PRE 2010 DOCSPermit Fee paid on Permit #11,315 for 1560 - 1570 69th Avenue N.E.
City of Fridley, inn 11. 2
6431 University Ave. N. E., Minneapolis, Minn. 55432
BUILDING PERMIT
Date: February_ 22, 1972
owner: ._.. Rice Creek Development Company Builder Approved Contxactors, Inc.
Address __33_Teie t._Road,_ Circle Pines. NLnAddress 1059 Qgho-rnP_ Road N.E., Fridley_
786-3680
157931580215832 LOCATION OF BUILDING
1585,1587,1589
No. ______.......__ Street _ _ 68th .Avenue N _R__ 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 20' Depth 32' Height 21Sq. FL 1213' Cu. Ft.
Front Depth Height Sq. Ft. Cu. Ft
Type of Construction — Wood Erne Est. Cost See #11,315 To be Completed —1. Year
In consideration of the issuance to me of a permit to constru t the building described Above I agree to do
the proposed work in accordance with the description above �rth and in copliance th a'll provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of $ See_All.3 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 buildiligs
w. ithin the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
9
® � � •� •• �TaiCc1�'CAI•
CLARENCE BELISLE
NOTICE:
This permit does not cover the construction, Installation for wiring, plumbing, gas heating, sewer or water. Be sure to we
the Building Inspector for separate permits for these items.
Application for Power Plaints and HoutlIS Cooling, Ventilation. RoMd9awioa and
Air Conditioning System 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 6.00
Repairs & Alterations each add. $800.00 &00
NECH. WARM AIR /n�
Furnace Shell & Duct Work to 120,000 BTU . �p. .. $10.00 r � 0 0
each add. 60,000 BTU .................... 3.00 =
Replacement of Furnace 6.00 $
Repairs & Alterations—up to $500.00 6.00 $�
Repairs & Alterations each add. $500.00 &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
2.00
$ _
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 BURNER (up to 199.000 BTU) .. . ...6 W
. 6.00
-0-62)
over 199,000 BTU See Fee Schedule
GAS FITTING FEES: NO RATE TOTAL
1st 3 Fixtures r.,
x$ zoo
$_ZJ_
Additional Fixtures
x .76
$
Gas Range to 199.000
a$ 500
$
AIR CONDITIONING
FAN HEATING SYSTEM
VENTILATING SYSTEM
ALTERATIONS & REPAIRS
ROUGH
tsi
See Fes
TOTAL FEE
�2 S®
(SURCHARGE $_.5®)
Dept. of Bldgs. Phos. W-3490
City of Fridley:
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City Ordinance:
and ruling of the Department of Buildings, and hereby declares that all the facts
and representations stated in this application are true and correct.
A'*�3'�TJiM�i-WIJ%/rI/_!i%/II.Ir%J
Kind of Building
Used as - tabout To be complet_��/
Estimated Cost,
OI New Building Permit No. Permit No.j
DATION OF WORK
HEATING or P74�-Z'
PLANTS -Steam, Hot Water, Warm Air—No�
Trade Name 2'ed � Size N&42- 2--
Capacitysi r7; 0) 0 0 Sq. Ft. E.D.R BTU PH -P
Total Connected Load Hind of Fuel
BURNER — Trade Name Size No
Capacity Sq. Ft. E.D.R BTU
imp.
(REMARKS -OVER)
177
SEP -29-2005 09:36 CITY OF FRIDLEY
r
Building
BUILDING
Permit No.;
Inspections
COMMERCULIINDUSTRUL
Received By:�
763-572-3604Date
CITY OF FRIDLEX
Rec'd:
0i AR,01
DATE k61l%S— YOUR E-MAIL ADDRESS rr ( o n u
SITE ADDRESS 7 '' f"J ;rJ (i
TENANTLj�' r L e k-- Ja'N 1i r:> n1 -e . � Suite No.
PROPERTY OWNER
NAME: 11 r}
ADDRESS: S1 tva 61 ems, ITY n��a, iP�S
rosion Control
_$
$
PHONE: C1:5--) -- -m Li i i
ARCHITECT
NAME:
ADDRESS: CITY STATE—ZIP
Special Assessments
CONTRACTOR
—h C.
NAME: S,�/
- I
ADDRESS: z;2'1 ( � I P" 4 4 1� �1TYSTATEIJN PS [g
w "FAX
$
ft + 6 ft = ft x $20 = $
PHONE: �D�a2- ���D7Z eefa-7FsJ— F%%
$ 4/9 7.7 V
*NOTE: CITY LICENSE REQUIRED FOR MULTI FAMILY/COMMERCIAL/INDUSTRIAL JOBS
PROPERTY TYPE
X TOWNHOUSE ig COMMERCIAL/INDUSTRIAL 0 INSTITUTIONAL
0 MULTI -FAMILY
PERMIT TYPE
D ADDITION 0 NEW CONSTRUCTION O OTHER
0 REMODEL IRROOF 0 SWIMMING POOL
PLEASE SUBMIT:
1.4 SETS OF DRAWINGS 5. CONTRACTORS LICENSE OR 6. SPECIAL INSPECTION
2. SURVEY/SITE PLAN LICENSE APPLICATION SCHEDULE
3. LANDSCAPE PLANS 7. PERFORMANCE BOND
4. ENERGY CALCS AMOUNTS
BUILDING TO BE USED AS: OFFICE SF WHS sF OTHER sr
TOTAL SIZE: STORIES FIRE PROTECTION (Y/) AC(Y/N)
DETAILED DESCRIPTION OF WORK Ve -
THIS IS 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 of all work w ' ires review and approval of plans.
OF APPLIC.
SIGNATURE PRINT NAME
ALL FEES ARE BASED ON VALUATION
Sq. ft. x $ Cost/sq. ft. = Valuation $
Sq. ft. x S Cost/sq. ft. = Valuation $
Sq. ft. x S Cost/sq. ft. = Valuation $
TOTAL JOB VALUATION: $ 7q, acl ,()USE OCCUPANCY TYPE
?ermit Fee
$ 34/. 06
See Back Page for Fee Schedule
?Ian Review
- $
65% of Building Permit Fee
Surcharge
$
(.0005) times the total job valuation - Minimum $.50
-ire Surcharge
$ 0? Lt. 30
.001 x Permit Valuation (1/100/.)
SAC Charge-$+�2
19 -Is—
$1450 per SAC Unit (Plans to MWCC for determination)
rosion Control
_$
$
$450 Conservation Plan Review
?ark Fee
$
Fee Determined by Engineering
Special Assessments
$
Agreement necessary ( ) Non Necessary ( )
Durb Cut Escrow
$
ft + 6 ft = ft x $20 = $
Cotal Due
$ 4/9 7.7 V
Make checks payable to: City of Fridley Attach tipula ioas
' P-7, m 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 1579-1589-68 TI 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.
S) 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.
\1ServerO2V-drive\Proposais\Proposals - 2005\Ray Ellis - 2005\1579-1589 - 6M.1650-1658 - 69th Avenue North.SH.re.si.doc 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:
gle Zeolo�
OenR,lr
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.
CCK � P&'f
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 Raycds 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 Raycds 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-half percent (1.5%) per
month will be added to past due accqyAts,e 1,'
Authorized
ACCEPTANCE OF PROPOSAL: The above prices, specifications and conditions are satisfactory and arqrer#by accepted. You are authorized to do the
work as specified. Payment will be made as outlined above. o ,�
DATE ACCEPTED: K 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.
\%.ServeMXf-drive\Proposals%Proposals - 20051Ray Ellis - 2131511579-1589 - 68111.1650-1658 - 69th Avenue North.SH.re.sl.doc Page 2 of 2
W .
P-7 F-) 0L L ,, 0 r) Rayco Construction, Inc.
211 St. Anthony Parkway • Minneapolis, MN 55418
P. V-3 -3-Dz 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
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's 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`s 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.
\\Server02\f<Uive\Proposals\Proposals - 2005\Ray Ellis - 2005\1579-1589 - 68th.1650-1658 - 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:
BUILDING
1579-1589
ARE-ROOFNUMBER
1650-1658
TOTAL
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 accented within twentv days.
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 merchentability, 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-half percent (1.551.) per
month will be added to past due acro
I ; COM% C710N, INC.••/
Authorized
are satisfactory and a%, erpy accepted. You are authorized to do the
is as specified. Payment ill be made as outlined above.
DATE ACCEPTED: SIGNATURE:
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.
\Server=\f-drtve\Proposals\Proposals - 2005\Ray Ellis - 2005\1579-1589 - 68th.1650-1655 - 69th Avenue North.SH.re.sl.doc Page 2 of 2
RU13-09-2005 13:34 CITY OF FRIDLEY
PLUMBING
RESIDENTIAL APPLICATION
City of Fridley
5 _ V Dau
Permit Number i
Received By
Date Received
NOTE IF PROPERTY IS NOT OWNERIOCCUPIED- A LICENSED CONTRACTOR MUST OBTAIN THE PERMLT.
YOUR L ADDRESS_ I
SITE ADDRESS
THE APPLICANT IS: (CIRCLE ONE) OWNER CONTRACTOR
E
PROPERTY OW:�?ADDRESS
TENANT
STATE ZIP
NE #
NAME
CONTRACTOR ADDRESS Z
CITY
PHONEI#
PERMIT TYPE S
TYPE OF WORK p NEW
ETAILED DESCRIPTION OF WORK
Y TWO FAMILY
W REPLACEMENT
_TW -2--Y
L-�
FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED
FIXTURES: (INDICATE TOTAL NUMBER OF EACH)
_BATH SINK/IAV FLOOR DRAINS SHOWER WATER PIPING
BATHTUB GAS PIPING (Need Cfly License) SWIMMING POOL WATER SOFTENER ($35)
CLOTHES WASHER KITCHEN SINK -WATER CLOSET' BACKFLOW PREY. ($Is)
DISHWASHER LAUNDRY TRAY WATER HTR ($35) FOR IRRIGATION
WATER METER OTHER
-P-l�1> it PSE - $ i � - - - o -- _. .
iii l�il�VIl1M 445 0a or 5 f of-c-ost-of the lmproveem-eTit-Whichever- is -
Plan Review $ greater on work fess than $300
Surcharge $ .50
TOTAL DUE qs-ieo- Make checks payable to: City of Fridley
- --- ..... _ . �._�...�... v.. � rcn.an --w1 V PAJLA UN 1IL h'KWt5StD
I hereby apply for a plumbing permit and I acknowledge that the information above is complete and accurate; that the work will be in conformance with
the ordinanc�es 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 Far 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 all work which
requires review and approval of p s.
4MEOFAPPUCANT�(iL✓� DATE
PI se type orPi se type or print
SIGNATURE OF APPLICANT
6431 UNIVESITY AVENUE NE. FRIDLEY. INN 554,32
City of Fridley Building Inspections Dept. Ph: 763-572-3604 FAX: 763-571-1287
6431 University Ave NE
Fridley MN 55432
Mechanical Permit #D®S ea X92
Residential Application
City of Fridley
See Back Side For Required Information
The applicant is:
Properly Owner.
Address: /6✓ Z
City:!
Contractor I
Company N
Contact Per
Address, 0Z
City:,
Phone:A-57
Email: rpm
Type of Work
Detailed Desc
Site Address:
Owner Contractor
State: Alh/ Zip: j�
Cell:
79
State: ALIN
Cell: 6(,& Fa) c:
ti"YA_MN Bond# & Exp Date
one): New Replacement Alteration/Remodel
of work: A-'- �W
MFG:
MFG:_
Please check all that apply:
_A/C $25.00
Air to Air exchanger $15.00
Chimney Liner $10.00.
Duct Work $10.00 —
Model:
Model:
Model:
_Fireplace (gas) $15.00
Fireplace (wood) $35.00
_Furnace $35.00
Gas Dryer $10.00
_Gas Piping $10.00
Gas Range/Oven $10.00
Size/BTU:
SizeBTU:
New Gas Grill $10.00
_Gas Unit HTR $10.00
_Pool Heater $35.00
Ventilator $15.00
r.f
Permit fee $ (Total from above -Minimum fee $35.00��A
Surcharge $ 0.50 C�
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 yy /
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. 0/ �Y�C
Signature of Applicant: Date:
ate:
Approval Inspector Signat
7
Please Note: Separate permits are required for Building, Plumbing, and Electrical work
HUU-177—eI0M 1.3;,34 l.1 IT UI- I'K 1 LLC T
City of Fridley Building Inspections Dept Ph: 763-572-3604 FAX: 763-571-1267
6431 University Ave NE
Fridley MN 55432
Mechanical Permit#�
Residential Application
City of Fridley
See Back Side For Required Information
Date Site Address:_ _ / 5 ZN4A
The
Owner Contractor
Address:
City: State: Zip:
Phone: Cell: Fax:
Contractor Informat ,
Company Name: V- fiwwyb /
City:
Cell: 07 f90Z Fax•!
7•Gej=� MN Bond# &
Detailed DescriDtlon of work
MFG:
Model:
Size/BTU:
MFG:
Model:
Size/BTU:
Please check all that apply.
____,Fireplace (gas) $15.00
New Gas. Grill $10.00
A1C $25.00
,Fireplace (wood) $35.00
_Gas Unit HTR $10.00
Airto 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
--Gas Piping $10.00
Duct Work $10.00
Gas Rance/Oven $10.00
e(0
Permit Fee $ �c�bu
(Total from above -Minimum fee $35.00)
-
Total Due $ 2rb Make check paypble 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 will be in conformance with the ordinances and codes of the City of Fridley and
with the Minnesota Construction Codas; that 1 understand this is not a permit but only an apprication
for a permit and work Is not to start without a permit; that the work will be in a cordanoB with the
approved plan in case of all work which requires review and approval of plans.
Signature of
Approval inspector
IN
M
Building
PLUMBING
Permit No.
Inspections
COMMERCIAL APPLICATION
Received By:
763-572-3604
763-502-4977 FAX
CITY OF FRIDLEY
e,�
EFFECTIVE I-1-08
DATE /-/0- � YOUR E-MAIL ADDRESS
SITE ADDRESS &-
TENANT �/l/ %� �� SUITE NO.
PROPERTY
NAME: % E'/d/10 D (= ,IT
ADDRESS: CITY STATE ZIP
OWNER/
TENANT
PHONE:
NAME:
STATE LICENSE # EXP DATE
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE
PLUMBING BOND # EX j)ATE C
LICENSE AND BOND
ADDRESS:,t Z- STAT ZI 492)
PHONE So V ���- �Gr
PERMIT TYPE
❑ INSTITUTIONAL ❑ MULTI -FAMILY ❑ SWIMMING POOL
WNHOUSE ❑ COMMERCIAL/INDUSTRIAL ❑ OTHER
TYPE OF WORK'
❑ NEW -REPLACEMENT ❑ ALTERATION/REMODEL
/
DETAILED DESCRIPTION OF WORK
" I a
WASHER _ FLOOR DRAINS _ RPZ VALVE _ URINAL
—CLOTHES
—DISHWASHER _ GAS PIPING (CITY LIC REQ'D BACKFLOW PREY. j WATER HEATER
_ DRINKING FOUNTAIN _ GREASE TRAP _ ROOF DRAINS _ WATER METER
—FAUCET _ KITCHEN SINK _ SHOWER _ WATER PIPING
_ FLAMMABLE WASTE TANK _ LAUNDRY TRAY _ SLOP SINK _ WATER SOFTENER
LAVATORY SWIMMING POOL — WATER CLOSET
� `i..S �::,.,✓'..... y m . ,x , 1..., .,. z� � 3. vj, 3 t - �:} � „ ,..�.w L..w . :.. � u _ -.. .. , F . 3. a.. ,1..... ,... _ � sx ».. : � �E 1�„<� ,� � .nx.,, s z. ;. .�_s.7 � ��. a`.�v .. kx
��
Total Job $�r All fees are based on valuation, including the cost of labor and materials.
Valuation
d�
Permit Fee $ �' (1.25% of Job Valuation / Minimum fee: $35)
Surcharge $ R J v Valuation X.0005 ($.50 Minimum)
Total Due $ Minimum $35.50 Make Checks Payable to: City of Fridley
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for a mechanical permit an acknowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and c e of the City o Fridley and with the Minnesota Construction Codes; that I understand this is
not a permit but only an application fo permit d ork is not to start without a permit on site; that the work will be in accordance
with the approved plan in the case of a re ires r iew and approval of plans.
/ �`
fig®
. PRINT NAME ° IG�iSU DATE
SIGNATURE OF APPLICANT77
APPROVED BY 1 DATE
City of Frid* Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 763-502-4977