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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT Date: _ `.6March 1967 Owner: Andrew J. Donnay Builder Address 914 Thomas Ave.. S t . Paul Address Same LOCATION OF BUILDING No. 174._.— Street ..— Pearson Way NEPart of Lot '949�-7 N° 9150 Lot — 12 .._.___ Block 6 Addition or Sub-DivisionPearson's Craigway Estates 2nd Corner Lot — X Inside Lot _ Setback __ Sideyard __ 17 Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Double Bungalow Front _32__._ Depth 50__— Height 24 Sq. Ft. 1600 Cu, Ft 32, 000 Garage— Front 22 Depth 22 Height 100 Sq. Ft. 4,84 Cu. Ft. 4. 840 Type of�Construction Frame Est. Cost 16_, ono _.._ _ __ To be Completed 1 June 1967 Sewer:�,,ll' West of Manhole Water: 20' West of Manhole Top of footing: 848.5' 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. A n /A In consideration of the payment of a fee of $ _1 I 87 -vu ., permit is hereby granted to aauurcw .00 J. Donny to construct the building or addition as described above. This permit is granted upon the express condition that theperson 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. CLARENCE BELISLE Biding Inspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, wwor or water. Be sure to ase the Building hapestor for separate permits for these items. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME BUILDER ADDRESS - ADDRESS II&LOCATION OF BUILDING NO. /J STREET ' a , � .-�'� �°L/ AN PART OF LOT LOT _JA BLOCK �� ADDITION OR SUBD SIGN '" CORNER LOT INSIDE LOT SETBACK SIDE -YARD ZZ U 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, AJ: DESCRIPTION OF BUILDING '� npnth ,1 Rei aht A441,, 2 Sq. Ft. Alo" Cu. Ft.— Fran t t._Front Depth Height 410 Sq. Ft. Cu. Ft. Type of Construction _ Estimated Cost To Be Completed Cdr l 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 deelgres that a1L the facts and representations stated in this application are true and correct. DATE ,J�-� (Schedule of Fee Costs can be found on the Reverse Side). To 560-3450 Cit Cyof. �1� ANOKA COUNTY 6431 UNIVERSITY AVENUE NE FRIDLEY, MINNESOTA 55421 Mr. A9xdrew Donnay 914 Thomas Avenue St. Paul, Minnesota Re: 174 Pearson Way Dear Sir: September 14, 1967 On June 29, 1967, a red tag was posted on your double bungalow at 174 Pearson Way N. E. Single wall construction is not permitted in the garage unless the west wall is covered with 5/8" sheet rock and the balance of the garage is covered with approved sheathing. A second red tag was posted Tuesday, September 12, 1967. In 15 days (September 28,•1967) the City Attorney will be advised to hold the owner in violation. He will then take steps to gain compliance. Your prompt cooperation would be appreciated. Thank you. Yours very truly, M-ARENCE BELISLE Building Inspector City of Fridley CB/bks Application for Power Plants 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 NECK. WARM AIR 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 yBach 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) .......A— . (9)...... 5.00 $ Z Q • 01 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 $ 121S EV ROUGH FINAL Dept. of Bldgs. Phone SU 4.7470 City of Fridley: " 6 /e, 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 !q—�� 1947 Owner Kind of Building � ing ��� Used as lJdi�w ,e //r n fa To be completed about Estimated Cost, $ Oldew. Building Permit No. — Permit No. Q a e_v DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam, Hot Water, Warm No Trade Name AAre n c4A STA,OC&A W Size No_ a G IS�® Capacity. q. Ft. E.D.R. ®0C' BTU—Ing- H.P. Total Connected Load .73A. 9916.3 C4 - S 0 �e Kind of Fuel �� _ 62 C BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. Signe : AND AIR CONDITIONING aNch 440 .EXCELSIOR BLVD. MINNEWULJO By 92a-3900;:��Fk. 42 2M Business Phone No (REMARKS -OVER) Application for Power Plants 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 Furnace Shell & Duct Work to 120,000 BTU ......I' p 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. IDR 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) .......est... ..... 5.00 $ 1 O • ehn 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 VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH FINAL $ See Fee Schedule $ TOTAL FEE $ Dept. of Bldgs. Phone SU 4-7470 -2�� )0 CA d �P �� i��^ sr, r..F c+A-► GL arc 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_ T - �' y 19 &V, Owner e,L. L� ¢ o f: (�° rzL t. o . Kind of Building Used as .lJu-� �'`� ✓eO u �►%� �zj4 le�w! To be completed about �d/ Estimated Cost, $ 1gby Old—�ewNBuilding Permit No. Permit No. r.._ DESCRIPTION OF WORK HEATING or POWER PLANTS --Steam, Hot Waters Warm Ar��-No /► r' � Trade Name?:"'0F'roCci'-J Size No- Capacity 164 - - Sq. Ft. E.D.R Q BTU_j�-* • A.P. Total Connected Load 6y 0-4 . 10 cep Kind of Fuel AKL 14 BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. Signed 1411AT4"S A QMOlg4V.,.:....ey, 4.@ LULSICR ®LVO. MINNEAPL^moi: By... AAA 2�fP1R C s D T�J'"SG7"�r craC <Z 2M Business Phone No (REMARKS -OVER) CRONSTROMS HTG. & AIR COND., I iC. Job Nam ` D-56 "10 Excelsior Boulevard, Minneapolis 16, Minn. ^9 Ze NEAT LOSS CALCULATIONS Job AddressI r A.S.H.V.E. Weatherstrips, Guide Construction No. I Insulation Windows Doors Reference Out. Wall Int. Wall Ceiling Roof FloorI Kind How Applied Yes—No Yes—No 19— i:►J .......:�,� Room I Lenlfth Width i S~Heisfht d` II Fl. Room I Length We v -Height endows arm Doors—Crackage and Area Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of Dane of pane lights of crack sq. fL Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. v qF Coef. Btu Coef. Btp �.. Infiltration r3 Coef. Btu Infiltration Glass Exp. wall Glass Net exp. wall /O O Exp. wall Exp. wall Ceiling % 0 Floor Net exp. wall X F' /70 7®. 2-o Int. wall Ceiling Ceiling i1c, Ceiling g-0 Floor Floor Total Btu. 01 V f Required sq. ft. E.D.R. or sq. ins. W.A. Leader area r►.1 -noom I a.eugmr --e- naqui ® aaoiguL p Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of Dane of pane lights of crack sq. fL Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Coef. Btp Coef. Ptu Infiltration r3 Infiltration Glass "b Exp. wall Glass Net exp. wall /O O Int. wall Exp. wall Ceiling % 0 Floor Net's . wall6. f"Y Total Btu. 151, O Required sq. ft. E.D. . or aq. ins. WA. Leader area Fl. 1J Room I Length i® t Width 4 Heiaht Windows and Doors—Crackage and Area f O Width Height No. of Llneal ft. Area No. of pane of pane lights of crack sq. ft. Width Height No. of Lineal ft. Area No. of Dane of pane lights of crack sq. fL t� Coef. Btu Coef. Btp Coef.1 s , Btu Infiltration Glass 'b Q Glass Ceiling '.0 Net exp. walla S- 4 Vr -.16C Exp. wall _ Int. wall Net exp. w Net's . wall6. f"Y "7 /70 7 Int. wall,,, Ceiling Ceiling i1c, jrT g-0 Floor ' Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Windows and Doors—Crackage and Area f O Width Height No. of Llneal ft. Area No. of pane of pane lights of crack sq. ft. Y y 5 t� Coef. Btu Coef. Btp Infiltration Infiltration TOT Glass 'b Q Exp. wall Ceiling '.0 Net exp. walla S- 4 Vr -.16C BF J, Int. wall Net exp. w , 4--k ! _ fw Ceiling . 51- /a• C, Cl Int. wall Floor Total Btu. I &V Required sq. ft. E.D.R. or !g. ins. W.A. Leader area F7_ V linen I Eenth Width Height Windows and Doors---Crackage and Area f O V Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. t� Coef. Btu Coef. Infiltration 3 Glass Ceiling '.0 Exp. wall Net exp. w , 4--k ! _ fw /Q3 Cl Int. wall Ceiling S + 1) f 5-0 Floor Total Btu. ,j" JNW U Required sq. ft. E.D.R. or sq. ins. WA. Leader area F7.1 Rtnm 1 Lenath Width Heisfht Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. -of pane of pane lights of crack eq, tL Coef. Btu Infiltration Glass % Exp. wall Net exp. wall Int. wall Ceiling Floor Total 13tu. Required sq. ft. E.D.R. or sq. ins. WA. Lrader area SUBJECT City of Fridley 9442 AT THE TOP OF THE TWINS BUILDING PERMIT COMMUNITY DEVELOPMENT DIV. R 6 �O. f PROTECTIVE INSPECTION SEC. I CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 5/10/99 JOB ADDRESS 174-176 Pearson Way NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DES CR. 12 6 Pearson's Craigway Estates 2nd Addn SHEET I 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Vic Daml 1 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO K & K Roofing 9401 McCamus Rd. Brookston, MN 55709 624-2805 20094111 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Duplex 7 CLASS OF WORK p ❑ NEW ❑ ADDITION ❑ ALTERATION X REPAIR 0 MOVE ❑ REMOVE S DESCRIBE WORK DU lex Reroof X59" & Garage (32 Sq) 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 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 BO 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 2 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2,742 $1,37 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 r PLAN CHECK FAL FEE % Lic S $5 7$92.36 SIGNATU OF CO AC TOR OR AUTHORIZED AGENT IDATEI WHE P INSV- Y A THIS 14.XQyR � iMIT F� MATE SIGNATURE OF OWNEPoF OWNER BUILDERI IDATEIOG NEW[ ] Effective 5/10/99 ADDN [ J CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: 171-/- / 74, "5e Legal Description: Owner Name & Address:('/"C'd Tel. # 7 RZ/- S-3 7 Contractor: 14 1) MN LICENSE # Address: �9yGI �'7� �m Lrs W A.yCA42L:1 Tel. # aO09t//I / 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 _ GARAGE AREA: Length Width _ DECK AREA: Len Width OTHER: ;2 7 e Height Sq. Ft. . Height Sq. Ft. Hgt/Ground Sq. Ft. J—� 5- /CAW -),C Construction Type: Re Estimated Cost: $ ^����-� o2 Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ E99 DATE: /p Q APPLICANT: 7� i�c✓r���� Tel. # .21k- �49e/-.2,Fa— CITY USE ONLY Permit Fee $ �3-�S� Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ 1,312 $.50/$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $ 57- c)0 $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 [ J Not Necessary [ ] TOTAL $ -� STIPULATIONS: SUBJECT , City of Fridley 32724 AT THE TOP OF THE TWINS BUILDING PER M O. i F • _ COMMUNITY DEVELOPMENT O r 1 � PROTECTIVE INSPECTION SEC.. NUMBERDATE 171 PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910415 6/24/02 JOB ADDRESS 174-176 Pearson Way NE I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 12 6 1 Pearson's Craigway Estates 2nd Addn SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Victor Daml 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Rite Way Waterproofing 448 Lilac St, Lino Lakes, MN 55014 651-786-0550 Cit 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential Duplex 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION Q REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Install interior basement drain tile system 9 CHANGE OF USE FROM TO STIPULATIONS 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 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 OWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 ISTALLS GARAGES AND KNOW TME SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2,495 $1.25 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 City c nse 11 $87.00 SIGNATURE OF CON TRACTOR OR AUTHORIZED AGENT IDAiEI HE PR LY VALI&TED THIS ISyy,OUR _ JIFOG INSP CPERMIT 4 GATE S-GNATURE OF OWNEROF OWNER BUILOEAI tOATEI NEW [ ] ADDN [ ] ALTER j>Q Construction Address: Legal Description: Di e Owner Name & Address: CITY OF FRIDLEY Effective 1/1/2002 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Tel. # 7u3 - -7g(/ - 53/7 Contractor. Rite -Way Waterproofing MN LICENSE# Address: 448 Lilac Street, Lino Lakes MN 55014 Tel.# 651-786-0550 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: Tnteri ter Ratpmpnt Drain Tilt- System Construction Type: Estimated Cost: $ Dnvevay Curb Cut Width Needed Ft + 6 Ft Ft x $ $ DATE: Co -! 1 - n�;) APPLICANT. A Call (763) 572-3604 for Permit Fees if mailing in application or Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1200 per SAC Unit $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 [ ] lkq STIPULATIONS: Building MECHANICAL Permit No.: -0 6 Inspections RESIDENTIAL APPLICATION Received By: '.�§ 763-572-3604 CITY OF FRIDLEY DRMICT 2 763-502-4977 FAX EFFECTIVE 2-19-09 SITE ADDRESS V THIS APPLICANT IS: PROPERTY OWNER/ TENANT ❑ OWNER YOUR E-MAIL ADDRESS CONTRACTOR COMPANY NAME: V cc s. SUBMIT A COPY OF CONTACT PERSON: YOUR STATE STATE LICENSE # bV\VA EXP DATE LICENSE WITH ADDRESS. APPLICATION PHONE �tSl �%�- r���-i- FAX 11I l - PERMIT TYPE AsINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK. ❑ NEW REPLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF TEWLI'5511W FEES ARE BASED ON $10.00 PER FIXTURE EXCEPT WHERE NOTED. FIXTURES: NDIC T Al,NUMBER OF EACH B L W) Equipment Installed MFG: I b1� MODEL: /� f y[j' J�, SIZFJBTU h MFG: U ( MODEL:l7 b i Vnio'3t#8-®rtV SIZEt TU 06 6 A/C $25.00 _AIR TO AIR EXCHANGEER $15 _BOILER $35.00 _CHIMNEY LINER $10.00 DUCT WORK $10.00 MFG: MODEL: _FIREPLACE (GAS) $15.00 _FIREPLACE (WOOD) $35.00 FURNACE $35.00 'K _GAS DRYER $10.00 GAS PIPING $10.00 SIZEIBTU _GAS RANGEIOVEN $10.00 NEW GAS GRILL $10.00 _GAS UNIT HTR $10.00 _POOL HEATER $35.00 VENTILATOR $15.00 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 applica 'on 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 al ork which re e and approval of p � SIGNATURE OF APPLICANT PRINT NAME kjbYA7i3 p.. DATE , 0- 20' 0 c City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977