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P - 48361
From: unknown Page: 2/3 Date: 5/23/2011 9:31:05 AM I�uilding BUILDING p��-n►�tNa� � InspeGti�nS RFSITa:�+ N�"I:11L APFLI(;ATIQN iteceived By: :`_ . 7��-572-3G04 76�-502-4977 FAX C:ITY O�' F���X.,�Y D�,te Rec'd: ., l� ,:l�,�L�_ 11 V k: 1-�-21� 11 nn� � '.2.3 '�� ... Y�1t11tL'-MAILAllDRkSS, C�e7,�c�.'%��%�r�,r;,�s�i�a�c. r1�.� ..... �. . si� annRrss .. �G 3 f - .2�ve � .r'.�E�€ : .v_r ,f�e., r] c � l►' 'I'HlS Al'YLtCAN'1' IS: � OWNIitt �t:ONI'RACTt7R . -• -• • ••-••---__--- PROPERTY OWNER/ ynMli: MlcifAEc. , C'r2Y.17�4 � C�'R� r"r4 t� _ TENANT nnnRrsa; 4G � 1• .��v.�s s r� .....---- .... . � ...... .. . .N_�..... _.. Gl'�'Y�.��.Q.�L.�}� . . s�ea�M��m, �� i�tU►�t::.........._..�L.�..,3.r_Z..'. �7..:3� CONTRACT4R HnMr; ' xf1/C�_ �D„/AI�/ e /J��34C/�il .,� •ZGC. SUI3MIT A CpPY qf ---°°°�"'_ • / -- STATT 1dCF.N3Ii M �.E�4��f ,�.��_._ . L�:AI) CB:R7' NiJM411L[2 /�� ... f✓ ��I \ YUIJIt B'1'A'Cli I.1Ct?NSI: ' _ _._ .... ...._.... _./_�'� ��f � /D•��� Z�l✓ t� ► ANU L}:re�r�r�it�A�r� or' nui�x�ss; �'�i >- �'� €�, � y'�r T N,� .. cr�•Y_.�',�'�r✓Q,9!% . , s�nTSMN�ar � ��30 - ..J Yt�s�uttANC� ��rwh� ,�.eo • 9�Pu ��'93 . . ... . r�-- :��a- :. y :�t, �. �RnPERTY TYPE jq stntrr.F r•n�vr�r.vnarw r.c>Nx•ixuc_�ilo►v au,z Q'fWUNAMlLY/NNWCUNS'j't2U("fIQN $7't)lt]Ii$ ... ��RMLT TYPE ❑ nnnt'rT� �N D vnxnc;�r�Hev ❑ v�ni+nx�ws ❑ HA5HME?N7' FINlSH ❑ iLWl� O ll1�A1N'I'!!.G A U�:c[: ❑ 5I17INCi o nTTR;R O SWIMMINCr Pl�Oi. "M'Y�'� U�"WC�RK: o x�w rcc�.� roNS�rxvc.�noN ❑ nnn►a��N 0 ,wtNN'1'LNANC.IiAi]iLyA1K d R7'MQDAf.ING nFSC`ItUiliWt7RK}.ililNLibUN�; Brc��� 1��'�'i�,.0i'a� tx�sr:�/4 Frto�yT .srcar". ..:..._._ SI%ISfT1�IMi'ROVI?MT�T1T i,tiNCT'Ii WI1YfH '� Hf:ICiH'I' �t' ��1' �� 2 n t D 11UUSLi UNLY NUMl3L'1t U!+ SC�LfART4 n ir�ugr ,a. cnRncr sasfi��rr RF�nn�:�dNti !illtiMC1': ' 1. �xiating f+loor t'Vn 1;n12,�t;k.:t Ct Al"L'AC,HL�D GA1tA(i� 2. 1}�opnrcd tlaorplan PRQPf)9Ni) 9I7.R: p D!i'1'AC'lllill CiAKAtiL: i. I.ittt trt'ww�uu�l mcmA� to ba iacd PRQPORi'•.A1tb7CIiT; _..........._.._ �O� (��C' �/`�V�+UW� s�ninc /. 1'C�lt N� W CUNS'fRU(;'i1UN 1NCLUUINC nTC.i:R, O Via 1 ds„�it N)Di1'ION4. &. [Y' R'1 1tS 11 Pl': y 1. Site i'lanlSurn shawin the e�cix�in zlruL4arw� 0 Numinum ID'1'rim �� Y R �4 ❑ 011a.r � I'aecia xnd propoearl proju�. .._ ....••- • - :i. '1'wn acls of contruclion pLm WiN11(7Wlt 3. Arcrg,yGalaulatiom� !N 1iXI51iNCi UI'fSNINGS ❑Yc� �No LfJCA770N C71► WJNIX?W:S f Uli wIN[X1WS - PKOViAi: iJ•VALi� AND URI'Olt NlW ol>IiNINC�s-bliSCiit191, s�n: oi� MANi1TArT[JRT RT[[:TCrR ON WINi)OW. a�:Nn�c� c:irnxcr.s � � Txrc ur w[Nnow 1Y� �L �xs�rn�.a:u r�iuru;�:x ur• ww,x�w� ALL RLLS q,R� �ASF.D ON VA,i.[].AT.tiDN, INCLUDjNG TIiE COST QF LAHQR AND MATERIALS: Perinit Fec T'la�i Itoview ]'irc Surcliargo Sutvht�r�;u l.iccnax: 5cacharg� 3/iC C:liarge Curb (.`nt I :RCmw Lrosiun (:ontrol Purk Fe:� Scw�:r Mnin Chnr�c � T!-IE 1997 U.B.C'N'L� SC:H'�:UULE) OCC'UA. S�w 13uck 1'it�te ft�r F4v �u'chu�lulv �J��o ilf�j3WtI�1t1$ I�4T71111. F' '4C ,0()t timva ttw tcrleil jc�U vtiluuliun .0005 x F'c;rmi! Vatuation Minimum $5.(lU $5.(}U (5tate f.icensed ltesidential Lontractots) T223Q ��r 5A[: i)nit (Plans to MWC� 1«r dGlCnninutivn) �t+Gtt= tix$25=$ $45U Cunscrvntion Ylan lteview Fc.ro Dc;tvKmin�xi by inginc,�exirrg A,�recsnunt n��a;ssury ( } Nun Nccc��ury (' ) 141ake cNerkY navs►b!c ta: Cttv of �'ridlcv dttac 'i'HIti [S AN AI'1'LICAITUN NqR A 1'�+KM!'i'-NU'1' VALlll UN71L YiZCN'_.}„'SSY;U 1 hcr�:by upply for s buildin� perniit und i acknowlixigo lh:�l tho infoni�►utian nbovc is camplctc :md �accurAfc:; lht�l llu; wcnk will bc in ccmfarniancc wilh tht: <>rdinanc:cs nnd cud�� uf lha Cily nf Fridlcy ancl wiQi lhe Mintuasutt� (:unsR'uctiun Ccxles; I�lll� 1 UIft�1.'CSGlIl(� Q'll`3 L`J IIUT A pertit�it lyut n;ily ar� pppaicuiton t'os� n perYUit a�id wnrk ix t1at t�� sta�t witliout a permit �n sitc; that tlic work will bc in accordanco with thc spgro�rc.�d plan in the caso of a� rk�yv ' rvyuucs rtwiow avd a�pprov.ji �r pitmy. / SIGNATURII OI� API'I.IC'ANT A(i.t.�"'j ��" PR1N1' NAMI: ��R�41 �i t�o J�?N' ��A1•L .S-/„��!/ A�'Rc�VAI,1NSPi:c`T<�� 3r<;N ;f`t1I313r � � From: unknown Page: 3/3 Date: 5/23l2011 9:31:05 AM � , , � W�� , a ��: �Q c�a� ,� �HO�N� �43��6 2 �� DA'�'�E JOB