PRE 2010 DOCSCity of Fridley, MHnn..
BUIILDING PERMIT N° 5362
Date: __-
Owner: Builder _
Address Addresses x
TIO 00: U DING
No. Street_ _ Part _ Lot
d r
Lot _ Block Adclition or Sub -Division
Corner Lot �'"Inside Lot Setback ... Sideyard _ r,
Sewer Elevation Foundation Elevation
DESCRIPTION OF BUILDING
To Used
Front Depth Height Sq. Ft. CU. Ftav-
Fron DepthHeight A Sq. Ft.� Cu. Ft.
'00
Type o Construction Est. Cost` _ """fCo 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.
X
In consideration of the payment of a fee of $.Z16 , 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 uponviolation �f any of the provisions of said
ordinances. ,,�I A ,i
NOTICE:
This permit does not cover the construction, Installation for whine, plumbing, gas heating, sewer or water. Be sure to we
the Building hupecior for separate permits for these Mann.
4
APPLICATION FOR BUILDING PROM
CITY OF FR.IDIEY, MINNESOTA
Owner's Name Builder
Address Address
LOCATION OF BUILDING
No.� Street �` Part of Lot
Lot Block Addition or Subdivision
Corner Lot Inside Lot Setback ..35Side-Yard / O
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
DESCRIPTION OF BUILDING
To be used as: a�`
Front 17 � � Denth 2' � Heiaht d` O
61 r �i
Sq. Ft. / Cu. Ft. 2
� s
,ale Front / -2 Depth %3 Height f O
Sq. Ft. Ft. �a
Type of Construction Estimated Cost
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 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. f
DATE ��i SIGNATURE
(A Schedule of Fee Costs can be found on the Reverse Side.)
Application for Power Plants and Heating. Cooling, Ventilation, -Reh igeration end
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
Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ 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 ....... :..... 1 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 $-5,_
GAS FITTING FEES: NO RATE 3!QTAL
1st 3 Fixtures x $1.50 $ V
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 $ 14.50
ROUGH
FINAL
Dept. of Bldgs. Phone SU. 4-7470
I: .0"; 6801 Oakley St. R. E.
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 6-27-61 19
Owner Paz,71 SdbwRytm-iCcmat - Cn -
Fr•
Kind of Building
Used as Rea.
To be completed about 7-2761
Estimated Cost, $ 450.00
Old --Nm. Building Permit No. S96 B Permit No.
HEATING or POWER PI ANTS -Steam, Hot Water, WarmAir—No
Trade Nam Size150"
Capacity.
Sq. Ft. E.D.R. ZOOM BTU H.P.
Total Connected Load 45t 631 Kind of Fuel Gas
BURNER — Trade Name Size No
Capacity Sq. Ft. E.D.R BTU H.P.
Plan R-1 (on file)
aZ 7M 7.59
(REMARKS -OVER)
Signed
By F7E'D V41•' ).
Business P#jATMG & AIR CONDITIONING
6530 West Lake St. s WE. 9-6767
St. Louis Park, Minnesota
City of Fridley
Application for Plumbing and Cow Ruing Perndt
Dept. of Bldgs. Phone SU 4-7470
DESCRIPTION OF WORK Locain 6801 Oakley Street N.E..
Number, Kind and Location of Fixtures
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO. RATE
TOTAL
Number Fixtures ......................
7 x $1.50
$ 10.50
Future Fixture Opening ................
x 1.20
$
New Fixture Old Opening ..............
x 1.00
$
.1
�d
UN'
W
�O
P
f
N
WATER HTR.
GAS
EIEC.
Base
$
New Ground Run Old Bldg. ............
x 3.25
$
1
1
1
ist
1
1
1
1
1
Dis
ospi
2nd
_
3rd
4th
• Future Connection Openings
New Fixture, Old Openings I
Connected with
Sewer
Cesspool �
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO. RATE
TOTAL
Number Fixtures ......................
7 x $1.50
$ 10.50
Future Fixture Opening ................
x 1.20
$
New Fixture Old Opening ..............
x 1.00
$
Catch Basin ............................
x 3.25
$
2,00
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
Description...................�
.............................
TOTAL FEE $ 1'.00
ob
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 July 10 1961
Owner haul Schwartz Const. Co.
Kind of Building Frame
Used as Dwelling
To be completed about Oct. 10,1961
Estimated Cost, $ 800.00
Old—New. Building Permit NoN,��& (& Permit No.
Signed STMDARD 1LUPABIRG a APPLIANCE
Bus ess f a No Vie 8 3589
ROUGH f -/
y ( t
FINAL
d z 2M 7-59
City of Fridley, Minn. N° 7915
BUILDING PERMIT
Date: June 17, 1965
Owner: Marvin W, Smith Builder Qreveo Const, Inq
Address 6801 Oakley St. Address 312. Kyle No. Mp1s. 22
LOCATION OF BUILDING
No. 6801 Street Oakley St. Part of Lot
Lot 12 _ Block Addition or Sub -Division Rraolcd ALj T.e=- Rnd. ��.--
Corner Lot — Inside Lot Setback Sideyard
Sewer Mevation ` Foundation Mevation
To be Used as:
Front
Front
Type of Construction
Repair Storm Damage
DESCRIPTION OF BUILDING
Depth Height
Depth Height
— Estcwt _. 5,9000
Sq. Ft Cu. Ft
Sq. Ft Cu. Ft.
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 the payment of a fee of $ 10.00 , permit is hereby granted to GrMyco Const- no.
to construct the building or addition as described above. This permit is granted upon
the express condition that the person to whom it pisargtranted add his agente, employees anworkmen, 3n all work
L
Minnesota g nthince. city limits ands permit may be revoked at any time upon violation of any of the provlalons of said
, nen Jensen Building Inspector
NOTICE: I'll
'lids peradt don net corer the construction, hwhffiation for vArb& plumbing, gn hon inp, www or water. Be sun to we
the BuMns Inspector for wparate pmft for thew hems.
i
APPLICATION FOR MaING PERMIT
CITY. OF FRIDLEY* NNESOTA
OWNER' S NAME BUILDER
ADDRESS6 000 ADDASS2��& 2�-
..
' LOCATION OF BALDING
No, R®Sheat Part of Lot.
Lot_ Block Addition' or Subdivibi®n
Corner Lot Inside Lot _,•,Setblitk Side Yard
SEWER EMATI(N FOUNDATION ELEVATION
Applicant attach to that form, Two Certificates of.Survey of Lot and proposed build—i.
ing location drAwn on these GQttificates.
DESCRIPTION OF RtMDING
Teo be used as:
Front Depth. Height,'
Std. Ft.. Cu. Ft.
Front Depth Height
Sq. Ft-. Cu. Ft.
Type of Construction Estimated Cos z 47-61-C
The undersigned hereby makes application for a permit for the work herein specified,
agreeing to do all work ift 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.
_tScbedu1s of Fee Costs can be found on the Reverse Side).
0.
City of Fridley, Minn..
BUILDING PERMIT
Date: June 26, 1970
Kenneth Strand
Builder S ame
Address 6801 Oakley Street Address Some
LOCATION OF BUILDING
No. 6801 street Oakley Street,, ___ Part of Lot
Lot — 13 __ Block
Corner Lot ._ Inside Lot
Sewer Elevation
10723
Addition or Sub -Division . ro kvi w TPrrarp 2nd Addn _
Setback __ Sideyard
Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Garage Front 24 Depth 26' Height 10 ' Sq. Ft. 624' Cu. Ft. 6240
Front Depth Height Sq. Ft. Cu. Ft.
Type of Construction Frame Fist. Cost — $2, 200._00 ____ To be Completed
Provide Hardsurfaced Driveway
In consideration of the issuance to me of a permit to construct the building described above I to do
the proposed work in accordance with the description above set forth and in compliance with ail ons of
ordinances of the city of Fridley.
In consideration of the payment of a fee of $ 12 Oil , permit is hereby granted to Kane h Si -rand
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. r-
GLARENCE BELISLE
NOTICE:
'fids permit does not cover the construction, Installation for whing, plumbing, gas hosting, sewer or water. Be amu to as
the Building Inspector for separate permits for thea hens.
APLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
ADDRESS:- (,,FO ) ST_ ADDRESS
NO:. STREET:
LOT: BLOCK: ;'� ADDITION:- b ot- V i E W v 4'D Add,
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:
a L Front:_ a � Depth• a (Q Height
Square Feet: Cubic Feet: -
Front: Depth: Height:
Square Feet; Cubic Feet:
Type of Construction: r.__Le M t? Estimated Cost: $ �2 V o a�
To Be Completed:
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:
(See Reverse Side For Additional Information.)
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SUBJECT
PERMIT NO.
City of Fridley
29099
AT THE TOP OF THE TWINS
BUILDING PERMIT
`
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
/� (�
1 v ____�_
r PROTECTIVE INSPECTION SEC.
`�dl a
F
NUMBER
REV
DATE
RAGE OF
APPROVED BY
i CITY HALL FRIDLEY 55432
612-571-3450
910-F15
3/29/99
JOB ADDRESS
6801 Oakle Street NE
T LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
13
2
Brookview Terrace 2nd Addition
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Ken Strand 6801 Owner Street NE
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO
Premium Roofiniz 6680 Lucia Lane 11 Fridley, MN 55432
571-3973
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP
PHONE LICENSE NO.
20097688
5 ENGINEER MAIL ADDRESS ZIP
PHONE LICENSE NO
B USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR
O MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof House & Garage 24 S Tear -off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday thru Friday; 9:00 am to
9:00 pm on Saturday; No work on Sunday.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING. HEATING.
TYPE OFCONST.
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 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
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 SE COMPLIED
$2,056
$1.03
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.
$74.75
Fire �.' $2.06
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE
TOTAL E
Li ns C $5.0
82.84
SIGNATURE OFCONTRACTOR ORAUTHORIZED AGENT iOATE,
ENP OPE LIDATE
,. BL -NSR
HIS IS V R PERMIT
GATE
SIGNATURE OF OWNER09 OWNER BUILDERt iDATEi
S
NEW [ ] Effective 1/1/99
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 ra
BUILDING PERMIT APPLICATION
ConstructionAddress• �f DO/
Legal Description: TC9,P -o V,--
Owner
FOwner Name & Address: &--ti -5171 /11_VP Tel. #
Contractor: flree�V,1 I 1�0�'l /�� MN LICENSE -6
Address: e�8V G uc- //+ 6,V Tel. # S 1 %3
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:
z64 71' <o/
446z-- -a
�AE 9/
?
oma, -c
Construction Type:&p0f--11Vo
Estimated Cost: $ i
(Fee Schedule on
Back)
Driveway Curb Cut Width Needed: Ft.
+ 6 Ft =
Ft x $
_ $
DATE:
APPLICANT:
Tel. #
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
CITY USE ONLY
$ Fee Schedule on Reverse Side
$ �� Q C .001 of Permit Valuation (1/10th%)
$ D $.50/$1,000 Valuation
$ $1050 per SAC Unit
$ S a U $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 [ ]
Building
$ W, C-0
BUILDING
$
Permit No.: OCJ
Inspections
Surcharge
RESIDENTIAL APPLICATION
License Surcharge
Received By:
763-572-3604
$
CITY OF FRIDLEY
$
Date o
DATE
YOUR E-MAIL ADDRESS
$
SITE ADDRESS
C. Q/ S l /U D L 6V InIv s-5- 3
THIS APPLICANT IS:
.,OWNER ❑CONTRACTOR
PROPERTY OWNER/
NAME: t Y yyGTf-1 /:? S-f1F 61%b
TENANT
ADDRESS: ST ASE CITY z!FgI D L E1/
STAT*#IPSSy3O-
PHONE: —Z& S- rZ 410 a
CONTRACTOR
NAME:
STATE LICENSE # EXP DATE
SUBMIT A COPY OF
YOUR STATE LICENSE
ADDRESS: CITY
STATE—ZIP—
TATEZIPWITH
V=APPLICATION
PHONE FAX
PROPERTY TYPESINGLE
FAMILY SIZE
C3 TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS
❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE
❑ DECK ❑ SIDING )tOTHER
❑ SWRAMING POOL
TYPE OF WORK:
❑ NEW ❑ ADDITION
❑ MAINTENANCE/REPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE:—,q/-(d ZVIAIUMc5a) •X/TS 4A4SC/A1 1A5UL#TbAJ°fo"-72F
Win) -Ls
SIZE OF IMPROVEMENT LENGTH � WIDTH 2,
HEIGHT Sq. Ft.
ROOFING
❑ HOUSE ONLY
NUMBER OF SQUARES
❑ HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
GARAGES
❑ ATTACHED GARAGE
I .
2.
Existing Floor Plan
Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3.
List of structural members to be used
PROPOSED HEIGHT:
SIDING
FOR NEW CONSTRUCTION INCLUDING DFyCKS,
❑ Vinylflit
ADDITIONS, & PORCHES SUBMIT:
13 Aluminum
Trim
1.
Site Plan/Survey showing the existing structures
❑ Other .
Ofascia
and proposed project.
VVINDOWS
2.
Two sets of construction plans
IN EMSTING OPENINGS ❑Yes ONo 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 $ = C% O OCCUPANCY_ TYPE
Permit Fee
$ W, C-0
Plan Review
$
Fire Surcharge
$
Surcharge
$ 5
License Surcharge
$
SAC Charge
$
Curb Cut Escrow
$
Erosion Control
$
Park Fee
$
Sewer Main Charge
$
Total Due
$ 5
See Back Page for Fee Schedule
65% of Building Permit Fee
.001 times the total job valuation
.0005 x Permit Valuation Minimum $.50
$5.00 (State Licensed Residential Contractors)
$1675 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$21=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks payable to: City of Fridley Attach
THIS IS AN APPLICATION FOR A PERMITNOT 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 requir review and appro of plans. /
SIGNATURE OF APPLIC i PRINT NAME2! jE it — H R cS i /` D DATE 0(0,//
A
Building
MECHANICAL
Permit No.:W K)1)1'1�P
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
Datl:��� o
CITY OF FRIDLEY
763-502-4977 FAX
EFFECTIVE 7-1-2010
DATE ' OOUR E-MAIL ADDRESS
n
SITE ADDRESS
THIS APPLICANT IS: O OWNER CONTRACTOR
PROPERTY
NAME: -
OWNER/
ADDRESS: CITY Md ZIPS
TENANTq
—STATE
PHONE: 7 "
l
CONTRACTOR
COMPANY NAME: SHARP HEATING & A.C.
CONTACT PERSON: FLOYD JOSWICR
SUBMIT A COPY OF
YOUR STATE
STATE LICENSE # EXP DATE
LICENSE WITH
ADDREss:7221 -University Ave. N.E. CITY Fridley sTATEMN zip 55432
APPLICATION
PHONE 763-572-0459 FAX 763-572-0164
PERMIT TYPE
O INGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK:
D NEW , ` I EPLACEMENT 0 ALTERATION/REMODEL
DETAILED DESCRIPTION OF WORKC
FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW).
PROVIDE HEAT LOSS CALC'S PER MAN: JJ 2A HRAE HANDBOOK. 9MVW Equipment Installed MFG: � MODEL: SIZE/BTU
MFG: MODEL: SIZEIBTU
MFG: MODEL: SIZEIBTU
A/C $25.00 _FIREPLACE (GAS) $15.00 GAS RANGEIOVEN $10.00
AIR TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00
BOILER $35.00 TFURNACE $35.00 _GAS UNIT HTR $10.00
CHIMNEY LINER $10.00 GAS DRYER $10.00 _POOL HEATER $35.00
DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00
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a. � ren � �.`. �. u a � 4 � �� � Y •m
9
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 ap 'cation 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 ofidl work w re s review and approval of plans. p
&*i�SIGNATURE
OF APPLICANT PRINT NAME DATE 0�`
APPROVAL INSPECTORS SIGN DATE
iol
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 763-5024977