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PRE 2010 DOCSBUILDING PERMIT Village of Date .4��!� • �u .. �, �........ . Owner .. ..... .v ..... . Address ht -.7.®...... . `. ............ Fridley, Minn. No 2921 Builder........................................ Address ................... LOCATION OF BUILDING No. ..�® ..... Streeter �.................... Part of Lot �...�.Q. ��... Lot .....r ....... Block ... `.'........... Addition or Sub -Division . . ................. ......... Corner Lot ..:......... Inside Lot ............ Setback Sideyard .........::::............. DESCRIPTION OF BUILDING To be Used as: Front ....... Depth ........ Height ..0 ...... $q. Ft. Cu. Ft. ........ Front . Depth.... Height/ MSq. Fi.Cu. Ft. ........ Type of Construction .............. Est. Cost F. ? To be Completed ..V.P . ............ 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 all provisions of ordinances of the village of Fridley. f l\ CD In consideration of the payment of a fee of $........ , permit is hereby granted :3 ......... :------- to .....to construct the building or addition as described above. This permit Is/granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings with- in the village limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. � Building Inspector NOTICE: This permit does not cover the construction, installation or alteration for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these items. City of Fridley, Mine 11.10 6431 University Ave. N. E., Minneapolis, Minn. 55432 BUIELDING PERMIT mate: fly_ 27- 1971 Owners Lestgr A. Kallis Builder Johnson Building Mart Address —.4707 - Lid Street N E Address '161 5. 9.at Lake Street LOCATION OF BUILDING No —4 Z 0 7 Street 2nd Street N.E. _ part of Lot Lot1�— Block - h Addition or Sub -Division - Plymouth Addition Corner Loi inside Lot Setback Sideyard Sewer Elevation Foundation Elevation To be Used as: Aluminum Siding Front Depth Height Sq. Ft. Front Depth Height Sq. Ft. Cu. Ft. Cu. Ft. Type of Construction Est. Cost -. $2., 200 00 To be Completed Aug . 1 In consideration of the issuance to me of a permit to conwftvmt the building described above, I agree to do $he proposed work in accordance with the description above st fr and incoM ce yv th all provisions of Ordinances of the city of Fridley. / In consideration of the payment of a fee of $---L 00 , permit is hereby, granted to Johnson Bldg Mast 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 Zridley, 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 JL v� w Building Inspector RANK ETRTcli NOTICE: This permit does not cover the construction, installation for whine, plumbing, gas heating, sewer or water. Be sure to see the Building inspector for separate permits for these items. APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAM: BUILDER ADDRESS 0 ,7 1 LOT: BLOCK: ADDITION: CORNEA LOT: INSIDE LOT: SETBACK: SIDEYARD: Applicant attach to this form Two Certificates of SurvgX of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: Front: Depth: Height: Square Feet: Cubic Feet: Front: Depth: Height: Square Feet; Cubic Feet: X v�v?/,a/('1-e Ov Type of Construction: C t/ Estimated Cost: $ Z A To Be Completed:u %5 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: f/,j7/f SIGNATURE: (See Reverse Side For Additional Information.) �'— �I z2C-V CV CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 Effective On January 1, 1991 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH Fi nna PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS Ld ®� % New Fixtures $ 7.00 Old Opening, New Fixture $ 4.00 Beer Dispenser $ 5.00 Blow Off Basin $ 7.00 Catch Basin $ 7.00 Rain Water Leader $ 7.00 Sump/Receiving Tank $ 7.00 Water Treating Appliance $10.00 Water Heater -Electric $ 7.00 Water Heater - Gas _ $10.00 Gas Range $10.00 Gas Dryer_ $10.00 Back Flow Preventer Required ( )Yes () No Type $5.00 Reinspection Fee $30.00 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1 % of Value of Fixture or Appliance State Surcharge .50 TOTAL FEE $-\,'5s ® 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. -11991 Owner rD I v Building Used As Estimated Cost®� �� •PERMIT NO. _ PLUMBING COMPANY Attns Judy nnagasco # SIGNED BY 700 W. Linden Avegtr. No. Minneapolis, MN 55440-116:` Approved By Rough -in Date Final Date 42� MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE PIN V'24 ll-, C;Co Ory— ('J0.j:vC'3 Z-ao,-15 ` f Minnesota Well and Boring WELL OR BORING LOCATIQ9 MI NESOTA DEPARTMENT OF HEALTH - Sealing No. H 6008 County Name WELL AND BORING SEALING RECORD Minnesota Unique No. Minnesota Statutes. Chapter 1031 or W -series No. Anoka(Leave blank if not known) Township Name Township G No. Range No. Section No. Fraction (sm. - Ign.) Date Sealed Approximate Date Well F r i d i e, 30 2 6 is N W, SU,i or Boring Constructed Numerical Street Addressor Fire Number and City of Well or Boring Location 37 4707 2nd St., Fridley Depth Before Sealing � ft. Original Depth ft. Show exact location of well or boring Sketch map of well or boring Static Water Level ❑ Accurate in section grid with "X-. location. showing property lines, N roads. and buildings. ElApproximate W MIME a Screen from to ft. Open Hole from to ft. EMEM PROPERTY OWNER'S NAME Sandrae Dykbui zee Mailing Address if different than property address indicated above. SEEN PUMP ❑ Removed E'' Not Present ❑ Other CASING Diameter Depth in. from to 34 ft: in. from to ft. in. from to ft. MEMS GEOLOGICAL MATERIAL COLOR HARDNESS OF FORMATION h` [N Single Aquifer ❑ Multiaquifer RE ft, below above land surface CASING TYPE �E �GA smile y $ Steel El Plastic ❑ Tile ❑Other 34 37 S 1-4-- r mile a Screen from to ft. Open Hole from to ft. OBSTRUCTIONIDEBRISWILL ❑ Obstruction ❑ Debris ❑ Fill none Type of dabDebdris/structre ObstructionlDebrislFili removed? [I Yes ❑ No PROPERTY OWNER'S NAME Sandrae Dykbui zee Mailing Address if different than property address indicated above. PUMP ❑ Removed E'' Not Present ❑ Other CASING Diameter Depth in. from to 34 ft: in. from to ft. in. from to ft. Set in oversize hole? Annular space initially grouted? El YesPfi No ❑Yes El No El Unknown ❑ Yes ❑ No ❑ Yes ❑ No ❑ Unknown ❑ Yes ❑ No ❑ Yes . ❑ No ❑ Unknown GEOLOGICAL MATERIAL COLOR HARDNESS OF FORMATION FROM TO If not known, indicate estimated formation log from nearby well or boring. METHOD USED TO SEAL ANNULAR SPACE BETWEEN No Annular Space Exists ❑ Annular space grouted with tremie pipe ❑ Casing Perforation/Removal in. from to in. from to Type 2 CASINGS, OR CASING AND BORE HOLE: ft. ❑ Perforated ❑ Removed ft. ❑ Perforated ❑ Removed of perforator ❑ Other GROUTING MATERIAL Grouting material �i 4" Cm t. from from from from 5 to 37 ft. yards 1 bags to ft. yards bags to ft. yards bags to ft. yards bags REMARKS, SOURCE OF DATA, DIFFICULTIES IN SEALING UNSEALED WELLS AND BORINGS Other unsealed well or boring on property? ❑ Yes ff No LICENSED OR REGISTERED CONTRACTOR CERTIFICATION This well or boring was sealed in accordance with Minnesota Rules, Chapter 4725. The information contained in this report is true to the best of my knowledge. Ho e3 _CQ %., JLn_p-jj in 02133 Contracto ass Name F..Wof or Registration No. -15-95 Authorized Representative Signature Rieke Date LOCAL COPY �HGreg 0 Name of Person Sealing Well or Boring HE -01434.01 CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1995 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES c JOB ADDRESS 47'Oj�6 RATE SCHEDULE The undersigned hereby makes application for a permit for the work herein Residential Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes ar Furnace Shell and Duct Work, Burner —, 0Q°/ rulings of the Building Division, and hereby declares that all the facts and Also Replacement Furnace $ 20.00 $ Z® representations stated in this application are true and correct. (Side Vent — Fill Out Back) 1995 Gas Piping (Needed with new furnace) $10.00 $ / % OWNER SGZ 1/2Ci(� Gas Range $10.00 $ �J BUILDING USED AS ��S lC-�' � x C Gas Dryer $10.00 $ ESTIMATED COST Zf�49 ® PERMIT NO.//91 *Air Conditioning — All Sizes $10.00 $ DESCRIPTION OF FURNACE AND OR BURNER All Others/Repairs & Alterations (LIST ON BACK) 1% of Value of. Appliance or Work $ No. of Heating Units Circle One (Steam) (Hot Water)arm Air Trade Name //677- Size No. r- Commercial/Industrial BTU OlJ® HP EDR 1 % of Value of Appliance or Work . $ Fuel Total Connected Load 1/ /014000 State Surcharge $ .50�' Burner Trade Name Size No. BTU HP EDR TOTAL FEE �_��� a� HEATING COMPANY MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE IL L 1, •) C REINSPECTION FEE $30.00 f J *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. Signed Tel No.Z r ApprovedRough—In Date Final Date , FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE NOTE: til through #8 required when using a side vent furnace. The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes W4 No ( ) 2. Is free from rust or deterioration Yes 04) No ( ) 3. Has no foreign objects lodged within Yes Qom} No ( ) 4. Is securely supported Yes No ( ) S. Meets all current Code requirements for size and total BTU's connected Yes (n- No ( } % 400 6 Has total heating BTU's of All other BTU's TOTAL BTU's d (� 7. Has a liner been provided for water heater Yes(?) No ( ) 8. Has combustion air been provided for water heater Yes (K) No ( } Remarks: HEATING CO: • Signed By: —w�� CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 Effective On Janpary 1, 1995 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR 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 Gas Range Gas Dryer Back Flow Preventer Required NO. RATE TOTAL JOB ADDRESS ..'17e 7 C )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 $5.00 Reinspection Fee $bO.00 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1% of Value of Fixture or Appliance State Surcharge TOTAL FEE 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. // J1 Owner _� 2 4 Z /tet U A Building Used As tl 00 r Estimated Cost �Z� G PERMIT NO. PLUMBING COMPANY �. 9 SIGNED 13(��;j TEL N0. V3/0S~ Approved Rough—In Date Final Date S 50 MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 $ IPLUS THE $.50 STATE SURCHARGE W SUBJECT City of Fridley AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. L-COMMUNITY DEVELOPMENT DIV. v r ; PROTECTIVE INSPECTION SEC CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED By 612-571-3450 910-F15 3/20/95 JOB ADDRESS 4707 2 Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 18,19 6 Plymouth Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Sandra Dykhyizen 4707 2 Street NE 572-8763 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. J & J Total Construction 6870 164 Ln NW, Ramsey, MN 55303 753-6558 9227 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 IR REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reside; reroof, shower walls, redo flooring and gutters and downspouts 9 CHANGEOFUSEFROM TO STIPULATIONS Provide smoke detectors adjacent to all sleeping areas. Replacement bedroom windows must meet the State Egress Code. ' E PERM-'"S REQUIRED F® . G, T, ING�, R PL'JM'31NG AND SIGNS. 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 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 $15,252 $7.63 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- $171.00 Fire SC $15.25 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION '� PLAN CHECK FEE TOTAL FEE SIG License SC $5.00 $198.88 ATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WHE PE YATED THIS IS YOUR PERMIT BLDG INS_P GATE SIGNATURE OF OWN ER I IF OWN E R BUILOE RI tDATEI W NEW [ ] Effective 1/ 1/95 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Construction Address: q 70 7 d dv � .5 eee /- Legal Description: Owner Name & Address: S;&'6R'q Q !;� kjg 3o4 -Z-. f_ Tel. # Sid Contractor:�MN LICENSE # 9,;)a Address: && `76 164114 /'ate. f°Z/' Z'U. s eX Tel. # -7-5- s -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 GARAGE AREA: Length Width DECK AREA: Length Width. OTHER: � � e �'� r,?0C -P'1 5�e .4J4,,Lhe Height Sq. Ft. Height Sq. Ft. Hgt/Ground Sq. Ft. Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks Type of Construction: %� .i Estimated Cost: $ /-T '2 '6C Approx. Completion Date: J u < (Cost on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x DATE: 2 5` APPLICANT: g,,z.::4 Tel. # a 5-3 CITY USE ONLY Permit Fee $ j -% l ° 00 Fee Schedule on Reverse Side Fire Surcharge $ % S� �� _ .001 of Permit Valuation (1 / 10th %) State Surcharge $ i , 63 $.50/$1,000 Valuation SAC Charge $ $850 per SAC Unit License Surcharge $ 5.00 $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 $ v p f STIPULATIONS: BID SHEET Sandra DyKhuizen 4707 - 2nd Street Fridley, MN 55432 572-8763$ Contractor Contractor's Signature Page 1 $ a. Seal countertop and backsplash behind sink and make impermeable to moisture. $ b. Install new range hood, mechanical ventilator, UL listed, mounted above cooktop (sized for cooktop surface), duct to exterior (through roof), insulate and size to code. Nutone or equal. Owner's choice of color. A4,.,a i / $ c. Cover edge of floor covering (confirm material and finish with owner). 2 r ®��� s e r S-3 BATHROOM $ a. Redo shower walls. Remove existing tile, drywall and window. Frame window opening and insulate exterior wall. Install new water resistant drywall. Remove cabinet on north wall and confirm disposal with owner. Install new 3 -piece fiberglas shower wall.surround with molded soap dish, white color. Kohler or equal. Seal joints. Repair damaged exterior side of removed window area to blend with adjoining work as close as possible. $ b. Redo flooring. Remove existing and install structural grade underlayment. Install new vinyl �( sheet floor covering of owner's choice of color and pattern. Armstrong or equal. $20.00 sq yd installed allowance. Edging of vinyl floor shall be covered (confirm material and finish with owner). Reset stool with new flange seal. $ c. Install new mechanical exhaust fan, secure in ceiling, duct to exterior, insulate to code, size to provide five air changes per hour and equip with damper for complete assembly. Nutone or equal. �4". 1)I�1��l�Li� $ a. Reside house. Remove old siding and haul away debris (two layers). Provide sound substrate far new siding. Install Tyvek or equal weather type barrier over sheathing. Installnew vinyl siding. Alside or equal. Rework items (shutters) that interfere with the siding application. Owner's choice of color and style. Seal around west entry threshold (water leakage in basement). $ b. Cover entire trim around windows and doors of house with .019 baked enamel prefinished aluminum. Alcoa or equal. Replace rotted and damaged boards. Owner's choice of color. $ c. Tear off shingles on house down to bare wood. Haul away debris. Replace rotted boards. Specify separate board replacement cost per sq ft $ Install ice and water shield/starter. Replace roof vents and plumbing jacs if defective, missing or damaged. Install metal drip edge along roof edge where gutters or ribbon boards are not installed. Install 240# 3 -tab asphalt shingles laid over one layer nonperforated Type 15 felt. Certainteed or equal. Ridge shall be laid "Boston" style. Owner's choice of color. $ d. Install new gutters and downspouts along west roof edge of house and garage, baked enamel prefinished aluminum, Alcoa or equal. Gutters shall be 5" seamless, secured to the roof edge 36" on center and pitched. Downspouts shall be 2" x 3" corrugated, secured to wall and with an installed extension, extending a minimum of 60" out from downspout. Owner's choice of color. Install along west roof edge. M 113.4: i 31-30r 4707 - 2nd Street Fridley, MN 55432 572-8763 Page 2 $ e. to S-7 HEATING AND PLUMBING $ a. Install new furnace. Haul away old unit. install new forced -air heating unit, natural gas, AGA or UL listed, Carrier or equal, that will maintain a supply of safe and adequate heat to each conditioned room in the dwelling (includes basement). The installed unit shall be designed to meet or exceed 78% AFUE. Installation shall include combustion air intake and new thermostat. Vent to approved flue. Reconnect to existing plenum and distribution system. $ b. Abate asbestos on flue and dispose properly. $ c. Disconnect basement gas space heater. A0 $ d. Install new shower/tub fixture, chrome, anti -scald (thermostatic or pressure -balancing type) and with 3 gpm showerhead. Delta Monitor or equal. Nie® $ e. Abandon well per State requirements. 3;S• $ f. Vent laundry tub. ill , df yd' $ R. Install back flow preventer to laundry faucet. &,f- $ h. Abandon floor drain in garage. S-8 GENERAL HEALTH AND SAFETY $ a. Blow insulation, UL listed, in attic to meet R-38. Seal thereto by-passes prior to insulation work. Install air chutes for soffit venting. $ c. Install wood handrail continuously along one side of basement stairs. Owner to paint. S-9 ELECTRICAL $ a. Install 100 amp circuit breaker panel with main breaker, UL listed, 20 pole. Tie in all circuits. Ground service. Service mast shall be properly sized. Locate meter to exterior. $ b. Protect wall receptacles within 67 of kitchen sink with GFI. Install 20 amp wall receptacle at countertop. $ c. Correct defective wall switch in kitchen. $ d. Install wall receptacle in bathroom, protected by GFI. $ e. Install 20 amp appliance receptacle for laundry. $ f. Wire installed furnace on separate circuit. $ TOTAL BID BID GOOD FOR 90 DAYS FROM This work write-up describes the rehabilitation work to be performed on the subject property. The contractor will be required to do all work in a trades like manner and in accordance with the building code and TECHNICAL SPECIFICATIONS. BID SHEET 4707 - 2nd Street Fridley, MN 55432 572-8763 ALTERNATES: Page 3 $ 1. Code plumbing system. Specify all other plumbing code work not listed above and the cost per work item. $ 2. Code electrical service. Specify all other electrical code work not listed above and the cost per work item. $ 3. Cover entire eave area of house with .019 baked enamel prefinished aluminum. Alcoa or equal. Replace rotted and damaged boards. Apply aerated material to vented soffit area and make soffit venting open to attic area for unobstructed air flow. Owner's choice of color. $ 4. Install new kitchen countertop,,one-piece custom top, square edge front and with backsplash. Laminated plastic on composition base. Formica or equal. Reinstall sink and faucet, unless specified otherwise. I From: Ofty of Fridley To: 9524743748 Page: 2/2 Date; 1/6/2009 0:46;1$ AM Building PLUMBING PermitNo.- - Inspections RESIDENTIAL APPLICATION Received 13y: 763-572-3604 CITY OF FRIDLEY V A 6 2AO( 763-502-4977 FAX LFI ECTIVE 1-1-08 DATE /-&^ 0 1 YOUR E-MAIL AIII)RE%q SITHADDRESS 4f_7o:7 2wW sr THIS APPLICANT 18, C] OWNFR OCONTRACTOR PROPERTY NAME:. Dw r, JM CA/ OWNER/ TENANT ADDRFSS,I ':5�4 crry �-PfA'fh ZIP MIONW, !7 -7 -10 CONTRACTOR NAM I --'- SUBMIT A COPY OF YOUR STATE STATE LICENSE'i ff EXP DATE LICENSE, BOND AND STATESOND CERTIFICATE OF AINIRliSS: CITY STATE INSURANCE —ZIP PHONE FAX PERMIT TYPE 1EI/SINOLE FAMILY 0 TW*O FAMILY El TOWNHOUSE TYPE OF WORK: El NEW: Pf&PI A CHM ENT DETAILED DESC-RIFr1ON OF WORK eD J41-tik Ac-lorth.. PEP, MS 16B.665 the permit fee is a mlininjum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a msidontial fixture, excluding the fixturm. (This should reflect only the cost of labor) Labor cost under ,5300 — $15,00; Labor cwst between $300 to $500 "cost of tat;or x.05plu. plus.50 OR FOR PROJECTS WHERE LABOR EXCEEDS $500, FULLS ARE BASED ON $10.00 PER I"IXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDIC-ATIi TOTAL NUMBER OF EACH BELOW). MINIMUM FEE $15.50. —HATHSJNKfLAV L __VLOOR DRAINS SHOWR WATER PIPING BATHTUB GAS PIPINVY tNEED CITY LIQ SWIMMING POOL —WATERSOFTNER($35) _CLOTHES WASHER KITCHEN SINK WATER CLOSET BACKFLOW PREV. ($1.5) DISHWASHfilk —LAUNDRY TRAY WA'I'liR RhAlhit ($35) FOR IRRIGATION WATER MYTER _OTHER p p Numborof fixtures @ $10.00_x$10.00 = $ SU5!1c .50, Number of fixturms ®R, $15.00 x $15.00 = $ OR Number of fixtures 0 $35.00 x $35.00 TOTAL DUE $ State Surcharge .50 (MINIMUM $15,50) (MINIMUM $15.50) Total $ THIS IS AN APPLICATION FORA PERMIT -NOT VALID UNTI), PROCESSED I hereby apply for a plumbing permit and I acknowledge, that the information above Ls complete and accurate; that the work will be in conformance with the ordinanccand codes of the City of Fridley and with the Minnesota Construction Code; that I Understand this is not a permit but on%X an application for a c1rmlt and work is not to start without a permit on site; that the work will be in accordance with the approved pl in the Oak f a,, w r which requires review and approval of plans, -1 SIGNATURE OF APPLIC T i'ovc�'Ik - &944.�A? PRINT NAME A41C, DATE/ - 4 APPROVED BY DATE 7/ k -P -T9'-A city of Fridley Building Inspections Department 6431 University Avenue NE, Ffidley, MN 55432 763-572-3604 FAX: 763-502-4977 A '['rust dNi A -Aaron's 't'tarlc your 8r.r':icU Plumbing . fielting- Camliztg - Sewer & I7ruin Clemning Goncrccf ORiu s: Y. 0.1kw 712. Cl ut uissocl . M n 55317 - 0712 t'l'c•I) !t>'_'•:77a-tf��t� Our 32" yeas, (Fax) Ka'r2.474•874R FAX Tlt rgc4111T'I'AI, l J TO: t i'Ah NO: .5 - 'Q 2 ' 45 71 Tl:l, NO: DATE L Y FROM: ] ORIGINAI. � "- C Y+r�h s Wt ptuakok4,- A 'f, ui ' f '�r►� h. t `{" -(7(\ n -v 'l'nuic PrflfC43i(HJNIM at Your Service 1'lumbin + I leating • Coolin • Sewer c&. Drain Ckunin g Vokm� From: unknown Page: 2/3 Date: 118/20091:08:17 PM A 0 7 Ri -42Z 4- City . y AP AS W W Ali AA Q FM CB @louse Tovvnhausc Condo Duplex Comm 5 K L FD B BT SH HWO Costlest�. -��'— Quote, Mt 69 V*2-814 198 for — _ , Chg S Ck CC�--- AO AutH�. ,Addrzsa....� Date jr Time 1'ramised P mI am R-12 10-2 12.4 _ to After — Cali to Mee Date _ Tech—. . Disp Finish, Date_,.__. 7eoh ._ Disp Finish E -ft Gv-' To Favo<-ites i- -dp htlp://tiaw+w doll,st�te,mn,u5/pdf/pe, . ) ® - -- L4 Page ib ToolsEll e6 • -- OLSON . ARIN M A 8 T EXCAVATION (OLSON GRIN M) MOHLER , TIMOTHY E A 1 PLUMBMASTER (MOHLER TIMOTHY E) LEES RICHARD A 1 REFRIGEiiATK7N OF HIBBING INC A 1 WATER CCAiDITIONWG (GITZEN JOSEPH C) MUHAMMAD , ELIJAH /( S- A AARONS (A TRUST) (/` j l WRENSHALL, MN 139052 2008 Certified Pspe Layer (No License Nufter) �,.,.. BLAINE. MH MN34700 2006 62774 -PM (Pre -2008# PMO05639) A ACTION DRAIN AND PLUMBING HIBBING. MN 93 GN 6630 4 2006 57282 -MR QnvaFrd In clttasltovms Met 5,000 poputatlan.) 2008 MOUND, MN RLI477848 2006 80980 -WC (Pre-2008#_WCDD0405) A AND A PLUMBING INC CHANHASSEN, Mid RLISI3029 2008 58918 -PM (Pre-2DO6 S: PM003569) ALEXANDRIA, MN 7900436107 ruwwr '.. ,+,.,,a..v �,.,.. -GREEN , DAVID A 59362 -PM (Pre -2008 #-. PM004115) A ACTION DRAIN AND PLUMBING ROSEVILLE, MN 9874444 2008 MCGUIRE , PATRICK J E0594 -PM (Pre -2008 #- PMDOS826) A AND A PLUMBING INC ALEXANDRIA, MN 7900436107 2008 TRENNE ARLYNV 58016 -PM (Pte -2008# PM003706) A AND E PLUMBING AND HEATING INC ST PAUL. MN 9330581 2008 STODOLA , JAMES J 23526 PM ('re -2006 # PMO03652) A E NELSON PLUMBING INC WOODBURY, MN 13883 2008 ALERTS , JAMES M 59-053 PM (Pre 2008 #: PMU04215) A J ALBERTS PLUMBING INC HOWARD LAKE, MN 69463036 2006 JORDAN , ARTHUR L Cer6Rad Pape Layer (No License Nufter) A L JORDAN INC ROCKFORD. MN 55 196780 2DO8 LARKIN , DANIEL P 63130 -PM (Pre -2008 #: PM006434) A MECH PLUMM INC �. DrIm u*mm ZOr)e