HomeMy WebLinkAboutResidential Permit Card with Standard Notes (392) BUILDING INSPECTIONS DEPARTMENT PERMIT NUMBER: PR23-000248
7071 UNIVERSITY AVE NE
FRIDLEY,MN 55432 ISSUE DATE:
PHONE: (763)572-3604
ADDRESS: 516 67TH AVE NE
PERMIT TYPE: Plumbing Residential Permit
PROPERTY TYPE:New Installation
CONSTRUCTION TYPE:New Installation
VALUATION: 0
NOTE: PLUMBING WORK FOR NEW CONSTRUCTION.INSTALLING THE FOLLOWING FIXTURES:Bath Sink/Lav,
Shower,Other Fixture r.CALL FOR FINAL INSPECTION WITHIN 10 DAYS OF WORK COMPLETION.
APPLICANT PROPERTY OWNER
Jeaneth Brubakken MAJOR,TREVOR J
519 67th Ave NE
Fridley,MN 55432 516 67TH AVE NE
763-670-4986 FRIDLEY,MN 55432
PAYMENT INFORMATION
Description Total Cost
Permit Fee 3.5.00
State Surcharge Fee 1.00
TOTAL 36.00
Payment(s)
Credit-PR23-000248-8870491770iL1/z36
AGREEMENT AND SWORN STATEMENT
This permit becomes null and void if work or construction authorized is not commenced within 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: 06/14/2023
Bldg Insp Date 06/20/2023
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
CITY OF FRIDLEY
7071 UNIVERSITY AVENUE NE ISSUED: 06/20/2023
FRIDLEY,MN 55432
(763)572-3604 FAX: (763)502-4977 Permit#PR23-000248
ADDRESS : 516 67TH AVE NE PERMIT APPLICANT:
PIN : 143024130054 Jeaneth Brubakken
LOT 9 BLK 7 RICE CREEK
LEGAL DESC : TERRACE PLAT 4,SUBJ TO 519 67th Ave NE
EASE OF REC Fridley,MN 55432
PERMIT TYPE : New Installation 763-670-4986
PROPERTY TYPE: New Installation
CONSTRUCTION TYPE: Installing bathroom in
basement
NOTE:
NOTE:PLUMBING WORK FOR NEW CONSTRUCTION.INSTALLING THE FOLLOWING FIXTURES: Bath Sink/Lav,
Shower,Other Fixture r.CALL FOR FINAL INSPECTION WITHIN 10 DAYS OF WORK COMPLETION.
BUILDING INSPECTION RECORD
24 HOUR NOTICE REQUIRED FOR ALL INSPECTIONS.
CALL FOR INSPECTIONS WEEKDAYS: 8 AM TO 4:30 PM
Inspection type Date Inspector Status Comments
Plumbing Rough In David Jensen
Inspection
Plumbing Final Inspection
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.