PRE 2010 DOCSCity of Fridley, Minn.
BUILDING PERMIT No 4108
Date•.._. ��
Owner: .................... ................................. ----........._..--•--•--—...... ... ................ .... Builder _ .....
Address..... .............. _.__._...._......._...._..__ -...._._--.._... __... _............... Address 41eQ.......... ......._ _....._...__ _4_.._...
LOCATION OF BUILDING
No. •16..Z.,Z.0. Street ._6...�...... ✓...... ........... .............. Part of Lot ............. ..................... ... _...._............_ _ ....__
Lot.................1................. Block ............ -Z........................... Addition or Sub-Division�_...-..._..-.
CornerLot ................................... Inside Lot .......... A ........ ........... Setback ...................................... Sideyard........................................................
Sewer Elevation ..... --------------/J"...'..a._�......... .............. ....................................... Foundation Elevation .......... .................................... ...... _.....
_..._..
DESCRIPTION OF BUILDING
To be Used as:
-- ............. Front 0 '�.O Depth..7.... Height Sq. Ft./40.S" Cu. Ft. 2®®..k /
..... ..............-..---................................. ��Front
........................ Depth .................... _.. Height ............. .---------- Sq. Ft. ........................ Cu. Ft. ......................
Type of Construction .... Est. Cost ......... ........... ... ..... ............ ............. To be Completed...�..'�-off......
In consideration of the issuance to me of a permit to construct th uilding described above, I agree to do
the proposed work in accordance with the description above set fort and in compliance with alLpr9adsions 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, 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.
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 BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
Owners
LOCA ON F BUILDING
No .� $treat Part of Lot
Lot B1Qck .Addition or Sub.Div.
Corner Lot Inside Lotet Back de -Yard
Baard ..
SEWER ELEVATION �� FOUNDATION ELEVATION
Applicant kttach to this form Certificate of Survey of Lot and proposed building
location."
DESCRIPTION OF BUILDING
To be usdd as:
FrontDepth Height
Sq. Ft.��Cs� Cu. Ft. OO cc
Front Depth Height
Sq. Ft. Cu. Ft. •
Type of -Construction
To be
Estimated Cost
The undersigned'•hereby makes application for a permit for the work herein specified,
agreeing o do!All work in strict.accordance with the City Or ces and ruling of
the Depart�e#�t o dinjgsi;and.heieby declares that all.t facts and representa-
tions stated:: th -application are true and correct.
DATE J SIGNATURE •
(A Schell eTof-,Fee costs can be found on the Reverie Side.)'
•
6A1
CJ
City of Fridley
Application for Plumbing and Gas Ming Permit
Dept, of Bldgs. Phone SII 4-7470
DESCRIPTION OF WORE vl ® / ':
Number, Bind and Location of Fixtures es �C (O
Cq�
YJ
NO.
RATE
TOTAL
Number Fixtures ......................
Z
a
�n
���'
3�-
�i
e�
Future Fixture Opening ................
QzZ
iio
=�
tg
�u
<3
0°d
w
(�
c7
a
t90
•
F
•
N
WATER HTR.
GAS
ELEC.
Base
x
2.00
$ 0
New Ground Run Old Bldg . ............
x
/
$
GAS FITTING FEES:
NO.
RATE TOTAL
1st 3 Fixtures ..........................
x
$1.50
$ �-
Additional Fixtures ....................
x
.50
1st
Gas Range to 200,000 BTU ..............
x
2.00
$
2nd
3rd
4th
• Future Connection Openings I
New Fixture, Old Openings
Connected with
Sewer ❑
Cesspool ❑
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES:
NO.
RATE
TOTAL
Number Fixtures ......................
x
$1.50
$ • G
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
$ 0
New Ground Run Old Bldg . ............
x
3.25
$
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
$
REPAIRS & ALTERATIONS—Refer to Code
Description................................................$
TOTAL FSE
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.
Fridley, ;Minn , 19-�Z-
Owner 19—
Kind of Building 19—
Used as
v
To be completed about - 9
Estimated Cost,
Old—New. Building Permit No /
Signed
f`sl.'
Business Phone No. 2y
11 POST 1M-12-58
City of Fridley, Minn.
BUILDING PERMIT
Date:' ....
Owner: _�L '�►�. '�'Z+��
Address
N° 5014
Builder
Address — —
/j LO T O F UILDING
NO. f Street/,a OF
t Part of Lot
Lot __ Block _ Addition or Sub-Divisi
Corner Lot _ Inside Lot . A---' &0back Sideyard _.—SPI/
Sewer Elevation _ Fo dation Elevation
DESCRIPTION OF BUILDING
To U Front Depth _ Height Sq. Ft. ", Cu. Ft.
ont Depth — t _ _ Sq. Ft. — Cu. Ft. —
Type of Construction �- — Est. Cost r�v o 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.
In consideration of the payment of a fee of $—;t= ., 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, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at any time upon viola#=-gf any of the provisions of said
ordinances _ . .I /
Building Inspector
NOTICE:
This permit doss not cover the construction, Installation for wiring, plumbing, gas heating, sewer or water. Be aro to acs
the Building inspector for separate permits for these items,
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
Owner's Name'6 �,�,�tl
S_
E h/ Builder
s S F- L/ ta.,
Address _4 moa O —
g,/ ;5�' S.'
Address_
C
LOCATION OF BUILDING
No. d2 ® Street _Cr. Z� .S Part of Lot
Lot Block Addition or Subdivision
Corner Lot Inside Lot Setback Side -Yard
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
DESCRIPTION OF BUILDING
To be used as:
fQ..Front Height
_1
Sq. Ft. Cu. Ft.
Front Depth Height
Sq. Ft. Cu. Ft.
Type of ConstructionEstimated Cost
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 Ordinances and ruling of
the Department of Buildings, and hereby declares that all the fact and representations
stated in this application are true and correct. 92& �
(A Schedule of Fee Costs can be found on the Reverse Side.)
ICE
BLOCK AJ)DRESS-G Z Z-0 VALUATZQN 71
ADT).
--rpypp F4(s-�-.-
. .......... ...................................................... .......... . ..................................................................... I ...................
...........................................................................................
Property 'ane
V
44
k:
fi
— a. -W
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7
wzac
H
Fx Li "q, IL l4r,
.House
N
Pro:7 a rt3r Line
.4 e- k
•
City of Fridley, Minn. N° 7604
BUILDING PERMIT MZ
Date: June 1, 1965
Owner:
Robert Rasmussen Builder Glisan Realty and Home Builders
Address 6220 6th. St. N. E. Address 519 loth St. N. W. New Br3&ton,
Minnesota
LOCATION OF BUILDING
No. 622o Street 6th. Street N. E. Part of Lot
Lot 7 _ Block 2 Addition or Sub -Division b nd s 2nd Ad ; on
Corner Lot _ Inside Lot Setback Sideyard
Sewer Elevation — Foundation Elevation
To be Used as:
DESCRIPTION OF BUILDING
Front Depth Height Sq. Ft. Cu. Ft.
Front Depth Height Sq. Ft. Cu. Ft.
Type of Construction Est. Cost To be Completed
• Stotm Damage Repair
1�1
In consideration of the issuance to me of a permit to construct building described above I agree to do
the proposed work in accordance with the description above s fo and ip p� provisions of
ordinances of the city of Fridley. / o) .
In consideration of the payment of a fee of $ 10.00 , permit is hereby granted toMi s n M d Irs.
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 location, construction, alteration, maffitenance, repair and moving of buildings
within the city limiffi ns permit may be revoked at any time upon violation of any of the provisions of d
ordinances.
Allen Jensen Building Inspector
NOTICE:
Ibis peen* don not eerwr tho candmcdw, hatdla:ton for vfbln& plumbing, gas has&& Sawa w wdw. Be naso to m
tha Buibilag IeapKler for npM to parm6s for than *ams.
APPLICATION FOR RtiiLDING PERMIT
CITY OF FRTDLEV, MIMNESO„
OWNER'S
G
ADDRESS 6 2- Z O ADDRESS,
LOCATION pig BUILDING
Nd
Street Part of Lot`
LOTBLOCK ADDITION OR SUBDIVISION /11
Corner Lot Inside LdT Sethac 51de-ya'd
SEWER ELEVATION FOWDATIot ELEVATION
Applicant attach to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF* ftib NG-.
To be used as 'ice`
Front DepthHeight
Sq. Ft.. Cu.. Ft:.
Front ,..Dpth Height
Sq. Ft Cu. Ft.
Type of Construction Estimated Cost �•� a�
To be completed �:
The undersigned hereby makesapplfcation for a peimit 'fo the' work hereinspecified,
agreeing,to do all work in strict accordance with the City of Fridley Ordinances
and rulingsf, of -the Department of Buildings;' and he'ieby decjaiieb that all -'the, facts
and representetiorns stated in. thin 'application afe` true' and `correct.
DATE
(Schedule of Fee osts can be found:on:the Rqyeriia Side)
e L�
w i � •
L sL`.
"I', 1000i• .. ,... v. ,. ,... +. ,. ,. ,..+:):tiSt•2S:S.i.., . + 2+2525, r2 iiSdfd52iii2t2f7ii4dRY2Y2.2Yi52i£fdG2c252+.+,+2f;v2i2idi2f2%I f25,i2ii37Y7ti2SMriIf252f2S7S2i7Y;Slftiif252'�wdSif242Y252;7fli;ftf2f2f2S;i2iiYE<.`i2<2.. f,. S:;i>in +>:S'S �..v , , + + + v. ., v v
CIIYOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287
February 18, 1993
Marvin and Sandra Peters
6220 - 6th Street N.E.
Fridley, MN 55432
RE: Property at 6220 - 6th Street N.E.
Dear Mr. and Mrs. Peters:
Recently I received information suggesting that you sometimes
remove snow from your driveway and place it on the property of your
neighbor to the south. Upon inspection, I observed evidence
indicating that this may be the case. Please be advised that you
may be held responsible for damages caused to private property by
these actions.
Feel free to call me at 572-3595 if you have questions or,wish to
discuss this further. Thanks for your cooperation.
Sincerely,
Steven Barg
Planning Assistant
SB:ls
CE -93-46
SUBJECT
PERMIT NO.
City of Fridley
AT THE TOP OF THE TWINS
BUILDING PERMIT
RECEIPT NO
COMMUNITY DEVELOPMENT DIV.
_
r PROTECTIVE INSPECTION SEC.
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
I'' 612-571-3450
910-F15
5/23/94
JOB ADDRESS 6220 6 Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
7
2
1 Upland 2nd SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Mary Peters 6220 6 Street NE -
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
�I NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 20' x 10' Shed
9 CHANGE OF USE FROM TO
STIPULATIONS
See notations on plan. Provide smoke detectors in dwelling 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
SO. FT.
CU. FT.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 60 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
$3,200
$1.60
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
PERMIT FEE Inv. Fee
SAC CHARGE
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
$63.00 $63.00
Fire SC $3.20
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
$130.80
HIZEDAGENT IDATEI
SIGfdATUREOFCO
HENLIDATED THIS IS YrERM
`-
�RLYNTRACTOROR
-
BLDG nA7E
$IGNA URE OF OWNER IIF OWNER 8 ILDERI (DATE)
NEW (( Effective 1/ 1/94
ADDN (( CITY OF FRIDLEY
ALTER (J SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Construction Address: _ 2 2 d 6 f Fr 11�---.----_.—_- --
Legal Description:
Owner Name & Address: �� tea/ PC 1-ess da z a 4 S�- We- Tel. # r7 6 5579
Contractor: 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 IMPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft. .
OTHER: S Re- A-
1 o X z o
Comer Lot [ ] Inside Lot Ft. Yd Setback Side Yard Setbacks
Type of Construction: Estimated Cost: $
J
Approx. Completion Date: 5 09
(Cost on Back)
Driveway Curb Cut Width Needed: Ft. + '6 Ft = Ft x $ _ $
DATE: 3 V APPLICANT: Tel. # RSg
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
/X- CITY USE ONLY
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$800 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 ( ]
$ 13-o- eco
5�4 C&X4&7 'i Aa
zlr G.G.
V0
24 rLY xnnrex
0
,r -'Z-2,
Ir r zr P✓f v MiZD
WMIAV6
LEFTi SIDE ELEVATION Q/
PLAre3
�� •.�orsr
G. G.
TION FRONT WALL SECTION
• JC�'x IG'x 8' 5TATP5l7iiN
rarwu Dr.• 1-31�9�t
l=11'Jfltl5r�'1G5 fififfm
Dealer
Management
Bulletin
F --1j
77-9803-2411-3 (78011
Printing and Publishing Systems Division
3M Imaging Systems Group
Building 223-2N-01, 3M Center
St. Paul, MN 55144-1000
�—
-Ilk 'jj
C7 c'
667" 67"
Litho in USA with 3M offset plates. film and proofing systems.
0
3-
t
Ar
ENGINEERS AND SURVEYORS
LANP SURVEYIN® SOILS TESTING
CIVtt_ 8. MUNICIPP.L ENGINEERING Li f43 PLANNINC3
G418-SCTa AVENUE N.
AAINNEAPOL15 2Z, til!MN.
KE 7- 3637
%t' THEF<N LANA RE,4 F' Ti' a.
1 I
Sea/e: / 3�
SUBJECT
PERMIT NO.
City of Fridley
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
1 ,
R ,PT
COMMUNITY DEVELOPMENT DIV.
1 L PROTECTIVE INSPECTION SEC.
19'94
r 1 �
1
CITY HALL FRIDLEY 55432
"''
NUMBER
REV
DATE
PAGE OF
APPROVED By
612-571-3450
910-F15
5/25/94
JOB ADDRESS
6220 6 Street NE
I LEGAL
LOT NOCK
BL
TRACT OR ADDITION SEE ATTACHED
DESCR.
7O.
2
SHEET
U
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Mary Peters 6220 6 Street NR 571-6859
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.
8 USE OF BUILDING
Residential
7 CLASS OF WORK
Cj NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 24' Round Above Ground Pool
9 CHANGEOFUSEFROM TO
STIPULATIONS See notations/stipulations on letter dated 5/24/94.
w
Before digging call for
all utility locations
SEPARATE PERMITS REQUIRED FOR 454-0002
RE
PLUMBING AND SIGNS. QUIRED
WIRING, HEATING, By LAW
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
OFFST,REET 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
$1,700
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
•85
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-
$39.00
Fire SC $1.70
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
41.55
5iG AOFC NTRACTORO, AU O 2EDAGENT (DATE r
WH ERLVALIDATED k11SIS YOUR PERMIT
Ile
BLDG INSP nATE
SIGN ATURE OF OWNER IIF OWNER BUILDER] ]DATE]
NEW I I Effective 1 / 1 /94
ADDN CITY OF FRIDLEY
ALTER (I SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
Construction Address: _ _ 6 Z Z. (j
Legal Description:
Owner Name & Address; I� �'' a CtJ jPe+e j's 12. Z® f( -z Sf '� Tel. # -?t
IUIr�'r� P o-e,�y �o�AV%1'e-rS6,-N
t ` 2 r- s n e ��
Contractor: -rt � r i� rs , 1-FItsem, k+e E.5 MN LICENSE # 32-3 � q y
Address: b C) )cc" C IAC. Tel. S`i
r t A I ck4,7$-71 - ze5S
Attach to this appliyCation, a Certificate of Survey of the W 7
6 2 Z 6 t, - theme ed 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: Ic coL\a
Lov-X'V-* Vcg-- rer Uri
LE,.Fn L� r 4- � r✓r l e.1'
Corner Lot [ ] Inside Lot (] Ft. Yd Setback Side Yard Setbacks
Type of Construction: Estimated Cost: $ %) -
Approx. Completion Date:
(Cost on Back)
Driveway Curb Cut Width Needed:
Ftp.. = Ft x $ _ $
DATE: �� C c APPLICANT:
Tel. # S-7/-(�0� S�
CITY USE ONLY
Permit Fee
$31-00
Fee Schedule on Reverse Side
I �°
Fire Surcharge
$
.001 of Permit Valuation (1/10th%)
State Surcharge
SAC Charge
$
$.50/$1,000 Valuation
$800 SAC Unit
I
/��L 3 �6
$
per
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
�� aCC • UGC
Driveway Escrow
$
Alt. "A" or Alt. "B" Above
UC �
/-C�S�
D
Erosion Control
$
$450.00 Conservation Plan Review
o
1 , �� c
Park Fee-
$
Fee Determined by Engineering
Sewer Main Charge
$_
Agreement Necessary (] Not Necessary [ ]
TOTAL
$ SS
STIPULATIONS:
'
FkIN,F) N11 \IC IPAL (_ F:\ VFR • 0431 IfNIVI:IlSIT) A\ L. \.I-. FRItA-1-1Y. 11\ 55432 - lb l_' 1 571-3450 - F-:\\ (012) 57 1 -1287
May 24, 1994
Mr. Mary Peters
6220 6th Street NE
Fridley, MN 55432
Re: Swimming Pool Construction at 6220 6th Street NE, Fridley
Dear Mr. Peters:
This letter is to make clear this department's requirements for the
swimming pool construction at the above address.
1. As indicated, one �1) skimmer approved by the National Sanitation
Foundation will be provided.
2. `As indicated, one (1) inlet of approved design for fresh and/or
repurified water will be provided.
3. The filter and pump shall be approved by the N.S.F. and be of
sufficient capacity to provide a minimum turnover of at least two (2)
times -in 24 hours. This department recommends a turnover rate of 6 -
8 hours.
4. A deck of at least three (3) feet wide, measured from the pool waters
edge, shall be provided which extends completely around all private
residential pools. Above ground private residential pools may be
provided with decking of a minimum size of 4 feet by 4 feet at pool
entry points and provided that such decking has the approval of the
City.
5. Fencing or other effective means including but not limited to walls or
buildings, acceptable to the City, shall be provided to positively
control all access to public and private residential swimming pools.
Fencing shall meet the following criteria:
a. The fencing shall prevent the entrance of children and be without
hand or foot holds that would enable a person to climb over it.
b. The fencing shall be at least 6 feet high and entrances shall be
equipped with self-closing and self -latching gates capable of
being locked.
C. Self-closing and self -latching devices shall be placed at the top
of the gate or otherwise inaccessible to small children.
d. The opening between the bottom of- the fence and the ground or
other surface shall be not more than four inches.
May 24, 1994
Mr. Mary Peters
Re: Swimming Pool Construction
Page 2
6. An automatic chlorinator should be provided with a suitable test kit.
7. All electrical and plumbing installations shall be inspected and
approved by the City Inspection Department.
8. All overhead electrical lines must be a minimum of 10 feet
horizontally from the pool surface and la feet straight line distance
from the waters edge.- An alternative is to bury said lines.
10. The pool fill spout must be protected by a vacuum breaker or air -
gapped.
11. Suitable safety equipment to include but not limited to a ring buoy
and rope that is 1 1/2 times the pool diameter, and shepherds crook
pole must be provided and maintained with the pool at all times.
Furthermore, these and any other requirements must meet the provisions of
the Fridley City Code, Section 115, Swimming pools. The building permit is
approved contingent on final inspections and approval by the,City.
If any questions or problems arise from this letter, please feel free to
contact me at 572-3604
Sincerely,
OSI PALAC I O
Chief Building Official
JP/mh
A-4
NJUND c o.91NCQ
Z�NiD
LAND 5URVE.'IrING $0IL3 TESTING
Cil,111, &. MUNICIPAL ENOINEERING LAND PL;"NiNG
6418 - SG ;,VENUE N.
It E 7 - 'I C, 3
Aff, 11 j!
OR THEP, Te
Zat 7 .91o6k 2, -
WE HEREBY CETUIFY" THAI' THIS 15 P, TRUE ANO CORRECT REPRESENT . XT%014 OF P% SUIZYEY OF THE BOUNDARIES OF THE
LAND ABOVE DESCRIBED AND OF THE LOCATION OF ALL BUILDINGS, IF AMY, 11AEREON , AND ALL. VISIBLE ENCROACHMENTS,
IF ANY, FROM OR ON SP -10 LAND. MINDER ENGINEERING CO., INC.
• EWA AFkader
Management
Bulletin
77-9803-2411-3 (7801 Litho in USA with 31V
Printing and Publishing Systems Division
3M Imaging Systems Group
Building 223-2N-01, 3M Center
St. Paul, MN 55144-1000
SUBJECT
R-MIT NO.
City of Fridley
23692
AT THE TOP OF THE TWINS
BUILDING
PERMIT
REC����
Ir
� • _ COMMUNITY DEVELOPMENT DIV.
~ PROTECTIVE INSPECTION SEC
NUMBER
REV
DATE
PAGE OF
APPROVED By
CITY HALL FRIDLEY 55432
612-571-3450
910415
9/5/95
JOB ADDRESS 6220 6 Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR,
7
2
Uplands 2nd
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP
PHONE
Marvin/Sandy Peters 6220 6 Street NE
571-6859
3 CONTRACTOR MAIL ADDRESS
ZIP
PHONE LICENSE NO
Panelcraft of MN Inc 3118 Snelling Ave S,
Mpls., MN 55406
721-6628 2179
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
O NEW ❑ ADDITION Ij ALTERATION ❑ REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Install bow window into existing opening in
living room
9 CHANGE OF USE FROM
TO
STIPULATIONS
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
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
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
$1.55
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$3,100
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS OF ANY OTHER ATE OR LOCAL LAW REGULATING CON-
Fire SC $3.10
STRUCTION OR THE P RFO NC FCO TRUCTION
$87.25
PLAN CHECK FEE
TOTAL FEE
Lice e bC $,h.
00
$96.90
SG U OF ONTRAC AORAUTHORIZEDAGENT IDATEI
HE P O
LY ALIDATED THIS IS YOUR PERMIT
LDG iNSP
1, TATE
SIGNATURE OF OWNEROF OWNER BUILDER) (DATEi
NEW (] Effective 8/1/95
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application .,354
ConstructionAddress:
Legal Description: —
Owner Name & Address: /& y /;1 -y- cls
Contractor: y iii --7-4 c
Address: 5111?
Tel. # -57/-
MN
5%/-
MN LICENSE #
Attach`fo 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
GARAGE AREA: Length Width Height
DECK AREA: Length Width Hgt/Ground
OTHER:
Tel. #
Sq. Ft.
Sq. Ft.
Sq. Ft.
Comer Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks _
Type / ePs1 Estimated C st: $ C7 —
of Construction: 6e'j i�lglaj - a
Approx. Completion Date: Z OleWl1� �
(Cost on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: APPLICANT: � yy %i o�� ��ry Tel. #
CITY USE ONLY
.s
,, t rM
Permit Fee $ ��' �/• S Fee Schedule on Reverse Side
Fire Surcharge $ .001 of Permit Valuation (1/10th%)
State Surcharge $ /.S S` $.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 $ ��
STIPULATIONS:
t�
SUBJECT
City of Fridley
7270 '
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
`
REC IPT NO.
Y-____ COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
r
5d��
NUMBER
REV
GATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910-F15
8/18/98
JOB ADDRESS 6220 6th Street NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
7
2
Upland - 2nd
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Marvin Peters
571-6859
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Modeen Co 6572 Meadowlark In Maple Grove MN 55369
425-3600
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 Rx REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Replace 6 vinyl windows
9 CHANGE OF USE FROM
TO
STIPULATIONS
Install smoke detectors to meet the State
Building Code - in each sleeping
room and on each level of house.
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
1974
.99
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVISIONS O ER STATE OR LOCAL LAW REGULATING CON-
STRUCTI�DAI�THE:PWX0RMAN ONSTRUCTION.
$62.25
Fire SC $1.97
�j
PLAN CHECK FEE
TOTFEE
-OR
Licens
5. 0
1
GN TUBE OF CON' TORAUTHORIZED AGENT iDATE1
ATHIS IS R P IT
A!!.!N&O
BLO INSP
r.TE
SIGNATURE OF OWNER i �F OWNER BUILDERI iDATEi
NEW [ ] Effective 1/ 1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 �b
BUILDING PERMIT APPLICATION
ConstructionAddress: �j o2� � S'%L /V.Z .
Legal Description:
Owner Name &�/,Address: �f���//%� I��T/�S Tel. #
Contractor: llAe, MN LICENSE # 3A4 %
Address: %7 ,���- ��✓/�� �r /�� p� G�� 3�Tel. #
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:
�* �L-
Construction Type: 1p VkVI &�ee,*,el3 Estimated Cost: $ %y
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $
01
DATE: 0� "T� APPLICANT: o�, �//���1 ��, Tel. # 5 Cocom
CITY USE ONLY
Permit Fee $ --S Fee Schedule on Reverse Side
Fire Surcharge $ /. G''� .001 of Permit Valuation (1/10th%)
State Surcharge $ gQ $.50/$1,000 Valuation
SAC Charge $ $1000 per SAC Unit
License Surcharge $C�C� $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 [ J
TOTAL
STIPULATIONS:
SUBJECT
City of Fridley
27938
AT THE TOP OF THE TWINS
BUILDING PERMIT
IN
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
PROTECTIVE INSPECTION SEC.
�3<9
1 �
NUMBER
REV
DATE
PAGE OF
APPROVED By
= CITY HALL FRIDLEY 55432
IL
---- A �'� 612-571-3450
910 -FIS
9/23/98
/ /
JOB ADDRESS 6220 6th St NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
7
2
Upland - 2nd
SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Sandy & Mary Peters
571-6859
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO
Tabor & Sons Roofing Inc 1805 Polk St NE Minneapolis 55418
789-1902 20014248
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
O NEW O ADDITION O ALTERATION REPAIR
O MOVE O REMOVE
8 DESCRIBE WORK
Reroof house (16SQ) Tear -off
9 CHANGEOFUSEFROM TO
STIPULATIONS
Underlayment must comply with the State Building Code.
SEPARATE PERMITS ARE REQUIRED FOR ELECTgICAI, 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
1 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
$1,371.00
$.69
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON.
$45.75
Fire SC $1.37
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
AT 9d - -9 3- /q�
PLAN CHECK FEE
License $5.00
.4 /
TOTA E
$52.81
SIGNATURE OF CONTRACTOR OR 4UTHORiZEO AGENT IDATEi
EN OPE A IDA THIS PIR I7
� � O
S-GNATURE OF OWNEROF OWNERBU4DER1 iDATEi
iNSo
DATE
NEW [ ] Effective 1/1/98
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 1��
BUILDING PERMIT APPLICATION
ConstructionAddress: oM Cl _jV 91 f _
Legal Description:
Owner Name & Address: Tel. #
Contractor: MN LICENSE #
Address: l g a S 4P1-Z!1f(1Zt Tel. # 1,� 9 -/So
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: '/6 S 2 '/'z" off ,
Construction Type: Estimated Cost: $
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $
DATE: APPLICANT: Tel. #
STIPULATIONS:
CITY USE ONLY
Permit Fee
$ 'L% S
Fee Schedule on Reverse Side
Fire Surcharge
$ 1,3 %
.001 of Permit Valuation (1/10th%)
State Surcharge
$ j 2
$.50/$1,000 Valuation
SAC Charge
$
$1000 per SAC Unit
License Surcharge
$ S - DO
$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
$ c l
STIPULATIONS:
Building
Inspections
763-572-3604
SITE ADDRESS CLQ G "'
THIS APPLICANT IS:
PROPERTY OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE LICENSE
WITH APPLICATION
PROPERTY TYPE
BUILDING
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
OWNER
STATE LICENSE #
ADDRESS' 416
❑ TWO
YOUR E-MAIL ADDRESS
❑CONTRACTOR
e -
Permit No.:
Received By:
Date Rec'd:
7700-1 t
2 -
CA 41A S f/2AC-fi ®/ti
2c'501.;? EXP DATE 3 M'V
V1U ()Ac . Aim—%V CITY N� f STATE ZIP S�2
-Ina - 5 9 92 FAx 7L 3 - 3 - S -0I i
PERMIT TYPE U AU17111UN U Utuwvcranru — ••+•+�•+••�
❑ BASEMENT FINISH ARTILEOOF ❑ DRAIN T
❑ DECK ❑ IDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK: ❑ NEW ❑ ADDITION
ANCEJREPAIR ❑ REMODELING
DESCRIBE WORK BEING DONE: JZ r-_fZoo r f31 too us i� -5 6-M A 6&
SIZE OF IMPROVEMENT
ROOFING rr�
NUMBER OF SQUARES r? l0 0
GARAGES
PROPOSED SIZE:'
PROPOSED HEIGHT:
SIDING ,` j13
❑ Vinyl I
❑ Aluminum .•JJ
❑ Other
LENGTH
❑ HOUSE ONLY
AROUSE & GARAGE
❑ ATTACHED GARAGE
❑ DETACHED GARAGE
❑Soffit
❑ Trim
❑ Fascia
HEIGHT
Ft. Ft.
BASEMENT REMODELING SUBMIT:
1. Existing Floor Plan
2. Proposed floor plan
3. List of structural members to be used
FOR NEW CONSTRUCTION INCLUDING DECKS,
ADDITIONS & PORCHES SUBMIT:
1. Site Plan/Survey showing the existing structures
and proposed project
2. Two sets of construction plans
WINDOWS3. Energy Calculations
IN EXISTING OPENINGS ❑Yes LOCATION OF WINDOWS
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 S OCCUPANCY TYPE
Permit Fee $ " See Back Page for Fee Schedule
Plan Review $ 65% of Building Permit Fee
Surcharge $ �' . /� (.0005) times the total job valuation — Minimum $.50
Fire Surcharge $ -001 x Permit Valuation (1/10%)
License Surcharge $ T $5.00 (State Licensed Residential Contractors)
SAC Charge $ ®.(� $1450 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow $ ft + 6 ft = R x $20 = $
Erosion Control $ $450 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( )
Total Due $ n Make checks payable to: City of Fridley 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 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 w 'ch require iew AV,!PRWTN"E
of plans. `'�""
SIGNATURE OF APPLICANT -vJ uADATE
Building
Inspections
7.63-572-3604
SITE ADDRESS _
THIS APPLICANT IS:
OWNER/
TENANT
SUBMIT A COPY OF
YOUR STATE
LICENSE WITH
APPLICATION
PERNIIT TYPE
TYPE OF WORK:
Vc - - Hermit No.:
MECHANICAL
LICATIUN Received By:
RESIDENTIAL APP
.CITY OF FRIDLEY Date Recd: �
A
CONTACT PERSON: UtYL11JUFIULL 11VU-- •••--
STATELICENSE# 2619 COON RAPIDSEM
ADDRESS: COON RAPIDS. MN 0
�C,TiLYa"Z��.•
PNGLE FAMILY 13 TWO FAMILY
O NEW �tEPLACEMEN7 —
DETAII.ED DESCRIPTION OF WORK
O TOWNHOUSE
O ALTERATION/REMODEL
ATE ZIP
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
only the cost of labor)
improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect
Labor cost under $300 = $15.00.
Labor cost between $300 to $500 = cost of labor x.05 =
FOR PROJECTS WHERE LABOR EXCEEDSY.FE—ES ARE BASED ON 510.00 PER FDMRU!. EXCEPT W—HNE/RrE�N,OTED. FIXTURES: MWICATETOTAL
NUArBER OF EACH BELOW) �OjAS q� lv s=MTU—TDt 00 O
EquipmentlnstaUed
MFG:� MODEL. SIZFJBTU
,. MODEL:
SIZEMTU
A/C 525.00FIREPLACE
MFG: MODEL:
(GAS) S 15.00 GAS RANGE/OVEN $10.00
NEW GAS GRILL $10.00
AIR TO AIR EXCHANGEER $15
EDII'�
FIREPLACE (WOOD) $35.00
FURNACE $35.00 GAS UNIT HTR $10.00
Y LINS35.00
CHIMNEY LINER $10.00
POOL HEATER $35.00
GAS DRYER SI0.00 POOL
815.00
VENTILATOR S1
DUCT WORK uQ00
GAS
PIPING $10.00
Permit Fee $
Number of fixtures @ $10.00 x SIU.UU _
Surcharge S .50
Number of fixtures ® $15.00 x $15.00 = $
TOTAL DUE
Number of fixtures @ $25.00 x $25.00 = $
Number of fixtures @ $35.00 x $35.00 = $
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
not a permit but only an applicatiovOlor a permit and work is not to start ut a permit; that the work will be' accor will the
approved plan in the case of q w# which requ /av',11.and . .appm�al f lans��
w A
SIGNATURE OF
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
'74'A_1q7'7_'Atina