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PRE 2010 DOCSSUBJECT PE IT NO. City of Fridley i WRECKING 2'6103 AT THE TOP OF THE TWINS PERMIT RECEIPT NO. tr �_____ COMMUNITY DEVELOPMENT D V. r PROTECTIVE INSPECTION SEC. NUMBER REV DATE PAGE OF APPROVED By CITY HALL FRIDLEY 55431 IL""A �'' 612-571-3450 910-F15 5/29/98 JOB ADDRESS 611 Lafayette Street E 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 22-23, 33-3 C .Riverview Heights SHEET 2 PROPERTY OWNER MAIL ADDRES ZIP PHONE Fridley HRA 6431 Univers ty Avenue NE 3 CONTRACTOR MAIL ADDRES ZIP PHONE LICENSE NO Rybak Excavating & Contracting Inc 3134 California St NE, Mpls., MN 55418 4 ARCHITECT OR DESIGNER MAIL ADORES ZIP PHONE LICENSE NO. 788-6577 5 ENGINEER MAIL ADDRES ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE REMOVE 8 DESCRIBE WORK Wreck House 9 CHANGE OF USE FROM TO STIPULATIONS Clean site of all Zolition debris which includes the foundation. Disconnect and have inspection of the water and sewer lines. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLMBING, 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 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 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PR DVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW F EGULATING CON- Waived STRUCTION THE PERFORMANCE OF CONSTRUCTIO f PLAN CHECK FEE TOTAL FEE /J(\ bl 2cj -9s A I Waived SI NATURE OF CONT RACTOR OR AUTHORIZED AGENT IDATEI PR�OPERLY„LII/DD TED THIS IS YOUR PERMIT ZWHEIN /P �fW 2tD INSP BATE SIGNATURE OF OWNER IIF OWNER BUILDER I IDATEt Effective 1/1/98 CITY OF FRIDLEY MOVING [ ] WRECKING 6431 University Ave NE PERMIT APPLICATION Fridley MN 55432 572-3604 Job Address: Legal Description: Owner & Address: Tel. # Contractor:Zr��,N Eycd V4 -7-1 y6_ Tel. # 180^6S7/' Address: SIJ 4/ ,dE 1:Z#", State License # DESCRIPTION OF BUILDING HOUSE: Length Width Height Sq. Ft. GARAGE: Length Width Height Sq. Ft. OTHER: Length Width Height Sq. Ft. Estimated Cost $ Approx. Completion Date UTILITIES City Water/Sewer Minnegasco NOTIFIED: 572-3529 [ ] 372-4720 [ ] Water Bill Paid: Yes [� or Collect [$ Moving Route: N S P 330-5500[ ] Cu. Ft. Cu. Ft. Cu. Ft. U S West 663-6000 [ ] ] Signature The undersigned hereby makes application for a permit to wreck/move the building described above, agreeing to do all work in strict accordance with the City Ordinances and rulings of the Building Division, and the State Code which requires any water well on the property to be sealed by a State licensed water well driller, and hereby declares that all facts and representations stated in this application are true and correct. ALL Moving: Principle Building into Fridley .... $300.00 Accessory Building into Fridley .... $ 42.00 Minimum Fee: $20.00 Through or within the City ...... $ 20.00 Move a building out of City ...... $ 80.00 Wrecking: For each 1,000 cubic feet or fraction .. $ 1.25 For structures which would be impractical to cube the fee shall be based on the total cost of wrecking at the rate of $6.00 for each $500.00 or fraction. PERMIT FEE: STIPULATIONS: Minimum Fee: $15.00 INSPECTION REPORT CITY OF FRIDLEY MINNESOTA (612) 572-3604 ADDRESS OWNER BUILDER NQ126142_ DATE /2i �%l,�i P%MIT NO. Im a DESCRIPTION INSPECTION REPORT DATE REPORT If no correcti ire listed above, approval is hereby given to procee 'ou will be in violation of th--dinance if you do not call for the proper inspections a- make correc- tions as called for. CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 C77_ 9R/1A APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR 1Nater. Bath, Wash Drink: Floor Catch Auto. srte Closet; Urinal Tub Shower Sink Tray Fount. Drain Basin Washer seregrit' .� ior`1 r IVVI_�L' Floor3 .' Floor -4 '. b: PLUMBING FIXTURE RATES: New Fixtures Old Opening, New Fix(ure Beer Dispenser Blow Off Basin Catch Basin Rain Water Leadsr Sump/Receiving Wank,=', Water Treating Appliance Water Heater-Elactria NO. RATE TOTAL Water Heater - Gas** Gas Range** Gas Dryer** is Back Flow Preventers Required ( )Yes () No Type $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 10.00 $10.00 14, $10.00 10-00 $15.00 Effective On March 1, 1996 Gad Gas Misc. Water Heater Appl. Range lFixt.: Gas Elec JOB ADDRESS 611 LAFAYETTE r 7 / 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 true and correct. Y?.-aj-aep ,1996 Owner S^( Building Used As SINGLE FAMILY RESIDENCE Estimated Cost r%5?%eo_ PERMIT NO. PLUMBING COM, PPAANY &LA_MM MFcHMiCAL CONTR_ACTDRS R INC. lz�jReinspection Fee$4Qa/Hr SIGNED BY �-,'` TEL No. 890-4868 2k ALL OTHERS AN0(OFfAEPAIRS AND ALTERATIONS 1.5% of Value of,Rixtre or Appliance Approved By Rough -In Date Final Date State Surcharge $ .50 MINIMUM FE OR ANY PLUMBING GAS PERMIT IS $20.00 >F S� PLUS THE $. VO STATE SURCHARGE k'. TOTAL FEE $SQi� v=, **CaMBl1STION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. MINIMUM SIZE 9 SO INCHES. City of Fridley AT THE TOP OF THE TWINS SUBJECT BUILDING PERMIT PERMUIND— r 19880 r ____ _ COMMUNITY DEVELOPMENT DIV. r v PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 ,.' 612-571-3450 R E C E I PT19U.- `j AP 7e NUMBER 910-F15 REV. DATE 5/8/89 PAGE OF APPROVED BY JOB ADDRESS 611 Lafayette Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 22, 23&33, 3 C Riverview Heights SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Gary Saxe 611 Lafayette Street N.E. 784-7276 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. R & M Associates 3482 Auger, White Bear Lake, MN 55110 770-9322 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW O ADDITION 1j ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Install siding, doors and windov� sashes 9 CHANGE OF USE FROM TO STIPULATIONS SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION ZONING SQ. FT. CU. FT. 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 1 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT VALUATION $6,700 - SURTAX $3.35 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 PERFORMANCE OF CONSTRUCTION. $90.00 PLAN CHECK FEE TOTAL FEE $93.35 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) WHEN PROPERLY VALIDAT D THIS IS YOUR PERMIT SIGNATURE OF OWNER OF OWNER BUILDER$ (DATE) BLDG INSP DA E NEW [ ] ADDN [ J R-1 AND R-2 ALTER [ ] Building Permit Application Construction Address: Effective 5/1/88 Legal Description: % r5 010? , �, 33, ? ! C - ft Owner Name & Address: # 72 A Contractor: A5 S 0 L X71 Aa L 4.1 C- Tel. # %7,or ` 93 z' Address: L/ Lez, 4 iT� 17!E e, Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. LIVIM AM: Length Width Height Sq. Ft. GAMM AM: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. 07MR: I ry C/ r'/©.6'C S PPI n Lu fi 4 S Corner Lot [ J Inside Lot Type of Construction: Approx. Completion Date: _ L ] Ft. Yd Setback Side Yard Setbacks Estimated Cast: $ �qr 76' 0 `- Proposed Driveway Width If New opening Is Desired: Ft. $ $ Width + 6' See Back Page 2 �7 - %3 GATE: � � APPLICANT: Tel. # 0 Permit Fee $ 00,"o C) State Surcharge SAC Charge $ Driveway Escrow $ Park Fee $ Sewer Main Charge $ TOM $ T3, sTIPVIAMCNS: CITY USE CINLY Fee Schedule on Reverse Side $.50/$1,000 Valuation $575 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Nary [ ] %3 The Chief Building Official small, 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: $1 to $500 $15 (Mininun Fee is $15 plus mmtorge) $501 to $2,000 $15 for first $500 plus $2 for each additional $100 or fraction thereof, to and including $2,000 $2,001 to $25,000 $45 for first $2,000 plus $9 for each additional $1,000 or fraction thereof, to and including $25,000 $25,001 to $50,000 $252 for first $25,000 plus $6.50 for each additional $1,000 or fraction thereof, to and including $50,000 $50,001 to $100,000 $414.50 for first $50,000 plus $4.50 for each additional $1,000 or fraction thereof, to and including $100,000 $100,001 to $500,000 $639.50 for first $100,000 plus $3.50 for each additional $1,000 or fraction thereof, to and including $500,000 $500,001 to $1,000,000 $2039.50 for the first $500,000 plus $3 for each additional $1,000 or fraction thereof, to and including $1,000,000 $1,000,001 and up $3539.50 for the first $1,000,000 plus $2 for each additional $1,000 or fraction thereof MtIVAW rPTIV.SSICM ESCKW (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. Permits for construction will be issued a minim m of 24 hours fr m the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the framing. 63-8L,416051 CITY OF FRIDLEY APPLICATION FOR PLUMBiNG AND GAS FITTING PERMIT 1 $3.00 0 $2.00 X $2.00 c $5.00 u $5.00 x $10.00 M $7.00 X Water �� a a� 14 ►+ Ln a .- V! � 0 b $4 a. w Heater H a o sr m a cl C•a C -+a N •.1 a 0 O .0 O —4 sr 7 Id ro 41 a b ++ V1 r U D M C4 to $ O :s. 0 ua U a3 r. s :gym C7 O as leC -= d 2:.d ii (R) = Ft:ture Cc:inection opening Connected with Sewer (*) = New Fixture, Old Opening Water PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE N' Ser Fixt=es F'Zv.=e F-xture Cpenirg New Fixture, Old Opening Catch Basin :rater F:eater - to 99,000 BTU l��,000 S.J to 199,000 BTU That__ Softeaer New Ground 111,in Old Building Electric hater Heater GAS FITTING FEES: 1st 3 fixtures Additional Fixtures Gas na rge to 199,003 BTU REPAIRS & ALTERATIONS First $103.00 each add. $100.00 or fraction X $3.00 X $2.00 X $2.00 X $5.00 X $5.00 x $10.00 X $7.00 X $5.00 X $5.00 X $3.00 X $1.00 X $10.00 $5.00 $2.00 State Surcharge TOTAL FF.E REINSPECTION FEE ($10.00) TOTAL $ Job Address 611 Layfayette Street Department of Buildings City of Fridley Tel. #571-3450 The undersigned hereby makes application for a pe Wit for the work here n. specified agreeing to do all work in strict accordance with t'le City Codes and rulings of the Department of Buildings, and hereby declares that all the facts and representations statod in this application are true and correct Fridley, Mn. 6-�3-81 19 0*M-R SAXE RIND OF BUILDING frame USED AS res. TO BE COMPLETED ABOUT 6-30-81 ESTIMATED COST 50_00 OLD - NEW BUILDING PERMIT NO. PERMIT NO. CompanVeep, Signed By Tel. NO. ROUGH INSP. Date FINAL INSP. Date APPROVAL FOR PERMIT r MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 PLUS $.50 STATE SUR= -TARGE 97 — 4 416051 1. 1 1 1 LiI I I%I UI - l. I APPLICATION FOR PUPIDING AND GAS FITTING PI:RNIT A w m c Water a a HG 7 w Hester U U C 1T,I 4.� " a 11 U QN iu. F U epi K t d U. ILA H Nro C U ]_ q tU 1A x A 4U. in I C4 U X 4 S R) y Future CUrMaCtjon Gpening I CC:,:neCLad with ') New Fixture, Old Opening PARTIAL Rill t SCIiEDULt ILUMBING FIXTURE RATES; I10, RATE 11ua.4-r Fixtures x $3.00 rULtlCa E'lature Opening x $2.00 NCC t'iAtuLe, Old Opening x $2,00 C%Lch bash x $5,00 Water Rester - Lo 97,000 b9U x $5,00 1U0,000 BM to 159,000 BTU x 510.00 Nstdt ScfLenar x $7.00 Neu Gtuund R.,n Old buildirq x $5,00 Glet:ttio Nater lies Ler x 55.00 iAS H f:FING FEES; lsL 3 ttxLuras x 43,00 XAAIL10ns1 Fixtures x $1,00 G%a h.lnya LJ 199,000 BTU x $1.0,00 LPAI kS 4 ALTERATIONS ri.i L 5100.00 $5.00 each aJJ- 5100,00 or frscuon $2.00 SLatq Surcharge TOTAL VC1: FLEI1t5PECTIO11 PLC Sewer Water Job Address 611 Lafayette Street NE Department of buaiinga City of Fridley Tel. 8571-3150 The underslgn,:d hereby makeo application for a permiL fcr the work herein specified agreeing to do all work in strict acccr_ience with, the City Codaa and rulings of tha Dep>arLmcnt of Buildings, and hereoy ,Ieclarei� that all tho faCtil and roprueuntntiony Statud in this 11pplication aro ttuo and eorruet Fridluy, ttn• 10-24-79 , 19 OWNER SAXE KIND OF BUILDIUG frame USED AS res. TO BE COMPLETED AhCUP 10-31-79 ESMIATED COST 40.00 OLD - NEM BUILGIIIG PEW1IT NO, t _ 81917 Company Siylned By Tel, No, ROUGH I11SP , Da to FItlhi, INSP, Date M111RUVAL F'OR PEitmvP MINIMUM FEE F01% MY PLUI<bING PEMIT IS 0,50 PLUS 'y.50 ST;.TS 6UROLAICCE �1F 20420 Building J®b Report ADDRESS OWNER • BUILDER TDE R DATE c- PERMIT NO. DESCRIPTION aa c - INSPECTION RECORD • DATE REPORT 7t& P OWNER REP. INSPECTOR City of Fridley, Minn. BUILDING PERMIT Date: Nov. 10,, 1967 Owner: Charles Hanson Builder Address 6426 18th Ave. South Address Same Same LOCATION OF BUILDING N9 9552 No. 611 _ Street — LaFayatte_._ Part of Lot Lot .._.._._..22,23 Block C Addition or Sub -Division .___Riverview heights Corner Lot _ Inside Lot — — Setback --- Sideyard -- Sewer Elevation To be Used as: _ Rend.iis Front Front Type of Construction Foundation Elevation DESCRIPTION OF BUILDING Depth Height Depth Height — Est. Cost _ 3 00.00 "!O� �'/r/-/ Sq. Ft. Cu. Ft. Sq. Ft. Cu. Ft. To be Completed In consideration of the issuance to me of a permit to constru9t the building described above, I agree to do the proposed work in accordance with the description above rth and in co plian=allprovisions ' of ordinances of the in of Fridley. l a&j)� In consideration of the payment of a fee of $–. 5.00 ., permit is hereby granted to— Charles Hanson to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. _ / �-- Offical Building Inspector NOTICE: This permit does not cover the construction, Installation for wiring, plumbing, gas heating, sewer or water. Be euro to we the Building Inspector for separate permits for these Items. rr ' APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY$ MINNESOTA OWNER'S NAME BUILDER DR SS ti( t�� tti, 1U� ,AORESS %pGAit OF BUILDING N0, i0, // STREET 1 ART OF LOT LAT i 3 BLOCK ADDITION OR SUBDIVISION .LIIP�i �T .COMR LOT „INSIDE LOT ' SETBACK ' ' SIDF YAYiD SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this fora Two Certificates of Survey of Lot and proposed building Ideation drawia •ton tle'se Certificates. ' "` f 4 MUOT OI OF B,t, To Be "Osed Ali ,. Sq.' Ft.. , .Cu. apt. .. „ .t .... .r . s -r,..:...,.... ,....tj!7r d Deptb.: Height: . Sq. Ft. Cu Ft. .: 4.. ,srtiratea cess ` o� Type of Construction . To Be Completed The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict 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 ar% true and correct. (Schedule of Fee Costs can be found on the Reverse Side). b �� r.. • Z BUILDING PERMIT FEE SCHEDULE SECTION 2. The Inspector of Buildings shall, before issuing permits for the'•er4mtjon.-of�4ny Buildtng'•or-*trttCt,are•; 'or- for•ariy­addition- to any ' existing structure or building, or for any alteration or repairs to any existing building or etructnre, upon -application therefore, require the the payment by the applicant for such permit of fees to the amount herein p manner in provide44%.to-wit:. . ..slaw: et,. forth and in the mann her ..... , bnfform' Buildiiig Code: 1, 2, & 4- $1.75° 'fdr' each one" Mou`send cubic feet, or •ftactibn thereof, in auch .cubical contepts.r -Type 3 & 5- •$1.5'0 ;dor each one thousaid'cubic"feet. - For the purpose of cvmputing..fees for building permits, the:cubicaj: ' contents of any building or addition µto a uniform height throughout by' multiplying the ground area coveared .fr.cpa.a point six (6) inches below the floo: line of the basement or the "cellar to tte average height of the upper surface or to the average height of the roof surface of the main gable of -4 pitched roof. 101; --repairs -or alterations . to an,existiQ'sisucture•, toe fee• shall beat the rate of $3.00 per each five hundred dol:-ars,•($500.00) or fraction thereof - in•• the• cost of al -1 proposed . work-. in no case shall -the fee _charged -for ,any peaitt as-- set- forth in- Section -•2. be less than $5.-00,., NSSSD Connectipq Charges based on location- Area 1 or 2,; 1'er --mr -a City of Fridley Application for Plumbing and Gas Fitting Permit Dept. of Bldgs. Phone 560-3450 DESCRIPTION OF WORK Number, Kind and Location of Fixtures PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ....... % x $2.00 $ I Z 2r� Z Z �jO , $ Z • • WATER HTR. GAS ELEC. x $3.00 $ New Ground Run Old Bldg . ............ x $3.25 $ Electric Water Heater $ $2.00 $ <T� GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $2.00 $ `�- ' Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ Base ad 63rd 4th • Future Connection Openings Connected with I Sewer � New Fixture, Old Openings Cesspool El PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ....... % x $2.00 $ Future Fixture Opening ................ x $1.50 $ New Fixture Old Opening .............. x $1.50 $ Catch Basin ... .. ..................... x $3.25 $ Water Heater (Up to 99,000 BTU) ...... x $3.00 $ New Ground Run Old Bldg . ............ x $3.25 $ Electric Water Heater $ $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $2.00 $ `�- ' Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ REPS AIRS & ALTERATIONS—Refer to Code Description $ TOTAL FEE $� City of Fridley: N, The undersigned hereby makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are true andcoc t. Fridley, Minn - - `� / L 19 1-7 Owner Kind of Building Used as To be completed about Estimated Cost, $ Old—New. Building Permit No Permit No. Signe By Business Phone No ROUGH FINAL 42