PRE 2010 DOCSCity of Fridley, NUmn.
BUILDING PERMT
0 Date: November 26. 1969
•
Owner: Thomas W. Klein Builder Same
Address 490-67 Avenue N -E. Address Same
421f,71;?-�
N° 10514
LOCATION OF BUILDING
No. _ 450 Street _ 67th A-vene K.E. —... Part of Lot
Lot ._._.11 -- Block 5 Addition or Sub -Division . Rig€ Creek,terrace Plat 3
Corner Lot , Inside Lot ._ X Setback -- Sideyard
Sewer Elevation ^ Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as:
Garage Front 251-4" Depth 24'-5" Height 10' Sq. Ft. 605' Cu. Ft 6050'
Front Depth Height _ _ Sq. Ft. Cu. Ft.
Type of Construction __ Framp Est. Cost-2.,.10D--QO -- To be Completed JulY.._1970
STIPULATIONS: 1. Maintain 15 feet between structures
2. New frost footings to be poured under East wall of �PM garage addition.
3. Gutter to be installed along East roof line.
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 nc ce wi�hh all provisions of
ordinances of the city of Fridley. 1-150,
In consideration of the payment of a fee of $ 2 0 - 0Q _.._., permit is hereby granted to Thomas Klein
to construct the building or addition as described above. This permit is granted upon
the eFress condition that the person to whom it is granted and his agents, employees and workmen, in all work
doneFridlMinnesota regarding lova.tion, constructt%n, alteration, maintenance, repair and moving of buildings
within the dty limits and this permit may be revoked at any time upon violation of any of the provisions of said
ondinanoes.
'� 2 -2&,z _ Building Inspector
z P mTTuTru—'R„i 1 rli no nffi ci_n.l
NOTICE:
Uls permb does not cover the construction, Installation for wiring, Plumbing, gas heating, sewer or water. Be son to see
the Building Inspector for separate perm(ts for these Nems.
10
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER 'S NAMEI #c m d t A'L' / n.) BUILDER
ADDRESSADDRESS
LOCATION OF BUILDING
NO. fJ STREET 7 � /1", �
LOT BLOCK ADDITION OR SUBDIVISION��2 �j,4,
CORNER LOT INSIDE LOT SETBACKSIDEYARD 7 1
SEWER ELEVATION TOP OF FOOTING
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 ;2J( S Height E '
Square feet 0 � Cubic Feet k,
Front Depth Height
Square feet Cubic Feet
Type of Construction L' Estimated
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 ,�— �� ' �' / SIGNATUR$'�,�
.(Schedule of Fee Costs can be found on the Reve se Side.
G e r
3 �3
1; f-::7
1
• n_
r
SUBJECT
R
PER NO.
City of Fridley
o
1. 5. 4_ 9 5
AT THE TOP OF THE TWINS
BUILDING PERMIT
_
r
RECEIPT NO.
`COMMUNITY DEVELOPMENT DIV.
L______
INSPECTION
S
r PROTECTIVE SEC.
1 �
i "I CITY HALL FRIDLEY 55432
I`J
NUMBER
REV,
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
9/27/79
JOB ADDRESS 450 - 67th Avenue N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
11
5
Rice Creek Terrace Plat 3 SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
INN Thomas Klein 450 - 67th Avenue N.E. 571-3407
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
ElNEW 13 ADDITION [j ALTERATION ❑ REPAIR [I MOVE ❑ REMOVE
B DESCRIBE WORK
Reroof house
9 CHANGE OF USE FROM TO
STIPULATIONS
Roof can be second but not third roof. Install ridged galvanized
valleys.
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
SQ. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 50 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
$450
$' S0
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-
$7.50
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$8.00
SI U E CONTRACTOR O A ORIZED D Et
WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
�
I �
C
BLDG INSP GATE
NATURE OF OWNER OF OWNER BUILD ) (DATE
CITY OF. FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PERMITS s
(New, Alterations, Additions, or Repairs)
• OWNER:r�� BUILDER:
ADDRESS: L`� v �' L �� ADDRESS: ��^✓�
TEL NO: %� G� TEL NO: '
- Construction Location
-STREET NO: STREET:
LOT:Z4 -BLOCK: ADDITION:
Corner Lot: Inside Lot: Setback: Sideyards:
Applicant attach to this form two Certificates of Survey of lot and
proposed building location drawn on certificates to scale.
DESCRIPTION OF CONSTRUCTION
Front: Depth: Height:
Square.Feet: Cubic Feet:
Front: Depth: Height:
Square - Feet: Cubic Feet:
Type of Construction:zk Estimated Cost: $
i: 21
Rb Be Cbmpleted:
�T Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired: $ $
SEE REVERSE SIDE OF SHEET .
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 Tridley Ordinances and
rulings of the Department of Buildings, and hereby declares that all the facts and
representation statnd in this application 15—t-2-W,and c r t.
DATE • %
SIGNATURE:.
Stipulations:
SUBJECT
PERMIT VA-
City of Fridley
AT THE TOP OF THE TWINS
BUILDING PERMIT
r
RECEIPT NO.
• COMMUNITY DEVELOPMENT DIV.
r PROTECTIVE INSPECTION SEC.
� t
i CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
5/13/83
JOB ADDRESS 450 - 67th Avenue N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
] ]
5
Rice Creek Terrace Plat 3 SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Tom Klein 450 - 67th Avenue N.E. 571-3407
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
❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct ' x 24' Three Season Pordh Addition
9 CHANGE OF USE FROM TO
STIPULATIONS
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
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
$3,300
$1.65
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-
$44.50
OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
'RUCTION
$46.15
A EOFCONTRA TO R AGENT ATE)
WHEN PROPERLY V A ED THIS IS YOUR PE MIT
GNATURE OF OWNER 0F OWNER BUIL ERI tD EI
BLDG INSP DAT
CITY OF FRIDLEY Effective Aug. 1, 1981
APPLICATIM FOR RESIDENTIAL BUILDVIG PER14ITS
(New. Alterations. Additions. or Repairs)
OWNER:
ADDRESS:
TEL NO: q %
BUILDER:
ADDRESS: r/
TEL NO: , r
Construction Location
-STRICT NO: STREET:
IAT: BLOCKS ADDITION:
Corner Lot: Inside Lot: Setback: Sideyards:
Applicant attach to this form two Certificates of Survey of lot and
proposed building location drawn on certificates to scale.
DESCRIPTIOR OF CQNSTRUCTION
`3,b2ront: I z Depth: a Height:
Square Feets 2 Cubic Feet:
Front: Depth: Height:
Square Feet: Cubic Feet:
�?? �y II.40 C. 3. o0
'type of Construction: P�t6*Y1 Estimated Cost: $
Rb be Completed:
Alt. A Alt. B
Proposed Driveway 'Width If New Opening Is Desired:
SEE REVERSE SIDE OF SHEET
site undersigned hereby makes application for a permit fcr the %.pork herein specified,
agreeing to do.all work in strict accordance with the City of Fridley Ordinances and
rulings of the Deih%xtment of buildings, and hereby declares that all the facts and
representations stated in this application are true and correct.
D.'%TE: S I GNATUIE :
stipulations: I
W'sn
Q
CIiYOF
FRIDLEY
CIVIC CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MINNESOTA 55432 • PHONE (612) 571-3450
April 1, 1987
Katherine Klein
450 - 67th Avenue N. E
Fridley, MN 55432
Dear Ms. Klein:
Please be advised that the house you are selling at 450 - 67th Avenue N. E is
in an R-1, single-family residential district. 7herefore, the dwelling,
including the separate unit in the basement with a private entry must conform
to Code for a single-family residential district. The code calls for no more
than five unrelated persons living in a dwelling unit in an R-1 district.
If you have any questions, feel free to contact me at 571-3450.
Re�pectf4ly yours,
Daryl Mo
Planning ssistant
DM/lmn
C-87-3 8
MR
SUBJECT
P •
City of Fridley
2120
AT THE TOP OF THE TWINS
BUILDING PERMIT
-
i �
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
v PROTECTIVE INSPECTION SEC.
r
� ,
CITY HALL FRIDLEY 55432
IL"--
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
�'� ,'� 612-571-3450
910-F15
2/11/92
JOB ADDRESS 450 - 67th Avenue NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
11
5
1 Rice Creek Terrace Plat 3 SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Steven/Penny Ulman 450 - 67th Avenue NE 571-5537
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Panel Craft of Minnesota.inc. 3118 Snelling Ave S, M is MN 55406 2179
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
❑ NEW ❑ ADDITION ❑ ALTERATION REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Vinyl siding on House & Garage
9 CHANGE OF USE FROM TO
STIPULATIONS
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. UNITSOFFSTREET
PARKING
ANY TIME AFTER WORK IS COMMENCED.
I HEREBY CERTIFY THAT i HAVE READ AND EXAMINED THIS APPLICATION
1
1STALLS 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
$2,500
$1.25
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
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-
Fire SC $2.50
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
$54.00
PLAN CHECK FEE
TOTAL FEE
$57,,75
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE
IS YOUR PERMIT
WHEN P O E Y Dj7-a-1
SP SATE
SIGNATUOF OWNER IIF OWNER BUILDERI IDATEI
MR
NEW [ l City of F- ai ey Effective 5/1/88
ADDN [ ] R-1 AND R-2
ALTER Building Permit Application
d
Construction Addri
Teged Descripticn
Owner Name & Address: f3in&22 YTel. # _V -4T37
Gbnt r actor : - -- 9�� Tel. 2
Address:
li, NN €0400
b
Attach to this application, a Certificate cf Survey of the
lot, with the proposoed construction drawn on it to scale.
DESCRIPTION OF IMPROVEM+2TP
LIVING AREA: Length Width Height S3. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DFt AREA: Length Width Hgt/Ground S3. Ft.
Corner Lot [ ] Inside Lot [ ] Ft. Yd Setback Side Yard Setbacks
Type of Construction: n a Estimated Cost: $ ®�
Approx. Completion Date:
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired: $ 5
W' + 6' See Back Page
DATE: APPLIOM: ���QLT o�
CITY USE ONLY
Permit Fee 5 _ Fee Schc-:ale on Reverse Side
State Surcharge 5 a $.50/51,000 Valuation
;p,-_T4J. 5 �? SD $550 per SAC Unit
Driveway Escrow 5Alt. "A" or Alt. "B" Above
Park Fee Pee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ]
ZEAL 5 — GIL
STIPULATIONS:
S7 Ai-I'L 6 -se -m _g cooa r?q
5
5
01
suejEtT
�NO.
City of Fridley
728�'7 81
57f -N THE TWINS
BUILDING PERMIT
RECEIPT NO.
�
y -------COMMUNITY DEVELOPMENT DIV.
SEC.
r PROTECTIVE INSPECTION
J�I
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
r PAGE OF
APPROVED By
�'j 612-571-3450
910 -FIS
12/28/98
10B ADDRESS
450 67th Avenue NE
1 LEGAL
LOT NO.
BLOCK
TRACTOR ADDITION
SEE ATTACHED
DEscR.
I 11
5
I Rice Creek Terrace Plat 3 SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Steve Ulmaniec
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Jayson Lindsay Roofing 2638 Clearview Ave
Mounds 20098263
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
❑ NEW ❑ ADDITION ❑ ALTERATION
Cc REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof house and garage (32 Sq) Tear -off
9 CHANGE OF USE FROM
TO
STIPULATIONS
Underlayment must comply with the State Building Code.
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 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
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
$2742
$1.37
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
$74.75
Fire SC $2.74
PLAN CHECK FEE
TOTA E
F.86
Li ns C 5.$23'
3
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT tDATE-
HE PROP VALIDATED HIS IS YOURPERMIT
I •
• S I
B DG INSR FfAfE
SIGNATURE OF OWNER,,F OWNER BUILDERI iOATEi
01
NEW [ ] Effective 1/1/98
ADDN [ J CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress:
Legal Description:
Owner Name & Address: , k,., tnq�111fG Tel. #
Contractor: J G MN LICENSE # 2a rri;aG 3
Address: d a*-rouc ecLJ _ 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: Sjef'�
G
�p
Construction Type: rP� 6 4 d- ke-- c� Estimated Cost: $
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft $ _ $ .2 % �✓
DATE: l - ��- %c� APPLIC Tel. # �9,9-fc5aS '7
CITY USE ONLY
Permit Fee $ 74/- 7.3 Fee Schedule on Reverse Side
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee $
Sewer Main Charge $
TOTAL $
STIPULATIONS:
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1000 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 [ ]
CITY OF FRIDLEY PERMIT NO.: 2004-01518
6431 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432 DATE ISSUED: 09/01/2004
572-36U4 YAX: (763) 571-1287
ADDRESS : 450 67 AVE NE
PIN : 143024240086
LEGAL DESC : RICE CREEK TERRACE PLAT 3
: LOT 11 BLOCK 5
PERMIT TYPE : ELECTRICAL
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDITION/ALTERATION
VALUATION
NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. INSTALL SAVERS SWITCH.
# INSPECTIONS 1
APPLICANT
HUNT ELECTRIC CORPORATION
2300 TERRITORIAL RD
ST PAUL, MN 55114-
1 .T
JILL GRAHAM
450 67TH AVE NE
FRIDLEY, MN 55432
ELEC PERMIT FEE - MIN (RESI) 20.00
STATE SURCHARGE, ELEC FLAT 0.50
TOTAL 20.50
PAID WITH CHECK # 117431
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction
authorized is not commenced witin 60 days or if construction
or work is suspended or abandoned for a period of 120 days
at any time after work is commenced.
I hereby certify that I have read and examined this
application and know the same to be true and correct. All
provisions of laws and ordinances governing this type of work
will be complied with whether specified herein or not. The
granting of a permit does not presume to give authority to
violate or cancel the provisions of any other state or local law
regulating construction or the performance of construction.
Applicant Date
Bldg Insp
Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.