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P - 39914�uilding Inspecti.ons 763-572-3504 763-�02-4977 k',A,� n�.z� . _ �r��,,, SISE ADDRFySS �: THIS APPLICANT iS: PROPERTX t��i z�rr,�v'x' SU$MtT A COFY C1F XOUR S?E1.'T'E LICF,NSF. AND C�RIIFiCATE OF INSUR.AIQCF Frorn: unknawn Page: 2l2 Date: 8l19(2011 2:56:05 PM ����1\ � �sT���r� ��px�ar��Tlo� CiTY OF �'�L�Y 7ravR E-rAart. n�pD�F�s � ' Y� � O OVGIV�R �ONTRACTi�R u�: � ���. .+� ann�s : 5 �� tj�' `� N� �xorr��: 71� �?Z.- $11�a rra�: .,�a�e._ (`'�o�aM, Co�tt : �s`` STATE i.TG�NSE ���}}����T% --- l�n�.�$�: c./ � V � { � 1. . .... . ��� �rot���'o3 231-(��5-�`..* `"���" NGLfi FA,NIIT.XlNSW 4^ON$Tli2JC1ION 4:1 Two FAMIx.X1NE� CONSTRiT4"�ON � AD}JITiON 0 GAR.A.GElSE�U CI BASEMENT FII3ISkx £1 ibOOF O DECK ❑ SIDI23G CI NEW b�.SGRIHE WORKS�IAiCi �� QF SQUARES � � Sr'`rr... :� F3zOP4S� SIZE: �t,oPasEn i��r; � o v�yi � ����e.�13� ���� � • I�i FJQ$TR«TC (�'ENiNG3 GY"c� C]No C�R FOTt NEV� OPEN(NGS-t�ESCRIBE SIZE OF tVP�N!]uEs' C:tiANCst5 dY AL�, Permit Fee Ylan RCVi�Vv �irc S�ur.ha,ge Surct�arge License S�cbarge SAC Ck�ar�e t`ix� Cut Esci+ow Eros�otl ConSsol P�k Fcc &nvrr Mais� Chargo . �'13dU5E ONLY G HoUSE & GARA�E � /k�'I'AC�tik.`!] tiAliACik G I?ETAQi�A GAIiAGE l9�'offe �m [� aa LOCATION OT a+II�1DC1W5 t� DRAIN'm:A O' OTHE� Permit No.: 2 G � � ' � �j� Re+ceived $y: �ate ��'�� � � 0 BA3Er+f�.�RHh�C1DFLING SC18MIT. 1. ExistingFloorPlWf 2. Propesutfloo`phn 3. Liet of s�uc4aal m;cmEeta W ba med FnR f+tPi�r �ONSTRi�LlaN �`CLzJAA�IG BECiiS, i. s;�e �JSuevey ehowvag �he exiatmg strucd�es �a ��;ea �;�c �. 'two aets at oa�tror#iop gt�e 3. Bnc�y (;elcalationK Fc7R WINDOWS —Pi€OVIDE Li-VALUE A1+ID ..._ MANI:JFACTLTtF.:iTf(zcF.R AN W1nv.�1!_1W, NUM$ER 0� WiND05V5 ALVA'TiON, INCLUD�iC T.1� C43T o�' , suv� z� i��`u.�,c ��E se��u�Ej r See Back Pa�e fox Fee Schedute GS% a�' Btuldi� Per�it Fx _, .001 �nes the totaT job valuation _ Mtt� x Pcrmit V'a�aurtioa Mix,�ro,�.[�n �S.pp _ $S.Of? (State L�censed Resi�tisl Go�aetoTS) �$2230 per SAG Unit (�ans to MWCC for detern¢iaatioa) � _ fttCrll� Rx�25=$___ �Sd Cansetvation Plaxlt R�.wiew ,� Fee D�ete� by �aginCaing _ Rgrecntcnt necessary ( ) N� Neccssary ( ) a�IIS IS AN .4PF�JCATIC}t�f F4R I�. PF.xnarc Nt1T V az.fn i�Niii �ssEn - I herebq apply for a buiIding permit a�d I acknowledge th�t tve infox�umtion above is complete aund ece�uate; that d�e wo�c wwill be in canlFormanc� with #t�e or�duranc�s and codes of the Ci��tyy of Fridley a.nd with ttie Minnesota Canstn�a�icm Codcg; that I umderstan� tius is not a permit btit anly an appliCatinn f�r a�e�iitt Ai�d worlc is t�ot to s'tart without n perm.it aa sitc; that the yv�ork wi11 lym i�A a,,�-c�d� �,v�� � �ppio�ed pian in th€ Case o work q��u�es s�vi,cw and approvai ai p s. S[GNAT'URE OF A,PPS.IeAIvZ' " __ PRxNT NAME�Q.+V�n .� DA'FE APPROV,�,i, IN$pECTtyR SiG A A • - ��