PRE 2010 DOCSCity of Fridley, BE
BUILDING PERMIT N°5 2 5 5
Date: _
Owner: Builder -
Address Address —
L ION f V
ILDINIG
No. Street =� a of Lot
Lot.._ Block ____ Addition or Sub-Divisi
Corner Lot ___.___ Inside Lot Setback S deyard
Sewer Elevation
Foundation Elevation
DESCRIPTION OF BUILDING
d oiv_ �_� _ / '� 'kph
Front Depth Height Sq. F't. Cu. Ft _
Depth oV t Sq. Ft. Cu. Ft.
Cie Me
of Construction "�'°"' �. " REst. Cost_ A _- =I o be Completed _
,.
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with all provisions of
ordinances of the city of Fridley.
In consideration of the payment of a, fee of $_ _''"' "'" ` ., 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:
We permit does not cover the construction, Installation for wiring, plumbing, gas heating, sewer or water. Be an to as
the Building Inspector for separate permits for these Items.
• 4 •
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDIEY, MINNESOTA
Owner
I s Name /i/z.ffwadlLAf, Builder S1.,-4 A;:
Address r Z% Address ;° rte,
LOCATION OF BUILDING
No. j�Street Part of Lot
Lot Block Addition or Subdivision
Corner Lot inside Lot Setback Side -Yard
SEWER. EMATION FOUNDATION ELEVATION
Applicant attach to this form Certificate of Survey of Lot and proposed building
location.
To be used as:
DESCRIPTION OF BUILDING
4
W
Sq. Ft.Cu. Ft.��
Front Depth 3
Sq. Ft. /`i % Cu. Ft. / a
C'.
Type o Construction s aq Estimated Cost
To be Completed
The undersigned hereby makes appli4tion for a permit for the work herein specified,
agreeing to do all work in strict accordance with the City Ordinances and ruling of
the Department of Buildings, and hereby declares that all the fact and oeprese tat ong
stated in this application are true and correct. �
DATE 15-7 C 4 SIGNATURE F
(A Schedule of Fee Costs can be found on the Reverse Side.)
0
..........................................................................................................................................................................................................
Y 10
ell
•�
J9
i
�4
L
104
l
E.
® `c,r,v •c c x
40 T
s
B®L,T5
• E
J9
i
�4
L
104
E.
® `c,r,v •c c x
40 T
s
Z Z--�7
ul
�7CiJ�4�� �eili Tfi %T ®f�S�.
0
11
............................................................. .............................................................. ........................ ........ ...... _+
x
J9
L
104
Fe -o M
® `c,r,v •c c x
40 T
s
11
............................................................. .............................................................. ........................ ........ ...... _+
x
SUBJECT
PER
City of Fridley
19695
AT THE TOP OF THE TWINS
BUILDING PERMIT
_
If `
R
I • COMMUNITY DEVELOPMENT DIV.
�y-------I
INSPECTION SEC.
r I PROTECTIVE
l '-'-/, CITY HALL FRIDLEY 55432
,
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
L ---.� j
612-571-3450
910-F15
10/3/88
JOB ADDRESS 481 - 67th Avenue N. E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
2
4
Rice creek Terrace Plat 3 SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Marilyn Boe 481 - 67th Avenue N.E. 422-7370
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
Morningside construction 4003 Morningside Road, Edina, MN 55416 927-6081
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 CR REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof Dwelling (16 Squares)
9 CHANGEOFUSEFROM TO
STIPULATIONS
Roof can be 2nd layer but not the 3rd. Install ridged galvanized
val ley s .
On all new roofs or tear -offs and replacement roofs
State Code requires that a layers of 15 Ib. felt,
mopped together, be installed to a point 24 inches
up from exterior wall line, or the use of other
approved underlayment membrane.
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
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$80Q
$. 550
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-
$21.00
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTAL FEE
$21. 50
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE)
WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
o
DG INSP A YE
SIGNATURE OF OWNER IIF OWNER BUILDER) IDATEI
NEW I ] City of Fridley Effective 5/1/88
ALAN I ] R-1 AMID R-2
AMER [ ] Building Permit Application
: s
&Untractor:��I1 11 s 3� �►' / Irf ri lL�' G��i%yid -
MM -a " MY
Attach to this application, a Certif icate of Survey of the
lot, with the proposoed construction drawn on it to scale.
ght sq. Ft.
Height Sq. Ft.
Sq. Ft.
Corner Lot I I Inside Lot I I Yd Setback Side Yard Setbacks
Type of Oonstruction: S�v (tel' Estimated Cost: $
Approx. Completion Date: % .00
Alt.
Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired: S $
Width + 6' See Back Page
DATE: APPLICANT: �, T2�� Plr� IJ v Tel. # Z
QTY USE ONLY
Permit Fee
State Surcharge
SAC Charge
Driveway Escrow
Park Flee
Sewer Main Charge
TOTAL
I TI ULPTIONS:
$ _ 21 O 0
$ a r. �;D
�, O 0
S&.,b
Fee Schedule on Reverse Side
$.50/$1,000 Valuation
$550 per SAC Unit
Alt. *A" or Alt. 'B° Above
Flee Determined by Engineering
Agreement Necessary I I Not Neoessary [ ]
SUBJECT
PER R
City of Fridley
18148
AT THE TOP OF THE TWINS
BUILDING
PERMIT
r
1 1
1
COMMUNITY DEVELOPMENT DIV.
_
r PROTECTIVE INSPECTION SEC.
1 . �
NUMBER
REV
DATE
PAGE OF
APPROVED BY
CITY HALL FRIDLEY 55432
612-571-3450
910415
10/8/98
10B ADDRESS
481 67th Avenue NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
2
4
1 Rice Creek Terrace Plat 3 SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Marilyn Boe571-7436
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Custom Remodelers Inc.7R4-2646
174A
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
O NEW O ADDITION ❑ ALTERATION REPAIR ❑ MOVE O REMOVE
8 DESCRIBE WORK
Reside house and garage
9 CHANGE OF USE FROM TO
STIPULATIONS
Call for building wrap inspection before covering.
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
SQ. 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
1
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
9000
$4.50
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
$149.75
Fire SC $9.00
/40 198 8
PLAN CHECK FEE
License SC $5.00
TOTAL FEE
$168.25
Si NATURE OF CON'RACTOR OR AUTHORIZED AGENT 'IDATI,
WHEN PROPERL
ALIDA ED THIS IS YOUR PERMIT
BLOd INSP
40SSGNATURE
HATE
OF OWNER.IF OWNER BUILDERI 'DATE'
M
NEW [ ] Effective 1/1/98
ADDN [ J CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
ConstructionAddress: Z10 1 6 7 7--b 4i/ -e tY5_;
Legal Description: R -e C, td����
Owner Name & Address: rLt(el yh F>o e Tel.�-
Contractor: Co e; 4ory— R,e MN LICENSE # 17 `W
Address: 1(,ZL/ 46L-10 D r. L_� Ko i�A k e e, kn1l 5T'o t 4( Tel. # 78S' 2 6 ei�_'
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: Lengt1i Width 4 Hgt/Ground Sq. Ft.
OTHER: S i � �_ a.S
Construction Type:
Driveway Curb Cut Width Needed:
L
Estimated Cost: $ &20
(Fee Schedule on Back)
Ft. + 6 Ft = Ft x $ _ $
DATE: l6 - 6 —g 9 APPLICANT: Tel. # 7af ej Z c c( 4
TOTAL
STIPULATIONS:
$ 600 ."")S
CITY USE ONLY
Permit Fee
$ It9 '%S�
Fee Schedule on Reverse Side
Fire Surcharge
$ 4 d
.001 of Permit Valuation (1/10th%)
State Surcharge
$
$.50/$1,000 Valuation
SAC Charge
$
$1000 per SAC Unit
License Surcharge
$ 5,66)
$5.00 (State Licensed Residential Contractors)
Driveway Escrow
$
Alt. "A" or Alt. "B" Above
Erosion Control
$
$450.00 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement Necessary [ ] Not Necessary [ ]
TOTAL
STIPULATIONS:
$ 600 ."")S
' 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
Effective On January 1, 1999
PLUMBING FIXTURE RATES
NO. RATE TOTAL
JOB ADDRESS
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
Rain Water Leader
$ 7.00
_,1999
Sump/Receiving Tank
—r $ 7.00
Water Treating Appliance
$10.00
Owner
Water Heater -Electric
$ 7.00
Water Heater - Gas** -T $10.00
Gas Range** $10.00
Gas Dryer** $10.00
Back Flow Preventer Required ( )Yes () No
Type $15.00
D.1%
Reinspection Fee $42.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance
State Surcharge $ .50
TOTAL FEE $ D 10
Building Used As,
Estimated Cost = . l/U
PLUMBING CONY 1ND 5 i0IM AVE N.#114
SIGNED �� TEL N0. �U
Approved By Rough -In Date Final Date5c� ��
PLUS THE $.50 STATE SURCHARGE
**COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. MINIMUM SIZE 9 SO INCHES.
1
CIIYOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (612) 571-3450 - FAX (612) 571-1287
September 18, 2000
Marilyn Boe
48167 Ave. NE
Fridley, MN 55432
Re: Final Inspection 48167 Ave. NE
Contractor: Mr. Rooter of Anoka Co.
Dear Ms. Boe:
A plumbing permit was issued on June 3, 1999, for the above noted address,
to install a gas water heater. According to section 4715.2800 of the State
Plumbing Code, a final inspection shall be conducted on the plumbing authorized
by this permit. As of this date no inspection has been called for.
You will be given thirty (30) days from receipt of this notice to respond. If we do
not hear from you, we will expire the permit and any inspections on this
installation will require a new permit.
Any questions can be addressed to myself at (763) 572-3603.
Sincerely,
CITY OF FRIDLEY INSPECTION DIV. Effective April 1, 2004
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT A--
(763)
(763) 572-3604, FAX (763) 571-1287 F �-
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
PLUMBING FIXTURE RATES: NO.
RATE TOTAL
New Fixtures
$10.00
Old Opening, New Fixture
$10.00
Beer Dispenser
$10.00
Blow Off Basin
$10.00
Catch Basin
$10.00
Rain Water Leader
$10.00
Sump/Receiving Tank
$10.00
Water Treating Appliance
$35.00
Water Heater -Electric
$35.00
Water Heater - Gas"
$35.00
Gas Range'
$10.00
Gas Dryer**
$10.00
Back Flow Preventer Required (i-' s () N�
Type
$15.00
JOB ADDRESSrf/ � ` �-
The undersigned hereby makes application for a permit for the 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.
OWNER
BUILDING USED AS
ESTIMATED COST
PLUMBING COMPANY
Reinspection Fee $50.00/Hr SIGNED BY
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.25% of Value of Fixture or Appliance
State Surcharge $ .50
TOTAI FFF �t/j .SO
DATE: / , 20-.e) S
a
PERMIT NO.
Approved By
Rough -In Date
TEL N0. % Lc Ej 6 S� 10 , P
Final Date
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. "PROVIDE COMMON VENT INFO ON BACK SIDE
i
FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS
COMMON VENT; VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When replacing an existing furnace, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required. Yes () No( )
The venting system is plastic/PVC and meets all current codes and manufacturer
specifications including sizing, length, number of elbows and terminatidn. Yes () No
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufacturer's specifications. This does
include AGA-GAMA Category I Central Furnace Venting Tables for fan
assisted and natural draft appliances. Yes () No( )
Tfie existing combustion air is sized and installed to meet the current codes
and manufacturer's specifications. Yes () No
When required to install a new combustion air, it will be sized and in6talled
to meet the current codes and manufacturer's specifications. Yes () No
When installing a new venting system, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturer's,
specifications. This does include AGA-GAMA Category I Central Fumice
Venting Tables for fan assisted and natural draft appliances. Yes () No( )
Is the common vent and vent connectors sized and installed correctly after
an appliance has been removed from the common vent and vented
separately as per current codes. Yes () No ( )
Appliance Type and Size/Common Vent and Vent Connector Information
Appliance #1 Type
BTU Input Fan Assisted or Nat
Appliance #2 Type
BTU Input Fan Assisted or Nat
Appliance #3 Type
BTU Input Fan Assisted or Nat
Total Appliances
Total Btu Input
Common Vent Type
Vent Height Diameter inches
Appliance #1 Vent Connector Height ft Length ft Diameter in Type
Appliance #2 Vent Connector Height ft Length ft Diameter in Type
Appliance #3 Vent Connector Height ft Length ft Diameter in Type
ALTERATIONS: (Describe)
HEATING CO:
Signed By: Date:
Build'
g
MECHANICAL
Permit No.: 5
Inspections
RESIDENTIAL APPLICATION
Received Byr�rV
763-57
-3604
CITY OF FRIDLEY
Da " ` a'
763-50
-4977 FAX
I
EFFECTIVE 2-19-09
DATE
` O^i 0 10 YOURE-MAIL ADDRESS
SITE ADD
SS 4A g I (.D -- Civ c- Nk
THIS APPLI ANT IS: ❑ OWNER hCONTRACTOR
PRO
RTY
NAME: a ` O,e
O
R/
ff 1 '1
ADDRESS: LAV ' LC_)"" Vc MV CITY r i cl 1 STATE MgIP SS4
TE
•
ANT
PHONE:
CONTCTOR
COMPANY NAME: CENTERPOINT ENERGY
SUBMIT
COPY OF
CONTACT PERSON: JOANN ZINKEN
STATE LICENSE#! BOND 22013346 EXP DATE08/1912009 _
YOUR STATE
LICEN
EWITH
ADDRESS:9320 EVERGREEN BLVD NW SUITE B cITYC00N RAPIDS STATE MN ZIP 55433
APPLI
ATION
PHONE 763-757-6202 FAX 763-757-6701
PE
T TYPE
SINGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE O F WORK:
❑ NEW REPLACEMENT ❑ ALTERATION/REMODEL
DETAILED
DESCRIPTION OF WORK nod
FEES ARE
ASED ON $10.00 PER FIXTUREXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW)
Equipment I
tailed MFG: MODEL: LA 6,MWL O(p SIZE/BTU 60, 6CX')
MFG: MODEL: SIZE/BTU
MFG: MODEL: SIZEBTU
A/C $25
00 _FIREPLACE (GAS) $15.00 _GAS RANGE/OVEN $10.00
AIR TO
IR EXCHANGEER $IS FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00
_BOILS
$35.00 RNACE $35.00 UNIT HTR $10.00
_CHI
_GAS
Y LINER $10.00 _GAS DRYER $10.00 HEATER $35.00
DUCT
_POOL
WORK $10.00 _GAS PIPING $10.00 VENTILATOR $15.00
v,y2
i@a.x�`yFF .Y3y
cam.. s'� s.`� ks°"1# e`?,x-r3• `^ � ,s#`�. ''x � � � : P2"�krg ..°�' "� Y ? .sot ". �"c � m, � � � lx '� �� �.",�,�,..''t ,�"+' .'S" ^"�'" f ^rs:;-'" '�'�`,� �.
.� *'�"'%.nt.s-`,�'2? u , �Y. •' '�..�,' �a�+., 4
y yaT'ai� � �� �.}+s.�•� .,k.,�^;. �d?r���,��...., �5--�,-.3�R'�s� � �4,..yy.zr,. r� �� .�'�v�-`l;�" ��".¢'.
`�Z..r�
s��.�,,, ,
F �qY Pcz'� � S �' 1 P S� Y' qvd .°. h*H� f^Y4zU:'a. S>J` w 4 i''•S'� xY, '.SSF" �"� �
J.il'� F,'` � �.!' .�.F 'S"�w� Y3 t£ `'�,' `.r�Y %4 r S � 5 a�. 4.2•�'r�,w$ ix E�� �''�,'., � 'f Gb`
c � ' � �, ' '`�r.�' a°�,-i y,w.� � �� � X ..�.x. �, s h��''��fi° �+a' ,,,,yz xs� �` ".�s.3 •L F'R'.• '�rt+� �.t��",�i.'$ agjY�?'f
?��ry �. :moi kt...+ i������"� s �'' "'.,,:: '��t� t�'S�;p���, iY��_.', �"�fix° w:.
r '�fi�".,��`' �a
��z3vr� �t•.,��
c{"`•i: .;?. ,f t .a 3r ���i"�;
¢-^ , � 3 � . �" 6 HF.t f• � h '( i� ,n. �� > fy .. zk j R"`ki �` � ��-A� � 4 � TY. � ,mss '#u
,..;YiZ �' :!'Fs� `�s,,Nv. '�d4';� �S' u:,��' �,,�' � ��, • -�,+2P y, s"y^: �»��� r .. �,� a� r fir'„ y `. � �� �* 4.�.�'s�'-, ^�.,� �$ v !
�, � �J .z�`- C � ttk �� �} � �, 5�sv „� 1- �'� � 5^` .rP9 . �+.& c �� �•ii�Ey.. �' � � S v � 3
T - S V .Z �' ,t"..�y.` '• �. pk f�S� ;v �i 'Z't�.. •".t#Z �FTi .'z A"' A:t'#-&,,,,� � ax�y
� � +"'.^.5... e . � 14 ¢��^. "'�d'�a� '�"�• � dtt��� v ��'�-� '�w� A .E� jry �C-'a � Y°hy�y 3.i 2= r �- �" v
y ` � f x 3 Aw >i 2��A'v. N' 22 t � ' �Jy x5Y Y�4, 4x.•37' ..4 �-iS ?e �L �y�dz
n �X'' �J.-,� YS+ 3� i 'r$ �' � ,a•tJs^'ko' �gF. � � i� S,, y ��z ���,-�y��.e,",,�,i £'i` �7 '.:
? 7 . k+--y.�r'f � ''^dii J': '• y� 1 �E. .� ," 4'.� G'"�,� .� �,' P ,'�f'-�� � 0. 4� 4 '.^ c, `�-
R'
�-
"' h i' �-(F ?^�.u#. �. R S�fT&�' Kx,,y�"`v� cN'r3�'k3 Sx �y'�'$ ' H,v'i
F.` � 3J^S�ixti�'-
�
>.._
.'-`.,�
: T��•',�- Y?��.� � Dt S .. V M.+L :#��g;
5i `''� iP'�� �y3t S ;. a.4F°'a.�'' � L"T.a�nY'.` "��. i.
T � e�' t•t°C'¢�j�,�fim� P' .4`.;C - Tx'w'Y?.��' YX4-T3 5�%i
.Y+ � „��f r^ "� � - 4 � �zzYS�,r�.:. r-s"%�+ w':�a-e��� •�?F• �Z^`^t,,. 1 3 `^aa "'1 t"3 Be ,q; E b ,�-'
''3�
+�
~d�,. �
w•,�5 F �..`4fi�.` -.uY #',`>". 1. 9 e'�'CKs�"�a=N�� 1��'�a'�'"°x.: tai 'E3 .,."?T� .� ,yn,.; fF,.'
J is. •j' a� '�"�, •-. a^ '4�'£..' �N�*�r� 'z' va ix"N Y �� i� 'f � � a kkYn' R� 5s• � j i `�1 � f °.#bpi � $����1 �,pY 'J}A'L (q"1 C"..
h..� •'4: 3JiL `i�jL.
�iG
y ;9...."h
�A� F
T�h o 7 _wi'i -M. in, -'"icy "'-� 6Z :^•i� ••vxi - »�ir� +i 2..:µ {z�':S
,•.}.-.:
v "v'
THIS 1S }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 all work r uire approval of plans. rr
� whi h review and
ROGER HOFFHEIN ,,
I % 110
SIGNA
E OF APPLICANT PRINT NAME DATE `�C
f.... �,`�,�
j�..T?�' ��#�., �����.`�'}.
#���.`�,
,�.•:s ,.,.: .:^�., ..�:�T�Y ,._ '.� ,�,. t., ;7193 �:r%� ',,, �.V, ..
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 763-502-4977