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PRE 2010 DOCSI V erge of Fridley, gym. BUILDING PERS �® 50 Office of INSPE CTOR OF BEINGS (I � I . Fridley, Minn., LOCATIO OF BUILDING j Street "'" Part of Lot Block Addition or Sub -Division A 04444 N DESCRIPTION OF BUILDING Frontes Dept _ Height_ Stories manner of Consttruction 6 GNP To be used as y To be coanpleted' go-/ Mstimated Cost I i Permit is hereby gr,anted to—,to 1 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, a0und and upon said building, or any part thereof, shall conform in all respects to the ordi- nances of Fridley, Wnn.. regarding the construction, alteration, maintenance, repair and moving of ' buildings within the city limit , and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. AGREEMENT AND SWORINT STA.TEM= In consideration of the issue and delivery to me by the Inzpector of Buildings of Fridley of the above germs I hereby agree to do the proposed work in accordance with the description above set forth t ad according to the provisions of the ordinances of Fric?ley, and, being first duly sworn, I hereby ftate and say that the facts stated by me and contained in the above permit are true as therein sfted. Subscribed an I sworn to ''before we at Fridley, ` Minnesota, this day o£_ A.D. 19 City of Fridley SUBJECT -J�? 13691 AT THE TOP OF THE TWINS BUILDING PERMIT >711 • COMMUNITY DEVELOPMENT DIV.�� r PROTECTIVE INSPECTION SEC. 1 � = CITY HALL FRIDLEY 55432 IL NUMBER REV. DATE PAGE OF APPROVED BY L"� � -' ,'J 612-560-3450 910-F15 8/9/76 JOB ADDRESS 5618 - 5th Street N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 4, pt. 5 3 Hamilton's Addn. to Mechanicsville SHEET 2 PROPERTYOWNER MAILADDRESS ZIP PHONE Edward Dupay RR 5618 - 5th Street N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW QA ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 22.4' x 14' Addition onto dwelling 9 CHANGE OF USE FROM TO STIPULATIONS provide collar ties in rafter area 32" on center. Insulate ceiling R-24 mW or reduce window size. WARN111 Before digging calk local utilitift PERMITS REQUIRED FOR VVl t 6i TELEPHONE• ELECTRIC -GAS Etc. SEPERATE $(." REQUIRED BY LAW HEATING, PLUMBINQ AND. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Wood RKM 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 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, $7,500 $3.75 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- $37.90 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE 9 $41.65 SIGNATURE OF CO TOR OR AOTHOP&EDAGENT ATE) WHEN PRO ERLY VALIDATED THIS IS YOUR PERMIT /y k) I s I BLDG.INSP DATE SIGNATURE OF OWNER (IFOWNER BUILDER) (DATE) CITY OF FRIDLEY fyk . APPLICATION FOR RESIDENTIAL ALTERATION, ADDITION, OR REPAIR BUILDING PERMIT OWNER'S NAME: BUILDER :C� ,�� c ADDRESS :� ,-/ ✓ `� , ADDRESS: NO • / STREET • LOT: BLOCK: -3 ADDITION: 1:7,7 ,�;7 CORNER LOT: INSIDE LOT: ;tel SETBACK: _3- 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 ..Jsed As: i Front:. - % __Depth: / `� Height: _,�l C' Square Feet: � / 3. ( Cubic Feet: C Front: Depth: Height: Square Feet; Cubic Feet: Type of Construction: ' a� z z Estimated Cost: $`*�_ To Be Completed: Y'C 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. ii DATE: SIGNATURE: (See Reverse Side For Additional Information.) i� 2 06 y� �iC6d �E cod.'. 44 "W* 32 "C.C!. * • ' �� An AAA -cc 7A 4 - Depth: - FT. 'T7 t' r- i J I 4� o i %Eb 313. J f- -� i , Y _ 1 I i 1 b y j c o � .. � I j .. ... ,� o�� • .. _ ,_ J ... 4� o i %Eb 313. J f- AM , 1 I i 1 b y j c o � .. � I j .. ... ,� o�� • .. _ ,_ J ... o i %Eb 313. AM , Y _ 313. AM , 77- j . . . . . . . . .. . . 44- P 47 7t 41 7'1 ....... .... I.Y -T� as ....... .... I.Y -T� �� Page 1 of 4 EXTERIOR ENVELOPE AVERAGE U COMPUTATION s OWNER: SITE ADDRESS: ! �x CONTRACTOR: DATE PHONE: Determine working square footage of each 1. Total exposed wall area....... Y.4 . sq. ft. x .17 2. Toal roof/ceiling area ...... 309 sq. ft. x .05 = / r, V Total exposed wall area above floor = .3.�� a. Total wall window area ................................. ✓� 2 b. Total door area ....................................... c. Total sliding glass door area ......................... 0 d. Total fireplace wall area ............................. v V e. Total wall framing area (average 10%) ................ 3 f. Total rim joist area.................................60. g. wall area above floor .......................... >_ h. wall -area above floor .......................... i. wall area above floor .......................... j. wall area above floor .......................... Total exposed foundation area = k. Total foundation window area ........................... c 1. Total net foundation area above grade ................. Determine "U" value of each wall segment (e.g. window, door, a separ_awall section) a.oZ X ��U�� .-5 _ ---0/ A& IM X "Un = X "U" d. X e. X f. X g .' X $gull — $fU„ flull ® �- u u" h. X "U" - i X "U" _ j' X "U" — k X nun a 1 X "U" _ AV 3. ............................. Total = �� If item #3 is the same as, or less than item #1, you have met the intent of -SBC 6006 (c) 2. Ex=terior Envelope Average "U" Computation Total exposed roof/ceiling area = m. Total skylight area .......................... n. Total roof/ceiling framing area (average 10%)... o. Total net insulated roof/ceiling area........... Determine "U" value for each roof/ceiling segment M. X "U" _ n. X "U" _ o. X "U" _ Page 2 of 4 4....... ..................... Total = If total of #4 is the same as, or less than #2, you have met the intent of SBC 6006 (c) 1. Alternate Building Envelope Design To utilize the total envelope system method, the values established by the sum of items #3 and #4 shall not be greater than the sum of items #1 and #2. 1. + 2. _ 3. + 4. _ Ab WALL SECTIONS NOTE: Use 10% of opaque wall area for frame construction �i i FIG. #I1 TOPVIEW OF FRAt1E VALL -77 E.IG. #3 F -• o c Page 3 of 4 Construction R -Value 1. Interior air film 0.68 2. 3. 4. 5. 6. Exterior air film 0.17 1. Interior air film Total 0.68 2. 3. 4. 5. 6. Exterior air film 0.17 1• Interior air film Total 0.68 2. 3. 4. 5. 6. Exterior air film 0.17 Total v� Interior air film 0.68 V. 2. 3. 4. S. 6. Exte or air tilm 0.17 Total FI6: #4 Op /Jl • /l(W !�t NOTE: Indicate type, "R" value, depth and a ROOF/CEILING 11.1� Vented . Heat flow up FIG. ¢r5 r J }:eat flo1•Y up ;•vented. FIG. 416',. -03 ' arVa:'•'Y1:l�1�.1J Hent £low up - „ ' • ' i pxc. /'7 . Page 4 of 4 - Construction R -Value 1. Interior air film 0.61 2. 3. 4. Exterior air film (still) 0.61 Total �, m , ti 774 G 1. Interior air film 0.61 2. 3. 4. Exterior air film (still) 0.61 Total 1. Inside air film 0.61 2. 3. 4. 5. Outside air film 0.17 Total Note: Use additional sheets if more space is needed for details and calculations A If d � �� �� � J ���� �e� .�� � I ( � �S� -� � �� �� �o We the property owners on the South side 57th Avenue who border the right-of-way between 4th and 5th Streets, do hereby declare our intent to have 176 feet of this right-of-way blacktopped by a private contractor. We the undersigned, will be responsible for the financing of this improvement as per agreement between us. We will also be responsible for the maintenance of this portion of the right-of-way and it is agreed that this alley will not be posted as a private drive. We the undersigned, do reserve the right to solicit an appropriate portion of the cost for this improvement to the property owners along this right-of- way who make major improvements (such as garage, shed, parkinq area, etc.) or constant usage of this alley due to -our improve- ments. Signed: 1. 2. 3. Date 391 57` s7 /)L / 'Y 51k 5. S 'e' 5't � ; 7, A ,E, SUBJECT PEAMIT NO. City of Fridley AT THE TOP OF THE TWINS BUILDING PERMIT r 1. Lu ------- COMMUNITY DEVELOPMENT DIV. INSPECTION f PROTECTIVE SEC. 1 ! � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY L 612-571-3450 910-F15 4/20/87 JOB ADDRESS 5618 - 5th S'tree't N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. S1/2 5 � 6 3 1 Hamilton's Addition to Mechanicsville SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Edward Dupay same 574-9470 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Lloyds Home ovements = 1012 - 42 1/2 Avenue N.E. 788-5602 4 ARCHITECT OR DESIGNER MAILADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Tear off and reroof house 9 CHANGE OF USE FROM TO STIPULATIONS 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 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 $1,860.00 $.93 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- $31.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $31.93 SIGNATURE OF CONTRACTOR OR AUTHORIZED GQ IDATEI V HEN PRO PE LY L BLDG )NSP A D THI IS YOUR P MI T1ATE SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) NEW [ ] City of Fridley Effective 4/1/86 ADDN. [ ] tR-1 AND R-2 ALTER. [ ] Building Permit Application Construction Address:_ Legal Description: 51 Owner Name & AUress : Contractor Address: lilt a — Tel. # �_' 7 C/- lc- e -/7v Tel . # ®� vc2 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: Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback Type of Construction: 154A' ' tee- t oo Estimated Cost: $ a 0 - Approx. Completion Date: yY _1_1F Proposed Driveway Width If New Opening Is Desired: Alt. A Alt B See Back Page for Explanation DATE: / % APPLICANT: .F Tel. #_I G� Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge TOTAL STIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side 25% of Building Permit Fee $.50/$1,000 Valuation $ 525 per SAC Unit Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 571-36U4 VAN: ADDRESS : 5618 5 ST NE PIN : 233024310033 LEGAL DESC : UNAVAILABLE : LOT BLOCK PERMIT TYPE : ELECTRICAL PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION PERMIT NO.: 2004-01795 (- 1 DATE ISSUED: 10/06/2004 ���� 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 - OWNER DUPAY PATRICIA J 5618 5TH 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 work 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. C2009- ()190a City of Fridley 6431 University Ave NE Fridley MN 55432 (763) 572-3602 or Fax (763) 502-4977 Water and Sewer Permit Application ❑ New Connection OUtility Line Repair/Relocation 0 Existing MWater and Sewer Connection Date: es - Job Address: S& PK Name of Applicant (Plumber): Name of Property Owner: G Existing Structure Permit # Permit Type: Sewer Fee: Water Fee: Meter Fee: Repair Fee: d Relocation: State Surcharge: SAC Charge: Special Assessment Fee: To Applicant Signature: Inspector approval: 45 S "M .t,t-, - "R. __ . i a r—^ Water Meter Repair — Weekend & Holidays $125/hour Water Connections Permit $50 Sewer Connections Permit $50 Inspection Fee for Water/Sewer Line Repair $40 Special Assessments See Engineering Cost of Water Meter See Utility Billie SAC Charge $1450 State Surcharge $ .50 Water Tap See Engineering 04/04/05 3uildin9 $ 3 . BUILDING Permit No.: JOO o Inspections 65% of Building Permit Fee RESIDENTIAL APPLICATION Received By: 763-572-3604 Surcharge CITY OF FRIDLEY Date Rec'd: ' )ATE �� YOUR E-MAIL ADDRESS ;ITE ADDRESS SAC Charge $ HIS APPLICANT IS: ❑ OWNER MICONTRACTOR $ PROPERTY OWNER/ NAME: sA �L $ TENANT ADDRESS:_ 6�� \9 � d '&A-. Kyi CITY 9 $ STA _ Fee Determined by Engineering PHONE: 5 g — g l go $ CONTRACTOR NAME: .. -( $ 91 '2i *-2 SUBMIT A COPY OF STATE LICENSE # 2 -OA (*ab DATE YOUR STATE LICENSE ADDRESS�,: (C V6tyX ''R ,A'fCA 1A 4, CITY STATI4ZIP WITH APPLICATION PHONE 517— —'AFAX bS PROPERTY TYPE ❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMMY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGEISHED ❑ WINDOWS ❑ BASEMENT FINISH l�OOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK:❑ ElADDITION "ANCE(REPAIR ❑ REMODELING el:DESCRIBE WORK BEING DONE: fh dvv SIZE OF IMPROVEMENT qt LENGTH a WIDTH HEIGHT 5 v' Sq. Ft. ROOFING �+- OUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE 1. Existing Floor Plan 2. Proposed floor plan PROPOSED SIZE: ❑ DETACHED GARAGE 3. List of structural members to be used PROPOSED HEIGHT: SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS. & PORCHES SUBMIT: ❑ Aluminum ❑ Trim 1. Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project WINDOWS 2. Two sets of construction plans IN EXISTING OPENINGS ❑Yes ❑No LOCATION OF WINDOWS 3. Energy Calculations OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED NUMBER OF WINDOWS ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ ei-O%s � OCCUPANCY TYPE Permit Fee $ 3 . See Back Page for Fee Schedule Plan Review $ 65% of Building Permit Fee Fire Surcharge $ .001 times the total job valuation Surcharge $ 1 _O .0005 x Permit Valuation Minimum $.50 License Surcharge $5.00 (State Licensed Residential Contractors) SAC Charge $ $1550 per SAC Unit (Plans to MWCC for determination) Curb Cut Escrow $ ft + 6 ft = ft x $21= $ Erosion Control $ $450 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( ) Total Due $ 91 '2i *-2 Make checks oavable to: Citv of Fridlev Attach Stipulations THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be 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 the approved plan in the case of all work which requi r d val of plans. P SIGNATURE OF APPLICANT _PRINT NAME_ 5 " ,t DATE Building MECHANICAL Permit No..V6 in Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY 'OF FRIDLEY C'9 DATE YOUR E-MAIL. ADDRESS SITE ADDRESS THIS APPLICANT IS: ❑ OWNER )(CONTRACTOR PROPERTY NAME; FA-f1?1C.1A 0,10d OWNER/ ADDRESS:Jr . N•E CITY Foij STATE ZIP 5 0� TENANT PHONE: - CONTRACTOR COMPANY NAME: S SUBMIT A COPY OF CONTACT PERSON: YOUR STATE LICENSE WITH STATE LICENSE # EXP DATE ADDRESS:al wI 1 k' •It - CITY IES/ STATE � � APPLICATION f I ZIP S PHONE ,- S FAX PERAM TYPE SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW XREPLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK 'D kEF PER MS 16B.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 ) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x.05,= FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW) p� J Equipment Installed MFG: f( Y MODEL: Mau SIZEBTU MFG: �d MODEL: GPS SIZE✓BTU ' A Mk— MFG: MODEL: SIZE/BTU A/C $25.00 FIREPLACE (GAS) $15.00 GAS RANGE/OVEN $10.00 __ _AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 _BOILER $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 GAS PIPING $10.00 VENTILATOR $15.00 Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $ Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ Number of fixtures @ $25.00 J_ x $25.00 = $_ Number of fixtures @ $35.00 _L_x $35.00 = $ Q � State Surcharge = $ 50 Total = $ THIS IS AN APPLICATION FOR A PERMIT NOT VALID UNTIL PROCESSED I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota -Construction Codes; that I understand this is permit but only an ap lication for a permit and work i 0t to start without a permit; that the work will be in accordance with the oved plan in the case o all work w r es reviewiff proval of plarna. APPLICANT PRINTNAME V S N DATE -4 ~o A;;OF L City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977