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PRE 2010 DOCSCity of Fridley, Minn. BUH DING PERMIT 'dDate:.......... .®. ..................... owne.`.. ..... .. 1�T® 3163 1�uilder .............. ................ Address............................................. LOCATION OF BUILDING No. .63o. o Street ... ........ ... ..... Part of Lot .,y.. .. e. Lot .......... Block ...�.... Addition or Sub -Division .�. ... J Corner Lot ............ Inside Lot ............ Setback Sideyard ... /A ..0..... .. DESCRIPTION OF BUILDING To be Used as: ............. Front A-0... ... Depth �Y .. Height .... Sq. Ft. .1!.Y Cu.. Ft. 7 `?� J 1r Front ........ Depth ....... Height ........ Sq. Ft. ........ Cu. Ft. ........ Type of Construction ................ Est. Cost.� �....... �...... To be Completed .. ......... . -.7 7 .3,,0 , AV Q 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 all provisions of ordinances of the city of Fridley. V - In consideration of the payment of a fee of $.� .., permit is hereby granted to ......................... to construct the building or addition as described above. This '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 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 Items. Date: Owner: Address City of Fridley, Minn. BUILDING PERMIT Builder ............. Address .... ... ... LOCATION OF BUILDING .No. Street ' ... .. .. Part 'of : pt Lot ........... e ................. Block ..... . ...... . ......... ...... u" Addition or S b D' Comer Lot .................................... Inside Lot ....... ............... aback ... Side yard .......... ............. ........ ................. SewerElevation .............. ................. ......... . ......... ----- ------- * ----------- roy'dation Elevation ..................... .. .................................. ...................... DESCRIPTION OF BUILDING To Used as; Front .. ... Depth Height Sq. Ft. Cu. Ft FIF r m Depth�; Height S-4. Ft. Cu. Ft. 10_46 Type of ction Est. ......... . ... To be Completed .......... ................. .............. CAUTION THIS PERMIT DOES NOT AUTHORIZE VIOLAT- ION OF ANY PRIVATE LAND COVENANTS AND BUILDING REST21CTIONS. 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 $-_'j ..... .. .......... 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 upon violationf violationany of the provisions of said ordinances. Building Inspector NOTICE: This permit does not cover the construction, Installation for wiring, plumbing, gas heating, sewer or wafer. Be sure to see the Building Inspector for separate permits for these items. . APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MDwWTA Owners Name �e �, „���� Builder,,.ZZL/ee s Address 1,,6 IeP - Address �� � eve�/e- 166 ✓ 6, LOCATION OF BUILDING Noe of Lot Lot Block. - Addition or Sub.Div. Corner Lot Inside Lot r/ Set Back Side -Yard - SEM ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. DESCRIPTION OF BUILDING To be used as: � 9cde o/ . a Front e„ _ Depth.__2.,,,C, Height / Sq. Ft. z e0 ` Cu. Ft., _� ,X 0 6 —Front 4. Depths Height Sq. Ft. f,Z, el Cu. Ft Type of Construction azt,, 44;:, _,f& 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 1 the facts and epresenta- tions stated in this application are true and correct. �r � DATE >/,,,��______. SIGNATURE - (A Schedule of Fee costs can be found on the Reverse Side.) r , 4 original Permit for FL INN AND GAS FITRNG N.B. When work covered by this permit is ready, the Plumbing Ordinance requires that request for inspection shall be phoned in to the plumbing Inspector, 560-3450 giving number of this permit., DESMIPTION OF WORK Number, Hind and Location of F=tures Stories m a W Q J 3 U Q U xy 6 7 m h Z 6 m Z tll = 1p < 5y 3 F Y F' W 3: ¢ O °x C Y. N C to 0 O �- O = W aFa m U m z rc K m K E Y. N y O Q W m za (ary K WATER HTR. GAS ELEC. Basement 1.st 2nd 3rd 4th Connected with Sewer -Cesspool Qas Piping for Openings Permission is hereby granted to do the plumbing and gas fitting in the building described in the s tement hereto attached, upon the express condition that the person to whom this permit is granted, and his agents, employees and workmen, in the plumbing or gas fitting of said building shall conform in all respects to ordinances of the City of Fridley, and this permit may be revoked at any time upon the violation of any of the provisions of said ordinances. By Order Of The Inspector Of Buildings Roughing in Inspection Date Inspector. Final Inspection Date S ;) C-- o 6 Permit Fee Kind of Building e used as Q),- '�el" To be Completed '19— Estimated 19_ Estimated Cost $_ �VV-. -0 0 Old -Near. Building Permit No. Date Inspector. Inspector of Buildings. Base 1st 53-84-S915.51 City of Fridley I Appricallon for and Gas Dept. of Bid". Phone 580-3450 DESCRIPTION OF WORK 6310 N E QllineX S - Number, Kind and Location of Fb tdires Q Za< tt ,$i yQ� • • WATER WM. tof CU` t7 V I N GAS ELEC. o 1 =�m���tltt�tlta�ttassis. ■.■� mm m■.■.■■■■■._. _ ■ 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 $ Eleatric Water Heater .............. x $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures ....... • • • • ..... . x $2.00 # Additional Fixtures .................. x $ .75 $ Gas Range to 199,000 BTU....... 1 x $6.00 $- --3X0- REPAIRS & ALTERATIONS—Refer to Code Description ............................. a ................ S TOTAL FEE $ 3.00 City of Fridley: The .undersigned hereby makes application for a permit for the- work herei specified, agreeing to do 411 work in strict accordance with the QtY Ordinance and ruling of the Department of Buildings, and hereby declares that alk the fact and representations stated in this application are trite and correct Fridley, Minn 7-7-70 19, Owner ^^-i+i Pepper Kind of Building frame Used as res To be completed about Estimated Cost, $_ 1-0-00 Old—New. Building Permit No. ° P rrm o''y y ` Signed By LL��I��qq. ��ii9�1 /6i��S U Business Phone No - ROUGH FINAL Lt City of Fridley App icalion for Numbbkq and Gmn R"I" Pemdt Dept. of Ridge. Phone 980-3450 DESCRIPTION OF WORK 6 / Number. Kind and Location of Fixtured UUUMBIMME MEN NEEN .. _77 M Fd I/ N WATER MTI1. City of Fridley: 1�' v .ate ° _7 `'�jj N 3 3 v N GAs ELEC. The .undersigned hereby makes application for a permit for the weak herei d (7 3 specified, agreeing to do all work in strict accordance with the City Ordinance and railing of the Department of Buildings, and hereby declares that alai the fact and representations stated in this application are true and correct PARTIAL RATE SCHEDULE Owner Kind of Building CesspoolSewer a Used as PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ................ x $2.00 $ Future Fixture Opening ............ x $1.50 $-- _New New Fixture Old Opening .......... x $1.50 $ Catch Basin .................... x $3.25 $ Water Heater ;Up to 89,000 BTU) .... x $3.00 $ New Ground Run Old Bldg......... x $3.25 $ Electric Water Heater .............. z $2.00 $ :AS FITTING FEES. NO. RATE TOTAL 1st 3 Fixtures ................ x $2.00 $ Additional Fixtures .................. x $ .75 $ Gas Range to 198,000 BTU.. . x $5.00 $ REPAIRS & ALTERATIONR—Refer to Code Description ....................... , .....................$ TOTAL FEE $ � To be completed Ott Estimated Old—New. Building Permit No. Permit No. Signed. By _ Business Phone o 1! ROUGH GMATITT WARM FAIR: RATE TOTAL Furnace Shell & Duct Work ........................... $10.00 RepIacement of Furnace ............................. '6.00 $ Repairs & Alterations—up to $500.00 ............`..... 6.00 $ Repairs & Alterations each add. $500.00 ............... 3.00 $ NECIL WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ $10.00 $ each add, 60,000 BTU ....................... 3.00 $$ � ,� � Replacement of Furnace ............................ 6.00 p-�..,--� Repairs & Alterations—up to $500.00 ................. 6.00 $ Repairs & Alterations each add. $500.00 .............. 3.00 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam .... .$10.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water .. 10.00 $ Each add. 200 sq. ft. EDR Steam ...............:...... 3.00 $ Each add. $20 sq. ft. EDR. Hot Water ... 3.00 $ OIL BURNER—to 3 gal. per hour 6.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 199,000 BTU) ....... :........$ ........ 8.00 r am 199,000 BTU See. Fee Schedule GAS FITTING FEES: NO RATE TOTAL P Ist 3 Fixtures ............. x$ 2.00 $�' Additional Fixtures x .78 $ Gas Range to 199AM ........... is 600 $ AIR CONDITIONING $ FAR BEATING SYSTEM See Fee Schedule VENTILATING SYSTEM ALTERATIONS & REPAIRS TOTAL. Fid Dopt. of Bldg. Phone 86 3490 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 Ordinance. 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- It 1 3 L) ,_ I&-Z/- .001 SZ/ Owner°z� Kind. of Building Used as To be completed about — 4 r Estimated Cost, Old New. Building Permit No. Permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS --Steam, Hot Water, Warm Air—No Trade Name Size No Capacity Sq. Ft. E.D.R BTU/" "J H.P. Total Connected Load '7'54 d Kind of Feet BURNER — Trade Name Size N Capacity Sq. FL E.D.R BTU l e"� -1 HYt (REMARKS -OYER) fior Power Phaft oW Cooling. Venftelbn.Refn and Air ConMonl" Spftm and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work ................ $10.00 $ Replacement of Furnace .. ..... .. 6.00 JL - Repairs & Alterations—up to $500.00 ... 6.00 $ Repairs & Alterations each add. $500.00 3.00 $---. NECK WARM AIA Furnace Shell & Duct Work to 120,000 BTU ........ ..$10.00 $_ each add 60,000 BTU .................... 3.00 ; Replacement of Furnace.. .... .. .... 6.00 $�.— Repairs & Alterations --up to $500.00 6.00 $ Repairs & Alterations each add. $500.00 .... .. .... 3.00 $ STEAM or HOT WATER SYSTEM 6.00 Furnace Shell & Lines—to 400 sq. ft. EDR Steam $10.00 $. Furnace Shell & Line --to 640 sq. ft. EDR Hot Water 10.00 $_ Each add. 200 sq. ft. EDR Steam 9.00 $-_ Each add. 320 sq. ft. IDR Hot Water 3.00 $— OIL BURNER—to 3 gal. per hour 6.00 $ — over 3 gal. per hour --See Fee Schedule GAS BURLIER (up to 199,000 BTU) ... 6.00 over 199,000 BTU See Fee Schedule GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures .... x$ 100 $---12 Additional Fixtures x .75 $ Gas Range to 199,000 a$ 500 $ AM i?LOIIfII1a 6 FAN HEATING SYSTEM Sea Fee Schedule TING SYSTEM$ ALTERATIONS & REPAIRS TO?AL FEE $ ROUGH— FINAL--9 OUGH FINAL.% (SURCHARGE $-.50) Dept. of Bldgs. Phone SWUM 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 Ordibance: 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- Owner Kind of Building ._ Used as - To be completed about Estimated Cost, Old—New. Building Permit No. Permit No. DF.BCRLPTION OF WORK HEATING or POWER team, Hot Water, Warm Air—No Trade Name– C' f 12 n Size leis_ ZZLj, 6 Capacity Sq. Ft. E.D.R BTU H.P. Total Connected Load Kind of Fuet BURNER — Trade N Size No Capacity Sq. Ft. E.D R- BTU Br. {� (REMARKS -OVER) Busies Phan No SUBJECTERMIT NO. City of Fridley 2 0 6 2 7 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r i 1 i "1 CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 10/15/90 JOB ADDRESS 6310 Quincy Street N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED 8 7 Christie Addition SHEET DESCR. 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Thomas Hoch/Mary Blank.Hoch 6310 Quincy Street N.E. 571--5772 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 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 ❑ ADDITION (ji ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Remove single garage door/install double garage door 9 CHANGEOFUSEFROM TO STIPULATIONS See notations on plan TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. ZONING SQ. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT NO. DWLG. UNITS OFFSTREET PARKING ANY TIME AFTER WORK IS COMMENCED. I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES VALUATION SURTAX AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $5.0.0 $,50 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $15,00 Fire SC $.5Q. STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $1j,00. SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WHE ROPERLY V LI HIS Y UR PERMIT - It-J"S-Yv . NSP GATE SIGNATURE OF OWNER OF OWNER BUILDERt IDATEI NEW [ ] Effective 8/16/90 ADEN [ ] R--1 AND R-2 ALTER [ ] Building Permit Application Construction Address: legal Description: _ Owner Name & Address: •.1 _ M . Ltf el . �«" I• �,. •16;13±; Sc'le AW 4,11 Tel. Tel. s� Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF nam m= Length Width Height Sq. Ft. Length 6 ' Width Height (`� Sq. Ft. Length Width Hgt/Ground Sq. Ft. Corner Ipt [ ] Inside Lit [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: /6 SC 6r Estimated Cost: $ 0 - ©cam Approx. Completion Date: Proposed Driveway Width If New Opening Is Desired: Ft. $ $ i + 6' See Back Page DATE: o a APPLICANT: Tel. # S -w S n 2 Permit Fee Fire Surcharge $� State Surcharge $ S� SAC Charge $ Driveway Escrow $ Park Fee $ Sewer Main Charge $ STIPUTATIONS: CITY USE ONLY Fee Schedule on Reverse Side .001 x Permit Valuation (1/10th �) $.50/$1,000 Valuation $600 per SAC Unit Alt. "A" or Alt. 'B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] NEW [] ADDN [] ALTER [ ] �yl Construction Address: Legal Description: Owner Name & Address: Contractor: CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Tel. # Effective 1/1/2000 (763) 572-3604 Bldg Insp Q MN LICENSE # Address: Tel. # 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: $ riveway Curb Cut Width Needed: �Ft. +�'Ft = Ft x $ _ $ ?y /. � DATE: A)/m4PPLICANT: Tel. # CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge Call (763) 572-3604 for Permit Fees if mailing in application $ Fee Schedule on Reverse Side License Surcharge $ Driveway Escrow Erosion Control Park Fee Sewer Main Charge 11011101 .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1100 per SAC Unit $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "B" Above $ $450.U0 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] $ STIPULATIONS: - 1 �'1 / CITY OF FRIDLEY INSPECTION 6431 University Ave NE Fridley, MN 55432 763-572-3604 RATE SCHEDULE DIViSION APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Residential Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace, but not replacement) Gas Range Gas Dryer *Air Conditioning - All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work Rate $ 30.00 $ 10.00 $ 10.00 $ 10.00 $ 25.00 State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR. CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. Effective On January 1, 2001 JOB ADDRESS 1 v QAl� OWNER —TCS(Y-\ Cl -N TOTAL BUILDING USED AS ESTIMATED COST PERMIT NO. 0 � $ $ .50 DESCRIPTION OF FURNACE AND OR BURNER No. of Heating nits� Circle One (Steam) (Hot Water) ((Warm Air Trade Name �A Size No. -7neN 1 8 BTU c) HP EDR ' Fuel -Total Connected Load Burner Trade Name Size No. BTU HP EDR 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 an rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. DATE I I C9 HEATING CO Signed Ai A0 TEL # 'S_T� _(� Ll Z Approved By&gnp Rough -In Date t� Final Date 5✓'(_/_O1 BACK SIDE MUST BE FILLED IN ON VENT SIZE, VENT CONNECTORS AND COMBUSTION AIR VERIFICATION COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furance, the undersigned hereby verges that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes No ( ) J The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes 1K No( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yesk No( ) The existing combustion air is sized and installed to meet the current codes Yes No ( ) and manufacturer's specifications. When required to install a new combustion air, it will be sized and installed Yes No( to meet the current codes and manufacturer's specifications. ) When installing a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Yes (Q6 No ( ) Venting Tables for fan assisted and natural draft appliances. Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented YesC No( ) separately as per current codes. Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type Irij f- BTU Input Fan Assisted or Nat ZCX�- Appliance #2 Type W44VI BTU Input�e) Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliance Total Btu Input y Common Vent Type C� %ent Height /0 Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) HEATING CO. Signed By: Date : �� CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-3bU4 FAX: ( 763) 5"/1-IZ57 PERMIT NO.: 2004-02119 DATE ISSUED: 11/18/2004 ADDRESS : 6310 QUINCY ST NE PIN : 143024410019 LEGAL DESC : CHRISTIE ADDITION : LOT 8 BLOCK 7 PERMIT TYPE : ELECTRICAL PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION VALUATION NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. 1;1 # 0-100 AMP CIRCUITS APPLICANT ASHLEY ELECTRIC INC 8201 CENTRAL AVE NE STE M SPRING LAKE PARK, MN 55432 OWNER HOCH MARY L 6310 QUINCY ST NE FRIDLEY, MN 55432 STATE SURCHARGE, ELEC FLAT ELEC CIRCUIT FEE (0-100 AMPS) ELEC AMP SERVICE FEE TOTAL PAID WITH CHECK # 19694 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of worl will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. Applicant Date Bldg Insp Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 3 0.50 18.00 30.00 48.50