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PRE 2010 DOCS'/® ® 4:� -- 2� City of Fridley, Minn. 9539 BUILDING PERMIT Date: Nov. 6. 1967 Owner: Osborne C ons t . Builder Address 7565 University Ave. N. E. Address Same Same LOCATION OF BUILDING No.._._ 270 Street ...._ LibUrty St. N. E. _.._ __ Part of Lot Lot 47 & 48 Block 6 Addition or Sub -Division -spring Brook Park Corner Lot Inside Lot — Setback --_ Sideyard -- Sewer Elevation Rifidic846.61 849.61 Top of Footing DESCRIPTION OF BUILDING To be Used as: _welling Front 40' �p 24' Height 2U'_ Sq. Ft, 960 Cu. 19, 200 Front Depth _ _ Height _ _ Sq. Ft. __ Cu. Ft. Type of Construction — Fie Fat. Cost ----t12 , 000 _.... To be Completed SEWER = LOCATION - 115' West of Manhole or 221.5' Eaat of Manhole on Ruth WATER LOCATION - 10' East of the Sewer 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 description above set forth and In com ce with all provisions of ordinances of the city of Fridley. $100.00 Sewer Connection Charge In consideration of the payment of a fee of 29.00 , permit is hereby granted to Osborne Construction 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 ]lofts and flue permit may be revoked at any time upon violation of any of the provisions of said ordinances. CLARENCE BELISLE Building Inspector NOTICE: This permit does not cover the construction, installation for whdng, plumbing, gas heating, sewer or water. Be sure to no the Building Inspector for separate permits for them heaps. ADDRESS APPLICATION FOR BUILDING PERMIT CITY OF FR:'MLEY, MINNESOTA "A "CORNLlt LOT, NSIDE %fly OF 13uMINfi ; ►`.SRT ` OL_.�0� SIDE=YAFM r. -, yv: SEWER ELEVATION FOUNDATION ELEVATION � `Y - 6 Applicant attar to this"#orm Two Certificates of Survey o€^Lot and. proposed . '�ipilding ° l+�eation'ilraw�l=orr these CertifiC�ites. " ` y{�SCRi14 0i BUir.�;I G 1`o Be'Ude .Prot 'l3 Depth Height- o ;xy Sq. Ft.o Cu..Ft. •awi...i�.���a6!...Niir/!NM��rL r�r,'+r4.rrFL�Ti:flar:. -Depth ,Height S Ft. Type of Construction` `"14-�-- �F.etimated'Cost ar��.rir.ut.�.w.r..+r.�r To Be Completed "y The undersigned hereby makes application for a permit for the work herefn 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 are true and correct. DATE�- (Schedule of Fee Costs can be found on the Reverse Side). City of Fridley Application for Plumbing and Cas F'Mng Permit Dept. of Bldgs. Phone 560-3450 DESCRIPTION OF WORK Number, Kind and Location of Fixtures y GG77 W NO. RATE TOTAL Number Fixtures ...................... x $2.00 $ TjT�� Y $ a 8up Z N < �� W �O' Z 0 O • F + N WATER HTR. GAS EIEC Base New Ground Run Old Bldg. ............ x $3.25 $ Electric Water Heater a $2,00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... �x $2.00 — $ 2-' -ci Additional Fixtures .................... x $ .75 1st I Gas Range to 199,000 BTU .............. x $5.00 $ % 2nd 3rd 4th • Future Connection Openings e New Fixture, Old Openings I Connected with Sewer El 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 a $2,00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... �x $2.00 — $ 2-' -ci Additional Fixtures .................... x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE $ '1c Le City of Fridley: a 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 facl and representations stated in this application are true and correct. Fridley, Minn. Owner l��/��% /1 /� en Kind of Building �� Used as p�� To be completed about — Estimated Cost, $ Old—New. Building Permit ROUGH FINAL 42 0� + Permit No. Phone No -7 )V, Vs- 7 Application for Power Plants and Heating. Cooling. Ventilation. Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work ..........................$10.00 $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 .................. 6.00 $ Repairs & Alterations each add. $500.00 ............... 3.00 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ $10.00 $ each add. 60,000 BTU ....................... 3.00 $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 ................. 6.00 $ Repairs & Alterations each add. $500.00 .............. 3.00 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam .$10.00 $ Furnace Shell & Line,—to 640 sq. ft. EDR Hot Water ... 10.00 $ Each add. 200 sq. ft. EDR Steam ...................... 3.00 $ Each add. 320 sq. ft. EDR Hot Water .................. 3.00 $ OIL BURNER—to 3 gal, per hour ........................ 6.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 199,000 BTU) ....................... 5.00 $ over 199,000 BTU See Fee Schedule GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures x$ 2.00 $ Additional Fixtures x .75 $ Gas Range to 199,000 ........... x$ 5.00 $ AIR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH ,. FINAL See Fee Schedule $ TOTAL FEE $ Z! Dept. of Bldgs. Phone 560-3480 City of Fridley: The undersigned hereby makes application for a permit for the work herein, specified, agreeing to do all work in strict accordance with the City Ordinancec and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application aree true and correct. Fridley, Minn CT "�'� - t_ 17-- 19 d Owner Kind of Building Used as v To be completed about Estimated Cost, $�7`c� G� Old—New. Building Permit No. 5,3 Permit No. ®rP DESCRIPTION OF WORK HEATING or POWER PLANTS–steam, Hot Water, Warm Air—No / Trade Name - �� Size Nn_�%�" L`% f® -0 Capacity Sq. Ft. E.D.RZ '/ , /T� BTU ` ,.� H.P. Total Connected Load o �g T_ 1 . Kind of Fue a BURNER —Trade Name Size No Capacity Sq. Ft E.D.R I BTU H.P. (REMARKS -OVER) Signed 22 )G By � fit/ CQjD)D 4E Business Phone No- C D 56 z B A® 7 ® o�I A t- d f f / �eV Width Height No. of Lineal ft. Area No. of pane of pane lights of crack eq. ft. � a Z p 2 26 :z- 30 1? MAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS Infiltration 19 Weatherstrips A.S.H.V.E. Guide Reference 19— Btu Construction No. 7 Insulation dows Doors I —Q:::7— Out. Wall Int. Wall Ceiling Roof Floor Kind 1 How Applied Ye " No 1 1 G L4J, 1yds; a e / Fl.l / en/ / A!.^ Room I Length '2- 2- Width 12- Height P II 1Fl.1 _R P RoomI Length IZ Width S I Height Windows anh Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack eq. ft. Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. f//t. Width Height No. of Lineal ft. Area No. of pane of pane lights of crack eq. ft. � a Z p 2 26 :z- 30 1? I of pane Coef. Btu Infiltration 19 2,b Coef. Btu Infiltration 7 L) Exp. wall Glass 3 3 11 Glass !Coef. Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area wallNet o50 Room I Length i Width 1A 35Uv_ Exp. wall Ceiling exp. wall �S G ® Floor Net exp. wall Int. wall j 11L I /P Z Int. wall ®� % Floor Ceiling Floor 7 2 C 14 / v ' Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area, 1 F1.1 h-� i Room I Length Width I L Height P Windows and Doors—Crackage and Area Coef. Width Height No. of Lineal ft. Area No. of pane of pane lights of crack eq. ft. Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. f//t. -7, SK 2-6 '?i � G I 610 /0� .Z&e� D 3nR .,. 11P No. of pane of pane Coef. Btu Infiltration 13 Btu Infiltration Glass Int. wall 7 L) Exp. wall Glass C Floor �41000Exp. !Coef. Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area wallNet Int. wall Room I Length i Width 1A Height,;, Ceiling exp. wall �S ® Floor /00 Int. wall j Ceiling ®� % Floor 7 Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area J F1.I r ',.; Room I Length 14 Width '7 Height Windows and Doors—Crackage and Area Coef. Width Height No. of Lineal ft. Area No. of pane of pane lights of crack eq. ft. Windows and Doors—Crackage and Area Width Height No. of Lineal tt. Area No. of pane of pane Coef. Btu Infiltration 13 Net exp. wall 3e '' Glass Int. wall 7 L) Exp. wall E' C Floor ` Net exp. wall 2—. Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area ( Int. wall Room I Length i Width 1A Height,;, Ceiling Ceiling �S Floor Floor 1 qo Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Windows and Doors—Crackage and Area Coef. Btu Windows and Doors—Crackage and Area Width Height No. of Lineal tt. Area No. of pane of pane lights of crack Btu Infiltration Net exp. wall Windows and Doors—Crackage and Area Coef. Btu Enfiltration 0 32 1 1 LIO Glass 2-0 50 1000 Exp. wall Btu Infiltration Net exp. wall b' 1 d Int. wall 2® Ceiling, E' 2 Floor 2 2—. Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area ( I Fl.l RPA Room I Length i Width 1A Height,;, Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. G.� 0 Coef. Btu Infiltration I go 1 d Glass 2® or) Exp. wall 2 Net exp. wall OL I I tai 172-0 Int. wall Ceiling `9 Floor 1 qo j Total Btu. I b Required sq. ft. E.D.R. or sq. iris. W.A. Leader area I I F1.1 Ra 1 Room I Length / Z Width 9 Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack eq. ft. Coef. Btu Infiltration Glass Exp. wall 2 Net exp. wall / �► _ Int. wall Ceiling `9 Floor Total Btu. ,,,, 2 2. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area C I T Y O F F R I D L E Y 6431 University Ave. N. E. Fridley, Minnesota 55421 Johnsville Electric Co. 1380 109th Ave. N. E. Minneapolis, Minnesota March 14, 1968 RE :RP4IT SHORTAGE 270 Liberty St. N. E. Gentlemen: Your permit for the above captioned address was short the following: $4.00 We would appreciate it if you would kindly give this matter your preferred attention. When sending in the above amount, kindly place it on a regular Minnesota State Affidavit so that we may properly process this permit. Thank you. LE :bks Yours very truly, LEONARD EICHMILLER Electrical Inspector City of Fridley Application for Power Plants and Heating. Cooling, Ventilation. Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work .......................... $10.00 $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 .................. 6.00 $ Repairs & Alterations each add. $500.00 ............... 3.00 $ MECH. WARM AIR $.6 y� Furnace Shell & Duct Work to 120,000 BTU ............ $10.00 $ each add. 60,000 BTU ....................... 3.00 $ Replacement of Furnace ............................. 6.00 $ Repairs & Alterations—up to $500.00 ................. 6.00 $ Repairs & Alterations each add. $500.00 .............. 3.00 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam ...... $10.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 10.00 $ Each add. 200 sq. ft. EDR Steam ...................... 3.00 $ Each add. 320 sq. ft. EDR Hot Water . ................ 3.00 $ OIL BURNER—to 3 gal. per hour ........................ 6.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 199,000 BTU) ....................... 5.00 $ over 199,000 BTU See Fee Schedule GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x$ 2.00 $ Additional Fixtures ................. x .75 $ Gas Range to 199,000 ........... x$ 5.00 $.6 y� d o AIR CONDITIONING Q 'j�' I e N�ev $ FAN HE See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE $ ROUGH FINAL Dept. of Bldgs. Phone 860-380 1i4L p Location L 1 City of Fridley: The undersigned hereby makes application for a permit for the work hereir 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. Fridley,, 1VJinn 19 L-4 Owner d l - U .1-e 1 Sit a/ Kind of Building F f` A M p,sv 4f Used as 1 To be completed about N e I s Estimated Cost, $ '55'6 Old—New. Building Permit No. Permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. Total Connected Load Kind of Fuer BURNER — Trade Namp Size No Capacity Sq. Ft. E.D.R BTU H.P. (REMARKS -OVER) Signe , 6A"", By <a Business Phone No Original PERMIT for Power tants and Heating, Cool- ing, Ventilation, Refrigeration and Air Conditioning Systems and Devices DESCRIPTION OF WORK No. of H.. eating)J Plants to be installed-altered—repaired eq-�Makel , Size Z ry� 0 ; Oil fired—; Coal fired—, Gas fired ; Cas Authorization No. Remarks Approved by. Final Inspection 19_ Inspector </7V�® Permit N° 4506 Fee $ Office of the Inspector of Buildings City of Fridley City of Fridley, Minn. 7 , 19 Owner Location Za Kind of BuildinJg How Occupied Work to be Commenced To be Completed & m " S ,19-�eq Estimated Cost, $ 45 GO • 6-6 Old -New, Building Permit No. Permission is hereby granted to © I , W ' LV o to install—erect—use the material and devices described in the above statement. This permit is granted upon the express condition that 4the person to whom it is granted, and his agents, employees and workmen, in all the work done and materials used under this permit, and in the operation of the devices herein mentioned shall conform in all respects to the ordinances of the City of Fridley relating to or governing the work to be done and the operation of the devices herein named, and to the specifications set forth in the approved application for this permit on file in the office j°ice o f the Inspector of Buildings. C � �) I ltd.c-is�.� , Inspector of Buildings 42 2M 11-67 V s6 i� City, of Fridley, Minn. 1 Q - . 6431 University Ave. N. E., Minneapolis, Minn. 55432 BUILDING PERMIT Date: May 4. 1971 Owner: __Arvid_Nel enn Builder _Saine Address __2Z0Liberty Street X.E. Address Same LOCATION OF BUILDING No- --47-9..--- Street — Liberty Strtaat–N,R Part of Lot Lot --47._1E$..__.__ Block _ 5. _._..__._.___ Addition or Sub -Division Sgrixi9—Erook Rark Corner Lot _.___.._ _ _ Inside Lot ____ Setback — Sideyard Sewer Elevation Foundation Elevation _.._... DESCRIPTION OF BUILDING To be Used as: Garage _ ___ Front —24t_ Depth 241 _ Height _ LQ! _ Sq. Ft. _ 57.6_, Cu. FT.. 5.76.Q Front . _ Depth Height Sq. Ft Cu. Ft Type of Construction—Fra*ne I Est cost — $2,000, To be completed Sept. 30,---19 Provide hard surface driveway. In consideration of the issuance to me of a permit to construct the building described above I agree tp do the proposed work in accordance with the description above set forth and in compliance with ail provisions of ordinances of the city of Fridley. %YIAn In consideration of the payment of a feanof $ 11.00 , permit is hereby granted to Arvid E. Nelson 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 ordin4nees of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings wig city limits and this permit may be revoked at any time upon violation oaf_=of the provisions of Said Building Inspector 51 NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to no the Building Inspector for separate permits for these items. APLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME: /q#fU t Q 12-' ZC .P®" BUILDER: ADDRESS • � 7 d ; Z „ J',Y S� /y ADDRESS: NO:. D ? 0 STREET:_ L/ Z'- LOT:1/ 2 - 'qX BLOCK: ADDITION:- S� T.., �� ,� /'ark CORNER LOT: INSIDE LOT: SETBACK: '� SIDEYARD: Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: qac Front: ay. Depth: Height: �! J g s' ght• Square Feet: s' ? f® Cubic Feet:� Front: Depth: Height: Square Feet; Cubic Feet: Type of Construction: /`—/�/ Estimated Cost: To Be Completed: 5 !�/7 ;�- C7,71 The undersigned hereby makes application 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 true and correct. DATE: _C'�r""' �y l?il_ SIGNATURE: ave' (See Reverse Side For Additional Information.) I If, Land Planning s��lLn 6875 Highway No.BS N.E. Land Surveying • �l /a Minnea olis Soils Testing n��aee�c� , vme. Minn. 5431 Civil Engineering ell ef Telephone 784-6066 Municipal Engineering Engineers & Surveyors Area Code 612 Mortgage Loan Survey for ARVI D WEL.GON LisF-R-Ty STFzEET 12 ALLEY O''- Scale- 1 30tt�et Lo -T5 41 E 42lBioc�< (2:> e�--,WoKr1 COUNTY This is atrue and correct representation of a survey of the boundaries of the land above described and of the location of all buildings, if any,. thereon, and all visible encroachments, if any, from or on said land. This survey is made only in connection with a mortgage loan now being placed on the property and no liability is assumed except to the holder of such mortgage or any other interest acquired by the reason of such mortgage. It is understood and agreed no monuments have been placed for the purpose of establishing lot lines or boundary corners. Dated this 144 day of /-%F- I A. D. 19_JL. SUBURBAN ENGINEERING, INC. LEng4-1 in t1rr 1 c C) I a Land Planning %LyZ 6875 Highway No. 65 N.E. Land Surveying • Minneapolis, Soils Testing ��y2�2ee,►�, Vifs Minn. 55432 Civil Engineering Telephone 784-6066 Municipal Engineering Engineers & Surveyors Area Code 612 , Mortgage Loan Survey for ARVl D WE-LC.ON LiBE'R—Ty GO. — 1 e 4� 9 M ' 40.'2 F,ly-e"Izz' C4 CJ 2-i 0 40.Q. a � o inch�� < Scale- �1—=3Q ' r Mewl add,�a �+ e, te�1CQ ' — Cob • O — a3- 2•l± 12' ALLEY Lo -Ts 47 �4 SOCK (2:> This is a true and correct representation of a survey of the boundaries of the land above described and of the location of all buildings, if any, thereon, and all visible encroachments, if any, from or on said land. This survey is made only in connection with a mortgage loon now being placed on the property and no liability is assumed except to the holder of such mortgage or any other interest acquired by the reason of such mortgage. itis understood and agreed no monuments have been pieced for the purpose of establishing lot lines or boundary corners. Dated this_j" day of_NPri A. D. 19I SUBURBAN ENGINEERING, INC. 32 EnEllno i • w PI.WLBIRG. FIXTURE RATES, NO, r, ■ q Nture e-litura OponLng U . New FLKture, OLd'Oponing � � u $2,00 Hater x $5,00 A x $5.40 a b; a M" Macer Saf caner x •.. q W .pp+ n1 x o► 5 Lloe cxlc Nater Hester - ^� 1104 or ' , ^C lot 1 fLxtures' F•, ..e, 4 e� )Jdltic.%•1 rLxturse W w c ((,, u x $10,00 RFP 1 ' r 0 r ,Nq N rl d S +q� NN N N Np v a Q . Q LI Jt Q a 1h w U W c 1e 7. li 0 Pas '100 �d re.' (R) - N taro Co nnect.Lon Opening Connaccad with Suuor (•) - 11aw Fixture, Old opening Hater -PARTIAL RATE SCHEDULE PI.WLBIRG. FIXTURE RATES, NO, RATE Nture e-litura OponLng >1 $2,00 New FLKture, OLd'Oponing � � x $2,00 Catch Basin • x $5,00 !_water Hoayer - to 99,000 BTU.,'. x $5.40 100; C00 'BrJ to 199s000 BTU x 110,00 Macer Saf caner x $7.90 ' 1Jew Ground• Pun Old Building ._-.._� x 15,00 Lloe cxlc Nater Hester - ^� x $5,00 CAS FITTING FEES; lot 1 fLxtures' x $1,00 )Jdltic.%•1 rLxturse x :1100 :C11 MA9 a to 199,000 BTU x $10,00 RFP 1 ' _ A RS 4 ALTERATIONS rLrat 1100,00 each ►cd. 5100.00 or fraction S,wto Surcharge TOTAL, FEE TOTAL 97 �-879001 ]ob l►d reel • 270 NE Libe ty Department of Buildings City of Fridley I Tot, 1511-3450 , 1 The undersigned hereby makoo application for A parmtt for the w 0000ified agrueing•to .do all work in strict accordance with the C and rulings of Elie OapartMOnt Of Buildtngi, and haroby doclaros t the !acts and rol)rgountationa itatod in thir APPlicatloR are true Fridley, Mnn, 3-30-78 OIJIIFR BARTEL ' KIND OF DUILDI110 'frame USED AS res_ TO DE C014PLETED ABOUT 4-6-78 , ESTIMATED COST OLD - NI:H HUILDING PERMIT 1401 PEfq4IT 110. Company NENSCO Signed By' Tol, No, ROUG11 INSP. ' Dnte ' • FI111}L IIJSP, /�2 a - 7 • i Data 1 APPROVAL FOR PERMIT ,e12K. $5.00 $ ' $1,00 $ �— MIIIIMUM 1'E6 FOR A11Y PLUMDIHG PERMIT 15 17150 $ .50 ' 1 8.00 60 SUBJECT PERMIT NO. City of Fridley 5 341,31 AT THE TOP OF THE TWINS BUILDING PERMIT r ftQQPT NO `L _ ____ COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. i CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 9 7/12/79 JOB ADDRESS 270 Liberty Street N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 47,48 6 Spring Brook Park SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Albert Bartell 270 Liberty Street N.E. 786-9376 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. = Statewide Builders 4790 Lakewat Terrace, Excelsior, MN 55331 370-053 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIPPHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK O ElNEW % ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 24' x 12' Garage Addition and a 22' x 14' Deck 9 CHANGE OF USE FROM TO STIPULATIONS Provide a hard surface driveway. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Wood Frame 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 288 2880 ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION I 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 BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $4,950 $1.65 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- STRUCT N OR TriEF MANCE OF CONSTRUCTION. $21.00 rjONr+, PLAN CHECK FEE TOTALFEE �- 7.90 SIGNATURE OFC TRACTOR OR AUTHORIZED AGENT (DATE) r WHEN ROPE Y L A D IS IS YOUR PERMIT INSP f1A7E SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI 60 CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PERMITS (New, Alterations, Additions, or Repairs) OWNER: A q i4p iADDRESS: � /� � t ip 64&77 TEL NO: zs STRUT NO: LOT: STREET: BUILDER: ADDRESS: y% %C �ra.���a��$ /�r�i2 �eC�•ls�a TEL NO: Construction Location BLOCK: ADDITION: Corner Lot: Inside Lot: Setback: Sideyards: DOCC Ic- Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTION OF CONSTRUCTION J Front: Depth : Height: Squane Feet: Cubic Feet: Ma Front: Depth: Height: Square Feet: �_ Cubic Feet: �SZ Type of Construction :mvt Estimated Cost: $ 7b Be Oumpleted:� - f Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ $ SEE REVERSE SIDE OF SHEET 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 applicat' arm true dcorrect. DATE: �� C SIGNATURE: G Stipulations: 2833 x 8-39 Z1. 00 BUILDING PER141T FEE SCHEDULE SECTION 2. The Inspector of Buildings 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 repairs 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: NEW CONSTRUCTION: Single Family Homes and Garages: $4.00/1,000 cubic feet. PLAN CHECK: 25 percent of building permit fee. DRIVEWAY DEPRESSION: (Concrete Curb Streets Only) Alternate A: Removal and replacement of concrete curb and gutter only; Driveway width plus 6 feet x $15,75 Alternate B: Removal and replacement of concrete curb and gutter and install a 3 foot wide approach with 6 inch depth; Driveway width plus 6 feet x $17.85 Iffa wis Mommallujam ate1 For the purpose of computing fees for building permits, the cubical contents of any building or addition, is determined by multiplying the ground area covered from a point six (6) inches below the floor line of the basement or the cellar to the average heights of the upper surface or to the average height of the roof surface of the main gable of a pitched roof. For repairs or alterations to an existing structure, the fee shall be at the rate of $3.00 per each five hundred dollars' -($500.00) or fraction thereof in the cost of all proposed work. In -no case shall the fee charged for any permit as set forth in Section 2 be less. than $7.50 plus $.50 state surcharge. ILL ►�G �l NOTE: 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 construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has been constructed will be required before proceeding with the framing. NU i Application for a Certificate of Occupancy shall be made ten (10) days prior to the use or occupancy of -any structure for which a building permit has been issued; and said structure shall not be used or occupied until a Certificate of -occupancy has been issued. City of Fraley SUB�F& P, ,f 3 2 7 8 3IN AT THE TOP OF THE TWINS BUILDING PERMIT r ` RECEIPT NO. COMMUNITY DEVELOPMENT DIV. r y PROTECTIVE INSPECTION SEC. 1 . i NUMBER REV DATE PAGE OF APPROVED BY I = i."I CITY HALL FRIDLEY 55432 ....... 612-571-3450 910-F15 7/15/02 JOB ADDRESS 270 XXXX Liberty St NE I LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 47,48 6 Spring Brook Park SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE John Rejman, 270 LIberty Street, Fridley, MN 55432 612-280-4265 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Royalty Remodelers, 4411 Slater Rd, Eagan, MN 55122 651-882-1460 20274044 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK jo NEW O ADDITION O ALTERATION ❑ REPAIR ❑ MOVE O REMOVE 8 DESCRIBE WORK Re -roof (tear -off) 27 squares 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with State Building Code. 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 ZONING SQ. FT CU FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 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 BE COMPLIED $2,894.00 $1.45 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 REGULATING CON. $$3.25 Fire SC $2.89 CT OR THE PERFORMA CE Of CONSTRUCTION -�- PLAN CHECK FEE TOTALF , 2 . Licen $5.00 HEN PROP $92 Y A ALIDATED T S IS YOUR PERMIT SIGNATURE OF CON7R CTOR OR AUTHORIZED AGENT IDATEI BL G INSD OLTE S,GNATURE OF OWNERIIF OWNER SUILDERI MATE, w -. NEW (] CITY OF FRIDLEY Effective 1/1/2002 ADDN (] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp ALTER (] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: l 7o Legal Description: Owner Name & Address: Tel. # � 9S6�"�^ S Contractor. Nn L e,--deIcl-S MN LICENSE # Address: q1t /1 S /cz 7`eCX Tel. # %" r Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft GARAGE AREA: Length Width Height Sq. Ft DECK AREA: Length Width Hgt/Ground Sq. Ft OTHER: Construction Type: Estimated Cost:$CX 64 e q V. Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ =$ DATE: APPLICANT: Tel. # Call (763) 572-3604 for Permit Fees if mailing in application or Fax to 763-571-1287 if using credit card and we will call you for card number. Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge CITY USE ONLY- Permit NLY- $ 4 3• Fee Schedule on Reverse Side $ .001 of Permit Valuation (1110th% $ 1,45 $.50/$1,000 Valuation $ $1200 per SAC Unit $ S.0-0 $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 [ ] TOTAL $ 901-59 STIPULATIONS: . sJL.L.. V li' 4- "v , iUN Ui . 6431 University Ave NE Fridley, MN 55432 (763) 572-3604 Stories Basement Floor 1 Floor 2 Floor 3 Floor 4 PLUMBING FIXTURE RATES: New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas!* Gas Range' Urinal NO Gas Dryer`* Back Flow Preventer Required ( )Yes () No Type Reinspection Fee $47.00/Hr APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Washlitf{zii`'{ Floor »>` A uto. >> iShowerkWTra.........��»>' Drain .......v I+Qtiit<�»: __ B��tt��»>'» Washer RATE $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 $15.00 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge TOTAL FEE Effective Un Jan 1, 2UU2 w#�erat;��4_ Gas :' <`; ater Heater 1....:: M...... Ran a »»{:::::>:> Gas TOTAL JOB ADDRESS L— 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. L] , 20 v2_ Owner 50 Building Used Ash/\ (��f Estimated Cost PERMIT NO. PLUMBING COMPANY - o SIGNED BY TEL N0. 7, 92A4C, FAX # Approved By� Rough -In Date Final Date MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $20.00 PLUS THE $.50 STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED Mn IMM `EKITF VENT r_ONNF(__TOR AND n(WRIPMON AIR VERIFIrATION When rr Ian ning an _xie ina furamp-, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes (► No ( ) The venting system is plastiGPVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes( ) No( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) The pYisting cnmhu_stinn air is sized and installed to meet the current codes and manufacturers specifications. Yes( ) No( ) When required to install a new _nmh ustinn air. it will be sized and installed to meet the current codes and manufacturer's specifications. Yes( ) No( ) When installinna new venting system, 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 Furnace Venting Tables for fan assisted and natural draft appliances. Yes( ) No( ) 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. Yes( )No( ) 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 Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type Y HEATING CO: Signed By: Date: NOV-02-2005 12:42 CITY OF FR I DL.EY 3uildiing $I I 1'- 2-6' BUILDING 1?err�it No.: uslipect+iJonsf�an. urcharge RESIDENTIAL'�'1 APPLICATIONDate By: 163-5 t2-a7VO4 -..!p $ CITY 3 LE i +pR=e3ved �. ate L1ec'd- SATEffib � YOUR E4LAM ADDRESS h x� ®nk- 0" MS A) • C a ^1 rm ADDRESS L: S $1450 per SAC Unit (Flans W MWCC for determination) :urb Cut Escrow HIS APPLICANT IS: Q OWIqR CONTRACTOR. 'ROPERTY OWNER/ 9k'J F � AA- h, � �MAJ o c , b+�i s+ A] E2: TITAN I $ CONTRACTOR O- NAME Ce -JJOIJ k $: i,r 60' STATE LICl:1 SE O: 2-00 0 ` 3/S1/04 45:0 C-7 (U R !72• ' Ii SURMI'r A COPY OF SURMI'r YOUR STATE LICENSE AMkWS--.----- __. p STATE --,ZIP VRM APPLICATION pH0 - gq ( -5q00 FAx 2 - iia I - q2.roh PROPERTY TYRE LH FAAdII fNEw CONSTRU{;t'K}N Sly C CC1AlSTRGGl1t?N STORIES PERMIT TYPE ID ADDITION o GAltAGEISHED 13 WINDOWS bmASEMENT FINISH Q ROOF D DRAIN TILE © DECK ❑ SIDING ❑ OTHER 0 5WBABO40 POOL TYPE OF WORK: 13NEW a ADDITION NC41QMANCE/REPAIR XRMAODEIM >ESCR>BE WORK B J NG DON'E: J0 Qe S, Ca : N�, Via, i' IZ` 14 as 1 114N T= .,n Tk Ann ltZ TLA A L`L rr• T lw4u urmlm TA=M" G V* UMBER OF SQUARESARAGn _ RQPQSED SIZE: ROPOSED FII=ICiW; I Vinyl I Aluminum 1 Otter 4 MSTINQ OPENNGS OYes EDNn R FOR NEW OPENNCS-DESCRIBE 517.,E OF IPENING CHAN= & CI ROUSE & GARAGE 0 ATTAa= GARAGE DETACHED GARAGE MOM 13 Trina C Fascia LOCATION OF WDMWS BASEHRU REIv OMM WSW: 1. Exbft Hoot P1ffl ✓ 2. Ps qWA fm plan ✓ 3. List of sttut*ral munbas to be uW FOR NEW CONSTRUCMN INC=TNG DECKS, ADDITIONS, & Pt7RQW SUBho. 1. Site Ply dowing the g sb chums and Ptpsed PRIca 2. Two secs ofamnmetiann plans 3. Energy Calcul YPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS I ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF ]L"Ok AND MATRRfAT S: (USING THE 19 97 v.8.0 FEETOTAL JOIR VALUATIONS <n�S(OOCSCHEDULE) TYPE 'ermit Fee $I I 1'- 2-6' See Back Page for Fee Schedule �lan Review �. y $ -r t o . y6?65% of Building Permit Fee urcharge $ (.0005) times the total job valuation - Minimum $.50 ire Surcharge S#vgr -..!p $ .001 x Permit Valuation (1l10%) ,icense Smharge ,c� $ $5.00 (State Licensed 1Lesider tial Corttractars) .AC Charge $ $1450 per SAC Unit (Flans W MWCC for determination) :urb Cut Escrow $ - -- - ft + 6 ft ft x $20 =$ xosioa Control $ $450 Corwrvatit n plan review ark Fee $ Fab Determined by Engineering ewer Main Charge $ Agement necessary ( )Rion Necessary ( ) .otal Dile S 1 q 1 . I Make ehftks Payable to: City of Fridley Attach Stipulations _ _ -- THIS IS AN APPLICATION FOIL ,A PSS f NETT VALL0 CiY+ M PROCW= hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in onformanre with the ordinances and codes of the City of Fridley aAd with the Miunesota Construction Codes; that I understand this is not a ermft but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved ' Ian in the case of all work w h es re and approval of plans. IGNATURE OF APPLICANT _1 � �/o� _ __ PPJNT NAW ' IBJ 9� (L I�S� Building PLUMBING Permit Nq.-; QQ a Inspections RESIDENTIAL APPLICATION Received By. 763-572-3604 CITY OF FREDLEY Dace Rec'd4 L_ DATE o -7 YOUR E-MAIL ADDRESS SITE ADDRESS 70 , A.44-r f T THIS APPLICANT IS: 0 OWNER 64ONTRACTOR PROPERTY NAME: ®HAJ F-J M A 11) OWNER/ ADDRESS: `? o Lig k 2 T X ST CITY EA, O C, F 0, STA l `13 i TENANT PHONE: % 8's // e CONTRACTOR NAN&: o t 2 2 d L16 2 A C. ®c F-,e, /0 G6 6 /.0 C_ SUBMIT A COPY OF STATE LICENSE 51-4 y PP, EXP DATE / Z/3, /C) 7 /G 2 4' (27 , SP 1­4 K E le k STAT�aJZIP�� Y3� YOUR STATE LICENSE WITH ADDRESS: �, u _ CTTY 14.4 �— `7r°o3 5 a fedi' 15 PHONE `�� 3 S' 2 d d �® FAX APPLICATION PERIVUT TYPE 1a SINGLE FAMrLY O TWO FAMILY O TOWNHOUSE TYPE OF WORK: O NEW *kEPLACEMENT DETAILED DESCRIPTION OF WORK PER MS 16B.665 the permit fee is a minimum of $15.00 or 5% of the total cast up to 5900.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtm . (This should reflect only the cost of labor) Labor cost under $300 – $15.00. Labor cost between $300 to $500 = cost of labor x .05 – FOR PROJECTS WHERE LABOR EXCEEDS SSW, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) BATH SINKR AV FLOOR DRAINS SHOWER _ WATER PMNG _ BATHTUB GAS PIPING (A® cn7 Lin a)_ SWAAIRNG POOL _ WATER SOFINER ($35) �_ _ CLOTHES WASHER KITCHEN SINK WATER CLOSET • _BACKFLOW PRE/. (SIS) —DISHWASHER ` LAUNDRY TRAY aWATER HEATER ($35) FOR IRRIGATION _ WATER METER —OTHER Permit Feep Number of fixtures @ $10.00 x $10.00 = $ Surch .50 Number of fiXWM @ $15.00 x $15.00 = $ Number of fixtures @ $33.00 x $35.00 = $ TOTAL DUE State Surcharge = $ .50 Total = $ THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building 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; that the work will be in accordance with the approved plan in the case of all work which requires review and approval of pians , Y4 z' SIGNATURE OF APPLICANT �- PRINT NAME d K, ,E k ey��DATE r /0 7 .. tffl`��+` • ` _ , ` T$`' ` • r `:l�)'3` RB.D 3VWMA`NI_ ' - - s City of Fridley ]Building Inspections Department _6431 University Avenue NE, Fridley, -MN 55432 763-572-3604 FAX: 763-502-4977 90 Building MECHANICAL Permit No.: ' Inspections RESIDENTIAL APPLICATION Received BA-D�� 763-572-3604 CITY OF FRIDLEY DatR"dKjrjkj 763-502-4`977FAX EFFECTIVE 2-19-09 IE-MAIL DATE , ��'(�1 i m YOUR E -MA L ADDRESS SITE ADDRESS e97) 0 L v THIS APPLICANT IS: PROPERTY NAME:_ OWNER/ ADDRESS TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION COMPANY NAME:_ CONTACT PERSON: ❑CONTRACTOR STATE LICENSE # EXP DATE �{� ADDRESS: i'I CITY r STAT O /! 6 PHONE �S�_�'L% I FAX PERMIT TYPE I SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: j REPLACEMENT DETAILED DESCRIPTION OF WORK City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977