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P - 45832I3u�ding I�spection,s 763,572-3�44 76�-502-4977 FAX nn� fe — � e� ... SITE Ai]Ta1tF�Sg 7�NqNT 1.1W N L.[il �'TNA,NT evNr�c-roR SirsNIIT A COPY �r• YOUR 5TATE LICEN$�, F}p:t�TA AN�j C�RITFICr�1`E p� nvsu�uvc� From: unknown Page: 1/3 Date: 6/20/2011 9:34:13 AM FLIT�VI$Il�TG �'�it N°.=� 1VIM�'+'12CIQi,I.� APPLICA�'I"ION �eceived By: CX�'� OF FRID►LEX ��#� xouzi �n�uL AbaR�ss � ��,,�,� F,,�, NAME:. , 3 � � 0 AADRTS : � PHON�; ,, NAMB; STA7E LI '�NSE 1�_�i,�� PLUMB . J3p� # �� ADD�$ �� r�z-ia� .��5"1— ``1.2 /�.. � �, PT.RMiT 7'Xp� � INSTI ❑'rowr TYP�E OF WORiC: o xEw DETA,II,fiD DESC1iIpTION QF rix�tm.es: �mrnrca� rorAL ,_ C40THES WA9HRR ^,nzs�3wasxeR _, DRiNNICiNG FOUNTAIN `FAUC,gI' � �nn�,ns�t.� wnsrE rnwxc Tatal Job Valeation UF FA,C�I) SU�tF,1v0. '�,'rE z� EXP DAT'� ... / �/.� �' Da'r�? lZ/.3/ ysy/L�/i;r �17 �� . /fif ^ . u .�� C�G�1Ut.7T-FAMILY ❑ CONtiv�RCfATJ[NI]U5TRIAL �LAC�I4�.iVT%��ti'i r B Suv;�NlA�m�IG P004 ❑ aLr�RATTOx/RFMC1nFr. FI.00R hRN.NE _ RPZ vAI.VE � iJRINAL GAS �r�,T� sA.CKFLOw pREV. � WATER HEA'T�R GREAgE TRAP _�OOF DRATNC � WATGR M.tsl'�R KiTCF�N S1NiC _ SHOV►�R WATER PIP[NC �uxn�x �Y „_ s�,or snvrc . .,,_, wa� soF�v� �.ava'roR� _ swrrzn�nYC �,. ^ wa,T�t c[.osET a� � �1��_ A11 f�s arc basc�l �n v�Iuarioa, including t#te cost vf la6or aad materials. Ycrmrt Fec $ 35�� (1.2,3"� of Job Valvation / 11+.[u�imum fce: �35) Sarcharge $ 6'ra Valuatian X .OQOS or Minimum _50 1'oEa] J3tl� $�,f �� Make C".hpr.ks P�yabl¢ to: G�iy of Fridley I3 AN APPLtCATtc�nT POR A�yT N�p'i' VALrr� UNiTf, PROC�SSED I heroby app1Y for a pIumbing pp a�d I sc[mawlcdgc that tlen informauon �hbve ts canlpieie and ar,curat�; that thC work wi�l be in �oaformance wilh the o�innnces nn codes o�the City of Fridley and with the Min�nesots �ons4vct�on Codes; that x �„derst�d �is ;s aot a perrr�it but or�ly an applicat�on a pemiit and work is not to starc with�out a with the apprnvPd plan in th� c.st�o of 11,�ork wluc:h ulr+es rev3iew and �rn'�t on site: that the work wa11 be iu� accordnncG �l gpp�roval of pians. � sr�xn� aF a�aca��vxx :� m�ur,r Nnn�s;�i'f �,�id,�%t% ��,.f��j�,..,� A PP4(1V e, n.n.,r....M... ....... - -- . r . , .f /1 � . /1 � _ ,��_ C1A'�[E: _!2._ �. v /� 1 of Fr'�dl� Bu�lding Ynspectxons Dcp�rtnaent i431 Uz�iversity Avemue ]�1E, Fridley, MN 55432 7E3-572-3b04 FAX: 763-502�4977 — —^ � .