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AF - 45219City of Fridley, Minn.. BUILDING PERMIT Date: .._.� � � _'� .�_�_� � _______._.. �5 `� ...���'.:!�?,,:� . �...�,. � _� :'�::1'' . Builder Owner: .: _ '` _ . _- �. Address ---.-��.,�._..�. ._.:...: .�..'� " .�c:`A Address i` N° 476 J �� ��- .._....._""..........._... _...w-�:F..___..._..v..�........_..�.«...._...__._....�_......__._.�._ ........_.. .. � __.�� .,.. . . . . , �..._.. . _. _.__._. _. _.�.._. _ ���--- ��' ,� CA I N Q � ILDING No. ... ... .... ....... Sfreei ..�:` ..e.��:: _.--- ` --.,.. . -----.._...---- P oP Lot .-------._ __..___._. .—_._... Lot _....� � _.�........ Block .._.._.� ......... ....._ ....._.. ... Addition or Sub-Div,�siozr' � `� ._ .... : �.�. .. --..�_��..`;� * • ,�r""' � - f�.�G��ideYaz'd --�-�--..._......--��--•---.........--��-------�•-------�- Corner Lot ...._.._.... -- ............._... Inside Lot _....... .................._....... l�l�ack .....__ ` --....... SewerIIevation _..------------------.....--- -----...---.....-------•--�---....---._...__. Foun tion IIevation ------------._...._----_.._.--------......_�........__-----••-----...--- DESCRIPTION OF BUILDING To Used as. � /� ��� .:;..�..�. :..t._ Front ._�_�- Depth ..�_,T-.- Height ...��._... Sq. F� _���G.' Cu. E'� -�;��'.� - ................._..._............................_.... Fron ._.._........----_.. Depth ....._.....�;� ei ... _............_ F Scl. Ft ..._._..._.......__.. Cu. Fi. .....__...........-- .............. o be Completed ....._........_..._.._..---�--�--�• ----- -..... Type of Construction _�'�. .1�-'-�..... Est. Cos�.._..... ..,�_� ..:..--��.� � �;���.��'��: �� THIS PEFi"�:";? ��+t;`:._�_� 1'�i�;i" ;i!'�f�-10;21�c 1/lOLAT- I C� �'a �v � ,^, ; --------------- �; i,'; � �' "i � �,�.!�� C� -; i` r��. '.� �_.Fi U t,.. d.. r (�.����'..�.� �._ I��` __. .. _ . .` ,�'�. _� t 4 � , +.:J. In consideration of the issuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the descxiption above set forth and in compliance with all provisions of ordinances of the dty of Fridley. �,., � In consideration of the payment of a fee of $�.�_....___..., pernut is hereby granted to..__......._-.---.._-.------_•--------_--.--- �._. to construct the building or addition as described above. This permit is granted upon the express�condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all r�sPects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, reAsir and moving of buildings within the dty ]imits and this permit may be revoked at any time-u olation oi;;any of the provisions of said ordinances. i , r !i�` i; ;�� Building Inspector NOTICE: This permh does not eover the eonstrueNon, inafallation for wiring, plumbing, gas hea�ieg, eewer or water. Be sure lo see fhe Building Inspecto� for separafe permita for these Nems. , ✓"'� 4 � .,, .._ �. >� C ��•3����- .. " / �, 1PPLICATION FOR HUILDiNG PF�iMLT CITY OF FRIDLEY, MINNESOTA Ownera Name � �-d � F � � Bt�il.der - Addreas � �� �'��.��-��.� , , dcldress �_ _..� �`�..� � LOCATION OF BIIILDING No. � St�reetar'�f �.v������°_. �'t of Lot , �� C i �� __���� �,o� , � Addit3on or S�.ib.Div. '� _ _\ Side-Yard �` Corner Lot,_„�,_Inside Lot� t Ba.ck . SEWER, ELEiTATION FOUNDATION ELEVATION lpplicant atta.ch to this form Certificate of Survey of Lot and proposed building location. DFSCRIPTIOIV OF BIIII�ING To be used ss P f � �� �, �"FroAt �" Depth � Height �� � Sq. Ft. � % � � �• �• -T� = Front Depth Height -- �. Ft. Gtii. Ft. � Estimatad Cost �ype of Con�truction ��'���� � ���,���- _ . To be completed , ,,.,_,.,._ �°.. -- 4`� � The undersigned hereby lnskes application for a perm�.t for the work herein specified, egreeing to do all �rorDc in �triQt acCordance with the Gity Ordinances and ru].ing of the Department of Buildings, and hereby declares that a11 the facta end representa tions atated in.this applicat3on are tru� and correct. DATE / � '� � � SIGNATiTAE - (A S�i�lul� o� F�e coats c� be frnmd on the Peverse S�de. ) � < s !�� 5 �1 m � � � � BIIILDING PERMIT FEE SCHEDULE Section 2. The Inspector of �ildinga sha11, before issuing anj► pernxi:t for the ere.ction of a�r builcling or structure, or for any acidition t+o any exiatin� btiiZding or structure, ox� for an�r alterations or repair� to any exiating building or structure, upon application therefor, require the p�yment by the applicant for such permit of fees to the amount herein beiow set forth and in the manner herein provided to-wit: � 2.1. For any such permit for the erection o£ any fire-proof building,.other � than a garage, warehouse, factory or grain ele�a.tor, or for the erectio� of any f3reproof addition, for similar occupanc�, to any existing Uui?.din� shall 1oe at the rate of $1.40 for each one thouse.nd cubic feet, or fraction thereof, in such cubical contents. , 2.2. For an�r euch permit for the erection of any fireproof gare,�e, ware- hous�� factory or grain elevator; or for the erection�of ang fireproof addit�.on for s�il.ar occupancy, to an3r existin� build3.ng shall be at the rate oP �]..2� for each one thousand cub3c feet, classiiied as "PireprooP° b�r Sect3on 502 of the Minneapolis Building Code. OUS 2.3. For any.suoh permit for the erection of any non-fireproof buiiding other tizan a garage, warehouse, factory or grai.n elevator� or any non- fireproof adclition, £or simi],ar occupancy, tc any exist3ng building. Permit �..� for each one thousand c�bic feet. GARAG .. 2.4. For any such permit for the erection of any non-fireproof garage: ti,rarehou�s, fac'tory or grai.n elevator, or for the erection of any non- fireproof addition, for sim3lar occupanc�►, to�arry existin� building for each auch building or addition. Ninety Cents for each one thou ,nd cubic feet or fraction thereof, in the cubical contents thereof with a minirm�m of �'1�..00. ' ' For the purpose a£ computing fees for bui.lding permita the cubice7. contaats of any building or addition �a a uniform l�eight throughout' by mu].tiplyin� the �round area covered f�om a point aix.(6) fnches be].ow the floor line of the basement nr cellar to tl� average haight of the upper�aurface or to the average_height of the roof surfa�e of the mai� gable of a p3tched roof. 2.5. For repaira or altergtions to an exis�ting��tructure, the fee shail be at the rate of �3.00 For�eech Five Hundred Do�.la� ($500.00), dr frac�ion thereoF 3n the cost of all propoaecl work.- � �2.6. In no case SectiQn�2" be less - , �. .= � shal]: - the fee chargecl tlzan �4.00. . � £or any p�rmi� aa set forth in . .;- /"� T _. n � � Ci of Fridley, Minn. B ING PERMIT Date: April 21, 1969 �: �� Chuck Anderson g�� Brennx Baco�s . ,Ad�re� 112 Gilbrator Ad�� ti0� i�r.� cr �_�.,. N° 10193 ����� No. 112 street Lot _ Block Corner Lot — Inaide Lot Sewer IIevatian LOCATION OF BUILDING Gilbrator Road p� ag �t Addition or Sub-Diviafon Setback � Sideyard -- Foundat3on IIevation DESCRIPTION OF BUILDING To be Used as: Family Room & �t 14' �p� 15' Height 10� Scl. Ft. Cu. Fti Dining Room Front Depth ITeight Sq. Ft G�. Ft Ty� og ����� Frame ��, �_ 5 00._Q.Q.__ To be Completed In conaideratton oP the issuance to me of a permft to construct the buildiug descrlbed above I agree to do the proposed work 9n accordance with the descrlption above Porth and in compliance with afl provlaions of ordinances oY the dty of Fridley. ,� Qo %� In comafderal3oa oP the psyment of a fee oP $ 12 . 00 � permit fa gp,reby granted tp �*—' ��� rna to construct the building or addition as described abwre. This �ermit fs gi�anted n�n the express condition that the pereon to whom it is granted and hia agents, employees and worl�en, in all work done in, around and u�n sa3d buflding, or any �art thereof, shall conform in all respects to the ordinance� of Frldley, Minnesota lpcation, conatruction, alteration, maiatenauce� repair and moving of bufldings within the dts► limfts� permit may be revoked at ar�y time upon violation of �► of the provisions of said NOTIC� 'Itds psrmit dee� aet eovee ths constrneHoe, insh�aftoe io� wtrleg, plumbieg, gn 6uHng, iwn� er wmr. B� soro fo re� 1ha Bnlldiee lesp�etor fo� ssparaN parmifs fo� 16as ttuds. � � � Fw / .�..„,� - 4 �� !� d � r� APPLICATION FOR BUILDING PERMZT CITY OF FR.TDLEY, MIIVNESOTg �.' _� - �♦ �' � � :� ,� :� ��- _�'/� ' /'` ' ���-�;. / ,��. .< LOCgTI N ' OF B[TI �G �� � � /� - - P�"`"�� N0. STREEI' LOT BLOGK AUDITION OR SIIBDIVISION CORNER ZOT INSIDE LOT SETB9CR SIDEYARD��, SEWER EI,EV'�TI�N TOP OF FOOTING AppliQant attach to this form Two Certificatea of Survey of Lot and proposed building location drawn on these Certificates. AESCRIPTION OF BUI�,DING�, � e //C.�t')i•�. To Ba Used gs: ��..�� T�,���-� " . ;r - �,' "!' � �� i �'*� � , �_ ,A 4,1 �- �? Front Depth � Height �'' ��- _ Squaxe feet Cubic Feet Front Depth Height � Squaxe feet �L� � Cubic Feet Type oi Conetruation �� Estimated Coat ��� � � To Be Completed ,'���''`c-- /� r' / / � The unde�si�q.ed Yiereby ma.kes application for a permit for the work herein epeGified, �Eein� to do all wo�;k in strict acaordance w�th the City of F'xicile�r O�dinances and rulings of the Department of Buildings, and hereby c�ealares that all the facte at�d repreaentationa stated in thie applica�tion are true and correct< DgTE � �� � SiGNATIIRE �— ` � {Schedule of Fee Coete can be fouxid on the Rever�e Side.) y� C � , ��� - �� �' ° 1 � �� ,( -- /�� � = /� �-� ,[ � � Z � V���//rozi 'j5� � -�- � � � °�' .ti� . �, BTTILDING PEftMIT � FEE SCFiE.DUI,E � SECTIOIV 2o The I:nspector of Buildings ahall, before issui�.g permits for the erection of any building or etructurey or for any addition to any �xi�ting atructure or building9 or .for axsy alteration or rep�.irs to a:ny egieting building o� structure9 upon application therefo�e, req�.ire the paymen.t by the �,pplicant fo� �uch perniit of fees to the amount herein below set forth and in the manner here�n provided to-wit: IIniform Build' Code: Type 1, 2, & 4-$1075 for each one thousa.nd cubic feet, or fraction thereof, ir such cubical c.ara.tents. Type 3& 5- $1 0 50 for each one thouse.ra.d cubic feet o For the purpose of computing fees for buildin� permita, the cubical � c�n't�nta of a�.y b�ii'din�r addi�ion� ��6 a uni�'orm hei��th�du�hout �by `� " multiplying the ground area covered from a point eix (6) inches below the floor line of the basement or the cellar to the average height.of the upper surface or to the avera.ge height of the roof surface of the main. gable of a pitched roof . For repairs or alterations to an ezisting structure, the fee shall be at the :�ate oi $3.00 per each five hundred dollaxs ($500.00� or fraction thereof i�a. the cost of all proposed worko In no case shall the fee charged for axiy permit as set forth in Section 2 be less than $50000 .r--.,-._.__._ ,-- - R-- _�,-�:__�»...L_ - � - �" _�"-` °�`N'�5�1�`�orine�ction.TCh.a,rges based on location - .Area 1 ~or 2. �.:� s' n �� �- � x f s' � � � � - _ " �I�. _ „'t -- -- _.___. .. __..---_ -_____ , _ _ . _ � - �I , c'yy, q,13 �¢6 -_ Yo� ic.o O 3i.i , . i : --; • i -• _ A . . - I ' . j . � �`erq �A 141 �- � I�► q11 N �,7. , . . • i . � Qd srr, w '� . I � � . � �' s. o _ Z!t � � ti 4� =��`' QS . j�9� ,� . '� c � b � � i. � � � ( � , , �. �,d , s'�� � � �� . ... � � � . 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'. � o \ �N �: . � i; � � - � �. do.z 3t.t 40.2 ro�j IZi"- ;- N . � "..., - j2.Z il.o a - _ ' i' � �• : i � ---�s-- . _ � ~ � N ~ 1 7 _ts.2_ .. . - , . �, 113 N �Oi�-, , ' - � - I OI N Il.o 1 _ . zs.i �- ; . � • �� _ _ , ,�, , - , ��. . . �Iro , �w ''O i .� � �� 53 r � P 75 ' 75 15 ' � ��� � . � M, , • .�c : * �' I here�y certify ta.At t:�e a,bovz .is a�la�cLP � ATine (9) throu�h Thirty-three i3}1, � Apo�:e County. b�innesota, showinU the loce�` : t.s surv�yed by u�e this 25th day of If.arc� = � E �1 - " � � �Y � � � � � .� r � � : o : � M M � � � � s ,�; � , � ' � r � � � �� � � � � � � � n W n 8 �' � � � $ � � M �. � � ~ o � � �� � �' � � � a o � •. � a ., • f° �j � � • o � � � � �e b' 1 o N y � . � o a ; 'O O : ln a � 6• �n �° � • m � �' °° � � : . : ' : y p 03 � O � . r . 0 . • . • � • • • • • : • • 3 . : • • • • • • • � • .. . . . . 0 0 � o� K M �o x ee x a x .�' p `� � � �! � � � � 8� 8� 8�i 8 6� $$ 8� M M M tA M 6► N M 0 I 0 � I � � � � � � � c � a A � � � r�, ► � � � D � rD- � � � N � ri1 v � T a � o z � � �e � � i � � � � � � Q � w � �� � � � i . z 0 ¢,� � � � ■.■■, - : . ■.., . i ■�� �i � � ■��w� � � ���t�� � ����I� ������. � 7� � o. � � M F �. � � arosRs uRU� r►rw � � SINRS wws� rw►rs DRINK. �. � OqA1Pi5 �ASINS AUTO WA41l� o� �nn. � � csw5 OVENINGS ,. _ • � N � S' � �. a � � �� � P. �� � � � � � � A ���$ �a� 0 � �� ���.� ���� ���� ���o 5 �� � �� m v ���� ���� ���� � � � � � 3�� � � d �� � O �A � � p � �i y � � � � , : � �. �� � � e �� R� 1 � � C, � � E T0: ZONING - �OTIFICATION OF INTENT Foster Family Homes � f�� 1 � �����_� �_-� r �street tiaare s� � ���,3� State CZ�p�---- FROM: ANOKA �OUNTY SOCIAL SERVICE ANOKA COUAiTY COt�RT HOUSE ANOKA, MINNESOTA 553�3 APPLICANT: 1 i�. C�..,�.� l� �Street w„ e (Number of Natural Children under 18 in Home: i (Number of Foster Children inCluded in License: (Number of Natural Preschool Ch3 �. . �� � (Atumber of Day Care Ghi].dren in� DATE O�F N(1TIFIG.�TI011T: 0�2345 (Circle Number) oa.Q345s7 (Circle Number) : 0 1 2 3 4 (Circle Number) in license:0 1 2 3 4 5 � (Circle Number) � �� ) ) � ) ) ) ) ) sue�ecr PER . City of Fridley 15 7 31 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r ; � RECEIPT NO. • COMMUNITY DEVELOPMENT DIV. � � ; V �'���'� r � � PROTECTIVE INSPECTtON SEC. i . � , � /'��1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BV �'""� � ��� 612-571-3450 910-F15 5/19/80 � � JOB ADDRESS 112 Giliraltar Road N.E. 7 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. ]_8 2 Ca.rlson's S�mit Ma.nor South Addn. SHEET 2 PROPERTY OWNER MAIL ADDRESS 21P PHONE Chas. Anderson 112 Gibraltar Road N.E. 3 CONTRACTOR MAIL ADDRESS Z�P PHONE LICENSE NO. Leonard Freund Stuc o 2 - 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 8 USEOFBUILDING 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK 9 CHANGE OF USE FROM TO STIPULATIONS r TVPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WOFiK 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. 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 VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL 8E COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $Z�7OO y��..35 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTFUCTION. �`�.B.00 PLAN CHECK FEE TOTAL FEE $19.35 NATUREOFCONT RORAUTHORIZE GENT IDATEI � m WHEN PROPERLY LIDATED THIS IS YOUR PERMI� CXlC�I ��e e SIGNATURE OF OWNERIIF OWNEF BUILDERI IDATEI BLOG INSP �PT CITY OF FRIDLEY � - APPLICATION FOR RESIDENTIAL QUILDIPdG PERMITS (f�ew, Alter�tions, Additions, or Repairs) � OWPdER: °'�� • ������ ADDRESS: �/ � ����s� /�� TEL N0: BUI LQER : �������s�s ���'���,��� �-- � ADDRESS: �/�-%D f�'��-� �� "�����-��� TEL N0: ��� /O',�� Construction Location STREET NO : � / 7� STREET: �''�.� .r°���� v`-'" - — � LOT: �� BLOCK: 2 ADDITION: L�'��� :.��.�I�G'�� � G����7- Corner Lot: Insicle Lot: Setback: . Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. '%�3K�- ��(-� �,r�,�,i� - DESCR�PTIOId OF CONSTRUCTION � �(-Z-IGGa �-_e-t i �� t, Height: � , Front: . . � �'-p� : 5qua�e. Feet_ C�.ibic Feet: Front: Depth: Height: Square• Feet: Cubic Feet: d0 � �� Type of Construction : Estiunated Cost: $� %o ' Zb Be Cbmpleted: ��L- � � Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $� $ SEE REVERSE SIDE OF SFiEET� , The undersigned hereby makes applicatian for a permit for the worl: herein specified, agreeing to do all work in stric� accordance wi�h the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct.�-, DATE: �—_Z____/ �_,�U SIGNATURE : 5tipulations: ��, o 0 f. � s _ l�-�� �� ��__ � . . BUILDI(JG f'ERt�IIT FEE SCHEDULE' , SrCTI01� 2. Tiie 7nsl�ector ot 13uilc]incJJ Jha].1, beLorc i�suing per.miL•s L-or Lhe erecLion ot- any building or :�L-ruci:ure, or �or any additi.on �o any er.i�L•ing buildiny or s�rucLwre, . oz L-or any a1L•cration or re�,�airs to •any c}:i��.ing bu�.ldi.t�g or structurc, upan application thcreforc, requirc fihe payment by the anplicanL tor. such permiL of fees to.t•he amount hercin below set forth and in the manner herein providecl to-wit: � Nr47 CONSTRUCTION: Single ramil.y }fomes and Garages: $4.00/1,000 cubic ieet. . PIJ�N CfiI:CY.: 25 percent of bui.lding Pexmit tee. DRIVEI�7AY D�PRL•'SSIOt1: (Concrete, GUrb Strcets Only) � " ' AlternaL-e A: Removal and replacement of concrete curb and gutter only; Driveway widt}i plus 6 feet x Y�,�.75 1�].ternate B: Removal and replaccment of cancrete curb and • � gutL-er and install a 3 fooL- wide approach with '' .� 6 S.r,ch depth; Driveway width plus 6 feet x$17.85 � :11 � t . 1 � � �� I'or the purpose oi' computing £ees for building permits, the cubical contenL-s of any building or addition, is determined by multiplying the ground area covered from a , �oint sir. (6) inches below the floor line of the basement or th� cellar to the average heights of ihe upper surface or to the average height of the roof surface of the riain gable of a pitched roof. � ' For repairs or alterations to an existing structure, the fee shall be a� the rate of $3.00 per each five hundred dollars-($500.00) or fraction ihereof .in the cost of all proposed work. . � In •no r.ase shal.l the fee charged for any permit as set forth in Section 2 be` less than $7.50 plus $.50 state surcharge. - _VERIFICATIO� OF FOINDATION NOTE: Permits �or construction �vill be issu�d a minimtun of 24 hours from the time of applica�ion to allow for proper review of the pro,posed structure and of the construction site. 1, Certifa.cate of Suxvey of the lot, showing the location of the foundation once i.t has been constructed �,rill be required before proceeding with the frami,ng, _CERTIFtCATE pF OCCUPANCY � Application �or a Certificate oi Oceupancy shall be made ten (10) days prior to the use or occap3ncy of any structure for wliich ��building permit has been issued; and said s'tructure shall not be used or occupied until a Certificate ot' Occu�,�ancy has been issued. 0 � •- • • • � � ��noF FR[DLEY <<� � ���� , � ��)� FRIDLEY MUNICIPALCENTER • 6431 UNNERSITYAVE. N.E. FRIDLEY, MN 55432 •(612) 571-3450 • FAX (612) 571-1287 March 5, 1999 Joe Ryman 112 Gibraltar Rd NE Fridley, MN 55432 Re: Final Inspection at 112 Gibraltar Rd NE Contractor: River City Sheet Metal Inc. Dear Mr. Ryman: A mechanical permit was issued on Februaiy 10, 1998 for the property located at 112 Gibraltar Rd NE for a replacement furnace and air conditioner installation. According to Section 305(a) of the 1991 Uniform Mechanical Code a final inspection shall be performed on the mechanical system. As of this date no inspection has been called for. You will be given thirty (30) days from receipt of this notice to respond. If we do not hear from you, we will expire the permit and any inspections on this installation will require a new permit. Any questions can be addressed to myself at (612) 572-3603. Sincerely, , Gh� BARR RIESCH gnilding Inspector BR/mh t .. � D m n � O �� � . o c�r� m = N � A o � 3 � Q o O (D � -a � � -a a o � -° � .�o � N � � � � m � � � O � �� � o C� � � W n �� � � � rn �� �, . � � � � l �• � e 1 W �O 1 ��. ��i � m z � rn � O Z T m rn � g -. � v 0 � � � �� � ° r�l � � � � � � � � -�{ N 0 Z O Z -�, � A? � sv+ � i.s�� \ � . � r���Z -� � Z = n � � . �Zz � Im�� O -o O � � � rn � � � � � � � O =� � c� � � �. m Z O � ` V � � 2 � Z � � � � � n � p ��D � 3 0 � � � o � o � � � ' � � C � c � � � m � o � o � D N 'i7 � 'v Si° v p�' pi D ? A � A � �. � O 7 , � � o � o �- � � � � Q;, Z m c n � 3 w cfl cD � � � U � c� ° � W � � ; � �. m z i � _ � � cND Z O m � � c � � o m a' — n. � o � � � � _. cfl r � � l� � ���n O QJ n �1 � � � � � (p � r. f�D N a cn � o m � �" � O = �' o .-r y� —I v�J 4 � n� � D 0 � �. � � (� I n � m N � � v (D 1 � � � ¢1 � cfl � � t� v� N � �. (n O O O � O tfl c� � � �� rn � � 0 n 0 � 0 � m � � --i Z � r� �, � � t� c � � c � m � � ` � D 'n � N p � y v,��o� m �• Q. 'II � •=-r� � m � ? w � � �m<°�-° m � � � Q. I ? a n. =T� C Cv � O � � ?�� m � �D � � n �� � � m. �. � � c� J (� 0 0 � O O � � � O D � r � � n 2 rn v C rn ���� • c� c� m �' m � �oa� ��� � ��.� , � �• � a ��:�� Q��� .00� ����' � � � -o' � �- a� � o m n' �Q, 7 � 'a O � � � � (D .n�► � � n � � � O O n. '�' m �, �, � �¢1 � 7 'a ` ` � (7 (D fl. .-. � � n S � � Q � '"► --w O � "~ (3D 3 . � n m p1 •� � � � �' � m � � �r,° m � Q � O � g � rn � � N . � � �y � ro °—. --� � ��co � � � Z � T cn�•� � D � (D Z rn � m � � z v < � � � C m y � O O Z Z O � � �. � D � � O � o � �� o .� zN z� � cn v � � �� z v� v� �� �_ Z �� � � � � ? ; � f�D �O 3 � 1 � � N � � y �� � � .� - J � � � CHIlVINEY AND STACg VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been cazefiilly examined Yes (� No O 2. Is free from nist or deterioration Yes (� No () �3. Has no foreign objects lodged within Yes � No () 4. Is securely supported . Yes � No () 5. 6 7. 8. Meets all current Code requirements for size and total BTU's connected Has total heating BTU's of %S, d�� All other BTU's _ 3 0 C� TOTAL BTU's f1D� (%�� : Has a liner been pmvided for water heater Has combustion air been provided for water heater Remarks: . List ALTF.RATIONS Being Done: HEATING CO: Signed By: Date: � Yes � No ( ) Yes ()L) No ( ) Yes �) No ( ) Building Inspections 763-572-3604 DATE� °%�'� SITE ADDRESS � THIS APPLICANC IS: PLiTMBIN G 1�ES�EN`�� �'�'LICATION CITY OF FRIDLEY YOUR E-MAIL ADDRESS ❑ OWNER $�CONTRACTOR PROPERTY NAME: � OWNER� qDDRESS: TENANT PHOtJE�!ri.I _ �►_ ►��171.1- i�4 i� _ CONTRACTOR SUgMIT A COPY OF ypUR STATE LICENSE WI'fH APPLICATION PERMIT 'I'YPE TYPE OF VF/0RI{.: Permit No.: �' � v 1�' ° Received By: ,� Date��: �� P 2 9 2( /�TE�ZIP�i� � U\1.�47�ri�.■��.�------ �( � �� �• � • � � �,� r,� ,rl--�/ u.� � _ � � � � ! (� �[%l i � : � y�� �� � � � � '�SINGLE FAMIL�1' ❑ NEW DETAILED DESCRIP'I`ION OF WORK p TWO FAMILI' � TOWN�OUSE �REPLACEIJ�NT R MS 16B.665 the permit fee is a minimum of $15.00 or 5°e% of t��COSf� s° �S��hO�d reflect o ly the c st of labor ) PE improvement, installation or rep lace m e n t o f a r e s i d e n t i a l f ix t u r , x .OS =,�_. Labor cost under $304 =$15.00. L a bor cos t b e t w e e n $ 3 0 0 t o $500 = cost of labor �� �O�D ��S• (�I�� TOTAL FOR PROJECTS W�� �OR EXCEEDS $500, FEES ARE BASID ON $10.00 PER FIXTUKE. wA� P�ING T1UIvIgER OF EACH BELOV� ��R DRAINS SHOWER _���g SO�It ($35) BATH SINK/LAV _ SWIMMING POOL BATHTUB _GAS PIPING fn��►T�'��``� WA�g �,OSEf _BACKFLOW PREV. ($15) KITCHEN SINK —wA.� �� �$3� FOR IRRIGATION CLOTHES WASHER "— LAUNDRY TRAY "� WATER MEPER _ OTHER DISHWASHER — _ � .,, , . , ,:. — _ _ ,�. _ . 3 . .> :. .: ' _ � , � :+� � , - Permit Fee $ TOTAL DUE � � � . � � � � a ,, �,,, ,��,. � .6-� , � � .. ,,.,, t . _. �: �� � �, ar�a�Y` , si : ; e. ,. , - r- . � TTumber of 5xtures @ �10.00 x $10.00 = ____ .50 Number of fixtures @ $1�•00 x $15.00 = $ � rTumber of fixtures @$35.00S�te Surch ge =$�?� Tota1= $_� THIS IS AN APPLTCATION FOR A PERMIT NOT VALID UNTII- PROCFSS� I hereby apply for a build'ufg permit and I aclrnowledge that the information above is complete and accurate; that the work will be in of Fridle and with the Minnesota Cons�uction Codes; that I understand this is conformance with the ordinances and codes of the City Y ermit but only an application for a permit and work is not to start without a permit; that the �'aork will be in a.ccordance vaith e not a p p roval of 1 s. approved plan in the case of all v�+ork wh' h req ' re 'ew and a p P DATE � �2� o� fi PRTNT NAME SIGNAT[JRE OF APPLICANT ' . s . .�e b . r... . x �,. . "', ` � . ,�,���;� City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 �:J�Z'� ��