PRE 2010 DOCS10 6
Village of Fridley, Minn.lcl
BUILDING PERMIT No c244-0— Date: .........
! R
Owner.. .......... Builder ........................ ........... .......
Address . f.. �. �...'.. Address ..�4�... ... �
O OF BUILDING
�
No.�(.f:�...�.. Street. (.. Part of Lot ......... .......
Lot ......l1..... Block .................. Addition or Sub -Division
/
Corner Lot ..... �X.
Inside Lot ........... Setback ..J.'. Sideyard �. ? s
DESCRIPTION OF BUILDING
To be Used
........
De
Front . f.
Depth ........ Hei ht Ft.
C` u. Ft.
P g B/�q
..................... •ont ........ Depth ........ Hei t ... Sq. Ft. ........ Cu. Ft. .. .
Type of Constructi .. '.� ........ Est. Cost ..... To be Completed .
Y
♦ T
In consideration of the issuance to me of a permit to construct the building de �aabe, I agreethe proposed work in accordance with the description above set forth and in co liancall provisions of
ordinances of the village of Fridley. — i
In consideration of the payment of a fee of $. / ....... permit is her by 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, 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.
. uilding Inspector
NOTICE:
This permit does not cover the construction, install ion or alteration for wiring, plumbing, gas heating,
sewer or water. Be sure to see the Building llspf.ctoror separate permits for these items.
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City of Fridley, Mian.. N° 7782
BUILDING '' PERMIT
Date: June 9, 1965
Owner: Chester Dorf Builder Ernster Construction Co.
Address 5901 lath Street N. E. Address 6342 Girard Ave. No,
561-575
LOCATION OF BUILDING
No. 5901 Street 4th Street N. Be — Part of Lot
Lot 1-1 _ Block 2 Addition or Sub -Division Bennett Pa]mer,, Add.
Corner Lot Inside Lot Setback SideyaM
Sewer Elevation
To be Used as:
Type of Construction
Foundation Elevation
DESCRIPTION OF BUILDING
Front Depth Height Sq. Ft.
Front Depth freight Sq. Ft.
Fast. Cost 8.2aMOQ--- To be Completed
•
Storm damage repair
L�
Cu. Ft.
Cu. Ft.
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 f and in;r>mWith ail rovisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of 2 10-00 , permit is hereby granted to, EMster Const.
C2mazw to construct the building or addition as described above. This permit isgranted 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 limitand this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
Allen Jensen
NOTICE
Ule permit does net emu the eonstroeNoe, iestapaden ter wiring, phaabin& Bas heating, sewer or water. Be sun to see
the Buildtea hop•etor for separate permtu for these Nene.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME ``.' a � BUILDER 6,eaw (�
Ze'0
ADDRESS ADDRESS-"
toV
LOCATION OF BUILDING
No. Street Part of Lot Q
LOT ! BLOCK ADDITION OR SUBDIVISION
Corner Lot Inside LOT Setback Side -Yard
SEWER -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���✓`c
To be used as:
Front Depth Height
Sq. Ft. Cu. Ft.
Front Dept Height
Sq. Ft. Cu. Ft.
Type of Construction/li L", Estimated Cost, SSC!
To be completed�G9 t W-1,56—
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.
(Schedule of Fee Costs can be found on the Reverse Side).
0
&16 --! F
City of Fridley, Mian.. N° 8786
BUILDING PERMIT
Date: APRIL 22, 1966
Owner: CHESTER R. DORF Builder BANE
Address 5 901 - 4th St. N. E. Address
Fridley Minnesota 55421
LOCATION OF BUILDING
No. 5901 get 4th St. N. E. part of Lot
Lot 11 Block 2 Addition or Sub -Division .— _Bennett -Palmer Addition
Corner Lot — X Inside Lot _ _ Setback __ Sideyard
Sewer Elevation _. Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Det. Garage Front 20 Depth 22 Height 10 Sq. Ft. 440 Cu. Ft 4,400
Front Depth Height Sq. Ft. Cu. Ft.
Tape f Constructs Frame Est. Cost _ $900.00 To be Completed
0 on
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 21 provisions of
ordinances of the city of Fridley. & _
In consideration of the payment of a fee of $ 4.00 , permit is hereby granted to CHESTER R. DORF
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.
ALLEN G. JENSEN Building Inspector
NOTICE
ibis pormh dos not corer the eendruoNoe, tndaildiea for wiring, plumbing, ga basting, awor or water. Be an to ao
the Building Impeder for aparab parmha for dna stow.
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME a BUILDER
ADDRESS Jr % o I - �-r . ____ADDRESS
LOCATION OF BUILDING
N0, STREET,_ PART OF LOT
LOT N
/ BLOCK , ADDITION OR SUBDIVISIO
CORNER LOT P INSIDE LOT SETBACK SIDE -YARD
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
To be used as;
DESCRIPTION OF BUILDING
Front C� 0 Depth o� o2 -Height
Sq. Ft.. 6Z 7` O Cu. Ft.
Front Depth Height
Sq. Ft. Cu. Ft.
0
Type of Construct on ��� Estimated Cost %�6 L o
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
a
L� SIGNATURE
(Sched le
of Fe
Costs
can be found on the Reverse Side).
SUBJECT
P
City of Fridley
2 2 215
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
____�__ COMMUNITY DEVELOPMENT DIV.
1 V PROTECTIVE INSPECTION SEC.
/ i -
aG�
r
CITY HALL FRIDLEY 55432
NUMBER
REV,
PAGE OF
APPROVED BY
612-571-3450
910415
JDATE
I
11/1/93
JOB ADDRESS 5901 4 Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Chester Dorf.- 5901 4th Street NE
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Richard Hastings Contr. 6331 Riverview Ter NE Fridley 55432 4051
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 C� REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof H-ouse & Garage (2nd Layer) 21 Squares
9 .CHANGE OF USE FROM TO
STIPULATIONS Roofing can be the 2nd layer but not the 3rd. Install adequate attic
ventilation. Provide smoke detectors as per UBC 1210 adjacent to all sleeping
areas and in basement.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
ZONING
SQ. FT.
CU. FT.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
NO. DWLG. UNITS
OFFSTREET PARKING
ANY TIME AFTER WORK IS COMMENCED.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
STALLS GARAGES
VALUATION
SURTAX
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
$1,600
$.80
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
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-
$37.00
Fire SC $1.60,
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
3
License SC $5.00
$44.40
' SIGNATURE OF CONTRACTOR OR UTHORIZED AGENT IDATEI
WHENPER ALIDATED THIS IS YOUR PERMIT
OS
/!-'?- l
BL SP IN0A TEJ
SIGNATURE OF OWNER OF OWNER BUILDER) IDATEI
NEW [ ] Effective 5/26/93
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 4 3%S
Building Permit Application
Construction Address: S % / S -
Legal Description:
Owner Name & Address: C1 G: S %`£ 12 D o R P Tel. #
Contractor: j�: c 4.4.e p SI`tAI-6 s MN LICENSE # yv S/
Address: 6 3 3 / p- Tel. # S7 s/ - P9G�
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA: Length
DESCRIPTION OF IMPROVEMENT
Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER: �C)c c S � �- U �4-e :vJc- �-
Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks
Type of Construction: ;fj R o o r- Estimated Cost: $ lig,' a a
Approx. Completion Date:
Driveway Curb Cut Width Needed:
Ft. + 6 Ft =
(Cost on Back)
Ft x $
M91
DATE:&Z14 APPLICANT: Tel. # 5-? K-! 9G 6
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
$
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$750 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
Conservation Plan Review $450.00
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
TOTAL $ "/ STIPULATIONS:
V
SuBjECT
PER
City of Fridley
,�
P,AT
THE TOP OF THE TWINS
BUILDING PERMIT
r
I
RECEIPT NO.
� • _ COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
r
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
4/25/95
JOB ADDRESS 5901 4 Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
11
2 1
Bennett Palmer SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Chester Dorf 5901 4 Street NE
571-2864
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑x ADDITION ElALTERATION ❑ REPAIR ❑ MOVE ElREMOVE
8 DESCRIBE WORK
Cosntruct a 10' x 12' Screen Porch
9 CHANGE OF USE FROM
TO
STIPULATIONS
See notations on plan.
WARNING
Before digging call for
all Utility locations
454-0002
REQUIRED BY LAW
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
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
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
$1,956
$.98
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-
Fire SC $1.96
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
$45.00
PLAN CHECK FEE
TOTALFEE
$47.94
SIGNA URE OFCONT RACTO RAUTHO�tiZEDAGENT (DATCEi
PROPER VALIDATED THIS IS Y UR PERMIT
� � /d
4WHIEN
� E
INSP BATE
S.GNATU E OF OWNERoF OWNER BUI RI IDATEI
V
NEW i I Effective 1/ 1/95
ADDN X CITY OF FRIDLEY
ALTER I I SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Construction Address: `j Zo / -41 .,U .IV,
Legal Description: ''-a L,)to-A —
Owner Name & Address:
Contractor:
Address:
, / - 4.8-,f .v —"�- Tel.
MN LICENSE #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
Tel. #
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground � P Sq. Ft.
OTHER:5 -r,jP 1 /0
Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks
Type of Construction: L&bDD j i'. A d Estimated Cost:
Approx. Completion Date: //
(cost on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $_
DATE:,/ — --d- 1-1- APPLICANT: Tel. fl_
STIPULATIONS:
b/L L 'L;lvew
1127-- Y26 r
CITY USE ONLY
Permit Fee
$ y Jam,
Fee Schedule on Reverse Side
Fire Surcharge
$ q
.001 of Permit Valuation (1/10th%)
State Surcharge
$
$.50/$1,000 Valuation
SAC Charge
$
$850 per SAC Unit
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
Driveway Escrow
$
Alt. "A" or Alt. "B" Above
Erosion Control
$
$450.00 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement Necessary [) Not Necessary ( ]
TOTAL
$ f
STIPULATIONS:
b/L L 'L;lvew
1127-- Y26 r
��
SUBJECT
City of Fridley
26390
AT THE TOP OF THE TWINS
BUILDING PERMIT
r ,
'
REC
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
r � �
NUMBER
REV
DATE
PAGE Of
APPROVED BY
CITY HALL FRIDLEV 55432
612-571-3450
910415
6/29/98
JOB ADDRESS 5901 4 Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
11
2
Bennett Palmer
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Charles Dorf 5901 4 Street NE
571-2864
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO.
Same
a 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
Reside House & Garage; Reroof House & Garage (23 Sq) Tear-off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State Building
Code.
Install building wrap and call for inspection before covering.
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
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
$4,168
$2.08
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-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOT FEE
06.00
SIG AT RE OF CONTRACTOR UTHORIZEDAGENT IDATEI
EN OP VALIDATE
K%_88_L75_1NSP
HIS IS Y UR PERMIT
40 990�
DATE
SIGNATURE OF OW NE R I IF OW N ER BUIL RI IDATEI
��
NEW [ ]
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress:
Effective 1/1/98
Legal Description: �— e % J ( _
Owner Name & Address: rt�� Tel. #
Contractor: 0 A -'Y — Ir MN LICENSE #
Address: , Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF EUPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. t.
OTHER:
%-If . . I
Construction Type: &;v L Estimated Cost: $ ;2S
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $
DATE: APPLICANT: Tel. # 3
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
g
$ /®6. ®a
CITY USE ONLY
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 [ ]
ab CITY OF FRIDLEY INSPECTION DIV.
6431 University Ave NE
Fridley, MN 55432
572-3604
i _0�7 `NG -).(-
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
Effective On January 1, 1999
S
Gas Mlsc Water Heater
Range 1::iF::I:x:t.::`,-.,.--_jGas I Elec
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**
$16.00
Back Flow Preventer Required ( )Yes () No
Type
$15.00
Reinspection Fee $42.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance
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.
1999
Owner
Building Used As
Estimated Cost �bo - PERMIT NO.
PLUMBING CO ANY Ms(;U+ree-& Sons
BYWninkTEL N0. 4Q 605 -12th Ave So. ��� �� 1 2�70
J/
SIGNED
Approved By ORough—In Date Final Date
State Surcharge $ .50
MINIMUM FEE F R ANY PLUMBING/GAS PERMIT IS $20.00
TOTAL FEE 66-50 PLUS THE $.50 STATE SURCHARGE
"COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SQ INCHES.