PRE 2010 DOCSCity of Fridley, Minn. �2
6431 University .Ave.
N.E., Minneapolis, Minn.
555432
G PE .9.
Date: - October 28, 1971
Owner: _,_.._..._.yiewcon. Incorporated Builder . Same
Address _._._.....5.201 Bmolyn_Hatii7ea�ard Address Same
NO. _._.5..SQA____. Street — West; Bavarian bass part of Lot
Lot __. 5_ Block ._._.._.._11_.._.___......__ Addition or Sub -Division Tnnqb-Mjr_k North Tnh:G , Site
Corner Lot ___._. . ___ Inside Lot —_X _ Setback
Sideyard
Sewer Elevation Foundation Elevation
o be U d as:
In ividual
Town , use llni.t..._.._.. Front _ ZQ_ Depth ___ _3.1! Height 28' Sq. Ft. - 620' Cu. Ft. .17 -j -W a
Gazag.2____.._._ _ Front 14' Depth _ _22.' Height 10' Sq. Ft. _30.$' _ Cu. Ft.
Type of Construction ---Waad Frame Est, Cost .$20,11.6_,4A To be Completed ,l'an- 1-9. 1972
Stipulations: Provide 10 foot wide plato at J'V elevation 857 for future walk around
the lake. All parking lot and street grades must be greater than .6%. Area to be
platted and filed before occupancy of units.
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.
10.16 State Surcharge
In consideration of the payment of a fee of $ 38.00 , permit is hereby granted to Viewcon, Inc.
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 buiidirig�
.within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
!2�Wed®l�Buijdjng Inspector
HANK MUNICH
NOTICE:
This permit does not cover the construction, installation for vetting, plumbing, gas heating, sewer or water. Be mare to we
the lluilding Inspector for separate permits for these items.
("B" Unit)
APPLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAM: VIEWCON, INC. BUILDER: VIEWCON, INC.
ADDRESS:, 5901 Brooklyn Blvd. ADDRESS: 590,1 Brooklyn Blvd.
NO:. 5„50 STREET: West Bavarian Pass
LOT: 5 BLOCK: 11 ADDITION: Innsbruck North Townhouse site
CORNER LOT: INSIDE LOT: X SETBACK: -- SIDEYARD: --
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:
Individual
Townhouse Unit Front: 20' Depth: 31' Height: 28'
Unit: 620 -- uAK-0 - c5; ,10
�i i 71 I Square Feet: F i n : 1240 Cubic Feet: 17,360
Garage Front: 14' Depth: 22' Height; 10'
1Square Feet; 308 Cubic Feet: 3,080
7777 077 7 �U =-T61
Type of Construction: Wood frame Estimated Cost: I2G ,
To Be Completed; 15, January. 1972 /73 4 G
err� /0 a 5g 2 Z
2 '/r/a
The undersigned hereby makes application for a permit for the work herein s -
specified, agreeing to do all work in sttict accordance with the City of �—
Fridley Ordinances and rulings of the Department of Buildings, and hereby /412-2 ° .0.
declares that all the facts and representations stat in this applic Lou /4 3 $ a °
are true d correct. Lo -Y e/
37, e % Pf
DATE: 10 13/71 SIGNATURE
(See Reverse Side For Additional Information.5
,P,�51FAI< 7' 11=Zr _ 3 k-
00,
t� �/7e
n
3 L� DO' CA 0
cf)
r 4
5
4N
not �j,vQj
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 .......................... 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 ............
each add. 60,000 BTU .......................
Replacement of Furnace .............................
Repairs & Alterations—up to $500.00 .................
Repairs & Alterations each add. $500.00 ..............
8.00
$ X
2.00
$
5.00
$
5.00
$
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 $ X
GAS FITTING FEES: NO RATE TOTAL
1st 3 Fixtures x $1.50 $ X
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 $ 17.50
ROUGH
FINAL�di'� ��
Dept. of Bldgs. Phone SU 4-7470
Location 5506 W. Bavarian Pass
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 December 13T1971 , 19 —
Owner ®iewcon, Inc.
Kind of Building Frame?
Used as Residence
To be completed about — janua=.y_19T2
Estimated Cost, $
Old—New. Building Permit No. Permit No.�
DESCRIPTION OF WORN
HEATING or POWER PLANTS --Steam, Hot Water, Warm Air—No 1
Trade Name Bryant Size No 393-80
Capacity Sq. Ft. E.D.R 80, 000 BTUH P
Total Connected Load 41 , ann Kind of FueL Nat _ Ggs
BURNER — Trade Name Size No
Capacity Sq. Ft. E.D.R BTU H.P
(REMARKS -OVER)
She AdvaAced H tge & Air Condo, I -c o
By
- Business Phone No 786 881
City of Fridley
Application for Plumbing and Comas Fitting Permit
Dept. of Bldgs. Phone X560-3450
DESCRIPTION OF WORK
Number, Kind and Location of Fixtures
C7
C
RATE TOTAL
Number Fixtures ......................
Z
x $2.00
$ �o
Y rF�F
c Z
8oS�
<� Z
Oi W
<
�G$
W
C79�
Z
�O
:
F
•
N
WATER HTR.
GAS
ELEC.
Base
x $3.00
$ O
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
$ —7-06
Additional Fixtures ....................
1st
$
Gas Range to 199,000 BTU ..............
x $5.00
$
2nd
/
3rd
4th
° Future Connection Openings
New Fixture, Old Openings I
_
Connected with Sewer ❑
Cesspool El
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE TOTAL
Number Fixtures ......................
16a
x $2.00
$ �o
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) ......
l
x $3.00
$ O
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
$ —7-06
Additional Fixtures ....................
x $ .75
$
Gas Range to 199,000 BTU ..............
x $5.00
$
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 l9%f
Owner
Kind of Building 2 cc inz/
Used as ' z' n 11
To be completed about
Estimated Cost, $ ® ®®®
Oldew Building Permit No Permit No. 1:S_
Signe�5
By /�-a-C tel' �-,_o•z...�
Business Phone
ROUGH
FINAL -
REPAIRS & ALTERATIONS—Refer to Code SD JA.LA�
Description ................................................$
TOTAL FEE $ az
City of Fridley
To be completed about , .. S e -o t . 18, 1972
PARTIAL RATE SCHEDULE
Estimated Cost, $ 10.00
old- New. Building Permit No. sPe Ot No.
PLVMNING FIXTURE RATES- NO. RATE TOTAL
Signed
Number Fixtures ................ x:$106 $
Future Fixture Opening .... o ...... x $1.50 $ By MINNEGASCO
New Fixture Old Opening .......... x $1.50 $ Business Phune No
Catch Basin .................... : $3.25 $
Water heater 'Up to 99.000 BTU) .... x $3.00 $
New Ground Bun old Bldg......... x $3.25 $ ROUGH
Electric Water Ifester .............. s $2.00 $ FIZilLL �?9 7- 7V
GAS FITTING FEEM NO. RATE TOTAL
1st 3 Fixtures 1 : $200
Additional Fixtures x $ .75 $
/! Atyf rpp♦ ' M 3.00 ( l) gas lite
Gas a to 10.000 BTU &/ .. o......... R $5.00 $
State Surcharge $ .50
REPAIRS S AL TI® t®r fe Ce&_
Description
TOTAL yEE $ 5.50
91
SUBJECT
PERMIT NO.
City ®f Fridley
AT THE TOP OF THE TWINS
U I L ®I PERMIT
BUILDING
N �\
�Ji
T
RECEIPT NO.
_ COMMUNITY DEVELOPMENT DIV.
tr PROTECTIVE INSPECTION SEC.
r ;
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
j 612-571-3450
910415
5/18/94
JOB ADDRESS 5506 West Bavarian Pass NE
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
5
11
INnsbruck North Townhouse SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Dicks Fire & Storm 864 19 Ave SE M ls. MN 55414 -
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
x❑
8 DESCRIBE WORK
Reroof House & Garage (Tear -off); Install gutters
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 REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
ZONING
SO. FT.
CU. FT.
THI$ 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 I HAVE READ AND EXAMINED THIS APPLICATION
1
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
$1.06
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$2,1nq
PERMIT FEE
SAC CHARGE
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING COW
$54.00
Fire SC $2.11
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
License SC 15.00
$62.17
EN RLY ALIDATED THIS IS YOUR PERMIT
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI
BLDG INS GATE
SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI
91
NEW
ADDN (( CITY OF FRIDLEY
ALTER SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Construction Address: 5506 - West Bavarian Pass _
Legal Description:
Owner Name & Address:
Tel. #
Effective 1 / 1 /94
Contractor: Dicks Fire and Storm MNLICENSE# 2481
Address: 864 - 19th Ave S.E , Mpls., Mn. 55414 Tel. # 781-6170
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: Remove
and replace
roofing on garage
Install g„t Pra
Remove
and replace
roofing on house.
$
Comer Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks
Type of Construction: Roofing /gutters Estimated Cost: $� 2.10 9 .0 0
Approx. Completion Date:
(Cost on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $_
DATE: 5/15/94' APPLICANT: Dicks Fire and S t o
Tel. #781-6170,
STIPULATIONS:
CITY USE ONLY
Permit Pee
$ n
Fee Schedule on Reverse Side
Fire Surcharge
$
.001 of Permit Valuation (1/10th%)
State Surcharge
$ d
$.50/$1,000 Valuation
SAC Charge
$
$800 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
$
STIPULATIONS:
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432 /
572-3604
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES TO BE INSTALLED oN FAr.H Fi MR
Effective On May 10, 1999
PLUMBING FIXTURE RATES:
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"'
NO. RATE
W
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
TOTAL JOB ADDRESS_ 55D6 tJ- 6l�/?9-/06
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.
9 L4 1999
Owner Oil, 6, 3
Building Used As S
Estimated Cost PERMIT NO.
MR RR OF ANOM COUNTY
PLUMBING COMPANY RO INDUSTRY AVE, N. #114
RMSEY, MN Ev
SIGNED BY TEL N0.
Approved ByAe'i Rough -In Date Final Date
$ .50
MINIMUM FEE R ANY PLUMBINGIGAS PERMIT IS $20.00
PLUS HE S.5W STATE SURCHARGE
"COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. MINIMUM SIZE 9 SQ INCHES.
SUBJECT
�•
city of Fridley
31043
AT THE TOP OF THE TWINS
BUILDING
PERMIT
t .
RECEIPT
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
` q
f
NUMBER
REV
DATE
PAGE OF
APPROVED Br
j
E �'••1 CITY HALL FRIDLEY 55432
612-571-3450
910415
6/8/00
JOB ADDRESS 5502, 06,10,14,18, 22 W. Bavarian Pass
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
OESCR: ,
1-6
11
Innsbruck North Townhouse Site SHEET
2 PROPERTY OWNER MAIL ADORES$
ZIP PHONE
Innsbruck.,Townhome Association
651-224-5482
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Garlock -French Roofing Corp. 2301-E. 25th
St...Mpls., MN 55406 612-722-7129
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
00001423
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
8 USE OF BUILDING
','Residential
I., CLASS OF WORK
O NEW O ADDITION ❑ ALTERATION )p REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Reroof Building
9 .CHANGEOFVSEFROM
TO
STIPULATIONS
Underlayment must comply with the State Building Code.
Par mit inspection Cards
will Be Mailed
-ro Homeowner To Post
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE'PERMITSRRE 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 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
6
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
$16,674.56
$8.33
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-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
PLAN CHECK FEE
TOTAL FEE
11101
304.25
SIGNATURE OF CONTRACTOROR AUTHORIZED AGENT IDATEI
HENR P VALI AT D THIS IS 10UR P_kRMIT
BL INSP QATE
SIGNATURE Of OWNERIIt OWNER BUILDERI IDATEI
Building
BUILDING
Permit No.:~ S
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572=3604
mate Rec'd: G
CITY OF FRIDLEY
DATE `` 6—o7 YOUR E - MNL ADDRESS 44 1,161
SITE ADDRESS O
Id cR
THIS APPLICANT IS:
❑ OWNER CONTRACTOR
PROPERTY OWNER/
NAME:
TENANT
ADDRESS: CITY
STATE ZIP
PHONE:
CONTRACTOR
NAME:
STATE LICENSE # ® EXP DATE
SUBMIT A COPY OF
YOUR STATE LICENSE
ADDRESS: CITY
STA IP S5 J
WITH APPLICATION
PHONE FAX
PROPERTY TYPEINGL
FAMILY/NEW CONS UC ON SIZE
❑ TWO FAMILY/1 CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGEISHED ❑ WINDOWS
❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE
❑ DECK OKSIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW ❑ ADDITION
❑ MAINTENANCE/REPAIR. NREMODELING
DESCRIBE WORK BEING DONE:¢
SIZE OF IMPROVEMENT LENGTH WIDTH
HEIGHT Sq. Ft.
ROOFING
❑ HOUSE ONLY
NUMBER OF SQUARES
❑ HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
GARAGES
❑ ATTACHED GARAGE
1.
2.
Existing Floor Plan
Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3.
List of structural members to be used
PROPOSED HEIGHT:
"MING
FOR NEW CONSTRUCTION INCLUDING DECKS,
myl
❑Soffit
ADDITIONS. & PORCHES SUBMIT:
❑ Aluminum
❑ Trim
I .
Site Plan/Survey showing the existing structures
❑ Other .
❑ Fascia
and proposed project.
WINDOWS
2.
Two sets of construction plans
IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS
3.
Energy Calculations
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USINq THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ -0 6 6 OCCUPANCY TYPE
Permit Fee
Plan Review
Fire Surcharge
Surcharge
License Surcharge
SAC Charge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Total Due
$ (,7t7D
$ -3 LID
$i G�
See Back Page for Fee Schedule
65% of Building Permit Fee
.001 times the total job valuation
.0005 x Permit Valuation Minimum $.50
$5.00 (State Licensed Residential Contractors)
$1675 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$21=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks savable to: City of Fridlev Attac
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 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 work w ' h review and approval of plans. j 9
SIGNATURE OF APPLICANT PRINT NAME DATE
Building
MECHANICAL
Permit No.:
Inspections
RESIDENTIAL APPLICATION
Received By:
U 0
763-572-3604
CITY OF FRIDLEY
Date : ' °
1763-502-4.977
EFFECTIVE 2-19-09
ppFAX
/
DATE E-MAIL ADDRESS
�Y%UR
SITE ADDRESS ® I �a 9s
THIS APPLICANT IS: ❑ OWNER ONTRACTOR
PROPERTY
NAME: R -L- -I �(� n
OWNER/
TENANT
a_I STATEPi/I �'
ADDRESS: -6 6 W rfi'1� LIP
7i r ZZ&
PHONE: to 17,—
CONTRACTOR
COMPANY NAMEU6E'� Co 7A C'ZJ Ct S 1% S T6-0'15'
SUBMIT A COPY OF
CONTACT PERSON: Nr0q 1) u
YOUR STATE
STATE LICENSE # EXP DATE
LICENSE WITH
ADDRESS: �� �7G�� �� C'IlTY/wts LpG�'f STATEtVkiIP53Z)�
APPLICATION
PHONE — ��Z ''� lD� FAX —7�Z g(o� 7
i Thi
PERMIT TYPE
#<NGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK:
❑ NEW PLACEMENT ❑ ALTERATIONJREMODEL
DETAILED DESCRIPTION OF WORK
FEES ARE BASED ON $10.00 PER FIXTURE, XCEPT WHERE NOTED. FIXTURES: I DIC TE TOT4L NUMBER OF EACH BELOW)
Equipment Installed MFG: � MODEL: rWE0Z� 2- 3c) SIZE/BTU Z(:4fQcnn
MFG: _� MODEL: C7! U" 364 -O�O SIZEBTU 70z
MFG: MODEL: SIZE/BTU
A/C $25.00. FIREPLACE (GAS) $15.00 _GAS RANGEIOVEN $10.00
_AIR TO AIR EXCHANGEER $15 FPLACE (WOOD) $35.00 _NEW GAS GRILL $10.00
_BOILER $35.00 _✓FURNACE $35.00 _GAS UNIT HTR $10.00
_CHIMNEY LINER $10.00 _GAS DRYER $10.00 _POOL HEATER $35.00
_DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00
kyr }�
44"":4
W- SI
"W-W7
c$
b F
�:' tis, Y � a 5 � � ,� ➢ a 5 2 - S y; h `.� � �.d�' C �
THIS 1S 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 applicat' or a and work is not to start without a permit; that the work will be in accordance with the
approved plan in the case of al] rich re es review and approval of plans.
,
SIGNATURE OF APPLICANT PRINT NAME M&CS't A DATECzs_h
f s
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 763-502-4977
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