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* City of Fridley, Minn A
BUILDING PERMIT N? 4 016
Date: ..---..... -.......- .............---..�......_............._............._..
Owner:..Irk...... .. _ile
....._ _�....... _.................... der
Address....._ ............._......._...._-_........._..._ _ ..._._.__..... ____..__....._........ Address
�- LOCATION OFF BUILDING
No. ....f1�...®..: ` Street ..... ...... &V.. ._.. i('S :.........._.............. Part of Lot .......... .....
Lot ............ Block .............. 1(0 ............................. Addition or Sub -Division ...
CornerLot ...........- ............. _........ Inside Lot ..... _................................ Setback ..... _............. -....................... 49deyard ..... .............. -......... ......................... .......... .......
SewerElevation .................................................. -........... ........................... ............... Foundation Elevation ................................... _............. _...................... _.... .............. _..
DESCRIPTION OF BUILDING
To be Used as:
l4r VA Fronto.'. Depth ..... Height a....6..._.. Sq. Ft. J._G...(j__ Cu. Ft.
l�
....-...................................................... Front ........................ Depth .................... _.. Height ........................ Sq. Ft......................... Cu. Ft. .................... _..
Type of Construction............................................................ Est. Cost ...----... .................. To be Completed ...........-.......
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. _ n
In consideration of thea
p yment of a fee of $�r...—., permit is hereby granted
..... __.............. _....... .......................................... 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
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.
4
SUBJECT
PER
City of Fridley
14a
19116
AT THE TOP OF THE TWINS
BUILDING
PERMIT
RECEIPT NO.
Ir
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
S 94
r
i �'1 CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
.-_.� •�
L 612-571-3450
910-F15
8/14/87
JOB ADDRESS 6045 - 211 Street N. E.
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DESCR.
25
6
Hyde Park
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Cindy Bergeron 6045 - 2'h Street N.E.
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Hermanson & Sons, Inc. 16935 Chisholm Strut, Ham Lake 434-4620
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 J3 REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof Dwelling (15 squares)
9 CHANGE OF USE FROM TO
STIPULATIONS
Roof can be 2nd layer but not 3rd. Install
ridged galvanized valleys.
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 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
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
$750
$.50WITH
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-
$lS.00
OR THE PERFORMANCE OF CONSTRUCTION.
AZ
LAN CHECK FEE
TOTAL FEE
��,�
$15.50
SIGNAIM&&EOFCONT RORAUTHORIZEDAGENT (DAT I
WHEN PROPERLY VALID THIS IS OUR PERMIT
SIGNATURE OF OWNER IIF OWNER BUILDER$ (DATE$
LOG $NSP
rlgT
NEW [ ] City of Fridley Effective 4/1/86
ADDN. f R-1 AND R-2
ALTER. [ ] Building Permit Application
Construction Addr,
Legal Description
Owner Name & Address: Tel. #
Contractor: \�, �-�- �� -, Tel. #
Address: `��� 5 C✓�;"e,'-� �'�° v
LIVING AREA:
GARAGE AREA:
DECK AREA:
OTHER:
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length Width Height Sq. Ft.
Length Width Height Sq. Ft.
Length Width
Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback
Type of Construction:
-
Approx. Completion Date:
Sq. Ft.
Side Yard Setback
Estimated Cost:
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: $ $
See Back Page for Explanation
DATE: APPLICANT: Tel. 0 2-p
CITY USE ONLY
Permit Fee $ -� C) Fee Schedule on Reverse Side
Plan Check $ 25% of Building Permit Fee
State Surcharge $ =�� $•50/$1,000 Valuation
SAC Charge $ $ 525 per SAC Unit
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $
Agreement Necessary [ ] Not Necessary [ ]
TOTAL $ l
STIPULATIONS•
CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
�*4.06 ` RATE SCHEDULE
Effective On January 1, 1997
APPUCHTiury FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
Residential Rate TOTAL
Furnace Shell and Duct Work, Burner -
Also Replacement Furnace $ 30.00 $
(Side Vent - Fill Out Back)
Gas Piping (Needed with new furnace) $10.00 $
Gas Range $10.00 $
Gas Dryer $10.00 $
*Air Conditioning - All Sizes $ 25.00 $
All Others/Repairs & Alterations (LIST ON BACK)
1 % of Value of Appliance or Work $
Commercial/Industrial
1.25% of Value of Appliance or Work $
State Surcharge $ .50
TOTAL FEE $ v v
MINIMUM FEE FOR ANY HEATING COOLINGNENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $42.00/Hr
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
JOB ADDRESS C' O <<5— ,->�_ S% _V6
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 a,r r`u'e n c ct. F
997
or,
OWNER
BUILDING USED AS P5'l /
ESTIMATED COST
PERMIT NO. „" -,,/ -/J
DESCRIPTION OF FURNACE AND OR BURNER
No. of Heating Units Circle One (St
Trade Name 74 o ) i�-o 1
BTU '? poo HP
am) (Hot Water) arm .
Size No.
EDR
Fuel Wo Total Connected Load
Burner Trade Name
BTU
Size No.
HP EDR
HEATING COMPANY
Signed B)( G Ems/ Tel No. 57
Approved By Rough -In Date
FILL OUT BACK SIDE FOR STACK VERIFICATION ON
REPLACEMENT FURNACE
Final Date
Id Y�
Scti S
Remarks:
List ALTERATIONS Being Done:
s
HEATING CO:
Signed By:
Date:
CHIlVINEY AND STACK VERIFICATION
The
undersigned hereby verifies that the existing chimney or
stack:
1.
Has been carefully examined
Yes (t4'No
{
)
2.
Is free from rust or deterioration
Yes (k-f—No
(
)
3.
Has no foreign objects lodged within
Yes (I4'No
(
)
4.
Is securely supported
Yes (V) No
(
)
5.
Meets all current Code requirements for size
and total BTU's connected
Yes (4' No
(
)
6
Has total heating BTU's of �®
All other BTU's
TOTAL BTU's
7.
Has a liner been provided for water heater
Yes (14 No
(
)
--"No
8.
Has combustion air been provided for water heater
Yes (0
(
)
Remarks:
List ALTERATIONS Being Done:
s
HEATING CO:
Signed By:
Date:
SuBjECT
City of Fridley
3 0 041
AT THE TOP OF THE TWINS
BUILDING
PERMIT
RE NO.
�
COMMUNITY DEVELOPMENT DIV.
b®
r � � PROTECTIVE INSPECTION SEC.
1
CITY HALL FRIDLEY 55432
NUMBER
DATE
PAGE OF
APPROVED BY
612-571-3450
910415
TREV
8/11/99
JOB ADDRESS 6045 2 1/2 Street NE
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
25
6
1Hyde Park
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Matt Miller
571-6895
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Pennington Constr. 4347 Central Ave. NE
Co7RR-4R74
20169A91
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 O ALTERATION XLH REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Reroof house and garage (23 S) 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 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 1 HAVE READ AND EXAMINED THIS APPLICATION
I
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
$2010
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
`P
1.01
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-
$83.25
Fire SC
STRUCTION OR THE PERFOR CE OF CONSTRUCTION
$2.01
PLAN CHECK FEE
TOTAL F
License "5.0Q,
91.
SIGNATURE O O TRA OR OR AUTHO NT IDAT .
IS IS YOUR PERMIT
7LW
r-
JLIIDAATTTED
SIGNATURE OF OWNEAoF OWNER BUILDERi tDATE.
Bl0 NSP
OAtE
NEW' - [ ] Effective 1/1/99
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Q P
BUILDING PERMIT APPLICATION fJ
ConstructionAddress: ®� �2 S4 ® E7 -
Legal Description:
Owner Name & Address:
Contract
Address:
Tela # Gla 671 GS J
ENSE # Qo t rag 3 g
Tel. # G42 7O O et 87�
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:
Lesg
Width Hgt/Ground Ft.
_ _Sq.
{ �EAve • o z:
OTHER:
C�
Construction Type: T(eaC
® ' +
R (0Ce Sh'OVtimated Cost: $ cy
6 ".Pt`'Ili (Fee Schedule on Back)
Driveway Curb Cut Width Needed:
Ft. + 6 Ft = Ft x $ _ $
DATE: ^//-17 APPLICANT:
; Tel. #/-/-,;2-
CITY USE ONLY
Permit Fee
$
Fee Schedule on Reverse Side
Fire Surcharge
$
O (
.001 of Permit Valuation (1/10th%)
State Surcharge
$ /. O (
$.50/$1,000 Valuation
SAC Charge
$
$1050 per SAC Unit
License Surcharge
$
• C) O
$5.00 (State Licensed Residential Contractors)
Driveway Escrow
$
Alt. "A" or Alt. "B" Above
Erosion Control
$
$450.00 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
-Agreement Necessary [ ] Not Necessary [ ]
TOTAL $ ��
STIPULATIONS:
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
572-36U4 t'AA: (763) 571-1287
PE NO.: 2004-01036
DATE ISSUED: 07/02/2004
ADDRESS :
6045 2 1/2 ST NE
PIN :
233024220031
LEGAL DESC
HYDE PARK
WATER TREATMENT APPLIANCE
LOT 25 BLOCK 6
PERMIT TYPE
PLUMBING
PROPERTY TYPE
RESIDENTIAL
CONSTRUCTION TYPE :
ADDITION/ALTERATION
VALUATION :
$ 500.00
NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC CHAPTER 6 AND TABLE 6-A. INSTALL A GAS WATER
HEATER.
TOTAL
# ELEC WATER HEATERS
0 # NEW FIXTURES (EXIST OPENINGS) 0
# GAS WATER HEATERS
1 # GAS DRYERS 0
# GAS RANGES
0 # OF NEW FIXTURES 0
VALUE (FOR MINIMUM CALC) 500 # WATER TRMT APPLIANCES 0
APPLICANT
NORT14WOODS MECHANICAL
BOX 1085
FOREST LAKE, MN 55025-
(651)257-4951
OWNER
TONY DIRCKS
6045 2 1/2 ST NE
FRIDLEY, MN 55432
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 worl
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
r tin construc ion or the performance of con traction.
Applicant Dat
Bldg Insp
PLBG PERMIT MINIMUM FEE
0.00
PLBG FIXTURES (NEW OPENINGS)
0.00
PLBG FIXTURES (EXIST OPENINGS)
0.00
WATER TREATMENT APPLIANCE
0.00
WATER HEATER - ELEC
0.00
WATER HEATER - GAS
35.00
GAS RANGE FEE
0.00
GAS DRYER FEE
0.00
STATE SURCHARGE, PLBG FLAT
0.50
TOTAL
35.50
PAID WITH CHECK # 6208
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
C1 l 1• ul 1 mul.t.1 11'CA •1 ,. wlv I,Iv
(343) UnrverSdy Ave NE
F rldley•"MN 55432
(763) 572.-3604
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK All INIRFR ng-- GrvTi imcc, -y-f,%
� �s a -
L Ilectrve Un Jan 1, LU02
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 ( )Yes () Nc
Type
NO. RATE TOTAL
$ 7.00
$ 4.00
$ 5.00
$ 7.00
$ 7.00
$ •7.00
$ 7.00
$10.00
$ 7.00
$10.00
$10.00
$10.00
$15.00
Reinspection Fee $47.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance
State Surcharge
TOTAL FEE
JOB ADDRESS_(1/(s�
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 Budding Division. and hereby declares that all the facts
and representations stated in this application are true and correct.
. 20Z.Y-1
Owner
Building Used
Estimated Cost PERMIT NO.' ` L4
-
PLUMBING COMPANY ����i► ,/ n� / �2�.�
SIGNED BY —L/ _l1 C TEL N0.
FAxlt r
Approved By Rough -In Date Final Date•"
MINIMUM FEE O ANY PLUMBING/GAS PERMIT: IS S2011110 +
PLUS THE $-50 STATE SURCHARGE�i
IlCOMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE
_, ji•
Water
Bath
Stories
]Closet Urinal
Tub
Wash
Drink.
Floor Catch
Auto. Gas Gas
Misc. Water Heater
Shower
Sink
Tray
Fount.
Drain Basin
WasherAppl, Range
I~It : ;Gas lElec
Basement
.;:
Floor l
Floor
..
Floor 3
�
......
•::.•::::::si
Floor 4
...
:;.s:.;.::.:::
.:.. v.
tea:
t
..:k
::::. ........
•t:;:•::•3,`�..:.
::::. xtt?.:rr::4:y:;:;:;
tiet•:: r:e.;,:>.
•.:
`�}}�a`....•, �, .
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 ( )Yes () Nc
Type
NO. RATE TOTAL
$ 7.00
$ 4.00
$ 5.00
$ 7.00
$ 7.00
$ •7.00
$ 7.00
$10.00
$ 7.00
$10.00
$10.00
$10.00
$15.00
Reinspection Fee $47.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance
State Surcharge
TOTAL FEE
JOB ADDRESS_(1/(s�
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 Budding Division. and hereby declares that all the facts
and representations stated in this application are true and correct.
. 20Z.Y-1
Owner
Building Used
Estimated Cost PERMIT NO.' ` L4
-
PLUMBING COMPANY ����i► ,/ n� / �2�.�
SIGNED BY —L/ _l1 C TEL N0.
FAxlt r
Approved By Rough -In Date Final Date•"
MINIMUM FEE O ANY PLUMBING/GAS PERMIT: IS S2011110 +
PLUS THE $-50 STATE SURCHARGE�i
IlCOMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE
_, ji•
THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE
APPLICATION WILL BE RETURNED
COMMON -VENT, VFmT cnmmFr.TnR ANn cnmgi IQTIAN AIR WRIFI n ATIAN ^.
When
M-12
ac1100 an_30=00 A�w, 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 plastictPVC and meets all current codes and manufacturer
BTU Input Fan Assisted or Nat
specifications including sizing, length, number of elbows and termination.
Yes () No ( )
The undersigned also verifies that the replacement unit Is a listed assembly
BTU Input Fan Assisted or Nat
and meets the current codes and manufacturer's specifications. This does
Total Btu Input
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 instar a now rnmhi inflinn airitwill be sized and installed
to meet the current codes and manufacturer's specifications.
Yes () No ( )
When installing a naw wanting system, the undersigned hereby verifies that
.t 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 #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
HEATING CO:
Signed By: Date :
CITY OF FRIDLEY
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432
572-3604 FAX: (763)571-1287
ADDRESS : 6045 2 1/2 ST NE
PIN : 233024220031
LEGAL DESC : HYDE PARK
: LOT 25 BLOCK 6
PERMIT TYPE : ELECTRICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDITION/ALTERATION
PERMIT NO.: 2004-01804
DATE ISSUED: 10/05/2004 O'
VALUATION
NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. INSTALL A SAVERS
SWITCH.
# INSPECTIONS 1
APPLICANT
HUNT ELECTRIC CORPORATION
2300 TERRITORIAL RD
ST PAUL, MN 55114-
IC]ARM9
TONY DIRCKS
6045 2 1/2 ST NE
FRIDLEY, MN 55432
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
ELEC PERMIT FEE - MIN (RESI) 20.00
STATE SURCHARGE, ELEC FLAT 0.50
TOTAL 20.50
PAID WITH CHECK # 118132
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.