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PRE 2010 DOCSCity of Fridley, Minn. BUILDING PERMIT N� Date:" Address Builder Address .# .--- LO TIO BUILDING 011 No. _ _r3/'S, Part of t Lot Block, ddition Sub -Division ,^ Corner Lot .___._...—..._ Inside Lot _ _ +� Setback 6 7 Si eyard „�" A- -- Sewer Elevation Foundation Elevation DESCRIPTION OF BUILDING - Front Depth Height 2 t. Sq. Ft. / Cu. F �r t Depth 35i Height 0t. ".19— Sq. FCu. Ft. Type Construction Est. Cost __ To 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 $ jV— ., 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 thew items. a r � APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Owner Ia N ��yBuilder Address o jLess LOCATION OF BUILDING No. Street Part of Lot Lot Block Addition or Subdivision; Corner Lot Inside Lot ��„ Setback_f 5 _, Side -Yard ,S ^ � S SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. Tbe used as: b DESCRIPTION OF BUILDING / Height �. �._ V Sq. Ft. ,/ 5 -e) Cu. Ft../ �- FrontDepth Sq. Ft. Type of Construction ���, � — Estimated Cog 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 facts and representations stated in a application are true and correct. DA�9 0 SIGNATURE (A Schedule of Fee Costs can be found on the Reverse Side.) G & 0L5019 COMBINING THE RECORDS OF HARVEY A. CARTWRIGHT JE. HILL, ANOKA COUNTY SURVEYS �. . J. CIVIL ENGINEER ESTABLISHED 1899 MINNEAPOLIS SURVEYS HBNN COUNTY SURVEYS LAND SURVEYORS C. F. SANDHOFF 8410 PALM STREET N. W. REGISTERED UNDER LAWS OF STATE OF MINNESOTA CIVIL ENGINEER ESTABLISHED IB08 SUNSET 4-76438 LICENSED BY ORDINANCE OF CITY OF MINNEAPOLIS OWNERJAMES NELSON 326 PLYMOUYk bUItDING FEDERAL 8-8721 SURVEYOR INDUSTRIAL - JUDICIAL HENNEPIN AT SIXTH • MINNEAPOLIS 3. MINNESOTA ESTABLISHED 1922 BUSINESS - TOPOGRAPHICAL tfor'g �eitltt[attMETROPOLITAN LAND CITY LOTS - PLATTING ` SURVEYORS. ESTABLISHED IPM ANDY HOHN & SON .o _ i�0 1 Nv.#21685 F. B. 714-10 I HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT REPRESENTATION OF A SURVEY OF: LOT 6, BLOCK 5, EDGEWATER GARDENS, ANOKA COUNTYc MINNESOTAr AS SURVEYED BY ME THIS 27TH DAY OF OCTOBERp 1960, 7 SIG NEED) RIGHTelCW*AND -C City of Fridley Application for Plumbing and Gas F*Hng Permit Dept. of Bldgs. Phone SU 4.7470 DESCRIPTION OF WORK Number. Kind and Location of Fixtures Location Iya O< � Z_ F= c w u°fi w 2 • • WATER HTR. <j Z N 3 o 3 Ci 4' Ci (7 O GAS ELEG 0 F- F LL LL Base 1st % 2nd _ 3rd 4th • Future Connection Openings Connected with Sewer � New Fixture, Old Openings Cesspool El PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL. Number Fixtures ...................... x $1.50 $ f 0 10 Future Fixture Opening ................69 x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ............................ x 3.25 $ Water Heater (Up to 200,000 BTU) ...... 1 x 2.00 $ 10- a d New Ground Run Old Bldg. ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures ..........................-� x $1.50 $ J 15s0 Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ O TOTAL FEE ` • % City of Fridley: Ott< C�4O Fj-- 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, Owner Kind of Building Used as To be completed about Estimated Cost, $ Old New. uilding Permit No Lf Permit No. Z of Signed By s Business Phone No ROUGH ®� FINAL az 2M 7-59 19k'/ Application for Power Plants and Heating, Cooling, Ventilation, .Refrigeration and 1 Air Conditioning _Systems and Devices PARTIAL RATE SCHEDULE Dept. of Bldgs. Phone SII. 4-7470 GRAVITY WARM AIR: RATE TOTAL, Furnace Shell & Duct Work .......................... 8.00 $ Replacement of Furnace 5.00 $ Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ MECIL WARM AIR Furnace Shell & Duct Work to 120,000 BTU ............ 800 each add. 60,000 BTU ....................... 2.00 $ Replacement of Furnace ............................. 5.00 Repairs & Alterations—up to $500.00 .................. 5.00 $ Repairs & Alterations each add. $500.00 .............. 2.50 $ STEAM or HOT WATER SYSTEM NO RATE TOTAL 1st 3 Fixtures ...................... Furnace Shell & Lines—to 400 sq. & EDR Steam ...... 8.00 $ Furnace Shell & Line—to 640 sq. ft. IDR Hot Water ... 8.00 $ Each add. 200 sq. ft. EDR Steam ...................... 2.50 $ Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ OIL BURNER—to 3 gal, per hour ........................ 5.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTI) ....................... 5.00 $ GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ...................... x $1.50 $67� Additional Fixtures ................. x .50 $ Gas Range to 200,000 BTU ........... x 2.00 $ AIR CONDITIONING FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM ALTERATIONS & REPAIRS TOTAL FEE S �-7�� ROUGH FINAL ax City of Fridley: r - 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- /� i4 C7 19 z tvner Kind of Building Used as To be completed about Estimated Cost, $_ �✓� 49 � Permit No \_.4'•-47 K / Permit OF WORK HEATING or POWER PLANTS team, Hot Water �arm��A�i>rNo Trade Nam Size No Capacity Sq. I . EM / 6 d BTU H.P. ��941, Total Connected Load— „f ;9 0 Sind of Fuel BURNER —Trade Name Size No Capacity Sq. Ft. E.D.R BTU H.P. (REMARKS -OVER) SigPi 11M ALHEATING By. Ar4OKA, MINN. TEL. HA; 1-1302 { •42 2M 7-59 Business Phone OTo- / rY�co GC/ Glass Required sq. ft. E.D.R. or sq. ins. W.A. Leader area N�:• Job Name_ - L( cS Net exp. wall )7 Int. wall zs HEAT LOSS CALCULATIONS Ceiling Floor Job Address Btu Weatherstrips A.S.H. E. Room 1 Le Width Windows and Doors--Crackage and Area Construction No. Height No. of Lineal It. Area of Dane lights of crack eq. it Insulation Guide t� Net exp. wall InL wall Windows Doors Reference Out. Wall 1 Int. Wall Ceiling Roof Floor. Kind F How Applied Y o I YqOST 19— I F1.1 Room I Length a Width oo, 7 Height F1.1 Room Length Width / Height Windows and Doors—Crackage and Area Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. i3° 6 193 2,5 2v 36 y Yle e.0 71' Coef.1 Btu Coef. Btu Infiltration 163 4L) 9 -5-49 O Infiltration L d Glass 917 J-0 Glass Exp. wall Exp. wall oo Net exp. wall / I v ! o Net exp. wall 123 /v /7,30 Int. wall Int. wall Ceiling /,i Ceiling Floor Floor Total Btu. a/ Total Btu. © C7 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area r Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.1oom ( Length :7 A Width 13 Height e t FI -1 Bxk Room (L,ength `i Width Height Windows and Door*-Crackage and Area Windows and Doors--Crackage and Area Width Height No. of Lineal it Area No. of Dane of pane lights of crack sq. ft. Width Height No. of Lineal ft. Area No. of pane of pane lights of crack sq. ft. r) �' l 2 -& 3 ao d V! / Coef. Btu Coef. Btu Infiltration fl') J O ? Infiltration 1, v0 1 /.- %2ro Glass Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Exp. wall - L( cS Net exp. wall Utd Int. wall Width Height No. of Lineal ft. Area No. of pane of -pane lights of crack sq. ft. Ceiling Floor Total Btu. Btu Required sq. ft. E.D.R. or sq. ins. W.A. Leader area F1.1 Room 1 Le Width Windows and Doors--Crackage and Area Width No. of pane Height No. of Lineal It. Area of Dane lights of crack eq. it Glass Infiltration / Glass Exp. wall Net exp. wall Int. wall Ceiling Floor Tbtal Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Glass Exp. wall `3 a Net exp. wall Int. wall Ceiling Floor Total Btu. d 1 i73o or -01 Required sq. ft. E.D.R. or sq. ins. W.A. Leader area 1 F1.1 Room I Length Width Height Windows and Doors—Crackage and Area Width Height No. of Lineal ft. Area No. of pane of -pane lights of crack sq. ft. Btu I Coef. Btu " O Infiltration Glass Exp. wall t� Net exp. wall InL wall Ceiling Floor Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area SUBJECT P. City of Fridley 13225- AT THE TOP OF THE TWINS BUILDING PERMIT r R iPTN • COMMUNITY DEVELOPMENT DIV. ��/�� r PROTECTIVE INSPECTION SEC. 1 � ! CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-560-3450 910-F15 9/25/75 JOB ADDRESS 54 - 66th Way N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 6 5 1 Edgewater Gardens SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Clifford Flecton 54 - 66th Way N.E. 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSE NO. Lloyd's Home Improvement 4911 - 4th Street N.E. 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 C$ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof structure 9 CHANGE OF USE FROM TO STIPULATIONS SEPERATE PERMITS REQUIRED FOR WIRING, HEATING, PLUMBING AND SIGNS. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Asphalt THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING '$Q. FT. CU. FT. AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION R 1 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 $1130 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT .56 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- $9.00 STRUCTION OR THE ERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE ��y�-®�� $9.56 SIGNATURE OF CONT ACTOR OR AUTHORIZE N (DATE) WHEN PROPERLY VALIDATE D THIS IS YOUR PERMIT 1;Z� BLDG INSP DATE SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE) APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA NO:. �;— Ljl STREET: G'/ y LOT:+ BLOCK: 4 ADDITIONo47, CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD: Applicant attach.to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. To Be Used As: DESCRIPTION OF BUILDING Front: Depth: Height: Square Feet: Cubic Feet: Front: Depth: Height-: Square Feet; Cubic Feet: Type of Construction: — Estimated Cost• • j—� To Be Completed: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in stxict 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: c%� P S— SIGNATURE : (See Reverse Side For Additional Information.) c�' she v / G SUBJECT IT , of Fridley 2 9 3 9 8 PCity AT THE TOP OF THE TWINS BUILDING PERMIT EI—PT NO. , � r.COMMUNITY DEVELOPMENT DIV. v�_�___ a5 -3d' f PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY U432 NUMBER NEv OATS PAGE OF APPROVED BY l J` 612-571-3450 910415 5/5/99 JOB ADDRESS 54 66 Way NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 6 5 Edgewater Gardens SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jerald Willey 54 66 Way NE 586-9799 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 j NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Construct an 18' x 14' Deck 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plan. WARNNN6 Before digging call for . all utility locations 454 -CM2 REQUIRED BY LAW 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 1 ISTALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2,323 $1.16 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 ire SC $2.32 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE 0FrOTAL FEE $78.23 OR R GENT iDATE- SIGN�E009-F6CVy P Y V ED THIS ISIT r �ER ARDER� iDATE� OEWH OG �NP r'A t v / G NEW [ ] ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION f�e /4`b'-' ConstructionAddress: Legal Description: l -'t- L 46/0 . (F - I./I Effective 1/1/99 Owner Name & Address: .Jera (1 4). (A-) � `0 5 Tel. # -S-V,6-.V 7P P Contractor: S P j MN LICENSE # Address: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Tel. # LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length ! F' Width / `/ Hgt/Ground Sq. Ft. -252 / 17 Z OTHER: = �, 323, Y Construction Type: C Estimated Cost: $ 15 ,5- / -L—Y (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: -Y/-3c, 19 i Permit Fee $-�-7y�-7� Fire Surcharge $ State Surcharge $ /L SAC Charge $ License Surcharge $ Driveway Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ TOTAL STIPULATIONS: Tel. # xfr6- 9 72,-P CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1050 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 [ ] r � Df —31-1997 10 35 PP.EST I QE T I TLE 2631323 P.01/01 PRESTIGE, TITLE Fite #R PT -21432.97A, 84 66th Way ice, Fddlq o� IQ/m7 Ut 6, B104 S, FApvmter Gardw yg1.0 i Dupecud by; DsvW C•rpmer i_ s4 asp +W4y NB AeeoMmo4odon 5koo ; Plot Dmvgns Not; SwVAV ."fie lorgdva of tit It+ONVA noxa Aon oe ft dM*b; Am 9PMXlmte aad as bmd ae rival 141dam Dftho mat, no lot ditpo dere ue rs%M ftffi dM t'eeord plM or MW y record& 'This, drawlas b fQf tatorruadatat purposes and rtAMd IM be tried w a mewy. ><t der4 not consda tt a iiatdtttj► of 0u eampmy and is lawaded for moetasP put omly,' . N T 1"•30' TOTAL D.Al .1 lesson 1917 8912 Please bring thug plans to the cashier to purchase. a. Post and Beam Dimension Sheet Design#:42974 2'2'6" 4'6" 116-1 S'6" �n $CD pGo_ � Me CD .Q C O s m d� o 4so O C Ah - go ` d � m 'D m � C ` � m � O n ami v n E + m J Jz �= o m � rzCD a+ ` dl O C m 4 O r C ? V C so O .O C C p m Y 1Q 1 ®- Denotes railing posts and are placed at a 48° maximum post spacing. Illustration may depict options not included. Design #: 42974 4/11/1999 * * ' Take this sheet to the Building Materials desk to purchase your materials. You have selected a 14' x 18' deck 2' off the groun Green Treated Framing Material Horizontal Decking 5/4" x 6" Cedar Deck Boards 36" Spindle Railing 2" x 2" x 42" Cedar Spindles, Beveled 1 End 4" x 4" x 48" Cedar Railing Posts Heavy Duty Cedar lattice Poured Footings 8" Tube 4' deep Premium Phillips Drive Screws 2" X. 8"Joists 2" x 8" Beams Below is a section of the railing style and options you have selected for your deck. � `I� `7 For Building Material's use only : / Selection Code:16821602401050415060004040480500000001 Today's cost for materials estimated in this design with options: $1551.84 'The base price may include: 40 PSF deck load, horizontal decking, 2x6 green treated decTc boards, green tread framing material, no stairs, 36" 2x4 railing, green treated railing posts, and galvanized box nails. * (BASE price): $913.36 FROM :Cl ty of Fridley Building Inspections 763-572-3604 DATE-„__ _ ......4i.. SIT, ADDRMS A TICS APPLICANT IS' PROPERTY OWNER/ TENANT C) 0.a (-- ,'d 696, From: 9529319677 Page: 2/7 Date: 2/14/200610:40:24 AM FAX NO. :7635711287 Feb. 06 2006 03: PLUMBING 13s•so' Permit No,: RESTDEN�TIAL APPLICATION Roceived Ry--_--- CITY y:-_ -._._— CITY OF 1+ MLEY Date Recd: YVUR K-MAII. AUDRES.SmielfilA 01C4Wre,L D CIWW..R j6CoWMCTOR .,,,.., CITYPf ay STATE' N IIPZESY�Z �'i.V�.Y. r . . -.M•. .-... P. CON'1`RA+CTOR” SIMMtT A COPY OF S'I'afSLIGF,Tfa>;Ia off• 17CI't�A'!>d',._ YOUR STATE ADnR855 CnaS _lei ��! S CITY— Ac-P-�C1U.�_�,.� _8TA'rr�z + ��3 LlafsNR 3 WITH >'Hti7VN 5 0, ,�. FAX 0-639 !231 t'11J APPLICAXION PEPM1T TYPE X160LE FAM11,,Y CITWO PANt1I.Y Q TOWNH4 use TYPE OF WOAD: 4 NF.W sPLAcEtvlctvr DETATLF.D DE,5CRTPTION OF WORK PERMS 16I3.665 the permit fee is a minimum oi'S15.00 or $"/e of the total cost up to sso0.00, whichever is greater, for the improvement, installation or replacement: of a residential fixture, excluding the fbMi es, (This Board reflect only the cost of labor) Labor cae;t under 5300 = S15,00, Labor cost between $500 to 9500 - cast FOR PROJECTS WII1rRE LABOR L•XCEMS M. FM UP.BAiED ON $1 O.00 PLR PIXTUftL•,1'XCUT WHPIU NCA213. FIXTt.iM' (INDICAN!; TOTAL. NUM13111t Or, EACH BLLoW) � wATCIt riP1NG HATI3 SINKILAY 1'LOOR I3RhINS _ SITOWCR _ AATH'1 U1t -_CCAS PIPING RV= 011MCMrsj _ S ING Pooh WATth7t 9a�ER (335) CLOTIMS WAR= -. , tCrrC:TiE"N SINK alAIT ATER q- 9= —BACKFLOW FRS►. 015) 17I5FiWA51RCR _LAUNDRY'MAY ,TR HHKM (S35) FORUMOATION M - NMA -- „ ,- OTIC - Nt3lilbel of flxwms (03. $10.00 X 310.W - $^ -.. , •. •.. Number oflCi%mres @ $15.00 x $15.00 - 5— Number of fixtures @ $35.00 %tate Surcharge S .50 Total = $ - - ------ TIA,S IS AN APM ICATION FOR A PHRMr1-NOT VALID UNTtI_ PROCESSED I hereby apply for a buildhsg permit and 1 :acknowledge That the Information above is complete ead accurate; that die work will be in et►nfonnanee with the ordinances and codes of the City of Fridley and with tho Minnesota Const VC ion Codes; that 1 undersmad this is not a permit but only an tLppliauion for a permit and work is not to start without a permit; that the work will be in aa=dancs with tits approved plan in the case o w rk 'eh q3t' review and approval of plana. /C-)( SIGNATURE OrAl'TLICA PriKrNAM i 1'lpf) i'rV .- _DATR_ C�.ld City of Fridley Suflding 1nspectrnns Department 6431 Univel-sity Avanue NF, Pridley, MN 55432 763-572-3604 FAX: 763-502-4.977