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City of Fridley, Minn. BUILDING PERMIT No 4 0 4 0 Date: ....._..... k7....._.........__ .................... ........ Owner: ............ ._............................. _......... _....... ......... _.......... _............ ..................... Builder Address....._............._......._...._......._...._....._....._......._...._......_...._......_............--•-- Address ....................... .............. .............. ....................... _................................... OCATIO OF BUILDING No..3...L....... Street ....f..!,� .0O.. ���-_..... Part of Lot Lot ....................................... Block ........... .............................. ......... Addition or Sub -Division .................................... Corner Lot .................................... Inside Lot ...................................... Setback ............... .............. _.............. Sideyard Sewer Elevation ------ ............. .............. _............ ._............. -............. ........................ Foundation Elevation .................. To be Used as: AAJ Type of Construction DESCRIPTION OF BUILDING Front l.... J. Depth a;?5q .Height A�.�. � Sq. Ft. -� Cu. Ft. Front........................ Depth ...................._. Height ........................ Sq. Ft......................... Cu. Ft. ...................................... ........... Est.— st. Cost® ..._�..._' Au 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 the payment of a fee of $.. ...... _..................... 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. / l� 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 f .. ........ ........................... ..... .......................... AT* IUATI(xf TYP2 P2ope=,, ty Li -:ie IIJ VIF T/P H.-.)uze Pront Prcperi4. Idme ................................... ..................... ............ . 'o City of Fridley, Minn.. N° 7603 BUILDING PERMIT �-2 el q y per: Jerome TAT. Ostwald Wider Cooper Construction Co. Address _6331. son St. N. E. Address 6431 Univ. Ave. N. E. LOCATION OF BUILDING No. 6331 street Madison Street N. E. Part of Lot Lot 14--._ Block 6 Addition or Sub -Division MWSTTT+: AMMON Corner Lot Inside Lot. _ Setback Sideyard Sewer Elevation Foundation Elevation To be Used as: Type of Construction DESCRIPTION OF BUILDING Front Depth Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Frame Fast. Cost ._ .00 To be Completed Storm Damage Repair In consideration of the issuance to me of a permit to c the proposed work in accordance with the description above ordinances of the city of Fridley. and bu 11des nth of 1 % a=viaions off of In consideration of the payment of a fee of1S 0-00 , permit is hereby granted to Cooper Const. Co- 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= thereof, shall conform in all respects to the ordinances of Fridley, Minnesota reg location, construction, alteration, maintenance, repair and moving of buildings wiorthi nthe city limits and this permit may be revoked at any time upon violation of any of the provisions of said A13 en Jensen Building Mmspector NOTICE: 'tlds permit den net cavw the eousbudbe, hutaflMsn for wiring, phn"e, an boating, sw w or crater. Be wn to no the Building bwa for for sopmft permib for thm Berra. APPLICATION FOR BUILDING PERMIT 14 03 CITY OF FRIMEY, MINNESOTA OWNER'S NAME C v- C) rvvew n BUILDER 6� ADDRESS__ ADDRESS LOCATION OF BUILDING No. Street Part of Lot LL � I LOT BLOCK ADDITION OR SUBDIVISION Corner Lot `Inside. LOT Setback Side: Yatd SEWER ELEVATION FOUNDATION ELEVATION l Applicant attach to this form Two Certificates of Survey of Lot and proposed building location dn:n: hese Certificates. O-0 zx�_ DE ION OF BUILDING '--� `/ o To be used as: Front Depth Heighti Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction_ 4�_:' Estimated Cost 0-6 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 11 the facts and representations stated -In this applinat are true d'corr t DATE SIGNATURE of (Schedule of Fee oats can be found on the Reverse Side). JjAel� VIP, CITY OF FRIDLEY r APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND .AIR CONDITIONING SYSTEMS AND DEVICES PARTIAL RATE SCHEDULE GRAVITY WARM AIR: Furnace Shell & Duct Work Replacement of Furnace Repairs & Alterations -up to $500.00 Repairs & Alterations each add. $500.00 4ECRANICAL WAPVM AIR: Furnace Shell & Duct Work to 100,000 BTU each add. 50,000 BTU Replacement of Furnace Repairs & Alterations -up to $500.00 Repairs & Alterations each add. $500.00 j rFAM OR HOT WATER SYSTEM: Boiler & Lines up to 100,000 BTU each addn. 50,000 BTU Boiler only up to 100,000 BTU each addn. 50,000 BTU SIL BURNER- to 3 gal. per hour each add. 3 gal. per hour RATE $12.00 7.00 7.00 4.00 TOTAL S S S $12.00 $ 4.00 $ 7.00 $7, DO 7.00 $ 4.00 $ $12.00 $ 4.00 $ 7.00 $ 6.00 $ $10.00 $ 10.00 $ ]AS BURNER- from 100,000 BTU to 199,999 BTU $10.00 $3ou_ (over 199,999 BTU see Fee Schedule) $ 3AS FITTING PEES: 1st 3 Fixtures -1 x $ 3.00 Additional Fixtures x $ 1.00 $ Gas Range to 199,000 BTU x $10.00 • $ AIR CONDITIONING $10.00 VENTILATING SYSTEMS Sea Fee Schedule $ ALTERATIONS f, REPAIRS $ State Surcharge $ .50 TOTAL FEE 00,50 Job Address 6331 Madison St N.E. I 0 a Department of Buildings City of Fridley Tel. #571-3450 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 application are true and correct. Fridley, Minn. April 11 197 OWNER Jerry Ostwald KIND OF BUILDING Frain USED AS RpcidArtt-ial TO BE COMPLETED ABOUT 3/27/79 ESTIMATED COST $1850.00 • OLD - NEW BUILDING PERMIT NO. PERMIT NO. DESCRIPTION OF FURNACE/BURNER HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. Trade Name Frei dri ch TPrnpO Size No. 100.000 grrTT Capacity Sq. Ft. EDR BTU IHP Total Connected Load BURNED Trade Name, Kind of Fuel G c Size No. t 'ROUGH INSP. REINSPECTION FEE Capacity Sq. Ft. EDR BTU HP Date 010. 00Y., �-/ Company Nort-hPaat Chao I "2j FINAL INSP. �7/ - Date Signed By I APPROVAL FOR PERMIT Tel. No. 7 81-2 7 7 6 kUNItM FEE FOR ANY HEATING PERMIT, IS $7.50 PLUS $.50 STATE SURMMWE ,. _ ..:'� '*- '�' • ' J _ - Y O .- 't�... a .. .., fi5 F .v,.. _ ,2.:b: :.t^.ws Win.. ! ,.a^c,pf .� ... ?�t ..,.«.. ,c**s,,:h�..'h ... .s.a� roan lvk �c:�t7 _ � .. a CITY OF FRIDLEY APPLICATION FOR HEATING REPLACEMENT CHIMNEY AND STACK VERIFICATION THIS FORM MUST ACCOMPANY STANDARD APPLICATION FOR HEATING PERMIT FORM. LOCATION 6331 Madison St. N.E. DATE April 11, 1979 OWNER Jerry Ostwald ADDRESS same The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined 2. Is free from rust or deterioration xx 3. No foreign objects are lodged within xx 4. That it is securely supported xx 5. That it meets all current Code requirements for size and total BTU connected xx 6. Total Heating BTU 100,000 BTU input All Other BTU TOTAL REMARKS HEATING PERMIT # SIGNED r Licensee bY-T_ortheast Sheet Metal Address 4347 CentralAve. N.E. Telephone 781-2776 Fridley City License 14001 7 sue�Ecr PERM City of Fridley - 17 038 AT THE TOP OF THE TWINS BUILDING PERMIT _ r L. RECEIPT N • COMMUNITY DEVELOPMENT DIV. SEC. r � � PROTECTIVE INSPECTION CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 7/11/83 JOB ADDRESS 6331 Madison Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 14 6 Christie Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jerome W. Ostwald 6331 Madison Street N.E. 571-7823 3 CONTRACTOR MAIL ADDRESS 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 ElREPAIR ❑ MOVE ❑ REMOVE X 8 DESCRIBE WORK Construct a 161,x 18' Addition to Dwelling 9 CHANGE OF USE FROM TO STIPULATIONS VI{AR�IHG call 1C al t;,►t►�s Before digging GAS Etc- SEPERATE PERMITS REQUIRED FOR WIRING. TELEPHONE -ELECTRIC- BY LAW HEATING, PLUMBING AND SIGNS, REQUIRED TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, 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 1 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 $11,400 $5.70 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- $92.50 NONE STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $23.13 $121.33 SIGNATURE OF CONTRACTOR ORA IZ DAGENT (DATE) WHEN PROPER VALIDATE THIS IS YOUR P RMIT ®//�� • / BLDG INSP 0AT SIGNATURE OF OW RIIF RBUILDERI (DATE) 7 CITY OF FRIDLEY APPLICATIO'1 FOR RESIDENTIAL BUILDING PER141TS (New, Alterations, Additions, or Repairs) OWNER: J 0'o�6 tLi• ADDRESS: �� % TEL NO: 5-71- BUILDER: ADDRESS: TEL (10: Construction Location Effective Aug. 1, 1981 STRMT NO: �"" STREET: �C� /Sd- �7 1_ 'E LOT: /� BLOCK: ADDITION: Corner Lot: Inside Lot: - Setback: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTION OF CONSTRUCTION e) Front: Depth: �b Height: Square Feet: Cubic Feet: Front: Depth: Height: Square Feet: Cubic Feet: _ 40 Type of Construction: 1 00A Estimated Cost: $ ®® To Be Mrapleted: Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: $ $ SEE P.EVER.3E SIDE OF SHEET . 19ie undersigned hereby makes application for a permit for the t:.,ork 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 /are true and correct DATE: -S dJ _ SIGNATUF.e^. Stimulations: C r P. 6330• - rjoe 14I V I\3 L .. - V SUBJECT P City of Fridley 25879 AT THE TOP OF THE TWINS BUILDING PERMIT r COMMUNITY DEVELOPMENT DIV. � PROTECTIVE INSPECTION SEC. r � 1 � NUMBER REV DATE PAGE OF APPROVED BY = I --1 CITY HALL FRIDLEY 55432 612-571-3450 910-F15 3/30/98 10B ADDRESS 6331 Madison Street NE I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 13 3 1 Christie Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Pat Oswold 6331 Madison Street NE 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Richard Hastings Contr 6331 Riverview Terrace NE Fridley, MN 55432 4051 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 574-9966 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House 20 S Tear-off 9 CHANGE OF USE FROM TO STIPULATION S Underlayment must comply with the State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, 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 BO DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R-1 ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING 1 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 VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $.83 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1,668 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- $54.00 Fire SC $1.67 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TO TA EE Licens C $5. 61.50 SIGNATURE OF CONTRACTOR OR AUTH05PZED AGENT IDATEI EN ROP ALIDA HIS IS YOUR PERMIT BL06G INSP a .5 PEr GATE SIGNATURE OF OWNER OF OWNER BUILDER) ]DATE) .. - V NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER (] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 �P # BUILDING PERMIT APPLICATION ConstructionAddress: 6.33 % MA o,1 Legal Description: Owner Name & Address: 1y( oZ S. ?A% c`�s �, L r/ Tel. # Contractor: % c %A R �s�;r S MN LICENSE #t�Si Address:_6 3.31 J� ; Cc iZ � r e � � j` � k . Tel. # S ��4"' 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: OFF i? -,v 0 Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: 3/J? 0' _ > STIPULATIONS: 4 CITY USE ONLY Permit Fee $ �� Fee Schedule on Reverse Side Fire Surcharge $ e-7 .001 of Permit Valuation (1/10th%) State Surcharge $ 3 $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] ( TOTAL $ STIPULATIONS: 4 City of Fridley AT THE TOP OF THE TWINS SUBJECT BUILDING PERMIT 30069 • COMMUNITY DEVELOPMENT DIV. __ r � -_ PROTECTIVE INSPECTION SEC. 1 . � CITY HALL FRIDLEY 55432 l 612-571-3450 RECEIPT NO. NUMBER 910-F15 pEv DATE 8/17/99 PAGE O: APPROVED By JOB ADDRESS 6331 Madison Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 13 3 Christie SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Mark Ostwald 571-7823 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO The Gopher Co. 445 Malcolm Ave SE M is 55414 331-1555 8617 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 fEk REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reside 9 CHANGEOFUSEFROM TO STIPULATIONS Call for building wrap inspection before covering. SEPARATE PERMITS ARE REOUIRED 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 SO. 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 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 $1289 SURTAX $.64 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PERMIT FEE $47,90 SAC CHARGE Fire SC $1.29 PLAN CHECK FEE TOTAL FEE Lice e C $5 54.83 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI E PR VALID D THIS I$ Y UR PER IT SIGNATURE OF OWNEROF OWNER BUILDERI IDATEI BL40G -NSP HATE NEW [ ] Effective 1/1/97 ADIIN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (JO BUILDING PERMIT APPLICATION ConstructionAddress: Legal Description: Owner Name & Address: Mz '0 b-. wai-ot Tel. # S 71— %� _ Contractor: C.Z7MN LICENSE # Address: %Y1 0A 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 Heigh! Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Construction Type: Estimated Cost: $� p.p (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft I $ — $ DATE: k'—((o-�i APPLICANT: Tel. # 33/"%✓�S� TOTAL $ sq% 83 STIPULATIONS: CITY USE ONLY Permit Fee $ �/ %, �% 0 Fee Schedule on Reverse Side Fire Surcharge $ /•a j .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $950 per SAC Unit License Surcharge $ S$ 00 $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ sq% 83 STIPULATIONS: 0o/a9),?ooa From: 7634279448 Page: 2J2 Date: 1/7/2008 2:07:31 PM FROM :iity of Fridley FAY, NO. :7635711287 Jan. 07 2008 03:13PM P2 !Building PLUM13I N G ' """°" hispections . RESIDENTIAL APPLICA.TIO necol.vea By:_...._ 763-5' 2-3604 CITY Off' 3FRIDL `�' p . DATE Novempbg r 2. 2007 YOUR ].-MAA.ADDPMs lumbina,6orn 31TBAMM3___fi,_TJ3 MA -SMS l+T'I'I ICANT IS: oVNM t W11TRACTOR OWAtlflt/ AIYDRESS: TMANT sTA'rs>~ICl Mp p 334'1 PM r3XP DATE 114/.5 l r;-UUI I SUBMT A GOI''Y OF '��'"""� "`" _ clave► S 'ATLM N 7UP YOUR STATE AD�DOSS• 3095 -162nd lane NW LrrY An ..� .......,.........._ .. LICTINSE W IT 763/427.7630 - - aax Z63%Z794-48 p$RMT TM 19.94HOMPAJ ILL U TWO FAMILY C7 TOWNHOU38 ..a.�ursarw �r..^^.w.r •..o.w... n r. T YI)R OP W©M M A1BW REPLAG�1` DUTA.ILED MCiZtP }pN w wolty „,•.„,. water Heater Replacement PER 9816B.665 the p Mit flee is a minimum of $15.40 or 5°10 of, the tofial cbyt up to X504,40, wl)lCl►Dver is grcaEer,1'a the improvenic^nt, instaltatl n or replacement of a residential ;fl oxre-, excludbig the fixtures. (This sliould reflect only the cost of labor) Labor Dost under $300 FOT(PROMMS WUM NUMBER OF EACH EcTr.T, BATH $Y�1TUI,AV - RATEiT B C=HES WASIM DISHVIASHM, X15,00, :Labor cost bdtween 5300 to $500 - COA of !alcor , x.05 -- City .05 — BXCZSDS $500, PSS ARTS BASED ON $ Io.00 PER rtXrM... EXCEPT WlJEtl; NOTED. 1=17. ` : (rmDicATE *rUrAJ. ""' ip PIPING AW Gcr YMCM) KITCHEN Sir•1K LAUNDRY TRAY SI40VIBR WATER CLOWT _WAM RVATER ($35) WA'1`z'tL MP -MR Atatnber of fiat res Ntunber of fixtures WA7'FIt PIPING �... BACY,"w PXr;V, ($i 5) FOR 1KRIGA11014 —OTHER $1s.00..._. x$t5.00-T, $35.00 _I _x$35.00=$.�� S tC Snrcharso - $ TIM tS AN APPLICATION FOR A PUMrr fib? VALID UNTIL PROM SED ( hereby apply for a 1i n t g peMit and I avkaowledga that the information abavo is cor>aplate and accurate; that the work w111 be in conforynqu.*.e with the, dinetaees and aodos oftho City of Fridley and with the Minnesota Constnlotlon rodos; that I ultderstar,d this is not a permit but oti)y r application for it permit a -ad WO11t is not to start withont a pennit; that the work will bs lit aecordance with the approved plan in the ct so aCkal work which requirft reviowlnd approval of plaits. --rP AMP Mlohael MB11rli:18kL__ nA'rg 11.AJ0? StONA7`M, OF APPLiCAN-I-,.•. Citi' of Fridley Building 7aaspectloms Department 6431 1. rdversity .Amenue, NE, I•ridley, MN 55432 S� 763-572-3604 FAX: 761-502»4977 � `CAu�M— :763-572-3604 4 Budding PLU.�YIlBI N U R ESID ENTIAL A.PPLICA TION A \+Alin{. LSV..Insgedions Received CITY OF FRIDLEY 9B(K eAJ N DATE Navembor 2, 2qq r YouR>~-�rc.AvraRFss wnelson larsonplumbina.com s1TEADDRESs f�331 1Vra is�n Street 1�iF .-�. THIS APPLICANT 1S: 0 OWNER S9CONTRACTOR PROPERTY NAME: Jerome Ostwald OWNER/ ADDRESS: 6331 Madison Street. NE prTy Fridley STATE_I ffiZIP 55432 TENANT PHONE.— 70,657- -78 3 cONTRACTOR NAw:, Larson Plumhina Inc STATE LICENSE #__33411 PM � WO DATE 12/31/200,7 SUBMIT A DOPY OF ADDRESS: 3095 -162nd Lane NW CITY Andover sTATt:MN zip 55304 YOUR STATE LICENSE WITH PHONE 763!427-7680 FAX 7631427-9448 APPLICATION PERMT TYPE rx SINGLE FAMILY 0 TWO FAMLY 13 TOWNHOUSE TYPE OF WORK: O NEW N REPLACEMTrT 7 DETAILED DESCRIPTION OF WORK,•„,,,,,-, Water Heater Replacement PER MS 1613.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to 5500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, 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.05 WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. F1XT'rJRES: (INDICATE TOTAL. FOR PROJECTS NUMBER OF EACH BELOA1 FLOOR DRAINS SHOWER WATER P1P[NC3 BATH SINK/LAV r SWIMMING POOL — WAFER SOFTNER ($35) GAS PIPING (NEBAC17YLlcan+ss)____ BATHTUB BACKFLOW PREY, (SI 5) —CLOTHM UtASHER_KITCHEN SINK WATER CLOSET -- LAUNDRY TRAY X WATER HEATER ($35) ~ FOR IRRIGATION DIS14WASHER _ WATER METER OTHER _ —;.. ,,,; r,.A:-..:.F;:•;�3.TM;z'x-v:��G,• ;�,:;i�^�4 �f,::u��;,..• ..,,.. x �- �� �3�G'`f">1''-Oe rR'.$.SOO., fi�en. .j� y. `�r�vt �y $•F'4' •sa F �. 3:' �j.•!�. �+ �si� �}y >... •;�F!����°"""...�'• ;='::a. . �s� oa;if;:t.'. �%;iS^'/y.•.;h: 6+� it 1 `' 'l Yr � n R A?M .1'n d �''T•4f>r✓�� i.•��7'+��J�> ':�`.' - fixtures @ $10.00 x $10.00 = 5. Permit Fee. (,ZQ Number of _ Snrcbar a S0 Number of fixtures @ $15.00 �_ x $15.00 = S Number of fixtures @ $35.00 ,x $35.00 = $ TnTA r nr ttZ 5 3c'i 0 A-. THIS IS AN APPLICATION FOR A PERMIT NOT VALID UNTIL PROCESSED State surcharge = a Total = $ I hereby apply for a building permit and I acknowledse that the information above is complete and accurate; that the work will be in conformance wait 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. -- -- — - __-- PRfNTNAMB Michael Malinoski DATE 1.1/2107 SIGNATURE OF APPLICANT _ City of Fridley Building Inspections Department 6431 University Avenue NB, Fridley, MN 55432 763-572-3604 FAX- 763-502-4977 �� ��