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PRE 2010 DOCS• 0 0 .0 City of Fridley, »ren. BUILDING PERMIT N° 6419 Builder - Address / OC ONWX.0 DING No. Street s _ -Part o Lot ai Lot _ _ ___ Block 01Addition or Sub -Division Corner Lot — Inside Lot — Setback —_ _ Sideyard �r Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To Used - Front Depth Height Sq. Ft. %��/ Cu. Ftxf Fro t Depth,hleight� ^ 5q. Ft. a CFt. Type of Construction Est. Cost y�� Ste' '�To be Completed _ In consideration of the issuance to me of a permit to construct the building described above, I agree to 0 the proposed work in accordance with the description above seqfo;��In mpliance with all provisio of ordinances of the city of Fridley. r In consideration of the payment of a fee of $ permit is hereby granted to, th to construct the building or addition as described above. This permit is granted upon e express condition that the person to whom it is granted and his agents, employees and workmen, in aII work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of 7Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings whin the dty ]units and this permit may be revoked a t any time upon vio n of any of the provisions of said Building Inspector NOTICE: ibb perm doss not corer t6 censtroction, hataMon for Wh%& plumbing, an henthm saver or water. Be sura to �• the Bu[Mh* hnpsetor for nparaM permhs for these Items. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA ADDRESS LOCATION OF BUILDING No. % lStreet /`�` �, Part of Lot 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 build- ing location drawn on these Certificates. To be used as: DESCRIPTION OF BUILDING Front Depth Height, Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Estimated 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 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. S DATE S IGNATITRE (Schedule of Fee Costs can be found on the Reverse Side). . , , r 0 City of Fridley Application for Plumbing and Gas Fitting Permit DESCRIPTION OF WORK Number. Kind and Location of Fixtures PARTIAL RATE SCHEDULE r PLUMBING FIXTURE RATES: NO. RATE DOTAL Number Fixtures..... x $1.50 $za IS -0................. Future Fixture Opening........ ........ x 1.20 $ New Fixture Old Opening .............. x NU' F N WATER HTR. GAS EIEC Water Heater (Up to 200,000 BTU) ...... -----,,/x 2.00 $ d. 0 New Ground Run Old Bldg. ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... 1 x O $I� Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ Base 1st % l 2nd 3rd 4th • Future cc! i Sion Openings Connected with I Sewer e New Fixture, Old Openings Cesspool PARTIAL RATE SCHEDULE r PLUMBING FIXTURE RATES: NO. RATE DOTAL Number Fixtures..... x $1.50 $za IS -0................. 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 $ d. 0 New Ground Run Old Bldg. ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... 1 x $1.50 $I� Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS -Refer to Code Description ..................:........:....................$ TOTAL FEE -� Dept. of Bldgs. Phone SU 4-77470 .�,[ All,# Locat* 7 (° 7 f0 vim, T`" � fo �: (Wit, City of Fridley: The undersigned hereby makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this application are true and correct. % Fridley, Minn- f�d If 4 19_ Owner L &ay 0 T Kind of Building ®®� Used as 42 nn� To be completed about didf0, Estimated Cost, $ Old New Building Permit No Permit No. Cg—:2 ROUGx �" 3 FINAL 42 2M Business Phone City of Fridley, Minn. • BUILDING PERMIT Dates JUNE 1, 1966 is • Owner: CLIFFORD RICK11OFF Builder Address 1567 - 60th Avenue N. E. Address Fridley, Minnesota 55421 No. 1567 Lot 2 LOCATION OF BUILDING SAME Street 60th Avenue N. E. part of Lot . Block 1 Addition or Sub -Division SAKARIASON Corner Lot _ Inside Lot X Setback — Sideyard Sewer Elevation ___ _ — Foundation Elevation DESCRIPTION OF BUILDING N° 8865 To be Used as: DET. GARAGE Front 22 Depth 24 Height 10 Sq. Ft. 528 CU, Ft, 5.280 Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Frame Est. Cost _ 1 5 00 To be Completed In consideration of the issuance to me of a permit to the building described above I agree to do the proposed work accordance with the description above se Drib and in compliance with, 6provisions of ordinaacos of the cityof Fridley. --� ✓ "�,/ In consideration of the payment of a fee of $ 5.00 , permit is hereby granted to CLT-IMORD RICKHOFF 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 aad his agents, employees sad workmen, in aII work done in, around and upon said building, or say part thereof, shall conform in all respects to the ordinances of OtFridley, Minnesota location, construction, alteration, maintenance, repair and movhzg of buil�ags wr8E city limits permit may be revoked at aqy time upon violation of any of the provisions of said WILLIAM H. SANDIN Building Ncmclh We po mIt don not emu the aondrucHm, f ouffadw for wbb& phmbine, an heaft& awar m water. Be am to an tM 6eHdleo hopeftr for vgwde pwmhs for thea h ms. APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME BUILDER ADDRESS / S 6 %- y ADDRESS LOCATION OF BUILDING N0, 5 STREET a—� `� - PART OF LOT LOT o2 BLOCK ADDITION OR SUBDIVISION X_ /A S® ®I1 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 To be used as; Ct 9,A-14& A Front � � Depth-"�_ZHeight Sq, Ft. e Cu. Ft. Front Dept ^ Height Sq. Ft. Cu. Ft. Type of Construction_ C,44,g C-� Estimated Cost / .old d 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 SIGNATURE (Sched a of Fee Costs can be found on the Reverse Side). Roger Sareoleil or. 9986 172-47 F. C. JACKSON � dky L Sca/e : /" LAND suRVErore REa1STERED UNOER LAWG OF STATE OF NINNESDTA UCKNSED /Y ORDINANCE OF CITY OF NINNEAFCKM 'e? 3616 EAST 55TH I"EET PA. A-AGBI btttti m'o pruhut" t �,f 1 HERESY CERTIFY THAT THE ASOVE 19 A TRUE AND =1lRECT RAT of A SURVEY OF V Lot 1 Block 1, Sakariasan's Addition. Anoka Cauuty, Minnesota. Al *U*VgrW UV ME TN> 270% _DAY OF�Oct. A.D. Nov. 4 m m N cp N N (D W J A .-e LL En A D_' iE z W { Z: O Q' M L r CD v 11) D m m ID � N CD U W A DESIGN INFORMATION FMLSY JF"Y NSUMAN Nv0: FRID8497 TI: 61212 : 11 '►eh aao4p n `► boa taw a,rfWw sewtaavee.( lwreeotwdreeldwmtiks i'a� Cil�ti38t 2x4 � 411/412 OD r All 0C4FR8981Qt OfoCAa eie aateraed to be erect®a�ooeragiOtIIt Imeatitlms�a.me...oaea 09) 8- 2-13 ptatlidbvdrra/hedlaidrcrartfrorms DO Oil M3 23c4 OF N/N2 M camtirmowly bViced eaaleeq noted othetwiet•. 11 0- 0- 0 6) 12- o- 61 22- a- o lo) o- 0- 0 asyxryt"e9111eyRttotraptaxarcattN f aqulaocwOctlbRaaati iir"waatkcs 1etlN tkmu act tttsw.Qtoxy VMS1 24 fi0'P 8= on 1WX LIVE TAM t8FLA 40111 r TC... NORM ... CSI ..BC ... fORCS...C23 21 S- 9. 4 3) 11- 0- 0 7) 13- 9. 3 41 16- 1-12 0) 12- 0- 0 sod thecdea artaxa+setAaanaasstfrtoaracy t4 t+lxraetten x k wq Rilttt a a tp &/999 IA -0.09, Dx-0.030 Tn-0.14' 1- 2 -9452 0.74 10- 9 1921 0,79 4- 3 -1093 0.71 9- 8 1117 0.63 ffrt pm)joa tad soceyC mf ntys.uibMI or 7- 4 -1893 0.71 8- 7 1297 0.63 ettRlaaa sofMRNniER to MACA- 4- 5 -2232 0.74 7- 6 3921 0.19 Mft liasABtj, 71it�fxiR! M d Iforaa 71Arwanimbeasdm4p4isN I A N rRR`j * .1$0...vw(Z... GSI .M...Palm ... G9E -bl7 0.30 ' ~ 17 �� go bm"pe ord it prl erlde bailct del6+br a Baiatai I f 3- 9 0.40 �- 349 0.30 DdPrr frghtsrd rrdiba er r ftdm rI t010001 Vba MTawd @rsp}r.� d ortm 0 46 I�►�A � o ori+«wandp�c.�oessi6aleseretta.wtr. r:usbeibecLV cote sure to eoa.lfw ar.ra4rteettat wtM do trdk.Am%ks eo6sy e�RRN " S TAR ►pp�qq a011.1: RCttr(O fef vej tf rsvw kraft ItrMw` own"tnl�bn:tivin4kopudIIV �7 /` (� r r 15(0-1 (00TR ANC IVC t►Yayt a mov rey baA. Tau aatLe mama cea/rraiawtictdsp srbagtf)metcaaaso ka:be"�"�a'�'�.e �RzDtry FOR 3ERRy bendIacetsttyd -- N&WKAMM fh"I'll "I" x a ws�p� .19 'N 161r o c. 1-40 1] 4 FABRICATION NOTES t 4 S fm is WWW". 0* 4k wAv SAN ratkw =r-." w ,0a Dot Wt.+rwiQ, ht 6-00 fe:t�9ea0t wilt fk }blai(tY.T'l pfraa id to #tube a een60aias tegramellry fir Vara ml. SX6 ftrAm Any&wroeasfet an robs yet kw rriS.3 befou «wtnz er f1MlCartt Qeruat yetat MA& be nxuLamMU Rex M�t bel- .araera Utel taeaU7 AVFm A 411 Orratt0, ret ai►gea b r+r.+ad wtkat ea6l. rlatri tLU n0iba fsatalkd war beMNkti . le"aar a+fto, Vtmbeo*Abtw rtt t+ab n ,wl eo av" twhea t. coo. 2x X4 xatw ytam ttaatt re re:atol en Esse tact rt bis aMrA Ia V#d obey ahtl re S•16-9 . of 01, ftfr .aa�.rt.rrwla+••e+tm.�a�arrt.cdw.n a ' ,,Z thi'-Wsa'Iof A6eaOloetIta' 6-9-1$ .aat;ef' kw Jkx rye:kr))ww ►t+xlitl ro tla pbte krttbl t►nfia•S 0w+rk euLt on utr 1 a.eeeren rarR x 4 aawabl of tlrt cert OtkU teAlfaite Aefa.�. Caoayot yhaf IIsA 0-�3 0-4-3 aK Rata Aaabaad Mdt tbtoe'a 3Vwn ettf w N 611 ffa'tlated fbr fa)eiFn AiL 1 r p atal"A tbt Uta TUs tree is set ubeAbeiestea.HeAMRtataea�sea 3X6 3X4 3R8 3X4 3x6 Iw Wo wAtb oaa Nrnwtea Ir/or t4fl"aa FOR Imim M Qt WRY Moorti arfe 'QW19y SU2AW4 for bkW rlws conr0=4 ww0 lY.sar, Q�-!6 atd Tyl ReeesrsM6A cads of fAadael rreatics`. PRECAUTIONARY NOTES Auttrwhw and atctlae tteaem.a filem we ish fdlowad to axecdom w1da'Mae/rp Mu ti; a mebm" 11041. Tease" we be 124-0 to hVAGM Vd*y xeketlrettaAWf a UMMM 10 9 i 7 6 rdloodka.lalWereardImAo almts a cit d pal�r"t>w W dicup �Our 132M 3.5V 15Z1�Al 32-0 Ir Vwra fetILterne /Ya 244 0 _� *104 ctrl bar lfed try �..•ctoAd h rd, livisossomdolJedefsNlsnle Isdwa)a (822.13) 22-0 0 (A2 2.131 «ylssi.Aitmtlinivoo =..rtr was) regillsw irts"Inykwims4urrp Exc AS SHOWN PLATES ARE MUO GA TESTED PER A,NS9l1'PI 1.19% scale OM77 WMAnnbn"ert aum arobl 4�lil►'R i PLEAD ALL NOTES ON THi$ SHEET. A COPY OF THIS DRAVN tI�1G TO BR OMN TO ERECTING Fes• Jt>8,r D9�° 0: FRIDVM lvflss ID: 61=2 We. TbsR*tn(r.wefaetrland twaeew$aW bAlabe taster eptttn+¢gl of ptnoet agevieata In At icase&U'4Of eeot"LT vaereealt.al u4. ct tart rt feettM itlarOlra. 4Ma�a8is rf fOatlttied0a lath ysatrr dRI.e CONTRACTOR. c>>ti:: Dale; 9-20-%t3awde ktlp Iwdr te.0 not K tp4t'ici a eman or my 6Rs. N►Iwdi otntralwt tLc .Q TC Live 40.0 PC D AW - UW-' US D weilla of eb eoecters tltalbe ederat n WSW intra Orel an faacwrlr tral NscMK SBACING WARNING Brxkq tbam ee eNt bawb+{ 4 qDl erefatr.trrat Iy >.iea lractea, perttirt� et t o/x bradns TC Dead 10.0 pd 1?IlrFac -Pit: I.1S lraergkwl. vAkAA lrs7eel of tls UeiRVnR 4aly+vd>.MrA o.vUh wePLrdbyeMe..ilAesudcef0ut. Worm; 'f 11� 1.he 0.0 p6t O.C. ¢pod 24.0° " "�� SPLICES 11 11 l��� tra.n 4 for hwo wMan al cum mseebatt awry N rachet bNifieo kan.1 hmidw rmA be e.rJr u aarrr trarsr N,uit4 x tecta rA gertRad lautem urn+laM bt tM Cwtw+6 aaxtner. �C Deed L9.0 D � Cdt¢ela: UHC 1.4w va'iagqtneP cyiksaxpyros. 104 -if potlknfil.th'eta.yGsk!:4 wnfybArrwnea AdtGles>olhw-re)octrr s.txll ae.a:teae may ►e nywrtJ_ WxHl0Al efiPf). Rr geNRt `+ ^lmatemenu.oeaRaw++9v6aimta. t7ruwPirttrnuwm.tYt_ateuerar Code De.4c. ' MIDWiI.STMANl1FACTU(p(SPEC)AlS) ttatrHt» Jct. ID 376J353 fax 713 b77bb-3565 161 D�utata 0rtvs. Ated)tsa. Wttavwua flytfl• TOTAL 68.0 QSi - ML &- a Moo U 3E m in CD ca O 3 3 C E m -t A C N ul -4 O Tt M f:] Lill Ur rhibLLY _ APPLICATION FOR PLI MBING AND GAS FITTING PEF#i1T-. —_ RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures. ; 5.00 $ Future Fixtures $ 3.50 $ Old Opening, New Fixture $ 1.50 $ Beer Dispenser — $ 4.00 $ Blow Off Sarin $ 5.00 $ Catch Basin $ 5.00 $ Rain Wt -at header S 5.00 $ Hydraulic valve S 5.00 $ Sump or Receiving Tank S 5.00 $ rater Treating Appliance $ 7.00 $ Mot Water heater $ 5.00 S Gee Range S 10,00 S Zas Dryer 1u.00 S ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1% of Value of Fixture or Appliance $ Reinspection tea S State Surcharge $ .50 TOTAL FEE SM -13-6 Job Address Department of Buildings City of Fridley - Tel. IS71-3450 The -.undersigned hereby makes application for &_permit for the work herein specified agreeing to do all work in strict accordance with the Ci q Codes and rulings of the Departmentbf-$ulldings,_ind hereby declares that all the facts and represent&tions. NSA Led.ln this Application are true and-ivrrect Fridley, Mn. , x.9...0 j9 OWNER72- -6W3 KIND OF BUILDING - US ED AS TD BE COMPLETED ABOUT�� _ - - ---- ESTIYA:ED C ZT - y� OLD - NEW BUILDING PERMIT NO. PEP_KIT NO. Company Signed By 474---) 000, 14 Tel. No.f . hclu-f INSP. Da t e�-J �I FINAL INSP.---'— Date — APPf•.JJA.L FOR PE M!T !11::I!1114 FEE FOR ANY PLUMUINC PERMIT IS $10.00 PLUS THE $.50 STkTE SURCIIAHGE _ - r -. ✓ o Waterx oi- t9sA a Q. a Heater S 'cc t. o Cl! c 'a ` e.vr:Oi Y• rar - a Ic m a s r H 0 .as lac let 2nd '- 3rd 4 th (R) - eFuture Connection Opening Connected with Serer (') a New Fixture, Old Opening* aster RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures. ; 5.00 $ Future Fixtures $ 3.50 $ Old Opening, New Fixture $ 1.50 $ Beer Dispenser — $ 4.00 $ Blow Off Sarin $ 5.00 $ Catch Basin $ 5.00 $ Rain Wt -at header S 5.00 $ Hydraulic valve S 5.00 $ Sump or Receiving Tank S 5.00 $ rater Treating Appliance $ 7.00 $ Mot Water heater $ 5.00 S Gee Range S 10,00 S Zas Dryer 1u.00 S ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1% of Value of Fixture or Appliance $ Reinspection tea S State Surcharge $ .50 TOTAL FEE SM -13-6 Job Address Department of Buildings City of Fridley - Tel. IS71-3450 The -.undersigned hereby makes application for &_permit for the work herein specified agreeing to do all work in strict accordance with the Ci q Codes and rulings of the Departmentbf-$ulldings,_ind hereby declares that all the facts and represent&tions. NSA Led.ln this Application are true and-ivrrect Fridley, Mn. , x.9...0 j9 OWNER72- -6W3 KIND OF BUILDING - US ED AS TD BE COMPLETED ABOUT�� _ - - ---- ESTIYA:ED C ZT - y� OLD - NEW BUILDING PERMIT NO. PEP_KIT NO. Company Signed By 474---) 000, 14 Tel. No.f . hclu-f INSP. Da t e�-J �I FINAL INSP.---'— Date — APPf•.JJA.L FOR PE M!T !11::I!1114 FEE FOR ANY PLUMUINC PERMIT IS $10.00 PLUS THE $.50 STkTE SURCIIAHGE _ - 0 SUBJECT PER - City of Fridley AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. Ir L. • COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. r NUMBER REV DATE PAGE OF APPROVED 10 CITY HALL FRIDLEY 55432 612-571-3450 910-F15 9/16/96 JOB ADDRESS 1567 60 Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 1 1 Sakariason's Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jeffrey/Cheryl Sliter 1567 60 Avenue NE 647-4774 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 p NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE REMOVE XX 8 DESCRIBE WORK Remove existing garage; Construct a 24' x 22' & 9' x 15' Garage 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. Provide a hard surface driveway. 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 1 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 @ @ $6.14 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $12,283 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- $199.75 Fire SC $12.28 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECKFE TO A FEE __/N $218.17 URE NT D UTw (DATE, PA LY VALIDA THIS IS Y UR PE MIT / 44eo INSP narE RE F ERt F O BUILDER, IDA E, 0 SEP 12 196 14:22 FROM NORWEST MORTGAGE PRGE.002 OrNL Effoctive 3/1/96 ADDN C ] CITY OF FRIDLEY ALTER [ J SINGLB FAMILY AND DUPL R-1 AND R-2 (/ Buikft Pcrnorit Application s jj l CdnsUWdonAddress: M (off n 44.1 Lnal i r - Owner Name & Address• _Dt EE `-e.c4 Z�. Jr C. �•��� -ke— _ Tel. ?!Y �%7• y� 7 CODU=tor: Tel. R Attach to this application, a CeWficft of Sutr►Cy of the lot, with the proposed cou traction drawn on it to scale. UVM AREA: Length �.. wider ...� -HCWSq. rit. GARAGE AM: Length & Y Wide Heist Sq. Pt. - DEG AREA; Lenah Width � IWGfMnd omm; it Ill 2�3' coiner Lot j) ludde Lot FL Yd .Setback SW Yasd weft of Constructian:-p,ie,d •$� ►pproa..Compledm Dau: on imelc) WRVMy Cutb Cut Width Needed: Pt. + 6 Ft = Pt R $ 1A1B:9 4 APPLICANT: �1� i % Tel. if *y. �V TOTAL $ '91 / 7 17PULATIONS: . C'11'Y US�p111L'� etmit Fee $Ri Z' ' Fee Sche&* out Reverse Side ire surchw e $ .001 of Permit 'Valuation (11101h%) Patin .Snroharge $ / $.501$1,000 Valeatlon AC Charge $L__ $900 per SAC Urft iceme 5=harge $ $5.00 (State Lkensed Residential Cotrtraetors) riveway Barrow $ Alt. "A" or AIL 'B" Above codon Conchal $ $450.00 Comwrvadou Plain Review uk Fee $ Fee Determined by Eggine rk% ;wer Main Charge $ Agreement Necessazyr [ j Not Neeceeaty j TOTAL $ '91 / 7 17PULATIONS: SEP 12 '96 14:23 FROM NORWEST MORTGAGE PAGE.003 c h v to Roger Sarsaleil or. 9986 172-47 F. C. JACKSON �` �(ftZ� L �4m-`�`)go "NO SURVEYOR 074 REGISTERED UNDER LAWS OF STATE OF MINNEaOTA UC&NG9D MY ORDINANCE OF CITY OF MINNEAPOLIS 5616 EAST 55TH STREET PA. 4-4681 �ttrbtpor'g 6trti a �` Z 5.4 1 1 y Z� c; N Q 4- j � v - 3�-7 - • - /ZS.a 1 HERESY CERTIFY THAT THE ABOVE Ie A TRUE AND -CORRECT PLAT OF A SURVEY OF Lat 1 Black 1, Sakarias= 's Addition. M Anoka Caunty, Minnesota. _ �v As *V*Ve tO WY qE TN th.__DAY of Oct_ �.D. Nov. /' SUBJECT NO. - City of Fridley 2 517 3" AT THE TOP OF THE TWINS BUILDING PERMIT r �• RECEIPTNO. __ COMMUNITY DEVELOPMENT DIV. v PROTECTIVE INSPECTION SEC v r NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 6/13/97 JOB ADDRESS 1567 60 Avenue NE I LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 1 Sakariason's Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Cheryl Sliter 1567 60 Avenue NE 571-0117 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Panelcraft 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 ❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Soffit/Fascia 9 CHANGE OF USE FROM TO STIPULATIONS Install ventilation to meet the State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING 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 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 $3,000 $1.50 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- $74.75 Fire SC $3.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE License SC $5.00 $84.25 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WHEN PROPERLY LID ED THIS IS YOUR PERMIT BLD INSP OATS SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI NI"W I I Ulective 1/1/94 ADDN I I CITY OF FRIDLEY ALTER I I SINGLE FAMILY AND DUPLEXES R -i AND R-2 Building Permit Application�� ConstructionAddress: �Sla % �Q'' aGyo,ltj Legal Description: Owner Name & Address: _ /' G � ✓�/ ��%v D 9 %% Tel. # Contractor: l `,?Zo- I-aA �B-/ 1%7 MN LICENSE 11 Address: 3//� _ClY2-ell Tel. # 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 Length Width Height Length Width Hgt/Ground Sq. Ft. Sy. Ft.- Sq. t.Sq. Ft. Corner Lot Inside Lot Ft. Yd Setback Side Yard Setbacks Type of Construction: �4� f ��lf'Cl� z�Estimated Cost: $ I o Approx. Completion Date: (Cost on Back) Driveway Curb Cut Width Needed: Ft. + G Ft = Ft x $ DATE: i0';� APPLICANT: LJ%1/TA14.11r�i;.2��i�it� Tel. #el CITY USE ONLY Permit Fee $�°y Fee Schedule on Reverse Side Fire Surcharge $__, .001 of Permit Valuation (1/ IOIh l ) State Surcharge $.50/$1,000 Valuation SAC Charge $__ _ $800 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 Charl;e $ - ----_-___-- Agreement Necessary I I Not. Necessary - TOTAL p � 'STIPULATIONS: . . �� CITY OF FRIDLEY INSPECTION DIV, 6431 University Ave NE Fridley, MN 55432 572-3604 RATE SCHEDULE Residential Effective On January 1, 1997 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Furnace Shell and Duct Work, Burner Also Replacement Furnace (Side Vent — Fill Out Back) Gas Piping (Needed with new furnace) Rate TOTAL $ 30.00 $ $ 10.00 $ /0' y0 Gas Range $ 10,00 $ Gas Dryer $10.00 $ *Air Conditioning — All Sizes $ 25.00 $ All Others/Repairs & Alterations (LIST ON BACK 11% of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work State Surcharge TOTAL FEE $ .50 a$ S -SD MINIMUM FEE FOR ANY HEATING/COOUNG/VENTILATION 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 1 — LO The undersigned hereby makes application for a permit forthe 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. -)_1�p. 1997 OWNER. S�►-ky- 57/- b►17 BUILDING USED AS ESTI TED COST 3 dO • U�_ PERMIT N0. Se d_+ ►^ DESCRIPTIO OF FURNACE AND OR BURNER No. No. of Heating Units Circle One Trade Name_ BTU Fuel Burner Trade Name BTU HP (Steam) (Hot Water) (Warm Air) _ Size No. EDR Total Connected Load Size No. HP EDR HEATING COMPANYC Signed 8 tv, ITel N4..111 Approved By Rough—In Date Final Date 7 ' 2 ' q7 FILL OUT BACK SIDE F R STACK VERIFICATION ON REPLACEMENT FURNA E CFfMJNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. . Has been carefully examined Yes O No ( ) 2. Is free from rust -or deterioration Yes ( ) No ( ) 3. Has no foreign objects lodged within Yes ( ) No ( ) 4. Is securely supported Yes ( ) No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes () 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 ( ) No ( ) 8. Has combustion air been provided for water heater Yes ( ) No ( ) Remarks: List ALTERATIONS Being Done: HEATING CO: Signed By: Date: sueJEtr IT NO. City of Fridley 30054711 AT THE TOP OF THE TWINS BUILDING PERMIT 6. i • y .......COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 = � CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 8/13/99 JOB ADDRESS 1567 60th Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 1 ISakariason's Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Cheryl & Jon Knudsen 571-9722 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Owner 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 ❑ ALTERATION -49 REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof house (18 S Tear -off; Reside house Storm Damage) 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code Call for building wrap inspection before covering. REFUNDED RESIDING PART OF PERMIT 5/9/00. THIS PERMIT BASED ON $1,573 VALUE/ROOFING PF $57.05 PAID $181.25 REFUND $124.20 SC $ .79 it 4.53 " 3.74 FC $ 1.57 if 9.07 " 7.50 $59.41 $194.85 $135.44 APPLIED TO BLDG PERMIT #30925 ISSUED 5/9/00. 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 $9073 $4.53 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 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $Un $181.25 $9.07 PLAN CHECK FEE FTOTAL FEE $19Y. 85 1 A, O ACTORORA N GENT DATES HEN ROPE (DATED IS YOUR PERM( 1V / 6 N UR OW NER ���OWNER B U.IDER� iDATE� 8YbG INSO f,ATE NEW[ ] ADDN ALTER Effective 5/10/99 I l CITY OF FRIDLEY [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: Legal Description: Owner Name & Address: Contractor: Address: )-'& ate- k -e- $ _ Tel. # toc`l7aZ�- MN LICENSE # Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF-EMPROVEMENT LIVING AREA: g- 7 r x `� 7,K �g ``� Int(' X $ qS• GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width ' Hgt/Ground Sq. Ft. OTHER'AS' � 4'La-6v _ s Construction Type:9�001aCC-"kco��� Estimated Cost: $ y Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ =$ '75to 3 DATE: QAPPLICANT: O (2,W hT�jY-eq Tel. # jo t f1 L- STIPULATIONS: CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ . ®`/ .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,00 Valuation SAC Charge $ $1050 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 $ / 7 - 8! STIPULATIONS: L SUBJECT P City of Fridley 3 0 929 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT O ______ COMMUNITY DEVELOPMENT DIV. v }N�,�.� ) r PROTECTIVE INSPECTION SEC (�" 1 = � CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY 612-571-3450 910415 5/9/00 JOB ADDRESS 1567 60 Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DEscR. 2 1 Sakariason's Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Cheryl/Jon Knudsen 1567 60 Avenue NE 571-9722 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 B USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 19' x 10'4" Deck and a screen porch to wrap around existing and new deck 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. Provide smoke detectors in all sleeping rooms and on all levels of the dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. Fees applied to this permit from Bldg Permit #30054 (Residing not to be done) Permit Fee $124.20 This Permit Permit Fee $111.25 SC 3.74 4.52 Fire SC 7.50 2 26 �— $135.44 $118. 3 Refund $17.41 WARNING 80011e digging call for all utility locations ACA SEPARATE PERMITS ARE REQUIRED FOR ELE I� TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD OR AIR �H (CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK ORCONSTCTIO NG SO. FT CU FT. AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 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 @ $2.26 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT `Y4,523 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- $111.25 Fire SC $4.52 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL FEE $118.03 19NAT� OFC N' ACTOROR4 1Z AGENT i0 TES ,FO/L ® W&HN P RLY A DATED THIS IS YOURPERMIT LDG NSP BATE ATU E ���OW NER BUQDERi i0 L NEW [ ] Effective 1/1/2000 ADDN [ ] CITY OF FRIDLEY (763) 572-3604 Bldg Insp ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: Legal Description: Owner Name & Address: _L!h9,LA4 I cV 36-Y- Tel. #.2423 Contractor: -<i �`E MN LICENSE# Address: Tel. # Attach to this application, a Certificate of Surveyof 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 4 Hgt/Ground Sq. Ft. OTHER: VeCA-- (O -W -r T dl Construction Type: U0 ® Estimated Cost: $�� 7S� 3 so Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: r7 APPLICANT:0— Low LoQ La -L'— Tel.# %65- ?09) e& - 6[ z - -PW CITY USE ONLY - Call (763) 572-3604 for Permit Fees if mailing in application Permit Fee $ // / • a Fee Schedule on Reverse Side Fire Surcharge $ > 001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Iq $1100 per SAC Unit $5.00 (State Licensed Residential Contractors) "A" or Alt. "B" Above $450.00 Conservation Plan Review $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not [Necessary [ ] TOTAL STIPULATIONS: BUILDING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any. addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to -wit: TOTAL VALUE FEES $1 to $500 $501 to $2,000%�/� • $100 or � ` l �d �e� x' l $ g7,3 W/o &k4 $2,001 to $25,000 _ Ol��� --ig, elo nal $1,000 x /.)O..' $25,001 to $50,000 T tional $1,000 $50,001 to $100,000 �- / Tonal 1:7? W 00 $100,001 to $500,000 / itionalr - a 00. $500,001 to $1,000,000 � 41g3s Z ;h additional �, / � A1U� d 1,000 and up S $1,000,001 r .ach additional Alternate "A": Removal an l /" s 6 feet times $15.50. Alternate "B": Removal an approach w�Lu ., VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the framing. New Houses Only Ya` PURCHASE ORDER JDATE 6--lo-00 P6) A) F 65350 THIS NUMBER MUST APPEAR ON ALL CORRESPONDENCE SENT TO US THIS DOCUMENT GOOD FOR PURCHASES UNDER $1.000.00 ONLY SUPPLIER I� L 1�.J f✓C.�J �" _ ADDRESS s^�O (O D A r L� J rl Cff OF 643 AVE. LI PHONE NO. 92 E. FRIDLEY, MN 55432-4384® 812-571-3450 CONTACT PRINTED ON RECYCLED PAPER PAYMENT VOUCHER BY SIGNING THIS DOCUMENT BELOW I HEREDO AUTHORIZE PAYMENT AND THAT THE GOODS AND SERVICES HAVE BEEN RECEIVED OR RENDERED AND ALL CITY GUIDELINES HAVE BEEN FOLLOWED IN THE PROCUREMENT OF THE BELOW STATED ITEMS. 16 DA lCEI E tto jj W PAYMENUTAUTNO ZED BY ACCOUNT OTY. UNIT PLEASE ENTER OUORDER FOR THE FOLLOWING UNIT PRICE AMOUNT �0 PA-pt--or-l' < !L uc" < #3 e-,, lD/-oDvo -3-w -lew F /m?. TOTAL T / THIS AGENCY HAS AGREED NOT TO DISCRIMINATE IN HIRING PRACTICES ON THE BASIS OF RACE, SEX, COLOR, CREED, MARITAL STATUS, RELIGION, OR NATIONAL ORIGIN AND HAS AGREED TO TAKE AFFIRMATIVE ACTION TO RECRUIT MINORITIES AND WOMEN INTO EMPLOYMENT. IT ENCOURAGES FIRMS AND OTHER AGENCIES WITH WHOM IT PURCHASES PRODUCTS OR SERVICES TO DO LIKEWISE. WHITE, VENDOR - YELLOW, PURCHASING - PINK, ACCOUNTING - GOLDEN ROD, DEPT. HD. SURVEYOR'S CERTIFICATE I LEROY H. WINNER N Registered Under Laws of State of Minnesota I SCALE . 1 30' r ROUTE NO. ♦ • ANOKA, MINN. PHONE HARRISON 1.1859 0 DENOTES IRON PIPE 74.07'- S A K I A 4.07-SAKARIA S AD IT10N i I I B L 0 C K to to I1 _ I L -- 6 DRAINAGE AND I UTILITY EASEMENT a I� I �L---------- 74.05 _--------�— N N 60 TH. _ _ _____ _ AVENUE LO N N T--.-r-----T-----------T--- - ---- -- Ali A itI�HEREBY CERTIFY THAT ON NOVEMBER 3,1962 1 SURVEYED LOT 2, _ .mo-. . BLOCK 1wSAKARIASON'S ADDITION, ANOKA COUNTY, *MINNESOTA AND THAT - - -• -� '^ A ^^oocr%T 000CCQ17tiTATION of SAID SURVEY. Building PLUMBING Permit No.: Inspections RESIDENTIAL APPLICATION Ree ��-1 763-572-3604 CITY OF FRIDLEY Date Ree'd: 763-502-4977 FAX EFFECTIVE 2-19-09 DATE 04/06/10 YOUR E-MAIL ADDRESS wnelson@larsonplumbing.com SITE ADDRESS 1567 60th Ave N E THIS APPLICANT IS: ❑ OWNER MCONTRACTOR PROPERTY NAME: Rebecca Lewis OWNER/ ADDRESS: 1567 60th Ave NE CITY Fridley M 55 TENANT STATE zIP PHONE: 612-327-7934 CONTRACTOR NAME: Larson Plumbing Inc SUBMIT A COPY OF STATE LICENSE* 58757f3341) EXP DATE YOUR STATE LICENSE, BOND AND STATE BOND ff EXP DATE CERTIFICATE OF ADDRESS: —3095 162nd Lane NW CITY Andover STATE MN ZIP 55304 INSURANCE PHONE 763-427-7680 FAX 763-427-9448 PERMIT TYPE IN SINGLE FAMILY 13 TWO FAMILY © TOWNHOUSE TYPE OF WORK: rl NEW 19 REPLACEMENT DETAILED DESCRIPTION OF WORK Replace Water Heater FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER• OF EACH BELOW). MINIMUM FEE $35-50. 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'�,i' < s,�v. . i ,.<�, . �:�..�apt*.':' i:.lgx`� :c THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a plumbing 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 on site; that the work will be in accordance with the approved pla n e case f a rk whic requlr s review and approval of pians. SIGNATURE OFAPPLICA PRINTNAME Michael Maloniski DATE 04/06/10 aW F7•ai '�?R�bv T• y? j{ 7�4'n,�••�.%�� `meq vl.. .. y! ��}± `� y�,�,/� •� �e�t �•/Y �x �yyy';�{ y� .. %.��y }� -'9a£S,�,J:%���V.'+'.�„�,Y•j`1.�'.,li��Ck•�•��'L�'i����AilCIl; ��]l'���11�I17�('��7.rLaL,llJ���7-l�.�V'3171'1.11LJ.[l�''tt i r,;e City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, NDN 55432 763-572-3604 FAX: 763-502-4977