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PRE 2010 DOCSI,! I � Village of Fridley,, 311nn. �p o BUILDING PElli1�IF l� O 8 0 Office of INSPECTOR OF INGS I Architect Fridley, Minn., Builder LOCATION OF BUILDING _. No. Street ' e Part' of Lot Lot ' �^ it Block Addition or Sub -Division, 7, �` 9 �- DESCRIPTION OF BUILDING Front==� Dep�h Height Stories/ Y-- Manner of Construction -.11A To be used as C'e- , `il--tea "° To be completed `® �` °` Estimated Coat ti I Permit is hereby wanted to I Ft the building described in the above statement. This permit is granted upon the express condition that the person to whom it is granted, and his agents, employees and workmen, in all the work done in, round and upon said building, or any part thereof, shall conform in all respects to the ordi- nances of Fridley, Minn., regarding the construction, alteration, maintenance, repair and moving of buildings within the city lits, and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. Inspector of Buildings. In consider; the above perm above set forth sworn, I hereby true as therein i Subscribed day ti AGREEMENT AND SWORN STATEMENT to of the issue and delivery to me by the Inspector of Buildings of Fridley of I hereby agree to do the proposed work in accordance with the description I according to the provisions of the ordinances of Fridley, and, being first duly ite and say that the facts stated by me and contained in the above permit are sworn to before me at Fridley, Minnesota, this Q.D. 1 LSM._ City of Fridley, Minn. 11N9 10396 BUILDING PERMIT Date: September 8. 1969 Owner: David. Walker Builder Sus sel Company Address 4868-2g Street N.E. Address 1850 Como AV-Qnue, LOCATION OF BUILDING No. 4$ 6 8 _street2a Street N . E, part of Lot Lot __ Block Addition or Sub -Division Corner Lot Inside Lot _ _ Setback Sewer Elevation Sideyard Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Base, Alters, Front Depth Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction — Frame Est. Cost ..._.$.BOO 0_,–Q -Q __ To be Completed Nov- - 1-5,__196-9 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 setforthand=mipltanceth null visions of ordinances of the dty of Fridley.'� In consideration of the payment of a fee of $18-Q_Q_.._, permit is hereby granted tOS-U S e� I r ammo Y to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. n CLARENCE BEL LE NOTICE: 'fids pem* don not cover the eonstroction, iestaMon for whing, phomhing, gas heating, sower or water. Be core to as the Building Inspector for separate permits for these items. APPLICATION FOR.BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWATEft'S ® V.4 2 BUILDER ADDRESS 4£SG e 2 ST Xl� ,,!f- ADDRESS LOCATION OF BUILDING NO�6-'R STREET LOT BLOCK ADDITION OR SUBDIVISION CORNER LOT INSIDE LOT SETBACK SIDEYARD SEWER ELWATION TOP OF FOOTING Applicant attach to this form Two Certificates of Survey of Lot and proposed buildinglocation drawn on these Certificates.. DESCRIPTION OF BUILDING To Be Used As: ,,Us�rT• .q�T��,��iv�ri ,_Front Depth Height Square feet Cubic Feet Front Depth Height Square feet Cubio Feet Type of Construction Estimated Cost r To Be Completeda The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE �S�G SIGNATURE (Schedule of Foe Costs can be found on the everse-Side,) P.M. `7 1 -(A m -i r M LO L9 °$��� q.tt � � QJ � • � wA� �.rs. ! USE=- t �l.-No 2nd 3rd 4th ' Fn![es® Co rainga �eills ee..es � • now .018cesepow PARTIAL RATE SCHEDULE ALVMBINt,I FIXTURE RATES- NO. RATE TOTAL Number Fixtures ................ --x52.06 $ Future Fixture Opening .... a ...... x $1.50 i New Fixture Old Opening .......... x $1.50 i Catch Basin .................... x $3.25 _ Water Beater 'Up to 89,000 BTU) .... x $3.00 $ New Ground Bun Old Bldg......... x $3.225 S Electric WaterHeater. . . . . . . . o o . o • • a $too $ GAS FITTING FEES. NO. RATE TOTAL 1st3Fixtures ..•.••••.••••.•.•• x$100 $ Additlonal Fixtures..t -. x $ ..75� $ Mt... �........... Gas a to 180.000 BLV o . •. e o . . • ... x $5.00 $ State Surcharge $ .50 REPAIRS A AL 'TI® ter ft Cc&_ Install Gas mh:........................$ 5.50 Description ®1®.L TOTAL rZE 8 5.50 City of Ridley: The undersigned hereby makes application for a permit for the work herei< specified, agreeing to do 0 work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the favi and representations stated in this application are true and correct Fridley. Wnn 10/11172 David 14alker Kind of Building Frame Used as Res. To be completed about 10/16/72 Estimated Cost, S 10.00 Old $New. Building Permit No. permit N . Signed L::Ii� By MINNEGASCO Business Phune No ROUGH � FINAL r/�� 97-84-h16051 CITY 6F FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT PARTIAL RATE SCHEDULE at PLU.\3ING FIXTURE RATES: NO. N m TOTAL .V ..: er Fixtures x u $ n 0 $2.00 Water e m m o Catch Basin m w rn c ee 0 $ u A W •+ ++ 0 U r+ a. c' + w to $10.00 Heater O Y .a R $ C: H C7 X 4j $4 U fa 4 C a O .4 GAS FITTING FEES: N 1st ? fixtures x -, $ Additional Fixtures x $1.00 $ Cas Range to 199,000 BTU x $10.00 $. REPAIRS & ALTERATIONS First $100.00 O $5.OQ $ $2.00 O State Surcharge vj TOTAL FSE rC N N +� h .C+ u I4 a r. c ..i ,s y a s.i o a. .00 CA .O -I a rd u w p �0 a o a � u`� o as lee L 1'_s�TT 1 �. tad 4 1 3rd ; I HEI (R) - rFlavare Connection Opening Connected with Sewer (;} - Now Fixture, Old Opening Water PARTIAL RATE SCHEDULE PLU.\3ING FIXTURE RATES: NO. RATE TOTAL .V ..: er Fixtures x $3.00 $ Fat.:re Fixture Opening x $2.00 $ New mixture, Old Opening x $2.00 $ Catch Basin x $5.00 $ :Cater Heater - to 99,000 BTU x $5.00 $ 100,000 B_J to 199,000 BTU x $10.00 $ Water Softener x $7.00 $ New G=round Fin Old Building x $5.00 $ Electric Water Heater x $5.00 $ GAS FITTING FEES: 1st ? fixtures x $3.00 $ Additional Fixtures x $1.00 $ Cas Range to 199,000 BTU x $10.00 $. REPAIRS & ALTERATIONS First $100.00 $5.OQ $ each add. $100.00 or fraction $2.00 $ State Surcharge $ .50 TOTAL FSE s8.00 REINSPECTION FEE ($10.00) Job Address AAjxq --,2 ,_ Department of Buildings City of Fridley Tel. #571-3450 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 Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct Fridley, Mn. 10-20-80 , 19 OWNER KIND OF BUILDING fr USED AS res. TO BE COMPLETED ABOUT 10-27-80 ESTIMATED COST 50•00 OLD -NEW BUILDING PERMIT N0. PERMIT N0.k / '- ; / / /)- - ,O Signed By MINNOGASCO Tel. No. ROUGH INSP. Date FINAL INSP. 7 Z Date APPROVAL FOR PERMIT ��V MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 PLUS $.SO STI+TE SURCHARGE ra sueaEcr MIT NO. City ®f Fridley27410 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. �COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. '. / 330 NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 �..__ !l.' �•� 612-571-3450 910415 8/26/98 JOB ADDRESS 4868 2 1/2 Streqt t LEGAL . LOT NOBLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 3, 4 3 -1 011th SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Dario & Gloria Tion son - 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Milton Johnson Co. 525 Lowry A e7RI-954R 9083 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof garage (6 Sq) Tear -off; Soffit & fascia 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State BBuilding Code. Install soffit ventilation to meet State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING. HEATING, VENTILATING OR AIR CONDITIONING. THIS .PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 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 $2500, PERMIT FEE SAC CHARGE DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORM CE OF CONSTRUCTION. PLAN CHECK FEE TOT L FEE Ar,-()/ 3-50 J SIGNATURE OF CON ' RACTOR OR AUTHORIZED AGENT IDATEI N P QP BL )NSP VALID THIS IS U ERMIT �l E SIGNATURE OF OWNER OF OWNER BUILDER) IDATEI ra NEW [ I Effective l/l/97 ADDN " [• f • CITY OF FRIDLEY ALTER [Xl SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: 4868 2�,- St. N. E. Legal Description: Owner Name & Address: Dario & Gloria Tiongson ( same) Tel. # 571-6087 Contractor: Milton Johnson Co. MN LICENSE# 2083 Address: 525 Lowry Ave. N.E., Mpls. 55418 Tel.# 781-9548 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: gar.-oo , ** Construction Type: , sof. ` . , & fas. Estimated Cost: $ 4 C1Q Driveway Curb Cut .Width .Needed: Ft. (Fee + 6 Ft = Ft x Schedule on $ Backj'—��006) DATE: r APPLICANT: . J � � _ Tel781-9548 . # CITY USE ONLY Permit Fee $/ Fee Schedule on Reverse Side sire Surcharge c?, �Z� $ `- ,001 of Permit Valuation (1/10th%) State Surcharge $ 1S $.50/$1,000 Valuation SAC Charge $ $950 per SAC Unit License Surcharge- $ . (i $5.00 (State Licensed Residential Contractors) '3riveway 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 �'rtt'ULATIO,NS: SuBjECT City ®f Fridley 1 AT THE TOP OF THE TWINS BUILDING (W560 PERMIT r O. COMMUNITY DEVELOPMENT DIV. f PROTECTIVE INSPECTION SEC. I = I CITY HALL FRIDLEY 55432 ,"� NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910.F15 5/20/99 JOB ADDRESS 4868 2 1/2 Street NE 1 LEGAL LOT NO. I BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 3, 4 3 I Plymouth SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Gloria Tiongson 296-5231 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Milton Johnson Co. 525 Lowry Ave NE M is 55418 781-9548 2083 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION IP( REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house (15 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 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 $1285 $.64 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE 0 LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE F C NSTRUCTION $47.90 Fire Ci 1.28 PLAN CHECK FEE TOTAItFEE ' ?SIGNATURE Licens2ISI 5.00 $54.82 OF CONTRACYOR OR AuiHORiZED AGENT 16AfEt N eIROPE BL0 �NSo ALIDAT IS IRgERyIIT/,7/7 .:WIT gAtE SIGNATURE OF OWNER. -F OWNER BUILDER, IDATEi N EW [XT Effective 1 / 1 /97 ADDN [ ] 'CITY OF FRIDLEY ALTER 1. J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION �1 ConstructionAddress: 4868 2 1/2 Street N. E. Legal Description: Owner Name & Address: Gloria Tiongson (SAME AS ABOVE) Tel. #296-5231 Contractor: Milton Johnson Company MN LICENSE# 2083 Ad.dress: 525 Lowry Avenue N.E., Mpls. Tel. # 781-9548 _ Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width _ Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Construction Type: Tear off and _r . e-roJouse Estimated Cost: $ a P® (Fee Schedule on Back) Driveway Curb Cut Width.Needed: Ft. + 6 Ft = Ft x DATE: APPLICANT: Tel # 781'-9548 . CITY USE ONLY Permit Fee Fee Schedule on Reverse Side "ire Surcharge $ 2 .001 of Permit Valuation (1/10th%) State Surcharge $ o i -f $.50/$1,000 Valuation SAC Charge $ $950 per SAC ' Unit License Surcharge' $. 00 $5.00 (State Licensed Residential Contractors) driveway Escrow $ Alt. "A" or Alt. "B" Above :rosion Control $ x$450.00 Conservation Plan Review 'ark Fee $ Fee Determined by Engineering ;ewer Main Chargc $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ 5I1 -5—Z nPUI.ATIONS: . . .r CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-36U4 VAN: (7631 ADDRESS : 4868 2 1/2 ST NE PIN : 263024320030 LEGAL DESC : UNAVAILABLE LOT BLOCK PERMIT TYPE HEATING PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE ADDITION/ALTERATION PERMIT N 4 .: 2004-00469)�) DATE ISSUED: 04/09/2004 VALUATION NOTE: AIR CONDITIONERS CAN NOT BE PLACED IN A SIDE YARD WITHOUT WRITTEN PERMISSION FROM ADJOINING PROPERTY OWNER. COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A REPLACE FURNACE (WARM AIR, LENNOX, 70,000 BTU'S) AND AIR CONDITIONER # A/C UNITS 1 VALUE OF APPL OR WORK # FURNACES # GAS RANGES APPLICANT DAVES APPLIANCE HEATING & AIR INC 160137 AVE NE COLUMBIA HEIGHTS, MN 55421 (763) 781-6901 OWNER TIONGSON GLORIA & DARIO 4868 2 1/2 ST NE FRIDLEY, MN 55421 1 # GAS DRYERS 0 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of wort will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. Bldg HEATING PERMIT M 41MUM FEE FURNACE SHELL/DUCT WORK GAS RANGE FEE GAS DRYER FEE HEATING REPAIRS/ALTERATIONS STATE SURCHARGE, MECH FLAT AIR CONDITIONING FEE TOTAL PAID WITH CHECK # 34183 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. 0 0 0.00 30.00 0.00 0.00 0.00 0.50 25.00 55.50 W RID�NE BUILDING INSPECTION ty Av Fridley, MN 55432 763-572-3604 FAX 763-5711287 RATE SCHEDULE Residentlal Furnace Shell and Duct Work, Burner & also Replacement Furnace Gas Piping (New Furnace, Fireplace, Insert) Gas Range Gas Dryer *Air Conditioning -All Sizes All Other Repairs or Alterations (List on Back) 1% of Value of Appliance or Work Minimum Fee $15.00 for Residential or 5% of cost of Improvement whichever is greater Commercial/Industrial/Instft to Effective 4/1/2004 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS � i � D -A Fee Total $35.00_-- Building Used $10.00 $ ESTIMATED COST PERMIT NO $10.00 $ DESCRIPTION OF FURNACE AND BURNER $10.00 $ # of Heating Units _ Circle One (Steam) (Hot Water) rm A' Trade Name L Size No. $25.00 BTU HP EDR Fuel Total Connected Load $ Burner Trade Name Size No. BTU HP EDR 1.25% of Value of Appliance or Work (List on Back) $ Minimum Fee $35.00 for Commercial/Industriai/Institutional State Surcharge $ TOTAL FEE $ REINSPECTION FEE $50.00/HOUR *Air Conditioners can not be placed in side yard without written approval from adjoining property owner - copy to City 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. FAX# I10�_ FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE Approved b Rough -in Date Final Date THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED ('*'rl6"mnR VFNI, EVENT GQNNF=R Am rQMRt1SjIn1Y QR VFRIFICATInN When raglInnn;:..,,�w haranna, 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 plasticJPVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes { _ No.,K The undersigned also verifies that the replacement unit 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 Yes Vi No( ) assisted and natural draft appliances. The is sized and installed to meet the current .codes and manufacturer's specifications. Yes( ) ,No When required to ' will be sized and Installed to meet the current odes and manufacturer's specifications. Yes No( } When installing a g= venting sg t�, 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 Yes No ( } Venting Tables for fan assisted and natural draft appliances. Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented YesNo ( ) separately as per current codes. YN ,ACISIl nr_r -e and i7sanmmnn Veit and Vant Cnnnactnr Information Appliance #1 Type, A_ .�. BT:U Input Dd10 Fan Assisted or Nat aha Appliance #2 Type I 67 U Input-� Fan Assisted or Nat Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances ��___ Total Btu Input ll Common Vent Type 1b " 4s0l wA L`tVent Height –iSl Diameter_ ___ inches Appliance #1 Vent Connector Height ft Length ft Diameter in Type •,., ' ht ft Length .ft Diameter in Type Appliance #2 Vent Connector Height _,___ g ft Diameter rn Tyles Appliance #3 Vent Connector Height ft Length M] •Signed BY' elt*— ' CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-36U4 tAX: (763)571-1287 ADDRESS : 4868 2 1/2 ST NE PIN : 263024320030 LEGAL DESC : PLYMOUTH : LOT 3 BLOCK 3 PERMIT TYPE : ELECTRICAL PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION PERMIT NO.: 2004-00553 n I DATE ISSUED: 04/21/2004 �l- VALUATION NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. # INSPECTIONS 1 APPLICANT HARO ELECTRIC SOLUTIONS 415 DECATUR AVE N GOLDEN VALLEY, MN 55427 OWNER TIONGSON GLORIA & DARIO 4868 2 1/2 ST NE FRIDLEY, MN 55421 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of wort will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. Applicant Date Bldg Insp Date STATE SURCHARGE, ELEC FLAT 0.50 ELEC PERMIT FEE - MIN (RESI) 20.00 TOTAL 20.50 PAID WITH CHECK # 1311 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.