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PRE 2010 DOCSCity of Fridley, Minn. N° 8970 BUILDING PERMIT Date: AUGUST 17, 1966 Owner: WILLIAM F. FINK Builder Address 6101 STARLITE BOULEVARD Address FR.IDLEY, MINNESOTA 55421 No. 6101 Street Lot 12 Block LOCATION OF BUILDING STARLITE BOULEVARD Part of Lot 2 Addition or Sub -Division SYLVAN ELLS, PLAT 2 Corner Lot — X Inside Lot _ _ Setback __ Sideyard 25' Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To be Used as: ATT. GARAGE Front 22 Depth 25.4 height 10 Sq. Ft 55 0 Cu. Ft 5,500 Front Depth Height Sq. Ft — Cu. Ft. Type of Construction FRAME Est Cost r 2�0 _ 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 aak provisions of ordinances of the city of Fridley. - In consideration of the payment of a fee of $6.00 -,permit is hereby granted to WHIM F. PINK 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 nay pmt thereof, shall oanform in all respects to the ordinances of Fridley, Minnesota reg location, conatructioa, alteration, maintenance, repa9r sad moving of buildings within the city limits aa� permit may be revoked at any time upon violation of any of the provisions of said ordtnanca3s. CLARENCE BELISLE Building Inspector NOTICE: Ub permit don not cover the coestroction, hufaMen for v Mhe, phnnbbna, Bas hoafin& sewer or water. Be sore to no the Bo Mh* Inspector for sepotle pen dts for these Nems. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAM�/I %II 1lL BUILDER x, ADDRESS 1/ / _Aa ADDRESS. LOCATION OF BUILDING N0STREET _2 1-z-(�17 PART OF LOT LOT 2s BLOCK ADDITION OR SUBDIVISION CORNER LOTINSIDE 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 used as: -� Front Depth Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft._ Cu. Ft. Type of Construction-*, 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. N e DATESIGNATURE�Z'; c �_ (Schedule of Fee Costs can be found on the Reverse Side),. SUBJECT PERMI City of Fridley 19 968 AT THE TOP OF THE TWINS BUILDING PERMIT R � COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. ��� c;7r 1 � � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY L J\ 612-571-3450 910-F15 6/27/89 JOB ADDRESS 154 Longfellow Street N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 37,38 4 Spring Brook Park SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Leonard Benser 154 Longfellow Street N.E. 784-6251 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 8 DESCRIBE WORK Reroof.Dwelling (.15 Squares) 9 CHANGE OF USE FROM TO STIPULATIONS Roof can be 2nd layer but not 3rd. Install ridged galvanized valleys. 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 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 ISTALLS 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$750 $.50 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- $21.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE $21.50 SIGNATURE OF CONTRACTOR OR. AUTHORIZED AGENT (DATE) 1 - WHEN PROPERLY V ED THIS IS YOUR PERMIT SiGNATURE OF OWNER 0F OWNER BUILDER) IDATEI BLDG )NSP DATE Mm I ADM [ ] ALTER [ ] Construction Address: /.7 R-1 AND R-2 Building Permit Application Effective 5/1,/88 Legal Description: .:--i✓ Owner Name & Address: Tel # Contractor: L Address: Attach to this application, a Certificate of Survey of the lot, with the Proposed const ictim drawn on it to scale. DESCRIPTIarT OF IIVF1►�n' LIVIM AM: Length gVe� Width 94, Height Sq. Ft. C:RMM AEE,: lexqtA Width Height Sq. Ft. U= Aim: length Width Hgt/Gmauxd Sq. Ft. o►�t: 7S- (."a -"t az Corr Lot [ ] Inside Lot ] Ft. Yd Setback Side Yard Setbacks 7YPe of Cmwtructian: Estimated Cost: $ Apprmc. Campletion Date: Proposed Driveway Width If New Opening Is Desired: Ft. $ $ Width + 6' See Back Page DATE: APPLIaW: Tel. # Permit Fee $ /. () U State Surcharge $ SAC $ Driveway Escrow $ Park Fee $ Sewer Main Charge $ STIPUUMMS: CITY USE ONLY Fee Sd2e2ule an Reverse Side $.50/$1,000 Valuation $575 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined byi rri Aunt Necessary j ] Not Necessary [ ] 01 SUBJECT ITERMIT City of Fridley140 19967 AT THE TOP OF THE TWINS BUILDING PERMIT - RECEIPT NO. • COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. /�--t CITY HALL FRIDLEY 55432 1•j NUMBER REV. DATE PAGE OF APPROVED BY 612-571-3450 910-F15 6/27/89 JOB ADDRESS 6101 Starlite Bou.lev wd N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 12 2 Sylvan Hills Plat 2 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Lorayne Fink 6101 Starlite Boulevard N.E. 757-2582 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. DuAll Services 636 -39th. Avenue N.E., Columbia Heights, 55421 788-9411 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 8 DESCRIBE WORK Fire Repair 9 CHANGEOFUSEFROM TO STIPULATIONS Provide fire alarms on both levels of dwelling 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 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 $ 30 QO.Q $15.QQ. 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- $284.50 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $299.5Q SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) WHEN PROPERLYLIDATED THIS IS YOUR PERMIT i BLDG WSP DA SIGNATURE OF OWNER OF OWNER BUILDER( (DATEI 01 NEW [ ]e djoe-Q ADEN [ ] ALTER [ ] R-1 AND R-2 Building Permit Application ClonstnUction Address: CQ I b ! G1'" 1 t -Y 61%j 421 Effective 5/2,/88 legal Description: Owner Name & Address: _ Lo e Ay tjl�q G i;� Tel. AU �� V �� Tel. • # 7 $ `til 1 Address: �� '�' L, C0(, 4 l Attach to this , a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. D tIMCM OF I' I Ovim= LXVIM AREA: lengt • Width height Sq. Ft. GRRAM ARS: nth Width Height Sq. Ft. E= ARS: Length Width HWaraund Sq. Ft. OTR• Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Orion: Estimated Cost: $OZ5,-o Apprmc. Completion Date: I't Proposed Driveway Width If New opening Is Desired: Ft. $ $ ��,,• Width + 6' See Back Page DATE: 7 APPLICANT: p(6 Tel. # 1 fS% --q q 11 State Surge $ f r p (I SAC Charge $ Driveway Escrow $ Park Fee $ Sewer Main Qkarge $ SZTPULATIONS: CITY DBE Oi�II,Y Fee Schedule on Reverse Side $.50/$1,000 Valuation $575 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Necessary t ] Not Necessary [ ] O� LOWE s �, oo • 251. o0 SY`.S� 3t,3� a sue�ECi PERMIT NO. City of Fridley 2 815 0 AT THE TOP OF THE TWINS BUILDING PERMIT COMMUNITY DEVELOPMENT DIV. f `- _ ___ r PROTECTIVE INSPECTION SEC. 1 . � NUMBER REv OAT 110/8/98 PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910415 JOB ADDRESS 6101 Starlite Blvd I LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 12 2 $ lvan Hills Plat 2 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Lorain Fink 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Advance Aluminum Supply Inc. 7701 Main St NE Fridley 55432 571-3440 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO B USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW 0 ADDITION ❑ ALTERATION Rk REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reroof house and garage (23 Sq) Tear-off-hail ama e • Reside -partial 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. Call for building wrap inspection before covering. 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 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 2471 $1.23 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 $74,75 Fire SC $2.47 PLAN CHECK FEE TOTAL FEE IT-4panca SC 5.00 83.45 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WHEN PROPERL !LIIDDAAATED THIS IS YOUR PERMIT S-GNATURE OF OVVNER IIF OWNER BUILOERI IDATEI BLzn INSR 6ATE a r y NW [] ~ADDN [ ] ALTER [ ] 2 612 571 2260 ADUANCE ALUMINUM Effective 1/1/98 CITY OF FRIDLEY 'A� p " ,/'50 SINGLE FAMILY AND DUPLEXES R-1 AND R-2 S-�®-j 7 BUILDING PERMIT APPLICATI®N S7:2 -366Y ConstructionAddress: 4) 0 1 5 �d9a� t- 17x 1'C_1147 01 Legal Description: .... Owner Name & Address: b /Z l &K Tel. # Contractor: A O ✓";" e'MN LICENSE # Address: '17 -'JG Ag 4r.i.- S: ^-'qc 6-*' 9,p(V..x 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 Ileight __._ Sq. Ft. DECK AREA: Length _ Width _ Hgt/Ground Sq. Ft. Iq Construction Type: o v /✓. e niv,�- s & Estimated Cost: (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ -- $,_,__ DATE:/ — APPLICANT: -. v Tel. # st z / — 3`yQ Permit Fee $ Fire Surcharge $ • '41% State Surcharge $_� 1. -�3 SAC Charge License Surcharge $ S-. oc) Driveway Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ CITY USE ONLY Fee Schedule on reverse Side .001 of Permit Valuation (1110th%) $.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 [ ] TOTAL $ 4/S® STIPULATIONS: ,tw :.ITY OF FRIDLEY INSPECTION DIV. 3431 University Ave NE Fridley, MN 55432 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO RF INSTAI I Fn ON FArW FI nnR Effective On Jan 1, 2000 R r.. tR • R' � oo ,. ' R�'R • �� PLUMBING FIXTURE RATES: New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader NO. RATE TOTAL Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas** Gas Range`* Gas Dryer** Back Flow Preventer Required ( )Yes () No $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 Type $15.00 Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge $ .50 TOTAL FEE $M._550 JOB ADDRESS_ 3$NIE- ts dWO 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 codes and rulings of the Puilding Division, and hereby declares that all the facts .and representations stated in this aDDlication are true and correct. FINK, LORAYN 6101 STARLITE BOULEVARD N.E. j FRIDLEY, MN 55432 ' 20�� (763)571-4428 Owner _ Building Used As S-aiCz i r:.)J&' n e 4er- 4 , Estimated Cost PERMIT NO. PLUMBING COMPANY C?i^��'11•��ZUI✓d�i�Cr �� SIGNED BY _ L NO.410-8Z7-yo � Approved By Rough -In Date Final Date COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE COMMON VENT VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furance, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes( ) No( ) The venting: system is, plastic/PVC and meets all current codes and manufacturer specifications .including sizing, length, number of elbows and termination. Yes O 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. Yes( ) No( The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes ( ) No When required to install a new combustion air, it will be sized and installed To meet the current codes and manufacturer's specifications. Yes ( ) No When instailina 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 Venting Tables for fan assisted and natural draft appliances. Yes( ) No( Is the common vent and vent connectors sized and installed correctly after an appliance* :has been removed from the common vent and vented separately as;per current codes. Yes( )No( Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type BTU Input Fan Assisted or Nat Appliance#2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height 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 3uilding011- BUILDING Permit No.: Inspections RESIDENTIAL RESIDENTIAL APPLICA'TI®N Received By: 763-572-3604 CI7['�r �]� ��� '�O& SATE �®� / D YOUR E-MAIL ADDRESS -010. r�1LJi%F11YG/ i ■• PROPERTY OWNER/ NAME: See Back Page for Fee Schedule Plan Review TENANT ADDRESS:4 //1 / SJ—P Y Ll 8T CITY STA _ Z .001 times the total job valuation PHONE: ":.'4a $ 1-6(a CONTRACTOR NAME: U ®r ei- ! oxs ° SAC Charge $ STATE LICENSE # /mss 6 4- EXP DATE '�3 JD SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: D - S` > �� Aly l �rr� CITY f STATEt'�` QIP °��20 WITH APPLICATION PH6NE FAX J, -1 PROPERTY TYPE SINGLE F Y Agreement necessary ( ) Non Necessary ( ) IZE $ 011, 455 D TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE 0 ADDITION 0 GARAGE/SHED INDOWS 0 BASEMENT FINISH 0 ROOF 0 DRAIN TILE O DECK 0 SIDING 0 OTHER 0 SWARMING POOL TYPE OF WORK: 0 NEW 0 ADDITION ❑ MAINT SIANCE/REPAIR 0 REMODELING DESCRIBE WORK BEING DONE: 1e10i r — SA7L't-e. Qom+ o�,� . SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. NUMBER OF SQUARES GARAGES PROPOSED SIZE: PROPOSED HEIGHT: SIDING 0 Vinyl 0 Aluminum 0 Other 0 HOUSE & GARAGE 0 ATTACHED GARAGE 0 DETACHED GARAGE OSoffit 0 Trim 0 Fascia BASEMENT REMODELING SUBMIT: 1. Existing Floor Plan 2. Proposed floor plan 3. List of structural members to be used FOR NEW CONSTRUCTION INCLUDING DECKS, ADDITIONS. & PORCHES SUBMIT: 1. Site Plan/Survey showing the existing structures and proposed project_ WINDOWS 2. Two sets of construction plans IN EXISTING OPENINGS DYes ONo LOCATION OF WINDOWS 3. Energy Calculations OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS r ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ o? I Q4." OCCUPANCY TYPE Permit Fee $ a 2, �y 5 See Back Page for Fee Schedule Plan Review $ m 65% of Building Permit Fee Fire Surcharge $ _ 1 Z .001 times the total job valuation Surcharge $ 1-6(a .0005 x Permit Valuation Minimum $.50 License Surcharge $ ,��— $5.00 (State Licensed Residential Contractors) SAC Charge $ $1550 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $21= $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ 011, 455 Make checks payable to: City of Fridley Attach Stimulations 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 it conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not permit but only an application 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 all wok hich esu' s review and approval of plans. �/ SIGNATURE OF APPLIC PRINT NAME (TAWJ9.9- U 1ZV�1�DATE / —Z_ '6 7