P - 42213From: 6128277351 Page 2/3 Date 7/7_O/2U1 Q 1 1 43 29 AM
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Buildin� B�.TI.LDING
Inspecti.ons I�E�II7��+ NTIAI� APPI,�ICATI(��Y
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7"63-502-4977 FAX �r•�crivE �-�-ao�o .
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O MiTACFTED CARAGE
O F�'I'ACI�?n GARAG�
f�$pffit
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LocA'nar� oF wwnows
OPENIN NU14IIi�R.OF WTNllUW`�
TygL pF W1Ni)�W TO SE [NSTALLED
AI.L F�ES ARE BAS�D� ON VAI.UATION, li�1CLUDING THE COS'Y' (�F
(US1NG T�iE 1997 U.S.0 FEE SCT�DULE)
��gW[gATf R�MODELtNG SUpiML�
1. Fxiaring Flaor Plan
2. Prnposcd floor pinn
3. LiSt ot strut:CUfAI meltDbOrs ta bC u9ad
POR NEW CC1N1S'TRL1Cf10N INCLUD[NG DFC1fS,
A.�T7f & CH NtIT'
1. 5itc P1unl3tuv�7' ShowmB the exi�.iag structuro�
m,d proyos�l Pxu.iocL
2. Two sets ofev�rion plans
3. Ersergy Celculsttor�n
FOR WINUUWS -PRd'VID� U-VA1.UE ANA
MANUFACTUkE S'i7CKER ON WINDC7W.
AND MAT�RIAi„S:
'Q'TAl,, JOB VALUATIQI�I � � v - - - - -
Permit Fee ffi '�' See Sack P'ag� for Fee 5cbedule
plan Review � _ 6�% of Building Pecnrtit Fee
Fire S�'eha�e $ f „� -001 dines the tatal job valuation
Surcharge � �. .Ob05 x P'ermit'Vatu�atian Minimun� $5.00
License Surchar�e ,�„ $ `'r $5.00 (State Lic�sed Rcsidential Conu�acturs)
�,u� ,�,/� $,-Z2 �. S—�2100 per SA� Unit (F'Is� ta MWGG for detert�tinstton)
M/4� fj+dft= ftx$24-$
Curb Cut Escrow �Ff'Z $ $450 Conscrva�on Plan Keview
Erasion Con�ol $ �.� D��� �, ��,cenng
Park Fee $ � Non Necas
S�wer Main Charge $ A ent necessary O �5' O
$ t Attnc6 Sti ulallons
Total Due Nlake ehecics a �tble to: Ci oi Fridlcly� ��„_.��
77i15 4S AN AiyP'LICATl01`i r`OR A f'ERM1T-hiOT VAL113 UN'ff1- PRi}�ES3ED
I hereby apply for s buiiding pernut and I acknowledge that the infotYnation above is eamplete and acciu�te; that the work wiil be in
eonfic►rrnar►ce with the ordinat7ces and cr�des of t}�e Ciry of Fridley and with tho Minnes�ta �onstTuet�an �odes; thaf I underst�d � is not a
permit buC only aat appf'ic�tiott fnr $ ' and wor is not to st�ut without a permit ov site; thaAt th� work wn'll be in accocdance wit4 the
arrroved flan in the case of all work which ires vlew and �pPi'�V�i a
e� rxmz N�� ri.f�w �--- DATE: %
SIGNATUItE OF APfrE,FGANT kC _ . � � - - - _f.R�..