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PRE 2010 DOCSCity of Fridley, Alinn. BUILDING PERMIT N° �z 1 4 Date: Owner: BuilderOr -- J' x Address _ ...... .._. ._ ____�__..___... Address ...._._ ._._.._..._ ..�_...__._..._ ._._.._�....._.. f_1 LOCAYIF, N OF BUILDING No. _ Street . L,.:,:. Partes Loi Block Lition or Su -Division Corner Lot ___ __ __ Inside Lot _'"_ Setback �_� _ Sideyard Sewer Elevation _ _ _ _ _ _ __ _: _ __ Foundation Elevation DESCRIPTION OF BUILDING _ Front Depth a Height Sq. Ft. Cu. Ft./—' Front JYL Depth IX : Height Sq. Ft. .s6 Cu. Ft.let J Type of nsiruction " t Est. Cost - `-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. t r u° In consideration of the payment of a fee of $ s _ __, 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 violation of any of the provisions of said ordinances. 1117 " ,�� building Inspector NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Besure to see the Building Inspector for separate permits for these items. 4 APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owner's Name 'P -t,\ `lt Builder A +?,�%ok t ,� Z ,r � b'*,- e Address Address %S-1 ' wtllSels'a LOCATION OF BUILDING No. t d �Street i�,� �-"�� �,� ,_Part of Trot Lot Block Addition or Subdivision v W` Corner Lot I V 1 inside Lot yerSetback Side -Yard SEWER ELEVATION FOUNDATION ELEVATION. Applicant attach to this form Certificate of Survey of Lot and proposed building location. To be used as: 4 DESCRIPTION OF BUILDING 6 nAnth CA Sq. Ft. Cu. Ft. aq. Ft. Type of To be Completed ight Gu. Ft. ted Cost s 1j 0 — 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. - n Q (A Schedule of Fee Costs can be found on the Reverse Side.) City of Fridley Application for Plumbing and Gas Fitting Pern►itt DESCRIPTION OF WORK Number, Kind and Location of Fixtures y $ - � 3.25 Z =QQQ �y zp 3.25 jm� �V" rj6 �° �z z �a • R f, WATER FtTR. N GAS ELEG 3Ci Is�� ;t cu LLo a3 C7'd G� (70 Base 1st 2nd _ 3rd 4th • Future Connection Openings I Connected with Sewer � * New Fixture, Old Openings Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES:RATE TOTAL Number Fixtures ...................... 20,x $1.50 $ 9. �O' Future Fixture Opening ................ x New Fixture Old Opening .............. x Catch Basin ...... ..................... x Water Heater (Up to 200,000 BTU) ...... x New Ground Run Old Bldg . ............ x 1.20 $ 1.00 $ 3.25 $ 2.00 $ 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... / x $1.50 $ 1,5'0 Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code . Description................................................$ TOTAL FEE $ Dept. of Bldgs. Phone �SyU 4-7470 . __ .:__ 0� Yl - 171�a City of Fridley: 6U2" 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, cc���n2dinn � Owner / 'eelt % Kind of Building Used as To be completed about Estimated Cost, $ !f �j 016— ew Building Permit No cJ�` �` _ —Permit No. J ROUGH FINAL 4 2 2M 7-59 I Refrigeration and Application for rawer Plants and HeaRti�tg. Caoling. Ventilation, er Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone SII 4-7470 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 .............. 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 • 00 GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x $1.50 $_ ]_o 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 $ 14,50 REMARKS: Locaialoa 108 Rivers Edge Way 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 June 20, 1961 195— Owner Mark Z Jones 195_ Kind of Building ffie Used as Dwelling To be completed about August 1961 Estimated Cost, 195— Building Permit No. Mew -192VI IWRI " DESCRIPTION OF WORK HEATING or POWER PLANTS—Steam, Hot Water4Warm Air--No1 , Trade Name Delco size No DGH100B2 Capacity Sq. Ft. E.D.R loll BTU H.P. Total Connected Load379370 Kind of Fuel Ga S BURNER — Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. Sign By PERFECTION HEATING CO 11 POST 1M-12-58 Business f ;" AYLrSM 9 SA, 3252871 MINNEAPOLIS. 8 MjtjNESOTA D,56 7 v / ® / I. -,5zl— HEAT LOSS TIONS DEPARTMENT OF BUILDINGS Weatherstrips A.S.H.V.E. Construction No. Guide Windows I Doors Reference Out. Wall IfJ X-14—hir Ceiling Roof Floor Yes—No Yes—No 19_ FI 1 [.. t R....,.. I i e,.., , _ ul- t 1 11 9 FI I Windows an Doors—Crackage and Area Height No. of Lineal ft. Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. pane .J Z a l0 1Q G 2 r9 Z 2— 2_i v Coef. Btu Glass Infiltration x' f _ Net exp. vfall / 6 Z to Int. wall Glass Coef. Btu Ceiling G Int. wall 25 o Exp. wall Ceiling 2_ `,'4 Floor U_? Net exp. wall 4 0 o 6 g * D Int. wall Ceiling Floor Z,.3 is 3 Total Btu. u '67-) Required sq. ft. E.D.R. or sq. ins. W.A. jAader area F1.1 F 1 P Room I Len � i Width / Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. ofpane_of pane lights of crack sq. ft.. G 2 r9 Z 2— 2_i v Glass "a Glass / x' /003 Net exp. vfall / 6 Int. wall Net exp. wall Coef. Btu Infiltration qz� Z l b Glass T --Z, o v Exp. wall Net exp. wall i) Int. wall Ceiling Floor Total Btu. _ Required sq. ft. E.D.R. or sq. ins. W.A. Leader area % F1 l / Rnnm 11-rnoth 4r W;,Ith J12146ht Cl Windows and Doors—Crackage irnd Area Coef. - Width HeightNo. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. z Glass Coef. Btu Infiltration �� Z Glass "a Glass Exp. wall x' /003 Net exp. vfall / 6 Int. wall Net exp. wall Total Btu. Ceiling "ID Int. wall Floor !ir 7J Total sq. it. in.u.m. or sq. ins. w.A. t.eacer area l k" 0 —II Kind MINNEAPOLIS. MINN. Insulation How. Applied W;at // f_014;.ht ..l r - - ---o--- - Winel and Doors—Crackage and Area Coef. - Width Height No. of Lineal ft. Area N of pane of pane lights of crack sq. ft. G 2 Z Z� Glass Coef. Btu Infiltration Z j o l� Glass L� x' /003 Exp. wall / 6 Floor ` Net exp. wall Total Btu. 0 "ID Int. wall Ceiling Floor U_? l 4 0 Total Btu. 0 Required sq. ft. E.D.R. or sq. ins. W.A. Lea er area --7—M—I'l R O I Rnnm I L.enath Cr Width Heistht Windows and Doors—Crackage a d Area Coef. Btu Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. 2 Z� Glass Coef. Btu Infiltration Net exp. wall j o N Z$ Glass /0 00 Exp. wall / 6 Floor ` Net exp. wall Total Btu. 1® I "ID Int. wall Ceiling Floor U_? /S-, Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.1 Room I Length Width Windows and Doors—Crackage d Area Width Height No. of Lineal ft. Area No. of pane of.pane lights of crack eq. ft. Height Coef. Btu Infiltration el D Glass Exp. wall Net exp. wall j o c�, v Int, wall Ceiling Floor ` o Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area R SUBJECT PER '�7 City of Fridley ®12962 AT THE TOP OF THE TWINS T I I D I N i� PERMIT BUILDING r 4. D V L v RECEIP NO. • COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION r SEC. 1 � = CITY HALL FRIDLEY 55432 �•'�' ,'� NUMBER REV. DATE PAGE OF APPROVED BY 612-560-3450 910-F15 5/27/75 JOB ADDRESS 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 26 River Edge Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Fred C. Harvey 108 River Ede Way N.E. 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 7 CLASS OF WORK ❑ NEW EX ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK 11 x 22 addition to a garage 9 CHANGE OF USE FROM TO STIPULATIONS SEPERATE PERMITS REQUIRED FOR WIRING, HEATING, PLp,.MBING AND-.§I1GhtSm TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, frame VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU.FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION 242 2,420 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 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. $19800 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT .90 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- $5.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE/-ATOTAL FEE 14 1 $5.90 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) HEN OP DATED THIS IS YOUR PERMIT SIGNATURE OF.OWNER (IF OWNV BUILDER) (DATE) ALDG. INSPk DATE R APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S BUILDER: 2 ADDRESS :-ICI 0 e® Vers e cye, Ala i4 ADDRES S NO:. IVO STREET: R i y e.-,�Vd Q e c9 LOT: BLOCK: I ADDITION:-ayex— AV,& e. CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD: Applicant attach to this form Two Certificates of Survey of Lot and propose•.'. building location drawn on -these Certificates. DESCRIPTION OF BUILDING To Be Used As: eC. ront: Depth: *)'a Height: 9 A q -t' Square Feet: Cubic Feet: Front: Depth: Height: Square Feet; Cubic Feet: Type of Construction: A-rw-ow e- Estimated Cost: v To Be Completed: E3 ®7 A 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: _-�j -7 - 7� 7 SIGNATU2ion •(See Reverse Side For Additional Info.) Vx3 ® o ou /n j �`it SUBJECT P. City of Fridley pp 3298_, AT THE TOP OF THE TWINS BUILDING P E R M I r R NO. � • _ COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED By 612-571-3450 910-F15 4/20/95 JOB ADDRESS 108 River Edge Way NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 26 1 Rivers Edge Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Fred Harvey 108 River Edge Way NE 571-3961 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. B & B Roofing Inc 6760 Madison Street NE, Fridley MN 55432 571-0248 9046 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 ❑ ALTERATION jJ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (20 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL, PLUMBING, HEATING, 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 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 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 W ER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $.75 DO NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE P VISIO S OF ANY OTHE ATE OR LO AL LAW REGULATING CON- S R CTI N OR THE PERFO NCE OF STRU TION $35.00 Fire SC $1.50 PLAN CHECK FEE TOTALFEE License SC $5.00 $42.25 SIGNATURE OF 0 ACTOR ORAUTHORIZ AGENT DA ) WHEN PROPERL VALIDATED THIS IS YOUR PERMIT BL G INSP 02%%IN, �e b DATE S,GNATURE OF OWNER OF OWNER BUILDER) IDATEI NEW ( ] Effective 1/ 1/95 ADDN (] CITY OF FRIDLEY ALTER (] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application ConstructionAddress: Legal Description: Owner Name & Address: Tel. # —57/--& Contractor: kpai`/4 C S MN LICENSE # a te Address: &74.--o ,Z 0 1. yol S i Tel. # 5 7/ Q Z �� 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: Len Width Hgt/G"ro7 Sq. Ft. OTHER: ✓L L40� /�/O U S� G oZO 41� —Tl�w C ® /4':/ -- Comer Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: .�? 1%0 y/15 -F --9L" ss' Estimated Cost: $ Approx. Completion Date: (Cost on Back) Driveway Curb Cut Width Needed: F + 6 Ft = Ft J $ _ $ DATE: APPLICANT: Tel. # —z) e� TOTAL $ �° STIPULATIONS: CITY USE ONLY Permit Fee $ - Fee Schedule on Reverse Side Fire Surcharge $ 1 . S -e) .001 of Permit Valuation (1/10th%) State Surcharge $ - ?S_ $.50/$1,000 Valuation SAC Charge $ $850 per SAC Unit License Surcharge $ 5-06 $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 [ ] Not Necessary [ ] TOTAL $ �° STIPULATIONS: CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-3604 VAX: (763) 571-IZ57 ADDRESS : 108 RIVERS EDGE WAY NE PIN : 153024430067 LEGAL DESC : RIVER EDGE ADD : LOT 26 BLOCK 1 PERMIT TYPE : ELECTRICAL PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION PERMIT NO.: 2004-02221 DATE ISSUED: 12/01/2004 VALUATION NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. 2;2 # 0-100 AMP CIRCUITS APPLICANT SCHOO ELECTRIC 4065 LANCASTER LN #2 PLYMOUTH, MN 55441 - OWNER HARVEY FRED C & BARBARA K 9156 ORIOLE LN SW ALEXANDRIA, MN 56308 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 ]nsp Date STATE SURCHARGE, ELEC FLAT ELEC AMP SERVICE FEE ELEC CIRCUIT FEE (0-100 AMPS) TOTAL PAID WITH CHECK # 12276 SEPARATE FERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 8 0.50 30.00 42.00 72.50 Building PLUMBING Permit No.: Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY DATE /O Z S 7 YOUR E-MAIL ADDRESS SITE ADDRESS aeg THIS APPLICANT IS: 17 OWNER CONTRACTOR Brett Harvey PROPERTY NAME: 108 River Edge Way Northeast OWNER/ Fridley, MN 55432 ADDRESS: ATE ZIP TENANT 7635713961 PHONE: CONTRACTOR NAME: SUBMIT A COPY OF STATE LICENSE # C% EXP DATE ADDREss kr14crrY /s YOUR STATE ,- m_STAT'EAs'J_Nlr LICENSE WITH • PHONE — 6`0 FAX — APPLICATION PERMIT TYPE SINGLE FAMILY 0 TWO FAMILY IS TOWNHOUSE TYPE OF WORK: 0 NEW REPLACEMENT DETAILED DESCRIPTION OF WORK &Ilftf PER MS 16B.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. CMis.should_reflect only.the cost of labor ) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor X.05 = FOMROIECTS WHERE LABOR EXCEEIISiS00;7EES ARE BASED ON310.00 PER FIXTURE; EXCEPT VIRE NQTEiIH:FIICTiI1 Ss_ jiND1GATE TOTAL NUMBER OF EACH BELOW) BATH SINK/LAV DRAINS _ SHOWER _ WATER PIPING _ _FLOOR _ GAS PIPING (sm crjy ucrost) SWIMMING POOL _ WATER SOFTNER ($35) —BATHTUB CLOTHES WASHER _ KITCHEN SINK WATER CLOSET _ BACKFLOW PREY. ($15) _ DISHWASHER =LAUNDRY TRAY •LWATER DATER ($35) FOR IRRIGATION WATER METER OTHER Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ Surcharge .50 Number of fixtures @ $15.00 x $15,00 = $ TOTAL DUE $ Number of fixtures @ $35.00 --�- x $35.00 = $ 3S.0o State Surcharge = $ 50 Total = $ THIS IS AN APPLICATION FOR A PERMrr 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 ann app ' ation 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 oLowhicquires review and approval of plans. /SIGNATURE OF APPLIC "� PRINT NAME J /r/O/b /DYYi DATE 1,01-7f 147 City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977