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PRE 2010 DOCS. M a 4 CITY OF FRIDLEY NOTE: Applicant should obtain building permit proced»t e nfrmA+i on from Building Inspection BUILDER: Approved Contractors, Inc. V Department Secretary. ADDRESS: 1052 Osborne Rd. N.E. Fridley 554 NOTE: A Certified Survey of the lot, Street City Zip Code showing the location of the foundati n, TMXPHONE: 786 368o once it has been constructed, will be some Business required before proceeding with the. f naming. PROPERTY OWNER(S) Roger W. Larson ` " Donald. Wehlast James E. Wiensch Al iL w a vA/mg 85 West R4. Circle Pines, Minn. ADDRESSES) $$04 Lexington New Brighton, Minn. 55112 Street s City Zip Code 614 W. Brown Deer Rd. Milwaukee, Wisc. -' Street City Zip Code TELEPHONE NO -(S) Rome Business Property Location on Street or bract 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-30, R-24 City of Fridley, County of Anoka, State of Minnesota Total Area of Property eq. ft.cy Present Zoning classiiicarlon DESCRIPTION OF BUILDING Proposed Building Use: Multiple 141 units Each unit Building Dimensions: ;, Front 20 Depth 32 Height .21 Square Ft. 1_21_3 Cubic Ft. Type of Construction: Wood Frame each unit Proj6ct Estimated Coat —1, 6.000.00 To Be Completed 7-1- 1 DATES APPLICANT'S SIGNATURIP 6q F T (rti/ T f �� f ��T_ e acv, roar 7 3 0 ® 7V7`* -1 CfT,v rye PES UX117" 6� ' 19-5-,2 {rte lSG4 v �L 97 �o 51-0 5741 l/ 4 � sq � v A 73 93 06 lsip Uti� r P� R (/l/l,vF l�,s ux//,t Biu>NG AA!S74 yod 2`�3( ®o 0 -o .r R13s� PPr`ui �fz 270 ��7oTist c/ y��h �o/� ALL �r�� 1 z�►q 38�a �-��y�3 S��J-Tc� V�F-Lv�4-TibN.,��id f=orrT 7, il', So ?d T,44 1/.4 LV C C,.- AA co 0 6k91,923o 69 S. 97 ,000 S YAL SC NF_ Ovd� 3 7 Z 2 ly U l#k v e Ple /? , V6—, -AA -,VT 7 0 S Tff 7`6- S vol cf-/��� W� .V c T S I cl c��P — /�� Xc(a = Y.7 o o Sq FT _ /� e� -Lo c619 _. l o y x d= y 2� o Sa 3 ® 5-0 7 -un. -.4 547 5 yod 2`�3( ®o 0 -o .r R13s� PPr`ui �fz 270 ��7oTist c/ y��h �o/� ALL �r�� 1 z�►q 38�a �-��y�3 S��J-Tc� V�F-Lv�4-TibN.,��id f=orrT 7, il', So ?d T,44 1/.4 LV C C,.- AA co 0 6k91,923o 69 S. 97 NON-RESIDENTIAL BUILDING PMMIT CITY OF FRILLirf V.11 a ROM I I MANI ZONING: -? ADDRESS: 1600 194- G 9" A/ Nr= VARIANCE REQUIRED: / c' LEGAL DESCRIPTION: E �� o f N6 SPECIAL USE REQUIRED: �o� R &L -AL SPL7=.3 PLOT PLAN: TOTAL AREA GRADE ELEVATION S7 BACKS: FRONT YARD SIDE YARD REAR -YARD c 04/ -/re 4XP1?vv.4j SUBMIT TO: BUILDING BOARD BOARD OF APPEALS PLAN. COMM. COUNCIL 91 lr-/3-- / APPROVAL DATE: � - REMARKS: U FIRE REQUIREMENTS: FIRE MARSHALL FIRE-REVENTION BUREAU EXITS (dates App) H W U W INSIDE UTILITIES: PLYING VENT & HEATING MMTRICA14IV, aI �- Date Approved s r rawl 1___) a H A OUTSIDE UTILITIES & SITE DEVELOPMENT: Date Approved City Engineer WATER SEWER ELEV CURBING DRAINAGE SCREENING & PLANTING /-5j�4� Sewer Connection Charge Receipt No. q 1 Permit Fee &Plan Check 1, Receipt No. .Jsw�/aatic� `�a yya/ y��r _7�° 3� 'Re - Less e' Less Deposit:%, -7'` —,- , 17 Receipt No. �`� y c?6J C 2, 7,Y Net Permit Fee DueQ4.4 U./ • Receipt No. 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. AGRMU NT NECESSARY Finance Director AGREEMENT UNNECESSARY Reginte>:ed Engineer's Stamp Legal Description Check (A) FOUNDATION PrERMIT FINAL APPROVAL �. it ing Official Building Official (B) FINAL APPROVAL C NOTE: Easements, R/W, Special Agreements sx: City Engineer DATES CERTIFIOATE OF OCCUPANCY: ' PARTIALS DATES FINAL: DATE: ca 1.4 REMARKS ` REMARKS: - 4f3 !) ��4= <�'!1>TIpLTF/� cv7P� ,7cCcC-b f %�? t n S �z = a v CCJv✓'� � c t. E 3- Y 0 7 rc'% PC • Soa�I-V/ 'e" T✓G6jv e%' 3'z`%9Gs � rl�/ �JC� �� •�-S • � �. � SGL•. �C' .�- S � � �,�'� 7/ %�/1 � j✓('/'i� /�� % r� � d'� �' L`/1✓,✓? G�� f✓J �'�i°r/r1f' 7� r�J F_ (_1 fI'�/—✓� r � � co C17 -X /c� 6 �E r -6R f t 1/11/,V6 ilkl rs 7- AeR 7-07.4 7fJTAL € -1/P/Asra VAW-s yaCa v Whole Building Permit Fee, Plan Check Fee and Surcharge Fee paid on this permit. Separate permits for each buildin Uty of Fridley, Mine 131, 6431 University Ave. N. E., Minneapolis, Minn. 55432 BUILDING PERMIT Date: February 22, 1972 owner: Rice Creek Townhouse Company Builder Approved Contractors, Inc. Address 83__Wedt_.3.izad. Circle Pines, Minn_ Address 1092 (lchnrnp Bond N F TFrialeay 786-3680 15602 15623 15642 LOCATION OF BUILDING 1506,., 1568, 1570 69th Avenue N.E. No. _ _ __._� S&tre2et _ Part of Lot Lot Parcel 10 Block Section 13__.____ Addition or Sub -Division Corner Lot _.___ _ ____ Inside Lot Setback — Sideyard Sewer Elevation Foundation Elevation _...__. _R-3 Zoning 14.1 Acres DESCRIPTION OF BUILDING To be Used as: Each Unit 6 Garages use Units Front � Depth 32' Height, 21' Sq. Ft, 1213' Cu. Ft. 1 Garages Front Depth _ 5 .51 Height Sq. Ft. Ca Ft. Type o Construction Wood F.rLuam-e Fast. Cost _.$2.2.590, -362 To be Completed 1 ypar (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 easterty 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 a building described abI agree to do the proposed work in accordance with the description above set and q� and in compliance witjs :jdil provisions of ordinances of the city of Fridley. -0 l In consideration of the payment of a fee of $ 60 g7g.. S_Q_, 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 id all respects •to the ordinktces of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buUdbw pyithin the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. C/ Inspector CLARENCE BELISLE NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to no the Building Inspector for separate permits for these items. a Application for Purer Plants and Heating, Cooling. Yenaa&n. Rej%1- - anon and J Air on -L-- Systems and Derives PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell &Duct Work.. $10:00ten Replacement of Furnace ... ..... ..... 6.00 $ Repairs & Alterations—up to $500.00 6.00 $, _ Repairs & Alterations each add. $500.00 3.00 $—__ MECH. WARM AIR Furnace Shell & Duct Work to 170,000 BTU ...... J�p .. $10-00 each add 60,000 BTU .................... . 3.00 i 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 & Lines—to 640 sq. ft. EDR Hot Water 10.00 $_ Each add. 200 sq. ft. EDR Steam 3,0() $ _ Each add. 320 sq. ft. EDR Hot Water 3.00 $ Dept. of Edge. Phone W -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. � . , n - - 0 Vii' '"1 if'lI�W��tr!/�I Kind of Building Used as - — To be completed about Estimated Cost, $-.__. Old ew. Building Permit No. Permit No. 11� AIR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH FINAL c0�� (� Capacity Sq. Ft. EMM BTU Hr. iSao F» Sehodde 7z� v TOTAL FEB s� a/6 . S 0 (REMARKS—OVER) DESCREMON OF WORK OIL BURNER—to 3 gal. per hour 6,00 $ over 3 gal. per hour ---See Fee Schedule — HEATING or PO PLANTS—Steam, Not Water, arm Afr ° No GAS BURNER (up to 199,000 BTU) 5.00 $ 'In. b O Trade Name size Q () D 2— — 9L over 199,000 BTU See Fee Schedule ® GAS FITTING FEES: NO RATE TOTAL Capacity Sq. Ft. EDR BTU gp 1st 3 Fixtures ' x$ z00 / $� , ®d Total Connected Load Kind of Fuel Additional Fixtures x .76 $ Gas Range to 199,000 .. z; 600 $ BURNER —Trade Na.ne Size No AIR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS & REPAIRS ROUGH FINAL c0�� (� Capacity Sq. Ft. EMM BTU Hr. iSao F» Sehodde 7z� v TOTAL FEB s� a/6 . S 0 (REMARKS—OVER) e City of Fridley Dept. of BUkw Phone 560 -UW % Q DESCRIPTION Or wont go —6,A— fo =/ -61, Number. Kind and Location of nxtuw@ -- PARTIAL RATE SCHEDULE PLUMBING FIXTURE )RATES. NO. RATE TOTAL Number Fixtures ................ . x $2.00 5 !Vl s� Future Fixture Opening .... a ...... x $1.50 5 New Fixture Old Opening ...... o ... x $1.50 5 Catch Bain .................... x $3.25 f � erZs Water Beater 'Up to 99.000 BTU) .... x $3.00 New Ground Bun Old Bldg. . . . . . . . . x $3.25 S Electric Wates Boater .............. a $2.00 $ GAS FITTING FEES.- RATE TOTAL lot 3 Fixtures ............ • • • . • • fNO. `� x $2.00 ;1c2— 0 0 Additional�r s ................ x $ .7b $ Gat Range to 1911,000 BTU x $5.00 ; State Surcharge $ .50 REPA 1115 &��ALTERATIONS— tafu to Citi _ Deesripdan ....e.. a e•e.eewe..eew.e• •e..e.eee.eeoee.ee.; TOTAL FEE ;C 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 Citi Ordinance and rating of the Department of Buildings. and hereby declares that all the fact and representations stated in this application are true and correct 4C - Fridley. MinnOwner � Kind of Building :7 =" � � � �d"�F° 4 Z2�' Used pass lura To be completed about . ®C� Estimated Cost. $ Old—New. Building Permit No. Permit ROUGH City of Frid1Qy Applicatten for Pir ing end CTM MM2 P® it Dept. of Bldgs. Phone 580-3430 ' DESCRIPTION OF VIOYIX LpCgt�ea 1,5 qSv %&g �7, Number, Kind and Locetion of Fixtures ^�S l !—�� • Futuro Connection Openings e New Fixture, Old Openings PARTIAL RATE SCHEDULE 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 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, hUnn Owner , Kind of Building Sowel Q Used as C I PLUMBING FIXTURE RATES: NO. RATE TOTAL oil= x $2.00 $ Future Fixture Opening ........... x $1.50 $ _. New Fixture Old Opening ......• .... x $1.50 $ _ Catch Basin .................... x $3.25 I Water Heater 'Up to 99,000 BTU) . • • • x $3.00 $ New Ground Run Old Bldg......... x $3.25 $ Electric Water Heater, ..... ..... 2 $2.00 S :;AS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures • • • ............. • • x $2.00 $ Additional Fixtures ............... x $ .75 $ Gas Range to 199.000 BTU ........... x $5.00 3 owl YZZ • ■EMMEMMEMaMN����� ■MMMEMMMENEENNE00 • Futuro Connection Openings e New Fixture, Old Openings PARTIAL RATE SCHEDULE 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 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, hUnn Owner , Kind of Building Sowel Q Used as C I PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ................ x $2.00 $ Future Fixture Opening ........... x $1.50 $ _. New Fixture Old Opening ......• .... x $1.50 $ _ Catch Basin .................... x $3.25 $ Water Heater 'Up to 99,000 BTU) . • • • x $3.00 $ New Ground Run Old Bldg......... x $3.25 $ Electric Water Heater, ..... ..... 2 $2.00 S :;AS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures • • • ............. • • x $2.00 $ Additional Fixtures ............... x $ .75 $ Gas Range to 199.000 BTU ........... x $5.00 3 To be completed about Estimated Cost, $ Old—New. Building Permit No. Permit No. ^1 ROUGH FINAL REPAIRS is ALTERATIONS—Rofor 20 Code .50 State Surcharge Description ........................................ TOTAL FEE 3 Signed By _ Business Phone No FA SUBJECT PERMIT N City of Fridley 31432 AT THE TOP OF THE TWINS BUILDING PERMIT f ECEIPT NO. COMMUNITY DEVELOPMENT DIV. f PROTECTIVE INSPECTION SEC. 1 ; NUMBER REV OAT fi PAGE Of APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 2/22/02 JOB ADDRESS 1570 69th Ave NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. parcels 101& 200 1 Section 13 SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Rice Creek Townhouses 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Rayco Construction Inc, 3801 5th St Columbia Heights, 612-547-3011 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Dwelling 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION Q. REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof (tear -off) 25 squares 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with State Building Code. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING. HEATING, TYPE OFCONST. 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 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 $2,680.00 $1.34 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON• STR TION OR THE PERFORMANCE OF CONSTRUCTION $83..25 $2A68 eN�� PLAN CHECK FEE 5.00 y nse TOT FEE 2.27 NATURE OF ON ACTOR ORA ORIZEDAGENT iDATE-HE P O Y VALI T THIS IS OUR PERMIT S,GNATURE OF OWNEROF OWNER SUiLOERs -,DATE, B -NSP OAtE FA Mfg ogb �Jat'4 NEW i j CITY OF FRIDLEY Effective 1/1/2002 ADDN [ j 6431 University Ave NE, Fridley, MN 55432 (763) 672-3604 Bldg Inst, ALTER [ j SINGLE FAMILY AND DUPLEXES R-1 AND R-2 3.7 q3& BUILDING PERMIT APPLICATION Construction Address: Legal Description: a T s Owner Name & Address: Contractor: RpQ-C-C� err.,...... Z Q -\l _ C---tv' 1711 L_3 GARAGE AREA: DECK AREA: Tel. # e�C�nSc -T�1e �L MN LICENSE # S-� j�%�� a�l��-►b;�� O` NO Tel. # to la -64 1-3®I 9 JL01\ Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height _ Sq. Ft. Length Width Height Sq. Ft. Length Width _ _ HgVGround Sq. Ft. OTHER: V911` l �- `(,�� 7— U a' a Construction Type: �.0"t� Estimated Cost: ffi Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x $ m $ DATE: '4-�-1- 0 ►PLICANT: Tel. tf�1 Cali (763) 572-3604 for Permit Fees if mailing in application o ax to 7635714287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Parte Fee Sewer Main Charge TOTAL $ 5.z5 $ 3-.. --I Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.501$1,000 Valuation $1200 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or At. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ j Not Necessary [ STIPULATIONS: Z0/10'd 9916T13L3T9 01 ATU18d d0 A1I0 WONJ 02:01 Z00Z-T3-93d City of Fridley Building Inspections Dept. Ph: 763-572-3604 FAX: 763-571-1287 6431 University Ave NE Fridley MN 55432 Mechanical Permit# 9005-61 aSvR Residential Application City of Fridley Can Rar-k Girla Fnr Rpnuirpri Infnrmation Date 7 Site Address: The applicant is: (cirl a one) Owner Contractor w—' Property Owner: 2,2 Address: � WKW� airy:'04r.o lam. State: Wk/ Zip: j4:k_y_2. Phone: Cell: Fax: Contractor Informati n ' Company Name: Contact Person: -i Address: 8 City: �� /�JJ� State: Phone: 6-57 4/ to -- -- Cell:! �l9O ���7 Fax: d�a Email: oL MN Bond# & Exp Date E !� a Type of Work (circle one): New Replacement Alteration/Remodel Detailed Description of work: /?- � 6 Cw6L' 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 "7 Duct Work $10.00 Gas Range/Oven $10.00. Permit Fee $ (Total from above -Minimum fee $35.0 Surcharge 1 0.50 e— 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 L& 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. i Signature of Applicant., . Approval Inspector Signature:, oioocp Nlnta• gPnnrPtP nPrmits are reouired for Building. Plumbing, and Electrical work AUG -09-2005 13:34 CITY OF FRIDLEY P.02iO4 ZEESIDENTIAL �a61x36 LUMBING Permit Number APPLICATION Received By City of Fridley Date Received NOTE: IF PROPERTY 13 NOT OWNERIOCCUPIED- A LICENSED CONTRACTOR �MUST �OBTAIN THE PERMIT. DATE /Z, YOUR L ADDRESS SITE ADDRESS THE APPLICANT 13: (CIRCLE ONE) OWNER CONTRACTOR _ NAME PROPERTY OWNER/ TENANT ADDRESS CITY STATE ZIP PHONE # r NAME O �ICENSE # 2 CONTRACTOR ADDRESS V 4k CITY STATE Af AJ ZIP PHONE # FAX#� w ia PERMIT TYPEECQI INGLE FAMILY TWO FAMILY TOWNHOUSE ME OF WORK W REPLACEMENT DETAILED DESCRIPTION OF WORK FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED FD(TURES. (INDICATE TOTAL NUMBER OF EACH) BATH SINKILAV FLOOR DRAINS SHOWER WATER PIPING BATHTUB GAS PIPING (Need CO 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 00 Permit Fee $ 5 MINIMUM: ---$15.00 or 5% of cost of the improvement -Whichever -is Plan Review $ - greater on work less than $300 Surcharge $ .50 TOTAL DUE $ --, Make checks payable to: City of Fridley ....�+ ru"nrrL-wrRwn rVRh rMIMMI— rvv I VAUU UNTIL PROCESSED 1 hereby apply for a plumbing 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 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. / f� NAME OF APPLICANT Com° 1-11-4 f DATE v �J PI a type or print SIGNATURE OF APPLICANT OF FRIDLEY COMMUNITY DEVELOPiNENT DEPART 6931 UNIVESITY AVENUE NE, FRIDLEY. MN 56432 AUG -09-2005 13:34 CITY OF FRIDLEY P.03/04 City of Fridley Building Inspections Dept, Ph: 763-572-3604 FAX: 763-571-1267 6431 University Ave NE Fridley MN 55432 Mechanical Permit# Residential Application City ®f Fridley See Back Side For Rpnidrad Infnrmatinn Date Site Address: b The applicant is: Brice one) Owner Contractor Property Owner. Address: City: State: Zip. Phone: Cell: Fax: Contractor Informat , Company Name: Contact Person: Address:Z City: State: Zlp: Phone:_ earl Wil?Akj(,!: Cell: Edd Fax: �3°�e�, Email: s 4 anBh, MN Bond# & Exp Date .� Typeof Work (circle one): New Replacement Alteration/Remodel Detailed Description of work- /at AmtAA, hi, 06U. asie Equipment Installed: MFG: Model. Size/BTU: �w 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 Air 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 Permit Fee (Total from above -Minimum fee $35.00) Surcharge Total Due q5Zb Make check payable to City of Fridley D ms s do oppiicamon ror a permit- not vaiia unizu 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 Codes; that 1 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 Approval Inspector