The URL can be used to link to this page

PRE 2010 DOCS0 • Village of Fridley, Minn. BUILDING PERMIT N? 1030 Office of INSPEM01%1 OF BUILDINGS �r Owner�e , ti Architect Builder '7LOCATION Street ' Ac Lot Block Addition or BUILDING a Of Lot DESCRIPTION OF BUILDING Front '` Depth ='` Height Stories t II! Manner of Construction' To be° used as - � {� ` �•• `:6` To beco��III}pleted ""f "''"` Estimated Cost _. .'`y�+�' rl��N%' �""-".�' .-4.��.'[4�r'..�_.,7' �•.�-{�h'�.: �i�._9r`,�e:_` k.w i Permit is herebygranted tors �. ' .., g- C. ._. to 4-z the building °'"` ' described in the above statement. This permit is granted upon the express' condition that the person to whom it is granted, and his agents, employees and workmen, in all the work done In, around and upon said building, or any part thereof, shall conform in all respects to the ordi- nances of Fridley, Minn., regarding the 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. c-�.,. Inspector of Buildings. AGREEMENT AND SWORN STATEMENT In consideration of the issue and delivery to me by the Inspector of Buildings of Fridley of the above permit, I hereby agree to do the proposed work in accordance with the description above set forth and according to the provisions of the ordinances of Fridley, and, being first duly sworn, I hereby state and say that the facts stated by me and contained in the above permit are true as therein stated. Subscribed ,and sworn to before me at Fridley, day o�_�. * �', .. A.D. 1LL • Minnesota, this Li V p • • City of Fridley, Minn. BUILDING PERMIT N® .7199 Date: Owner: Builder _ — Address Address CATION OF BUILDING No.1-6 IT-' Street Z6r� ' V- f' - - Part of Lot Lot _ Block Addition or Sub -Di on _ u Corner Lot , Inside Lot Setback Sideyard Sewer Elevation — Foundation Elevation DESCRIPTION OF BUILDING T)e U Front Depth Height L O - Sq. Ft. / Cu. Ft Fro t Depth Height � �_ Sq. Ft. Cu. Ft Type of Construction Est COO _ To be Completed In consideration of the issuance to me of a permit to construct the building described above I agree to do the proposed work in accordance with the description above set forth and in pliance th 21 provisions of ordinances of the city of Fridley. c� 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 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, Mnuesota 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. _ �\ NOTICE: ihb permit does net sever the sonmustfon, hrshlbtfen for wiring, phrmhhng, gas heating, Sewer or water. Be sura to we the Bnlldhig hopecter for Separate pormhs for these Nana. OWNER'S NAME ADDRESS ruu�aJ APPLICATION FOR BUILDING PERMIT CITX:OF FRIDLEY, MINNESOTA LOCATION OF BUILDING No. � Street / , _Part of Lot Lot Block.: Addition or. Subdivision Corner Lots_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 on.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 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 stated in this application are true and correct. DATE SIGNATURE (Schedule of Fee Costs can be found on the Reverse Side). tl 1. V 9418 CD S SUBJECT City of Fridley ;PERMIT AT THE TOP OF THE TWINS BUILDING PERMIT .12662 r EIPT NO COMMUNITY DEVELOPMENT DIV. I L INSPECTION r PROTECTIVE SEC. I � NUMBER REV. DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-560-3450 910-F15 g/5/?4 JOB ADDRESS 1525 - 75th Avenue N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 12 2 1 Spring Lake Park Lakeside SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Lloyd Dawson 1525 - 75th Avenue N.E. 3 CONTRACTOR MAILADDRESS 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 ❑ NEW ® ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 12' x 14' Addition to the back of the garage 9 CHANGEOFUSEFROM TO STIPULATIONS Install frost footings under addition SEPERATE PERMITS REQUIRED FOR WIRING, HEATING, PLUMBING AND SIGNS. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, Wood Frame 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 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 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 $890.40 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT .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- $5.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $5.50 SIGN TUfifiOFCON RACTO AUTHORIZED AGENT IDATEI Y W EN PROPERLY VALJDAD, IS YOUR PERMIT . (� 6-� ✓ O S % 91 -jw-ec— SP - DATE SIGNATURE VOWNER IIF OWNER BUILDER) (ATE)BL S APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME : 4h o` L a m& Q AJ BUILDER: .30- Mi! ADDRESS: % �� S— /�' V �� ADDRESS: NO:. �S�`f � STREET: %,S 7'A- AO IZ NA Z , LOT: % BLOCK: e2 ADDITION: X S Kk Pot� CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD: 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: (go- Q, Front: Ja l Depth: ) / Height: Square Feet: Cubic Feet: Front: Depth: Height: Square Feet; rr Cubic Feet: Type of Construction: Estimated Cost: $ -��• To Be Completed:` 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 stated in this application are true and correct. DATE:CL_ SIGNATURE: 17 (See Reverse Side For Additional Information.) . ��4. .,... �'e o•-��.: v�: Ate: �... r. ... �`7 a" .(!'.. Wg �.SE..� ... �� n.. �°.•� R t°'.. ....� T.�P' 4 �"° Yi y. .�I _:i .'.•. L•J ffi• a -J L lY .. .u.�J V..r� CiU\l♦ .Lv�� •:Gl.ty"'. a• y�% V.-.. 1...f... W.�\'.✓aUB t\Lv Jt.:. ate_.. 'a�.:r :.s°� �.., t��.� {N�nr as;s, �•�.e•. �i: *a.we�.;,. �::�VVV��^dAT. "^r?.'�' Im`r.-� �. M r L�ti.>d w.rrv:w:�f.v�`..;,i � '[qt ID CsWaoi.�+ 4-a`ti. �r 5:s• V' W Gily� PAvvs:TI,> L RATE SCI I'MU E GRAVITY W.FnM AM*: R � TO�� r.iramc• Sl:e.l & Duct Work ... ... ..... .. $10.03 $ Replacertert of rLrnact 6.00 $ Repairs & Alterations—up to $500.00 600 3 Repairs c:c Alterations each add. 3500.00 300 $ IMCM WA:*_m AM Furnace Shell & Duct Work to Ir0,00 BTU each add. 60,0;0 BTU . .. ...... Tt-r,1acmrnt of Furnace Alterations—up to $500.00 :L:r. irs & A ltera tion each add. $500.0 STFX-M or XOT WILY= =7_1-11 ..$1000 •$ Dost. of City of re.dley: The undersigned hereby 'makes application for a permit for tie worts hereat' specified. agreeing to do all work in strict accordance with the City Ordi:xa^.cer and ruling of the Depai tment of Buildir:gs, and hereby declares that all Me fad and representations stated in this application are true and correct. 3.W $ Owner 6.00 $ Kind of 6.00 $ Used-. as 3.00 $ F urr:ace Shell & Lines—to' 400 sq. ft. £.DR Steam x20.00 $ Furnace Shell & Line --to 640 sq. ft. EDR Hot Water 20.00 $. Each add 200 sq. h. EDR Steam x(h) $ Each add. 320 sq. ft. EDR Hot water 3.00- $ OIL BURN=—to 3 gal. per hcur 6.03 over 3 gal. per hour—See Free Schedule GAS BUMMER (up to 1✓9,G30 BTU) 3.00 g a.z 10,E =see F"txhgdule cits FIT a i 1M F -,7:z : VIO RATE TOTAL 1st 3 nxtures —_ x$ 200 3 Additlo-Jal Fixtures x .75 $_—•___ Gas Range to 19.3= z S.Go $ — State Surcharge .50 A1rZ Ca?;.T3' w iL` s 23 t � FAQ f+�9'�a�ivrims F16fl °si0r..a'1:3 P..1.1' `�LiaTYOic'8 8i BEF km TO T ZL FM i�� d - �o- •7 i To be completed about _ Estimated Cost; $ 21aa told New. wilding Permit No. por=it No. �S 13 C."lrMON O WOZZ EMIkTING or POE9 PLANTS—Stearn, Hot Water, Warta Air—No— Trade Name size No-; ' Capacityt, E. .----- — Sq. Ft BTU 'r^� 23.P Total Connected Load r Irfnd of y"et i BURNER — Trade Ila rrte Sire No Capacity aa,. Ft. Emit WHEY 1 tramsstiaat—ovaal $mid Sl1RI;!'rgAN A I r 8419 CENTER DRIVE . e iii 'OSI;;, IV1INN ROTA 55432" 1/ 01 SUBJECT PERMIT NO. City of Fridley 5100 AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. v -------COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-560-3450 910-F15 4/4/79 JOB ADDRESS 1525 - 75th Avenue N.E. 1 LEGAL LOT NO. BLOCK T5A 4%01 DDJT101�L p/ SEE ATTACHED DESCR. 12 2 oSF' Lakeside SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Lloyd Dawson 1525 - 75th A Amue N.E. 784-3690 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE X 8 DESCRIBE WORK Construct a 18' x 12' Addition to.Existipg Dwelling 9 CHANGEOFUSEFROM TO STIPULATIONS SEPERATE PERMITS REQUIRED FOR WIRIK WARNING HEATING, PLUMBING AND SIGNSm Before digging call local utilities TELEPHONE - ELECTRIC - GAS Etc. REQUIRED BY LAW TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. japed Frame ZONING SO. FT. CU. FT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT 216 2592 ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 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. $2.75 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $5,500 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- NONE STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $33.00 PLAN CHECK FEE TOTALFEE .25 $44.00 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) ydsID LOW ,ELR WH PROPE LY A I ATE )HIS J I-UZERM % SIGN�A�TUR.E� BUILDER) ATEI DGINSPOF�4E DATE 01 CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PERMITS (NEW, ALTERATIONS, ADbITIONS,' OR REPAIRS) t�WtiER: a f'1 h ®� D- w S 0 v BUILDER: fit w S® 4 e Address: L�'-�' �s-�1� 14#(- )�4. Address: /S'as- ? �'tJ�►U` AUL` Tel. No. -3 6 'F O No, s 1 Streets ZS—"4J-r ADDITION: A a Z S i Ol PC COMER LOT: INSIDE IAT: SETBACK; /"' SIDEYARDS: Applicatst 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; 1 a »� iy 6' o ►'� Fronts Depth: / ° Height: s r y Square Feet: 2 (a Cubic Feet: 422'1s Fronts Depth: Height: Square Feet: Cubic Feet: Type of Constructions ick 12Z 0 Estimated Cost: $ To Be Completed: )720 r 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 stated in this application are true and correct. See reverse side for additional rnation. DATE: z4f, SIGNATURE: Stipulations: ZI X'a.S.SZ = S, 5/2.3-L a. SSod PLAPJ c1 ;-� a. . _..... _ .. .._._. ..... _......._ .��.. _._._ :rte �' b MUM . -do 5a;ll SAX z 0 04P xv PURCHASE ORDER BY THIS DOCUMENT GOOD FOR PURCHASES UNDER $1,000.00 ONLY F 17297 THIS NUMBER MUST APPEAR ON ALL CORRESPONDENCE SENT TO US SUPPLIER Ad - Z,& -s &—SAIV/`LLL ADDRESS �a� 7E7/-1IJg- �� /L f L2 AJ S03 -Q , l!F CITY 1 OF PAIDLEY PHONE NO. S� - 6431 UNN. AVE. N.E. FRIDLEY, MN 55432-4384 CONTACTAT�RECE 612-571-3450 PAYMENT VOUCHER BY SIGNING THIS DOCUMENT BELOW I HEREDO AUTHORIZE PAYMENT AND THAT THE GOODS AND SERVICES HAVE BEEN RECEIVED OR RENDERED AND ALL CITY GUIDELINES HAVE BEEN FOLLOWED IN THE PROCUREMENT OF THE BELOW STATED ITEMS. PAYMENT AUTHORIZED BY ACCOUNT OTY. UNIT PLEASE ENTER OUR ORDER FOR THE FOLLOWING UNIT PRICE AMOUNT /®I -D c)9-Qo FOR,- . 4 (:�ojs ys� TOTAL c� THIS AGENCY HAS AGREED NOT TO DISCRIMINATE IN HIRING PRACTICES ON THE BASIS OF RACE, SEX, COLOR, CREED, MARITAL STATUS, RELIGION, OR NATIONAL ORIGIN AND HAS AGREED TO TAKE AFFIRMATIVE ACTION TO RECRUIT MINORITIES AND WOMEN INTO EMPLOYMENT. IT ENCOURAGES FIRMS AND OTHER AGENCIES WITH WHOM IT PURCHASES PRODUCTS OR SERVICES TO DO LIKEWISE. EXEMPT FROM SALES TAX AS A POLITICAL SUBDIVISON OF THE STATE OF MINNESOTA CITY OF FRIDLEY NO. 8030301 WHITE, VENDOR — YELLOW, PURCHASING — PINK, ACCOUNTING — GOLDEN ROD, DEPT. HD. City of Fridley AT THE TOP OF THE TWINS SUBJECT BUILDING PERMIT PERM _ 20252 r COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 ti..__ll.' �•� 612-571-3450 RECEIPT NO. S�� NUMBER 910-F15 REV. DATE 3/9/90 PAGE OF APPROVED BY JOB ADDRESS 1525 - 75th. Avenue N.E. 1 LEGALLOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. Pte 12.-15 2 Spring Lake Park Lakeside I SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Lee DeSantell 1525 - 75th.Avenue N.E. 780-2852 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 ❑ NEW ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 2V x 101 Deck Addition 9 CHANGE OF USE FROM TO STIPULATIONS See.notations on plan. All portions of deck 30 inches or more off the ground must have a 3611 high.guardrail with 6" maximum openings. 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 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT VALUATION $1,900 SURTAX $.45 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. $43,00 PLAN FEE TOTALFEE $43.45 �OFCONTRACTOR ORAUTHORIZED AGENT MATE) ��SIGNATURE WHEN P OPERL V 1 T THIS IS YOUR PERMIT SiGNA RE OF OWNER IIF OWNER BUILDERI IDATEI BLDG INSP NATE NEW [ ] Effective 1/1/90 ADEN] R-1 AND R-2 ALTS [ ] Building Permit Application Construction Address : Legal Description: I > Owner Name & Address: 0-e( 4 she " �� !� /� A c Tel. # Contractor: Te. # Address: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. D)Z<64 z•J k, 90)' 1' '.• x 13i LIVIIJG AREA: Length Width Height Sq. Ft. GAP -%M AREA: Length Width Height Sq. Ft. DECK AREA: Length �(�� a�� Width J 0" 0-" Hgt/Ground a1�" Sq. Ft. I ( 0 07MM: �icyc z IM,20 Corner Lit [ ] Inside Int [ ] Ft. Yd Setback Side Yana Setbacks Type of Construction: ILZI-fTh cc-)hn o Estimated Cost: 39 10 C Approx. Cmgpletion Date: ) 900, 00 Proposed Driveway Width If New Opening Is Desired: Ft. $ $ + 6' See Back Page DATE: �� APPLICANT: p�Q Q o Tel. # Permit Fee $ 43,00 State Surcharge $ ,u SAC Charge $ Driveway Escrow $ Park Fee $ Sewer Main Charge $ - $443 � STIPULATIONS: CITY USE DULY Fee Schedule on Reverse Side $.50/$1,000 Valuation $600 per SAC Unit Alt. "A" or Alt. "B" Above Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] 19U, P0=4" s OF awe W 11aA. Mo" �r�•r� Uurriv (o y AI AAe GP9AJ UJ` S o z8 �X Z % .Od Fm S ob I , il. C14'► U� Q I i I 6S ` I� / — r, • G I I ?50711-1 CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 Effective On January 1, 1991 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADD , � 4 0-,"- 3 - /Xv e - New Fixtures $ 7.00 The undersigned hereby makes application for a permit for the work herein Old Opening, New Fixture $ 4.00 specified agreeing to do all work in strict accordance with the city codes Beer Dispenser $ 5.00 and rulings of the Building Division, and hereby declares that all the facts Blow Off Basin $ 7.00 and representations stated in this application are true and correct. Catch Basin $ 7.00 Rain Water Leader $ 7.00 Z '1991 Sump/Receiving Tank $ 7.00 % Water Treating Appliance $10.00 Owner. Z e <' Water Heater -Electric $ 7.00 Water Heater - Gas $10.00 'Zp _.. Building Used As Gas Range $10.00 � Gas Dryer $10.00 Estimated Cost PERMIT NO. Back Flow Preventer Required ( )Yes () No Type $5.00 PLUMBING COMPANY Reinspection Fee $30.00 ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1 % of Value of Fixture or Appliance _ State Surcharge .50 5� TOTAL FEE $�- SIGNED BY Approved By Rough -In Date TEL NO.2 O ! —199�7 Final Date. o SuBJECTP NO. City of Fridley - 8 065 ` AT THE TOP OF THE TWINS BUILDING PERMIT • _ COMMUNITY DEVELOPMENT DIV. INSPECTION SEC. 77 r � � PROTECTIVE 1 ; CITY HALL FRIDLEY 55432 NUMBER _[Wi7 DATE PAGE Of APPROVED BY 612-571-3450 910-F15 10/1/98 F/ � 10B ADDRESS 11525 75th Avenue NE 1 LEGAL PLOTY T fE 1 / 102 BLOCK TRACT OR ADDITION SEE ATTACHED DEscR. 13 1 15 2 S r SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Jon Alexander 785-4035 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Owner 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 NEW ❑ ADDITION ❑ ALTERATION C3X� REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reroof house and garage 18 S Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment xsmust comply with the State Building Code. SEPARATE PERMITS ARE REOUIREO FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 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 1542 .77 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 $51.25 Fire SC $1.54 PLAN CHECK FEE ffOTALFEE 53.56 SIGNATURE�Cr-- OR 0 AUTHORIZE AGENT IOATEj 0/ WH P B G NSP TED' THIS ISYOUR 5E FATE ,GNATUREOF ERIIF NEA BU�E i 1 ATEA NEW [ ] ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: t .� S' �,� e IVC j )q-l`dl�-j n/ Legal Description: Effective 1/1/98 11�o U' �06 32- %- A I I a - Owner Name & Address: J®-;,, 2H -1Z;— Tel. # `ZST-1Ko3,r Contractor:,/ MN LICENSE # Address: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Tel. # 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:Iea.,- -R-Estimated Cost: $ Z!j�: Z Z 09 - (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: f 4 ! APPLICANT. Tel. # 71 5-t%03 CITY USE ONLY Permit Fee r $ �q Z 5' Fee Schedule on Reverse Side Fire Surcharge $ 1, ,` W .001 of Permit Valuation (1/10th%) State Surcharge $ .77 $.50/$1,000 Valuation SAC Charge $ $1000 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: $ 5-3.610 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. CITY OF FRIDLEY PERMIT N.: 2004-00874` 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 DATE ISSUED: 06/10/2004 (763) 572-3604 FAX: (763) 571-1287 REPRINTED ON 6/10/2004 ADDRESS : 1525 73RD AVE NE PIN : 123024140083 LEGAL DESC : JIM LUND ESTATES : LOT 7 BLOCK 3 PERMIT TYPE : BUILDING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : DECK VALUATION : $ 1,788.00 NOTE: SEE NOTATIONS ON PLAN. CALL GOPHER STATE ONE AT 651-454-0002 FOR UTILITY LOCATIONS. CONSTRUCT A 12'X 12' DECK STATE LICENSED CONTRACTOR 1 APPLICANT BUILDING PERMIT FEE PLAN CHECK FEE 63.15 41.05 ,SKYLINE EXTERIORS (20215480) 6491 ARTHUR ST NE FIRE SURCHARGE 1.79 FRIDLEY, MN 55432 STATE SURCHARGE, VALUE 0.89 LICENSE SURCHARGE 5.00 TOTAL 111.88 PAID WITH CHECK # 2655 OWNER KEPULIS ROBERT & EVA 1525 73RD AVE NE FRIDLEY, MN 55432 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulatingduct' n r the performance of construction. ` Appl' Date &-ro Bldg Ins p Date + SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. NEW [ ] CITY OF FRIDLEY ADDIS! [ ] 6431 University Ave NE, Fridley, MN 55432 ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: /:-)--d5- 73 f`-' � A"e- Effective 4/1/2004 (763) 572-3604 Bldg Insp (763) 571-1287 Fax Legal Description: Owner Name & Address: ®b�l� ��► ��-� j Z MTel. # Contractor. �{ �� — �` `�'"`� MN LICENSE # Address: Won 1¢�¢4cf' S �` �lc /� `7 Tel. # 15-3 Attach to this application, a Certificate of Survey of the j lot, with the proposed construction drawn on it to scale. V� 1 DESCRIPTION OF IMPROVEMENT LMNG •AREA: GARAGE AREA: DECK AREA: OTHER: Length Width Height Sq. Ft. Length Width Height Sq. Ft Length �_ Width Hgt/Ground Sq. Ft �„ "� - . - - Construction Type: Ac" �� Estimated Cost: $ � d - Bab Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x' = $ DATE: 6,' APPLICANT: ��1� ` J Tel. # 2 Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Plan Review Fire Surcharge State Surcharge SAC Charge License Surcharge Curb,Cut Escrow Erosion Control Park Fee Sewer Main Charge $ -� 9 $ ®ate Fee Schedule on Reverse Side 65% of Permit Fee .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1350 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 ( ] TOTAL $ jff q STIPULATIONS: Design #: 38224. 0 6/7/2004 C�—M—OP * * * Take this sheet to the Building Materials desk to purchase your materials. You have selected a 12' x 12' deck 6' off the ground. Below is a section of the railing style ani Pressure Treated Framing Material options you have selected for your deck. Horizontal Decking 7/4" x 6" Pressure Treated Deck Boards 36" No Post Spindle Railing 2"x2"x42" Pressure Treated Spindles, Beveled 1 E 2"x6" Pressure Treated Hand Rail Poured Footings 8" Tube 4' deep Premium Green Combo Drive Screws Galvanized Framing Fasteners 2x 8 Joists 211 x 8 Beams 0 SF Dec Live ve to P I (The posts shown in this luded tless railing type you selected!) Stair Widths: 36 , For Building Material's use only: 1441440720102090600050004048130200000001 Today's cost for materials estimated in this design with options: $847.43 *Base price may include: 40 PSF deck live load, horizontal decking, 2x6 pressure treated deck boards, pressure treated framing material, no stairs, 36° 2x4 railing, pressure treated railing per, and galvanized box nails. * (BASE price): $619.90 Joist Layout for Your Deck The Scala is 1/4" :1' Design#:58224 _ � L • � m Bmem mo � m O L 3 = .CO CD d ... s m _ � � o _ -'L-�� L v O L r m d -Q ._ L m �� W Mark length Description Usage ".2 A 11'9" 2x8 Green Treated Joist A A 1119" 2x8 Green Treated ledger B 11'10-1/2" 2x8 Green Treated Rim joist S m 0 12' 2x8 Green Treated Rim joist w Joists to be on 16" centers. Joists to be hung from the ledger with joist hangers. Joists to be toe -nailed to beams with 2-1/2" (8d) galvanized nails. /u W ;- Rim joists to be face -nailed to joists $ ledgers with 3-1/2' (16d) galvanized nails. _ = o Blocking and bridging is not shown, but may be required by your local code. = o _ E ae m m � l Illustration may depict options not included. Beam layout for Your Deck The tools is 1/4° :1' Design#:58224 Mark length Description A 12' 2-2x8 Green Treated Illustration Illustration may depict options not included. ,1k •popoloui tog suoi}do joldep Aew uoilei}shIll N W eseyrind 0;Jalgser e41 „911 Alt 01 sueld ese44 6uuq es"Id l I 9w I I 11911Z�68 Ll6b �►ZZss�#u6ise 1994S uoisuawid weeg Joe Isod CERTIFICATE OF SURVEY FOR: JAMES LUND °••'••Utility � Qt-alnage Easement F `��:� o 0 r.• pno Foun; Road N Easement Q7 �n o Denoics 'iron monumen-t No4e : Description invalid un-ki l p\cx* -n f fled Revise d to/z3/74 to show 'foundation — :3 W P "VE._" r DESCR1PTl01a pct 1, 'Block 3, Proposed JIM LUND ESTATE -S, Anoka Ca, M inn.. dJOWK COUKtr I hereby certify that this is a true and correct representation of a survey of Job No. the boundaries of the above described land and of the location of all buildings, if .any, thereon, and all visible encroachments, if any, from or on said land. 150 Suruey9r� Book —Page Land Surveying • Site Planning As surveyed by me this day of AW!A, 1914_.. Civil Engineering �p 11 — 66 8816 70th Av. N. (1 94 at Boone Av. N.) --- �'r'°" ''Q ge, .21AAA Scale Brooklyn Park, MN 55428 V. 40! Phone: 533.7340 Minn. Reg. No. 109A4 Building Inspections 763-572-3604 DX SITE ADDRESS _, THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION PERMIT TYPE TYPE OF WORK: MECHANICAL RESIDENTIAL APPLICATION CITY OF FRIDLEY ❑ OWNER COMPANY NAME:_ CONTACT PERSON: YOUR E-MAIL ADDRESS (CONTRACTOR Permit C4. k;1 r J75 li ATE /4 S of STATE LICENSE # EXP DATE f � ADDRESS: ICA00 Wsri �'� A -y N CrrY ��W �69Q STA PHONE %� c7 30,3 �� 3 FAX 7617—le- 3 — $5C)CI i(sLNGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE ❑ NEW REPLACEMENT ❑ ALTERATIONIREMODEL DETAILED DESCRIPTION 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 ) Labor cost under $300 = $15.00. Labor cost between $300 to $500 = cost of labor x.05 = FOR PROJECTS WHERE LABOR EXCEEDS 5500, FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: P DICATE TOTAL NUMBER OF EACH BELOW) —�,Q► q,r MODEL: Gl®A 9316 SIZE/BTU B�0d2® Equipment InsWIcd MFG: SIZE/BTU MFG: MODEL: MFG: MODEL: SIZE/BTU A/C $25.00 —FIREPLACE (GAS) $15.00 GAS RANGE/OVEN $10.00 AIR TO AIR EXCHANGEER $IS FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 BOILER 535.00 _LFURNACE $35.00 _GAS UNIT HTR $10.00 _CHIMNEY LITTER $10.00 _GAS DRYER $10.00 POOL HEATER $35.00 DUCT WORK $10.00 _GAS PIPING $10.00 VENTILATOR $15.00 Permit Fee $ +� Number of fixtures @ $10.00 x $10.00 = $ Surcharge $ .50 Number of fixtures @ $15.00 x $15.00 = $ TOTAL DUE $ Number of fixtures @ $25.00 x $25.00 = $ Number of fixtures @ $35.00 x $35.00 = $ `x P State Surcharge = $ .50 Total = $—.35-.40 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 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 ork w ich equires review�PRINTNAME_;�� approval of plansJJ �-�/�yy G SIGNATURE OF APPLICANT / `'O DATE �'G�/'"�D City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX 761-502-4977 JUN• -15-2004 16:49 FROM CITY OF FRIDLEY TO 3B3B500 P.03iO3 FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT, VENrCONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furnace, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes ( ) No( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes ( ) No ( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes ( ) No( ) The existiria combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes ( ) No( ) When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes ( ) No( ) When installing anew venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes ( ) No ( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes ( ) No( ) Appliance Tyne and Size/Common Vent and Vent Connector Information Appliance 01 TypeF 'f e� BTU Input ra 0®o Fan Assisted or Nat Appliance #2 Type1c BTU Input Fan Assisted or Nat Aiti � Appliance #3 Type BTU Input Fan Assisted or Nat Total Appliances Total Btu Input Common Vent Type Vent Height Diameter inches Appliance #1 Vent Connector Heightft Length ft Diameter ' in Type `ft Appliance 02 Vent Connector Height _eft Length Diameterin Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS: (Describe) CO:HEATING n—=O— 9;!kNN15C— aJSigned BY: M TOTAL P.03 C41. K9 Building $ BUILDING Plan Review Permit No.: Inspections Fire Surcharge RESIDENTIAL APPLICATION .001 times the total job valuation Received By: 763-572-3604 0005 x Permit Valuation Minimum $.50 CITY OF FRIDLEY $ DafMdit" 2001 DATE YOUR E-MAIL ADDRESS®``CilI��S� o SITE ADDRESS 17,"y e . fl—n 6 U QA ft + 6 ft = ft x $21 =$ THIS APPLICANT IS: ❑ OWNER CONTRACTOR $450 Conservation Plan Review PROPERTY OWNER/ NAME. �/ Fee Determined by Engineering TENANT r� n ADDRESS. 1152- .r J `"16� CITY U STA _ IP %z Total Due PHONE: checks Davable to: Citv of Fridlev Attach Stipulations CONTRACTOR NAME: -L S STATE LICENSE tl EXP DATE ADDRESS: I I OZ I$3 mr-7kdntl CITY 15IM N STATMIP SUBMIT A COPY OF YOUR STATE LICENSE WITH APPLICATION pHONE-7llaq `G41 FAX PROPERTY TYPE SINGLE FAMILY/NEW CONSTRUCTION SIZE ❑ TWO FAMILY/NEW CONSTRUCTION STORIES PERMIT TYPE ❑ ADDITION ❑ GARAGE/SHED INDOWS ❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE ❑ DECK ❑ SIDING ❑ OTHER ❑ SWIMMING POOL TYPE OF WORK: NEW ❑ ADDITION ❑ MAINTENANCEJREPAIR ❑ REMODELING DESCRIBE WORK BEING DONE: �n � (Gf �� t, fA.� j n At `j SIZE OF IMPROVEMENT LENGTH WIDTH HEIGHT Sq. Ft. ROOFING ❑ HOUSE ONLY NUMBER OF SQUARES ❑ HOUSE & GARAGE BASEMENT REMODELING SUBMIT: GARAGES ❑ ATTACHED GARAGE I . Existing Floor Plan PROPOSED SIZE: ❑ DETACHED GARAGE 2. Proposed floor plan PROPOSED HEIGHT: 3. List of structural members to be used SIDING FOR NEW CONSTRUCTION INCLUDING DECKS, ❑ Vinyl ❑Soffit ADDITIONS, & PORCHES SUBMIT: ❑ Aluminum ❑ Trim I . Site Plan/Survey showing the existing structures ❑ Other ❑ Fascia and proposed project. WINDOWS 2. Two sets of construction plans IN EXISTING OPENINGS 4Yes ❑No LOCATION OF WINDOWS 3. Energy Calculations OR FOR NEW OPENINGS -DESCRIBE SIZE OF OPENING CHANGES & TYPE OF WINDOW TO BE INSTALLED 611 d& NUMBER OF WINDOWS1 ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS: (USING THE 1997 U.B.0 FEE SCHEDULE) TOTAL JOB VALUATION $ 674a-.5. 06 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 $ (State Licensed Residential Contractors) SAC Charge $ $1675 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 $ Agreement necessary ( ) Non Necessary ( ) Total Due $ L4 11 15Make checks Davable to: Citv of Fridlev Attach Stipulations 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 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 wor�chre revs andnapprovalAof, plans.r��rSIGNATURE OF APPLICANT/ 1 M 11 //B M/T/I�tAMN� 0 W IV f /4f W-1 IIA11TR �a Building PLUMBING Permit No.: Inspections RESIDENTIAL APPLICATION Received By: 763-572-3604 CITY OF FRIDLEY Date R ° 763-502-4977 FAX EFFECTIVE 1-1-2010 DATE 'I -OC" ( SITE ADDRESS _ THIS APPLICANT IS: PROPERTY OWNER/ TENANT MAIL ADDRESS J 0 OWNER ' ' WONTRACTOR ADDRESS: CITY STATE ZIP. CONTRACTOR NAME: Champion SUBMIT A COPY OF STATE LICENSE # # 617701 GAA EXP DATE YOUR STATE LICENSE, BOND AND STATE BOND # 651-365-1340 EXP DATE CERTIFICATE OF ADDRESS: 3670 Dodd Rd. CITY STATE ZIP INSURANCE PHONE r-agan, MN 55123 FAX PERMIT TYPE TYPE OF WORD: &SINGLE FAMILY 0 TWO FAMILY 0 TOWNHOUSE 0 NEW D,REPLACEMENT DETAILED DESCRIPTION OF WORK FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW). MINIMUM FEE $35.50. BATH SINKILAV _FLOOR DRAINS _ SHOWER _ WATER PIPING WATER SOFTNER ($35) BATHTUB _ GAS PIPING (NEED CITY LIC) KITCHEN SINK _ SWIMMING POOL WATER CLOSET _ BACKFLOW PREY. ($15) _CLOTHES WASHER DISHWASHER _ LAUNDRY TRAY _ _WATER HEATER ($35) _ FOR IRRIGATION - - WATER METER -OTHER 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 on site; that the work will be in accordance with the approved plan in the case of all^ork wc1 re res review and approval aof plans. A SIGNATURE OF APPLICANT City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977 010 y_NssEkD