2019-02296*2019-02296*
ISSUED: 11/01/2019
CITY OF FRIDLEY
7071 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432-
(763) 572-3604 FAX: (763) 502-4977
Permit # 2019-02296
ADDRESS :6361 PIERCE ST NE
PIN :133024310025
LEGAL DESC :DON ADD
:LOT 4 BLOCK 1
PERMIT TYPE :PLUMBING - FIXTURE BASED
PROPERTY TYPE :RESIDENTIAL
CONSTRUCTION TYPE :VALVE REPLACEMENT
NOTE: CALL 763-572-3566 TO SCHEDULE SHUT OFF.
CALL FOR FINAL INSPECTION WITHIN 10 WORKING DAYS.
REPLACE VALVE FOR 2ND FLOOR GAS STOVE
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
NELSON JEFF & CATHLEEN
P O BOX 131
WYOMING, MN 55092-
HOMETOWN PLUMBING AND HEATING
2440 152 LN NE
HAM LAKE, MN 55304-
(763) 755-6886
Minnesota State License #: PLBG-PC643882
APPLICANT VALVE REPL FEE, RESI 35.00
STATE SURCHARGE, PLBG FLAT 1.00
TOTAL 36.00
Payment(s)
36.00CHECK157102296
CITY OF FRIDLEY
7071 UNIVERSITY AVENUE NE
FRIDLEY, MN 55432-
(763) 572-3604 FAX: (763) 502-4977
ISSUED: 11/01/2019
Permit # 2019-02296
PERMIT APPLICANT::ADDRESS 6361 PIERCE ST NE
HOMETOWN PLUMBING AND HEATING133024310025:PIN
DON ADD:LEGAL DESC 2440 152 LN NE
LOT 4 BLOCK 1:HAM LAKE, MN 55304-
PLUMBING - FIXTURE BASED:PERMIT TYPE
(763) 755-6886RESIDENTIAL:PROPERTY TYPE
VALVE REPLACEMENT:CONSTRUCTION TYPE
BUILDING INSPECTION RECORD
24 HOUR NOTICE REQUIRED FOR ALL INSPECTIONS.
CALL FOR INSPECTIONS WEEKDAYS: 8 AM TO 5 PM
INSPECTORDATEINSPECTION TYPE COMMENTS
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.