PRE 2010 DOCSPermit Fee paid on Permit #11,315 for 1560-1570 69th Avenue N.E.
City of Fridley, NUmn. -11330
6431 University Ave. N.E., Minneapolis, Minn. 55432
BUILDING PERMIT
Date: - FabTnlaxy 92. 1979
Owmer: —Rice Creek Development Company Builder Approved Contractors, Inc.
,Address 83 West Road, Circle Pines, Minn. Address 1052 Osborne Road N.E., Fridley
786-3680
167321675,16772 LOCATION OF BUILDING
Na L67921681 k&4& 68th Avenue N.E. part of Lot
Parcels 10 && 200, Section 13
Lot -lock Addition or Sub -Division
Corner Lot Inside Lot Setback _ _ _ _ Sideyard
Sewer Elevation Foundation Elevation
DESCRIPTION OF BUILDING
To be Used as: Each Unit
6 Towghouse Units Front 2_0' _ Depth 32' Height 21' Sq, Ft, _1213'
Front Depth Height
Sq. Ft.
Cu. Ft.
Cu. Ft.
Type of Construction Wood Frame Est, Cost .S.ee, #11x.15__ To be Completed 1 year
In consideration of the issuance to me of a permit to cons the building described a I agree to do
the proposed work in accordance with the description above s rth and in co ante provisions of
Ordinances of the city of Fridley.
In consideration of the payment of a fee of - See #11.31 permit 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
city limits and this permit may be revoked at any time upon violation of any of the provisions of said
a
C
CE BELISLE
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see
the Building Inspector for separate permits for these items.
AppRcatia� for Power Mw t: and Heating, Cooling, Ventilation. Re/dgera!ioe and
Air Con0loning Spten s and Devices
PARTIAL RATE SCHEDULE
GRAVITY WARM AIA: IIATE TOTAL
Furnace Shell & Duct Work ;10.00 =
Replacement of Furnace .... . ..... 6.00 ;
Repairs & Alterations—up to $500.00 6.00 $ _
Repairs & Alterations each add. ;500.00 3.00
MECH. WARM AIA rr
Furnace Shell & Duct Work to 120,000 BTU ......(O. ..$10.00 100
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
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 BURNER (up to 199.000 BTU) ...... . . 5.00 $_3L. yy
over 199,000 BTU See Fee Schedule
Dept. of Bldgs. )Phone N04M
a (F
City of Fridley:
RN
The undersigned hereby makes application for a permit for the work herein
specified, agreeing to do all work in strict accordance with the City Ordinancee
and ruling of the Department of Buildings, and hereby declares that all the farts
and representations stated in this application are true and correct.
Kind of Building
I%II1_'
Used as n, A To be completed about __
../.
Estimated Cost,
Building Permit No,
It_ 2
Permit No.� 7 8
DESCRIPTION OF WORK
HEATING or PO PLANTS -Steam, Hot Water,_
No7
Trade Name_ Q��?/�iSL Size No.. C Z0 0 oq
NO RATE TOTAL
GAS FITTING FS: EECapacity O ®D Sq. Ft EDR nl u Hp
1st 3 Fixtures x$ zi o $�//2 • 0 ® Total Connected Load Kind of Fuel 6Z-6
Additional Fixtures x .75 ;
BURNER —Trade Size No
Gas Range to 199,000 x= 5.00 ;
Q0Capaci Sq. Ft. E.D.R BTU HNI
AIR COLtDLTIONING Cp
FAN HEATING SYSTEM See Fee Schedule
VENTILATING SYSTEM
ALTERATIONS & REPAIRS TOTAL. FEE UZ - U �
ROUGH � /
E,
(REMARKS -OVER)
121 V WN,
r
City of Fridley
ApPuaflon for Phmbbig and ccm
Dept. of Bldgs. Phone 880-34!D "
DESCRIPTION OF WORE j & 1 U'15- i6'1-7 - i ') `i — i G S- i
Number, Kind, and Location of Fixtures 1,0942104% - -
PARTIAL RATE SCHEDULE
PLVMSING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures ................ -,/ x sloe $�
Future Fixture Opening .... :...... x $1.50 i
New Fixture Old Opening .......... x $1.50 $
Catch Basin .................... x $3.25 S
Water Heater !Up to 99,000 BTU) .... x $3.00 $
New Ground stun Old Bldg......... x $3.25 S
Electric Water Heater .............. a 52A0 5
GAS FITTING FEES: NO. RATE TOTAL
lat 3 Fixtures x $200 1
Additional Fixtures ................ x $ 35 5
Gas Range to 199.000 BTU .. ,......... x $5.00 a
State Surcharge $ .50
REPAIRS t ALTERATIONS—Hager to code
TOTAL FEE 5
let G-4?)
City of Fridley:
The undersigned hereby makes application for a permit for the work herei,
specified, agreeing to do all work in strict accordance with the Cit•,tr Ordinance
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, reins
Owner
C
Kind of Building
Used as t VA-
To
iTo be completed about t`'
Estimates Cost. $
Old—New. Building Permit No. Permit No.
Sign
By
w " '�
Business Phone No �`:('-ee i���
ROUOiIFIKM
..................
PARTIAL RATE SCHEDULE
PLVMSING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures ................ -,/ x sloe $�
Future Fixture Opening .... :...... x $1.50 i
New Fixture Old Opening .......... x $1.50 $
Catch Basin .................... x $3.25 S
Water Heater !Up to 99,000 BTU) .... x $3.00 $
New Ground stun Old Bldg......... x $3.25 S
Electric Water Heater .............. a 52A0 5
GAS FITTING FEES: NO. RATE TOTAL
lat 3 Fixtures x $200 1
Additional Fixtures ................ x $ 35 5
Gas Range to 199.000 BTU .. ,......... x $5.00 a
State Surcharge $ .50
REPAIRS t ALTERATIONS—Hager to code
TOTAL FEE 5
let G-4?)
City of Fridley:
The undersigned hereby makes application for a permit for the work herei,
specified, agreeing to do all work in strict accordance with the Cit•,tr Ordinance
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, reins
Owner
C
Kind of Building
Used as t VA-
To
iTo be completed about t`'
Estimates Cost. $
Old—New. Building Permit No. Permit No.
Sign
By
w " '�
Business Phone No �`:('-ee i���
ROUOiIFIKM
SUBJEdy
P
City of Fridley
31459
AT THE TOP OF THE TWINS
BUILDING PERMIT
r?
RECEIPT NO.
COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC.
r � � PROTECTIVE
1 ; �
CITY HALL FRIDLEY 55432
NUMBEp
REV
DATER
GE OF
A6PROVED BY
612-571-3450
910415
10/10/00
JOB ADDRESS 1673, 1675, 1677, 1679, 1681, 1683 68 Avenue NE
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
Parcels 10
& 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
BES 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
8 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
OCCUPANCYLOAD
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
STALLS
GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$5,419
$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.
$125.25
Fire SC $5.42
STRUCTION OR IF CONSTRUCTION
PLAN CHECK FEE
E
TO;73.38
uaF
TCON'aACTOQORAUTHOAl2EDAGENT DAiEieo—
EN ROPE ALIDAT I$ IS YOU PERMIT
_
404
BLD IhSP
rIArE
S.GNATUREOF OW NEA, -F OWNER BUILDER, IDAfEi
Prepaid Plan Check $
Estimated Cost $
Receipt #
Construction Address
Legal
Owner & Address
CITY OF FRIDLEY
R-3, COMMERCIAL & INDUSTRIAL
BUILDING PERMIT APPLICATION
Tel#
Effective 1/1/2000
(612) 572-3604
Zoning
(96�) ��%77w
CONTRACTOR & ADDRESS (2)(0�27
Architect
TYPE OF WORK [] New
Reg. #,
Engineer.
BUILDING CONSTRUCTION
[] Addition [] Alteration -Describe,
0
OFC. AREA: Length Width
WHSE AREA: Length Width
OTHER AREA: Length Width
Reg.#
Height
Sq. Ft.
Height
Sq. Ft.
Height
Sq. Ft.
APPLICANT Tel # 6 P ' ��I Date
Building Use
Air Conditioning []Yes CINo
Performance Bond Amount $
Permit Fee
Construction Type Occupancy Group
Fire Protection Provided []Yes []NO
See Reverse for Schedule Received []Yes
Plan Check $
Fire Surcharge $ r. . =�o?
State Surcharge $ o� .
SAC Charge $
Erosion Control $
Park Fee $
Spec. Assessments $
Driveway Escrow $
TOTAL $
[ ] No
PERMIT FEES
See Fee Schedule on Reverse Side
In Excess of Prepaid Amount - See Reverse Side
.001 x Permit Valuation (1/10th %)
$.50/$1,000 Valuation (See Sched. for > $1 Million)
$1100 per SAC Unit (Plans to MR= for determination)
$450.00 Conservation Plan Review
Fee Determined By Engineering
Agreement Necessary [l Not Necessary []
feet x $15.50/foot
ATTACH STIPULATIONS
C
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 CINo
Performance Bond Amount $
Permit Fee
Construction Type Occupancy Group
Fire Protection Provided []Yes []NO
See Reverse for Schedule Received []Yes
Plan Check $
Fire Surcharge $ r. . =�o?
State Surcharge $ o� .
SAC Charge $
Erosion Control $
Park Fee $
Spec. Assessments $
Driveway Escrow $
TOTAL $
[ ] No
PERMIT FEES
See Fee Schedule on Reverse Side
In Excess of Prepaid Amount - See Reverse Side
.001 x Permit Valuation (1/10th %)
$.50/$1,000 Valuation (See Sched. for > $1 Million)
$1100 per SAC Unit (Plans to MR= for determination)
$450.00 Conservation Plan Review
Fee Determined By Engineering
Agreement Necessary [l Not Necessary []
feet x $15.50/foot
ATTACH STIPULATIONS
C
63-811-416051
CITY OF FRIDLEY
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO.
RATE
TOTAL
.%%--Wer Fixtures
x
$3.00
$
:at•_re Fixture Cpenirg
d
$2.00
Water
ra
m
$2.00
$
Catch Basin
$4
e M
a
to
Q54
x
to s+
R
w
x
$10.00
Heater
o .0.+
'•'� �`
rl
$7.00
r.
r
0
H
••+
$4
a
it
m
-C C
5 fJ
04
:.
>v
O U C
++
^
i+
+
tr��
C
N
••Ci 7
3
O
O
L 7
4j N
to
N
N
N � U
❑
G
GC
N
3❑
:w
N
W
U W
4 3V
8
❑
a5
•leC
'St
� _�
..
,
gr
1
1;_. I
I
F,:ture Connection Opening
Connected with Sewer
New Fixture, Old Opening
L(I
Water
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO.
RATE
TOTAL
.%%--Wer Fixtures
x
$3.00
$
:at•_re Fixture Cpenirg
x
$2.00
$
New :fixture, Old Opening
x
$2.00
$
Catch Basin
x
$5.00
$
:Cater Heater - to 99,000 BTU
x
$5.00
$
=-0,000 B:J to 199,000 BTU
x
$10.00
$
Water Softener
x
$7.00
$
New Ground Rin Old Building
x
$5.00
$
Electric Water Heater
x
$5.00
$
GAS FITTING FEES:
1st 3 fixtures x $3.00 $
Additional Fixtures x $1.00 $
Cas Range to 199,003 BTU x $10.00 S
REPAIRS & ALTERATIONS
First $100.00 $5.00 $
each add. $100.00 or fraction $2.00 $
State Surcharge $ .50
TOTAL FEE $ 8.00
REINSPECTION FM
(•$10.00)
Job Address 1683 68 Ave. NE
Department of Buildings
City of Fridley
Tel. #571-3450
The undersigned hereby makes application for a peewit for t.%e 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 axe true and ccrrect
Fridley, Mn. 4-3-81 19
OWNER LORENCE
RIND OF BUILDING
USED AS res.
TO BE COMPLETED ABOUT 4-10-81
ESTIMATED COST 50.00
OLD - NEW BUILDING PERMIT NO. PERMIT NO.
Company,,
Signed By MINNMARM,
Tel. No.
ROUGH INSP.
Date
FINAL INSP. 11-12y81
Date %� f
APPROVAL FOR PERMIT
MINIMUM FEE FOR ANY PLUMING PERMIT IS $7.50 PLUS $.50 STI►TE SURCirIARGE
City of Fridley Building Inspections Dept. Ph: 763-572-3604 FAX: 763-571-128;
6431 University Ave NE
Fridley MN 55432
Mechanical Permit #
RGSidential Application
City of Fridley
See Back Side For Required Information
Date Site Address:
The applicant is: (cirl a one)
Owner Contractor
Property Owner:
/�
Address: /0-Z / 40-49 1lle-1
City:
State: 041 Zip: A�4172
Phone:
Cell: Fax:
Contractor Informati n
-
Company Name:
GC�
Contact Person:
f
Address:
city: me;jia / -e
State: ,&4/
Phone: 6W g/ #e?
Cell:&Zf -WO 6(AL4,�Z Fax: O'loV
6/06/of-
Email: a
MN Bond# & Exp Date da_Z�5_/ �0o a
Type of Work (circle one):
Type
New Replacement Alteration/Remodel
Detailed Description of work:e�
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
$25.00
_Fireplace (wood) $35.00 _Gas Unit HTR $10.00
_A/C
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
Duct Work $10.00
Gas Range/Oven $10.00-
Permit Fee $
(Total from above -Minimum fee $35.00
Surcharge $
0.50
Total Due $
Make check payable to City of Fridley
/17
This is an application for a permit- not valid until processed 4T C50 '
I hereby apply for a mechanical permit and 1 acknowledge that the information above Is complete and e "
accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and B.�J
with the Minnesota Construction Codes; that I understand this is not a permit but only an application
for a permit and work Is not to start without a permit; that the work will be in accordance with the
approved plan In case of all work which requires review and approval of plans.
Signature ofApplicant: Date: l �
Approval Inspector Signature: Date:A'�
Please Note: Separate permits are required for Building, Plumbing, and Electrical work
AUG -09-2005 13:34 CITY OF FRIDLEY P.02iO4
PLUMrDsteReceived
B' umber
RESIDENTIAL APPLICATION ed By
City of Fridley
NOTE: IF PROPERTY IS NOT OWNER/OCCUPIED- A LICENSED CONTRACTOR MUST OBTAIN THE PERMIT.
DATE YOUR L ADDRESS Ir
SITE ADDRESS
THE APPLICANT IS: (CIRCLE ONE) OWNER CONTRACTOR i
NAME
PROPERTY OWNER/ ADDRESS
DDRESS
CITY STATE ZIP
PHONE Ile
NAME ® &LCENSE#
CONTRACTOR ADDRESS S '9 vo
CITY STATE /f ZIP
PHONE # FAX#2
PERMIT TYPE SINGLE FAMILY TWO FAMILY
TOWNHOUSE
TYPE OF WORK p NEW tr REPLACEMENT
DETAILED DESCRIPTION OF WORK
FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED
FD=RES: (INDICATE TOTAL NUMBER OF EACH)
BATH SINK/LAV FLOOR DRAINS SHOWER WATER PIPING
BATHTUB GAS PIPING (Need City License) SWIMMING POOL WATER SOFTENER ($35)
CLOTHES WASHER KITCHEN SINK -ATER CLOSET BACKFLOW PREY. ($15)
DISHWASHER LAUNDRY TRAY WATER HTR ($35) FOR IRRIGATION
WATER METER OTHER
00
.Permit Fee - $ ,� MINIMUM:- $15.00 or 5% of cost of the improvement-Whicheveiris-
Plan Review $ greater on work less than $300
Surcharge $ .50
TOTAL DUE $ �� Madre checks payable to: City of Fridley
••••.+ w ram �rraa�.ruairy rVR h r'CRIVII I IVV 1 VALID 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 worts is not to start without a permit; that the work will be in accordance with the approved plan s the Case r all work which
requires review and approval of p s_ �✓
- in
NAME OF APPLICANT DATE d �J
PI se type or print
SIGNATURE OF APPLICANT
6431 UNIVESITY AVENUE NE. FRIDLEY. NUIN 56432
AUG -09-2005 13:34 CITY OF FRIDLEY P. 03/'04
City of Fridley Building Inspections Dept. Ph: 763-572-3604 FAX: 763-571-1287
6431 University Ave NE
Fridley MN 55432
Mechanical Pen*tit# ;00'C -015-2q0
Residential Application
City of Fridley
See Back Side For RanuirAd Infnr.v vitinn
Date W 1Z T Site Address:
The applicant is: circce one)
Owner Contractor
Property Owner.
Address:
City:
State: zip:
Phone:
Cell: Fax:
Contractor InformaMZ14&W_1CZ1
Company Name:
Contact Person: JrUfla
Q017
Address:Z
City:
State: &&2
Phone:_ 41C<SlkalAit—
Cell: 6d3 ego ff_V- Fax: 7TW4
Email: ar,Bh. MN Bond# & Exp Date .TI} �`3�04
Typeof Work (circle one):
New Replacement Alteration/Remodel
Detailed Description of work:
[ .Lt.> tg6'_
hem- Ida&cit .
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
V/C $25.00
,Fireplace (wood) $35.00 _Gas Unit HTR $10.00
Air to Air exchanger $15.00
_Furnace $35.00 _Pool Heater $35.00
_Boiler $35.00
_Gas Dryer $10.00 Ventilator $15.00
_Chimney Liner $10.00
_✓Gas Piping $10.00
Duct Work $10.00
Gas Range/Oven $10.00
Permit Fee
b�
(Total from above -Minimum fee $35.00)
Surcharge
Total Due
Make check p2yable to City of Fridley
u ups ,s or dppiii:auon for a permit- no[ vaim unto processes
1 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 apprication
for a permit and work is not to scan 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 Appli
Approval lnspecto
2�
City of Fridley Building Inspections Dept.
6431 University Ave NE Mechanical
Fridley MN 55432
Ph: 763-572-3604 FAX: 763-571-1287
Permit# . L ®(,(# S
Commercial Application
City of Fridley
111
Date Site Address:
Thepplicant is: (cirlce one) Owner n racto Architect/Engineer
Property Owners i
Address:
City:
State: Zip:
Phone:
Cell: Fax:
Contractor Information
Company Name: &W/l7�/��
���> li�%l��✓lC°
Contact Person: Sem
Address:
City:
State: Zip:
Phone:
Cell: Fax:
Email:
MN Bond# & Exp Date
Permit Type (circle one):-famil
Commercial Institutional Condo building
Industrial building
Swimming pool Other:
Type of Work (circle one):
New RQplaceme 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:
XA/C
_Duct Work _Roof Top Unit (RTU)
_Refrigeration
_Furnace
_Gas Dryer Steam/Hot Water Heat
_Boiler
I Hood
_Gas Piping _Swimming Pool
_Class
II Hood
_Gas Unit Heater _Temporary Heat
_Class
Kitchen
_Pool Heater _Other
_Commercial
All fees are based on valuation, including the cost of labor and materials:
Total Job Valuation: $ f a& 00
Permit Fee $ JS �� (1.25% of Job Valuation / Minimum fee $35.00)
Surcharge $ Valuation X.0005
Total Due $ 3 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 I
for a permit and w
approved
Signature of
Approval Inspector Signature:,
Please Note: Separate permits are requi
Revised 6/14/2005
ion Codes; that I understand this is not a permit but only an application
to s outa rmit; that the work will be in accordance with the
ork is re ires r ew and approval of plans.
Date:
�—
Datoll/
e for Building, Plumbing, and Electrical work