Loading...
PRE 2010 DOCSH a CITY OF FRIDLEY NOTE: Applicant should obtain building permit procedure i nfnrMX&+; nn from Building Inspection BUILDER: Approved Contractors, Inc. V' Department Secretary. ADDRESS: 1052 Osborne Rd. N.E. Fridley 554NOTE: A Certified Survey of the lot, , Street City Zip Code showing the location of the foundati n, TELEPHONE: 1 786 368o once it has been constructed, will be Home Business required before proceeding with the. f naming. PROPERTY ow=(S) Roger W. Larson DoonaiT'iA. Wehlast James E. Wiensch 85 West R$. Circle Pines, Minn. ADDREss(ES) 8804. Lexington New Brighton, Minn. 55112 Street T City Zip Code 614. W. Brown Deer Rd. Milwaukee, Wisc. —' Street City Zip Code TELEPHONE NO -(S) Rome Business OF Property Location on Street or Exact Street Address (if any): County Rd. H or 69th Ave..:: N.E. Legal Description of Property: The East 3/4. of the NE 1/4. of the NE 1/4. of Section 13 T -102- R-24 City of Fridley, County of Anoka, State of Minnesota Total Area of Property eq. ft.c', Present Zoning ctassiricatiion DESCRIPTION OF BUILDING Proposed Building Use: Multiple 14.1 units Each unit Building Dimensions:,, °wont 20 Depth 32 Height .21 Square Ft. 121 Cubic Ft. Type of Construction: Wngd Frame each unit Project Estimated Cost l. 6.000,00 To Be Completed 7-1— DATEs„�' APPLICANT'S SIGNATURX P` xz Fats r rl .3 C17>1 /_ c -e .5r .2 15G�� 5 y G y ° 4 � 2-o 7 Z Y l/ i/i¢�!O/s p R Clay r S Pe R VuOF esA uAll't l% 3 9 3: ©(�r s r•v rF // 7 a y 'o 0 o s YA4. v�r�c�ty Sc HEOvd / 0 100F,7016, 7- ___. f d 5� 3 0 �e 57-0�.4 sq Fr 67-�,&A-5 JO�q, �r yoo ®0 3 o !� 13 S O ,VL -7-or,-f,4 C/ >` yAAI-4 +r2 S4' FT sr+rE bA 4-V *)'Y&A' .P," Foci 7-0 TA -t VAL u e o F A A t 6,411, 46,s S 7`47` 4v,? c-//t� C,6 Gk,9G92.5o oF G z N NnN-RESTDENTIt?L BUIIDING PERMIT IR I ill a 'il MAN Ill ZONING: —3 VARIANCE REQUIRED: SPECIAL USE REQUIRED: PLOT PLAN: TOTAL AREA GRADE ELEVATION SF - p /U S/ r/= Arc&s av ctry CITY OF F'RTLLiTf ADDRESS: 16ov /94 - G 9'-' AUe Nr LEGAL DEASCRIPTION: E ec 7 T— 3 BACKS& FRONT YARD SIDE YARD REAR YARD SUBMIT TO: BUILDING BOARD BOARD OF APPEALS PLAN. COMM. COUNCIL 9( 1 APPROVAL DATE: -5-- -y -2j //- / REMARKS: U FIRE REQUIREMENTS: FIRE MARSHALL FIRE :REVENTION BUREAU EXITS (dates App) W U INSIDE UTILITIES: PLUMBING VENT & HEATING MMTRICA14 Date Approved H D AL OUTSIDE UTILITIES & SITE DEVELOPMENT: Date Approved City Engineer WATER SEWER ELEV CURBING DRAINAGE SCREENING & PLANTING Z- S /1 5 PC R IAL140 a. SPECIAL ASSESSMENTS: IF LATERAL ASSESSMENTS HAVE NOT BEEN PLACED ON THIS PROPERTY, AN AGREEMENT MUST BE SIG AGREEI G TO ASSUME SUCH LATERAL ASSESSMENTS BEFORE A PERMIT WILL BE ISSUED, AGREEMENT NECESSARY Finance Director AGREEMENT UNNECESSARY Registexed Engineer': Stamp Legal Description Cheok `— (A) FOUNDATION PrZRMIT FINAL APPROVAL �. Building Official Building Official (B) FINAL APPROVAL / M-At—� NOTE: Easements, R/W, Special Agreements City Engineer DATES CERTIFICATE OF OCCUPANCY: PARTIAL: DATE: FINAL: DATE: REMARKS s REMARKS s - Ca -> ,r, --. s - -2,0 — c ,e� � ✓V 1. �y' l._ —) G;_ 'T /-�,� L r= /-�,r�e �� .Cr�J� �'i�,"r' i.; S _, �� 0= 2i'— = 3,' icy t} �ern�nLs Ira>c/J>Tr�c rF_Cs cL-,rr� �'jcccz f, S7s4GG�,r �k�l'!f•; '��',.d'S .`r t: frCi�//_ c�� /'�-.�=,%r-�,�:.c�r�t' f ���� ,```��' Sewer Connection Charge Receipt No. -2 = l Permit Fee & Plan Check 5l, Receipt No. _3 ;-61 Less Deposit �< t c� � svRC.,— — Receipt No. 0" y o,J 7f' Net Permit Fee Due � 2 / Receipt No. a. SPECIAL ASSESSMENTS: IF LATERAL ASSESSMENTS HAVE NOT BEEN PLACED ON THIS PROPERTY, AN AGREEMENT MUST BE SIG AGREEI G TO ASSUME SUCH LATERAL ASSESSMENTS BEFORE A PERMIT WILL BE ISSUED, AGREEMENT NECESSARY Finance Director AGREEMENT UNNECESSARY Registexed Engineer': Stamp Legal Description Cheok `— (A) FOUNDATION PrZRMIT FINAL APPROVAL �. Building Official Building Official (B) FINAL APPROVAL / M-At—� NOTE: Easements, R/W, Special Agreements City Engineer DATES CERTIFICATE OF OCCUPANCY: PARTIAL: DATE: FINAL: DATE: REMARKS s REMARKS s - Ca -> ,r, --. s - -2,0 — c ,e� � ✓V 1. �y' l._ —) G;_ 'T /-�,� L r= /-�,r�e �� .Cr�J� �'i�,"r' i.; S _, �� 0= 2i'— = 3,' icy t} �ern�nLs Ira>c/J>Tr�c rF_Cs cL-,rr� �'jcccz f, S7s4GG�,r �k�l'!f•; '��',.d'S .`r t: frCi�//_ c�� /'�-.�=,%r-�,�:.c�r�t' f ���� ��7Crs .cKs � �! S,17'v &VJ P'6 ,C._ ✓ c 1 '/� / vS 7y Avnj-,--� 4 ot C17 -y /�(/ GN/ r -s A i' /2651 2- R /f t 1111IM6 r,,A,1 rs P,5,? li7 PCSif Tor.¢• 7-9r-.CffOrP6 11N17F 56 e*6cx, ON c� iGTAl- -i L Gs+RAI�Gs Z/t��r�'�✓i %� �P � 02 ?";2- ��✓T G`� � �',!C' � o��'�✓�'vr° fes' �i7 10 Whole Building Permit Fee, Plan Check Fee and Surcharge Fee paid on tlsis permit. Separate permits for each buildin 1 3 1 Ut , of Fridley, Minn. 6431 University Ave. N. E., Minneapolis, Minn. 55432 BUILDING PERMIT Date: February 22, 1972 owner: Rice Creek Townhouse Company Builder Approved Contractors, Inc. Address .8.5._Wes.t__RQad. r-irsle_Pines, Minn. Address 1052 nehnrne Rnad NSR , RX4d1e* 786-3680 15602 15622 15642 LOCATION OF BUILDING 1506,., 1568, 1570 69th Avenue N.E. No. _ _ _ Street. Part of Lot Lot Parcel 10 Block _Section 13 ____ Addition or Sub -Division Corner Lot __._._. ._._.._ Inside Lot ._..... Setback Sideyard Sewer Elevation R-3 Zoning 14.1 Acres Foundation Elevation _..._.. DESCRIPTION OF BUILDING To be Used as: Each Unit 6 Gara Oguse Units int es � Depth 32' Height .- - 21' Sq. Ft. 1213 ` Cu. Ft. 2 Gars gee _ Front .44' _ Depth 5 - V- Height _ Sq. Ft. Cu. Ft. 1 Garages Lu, 57.6 Type of Construction Wood Frame Est. Cost .._.2.2.5.RC0h To be Completed 1 year (Total Complex) Stipulations: 1.Sides of garages along 69th Avenue to be brick. 2. Units along 69th Avenue to have brick fireplaces (5) 3. Wood panels to be substituted with stucco. 4. Stagger brick colors to achieve pleasing effect. 5. Provide playground equipment and recreation area. 6. All driveway, roadway access and parking area to have concrete curbing, except the easterAy side of the access on the east side of the property. 7. Frost footings required on all garages over 200 square feet. In consideration of the issuance to me of a permit to construct lbe building described abWL% I agree t9 do the proposed work in accordance with the description above set f/Qa! and in compliance wiJt,K/Il provisions of ordinances of the city of Fridley. _A'1 In consideration of the payment of a fee of $ A79. 50 , permit is hereby granted t, 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 ordinance8 of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings Within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. Inspector CLARENCE BELISLE NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sower or water. Be sura to no the Building Inspector for separate permits for these items. s Application for Power Plants and Heating Cooling. Ventilation. Rohl- ration and J Air Conditioning System and Devices PARTIAL RATE SCHEDULE Dept. of B1dge. Pte. M -M GRAVITT WARY! AIR: MTN 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 NECK WARM AIA Furnace Shell & Duct Work to 130,000 BTU... .. .6;".$10'00 each add 60,000 BTU .................... . 3.W ;- Replacement of Furnace .. . .. .... 6.00 Repairs & Alterations -up to $500.00 6.00 $ Repairs & Alterations each add. $500.00 ... 3.W $ 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 un $ _ Each add. 320 sq. ft. EDR Hot Water 3.00 $ yrs M 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 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. r,, . , n _ - 0 � W�W�teJl l Kind of Building -7 Used as . _Q�AJ-{ To be completed about Estimated Cost, $__-__ Old ew. Building Permit No. permit No. it 7 180 AIR C017DTAONING FAN HEATING SYSTEM L VEIMATING SYSTEM ALTERATIONS & REPAIRS ROUGH FINAL dif • / 6 U 0 Capaci Sq. Ft. E.D.R BTU Hp. See Fee Schedule (� IL 6'(0,U TOTAL FEE $a& S� 0216 ".i' (REMARKS—OYER) DESCA=PTION OF WORK OIL BURNER -to 3 gal. per hour 6,00 $ over 3 gal. per hour -See Fee Schedule _ HEATING or PO PLANTS --.Steam, Hot Water, arm Air` No—(45-1— GAS BURNER cup to 198,000 BTU) ...... &00 -:'6� o Trade Name �/�/�. Size No. Q0 l- over 189,000 BTU See Fee Schedule GAS FITTING FEES: NO RATE TOTAL Capacity Sq. Ft. EDR BTU— gp, 1st 3 Fixtures x$ zoo $-/Cv—.0 d Total Connected Load Rind of Fun Additional Fixtures x .76 $ Gas Range to 199,000 a$ 600 $ BURNER - Trade Dame Size No AIR C017DTAONING FAN HEATING SYSTEM L VEIMATING SYSTEM ALTERATIONS & REPAIRS ROUGH FINAL dif • / 6 U 0 Capaci Sq. Ft. E.D.R BTU Hp. See Fee Schedule (� IL 6'(0,U TOTAL FEE $a& S� 0216 ".i' (REMARKS—OYER) City of Fridley Applicd4on for Mmbbig and Gait Rnbiq t Dept. of Richer. Phone 5604%W % Q DESCRIPTION OF WORE y s-6760 Kumber. Kind and Loeadon of 1UIuR" -- B PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES- NO. RATE TOTAL Number Fixtures ................ x $2.00 3 Future Fixture Opening .... :...... x $1.50 : New Fixture Old Opening .......... x $1.50 3 Catch Basin ............... a .... x $3.25 i � g, Water Beater 'Up to 99,000 B'lTg9 .... x $3.00 $ New Ground Run Old Bldg......... x $3.25 $ Electric Water Heater ........... a $2.00 3 - GAS FITTING F'EEM. RATE Ist 3 Fixtures ... a ..... a ..... _ .. /NO. `� x $2.00 �TO1T(AL�� Additional Fixtures ................ x $ .?5 : Gas Range to 199,000 BTU x $5.00 $ State Surcharge $ .50 REPAIRS & ALTERATIONS- Refer to Cedo r esc iption .. .. . .. . .. ... a s .. e e ,e... iL/_ . ...a . e e.. e e ...► . TOTAL Y aU 41t City of Fridley: The undersigned hereby makes application for a permit for the work herei. specif$ed, 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 fact and representations stated in this application are true and correct Fridley, Minn Owner Kind of Building 2�,e? Z 4"fy Z�- Used as �14 To be completed about _ Oc 7 / " Estimated Cost, $ Old—New. Building Permit No. Permit ROUGH FINAL. - S - % ,-�' Ir SUBJECT - MI City of Fridley 32433 AT THE TOP OF THE TWINS B U I L D I N G PERMIT pS Ir? COMMUNITY DEVELOPMENT DIV. _ r - PROTECTIVE INSPECTION SEC. � 1 . � NUMBER pEv DATE PAGE OF APvnOVEO By CITY HALL FRIDLEY 55432 L 612-571-3450 910415 2/22/02 108 ADDRESS 1560 69th Ave NE 1 LEGALLOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. Parcels 10 & 200 Section 13 SHEET 2 PROPERTY OWNER MAIL ADORES$ ZIP PHONE Rice Creek Townhouses 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Rayco Construction Inc, 3801 5th St NE, Columbia Heights, MN 55421 612-547-3011 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 3396 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO B USE OF BUILDING Dwelling 7 CLASS OF WORK ❑ NEW ❑ AODITION ❑ ALTERATION Ck REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reroof (tear -off) - 25 squares 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with State Building Code. SEPARATE PERMITS ARE REOUIRED 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 80 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 STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION $2,680.00 SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIEDT��,�r<Qy�,•�� WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT A608M= $1.34 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROV ONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRU I N OR THE PERF RMANCE OF CONSTRUCTION $83.25 .68 Fire SC PLAN CH;;�L2censv, TO FEE $5. 92.27 IGNATURE OF CONT A OA OR AU RIZED AGENT IDATEI EN ROP ALID THIS IS XqU R //�� C/— S,GNATUAE OF OWNER,1F OWNER gUILDE AI IDATEi'' BLD INSo gA1t NEW [ j CITY OF FRIDLEY ADDN [ I 6431 University Ave NE, Fridley, MN 55432 ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: n % ----)ko — Legal Description: Lf k— Cv--ta It ;�L �0 8�) 00-� ;)- S -SI Effective 1/1/2002 (763) 572.3604 Bldg Insp Owner Name & Address: n Tel. # Contractor: V':'(� MN LICENSE #_ 33'9k)-- Address. 3'1i--Address. - 5-�" Tel. # W,4-5 �}'1-3�1 IQ 551-4a 1 Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to sale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height _ Sq. R. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width OTHER: - 6( Construction Type- ®�� Estimated Cwt: $ Sq. Ft. Driveway Curb Cut VVIdth Needed: F + 6 Ft = Ft x � _ $ DATE: Q"—� 1'0 APPLICANT: Tel. # � Call (763) 572 3604 for Permit Fees if mailing in appliaatio Fax to 1-1287 if using credit card and we will call you for card number. c1T1t USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL Fee Schedule on Reverse Side .001 of Permit Valuation (1J10th%) $.50!$1,000 Valuation $1200 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. T" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ j Not Necessiary [ STIPUTATIQLS: Z0/Z0'd 99L6TeL3T9 Ol A3-UldJ J0 A110 WOdJ OZ:OL 2OOE-TE-93d City of Fridley Building Inspections Dept. Ph: 763-572-3604 FAX: 763-571-1287 6431 University Ave NE Fridley MN 55432 Mechanical Permit# A d6� Residential Application City of Fridley Spp Bark Side For Reauired Information Date 72,1-05"Site Address: The applicant is: (cirl a one) Owner Contractor Property Owner: Address: City State: All Zip: Phone: Cell: Fax: Contractor Informati n ' Company Name: - Contact Person: -� Address: City: State: , jW Zip: ZS Phone: 6 Mte Cell: �,_/9 4AW ���2 Fax: ii4 Email: MN Bond# & Exp Date /413V a Type of Work (circle one): New Replacement Alteration/Remodel Detailed Description of work: /Z � J V 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 $35.00 _Gas Dryer $10.00 Ventilator $15.00 _Boiler _Chimney Liner $10.00. _Gas Piping $10.00 ,- Duct Work $10.00 Gas Range/Oven $10.00 Permit Fee $ (Total from above -Minimum fee $35.0 Surcharge 0.50 Total Due $ Make check payable to City of Fridley This is an application for a permit- not valid until processed I hereby apply for a mechanical permit and I acknowledge that the information above is complete and accurate: that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in case of all work which requires review and approval of plans. Signature of Applicant: Date: Approval Inspector Signatur Date* 2� Please Note: Separate permits are required for Building, Plumbing, and Electrical work i' AUG -09-2005 13:34 CITY OF FRIDLE`f P.02iO4 � Ref 'PLUMBING r o���U Permit Number RESIDENTIAL APPLICATION Received Sy I"1 City of Fridley Date Received NOTE: IF PROPERTY IS NOT OWNERIOCCUPIED. A LICENSED CONTRACTOR MUST OBTAIN THE PERMR. DATE YOUR L ADDRESS ��� �� •C,D SITE ADDRESS (� THE APPLICANT IS: (CIRCLE ONE) OWNER CONTRACTOR �— NAME PROPERTY OWNER/ TENANT ADDRESS CITY STATE ZIP PHONE 0 j NAME CONTRACTOR I AJDDRES.SS PHONE PERMIT TYPE SINGLE FAMILY TWO FAMILY TYPE OF WORK p NEW Er' REPLACEMENT DETAILED DESCRIPTION OF WORK FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED FDCTURES: (INDICATE TOTAL NUMBER OF EACH) BATH SINKILAV FLOOR DRAINS SHOWER WATER PIPING BATHTUB GAS PIPING (Need Ciar License) SWIMMING POOL WATER SOFTENER ($35) CLOTHES WASHER KITCHEN SINK _V TATER CLOSET BACKFLOW PREY, ($is) DISHWASHER LAUNDRY TRAY WATER HTR (535) FOR IRRIGATION WATER METER OTHER 00 Permit Fee $ 35, MINIMUM: --$45.00 or 5% -of -cost of the improvement-whicheveir is" Plan Review $ greater on work fess than $300 Surcharge $ ,50 TOTAL DUE $ e Make checks payable to: City of Fridley ••­ w i T ru-r r.n.r uvl'% r'WM K r=M1Y111 '-1vV 1 VALID UNTIL PROCESSED 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 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 plans - NAME s_NAME OF APPUCANT ° � Z1/ DATE � �J Pl se type or print laz SIGNATURE OF APPLICANT OF FRIDLEY COMMUNITY DEVELOPMENT DEPART $431 UNIVESITY AVENUE NE, FRIDLEY. MN 55432 AUG -09-2005 13:34 CITY OF FRIDLEY City of Fridley Building Inspections Dept. 6431 University Ave NE Fridley MN 55432 ? > I6 Mechanical P. 03X04 Ph: 763-572-3604 FAX: 763-571-1287 Residential Application City of Fridley See Rack Sida Pnr RantilraA infnrrr�t:n., Permit # 07om"= ® t5;2 l Date Site Address: The applicant is: (cirice one) Owner Contractor Property Owner. Address: City: State: Zip. Phone: Cell: Fax. Contractor Informat11, Company Name: Contact Person: Address:Z City: State:mp: Phone:_ fes! S/ 9� �� Cell: 1617�ZEO jP7- Fax: ��'� !/Z!/?$ Email: ..rah 4 al ah. MN Bond# &Exp pate .>v ��04 Type of Work (circle one): New Replacement Alteration/Remodel P 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 _A/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 Eyable to City of Fridley u,..� •J pn wr a FUNAAA 1J' nut. vduu wra1 t7rvrieS'sea 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 Cedes; that 1 understand this is not a permit but only an application for a permit and work is not to sten without a permit; that the work will be In accordance with the approved plan in case of ail work which requires review end approval of plans. Signature of Approval Inspector Sig