2019-02076 ELECTRICAL*2019-02076*
ISSUED: 10/09/2019
CITY OF FRIDLEY
7071 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432-
(763) 572-3604 FAX: (763) 502-4977
Permit # 2019-02076
ADDRESS :645 67TH AVE NE
PIN :143024130070
LEGAL DESC :RICE CREEK TERRACE PLAT 6
:LOT 13 BLOCK 4
PERMIT TYPE :ELECTRICAL
PROPERTY TYPE :RESIDENTIAL
CONSTRUCTION TYPE :ELEC SERVICES, NEW
NOTE: CALL ROBERT CLAUSON AT 651-777-7885 WEEKDAYS FROM 7-8:30 AM FOR REQUIRED INSPECTIONS.
ELECTRIC PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE
ADD $1.00 T(MINIMUM) STATE SURCHARGE TO THE FEE OR IF OVER $1,010 MULTIPLY .0005.
INSTALL OUTLET FOR FIREPLACE ON AFCI PROTECTED CIRCUIT (EXISTING)
This permit becomes null and void if work or construction authorized
is not commenced witin 180 days or if construction or work is
suspended or abandoned for a period of 180 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 regulating construction or the performance of
construction.
Applicant____________________________Date________
Bldg Insp____________________________Date ________
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
AGREEMENT AND SWORN STATEMENT
OWNER
HAUGE CARROL K & MAVIS E
645 67TH AVE NE
FRIDLEY, MN 55432
FURTHER SOLUTIONS LLC
13098 GOODHUE ST NE
BLAINE, MN 55449-
(612) 600-8826
Minnesota State License #: ELEC-CA04564
APPLICANT ELECTRICAL PERMIT FEE 35.00
STATE SURCHARGE, ELEC FLAT 1.00
TOTAL 36.00
Payment(s)
36.00CREDIT CARD 9445