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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT ... _. J�%,-� 0A.. Builder Address OCATION UILDING No. Street Part of Lot Lot _ Block Corner Lot _ Inside Lot Sewer Elevation Addition or Sub -Division Setback --- Sideyard Foundation Elevation DESCRIPTION OF BUILDING /f��-3 N° 6355 vsed a Depth Height Sq. Ft. Cu. Ft VA—;d11t ly nt Depth±ght Sq. Ft Cu. Ft Type of Constructt Fst o be Completed In consideration of the issuance to me of a permit to construct the building described a e, I agree to do the proposed work accordant' with the description aboveTth a d in comp�nL� p� e f ordinances of the cityof Fridley. // In consideration of the payment of a fee of $076 .,permit is hereby granted 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 limps and this permit may be revoked at agyit u��violaticbSof�any of the Provisions of said ordinances �/ 33��/ / // !! Building Inspector NOTICE: 'This permit does not corer the construction, Iestallalloa for wiring, Plumbing, gas hosting, sewer or water. Be core to see the Building Inspector for separate permift for these horns. CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT RATE SCHEDULE PLUMBING FIXTURE RATES: NO. >. a p 7.00 - $ U M e Beer Dispenser Water W 5.00 - $ m $ 7.00 - $ Catch Basin e 4 m 7.00 - $ Rain Water Leader ug $ a a Heater M0 m S CC .i Water Heater - Electric $ 7.00 - $ Water Neater - Gas $ 10.00 - $� Gas Range 10.00 - $ Gas Dryer w u 10.00 - $ $ ( ) Yes ( )• No Type $ 5.00 - $ 0 P- lot 2nd 3rd 4th (R) - Future Connection Opening Connected with Sewer (�) - New Fixture, Old Opening Water RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures $ 7.00 - $ Old Opening, New Fixture $ 4.00 - $ Beer Dispenser $ 5.00 - $ Blow Off Basin $ 7.00 - $ Catch Basin $ 7.00 - $ Rain Water Leader $ 7.00 - $ Sump/Receiving Tank $ 7.00 a $ Water Treating Appliance S 10.00 - $ Water Heater - Electric $ 7.00 - $ Water Neater - Gas $ 10.00 - $� Gas Range $ 10.00 - $ Gas Dryer $ 10.00 - $ Back Plow Preventer Required ( ) Yes ( )• No Type $ 5.00 - $ ALL OTHERS AND/OR REPAIRS AND ALTERATIONS Is of Value of Fixture or Appliance REINSPECTION FEE $30.00 State Surcharge TOTAL FEE $/0 .6 d $ .50 Effective Date January 1, 1991 Job Address �� 5 // a,Id W'4tJ cy, R,<t 0o (Z- a Building Inspection Div. 6431 University Ave HE Tel. No. 572-3604 Fridley MN 55432 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 applicati are true and correct /� , 19 7/ USED AS t TO BE COMPLETED ABOUT ESTIMATED COST OLD - NEW BUILDING PERMIT NO. PERMIT 90. company Signed By Tel. No. ROUGH INSP. Date FINAL INSP. ` fp Date APPROVAL FOR PERMIT '&�t 41,'A / — MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT I8 $15.00 PLUS THE $.50 STATE SURCHARGE CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 Effective On January 1, 1993 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR stet '`"'`'• nth... ��S ower .. •� Wash Tray Drain . o Washer : Range Water Heater Stories EecSto as e Bas ment' specified agreeing to do all work in strict accordance with the city codes Beer Dispenser $ 5.00 and rulings of the Building Division, and hereby declares that all the facts Blow Off Basin $ 7.00 and representations stated in this application are true and correct. Floor 1 $ 7.00 Rain Water Leader $ 7.00 Sump/Receiving Tank $ 7.00 FI oor 2 Water Treating Appliance $10.00 Owner / t- F A -%SU Water Heater —Electric $ 7.00 Water Heater — Gas Floor 3 Building Used As f zC? %Y Gas Range $10.00 Gas Dryer $10.00 Estimated Cost PERMIT NO. Floor 4 Type •$5.00 PLUMBING COMPANY .1Vor s Reinspection Fee $30.00 PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS 'S 7/0 Q cQ �! w©dc% A6,zr 4 •P r1 New Fixtures $ 7.00 The undersigned hereby makes application fora permit for the work herein Old Opening, New Fixture $ 4:00 specified agreeing to do all work in strict accordance with the city codes Beer Dispenser $ 5.00 and rulings of the Building Division, and hereby declares that all the facts Blow Off Basin $ 7.00 and representations stated in this application are true and correct. Catch Basin $ 7.00 Rain Water Leader $ 7.00 Sump/Receiving Tank $ 7.00 �_ 0L o Water Treating Appliance $10.00 Owner / t- F A -%SU Water Heater —Electric $ 7.00 Water Heater — Gas $10.00 Building Used As f zC? %Y Gas Range $10.00 Gas Dryer $10.00 Estimated Cost PERMIT NO. Back Flow Preventer Required ( )Yes () No Type •$5.00 PLUMBING COMPANY .1Vor s Reinspection Fee $30.00 SIGNED BY TEL N0. Ste'/—/ SSS ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1 % of Value of Fixture or Appliance Approved By Rough—In Date Final Date State Surcharge $ .50 MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 TOTAL FEE _ S A5• _'� D PLUS THE $.50 STATE SURCHARGE builc1mg NES; j I(; Pe=tNo..*"Lc�q-c , I Inspections p RESIDENTIAL APPLICATION Received By jA1 763-572-3604 -n DaMUCT CI ®� I�LE� 763-502-4977 FAX EFFECTIVE 2-19-09 DATE 10-,r- d q YOUR E-MAIL ADDRESS SITE ADDRESS SV/0- Sty 614-v�G`� _-V THIS APPLICANT IS: 13 OWNER CONTRACTOR PROPERTY NAME: .0 6 n OWNER/ ADDRESS: SQ 16 Qx k<w,w �" H A `1b�'— CITY �'1� i rOt� STATE N0 ZIP .,rJ �3� TENANT PHONE: 7b:s- S-71- b S a1 CONTRACTOR COMPANY NAME: fei ,,,. J SUBMIT A COPY OF CONTACT PERSON: C k YOUR STATE STATE LICENSE # EXP DATE LICENSE WITH _ ADDRESS400 6 T10-t, & a' CITY doe.. � STATE 11°J ZIP 5SL(3 a APPLICATION PHONE -1 6a - "l S �F 91 q i FAX PERMIT TYPE SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: 13 NEW REPLACEMENT 13 ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK 1Q14 (Q-C.L rt" Lk FLK e, A *-1 FEES ARE BASED ON $10.00 PER.FIXTUIM EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) Equipment Installed MFG: JLu V in MODEL: VC &L• 04, Ai MA 1° o SIZE/BTU J d V MFG: MODEL: SIZE/BTU MFG: MODEL: SIZEIBTU A/C $25.00 _FIREPLACE (GAS) $15.00 _GAS RANGE/OVEN $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 $15.00 4 r z N$ x Y,y;„�Fsf m,,._ .� ; * y..,c .r ;3-52 .M• d r^e ^e x t^ _r d �'.xyy m sem, r'Y ,h . �t * �.Y tu'.�` e" F s7lIi �7 .. -1i w d_.y s ', -•`xY F t.'s,..�.� 4 T ^.4 .uv.'F 5am 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 work which requires review and approval of plans. SIGNATURE OF APPLICANT C��1-10 kt- 190 PRINT NAME L-1 rf J DATE if PLEASE.NOTI✓i SEPARATE.PER-�'arS ARI •REQ:UI-REi3•FOR BUILDING EIYEC`IRI AL: A:ND.,MECHANICAL W-01M City of Fridley Building 'Inspections Denalr4$nent 6431 University Avenue NE, Fridley, MN 55432 763-57/2-3604 FAX: 763-502-4977