Loading...
PRE 2010 DOCSi ,y iaa consid ra on: of the issue an delivery to i, a toy the i a ec' o�`' of l andings' of Fridley of they above .perms Thereby .pgm—Ao do.the propose in' abcoroiance :with the description above set forth d°'according to: the twovissiorls iaitleI, ordinances o FAdlev, .and, 'being first duly, E Village of Fridley, Minn. • BUILDING PERM" N? 733 Office of INSPECTOR OF BUHMEWS Owner, 44 Architect Fridley, Builder LOCATION OF BUILDING NO, 6-4-3 street- 61 6-1 —Part of e*Aj OF Lot, Block Addition or Sub-Division'-tLce-(- Y DESCRIPTION OF BUILDING Front Dept Height— Storied' 7`0— Manner of Construction—,.� - To be used as To be completeii"{. 'Estimated Cc Permit is hereby granted to the building described in the above statement. This permit is granted upon the express condition that the person to whom it to granted, and his agents, employees and workmen, In all the work done In, around and upon said building, or any part thereof, shall conform in all respects to the ordi- nances of Fridley, Minn., regarding the 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. of Buildings. I AGREEMENT AND SWORN STATEMENT In consideration of the issue and delivery to me by the Inspector of Buildings of Fridley of the above permit, I hereby agree to do the proposed work in accordance with the description above set forth and according to the provisions of the ordinances of Fridley, and, being first duly. sworn, I hereby ,otate and say that the facts stated by me and contained in the above permit are true as therein stated. \N. ez- Subscribed and sworn to before me at Fridley, Minnesota this C -- I day of A.D. IV City City of Fridley, Minn. BUILDING PERMIT N? 62.10 Date: Owner: Builder Address Address 41fMNOF BUILDING NO. StreetB f LotA IL Lot_Block Addition orSVb-r v -Im Add, '060... Sideyard 22 Comer Lot —_ Inside Lot ke 410tv Sewer Elevation Fo dation Elevation DESCRIPTION OF BUILDING as: Depth Height Sq. n7 Cu. n AW t Depth t Sq. Ft. Cu. Ft. Type of Construction Est Cost A To be Completed In consideration of the issuance to me of a permit to construct the building described above, I agree to do :&==k In accordance with the description above set forth and In compliance with all provisions of city of Fridley. In consideration of the payment of a fee of I fY Oro' permit Js hereby granted to 7e 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, alteration, maintenance, repair and moving of buildings within the city limits and this t y be revoked any time upon violM of any of the Provisions of said ordinances. —,& Building Inspector NOTICE: Sh ponnit don not euver the conaustioe, hwalleffen for wkb& plundoag, on heatieg, Seim or wafer. Be sure to we the Building lespWar for sopmft pennift for then hens. Owner's Address APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA LOCATION OF BUILDING No. b Street part of Lot Lot Block Addition or Subdivision Corner Lot Inside Lot _/ etback 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: ° FrontDepth T Height ! Sq. Ft. /b Cu. Ft. 71=;� Front Depth Height Sq. Ft. Cu. Ft. Type of Construction %P- e Estimated Cost I To be Completed (�3 0 - & -)-- 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 tru/e'� and correct. DATE (//�// - SIGNATURE (Schedule of Fee Costs can be found on the Reverse Side). is Receipt No. 28459 City of Fridley, Minm N° 8182 BUILDING PERMIT Date: Daly 13, 1965 Owner: ANTHONY SOMI Builder DE MARS BUIWERS Address 543 - 66th AVE. N.E. Address 5208 N. lexington Fridley 21, Minnesota�� LOCATION OF BUILDING No. 543 street 66ht AVE. N.E. p f ��-121r zt-rr�-Rice-mak Lot 2 Block Addition or Sub -Division Terrece��ndddn. Corner Lot _ Inside Lot — Setback Sideyard Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Front Depth Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft. Type of Construction Fast. Cost $5 s OQ2-� To be Completed REPAIRS DUE TO STORM DAMAGE 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 a'll provisions of ordinances of the city of Fridley. / . In consideration of the payment of a fee of $ 10.00 , permit is hereby granted to A=QATY KOWE7_T to construct the building or addition as described above. This permit is granted -upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. ALLEN G. JFNSEN Build Inspector NOTICE this penult does net carer the condredioe, IenaliaHon for wiring, phm bbng, gas besting, sower or water. So an to son tho Building kgmtor for separate permit for thea hams. OWNER'S . ADDRESS A/e APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY.,. MINNESMA LOCATION OF BUILDING No. Street 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 building location drawn on these Certificates. DESCRIPTION OF BUILDING To be used as; Front Dept Height Sq. Ft. Cu. Ft. Front Depth Height Sq. Ft. Cu. Ft.'- Type t.' Type of Construction Estimated Cost Q �� To be completed The undersigned hereby makes application for a permit for the work herein specified, Agreeing to do all work in strut 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. 1.1 (Schedule of Fee Costs can be found on the Reverse Side). CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS SY 3 X04 -� q. Vg ,y,7 New Fixtures $ 7.00 The undersigned hereby makes application for a permit for the work herein Old Opening, New Fixture $ 4.00 specified agreeing to do all work in strict accordance with the city codes Beer Dispenser $ 5.00 and rulings of the Building Division, and hereby declares that all the facts Blow Off Basin $ 7.00 and representations stated in this application are true and correct. Catch Basin $ 7.00 S/�� Rain Water Leader $ 7.00 , 199' Sump/Receiving Tank $ 7.00 Water Treating Appliance $10.00 Owner Water Heater —Electric $ 7.00 Water Heater — Gas 1 $10.00 s •ti o Building Used As t+ o ,,. 6 - Gas Gas Range $10.00 Gas Dryer $10.00 Estimated Cost PERMIT NO. l Ste, Back Flow Preventer Required ( )Yes () No Type $5.00 PLUMBING COMPANY Tirr.s Qu/+tiry �°�um/s��6 Reinspection Fee $30.00 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1 % of Value of Fixture or Appliance State Surcharge SIGNED BY TEL N0. S -7 I- b U 5 y IS 06 Approved By Rough—In Date $ .50 TOTAL FEE $ f �'S PLUS THE $.50 ST TE SURCHARGE Final Date Jr 0/� .Y�4 l% P s CITY OF FRIDLEY INSPECTION DIV. Effective On August 1. 1995 6431 University Ave NE �,si Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION.AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS 1 �f�lis N' RATE SCHEDULE :.The undersigned hereby makes application for a permit -%r the work herein Residential Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes and Furnace Shell and Duct Work, Burner — rulings of the Building Division, and hereby declares that all the facts and Also Replacement Furnace $ 30.00: $ representations stated in this application are true and correct. i vi6 (Side Vent — Fill Out Back) �" � J e q�0 ,1 Gas Piping (Needed with new furnace) $10.00_ ' $ o —71 — 7777 977 OWNER Gas Range $10.00 $ BUILDING USED AS Gas Dryer $10.00 $ ESTIMATED COST ��t�� � PERMIT NO. *Air Conditioning — All Sizes $ 25A0: $�,�.�®4 Ail Others/Repairs & Alterations (UST ON BACK) DESCRIPTION OF FURNACE AND OR` Ufa RNER 1% of Value of Appliance or Work $ No. of_Fieating Units_ Circle One (Steam) (Hollater) arm Air) Tmd"ame 4 QC-Q Size No. C C-'9 Commercial/Industrial BTU n HP EDR 1.25% of Value of Appliance or Work $� Fuel i c,�����_ Total Connected Load State Surcharge X50 Burner -Trade Name t`� Size No. MQ®^I ' • • = s �. ��, BTU. HP EDR S S•`� TOTALFEE � HEATING COMPANY MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 Si -T-1 No.� ` 1 PLUS THE $.50 STATE SURCHARGE Q REINSPECTION FEE $42.00/Hr Approved By Rough—In Date Final Date *Air Conditioners can not be placed in a side yard without FILL OUT BACK SIDE 4R STACK VERIFICATION ON written permission from adjoining property owner. REPLACEMENT FURNACE ,coo /av��® �� -6 Has total heating BTU's of �,CJ All other BTU's TOTAL BTU's %,j )ey i. Has a liner been provided for water heater Yes () No 8. , Has combustion air been provided for water heater Yes () No Remarks: HEATING CO: Signed By: Date: CHIMNEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes (-A No ( ) 2. Is free from rust or deterioration Yes t4) No ( ) 3. Has no foreign objects lodged within Yes ",-A 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 �,CJ All other BTU's TOTAL BTU's %,j )ey i. Has a liner been provided for water heater Yes () No 8. , Has combustion air been provided for water heater Yes () No Remarks: HEATING CO: Signed By: Date: SUBJECT ERMIT NO. City of Fridley 27800 AT THE TOP OF THE TWINS BUILDING PERMIT r � ` RECEIPT NO. _ COMMUNITY DEVELOPMENT DIV. L PROTECTIVE INSPECTION SEC. 'i or r I NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 9/15/98 / / JOB ADDRESS 543 66th Ave NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 2 1 Re -arrangement of Rice Creek Terr. 2nd SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Betty Calistro 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Richard Hastings 6331 Riverview Terrace NE Fridley 55432 574-9966 4051 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 jP REPAIR O MOVE O REMOVE B DESCRIBE WORK Reroof house & garage (20SQ) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with 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 ISTALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION $1,714.00 SURTAX $.86 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 PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE License—SC $5. TOT L FEE $64.32 SIGNATURE OF CONTRACTOR O UTHORI2ED AGENT (DATE) HEN PROP VALIDATHIS BLQ9 INSP URM I f DATE SIGNATURE OF OWNER OF OWNER BUILDERI IOATEI NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION C� C ConstructionAddress: 55Q 9� IX A6/, Legal Description: Owner Name & Address: ate'7-7-V G4 ; 1 f2 0 Tel. # Contractor: a c �� A k o ,-5�� MN LICENSE # i(c S/ Address: 3Tel. Tel. #) -�'G 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: Construction Type: )A-tk_ e) FF Estimated Cost: $ / 2//7/ (Fee Schedule on Back) - Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: 1 / S -1 e APPLICANT:_ Tel. # 5_2ir CITY USE ONLY Permit Fee $ �o • 7S� Fee Schedule on Reverse Side Fire Surcharge $ % _ �%/ .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ 0 6 $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: FROM ;Cii*f Fridley r r 3uilding Inspections 63 572-'3604 FAX NO. :7635711287 Apr. BUMDI]N U RESIDENTIAL APPLICATION CITY OF FR.IDLEY• 19 2006 08:38AM P2 Permit . 0.:� �® -I Received By - ]?ate Ree°d: CL YOUR F -MAIL AI)DRKSS _— �w SITH AUDRESs _.�.�3—. -- �- —. — —. — 1131ti APPLICANT IS: WNt R [3CONTRACTOK I T.'It01'ERTY WA TENANT — CON'TRACf0R SUBMIT A COPY OF YOUR STATE I TCBNSa J11 NAM L:—. }, STA'I'El¢ri`II'..cyrS 3 her• HATE _..—...—...—...—..�.. --. — STATI; LI(. 'I�NSiti 4—.. — .—. — — — - FFATE- ADDRESS:—..—.—�— WITH APPLiC:ATION F'H ) NE — SIZB �PYtOPrRTY TYl'T>- O SINGLE rnivin.Y/N>xW Cc)NSJ KUGTION STOttIES— _ L� TWO t•AMIt ytollK Gt)NSTKUCTION 0 W'NDOWS — O ADDITION — — — O GAItAG>~/SH>�U �1 DRAIN TII.4s PERMiT TYrlr. D BASEMENT PINISl3 0 ROOF 0 OTHER ,gym lC 0 SIDINGNEW —• — TY E UF' V�VURKI 0 MAINTKNANc:tJRBYAIR O tFMODFI.ING — DFSCRTBH WORK BEING DONE: ——�i�C'G��..— . — • — � " — . FI I �i LENGTH -r HGHT 70 S Ft. SIZE OF IMpROVFM1'I! 0 Ii�UgE iNLY '�� j 7, Of — J40US)? & GARAGh NUMBER OF SU,IJARKS �.—, —®8 — Firc Surcharge Surcharge 0 A7'fACNRD GARA(iY, GAKA � F3 O TAc'HED GARAc:iB PROP SIZE:_.— — PKOPOSrD IIA GGT: _ ..— $ SIDOSuliit M Vinyl Curb C%it Escrow— 0 Aluminumi] 0 Trim Fuscjs 0 Other —. _ $ SAV-EMIRcI PidLG.31m3K T I. Axisting Floor Plan 2. Pruposcd door plan 3. f ist of structural members to be 119=1 FOR NEW CONSTRuc,rm INCLVDINCI DECKS, A 0D1TJQ'I'IS.A_PO :FE$S(MM1L. t. site planlsurvoy,yhowing the-isting ArurWre8 and propos=d ptloJcct. z. Twn sets of construction plans 3. BUCTO Calculations IN E)RST•I1NG OPENINGS 13Yes ANO LOCATION OH WINDOWS Olt HORNRW OPFsNINC3.ti-DES(-'K 3'SIZE ON — •—• ()PENIN() CHAN43ES & NUMRIiROF WANDOWS _� TYPB OF WINDOW TO Till INSTALLET: r_ AI..L FENS ARE BASED ON VAY.UATI'ON7 IN - LUDTNG THLI' C 49T CIIN� LABOR AND M c.'•� 8® 'AJO (LJSMG'r ]Y i997u.B.0 H'EF SCFi<EDLTi.IE) TWE ,rf1TAV 7[)Yt VAI TJA'i'ION S OCrU1P,__ _ - PeMIA Fee $7�. j 7, Of — Pian Review $ —®8 — Firc Surcharge Surcharge —$�- ,7.:-D — License Surcharge $ _ — SAC Charge $ — Curb C%it Escrow— Erosion Control $ _ - Park Fee S — sewer Main Cho Kgs $ See Hack Page for. Fee Schedule 65% of. Building Permit Fee .001 times the total job valuation .0005 x Permit Valuation Minimum $.50 $5.(10 (State Licensed Rcsidcntial COntrrt•Ctors) $1.550 per SAC iJnit (Plans to MWCC for dctermivatiotl) it4.6fY_ftx$20 $450 Colncrvat,ion Plan Review Fee T)cterminc;d by Engineering Agreement necessary ( ) Non Necessary ( ) THIS IS AN APPI.ICATIUN FOR A PSRMIT.M.)'r VALID MOIL PRO(:tiSShD I hereby apply for a building permit and I %cknowledgc that the infurmation above is complete and accurate; that the work will be It conformance with the ordinances toad codes of the City of. Fridley and with a).e Minrlesot% Construction Codes, that I utrderstand this is not s pexmut but only an application .for a •permit wid work is not to start witlacntt a Permit; that tho work will be in accordance with the approve( plim in the case of all work which r�; qo 1res review attarid.J approval of Plans- _ 51--9 61 1u_DA'1'ts 6 SIGNATUKR OF Ai'PUCAN'f'_ MU U S1111MAM d 1 ievrdl l ILA Will]. eio I a section of a caning sale and Pressure Treated Framing Material ! op ons you have selected for your deck. Fl 4 ('aiding Pasts �i4" x 6" Pressure Treated Deck Boards r<-� � ouired Footings 8" Tube 4' deep �k , , I "' ��� it Premium Green Combo Drive Screws Stainless Steel Framing Fasteners Handrail selections: :1 f'�q0 36a Spindle T Railing "Q" x Z' Pressure Treated Spindles, Beveled 2 Ends 4",'4'08" Pressure Treated Utop Notched Railing Posh 1!46 Pressure Treated Plain Handrail f 1N You may buy all the materials or any part at low cast; and ca�y prices. Because of the wide variable in codes, Menards cannot guarantee that mater Is listed will meet your code requirements. Cheek with our local municipality for plan compliance and building permit. T�ese ptans are suggested des► ns and material lists only. Some items may vary . from those pictured. We do not guarantee the coriipleteness or prices of the structures. Tax, labor and delivery riot Included. Illustration intended to show general deck size anc s ape. _:_ E Today's cost for riestimated in this design with 'The baso price includes: FSC live lad, AQ tr o h l yx6 dick bunds, 44 , 2 'old Ifis, l nlzw flaming fasteners, AC2 vertical handrall to joist pasts, and premium screws. fte): f Level 1. 1 O'x 1 �.' -3" off the cround ofizontal Decking 9' vkiIni&e, 40 PST Deck Live Load a rs cosstfor matern a Is estimated in. this design with options $7203 the base pike inclubs: 40 PSF d live lomi, AC2 treated - horizoohl Wilk Weds, 4A pis, W'oisb afid ares, galindfraffilfig hsWers, AC? tm*d 36" Vertical handrail to joist without, and premium wows. * (ME pfte): T165.29 posts 1,9" I *, tA it -I . ---� Postand 'e m aion Sheet en m 1.31. 4'.3" 1191. �. e -C-� Oil 'E3, Ei E co -C> dci C -S cn Cl, C= im Ec:z- co .......... § ;Rj 6=411 K.1 0 2 cii 9A R 4-0- - M� CO E -7' CLQ ki 1E ZS (i aW 0 P kal oil Mi=M MM -LM MIM You may buy all the materials or any part at low cash and carry prices. Because of the wide variable in codes, Menards cannot guarantee that materials listed vAll meet your code requirements. Check with your local municipality for plan compliance and building permit. These plans are suggested designs and material lists only. Some items may vary from those pictured. We do not guarantee the completeness or prices of these structures, Tax, labor and delivery not included. II �I !� Is i. A A �I it ;I .19 I Joist Layout for Your, k The Scale is 1/2": 1 Mark — I.erh --- -- De�cn�tion . _ A 99" 2x8 Green Treated B 1119" 2x8 Green Treated C 910-1(2" 2x8 Green Treated D 12` 2x8 Green Treated Joists to be on 16" centers. Joists to be hung from the ledger with joist hangers, Joists to be toe -nailed to beams with 3-112" (16d) galvanized nails. Rim joists to be face -nailed to joists & ledgers with 3-1/7 (16d) galvanized nails. Blocking and bridging are not shown, but may be required by your local code. [ avnid dirnensinn shApts arp intended as a cnnstructinn aid. Not all notions selected are shown. � cu A A A i�22 0 I� a C= J6 j as UO t�y CO �1 C� 10 E. V i Joist, Ledger o Rim joist 4SIL" gg Rim joist CO CD _ 2 CL .p [ avnid dirnensinn shApts arp intended as a cnnstructinn aid. Not all notions selected are shown. Building PLUMBING Permit No.: Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FR][DLEY Date Rec'd: 4'0(' DATE�YOUR E-MAIL ADDRESS SITE ADDRESS" -8 L 3-47& AI -E THIS APPLICANT IS: ❑ OWNER .000NTRACTOR PROPERTY NAME: J JE 8N Cr�P/S ADDRESS: Ate /5,225 CITY � STATFbWZIP, - OWNER/ TENANT PHONE: Wield 7� CONTRACTOR NAME: STATE LICENSE # EXP DATE )= 3J-lYa, STAT ZIP (3 SUBMIT A COPY OF YOUR STATE ADDRESS: 10(o7 iD 1—wa t",V CITY__ejj4yiIth LICENSE WITH PHONE �� 4�/i / FAX APPLICATION PERMIT TYPE A SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK: ❑ NEW A REPLACEMENT DETAILED DESCRIPTION OF WORK iC4)111,12 a U /2,6' PER MS 1613.665 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) _ BATH SINK/LAV _FLOOR DRAINS _ SHOWER WATER PIPING SWIMMING POOL WATER SOFTNER ($35) BATHTUB GAS PIPING � crrrucEmo _ _ _ CLOTHES WASHER KITCHEN SINK WATER CLOSET _BACKFLOW PREV. ($15) _ _ DISHWASHER LAUNDRY TRAY =WATER HEATER ($35) FOR IRRIGATION _ _ WATER METER —OTHER PERMIT FEE ROE TS�EQ Z �� �F ., N � � ,zl r ? � ''.. { T f:T t?Ei ' Permit Fee $ 3 Number of fixtures @ $10.00 x $10.00 = $ Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ , Y.-dt) 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 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 requires revi w and approval of plans. �� SIGNATURE OF APPLICANT PRINT NAME �%� �/E L�` DATE N 'PLEASE NOTLEFE��sY�ttlt�tckst1Iti�"�a�, City of Fridley ]Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977