Loading...
PRE 2010 DOCSCITY OF FRIDLEY NOTE: Applicant should obtain building permit �r�neA,rP i nfe*nns�ti nrL __ 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, TELEPHONE: 1 786 3 680 once it has been constructed, will be Home Business required before proceeding with the. framing. PROPERTY Owm(S) Roger W. Larson rJames E' Wiensch MiL w e? vAlme: 85 West RC 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) Home Business Property Location on Street or Exact Street Address (if any): County Rd. H or 69th Ave,..-: N.E. Legal Description of Property: The East 3/4o' f 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 sq. ft.,-, Present Zoning Classification DESCRIPTION OF BUILDING Proposed Building Use: Multiple 14.1 units Each unit Wilding Dimensions:_,. `_.ront 20 Depth 32 Height .21 Square Ft. ,...121-3 Cubic Ft. Type of Construction: Wnod_ Frame each unit Prgject Estimated Cost _16.000.06 To Be Completed 7-1-73 DATE1, -Lie APPLICANT'S SICNArMl `� ,-,4 a l vFT ���' UylT l S � � � %��-/ti1/ �h<�K /;� � �� y . U/U�T — / �• � 5tQ-r,� ��.v� ? b�, 3 0 ® 797`i�,( C /T Y r c�-e AES U*17- l5 G4 � 7 Z /e/U�4 /=r q 4 V4 ° 4 0 � 2- i X73 93 ,011 70W 4- / a jp *1 R l % 3 93r0,5- sr -,1- l/ A 7 a ca o 5 Y•4L v�T�c�/ SC HF_ Ovd.� 170 S Tom{ 7`L S ae� e��F�P� � �d� f�N -"Al 4 tale c T I l cAOP — /0 Xc(o = �(,7 o /- Sc y G to y t y 0 = �%2r� O /SIf C'4—92.��x - ®sem ® Z,�J _7 -5-- //-,q-j ' -,q-j') yo O 2L(34 ®o '00 33 P � = � � �'_ `— Fr �, Cf 2- F 7- lps� F r 3 ® o/��� s� r ��� 5;04- -TFE VAGVATilr rs.,�aa pav3' 7 , '? 3A', 5-0 70 rA-1. L1,* LV e c, c A A C X 411.46A -S 0101 U/NG 56? r -r 30`��� 13 e� z�►q 38' ,oma® 5 tok9492.50 NnM-RESIDENTI:?I, BUILDING PhRMIT riblj III MIR31 00 9 IffeW.N1,119 ZONING: VARIANCE REQUIRED: ca SPECIAL USE REQUIRED: PLOT PLAN: TOTAL AREA GRADE ELEVATION SFT -Af,/ tw c,ry ekc. CITY OF FRJDLiTf ADDRESS : f 6 O v /.?< - G 9 �y -14� iV le - LEGAL LEGAL DESCRIPTION: 4 BACKS: FRONT YARD SIDE YARD REAR YARD SUBMIT TO: BUILDING BOARD BOARD OF APPEALS PLAN. COMM. COUNCIL 1--/7- TT //-/5—%/ APPROVAL DATE: .5- _ `y— —2� REMARKS: FIRE RF3QUIREMENTS: FIRE MARSHALL FIRE-REVENTION BUREAU EXITS (dates App) wCj . W INSIDE UTILITIES: PLUMBING VENT & HEATING ELECTRICA �-- E-4Date Approved a H A OUTSIDE UTILITIES & SITE DEVELOPMENT: Date Approved City Engineer WATER SEWER ELEV CURBING DRAINAGE SCREENING & PLANTING ,E5 Peij�/ *.-q /4 5 ISG R p 4Ai T(`_44 "4"'Sewer Connection Charge Receipt No. �., IN �� 7�`�T� Permit Fee & Pla Check(0 5 9, Receipt No. 3 � , t & Less Deposit ���� Receipt No. __111 r1�� q �, �� Net Permit Fee Due 5 `I Ill `7 Q4.4 'Receipt No. SPECIAL, ASSESSMENTS: IF LATERAL ASSESSMENTS HAVE NOT BEEN PLACED ON THIS PROPERTY, AN AGRERWE MUST BE SIG AGREEI G TO ASSUME SUCH LATERAL ASSESSMENTS BEFORE A PERMIT WILL BE ISSUED., LAGREEMENT NECESSARY L/� Finance Director AGREEMENT UNNECESSARY Registe>:ed Engineer's StampC Legal Description Check Ai00, (A) FOUNDATION PFItNIIT FINAL APPROVAL %��//%G�. ilding Official Building Official ' (B) FINAL APPROVAL G (2,,O, NOTE: Easements, R/W, Special Agreements City Engineer DATES CERTIFICATE OF OCCUPANCY: PARTIAL: DATE: FINAL: DATE: ' REQ' is s REMARKS s Cv�V IV17-S, 4 A v ✓V C e ri s s _ 3r 7-0 57"C- 6 f.,r,' ly /J IV LVDA� 1 7�? �<n / <z S � � '`� v C av✓'� ��c��%c �.• �%� y/i%1 Yc"f c� C � � 4 mei.;' ,+cc/=5s s\ v gy C17 -1v 42 6 z L�iV ecce / P y, �` F�,� ITi i vIA16�al rS PE�Q)1i7 AMO 7.0 r,¢ 4- 7 � �R�' i�s � �ff0/�i6 vA✓17�F Tui 1 C ,.s.Q,ge6s /,72 4/1 �� Permit Fee paid on Permit #11,315 for 1560 - 1570 69th Avenue N.E. -� "ty of Fria�eyr, �.ne 1131 6431 University Ave. N.E., Minneapolis, Minn. 55432 BUILDING PERMIT eft: _ February 22. 1972 t- .. Road, PinessMinn.Address 10-921'.•■.- i... A 786-3680 16401163831636, LOCATION OF BUILDING No1634,1632,1AaOeet 69th Avenue N.E. part of Lot Uparcels 10 , Section 13 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 90 Depth 39 Height —21L— Sq. Ft. __3 233 Cu. Ft. Front Depth Height Sq. Ft. . _ Cu. Ft. Type of Construction _ Wood Fraise— Est. Cost See All -31-1-5 To be Completed" In consideration of the issuance to me of a permit to construct the building described bove, I agree to do fte proposed work in accordance with the description above set and in com fiance th all provisions of Ordinances of the city of Fridley. In consideration of the payment of a fee of $BU, permit is hereby granted to Rice Creek Dem. 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 !Within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said r lop CLARENCE BELISLE NOTICE: This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to sae the Building inspector for separate permits for these items. Application for Power Plants and Hea ft Cooling. Ventilation. RefElg n*60 and Air Conditioning Stens and Devices PARTIAL RATE SCHEDULE GRAVITY WARM 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 $-_- MECIL WARM AIA Furnace Shell & Duct Work to 120,000 BTU ..... (a. .. $10.00 $L ®• 0o 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 ... 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 &o()Each add. 320 sq. ft. EDR Hot Water 3,00 $ Dept. of Bldgs. Phone 890_3450 V ?/-/-, —� z .� � 0" P,- -//o 19k'1-10- 04�' City of Fridley: 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 !pd correct. 1 19l Z-' Kind of Building "-L/ e Used as To be completed about Estimated Cost, Old -0. Building Permit No. Permit No. _ �0�-q15� AIR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS It REPAIRS ROUGH FINAL dvy ' O / a Q ® Cappadty Sq. FIL EM.R BTU B1P SeeFee Schedule z(p TOTAL FEE $"U .5® (REMARKS—OVER) DE'50MMON OF WORK OIL BURNER -to 3 gal. per hour 6,00 $- -over 3 gal. per hour -See Fee Schedule HEATING or P07MANTS-Steam, Rot Water Warm -No GAS BURNER (up to 188,000 BTU) Lo.. 8.00 $ �� D , o o p Trade Name_ Size No g -&D2 - d over 189,000 BTU See Fes Schedule Capacityns� Sq. Ft. E.D.R GAS FITTING FEES: NO RATE TOTAL BTU gp.�% 1st 3 Fixtures x$ Zoo $-41VOW Total Connected Load Kind of Fuel •�GJf � Additional Fixtures x .78 $ Gas Range to 189,000 x$ 5.00 $ BURNER - Trade Name Size IfTo AIR CONDITIONING FAN HEATING SYSTEM VENTILATING SYSTEM ALTERATIONS It REPAIRS ROUGH FINAL dvy ' O / a Q ® Cappadty Sq. FIL EM.R BTU B1P SeeFee Schedule z(p TOTAL FEE $"U .5® (REMARKS—OVER) Cify of Fridley li—ioa for P&wAbbig cad Gag Fbtbtg Pmt Dept. of Bldgs. Phone 50 -UW DESCRIPTION OF WORE Number. Kind and LocaBou of F Xtureo e e wATU "M. 33 lifs; ' ;I�1r11 sGAS[IEC!ii!1-11 Bast PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES- NO. RATE TOTAL Number Fixtures ................ ;2.00 S q %. (2 o Future Fixture Opening .... a ...... x $1.50 S New Fixture Olaf opening .......... x $1.50 $ Catch Basin .................... x $3.26 S Water Beater fUp to 99.000 BTU) x 53.00 $ I R -00 New Ground Run Old Bldg......... x $3.25 S Electr9e Water Heater a ..... a $2.00 5 GAS FITTING PEES. NO. RATE TOTAL lot 3 Fixtures • .. • • • . • • • • • • • • • • : $200 : " o C) A%"f4onal Fixtures ................ -3 x $ .76 $ -2 . e2 S,- &0-60 Gas Range to 190,000 BTU ............ x $6.00 f State Surcharge $ .50 REPAIRS b ALTERATIONS—Rater to Cede Dessrlption o • o. •. o. oo..•e..e..oa ...•s.......... _ TOTAL TEL 14 , i� r ...�.Em le. 1�10 - 3 r - 3 6 - 3 41- ? (R - •3 ® City of rridiev The undersigned hereby makes application for a permit for the work herei, speeifled� 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. Mina Owner la a=//,�/ Find of Building Used as To be completed about Estimated Cost, $ Old—New. Building Permit No. Permit N Signed By Business Phune No ROUGH FINAL f'1._ City of Fridley AT THE TOP OF THE TWINS SUBJECT B U I L D I N G P E R M I T NO. 270 2 6 �• ____ COMMUNITY DEVELOPMENT DIV. may- -7 r � � PROTECTIVE INSPECTION SEC. I � CITY HALL FRIDLEY 55432 � 612-571-3450 RECEIPT NO. NUMBER 910415 REV DATE 8698 PAGE OF APPROVED BY JOB ADDRESS 1630-1640 69 Ave NE 1 LEGAL DESCR. LOT NO. Parcles 1 BLOCK & 200 TRACT OR ADDITION Section 13 SEE ATTACHED SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Rice Creek Development 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO AAAmerica's Best XXXI&M 2400 Interlachen Drive #222 Spring Park 55384 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 707-0100 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING 11 XMW Commercial 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION AR REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reroof 6- lex 57 SO Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with 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 AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION ZONING SO. FT. CU. FT. 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 AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED VALUATION SURTAX WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 4753 $2.37 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMAN OF CONSTRUCTION. 99.75 4.75 Fire SC PLAN CHECK FEE TOTAL FEE 6 Fe 106.87 T NTRACTORORAU RIZEDAGENT ATEI SIG AREOFC WHEN�PSRO�PERLY 9L INSP IDATED THIS IS YOUR PERMIT 7 PATE S,GNATURE OF OWNERIIF OWNER BUILDER$ (DATE$ Prepaid Plan Check $ \ Effective 1/1/98 Estimated Cost $ ��- CITY OF FRIDLEY Receipt # R-3, COMMERCIAL & INDUSTRIAL �jQ � aab BUILDING PERMIT APPLICATION Cq /6 30 _ Construction Address %y/ V �� �v P /U Zoning Legal e Creet< Q Owner & Address Tel# CM'RACMR & ADDRESS AA s� vti ems ,gam %- �l r®� L�r�c %e -i Tel# j o 7 0 /� o Architect Reg. # Engineer BUILDING CONSTRUCTION TYPE OF WORK [] New [] Addition [] Alteration -Describe Pr®6 f 6 -4440 yg�c - OFC. AREA: Length Width Height Sq. Ft. WHO AREA: Length Width Height Sq. Ft. an -m ApxA: Lenqth Width Height Sq. Ft. Tel # X07 LIVDo Date 5 01 ,9 V ALUA"1'111N Sq. Ft. x $ Cost/Sq. Ft. = Valuation $ ) i Sq. Ft. x $ Cost/Sq. Ft. = Valuation $ Sq. Ft. x $ Cost/Sq. Ft. = Valuation $ ) TOTAL VALUE Building Use Construction Type Occupancy Group Air Conditioning [] Yes (]No Fire Protection Provided [] Yes [] No Performance Bond Amount $ See Reverse for Schedule Received []Yes []No Permit Fee Plan Check Fire Surcharge State Surcharge SAC Charge Erosion Control $ Park Fee 1 $ Spec. Assessments $ Driveway Escrow $ 70M $ Zr% See Fee Schedule on Reverse Side In Excess of Prepaid Amount - See Reverse Side .001 x Pezmit Valuation (1/10th !W $.50/$1,000 Valuation (See Sched. for > $1 Million) $1000 per SAC Unit (Plans to MCC for determination) $450.00 Conservation Plan Review Fee Determined By Engineering Agreement Necessary [] Not Necessary [] feet x $13.50/foot ATTACH STIPULATIONS City of Fridley Building Inspections Dept. 6431 University Ave NE Fridley MN 55432 Ph: 763-572-3604 FAX: 763-571-1287 Mechanical Residential Application City of Fridley coo Rai-I� Atrlp Fnr RPnuired Information Permit # This is an application for a permit- not valid un i proce 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 T�Y> 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. An— Signature of Applicant: Date: Approval Inspector Signature: Date: Please Note: Separate permits are required for Building, Plumbing, and Electrical work Date Site Address: The applicant is: (cirl a one) Owner Contractor Properly Owner: a0eggf Ag - Add City State: AAJ Zip: Phone: Cell: Fax: Contractor Informati n Company Name. Contact Person: -r Address: City: 4144 / 4a4e,- State: /1?N Zip= 53L52 -S 57 4 M T� Phone: 6s% y �� Cell: �/� y9O 4(f4 -1 Fax: S %6a Email: a MN Bond# & Exp Date Type of Work (circle one): New Replacement Alteration/Remodel _ calk—, Detailed Description of work: /r- 6 34 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 Fumace $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 , LA Duct Work $10.00 Gas Range/Oven $10.00 Permit Fee $ (Total from above -Minimum fee $35.0017�� Surcharge $ Total Due $ 0.50 Make check payable to City of Fridley t•1 ssed This is an application for a permit- not valid un i proce 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 T�Y> 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. An— Signature of Applicant: Date: Approval Inspector Signature: Date: Please Note: Separate permits are required for Building, Plumbing, and Electrical work REQUIRED INFORMATION NEEDED TO PROCESS PERMIT RESIDENTIAL PERMIT APPLICATION HVAC ❑ NEW HOMES/ADDITIONS ❑ EXISTING HOME ❑ MAKE-UP AIR REQUIRED FOR NEW/EXISTING HOMES 1. Combustion Air (See note below) a. Oil or solid fuel IMC Chapter 7 with MN Amendments b. Natural Gas or Propane/1FGC Chapter 3 with MN Amendments 2. Make-up Air (See note below) a. IMC Chapter 5 with MN Amendments 3. Venting a. Gas appliances 1FGC Chapter 5 with MN Amendments b. Fuel other than gas IMC Chapter 8 with MN Amendments REQUIRED FOR NEW HOMES 4. Heat loss & cooling load per room a. Required on new construction IMC 1346.0312 5. Ventilation a. Per MN Energy Code 7670 or 7672 6. Duct Design Per IMC 1346.0603.2 a. ACCA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make up air calculations RUG -09-2005 13:34 CITY OF FRIDLEY P.02/04 t� zw Permit Number "" ,PLUMBING12 RESIDENTIAL. APPLICATION Received ved By J/ City of Fridley Date- ateNOTE: NOTE:IF PROPERTY IS NOT OWNERiOCCUPIED. A LICENSED CONTRACTOR THE PERMIT. DATE Z� YOUR AIL ADDRESS_ Ire�� �M�U.STTJOBTAIN SITE ADDRESS THE APPLICANT 13: (CIRCLE ONE) OWNER CONTRACTOR �— NAME PROPERTY OWNER/ TENANT ADDRESS CITY STATE ZIP PHONE # r NAME ® (.CENSE it AkY2 3 y ADDRE:SSZ CONTRACTOR CITY tL�li STATE Af �P �® PHONE # FN(#, GaIAe �/ 7,4/, PERMIT TYPE SINGLE FAMILY TWO FAMILY TOWNHOUSE TYPE OF WORK p NEW Er REPLACEMENT DETAILED DESCRIPTION OF WORK FEES ARE BASED ON $10.00 PER F=IXTURE, EXCEPT WHERE NOTED FIXTURES: (INDICATE TOTAL NUMBER OF EACH) BATH SINK/LAV FLOOR DRAINS SHOWER WATER PIPING BATHTUB GAS PIPING (Need City License) SWIMMING POOL WATER SOFTENER ($35) CLOTHES WASHER KITCHEN SINK ATER CLOSET BACKFLOW PREY. ($is) DISHWASHER LAUNDRY TRAY WATER HTR ($35) FOR IRRIGATION WATER METER OTHER Permit Fee $ 5 -- MINIMUM: --$15.00 or 5QA-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 THIS IS AN APPLICATION FOR A PERMIT — NOT 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. �Z, NAME OF APPLICANT DATEZ �� PI. sattypeorpdnt SIGNATURE OF APPLICANT , X31 UNIVESMe AVENUE NE, FRIDLEY. MN 56432 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 0 Mechanical Permit Residential Application City of (Fridley i See Back Side For Required Informatinn Date Site Address: !Q The applicant is: cirlce one) Owner Contractor Property Owner. Address: City: State: zip: Phone: Cell: Fax: , Contractor Informati�r����� ��JJ Company Name: �,6 Contact Person: Address- :Z City: V State: Phone_ Cell: Edd �P ?$ � /9?0F�� Email: 1�i � ar?Bh. MN Bo nd# &Exp Date iW.TS or, 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 Air to Air exchanger $15.00 _Furnace $35.00 _Pool Heater $35.00 _Boller $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 00 (Total from above -Minimum fee $35.00) Surcharge $ — - . _. _ .... 0.50 ._.._ Total Due $ Make check payable to City of Fridley This is an application for a permit- not valid until processed 1 hereby apply for a mechanical permit and I acknowledge that the information above is complete and acmrate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codas; that I 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 accordance with the approved plan in case of all work which requires review and approval of plane. Signature of Applicant: Date:f�L/41_0�� Approval Inspector Signatur Date, Building PLUMBING Permit No.: Inspections COMMERCIAL APPLICATION Received By: 4L$ 763-572-3604 : J 20 CITY OF FRIDLEYDat 763-502-4977 FAX EFFECTIVE 1-1-09 p DATE - -//O 7 YOUR E-MAIL ADDRESS SITE ADDRESS ��0 4O ?.� TENANT _ lC� CIJ- &*-'�j(�✓/✓ KT/ rYt �S SUITE NO. PROPERTY NAME: V !/Yt '� Fes/✓ ��Z�+ ��/L7- ' OWNER/ TENANT ADDRESS: CITY STATE ZIP PHONE: CONTRACTOR NAME: tp Ad 10-&YOUR SUBMIT A COPY OF STATE STATE LICENSE # EXP DATE LICENSE, BOND AND PLUMBING BOND # EXP DATE CERTIFICATE OF ADDRESS: :2- ++ 7- 40 64c_ 'IV1n/ �06TY ire %- STATE AIP_ 5-5702 INSURANCE PHONE S¢ Z.�Jr1� �% FAX 6 l'fj6Y"Z PERMIT TYPE 0jNSTITUTIONAL ❑ MULTI-FAMILY ❑ SWIMMING POOL TOWNHOUSE ❑ COMMERCIAL/INDUSTRIAL ❑ OTHER TYPE OF WORK: ❑ NEW OREPLACEMENT ❑ ALTERATION/REMODEL DE�TAAIIILED DESCRIPTION OF WORK ,Z^/L 5 �'�-G�- GNUS to •�+ ><-2 � r/C� lJ G t F J Gt/�-T�R :OXTiJI �u� jll�OXXTE10M NdMOI, dl Y ; F CLOTHES WASHER _ FLOOR DRAINS _ RPZ VALVE _ URINAL DISHWASHER _ GAS PIPING BACKFLOW PREV. Z<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 Total Job $ All fees are based on valuation, including the cost of labor and materials. Valuation Permit Fee $ 0.25% of Job Valuation/ Minimum fee: $35) Surcharge $ Valuation X.0005 Total Due $ Make Checks Payable to: City of Fridley THIS IS AN APPLICATION FOR A PERMIT-NOT 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 1 understand this is not a permit but only an application for a permit and work is not to start without a permit on site; that the work will be in accordance with the approved plan in the case or f all work which requires review and approval of plans. ll � / NAME OF APPLICANT J (5-70 r G KS DATE SIGNATURE OF APPLICANT t� iJR1313IrIt,i,1;'ILALEA1�1% bid ,7IREf3 City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977