Loading...
P - 39349From: unknown Page: 2/2 Date: 9!6/2011 9:39:47 AM .�r, „ ..�„ , ., ,.�,��„ „ �,� �uilding BT.TILDING Permit No.: �I lnspections �����p���'�� AFPLICATION Received By; .1V i,� ' 763-572-3604 C�TY ('1k' �'�I��EY' Date��: � � �' � � � "� 7b3-S02-4977 FAX �,rr�CrtVti i-t-2011 DATE ���� ���' _,,, ___,,._ Y�l.)i2 F.-MAIL anDRFSS _..... srr� A�uK�ss G 7r �e t,�. ;�7 �� �'��� fey /hn �Sils'.Z 1TQ5 APPLICAN'f I5: �� OwNEk OCC�rrrR,�c�rpR PIit7P�Yt1'Y I�WNER/ N.v�,t�.: iI� ��a TENANT AD�RESS: G.7( �C-�P�tc. l�/ rlc--- , Gi1Y �` P� �sTnTEr'�1 ziP 5„���3ar PI�ONE: if�. ��� o�li �e2 --- ^- -- CUNTRACTOR N�MF; SUFSMTT A COFY OF STATE LtC�tdsL� JF . YUUR S'FATE LICF.NSii -...-_.-.. ,...._.__.__�._ ._-.....I.EAn CF..RT NL111�ER ANll C�R'flr'iLA'FE C7F AUURF„55: CPTY�,,_ _,,,_ STATE ZIP [NSU�C�+ FiIpN� NAx PRCyPE1tTY TYPF �TSIIVGLC CAA,IILY/NEW CANS��x��Cru)N svF 0 7WU NAMILYMF.W (;(7NSTRUC[TON 3TORILS PERMIT TYPE ��ll���<�tv fl GARAGE/SHED o wINDOWS ORASEMENTFfNISiI �ROOr ❑llRAIN'fiLFi G DECK ❑ StUING ❑ c)l�-IF.R ❑ SW1MMtN(i PpOL T'YPE U� WOItK: ❑ NEW HUM�: GC)NS'I'R(,1('TIQN ❑ nnrn�qx ❑ MAINT�NqNCFJREpAIR ❑ R�MODELING DF,$GAIAfi W�RK AFiJN�rp�NE: SIZE OC I1�RdVL'IvIENT' I.F.NCiTH WIpTH II�IGIIT 5< FT Rt 1�' • O,�iOUSE ONLY NI]MI3�Jt ()F SQUARF5 �� 1ffi�IOUSC & GARAGi i�►$�M�N7' Kk.tilAUEsI.iNf3 SLfH1vFiT: 1, F.xistingElporPlan � �ATTAGHF.n GARAGF. 2. Ftopose�t pvurplm� PAQP�S�d Sl��:__, �.� 0[}ETACiIED GAitAGE 3. Lisi Uf shuchaal mcmbcrs to be used PRUP(1tiF13 Hfs1CsHT; �p�� � FORNEW CONSTILUC1TdN INCLUIiI'NC,i 17F.[:KS, ❑ Vuryi CSp�t ADDITIQN3 $ �2�H�.1 ST7RMIT• 0 Aluminum ❑ Trim i. 5irc PlenlSurvey showing Use existing sEru�!►acs G Other [] Favcia � M�� t�i� 2. Twc> sels uf conlructicm pians �Q}� 3. �ncrgy Catculations IN E7(ISTING OPGN[NCS I�Yes �No LOCA'[1dN OF WINUUWS POR WQ�IDOWS -PRQVIDi U-YRLUti AND ' OR POR NIiW OPfl�tINGS-D�SCIUk3E Slz� c)!� M�4MTI'ACTUR� STICK@K t)N W INIJ()W, OPtiNINEi CHAN(i� d� TYPE OF WINDOW TO HE INSTALL�D NUMSEIt ON W 4NllOWS AI,I. FEES AR� $AS�D ON VALUATION. INCLUDING THE CC?ST OF LABiiR AND MATERIA�S: 1il Plan Review Fire Surcharge Surcharge License Surcharge S�C Char�e Curb �ut Fscrow Erosion Control Park f�ee Sewer M:ain Charge (USING THE 1997 U.R.0 FF.E SC�(k',DULE) See i3ACk P�ge for ree Scheaule 65% of Building Permit Fee A01 times the totai job valusrinn .000� x Permi! Valu$lion Minimum �5.00 $5.40 (5tat� Liu,-n�cd Rc.�sidcntial Cc►rtr�ctc�rs) 527.30 per SAC Unit (Plans to MWCG f�r determi��tion) �+6 R= ftx 525=$ $4S0 Conservation Plan Review Fee Detsrmined by Engineering A�ernent necessary ( ) Non Necessary ( ) 'i'F115 I3 AN APPLICATION FOR A FERMIT-NOT VALID UN7IL PKOCESSED Y 8tasby apply [or a building pem�it and i acknowlecige that the information above is compl�te end accurstt; that the wark will be in ccsnforrtt�nce with the ordinances and codes of tlte Ciry of Fridlty aitd with the Minncsota C,onstruction Codes; that I understand iltis is not a perrnit but oi�ly en application for it d work is nat to start withaut a permit on site; that the wark witl bc in accordance with the approved ptan in the E�e of requires review and approval af pl D SI(iNA7VRF. UF APPt.IC.ANT , � PRIlVT NA14� ��� ' .� � +�� UA'I'F: ( � �r 2ai� AND MECHANiCAL, WORK : ' .'