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PRE 2010 DOCSPermit Fee paid on Permit #11,315 for 1560-1570 69th Avenue N.E. City of Fridley, Minae 11331 6431 University Ave. N.E., Minneapolis, Minn. 55432 BUILDING PERMIT Owner: - Development Company Builder.. Address R9 W at Road, Circle Pines, Minn. Address 1052 nsbnrnp- Rnarl N -F,-. *Fziel P_y i• •il 156621568,15702 LOCATION OF BUILDING N0.1572 157468th Avenue N.E. part of Lot Parcels & o; Section 13 Lot _ __ _ _ Block _ ______ Addition or Sub -Division Corner Lot. Inside Lot _ _ Setback Sideyard Sewer Elevation Foundation Elevation ..._...... DESCRIPTION OF BUILDING To be Used as: Each Unit 6 Toynhn+,_s.�iTnita._ Front _201 Depth -321 Height 211 Sq. Ft. 12131 Cu. Ft Type of Construction Front ._ _ Depth Height Sq. Ft Cu. Ft Wood Frame Est Cost See #113,15 To be Completed 1 year In consideration of the issuance to me of a permit toconstru the building described a I agree tp do the proposed work in accordance with the description above se and is comp wi provisions of ordinances of the city of Fridley. In consideration of the payment of a fee of $ See #11,=permit is hereby granted to Rice Greek DoZ. Co. 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, to all work done in, around and upon said building, or any part thereof, shall conform to all respects -to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildt— within the city limits and this permit may be revoked at any time upon violation of any of the provisions of Said ordinances. e ding tspector CLARENCE BELISLE NOTICE: This permit does not, cover the construction, installation for wh�ing, plumbing, gas heating, sewer or water. Be sure to we the Building Inspector for separate permits for these items. 1 for Pewer Root and Heating. CooiingR Ventialion, Rewhigeration and Air Conditioning Systoms and Devices 94 PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATZ TOTAL Furnace Shell & Duct Work ... ...... I ..... ..;10.00 $ Replacement of Furnace . . ..... ..... 6.00 $ Repairs & Alterations—up to $500.00 6.00 $ Repairs & Alterations each add. $500.00 3.00 $—___ MECH. WARM AM Furnace Shell & Duct Work to 120,000 BTU ...... . $10.00 $ v 6) each add. 60,000 BTU .................... 3.W i Replacement of Furnace 6.00 ; Repairs & Alterations—up to $500.00 6.00 $ Repairs & Alterations each add. $500.00 &W ; STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to 400 sq. ft. EDR Steam $10.00 $. Furnace Shell & Line—to 640 sq. ft. EDR Hot Water 10.00 $_ Each add. 200 sq. ft. EDR Steam 3.(1(1 Each add. 320 sq. ft. EDR Hot Water 3.00 $ OIL BURNER—to 3 gal. per hour 6.00 $ — over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 199,000 BTU) 8.00 $'�n l 06 over 199,000 BTU See Fee Schedule GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures x; Z00 $ 10?' Q Additional Fixtures x .75 $ Gas Range to 198,000 x= 6.00 $ AER - A_-IONIIIG FAN HEATING SYSTEM Sae Fee Schedule VENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE ROUGH (SURCHARGE $_,50) FINAL d - 2 e' - 7 Dept. of B1dgL Phone 860-3480 City of Fridley: The undersigned hereby makes application for a permit for the work :herein 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 facts and representations stated in this application are true and a rest 7 Fridley, Minn. _^/18��In To To be completed about Estimated Cost, Old ew. Building Permit No. Permit No. DESCRIPTION OF WORK HEATING or PO NTS—Steam, Hot Water Warm Air No L7 Trade Name LO/fQ/!//.f/1/ She No -C1107 2 Capacityj,D e-) 6 Sq. Ft. E D.R BTU HB. Total Connected Load Hind of Fuel BURNER — Trade Name Sin No Capacity Sq. FLED R- BTU HP. (REMARKS -OYER) SUBJECT i P MIT NO.� City of Fridley 32800 AT THE TOP OF THE TWINS BUILDING PERMIT 1 r ` R IPT NO.- `L ______ COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. d / �� ! e PROTECTIVE //-'o) NUMBER REV DATE PAGE OF APPROVED BY `w '�';'� CITY HALL FRIDLEY 55432 IL ._-- „ 612-571-3450 910415 7/18/02 JOB ADDRESS 1566-1576 68th Ave NE 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. arcels 10 200 Section 13 SHEET 2 PROPERTY OWNER MAIL ADDRESS Rice Creek Townhomes ZIP PHONE Jim Bern Management Co, 1566-1576 68th Ave, Fridley, MN 55432 952-854-7788 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Rayco Construction Co, 3801 5th St NE, Columbia Hts, MN 55421 612-547-3011 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Townhomes 7 CLASS OF WORK ❑X NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Re-roof (tear-off) 52 squares 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with State Building Code. SEPARATE PERMITS ARE REOUIREO 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 $5,573.88 $2.79 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PR VISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- ST TION OR THE PERFORMANCE $125.25 Fire SC $5.57 OF CONSTRUCTION PLAN CHECK FEE TOTAL FEE Licens $5.00 38.61 Si T REO�C :R TOR TAGEN iDATEi 1��147EP4AOPVALIOAT Bl NSP THIS IS YOUR PERMIT S-GNATURE Of OWNERO6 OWNER BU4DERi iDATE. uaic� v0 1/ .L/ L V VU Estimated Cost $ CITY OF FRIDLEY ( 612) 572-3604 Receipt # R-3, COMMERCIAL & INDUSTRIAL BUILDING PERMIT APPLICATION f�P 14 3�O� ConstructionAddress l�� - ��" Zoning Legal R,,.Le- - Q _L Owner & Address �l �fh�/� 0-\Ciey- Cp Tel# CONTRACTOR & ADDRESS ,� ,i\��}�(J �-�h pf1 ..r �►� C, Tel# ((AICi *Auk - s n.1, , -k a- , Architect NA Reg.# Engineer Reg.# BUILDING CONSTRUCTION �(( TYPE OF WORK [] New 0Addition [] Alteration -Describe_. O -P4- `E' vc ro OFC. AREA: Length Width Height Sq. Ft. WHSE AREA: Length Width Height Sq. Ft. OTHER AREA: Length Width Height Sq. Ft. APPLICANT "�Ly i , ��/"S Tel # �0 l a—Sym'- Date g VALUATION Sa5939-O Sq. Ft. x $ Cost/Sq. Ft. = Valuation $ ) Sq. Ft. x $ Cost/Sq. Ft. = Valuation $ ) _ $-4k, Sq. Ft. x $ Cost/Sq. Ft. = Valuation $ ) TOTAL VALUE Building Use 100-)v) mp, Construction Type Occupancy Group Air Conditioning [] Yes [] No Fire Protection Provided [] Yes [)No Performance Bond Amount $ See Reverse for Schedule Received []Yes []No Permit Fee $ IQL5 • a S Plan Check $ Fire Surcharge $ 5 . State Surcharge $ ®�.1 SAC Charge $ Erosion Control $ Park Fee 61, 4ek, $ , tl� Spec. Assessments $ Driveway Escrow $ _ TOTAL $ 12 PERMIT FEES See Fee Schedule on Reverse Side In Excess of Prepaid Amount - See Reverse Side .001 x Permit Valuation (1/10th k) $.50/$1,000 Valuation (See Sched. for > $1 Million) $1100 per SAC Unit (Plans to MWCC for determination) $450.00 Conservation Plan Review Fee Determined By Engineering Agreement Necessary [] Not Necessary [] feet x $15.50/foot ATTACH STIPULATIONS CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL ,q -=.her Fixtures suture Fixture Opening ,;ew Fixture, Old Opening Catch Basin Water Heater - to 99,G00 BTU 100,000 BTU to 199,000 BTU Water Softener New Ground Ran Old Building Electric Water Heater GAS FITTING FEES: 1st 3 fixtures Additional Fixtures Gas Range to 199,000 BTU REPAIRS $ ALTERATIONS First $100.00 each add. $100.00 or fraction x $3.00 $ q. $2.00 $ >- m $ ri $5.00 o x y N x Wa to $ x $7.00 $ r. $5.00 $ x $5.00 $ y M W C Heater v u . m E r 4 r ro u - -4 w r q ..� N ro 3 S, U (+• t!) .-, W ro ro U W r.3 l ^a ro U •.i <^. C7 O ',as 'lee to is Q #�' 1st Zn3 3rd a.h I (R) a Future Connection Opening Connected with Sewer (k) _ :;ew Fixture, Old ripsning Water PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL ,q -=.her Fixtures suture Fixture Opening ,;ew Fixture, Old Opening Catch Basin Water Heater - to 99,G00 BTU 100,000 BTU to 199,000 BTU Water Softener New Ground Ran Old Building Electric Water Heater GAS FITTING FEES: 1st 3 fixtures Additional Fixtures Gas Range to 199,000 BTU REPAIRS $ ALTERATIONS First $100.00 each add. $100.00 or fraction x $3.00 $ x $2.00 $ x $2.00 $ x $5.00 $ x $5.00 $ x $10.00 $ x $7.00 $ r. $5.00 $ x $5.00 $ Sob Address Department of Buildings City of Fridley Tel. #571-3450 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 Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correc / Fridley, Mn. A , 192-6, OWNER -vv KIND OF BUILDING USED AS TO BE COMPLETED ABOUT ESTIMATED COST C� OLD - NEW BUILDING PERMIT NO. PERMIT NO. Company Signed By Tel. No. _7 -12 -,,2 - ROUGH INSP. Date FINAL INSP. Date x $3.00 $ x $1.00 $ APPROVAL. FOR PERMIT'_�� x $10.00 S $5.00 $ $2.00 $ MINIMUM FEE FOR ANY PLUMBING PERMIT IS $7.50 State Surcharge $ .50 TOTAL FEE $ REINSPECTIO:J FEE ('$30.00) CITY OF FRIDLEY APPLICATION FOR PUMBING AND GAS FITTING PERMIT PARTIAL RATE SCHEDULE n ?LUMBING FIXTURE RATES: 1\10. RATE j, v x $3.00 q c7'jt•=e Fixture Opening v $ L x ai $ Water x $5.00 $ Water -eater - to 99,000 BTU x $5.00 $ V E c ` a+u $ q N -•4 o $4 .4 a. •.4 w 01 Electric Stater Heater Heater $ GAS FITTING FEES: 1st 3 fixtures x $3.00 $ U Wp a C Cas R r.ge to 199,003 BTU x $10.00 $ E ?AIRS $ ALTERATIONS ld . First $100.00 $5.00 $ each add. $100.00 or fraction $2.00 $ State Surcharge $ .50 TOTAL FEE $ 10 O 0 1J C a L N c V. •-� 7 O O +U a 4J V. N N N .c to ',t U G F` tll esu 2. 0 O :. r IA -+ w m o U G: a c 4 a 4das 0 � eea� C7 " O lee 1 Is t np) 7R 2nd 3_d (R) - Future Connection Opening Connected with Sewer t •) a New F LYt:re, Old Opening Water PARTIAL RATE SCHEDULE ?LUMBING FIXTURE RATES: 1\10. RATE TOTAL FiYt.:res x $3.00 $ c7'jt•=e Fixture Opening x $2.00 $ Ne- Fixture, Old Opening x $2.00 $ Catch Basin x $5.00 $ Water -eater - to 99,000 BTU x $5.00 $ :23,003 BTU to 199,000 BTU x $10.00 $ . Stater Softener x $7.00 $ Ne••r Ground tin Old Building x $5.00 $ Electric Stater Heater x $5.00 $ GAS FITTING FEES: 1st 3 fixtures x $3.00 $ A-1dit_onal Fixtures x $1.00 $ Cas R r.ge to 199,003 BTU x $10.00 $ E ?AIRS $ ALTERATIONS First $100.00 $5.00 $ each add. $100.00 or fraction $2.00 $ State Surcharge $ .50 TOTAL FEE $ 10 O REINSPECTION FEE (510.00) Job Address 1566 68 Ave. NE Department of Buildings City of. Fridley Tel. $571-3450 The undersigned hereby makes application for a pe wit for the work herein specified agreeing to do all work in strict accordance with the City Codes and rulings of the Depart-ment of Buildings, and hereby declares t:.at all the facts and reprosentations state in this application are true and ocrrect Fridley, Mn. 8-11-$1 , 19 OWNER WILSON KIND OF BUILDING f rame USED AS res. TO BE COMPLE—TED ABOUT r� 8-11-81- ESTIMATED COST 50•o0 OLD - NEW BUILDING PMV..IT NO. PERXIT NO. O� T�:�-/ 0?' Company luiINNI!FGASC; Signed By Tel. No. ROUGH INSP. Date FINAL INSP. / - 9,3 Date APPROVAL FOR PER4IT (� MINIMUM FEE FOR ANY PLUMBING PERMIT IS S7.50 PLUS $.50 STATE SUI =kpA*v RUG -09-2065 13:34 CITY OF FR I DLEY P-02/04 ;a* o�CJPLUMBING tit NumberRESIDENTIAL APPLICATION ceived ByCiiy of Fridley R7- NOTE: IF ?ROPERTY IS NOT OWNER/OCCUPIED- A LICENSED' CON TRACTOR MUST OBTAIN THE PERMIT. DATE v YOUR WWLjwDmss %/c%.(� �j - •�Q SITE ADDRESS THE APPLICANT I5: (CIRCLE ONE) OWNER CONTRACTOR NAME PROPERTY OWNER/ ADDRESS TENANT CITY 3TATi: ZIP PHONE 0. oil NAME O ' ` r �GjoteNSE e 3 CONTRACTOR ADDRESS CITY � STATE / f �p PHONE # FAX# PEFI6111TTYPE SINGLE FAMILY TWO FAMILY TOWNHOUSE TYPE OF WORK p NEW REPLACEMENT DETAILED DESCRIPTION OF WORK FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED FIXTURES: MIDICATE TOTAL NUMBER OF EACH) BATH SINK/LAV FLOOR DRAINS SHOWER WATER PIPING _BATHTUB GAS PIPING (Need City License) SWWIMING POOL WATER SOFTENER WA CLOTHES WASHER KrrCHEN SINK_ yyATER CLOSET BACKFLOW PREV. ($qs) OtSHWASHER LAUNDRY TRAY WATER HTR (5366) FOR IRRIGATION WATER METER OTHER . On 2<7 M1NIttflllM:-$F5.00--or 5-of-mst-of the improveMMOnt-Nfiidiieveris- Plan Review $ greater on work less than $300 Surcharge $ .50 TOTAL DUE $ 5-V Make checks payable to: City of Fridley 1 rua 1,11 AN ArruUATION FOR A PERMIT — NOT VALID UNTIL PROCESSED I hereby apply for a plumbing permit and I admowledge that the infotnradon 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 alt work which requires review and approva70fp S.�ME OF APPUCANT �_' 6te) Ll m,�,t� DATE �J PI se�Weorprint SIGNATURE OF APPLICANT $431 UNIVESITY AVENUE NE. FRIDLEY. MN 55432 HUU-107—& UM 1 .5; .54 1. ! I r Ur rK L IA P- 7 City of Fridley Building Inspections Dept Ph: 763-572-3604 FAX: 763-571-1287 6431 University Ave NE Fridley MN 55432 Mechanical Permit #c)5- 62-07 I Residential Application City of Fridley See Back Side For Required Information Site Address: 1 The applicant is: (;irice one) Owner Contractor Property Owner. Address. City: State: Zip: Company City: GDi'Y� 49"= v _ .State: &U Zip: J fug Phone:Emal: _ fes"! r16 il 2 4 y �h ell: 6`d 020�P�%MN Bond# &Exp Date ��0F ,Type of Work (circle one): New' Replacement Alteration/Remodel Detailed DescriDtlon of work: Equipment Installed: MFG: Model: SizeBTU: MFG: Model: Size/BTU: MFG: Model: Size/BTU: Please check all that apply. _Fireplace (gas) $15.00 New Gas. Grill $10.00 _AIC $25.00 ,Fireplace (wood) $35.00 _Gas Unit HTR $10.00 Air to Air.exchanger $15.00 _Furnace $35.00 _Pool Heater $35.00 _Boiler $35.00 _Gas Dryer $10.00 Ventilator $15.00 _Chimney Liner $10.00 Piping $10.00 __Duct Work $10.00 _✓Gas Gas Range/Oven $10.00 u Permit Fee $ ��b (Total from above -Minimum fee $35.00) - Total Due $ Z'' Make check p&able to City of Fridley This is an application for a pennit. not valid until processed I hereby apply for a mechanical permit and 1 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 case of all work which requires review and approval of plans. Signature of Applicant: a Date: / Approval Inspector Signature ®A� City of Fridley Building Inspections Dept. 6431 University Ave NE Fridley MN 55432 Mechanical Ph: 763-572-3604 FAX: 763-571-1287 JV" Residential Application City of Fridley C..., Qn4 Clrin Gnr Rnrrrntirarl Wnrmntlan Permit # Date Site Address: The applicant is: (cirl a one) Owner Contractor +� Property Owner.gKlg5e, 6Z"& , 0 Address:/6S2 or City: State: fid(/ Zip: Phone: Cell: Fax: Contractor Informati n Company Name: - Contact Person: -r Address: 6F 8 City: State: ZfA ZIIp:�E=4C L� 57 c{ Phone:_6_57 ti/� ?flee- Cell:6U, y4a 6(tAf9 Fax: Ss 6��o Email: E MN Bond# & Exp Date a Type of Work (circle one): New Replacement Alteradon/Remodel _ Detailed Description of work: &:W6 -., Equipment Installed: MFG: Model: Size/BTU: MFG: Model: Size(BTU: MFG: Model: SizeBTU: Please check all that apply: _Fireplace (gas) $15.00 New Gas Grill $10.00 $25.00 _Fireplace (wood) $35.00 _Gas Unit HTR $10.00 _A/C to Air exchanger $15.00 $35.00 _Pool Heater $35.00 _Air $35.00 _Furnace _Gas Dryer $10.00 Ventilator $15.00 _Boiler _Chimney Liner $10.00. _Gas Piping $10.00 J ' Duct Work $10.00 _Gas Range/Oven $10.00 Permit fee $ (Total from above -Minimum fee $35.0 _ 1 Q� Surcharge $ 0.50 Total Due $ Make check payable to City of Fridley This is an application for a permit- not valid until processed I hereby apply for a mechanical 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 case of all work which requires review and approval of plans. AY 6 Signature of Applicant: )r Approval Inspector Signatu Please Note: Separate permits are required for Building, Plumbing, and Electrical work a 5�-��a3 3S� ��6b8�g►� Building MECHANICAL Permit No.. H II Inspections RESIDENTIAL APPLICATION Reeeived By:mqj 763-572-3604 CITY OF FRIDLEY 763-502-4977 FAX EFFECTIVE t -t -os DATE (y ® YOUR &MAIL ADDRESS SITE ADDRESS THIS APPLICANT 1S: O OWNER MCONTR4CTOR PROPERTY ME11y'Yl eX-n NEi OWNER/ SS: 8 5P� ')'� 61-00/TMJ CITY STATE �uZ TENANT O CONTRACTOR COMPANY NAME: NOTE:- SEPARATE CITY MEMO" KM AM GUA • CONTACT PERSON: t LICENSES ARE STATE LICENSE # REQUIRED FOR GAS ADDRESS: CITY STATE ANDHVAC. SUBMIT COPY OF BOND —2V PHONE 57 "-5b 40 FAX 'X3-75-7-5-75-1 ANDINSURANCE PERMIT• TYPE ❑ SINGLE FAMILY 0 TWO FAMILY &/PQWNHOUSE TYPE OF WORK: O NEW 4EPLACEMENT 0 ALTERATIONMEMODEL DETAILED DESCRIPTION OF WORK 4-U!LL� LA) H" Lu -k 4i re— m cD� LLLKT(F? %56coon 1.;-fv-, P? PER MS 1613.665 the pem it fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater. fbr the improvement, installation or replant of a residential fixture, excluding the fn s. (This should reflect only the cost of labor ) OR 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) Equipment fnstalled MFG: MODEL: S1ZF/8TU MFG: MODEL: SIZEJBTU MFG: MODEL: S12MTU A/C W.00 FIREPLACE (GAS) $15.00 GAS RANGE/OVEN $10.00 AIR TO AIR EXCHANGEER $i5 _FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 BOB ER $35.00 t;; -FURNACE $35.00 GAS UNIT HTR $10.00 CHM4EY LINER $10.00 GAS DRYER $10.00 POOL HEATER $35.00 DUCT WORK $10.00 _GAS PIPING $10.00 _VENTILATOR $15.00 PERMIT FEE PROJECTS FOR UNDER $500 PERMIT FEE FOR PROJECTS OVER $500 Permit Fee $ . ® Number of fixtures @ $10.00 x $10.00 = $ Surcharge S SO Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE OR Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 x $35.00 = $ State Surcharge = $ 30 MINIMUM $1550 NIMMIUM $15.50 Total = $ THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED I hereby apply for a mechanical permit and [ acknowledge that the ' above is complete and accurate, do the work will be is aonfo»ue with the ad a>anoes not a permit. tart only an application for a permit and work is not to and codes of the City of Fridley and with the COw:W:w ion I�MfNT start without a permit that the work will be' rna�oce with the rk which regimes review and�aipapnro'val ofplaos. AME 0142.E 5 1! ChS&U � DATE 16 �'� SIGNATURE OF APPLICANT APPROVED BY DATE PLEASE NOTE: SEPARATE PERMITS ARE RE U1RID FOR BUILDINGELECTRICAL AND MECHANICAL WORK City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977