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PRE 2010 DOCS
City of Fridley, Minn. BUILDING PERMIT xo 4273 /C v � Q° Date: __.._._.. - - - .._............._.. ..._ �•— _......_...._.. Owner-------------------------------------------------------------- --------- ---- _..._........... -.................... Builder _.. ......._..... ....... ....... .... Address... _....... ..... ................................. _...._...._ _.._.._...._.... _._............ Address No. �/ ��ff LOCATION OF TBULDING 1.j._./...._9. Street ........... _........... ..........------... - .Part of Lot ..... _............._.....�..._.._......._.....__.._-_. _ LotlBlock............ 3 ............ ........... _ Addition or Sub-Divisionl ........... .... ... .._._... �� Corner Lot ... _._..._....................... Inside Lot ._..X..- --. .__...... Setback ..1-50_.`......._..._.......d . Sideyard ...1.67_!x, ......... --............ -- SewerElevation .................................................. _........................ _.._....................... Foundation Elevation ................................... .............. .............. _........... ---•--...... DESCRIPTION OF BUILDING To be Used as: .. .. ......_.. a ....... Front ... Depth_3..6.:�..� Height f...�.® Sq. Cu. F11401A . X sri ......... _. Front ....................��Depth.:(........_.. 0. Height .............---......_. Sq. Ft..............._.. Cu. Ft........_.. Type of Cons cdon ......Y* '?y- ................._. Est. Cost......... 1 ..� _ '. To be Completed ..... ............. ... .......................... 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 compliance with all provisions of ordinances of the city of Fridley. In consideration of theayment of a fee of P ..........-permit 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 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. Building Inspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these items. 4 City of Fridley Application for Plumbing and Gas Fitting Perndt Dept. of Bldgs. Phone SU 4.7470 DESCRIPTION OF WORK`I di LAI Number. Kind and Location of Fixtures Location l i q TOTAL 2n 12 xi Zz3Z_ c� $ i�4'a (� O�j < �U°d �� Z �O F N WATER HTR. GAS ELEG Base Water Heater (Up to 200,000 BTU) ...... / x 2.00 $ New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 Additional Fixtures .................... x .50 1st Gas Range to 200,000 BTU .............. x 2.00 $ 2nd 3rd 4th • Future Conaect%n Openings New Fixture, Old Openings Coaaected with Sewer Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL G Number Fixtures ...................... x $1.50 $ Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ Water Heater (Up to 200,000 BTU) ...... / x 2.00 $ New Ground Run Old Bldg . ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code 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 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, Minn. I' 1—" Owner �" Pa tn Kind of Building / K r2 - Used as LL) 10 To be completed about Estimated Cost, $ Old—New. Building Permit No 7 Permit No. 066 Signe c ROUGH 6 FINAL Description ...........$ Ire TOTAL FEE $i��QM042 2M 7-59 Business Phone No.��— cil y 0.5 Fi i8loy .. wSiluli��tSi i� ��C� �J� f^•.:o� tw ,.i ul T„�• � if �!dii2'`•.� i��1:.:14 "b' � 3Uop't. of Bldgs. Phono SM -3" DESCBIPTI011 0:' Woo— Lam= ���•, Xt:MS,_r. Ki --j &-jA Lecr_ie^. of FtMtsres ` :� iX Z v N Ip Ion;• I` U 1 I �• I = 0 6 I WtiTf4 Hix. MC. ;•. ser F`lxtu:es ................ ��' I 7<i74Y v w�cAs New Fix: -.:re O;rl O*>ening. • . • • : • • • • x 51.50 ��.--- x eo v3..05 Ea:Z- tInd Catch Las:n . .. • .............. a . Watcr Hester 'L'p to S-9.000 BTU) • • • • x Z-3 tt? -= ' New Ground pun Old B!dg......... x M.25 3 'et::lc t':a:e; Yos:at...... ...... •N0. Ri.:n': TOTnL ;'s F'•TTI N G FEES: x 52.G3 Ist 3 Fixtures ............ • • • • .. In d 3rd s Add!;Scnal Fixtures ............... -- G:s P.=ze to IS-3.OG3 B—LU ........... x 55.W y 4:h Old Ops lL'n % Cca pccsl El PARTIAL RATE SCHEDULE L ?3ItiG F'IXT. J:? PATES: 1Y 0. RATS I OTnL ;•. ser F`lxtu:es ................ Ft ::re Fixture 01'er.ing ............ New Fix: -.:re O;rl O*>ening. • . • • : • • • • x 51.50 ��.--- x eo v3..05 � — Catch Las:n . .. • .............. a . Watcr Hester 'L'p to S-9.000 BTU) • • • • x Z-3 tt? -= ' New Ground pun Old B!dg......... x M.25 3 'et::lc t':a:e; Yos:at...... ...... •N0. Ri.:n': TOTnL ;'s F'•TTI N G FEES: x 52.G3 Ist 3 Fixtures ............ • • • • .. x IV .75 s Add!;Scnal Fixtures ............... -- G:s P.=ze to IS-3.OG3 B—LU ........... x 55.W y City of F :dlcy:. The undcrs;;ancd hereby makes SPP,- cation for a p•ersnit fct the work her g do a l work in ^ct accord'^c= w- and the CitU Cr-- ra-- specified, a,;. coin to ' ' ` L*.e f. and haling of the Depsr tMe nt of B :ily ^^° and ?-ereby declares t.`:at a.I and represc-ntatlons stated in lh;s app:ica:ion 're t- rue :rd co=r^ez�i r idley, bvnn / 19_ Owner Kind of B::ildin ; Used as To be co:r,ple:ed about Estimated Cost, S O:d—Iv'ew. F3ui:ding Pe::nit :`o. - By nOU0i3 FINAL .90 State St'.=crar54 ?�L;E$ Yr At.:.T'.P.ATIvYr—�a;et is Cuda ' c .ISes:.1Y::on ...............:........ ,.............. . 1.: I i :/i ! 1.iULL1 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 $12.00 $ Replacement of Furnace 7.00 $ Repairs & Alterations -up to $500.00 7.00 $ Repairs a Alterations each add. $500.00 4.00 $ MECHANNICAL WARM AIR: Furnace Shell & Duct Work to 100,000 BTU $12.00 $ each add. 50,000 BTU 4.00 S Replace.:.ent of Furnace 7.00 $ Repairs & Alterations -up to $500.00 7.00 $ Repairs & Alterations each add. $500.00 4.00 S STEAM OR IDT WATER SYSTEM: Boiler & Lines up to 100,000 BTU $12.00 $ each addn. 50,000 BTU 4.00 $ Boiler only up to 100,000 BTU 7.00 $ each addn. 50.000 BTU 6.00 $ OIL BURNER- to 3 gal. per hour $10.00 $ each add. 3 gal. per hour 10.00 $ GAS BURNER- from 100,000 BTU to 199,999 BTU $10.00 $ (over 199,999 BTU see Fee Schedule) $ GAS FITTING FEES: e� 1st 3 Fixtures x $ 3.00 $ 3,, oo 47 Additional Fixtures x $ 1.00 $ Gas Range to 199,000 BTU x $10.00- 10.00-AIR AIRCONDITIONING FA,\ HEATING SYSTEMS See Fee Schedule $ VENTILATING SYSTEMS $ ALTERATIONS $ REPAIRS $ State Surcharge $ .50 TOTAL FEE $- . , n: 4 1 , Lace FINAL INSP. Date �/� APPROVAL FOR PERMIT '' / "7'� REINSPECTION FEE ($10.00) MINIMUM FEE FOR ANY HEATING PERMIT IS $7.50 p;LUS $.SO STATE SURCHARGE Job Address Department of Buildings City of Fridley Tel. #571-3450 j The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes % and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this applicationa e true and correct. F idley, Minn. , 19i OWNER KIND OF BUILDING USED A TO BE COMPLETED ABOUT �•� n ESTIMATED COST 64" " OLD-- NEW BUILDING PERMIT NO. PEP14IT NO. DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Ho Water, Warm Air- No. Trade Name e? Size No. h?0? - _ =36-0 Capacity Sq. Ft. EDR B d7J HP Total Connected Load Kind of Fuel BURNER - Trade Name Size No. Capacity Sq. Ft. EDR TU HP Company 9� Signed By Tel. NO. City of Fridley SUBJECT PER 15083 AT THE TOP OF THE TWINS BUILDING PERMIT r S R EIPT N0. `L -------COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 ` � ICITY HALL FRIDLEY 55432 ,�j NUMBER REV. DATE PAGE OF APPROVED BY L---- 612-560-3450 910-F15 3/20/79 JOB ADDRESS 5179 Lincoln Street N.E. 1 LEGAL LOT NO. BLOCKTRACTOR ADDITION SEEATTACHED DESCR. 1 3 Marian Hills SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Frank Kostick 5179 Lincoln Street N.E. 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE X❑ 8 DESCRIBE WORK Enclose present porch and add deck. 9 CHANGEOFUSEFROM TO STIPULATIONS This area can only he used as a three season porch and not be heated or converted unless a variance is granted and building envelope meets the State Energy Code. Provide 10 foot clearance between deck and electrical service. �► HrNC2 64" dfggfng call local u�lfig" SEPERAT� rt -R TS REQUIRED FOR y�fjRi �• rD'�NE -ELECTRIC a$ - etc. HEAfitNG, PLUMBING AND SIGNS. REQUIRED BY LAW 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 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 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. $•50 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $900 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- $7.50 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $8.00 SIGNATURE OF CONTRACT ROR AU. ORIZED AGENT (DATE) WHEN PROPERLY Ll DATED THIS IS YOU P RMIT JSIGMIUREOFOW BLDG. INSP DATE ER IIF OWNER BUILDER) (DATE) 01 • CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PERMITS (NEW, ALTERATIous, ADDITIONS, OR REPAIRS) OWNER:' �,�C'�in%K �®s /G.� _- MILDER: / Address: •5 7 % % � 1A -1L' -0L /l� Address: • d Tel. No.: No.: Street: $" LHLOCY.: � ADDITION: ,14X1< j OT: �® J COMER LOT: INSIDE LOT: � SLTPACY.: SIDEYARDS:. Applicant attach to this form Iloo Certificates of Survey of Lot and proposed building location drawn on these Certificates. ' VI DESCRIPTION OF BUILDING To Be Used As: bva- aS Depth: Height: Square Feet: Cubic Feet: Front: Depth: Height: Square Feet: Cubic Feet: 01 �/%/ri/�Estimated Cost: $200-%- 726 Type of Construction:--,. i To Be Completed: 14,4Z JVO Alt. A Alt. B Proposed Driveway 11idth If New Opening Is Desired $ $ (SEE. REVERSE SIDE OF SHEET) The bndersigned 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 nilings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. See reverse side for additional information. DATE: /9,bz SIGNATURr: stipulations: 'M Oo • -do`s A �. � ►� Alik k, j�osS�s' EN6��e , C*,.► 0AX.1r 13C � u „row'c• Ems+ v C�c►ot, pone -W, Amp, , 14 * ()A4.# "%9A IS &m4w1V v d - IN C vis -roc S?oo= 1 It V V!' is a 4 AI.TiRATlurd sioU.oU s�.i. e.:A. Slaw QO or ItaCUOn SLaln S,.rcr,nrge %r/.L , i.L $5.00 , $ $2.00 $ 5 8.00 HIMMUil I'LL: I,.h r-lY PLUI:uIIIZ FLiu;Ir IS 57.5J FLUS 'v.:0 ::)-TY Malu.hf.0 ' 97-84-1116051 hf•PLICATION FOR PUMBING AND GAs FITr1IrG Pftc;IT j. N 7—pi-C47 I w 0, Hater Job Addresfi 5179 NE Lincoln MI 3 Iieatet Lij T.` N •• DeparLMent or tr,:l,:jiry�y CCity Lt Prldlcy i ---,—I Tel, h571 -j453 L I Ii1 I _I Tha undornlgnsd L rety r. kkea appli.et::.= e eClfled a, P r e artttt („ r tho t wank Lecrin - ) - _ j �recln, w Jc' ; j «1 Werk ir. strict and rulings cl thi GL:paAmen[ -c:crlar,co rltt. U.r City CCdue ; 't ! of B-111JIrgs, 010 faclil mid 9L3LOd teat ei1 �I 1r ' �� •--i—I _ FP: 11oy, r r . _ 1I-29-80 Ito `I CIiNER KESTICK hI le Cu nnCct1On Gj'-nr, j y C- .; c,;tcd with Sexier KI11D OF 11UILLI::,; frame ' '1 r.e- t leturo, OIJ Optn1t.1 Hater "�-•--^ _ I USED AS res. 1 t TO DE C019PLCiLG /w:;J r 5-6-80 `� !• ESTIN&TLO COS•r 50000 !•111Jkl: kATES I lvu. RATE TOTAI. OLD - HIM BUILOIuZ pL1,;9I1 ,l..J: .r t Iwlurti x 53.00 — tul,.,c l:,.G,te G•cnl x "ed Il.t.na, OldGpe:.L• x $2.00 ""--• L..:a,l:�ny $ lLitrJNEGAS:�p x $5.00 5 St;lnea By Na le, ,taat.r - w 99,000 6'it1 x $5.00 g tu,,,000 GIU t0 I$ 0;.0 BIU=e1. x $10.00 $ Na. r+alor a..ltenac _ _ x 67.00 S 11,w ta�.,nJ Kin Old Bu1141r.,r x $5.00 $ L1ecl�,, Natee 11natee ROUGH I115p. x $5.00 Data �.5 111 TI1;G FtES: ' lat FIghL IIISp, ''-30-�U 1 ft.tureat Al.l,cts:ral rt -[urea x $3.00 $ —T-^ Oatu x $1,00 $ t0 1$5,006 6Iu x $10.00_ $ AI'1'IIUVAL t'Gh I-Liu-1i'r 4 AI.TiRATlurd sioU.oU s�.i. e.:A. Slaw QO or ItaCUOn SLaln S,.rcr,nrge %r/.L , i.L $5.00 , $ $2.00 $ 5 8.00 HIMMUil I'LL: I,.h r-lY PLUI:uIIIZ FLiu;Ir IS 57.5J FLUS 'v.:0 ::)-TY Malu.hf.0 CITY OF FRIDLEY INSPECTION DIV, Effective On January 1;1993 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Residential Furnace Shell and Duct Work, Burner - Also Replacement Fumace Gas Piping (Needed with new furnace) Gas Range Gas Dryer *Air Conditioning - All Sizes All Others/Repalm & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commercial/Industrial 1% of Value of Appliance or Work Rate TOTAL $ 20.00 $ $ 10.00 $- $10.00 $10.00 $$10.00 $ $10.00 $ State Surcharge TOTAL FEE C --L) MINIMUM FEE FOR ANY HEATING/COOLINGNENTILA ION REFRIGERATION/AIR CONDITIONING PERMIT iS $15.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $30.00 *Air Conditionem can not be placed in a side yard without written permission from adjoining property owner. JOB ADDRESS SI -19 b m c of `-, Sr 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, 5IZ1 ,1993 OWNER V UALDIEM R6MO BUILDING USED AS ESTIMATED COST 'q"OD ' PERMIT NO. l/ QESCRIPTION OF FURNACE AND OR BURNER RC'PL1AcE' cL-v-�sS 9'%' Fb#E; P1 PC - No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name Size No. BTU HP EDR Fuel Total Connected Load Burner Trade Name Size No. BTU HP EDR HEATING COMPANY WAIW Rngnpi1 a `*" Ira, C®w° �l�G Signed By Tel No.753-15a� Approved By A . Rough -in Date Final Date T �� FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE CHIMNEY AND STACS VERIFICATION The undersigned hereby verifies that the existing chimney or stack: I. Has been carefully examined Yes (14 No ( ) 2. Is free from rust or deterioration Yes (VS No (') 3. Has no foreign objects lodged within Yes (✓) No ( ) 4. Is securely supported Yes No ( } S. Meets all current Code requirements for size and total BTU's connected Yes (Vj No ( ) 6. Has total heating BTU's of l os l bo o All other BTU's TOTAL BTU's Remarks List Alterations Being Done: OLID ' -LUQ � L i4G L�Urt CLtR S '-LU e- bSr SAM HEATING COMPANY Signed By C lllYt '00 Date-- 3uilding BUILDING PeM2it NO.: 0f U(40— :nspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: 19+6 )ATE ITE ADDRESS 0 'HIS APPLICANT IS. YOUR E-MAIL ADDRESS ❑ OWNER 10eONTRACTOR PROPERTY OWNER/ NAME: IrXff /1(0. TENANT ADDRESS: S' %V �Off �ItSTAII%J O $ I T1 PHONE: D Ply $ y_ to ( CONTRACTOR NAME: /�oC.�`YJlid- ®/Y� )Pw i 11� me STATE LICENSE # 0)0 :'©S�1 EXP DATE — STATldv�/ -`-�' __ � r)®QE APORP Com' l��� SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION ADDRESS: PHONE ' &W_ .,E L3z- FAX 12 PROPERTY TYPE SINGLE FAMILY/NEW CONSTRUCTION SIZE $ ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ BASEMENT FINISH ❑ GARAGE/SHED 101OOF ❑ WINDOWS ❑ DRAIN TILE Make checks payable to: City of Fridley Attach Stipulations ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: 4c_ Ao"r SIZE OF IMPROVEMENT nvur Jul ky NUMBER OF SQUARES Iq GARAGES PROPOSED SIZE: PROPOSED HEIGHT: SIDING ❑ Vinyl ❑ Aluminum ❑ Other WINDOWS IN EXISTING OPENINGS ❑Yes ❑No OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING1997 U.$.0 FEE SCHEDULE) TOTAL JOB VALUATION $ �Dc OCCUPANCY TYPE ❑ HOUSE ONLY ❑ HOUSE & GARAGE ❑ ATTACHED GARAGE ❑ DETACHED GARAGE ❑Soffit ❑ Trim ❑ Fascia LOCATION OF WINDOWS NUMBER OF WINI HEIGHT Ft. BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan 2. Proposed floor plan 3. List of structural members to be used FOR NEW CONSTRUCTION INCLUDING DECKS, ADDITIONS, & PORCHES SUBMIT: 1. Site Plan/Survey showing the existing structures and proposed project. 2. Two sets of construction plans 3. Energy Calculations Permit Fee $ See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ I T1 .001 times the total job valuation Surcharge $ y_ to ( .0005 x Permit Valuation Minimum $.50 License Surcharge $ • OCl $5.00 (State Licensed Residential Contractors) SAC Charge $ $1550 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $20 = $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ J61n I,;) Make checks payable to: City of Fridley Attach Stipulations 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 lan in the case of all work ieq� a epi was oval of plans. M n A