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PRE 2010 DOCSPermit Fee paid on Permit #11,315 for 1560-1570 69th Avenue N.E. City of Fridley, Nzn. -11-330 e 6431 University Ave. N. E., Minneapolis, Minn. 55432 BUILDING PERMIT Date: - EehTnin3 ; 29. 1979 Owner: __Rice Creek Development Company Builder Approved Contractors, Inc.. ,Address 85 West Road, Circle Pines, Minn. Address 1052 Osborne Road N.E., Fridley 786-3680 167331675216772 LOCATION OF BUILDING no. 167921681,h 68th Avenue N.E. Part of Lot Parcels 10 & 200, Section 13 Lot Block Addition or Sub -Division Corner Lot inside Lot Setback _____ Side -yard Bower Elevation Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Each Unit 6 Townhouse Units Front 20' Depth 32' Height _ 21' Sq, Ft, 1213' Front Depth Height Sq. Ft. Cu. Ft. Cu. Ft. Type of Construction Woo d -R -r mp I Fust. Cost See_ #11,1_ To be Completed 1 year In consideration of the issuance to me of a permit to constrVqt the building described abimp, I agree to do ft proposed work in accordance with the description above 7S= and in cOM3231ance provisions of Ordinances of the city of Fridley. In consideration of the payment of a fee of $ See #11 31permit is hereby granted to Rice Creek Dev. 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 buildings vithin anceae. city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinn S CE BELISLE NOTICE: This permit does not corer the construction, installation for wiring, plumbing, gas heating, sewer or water, go sure to see the Building Inspector for separate permits for these hems. Application for Power Plants and HeathM Cooling. Veeti O&R. Re1jigerrotion and Air Conditioning Sydem and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work ................ .. $10.00 i Replacement of Furnace ... . 6.00 i Repairs & Alterations—up to $500.00 600 $ _ Repairs & Alterations each add. $500.00 3.00 $—__ _. MECH. WARM AIR //�� Furnace Shell & Duct Work to 130,000 BTU ......CO. .110.00 $��� 0 C) 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 .... .. 3.00 $ STEAM or HOT WATER SYSTEM NO RATE TOTAL 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 over 3 gal. per hour --See Fee Schedule GAS BURNER (up to 186,000 BTU) `p over 199,000 BTU See Fee Schedule Dept. of Bldgs. Phone 680-3480 — -,,/ C-- —,&./—lV/—.i- 4 City of Fridley: if The undersigned hereby makes application for a permit for the work :hereir specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Owner RWiW/7�r1�/.Y'lS�r/J111 Kind of Building 4ZZ& Used as jro be completed about Estimated Cost, Building Permit No. 1t- 2 Permit No. S�� DESCRIPTION OF WORN 6.00 $ HEATING or d PLAN1Stem, Hot Water, 5.00 $3D.oo Trade Name- �Size ANo- ir�N-o S�� r.-;4 C1 ®OO off'QD_�7i GAS FITTING FEES: NO RATE TOTAL y --- --"4• miE.D.R BTU H.P. 1st 3 Fixtures x$ Zoo $ /2 • 0 O Total Connected Load Hind of Fuel Additional Fixtures x .76 $ Gas Range to 199.000 .. s$ 600 $ Q�Capadty BURNER — Trade Name Size No AIR COIfDTRONI1fa (49b Sq. Ft. EDR BTU l3P p FAN HEATING SYSTEM See Feo schedule 1.� VEIrMATING SYSTEM ® V fJ ALTERATIONS & REPAIRS TOTAL FEE U V Pq ROUGH FINAI. 4� e l (REMARKS -OVER) City of Fridley Appiicalioe for Pkmbiftg and G= luting Pwn* DESCRIPTION OF WORK Number. Kind and Location of Fixtures MuMBIMMUMMMMMM1140" MEMEMEMOMMEMOMMEMM MOMMOMMEMEMEMEMEMN MEMMMEMMEMMEMEMEM MM MMMMMM .................. PARTIAL RATE SCHEDULE PLOMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ................ C/ x52.00 t Future Fixture Opening .... :...... x $1.50 New Fixture Old Opening .......... x $1.50 i Catch Basin .................... —x$3.25 S Water Heater !Up to 99,000 BTU) .... — 16 woo i New Ground Run Old Bldg......... x $3.25 S Electric Water Heater .............. a $2.00 $ GAS FITTING FEES: NO. RATE TOTAL lot 3 Fixtures :5200 i ) Additional Fixtures ............... x 41.75 $ Gas Range to 199.000 BTU ............ x $5.00 S State Surcharge $ .50 REPAIRS A ALTERATIONS— Refer to Code Description • . . . . . . . . . .. • • . . • . . A.. . . . ..... . ... . .-. 1.. � TOTAL FFA Dept. of Hldaa. Phone 560-3490 Leca�/�'/gym Il,®7S-i6,17-11, V—ILS'l -/&,S-- City of ilridley: The undersigned hereby makes application for a permit for thee work herei: specified, agreeing to do all work in strict accordance with the Citar Oretin m a and ruling of the Department of Buildings. and hereby declares that all the fact and representations stated in this application are true and correct Fridley. Ml— ;y l9. Owner `- r lAr Cr K lJ '(2 (' Kind of Building Used as To be completed about` e. Estimated Cost, $ Old—New. Building Permit No. Permit No. Sign By Business Phune No' ROUGH SUBJECT P City of Fridley('31459 AT THE TOP OF THE TWINS BUILDING PERMIT . RECEIPT NO. COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. 7O 1 . � NUMBER REV DATE PAGE OF AVPROVEO BY ---I CITY HALL FRIDLEY 55432 L J` 612-571-3450 910-F15 10/10/00 JOB ADDRESS 1673, 1675, 1677, 1679, 1681, 1683 68 Avenue NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. Parcels 101& 200 Section 13 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jim Bern Co 8162 Bloomington Ave S, Bloomington, MN 952-854-7788 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO BEL Exterior Maintenance Corp 405 W 60 St, Mpls., MN 55419 612-861-6243 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Townhouse Building 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION] REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reroof 6 Unit Townhouse Building (53 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING. HEATING. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING 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 6 ISTALLS 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 $5,419 $2.71 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY O ER TATE OR LOCAL LAW REGULATING CON- Fire SC $5.42 STRUCTION OR T F CONSTRUCTION $.125.25 PLAN CHECK FEE TOTAL F E 1 $ 3.38 TUR CON'RACTORORAUTHOR,2EDAGENT ,DATE, EN ROPE LI )AT PHIsIS YOtj_q PERMIT OL OGI.NSP , DATE S,GNATURE OF OWNERai OWNER BUILDER, ,DATE, Prepaid Plan Check $ Estimated Cost $ Receipt # Construction Address Legal Owner & Address CITY OF FRIDLEY R-3, COMMERCIAL & INDUSTRIAL BUILDING PERMIT APPLICATION Effective 1/1/2000 (612)572-3604 Zoning Tel# (��✓�) �� / ��/cN CONTRACTOR & ADDRESS', fiY%dY1i✓ dV/ct.,Y�}n ��'!!-'`" ••`"'� Tel* ® S frlS✓(0 Architect TYPE OF WORK [] New Reg.# Engineer. BUILDING CONSTRUCTION U Addition [] Alteration -Describe Reg.# Building Use Air Conditioning [] Yes [] No Performance Bond Amount $ Permit Fee $ Construction Type Occupancy Group Fire Protection Provided []Yes []NO See Reverse for Schedule Received []Yes Plan Check $ Fire Surcharge $ 6-, �62 State Surcharge $ r .� SAC Charge $ Erosion Control $ Park Fee $ Spec. Assessments $ Driveway Escrow $ TOTAL $ PERMIT FEES See Fee Schedule on Reverse Side In Excess of Prepaid Amount - See Reverse Side .001 x Permit Valuation (1/10th t) $.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 �et — v OFC. AREA: Length Width Height Sq. Ft. WHSE AREA: Length Width Height Sq. Ft. OTHER AREA: Length Width Height Sq. Ft. APPLICANT �. Tel # (laIa r I / �� DSte v ' �� VALUATION Sq. Ft. x $ Cost/Sq. Ft. = Valuation $ Sq. Ft. x $ Cost/Sq. Ft. = Valuation $ ) _ $ Sq. Ft. x $ Cost/Sq. Ft. = Valuation $ ) TOTAL VALUE Building Use Air Conditioning [] Yes [] No Performance Bond Amount $ Permit Fee $ Construction Type Occupancy Group Fire Protection Provided []Yes []NO See Reverse for Schedule Received []Yes Plan Check $ Fire Surcharge $ 6-, �62 State Surcharge $ r .� SAC Charge $ Erosion Control $ Park Fee $ Spec. Assessments $ Driveway Escrow $ TOTAL $ PERMIT FEES See Fee Schedule on Reverse Side In Excess of Prepaid Amount - See Reverse Side .001 x Permit Valuation (1/10th t) $.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 Ettective Date May 1, 1988 CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT Job Address l 1a 6l (�' 9 - W< E— RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures �. m Future Fixtures ro $ 3.50 o Old Opening, New Fixture X 0 $ Water Cd mo q� $ qm $ 5.00 Cd " HA 0 -A M q $ it � p0.a' wR� $ Hydraulic Valve Heater +i m Sump or Receiving Tank R N Water Treating Appliance Al N t N .0 m $ Gas Range $ 10.00 $ o $ 10.00 $ Back Flow Preventer Required. . . Yes ( ) No Type $ ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1% of Value of Fixture or Appliance 13 0 "qq State Surcharge N $ .50 ($15.00) TOTAL FEE O N N34 Y Wro v Mani cin 3 n� w cn w v w a' 3 o as lec Base - 1st 2nd 3rd 4th (R) = Future Connection Opening Connected with Sewer (*) New Fixture, Old Opening Water RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures $ 5.00 $ Future Fixtures $ 3.50 $ Old Opening, New Fixture -$ 1.50 $ Beer Dispenser $ 4.00 $ Blow Off Basin $ 5.00 $ Catch Basin $ 5.00 $ Rain Water Leader $ 5.00 $ Hydraulic Valve $ 5.00 $ Sump or Receiving Tank $ 5.00 $ Water Treating Appliance $ 7.00 $_ Hot Water Heater $ 5.00 $ Gas Range $ 10.00 $ Gas Dryer $ 10.00 $ Back Flow Preventer Required. . . Yes ( ) No ( ) Type $ 5.00 $ ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1% of Value of Fixture or Appliance $ Reinspection Fee $ State Surcharge $ .50 ($15.00) TOTAL FEE $ 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 correct Fridley, Mn. OWNER ✓ ��D-G� KIND OF BUILDING USED AS TO BE COMPLETED ABOUT 5Zl-.;So ESTIMATED COST �j bra OLD - NEW BUILDING PERMIT NO. PERMIT NO. - Company Signed By Tel. No. a ROUGH INSP. Date FINAL INSP. Date APPROVAL FOR PERMIT 'ems MINIMUM FEE FOR ANY PLUMBING PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE City of Fridley Building Inspections Dept. Ph: 763-572-3604 FAX: 763-571-1281 6431 University Ave NE Fridley MN 55432 Mechanical Permit # O?d®�- 0IRq Residential Application City of Fridley See Back Side For Required Information Date Site Address: O `6 The applicant is: (cirl a one) Owner Contractor Property Owner: Address:/6.5-7- 49/07 VKe7cca1 City: jrrAA State: AA/ Zip::e�2 Phone: Cell: Fax: Contractor Informati n - Company Name: Contact Person: r Address: City: State: /d?A/ Zip:,�S Phone: 6-177 4,%%��� Cell: S/�® �e�9 Fax: lo.°S! 0%V �� Email: e a MN Bond# & Exp Date Type of Work (circle one): New Replacement Alteration/Remodel Detailed Description of work: fi-"6am'64,2L e-49 calk, 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 _A/C $25.00 _Fireplace (wood) $35.00 _Gas Unit HTR $10.00 to Air exchanger $15.00 _Furnace $35.00 _Pool Heater.$35.00 _Air _Boiler $35.00 _Gas Dryer $10.00 _Ventilator $15.00 _Chimney Liner $10.00. _Gas Piping $10.00 T ,_F ft 1 Duct Work $10.00 Gas Range/Oven $10.00 Permit Fee $ (Total from above -Minimum fee $35.00 Surcharge $ 0.50 e— a 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. a Signature of Applicant: // Date: Approval Inspector Signature: Dater-Z.�d,:�- Please Note: Separate permits are required for Building, Plumbing, and Electrical work r AUG -09-2005 13:34 CITY OF FRIDLEY PLUMBING RESIDENTIAL APPLICATION City of Fridley Permit Number Received By Date Received NOTE: IF PROPERTY IS NOT OWNERIOCCUPIED. A LICENSED CONTRACTOR MUST OBTAIN THE PERMIT. DATE / Z_ YOUR L ADDRESS IfA� � �/ uA h SITE ADDRESS THE APPLICANT Ia: (CIRCLE- ONE) OWNER CONTRACTOR f_.— NAME PROPERTY OWNER/ ADDRESS TENANT CITY STATE: ZIP PHONE # NAME ® \rlJ �ICENSE # 2 CONTRACTOR ADDRESSZ 4, Z CITY STATE /k ZIP PHONE # FAX# _ _ 41L -�r iyz P PERMIT TYPE SINGLE FAMILY TWO FAMILY TYPE OF WORK ❑ NEW Ee REPLACEMENT DETAILED DESCRIPTION OF WORK es _ FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED FDCTURES: (INDICATE TOTAL NUMBER OF EACH) BATH SINK/LAV FLOOR DRAINS SHOWER WATER PIPING BATHTUB GAS PIPING (Need Co License) SWIMMING POOL WATER SOFTENER ($35) CLOTHES WASHER KITCHEN SINKVyATER CLOSET BACKFLOW PREV. ($15) DISHWASHER LAUNDRY TRAY "WATER HTR ($35) FOR IRRIGATION WATER METER OTHER 00 PermitFee$ , 3► MINIMUM: --$15.00 or 5% of cost of the improvernent-whichever-is- Plan Revi®w $ greater on work less than $300 Surcharge $ ,SO TOTAL DUE $ _-, Make checks payable to: City of Fridley • • • w ray ti- r -4-r I w'% ryR /K rr-AIVI11 - 1Yv 1 VAULO UNTIL PROCESSED 1 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 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 which requires review and approval of p s. NAME OF APPUCANT SIGNATURE OF APPLICANT type or print OF FRIDLEY COMMUNITY —DEVELOPMENT DEPARI $01 UNIVESITY AVENUE NE, FRIDLEY. MN 55432 AUG -09-2005 13:34 CITY OF FRIDLEY P.03iO4 City of Fridley Building Inspections Dept. Ph: 763-572.3604 FAX: 763-571-1287 6431 University Ave NE Fridley MN 55432 Mechanical Permit# '�po�- 06 Residential Application City of (Fridley // See Back Side For Rpnidrad Infnrmn inn Date Site Address: The applicant is: (cirice one) Owner Contractor Property Owner. Address: City: State: Zip. Phone: Cell: Fax: Contractor Inforrnatj r, % ® , Company Name: ((�� Contact Person: Address: City: State: Zip: Phone:_ WIZA lid Cell: B17 i0p Fax: 0P® 4/LU24' Email: CA a 4 ~b- MN Bond# & Exp pate .T6 66S` Type of Work (circle one): New Replacement Alteration/Remodel Detailed Description of work 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 _AIC $25.00 Fireplace (wood) $35.00 _Gas Unit HTR $10.00 Vir 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 _✓Gas Piping $10.00 Duct Work $10.00 Gas Range/Oven $10.00 Pemvt Fee $ &6-00 (Total from above -Minimum fee $35,00) Surcharge _ $-.—_.. -- ._ ...... 0.50'-- - - _ - .. . Total Due $ Make check payable to City of Fridley u ms rs do dppnvauon Tor a pennti- not vara un -w 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 actordance with the approved plan in case of all work which requires review and approval of plans. Signature of Appli Approval Inspect Building MECHANICAL Permit No.: Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 Dated Ql:MAY 20 CITY OF FRIDLEY DATE S^ % YOUR E-MAIL ADDRESS SITE ADDRESS 14 5'� O !,!!"CL t/[— THIS APPLICANT IS: ❑ OWNER [-ONTRACTOR PROPERTY NAME: jT" µ �Cistc� P� U l% C—s2 F/ FJ ADDRESS: CITY STATE ZIP OWNER/ TENANT PHONE: CONTRACTOR COMPANY NAME4::_�.i e_(ej:j1, CONTACT PERSON: �- &/1 t U w SUBMIT A COPY OF ��Gn YOUR STATE LICENSE WITH STATE LICENSE # EXP DATE / / ADDRESSZ66/7 S ��'b/L WA� efi F CITY d /Z- STATW /ZIP APPLICATION PHONE FAX PERMIT TYPE ❑ SINGLE FAMILY 13TWO FAMILY TOWNHOUSE TYPE OF WORK: ❑ NEW *EPLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK6�s PER MS 1613.665 the permit fee is a minimum of $15.00 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor ) 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 Installed MFG: MODEL: SIZE/BTU MFG: MODEL: SIZE/BTU MFG: MODEL: SIZEBTU $25.00 _FIREPLACE (GAS) $15.00 GAS RANGEIOVEN $10.00 _A/C TO AIR EXCHANGEER $15 (WOOD) $35.00 _ EW GAS GRILL $10.00 _AIR _FIREPLACE $35.00 _FURNACE $35.00 _GAS UNIT HTR $10.00 _BOILER LINER $10.00 DRYER $10.00 _POOL HEATER $35.00 _CHIMNEY _GAS DUCT WORK $10.00 _GAS PIPING $10.00 VENTILATOR $15.00 Permit Fee $_ + Number of fixtures @ $10.00 x $10.00 = $ Ifi• On Surcharge .50 I Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ Number of fixtures @ $25.00 x $25.00 = $ _ Number of fixtures @ $35.00 x $35.00 = $ • State Surcharge = $50 Total = $-= 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 ap i ion f r permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case o 1 w ich re ires review and approval of plans. /�/ W f0kSO(­ 7 SIGNATURE OF APPLICANT PRINT NAME c; —DATE- City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977