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AF - 47920; � City of Fridley, Minn. BUILDING PERMIT Date: _.._.._June_.29_�___1970 ��__�� pwner; _� Marv in J ohns on , BuiIder � S� E� Tem.p 1 in .._._.,__._��_.__. Address ._.._.___..__.._....._._..___.__._.._...._._._..____.._.._.._..........___.._.._.._ Address _..fi.].$..4 St�.Son Sn +�ard ��� 3 � � N° 726 e"a_,�.�o LOCATION OF BUILDING §1r11 T�erry Lane -- ----_._. Part of Lot ._.._.._.._.. No. _---__._......____._.. Street _..___r..___.__.._......_..___.___...�M....._...___. _. Lot _.__.._6..__._._.__ Block _. ?_.._.__.._..._._.____. Addition or Sub-Divisi� ....__Heather Hills Addition Corner Lot ___---.._...__.._ Inside Lot _.._X._...._.._._...---._ Setback ._._...---_4Q_'..____..._ Sideyard __._.1.Q.'_t... — Sewer Elevati� __.___._._._.__.__._.._�.._..�._._.....______ Founda.tion Elevation ....__ �_ DESCRIPTION OF BUILDING To be Usec3 as: H& Garage __� �t 24 � �p� � 40' � Height ._._.20 � Sq. Ft 960' �� 19, 344' •_�Gaxa$.e.�.._.._..____ Front _2.Q�._..__ Depth _..22 �..._ Height ___1Q'_- ScY. F't. _. 44.� � Cu. F't. _.�.4DD � Type of Construction _._.._Frame.._..__..._._.._.. Es� Cost _........�25,_000 ....._.._.._ To be Coznpleted _.._.. December 31, 1970 ����y�,Q,� ��-Q,�n� �Ot� �OS'.3 � �L i�,1v�7 In consideration of the issuance to me of a permit to constru e buil ' g deecribed above, I agree to c10 th� proposed work in accordance with the description above set and ' compliance 'th all pro!vfsions of ordinanoes of the city of Fridley. • In comsideratfon of the payment of a fee of �._..�.4...SZQ..._..._.._.., permit is hereby Sranted to �_ F. _ T,gmnl i n to construct the building or addition as described above. Thispe rmft is granted upon the express condition that the person to whom it is granted and his agents, einployees and workmen, in all wark done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances o� Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and. moving of buildfu�s within the city limits and this permit may be revoked a t any time upon violation of any of the provisions of seud ordinances. J��X� �����Y��+uildin8 � HANK MUHICH NOTICE: This p�emh dea no� eowr !h� eonifeuelion, inshllallon fo� widna. Plumbine. tias 6�afk��. aww � wat�r. !� wn M sN 16� Buildiog Imp�etee fer »p�nN pwmhs for fh�a iMms. , - :;� 6 y � � - �-��-�o .� � , ,. APLICATION FOR RESIDENTIAL, ALTERATION, OR AllDITION BUILDING PERMIT CITY QF F IDLEY, MINNESOTA . �� � OWNER' S NAME : ��'� BUILDER: C./ (.^ . � �– �%/pL� ADDRESS : ADDRESS :_ ��� d�?'lZS o �EJ �c�a�o NO:. STREET• / � , � ` LOT: BLOCK: � A ITION: ,/��, � r CORNER LOT: INSIDE LOT:_��SETBACK:__�V_ SIDEYARD:��^'�'� �— Appli�ant attach to this form Ttao Certificates of Survey of Lot and proposed building location drawn on these Certificates. �ESCRIPTION OF BUILDING T Be Used As: � � � � 2° Front: Depth: p Height: G� _� - Square Feet: O Cubic Feet: _ �� ��� .. Front: � Depth: ZZ Height: /'� Square Feet; �. Cubic Feet: � � a � 1i � Tj�pe of Construction: �.. Estimated Cost: $ /��i �-� To Be Completed: — e C — /= l�? lJ The undersigned hereby makes applicativn for a permit for the work herein specified, agreeing to do all work in sttict accordance with 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 e and correct. w DiATE : � S IGNAT[TRE : - (See erse Side F r Additional Infos�nation.) ��' �� ----�.. i • City of Fridley _ Ap�icdion Ior Piwnbieq and Gat FiMi�q Itin�it Dep�t. of Bldqs. Phon� 560-3� DESCAIPTION OF WOR1C Numb�r, Kiad aad Locatfoa o! flxtures ��� � �_�� � ( � ������� � �����������������$ Base lst 2nd 3rd 4th • i'utur� Coaa�clio� Op�ain�s * N�w Fixlur�, Old Op�ni�s PARTIAL RAT� SCHEOULE WATEN NTII. • • / N GAS ELEC. 8r►�s � c...� n PI.IIMSING FIXTUAE AATE3: NO. RATE TOTAL Number Fixtures . . . . . . . . . . . . . . . . _,.._� x 3200 $ / �, � F'uture Fixture O��ening . . . . . . . . . . . x E1.50 E _ New Fixture Old Opening . . . . . . . . . . Catch Basin . . . . . . . . . . . . . . . . . . . . x 51.50 x �3.25 E--- f Water Heater :Up to 99,000 BTU1 •••• _� x 53.00 = 3" � New Ground Run Old Bldg. . . . . . . . . x E3.25 $ EL�cti3c Wat�s H�at�r . . . . . . . . . . . . . : =2.00 : GAS FITTING FEE$: NO. R111`E TOT11L lst 3 Fixtures • . . • . • • • • • • • . . . . • �— : S2.00 ; �. � Additioual Flstures . ... . ... ..... . . . . . a = .76 ; Gas Ran�e to 199.000 B'1'U .. . ... . .. . . ... x E6.0� � REPAIRS t ALTERATIOI�S--R�l�s !o Cod� Descriptton . . . . . . . . . . .. . . .. . .. . . ... , . . . . :.. . . .. . ... . ... . .i 3% ro►r�. r� �- � City o1 Pl�idley: 0 r� J The undersigned hereby makes appllcation tor a permit for the osoak herei specified, agreeing to do all work in strict accordance with the Ci� Qrdinance and ruling o! the Department oi Buildings. and hereby declares that alt the tact and representations stated in this application are true and mrrect l�idley, Minn G�� � l9 �D Owner 7L- �.,�i>}L�t7� Kind of Building _aG-��cd!!'l2�2/ Used as To be completed about ��� � �9 7� Estimated Cost, a /,�0`a .�-u Old—New. Buitding Permit No. Psrmit No. �� /X� i Signed U ��� sy . --�- Business Phune No. ���`J`s� ,� ROUDii FINAL �'�S ' / f e N° 5i'76 �� �ermit for PLU BiNG AND GAS FiTTI 5 3 a�,— N.B. When work covered by thie permit is ready, the Plumbing Ordinance requirea that request for Permit � inspection shall be phoned in to the plumbing Inepector, 560-3450 giv9ng number of this F� ��`� �� � permit., . r�c�ennmTr�wr �r �vi.ns �. Stories Basement ist 2nd 3rd 4th J Z I 0 � m r�. Connected with � z i m � Number. Kind and I.ocation of Fixtures N I�+ � I �� I N 1 O � 1 U m I ah' � I i�r I tU' < I ta5 a� GASE, ELEC. Gas Piping for Openings Permission is hereby granted � v to do the plumbing �nd gas fitting in the building described in the statement hereto attache , upon th.e express condition that the person to whom this permit is granted, and his agents, employees and workmen, in the plumbing or gas �itting of said bualdin� shall conform in all respects to ordinances of the City of Fridley, and this permit may be reuoked at any time upon the violation of any of the provisioras of said ordincances. By Order Of The Inspector Of Buildings Roughing in Inspection Date 7nspector. Fi»allns1vection Date lnspector. �z 1M-6-69-V City of Fridley , 19� r Owner (y2�{O Location �J ' �-�� � (� . Kind of Building ��irn:2� Used as To be Completed_ �n� , 19Z Estimated Cost $ �.��d. � O Buiiding Permit No. Date � Inspector of Buildings. . , � � � �� , � �' � ; Application �or Power Plants and Heafing. Cooling, Yemilation. Ref�iqN+alion and Air Conditioning Syst�rns and Devices PARTIAL RATE SCHEDULE GAAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work . . . . . . . . . . . . . . ... . . . . . . . . . . 8.00 � Replacement of Furnace ............................. 5.00 � Repairs & Alterations—up to $500.00 . . . . . . . . . . . . . . . . . . 5.00 $ Repairs & Alterations each add. �500.00 ............... 2.50 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTCT . . . . . . . . . . . . each add. 60,000 BTU .. ........ ... .. ... .. .. . Replacement oP Furnace ............................. Repairs & Alterations—up to $500.00 . . . . . . . . . . . . . . . . . R.epairs & Alterations each add. $500.00 .. ... . . . . . . . .. 8.00 � $ 2:00 ; 5.00 $ 5.00 $ 2.50 $ STEAM or HOT WATER SYSTEM _ Furnace Shell & Lines—ta 400 sq. ft. EDft Steam ..... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $ Each add. 200 sq. ft. EDR Steam . . . . . . . . . . . . . . . . . . . . . . 2.50 $ Each add. 320 sq. ft. EDR Hot Water . . . . . . . . . . . . . . . . . . 2.50 $ OIL BURFER—to 3 gal. per hour . . . . . . . . . . . . . . . . . . . . . . 5.00 $ I over 3 gal, per hour—See Fee Schedule , GAS BURNER (up to 400,000 BTU) . . . . . . . . . . . . . . . . . . . . . . . 5.00 • $ GAS FITTING FEES: NO RA'1'E TOTAL lst 3 Fixtures ...................... x $1.50 $ — Additional Fixtures ................. x .50 $ , Gas Range to 200,000 BTU . . . . . . . . . . , x 2.00 $ i AIR CONDITIONING a FAN HEATING SYSTEM See Fee Schedule I VENTILATING SYSTEM �—�� ALTERATIONS & REPAIRS TOTAL FEE $�_ ROUGH FINAL �9�'' � Dept. of Bldgs. Photu SII �-7470 �,,� �v Locetion ��i Kerry Lane // � City of Fiidley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. FY�idley, Minn. �/SG , ig/ � Owner Sam Templin Const. Kind of Building �'rame Used as +""' y • To be completed about Estimated Cost, $ /i Old—NewXBuilding Permit No. Permit No. `7 c:� C� � DESCRIPTION OF WORK HFATING or POWER. PL.ANZS--,Steam, Hot Water, Warm Ai�–No. � Trade Name �1FC0 Size No. GB 1104–OHE Capacity Sq. F� E.D.R. 1������ BTU H P Total Connected Load 51 , 4 9 0 Kind of Fue] Na't . Ga S BURNER — Trade Name Size No. Capacity Sq. Ft. E.D.R BTIJ A.P. (REMARKS-OVER) �42 S�� Mill City Heating Co. Bs G(/� rh � ,.._ Business Phone No 5 4 4-15 O 1 . . _ . _ � . �y _... ._ �... � . . _ . _ �..�`..»...«."a_ T..x.�..�e,.,.i:�1-� ys;.�:�i�a.e��L.k__��;'-' ,�,..,,,, :"'F�'r�,"">-- , . , . . .:, . ., . • . . _•,'�w�� � ' `- .�' A , .. r ;, ., ' Z,�„ � � `' t,J - _ '� � �.���3 ! o i� �+- ��G4T LOSS CALCIJIATIni`<� [)t�����Ii"(���IEV�7" �it� t'��PE�:C:�3��(�i�' n,.iti�c„on�rc� Vbeather�trips �� �+�S.H.V,E C,uide y ows�� ?rs � fZef�rencr. s !Vo Ye No ,I 19�_ Cer.structicn No. InsulaEio❑ � -I�-- Out. Wa11 Int. �Vall Ce�ling Etoof 1=(oor � Kind How - - �- �- - -1 � � r Fi. • F.00m j Lengt�:`�' �'idth _ Windcws and Doors-Crackage and Area \�'iJlh }�eiKht \u. o! i.lneal tL Ar.e, N0. of pan�nr iiKh!v n( Crg�� aq. [t. Infiltration c.tas: Exp. weU Iti'et ezp. wall Int. wall Ce�Iing , �Ff oor Tota! Btu. Required sq.� ft. Windaws and 1 wi�ttn t, No. oj�ane ot Infiltratioa Glas+ _F.:p. wafl Net txp. wall Int, well Ceiling Floor Tota) Btu. .R, or a�. ins. W.A. L adrr area +r` --- �toomiLenAth //�-�idth ors--Craekagc a�d Area �t no o[ l.tne:�; tt. n---. . ne lig�u �f�ra..k x� t:. �� -- �..�-r_ � Requirc . ft E.D.R. or sq. ine. W.A. eader area • • Room l Length / .�11�'idth Windows and Doora-Crackage and Area Wltlth }i��ght Nu. o(TLlr.eal tt. wr.-a No• �Ot ane o[ par,e Ilghts of reck eq. ft. -- , ,o 0 Gisu Exp. w�il Net exp. w�q int. waU Fbor Tatal � � �_ - -s _ _ _ �-- , - -- � � _ ' . . ". � . - - ___-.2. ' ' —, .__. ' � --�feibht F1'i,, Rcwm Length�—Widtho r--- -- -- ' -- - - �' �dews an �oers-Crackage and Area tL. ' / -- - - /� �,'y/,�/ � 1� �, � 1..--Nr'�;hi Nu. uf Llneal fl. Area ," � ��°� .r t�.'+ P n( { ane Iightn o[ crack e�. tt. _ . `7��_9�'d �T� Y '�- � : - -- �(-l' i! -- - -�- -- - -__ _-- �- � � --�-_ Coef $tu ;� ---- I -- -- � � =_ __-- -_=__--: -- __--_ � rn��i�.�r�o� ,' - i -- - _------- - s� � 'I Glass � � �' -- ----- -- -- - -- - � � j+ F��_�_a�i � �( 7 — SI �� - - -_ �,�s�. -- -- `': Net exp. K�all � . ; � - -- - _. � ---- - -- �, ;i YInt_wall_._ ----------- — �---l�eiiing — ' --- --- ---- _------� �'' t � � � ��, �� r �--_ �' �-� -- — ___ __ � � ""__.� '�.' _ ' Total i3iu. � -- _ _ -- ----- �`' ' IZequ�red sG ft E. .R, or sq. ins. W.A. L.eader area �--Hught_�G' j �2� r Room I Lcngth �Jiath i -" !�._ _ ------ ; -- ----- -- ,; \'v'wndu:+s and Uoors-Crackage and Area �� �rF[rt .�t Nc.. ,t Lfneal(t. Area / _ •_ �•f t��e � 1!ghts ut crack �q. ( , : ;:. , � � : l ! �- �_ �. _ _� _ -_ --, -- - - -- __. � o �� - � � � .. . , , _ -- ---- r---- - -- -_ � : , - ca�t. t?�� � - _ -- - -- - - - �� � � �o � e� Bpt � 2�`,►. � 2f _.. .. _ � � _ _1�-_ e . _ _ _---.. � � Y 1 .�,'tration �� � � -- �% !� __ _ _ __-- � � ��" �: Vi355 � � .- _ __ _ � _ � - Exp. wal! x �-_- '� Net �xp. wali � -- -- I � -- -- - -- _ _ _ '� lat. wall -i--- i; i� -- -- i� C�e�ii!ig � , �, ------ _��---X /_ � v :� ���j���r :� - - �� 7'ota; 8tu. .` � ---- ---- i; Rec�ui-ed s ft. E.D.R. or sq. ins. W.A. Leader area �' Neight `� �� j,� m I Length Width Height � �; -�_-_-' � /� ;' __ �/indows and Doors-Crackage and Area � � � �rR�Itt: Hel�ht No. ot Lfaeal It.. Area �,(/ i! '���� t pane ot pane Ifghts o[ crack ��. tt. , � __� ��!; -Z_� o �'� � !I sfiaa� . -......�...J Infiltration Glass Exp. wall Net exp. wal) Int. wall ------ Ceiling Floo---- ` Tata---1 B b(� � �: B�� �-�-- -.{–V. ,; M-Y_� . -r-,,-t-.—: _--.�-s•���-.�..�:�.�.,m.,M.t�,-.Y,w:= -�'��"�= - - .. _ _. ,... ..,--.�.-.,.,..--- � : ,.� ., ._ � �,� ..� �. , 1 _ _.... r - r , . �... . - i �' , f , . . . / ,w '�/..��r �J C i �..! . p�'* ,� ��' ♦ ! , "� l��a+r� j �.•( �,: R.. �) ��.�y.:; �.�� �-�.,'9 / �i L �{r�.�..r..v./�' +� / �, ' . �_?R� ¢. �.S � �'L>�'�d� � ". Ir L i(�,;-',t� �, 4-. r.y. �,.- . �. ,�,. a i - � i ��1 l y • ` . •. . 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O a��� p> � .N N A d +� �' 'D O '� o�i �v�a ao N � � O � � ti � � N a CITY OF FRIDLEY INSPECTION DIViSION ��� �� 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VEN7ILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE Residential Furnace Shell and Duct Work, Bumer – Also Replacement Furnace (Side Vent – FiN Out Back) Gas Piping (Needed with new furnace) Gas Range Gas Dryer *Air Conditioning – All Sizes All Others/Repairs & Alterations (LIST ON BACI� 1% of Value of Appliance or Work Commercial/I ndustrial 1.25% of Value of Appliance or Wo�k Rate TOTAL � 30.00 $ . �D $10.00 $ $10.00 $ $10.00 $ $ 25.00 $ State Su�charge TOTAL FEE $ $ ,5p � MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25 00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr *Air Conditione�s can not be placed in a side yard without written pe�rnission from adjoining property owner. Effective On January 1; � ssa •c ' ��' '. � ♦ ; z �.��. The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes and rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are rue and corre�. �� ,1998 OWNER �(.[q�2 ��1 �e.{1� —`�'- BUILDING USED AS eL`/rJ ESTIMATED COST �7/�Q � PERMIT N0. �,� �-� DESCRIPTION OF FURNACE AND OR BURNER No. of Heating Units Circle One (Steam) (Hot Water) ir TradeName /�Ll4R� SizeNo. LtG�'/�7�l�'4� BTU '�7� ��� HP EDR Fuel Total Connected Load Burner Trade Name Size No. B� HP EDR HEATING COMPANY��. %�`�,pao %� Signed By ~ Tel No. �� � � Approved By • Rough–In Date Final Date FILL OUT BACK SIDE F STACK VERIFlCATION ON �(. � REPLACEMENT FURNACE CHIlVINEY AND STACS VERIFICATION The undersig�d hereby ve�es that the exist�ng chimney or stack: 1. Has been carefully examined Yes (� No O 2. Is free from rust or deterioration �3. Has no foreign objects lodged within 4. S. 6 7. �� Is securely supported Meets all current Code requirements for size and totai BTU's connected Has total heating BTU's of All other BTU's TOTAL BTU's Has a liner been provided for water heater Has combustion air been provided for water heater Yes (� No ( ) Yes (� No ( ) Yes (/� No ( ) Yes (� No ( � Yes ( /j No ( ) Yes (� No ( ) Remarks: . ,. . �.ist �ALT�..�tA'�IONS Being. Done: � HEATING CO: Signed By: Date: 0 CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 °-� PERMIT N6_: 2004-01285 _ - -_ ____ __._--� DATE ISSUED: 08/09/2004 (763) 572-3604 FAX: (763) 571-1287 ADDRESS : 6240 KERRY LN NE PIN : 133024430026 LEGAL DESC : HEATHER HILLS : LOT 6 BLOCK 2 PERMIT TYPE : BUILDING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : DECK VALUATION : $ 1,887.00 NOTE: SEE NOTATIONS ON PLAN. � CALL GOPHER STATE ONE AT 651-454-0002 FOR UTILITY LOCATIONS. CONSTRUCT A 12' X 12' DECK. STATE LICENSED CONTRACTOR 1 APPLICANT BUILDING PERMIT FEE 66.20 TW1N CITY HOME REMODELING (20385210 PLAN CHECK FEE 43.03 6527 CENTRAL AVENUE FIRE SURCHARGE 1.89 FRIDLEY, MN 55432- STATE SURCHARGE, VALLJE 0.94 (763) 572-2577 LICENSE SURCHARGE 5.00 TOTAL 117.06 PAID WITH CHECK # 22574 OWNER SCHAEFER EUGENE L& J Q 6240 KERRY LN NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time a8er work is commenced. � I hereby certify that I have read and examined this application and lrnow the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whe specified herein or not. The granting of a pe ' does presume to give authority to viola or canc p'' n any other state or local law regulat' co s t' cons ion. Applicant Date ' �% Bldg Insp Da SEPARATE PERMITS REQUIRED FOR WO1�K OT�R THAN DESCRIBED ABOVE. NEW ADDN ALTER _ aoa� ala��.�,��� [] CITY OF FRIDLEY Effective 4/1/2004 [] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bidg Insp [] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax BUILDING PERMIT APPLICATION . � Construction Address: � � �o �.�.�,��, �,� w f � � �" t�' ; . � ; , j� � `�a � �-�. Legal Description: Owner Name & Address: L�� �o �� -� _ �$'c-G� .9 t,��erL Tel. # %(0 3 S' 7 � - � �o �3 Contractor: �rr,�u—.�:..� MN LICENSE# Address� s Fil�� 1�N 5.5d.�2 � Tel. # LIVING AREA: GARAGE AREA: DECK AREA: OTHER: ph.7�672-2577 �Att��,l�i�tion, a Certificate of Survey of the bt, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT iWqr CITY HOYE REMODELING : 6527 Old Central Ave. 4 F�y, MN 55432 Ph. 7�63�672-2577 . - MN Uc. 20385210 . Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length 2� Width 2-� HgUGround �� Sq. Ft. ._1-�v-� iJ�� v �� ��-� i�-����y� Construction Type: � � vewa Width �o TE: �^�'�`� / you for card number. Estimated Cost: - �/ �� 1 �o �/ Ft. + t x $ _ $ IT: G/v Tel. #� 5`� � 2� Z S� 7% Permit Fees if mailing in application. Fax to 763-571-1287 ff using credit card and we will call Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge TOTAL CITY USE ONLY - $ 01� °� Fee Schedule on Reverse Side $ . bJ 65% of Permit Fee $ .001 of Permit Valuation (1/10th%) $ $.50/$1,000 Valuation $ $1350 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: � �� �'�/ � 1 � � n�/) � Z� ,� � w � , ' � � � � , �w► ♦ .•• t' �.' � : . , � • � I+ � � =�_ . ' / � "11't�'d 3D dQl O„L �i?3Q • � � � \ t • '. . � ' \ ` ��� �. � , .. , � � � � , � r, , 1� '' ,_ �, � � ' �� � , .� � � J � � � N � � � � 3 ��•` � � - �-�- �� - - � f Z � � � ��� ��:�c,cn �,; _. ;� _ : --? -.. � _ h U � i-- � l�J '�L �-- 't'— lJJ `'� ao=� o t-.. .. UJ�� m m O Z 0�11..� CJ)QI.J� F— �. �~ Z ''� M f� ���Yl __ u � � � ♦ . .. � , � � J . � � � � q � � �' � r Y �� � � � W � � �.s �1. � . �,. � � � �- � � r_ �� � � � � 0 ,�`, � S ����C \ �� � � � �. � � � � �� � � � � ca . 0 \ � � � � � � � .� � � � � .__._ — (� ��i � � �� � 11. t i� � J �- W � O ` �" � t►r � � �° � O; �: � �,.. "V � ❑ .,o�,,y - ,g/� - � � � � � �1 � � i l � �' i � �O N �� ��� �3 s� �� J � z � - 2� ,� o � r� -x �� � � � '_ r� n, �� N voo x .,z a�0 r�� I 10�' �%'i � „Q 1 % r7i � � w ' _� e � � ,. � N � �� `� 1�y�� {Yy � /� ` � �"'� V J7 1� 1 /�4lr ���� � �� L � � •) a0- �� � %`=sa '�77 �' �` �" i q i ri.Z '� \ � �� \ � i \ / ti � � x � ;d v • !� _--���L �� ` � : ,� � `----s1c� � ` �i � � � � Q r \ (�j . � �+•. tj.. � � � � l�.� � .i� � � �� � � x _ � O , � � � 1 ..�+ � .. ._ � � �� V � � � � .S ,l, � �J ,Z S O ' � G) �� � � ,_ � �7 � � --�,r' c/I � u �, _ � I � � • �i r2,, � � ,� r w ,� � � .� ��� ��� " ��� r � �� � � � r Q v T� N�4 -a Q N� � 0 �v�,� ► 2 Q � --� � � .� ; � a av ,� X � � � ; c�- � � � � � � . ����� � � �( r ,7 L i �y,; `•' � 7 ry ,.�'. ' . � � � �_ . W V �� i V U � = �~ ol � � L _ �� 2� � - �' -' Y � �� � ��i � � s-� � � � � � � � r � � � v � � � � ° � ° ' V.. a �a� ,�, . 6 { � ���� - � `� OC�' � ` � �" � � t�� � !�' _1.1^�.� � + � � � � 0 0 -�' � � � Y � � � � , � � iY tt� � { � .� � � S � � i� � � r� � J �I � p� � � ti� m � r - ��� -�l�c� � � �`�'� �U��� • � � � � � i'' � � � � � � li+/ � \/ � � � � � � .i.� � I '� " I.OT. lsUAVB?� � }�OU8� . LOCATION J'. LOT d. DLOCR 2� SURYBY� r0A . •, : . ., Y,:. � (� a� v . �� � Cc�� � �a , ��.� �,� :, CITY OP FRIDLBY ABAYHBR gxLLB M8. MI1i� 0' �AAtIiON /37, 3,�� �� h yD t.. t . �I O '� Q� � , �I ► � h `,' �`l zs � � o G�I701�C� �/`Oh /�%dn , �G Q lc ; � ��= 30 ` � , � ' DI,BCxIY?I01it Lo� 6� nlock 2� tleath�r flills, .City oi tridlsy. Mi�naesots. ••I�.barab� c�stit� that tAis aurve� was �ad� uad�r �r dinat su��rvi�ia� �ad that ._.:.i'-rs , a dul� aathorissd '�si�tsssd Laad Surv�yor nudsr tb� lawa o! Lb� Stata oi . . � � �f�1�iOti. � / _ ._.._. � .�• . � � �%, � �� Wi ia�. S. Loya, 8. L.8 . � • •� Mian. R��. bo. 6787 • ., � �' Ju1�.:,,�7. 1970 _ : ;,. . . 11 I . • � � � � �uilClill� � ��,���� � � Permii No.: L�t'��ZQ� �� � �11Spevt1012S ��'�'��i ��'��, ����,��;�'�'��� Received By:N�+r i� � 763-572-360� ���'� ��' ���E�r D���e�d� �� 17 2�� 76�-�02-4977 FAX EFFECTTV� 1-7-08 DATL I_ � I I��7� YOUR E-MAIL ADDRESS I SITL ADDRESS ID Z�I �% P.I'�''tl Ii�C �C� THIS APPLICANT IS: ❑ OWNER CONTRACTOR PROPERTY NAM�: � n e OWNER/ ADDRESS: i/ D GYY � � CITY STATE�ZIP (j� 2 TENANT PHONE:� — 5'�'I � b CONTRACTOR NAME: f4(VG/ G��1 Q��j✓IM %.7'!!• __ _ SUBMIT A COPY OF STATE LICENSE # � EXP DATE YOUR STATE LICENSE, BOND AND STATE BOND # EXP DATE "'"'�4� CERTIFICATE OF ADD�ss: ��j,b IU.a+n �j- �,� +�39 CITY STATE_�ZIP sS�32 INSURANC� PHOI�IE �'' 7,7y � 1iI C1 � FAX �10� �J �� LQ� PERMIT TYPE ��GLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: � ��' �,�P�CE1v�taT DETAILED DESCRIPTION OF WORK �C�t/I�{'I'll,((.41�j� � rGd�u•cPM�� Ui�� I�IiQI��A' � PER MS 16B.665 the permit fee is a minimnm of $15.00 or 5% of the total cost np to 5500.00, whichever is greater, for the improvement, installation or replacement of a residential fixtiue, 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 $500, FEES ARE BASED ON $] 0.00 PER FIXTURE, FJCCEPT Wf�RE NOTED. FlX1URES: (IIdDICATE TOTAL NUMBER OF EACH BELOVI�. MINIMCTM FEE $15.50. BATH SINK2AV _FLOORDRAINS SHOWER WATIItPIPING BATHTUB GAS PIPING (NEED QTY LIC7 SWIMA�IING POOL .. WA7ER SOFTNER ($3S) CLOTHES WASHER KTfCHEN SINK WATER CLOSET BACKFLOW PREV. {$15) _ DISHWASHER _ LAUNDRYTRAY � �WA'TER HEATER ($35) FORIRxIGATlON ` _ WATER ME'fER _OTH�R , � . . _ . ..... �� . �, �. � z :: - - r . x r � � � � .� ` __� n ,...;� ,tsk��_. ?; ,,, , . ;.. .r°t y , � . . s:. _. - _ . ,..._ ... Permit Fee $ N umber of fixnues @� 10.00 x$10.00 =$ Surchar e .50 Number of fixtures @$15.00 x$15.00 =$ TOTAL DUE $ OR Number of fixtures @$35.00 ( x 535.00 =$ 35• �° . State S�acharge = $ .5 0 (MINIMUM $15.50) ' � (MINIMUM $15.50) Total = $ S• THIS IS AN APPLICATION FOR A PERMIT-IVOT VALID UNTII. 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 permi d work is not to start without a permit on site; that the work will lie in accordance with the approved p(an in the of all work ich requi s review and approval ofplans. SIGNATURE OF APP T / PR1NT NAME,. �I � C'�S/�CI" DATE I Z �S a iAYPROVED BY DAT� �f ; � PLE2:S�`N�TE: SE . FrA'TE :PEIt3V1IT� AKE `FZE(�I:JIREi) FflR'B.UILDING,:EI;EGTItICAL AI�TD. M�I1���AI;. � a�RI� ' � �'itv nf �i rir�ilr�v �uilding �nspectioas �ea�artment 0�31 Universitv ,�venue NE. jririlev. ;VIN ��4�� 763-�7?-3604 ; � :�.��i: ?6�-�02--+07 �` �