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PRE 2010 DOCSDate: MAY 10, 1966 City of Fridley, Minn. BUILDING PERMIT Builder HOMBDALE BUILDERS N° 8815 Address Address 3017 Lyndale Avenue South Minneapolis, Minnesota LOCATION OF BUILDING No. 7479 Street MELODY DRIVE N.E. Part of Lot Lot 5 Block 5 Addition or Sub -Division MELODY :MANOR, 4TH ADDITION Corner Lot ._ Inside Lot % Setback 35' . Sideyardd 10' Sewer Elevation )NOMMM n Elevation ? 883.00 TOP OF FOOTING 886.00 DESCRIPTION OF BUILDING To be Used as: DWMLMG Front 37 Depth 24 Height _2O 2O Sq. Ft. 888 Cu. Ft. 17$76 GARAGE Front 14 Depth 24 Height 10 � Ft. 336 Cu. Ft. 3,360 Type of Construction FRAME Est Cost _ $191000 _ To be Completed BNWER LOCATION 4' West of Manhole WATER LOCATION 5' East of Manhole In consideration of the issuance to me of a permit to construct the building described above I agree to do the proposed work in accordance with the description above set and in compliance with ail provisions of ordinances of the city of Fridley. ® � In consideration of the payment of a fee of S 23.00 , permit is hereby granted to HOMEDALE BUILDERS to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, BRinnesota � location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any ume upon violation of any of the provisions of said ordinances. ALLEN G. JENSEN Building Inspector NOTICh Ub pumb don sot cora the conduction, huta0a m for rrMb& pi"Ing, on heating, awn or water. Be s m to en the Beuhm bgmtor for apards permbe for thea Mesa. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY$ MINNESOTA OWNER'S NAME ADDRESS ADDRESS 3.4�71 LOCATION OF BUILDING NO, STREET PART OF LOT. LOT BLOCK ADDITION OR SUBDIVISfON2ye, CORNER LOT INSIDE LOT « SETBACK .�J� SIDE YARD SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. To be used as; Type of Construc To be completed DESCRIPTION OF BUILDING Front epth !;r/ Height Sq. Ft.ecu. Ft. Front Depth_14�_Height /23 Sq. Ft. raj �j �® Cu. Ft. Estimated Cost 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 are true and correct. DATE SIGNATURE (Schedule of Fee Costs can be found on the Reverse Side). hhhh. If j Application for Power Plains and Heating. Cooling, Ventilation, Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work ........................... 8.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ MECH. WARM AIR t� Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ each add. 60,000 BTU ....................... 2.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 ................. 5.00 $ Repairs & Alterations each add. $500.00 .............. 2.50 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam ..... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water .. 8.00 $ Each add. 200 sq. ft. EDR Steam ...................... 2.50 $ Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ OIL BURNER—to 3 gal. per hour ........................ 5.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) ..... ................. 5.00 $ v_ 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 $ AIR CONDITIONING $ FAN HEATING 'SYSTEM See Fee Schedule VENTILATING SYSTEM ALTERATIONS & REPAIRS TOTAL FEE J ROUGH FINAL 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 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. Owner Kind a Used a: To be c Estimated Cost, $_ `7"0 % .— Old New..tuilding Permit No. `� Permit No \y DESCRIPTION OF WORK BEATING or POFER PLANTS -Ste , Hot Water, Warm Air— o Trade Nam Size No Capacity. Sq. Ft. E.D.R ,/o�6 v ` BTU H.P. Total Connected Load i T Kind of Fuel '-y"_ 011 BURNER — Trade Name Size No Capacity Sq. Ft. EM.R BTU H.P. (REMARKS -OVER) RAY N. WELTER HEATINGX0-_-' Signe �r By MINNEAPOLIS 7, MINN,^E/SOTA 3, 4 z Business Phone No- d ��o 4 1 suBIECT P MIT NO. - ` City of Fridley �16 7 3 6 AT THE TOP OF THE TWINS BUILDING PERMIT _ r RECEIP • ' ► -------- COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. NUMBER REV. DATE 18/19/82 PAGE OF APPROVED BY �'---1 CITY HALL FRIDLEY 55432 612-571-3450 910-F15 JOB ADDRESS 7479 Melody Lane N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 5 Melody Manor 4th Addition SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE John Miller 7479 Melody Lane N.E. 786-2049 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO. Sawhorse, Inc. 6325 Welcome Avenue, Brooklyn Park, MN 533-0352 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 Construct a 21X 15110" x 20' Addition to Dwelling 9 CHANGEOFUSEFROM TO STIPULATIONS Provide outside combustion air to fireplace or existing furnace. Install products of combustion alarm in existing bedroom area. WAR1 N G WON dining cap local utilities TELEPMON1- ELECTRIC - GAS Etc. �t C �J1KgD BY LAW SEPERATE PERMITS REQUIREO FOR WtRtNG, HATING, PLUMBING ANO SIGNS, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, Wood Frame 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 317 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 $6.90 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $13,800 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMITFEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $104.50 NONE STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE L-, na GApn. / , . 3 $137.53 SIGNATURE OF CONTRACTORO AUTHORIZED AG DAT' PROPE LY A D THIS I�_YOUJ PERMIT jZWHE G INSP DATE SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI CITY OF FRIDLEY Effective Aug. 1, 1981 APPLICATIM FOR RESIDENTIAL BUILDING PEPHITS (Neal„ Alterations. Additions, or Repairs) OWNER: J C)4 /V & IL-- LEp- BUILDER: S4W N 0zSe - /A- JC ADDRESS: , 74- 79 N ELODY A A;;C, ADDRESS: 63 2 - 1. 1E LC6� -c fly— Pw TEL N0: _ 7, -- Z 01- 9 TEL 110: Construction Location • STRITT NO STREET: L LOT: y I BLOM : _ � ADDITION: - MD\l 1-j¢'} &A -A DI) Corner Lot: Inside Lot: X_ Setback: Sideyards: Applicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. 3G•Z� DESCRIPTION OF CONSTRUCTION 7 ,1� p+ Front: 1) Depth: Z0 _ Height:/ 7 �- Square Feats 317 Cubic Feet: Front: Depth: Height: Square Feet: Cubic Feet: 13.33x7b 9!A)X"43.4rr I'S Sqr - Rype of Construction: -FP-IF— 9b Be Wrapleted: Z. *Igam Estimated Cost: $ Z . Alt. A Alt. 8 Proposed Drivmiay Width If New Opening Is Desired: $ ' $ SEE REVERSE SIDE, OF SHEET . Mie undersigned hereby makes application for a permit for the yjork 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. _ DATES Stipulations P laq. so Pe a4.i3 .y. (A. 10 r3 t1aS3 SI MUM CITY OF FRIDLEY Ae Effective Date January 1, 1991 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE ' 3ESIDEGTL#L RATE TOTAL Job Address /an, Furnace Shell and.Duct Work, it GV Building Inspection Div. 6431 University Ave NE FridleyMN 55432 Burner (Also replacement furnace) $ 20.00 $ g p y Tel. No. 572-3604 Gas Piping $ 10.00 $ (piping needed with now furnace) Gas Range $ 10.00 $ Gas Dryer $ 10.00 $ • Air Conditioning (all sizes) $ 10.00 S All Others/Repairs and Alterations It of Value of Appliance or Work $ COMMERCIAL/INDUSTRIAL It of Value of Appliance or Work $ 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. OWNER - 1171 KIND OF BUILDING -2 i/ "27/ L - USED AS% TO BE COMPLETED ABOUT ESTIMATED COST - State Surcharge � e OLD - NEW BUILDING PERMIT NO. '� PERMIT NO. oro, TOTAL P'EE REINSPECTION FEE $30.00. DESCRIPTION OF FURNACE/BURNER Rough Insp. / Date Final Insp. -Ap ® Date Approval for Permit HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. Trade Name Size No. capacity Sq. Ft. EDR BTU NP Total Connected Load Kind of Fuel BURNER - Trade Name �L%/ICY size No. Capacity Sq. Ft. EDR _ MINIMUM FEE FOR ANY HEATING/COOLING/VENTING PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE SUBURBAN AIR C0MNING CO. 8419 CENTER DRIVE 1.11rIMEAFOIIS, MINNESOTA 55432 *Air Conditioners can not be placed in side yard without ' written permission from adjoining neighbor. Company Signed B Tel. No. Fill out back side for stack verification on replacement furnaces SuBjECr PE City of Fridley 32379 AT THE TOP OF THE TWINS BUILDING PERMIT � REC `L COMMUNITY DEVELOPMENT DIV. INSPECTION SEC.9 r PROTECTIVE NUMBER REV DATE PAGE OF APPROVED BY ...... /..'1 CITY HALL FRIDLEY 5$432 612-571-3450 910-F15 1/7/02 JOB ADDRESS 7479 Melody Drive NE I LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 5 1 Melody Manor, 4th Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS zip PHONE John & Nancy Miller, 7479 Melody Manor, Fridley, MN 55432 763-786-2049 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Advance Home Products, 3770 W'Broadway, Minneapolis, MN 55422 763-521-9211 2332 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Dwelling 7 CLASS OF WORK NEW O ADDITION ❑ ALTERATION C1 NEW REPAIR ❑ MOVE - ❑ REMOVE 8 DESCRIBE WORK Re -roof - tear -off H & G 9 CHANGEOFUSEFROM 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 SO. 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 $3,109.00 $1.55 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- $97.25 $3.11 (Fire SO STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FE TOT L FEE $5.00 ense 06.91 SIGNATURE OF CON 'R11T TOR OR AUTHORIZED AGENT (DATE, EN ROPE VALID E THIS IS OU ERMIT SIGNATURE OF OWNER,it OWNER BUILDER) iDATE, BLQ& NSo ZQAfE NEW [ ] Effective 1/1/2001 ADDN [ ] CITY OF FRIDLEY (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address:i y 2 2 - ti, Legal Description: ca a*. Owner Name & Address: 44 OLM,— )A1Ae - /*' ,. //. Tel. #63 -7f( - 2,0r/9 Contractor: tos MN LICENSE # —;?33d- - Address ?33d- Address: ®- e i, --e Tel. # 5;d /- -?,,// 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 04 Width Hgt/Ground Sq. Ft. OTHER: & Poo-( - -11e`F5-e °` X�q VH -Y "C d-'7 (Tea 1-- d Construction Type: L6, 6rTr- / / v; -C .± Estimated Cost: $ Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: / -� _ �'� APPLICANT:�al Tel. # �� 3- S.2/- Y�(� CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application Permit Fee $ 1 .� Fee Schedule on Reverse Side Fire Surcharge $ : / l .001 of Permit Valuation (1/10th%) State Surcharge $ /, .S-� $.50/$1,000 Valuation SAC Charge $ / $1150 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 $ 106., 21 STIPULATIONS: Building $ 1 5A 5- BUILDING Plan Review Permit No. O- D03 Inspections Fire Surcharge RESIDENTIAL APPLICATION Received By.-AAO 763-572-3604 $ 5-- .0005 x Permit Valuation Minimum $.50 License Surcharge MAY 4 20 $5.00 (State Licensed Residential Contractors) SAC Charge CITY OF FRIDLEY $1825 per SAC Unit (Plans to MWCC for determination) Datelixa. 763-502-49,077 FAX ft + 6 ft = ft x $21 =$ Erosion Control $ $450 Conservation Plan Review Park Fee EFFECTIVE 1-1-08 Fee Determined by Engineering Sewer Main Charge DATE✓ ®� YOUR E-MAIL ADDRESS Q� 17 fl C� IMS 07 CG M SITE ADDRESS � % f Z2&10& Make checks payable to: City of Fridley Attach Stipulations THIS APPLICANT IS: ❑ OWNER PC'&NTRACTOR PROPERTY OWNER/ NAME. O ADDRESS: ` '/,7q- �i��l� �� CITY STATF,gs%�ZIP TENANT PHONE: NAME: ADDRESS: �O� 1I / 9l� �� CITY &7 ATE/ LIP --52V CONTRACTOR SUBMIT A COPY OF PHONE L113 3 $ FAX 176P 3 — Gid ��ig�y YOUR STATE LICENSE STATE LICENSE 9 EXP DATE PROPERTY TYPE P-SMGLEFAM1ILY`/VWcoNsTRucnoN SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGEISHED ❑ WINDOWS ❑ BASEMENT FINISH❑ROOF ❑ DRAIN TILE ❑ DECK F]'S DING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR CI-R'MODELING DESCRIBE WORK BEING DONE: /Q� /� �y//r Sc, �G Gci/ //ii/yZ SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING ❑ HOUSE ONLY BASEMENT REMODELING SUBMIT: NUMBER OF SQUARES ❑ HOUSE & GARAGE 1. Existing Floor Plan GARAGES ❑ ATTACHED GARAGE 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, myl Won ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other M T' ascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS []Yes ❑No LOCATION OF WINDOWS OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 UBC FEE SCHEDULE) TOTAL JOB VALUATION $ #/U,o?) `— OCCUPANCY TYPE Permit Fee $ 1 5A 5- See Back Page for Fee Schedule v Plan Review $ 65% of Building Permit Fee Fire Surcharge $ .001 times the total job valuation Surcharge $ 5-- .0005 x Permit Valuation Minimum $.50 License Surcharge $ 6'-00 $5.00 (State Licensed Residential Contractors) SAC Charge $ $1825 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $21 =$ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ 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 on site; that the work will be in accord th the app Ian in the case of all work which requires rev' w and approval pl ns. SIGNATURE F � II ANT PRINT NAME e DATE APPROVED BY %! L1 -CAW- DATE From: 7634283682 Page: 212 Date: 10/11/2010 8:02:29 AM 1 Building MECHANICAL Permit NO.:_ Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OFFRIDLEY j ..s 763-502-4977 FAX EFFECTIVE2-19.09 DATE YOAiIL ADDRESS SITE ADDRESS PVl $--. THIS APPLICANT IS- l OWNER ONTRACTOR PROPERTY NAME: _ OWNER/ TENANT ADDRESS: CFTY STATE.,•_—ZIP PHONE: CON'T'RACTOR COMPANY NAME: . _. _. t �'�YTWO INQ ISUBMIT A COPY OF CONTACT PERSON' _ COty OUR STATE 1 STATF. LICF.NSC p LICENSE WITH ADDRESS: _ (763) 28■3677 CITY STATE_ ZIP _ APPLICATION PHONE www,h@A1o. 2&Qm PERMIT TYPE INGLE FAMILY O TWO FAMILY C3 TOWNHOUSE TYPE OF WORK: 0 NEW REPLACEMENT 0 ALTERATION/REMODEI. DETAILED DESCRIPTION OF WORK31a FEES ARE BASED ON $IU.UO PER FLUTUBF, F CEPT WHERE NOTED. FIXTURF,S: (INDICA'T'E TOTAL NUMBER OF EACH BELL w) Equipment Installed MFG: , MODEL: _1• 6k1/i "ow SIZE/BTU MFG; MODEL: ( food SIZE/BTU MFG: MODEL: _ S1zE/BTU �CAIC $25.00 _FIREPLACE (GAS) $15.00 _GAS RANGE/OVEN $I0.0[ AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 _NEW GAS GRILL $10.00 BOILER $35.00 5 FURNACE $35.00 _GAS UNIT HTR $10.00 _CHIMNEY LINER 510 00 DRYER $10.00 _POOL HEATER $310) _GAS DUCT WORK $10.00 GAS PIPINU $10.00 VENTILATOR $15.00 Number of fixtures @ $10:00 x $10.00 = $ Number of fixtures @ $15.00 x $15.00 = $ .i . Number of fixtures a? $25.00 _ j x $25.00 = $ A' Number of fixtures rt $35.00 x $35.00 = $ StateSurcharge =$ .50 _ MINIMUM FXr1, .5n$0 Total = $ THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED 1 hereby apply for a building permit and 1 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 1 understand this is not a permit but only an application for a permit anAOork is not to start without a permit; that the work will be in aca,rdance with the approved plan in the case of all w hich d approval of plans. kIJ4-14-- 4!!f DATE SIGNATIJREOFAPP[.ICANT PRINTNAME . PLEASE NOTE: SEPARATE PERMITS ARE RE U.0 D•EOR•B.UIL.DING�-ELECTRICAL. AND.'MECIIANICAL WORK City of Fridley Building Inspections Department 6431. University Avenue NE, Fridley, MN 55432 763-572-3604 FAQ: 763-502-4977 i IV