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PRE 2010 DOCSLOCATION OF BUILDING No. 0 Street ... e .... ................. Part of Lot .� .. .. .... . e . ...J. Lot .......... B10-*.. ..... ... ... Addition or Sub -Division .. .. . . .. . Corner Lot ............ Inside Lot ............ Setback .. .... Sideyard . ......... DESCRIPTION To Used as: .:... ............. Front Depth Height ...... Sq. Ft. Ft. Front ......... Depth ........ Height ........ Sq. Ft. ........ Cm Ft. Type of Construction i.. ...."�..... Est. Cost.. 13 e. �......... To be Completed ..�. �'u ........ o -&'U tL4.4�a Y a . In consideration of the issuance to me of a permit to construct the building desribed above, I agree to do the proposed work in accordance with the description above set forth and in compliance with alk provisions of ordinances of the city of Fridley. .......... In consideration of the payment of a fee of $.a ....., permit is hereby granted to % ........ ....................... to construct the building or addition as describe_ d above. This p 't 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. building Inspector 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 Date: . 3 3 .0 ....�e � ........ Address...................................... N® 3744 Builder ..................... .. ....... Address............................................. LOCATION OF BUILDING No. . ®. Street .. � .... ... .... Part of t .......... ..... ............ Lot ......q ... Block ...... -1. 1/77 .......... dition or Sub -Division �.... ... ........... .............. Corner Lot .......... Inside Lot ............ Setback ...c.. Sideyard ........................... DESCRIPTION OF BUILDING � �oLbe U d as: 1 �` � �� A ..... Front Q, Depth Height . �i�� �� Sq. Ft. T ��Cu.CFt i ./ �.� .................... Front ........ Depth ........ Height ........ Sq. Ft. ........ Cu. Ft. ... Type of Construction ................... Fist. Cost. .13.Q....:®'.... To be Completed .................. In consideration of the issuance to me of a permit to construct the building desribed above, I agree to do the proposed work in accordance with the description above set forth and m compliance with all provisions of ordinances of the city of Fridley. • .� ,..��'............... V- In consideration of the payment of a fee of $. X......... 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. W-affinalm 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, soparate permits for these Items. V Is APPLICATION FOR BUILDING PERMIT.. CITY .OF F"RIDLEY, MINNESOTA c Owners Name --� BuLilder _ Address Address •LOCATION OF BUILDING No,, Street ._:� _ . _:. .� Part of Lot • Lot Block -.Addition-or Sub. Dive �.. Corner Lot -Inside Lot� Set Back Applicant attach to this form. Ccr° ificate of'Survey. of . Lot and proposed building 16' tion, DESCRIPTION OF BUILDING To be used as Front,>. r,_.... 'Depth Height 17 Sq,� Ft .��° ® Cu., Ft. ..�< .y. Front. -Depth Height To: be :c ognpleted .,......_ . The -updersigned.�h.ereby makes application:•for. a permit for the work heroin ;ipecry fiod� agreeing to. do X11-, work ;in ,.strict accordance with the c1ty, C does s and ruling of thQ Deptmext o€; Buildings, and hereby declares that, all the .fr tz and represen ations-sts.ted in this application axe: true. and _ccrrect P"Ite � °.YZ=- .,,. Signature � . (L,.Schedule of Fee Cost, can be found on the Reverse Side) J. 1 City ®f Fridley, NUnn. W? 8112 Date: July 6, 1965 Owner: Ronald Riste Builder Arden J. Hovland Address 6300 Quincy Street N. E. Address 4242" Quincy St. N. E. LOCATION OF BUILDING No. Streeti1a St zeetN. EA Part of Lot Lot 9 _ Block 7 Addition or Sub.Division Christie Adds Corner Lot Inside Lot _ _ Setback Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Front Depth Height, Sq. Ft. Cu. Ft. Front Depth Leight Sq. F't. Cu. Ft. Type of Construction Est. Cost 5s100.00 To be Completed Storm damage repair: Rebuild to original 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 pro�vision,,s of. ordinances of the city of Fridley. fl)d q1 _� ,= , In consideration of the payment of a fee of $�'� • , permit Is hereby granted to Arden J ._Hovland to construct the building or addition as described above. This permit is granted upon the eFress condition that the person to whom it is granted and hiss agents, employees and workmen. in all work. A one around andFridlMinnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit meq be revoked at any time upah violation of any of the provisions of said ordinances. .Alen Jensen - Building Inspector NOTIM ibb p4 mb does mot corer the eendmdHoe, hufthdon for whbig, pbjmhbg, ga heathgb awes w crater. Be sur® to we the Building Inspector for sepmft permits for thea hems. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA 0 OWNER'S NAMEBUILDER ' i % -----°— ADDRESS �y'J - �/ ADDRESS LOCATION OF BUILDING NO. STREET -PART OF LOT LOT______. BLOCK ! ADDITION OR SUBDIVISION` CORNER LOT_„_INSIDE LOT SETBACK 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. DESCRIPTION OF BUILDING To be useds; 14_�%.� Front Depth Height Sq. Ft. Cu. Ft. Front = Depth Height Sq. Ft.'/ Cu. Ft. lf { CL - Type of Construction X13 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 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/ - ; S (Schedule of Fee Costs can be found on the Reversi/Side). 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 ... Urinal ..... owe�Y. :Wash . ... Floor or s Aut o. Washer Gas Range eater Gas E ecSto Stories a e e Bsmnt Floor 1 0 Flo r 2 0 Flo r 3 0 FI or 4 PLUMBING FIXTURE RATES; NO. RATE TOTAL New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater —Electric Water Heater — Gas Gas Range Gas Dryer Back Flow Preventer Required "Yes (j No $ 7.00 $ 4:00 $ 5.00 $ 7.00 $ 7.00 $7.60 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 Reinspection Fee $30.00 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1 % of Value of Fixture or Appliance State Surcharge (o3 LIZ JOB ADDRESS ft Ul to . 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 Building Division, and hereby declares that all the facts and representations stated In this application are true and correct. Owner ILon 1( Building Used As c Estimated Cost PERMIT NO. / 162e) PLUMBING COMPANY SIGNED BY. TEL N0. 5 ' ( r,;� dq0 Approved By Rough—In Date 50 Final Date _ MINIMUM' FEE 'FOR ANY PLUMBING/GAS PERMIT IS $15.00 TOTAL FEE $ /­• sb PLUS THE $.50 STATE SURCHARGE ' SUBJECT - - - City of Fridley 2 S 6 06 THE TWINS m BUILDING PERMIT 57 ® R O. • _ COMMUNITY DEVELOPMENT DIV. ,� r PROTECTIVE INSPECTION SEC. �� NUMBER REV DATE PAGE OF APPROVED BY I = 1 CITY HALL FRIDLEY 55432 612-571-3450 910-F15 11/18/98 JOB ADDRESS 6300 Ouincv Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED oEscR. 9 7 1 Christie Addition SHEET 2 PROPERTY OWNER MAIL ADORES$ ZIP PHONE Ron Riste 571-2290 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Steve Bodinski Const. 2215135th Ln NW Andover 55304 754-8917 2001 069 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 0 ADDITION ❑ ALTERATION 6dx REPAIR ❑ MOVE 0 REMOVE B DESCRIBE WORK Reroof house and garage (20 Sq) 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 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 FORA 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1714 $.86 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS 0. OF ANY OTHrRR STATE OR LOCAL LAW REGULATING CON. STRUCTIpR-r9,wPERP'0'P4ANCE OF CONSTRUCTION $56.75 Fir/)SC $1.71 J PLAN CHECK FE TOT L EE • L Lic S $5 . $ 4 32 SIGN URE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI N OP Y I A IS IS Y U PER IT zuSIGNATUREOF OWNEROF OWNER BUILDERI IDATEI BLDGSP P QATE NEW [ ] -,,&,D-PN [ ] ALTER [ ] Effective 1/1/98 CITY OF FRIDLEY °U - SINGLE FAMILY AND DUPLEXES R-1 AND R-2 n� BUILDING PERMIT APPLICATION � 4 6 ConstructionAddress: 3 0®� 0 1 Or/ � Legal Description: Owner Name & Address: A9111 / Tel. # Contractor: �j yr � st i` rn 5 MN LICENSE # �?QQ �� 7 Address: 2,� ) 5 Ior � ���'� � �v��. %51. �r->Cx- Tel. # '/',5 57,v- 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: Construction Type: Estimated Cost: $ l / (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: APPLICANT:Tel. #I Z�'z 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 .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1000 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 [ ] CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT Effective On Jan 1, 2000 —MARK NUMBER OF FIXTURES __ -INSTALLED ON EACH FLOOK- $ 7.00 The undersigned hereby makes application for a permit for the work herein Old Opening, New Fixture = Wash :: t`>>:::::. Floor >:::<:::: Auto. ds:<: >: Gas Water Heater Stories Urinal Shower Tray $ 7.00 Drain WasherRange Rain Water Leader Gas Elec RISTE, RONALD - Sump/Receiving Tank $ 7.00 6300 QUINCY STREET NORTHEAST - FRIDLEY, MN 55432 Water Treating Appliance eme nt Basement Owner _ (763} 571-2290 Water Heater -Electric $ 7.00 Water Heater - Gas' * $10.00 Building Used As E�t� 1lY CeC. r1: Floor $10.00 �_ , ®°� Gas Dryer** $10.00 Estimated Cost PERMIT NO. / Back Flow Preventer Required ( )Yes () No Floor 2 .<>> $15.00 PLUMBING COMPANY T1�&0Ql PLO /J (4 Reinspection Fee $47.00/Hr Floor 3 SIGNED BY TEL N0. Z` ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance �a Floor 4 Approved By Rough -in Date Final Date State Surcharge $ .50 Jc TOTAL FEE —7A MINIMU 1%" ANY PLUMBINGIG&S PERMIT IS $20 .00 50�STATE SURCHARGE PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS _'A&C ItS 6W015e— New. Fixtures $ 7.00 The undersigned hereby makes application for a 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 3 200, Rain Water Leader $ 7.00 RISTE, RONALD - Sump/Receiving Tank $ 7.00 6300 QUINCY STREET NORTHEAST - FRIDLEY, MN 55432 Water Treating Appliance $10.00 Owner _ (763} 571-2290 Water Heater -Electric $ 7.00 Water Heater - Gas' * $10.00 Building Used As E�t� 1lY CeC. Gas Range** $10.00 �_ , ®°� Gas Dryer** $10.00 Estimated Cost PERMIT NO. / Back Flow Preventer Required ( )Yes () No Type $15.00 PLUMBING COMPANY T1�&0Ql PLO /J (4 Reinspection Fee $47.00/Hr SIGNED BY TEL N0. Z` ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance �a Approved By Rough -in Date Final Date State Surcharge $ .50 Jc TOTAL FEE —7A MINIMU 1%" ANY PLUMBINGIG&S PERMIT IS $20 .00 50�STATE SURCHARGE UMC SECTION 504 A AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE COMBUSTION AIR SHALL BE PROVIDED PER ( } Building PLUMBING Permit NO.' `' ,tyr \� Inspections 763-572-3604 RESIDENTIAL APPLICATION Received Bye .. ' CITY OF FRIDLEY D. ' 763-572-4977 FAX EFFECTIVE 1-1-08 -yy r� , DATE d-' ® C\ YOUR E-MAIL ADDRESS SITEADDRESSMErl.�� 3Z '��- THIS APPLICANT IS: ❑ OWNER (ONTRACT��OaaR PROPERTY NAME: o_ .a Lim Aji-Z- OWNER/ ADDRESS: (e 30® �cM11CL� SI`A� CITY ��j S STATE IP S�y3� TENANT PHONE: i tv 3- S-7 I- aAR 0 CONTRACTOR NAME: 1 C, m sw\-5k SUBMIT A COPY OF STATE STATE LICENSE # 0 EXDATE ��e a ( O Gl LICENSE, BOND AND p STATE BOND # -7 b'D $ 3 (, y EXP DATE &--30 - O 1 CERTIFICATE OF ADDRESS: 1 11 C : �1.JC t� g -Q S'- CITY STATE ZIP INSURANCE PHONE FAX PERNUT TYPE SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW *EPLACEMENT DETAILED DESCRIPTION OF WORK �p + PER MS 1613.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x.05 = plus .50 surcharge OR FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE $15.50. BATH SINK/LAV DRAINS SHOWER WATER PIPING _ _FLOOR _ GAS PIPING (NEED CITY LIC) SWIMMING POOL _ WATER SOFTNER ($35) —BATHTUB _ _ CLOTHES WASHER KITCHEN SINK je WATER CLOSET _ BACKFLOW PREV. ($15) _ _ DISHWASHER W LAUNDRY TRAY HEATER ($35) FOR IRRIGATION _ _WATER WATER METER OTHER flMN I1 OVER $504T E. Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ 40 ago Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $ OR Number of fixtures @ $35.00 x $35.00 = $ TOTAL DUE $ State Surcharge = $ .50 MINIMUM $15.50 MINIMUM $15.50 Total = $ p S -b THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a plumbing 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 accordance with the approved plan ' ' e ase of all work4hich requires review and approval of plans. SIGNATURE F PRINT NAME � ? !d_ DATE APPROVED BY D ,FOR aAWC 140, "",0144 -ASE N '. ., R I ON City of Fridley Building Inspections Department 6431 University Avenue NE; -Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 / • 04'h Building BUILDING Permit No.� Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: 763-502-4977 FAX EFFECTIVE 1-1-09 5- J 7-09 DATE YOUR E-MAIL ADDRESS SITE ADDRESS __61 1 coo 57-/, THIS APPLICANT IS: ❑ OWNER *CONTRACTOR PROPERTY OWNER/ NAME:O K `S TENANT —ADDRESS: CCS �S o " - CITY STATE ZIP PHONE: CONTRACTOR NAME: U °_, SUBMIT A COPY OF YOUR STATE LICENSE STATE LICENSE #_ 06Y670 &57 EXP DATE AND CERTIFICATE OF ADDRESS: '� o� (T % �' �h. e W4J, ,�J CITY/? y��✓- STAT^/'rZIP INSURANCE PHONE — %6 t 2. FAX PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED ❑ WINDOWS ❑ BASEMENT FINISH .GOOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW HOME CONSTRUCTION ❑ ADDITION ❑ MAINTENANCE/REPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: C-49— CJ7� �'� c bo ,� P ^ly r l� •-- ��� R f c SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT SQ FT ROOFING d7 ❑ HOUSE ONLY NUMBER OF SQUARES of t ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: 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, ❑ Vinyl ❑Soffit ADDITIONS_ & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia 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 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION Permit Fee Plan Review Fire Surcharge SAC Charge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge Total Due OCCUPANCY TYPE 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) $2000 per SAC Unit (Plans to MWCC for determination) —ft +6 ft= ftx$22=$ $450 Conservation Plan Review Fee Determined by Engineering Agreement necessary ( ) Non Necessary ( ) Make checks savable to: Citv of Fridlev Attach Stisulations 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 accordance with the approved plan in the case of all w ' fires review and approval of plans. v� /jam f� 57— SIGNATURE / SIGNATURE OF APPLIC PRINT NAME dt' DATE From: 612 822 5408 Page: 2/2 Date: 7/301200910:39:57 AM Building PLUMBING PermitNo.° Inspections RESIDENTIAL APPLICATION Reicy 763-572-3604 CITY OF FRIDLEY 1)a d: 2 763-510-2-4977 FAX EFFECTIVE 2.19.09 YOUR E-MAIL ADDRESS SITEADDRESS THIS APPLICANT IS; 0 OWNER )(CONTRACTOR PROPERTY NAME; Fyprod OWNER/ TENANT r� ADDRESS; Q7'rr�uc,llC?tA. 1J� C11'YitCild SCATEIYY(.�L1P PHONE;'r%t a � —551 gr -- F, CONTRACTOR NAM;;°. M' A Plum IY'i �," SUBMIT A wry OF YOUR STATE _ t STATE LICENSE /ir EXP DATE Lr=-NSF„'80NU AND 51ATE BOND 9 , j7 •,_ FXP DATE CERTIFICATE OF ADDRESS: l�t l ,�- f � CrrY ? %i _) _ ZIP _.S•TA�TFj . FPHONEINSURANCE �j- 1f?5`23—(bAI� FAX i+O / PERMIT, TYPE ASINGLE FAMILY 0 TWO FAMILY Q TOWNHOUSE TYPE OF WORK. E3 NEW VR1:PLACEML•'NT DETAILED DEscatp 10N OF WORK ��- pt�•p�(~ a FEES ARE BASED ON S I D.DD PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL N UM1 BR OF EACH BELOW). MINIMUM FEE $35.50. _ BATH SP K/LAv FLOOR DRAINS SHOWER WATER PIPING BATHTUB .—GAS PIPING =MI Ctl'Y LIC) SWIMMING POOL = WATEIt SOnNGR (S35) CLOTHES WASIMR KITCHEN SINK _ WATFdt CLOSET _ RACKFLOW PA V. (SIS) DISHWASHER _, _ LAUNDRY TRAY __ WATER HEATER($3S) FOR IRRIGATION w WATER METER _ OnMR 7.' y,6 ,11 h , ; •�u 6 uM,ryy+k kh�5 , II t f r r�� u 41 `' r s 1 �`in'� CJS u g` 1 ; r / ti ' ° ` r yl l ";1� 1'1`y'ir, r+ ° 1p'1•'.; :4P iib 1! `'ti�r�i �kb�� � IS! s el .'. 1 k 1• �}3 .:.,F 11 {Irr ry rr, +•u. ` �,: k . + :: ;rf :� t .°s• :i :}.i. i°[* a it i•�•ai.•�r ..+ lsyr•r':: v. :' ' .. i r } .: t1TM 'r .. •: nti �,•• �r�, , ;: ••}•tr a.1.,yr ;{,• .1.'r'r , { ,. •.: I.' I•a•'r s l,r ': ,r ..; a ,':'i" iI?,lli ',.'. .:•.';; ,Ii.:it,rl.Y rr L i.r.-1g ry � °f .e 1 r;.nlrl fE '•. •. r' sri' Yr,•�•��,���,S•r"n"n + , +Is �: '•t 1 r,: •k••;.v% r: ?:.a,pr s Ir. sr,r � E n1 1 r.: .� � k:'g�:•; • : a 3, r 'i`�a' � ° ° .m ••�' }a1��,'a `� ` `' •r,� •nT{ ( t4$! �! a •II I�--^i ,°`+'k'i;}1 t tsn;j�'f§'�S}µ,{�lyµ�}p`'n',�'�`i�{��({{�1}{' L1 , I 1 t i I 1 I+TNI, t{ 1 �rlts�� 1 + +� �, tl li'1�'';fl# +,�i 1+II 11 l IMtrt if{MIW+SriTfl"1,11'YI' IIIII�r ii �r� "` ..t� III'• •' •1' !II .•. E + + `t!p��`S•+ r �. i nr Asa :'.:; { �:'ru# S , 1N ri+ : •.. :• li ••.t� ri #�''!; •� :' :r. k.:{: f`I (tfrilla •: .+ •.:•152, r.b, �i+),) 4{�lliiib+—�i{•, • t�C:..; ;' •• •• i � n1`I+1+}��y} fY1�It•' ''•.T n` 'P • '•.. a _ ' S }(( Q •8:A .;' l i �`'1 .'t'$ ••• ia'• ';;:'•,.,� ,�,� Ft{• +, ,� � . �` f, .;.ti•:� iTr`0 d yi?' .• ` 11 �s :•. •;t �` •r �,, '.4i {::{ .. • .:.:}; iii ��,, � :•r: •. � ` 4 d •:': r: • ° r`iiir' •+I`s ��` . , ml(�,ik�yv14��11 471 I iaii • ' Til' a.. 1 , � •;:� ;*�;i�p, a' :. r:•'' +'rtr+`�if ,4t+t,ii'� '•%diI THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCII.SSED I hereby apply for a plumbing it and l acknowledge that the information above is complete and accurate; that the work will be in conformance with the or='!c and codes of the City of Fridicy and with the Minnesota Construction Codes; that S understand this is not a pcnxat but oltly an app ' on for a permit and work is not to start Without a permit on site; that the Work will be in accordance with the approved plan in the of all work which requites review and approval of plans. 7 SIGNATURE, OF APPLICANT PRINT NA YJ 7 DATE11T/ 1 `;5M.k'k I] 1 :1 : =- M, 5s'+ ' ,9iW 1.M>�MAI�i $l City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX 763-5024977 9