AF - 41065N° 925
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Village of Fri�lley, Minn.
�IT�ING PE�II�
08ice of IN�PECTOF OF BUYLDINGS
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Architect Frid.e Minn. ��� E-�'��"� "� � 19 `� ��
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Builder
LOCATION OF BUII.DING
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No. � Sireet �� - a°`� �- Part oP Lot
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Lot.� � � '�� � � ��° Block � Addition or Sub-Dfvision
DESC�,IP�IION OF BUII.DIlVG
�ront ���•> Depth� I3eight Storlea �s`�' ����lanner of Conetruction ��`��-+�-�^— �.h-,.__
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To be used as� _�`=- �' �--�.�m-�-�� To be completed Eetim�ted Cost
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Permit ie hereby granted to���'�v°''r.'�'� �.r��`�'�' "c�:' 6�°� },� �.� ''`� _?''"�
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the building '"`=-��s=' deacribed in the above statement. Thie pernaft ia granted
upon the egpreas condition that the person to whom ft ia granted, aad his ageate, employees and worlanen, ia all
the work done in, around aad upon said building, or any part thereof, ehall conPorm in all respects to the ordi-
naacea of Fridley, Nlinn., regarding the construction, alteration, maintenance, repa3r and moviag o4 bwlldinga
within the city limita, and thfs permit may be revoked at �ny time upon violation of sny of the provieions oP said
ordinaacea. :�
�� • ..�� r' �'..•.�.,-� �� �, �'..c,� �-� � .7a�nactor of Buildings.
AGftEEMENT AND SWORN STATEN�NT
In consideration of the isaue and delivery to me by the Inspector of �uildings of Fridley of
the above permit, I hereby agree to do the proposed work in accorda.nce with the description
above set forth and according to the provisions of the ordinances of Fridley, and, being first duly
sworn, I hereby state and say that the facts stated by me arid contained in the above permit are
true as therein stated.
Subscribe�d and sworn to before me at Fridlgy,
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SUBJECT IT NO.
City of Fridley o 1�44
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
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� • COMMUNITY DEVELOPMENT DIV.
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r � � PROTECTIVE INSPECTION SEC.
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---_� /"'�1'� CITY HALL FRIDLE� 55432 NUMBER REV. OATE PAGE OF APPROVED BV
i � � 612-571-3450 910-F15 4/24/89 � �
JOB ADDRESS �948 East River Road N.E.
LOT NO. BLOCK TRACT OR ADDITION
1 LEGAL SEE ATTACHED
oescR. 24,25 2 Spring Brook Park Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS Z�P PHONE
Winfred Morphew 7948 East River Road N.E. 784-6536
3 CONTRACTOR MAILADDRESS Z�P PHONE LICENSENO.
Ariel Remodeling Services 5744 �niest Moore Lake Dri.ve N.E., Fridley 571-9531
4 ARCHITECT OR DESI(3NER MAIL ADDRESS ZIP PHONE LICENSE NO.
e
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5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
8 USE OF BUILDING
Residential
7 CLASS OF WOHK
❑ NEW � ADDITION � ALTERATION �7 REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WOflK
Change roo� pitch on back of house from 2112 to 4/12 and replace ceiling
9 CHANGEOFUSEFROM TO
STIPULATIONS
See notati,ons on plan.,
SEPARATE PERMITS ARE RE�UIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV LOAD
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WOHK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINEO THIS APPLICATION STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND,ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHEF SPECIFIED HEHEIN OR NOT. THE GRANTING OF A PERMIT $2►50Q $1'.25
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOIATE OR CANCEL THE pERM1T FEE SAC CHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $S4. OO
PLAN CHECK FEE TOTAL FEE
$55.25
SIGNATl1REOFCONTRACTOAORAUTMORIZEDAGENT IDATEI WHEN PaqOPERLY LIDATED THIS IS YOUR PERMI
2 A � __
SiGNATUAEOFOWNERIIFOWNERBUILDENI �DATE� BIDG �NSP � � �
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AL'PF�t )
Construction Addre�.�s: _
IEgdl D2SCY'1pt10I1: � o
R-1 AND 1�2
Building Piermit Application
���f' 0 � A f� /[ �' v 4 rr ft �
�e s�i/ss
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� � , �s ��o�� �. f//Jv�'y � 1(seo/C �v� a0��'/�/,�6�!
.
ownex rTame &�,aaress: �; � l vtd� /L/I a v�.�v► e G- Te.t. # i��-� S 3!
Contractor: � t�: �� 1��� o��e �, %� ,f e d vi �.� �1. # S" � l- 9 s' 3I
,
l�kiress: S �<< �( G-�. /j/l � ov< `��. l��.
Attach to this application, a Certificate of S�vey of the
lot, with the pro�osed constructioa�► drawn on it to scale.
�IPTI�T 0�' II�VII�Tr
I1VII�G AREA: I,�rigth Width Height Sq. F't.
C�ARAGE AREA: IP_Tigt'$ Width Height Sq. Ft.
D�[C AREA: Iencrth Width H�at/Grcund Sci, Ft.
'i ��i�•
0
rra
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Cbrner Iat [] Inside Iat [] Ft. Yd Setback Side Yard Setbacks
ZYpe of (bnstruction: Estimated Cost: $ rt �0 d°i
Approx. Ccanpletion Date:
Propo�ed Dtiveway Width If New Openis�g Is Desired: Ft. $ S
� � Wiat� + 6' See Back Page
�: � `�Y � 8° � �r�c�r: �,��y---r/r`�t �✓�( Te.t. # 5' � � ' �`� G Y
F+ermit Fee $ �� D U
state surrharge S /- 02 �'
SAC Q�arge $
Driveway �scrow $
Park Fee $
Se�er Main Qza�e S
. �•
siz�,TTa� :
$ �S,�S-
��
9G.��—
CTPY �E �Y
Fee Scivedule aai Rever�.�e Side
$.50/$l,00o valuation
$575 per SAC Unit
Alt. nA�' oY' Alt. nBn AbOVe
Fee Determined by En4ineerin4
Agree�ent Ne�ssaty [ ] Not Necessary [ ]
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The C2�ief Huildirg Official shall, i�efore i SQ» *� permits for tha erection of arry
building or sti�ucture, or for ariy additioaz to a� existinq buildirig or structure, or
for a� alteration or r�air to ariy PYl � 1� building or s�ucture, upon application
therefore, �equire the payment by the applic�nt for s� pezmit of fees to the amount
hernin belvw set forth ar�d in the maivier herein provided to-wit:
TD►rAL VAIITE
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25,001 to $50,000
$50,001 to $100,000
$100,001 to $500,000
� a.
$15 (Mini�mm Fee is $15 plus �„�r�,a,�)
$15 for fiYSt $500 plus $2 for each additional $100 or
fYacti.aa� the.reof, to ard 9ncluding $2, 000
$45 for fi��t $2,000 plus $9 for each additional $1,000
or frackioai thereof, to and inclu,ding $25, 000
$252 for first $25,000 plus $6.50 for each ac�ditional $1,000
or fraction �f, to and including $50,000
$414.50 for first $50,000 plus $4.50 for each additional
$l, 000 oz' fraction thereof, to arid iricludirx3 $100, 000
$639.50 for first $100,000 plus $3.50 for each additional
$1,000 or fraction thereof, to arid including $500,000
$500,001 to $1,OOO,Q00 $2039.50 for the first $500,000 plus $3 for each additional
$1,000 oY'fraction thereof, to and including $1,000,000
$1,000,001 and up $3539.50 for the first $1,000,000 plus $2 for each additional
$1,000 Or fraction thereof
�tIVE�1Y �SI�T ffiQi0�F1
(�rete CZirb Streets On1Y)
Alternate ��A�� s Remwal arid replaoe�nent of c�arb aryd gutter �ly - Driveway width plus
6 feet times $13.50.
Alternate "B" : Resnoval aryd �plac�ent of curb arid gutter and install a 3 foot wide
appraach with 6 incc�i dep�th - Driveway width plus 6 feet times $15.75.
� :�• ■� v •; •)� °�yu,i��• � r
PeYmit� for �ioai will be issued a m�*+��++�m+ of 24 hours fraan the t�me of
a�lication to allc�w for prc�per revie�r of the pra�ed stxucture ar�d of the
oonstruction site.
A Oertificate of S�vey of tl�e lot, showing the location of the frnuidation once it has
it has been v�r�tn�ed will be required before prooeeding with the fiaming.
i
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.y
DATE: March 19, 1997
TO: FILE
��� � a� ��� ��
MEMORANDUM
PLA,NNING DIVISION
FROM: Michele McPherson, Planning Assistant
SUBJECT: Nonconforming Properties Adjacent to East River Road
As a result of Anoka County acquiring additional right-of-way for expansion of East
River Road, this property was rendered nonconforming. Please refer to the attached
chart which indicates the extent of the nonconformity.
MM:Is
M-97-137
EAST RIVER ROAD PROPERTIES AFFECTED BY ANOKA COUNTY RIGHT OF WAY
ACQUISITION
ADDRESS EXISTING NEW REQUIRED SETBACK CONFORMING
USE SETBACK SETBACK SETBACK TYPE
7845 East 97.02 ft 89.1 ft 35 ft front yard yes
River Road
apartments
Apartment 46 ft 3$.28 ft 35 ft front yard yes
garage
321 79�' Ave. 53 ft 36.3 ft 35 ft front yard yes
apartment
7948 East 32.34 ft 17.49 ft 17.5 ft side comer yes
River Road
132 28.38 ft 27.06 ft 17.5 ft side comer yes
Stonybrook
7950 East 34.65 ft 28.7 ft 17.5 ft side comer yes
River Road
Garage north 24.75 ft 23.76 ft 35 ft front yard no, before and
of above after
8051 East 41.91 ft 30.36 ft 35 ft front yard no, after
River Road
305 Liberty 93.06 ft 72.93 ft 17.5 ft side comer yes
440 Ely Street 79.2ft 61.38 ft 17.5 ft side comer yes
8161 Fairmont 93.39 ft 65.01 ft 35 ft front yard yes
Circle
450 Hugo 73.92 ft 43.89 ft 17.5 ft side comer yes
8191 East 71.28 ft 40.92 ft 35 ft front yard yes
River Road
500 Ironton: ` 55.11 ft� 31.15 ft 35 ft: front yard: - no, after .
97 Craig Way 47.5 ft` 23.1 ft 35 ft,, front yard `: no, after
7680 East 37.95 ft 13.5 ft 17.5 ft side comer no, after
River Road 38.94 ft 23.76 ft� 35 ft front
119 Craig Way 63.69 ft 40.92 ft 17.5 ft side comer yes
50.82 36.3 ft 35 ft front
7942 East 49.5 ft 33.3 ft 35 ft front yard no, after
River Road � �
8080 East 58.74 ft 33.9 ft 35 ft front yard no, after
River Road
8100 East 50.16 ft 50.16 ft 35 ft front yard yes
River Road � -
Laundromat 31.68 ft 1.65 ft 35 ft front yard no, after
499 Glencoe 38.28 ft 8.58 ft 35 ft front yard no, after
ADDRESS EXISTING NEW REQUIRED SETBACK CONFORMING
USE SETBACK SETBACK SETBACK TYPE
8164 East 43.56 ft 14.19ft 35 ft front yard no, after
River Road
8180 East 37.95 ft 8.58 ft 17.5 ft side comer no, after
River Road ,
8182 East 38.28 ft 14.19 ft 17.5 ft side comer no, after
River Road �
8184 East 38.28 ft 14.52 ft 35 ft front yard no, after
River Road
8200 East 34.98 ft 9.9 ft 17.5 ft side comer no, before and
River Road after
510 Janesville 38.61 ft 12.54 ft 17.5 ft side comer no, after
421/432 39.27 ft 8.58 ft 17.5 ft side comer no, after
Ironton
461 Hugo 33.66 ft 3.63 ft 17.5 ft side comer no, after
Street
8114 Fairmont 36.96 ft 8.58 ft 17.5 ft side comer no, after
Circle
8102 Fairmont 33.99 ft 5.61 ft 17.5 ft side comer no, before and
Circle 33.99 ft 17.16 ft 35 ft front after
8104 Fairmont 35.31 ft 26.73 ft 35 ft front no, after
Circle
8027 Fairmont 21.45 ft 9.9 ft 17.5 ft side comer no, after
Circle 46.53 ft 17.16 ft 35 ft front
7899 East 52.8 ft 33 ft 35 ft front no, after
River Road 0 ft 20 ft hardsurFace
7663 East 64.35 ft 34.65 ft 35 ft front no, after
River Road
Fire Station 29.7 ft� 0 ft 35 ft front no, before and
._. .
� � after
7701 East 80.19 ft' 62.37 ft 35 ft front yes
River Road
8061 Ea�t 90.09 ft 78.54 ft 35 ft front yes
River Road
sue�EC. NrfT NO��
c�cy of Fridley � 33374
AT THE TOP OF TNE TWINS g � I L D I N G P E R M I T -�'
r
� � COMMUNITY DEVELOPMENT DIV. RECEIPT NO.
i ►V � � � �
f � � PROTECTIVE INSPECTION SEC.
� . .
� � �"'\ � CIiY HALL FRIOLEY SS13Z NUMBER pEV DATE PAGE Of APPROVED B�
�""'� � �'' 763-571-3450 siaFiS 3/18/03 / /
JOB ADDRESS 7g48 East River Road NE
1 LEGAL LOT NO. BLOCK TRACT OR ADOITION SEE ATTACHEO
DESCR. Z�F,25 2 Spring Brook Park SNEET
2 PROPERTY OWNER MAIL AODRES$ ZIP PHONE
Anoka County
3 CONTRACTOR MAIL ADDRESS ZIP PMONE IICENSE NO
MN Superior Exteriors i048 Payne Ave, St Paul, MN 55101 651-774-5582 20219220
d AqCMITECT OR OESIGNER MAIL ADDRESS ZIP PMONE LICENSE NO.
5 ENGINEER MAII ADORESS 2�F PHONE IICENSE NO
8 USE OF BUIIDING
Residential
7 CLASS OF WOFiK
O NEW O ADDITION � ALTERATION � REPAIR O MOVE O fiEMOVE
8 OESCRIBE WOfiK
Reroof Garage (3 Sq); Install new interior steps to basement; Repair basement wall
t at owe nwar ; Repair garage framing
9 CHANCiE OF USE FROM T�
STIPULATIONS
Submit plan for new stairs and bsement wall repair. Stipulations per
Building Inspector's gnspection o� 3/20/03. Need engineering on block wall per
Building Official.
SEPARATE PERMITS ARE REOUIflED FOR ELECTRICAL. PLUMBING. HEATING, TYPE Of CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIF CONDITIONING
TMIS PERMIT BECOMES NULI AND VOID IF WORK OR CONSTRUCTION 20NING S�. FT CU FT.
AUTHOR12ED IS NOT COMMENCED WITHIN 80 OAVS. OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERI00 OF 120 OAYS AT
ANV TIME AFTER WORK IS COMMENCED. NO OWLG. UNI7S OFFSTAEEI PARKING
I HEREBY CERTIFV THAT I MAVE READ AND EXAMINED THIS APPLICA710N 1 STALLS GAFAGES
AND KNOW TME SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS yA�UATION SURTkX
AND OFlDINANCES GOVERNING TMIS TYPE Of WORK WILL BE COMPLIED
WITM WMETMEii SPECIFIEO HEREIN OR NOT. TME GRANTING OF A PERMIT �3fOOO ��1.SO
DOES NOT PRESUME TO GIVE AUTMOiiITV TO VIOLATE OR CANCEL TME pEqMIT FEE SAC CMARGE
PROVISIONS OF ANV OTHER STATE OR LOCAL LAW REGULATING CON- @83.25 Fire SC �3.00
STFiUCTION OFl THE PERFORMANCE OF CONSTRUC710N `P
� � PLAN CHECK FEE TOTAL FEE
License SC $5.00 $92.75
S�GNOTUAE O� CON"AACTQA Q UTMOA�ZED sGENT io�TE� �� EN PROPERIV VALIDATED 7HIS IS VO ii PER IT
� �
S�GN47UAE O� OWNEA ��� OwroEa Bu��DEp� �D�iE� � �tiSo r� t
e, .�
NEW I l
ADDN [ ]
ALTER [ ]
CITY OF FRIDLEY Effective 1/1/2003
6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bidg Insp
SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPLICATION
Construction Address: %�y �i ��-� �-` �
Legal Description:
Owner Name & Address: l��vo�� �e-�'! Tel. #
Contractor: __ i��v �� lz x T��o � MN LICENSE #�oa �g a��
Address: ��' � �l i�.�y.� � �v� S% :c�u�� �1�✓�'.S�o/ Tel. # � s /- �7� -S'5��.
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER: ��4a� � s .3s�
�
y��• �1�� .Z'svi`�ii �m%� i2w s��.v..�e's/ ��.`. ,��l��r/�, .7s°r9B `—
Construction Type: Estimated Cost: $�� ��� S�°`
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _$
DATE: 3 � � o APPLICANT: �/„�,� Tel. # GS! -1Y8' • `� �`� �
Call (763) 572-3604 for Pertnit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will
cali you for card number.
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
$ ��� �.��
$ �, c-�r
$ /� ���
$
� �_A � 6./� L'
$
$
$
$
CITY USE ONLY -
Fee Schedule on Reverse Side
.001 of Permit Valuation (1/10th°/a)
$.50/$1,000 Valuation
$1275 per SAC Unit
$5.00 (State Licensed Residential Contractors)
Alt. "A" or Alt. "B" Above
$450.00 Conservation Plan Review
Fee Determined by Engineering
Agreement Necessary [ ] Not Necessary [ ]
TOTAL $ �i ° �/ �� STIPLILATIONS�
BUILDING PERNIIT FEE SCHEDULE
The Chief Building Official shall, before issuing perm.its for the erection of any building or structure, or for any
addition to any existing building or structure, or for any alteration or repair to any e�sting building or structure,
upon application therefore, require the payment by the applicant for such permit of fees to the amount herein
below set forth and in the manner herein provided to-wit:
TOTAL VALUE
$1 to $500
$501 to $2,000
$2,001 to $25,000
$25,001 to $SO,OQO
$50,001 to $100,000
$100,001 to $500,000
$500,001 to $1,000,000
FEES
$23.50
$23.50 for first $500 plus $3.05 for each additional $100 or
fraction thereof, to and including $2,000
$69.25 for first $2,000 plus $14.00 for each additional$1,000
or fraction thereof, to and including $25,000
$391.25 for first $25,000 plus $10.10 for each additional $1,000
or fraction thereof, to and including $50,000
$643.75 for first $50,000 plus $7.00 for each additional
$1,000 or fraction thereof, to and including $100,000
$993.75 for first $100,000 plus $5.60 for each additional
$1,000 or fraction thereof, to and including $500,000
$3,233.75 for the first $500,000 plus $4.75 for each additional
$1, 000 or fraction thereof, to and including $1,000,000
$1,000,001 and up $5,608.75 for the first $1,000,000 plus $3.15 for each additional
$1,000 or fiaction thereof
c�r�s cu�r EscROw
� (Concrete Curb Streets Only)
Removal and replacement of curb and gutter only - driveway width plus 6 feet times $17.00.
Permits for constivction will be issued a minimum of 24 hours from the time of applicaxion to allow for proper
review of the proposed structure and of the construction site.
VERIFICATION OF FOUNDATION
A Certificate of Survey of the lot, showing the location of the existing founda.tion will be required before
proceeding with the framing. New Houses Onlv
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763�572-36U4
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W1T11 AT'�LICATIUN PNf1N4' I
BUILDYI�T�
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C� Tw'U FAMIL�Y/N�W CONSTR(J(°I7UN S'fi7IlIiS __
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Yi:�TT Typ4� o r+nniT�aN� r� i:�a,kAC,�si�r> � nvuaws
D ktASNM1�NT PINISII � Rtri:1P O DRAIN TiL�
❑ ULCIt ❑ SIP].NG ❑ O'1'HLK
❑ SWiIviMINt3 PCx�E.
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�IZ.F, QF IMPitUVFMF,TT"T LENGTH q� � WIL�TH IIEIGHT
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❑ ATTAC:liEI3 t,AttACi�
❑ 'uLTACIIEn r,a.xac�r.�
S� 1�'t.
1. Fixisting Ploor Plan
2. Proposcdflnorplun
:i, LiSt i�f5tructural mcmbnrb 4o bc usexi
� fiT7�ING Fc)(� NH'W C'ONSTRUCTION 1NC:l.,�JiA"NC� ULCKS,
fl Vinyl t7Soiiit AllUT'1TUN$,�tta'C�RC'HFS SI'!)iMT'T';
❑ Aluminum ❑ Trim 1. Sitn Plun/SuCVUy showin� U7C cxisting slruclurns
❑ Uther _ ❑ Yrdscia and pmF,oeexi prnjec:6
` 2. '1'wo sets c+f constiucticm plans
w��'�S 3. F,.ncr�;y (:alculutiuns
1N LXLS'TINr [)P13NlNCiS CF ❑No T,fjCAT1UIV UF W1Nf�w5
OR FOR NEw OfiENJNG.. SCRIDC SIZP c.�H
---°.... . . ....
OPEN.ING c,''(dANGES !4�
TYP1s ()H, WiNPOW'1x) aL INSTALI.,F.Ii _ _ NfJMF3LR OF WIN1x')W'S. _..
ALT. k'EES Altl� �fASED ON VA'LTJAT�'4N, IlVG:LCTDJNG TIiE COST OF T,,ABU12 AlY1? 1V.CA�TFRI.ALS:
(i]'SII�i . � � U.�',�F;F. SC::�,lILTLE)
TQ'�'�i1, .��R VALUAT1vi�T � ��]%FFY�� C��C� Ut'��"L]l�ANCY '1`Yp'E
Permit �"ce
Plan k�vi.ew
.l' ire Surcherge
Surclia.rge
Liceusa Surchargd
SA� G'harge
(.urb Glit Escz�w
kimsion Conf;eol
i'arl�. Fee
Scwcr M�.in G7iar�c
'E'c►ta! Due
$
$ , _ =� � � � --.. . --
$ .�.���
� �6��
� ...,.... —
�
� 1--�
65% of Building Yeru�it Fee
.U01 titnzs the total job v�il'�1a.tion
.0005 x Yermit Valuaticm Minirnum $.SO
g5.0(i (Sta�c Licensed Itesi.dential Cuntr�c;tc,rs)
$1550 pet SAC: i.3niY (Plaus io MWCC for dctzrmiilatiou)
ft + 6 fi = , t't x �2U — $ _.
$4�0 t'.�n.servation Plan R�view
Fcc Deterttunec� by .F,.nginncring
�rsemcnl necess�ty ( ) Non Nccnss�ry ( )
tu: C.
Att�eh
T°lil5 JS AN AYYLICl�TI�jN R A YH;1tTvIfT-IdOT �%A1�ln 11N'l'u. YItUC�SSLU
I hcr�by �p�ly fcrr a buildin� pcnnit �� gG tha.t t}�e infam�tiun above i�s camplete a,nd a.ccurate; th�t the work will be iF�
conCormanee wifli the c�rd'ui�tices rtind c�dcs of Lhe City O�Fridl�y atld WIt�I t�7e �1mne:3Ul& COIIStxU�t�(�n CUdcS; i;hat T uuderstand this is nol H
permit t�ut Unky an appli •ation for a pennit and work is nvt ta scart without a Permit; that the work will be in accflrdance ' h ltte appYOVed
plan. iu thc case of all w � � r v �� f ans. �� � ��' �
S1CiNA1iTRF OF AYYT,ICAN , , '. p T1'f 1`7 '
Td Wdi£:60 900Z 90 'adti LSZZTLS�9Z: 'ON Xd� Fatp�,�� fo h t
� . � : W0�1.�