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P - 45133BuiXdi�g �s�ections ��3-��z-3�t�4 7�3-5�2-4977 FA� A,fs,'�,� 1 c.�.:? STiE ADIIIL�SS �r�ts n���;tc� zs: From: 7637834566 Page: 1/4 Date: 10/20/2011 2:24:36 PM P`LU�B�NG ���m�t No.: � �+ S�D�+ NTIAL AP�'X..�ZCATION R.eceived �y_ CTTY C1�' ��LEX �ate�c�:J Y�UR E•iv�P�Lt, ,AQARE55 �'OWN�R �CQNTFtACTOR i � �-� 4WNEIt/ I eURT�1(�SS: cz�x . s�R� zre "X"�N:A.N'x' � PHttiN& $U�MIT ,0. CIiP'Y OF STATE LICEA151E �; YC3UR STA7E LxCE�fST, F3i�+113 AND 5�`A'fE 8(7x.tA #� c��,�zca-r� taF an��ss: �'--1,'"� rrrs�r,c� _.._.._ —4 f _ } P�FtMYT �'Yk'� � �GL��t+Mtt,�t x�x�� a� wo� � o rr�w 1?E'�'AII,ED DBSCRIPTIC7IV aF WO1.�C e v �rwo �,�u.�r � �er.�c� �iCF I?AT1a"s _ �F DATE ��i GiTY �+-1 Cw. tmt+,� ` ��x �'� � g � p TOwN�4tJSE FEE3 AlRS BtIS� Q�I $ t 0.b0 PER PULTURE, FJEC�SF''X' W�E�:£ t�tt)TED. FI7{TtrRES: i�"FAIC�1.'I'G TOTAL NUMEER OF EM,CIFX ��.I.OW ), M11�tIMUM FEE 533:54. ,�, BATH S3NK/LAV kll.t�R ISRA7N�w SHOWER .,_ WATER PIPINQ �s�rr•rru� � GA5 PJPTNG (N�D Ci7'1' LIC) � swrn�mrntc r�wL waz�z sor• rt��t 4a�s3 i c�.trr�ES wns�t _,_, �t�'CI�Ert stKtc _ wn-r�c c�os�x .� a�cx�c.aw ��xv. {�1 s� Bl$HWASHER � LAUNDlZY 7RA5' _W AIER HEAT�t E$35) Fc�R iRRIC3Ai'IOi',1 _ W ATE.Ih NLETER U'�k1ER ; _ ... . Tdusnbec of `Sxtwes (� S'��p.at� � x $10.40 � $ . �� . . . . • • . . Ni�ztbcr of �t:etiues � $15:OU ,�,,,,;,,�, � ��S.t3D = � : � .. . _. , .. . . � . . � . . . �tw�,ber. of �xtures'(�, 535.90 „_,,,,,,; x $3S:�QO g �S ' � • . , . ' . Stax� S • . . ' • . ,� . � � .. . . , • ... • ,•.. �T :� : . '�.�' � . . ' . . �• . . . ., ... .. , . .: , . 'FFi?S iS AN t1PPLiC�l�t3�d fOxt.A, R�R1�4FF NOT VALID [TN'��. J?xt,�SS�A I her+�by apply fc�� � pltetntbl»g permi� agd actrnttwledge ths�i ihe pz��'o�rta�ito�n above is t�mplete and accwrate: t�►at the wor'k will b� i� oontbrmance with th� o�di�aa�ces codes �'ridley �d witt� the I�riitrna� Const�vcti�aia C�des; t}� I��d t�.is is nac a pernnit but on,#y ain� app ' ..p ' w as not ta staet without � perrnit gn sz�e; that the wc,rk vvi11 ba in accorda�,ce wi#x the a�s�roved plan irt tFte as rcvieiv and a�spro��} 1 SIGNATt1RE C?F APi'[,iCAN1' , �t 'ME_ `w'' '�, ����TE. 6�"' � "- {� `--(� City of Fri�ley l�u�i��i�$ �a�spections De�art�en►t 6431 iJnive�'s�ty ,A:v��ue NE, Fridlcy, �i 55432 763-572-36t}4 0��