2012-00474 FIREPLACE
CITY OF FRIDLEY
7071UNIVERSITY AVENUE NE
FRIDLEY, MN55432-
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ISSUED:04122012
(763)572-3604FAX: (763)502-4977
Permit #2012-00474
4527 2 1/2 ST NE
ADDRESS:
PIN:263024330095
LEGAL DESC:REAR BL 13,14 & 15 PLYMOUTH
:LOT 10 BLOCK 1
PERMIT TYPE:HEATING - FIXTURE BASED
PROPERTY TYPE:RESIDENTIAL
CONSTRUCTION TYPE:FIREPLACE
NOTE: INSTALL GAS FIREPLACE W/GASLINE
HEATALATOR NNXT3933I 27,000
FIREPLACE GAS INSERT35.00
APPLICANT
STATE SURCHARGE, MECH FLAT5.00
FIRESIDE HEARTH & HOME
TOTAL 40.00
2700 N FAIRVIEW AVE
Payment(s)
ROSEVILLE, MN 55113-
CHECK20345140.00
(651) 633-1042
Minnesota State License #: 08719970
OWNER
THOMPSON JOHN & CAROLYN A
4527 2 1/2 ST NE
FRIDLEY, MN 55421-
AGREEMENT AND SWORN STATEMENT
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.
CITY OF FRIDLEY
7071UNIVERSITY AVENUE NE
ISSUED:04/12/2012
FRIDLEY, MN55432-
(763)572-3604FAX: (763)502-4977
Permit #2012-00474
4527 2 1/2 ST NE
:
ADDRESSPERMIT APPLICANT:
PIN:263024330095FIRESIDE HEARTH & HOME
LEGAL DESC:REAR BL 13,14 & 15 PLYMOUTH2700 N FAIRVIEW AVE
:LOT 10 BLOCK 1ROSEVILLE, MN 55113-
PERMIT TYPE:HEATING - FIXTURE BASED
PROPERTY TYPE:RESIDENTIAL(651) 633-1042
CONSTRUCTION TYPE:FIREPLACE
BUILDING INSPECTION RECORD
24 HOUR NOTICE REQUIRED FOR ALL INSPECTIONS.
CALL FOR INSPECTIONS WEEKDAYS: 8 AM TO 4:30 PM
INSPECTION TYPEDATEINSPECTORCOMMENTS
OK 2 30 LBS
GAS PIPING/AIR TEST04/17/12PDAVE
FINAL08/22/12PDAVE
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.