2019-02117 MECHANICAL*2019-02117*
ISSUED: 10/14/2019
CITY OF FRIDLEY
7071 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432-
(763) 572-3604 FAX: (763) 502-4977
Permit # 2019-02117
ADDRESS :129 HORIZON CIR NE
PIN :233024330034
LEGAL DESC :CARLSONS SUMMIT MAN NO ADD
:LOT 4 BLOCK 4
PERMIT TYPE :HEATING - FIXTURE BASED
PROPERTY TYPE :RESIDENTIAL
CONSTRUCTION TYPE :FIREPLACE
NOTE: INSTALLING GAS FIREPLACE
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
DZUBAK JOSEPH JAMES & MARY
129 HORIZON CIR NE
FRIDLEY, MN 55421
A.M. CONTRACTING LLC
3870 143RD AVE NW
ANDOVER, MN 55304-
(651) 352-3855
Minnesota State License #:
GAS-MB761130,HVAC-IR742102
APPLICANT FIREPLACE GAS INSERT 35.00
STATE SURCHARGE, MECH FLAT 1.00
TOTAL 36.00
Payment(s)
36.00CREDIT CARD 9055 02117
CITY OF FRIDLEY
7071 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432-
(763) 572-3604 FAX: (763) 502-4977
ISSUED: 10/14/2019
Permit # 2019-02117
PERMIT APPLICANT::ADDRESS 129 HORIZON CIR NE
A.M. CONTRACTING LLC233024330034:PIN
CARLSONS SUMMIT MAN NO ADD:LEGAL DESC 3870 143RD AVE NW
LOT 4 BLOCK 4:ANDOVER, MN 55304-
HEATING - FIXTURE BASED:PERMIT TYPE
(651) 352-3855RESIDENTIAL:PROPERTY TYPE
FIREPLACE:CONSTRUCTION TYPE
BUILDING INSPECTION RECORD
24 HOUR NOTICE REQUIRED FOR ALL INSPECTIONS.
CALL FOR INSPECTIONS WEEKDAYS: 8 AM TO 5 PM
INSPECTORDATEINSPECTION TYPE COMMENTS
GAS PIPING/AIR TEST
FINAL
INSPECTION COMMENTS:
IN ACCORDANCE WITH CITY ORDINANCE, NEW OR SUBSTANTIALLY REMODELED BUILDINGS SHALL NOT BE OCCUPIED UNTIL ALL
WORK HAS BEEN APPROVED, AND A CERTIFICATE OF OCCUPANCY HAS BEEN ISSUED BY THE BUILDING DEPARTMENT.
THIS CARD MUST BE POSTED AND VISIBLE AT ALL TIMES UNTIL WORK IS COMPLETE.