PRE 2010 DOCSPermit Fee paid on Permit #11,315 for 1560 - 1570 69th Avenue N.E.
City of Fridley, Minn. 11 3 2
6431 University Ave. N. E., Minneapolis, Minn. 55432
BUILDING PERMIT
Date: February 22., 1972
Owner: Rice Creek Development Company Builder Approved Contractors, Inc.
Address _..__.W- West_T?oad, CHr _l a PinPa _ Minn.Address 1059 Osborne Road N_1?_, Pri dl ew
786-3680
157931580,1583, LOCATION OF BUILDING
1585,1587,1589
No. __ ....._. _ Street 68th Avenue NSE_ Part of Lot
Parcels 10 200, Section 13
Lot _ B ock _ ____._.. _ ._ Addition or Sub -Division
Corner Lot ___.._..__._ _ Inside Lot Setback Sideyard
Sewer Elevation _ __ _ ____ _ Foundation Elevation __.._.
DESCRIPTION OF BUILDING
To be Used as: Each Unit
6 Townhouse Units.-- Front 20r Depth 32' Height 21' Sq, Ft. 1213' Cu. p,
Front — Depth Height Sq. Ft. Cu. Ft.
Type of Construction Wood Frame Est. Cost -See #11'315--- To be Completed 1 yearn
In consideration of the issuance to me of a permit to constru the building described bove, I agree to do
the proposed work in accordance with the description above and A, and in coopliance th all provisions of
ordinances of the city of Fridley. _
In consideration of the payment of a fee of -aS P A 611-31 5 permit is hereby granted to Rice Creek . 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, 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 buildiII$s
:within the city limits and this permit may be revoked at any time upon violation of any of the provisions of Acid
ordinances.
CLARENCE BELISLE
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to as
the Building Inspector for separate permits for these items.
Application icor Fewer Ptanfs and Heaft% Cooling, Ventilaftne Re%igerafion and
Air Conditioning Spstems and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIR: RATE TOTAL
Furnace Shell & Duct Work ................ .. $10.00 =
Replacement of Furnace 6.00
Repairs & Alterations—up to $500.00 600 $— _
Repairs & Alterations each add. $500.00 &00
MECH. WARM AIA
Furnace Shell & Duct Work to 120,000 BTU ..6p. ..$10.00 no
each add. 60,000 BTU .................... .. 3.1x1 =
Replacement of Furnace 6.00
Repairs & Alterations -up to $500.00 6.00 $
Repairs & Alterations each add. $500.00 3,00 $
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
3.00
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 SURFER (up to 188,000 BTU) ... 6 dV
. 800
over 199,000 BTU See Fee Schedule
GAS FITTING FEES: NO RATE TOTAL
1st 3 Fixtures /n
x$ 200
$1.2
Additional Fixtures
x .78
$
Gas Range to 199,000
X$500
$
AIR C014DITIONINa
FAN HEATING SYSTEM
VENTILATING SYSTEM
ALTERATIONS & REPAIRS
ROUGH
Fww & m 1'r h f1
See Fee
a $ 0 u
TOTAL FSE
(SURCHARGE $_.50)
Dept. of Bldg& Phone M4=
aJO
City of Fridley:
W
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 correeL.
Kind of Building .___'S�
Used as
To be completed about_ ! �/
Estimated Cost,
OI New Building Permit No. Permit No.
DESCRIPTION OF WORK
HEATING or PO PLANTS—Steem, Hot Water, Warm Air—No---�-7
Trade Name x/27?��L Size N L
Capacity 7�Q Sq. Ft. E.DR BTU H.P
Total Connected Load Kind Of Fue
BURNER — Trade Nam Size No
Capaci Sq. Ft E.D.R BTU
IAP.
(REMARKS—OVER)
SEP -29-2005 09:36 CITY OF FRIDLEY
Building
BUILDING
Permit No.
Inspections
COMMERCIALANDUSTRIAL
Received By:
763-572-3604Date
CITX OF FRIDLLX
Rec'd:
A4
DATE G��%�O� YOUR E-MAIL ADDRESs.rlbnj���-)S&ruemkno.
SITE ADDRESS % -7 J 14 e- rJ O
TENANT Suite No.
PROPERTY OWNER
NAME: 51 IY,,� k e - n l -) ,--:m
ADDRESS: �l �a �I DatY1P _ TTYZJ=PA ►ATEOJtIPS
.rosion Control
$
PHONE: C1:5-9 ' YS q - -7 i
ARCHITECT
NAME:
ADDRESS: CITY STATE ZIP
Special Assessments
CONTRACTOR
NAME: c1 -L C
ADDRESS: of l ( 51 PW44- l � �J PL%TYSTATEA� 5T - r g
$
ft + 6 ft = ft x $20 = $
PHONE: I —4PO `�7 Z FAX' f� -"7 — %% �
$ yl:g 77 D
*NOTE: CITY LICENSE REQUIRED FOR MULTI FAMILY/COMMERCIAL/INDUSTRL-%L JOBS
PROPERTY TYPE
X TOWNHOUSE i l COMMERCIAIANDUSTRIAL ❑ INSTITUTIONAL
0 MULTI -FAMILY
PERMIT TYPE
D ADDITION 0 NEW CONSTRUCTION 0 OTHER
0 REMODEL IR ROOF O SWIMMING POOL
PLEASE SUBMIT:
1.4 SETS OF DRAWINGS 5. CONTRACTORS LICENSE OR 6. SPECIAL INSPECTION
2. STJ`RVEY/SITE PLAN LICENSE APPLICATION SCHEDULE
3. LANDSCAPE PLANS 7. PERFORMANCE BOND
4. ENERGY CALCS AMOUNTS
BUILDING TO BE USED AS: OFFICE Sr WHS sf OTHER sx
TOTAL SIZE: STORIES FIRE PROTECTION (Y/N) AC(Y/N)
DETAILED DESCRIPTION OF WORK VC- u 5 1 rZ •F (rl
ti --4 g -r i l
THIS IS AN APPLICATION FOR A PERMrt-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 allwort. w vires review and approval of plans.
OF APPLIC. PRINT L15i
SIGNATURE NAME )evl I DATE
ALL FEES ARE BASED ON VALUATION
Sq. ft_4--1 x $ Cost/sq. fL = Valuation $
Sq. ft. x $ Cost/sq. ft. = Valuation $
Sq. ft. x $ Cost/sq. ft. = Valuation $
TOTAL JOB VALUATION: $ %,—USE OCCUPANCY TYPE
?ermit Fee
$
See Back Page for Fee Schedule
Nan Review
$
65% of Building Permit Fee
Surcharge
$
(.0005) times the total job valuation -Minimum $.50
-ire Surcharge
$ pit}• 3D
.001 x Permit Valuation (1/10%)
SAC Charge -��-e
$ / a, /�'
$1450 per SAC Unit (Plans to MWCC for determination)
.rosion Control
$
$450 Conservation Plan Review
?ark Fee
$
Fee Determined by Engineering
Special Assessments
$
Agreement necessary { ) Non Necessary ( )
:urb Cut Escrow
$
ft + 6 ft = ft x $20 = $
notal Due
$ yl:g 77 D
Make checks payable to: City of Fridley Attach tiaula ions
F -, L f_> Rayco Construction, Inc.
211 St. Anthony Parkway • Minneapolis, MN 55418
Phone: (612) 781-6092 • MN License #3396 • Fax: (612) 781-8778
J
PROPOSAL SUBMITTED TO: DESCRIPTION OF JOB:
#95 PHONE: (952) 854-7788 SHINGLE RE -ROOF:
DIANA L. HOWEY FAX: (952) 854-0910 RICE CREEK TOWNHOMES
JIM BERN MANAGEMENT COMPANY 1579-1589 — 68TH AVENUE NORTH
8162 BLOOMINGTON AVENUE SOUTH 1650-1658 — 69TH AVENUE NORTH
BLOOMINGTON, MN 55425 FRIDLEY MN DATE: 09/26/05
REFER TO THE ATTACHED ROOF DIAGRAM FOR ADDITIONAL INFORMATION RELATING TO THIS PROPOSAL. THIS PROPOSAL IS TO TEAR OFF
AND COMPLETELY RE -ROOF THE SPECIFIED TOWNHOMES AT THE ABOVE PROPERTY LOCATION.
ROOF PREPARATION:
1) REMOVE ALL EXISTING ROOFING MATERIAL FROM THE TOWNHOMES.
2) REMOVE ALL ROOFING NAILS.
DECK EXAMINATION:
1) CHECK THE DECKING AND REPLACE ANY THAT IS DETERIORATED WITH NEW DECKING. THIS WORK WILL BE COMPLETED ON A
SQUARE FOOTAGE CHARGE BASIS AT A RATE OF $3.25 PER SQUARE FOOT. THIS WILL BE IN ADDITION TO THE BASE CONTRACT
AMOUNT.
NEW ROOF:
1) INSTALL PREFINISHED METAL DRIP EDGE AROUND THE PERIMETER OF THE ROOF. NAIL IN PLACE.
2) APPLY GAF® WEATHERWATCH° ICE AND WATER SHIELD SIX FEET UP AT ALL EAVE LINES. NAIL IN PLACE.
3) COVER THE BALANCE OF THE ROOF WITH GAF° SHINGLEMATe FIFTEEN -POUND UNDERLAYMENT FELT. FASTEN IN PLACE.
4) INSTALL NEW PREFORMED GALVANIZED METAL VALLEYS. NAIL AND SEAL IN PLACE.
5) INSTALL NEW SHEET METAL LOUVERED VENTS. NAIL AND SEAL IN PLACE.
6) INSTALL NEW GALVANIZED METAL PLUMBING STACKS. NAIL AND SEAL IN PLACE.
7) INSTALL ONE COURSE OF MINERAL STARTER AT ALL EAVES. NAIL AND SEAL IN PLACE.
8) COVER THE ROOF WITH NEW GAF® ROYAL SOVEREIGN® FIBERGLASS SHINGLES. NAIL IN PLACE USING A MINIMUM OF FOUR
ROOFING NAILS PER SHINGLE:
9) INSTALL BOSTON HIP AND RIDGE.
JOB PROCEDURE:
1) WHILE THE WORK IS IN PROGRESS, KEEP THE JOBSITE CLEAN AND NEAT. WHEN THE JOB IS COMPLETE, MAKE SURE ALL GROUND
DEBRIS IS CLEANED UP.
PERMITS, FEES, AND TAXES:
1) WE HAVE INCLUDED IN THE BASE CONTRACT AMOUNT ALL SALES TAXES AND PERMIT FEES TO COMPLETE THIS PROJECT.
2) MANY CITIES NOW REQUIRE A PLAN -CHECK FEE. IF THIS WERE ASSESSED AGAINST THIS PROJECT, THE COST WILL BE IN
ADDITION TO THE BASE CONTRACT AMOUNT.
\\Server02U-drive\Proposals\Proposals - 2005\Ray Ellis - 2005\1579-1589- 68th.1650-1658 - 69th Avenue North.SH.re.sl.doe Page 1 of 1
Rayco Construction, Inc.
211 St. Anthony Parkway • Minneapolis, MN 55418
Phone: (612) 781-6092 • MN License #3396 • Fax: (612) 781-8778
PROPOSAL SUBMITTED TO: DESCRIPTION OF JOB:
#95 PHONE: (952) 854-7788 SHINGLE RE -ROOF:
DIANA L. HOWEY FAX: (952) 854-0910 RICE CREEK TOWNHOMES
JIM BERN MANAGEMENT COMPANY 1579-1589 — 68TH AVENUE NORTH
8162 BLOOMINGTON AVENUE SOUTH 1650-1658 — 69TH AVENUE NORTH
BLOOMINGTON, MN 55425 FRIDLEY, MN DATE: 09/26/05
PRICING:
ffle % �� olo� /attic
R,r ho�eW /-A
BUILDING
NUMBER
RE -ROOF
PRICE
1579-1589
$13,888.00
1650-1658
$ 10,409.00
TOTAL
$24,297.00
We hereby propose to furnish labor and materials
complete in accordance with the above specifications for
the Sum Of:
AS SHOWN ABOVE
With Payments to be made as follows:
PAYMENT DUE UPON COMPLETION
NOTE: This proposal may be withdrawn by Rayco
Construction if not accepted within twenty days.
K � %�4 Wye✓IL'
ig
All material is guaranteed to be as specified, and all work shall be performed in a professional
manner in accordance with the above specifications. Alterations or deviations from the above
specifications will be made only upon written change order, signed by both Rayco and Owner,
describing the change and stating what, if any, additional amount is to be paid by Owner. Owner
assumes the risk of concealed or unknown conditions, including, but not limited to, the presence of
asbestos, which delay or increase the cost of Rayco's performance, and Owner shall agree to pay
reasonable, additional charges resulting from those conditions before Rayco shall be obligated to
continue performance. Rayco is not responsible for delays resulting from strikes, transportation
disruption, weather, accidents, materials shortage, or other causes beyond its control. Rayco is not
responsible for damages to the premises resulting from vibration caused neither by its
performance, nor for any incidental or consequential damages arising out of any error or omission
in performance by Rayco. Structural analysis, existing and future mold are excluded from this
contract unless otherwise noted. All materials shall be as specified above, and all work shall be
performed in a professional manner. All other express or implied warranties, including the implied
warranties of fitness and merchantability, are hereby excluded. Owner's sole remedy for breach of
any and all warranties by Rayco, whether expressed or implied, shall be limited to repair or
replacement, at Rayco's option, of the portion of the work and materials, supplied hereunder that
are determined to be defective. Owner agrees to pay additional reasonable charges, including
hourly rates for idle equipment resulting from delays of Rayco's performance caused by Owner or
Owner's other contractors. Unless otherwise agreed, payment shall be due upon completion of the
work by Rayco, and invoices shall be payable within ten (10) days after receipt by Owner. A
service charge of the lesser of the maximum legal rate, or one and one-haH percent (1.5%) per
month will be added to past due accoi sa r/ _
Authorized
ACCEPTANCE OF PROPOSAL: The above prices, specifications and conditions are satisfactory and ar er y accepted. You are authorized to do the
work as specified. Payment
will be made as outlined above. \ ,�
DATE ACCEPTED: / \ SIGNATURE: X
PRELIMINARY LIEN NOTICE: Any person or company supplying labor or materials for this Improvement to
your property may file a lien against your property if that person or company Is not paid for the contributions.
Under Minnesota law, you must have the right to pay persons who supplied labor or materials for this
improvement directly and deduct this amount from our contract price, or withhold the amounts due from us
until 120 days after completion of the improvement unless we give you a lien waiver signed by persons who
supplied any labor or material for the improvement and who gave you timely notice.
1\Server02V-driveTroposals\Proposals - 2005\Ray Ellis - 2005\1579-1589 - 68th.1650-1658 - 69th Avenue North.SH.re.si.doc Page 2 of 2
W
Rayco Construction, Inc.
n 211 St. Anthony Parkway • Minneapolis, MN 55418
9 Phone: (612) 781-6092 • MN License #3396 • Fax: (612) 781-8778 0
PROPOSAL SUBMITTED TO: DESCRIPTION OF JOB:
#95 PHONE: (952) 854-7788 SHINGLE RE -ROOF:
DIANA L. HOWEY FAX: (952) 854-0910 RICE CREEK TOWNHOMES
JIM BERN MANAGEMENT COMPANY 1579-1589 — 68" AVENUE NORTH
8162 BLOOMINGTON AVENUE SOUTH 1650-1658 — 69TH AVENUE NORTH
BLOOMINGTON, MN 55425 FRIDLEY MN DATE: 09)
REFER TO THE ATTACHED ROOF DIAGRAM FOR ADDITIONAL INFORMATION RELATING TO THIS PROPOSAL. THIS PROPOSAL IS TO TEAR OFF
AND COMPLETELY RE -ROOF THE SPECIFIED TOWNHOMES AT THE ABOVE PROPERTY LOCATION.
ROOF PREPARATION:
1) REMOVE ALL EXISTING ROOFING MATERIAL FROM THE TOWNHOMES.
2) REMOVE ALL ROOFING NAILS.
DECK EXAMINATION:
1) CHECK THE DECKING AND REPLACE ANY THAT IS DETERIORATED WITH NEW DECKING. THIS WORK WILL BE COMPLETED ON A
SQUARE FOOTAGE CHARGE BASIS AT A RATE OF $3.25 PER SQUARE FOOT. THIS WILL BE IN ADDITION TO THE BASE CONTRACT
AMOUNT.
NEW ROOF:
1) INSTALL PREFINISHED METAL DRIP EDGE AROUND THE PERIMETER OF THE ROOF. NAIL IN PLACE.
2) APPLY GAF° WEATHERWATCH° ICE AND WATER SHIELD SIX FEET UP AT ALL EAVE LINES. NAIL IN PLACE.
3) COVER THE BALANCE OF THE ROOF WITH GAF® SHINGLEMATe FIFTEEN -POUND UNDERLAYMENT FELT. FASTEN IN PLACE.
4) INSTALL NEW PREFORMED GALVANIZED METAL VALLEYS. NAIL AND SEAL IN PLACE.
5) INSTALL NEW SHEET METAL LOUVERED VENTS. NAIL AND SEAL IN PLACE.
6) INSTALL NEW GALVANIZED METAL PLUMBING STACKS. NAIL AND SEAL IN PLACE.
7) INSTALL ONE COURSE OF MINERAL STARTER AT ALL EAVES. NAIL AND SEAL IN PLACE.
8) COVER THE ROOF WITH NEW GAF" ROYAL SOVEREIGN" FIBERGLASS SHINGLES. NAIL IN PLACE USING A MINIMUM OF FOUR
ROOFING NAILS PER SHINGLE.
9) INSTALL BOSTON HIP AND RIDGE.
JOB PROCEDURE:
1) WHILE THE WORK IS IN PROGRESS, KEEP THE JOBSITE CLEAN AND NEAT. WHEN THE JOB IS COMPLETE, MAKE SURE ALL GROUND
DEBRIS IS CLEANED UP.
PERMITS, FEES, AND TAXES:
1) WE HAVE INCLUDED IN THE BASE CONTRACT AMOUNT ALL SALES TAXES AND PERMIT FEES TO COMPLETE THIS PROJECT.
2) MANY CITIES NOW REQUIRE A PLAN -CHECK FEE. IF THIS WERE ASSESSED AGAINST THIS PROJECT, THE COST WILL BE IN
ADDITION TO THE BASE CONTRACT AMOUNT.
11Server02\f drive'Proposais\Proposals - 20051Ray Ellis - 200511 579-1 589 - 68th.1650-1656 - 69th Avenue North.SH.re.sl.doc Page 1 of 1
r
Rayco Construction, Inc.
211 St. Anthony Parkway • Minneapolis, MN 55418
Phone: (612) 781-6092 • MN License #3396 • Fax: (612) 781-8778
PROPOSAL SUBMITTED TO: DESCRIPTION OF JOB:
#95 PHONE: (952) 854-7788 SHINGLE RE -ROOF:
DIANA L. HOWEY FAX: (952) 854-0910 RICE CREEK TOWNHOMES
JIM BERN MANAGEMENT COMPANY 1579-1589 — 68TH AVENUE NORTH
8162 BLOOMINGTON AVENUE SOUTH 1650-1658 — 69TH AVENUE NORTH
BLOOMINGTON, MN 55425 FRIDLEY, MN DATE: 09/26/05
PRICING:
l l e G00% all �c
BUILDING
NUMBER
RE -ROOF
PRICE
1579-1589
$13,888.00
1650-1658
$ 10,409.00
TOTAL
I $24,297.00
We hereby propose to furnish labor and materials
complete in accordance with the above specifications for
the Sum Of:
AS SHOWN ABOVE
With Payments to be made as follows:
PAYMENT DUE UPON COMPLETION
NOTE: This proposal may be withdrawn by Rayco
Construction if not accepted within twenty days.
�jf
All material is guaranteed to be as specified, and all work shall be performed in a professional
manner in accordance with the above specifications. Alterations or deviations from the above
specifications will be made only upon written change order, signed by both Reyco and Owner,
describing the change and stating what, if any, additional amount is to be paid by Owner. Owner
assumes the risk of concealed or unknown conditions, including, but not limited to, the presence of
asbestos, which delay or increase the cost of Rayco's performance, and Owner shall agree to pay
reasonable, additional charges resulting from those conditions before Rayco shall be obligated to
continue performance. Rayco is not responsible for delays resulting from strikes, transportation
disruption, weather, accidents, materials shortage, or other causes beyond its control. Rayco is not
responsible for damages to the premises resulting from vibration caused neither by its
performance, nor for any incidental or consequential damages arising out of any error or omission
in performance by Rayco. Structural analysis, existing and future mold are excluded from this
contract unless otherwise noted. All materials shall be as specified above, and all work shall be
performed in a professional manner. All other express or implied warranties, including the implied
warranties of fitness and merchantability, are hereby excluded. Owners sole remedy for breach of
any and all warranties by Rayco, whether expressed or implied, shall be limited to repair or
replacement, at Rayco's option, of the portion of the work and materials, supplied hereunder that
are determined to be defective. Owner agrees to pay additional reasonable charges, including
hourly rates for idle equipment resulting from delays of Rayco's performance caused by Owner or
Owners other contractors. Unless otherwise agreed, payment shall be due upon completion of the
work by Rayco, and invoices shall be payable within ten (10) days after receipt by Owner. A
service charge of the lesser of the maximum legal rate, or one and one-half percent (1.591.) per
month will be added to past due accoyats® 1,i
Authorized
ACCEPTANCE OF PROPOSAL: The above prices, specifications and conditions are satisfactory and ar e y accepted. You are authorized to do the
work as specified. Pa ent ill be made as outlined above. \ ,�
DATE ACCEPTED: SIGNATURE: X
PRELIMINARY LIEN NOTICE: Any person or company supplying labor or materials for this improvement to
your property may file a lien against your property if that person or company is not paid for the contributions.
Under Minnesota law, you must have the right to pay persons who supplied labor or materials for this
improvement directly and deduct this amount from our contract price, or withhold the amounts due from us
until 120 days after completion of the improvement unless we give you a lien waiver signed by persons who
supplied any labor or material for the improvement and who gave you timely notice.
USmeM\f-drlve\ProposalslProposals - 2005\Ray Ellis - 2 157&1569 - 68th.1650-1658 - 69th Avenue North.SH.re.sl.doc Page 2 of 2
le t
RUG -09-2005 13:34 CITY OF FRIDLEY
(PLUMBING
RESIDENTIAL APPLICATION
City of Fridley
10
11�)s 3
Permit Number
Received By
Date Received
NOTE: IF PROPERTY i3 NOT OWNER/OCCUPIED- A LICENSED CONTRACTOR MUST OBTAIN THE PEItMLT.
DATE _ c7 LA-.) YOUR WWLADDRESS %P �/��► %r'J - �.0�
SITE ADDRESS
THE APPLICANT IS: (CIRCLE ONE) OWNER CONTRACTOR j___,
NAME
PROPERTY OWNER/
TENANT ADDRESS
CITY 3rATE ZIP
PHONE#
CONTRACTOR
NAME
PHONE
;TATE /f AJ ZIP
Fc0'
PERMIT TYPE SINGLE FAMILY TWO FAMILY
TYPE OF WORK p NEW REPLACEMENT
'E'I'AILED DESCRIPTION OF WORK
Z?�
FEES ARE BASED ON $10.00 PER PIXTURIE, EXCEPT WHERE NOTED
FUTURES: (WDICATE TOTAL NUMBER OF EACH)
BATH SROCN V FLOOR DRAINS SHOWER WATER PIPING
BATHTUB GAS PIPING (Need Ck, license) SWIMMING POOL WATER SOFTENER ($35)
CLOTHES WASHER KITCHEN SINK�VjfATER CLOSET BACKFLOW PREY. ($1S)
DISHWASHER LAUNDRY TRAY ✓WATER HTR (535) FOR IRRIGATION
WATER METER OTHER
=Perlm"tFee .._ . $ — �Vl1 i�VIi1M: $'F5:00 -or s°f -of-cost-of the irnfprovement.�Vfiicftieveris-
Plan Review $ greater on work less than $300
Surcharge $ .50
TOTAL DUE $ ig5_� Make checks payable to: City of Fridley
1 ruo w AN ArrIJUA770N FOR A PERMIT — NOT VALID UNTIL PROCESSED
I hereby apply for a plumbing permit and I acknowledge that the information above fs complete and ac mHate; 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 thecase of alt work hit
requires review and approval of p s. w
J IIAE OF APPUCANT/�' w / L�G/�/ G�'� f DATE-
P1
ATEPl se type or print
SIGNATURE OF APPLICANT ,
OF FRIDL.EY COMMUNITY DEVELOPMENT DEPARI
5431 UNIVESITY AVENUE NE, FRIDLEY. MN 55432
City of Fridley Building Inspections Dept. Ph: 763-572-3604 FAX: 763-571-1287
6431 University Ave NE
Fridley MN 55432
Mechanical Permit# 0�00r"o--2193
Residential Application
City of Fridley
Gap Rack side For Required Information
Date Site Address: /T
The applicant is:cirl a one)
Owner Contractor
Property Owner.
Address:40-9 4011-7 Allee-14W
City: Grl, i2 u�,
State: 04/ Zip:
Phone:
Cell: Fax:
Contractor Informati n
Company Name:
-
Contact Person:
-r
Address: 8
City
State: /t?A/ Zip:—f
Phone: ��!' �/G �Pe Cell: -049 66L4p9 Fax:
MN Bond# & Exp Date X-4
Email: e m
Type of Work (circle one):
New Replacement Alteration/Remodel
Detailed Description of work: A-! J
Equipment Installed: MFG:
Model: Size/BTU:
MFG:
Model: Size/BTU-
MFG,-
Model: Size/BTU:
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 1 �-fi
�'
Duct Work $10.00
Gas Range/Oven $10.00. ��/
Permit fee $
(Total from above -Minimum fee $35.0017� tz
Surcharge I
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 startwithout 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: 0<5�6 Date: 0
'Ile
Approval Inspector Signature: Date: r—
Please Note: Separate permits are required for Building, Plumbing, and Electrical work
HUIa-b7-&MM 1.3; .34 1. ! i T Ur- t -K 1 LA -t_ T
City of Fridley Building Inspections Dept
6431 University Ave NE
Fridley MN 55432
Property Owner.
Ph: 763-572-3604 FAX: 763-571-1287
Mechanical
Residential Application
City of Fridley
See Back Side For Required Information
Site Address:
Contractor
City: State: Zip:
Phone: Cell: Fax
Company Nan
Contact Perso
Permit #
City: A9re.4" _ v _ .State: / KkJ ZIp: .rruz —
Phone:_ Cell: 6fd 90 �P�O�✓ Fax: 6T7_--12
Email: 1 (1 arzBh• MN Bond# & Exp pate -Ty II/3104
Typeof Work (circle one : New' Replacement Alteration/Remodel
Detailed Description of work:
N
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
_Fumace $35.00
_Pool Heater $35.00
_Boiler $35.00
_Gas Dryer $10.00
Ventilator $15.00
_Chimney Liner $10.00
►OGas Piping $10.00
Duct Work $10.00
Gas Ranue/Oven $10.00
u
PerTnit Fee $ ��b (Total from above -Minimum fee $35.00)
Surcharge: -- � -_.
Total Due $_J�� 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 1 acknowledge that the Information above is complete and
accurate; that the work wM be in conformance with the ordinances and codes of the City of Fridley and
with the Minnewta Construction Codas; that 1 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
Approval Ins
J
S