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P - 39915From: unknown Page: 2/2 Date: 8/23/2011 2:30:45 PM Buildin� ��iT���'i�TG pe�t rto.: 2.� i C`�. l InspcctiQns �ESI�ENTIAL AI"FLICAT�UN zteceiV�d,By: �`�� " 7��-s7z-��o4 CITY �F FRIDLEY z��.t�i��B; A��_2 2�1 7��-�a�-���� rAx �� �-�-�x� DATE � �J { � YOUR �MJ�II. ADDRE33 ST't� ADDIiESS � 7"Ei�S A;PPt,TCAN"I' IS: 'T'�NANI' SUBMI7 A COPY OF YOEJ�L 5'Ft'17E LIGi�tSE AND CE�'�FICATE OF INS[7RANC� PIZU,Y.k:At'1'Y '1'YYLr I7 O�NER STATE L[r_ENSE a, nnn�ss: �9DR �'SLNGE.� FAMILYlNEW f] TWO FAMILYlNEW CC ❑ snsr-.�rrr rir�ce�r �oaF ❑ 1?�CTG L� 3�1]ING c:��t�r �s-�, a.�y LEAD CEl2T �� -�-y�'�'X FAX _I_�� `�� 5I7F STOR7F�5 n wrr�mows o nxnar x� ❑ P'IT�ER "1'Y.P� Pk' RTORK: ❑ NEW FIOME CUNSFRUCT[Ot�I O AnTliiTf)N �"'1CdAiNfElvAlvC.��PnlR � R�MOA�NG D�sCRi�E wORiC BETlv� noN�r: bA�.� sr, � vr• nvv�xOVY.nn�N � LENGTH WIDTH ��+� F 5QUARES � ��ffOLISE dc GRRaGE PROPf3SFT� SIZH: ' ❑ D�'A,CHED GARAG& PRQPOSFfi �IGHT;�� fl�'� ❑ Atumiimm 0 0�� Ar[N,�,�I _QW'S IN�.YTSTINGOPF.N1NCi5 �Yw ONo �R F48. N�w�a�m.tG�-�S3c�t�t& SS7,fi O� �3FE�;G GHANGES � Per.r.rtit Fce Plan ki,�wiew Firc Surchax�e Surchar/�c License Surci�ge SAC Ck�arge Curb Cut Escrow FroSion Co�mn1 Park Fee Sewer Main Charge flso,�t a �hm, ❑ x�a� LOCATI�2v OF W�1ppWS • vA.l�UA� i'iOPi. iI�TCLTlI)i11TG TRF. [�nS'�' UF (i'fSING T�[� X997 i7.S.0 FEE SC�ELI�ULE) rin BASEMENT lt`Ftwc��P.r txc. ctmurrr- t. F„�Cia4id�floori'lan 2, Pf+o�oeed tIoor pl�n 3. • Liac of atrnatara2 mr.eth�re tn be uecd �'OR NE41 CONSTitUGi'�iDN INCZUI7�NG D��S, I Sitsl'liu/Sorvey�fosvLtgthe'<arietingxctuet�t� �a �;�a p,,,�.�. Z, Two ads o�oo�traction pluu 3. Emecgy CalcnTatio¢is FOR WiNDCyWS —PYtOVLLI� U VAZ,t3E AND M�WZJFRCxL1RE3ITldCLKUN W1N1X3W. A.1YD Pagc for �cc ',a'phcciule - - $ ' ,y_ 65% of $uildi�g Permit Fe.c $ .� ; .00I times the tatal job valuetian � _ c' .00tn x Permit valuauon Minunum �S.Od � ' $S.dO (5tate Licensed Residentiai Coritractors) $ $223b per SAC U�xit (Plans io MWGC �oi dcYermmation) $ #i�+ 6 ft = _____�—� ft x $25= $__. � $450 �onse�vation Pia� kZGwiew $ . . . Fe�e Dete�n�d by 'F'xtgirteerinE � A,grcement �ecessa�Y ( i Non NecessstY ( ) THZS [s AN wPFr-t�A7iON Fvn A k�lth�iT NOT VALID i.fl3�`l7, pR0(�3SED I k�ereby app�y for a buiidi�g pemlit and I ac�owiedge that the i.z�'oimation above is enu�plete and accu�ate; t'hat the wark wi� be im confvrmaace with the o�rdinances and codes of the City of Fridley and wifh the Iviisvo�esota Constzuction Cod�es: tbat I undexstan� tt�is fs n�n s peranit but c.aily aa applicatio� ;Cor a pesmit a�d vvbrk is not td sta�t �+vithput a permit on azte; that the wqXk will be i�ll �otd�E,ttCe y�rltt� �i¢ appraved p�an ia the ca� of���work ' c �es s+eview aud approve� of SfGNA7'[1I� bF APPI.ICANT ' ' FRIN!'NAME���Y1 � �I}ATF � l% Ai+PROV Ai tta�.r_.TnR SI A , _