiGNATURE OF OWNER �iF OWNER BUILOERI IDATEI " pG �NSP q4TE NEW ADDN ALTER I] [l [� CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application ConstructionAddress: � C' �' �( �� ?'� r� ( Legal Description: Effective 3/1/96 Owner Name & Address: J)�/� �c. J� �v� Tel. # Contractor: � �� ` °� ��i-� MN LICENSE # _ _�2-L/ � Address: �-- y o� � �• �"' '� � S'� �� ls' S��-%Q� Tel. # � ,�- � - ��S 3 Attach to this applicaxion, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVING AREA: GARAGE AREA: DECB AREA: OTHER: Length Length DESCRII'TION OF IMPROVEMENT Corner Lot [] Inside Lot [] Ft. Yd Setback Type of Constntcrion: _ Approx. Completion Date: Width Width Width Height Height Hgt/Ground Side Yard Setbacks Sq. Ft. Sq. Ft. Sq. Ft. �, Fstimated Cost: $ � 2G'o `� (Cost on Back) �tI UO � - � �� Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$ DATE: � / � � APPLICANT: �.z;.' �r�r s �c Tel. # 7 � `' - ��53 Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL $ d.�� $ /, o2C� $ .�� $ $ �;i C�� $ $ $ $ $ �� C�S-.�- CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/lOth%) $.50/$1,000 Valuation $900 per SAC Unit $5.00 (State Licensed Residential• Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] STIPULATIONS: � BUII,DING PERMIT FEE SCHEDULE The Chief Building O�cial shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: TOTAL VALUE $1 to $500 $501 to $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 $1�,001 to $500,000 $500,001 to $1,000,000 $1,000,001 and up FEFS $21 (Minimum Fee is $21 plus surcharge) $21 for first $SUO plus $2.75 for each additional $100 or fraction thereof, to and including $2,�0 . $62.25 for first $2,000 plus $12.50 for each additional $1,000 or fracrion thereof, to and including $25,000 $349.75 for first $25,000 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,000 $574.75 for first $50,000 plus $6.25 for each additional $1,000 or fraction thereof, to and including $1(�,000 $837.25 for first $100,� plus $5.� for each additional $1,000 or fraction tt�ereof, to and including $5(�,000 $2887.25 for the first $500,000 plus $4.25 for each additional $1,Ot� or fra.ction thereof, to and including $1,000,000 $5012.25 for the first $1,�0,000 plus $2.75 for each additional $1,Oilfl or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50. Alternate "B" : Removal and replacement of curb and gutter and install a 3 foot wide � approach with 6 inch depth - Driveway width plus 6 feet times $15.75. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the conshuction site. A Certificaxe of Survey of the lot, showing the location of the foundaxion once it has it has be�n constructed will be required before proceeding with the fra.ming. .� - -�. ! ny�� N S.:n� � � Y W.il<< K ('` Q C� F',�eM:. O 3 Su •eis UV M.��. � � lJ --� � � 'y:� G MEMU DUM TO: John G. Flora, Pub�c Works Director � FROM: Jon H. Haukaas, Assistant Public Works Director DATE: April 9, 1997 SUBJECT: Resident contact for the Central Avenue Bike Path �,�� ✓�J PW97-101 On Thursday Apri13'�, I met with Mr. John Perry at 6684 Central Avenue to discuss the concerns raised by his wife and son at our neighborhood meeting. Mr. and N.Irs. Perry are not opposed to the cancept of the bike path, but merely worried about its impact on their properiy. Their primary question was as to how they could access the boulevazd for mowing if there was retaining walls across the entire front yard. The house has a"tuck-under" garage and a fenced in back yard. Access to the drive�ra.y from either the front entrance or the back of the house is via steps and so there is no way to get a lawn mower down. I explained where the path and walls were to be located and how the lawn could be graded to leave a section open with no retaining walls. I will be creating a grading plan for the areas with re�taining walls and agrced to share it with them. Once everything was shown to them so they couId envision it in front o� their house they were satisfied and had no further reservations about the project. �!`� SuB�ECT c�ty of Fridle� AT THE TOP OF TME TWWS g u I L D I N� P E R M I T r � � � COMMUMITY DEVELOPM�NT OIY. i Ly ��.��, . . r � � PROTECTIVE INSPECTtON SEC. � _ � � �'�'1 � CITY MALL FRIOLE� SSIa2 NUMBER REV �.---�: �.' 612-571-34bp s�aF�S JOB ADDRESS 6684 Central Avenue NE t LEGA� LOT NO. 9LOCK TRACT OR ADOITION T8 � PAGE Oi 6/3/02 � � 3265� RECEIPT NO. `L.� �� APPROVED BY SEE ATTACNED oescA. 4S Revised Auditor's Subdivision ��21 SHEET 2 PiiOPERTY OWNER MAIL AOpRES$ John Perry 6684 Central Avenue NE 3 CONTRACTOR MAIL ADDRESS Advance ATumiaum Supply Inc 7701 Main. St NE, Fr 4 ARCHITECT OR DESIGNER MAIL ADDFiE35 5 ENGINEER 8 USE OF BUILDING Residentid? 7 CLASS OF WORK MAIL ADORE$S 21P PHONE 763-479-1715 IIP PHONE LICENSE NO , NIN 55432 763-571-3440 ZIP PHONE LICENSE NO. 7983 21P PHONE LICENSE NO O NEW O ADDITION D ALTERATIpN � REPAIR ❑ MOVE • O REMOVE 9 DESCRIBE WOFiK Reroof House (10 Sq) Tear-oif 9 CHANGE OF USE FROM STIPULATIONS Underlayment must comp�y with the State Building Code. Permit �nspe�t'on Cards Wiil �e Mailed To Horn�Q�n�r To Pos� SEPARATE PERMITS ARE REOUIREO fOR ELECTRICAL, PLUM8ING, HEATING, "rc vr �,�� VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WQRK OH CONSTRUCTION pONING AUTHORIZED IS NOT COMMENCED VyITHIN 80 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANqONEO FOR A PER100 OF 120 DAYS A7 i ANY TIME AFTER WORK IS COMMENCED ' NO. DWLG. 1 HEREBY CEHTIFV THAT I MAYE READ AND EXAMIN�D THIS APPLICA71pN �- AND KNOW TME SAME TO BE TF1UE ANO C04iRECT. ALL PROVISIQNS (�F LAW$ yALUATION AND ORDINANCES GOVERNING THIS TYPE OF WOAK WILL QE COMPUEO WITH WHETHER SPECIFIED MEREIN OFi NOT. THE GRANTING OF A PERMIT �1sO72 DOES NOT PRESUME TO GIVE AUTNORITY TO VIOLATE OW CAMCEL THE pEWMIT FEE PROVISIONS OF ANY OTMEFi STATE OR LOCAL LAW REGULATING CON- STqUCTION OR TME PERFORMANCE OF CONSTRUCT�ON ��FI.HO PLAN CNECM Licens S�GNATUAE OF CONraACTOp Oa nUTHOp12E0 AGENt IOAfE� N � _ � / UNITS STALLS C $S. P �OCCUPANCVLOAD CU fT. OffSTFEET PARKIN( IGAFAGES $.54 SAC CMARGE Fire C $1.07 TOTAL E � $`f8.41 IATED MIS IS YOUR PERL117 06/03/2002 07:48 7635712260 ADVANCE ALU�INUM SUP PAGE 01 �� , 5�J - >ag� .�. ADDN [ ] Effective 5/10/99 CITY� OF �ZtIDLEY ALTER [] SIl�TGLE FA1I�IILY AND DUPLEXES R-1 AND R-2 BUII,bIl�IG PERMTT AppLICATION Cons�uction Address: Legal Description: ° Owner Name & Address: V� � Tel. �` - - Conuactor: MN LICENSE # � � Address: � _/��, � �� j L�� Tel. � Attach to this applicatioa, a Certificate of Survey of the lot, with the proposed const�uction 8rawn on it to scale. LIVING AREA: GAR.AGE AREA: DECK ARF.A: OTHER: DESCRIPTION OF IlVII'�t0 1 � �' �� ---�-- I.�ngYh �� Width �,,,_ Height � Sq. Ft. Width Height Sq. Ft. � Width Hgt/Ground Sq. Pt. � � /__�� ° � �� , � . . � ': ' rr. .��i �►,." ;.r%.I� �%!%a . � , � � , . �� . , - �,�,�n:� � , ��,r�► .: �.,. D�iveway Cwrb C'�t'Width Needed: Ft. + 6 Ft = Ft x$ -$ . DATE: "� 'Q APPLICANT: .�,,�..� Tel. #. �%0��"��%C�O CITY U� 4N1LY Permic Fee Fire S�lrcharge State Surcha.rge SAC Charge License S�rchaxge Driveway Escrow Erosion Control Park Fee Sewer 1V,�aariin Charge TOTAL S'TIPULATIONS: �� GCu� � $ f�� 6 � � $ $ �� $ $ $ $ � '�o� �/ 1 Fee Schedule o� Reverse Side .001 af Per�o�it Valuation (1/lOth9�) $.50/$1,Q00 Valuation $1050 per SAC Uxiit $5.00 {State Licensed Resideatial Contractors) Alt. "A" or Alt. °'B" Above $450.00 Conservation Plan Review Fee Determaxa,ed by Engi.neering Agreement Necessary [ ] Not Necessary [ ] '71R3-5rI I - 3u�`Q 0 �- �:� ��e � � �� n � � C � Z D � D r r � m � O � m v -� m �3 C � C� � m � O Z - UI O � .�. D Z 0 D � r m � � .� O D r � m m n� m � c � � v cQ m � � � � D � � 0 � a � � 0 G � s � O � � � � v a m � � � m � � � � m 2 c� °,m� � � � � � Z c�D o, v � �Oo � � c 0 m m= o '� � -+ D v � v � �• D Z c�D � D � m � 0 Z � - W t,� t,� Z Z c c u ui - m`-' m` � � N y m m � � � � � � °" � v � S O � � .��-, -, � pOv � o � � 2 2 � � � W � in' � � ��:m n;. °;. v cfDi u ai. W�° �' � co N � * � � � = �• r � y. N � vfDi cu ;' ;' cc �• � � c�n Z rn co � N � � � � � � ., � � � � -L�. .� � � c _ � .. m n. ..� m � ,-. ( � I I� I I I � � � I I r= c � Z G� � � C � m � m � Z 0 � �� w w w � .� � � � � � u, o o cn cn cn Q o 0 0 0 o a_-�1 °o °o °o °o 0 0° °o °o o°o 0 o p m � � � C z � m � v Z � � n 0 � D Z .-< �, a V'1 . � � m r O � m 0 . 0 � r � m � � r�r � � O � � � � �� m �� z O � . � Pi � < a. a. N �' c � � o m m 2 � � Gi � N y � N C (D V.� N. m rt � � � o �; � �. m� � � W c° s � �� .� Q`� p. � � � � � � � � � � < o, � m m cc � �,°�� g � ��m� � .�. �• O (�p y -Zi`o a � v�, � �, coZ� � N a • m a° w r Z � �y N� �"D '� � S: �• nWi m � � � a:; C - � n � m � m � ._,, o � � � o � � �� m d �D �, -, � —�i (,�'� � v�i r; ^' a � 3 0 � o °». cn � — � su � m rt � � o � �� N y (D � ' o .. _. � � —i O D r c.. O � v � .'i7 rn � � � � � V' � � � � FILL 1N COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMCIN VENT. VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When realacinc� an existinp furnace, the undersigned hereby verifies that the ` venting has been examined and is free from rust, deterioration, obstructions, and is secure(y supported and firestopped where required. ' Yes (? No O The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, }ength, number of elbows and termination. Yes (,) No () The undersigned also verifies that the replacement unit is a lisied assembly and meets the cuITent codes and manufacturer's spec�cati�ns. This does include AGA-GAMA Category I Centra! Fumace Venting Tables for fan assisted and natt�ral draft appliances. The existina combustion air is sized and installed to meet the current codes and manufacturer's s�ecifications. When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. �� Yes ( ) No ( ) Yes ( } No ( ) Yes( ) No( ) ' When installing a new ventinca svstem, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Fumace Venting Tabies for fan assisted and natural draft appliances. Yes () Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. No ( ) Yes ( ) No ( ) Aaqliance Tvue and Size/Common Vent and Vent Connector Information Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat — Tot��►ppi'rar�ces — -- - —��a#-��a �nput � - -- - -- - -- Common Vent Type �lent Height Diameter ihches Appliance #1 Vent Connector Height ft Lengifi ft Diameter in Type Appiiance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) '` HEATING CO: Signed By: Date : From: City of Fridley To: 7637816681 Page: 2/4 Date: 5/27/2009 12�30•38 PM Building Inspections 763-572-3604 763-502-4977 FAX �,� rr. j �- j �-� S1T�. ADDR�SS � TH1S APPLICANT 1S: PROPERTY OVVNER/ TENANT CONTRACTOR SUBMIT A COPY OF YQURSTATE LICENSE `i'ITH .4PPLICATION PERMIT TYPE T�'PE OF WORK: DETAIL�i� I1�SC$,l NAM �: AUDR� PHON E: MECHANICAL � Pei-mit Ivo.: iZESIDEN�I'IAL APPLICATION ReCeived By:� CITY OF FRIDLEY D��'�� :Hr��cTiv� 2-� �-o� ❑ nWN�12 COMPANl' NAME:_ CnNTACT PERSON� STATE LlC'�N�S/��. i! AllU12tJ�S: 1N y. PHON� � (�"� - � � YOU12 E-MAIL ADDRESS NTRACTQR �WGLE FAMILI' ❑ TWO NAMILI' ❑ N�«' �2tPLAC:EMENT N Q#� W'O �,K e�C� C1TY '� 1 w �� '1- ' P llATt CITY ) NAXT �- %� ❑ TOb4'NHOUS}� ❑ ALTEKAi'IONiK�MODtI T�L_�.�li ATh;/�Ll�'.� FEES ARE BA5�,D OV SI(L00 1'ER F1X'I'UR� ''CN,'"f �VHN:R�, VU"CED. FIX7'UR�,S: (1VD1 E"C07'AL VU1IBN,R OF N.ACH B+ W �quiPmentlnstalled MHG: M011�L: �°a�d��-- Sl'L�'BTU–��I$�'� Mr•c: M011EI.: S 1'G�/BTU NIFG __ M011EL: SI"LEiBTU —�� =C.UU __FIREPLACE tCAS) $ IS.UO GAS RANGE/OVEN $10.0G _AIR TO AIR EXCHA.'�'GtER $ I i FIREPLACE (44'OOD) $3J.00 NtV.' GAS GI21LL $IO.Qb _BOILtR $35.00 �URNACE g35.GG GAS UNIT HTR $I0.00 _CHIMNtY LI�'tR$IU.00 GAS URYtK$10.00 1'OOLHrAT�K$35.00 _UUCT WnKK 51G.UG _GAS PIPING $10.00 _VENTILATOK $I5.00 ��11r��?c�f Q�'�Xt�1i� Cc� �+ 1 i� i�� :: ��(# t1� � h'�m�ii>r o�"F�t�res f�� I� 0€1 x:�� €�U $ Num�cr o�ftxt�ux,.� fir;:a�5 tIO: x>$2�. f3(3 �_. .:: i�r�rt�icr a€`�xtur�s fci:�3� (3€?: x`��S €l� � � �; Stais. Sure��r i $. .Jf3..... .. : . > � ----�,. ttY�l?til�iU��:FEE.��S >Q) T'c�ial.. . � ....... � ... . :: . ....... _. ... .... ... ...... _ .. _ THI$ IS APt APPLIC,4T10N h'OR,4 PEKMIT-NOT VALIL) UNT1L PknCESStD 1 hcrcby apply for a building permit and I acknowlcdgc that thc inf�nnation abovc is comE�lrtc and accuratc; that thc work will bc in conformancc with thc ordinanccs and codcs �f thc City �f Fridlcy and with thc Minncsota C'onstruction CodaS; that [ undcrstand this is not a permit but only an application for a per ' nd work is nut to start without a permit; lhat thc work will bc in accordancc with thc ' approvcd plan in thc c all �wh' � rcvic�v an� ��r al of� ans. � . � P. : � / �� IG1�.4TLUZE OF APPLIL, �T P121�+1i NA E , DATE /' /// � TT� E?��.,�fd'C� ��?A�'�� :�R.I�A.f'CS t1k�.� �.� llECt�i� �B� ��ti;l�.�i�i��, �[:��'Rl"C`..��..t1.k�C�,1�(��`k�.�l��..�C�� ...:, :: City of Fi-idley Builcling Inspections Department 6431 University Avenue NE, Fridley, iV1I�T 55432 763-572-3b04 FAX: 763-502-4977 0 �