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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