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P - 48477� I I i i �� a From; 612 822 5408 Page: 313 Date: 2/24l2012 4:23:53 PM � �� Bilildillg _ PL�T��i�'((i Perrnit No,: 6� Inspectians ��'�� APPLICA - Rcccived By: ��-s��-��oa� CIT� C�F �'��,EY �'�� . ��-sQ�-�a�� F�� .. r��......... . __._ R� � — !!l��11kS °' � � ), � . YOUR �-MAIL A13L7KES$ S1TE ADDRE55 � v' ...d.'rj'I �`� TH1S API'LZCAN'1'IS: CI dWNE1t �ONT2ACTOR pa��VN�� 1@AME: ,� � ��7 �� ,,� 1`�NANT An�RFSS; � ./ rr ;-f11•y✓ �`,7f � CITY �i�c fi� rtrQx�: `��'3 � "� �7 �- COIVTR.�Crbtt rrn�: � _ d r , 5[JPMIT A COPY OF S'rA'i�rs �iG61�5S n`t�C ��'r ��7' G3 '� Yovx s�rA� z.�crl�+rsr�, �ox� ,�rm �Tn,TC �orm # CF'RTITF�ATE OF ADARFtiS; �� '' 'i � ��y /rv,V iri1SURANCE PI30NE �/� , .�a t7 � -- �I,2 �''� FAX ��iM�� x�i� ! �SiN(i1.F FAMi1�5C TY�E OF WURK: �� N�W ❑ TWO PAMCC.Y �'RFsLLACEM�NT DETAit,ED i7ESC�iIP��t7N (7i' WOftK ��'§"�G� L✓� i�.'7� ❑ TQWNFiOUSb � E3(F I7hTE EkY DA'1'E,,,,�,_ '�Y�- /!' 3TATE�ZII� �'� _ f Y NliES AI3.E BASEt] ON $1 p,p0 PEA FIXTURE, rJCGEPT WHEttE NUT�Si7, FTX'NItE,S; (iND[CA1Z TOTAL I�IUMBCR OF EACI•I BTLC)W). MINTMI'JM �L� �35.50. _BATHSlNI�JLA'V FLU()H DI�,A�NS SFT�W�,iZ WA3'F.�t ?IP1NCr _ BATI3TCTB fiAS PIPII+fC (NCEI1 G1'CY LIL) � SWQvFM[NCr Pf7dL _ YVATER SdTTN'�R (�.35) CLO'!`I�YES WASHER KTfCI•I�N SINCC � WAT�R CLOS�'[' BACKI%LOW PREV. ($15) _ f�IS1�WA5HRR � LAU3�It7fiY l"RAY �WATER i�TEAT�It ($35) F'LiR LktltlGAT10N „„ WA7'ER MP..7'F,Ft _ pTHFR 'FHIS ts AN APPLICArtOrr r`Ox ,a psRn��T-NO'� vALtD LiNTlL PI�a�E55E7� : 1 hercby apply %r a plvmbin� �aermit and r acknowledg tl�at thc inforn�ation ab�ve is ca�npl�te and accurate; that the wvrk will be in . cQnformance with the ordinances and cades thc Ci f FridIey and with the Miuneso�► Constniction Codes; thzt i understtrud this is , no# a penziit but only an Applic�xtion for a pEnn an ork is nvt to start Wirhptt� R permit on site; th�t the �+ork will bo in a000rd�Q�c , wilh tihe approved plan in }hr�f i w r fe lt1t�.4 rOviGw tinti ap ofptans. / y.� � SIGNATUItE OF At�PLI�nIVT ' ; n._. FRiNT NAMi'�s�� Svt�,`7�-Ja7✓ n�Tr•. a� � d�� Z `� City of Fridl�y Bu��cl�ng �nspections Department 6431 Unirrcrsil� Avenue NE, �ridiey, XVtl�i 55432 763-572-36Q4 FAX: 7G3�502-4977