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PRE 2010 DOCSN° , 6149 L T ILDINC _411 4 No. Street Lot _ Block Addition or Sub- ry - -- Corner Lot Inside Lot Setback _ _ Sideyard, Sewer Elevation _ __ _ Foundation Elevation DESCRIPTION OF BUILDING TO Front Depth Height Sq. Ft. owcm r4.AW40 Front ._ _ _ _. Depth -eight _ _ Ft. Cu. Ft. Type of Construction -- Est.Coile!_r To be CompletedWOO— Go 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 city of Fridley. In consideration of the payment of a fee of $, permit is hereby granted 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, alteratio maintenance, repair and moving of buildings within the city limits and this permit may be revoked at' agy�upon violatiof any of the provisions of said ordinances. A 1 NOTICE: This permit door not eover the Construction, hntall en for rrhh phrmbk& on heating, sourer or Water. Be sure io we the Building Inspector for separate permits for thus hams, 1 'H APPLICATION FOR BUILDING PERMIT CITY OF FRIDL9Y0 MINNESOTA Owner's, Name Builder Address Address LOCATION OF BUILDING No. , ,�c� Street 1 Part of Lot Lot4 BlockI/ Addition or Subdivision �s Corner Lot Inside Lot I-' Setback00 Side -Yard SEVER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To be used as: Front 3 DepthHeight Sq. Ft._1 j6 �CU. Ft. � Front Depth Height Sq. Ft. Cu. Ft. Type of ConstructionEstimated C �ffiE To be Completed The undersigned hereby makes application for a permit for the work herein specified, agreeing to do"all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. _ DATE ^—° IL SIGNATURE (Schedule of Fee Costs can be found on the Reverse Side). -9 .._ 3 1 w I r'a-n %o Tole nsoh Cons trkLa-1�®n Go rP. )W.g8'. ko-;�s /eandll, 8look 24, 91de Task ■ "A City of Fridley Application for Plumbing and Gas Fitting Permit DESCRIPTION OF WORK Number, Kind and Location of Fixtures VlU0' NO. RATE TOTAL Number Fixtures...................... x $1.50 Z (14� x 1.20 Y o� et z 8Z 80 z Z_ W x 3.25 W Z �O F N WATER HT R. GAS ELEC. Base GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 - Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ 1st 2nd 3rd 4th • Future Connection Openings New Fixture, Old Openings Connected with Sewer Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures...................... x $1.50 $-��� Future Fixture Opening ................ x 1.20 $ 'New Fixture Old Opening .............. x 1.00 $ Catch Basin ...... ..................... x 3.25 $ Water Heater (Up to 200,000 BTU) ...... x 2.00 $ New Ground Run Old Bldg. ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $ i Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description................................................$ TOTAL FEE $ ,off Dept. of Bldgs. Phone SII 4-7470 a Location .� �3 ©_ �C sU% ,� �. 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 % /X , 19 Owner Kind of Building Used as To be completed about Estimated Cost, $ Old— ew. uilding Permit No �% Permit No. Signe ROUGH VIF - a FINAL 42 2M By Business Phone No Application for Power Plants and Hearing, 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 ............ 8.00 $ each add. 80,000 BTU ....................... 2.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 ................. 5.00 $ Repairs & Alterations each add. $500.00 .............. 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 $ ;ra 0 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 $ 4_1 0 O GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... / x $1.50 $ ®.._ d Additional Fixtures x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH F FINAL See Fee Schedule TOTAL FEE Dept. of Bldgs. Phone SU 4-7470 Location 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. p� AFridleey, Minn_ � X, � S (9-3, 19 � Owner ✓� � D /I% c? y d izn/W o ka/S / Kind of Building Used as To be completed about P� 0 -8 - Estimated Cost, $ / • ,5_Z 40 Old—New. Building Permit No. Permit No. DESCRIPTION OF WORK HEATING or POWER PLANTS --Steam, of Wate Warm Air—No 01V e. Trade Name 1_31*se�^ZeSize No /O - Capacity ® Sq. Ft. E.D.R 9A, ®®D.4T,BTU H.P. Total Connected Load ;720 Kind of Fuel& -a Z-, 41 a S BURNER — Trade Capacity. (REMARKS -OVER) .40P42 4M Size No Sq. Ft. E.D.R BTU H.P. ADVANCED HEATING. & AIR CONDITIONIN116 INC. 4709 N. E. MAIN STREET Signed IAINNEAPOLIS 21, NUN& _ ,3 au57 Business Phone No Room�Lenath� �' Width ✓l/ Ieiaht =11 / FIA /_, JI.— RoomILenath ?_� Width /V—Height Windows and Doors—Crackage and Area 1 -.64.1 1 3 n -A - Width Height No. of Lineal ft, Area No* of pane of pane lights of crack sq, ft. D 9 t. y !o d J P 2 / -5-9,30- 2- `i-drwvA Width Height 'No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS MINNEAPOLIS, MINN. Weatherstrips A.S.H. .E. Guide Construction No. Infiltration Insulation WindowsI Doors Reference Out. Wall Int. Wall Ceiling Roof Floor Kind How. Applied Yes—No Yes— o_ 19` 117 _s- 7. 0 Room�Lenath� �' Width ✓l/ Ieiaht =11 / FIA /_, JI.— RoomILenath ?_� Width /V—Height Windows and Doors—Crackage and Area 1 -.64.1 1 3 n -A - Width Height No. of Lineal ft, Area No* of pane of pane lights of crack sq, ft. - 30, 7-0 /0 y !o d J P 2 / 5-0 ® Width Height 'No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. 3(,1 JCoef.j Btu / (° Coef. Btu Infiltration Glass / fa Z SS'0 W 4fj p Glass Net exp. wall 3,2_110 117 _s- 7. 0 Exp. wall / L 9;'7 0 Ceiling 10 2-2- 17 Net exp. wall j s % lr 0 Floor 12 - Int. wall Ceiling 30 3 Ceiling Floor Total Btu. Qv_ 0 0. Required sq. ft. E.D.R. or sq, ins. W.A. Leader area 12 FI I M_ -1 f7 _ d R__ I 1 e,,,sth ® -� S W;.lth a i-lo;el,t M' Windows and Doors—Crackage and Area 1 -.64.1 1 3 n -A - Width Height No. of Lineal ft. Area No. of pane of pantie lights of crack sq. ft. 34, !i 0 /V 21-0 5-0 ® Width Height 'No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. �alps O 2-0 JCoef.j Btu Infiltration 2- C' Coef. 'goo Glass / fa S- SS'0 Exp. wall 26 Net exp. wall 3,2_110 Z- 9('0 Int. wall / L 9;'7 0 Ceiling 10 2-2- 17 Floor j s % lr 0 Total Btu. Icequlrea sq. it. c..u.n. or sq. Ins. w.t►. Leaser area I .•'f i"1 �' e n 11 .1 0 10/• .1.1 70 r r • 9 i Ll . .. 4 `y'. 'f%ej..4.4.4,4 1 -.64.1 1 3 n -A - a iG.a4.4 Windows and Door s-Crackage and Area 21-0 5-0 ® Width Height 'No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. �alps O 2-0 Coef. •-- Coef. Btu Coef. Btu Infiltration ea -15 0 0 Glass p Exp. wall 3,2_110 Exp. wall 9('0 Net exp. wall / L 9;'7 0 Int. wall 10 2-2- 17 Ceiling 4 2- 9 0 Int. wall Floor S j Total Btu. - - — -[f) 13 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Windows and Doors—Crackage and Area - _ Width Height No. of Lineal ft. Area No. ofpaneof pane lights of crack sq. ft. e Z / 21-0 5-0 ® �, Coef. •-- Coef. Btu Infiltration 0 Glass 1a -15 1.)990 Glass p Net exp. wall 3,2_110 Exp. wall 9('0 Int. wall Net exp. wall 10 2-2- 17 /0 4 2- 9 0 Int. wall Ceiling 30 3 Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area I / Fl_I /eO%-/ 07- i Rnom I Length i ,� -!!- Width Height e..a_ Windows and Doors—Crackage and Area - _ Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. 2-2— Coef. Btu Infiltration 2- 3: 0 Glass 1a S., 6 Exp. wall p Net exp. wall /0 9('0 Int. wall Ceiling 10 D Floor Total Btu. CPS Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 9 LI ..-- Pa i R,...... I r e.4e.t14 > a Wrlth 0 144;aht R•= "1 a OJ ____ ___ ___® Windows and Doors—Crackage and Area - _ Width Height No. of Lineal ft. Area NO. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration j , 1,030 Glass 1a s 3 Exp. wall Net exp. wall p / Int. wall Ceiling 10 D Floor Total Btu. a 16, o 90 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area (P1 r • ID•56 v HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS Weatherstrips A.S.H.V.E, Construction No. Guide Windows I Doors Reference Out. Wall Int. Wall Ceiling I Roof Floor Yes—No Yes— 0 19_ FlLr-Room I Length z Width z — Height /A -2--II FLI Windows andboors—Crackage and Area .�c/Nl�✓/a 1-/ Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Width Height No. of Lineal f . Area No. of pane of pane lights of crack sq. ft. 17 3 Z ®2/ g— 2— C3 ^` Z_ Coef.1 Btu Infiltration Coef. Btu Infiltration U Net exp. wall j p 0 Glass Ceiling YS -9 G Exp. wall /2- 9' Net exp. wall /0 7 / 0 0 Int. wall F& /cc) I 9 ( 0 Ceiling 90 0 37'(, o Floor 9 t, ,5 0 I otal Utu. x I Z — Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.1 Room I Length / 2, rE- Width Height Flo �- Windows and oors—Crackage and Area .�c/Nl�✓/a 1-/ Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef.1 Btu Infiltration Coef. Btu Infiltration z o Net exp. wall 1 S (� 0 0 Glass Ceiling g-15 6, Exp. wall Net exp. wall Int. wall /0 7 / 0 0 Ceiling F& /cc) I 9 ( 0 Floor I f(- I 3 YFO Total Btu. 64 'g-7 C2 Required sq. ft. E.D.R. or sq'Ms. W.A. Leader area F1.1 Room I Length Width Height Windows and Doors—Crackage and Area .�c/Nl�✓/a 1-/ Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef.1 Btu Infiltration Glass Exp. wall Net exp. wall 1 S (� Int. wall Ceiling Floor 6, Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area MINNEAPOLIS. MINN. Insulation Kind How. Applied Room I Length Width Height Windows and Doors—Crackage and Area .�c/Nl�✓/a 1-/ Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall 1 S (� Int. wall Ceiling Floor 6, Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area r Fl.l Room I Length Width Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Requited sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.1 Room I Length Width Height Windows and Doors--Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Coef. Btu Infiltration Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Total Btu. Required sq. ft.:E.D.R. or sq. ins. W.A. Leader area S-9050 .City, of Fridley, Minn. 6431 .University Ave. N. E., Minneapolis, Minn. 55432 BUHDING PERMIT Owner:. - SlP.,a7, Barrott_ Builder Same Address _._..j.LU.0 dj,9on Street N.E. Address Same LOCATION OF BUILDING No.._5830— Street __ 2nd Street N.E. part of Lot Lot 1011_ Block 24 Addition or Sub -Division .._.. Hyde Park Corner Lot _.____. _ Inside Lot R Setback Sideyard Sewer Elevation Foundation Elevation To be Used as: Fire Repair (One Apartment Only) Front _ _ Depth . - Height Sq. Ft. Cu. Ft. --- Front — Depth Height Sq. Ft. Cu. Ft. Type of Construction R -rams Est. Cost To be Completed 'DP.r__3l . 1971 M.000.00 Require fire blocking & fire doors (2-1 Hour) In consideration of the issuance to me of a permit to o the building described above I agree to do the proposed work in accordance with the description abov and in complian with 21 provisions of ordinances of the city of Fridley. .00 State Surcharge In consideration of the payment of a fee of $ 24.00 , permit is hereby granted to Glenn Barrott 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, iu all Work done in, around and upon said building, or any part thereof, shall conform in all respects -to the ordinanCeas 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. �l HANK MUNICH Building Building Inspector NOTICE: This permit does not cover the construction, installation for wiring, 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 NAME �� /� /�' -) /� /BUILDER:_ �� /✓f ADDRESS: I 30 M 04(e, d T,10 ADDRESS : NO:. STREET: S� 3 o - Z -vi c) S l LOT: Ib "� i % BLOCK: oZ `f ADDITION:- L V L /Z L. 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: 6 N c Art' to / Z G'Front: Depth: Height: Square Feet: Cubic Feet: Front: Depth: Height: Square Feet; Cubic Feet: Type of Construction: R C. io, 0 or Estimated Cost: $ g, o D To Be Completed: D, C 3 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: /I- D-3- (See Reverse Side For SIGNATURE• Additional Information.) ` �J i �l `y- - 6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432 January 19, 1979 r. Glenn Barrott 30 - 120th Lane N.W. Don Rapids, MN 55433 TELEPHONE (612)571-34.50 Repair & Maintenance of the Rental Property Located at 5830 - 2nd Street N.E., Fridley, Minnesota Dear Mr. Barrott: It was confirmed by a routine on-site inspection on January 18, 1979 that the above listed rental property was being maintained in violation of Chapter 220, Residential Maintenance Code, of the Fridley City Code. The inspection on the above date found the following list of deficiencies which must be corrected. 'It is the City's hope that similar or other deficiencies in apartments that were not inspected will be corrected as needed. EXTERIOR Provide and maintain a screened enclosure to conceal the refuse container from view by August 1, 1979. In addition, a hard surface base should be provided for easier handling by the hauler. FURNACE/LAUNDRY ROOM 1. Immediately discontinue the practice of propping open the fire door.2 2 2 71 A— 2. Immediately discontinue the use of an extension cord to run from the east wall, across the ceiling to the west wall, outside through a hole in the wall, and to the gas grill. Z,, -LI ?,I (,-r 3. Repair or replace the crimped vent for the gas dryer. -Z-7_ 6 fC APARTMENT #3 No orders this date. A reinspection will be conducted on or about February 12, 1979 to determine compliance. We are confident in your cooperation on these matters and if any questions or problems arise, please feel free to call on us at 571-3450, extension 164. Failure to abate these violations may result in this matter being turned over to the City Prosecutor for his legal consideration. Sincerely, STEVEN ON Environmental Officer SJO/mh 7-L - _ i 5.9 0 IVO jh, /V� VVI-��� y�L-Ij i� AV J jr AeZ71 . , /177 �+ �}4a+,4)March 14, 1981 s f� 6431 UNIVERSITY AVENUE N.E., FRIQLEY, MINNESOTA 55432 Mr. Glenn Barrott 530 - 120th Lane N.W. Coon Rapids, MN 55433 TELEPHONE ( 612)571-3450 Res Repair & Maintenance of the Rental Property Located at 5830 - 2nd Street N.E., Fridley, Minnesota. Dear Mr. Barrotts It was confirmed by a routine on-site inspection on March 13, 1980 that the above listed rental property was being maintained in violation of Chapter 220, Residential Maintenance Code, of the Fridley.City Code. Although the general condition of the property was good, the inspection on the above date found the following list of deficiencies which must be corrected. Any repairs or improvements must be completed in a workmanship like manner. It is the City's hope that similar or other deficiencies in apartments that were not inspected will be corrected as needed. EXTERIOR Provide and maintain tight fitting screens on all openable windows. COMMON AREAS Current apartment license must be posted in a conspicious location. y _ 4?� LAUNDRY/FURNACE ROOM Repair & maintain the leaking hot water faucet for the laundry sink. A new handle should also be provided. el 'q 'F'�,< APARTMENT #4 "g As of January 1, 1980, City. and ate Fire Codes require that all rental properties have products of combustion detectors installed to protect the tenants. Please contact the Fridley Fixe Department for the exact specifications they require.. A reinspection will be conducted on or about April 7, 1980 to determine compliance. We are confident in your cooperation on these matters and if any questions or problems arise, please feel free to call on us at 571-3450, extension 164. Mr. Glenn Barrott March 14, 1980 Re: 5830 - 2nd Street N.E. Page 2 Failure to abate these violations may result in this matter being turned over to the City Prosecutor for his legal consideration. Sincerely, STEVEN J, OLSON, R.S. Environmental Officer SJO/mh 53G^ /2 0 ri-4 l�m A/, Le � f -t-12 33 i `7 - - I- "4 ,' ate.,Ak, III --7Z� t 'I I ii July 6, 1981 Glenn Barrott 22600 Typo Creek Drive Stacy, MN 55079. He: Exterior Site Improvements for the Residential Rental Property Located at 5830 2nd Street Northeast. Dear Mr. Barrott: On at least three occasions in the past, the City, has brought to your attention the need for some minimal exterior site improvements for the -apartment building located at the above address. A reinspection has determined that the following items continue to need corrective action: 1. Provide and, maintain striping for the parking lot to indicate individual parking stalls. A parking stall must, be a minimum size of 10t x 201. 2. The asphalt surface of the parking lot and driveway has the top aggregate exposed and consideration should be given to seal coating or having an overlay applied. At this time, the City must require that the above listed items be corrected or improved and that you provide us with a proposed plan and time table for completing this work. Please return your response and license application no later than August 109 1981 to the attention of the Code Enforcement Department. Your positive response to this needed improvement will assist us in evaluating your application to renew the license for the 1981-82 licensing period. We are confident in your cooperation and if any questions or problems arise, please contact me at 571-3450. Sincerely, Steven J. Olson, R.S. Environmental Officer SJO sar Eno: License Renewal Application SUBJECT P R City of Fridley 2 9 004 AT THE TOP OF THE TWINS B U I L ®I BUILDING G ®E R I E, 0 ®1 A REC O. � `L ____�_ COMMUNITY DEVELOPMENT DIV. d �f r " PROTECTIVE INSPECTION SEC / / (�. 1 � = CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910415 3/15/99 JOB ADDRESS 5830 2 Street NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 10,11 24 Hyde Park SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Violet Woods 5830 2nd Street NE, Fridley. MN 55432 586-9534 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Same 4 ARCHIT@T OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING 4-flex 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION Ck REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof Building (25 Sq ) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Call for building ice and water inspection or take pictures before covering. SEPARATE PERMITS ARE REOUIREO 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 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 4 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 $2,142 $1.07 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 FE TqftALFEE 77.96 SIGNATURE OF CON'RACTORORAUTHORIZED AGENT iDATE. \If C b t S�_ HEN PORO VALI T THIS IS YOUR PERMI �— — a u-4 "Le3 BLD -NS5i41gAfE S.GNATUREOFOwNEAoFOWNERBWLDERi �DATEi Prepaid Plan Check $ Effective 1/1/9q Estimated Cost $ CITY OF FRIDLEY Receipt # R-3, COMMERCIAL & INDUSTRIAL BUILDING PERNIIT APPLICATION Construction Address �� �y 2.n d ?oning Til Owner & Address K ® " DOA f �f 30 -L wl Sl-, q, 6-, Tel# CONTRACTOR & ADDRESS O W 4-e- l- Tel# Architect Reg.# Engineer -eg.# BUILDING CONSTRUCTION TYPE OFF WORK [] New [I Addition [I Alteration -Describe 5A f OFC. AREA: Length TO Width Yd Height Sq. Ft. WHSE AREA: Length Width Height Sq. Ft. OTHER AREA: Length Width Height Sq. Ft. APPLICANT \ /;. ®( C,4 "'d "Cj Tel # Date 3 -IS-21, VALUATION Sq. Ft. x $ Cost/Sq. Ft. = Valuation $ ) Sq. Ft. x $ Cost/Sq. Ft. = Valuation $ ) _ $ / Sq. Ft. x $ Cost/Sq. Ft. = Valuation $ ) TOTAL VALUE Building Use Construction Type Occupancy Group Air Conditioning [] Yes [] No Fire Protection Provided 0 Yes 0 No Performance Bond Amount $ See Reverse for Schedule Received 0 Yes 0 No Permit Fee $ Y-, 76 Plan Check $ Fire Surcharge $ J./ State Surcharge $ SAC Charge $ Erosion Control $ Park Fee $ Spec. Assessments $ Driveway Escrow $ TOTAL $, See Fee Schedule on Reverse Side In Excess of Prepaid Amount - See Reverse Side .001 x Permit Valuation (1/10th 0 $.50/$1,000 Valuation (See Sched. for > $1 Million) $1050 per SAC Unit (Plans to MKCC for determination) $450.00 Conservation Plan Review Fee Determined By Engineering Agreement Necessary ❑ Not Necessary 0 feet x $13.50/foot — ATTACH STIPULATIONS l SUBJECT P MIT NO. City of Fridley 29698 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. J f PROTECTIVE 'l : 1 CITY HALL FRIDLEY 55432 16 NUMBER RE DATE PAGE OF APPROVED BY L.__. 612-571-3450 910415 6/16/99 JOB ADDRESS 5830 2nd Street NE . 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 10, 11 24 1HYde Park SHEET 2 PROPERTY OWNER MAIL ADORES$ ZIP PHONE Violet Woods 586-9534 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Western Construction Co. 4301 Hwy 7 Ste 115- 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Residential CLASS OF WORK NEW O ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Construct a 42' x 22' garage 9 CHANGE OF USE FROM TO STIPULATIONS Provide a hard surface driveway located at least 3 feet from the lot lines. Verify property lines prior to concrete placement. Provide 1 HR firewall on garage side next to apartment.A lar_ Before digging call for an utlwq locations 454.0002 ?E PERWM REQUM rMREQUIRED BY LAW WIRING, HEATINC4 PLUMBING AW SIGNS. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL. PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 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 $17,556 $8.79 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 $262.25 Fire SC $17.56 PLAN CHECK FEE /TALFEE SIGNATURE OF CONTRACTOR ON AUTMONIZE04GENT IDATEI p. ENPR PER BLDG I So - LY ATED THI S X.PERMIJ ., OATE S,GNATURE OF OWNER..F OWNER BUILDERI IDATEI l NEW ADDN [ ] ALTER [ l ConstructionAddress : CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Legal Description: Ao% /®,i"v a Owner Name & Address: Contractor: 4-)eST Address: 4 �'4cs S��-1-1141 0 GlL az/1 sUr4x iZ Effective 1/1/98 W �� 0- f�1� j�-- Tel. # X86 MN LICENSE # 42-3A Tel. # C> --P-6 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 °`�a Width ;,)c;t- Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft.� OTHER: Construction Type: -9 A Estimated Cost: $ (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: A ` APPLICANT: Tel. #fS�� CITY USE ONLY Sewer Main Charge $ Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1000 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] a TOTAL $ STIPULATIONS: cn� 5 Permit Fee $ Fire Surcharge $ 7� State Surcharge $' s19 SAC Charge $ License Surcharge $'°�: �v Driveway Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1000 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] a TOTAL $ STIPULATIONS: Jun 11 99 03:56p Western Construction HARVEY A. CARTWRIGHT AKOUA COUNTY SURVEYS Hr6NNEPIN COUNYY SURVEYS MINNEAPOLIS SURVEYS 6410 PALM STREET N W SUnstr 6.71395 I11FhER INDUSTRIAL - JUOICIAL BUSINESS - YOPOORAPFIICAL CITY LOTS - PLATTING Ju.1i:.p Juhman 5 f plrUrm vk I 612-920-1172 CMTWRIGHT & OLSO Y LAND SURVEYORS REGISTEREO UNDER LAWS OF STATE OF M114NEUCTA LICENSr.O BY OROINANCC OF CITY OF MINNEAPOLIS 326 PLYMOUTH BUILDING FEO@RAL 8 E721 HENNEPIN AT SIXTH , MINNEAPOLIS 3. MINNESOTA �ttr�urpor's �rrtiitcatc Pot �. GM$ININ;i TME RECGRI'S OF �. E, HILL.. CIVIL ENGINEER QSYwBL/gK[O tag® C. F. SANDHOFF CIVIL F. I'I CiINEER 16"4146LI,IILL loon JAMES NELSON sURvEYOR tom!♦nLInMIL tyj` METROPOLITAN LAND SURVEYORS. Lnl.yuu„co ,a'. l �I°l 1 U::�rr3SaLa1dt 7 u :-vt,, J l ;.nla ?.°.., njoric `+::, rY�•..11, P .r e- xUrv,15-id m tl11J j.ut:: [ia r DC City Address -5936 o7 NO <5 7-. Al, _ Customer 1/16/-6r, Am44.5 Phone h: L/a, �-Bb- 95.3 `l_ w: Salesman G/W#d4) i Permit # Garage: x APO l x ire mesh 1/2" Rods Conduit Sandfill � Inches Driveway:/a?C/ayl fav '�rya'� Overhead door sizeZ'YJ 7X 5 Cement EAsphalt Sidewalk Excavation Waterproof: estem Owner Offset L LGentered 1 Offset R Backfill: Westem caner Block 6° 8° 12" Service door 2'8 L3'01 Right ZGE) WESTERN Comm" Cron co. ,• 4301 Highway 7 Minneapolis MN 55416 920-8888 Fax 920-1172 Lot Size .5�0 X/d 9 H — Al l_ Rows: / Lt ! Rr / Rt / Ft Overhead door sizeZ'YJ 7X 5 1 Offset L LGentered 1 Offset R Service door 2'8 L3'01 Right ZGE) 0 �� RO 2'8 = 37" 3'0 = 41" v Removal ffSPAIAGT Garage Slab LDrivewayj Ilk Western / Owner �urvey�,QN Stakes J(show location) ati3O i I IbLel- Vlc-)ob5 HARVEY A. CARTWRIGHT ANOKA COUNTY SURVEYS HENNEPIN COUNTY SURVEYS MINNEAPOLIS SURVEYS 8410 PALM STREET N W SUNSIT 47835 ONNER INDUSTRIAL - JUDICIAL BUSINESS - TOPOGRAPHICAL CITY LOTS - PLATTING u 'LLIj.:.r johm-oll 57r pl(Ijt#lvx., CARTMUGHT & OLSON LAND SURVEYORS REGISTERED UNDER LAWS OF STATE OF MINNESOTA LICENSED BY ORDINANCE OF CITY OF MINNEAPOLIS 326 PLYMOUTH BUILDING FEDL-RAL 8 8721 HENNEPIN AT SIXTH - MINNEAPOLIS 3. MINNESOTA Ctrtificatt G%ifsoNIN" THE RECOROS OF J. E. HILL. CIVIL ENGINEER LbIABLIGHea toga C F.SANDHOFF CIVIL ENGINEER LbrAk,LIb,jkL, 190, JAMES NELSON SURVEYOR tttl%bLlbHEL Iml,, METROPOLITAN LAND SURVEYORS, Lt-TAuLlbnEgi 2'.'309 7 Lots J.:)) .n,, rl tl,.LZ3E.Bil,ii 7Vof 1.9 c (316\1 -2,q t 0 I SIG Nkul", Construction Details Jtaib I • 4" floating monolithic cement slab w/8" thick, 6" wide perimeter • minimum 4" sand fill • 4000#/6 bag mix/4% air -entrained + 6x6x10 wiremesh reinforced • double U2" rerod around slab perimeter • 1/2" x 9" anchor bolts, embedded 7", 6'0 oc and 110 from corner/sill plate joint • 2' apron Frame • 2x4 treated bottom plate • 2x4 wall studs 16" oc, triple stud corners • overlapped double 2x4 top plates w/double lapped corners • double 2x 12 overhead door header • double 2x6 service door/window headers • 7/16" OSB wall sheathing Siding • .44 mil Vinyl siding Roof • 4/12 engineered factory trusses 24" oc • 7/16" OSB sheathing w/H-clips • 235# asphalt shingles e 15# felt underlayment Openings • 2'8x6'8 steel service door • 1W. steeI overhead door 0 allnninum slider window RO 46" x 20-3/4" ., city AV.DZf Y Address X836 .J *0 <S7: Al, E _ Customer Phone h: LIA, .586 9.53!_ w : Salesman L�lavnDa� i Permit # Garage: as I x APO I x.� / 4. ire mesh 1/2" Rods Conduit Sandfill G t/ Inches Driveway Ua? °/ail /'aD X V.7'J Cement Asphalt Sidewalk AMA, Excavation Waterproof: estem Owner Backfill:Western caner Block 6° 8" 12" Rows: / Lt / Rr / Rt / Ft Overhead door sizeLyJ 7X 1F Offset L LGentered J Offset R Service door 2'8 6'01 Right ZGID . RO 2'8 = 37" 3'0 = 41" Removal f4SP)/1*1T Garage Slab Western / Owner Driveway /Survey ) ^ , Stakes , (show location) 6 ,.._ - WESTERN COM:TRUCTIOM Co. ,• -- ---- 4301 Highway 7 Minneapolis MN 55416 920-8888 Fax 920-1172 .�, 5 Lot Size .6'rf> XM9 U3 _D�%UEk1�4�1. Y Lao' *Y., J 96, T,e.ff,' T ov E- I�rc - � () L terI�ya� 5 HARVEY A. CARTWRIGHT ANOKA COUNTY SURVEYS HENNEPIN COUNTY SURVEYS MINNEAPOLIS SURVEYS 8410 PALM STREET N W SUN%tr 4.7655 OMNFLR INDUSTRIAL - JUDICIAL BUSINESS - TOPOGRAPHICAL CITY LOTS t- PLATTING v LL� 1'.71 cjU! Yl! U11 !�;/ #1(/J( #I vK, CARTMUGHT & OLSON LAND SURi EYOR.S REGISTERED UNDER LAWS OF BTArx OF MINNESOTA LICENSEE) BY ORDINANCE OF CITY OF MINNEAPOLIS 326 PLYMOUTH BUILDING FEDERAL 8 8721 HENNEPIN AT SIXTH • MINNEAPOLIS 3. MINNESOTA +r<<rurpor's Certificate a ,f 6�N'rrwrinall %,qi .G%ir=,NIN1.i THE RECORDS OF J. E. HILL. CIVIL ENGINEER Lb7ARLIBNED leve C. F. SANDHOFF CIVIL ENGINEER Lb rAbLI9MLIj 19Ob JAMES NELSON SURVEYOR t:1AbLIbMEL 1YLt METROPOLITAN LAND SURVEYOR5. inlAbus..ED 1r.er e N t t:1 ..1 f'. ; .I. y. 0. il': CU:.^:7?'1ll�c^ I,:LIi:? CI tr Lots 30 :.7111 � .� a loalf r. 'UT'V",312:} i7`r j,":1.' this �.1it:: 'I•r 0f Ci1Ln, i•qr l � n CAIq G�� a(6�)n -2,to i SIGNlU'�•, r1lP rARTWi?Ir HT n1 _. _ N1-11111114 ' Construction Details Slab • 4" floating monolithic cement slab w/8" thick, 6" wide perimeter • minimum 4" sand fill • 4000#/6 bag mix/4% air- entrained • 6x6x10 wiremesh reinforced • double 1/2" rerod around slab perimeter �t • 1/2" x 9" anchor bolts, embedded 7", 6'0 oc and 1'0 from cornerisill plate joint,w,� • 2' apron Frame • 2x4 treated bottom plate ✓°� • 2x4 wall studs 16" oc, triple stud corners t0 • overlapped double 2x4 top plates w/double lapped corners • double 2x12 overhead door header • double 2x6 service dcor/window headers • 7/16" OSB wall sheathing Siding • .44 mil Vinyl siding Roof • 4112 engineered factory trusses. 24" oc • 7/16" OSB sheathing heathin '%H -clips • 235# asphalt shingles • 15# felt underlayment Openings • 2'8x6'8 steel service door • 16x? steel overhead door • al nninum slider window RO 46" x 20-3/4" ,ITY OF FRIDLEY INSPEC"I i )N DIV. ;431 Unlversity;,Ave NE :ridley, MN 55432 r63-572-3604 Urinal Floor 1 Floor 2 Floor 3 (Floor 4 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" APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR >,•J,: :, MFloor Auto. DrainW er "Shower Tray NO. RATE TOTAL JOB ADDRESS Gas Dryer• Back Flow Preventer Re uired )Yes () No TYPe � �XL- Effective On Jan 1, 2001 Gas E Heater Elec $ 7.00 The undersigned hereby makes application for a permit for the work herein $ 4.00 specified agreeing to do all work in strict accordance with the city codes $ 5.00 and rulings of the Building Division, and hereby declares that all the facts $ 7.00 and representations stated in this application are true and correct. $ 7.00 $ 7.00 $ 7.00 $10.00 Owner $ 7.00 $10.00 Building Used As $10.00 Estimated Cost PERMIT NO. $10.00 'du $15.00 PLUMBING Reinspection Fee $47.00/1 -Ir SIGNED BY ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance Approved By TEL N0. ®f Rough -In Date Final Date' State Surcharge L--50 u IILIRIII 11111 LE2 ApNY PLUMBINGIGAS RMIT IS CCS TOTAL FEE $ >pJ-US THE S.50 STATE SURCHARGE COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furance, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes( ) No( The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes ( ) No The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturers specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes ( ) No The existing combustion air is sized and installed to meet the current codes and manufacturers specifications. Yes ( ) No When required to Install a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes ( ) No When Installina a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes ( ) No Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes () No Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type BTU Input Fan Assisted or Nat Appliance #2 Type BTU Input Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances _ Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe HEATING CO: Signed By: Date v `" -­ V v. " From: 6127246656 Pa�e`1/2 �VvDate: 1/21/2009 3:38:50 PM -` Building MECHANICAL Permit No.: b Inspections RESIDENTIAL APPLICATION Received B : 763-572-3604 CITY OF IDLEY Da�AN 1 FR 763-5e2-4977 FAx F , E-MAIL ADDRESS SITE ADDRESS 9KNIO .57 THIS APPLICANT IS: DOWNER CONTRACTOR PROPERTY NAME: ADDRESS:. �g� � S?' /!��' CITY AV 0J_ STATIC&XIP� SIZEIBTU f0,MW — TENANT MODEL: SIZEBTU PHONE: CONTRACTOR COMPANY NAME: NOTE: _FIREPLACE (GAS) $15.00 SEPARATE CITY CONTACT PERSON: LICENSES ARE STATE LICENSE tlfi�. ' EXP DATE REQUIRED FOR GAS AND HVAC. ADDRESS: 3.�'� .�+%��l�CQ �' jd CITY %3 STATF.A.EZIP r� SUBMIT COPY OF BOND PHONE jrp� % FAX C42- 721- "Sto 1- ANDINSURANCE ANDINSURANCE POOL HEATER $35.00 PERMIT TYPE XSINGLE FAMILY O TWO FAMILY O TOWNHOUSE TYPE OF WORK: O NEW REPLACEMENT O ALTERATION/REMODEL DETAILED DESCRIP !QN OF WORK &44e4M J02ge' %age GG PER MS 168.665 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) OR 0 ov Labor cost under $300 = $15.00. Labor cost between $300 to $500 =cost of labor.ARW x .05 FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATETOTAL NUMBER OF EACH BELOW) Equipment Installed MFG: 6F&�y MODEL: a SIZEIBTU f0,MW — MFG: MODEL: SIZEBTU MFG: MODEL: SIZEBTU NC $25.00 _FIREPLACE (GAS) $15.00 CTAS RANGFJOVLN $10.00 IR TO AIR EXCHANGEER $15 —FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 OILER $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 fDAS PIPING $10.00 77 -.._,VENTILATOR $15.00 Permit Fee $ Surcharge $ .50 TOTAL DUE $ MINIMUM $15.50 Number of fixtures @ $10.00 x $10.00= $ Number of riixtures @ $15.00 x $15.00 = $ OR Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 x$35.00=$ ZE'L State Surcharge ='.t 50 MINIMUM $15.50 Total = $ Ic. So THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a mechanical permit and I acknowledge that 1ho information above is complete and accurate; that the work will he 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 in the case of all work which requires review and approval of plans. 100. SIGNATURE OF APPLICANT PRINT NAMEX �/4W&CLN DATE /d/moi APPROVED BY DATE City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432