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SUBJECT P
City of Fridley �, �� � �2 �
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T G
r
; � RECEIPT NO.
� • COMMUNITY DEVELOPMENT DIV. e
r � v � PROTECTIVE INSPECTION SEC. �/�,�
� ' 6
� � �
� � /"'1 � CITY HALL FRIDLE� SS432 NUMBER REV DATE PAGE OF APPROVED BY
�""'�' �'' 612-571-3450 910-F15 12/27/94 / /
JOB ADDRESS 7639 Central Avenue NE
t LEGAL ��T NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCF;. 2% 2 Meadowmoor Terrace SHEET
2 PROPERTY OWNER MAIL ADORESS ZIP PHONE
BMS Inc 11499 Ma.rtin St N6J, Coon Ra ids MN 55433 757-4240 8194
3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADORESS ZIP PHONE UCENSE NO
6 USE OF BUILDING
Residential
7 CLASS OF WORK
O NEW ❑ ADDITION C] ALTERATION ❑ REPAIR ❑ MOVE � REMOVE
R
8 DESCRIBE WORK
Construct a 24' x 37'4" Dwellin a 24'8" x 22'4" Gara e
9 CHANGE OF USE FROM TO
STIPULATIONS
See notations on plan. Provide a verifying survey before capping. Provide�
sod in the front and side yards.. Provide a hard surface driveway. See Engineering
Department .for sewer and water locations. y.
'SEPARATE PERMITS REQUlR�EQ FOR �
WIRING, HEATING, PLUMBING AND SIGNS°'�.
V�ARHII�
Before digging call for THE CITY 0� FR![���Y C�E�E;'� PJ�T G°�A!�ANTEE T
all utility locafions ACCURACY OF Ul'�LI i Y LC:Ci,�; ,nN:; qNp �- �'
_LCVqTtONS.
�4-(�02 THIS DATA IS FOR INFCFli�; n7IGiU PURPp$.E$ OkjLY,
REQUIRED �Y L.A1N 1�ND PER50NS USING THlS INFORMq'170N SHOUtp
YERIFY IT ON THE �ITE.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD
SEPARATE PERMITS ARE REQUIREO FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTHUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 OAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED Ofi 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 1 STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF IAWS VALUATION SURTAX Fire SC
AND ORDINANCES GOVERNING THIS TYPE OF WORK WIIL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $78 309 39. LS 75.31
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- @
STRUCTION OR THE PEFifORMANCE OF CONSTRUCTION. �S�FS.00 �pSOO.00
PLAN CHECK FEE TOTAL FEE
L c
SIGNATU�7EOFCON�RAGTORORAUTHORIZEDAGENT iDATEi HEN PROPERLY VA ATED THIS IS VOUR PERMIT
�
� � � ��s���
SiGNATUFlE OF OWNEFl iiF OWNEA BUILDERi IDATEI BLDG � P �1tiTE
NEW
ADDN
ALTER
�
[l
[l
CITY OF FRIDLEY �
SINGLE PAMILY AND DUPLEXES R-I AND R-2
Building Permit Applicatio�
ConstructionAddress: ���� 9 %�1��1, �z�
Legal Description:
Owner Name & Address:
Contractor:
Addre,cs: I l
�
Effective 1/1/94
Te1. � � 5 7 �-� � �
MN LICENSE # D� � l � �
v ss4-�
Attach to this application, a Certificate of Sulvey of ti►e
iot, with the proposed construction drawn on it to scale.
DESCRIPTiON OF III�PROVEMENT
Tel. #
� � y!/ xeight �/`�� l� sq. Ft, �9'�% C�
LIVING AREA: Length � Width � r
G A R A G E A R E A• L e n g th � y! g e� W i d t h ZT H e i g h t 8 �� g�� S q. F� 5�'�, g
DECB AREA: Length Width HgtlGtound Sq. Ft.
OTHER: e.2�+wL. sP,rc�e ��cv �J/ � `7 � �
S 7- � i� � � Z�- g ir
i !
Corn�r Lot [] rnside Lot � FL Yd S�tback �/ � 3 S Side Yazd Setbacks %/ d- Is,O�
Type of Construction: ` - — Estimaxed C�t: $ -- -
Approx. Completion Date: �o�.e.Q - U45i4�' ������
_ (Cost on �ackj
Driveway Curb t Width Needed: ��' Ft + 6 Ft = Ft x$ =�
DATE:1 APPLICANT: � AA � Tel. #
Permit Fe�
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway F,s�'ow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
� . �3, �'
$ %� ��
$ , 3`�. �
� �r�i:►, �
$ C: C� C�
$
!�M. `!_ � !._
Fe� Schedule on Reverse Side
..001 of Petmit Valuation (1/lOth°lo)
$.50/$1;�0 Valuation
$80Q �r SAC Unit
b�S�'IT,L �l,�s,f.k 1H �11= 7 ��S3rS�
�(�t '= y&'�f ��r /l, �l = k, / �l, v g
�Sfi��- qlrf°�' �G.3"� = g3',�,3�
���'i�9. �
$5.� {State Licensed R�idential Contractors)
Alt. "Ap or Alt. "S" Above
$ $450.00 Conservation Plan Review
$ F� Determined by Engineering ���
$ Agceemem N�ry [ ] Not Necsssary [ � �
$� p , ��
... '/+�
,.-
�
`!':1�����7T.:� 5i�i� �:l�3C't r:�DE rALC:a:.A�:�:l�
- 3a5cD U?� r,ci�l?T=q 7�JP 1'i��
"a -.. .t�3�'! �:�70E - lyn �7LTZOt�
�iupciun ct:fcti��r. �, l/b4
UwNER ��� ' _ —.— - -
SITL' aDllK
y_. Phane �5 `� ��
CONT�C:OR
;•hane
,duilding Classification: iype �1 (Single ra:�i7y .� 7��ai�x; 11 �� TJpe :�(ResidenciaiZ
. (3 stories �r
GcP1Er��L i NFt�r�MAT :ON
(Other,'• (Qver 3 st�r; es )
i. du�ld:ng ?�rimeter �'7O Tt.
Z. '�Jail 'neight �ground to eave) '� r;..
�
. �
3. 1.� x Z. (above) gross nal i��-n3 :",�3;_ f; .
. ,
.:, _
�, B:�ilding dimensians (l; � :c ;'d) = ,� ; �_ _ ft. rocr 1 *lcur �r
i. �quare *c�c are3 of rim •jaist - Floor joi=t si=e (Z x ?/v ).
• ? x Perimeter = Rim joist area =
. � �2 . � ..
6.
7.
8.
/ U Z � ` Z ` ••.
��ti .��.�.
,� • .
^ours - area �� sc t-r - � �onZ • .' . . . .. . ..._ i_._ .... . . . - .- . .
. ihickness � i a/y ' � in_. U�ctor ���',07 �.�. .:' .::.�.
Type af �Canstruction - c-rLe,� -r�,��r� - Perimeter � f�r��-.:.: �'.:....
_ . �
. t�tanufacturer _ ���s�� �-r►zLC.,oa�r . . . . ' • � _ ,=��; -
iotal docr's perimet�r ' ��, ft " � � � . � �.
t�indows: Manufact�rer c�r�+,�,z�lrcr� �2 :�. 2Z � S:atz aporove�� �'�� ���.�:�=
U. `ac*_ar y2 ` . `:'"•
�;::.:.. �- � � �� .�� � ; :
:��'EQE S.:ZE � �►'"'� (F=-`) �lUl4E�� 0= +
�.�., TOTAL �=-T„
�.: ;���� _ . _ ' . . �, . . UNITS • ,i.�(�/� ��'�-t�
� � prsi?.''L� ��t�iF
: ',� .:• . • . . . t' , �I � '�R�
L:• .
r.�rr�ErL � �;-� 2y � �- Z i z l� 7�
;.��• ��,- �.ti� =� ' • �. 20 3� - 3 /S / /f �
,;,,���;; .•.,..�- .. . Z�/ 3 G - I �_ _ .2 f�
-, ,
. �;
::���, � y, � ,yr,_ �, 2d c�- I _ R 2 !L �
,..:.._
•;- =r.. • - , 2!! �/..- 2 /� � f � '
.. .
Zo y� -' 2 G ._ 1 Zb
. � .. . -. . . . .
�� � � Tatai ' ft.2 Gi ass / ' � ' �
y. . 9 • y� . .
�10. Fir�piace area: Width x heiaht = x = - Ft
.. . . �
��� 1 j. Expased founda tian : He i ght Y��rime [er (� x i 7 �� _ .� S
�: ' .
��JMPLETiON OF THIS FORM IS R�QLI �EJ' F�R �lL P�E.s C�:�Si�UCTI�:i, ��J�R R"c:a00�E.i;IG ��:0 3UILDI.
'� M:Y�D �1NERE E�ERGY, QTNER TH�` THE t�tltliNA� CC'JE ►+ILQNA'10E, tS t1SED. �
'� • . . .• . , . ;..
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. , . / .
i,:� � _ . , • ,
�•�rraming area: IOh of grass fall-=area.
Grass weli area ? =!r' ft.Z
_ Z
y •
�
r 1 ndC'� 3 re3 � ��� � - - `t . U �' ^.�.OrrS = �! ? �� � ,; = � �-1
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Rim jv's � are� � /�-'',� f:,Z
.
Z
�oor are3 a °�'�
� t.
Fir��iaca are3 � �J'- f"Z
Exaos�c foundatian A �� f*..�
�
Frami�g arza � � �1 � ft. .
U r:,» joist = , �� v. �J x�= �
- -�.-
'.! �OOr d��3 = .�� U x.� _ �� �
;; rire�lace = —� U x � _ '-
iJ `oundation = , I � U :< ,� =� �
�
U`ra�ing arEa = �� U x A= �
Z�-'�
net ��a71 are3 � /���f ft. U wa11 = c� U x�= 4.4, v
( i � � ; i:. in�. . . . . . . . . . . U X .� = rj � ?
i
Gross wa11 are3 x Q.i1 (rl-1 single `amily S d:..:l�x = aiiawable � x:+/Code
(13. aCove)
x �.�3 ;�-2 o�her resi�ent'.a'.; �
x .23 f,v:her b�iiding�; �
x.2� rGve�• 3 s tci•i �� j
STUH �'M:is t be 1 argz�-•
a� - �21 O x l: _ade I� _ = 2U3, / "F. 138 ahc�e ._ ��
, c.� r3i1 ir.g fra�ing d:'_°3 ���`• =1�3i5 j0`. Of C�' �:�r.► cr23. ��� Or� Lt18 Sdm2 8S�
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.=r:_ .Gress cail in� �rea = r�� ' . . ..... . : . .. . ._ � x ���j-^�_::"' - - '._ -.:.-�!1 .._.ft.2.-:
. - _..
�::3 Joisz ar� (Af� = la�_ cailinc area. _- ..1=�7,.cl. ___ -.__ .. .:..... �t_Z . .
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Tc� "i't�� C'.i.iy c�f �'zir�ir:y- Bld�; �'�rmit D�pt.
R��ard�n�: 7� UId C�ntr�l AVe, �`ridley
7L��
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I�� ��f���ncr� tv the sodding ���th4 yard a.t t�� abt�ve addr�.�s.
LVe w��'� uta�.w�'� th�t this ne�ded sc��ding. Even thou tk�e ins�et•tor tt�1d us tc�d�y.
��e sc�l�i t��is hc�inc va�thout ��icing �t�le s�c� xntv �.ttd I h�ve discussed this with t%z .��v
hc�rxl� �wr��r. At �s pa�nt in #ime tli�y as� not �a-n�ial �b�e tt► st�d. I�ic�wever, w� ta�ked
to th� id�s��c:t�r azz��. to give �u.r. �e�u buyers a t•k�ance tc� do thz�. He ���e�t1 that we �uld
nt,�r �� yo4� in variti� that th� sad wi11 he cuEn.plet�d by AUCT. 31. Thi3 will giv� lhem
titn� ��'� ��i�c�rd t� dt� tttis.
�'�' �31��. ' . m�s, � : 3
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f ���. ��r,� �on5tr rnd.
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C�TY OF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(612) 571-3450 • FAX (612) 571-1287
June 27, 1995
BMS Inc.
11499 Martin St NW
Coon Rapids, MN 55433
Re: Final Inspection at 7639 Central Avenue NE, Fridley
Dear Sirs:
A final inspection was conducted on June 12, 1995 of the above address and the following item
was noted which must be completed before the structure can be finaled:
Provide sod in the front and side yards by September 1, 1995.
We will expect this item to be completed by the scheduled date and a reinspection called for.
If you have any quesdons on this matter, please feel free to contact me at 571-3450.
Sincerely,
ARR RIESCH
Building Inspector
BR/mh
sue�etr p i^
City of Fridley 33969 '
AT THE TOP OF TME TWINS g U I L D I N G P E R M I T
�
; � RE IPT NO.
� • COMMUNITY DEVELOOMENT OIV.
i j V ��'�� ,
r � � PpOTECTIVE INSPECTION SEC.
� � �'�'1 � CITY HALL FRIOLE� SS�32 NUMBEF REV DATE OAGE O� APGROVEO B•
�"""� � ��� 763-571-3450 9t0-Ft5 10/14/03 � /
JOB ADDRESS �639 CENTRAL AVENUE NE
1 IEGAL LOT NO. BLOCK TRACT OR ADD�TION SEE ATTACMED
DESCR. 2] 2 Meadowmoor Terrace SFIEET
2 PROPERTY OWNER MAIL ADORESS ZIP PMONE
Suburban Properties
3 CONTRACTOH MAIL ADDRESS Z�P PMONE LICENSE NO
M& R Home Services Ync 3336 S Coon Creek Dr, Andover, MN 55304 763-427-4036
1 ARCHITECT OR DESIGNER MAIL AODFiESS 21P PFIONE LICENSE NO
20225403
5 ENGINEER MAIL ADDRESS ZIP PMONE LICENSE NO
B USE OF BUILDING
Residential
7 CIASS OF WORK
O NEW � ADDITION ❑ ALTERATION 0 REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WOfiK
Construct an 8' x 14' Deck
9 CHANGE OF USE FROM TO
STIPULATIONS
See notations on plan.
_ � �
�efore digging call for
all utility location�
4540002
REQI�IRE� �� ��l�
SEPARATE PERMITS ARE REOUIRED FOF ELECTFICAL, PIUMBING. HEATING, TYPE Of CONST. OCCUPANCV GROUP OCCUPANCY LOAD
VENT�LATING OR AIR CONOITIONING
THIS PERMIT BECOMES NULL AND VOID IF WORK OFi CONSTRUCTION ZONING SQ. FT CU FT-
AUTHOR12ED IS NOT COMMENCED WITMIN 80 OAYS. OR li CONSTRUCTION
OR WORK IS SUSPENDED Oii ABANDONEO fOii A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO DWLG. UNITS OFFSTREET PARKING
I HEFiEBY CERTIFY TMAT I HAVE REAO AND EXAMINEO TNIS APPLICATION 1 STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORREC7. ALL PFOVISIONS OF LAWS yALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITM WHE7MER SPECIFIED M OR NOT. GRANTING OF A PERMIT � 1� 391 �.%O
DOES NOT PRESUME TO V VIOLATE OR CANCEL TM� pEpMIT FEE SAC CMARGE
PROVISIONS OF ANY T TE LOCAL LAW REGULATING CON-
TRUCTION OR T RMA OF CONST 1fai�l �.50.95 Fire .5�.' �1.39
PLAN CMECK FEE TOTAL FEE
cens SC $5.00 $58.04
5� NatuAE CON'AACTOpOpeUTNOA11E0AGENT iD�iE� � yy pq p p�Y VALIDATED THIS IS V UR P� MIT
U
S�GN4TUQEO�OWNEp���wtiEpBw�DEpi �OATE� ..a�rg� q� E
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NEW [ ]
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Construction Address: / r-� J
Legal Description:
CITY OF FRIDLEY
6431 University Ave NE, Fridley, MN 55432
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
�
Effective 1 /1 /2003
(763) 572-3604 Bldg Insp
(763) 571-1287 F�c �
(� �I��a�
v 4U
Owner Name & Address: �v� c�a�„n� ��oT.� .� a e,� '� Tel. #��t �- Z 1 7 C.e
Contractor: ���i, c,� �.�� � c$�, �-v� MN LICENSE#�j�2o"Z2�yb3
Address: �3`�C� S� Ccao�n er�r- Qr,��r1,An�t- I�!N '���I Tel.# `7c.`�--�iz7�yG�(�
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTH�R:
G %� Z� '7 1 lo --`b°1 $' /
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft.
Length Width Height �_ Sq. Ft.
Length Width Hgt/Ground �_ Sq. Ft. / 1"2,
\ I � ,�i
Construction Type:� r���n ��e �°�-e cJ Estimated Cost: $ -�� �'G� � ��` ��i`
Driveway Curb Cut Width Needed: Ft. + 6 Ft = x$ _$
DATE: I D b. APPLICANT: Tel. #$� Iar z.. �� �--�9 S-�
Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will
call you for card number.
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
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$
$ A I
$ , `�
$
$ ��, ��%
$
$
$
$
$ � .�
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
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
� •►
� Esfob: ished in 1962 � .
.- LC�'T �URVEYS C�MPA►HY, IHC� F B�ICE N0. ��
NO�� �
� ' � . LAND SURVEYORS SCAIE 1�,..�
�' • o Dsnotee I�on Monu�
ItEGIBTERED UNDEIt LAW9 OF STATE OF MINNE$OTA p Denotes �Wood Hub
�� ?601- 79rd Avenue North 660-8095 Fo� Excavafion Onl�
. ,,, . . • • '
• � i.' 14tinne�polb, Minne�ota 66428 x000.0 Dsnotee Exlttinq E
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BUILOERS MANAGEMENT SERYICES
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°AS BUILT SUftYEY" r�
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,° Denotee Proposed
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Proposed Top of 8
� Proposed Garape F
�_ Propoaed Loweit F
Type of Buildinq -
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1917 8912
Plase bring tl�ese plans b
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Post anc�Beam Dimension Sheet
esign#:93782
1'9" '
5'3"
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Illustration may depict options not included.
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Joisf layout for Your Deck
The Saale is t/2° : t'
Mark length Desaription Usa�e
A 9'9° ?x8 Green Treated Joist
B 9'10-1/2° 2x8 Green Treated Rim joist
C 13'9° 2x8 G�een Treated ledger
D 14' 2x8 Green treated Rim joist
Joiats to be on 16° eenters.
Joiats to be hung from the ledger with o' ers.
Joists to be toe-naifed to bea s with 2-1/2° 8d 'Is.
Rim oiats to be faoe-nailed to o sts ledg '�3-t/2" galvanized nails.
'n d 6ridging is not ehown, 6ut mey ba requi�ed by qour (oaal code.
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Illustration may depict options ,not ineluded.
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Beam layout for Your Deck
The saele is 1/2" :1'
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Design #: 93782 � ' ' ' � �o/s/�oo3
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��� Take this sheet to the Building Materials desk to purchase your mat�rials. ���
You have selected a 10' X 14� deek 6' off the ground. Below is a section of the railing style an�
Pressure Treated Framing Material
Norizontal Decking
S/4" x 6" Pressure Treated Deck 6oards
36" Spindle Railing
2"x2"x42" Pressure Treated Spindles, Beveled 1 End
4"x4"x48" Pressure Treated Utop Notched Railing P
POqPBd FOAt1119S g�� Tu6e 4� d88p
Premium Gold Phillips Drive Screws
Galvanized framing Fasteners
2" x 8" Joists /��� � ' �
2" x 8" Beams
40 PSF Deck live load
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options you have selected for your d;�ck.
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Stair Widths : 48"
For Building Material's use on(y :1201680720102040603000004048050200000001
REVi�vv�o
Today's cost for materials estimated in this desi9n with options: $932.01
'B�s� price mry include: 40 PSF deak live I�ad, hori�on�l decking, 2x6 pressure treated deck boaards, pressure trcat�d iraming ma�rial, no siairs,
36' �C4 railing, pressure treated railing pos�s, and galvanlied box nails. *� gpSE price�: $���.3�
�
/
Building PLUMBING Permit Ivo � �
Inspections R�+ SIDENTIAL APPLICATION Received By:
763-572-3604 CITY OF FRIDLEY vat
763-502-4977 FAX �� 08
EFFECTIVE 1-1-OS
DATE � � YOUR E-MAIL DDRESS it 1 C, ���(%( >� fo (!/l Gf' ; Y� G�Z-
SITE ADDRESS � �,�-a � ""i ��{°1 �'Gt I
THIS APPLICANT IS: ❑ OWNER ONTRACTOR
PROPERTY NAME:
OWNER/ ADDRESS: CITX STATE ZIP
TENANT
PHONE:
CONTRACI'OR NAME: � F°l U EfYI �� �—�- ��� � '
SUBMIT A COPY OF STATE LICENSE #�,�i�� G� ��� EXP DATE �� �`
YOUR STATE
LICENSE, BOND AND STATE BOND � AP� ��`� I�� EXP DATE I Ti� �
CERTIFICATE OF ADDRESS:�� � � � � � � C� �ITY �'t' o ��I %'e��iS� STATE �°1 � ZIP ��
INSURANCE PHONE ��� `� Z�'° �� FAX �IP� � ' "f �� � �� 7
PERMIT TYPE ��GLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK: � NEW �REPLACEMENT
DETAILED DESCRIPTION OF WORK ��j�/�, C� l�(�C� �� �� °�C. �
tl
PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the
improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor )
Labor cost under $300 =$15.00. Labor cost between $300 to $500 = cost of labor x.OS = plus .50 surcharge
OR �
FOR PROJECTS WHERE LABOR EXCEEDS $SOQ FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL
NUMBER OF EACH BELOW). MINIMUM FEE $I5.50.
BATH SINK/LAV _FLOOR DRAINS SHOWER WATER PIPING
BATHTUB GAS PIPING (NEED CITY LIC) SWIMMING POOL WATER SOFINER ($35)
CLOTHES WASHER KITCHEN SINK WATER CLOSET BACKFLOW PREV. ($15)
DISHWASHER _ LAUNDRY TRAY �WATER HEATER ($35) FOR IRRIGATION
WATER METER OTHER
��n�z�r� �xv�c�� �+�� ���, ��'oa . ' _ _ �.� = ���m �� ��� ��Q�c�.��� ���o :
Permit Fee $` Number of fixtures @$10.00 x$10.00 =$
Surchar e .50 Number of fixtures @$15.00 x$15.00 =$
TOTAL DUE $ OR Number of fixtures @$35.00 x$35.00 =$
State Surchai°ge = $ .50
h�NA!IUM $15.50 $15.50 Tota1= $
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
I hereby apply for a plumbing permit and I acknowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is
not a permit but only an application for a permit and work is not to start without a permit on site; that the work. will be in accordance
with the approved pl in ase o all work ich uires review and approval of plans. ,
SIGNATURE OF APP PRINT NAME 1 VICo��L� �_T�\_--DATE �✓ *
��
APPROVED BY DATE
. .::��.,�_a_�1'�TC)`�" � . �.... '�°ii"�I�I��1I�"�::.... ..,. �..........�{��L$iT�:�t�,+�,�.�''LE�'I'�C�rA:�.�ECHAI�TI�i�i..`�t�R�,:'m.."'
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City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
FAX: 763-502-4977
7