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PRE 2010 DOCSIn consideration of the payment of a fee 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 '4n all respects to the ordix}ances Of JI Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings with- in the village limits and this permit may be revoked at any time upon violation of any of theprovisions of said ordinances. . ... Building!,Inspeetor NOTICE: This permit does not Cover the construction, installation or,alterafilon for.wir plumbing, gas heating; sewer or water. Be sure to see siding Inspector for separate permits for items, City of Fridley Application for Plumbing and Gas Fitting Permit 879.01 Dept. of Bldgs. Phone 560-3450 DESCRIPTION OF WORK 4964 ROmn Rd Number, Kind and Location of Fixtures Location 4/ $ — x $1.50 $ — x $1.50 $ — x $3.25 HZ� X $3.00 S Z 8; a�a Zu, W „j Um <I *• WU' C�9 a� 0 Z �O F N WATER HTR. GAS ELEG Base 1st ep 1 2nd 3rd 4th • Future Conaection Openings New Fixture. Old ��9s I Connected with Sewer Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... Future Fixture Opening ................ New Fixture Old Opening .............. Catch Basin ............................ Water Heater (Up to 99,000 BTU) ...... New Ground Run Old Bldg. ............ Electric Water Heater GAS FITTING FEES: x $2.00 $ — x $1.50 $ — x $1.50 $ — x $3.25 $ X $3.00 $ — x $3.25 $ _ a $2.00 $ NO. RATE TOTAL let 3 Fixtures ....................... .. x $2.00 $ Additional Fixtures .................... —x$.75 $ Gas Range to 199,000 BTU .............. I x $5.00 $ 3.00 REPAIRS & ALTERATIONS—Refer to Code City of Fridley: The undersigned hereby makes application for a permit for the work herei 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 fact and representations stated in this application are true and correct. Fridley, Minn 16 May 68 19— Owner Allen Swanson Kind of Building Used as res To be completed about 21 May Estimated Cost, $ 14, Old --Mw. Building Permit No PF' 7%4�00w- 1111NNEVIORISI Signe GASCO. ROUGH FINAL Description ................................................$ TOTAL FEE $ 3.00Qb.42 By Business Phone No Original PERMIT for PowerRantsR and Heating, Cool- ing, Ventilation, Refrigeration and lair Conditioning Systems and Devices DESCRIPTION OF WORK No. of-_ Heating Plants to be installed—altered—repaired Make Oil fired ; Coal fired—, Gas fired ; Gas Authorization No. Remarks Approved by Final Inspection Date , 19_ Inspector ell ?_� Permit N° 4479 Fee $ Office of the Inspector of Buildings City of Fridley City of Fridley, Minn. , 190 Owner az'ex-111 Location Kind of Buildi»�g�- How Occupied -� Work to be Commenced—, 19 To be Completed____,__ ' C� ,1949 Estimated Cost, $ ° 5-,75, `"e Old -New, Building Permit No. Permission is hereby granted to to install—erect—use the material and devices described in the above statement. This permit is granted upon the express condition Aat the person to whom it is granted, and his agents, employees and workmen, in all the work done and materials used under this permit, and in the operation of the devices herein mentioned shall conform in all respects to the ordinances of the City of Fridley relating to or governing the work to be done and the operation of the devices herein named, and to the specifications set forth in the approved application for this permit on file in the office of the Inspector of Buildings. J Q Q — -zL,- A , Inspector of Buildings 42 2M 11-67 v Application for Power Plants and; Heating, Cooling, Ventilation, .RefFrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone SII. 4-7470 %J GRAVITY WARM AIR: RATE TOTAL. Location"///b' Furnace Shell & Duct Work .......................... 8.00 $ , Replacement of Furnace ............................. 5.00 $ City of Fridley: The undersigned hereby makes application for a permit for the work herein Repairs & Alterations up to $500.00 .................. 5.00 $ specified, agreeing to do all work in strict accordance with the City Ordinances Repairs & Alterations each add. $500.00 ............... 2.50 $ and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. MECIL WARM AIR Fridley, Minn 19 — Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ .each add. 60,000 BTU ....................... 2.00 $ Owner Replacement of Furnace ............................. .P.00 $ Kind of Building Repairs & Alterations up to $500.00 ... ... ............ 5.00 $ Used as Repairs & Alterations each add. $500.00 .......... .... 2.50 $ � 230 To be completed about STEAM or HOT WATER SYSTEM Furnace Shell &Lines -to 400 sq. ft. EDR Steam....... 8.00 $ Estimated Cost, $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water ... 8.00 $ ld New. Building Permit No. Permit No. Each add. 200 sq. ft. EDR Steam ...................... 2.50 $ Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ _ DESCRIPTION OF WORK OIL BURNER—to 3 gal. per hour ........................ 5.00 $ HEATING or POWER PLANTS—Steam, Hot Water, Warm Air—No over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ 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 4 `� $ - FAN HEATING SYSTEM rs� Fee Schedule Trade Name Size No. Capacity Sq. Ft. E.D.R_ BTU H.P. Total Connected Load Kind of Fuel BURNER — Trade Namp Size No Capacity Sq. Ft. E.D.R BTU H.P. VENTILATING SYSTEM $ ALTERATIONS & REPAIRS J A TOTAL ROUGH C 7"2M 'z � 7-59 FINAL (REMARKS -OVER) Signe CO. By Business Phone No �✓� X/0' C) W susJEcr PERM ' City of Fridley AT THE TOP OF THE TWINS BUILDING PERMIT r R COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. („V Q � �' 1 CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPRO ED BY 612-571-3450 910-F15 9/28/84 JOB ADDRESS 4964 Roman Road N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 25 2 Carlson's. Summit Manor South Addition SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE Allen Swanson 4964 Roman Road N.E. 572-8766 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. North.Star Builders 5408 - 84th.Avenue N,, Brooklyn Park, MN 55443 566-1549 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZI.P PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 24' x 241.Garage 9 CHANGE OF USE FROM TO STIPULATIONS Provide a hard surface driveway. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED 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 I 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 $6,456 $3.23 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 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- $62.50 STRUCTION OR THE P FORMANCE OF CONSTRUCTION. a &I -�Co 1-$65.73 PLAN CHECK FEE TOTALFEE SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE1 WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT SIGNATURE OF OWNER tIF OWNER BUILDER) (DATE) BLDG 14DA E NEW ADDN. [ ] [ ] City of Fridley Effective 4/1/84 IR -1 AND R-2 j ALTER. [ ] Building Permit Application Construction Address: [ G 6 / �`®//� Legal Description: Q / 2 '® a%r d / _ so p -,Tel . #te Owner Name &Address: Contractor: / �1 4t d d d-ee-S Tel .#516645-'t g Address: C 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.5_ % �? DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Corner Lot [ ] Inside Lot [] Ft. Yd. Setback Side Yard Setback/ Type of Construction: 1� �e� Estimated Cost: $ Approx. Completion Date: E-`( 9� Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ -- See Back Page for Explanation _ Tel. � '��6'_�•��� DATE: �� �y APPLICANT: L� �' CITY USE ONLY Permit Fee $ �� 5 Fee Schedule on Reverse Side Plan Check $ 25% of Building Permit Fee State Surcharge $ J•J-3 $•50/$1,000 Valuation SAC Charge $ $425 per SAC Unit Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ e lD STIPULATIONS: City of Fridley SUBJECT WRECKING PER _ . 17747 AT THE TOP OF THE TWINS PER I r RECEIPT NO. • _ COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY j 612-571-3450 910-F15 9/28/84 JOB ADDRESS 4964 Roman Road N. E, 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 25 2 Carlson's Sin mit Manor South. Addition SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Allen Swanson 4964 Roman Road N.E. 5728766 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO. North.Star Builders 5408 - 84th. Avenue N. Brooklyn Park., PIN 55443 566-1549 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE J] REMOVE 8 DESCRIBE WORK Wreck 221 x 221 Detached Garage 9 CHANGE OF USE FROM TO STIPULATIONS Glean site of all debris.. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, 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 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 None WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 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- $15,00 None. STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. q_ 2:� PLAN CHECK FEE TOTAL FEE �p $15.00 SIGNATURE OFCONTRACTOR OR AUTHORIZED AGENT (DATE) WHEN PROPERL ,V,{LIDATEY THIS IS YOUR PERMIT I 1 d BLDG' INSP If OAE ` SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) Effective Aug. 1, 1981 City of Fridley swucr Permit No. AT THE TOP OF THE TWOM r WRECKING PERMIT APPLICATION Receipt No. ------- COMIWNITY OEYELOPMENT DIV, r 1 1 PROTECTIVE 069ECT{OR 09PT. �J 1 --- OM HALL PRNMY f442 I HummmREV• GATE PAYE of APPROVED By Job Address [� AQ Zd a P7 Legal Lot No. Block No. Tract or Addition Desc. Property Ow er Address Phone 34 8 4 4 d6in cc J5-22 - 6C 2 6 f. Contractor �/ Addresa Phone Description Front Depth, Height Sq. Ft. Cu. Ft. of Bldg. �- a`� (sara �- No. of Dwelling Units Taxes Paid Tax Receipt No. Estimated Cost of Wrecking To Be Completed Utilities to be Notified and date Services Disconnected Mpls. Gas Co. N.S.P. Northwestern Bell Tel. Co. Engr. Dept. Cust. Bus. Ofc. Bus. Ofc. 372-4850 330-5540 332-4112 Date Date Date Wrecking Fees: $1.25 for each 1000 cubic feet or fraction For structures which would be impractical to cube, the fee shall be based on the total cost of wrecking such structure at the rate of $6.00 for each $500.00 or fraction. MINIRM FEE: $15.00 No State surcharge on Wrecking Permits. Approved By Water & Sewer Department: All Bills Are Paid Services Are Disconnected The undersigned hereby makes application for a permit to wreck the building described above, agreeing to do all work in strict accordance with the City Ordinances and rulings of the Department of Buildings, and hereby declares that all facts and representations stated in this application are true and correct. Contractor Date W Effective Date January 1, 1991 CITY OF FRIDLEY APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS1AND DEVICES RATE SCHEDULE 4ESIDErTIAL RATE TOTAL Job Address Furnace Shell and Duct Work, Burner (Also replacement furnace) Gas Piping (piping needed with new furnace) Gas Range Gas Dryer ' Air Conditioning (all sizes) All Others/Repairs and Alterations 18 of Value of Appliance or Work COMMERCIAL/INDUSTRIAL 1% of Value of Appliance or Work REINSPECTION FEE $30.00. Rough Insp. Date Final Insp. �' 2, a Date Approval for Permit $ 20.00 $ $ 10.00 $ $ 10.00 $ $ 10.00 $ $ 10.00 $ �• State Surcharge Building Inspection Div. 6431 University Ave NE Fridley MN 55432 Tel. No. 572-3604 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 application are true and correct. OWNER //y /I e -a? - KIND OF BUILDINGiy�- USED AS $ TO BE COMPLETED ABOUT ESTIM/ATED COST _ 3, d $ .50 OLD - NEW BUILDING PERMIT NO. PERMIT NO. S �1®�S DESCRIPTION OF FURNACE/BURNER �J HEATING or POWER PLANTS, Steam, Hot Water, Warm Air- No. Trade Name Size No. Capacity Sq. Ft. EDR BTU HP Total Connected Load Kind of Fuel MINIMUM FEE FOR ANY HEATING/COOLING/VENTING PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE *Air Conditioners can not be placed in side yard without written permission from adjoining neighbor. BURNER - Trade Name Capacity Size No. Sq. Ft. EDR BTU HP Company Standard Heating & A/C Signed By ? —� Tel. No. 824-2656 Fill out back side for stack verification on replacement furnaces City of Fridley`0 SUBJECT PE . . AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. • _ COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r i--'S CITY HALL FRIDLEY 55432 NUMBERREV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 4/24/96 JOB ADDRESS 4964 Roman Road NE 1 LEGALLOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 25 I 2 I Carlson's Summit Manor South Addn SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Allen Swanson 4964 Roman Road NE 572-8766 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 ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE 6 DESCRIBE WORK Reroof House (14 Sq) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REQUIRED 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 1 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 @ 1 12O $ $.56 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $41.93 S NA7U ONTRAC RAU RIZEDDAGENT IDATEI WHEN PROPERLY LIDATED THIS IS YOUR PERMIT - B20 INSP DATE A TUREOF OWN E R I IF UILDERI. IDATEI NEW [ ] Effective 3/1/96 ADDN [ j CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application ConstructionAddress:��� Legal Description: C Owner Name & Address:Tel. # Contractor: 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 V-0 Width Height Sq. Ft. 553 GARAGE AREA: Length Width Height Sq. Ft. DECK AREA:I/e��pgthr9 Width Hgt]Ground Sq. Ft. OTHER: A1� eC' �A / 44 / Comer Lot [ ] Inside Lot [ j Ft. Yd Setback Side Yard Setbacks Type of Construction: _ - I � Estimated Cost: //.20 Approx. Completion Date: (Cost on Back) Driveway Curb Cut Width Needed: J Ft. + 6r+ = Ft x = $ DATE: APPLICANT: Tel. # j �� 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%) r $.50/$1,000 Valuation $900 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 [ — .. . @ . 91%wa.0 I nvorcL. I lulm UI V. 6431 University Ave NE Fridley, MN 55432 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT Effective On May 10, 1999 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 () No Type $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 $15.00 Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge TOTAL FEE $,20.50 JOB 5 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. SWANSON, ALLEN Owner 4964 ROMAN ROAD FRIDLEY, MN 55421 {763)572-8766 Buildi% ------- ar� co Estimated Cost `TQ0 — PERMIT NO. C' PLUMBING COMPANY 0 Keot-ofd P1 -V 13iXJG SIGNED BY TEL N0. 6/2 r✓27" 7� 3 Approved By Rough -In Date Final Date Al -3-0j "COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. MINIMUM SIZE 9 SQ INCHES. IMAM nUMtstK OF FIXTURES TO BE INSTALLED ON EACH FLOOR E ::.... :>.:,...::.:::..:: Mash z.::.>;:,::w:Auto.::.:�}i'='< Floor Floor Gas�,<:.:::,:-:: Water He:Floor4 ; t: =>:<:: Shower ►## : Tra ;::v«:::::: .: v �1�t<i�1t«<:.>-: Drain :.:::;>:: .,;.,. �l#>� {.v:..:..:<.;�:<:�.:. Washer •. ater ��:4 i .. >:.,:<;;_. Ran a<k-Gas Elec jUirinal�.r.:r::...... ......:........ ....::.........: 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 () No Type $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 $15.00 Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge TOTAL FEE $,20.50 JOB 5 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. SWANSON, ALLEN Owner 4964 ROMAN ROAD FRIDLEY, MN 55421 {763)572-8766 Buildi% ------- ar� co Estimated Cost `TQ0 — PERMIT NO. C' PLUMBING COMPANY 0 Keot-ofd P1 -V 13iXJG SIGNED BY TEL N0. 6/2 r✓27" 7� 3 Approved By Rough -In Date Final Date Al -3-0j "COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. MINIMUM SIZE 9 SQ INCHES.