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City
5
City of Fridley, Minn.
BUILDING PERMIT NA .7058
Date:
i
Owner: _ ._ Build _ l ...._ __-_..
Address Address
nC4TION OF BUILDING
No. �® Street 1._a-� _ — P f Lot
Lot _2 Block Addition or Sub -Division .
Corner Lot . _ Inside Lot _ . Setback _5 _ Sideyard
Sewer Elevations �o� Fen Elevation 9(-/- k
OP OF roo ; IX)A
DESCRIPTION OF BUILDING
To �� Fronts- Depth Height Sq. Ft. Cu. Ft3347t10
Front Depth _4- Height — Z; V Sq. Ft. Cu. Ft.
Type of Construction_ _. _ Est. Cj� 'To be Completed
In consideration of the issuance to me of a permit to colGitruct the uil g descrilodbove, I agree to do
the proposed work in accordance with the description t orth mplian 11th all provisions of
ordinances of the city of Fridley.
In consideration of the payment of a fee of permit is hereby granted to
to construct the building or addition as described above. This permit is granted upon
ress:101
thces. _
Building Inspector
NOTICE:
This permit does not cover the construction, instdladon for whing, phnubing, gas heating, rower or water. Be sure to see
the Bu[Mhm Inspector for separate permiia for these hens.
APPLICATION FOR BUILDING PERMIT
CITY. OF FRIDLEY,.MINNESOTA. ;
OWNER'S NAME BUILDER
ADDRESS ' ADDRESS
LOCATION OF BUILDING
No. Street Part of Lot
Lot. Block: Addition or Subdivision
Corner Lot Inside Lot Setback Side -Yard:
SEWER ELEVATION FOUNDATION ELEVATION
Applicant attach.to this form Two Certificates of Survey of Lot:and,proposed build-
ing.location,drawn cin these Certificates._
DESCRIPTION OF BUILDING
To be used as:
Front Depth. Height..:
- Sq. Ft. Cu. Ft.
Front Depth Height
Sq. Ft.- Cu,. Ft.
Type of Construction Estimated Cost
To be Completed
The undersigned hereby makes applicatiIon for a -permit for the work herein -specified,
agreeing to do all work in strict accordance with the City of Fridley Ordinances and
rulings of.the Departmeat,of Buildings, and,hereby declares that all the facts and
representations stated in this application are true and correct.
DATE S
Schedule of Fee Costs can be found 9n,tjtq Reverse Side).
. . .
0
City of Fridley
Application for Plumbing and Gas s=itting Permit
Dept, of Bldgs. Phone SII 4-7470
DESCRIPTION OF WORK Location R
Number, Kind and Location of Fixtures
V!
0�ei1
z
C W
n�
ZaZ
8 30 S
O�x
< 3
J
(�9 $
fWy
U'
z
� Q
•
F
•
N
WATER HTR.
GAS
E1-EC-
LEGBase
Base
1st
2nd
3rd
4th
• Future Connection OpeningsI L:onnecreu wisa Sewer
* New Fixture, Old Openings Cesspool El
PARTIAL RATE SCHEDULE
PLUMBING FIXTURE RATES: NO. RATE TOTAL
Number Fixtures ...................... x $1.50 $
Future Fixture Opening .................. x 1.20 $
New Fixture Old Opening .............. x 1.00 $
Catch Basin .... x 3.25 $
Water Heater (Up to 200,000 BTU) ...... x 2.00 $
New Ground Run Old Bldg. x 3.25 $
GAS FITTING FEES: NO. RATE TOTAL
1st 3 Fixtures .......................... x $1.50 $
Additional Fixtures .................... x .50 $
Gas Range to 200,000 BTU .............. x 2.00 $
REPAIRS & ALTERATIONS—Refer to Code
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 applications are true and correct.
Fridley, AUnn `e -X 194�/
Owner
Kind of Building ® s )� 0 94
6•
Used as
To be completed about-
v ��
Estimated Cost, $
Old—New. Building Permit No- Q Permit No� �Y
ROUGH 36 — & 7 C(• )(
FINAL
Description ................................................$
TOTAL FEE �QJJ30.4=
Phone
111mkmm
SUBJECT
-�
City of Fridley
AT THE TOP OF THE TWINS
BUILDING PERMk4j
I
r
T NO EIP
• COMMUNITY DEVELOPMENT DIV.
��,------,
PROTECTIVE INSPECTION
9300
r � � SEC.
1 . �
NUMBER
REV.
DATE
PAGE OF
APPROVED By
CITY HALL FRIDLEY 55432
'-',,�
----
L .I� 612-560-3450
910-F15
9/6/78
JOB ADDRESS 370-372 74th Avenue N.E.
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
3
5
Melody Manor
SHEET
2 PROPERTYOWNER MAIL ADDRESS ZIP
PHONE
Richard Jenni 372-74t1i Avenue N.E.
780-1057
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO.
Same
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP
PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP
PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
(j NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR
❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 22' x 24' Garage
9 CHANGE OF USE FROM TO
TIPULATIONS provide a hard surface driveway.
SEPERATE PERMITS REQUIRED FOR
WIRIK
HEATING, PLUMBING AND SIGNS.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SQ. 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
2
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.
$3822
$1.91
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
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-
$21.12
STRUCTION OR THE PERFORMANCE 0 CONSTRUCTION.
PLA CHECK FEE
TOTALFEE
$23.03
HEN PROP RLY VALIDATED THIS IS YOUR PERMIT
BLDG. INSP DATE
SIG OFCON ACTO ORAUT Z AGENT (DATE)
r
Silk,6TURE OF OWNER (IF OW ER BUILDER) (DATE)
CITY OF FRIDLEY
APPLICATION FOR RESIDENTIAL BUILDING PEIMITS
(NEW, ALTL=RATIns, ADDITIONS, OR REPAIRS)
OWNER: -1J-,2 h I
Address: 3 % ,�- .-2
BUILDER:
Address:
Tel. No. OS 7
No. 3x ^A� Street: % 7' t C_ ry.� •
LOT: BLOC K: ADDITION:
CORNER LOT: 3 INSIDE IAT: SETBACK.: SIDEYARDS:
Applicant attach 'to this form Two Certificates of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Used As:
Front:- Depth: Height: l
Square Feet: _16;;Z4? Cubic Feet:
Front:
Depth: Height:
Square Feet: Cubic Feet:
Type of Construction:
Estimated Cost: $ 3 ZZ
To Be Completed: Alt. A Alt. B
Proposed Driveway Width If New Opening Is Desired $ $
(SEE REVERSE SIDE OF SHEET)
The undersigned hereby makes application for a permit for the work herein'
specified, agreeing to do all work in strict accordance with the City of
Fridley Ordinances and rulings of the Department of Buildings, and hereby
declares that all the facts and representations s ated in this application
are true and correct//- See reverse side for additi i information.
DATE: SIGMA
OO
St1DulAtlO11S:
gni
. S _
13
AGREEMENT
jam, VCJ /a , owner of the property
located at �� , `� fj yo. have no objection to the
City allowing the construction of a X .141 O e f arc ti.�ed- to be
located at %2 7q Qt_y without the required
certificate of survey that the City ordinarily requires for all new
construction.
Address
Date
s
Land Plonniny e 6875-,Wi bjvoy O`S Alt
load Surveuin9 �linireoPo/s 7l,
S05esfing ENGINEERING, Cs li�9inncsofo
Qvrl & Municipal SU�sef tr 6066
Ill
iticerit y Ery9 ineers Sur veyors
F, & M • DEVELOPMENT CO.
74'' AVENUE N. E.
F -L• 867 8 fit'` '" T5-
�70
1
I GROUND ELEV, 866.8 (03 HOUSE COkIeC.
i z
I
77 2 i
EL. 86A• 3
o DENOTES IRott __ ___ C�ENo�'ES UT141i`f �DiZA1NA6E EASFM>~NTS
PI•�cE.:-
1. F-LEVATIOMS ARE PRoPOS£'O
Z. FIRST FLooR E1_EVP.TJOW TO Be %S FEET ABOVE GROUND ELEV. SMOWtA
LOT .._")-- BLOCK 5 ME LOE)Y . "Amt O R.
I hereby cerhPy fbof /iris rs o true and wired represenfafivn o['a strvey e#)e hwndorres o "&- abort• c6w;W lmd,mnd
nj'lYae /arvfinn a�'op burldin9s , l/nrPon , ara�ol! risible eaachmeals , !cony, fr n or on said land. As survecyed 6y me Mi - eby
' s�, •n ��:C_ A.D. c -k. SUt3UR6AI EJVC7hVE•ERING , INC.
�� L 1" 3�, to
7s; E 5urr, ors
CITY OF FRIDLEY INSPECTION DIV. Effective On January 1, 1995
6431 University Ave NE
Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
JOB ADDRESSzI
Residential
Furnace Shell and Duct Work, Burner –
Also Replacement Furnace
(Side Vent - Fill Out Back)
Gas Piping (Needed with new furnace)
Gas Range
Gas Dryer
*Air Conditioning – All Sizes
All Others/Repairs & Alterations (LIST ON BACK)
1% of Value of Appliance or Work -
Commercial/Industrial
1% of Value of Appliance or Work
Rate
$ 20.00
$10.00
$10.00
$10.00
$10.00
State Surcharge
TOTAL FEE
The undersigned hereby makes application for a permit for the work herein
TOTAL specified agreeing to do all work in strict accordance with the City Codes ar
rulings of the Building Division, and hereby declares that all the facts and
$ representations stated in this application are true and correct.
=T=995
ESTIMATED COST PERMIT NO. `%
No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air)
Trade Name Size No.
BTU HP EDR
Fuel — Total Connected Load
Burner Trade Name Size No.
BTU HP EDR
MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT IS $15.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $30.00
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
U
Rough–In Date Final Date Wv
FILL OUT BACK SIDE FOR STACK VERIFICATION ON
REPLACEMENT FURNACE
NOTE: #1 through #8 required when using a side vent furnace.
CHIMNEY AND STACK YERIFICATI�
The undersigned hereby verifies that the existing chimney or stack:
1.
Has been carefully examined
Yes ()
No
( )
2.
Is free from rust or deterioration
Yes ()
No
( )
3.
Has no foreign objects lodged within
Yes ()
No
( )
4.
Is securely supported
Yes ()
No
( )
5.
Meets all current Code requirements for size
and total BTU's connected
Yes (
)
-No
( )
6
Has total heating BTU's of
All other BTU's
TOTAL BTU's
7. Has a liner been provided for water heater Yes ( ) No ( )
$: Has combustion air been provided for water heater Yes ( ) No ( )
Remarks:
List ALTERATIONS Being Done:
HEATING CO:
Signed By:
Date:
City of Fridley
SuBjECT
PER O.
AT THE TOP OF THE TWINS
BUILDING
PERMIT
f
r �
R
• _ COMMUNITY DEVELOPMENT DIV.
L PROTECTIVE INSPECTION SEC.
r
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BV
612-571-3450
910-F15
10/31/9
JOB ADDRESS 370-372 74 AVENUE NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
3
5
MELODY MANOR
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Jugal Agurwal 370 74 Avenue NE
625-9380
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Sussel Corp. 1852 Como Ave, St Paul, MN 55108
645-0331 1934
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO -
6 USE OF BUILDING
Double Bungalow
7 CLASS OF WORK
_❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
R
B DESCRIBE WORK
Construct 4,20' x 16' 2nd Accessory Building
9 CHANGE OF USE FROM TO
STIPULATIONS
Special Use Permit approved by Council on October 14, 1996 subject
to the following stipulations: The petitioner shall provide a hard surface
driveway at the time of garage construction; the accessory structure shall not
be used for a home occupation; the structure shall be architecturally
compatible with the existing dwelling; and vehicles, refuse and other materials
shall be stored in compliance with the City Codes.
See notations on plan.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
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
2
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
$2.93
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
$5,862
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-
$112.25
Fire SC $5.86
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
: /)-/
l ' J�,
PLAN CHECK FEE
T TAL FEE
r ) A--& l ^ 9
L n SC
. 00
$126.04
SIGNATURE OF CONTRACTOR O AUTHORIZED AGENT (DATE,
gAfAk.,
LY V LI TED THIS IS YOUR PERJM'IT
GATE
SIGNATURE OF OWNERUF OWNER BUtLDERI IDATEI
RN
i
NEW { Effective 3/1/96
ADDN [ CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
Building Permit Application
ConstructionAddress: -'7a ') 9 r4 jq z rVf/
Legal Description:
Owner Name & Address: J k a Gar, w 4,1 Tel. #
Contractor: S t,,- s f e MN LICENSE #
Address: 1 $ Z C rr m jy s -%r p, K % Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF RAPROVEMENT
LIVING AREA: Length Width. -Height Sq. Ft.
GARAGE AREA: Length , ',o '' Width• 'Height Sq. Ft.jW
X %y 32
DECK AREA: Length Width Hgt/Ground Sq. Ft. 2, YO
OTHER:
Comer Lot [ ] Inside Lot [ ] . Ft Yd Setback Side Yard Setbacks
Type of Construction: t x a �' G y Estimated 4.Cost: $ :;i�' �Cj d�`(j `f Z% f
Approx. Completion Date:
(Cost' on Back)
Driveway Curb Cut Width Needed: ` Ft. + 6 Ft = Ft x $ _ $
DATE: 1 b,. / C^ J (, APPLICANT: �� Tel. #
CITY USE ONLY
Permit Fee $ 112, Fee Schedule on Reverse Side
Fire Surcharge $ .001 of Permit Valuation (1/10th%)
State Surcharge $ . �1 $.50/$1,000 Valuation 1
SAC Charge' $ $900 per SAC Unit
License Surcharge $ $5.00 (State Licensed Residential Contractors)
Driveway Escrow $ Alt. "A" or Alt. "B" Above
Erosion Control $ $450.00 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement Necessary [ ] Not Necessary { ]
TOTAL $ Z2G , 01f
STIPULATIONS:
Mr. Jugal Agarwal #6672
370 -74th Ave. NE
1852 COMO AVENUE NAME Fridley, MN 55432
ST. PAUL, MN 55108 (� H 635-9380 W 490-2728
Permit by JOB ADC
Legal Descrlp 4on— 16x20 Det.Allbilt W/Cone.
Lot. BLDG CCBlk 10/16/96 Dennis Jarnot
Add'n SALESM, g Mailin Add: 3015 -12th St. NW
Value --!= New Brighton,MN 55112
Type Const—
SLAB: SLAB:
�fty SUSSEL
❑ By Owner Approx.
ln
2❑ -START! ¢POINTS ONLY : _ j f I I--
- -
S.P.L.
S.S.P. L.
R.P.L. :..I. - - ; -I- ^. I
Alley, _- -- - _
House
F. Street
Other
F--
'❑Square With
❑Sod Rem. • By
❑ ® Grade Point
�dbt3 -----
Blocks: LlBy Owner By Sussel _
❑Wtr.proof: ❑By Own. ❑By Sus.
❑Backfill: 13 By Own. ❑By Sussel
❑ Maintain 8' Total Wall Height
Including Blocks OR i._
❑Maintain 8' Wall Height on -1
Top of Blocks
L..
Block Size (Top course)
.. ,
Wall Height other than 8'
1
O r..
!
❑ r
i
❑ ttr i {��i
❑
Existinggarage: 9 9 I -
No ❑ - (
❑ Detached ❑ Attached Yes ❑ I ' f
Size of existing: x �.-
Existing garage will be:�
_ 1
❑ Left as is
J -
❑Converted to L.S. - By owner
❑ Removed By: Owner ❑
Sussel ❑-
Junk Must Be Removed By Owner i1 i
I
Stakes visible - ❑Yes ❑ No
Survey available - ❑ Yes ❑ No
a 1
❑ Special instructions from
Cement Man
tit
t ACCESS
0 Good 13 Fair 0 P or
DIRECTION
ROOF: GABLE REVERSE GABLE HIP
EAVE OVERHANG:
RAKE OVERHANG:
SEAL DOWN SHINGLES WITH PLYWOOD OR ,
WAFERBOARD ROOF, SHEATHING AND 15 LB. FELT
Roof Sheathing
Seal Down Shingles
Trim
Manufactured Trusses 2" x 4" Double Top Plate --�
i
f I
I
i
i
NOTE:
1) iRocsf"approved by Minn. State Building Dept. as meeting Minn. State
Code Requirements of 30# snow°load.
2) Hip roofs consist of 2" x 6" rafters, 2" x 6" cross ties 48" O.C., 2" x 8"
hip rafters and no plywood gussets are used.
RAFTERS: Trusses ® 24" O.C.
j STUDS: 2" x 4 1W' Q C. 24" O.C.
WALL SHEATHING: u!
SIDING: . *S,6
•
OVERHEAD DOOR HEADE a 2" x 12" o
2
—.Micro Lams x
i
Slab on grade construction approved per Minnesota State Code. Refer to State
Building Code Letter Number 11.
SLAB: 4" WITH MESH 6" x 6" #10 Gauge
�— Soffit
3/4" Cove
2-x 4" Studs
Siding
1"x4"
Sub Fascia
Fascia
7
-
112" x 7" Anchor Bolt
-- 2 x 4 Treated Bottom Plate
Grade
,ria ,
-30-96 FRI 14:17 JARNOT FAX NO. 6124511980 sY 496-16 P.01
6E'Z.r•N�9hnny
�19unr•_;p1,7
fig',/ fr dsiuni;q+ol ENGINEERINO, INC.
Sy..el f.06 i
rnyincers� Sur VC'.[ CICS
ce�r'�Y,."Cate Of S19LIOVeV Fares E v M DEVELOPMENT CO.
r
74" AVENUE N.E. ,r
F.L_Rn! $- -- %5 - Ebb.$
�I V
EL. 843. Y
O OEt30TC5 ZR -o14
N •'T E -
�2
I
Ge�OVNO E IEV. 86(,.o p
M6178H :�{!]CR°
� 1
�_.—�_,_ C,£*tOT£S U`Y�L.ITY DRAINAGE �ASEMTr.NTS
X. E, L.F_V/*"fIoIJS ARF- I'VoE'OS)�.o
Z. FIRST f1.00P, 8>~F_VATION Tp AE 2.7 F>vE:1' Af!�avE GRoUNfy ELEV
Al.! F.,NG!h'EER!NG . INC.
5 C � L � I�• jQ. fny;a� jc F.- C�,r,cuors
. SHOWN
� I !b�!by ttr{i%y r7rot ilia rs a h ue and cc -reel rtr,-csenfafon o`'o surrey 1bm h-n,ndories o('//e adc,e 4tw4ed /ond, ollwy ,
/ocv/ion b,ri/diys, I/,rrton, &do// rrsi6lc rnUooclirririj/S , ;l,wy. ran oi• M.1v;d lond. AS turvc rd iji mC ilus _ do
A. 17 y J l
.SUBung
LUMBER SPECIFICATIONS MEMBER FORCES FROM LEFT TO RIGHTS I
TOP CHORD 2X4 ISSOF-I-SE MSR S -P -F TOP CHORD BOTTOM CHORD WEBS REACTIONS
T l= -1978 8 l= 1874 N I= -547 N 3= -547 REACTION o B 1= 1140
BOT CHORD 2X4 1850F-I.SE MSR S -P -F i 2= -1442 B 2= 1874 N 2= 574 REACTION a 8 3= 1140
WEBS 2X4 *31STUD 3 -P -F T 3= -1442
T 4= -1976
BERRING REQUIREMENTS r
ALL BEARINGS SHOWN ARE 3.5' EXCEPT AS NOTEOt TRUSS LOADING ICON t)
UNIFORM LL ON TOP CHORD = 40.0 PSF
UNIFORM DL ON TOP CHORD = 7.0 PSF
LOCATE INTER -PANEL SPLICES AT t/4 PANEL LENGTH y- UNIFORM OL ON SOT CHORD = 10.0 PSF
12 INCHES FROM EITHER END OF THE PANEL INDICATED. TOTAL DESIGN LOAD = 57.0 PSF
ADDITIONAL LORDING
THIS DESIGN HAS BEEN PREPARED FROM COMPUTER INPUT CONCI TC VERT 228.01 180.OLL) LBS AT PANEL POINT 1
DEVELOPED BY THE COMPONENT MANUFACTURER. CONCs TC VERT 228.01 LBO.OLLI LBS AT PANEL POINT 5
LORD DURATION INCREASE = 1.15
'-0.0• 8'-0.
PLATE ROTA EO 90 DEO.
3-S-4
' REGISTERED -1
PROFESSIONAL
ENGWEER
JAN 1 9
'
�24•0�I-
RATE CODE SPRCIND
DATE
MODEL20 TPI 24.00 ` O.C.
1118/89
ecluaLI
0161057
OlnEN67
RN RNYTRUS®
DESIGN
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RU-S
FRBRICR
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W R L SPECIRI
No RTc�
DND. 279778 FILE.
BRAC IND
SYSTEMS o TARLI
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TRUSM.-STSTE111 CORPORATION R SIGN= C011PRNT 8000 TO
JOOICIO
IB2e
E EBCO
1
EBCO STRNDARO COMMON
Y.OS / 1.07
SUBJECT
NO. -�
City of Fridley
30182
AT THE TOP OF THE TWINS
BUILDING PERMIT
R-0.
`COMMUNITY DEVELOPMENT DIV.
V
INSPECTION SEC.
Qj
r � PROTECTIVE
(/J�
CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
612-571-3450
910415
9899
JOB ADDRESS 370 - 372 74th Avenue NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
3
5
Melody Manor
SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Jugal Agurwal
651-635-9380
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Seal Guard Systems 3770 Dunlap Ave N Arden Hills
55112 717-0700 20093688
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
8 USE OF BUILDING
Duplex
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION
M REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof duplex (40 Sq) Tear-off
9 CHANGE OF USE FROM TO
STIPULATIONS
Underlayment must comply with the State$ Building Code.
Permit Inspection Carus
Will Be Mailed
To Homeowner To Post
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 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
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
$3496
$1.75
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SA HARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION
$97.25
ire SC $3.50
PLAN CNE
EE
OTAL FEE
,$L' s
SC 0 4,$107.50
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT ,DATEi
N P Y VALI ED THIS IS R MIT
/V r i
K�WH
BLIG -NSP' V� OATE
S,GNA TORE OF OW NEA ,iF OWNEF+BU4 DERE #DATE-
NEW[ l Effective I/1199
ADDN [ > > C1TY,,OF FRIDLEY '
ALTER SINGLE FAMILY AND DUPLEXES 1-f AND R-2
�� D
BUILDING PERMIT APPLICATION
ConstructionAddress:317D 143` A AM, NG Fr) (11 CLI
Legal Description:
Owner Name & Address: J-CIN r SUM 3g0"3V- I +h AVC, f Tel. # 65) to 390
Contractor: S '1..1 b uAd 1'n 5 MN LICENSE # �XO 36 6 9
Address: 3T7 h bw L l W 6t ► U ' ntfn 115 5,5% / a Tel. # coi a -71-7 ® 700
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
Construction Type: t'(� �' IflNt-POW 4051. Estimated Cost: $ � � �� I � U
(Fee Schedule on Back)
Driveway Curb Cut Width Needed: Ft. + b Ft = Ft x $ _ $
� ]1
DATE: V9�f Oj APPLICANT: �� n L,4,� �" / 11 ��, /,� Tel. # 60 717 6 -70 D
TOTAL
STIPULATIONS:
CITY USE ONLY
,l
Permit Fee
$�
Fee Schedule on Reverse Side
Fire Surcharge
$ '�,�JD
.001 of Permit Valuation (1/10th%)
State Surcharge
$
$.50/$1,000 Valuation
SAC Charge
$
$1050 per SAC Unit
License Surcharge
$
$5.00 (State Licensed Residential Contractors)
Driveway Escrow
$
Alt. "A" or Alt. "B" Above
Erosion Control
$
$450.00 Conservation Plan Review
Park Fee
$
Fee Determined by Engineering
Sewer Main Charge
$
Agreement Necessary [ ] Not Necessary [
TOTAL
STIPULATIONS:
sue.,EtT
PMP
City of Fridley
3 i 4 � 5
AT THE TOP OF THE TWINS
BUILDING
PERMIT
RECEIPT NO.
� `y ------COMMUNITY DEVELOPMENT DIV.
INSPECTION SEC.
r PROTECTIVE
(/iJ
I" CITY HALL FRIDLEY 55432
NUMBER
REV
DATE
PAGE OF
APPROVED BY
L 612-571-3450
910415
10/4/00
JOB ADDRESS 370-372 74 Avenue NE
1 LEGAL
LOT NO.
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
3
5
1 Melody Manor SHEET
2 PROPERTY OWNER MAIL ADDRESS
ZIP PHONE
Jugal Agarwal 370-372 74 Avenue NE
651-635-9380
3 CONTRACTOR MAIL ADDRESS
ZIP PHONE LICENSE NO
Norsk Concrete Construction 1115 Osborne Rd NE, Fridley, MN 55432 786-1910
4 ARCHITECT OR DESIGNER MAIL ADDRESS
ZIP PHONE LICENSE NO.
7333
5 ENGINEER MAIL ADDRESS
ZIP PHONE LICENSE NO
8 USE OF BUILDING
Residential Duplex
7 CLASS OF WORK
❑ NEW ❑ ADDITION ❑ ALTERATION C. REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Remove and replace steps
9 CHANGE OF USE FROM
TO
STIPULATIONS
WARN11%
Before digging Call for
all utility location
4"tl2
Ito Y CAW
SEPARATE PERMITS ARE REOUIRED 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 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
2
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
3,000 $1.50
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 PERFORMANCE OF CONSTRUCTION
$83.25 F e SC $3.00
PLAN CHECK E TAL FEE
$87.75
SIGNATURE OF CON'RACTO OR AUTHORIZED AGENT IDATE-
HE ,PR LY VA ID D THIS ISyy�)UR PE M/fG►%
,Ns
S-GNATURE OF OWNEROF OWNER BUILDERS iDATEi
NEW [ I Effective 1/1/2000
ADDN [ ] CITY OF FRIDLEY (763) 572-3604 Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address: 3' 76 - 3 7 9- 7 �y
Legal Description:
Owner Name & Address:
Contractor: Wd--44 G
Tel. #
MN LICENSE # 33�
Address: ///5-- Tel. # 9 2K�" - / f/4'
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
Construction Type: Estimated Cost: $ oma'
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $
DATE: v
APPLICANT:<\Tel. # 7
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
Call (763) 572-3604 for Permit Fees if mailing in application
$ RS, -�� Fee Schedule on Reverse Side
$ :5,60 .001 of Permit Valuation (1/10th%)
$ f. $.50/$1,000 Valuation
$ $1100 per SAC Unit
$ $5.00 (State Licensed Residential Contractors)
$ Alt. "A" or Alt. "B" Above
$ _ $450.00 Conservation Plan Review
$ Fee Determined by Engineering
$ Agreement Necessary [ ] Not Necessary [ J
8
3
Pn
m
i. ■
ll�
Ifs FUEL RURmW APPUMCE PATE
When mgWing an WdW
the undenggined hereby VWMW that the
verb has been examined end is
ftm nest, deWoradon, cbstructlons,
Yea (} No ( ,
and is securely supported and
ped vire required.
The venft system is PIMSUCIPVC
d meeis all cunwt w6m and manuf4ftrw
of elbows and tOrmaudlon.
Y" (} N0( }
cificst#ons hA ding sizing, ten
number
The undersigned Woo Yl OW
replacsmeni unit � a m*
TMe does
and meets the int co&m �
dude AG LAMA C hVry
i F ay V GOOOM for fan
yes (' No( i
acted and natural draft appll
The oWd t 2MIS an air is
emi Installed to meet "wniert codes
Yes (} No( }
and tram %durees Weciflcatlons.
~ required to MWA,
li velli be sbmd and Insured
epacmeations.
Yes (} No( }
to meet the current codes and man
a
" undnigned hereby verifies that
When
it Is aOgWassent arW m9SW
current codes and m,16"'s
spediftwons. Thi$ do s indude
Calagory I Centrral Furnace
Yes (} No( }
VenI Tables lbr fan ascided
draft a
'
Is the common vent and vent con
ors etted and inserted condi* OW
the vent and vented
an applWnce has bow MMOved
common
Yes( No(
Appt�noe #1 Type
BTU Input Fen Aimed or Nat
+ BTU Inputor Ndt
FFan
� #2
BTU Inpuk Aesls#ed
or Not -r.--r.---
pT nceUd ala
.,...�_�..__
Tats Btu Input
Comm Vent Type
Vent Might .,.._.._ ®lameter ._.
lnam
1 Vent Connector
ft Length....._ ft DjameW .�in
ft LWQM Diameter
Type
In Type �-..
Apl�nce #2 Vent Conn
Appi �3 Vent Connector
ft i nt
1!n Tye ..._..---
__ _
Building
MECHANICAL
Permit No.: 22�S
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
CITY OF FRIDLEY
a
763-502-4977 FAX
EFFECTIVE 1-1-08
, 16
DATE YOUR E-MAIL ADDRESS ( 1����* �, '/ -Fb1dando
SITE ADDRESS
THIS APPLICANT IS: ❑ OWNONTRACTOR
ER
PROPERTY
NAME: Q
ADDRESS:L4!—Lv�CITY STATE
OWNER/
TENANT
PHONE:
CONTRACTOR
COMPANY NAME: I na. er
NOTE:
SEPARATE CITY
CONTACT PERSON:
STATE LICENSE # EXP DATE
1 ^�
ADDRESS: \ uGIJ` ik– CITY U Ickv TAWr 'n E
LICENSES ARE
REQUIRED FOR GAS
AND C.
7
SUBMIT COPY OF BOND
PHONE SSI » FAX -7
AND INSURANCE
PERMIT TYPE
INGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
TYPE OF WORK:
❑ NEW PLACEMENT ❑ ALTERATION/REMODEL
DE_ _TtJLED DESCRIP ION OF WORK
PER MS 16B.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 )
OR
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: SIZE/BTU
A/C $25.00 (GAS) $15.00 _GAS RANGEIOVEN $10.00
_FIREPLACE
AIR TO AIR EXCHANGEER $15PLACE (WOOD) $35.00 NEW GAS GRILL $10.00
$35.00 $35.00 GAS UNIT HTR $10.00
_BOILER _FURNACE
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 PROJECTS FOR UNDER$500 PERMIT FEE FOR PROJECTS OVER $500'
Permit Fee $ Number of fixtures @ $10.00 x $10.00 = $
_
Surcharge .50 Number of fixtures @ $15.00 x $15.00 = $
TOTAL DUE $ 63 OR Number of fixtures @ $25.00 x $25.00 = $
Number of fixtures @ $35.00 x $35.00 = $
State Surcharge = $ .50
MINIMUM $15.50 MINIMUM $15.50 Total = $
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 wi 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 wil bei accordance with the a p ved plan in the case of all work which req fres review and approval of plans..
112
SIGNATURE OF APPLICAVna &NT NAME±�� 1' ��
APPROVED BY DATE
PLEASE NOTE: SEPARATE PERMITS ARE REQUIRED FOR BUILDING, ELECTRICAL, AND MECHANICAL WORK
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 763-502-4977
,3
2-1
Building
BUILDING
Permit No. • 6&
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
763-502-4977 FAX
CITY OF FRIDLEY
EFFECTIVE 1-1-08
Da'dJ
DATE `U -
OUR E-MAIL ADDRESS
SITE ADDRESS ZO 3
THIS APPLICANT IS:
R q /TRACTOR
PROPERTY OWNER/
NAME:
ADDRESS: CITY rj)e,
l.. _STATE A ZIP
TENANT
PHONE:
CONTRACTOR
NAME:
ADDRESS: �s,+`�i l l l .c.. Ll� CITYC6 TATEjEnZIP 55:q5
SUBMITA COPY OF
YOUR STATE LICENSE
PHONE (c, I a 15-7'S' i Sn C� FAX `7 L '� -755 ' 6 _2Z 25
STATE LICENSE # a0 O _,� � -8r 3 3 EXP DATE -5 -
PROPERTY TYPE
❑ Sl?tGLE FAMILY/NEW CONSTRUCTION SIZE 166 "�
2rFAMILY TION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED111-WINDOWS
❑ BASEMENT FINISH❑ R ❑ DRAIN TILE
❑ DECK 41DING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW HOME CONSTRUCTION 0 Ag2i1IbN
❑ MAINTENANCE/REPAIR MODELING
DESCRIBE WORK BEING DONE:�yy y '� �c �c n� ��
� * SAO "x v0 ew
SIZE OF IMPROVEMENT
IZ14GTH WIDTH
HEIGHT SQ FT
ROOFING
NUMBER OF SQUARES
SP40USE ONLY
❑ HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
1. Existing Floor Plan
GARAGES
PROPOSED SIZE:
❑ ATTACHED GARAGE
❑ DETACHED GARAGE
2. Proposed floor plan
3. List of structural members to be used.
PROPOSED HEIGHT:
S10DQ
❑ Aluminum ❑ T
❑ Other ascia
FOR NEW CONSTRUCTION INCLUDING DECKS,
ADDITIONS. & PORCHES SUBMIT:
1. Site Plan/Survey showing the existing structures
and proposed project.
2. Two sets of construction plans
WINDOWS
3. Energy Calculations
IN EXISTING OPENINGSm ❑No LOCATION OF WINDOWS
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED -,NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUAT N, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 UBC FEE SCHEDULE)
TOTAL JOB VALUATION $ J 3 95O, 00 OCCUPANCY TYPE
Permit Fee $ See Back Page for Fee Schedule
Plan Review $ 65% of Building Permit Fee
Fire Surcharge $ .001 times the total job valuation
Surcharge $ .0005 x Permit Valuation Minimum $.50
License Surcharge $ $5.00 (State Licensed Residential Contractors)
SAC Charge $ $1825 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow $ ft + 6 ft = ft x $21 = $
Erosion Control $ $450 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ 4Agreement necessary ( ) Non Necessary ( )
Total Due $ • ,f Y, Make checks payable to: City of Fridle Attach Sti ulations
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
I hereby apply for a building permit'
I nowledge 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 Min sofa Constructio es; that I derstand 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 a Gordana with�th appy v an in the case of all work which re ' es review and approval of plans. / ��
SIGNATURE OF APPLICANT PRINT NAME , Z� DATE T I&
APPROVED BY DATE
Building
MECHANICAL
Permit No.: � D1a
Inspections
RESIDENTIAL APPLICATION
Re
763-572-3604
CITY OF FRIDLEY
Date Rec'd:
763-502-4(977 FAX
EFFECTIVE 2-19-09
DATE - -12" YOUR E-MAIL ADDRESS�GYe� C��� 1(10 anA dt C -C
SITE ADDRESS -1n-e—
3
THIS APPLICANT IS: ❑ OWNER ONTRACTOR
PROPERTY
N
OWNER/
ADDRESS: I ~L CITY ATOI IPU
`
TENANT
PHONE:(. L9?j5 ?Sc
CONTRACTOR
COMPANY NAM&D-ax
jeS e , r
CONTACT PERSON:
SUBMIT A COPY OF
YOUR STATE
STATE LICENSE # EXP DATE
LICENSE WITH
ADDRESS:V-0-n - ME \(\R--1-� CITY STATEI,/�
11 1GA
APPLICATIONPHONE,
-
FAX
❑
PERMIT TYPE
C JINGLE FAMILY ❑ TWO FAMILY TOWNHOUSE
TYPE OF WORK'
❑ NEW PLACEMENT ❑ ALTERATION/REMODEL
DETAILED DESCRIPTION OF WORKj� `� , %J'a4 1cit.,
" C"Ls(3 - 0'1
FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPTNOTED. FIXTURES: FDI E ..AL( 1I]�ER OF EACH ��/}�
(lam
Equipment Installed MFG: I(i MODEL: SIZE/BTU
MFG: MODEL: SIZE/BTU
MFG: MODEL: SIZE/BTU
A/C $25.00 _FIREPLACE (GAS) $15.00 _GAS RANGE/OVEN $10.00
AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00
FURNACE $35.00 GAS UNIT HTR $10.00
_BOILER$35.00
_CHIMNEY LINER $10.00 _GAS DRYER $10.00 _POOL HEATER $35.00
DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00
Number of fixtures @ $10.00 x $10.00 = $
Number of fixtures @ $15.00 x $15.00 = $
Number of fixtures @ $25.00 x $25.00 = $
Number of fixtures @ $35.00 x $35.00 = $
State Surcharge = $ .50
`S
(MINIMUM FEE $35.50 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 o ' ances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is
not a permit but only app 'cation 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 c4se of A work which re ires rv'ew d provalof ' ans.
(�C�
SIGNATURE OF APPLICANT T NAMFjl ebo_ ' DATE -y 1
PLEASE NOTE: Stl5ARATE PE T REQUIRED FOR BUILDING, ELECTRICAL AND MECHANICAL WORK
u City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 763-502-4977