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PRE 2010 DOCSCity of Fridley, Mie.. BUILDING PERMIT Date: --August, 28, 1968 Owner: Theodore Warburg Builder, ,Address 221 Satellite Lane, Apt. 7 Address Same LOCATION OF BUILDING '0 9908 No. - 270 Street - Sylvan Lane — Part of Lot Lot 3 Block 3 __._ Addition or Sub -Division __...._..Sylvan Hills, Plat 4 Corner Lot _ Inside Lot _.. x Setback —_ Sideyard Sewer Elevation _ _ 845.73 848.73 Approx. Top of Footing DESCRIPTION OF BUILDING To be Used as: Dwelling Front 40' Depth 35' Height 20' Sq. Ft. 1280 CU. F,t, 25,600 Garage Front 24' Depth 281 Height 12' Sq. YL624 7488 Type of Construction Frame Fat. Cost _ $18, 000 _ To be Completed SEWER LOCATION -xt 163' West of Manhole WATER LOCATION - 147' West of Manhole 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 a'll provisions of ordinances of the city of Fridley. 6 � � OA .00 Sewer Connection Char In consideration of the payment of a fee of $ 50.00 permitis hereby granted to eodore Warburg 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. Official Building Zmqxmbw les NOTICE: This permit does not cover the construction, installation for wiring, Plumbing, gas heating, sewer or wafer. Be sure to as the Building inspector for separate permits for these home. APPLICATION FOR BUILDING PERMIT CITY OF FR.I4EY, 01I1NE3OTA :OWNER.: S NAM.,' ef WA RBU e Cf $UILDER SF IL F _ •�.._._._.� • rax SLG r.E 19/rfE f f l� ' / t �'I1nR�s S/ M . :ADDRESS.._. SyL_ • LOBATION. •.• BUILbIVG a No.sT ET; : Y� - LOT . 3 BLbCK_ ADPXTION OR SUBDIViS �Ni �'z6!� �c�S PSA? CORDER LOT SISIDE .LOT : • SETBACK SIDE'XARD _ • , -- SEVER ELEVATION TOP OF FOOTING ApplippAt attach to this.fe J— -.Cpr #f4c-aces of Survey of Lot and groposed :buil ding location drawn on thnse;:Cer� ca ten., DESMPTI.OI ;QF B1I4DING To Be Used As: s . I'roat4101 pthHeight`_ �a >gquare feet Q i . Cubic Feet, ;Eront Z'd�-�, .,_•Depth � Height6 Lf 1Z Square feet Cubic Feet Type of Construction i ��'Estimated Cost � 62C To Be Completed /�� / S� l� X 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 -0, SIGNATURE C>l� (Schedule of Fee Costs can be found on the Reverse Side. / 0 O. _ Q r7a SCHEDULE SECTION FEE SECTION 2. The Inspector of Buildings shall, before issuing.permits'for the erection of any building or structure, or for an"'' ..yl addition' to any existing structure -or building, or for any alteration or repa.ir+ to any existing.buildi or structure* upon application therefore, require the Ag S the payment by the applic.antfor..such,permit'of fees to the amount herein below..set.-forth and in the manner herta-provided to -wit: Uniform Building:Code: Type.l,. 2; A-4-,$1.75 for each one thousand cubic feet, or.. fraction 'thereof, in such cubical qqnteAts... Type 3 &,5- $1.50 for each one thpV84tpd, cubic., feet. Fier the purpose of campgting.;-66s.for building permits, the cubical contents of any building or addition.to.a.-uniform,.Iliight,thr'o'ughout by multiplying the groqnd,. areA, bdVered a t;,,-., fkq* point (6) `inches below the floo: lineofthe basement I or_the the cellar td"the "average height of the upper surface or to the average height of the roof..'surface of the main gable of a pitched roof. For repairs or alterations to an "Isting,structure,-the.fee shall be at the- ra. ie!�of $3.00 per each five hundred dolla ire ($50O..Op) or fraction "thereof it cost of all prqposed, In no case shall the fee charged fir piny permit as set forth in Section 2 be less than ,$5,46.,­ NSSSP.C*n`dection Charges 'based on locatien,..Area I or 2. Application for Power Plants and Healing, Cooling, Ventilation, Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work ...........................$10.00 $ Replacement of Furnace ............................. 6.00 Repairs & Alterations—up to $500.00 .................. 6.00 $ Repairs & Alterations each add. $500.00 ... ........... 3.00 $ NECK. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ $10.00 $— f 6 ° !�`r✓ 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 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. 320 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) ....................... 5.00 $ -5- • O -e over 199,000 BTU See Fee Schedule GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x$ 2.00 $ P Additional Fixtures ................ x .75 $ Gas Range to 199,000 ........... x$ 5.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE $ ROUGH FINAL Dept. of Bldgs. Phone 560-3450 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. --z 19' Owner k=:�r_ . Kind of Building o�z . ,n 4 Used as To be completed about t . / � Estimated Cost, $ --T-- Old—New. Building Permit No. Permit No. % DESCRIPTION OF WORN HEATING or POWER PLANTS—,.Steam, Hot Water, Warm Air—No Trade Name / Size No Capacit I Sq. Ft. E.D.R BTU-/- O'er H.P. Total Connected Load Kind of Fuel h cam/ BURNER — Trade Name Size No Capacity. (REMARKS—OVER) Sq. Ft. E.D.R BTU H.P. Signe By C�a Business Phone No City of Fridley Application for Plumbing and Cas Fitting Permit Dept. of Bldgs. Phone 560-345`0 O DESCRIPTION OF WORK �� ^-�/�iti Numbef, Kind and Location of Fixtures Location PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: 3 Number Fixtures ...................... �� in� x $1.50 O� New Fixture Old Opening .............. iiG iaaTJZt�1 Um Oil <3 l d t9 �U' �n U' z �p t R t N WATER HTR. GAS ELEC Base a $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures ...... ............... x $2.00 $ �0 D Additional Fixtures ..................... x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ 1st l 2nd 3rd 4th • Future Connection Openings +x New Fixture, Old Openings Connected with Sewer Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... - /0— 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 $ Electric Water Heater a $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures ...... ............... x $2.00 $ �0 D Additional Fixtures ..................... x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ...............................................$ TOTAL FEE `2, r ® O 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 facl and representations stated in this application are true and correct. Fridley, Minn i / — 19�� Owner M Kind of Buildingti�^� Used as To be completed about Estimated Cost, $ Old New Building Permit No Permit No. Signed_ / 'r- ,2 Ale - By Business Phone No 76 & ej ROUGH FINAL 42 M SUBJECT City of Fridley p AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. COMMUNITY DEVELOPMENT DIV. r V PROTECTIVE INSPECTION SEC ���� CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED By 612-571-3450 910415 10/15/9 JOB ADDRESS 270 SYLVAN LANE NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 3 3 Sylvan Hills Plat 4 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Perry/Carrie Bergman 270 Sylvan Lane NE 574-0611 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 C]] ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Install 11 windows upper level; includes 3 egress 9 CHANGE OF USE FROM TO STIPULATIONS Replacement sleeping area windows must xxx meet the State Building Code. 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 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $10,500 $5.25 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 $174.75 Fim SC $10.50 PLAN CHECK F TOT FEE 190.50 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI I POP LY VALI AT THIS IS YOUR PERMIT �j/ LDG DATE Lx SIGNATURE. FOWNER U F OWNER BUILDERI (DATEt M NEW [ ] Effective 3/1/96 ADDN [ ] CITY OF FRIDLEY ALTER [ 1 SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application ConstructionAddress: -70 S y/ v ct n L- V'\' Legal Description: Owner Name & Address: Peery ,, cL r Tel. # s z,4 -c,6 ( ( 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 EVIPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: .s �� I i i1 w s r� & $ /D �-6 .001 of Permit Valuation (1/10th%) —rnCtVA� 5 3 £ve-ss $.50/$1,000 Valuation Comer Lot [ ] Inside Lot [ ] Type of Construction: Approx. Completion Date: Ft. Yd Setback Side Yard Setbacks Estimated Cost: $ 1 G S 0 0 STIPULATIONS: 5 -7 el 06 It (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: f - r s" ( APPLICANT: Pe r r y pj -e f q Tel. # CITY USE ONLY Permit Fee $ `%�/ %S Fee Schedule on Reverse Side Fire Surcharge $ /D �-6 .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $900 per SAC Unit License Surcharge $ $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 $ 196-'!20 STIPULATIONS: 5 -7 el 06 It BUILDING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to -wit: TOTAL VALUE FEES $1 to $500 $21 (Minimum Fee is $21 plus surcharge) $501 to $2,000 $21 for first $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 $2,001 to $25,000 $62.25 for first $2,000 plus $12.50 for each additional $1,000 or fraction thereof, to and including $25,000 $25,001 to $50,000 $349.75 for first $25,000 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,000 $50,001 to $100,000 $574.75 for first $50,000 plus $6.25 for each additional $1,000 or fraction thereof, to and including $100,000 $100,001 to $500,000 $887.25 for first $100,000 plus $5.00 for each additional $1,000 or fraction thereof,. to.and. including $500,000 $500,001 to $1,000,000 $2887.25 for the first $500,000 plus $4.25 for each additional $1,000 or fraction thereof, to and including $1,000,000 $1,000,001 and up $5012.25 for the first $1,000,000 plus $2.75 for each. additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50. Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Sufvey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the framing. 0 Su9jECT PE City of Fridley 874 9 9 AT AT THE TOP OF THE TWINS BUILDING PERMIT WC9T NO ! ` COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. —/r o PROTECTIVE I "'1 CITY HALL FRIDLEY 55432 BER REV DATE PAGE OF APPROVED BY ti____11.� '•� 612-571-3450 L191'0-F15 11/3/98 JOB ADDRESS 0 Svl an Lane— I LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3 3 Sylvan it s Plat 4 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Berggjan 574-0611 3 CONTRACTOR MAIL ADDRESS Owner ZIP PHONE LICENSE NO 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Windows in basement - Two egress 9 CHANGEOFUSEFROM TO STIPULATIONS Install smoke detectors to meet the State Building Code - in each sleeping room and on each level of house. Egress windows to meet the State Egress 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 80 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT @ $600 @ �.50 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 PLAN CHECK FEE TO/OL FEE 4.85 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IIATE, E FP LY VALI T THIS IS YO1JR PERMIT 8 G iNS GATE SIGNATURE OF OWNEROF OWNER BUILDER) [DATE) 0 NEON [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION t� ConstructionAddress: Legal Description: Owner Name & Address: ,y,'ef (y Tel. # Contractor: Address: MN LICENSE # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Tel. # LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: GL, 1 YL c 6 S =C ,r► 4 S �' 1,14,e Construction Type: Driveway Curb Cut Width Needed: Ft. + 6 Ft = Estimated Cost: $ (Fee Schedule on Back) Ft x $ = $ DATE: / 3 - `7 5-- APPLICANT: J��e : ,,-/ CJ ,e- d,% --, ,F ti t Tel. # S 7 Lr - '/ 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%) $.501$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 [ ] BUILDING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any additionto any existing building or structure, or for any alteration or repair to any existing building or structure," upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set' forth and in the manner herein provided to -wit: TOTAL VALUE FEES r $1 to $500 $21 (Minimum Fee is $21 plus surcharge) $501 to $2,000 $21 for first $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 $2,001 to $25,000 $62.25 for first $2,000 plus $12.50 for each additional $1,000 or fraction thereof; to and including $25,000 $25,001 to $50,000 $349.75 for first $25,000 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,000 $50,001 to $100,000 $574.75 for first $50,000 plus $6.25 for each additional $1,000 or fraction thereof, to and including $100,000 $100,001 to $500,000 $887.25 for first $100,000 plus $5.00 for each additional $1,000 or fraction thereof, to and including $500,000 $500,001 to $1,000,000 $2887.25 for the first $500,000 plus $4.25 for each additional $1,000 or fraction thereof, to and including $1,000,000 $1,000,001 and up $5012.25 for the first $1,000,000 plus $2.75 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50. Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the framing. Building PLUMBING Permit No. 0 -L-60113 ' InspectionsRESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date Rec'd: 763-502-4977 FAX EFFECTIVE 2-19-09 DATE YOUR E-MAIL ADDR SITEADDRESS �70 .SYLU,;q,,\j L/J /�)Z THIS APPLICANT IS: '^OWNER ❑CONTRACTOR PROPERTY NAME: BA_:44A) r AA),-,,) FMIN l=. � OWNER/ ADDRESS:-,,) 70 S > L U A N L-,jv CITY ��i �I'L �%r STATEN N ZIRS-_�_"%� TENANT PHONE: '7 C 3 - S / ' Zt3 T CONTRACTOR NAME: SUBMIT A COPY OF YOUR STATE STATE LICENSE # EXP DATE LICENSE, BOND AND STATE BOND # EXP DATE CERTIFICATE OF ADDRESS: CITY STATE ZIP INSURANCE PHONE - FAX PERMIT TYPE MSINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW `KrREPLACEMENT DETAILED DESCRIPTION OF WORK L r>� l�lU CrP E FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE $35.50. _ BATH SINK/LAV _FLOOR DRAINS SHOWERWATER PIPING _ —BATHTUB _ GAS PIPING (NEED CITY LIC) _SWIMMING POOL WATER SOFTNER ($35) _ CLOTHES WASHER _ KITCHEN SINK _ WATER CLOSET BACKFLOW PREY. $1 _ DISHWASHER _ LAUNDRY TRAY _WATER HEATER ($35) FOR IRRIGATION WATER METER OTHER { ipa „ _14641- , Y 3. SP31' � F .`°�' i3"ar4" �'' �, F. �` ..sY�, 'rc ; E l t' �• C ,,f���� �� `I �' 15Fr- i�.tT' _� S- "It 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 in tl case of all w whicl quires review and approval of plans. �n A C� SIGNATURE OF APPLICA -AN A% 6 ` i�L PRINT NAME�kn" DATE City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 Oti Building PLUMBING Permit No. • t) Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date ' DATE 71:7 ®9 YOUR E-MAIL ADDRESS SITE ADDRESS SntitrL as (nwv►tAr_ THIS APPLICANT IS: 0 OWNER ONTRACTOR B:"1ci11 i'a11i1E,171E-1 PROPERTY NAME: 270 Sylvan Lane OWNER/ ADDRESS: Fridley, MN 55432 ZIP TENANT PHONE. 7635714378 CONTRACTOR NAME: STATE LICENSE #C> EXP DATE SUBMIT A COPY OF YOUR STATE ADDRESS kel S CITY d.' .rJ o1%r STATEMLIP50f,yr LICENSE WITH , PHONE 7— 4'0;3 FAX 2 APPLICATION PERMIT TYPE SINGLE FAMILY 0 TWO FAMILY 0 TOWNHOUSE TYPE OF WORK: 0 NEW REPLACEMENT DETAILED DESCRIPTION OF WORK 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. CThis.should_reflect only.the cost of labor ) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor X.05 = FOR3'ROJECTS WHERE LABOR EXCEEDS-$300'; FEES ARE BASED ON $10.00 PER FIXTURE,-EXCE1xI i W RE'1JQ3E :FIBS: 4NDICATE TOTAL NUMBER OF EACH BELOW) BATH SINK/LAV - -.FLOOR DRAINS - _ SHOWER WATER PIPING —BATHTUB _ GAS PIPING (Nm ctrrucexst) _ SWIMMING POOL _ WATER SOFTNER ($35) _CLOTHES WASHER _KITCHEN SINKWATER CLOSET _BACKFLOW PREV. ($15) _DISHWASHER _ LAUNDRY TRAY TWATER 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 = $ Number of fixtures @ $35.00 x $35.00 = $ 3S.0o TOTAL DUE $ State Surcharge = $ .50 Total = $ O 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 applic ' n 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 o w ' r uires review and approval of plans. SIGNATURE OF APPLICANT / PRINTNAME �� / ardor., DATE 7 / `% % ` 09 City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977