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PRE 2010 DOCS53-84-S9155.%1 PLUMBING FIXTURE TPS: Vg Number Fixtures x $2.00 $ i1 �ZFi $ r of Z °o� ¢ U Q 3 W a Y O ® m M WATER HTR. GAS ELEC. Base a $2.00 $ GAB FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures ......... . .... ......... l x $2.00 $ 2.00 Additional Fixtures ..... .............. x $ .,M $ Gas Range to 199,000 BTU .............. x $5.00 $ Install (1) gas grill 3.00 1st 2nd 3rd — — 4th -- Fulms Connection Openino Connected new Fixhm, Old I er pool 0 PLUMBING FIXTURE TPS: NO. RATE TOTAL Number Fixtures 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 $3.26 $ Electric Water Heater a $2.00 $ GAB FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures ......... . .... ......... l x $2.00 $ 2.00 Additional Fixtures ..... .............. x $ .,M $ Gas Range to 199,000 BTU .............. x $5.00 $ Install (1) gas grill 3.00 AFFAIRS & ALTERATIONS --Rater to Code Description ................................. TOTAL. FSE $ 5.00 a 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, mina April 17k, 1970 19_ OwnerJolm J. Shea Kind of Building frame Used as residence To be completed about Aprill 22, 1970 Estimated Cost, $_10.00 OldX-New. Building Permit o.—_ _ __Permit No. d By - Business one No ' N,j�4' R OUGH ` s Q4,9 V ol FINAL / r - 5' - � D Laity ®f Fridley, Minn. ELTRDING PERMIT Date: February 8, 1971 Owner: Iienry_Wahlberg Builder Rodney Billmana Inc. Address Address 151 Silygr, Lake. Road LOCATION OF BUILDING No. _ _. 52 Street Windemere N.E. part of Lot Lot - g __ Block Addition or Sub -Division .:T,�isbruck 5th Addition Corner Lot , Inside Lot --X Setback _ __ Sideyard smummevation ---33-a.44 _ 981.44 (Approx) Wye Top of Footing DESCRIPTION OF BUILDING 109 To be Used as: Dwelling Front 40.27'Depth 34-15-6yleight 20' Sq. Ft. 1737 Cu. Ft 34 740 Garage Front __2.4' Depth 24' Height 10' Sq, Ft. 576' Cu. Ft. 5760 Type of Construction - Frame. Est, Cost — 37 000 _ To be Completed June 1, 1971 SEWER LOCATION: 114° W. of Manhole (Windemere Dr. & Windemere Circle E) WATER LOCATION: 124' W. of Manhole 10' W. of Sewer Service In consideration of the issuance to me of a permit to co et the buildin rcrcr}i above, I agree ®to do the proposed work in accordance with the description above set fo,�th and in 7' //with all R ulna of ordinances of the city of Fridley. r , Total 40,500 Cu. Ft. In consideration of the payment of a fee of $--Z5.00 5.00 , permit Whereby granted to Rodney B it lman, Inc . to construct the building or addition as desciibed 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 andmoving of buildings within the city ]amts and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. NOTICE: This peradt does not cover the condruction, Installation for wiring, plumbing, gas hen&& sower or water. Be sure to we the Building Inspector for separate penntrs for these Nems. s 17 V a 17"NIM APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNERIS NAME BUILDER ADDRESS ADDRESS /✓— - �✓ LOCATION OF BUILDING NO.1 SSS STREET L Ii el—I AW -e LOT �� BLOCK `,j ADDITION OR SU CORNER LOT INSIDE LOT SETBACK SIDEYARD SEWER ELEVATION TOP OF FOOTING 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 ' Square feet -,, bic Feet 7 4 cc 5E Front 7.. Depth 2 _ y_ _ Height ® e v Square feet -52 4 Cubic Feet 5--2 O_`�j� CIC/ P7 - Type of Construction Estimated Co e -Ga T To Be Completed (%,m 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. „� , //0' DATE 7- % ��SIGNATURE o* ,��• Schedule of Fee Costs can be found on the Reverse Side. tpT 7 r • A City of Fridley Applicafioni for Mmbbig and G= R"I" Petmit DESCRIPTION OF WORK Number, Kind and Location of Fixluaes ® la, a` M fit¢( ` {�jJ •t�9 V e N WATER MTR. GAS EIEC. Base / 1 1st 2nd 3rd 4th • Future Connection Openings Com with * New Fixture, Old Openings Sewer Cesspool ❑ PARTIAL RATE SCHEDULE PLUMSING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ................ x $2.00 $ / 9.0 Future Fixture Opening ............ x $1.50 $ New Fixture Old Opening .......... x $1.50 $ Catch Basin .................... x $8.25 $ Water Heater (Up to 99,000 BTU) .... / x $3.00 $ -?• 6 c-) New Ground Run Old Bldg. ........ x $3.25 $ Electric Wages Heater .. . ........... a $2.00 i GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures / x $2.00 $—a 06 Additional Fixtures .................. x $ .75 $ Gas Range to 199.000 BTU... ,........... x $5.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ........................, .................... $ TOTAL FEE $ 21 O � Dept. of Bldgs. Phone NO -3430 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 Z'� 19& Owner Kind of Building Used as To be completed about Estimated Cost, $ / ? Ol New uilding Permit No. Permit No. Signed By - - - Business Phone No `[- e l — ROUGH City of Fridley, Miran. 6431 University Ave. N. E., Minneapolis, Minn. 55432 U MG PERMIT Date: Jul_ 29,E 1971 owner: Henry Wahlberg� Builder Aquarius Pool Co, Inc. Address 1452WindemP�Drive N.E. Address 5275 -190 th St. W..est, T?n=i-Dgtnp LOCATION OF BUILDING No. --J-452-- Street _ Zindemer_e_ Drive N.E. Part of Lot Lot __ _ _ Block ____3 _. Addition or Sub -Division InLigbruck 5th Addn, Corner Lot _ _._. Inside I.ot 3Setback Sideyard Sewer Elevation _ _ _ _ Foundation Elevation _.... To be Used as: S LIMMi ng PoolFront 1 V Depth _ 321 Height 8 14"r Sq. Ft. Cu. Ft. Front . Depth - Height Sq. Ft. Cu. Ft. Type of Construction Wood -V inV l Est. Cost 439 200.►— To be Completed Ausu G t I 1 A 71 Approved subject to Health Inspectors stipulations that are attached. In consideration of the issuance to me of a permit to construct the building d cribed above, I. agree to do the .proposed work in accordance with the description above self ande '?ff ee with all provisions of Ordinances of the city of Fridley. �/ j Inconsideration of the payment of a fee of $ 21 -00 , permit -Ys hereby granted to Aquarius Pnnl Center 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 ofbuildings ly1thin the city limits and this permit may be revoked at any time upon violation of any of the provisions of Said NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to we the Building Inspector for separate permits for these items. APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER ° S NAME : ��%t/tr 5/ f�HL 6 �,rr� BUILDER :,�m�5 PD® .0 c ® ADDRESS:/YS-3 WipK r7ev r. /),., &, g _ ADDRESS :_,L2 7.4- ND S/G�esT NO.. I��S 2 STREET; 1(_)/1Vejt® 7a C y = LOT: BLOCK: J� ADDITION: /3 v e �^ ,�fjps 7- N CORNER LOT: INSIDE LOT: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: Su>i1-r^i1�g Re L aeo"'6) f Front:Depth:- Height: 9 � r Square Feet: Cubic Feet: Front; Depth: Height: Square Feet; Cubic Feet: Type of Construction: Woo d J///v . yl_ Estimated Cost: X2 00 To Be Completed: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work.in-sttict 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: / SIGNATURE: i (See Re -verse Side or Additional Informatio .i y 171 I I / I ' - -- II SII ' I.Ji I- - -- -- - --- - - -- - -- - - -0 _" `�`�'�`� - - - -- --- ---- f tong Planning �} (��� �dQ ` 6875 Highway Nt,.65 N.C. Lund 5tar'veying ° • f a in 00C. y 5aify Testing €�a � i� c Ne A1enn. 55437 !� i CivlI Engineering ?elepholm i'94-6066 mmmitipal inyrneerrng Engineers & Surveyors Area Code 617 or.tgage Loan Survey f®F-- SOD I,E.Y Btl,.-L IVOAN -JNC- Ile Aq Gin ._..C)7,.'., 0 This iy t7 true and correct ep-C%vnlation of a surm«•y of th:t bour+clur—t of «ham !orad r.tr«ve (1es'Cr+hed cold of t},e toca9rr,dn of all build;n+,Is, if tiny, tFrer.,Qn, orad uit „+..;?gin or,¢r�v<hm4«xts, +f any, frum or Or, e—'! toad. lh;s surrvxty :s "'Ode cim-Y in tonnetteon with a mortryggr Loon nqw hr+no tgla(ed oh the pi--:, e,ty and no Irobe;t4< is ussumed esovept to that holder of suth mortgage or ony Whrr �ntcrest c.equired by the r«+otcon of ouch movigt29e. it is widerstood and og,n,d �n rnonu—..ra have. bev i ::iao«>d ,s.r +its• gutposr of esioi,tishmq tot lines or boundary corners. *ote:d thit��'a do a i4i A. 0, 1:?il. r Coo, Application for Power Plants and Healing, Cooling, Ventilation, Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone 560-3450 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 $ MECH. WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ $10.00 $� 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 $ over 199,000 BTU See Fee Schedule GAS FITTING FEES: NO RATE_TOTAL 1st 3 Fixtures ..... x$ 200 Additional Fixtures ................. x .75 $ Gas Range to 199,000 ........... x$ 5.00 $ AIR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH FINAL 94 '7— 71 See Fee Schedule $ TOTAL FEE 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 ne and correct.. Fridlgy, Minn_ f✓ 19� Owner `n C4AA,'1-',- Kind of Building Used asJa `��/%�, To be completed about Estimated Cost, $ Old New Building Permit No Permit N DESCRIPTION OF WORK HEATING or POSMA ! , team, Hot Water, arm Air No Trade Name ® Size No.—��w��� Capacity Sq. Ft. E.D.R A 6 BTU H.P. Total Connected Loa o Riad of Fue ��S BURNER — Trade Nam �'� ' Z6- Size No. Ca acity Sq. Ft. E.D.R BTU H.P. S 1!-d_ N. V ELTER HEATING CO 4637 CH113AGO AVE. By 94;NftL^P0LA8 9t, e¢ Business Phone No (REMARKS—OVER) c nl 1. , : , ;+, y Ir �� ;��� '�(Xr i,� � �i t 1N' i 2 ! I I tr} f .; , fi` 1 1• t � A '.() ,N 1 i ti `:''. dl }�, i' 7 'c. t t l tl r p 1z E 7{ � , J',1 I � k §@� UI � � � :. M T 'lY il' �I 31 C..w•1Y1 l � ±`�,t M J a�}✓ pW f 1 fll � y t{ ;;, i .11 ;:1 ,� 1 y r12i�, `.f} f' Vti'J IN 11'.� 3a1{�� ?t:o@r� ,Ip 'Width,,.. He1Bht No. of - Lineal IL Area No., ' ' of Dane of vane lights of crack sq. !t. Oyy BV�:. 1MINV1•i l ; I �, 1gt81initpt ,, ��JLV 't"; „C�JI.AT$QNS 1 DW AR ; Tu�at� 5 rl ia4 �Coristruction'No.�� Ieatit+�t:itirlE M a �i{411 d t '+ ail.; Int.'O�al!:edeslg ROO# ]n,r Kurd �' How AppiFe .4lergFcet Btu Infiltratloit I (� ooiti, Length'Width' Height'` Fl % F t V�1Ind6" 464 Room Liie h Width'` e�h Doors --C and Area � F ' � � �s4 �r ' y, ,t'r {. "mdQwd' and': D,oers'-trackage and Area l a Width lei hit TJo at : Ltnaai i�, i►eoe Wlath ol`ht No o[ :Linea 4t. Ater i f No. - of Pana or'pnns lights o8 arabic eq tt. ,bt.pape ' ,6C vane" ' i' 9tghtb o[ crack ea• Ceiling Floor ' J ' 4 �ItlIli Ff?WiP '$ yt ! �' 1''' :''. t�'tl �ifdP o`�'�J}'`•iltyyit. .._�� f. Btu Coef. VM r Gass � , �' I' "�. t!s t {' t Y•�^ F I _ ' l' 4� A ! c7VIYs S I .� t�� i 7 I W ill f ,. a l Exp. wain,' Net exp. Wall r Int. wall' �II 1 � Ceding > , 1 Btu CS7 Total Btu. k Required sq. ft: E.D.R, oa sq.+intt.t ..A 'Leaden area >,'; tJ' 1: oiled sq rir.ia.R. o aq `ins.. W.A. Leader area :Roo t? ( (Letigth Width HeightLength ' Width / Heigit� Windows au oon—Crackage and Area , : ;I Q kl K'�i � A iindows and Doors---Cracka�e and Area Width ' 4Helghe No. o[ Lineal [t. Area ' o[ Nano ofpae4'81' ilghte of creak eq. it. width No. oS pane Height No. of Lineal [t i Area o! ins lights o[ crack sq. ft. t {I I ^q , { t. I •: ��. t .. ;., L,� � lit Ai i� � 11, Coef. Btu as, Y Glass t. x AV , 4 Net exp. wall exp +kali Int. wall Ceiling at'• dN 1,Is d Floors G� �QI ; ]l Btu:':' 1 Total Btu: equi ' sq ft:i'E:D " aq. 'pi. W r tea Room I Length Width r oor�1 Length / slid Height Win s:arad Doors--Crackage and Area Width Height No. of Lineal [t. ,Area ed. 'Width,,.. He1Bht No. of - Lineal IL Area No., ' ' of Dane of vane lights of crack sq. !t. asft, Na o! peas o! vase lights o! crack,, )kt { U ktlli i 1 . 1 1 : , I fp � N j kt i b 'u�tN 1 ?C il`•� tr' 8r, Coe£ Btu Infiltratloit I Glass Exp. wall :+ Net exp. wall iF 'Tiet exp::,wall `©fit ' Ceiling Floor Total Btu. Required sq. k. E.D.R.or sq. ins. WJL Leader area _'. e So.'ft, ED -M. oi: sq. urs. WA Fader area Reignited sq. ¢t. E.D.R. or 8q. ins. VA. LMder area Room I Length Width r : Height V/mdowa and ge . �tIt Area': Width Height No. of Lineal [t. ,Area ed. asft, Na o! peas o! vase lights o! crack,, is : � y 'u�tN 1 ?C il`•� Coe 1 . Bt , Infiltration Glass Exp. wall :+ Net exp. wall + Int. wall Ceiling Floor Total Btu. Required sq. k. E.D.R.or sq. ins. WJL Leader area _'. • "r Base 1st City of Widl®y Applic.016a for d Dept. of Bldgs. Phone 560-3450 DESCRIPTION OF WORK Number. Kind and Location of Fixtures V it R WrR. 116P 1<Ig lv. Ell •IeIWATE� '� � N GAS ELEC MEN 'M EMONN PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ................ x $2.00 $ Future Fixture Opening ............ x $1.50 $-- _New New Fixture Old Opening .......... . x $1.50 '$ Catch Basin .................... x $3.25 $ Water Heater :Up to 89,000 BTU).... x $3.00 $ New Ground Run Old Bldg. ........ x $3.25 $ Electric Water Heater .............. s $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures • • • • • • . • • ...... x $2.00 $ Additional Fixtures ............. , .... x $ .75 $ Gas Range to 199.000 BTU.. . x $5.00 $ REPAIRS & ALTERATIONS—Refer to Code Description. TOTAL FRE $ (SURCHARGE x_.50) 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 aretruetrue and correct 7 Fridley, Minnf / 18! Owner Kind of Building Used as To be completed about Estimated Cost, $ 3 � Old—New. Building Permit No. Permit No.l`JJ Signed' By _02 Business Pho No- a S ROUGH FINAL 53-84-879.01 MMMMMmm- m r k FARTIAL RATE SCHEDULE �r �.rgazo# 6--14-?�L r SUBJECT PERMIT NO City of Fridley 13999 AT THE TOP OF THE TWINS BUILDING PERMIT. ' r •______, 1 COMMUNITY DEVELOPMENT DIV. evr/j PROTECTIVE INSPECTION .SEC. 1 �` CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY L ---"A', 612-560-3450 910-F15 4/15/77 JOB ADDRESS 1452 Windemere Drive N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED' DESCR. 3 3 Innsbruck 5th Addition SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE Ernie Prow 1452 Windemere Drive N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Merles Construction 860 Randolph, St. Paul 55102 291-1169 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 f] REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Fire repair to garage 9 CHANGE OF USE FROM TO STIPULATIONS SEPERATE PERMITS REQUIRED FQR WIRIN% WELTING, PLUMBING AND SIGNS.. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Wood Frame 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 R-1 ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STALLS IGARAGES 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. $2,000 $1.00 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- $12.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE ��� 1� $13.00 SIGNATUREOF CONTRACTOR OR AUTHORIZED AGENT (DAVE) VALIDATED T IS -1S -YOUR PERMIT ,WHEN /yP`R'pOPERLY BLDG. INS, DATE SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE) CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PERMITS (NEW, ALTERATIONS, ADDITIONS, OR REPAIRS) OWNER:`Z✓ f ,2 1�7�� llJ BUILDER: ��/� �.S l X/ S Address: �3�02 /rU I&V17 o R"C -0 Address: �G 1�� fly (7 O �� 'f5 -5-11J 2- Te1. No.: �/ �/ 'c" No.: ZL2L Street: 10 / ocs pgo &Z P i? 2 LOT: 3 BLOCK: --3 ADDI ION: XJ �'&� � CORNER LOT: INSIDE LOT: SETBACK: SIDEYARDS: Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. To Be Used As: DESCRIPTION OF BUILDING Front: Depth: Height: Square. Feet: Cubic Feet: Front: Depth: Square Feet: Cubic Feet: Height: Type of Construction: �,� (�� /��//� Estimated Cost: $ 06� To Be Completed: Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired $ $ (SEE REVERSE SIDE OF SHEET) 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. See reverse side for additional information. DATE: 7//5/7 SIGNATURE: Stipulations: City of Fridley SUBJECT PERMIT 0' 76 9 7 AT THE TOP OF THE TWINS BUILDING PERM I T COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. / q NUMBER 910-F15 REV. DATE 9/5/84 PAGE OF APPROVED BY ��'���;•� CITY HALL FRIDLEY 55432 L 612-571-3450 JOB ADDRESS 1452 Wi.ndemere Drive N.E. 1 LEGAL DESCR. LOT NO. 3 BLOCK 3 TRACT OR ADDITION SEE ATTACHED Innsbruck 5th Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Wallace Lindgren 1452 Windemere Drive N.E. 572-0938 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO, Same 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 ❑ REMOVE B DESCRIBE WORK Construct a 27' x 10' and a 13' x 18' Deck 9 CHANGE OF USE FROM TO STIPULATIONS SEPERATE PERMITS REQUIRED FOR- WIRING, HEATING, P,LUM13ING AND SIGNS, SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. TYPE OF CONST. Treated Wocd OCCUPANCY GROUP OCCUPANCY LOAD THIS 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 ZONING SQ. FT. 613 Total CU. FT. 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 $3, 550 $1.78 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. $44.50 None PLAN CHECK FEE TOTALFEE /_�/ /i 11.13 $57.41 ATURE OF CONTRACTO UT5iiRED AGENT (DATE) HEN PR kPlYA IDA ED THIS IS YOUR PERMIT r VS1WNATUREOF OWN F OWNER B L I (DATE)) BLDG INSP GATE v NEW [ ] City of Fridley Effectiv 4/1/84 ADDN. [ ] �R-1 AND R -2j ALTER. [ ] Building Permit Application Construction Address: /7 '- 0 Af P r- M i k f P Legal Description: W__*_ Owner Name & Address: �� Tel. # 572 - 01'3 R Contractor: Tel. # Address: 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: th Width ® Hgt/Ground /� r� Sq. Ft . OTHER: 613 SSG, S3 o Corner Lot [ ] Inside Lot Ft. Yd. Setback Side Yard Setback Type of Construction: Estimated Cost: 1; Approx. Completion Date: Ta Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: See Back Page for Explanation DATE: " _ APPLICANT: Tel. CITY USE ONLY Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge TOTAL STIPULATIONS: 2L- Fee Schedule on Reverse Side 25% of Building Permit Fee $•50/$1,000 Valuation $425 per SAC Unit ' Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] i .44 r. MI T 1 1 - t SUBJECT PE City of Fridley 1786 AT THE TOP OF THE TWINS BUILDING PERMIT r CEIPT COMMUNITY DEVELOPMENT DIV. r t PROTECTIVE INSPECTION SEC. t � = CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY j 612-571-3450 910-F15 3/7/85 JOB ADDRESS 1452 Windemere Drive N.E. 1 LEGAL LOT NO. 3 BLOCK 3 TRACT OR ADDITION Innsbruck 5th Addition SEE ATTACHED DESCR. SHEET 2 PROPERTY OWNER MAIL ADDRESS Wallace I Lindgren 1452 Windemere Drive N.E. ZIP PHONE 572-0938 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 Ek ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE,WORK Construct an 18' x 141 Addition to Dwelling 9 CHANGE OF USE FROM TO STIPULATIONS If wood foundation is used, see attachments.. P l iQ 3i6d x. al DI-fore CI'srging' C@!I local LIl'll 1 TELEPHONE ® ELECTRIC - GA,2',', het '� SEPARATE PERMITS RE(� VVIR91b!G. �. CRED F R REQUIRED BY LA"-P" HEATF A���� y,I 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 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 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 $11, 100 $5.55 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- $92.50 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. LAN CHECK FEE TOTAL FEE $23.13 $121.18 OF CONTRACTO THORIZEDAGENT(DATE) WHEN PROPERLY ALIDATED THIS IS YOUR PERMIT MIGNATURE BLDG INSP - DA7 "GNATURE OF OWNER NER BUIL 1 IDATEI NEW [ ] City of Fridley Effective 4/1/84 ADDN. [ ] f R-1 AND R-2 ALTER. [ ] Building Permit Application Construction Address: / �� -A— P (W 0 F.M r K fr 1) R Legal Description: Owner Name & Address :.j Tel. # 621-2139 Contractor: I Tel. # a 2 �'_►�� Address: F JAw j el s 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 / t'�4 Height Sq. Ft.� GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: 2a,z_.< yq. Corner Lot [ ] Inside Lot Ft. Yd. Setback Side Yard Setback Type of Construction: P (3 0 M Estimated Cost: $ Approx. Completion Date: ti �"� 1 , 1 100 Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation DATE: 3 APPLICA Tel. # CITY USE ONLY Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge TOTAL Fee Schedule on Reverse Side 2% of Building Permit Fee $•50/$1,000 Valuation $425 per SAC Unit Fee Determined•by Engineering Agreement Necessary [ ] Not Necessary [ ] STIPULATIONS: I F W669 �6� ���`��� l� 654,0 Sick jr�i��it����, CITY OF FRIDLEY INSPECTION DIV, 6431 University Ave NE Fridley, MN 55432. APPLICATION FOR POWER. PLANTS.AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION ANO AIR CONDITIONING. SYSTEMS AND DEVICES RATE SCHEDULE Residential 3 -a S/o -1-2-5 Furnace Shell and Duct Work, Burner - Also Replacement Furnace 1 . (Side Vent FiII.O.ut flack) Gas Piping (Needed with new.furnace) Gas Range Gas Dryer t Rate $ 30.00 $14.00, $1000 $10.00 �( *Air Conditioning*- All Sizes $ 25.00 .�R340 All Others/Repairs & Alterations (UST ON SACK) 1 % of Value of Appliance or Work Corn me rcial jl nd ust Tial 11.25% of Value of Appliance or Work State Surcharge TOTAL FEE Effective On January 1, 1997 JOB ADDRESS /S2, Wt i✓®emllstt D1Z. fV6,. The undersigned hereby makes appUcatlon for a permit for the work herein TOTAL speciffed agreeing to do all work in strict accordance with the Cfty Codes and rulings of the Building Divislon, and hereby declares that all the facts and $®- representations stated in this application are true and correct. .,,1097 OWNER. WILDING USED AS_t Q ` ESTIMATED COST "3loc>o, PERMIT NO. A $ DESCRIPTION OF FURNACE AND OR BURNER' $ No..af Heating Units j CfrcleOne (Steam) (Hot Water) arm Air .'Le S-,TradeName Size No. - �Z.r✓ BTU -11" ; v HP ElR $ Fuel.. A hlr Total Connected Load 41 c+ou MINIMUM FEE FOR ANY HEA'TINa1CO1OLINPIMENTILATION REFFIIGEAATIONIAIR-GONDITIONING PERMIT IS 26.00 PLUS THE $.50 STAB .SURCUMde REINSPECTION FEE $42.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. .50 Burner Trade Name Size No. BTU HP EDR . S.> S-6 HEATING COMPANY iLe&A� A'✓� 3f ned By �" Tel No. 6 -06k 7 g �3 Approved ByRough-In Date Final Date FILL OUTBACK SI4PSITACK VERIFICATION ON REPLACEMENT FURNACE 8. Has combusdon.air.beea water •:Z : ./• List ALTERATIONS_Bei ifDo= ' HEATING CO: Signed By:�0�',,C- Date: Zo.20'd L8ZT TLS ZT9 A3108-1 d0 AII9 20:9T L66T-8T-Nnr CEMANEY AM STACK VERMCATION . The undersigned hereby verifies that ft.exisfng chimney or suck: 1. Has been carefalIy: e. • :.. _ .Yes . t. No ( ) 2, is free from rost.ordeteatm� Ye_ s ( "No { } ..3. Has no foreign objects Yes O No (. ) . 4 Is semreiy supported Yes (i() No ( ) 5. Meas all current Code. regauemcnts for size and total BTU's -com tcd , Yes No ( } 6 Has total beating`BTU's of J2!�,cxx> 8. Has combusdon.air.beea water •:Z : ./• List ALTERATIONS_Bei ifDo= ' HEATING CO: Signed By:�0�',,C- Date: Zo.20'd L8ZT TLS ZT9 A3108-1 d0 AII9 20:9T L66T-8T-Nnr SUBJECT O . City of Fridley �' 25�� AT THE TOP OF THE TWINS B U I L ®INC; P E R M I T COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r ze 1 NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 9/29/97 JOB ADDRESS 1452 Windemere Drive NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 3 3 Innsbruck 5 Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Wally Lindgren 1452 Windemere Dr NE 572-0938 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Dan Netko Exteriors 7118 Riverdale Rd M ls. MN 55430 566-3731 20060494 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 ❑ ADDITION O ALTERATION Ek REPAIR O MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof House & Garage (30 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building 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 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 $2,502 $1.25 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT UME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISI S OF ANY OTHER TATE O OCAL LAW REGULATING CON - $74.75 Fire$2.50 RU ION O THE PE ANCE CONSTRUCTION. /SC PLAN CHECK FEE TOTA FEE Li S $5. // $83.50 SIGNATURE OF NTRACTOR OR AUTHORIZED AGENT IDATEIENP OPE ALIDATE `BLDG SP ;TIS IS YO PERMI s � OATS SIGNATURE OF OWNER IF OWNER BUILDERI IDATEI NEW [ ] Effective 3/1/96 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1' AND R-2 Building Permit Application ConstructionAddress: ' , dr1 e Legal Description: '��-� / y- b N Owner Name &Address: \N'A'1:L`/1 1_I victoq-e br Tel. # 6-71- 0 q -39' Contractor: �) h'N �4 9-�Viy MN LICENSE # LI Address: -11 C'Vtp a w -Lk- VcLM �e S� RN �5 5Ll36 Tel. # J(o (o 31 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF E%IPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width _ Hgt/Ground Sq. Ft. OTHER: �� , c CSS" r� Comer Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: 2 / P.y- est' n!2) Estimated Cost: $ S Approx. Completion Date: 6 (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: � - 2 O -0)-7 APPLICANT: KI" Tel. # 5(66-3131 CITY USE ONLY Permit Fee $ ���. ° �' Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1 / 10th % ) State Surcharge $ /, -2S7 $.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 $ STIPULATIONS: Building $ BUILDING Permit No: n -65 Z419 Inspections $ RESIDENTIAL APPLICATION Received By: 763-572=3604 $ CITY OF FRIDLEY Date Rec'd:G�� ^' PJi CSbi �s� DATE YOUR ADDRESS �' License Surcharge /E-MAILL SITE ADDRESS / �'/S �G �"�' �Mei e � �/ 2 !/9 6c On $5.00 (State Licensed Residential Contractors) SAC Charge $ THIS APPLICANT IS: ❑ OWNER WONTRACTOR Curb Cut Escrow PROPERTY OWNER! NAME: o;1 A.".1Te ft + 6 ft = ft x $21 =$ /► ADDRESS: ��IS tul i / olere I'l, G CITY I' STA IP TENANT $450 Conservation Plan Review PHONE: 763 -c266- /1'2 & $ CONTRACTOR NAME: Sewer Main Charge STATE LICENSE #I E DATE SUBMIT A COPY OF YOUR STATE LICENSE ADDRESS: �� I CITY Zyzal I& STATAP65?1ro WITH APPLICATION PHONE 6,1 FAX PROPERTY TYPE 2lSINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGEISHED WINDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK 11M DING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: ❑ NEW ❑ ADDITION ❑ MAINTENANCE/REPAIR-6REMODE DESCRIBE WORK BEING DONE: SIZE OF IMPROVEMENT S p LENGTH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE I . Existing Floor Plan 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum` / ❑ Trim I . Site Plan/Survey showing the existing structures �/� 4A Other / 4/0 a ❑ Fascia and proposed project. 2. Two sets of construction plans WINDOWS 3. Energy Calculations IN EXISTING OPENINGS 49Yes ❑No LOCATION OF WINDOWS 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: (USING T 99 U FEE SCHEDULE) TOTAL JOB VALUATION $ OCCUPANCY TYPE Permit Fee $ See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ .001 times the total job valuation Surcharge $ p .0005 x Permit Valuation Minimum $.50 License Surcharge $ 6c On $5.00 (State Licensed Residential Contractors) SAC Charge $ $1675 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 $ v a Make checks payable to: City of Fridley Attach Stipulations 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 perm' w not to start without a permit; that the work will be in accordance 2 ;/o approved plan in the case of all work which r approval of plans. /� �%�+ SIGNATURE OF APPLICANT PRINT NAME ,�%e/ d;1-;'ez ATE City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 PLUMBING Permit NO. 6a -I ' & ilding Inspections F7- RESIDENTIALAPPLICATION Received By: 572-3604 CITY OF FRIDLEY c' 763-502-4977 FAX EFFECTIVE 1-1-08 DATE r b YOUR E-MAIL AMRESS SITE ADDRESS d<',A,e e- o/,-, ;,v rr"di' Cly Lq k / THIS APPLICANT IS: 'Ai�"OWNER 000NTRACTOR PROPERTY NAME: ,—J"® , h- ey OWNER/ _ ADDRESS: 1 4 d'�t i� l ncl c P. �o --g d/ ' ``� e CITY �P r 1 e �✓I STATE f"-AA&IP TENANT PHONE: CONTRACTOR NAME: STATE LICENSE # EXP DATE SUBMIT A COPY OF YOUR STATE LICENSE, BOND AND STATE BOND # EXP DATE CERTIFICATE OF ADDRESS: CITY STATE ZIP INSURANCE PHONE FAX PERMIT TYPE SINGLE FAMILY ❑ TWO FAMILY 0 TOWNHOUSE 0 NEW REPLACEMENT TYPE OF WORK: DETAILED Dv % �` ESCRIPTION OF WORK f Ce l ' I I rv' e �%e /"� �� d° � A .S e "_ .-744e- mler., S -- 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. (This should reflect only the cost of labor ) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x .05 = plus .50 surcharge OR FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FET; $15.50. SINK/LAV FLOOR DRAINS _ WATER PIPING —BATH —SHOWER _ BATHTUB _ GAS PIPING (NEED CITY LIC) _ SWIMMING POOL _ WATER SOFTNER ($35) CLOTHES WASHER KITCHEN SINK _ WATER CLOSET _ BACKFLOW PREV. ($15) _ _ DISHWASHER LAUNDRY TRAY _WATER HEATER ($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 = $ OR Number of fixtures @ $35.00 x $35.00 = $ TOTAL DUE $ State Surcharge = $.50 (NUNIMUM $15.50) (MINIMUM $15.50) Total = $ 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 the case of all work which requires review and approval of plans. SIGNATURE OF APPLICANT � PRINT NAME � DATE '7 VED BY DATE 1115 11 1 -a. G City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977