PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT
A -;z C/Date:............_....................
Owner .......................................
Address.......................................
N® 3522
Builderf4-- a • ... .. ........... .......
Address ............................................
LOCATION OF BUILDING
No.Street ...... Part o Lot ..............-�"''� ......... .
Lot ... r7....... Block ........... Addition or Sub -Division .. .... / ....... .
...iJ.=. �...
Corner Lot ............ Inside Lot A ......... Setback �� : �. r� Sideyard � ................
DESCRIPTION OF BUILDING
To be Used
... Front 7 � :�%� Depth�U. 6 Height ,l. f .. Sq. Ft. ��,7 Cu. Ft. � q ®��
.................... Front ........ Depth ..,.J� .. Height ..� Sq. Ft. ........ Cu. Ft. ........
Type of Construction ................... hist. Cwt. � q.9.5101........ To be Completed ....................
In consideration of the issuance to me of a permit to cog desribed above, I agree to do
the proposed work in accordance with the description above compliance with all provisions of
ordinances of the city of Fridley.
x. ......................................
f�
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 with -
In the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances. A
Building Inspector
''dJ-.
NOTICE:
This permit does not cover the construction, Installation or alteration for wiring, plumbing, gas heating,
sewer or water. Be sure to see the Building Inspector for separate permits for these item&
City of Fridley, Minn..
BUILDING PERMIT N° 6577
Date: -2 l
Owner: � � Builder Jr -
Address
Address Address
LOCATIONO UID G
No. f:' ,Street T P Lot09
- -- --�—
Lot _ _ __ Block ______�, . _.__ _ Addition or Sub-Di"-
Corner
ub- oCorner Lot _ Inside Lot _ _ "'� tback , . Sideyard
Sewer Elevation ____ -- Foundation Elevation
DESCRIPTION OF BUILDING
To U ar•
Front Depth Height Sq. Ft. 6� Cu. Ft
Fro __ Depth HZ--=To
Sq. Ft. Cu. Ft.
Type of Constructi Est. 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 ��mpliance 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 Idare in, around and uponFridley, Minnesota regardwithin te dty mits and t may be revoked at anytjmupon olatio of any of the provisions of said
ordinances.
Building Inspector
NOTICE:
This permit does not cover As conslrucNon, leslaWan for wiring, phm bkg, gas heating, rower, or water. Be sure to see
the Building hupector for separate permits for these Nene.
City of Fridley, Minn.
BUILDING PERMIT
Date: JUNE 28, 1965
B11MML BISTODEAU
Builder SAME
Address 6730 MONROE ST. N.E. Address
FRIDLEY 32, Minnesota
LOCATION OF BUILDING
No. 6730 Street Monroe St. N. E. Part of Lot
7® Y�—
N° 8051
Lot - 7 _ Block a___ _ Addition or Sub -Division __ _ _ Brook -view Terrace
Corner Lot — Inside Lot Setback Sideyard
Sewer Elevation Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as: PORCH ON GARAGE
Front 12 Depth 21 Height 10 Sq. Ft. 25 2 Cu. Ft. 2,5 2 0
Type of Construction
Front Depth Height Sq. Ft. Cu. Ft.
Fit. Cost _. X0._00 To be Completed
the pconsideration of the Issuance to me of a roposed agree to do
work in accordance with the description abovee smit to seett and in buildingtruct the th a�lescribed above l
compliance provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of $ 4.00 , permit is hereby granted to BERNELL BISTODEAU
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 �ngg location, construction, alteration, maintenance, all and moving of buildings
within
city limit this permit may be revoked at any time upon violation of any of the provisions of said
ALLEN G. JENSEN
NOTICE:
ibb posit don not cam tbo conshudion, hwhildlen for wiring, ping, gn baring, sower or water. go an to ere
the Wilding Wpodor for a pards paredb for dmo hems.
OWNER -'S
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
ADDRESS ADDRESS
LOCATION OF,BUILDING
Scree Part of Lo �_...w.,
LOT R ADDITION OR SUBDIVISION
Corner tot Inside LOT Setback Side -Yard
SEATER - ELEVATIDN FOUNDATION EE"ATIOX
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn On these Certificates.
DESCRIPTION OF BUILDING
To b used as;
`j Front_ 4 _ Dept Height
Sq. Ft._ �g;L. _Cu. Ft._,"
Front Depth Height
Sq. Ft. Cu. Ft. _
Type of Cons tructio .;i -�} Estimated c 15
To be completed
The undersigned hereby makes application for a permit for the work herein specified,
agreeing to do all work in strict accordance with the City of Fridley Ordinances
and rulings of the Department of Buildings, and hereby declares that all the facts
and representations stated in this applicetiog are true and correct.
—�1W� 1., S SIGNATURE
(Schedule of Fee Costs can be found on the Reverse Side).
City Of Fridley
App9carion for ng and Cv= Fbftg Pom*
Dept. of Bldgs. Phone SW -3480
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO. RATE TOTAL
�.
i�
aL
d
I
y
I 1 °CE1
< `a
160
�j
t
x $1.50
�
Catch Basin .. ....... ......
•
I
•
N
WATER HTR.
GAS
ELEC.
Base
x $3.25
$
Electric Water Heater
s $2.00
$
GAS FITTING FEES:
NO. RATE TOTAL
let 3 Fixtures ...... ...................
I x $2.00
$ 2.00
Additional Fixtures . ..........1.......-x$.75
$
Lias Range to 199,000 BTU ..............
x $5.00
lot
JINSTAIL
UA LTE
2nd
3rd
4th
° Future CoanecUm Openings Connect" with
New Fixture. ON OpeningsI Sewer
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
s $2.00
$
GAS FITTING FEES:
NO. RATE TOTAL
let 3 Fixtures ...... ...................
I x $2.00
$ 2.00
Additional Fixtures . ..........1.......-x$.75
$
Lias Range to 199,000 BTU ..............
x $5.00
. 66
REPAIRS & ALTERATIONS—Refer to Code
Description ....................................... $
TOTAL FEE $ SO
6730 MONROE ST, N.E.,
City of Fridley:
The undersigned hereby makes application for a permit for the work herei
specified, agreeing to do all work in strict accordance with the City Ordinance
and ruling of the Department of Buildings, and hereby declares that all the fact
and representations stated in this application are true and correct.
Fridley, Minn- ,19-6-9
Owner DENNIS A. ULSTAD
Kind of Building -FRAME
Used as REQ'.
To be completed about _5-28-69
Estimated Cost, $ 5.00
_Q d—New. Building Permit No. �parie " 7-
Sign
B„ MINNEAP S GAS CO.
ROUGH
FINAL -( 7 a
Business Phone No
September 10, 1982
Mr. Ken Liu
1309 McKinley Drive
Ames, Iowa 50010
Re: Residential Rental Property Located at 6730 Monroe Street
N.E., Fridley, MN
Dear Mr. Liu:
Enclosed please find the City's application form for a License to
operate residential rental property.
Section 220.11, of the Fridley Housing Maintenance Code, states that,
"To allow for a systematic enforcement of this ordinance upon rental
dwellings, no person on or following the sixtieth day after the
enactment of this ordinance shall operate a rentaL dwelling without
first having obtained a License to do so from the City of Fridley...
No operating License shall be issued or renewed unless the rental
dwelling and its premises conform to the ordinances of Fridley and
the Laws of the State of Minnesota."
Therefore, you are required to complete the enclosed application,
sign it and return it with the appropriate fee to the City offices no
Later than September 24, 1982. If there are any questions or
problems, please feel free to call on me at 571-3450.
Failure to abate this violation may result in this matter being
turned over to the City Prosecutor for his Legal consideration.
Sincerely,
s
STEVEN J. OLSON, R.S.
Environmental Officer
SJO/mh
ENC: 1
a
su9�Etr
City of Fridley
32
AT THE TOP OF THE TWINS
BUILDING PERMIT
(E7
r
' '
PT NO.
• COMMUNITY DEVELOPMENT DIV.
V....
r SEC.
/
72 04
l
NUMBER
REV
DATE
PAGE OF
APPROVED BY
TY HALL fRIOLEY SS132
�.j
612-571-3450
910-F15
9/16/98
JOB ADDRESS
6730 Monroe St NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
7
3
1 Brookview Terrace
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Mike Norman
574-2562
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO
Century Roofing 6336 L ndale Ave S Richfield 55423
869-5133 200 3168
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
NEW 0 ADDITION 0 ALTERATION Cj REPAIR
0 MOVE O REMOVE
8 DESCRIBE WORK
Reroof house & garage (24SQ) Tear -off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT
CU FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS. OR 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
1 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
@
$1.03
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$2,056.00
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-
$74.75
F SC $2.06
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
e
,�
PLAN CHECK FEE
TOT L FEE
P" 1/
Li SC $ 0
$82.84
S,G NATURE OF CONTRACTOR OR$ZED AGENT $DATE,
EN ROP V LIDTHIS IS R P R IT
BL G ,NSR
J
QATE
S,GNATURE OF OWNERJF OWNER BUILDER, $DATE,
a
NEW [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress:
Legal Description:
Owner Name & Address: ke / y b /'I' ciA Tel. #
Contractor: MN LICENSE #--2o6 q3/,c Br
Address: (356 x k ews , C.kf ie jc. 9;Q{ Tel. # 'L !-S/�—
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA:
Length
GARAGE AREA:
Length
DECK AREA:
Length
DESCRIPTION OF EWROVEMENT
Width
Height
Width
Height
Width
Hgt/Ground
OTHER: ,ie- V—&0 -.F �
7� n
Construction Type:
Driveway Curb Cut Width Needed: Ft. + 6 Ft =
Sq. Ft.
Sq. Ft.
Sq. Ft.
224 S9
Estimated Cost: $
(Fee Schedule on Back)
Ft x $ = $
DATE: 0111k H C1 1- APPLICANT:&AJ Tel. # SL 9' 5/3,3WZ
STIPULATIONS:
CITY USE ONLY
Permit Fee
$ �� 7��
Fee Schedule on Reverse Side
Fire Surcharge
$ &
.001 of Permit Valuation (1/10th%)
State Surcharge
$ /, U-�
$.50/$1,000 Valuation
SAC Charge
$
$1000 per SAC Unit
License Surcharge
_
$ UCS
$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
$ c�
STIPULATIONS:
SUBJECT
City of Fridley
331 19
AT THE TOP OF THE TWINS
BUILDING PERMIT
PT NO.
�` COMMUNITY DEVELOPMENT DIV.
__
r >. ___
PROTECTIVE INSPECTION SEC.
Ai(
�
6493
1 . �
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
763-571-3450
910415
9/26/02
JOB ADDRESS 6730 Monroe Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR,
7
3
Brookview Terrace
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Mike/Jayne Norman 6730 Monroe Street NE
763-795-5288
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO
Budget Exteriors 8017 Nicollet Ave S, Bloomington MN 55420
952-887-1613 6564
a 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
8 DESCRIBE WORK
Replace 6 windows within existing openings
9 CHANGE OF USE FROM TO
STIPULATIONS
Provide smoke detectors in all sleeping rooms and on all levels of the dwelling
per Section 310.9.1.2 of the 1997 Uniform Building Code.
Per"InsPecti®n Cards
11 ill 00 MOW
To homeowner To Post
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 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
1
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
$3,085
$1.54
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-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE
TOTAL FEE
License C $5.00
$196.87
SIGN eruRE OF CON 'PAC TOP OR AUTHORIZED AGENT iO4TE.
EN gOPE IOATED IS IS YOUR PERMIT/
BLO iNSP
OAft
S.GNATURE OF OWNER-IF OWNER BUILDERS iDATE,
NEW [ ]
ADDN [ ]
ALTER
ConstructionAd 3esl•
Legal Description:
CITY OF FRIDLEY
SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Effective 1/1/99
Owner Name & Address: J QYI't L0-*-%. Tel. #143 -X95-52a'
Contractor: I A A A )5 x i aY s MN LICENSE # 1, S�
Address: $QI -+ t i r -M leA AyC S. Tel. # 952-8d'3 - IL 13
�D» �A-Y' /-N� Attach to this application, a Certificate of Survey of the
SSW D lot, with the proposed construction drawn on it to scale.
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
DESCRIPTION OF IMPROVEMENT
Length Width Height
Length Width Height
Length Width Hgt/Ground
Sq. Ft.
Sq. Ft.
Sq. Ft.
Construction Type: S ,Estimated Cost: $ 3 _ 84
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $
DATE: L3-23-02- APPLICANT: e, Tel. #162-982-11,13
CITY USE ONLY
Permit Fee $ g4. 2S' Fee Schedule on Reverse Side
Fire Surcharge $ :3 dy .001 of Permit Valuation (1/10th%)
State Surcharge $ /. ,f'1 $.50/$1,000 Valuation
SAC Charge $ $1050 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 $ 1010. 8 ENTERED SEP 2
3 2002
STIPULATIONS: ,V
� b
Building
$
BUILDING
See Back Page for Fee Schedule
Permit No.•
Inspections
RESIDENTIAL APPLICATION
Received By: OW-
763-572-3604
CITY OF FRIDLEY
Date Rec' . 4 4W
DATE t_�m
YOUR E-MAIL ADDRESS
.0005 x Permit Valuation Minimum $.50
SITE ADDRESS
'30 hA p l%j-n ST. K
.Co
THIS APPLICANT IS:
❑ OWNER )g1CONTRACTOR
$
PROPERTY OWNER/
NAME: F t AA
Curb Cut Escrow
TENANTADDRESS:
b"7'3® A,�O^r®C1. rr
Iy (Z
<`�
CITY � a -e L, STATEZ&II'
Erosion Control
PHONE: 016 ?q
CONTRACTOR
NAME: 41,1A ` fi 9 5
$
SUBMIT A COPY OF
STATE LICENSE # D _ 7 L{ I EXP DATE
YOUR STATE LICENSE
ADDRESS: R z ll"-% 1-3(5t
/ `�
CITY 6tMA 1:5�c S STAT ZIP ✓��' 33 8
WITH APPLICATION
PHONE _T (,' % ;2t?Q FAX
- '-(V) - y I �7
PROPERTY TYPE
❑ SINGLE FAMILY/NEW CONSTRUCTION
SIZE
❑ TWO FAMILY/NEW CONSTRUCTION
STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED
❑ WINDOWS
❑ BASEMENT FINISH WROOF
❑ DRAIN TILE
❑ DECK ❑ SIDING
❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK: 1
❑ NEW ❑ ADDITION
❑ MAINTENANCE/REPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE: 4- `e{'®
SIZE OF IMPROVEMENT LENGTH
WIDTH HEIGHT Sq. Ft.
ROOFING�/
❑ HOUSE ONLY
NUMBER OF SQUARES 02 (
MOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
GARAGES
❑ ATTACHED GARAGE
1. Existing Floor Plan
PROPOSED SIZE:
❑ DETACHED GARAGE
2• Proposed floor plan
PROPOSED HEIGHT:
3. List of structural members to be used
SIDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vinyl
[]Soffit
ADDITIONS & PORCHES SUBMIT:
❑ Aluminum
❑ Trim
I. Site Plan/Survey showing the existing structures
❑ Other
❑ Fascia
and proposed project.
WINDOWS
2. Two sets of construction plans
IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS
3. Energy Calculations
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 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ ,q'4V•o0 OCCUPANCY TYPE
Permit Fee
$
3 dZ�
See Back Page for Fee Schedule
Plan Review
$
65% of Building Permit Fee
Fire Surcharge
$
.001 times the total job valuation
Surcharge
$
/ , r]
.0005 x Permit Valuation Minimum $.50
License Surcharge
$
.Co
$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 $21 =$
Erosion Control
$
$450 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement necessary ( ) Non Necessary ( )
Total Due
$
;V. (ol
Make checks payable to: Citv of Fridlev Attach Stiuulations
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 worhich re a rev'ew and approval of plans. !!ppo
SIGNATURE OF APPLICANT PRINT NAME D Vl!\ ftlt n DATE OC g o
DETAILEDDESCRIP'Cl•ONOFWORK _ — — —.-------
5 the Permit fee is a Fd9nirnnnt of �i15,00 or 5% of the total cost np to $Sdd.f]d, whichever is greater, for the
PERMS 1GB.G6 [� S Is should reflect only the Bost of labor )
improvement, instal or replacement of a residential fixture, excludin the fixtures. (Tb
Labor cosi under $300 = $1.5.00. Labor cost between $30Q to $500 =cost of labor �_�_
x.05=r�
FOR,,,,,,rS WHERE. LABOR EXCEEDS M, FEES ARE BASED ON S 10.00 PTsR FIX TURF, EX > C) NOTED S E (INDICATE B rOTA.i.
NUMBER OF EACH BELOW) MFO*: MODEi�i��^ S17..FJBTIJ
Fquipmcntinst:+llcd MFO:� MODEL: 'SIZE•1BTU
MFG: �� MODEL:—•_�—.— GAS RANGWOVEN $10.00
AIC 825.00 FIREPLACE (GAS) $15.00 -�V GAS GXU L $10.00
gTREPLACE (WOOD) $35.00 GAS UNIT iirR $190.00
Alli TO AIR EXCHANGEER $ilS FURNACE $35.00 �P POOL HEATER $35.00
�$01LER $35.00 —GAS DRYER 510.00—VENTQ.ATOR $15.00
CHID0MY LM1k $10.00 GAS PIPING $10.00
DUCTWORK$10,00 :. ,.•
.PEM
T F' • Number of fixtures @ $10.00 x
Permit Fee $ .50 Number of fixtures @ $1500 x
Surcharge Number of fixtures (a, $25.00
TOTAL 13LIE Number of fixtures @ $35.00 1 x $35.00
State Surcharge $0
Total $ b�S?_
THIS )S AN APPLICATION FOR A PERMIT•NOT VALID UNTIL PROCFSSED
I 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 I understand this Is
not a permit but only as application for a permit ork isnot to start without a permit; that the work will be in accordance with the
approved plan in the e o l Work w ra"lraes re iew pad approval of plans.
SIGNATURE OF APPT
`J City of Fridley
Building Inspections ]Department
6431 University Avenue NE, Fridley, MN 55432
763572-3604
FAX: 763502-4977
From: 9528814491 Page: 2/3 Date: 3/10/200812:14:33 PM
,GS�74�
Permit NO -%0 QL -
MECH.A�NiCAi
Building
RESIDENTIAL APPLICATION
Received By:-
Date
Inspections
763-572-3604
CITY OF FRIDLEY
YOUR E.MATL ADDRESS
DATR b
SITE ADDRESS
THIS APPLICANT 1st
O OWNER =0•NTRACTOR
PROPERTY
NAME:I� c
sTATt�'-��-�
OWN%RtCrrY
ADDRESS: ���
TENANT
FHONI;.�� '
�1
Co N 1 RAC'TOA
COMPANY NAME:
SUBMIT A COPY OF
CONTACT PERSON:
STATE LICENSE#
STATS ZiP,
YOUR STATE�
LICENSE WrM
AJDUKESS:
APPLICATION
PHONE
SIN iLE FAMILY O TWO FAMILY p TOW N140USE
PE[tMrr TWE
NEW 5CUPT.ACEMi NT C1 ALTERATION/REMODEL
•RSL
f YPE OF WORK
9 _
DETAILEDDESCRIP'Cl•ONOFWORK _ — — —.-------
5 the Permit fee is a Fd9nirnnnt of �i15,00 or 5% of the total cost np to $Sdd.f]d, whichever is greater, for the
PERMS 1GB.G6 [� S Is should reflect only the Bost of labor )
improvement, instal or replacement of a residential fixture, excludin the fixtures. (Tb
Labor cosi under $300 = $1.5.00. Labor cost between $30Q to $500 =cost of labor �_�_
x.05=r�
FOR,,,,,,rS WHERE. LABOR EXCEEDS M, FEES ARE BASED ON S 10.00 PTsR FIX TURF, EX > C) NOTED S E (INDICATE B rOTA.i.
NUMBER OF EACH BELOW) MFO*: MODEi�i��^ S17..FJBTIJ
Fquipmcntinst:+llcd MFO:� MODEL: 'SIZE•1BTU
MFG: �� MODEL:—•_�—.— GAS RANGWOVEN $10.00
AIC 825.00 FIREPLACE (GAS) $15.00 -�V GAS GXU L $10.00
gTREPLACE (WOOD) $35.00 GAS UNIT iirR $190.00
Alli TO AIR EXCHANGEER $ilS FURNACE $35.00 �P POOL HEATER $35.00
�$01LER $35.00 —GAS DRYER 510.00—VENTQ.ATOR $15.00
CHID0MY LM1k $10.00 GAS PIPING $10.00
DUCTWORK$10,00 :. ,.•
.PEM
T F' • Number of fixtures @ $10.00 x
Permit Fee $ .50 Number of fixtures @ $1500 x
Surcharge Number of fixtures (a, $25.00
TOTAL 13LIE Number of fixtures @ $35.00 1 x $35.00
State Surcharge $0
Total $ b�S?_
THIS )S AN APPLICATION FOR A PERMIT•NOT VALID UNTIL PROCFSSED
I 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 I understand this Is
not a permit but only as application for a permit ork isnot to start without a permit; that the work will be in accordance with the
approved plan in the e o l Work w ra"lraes re iew pad approval of plans.
SIGNATURE OF APPT
`J City of Fridley
Building Inspections ]Department
6431 University Avenue NE, Fridley, MN 55432
763572-3604
FAX: 763502-4977