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P - 46501From: bmoeller@hwconstruct Page: 2/2 Date: 11/8/2011 2:12:35 PM Fram: Beth Moeller Fax: (866) 970-1133 To: +17635024977 Fax: +17635024977 Page 2 of 2 11/8/2011 2:10 ,.. _...._._......._ .... ........� ' __..._ . �uildin� B�JILDING ���t No.: Inspectians RESIDEII�TIAI� APPI�ICATION �t�����a r�y-___..__ 763-572-360� CITY C)�' FRIDLEY ._v... 763 5�2-497? FA�;: ���'� � _.�,r �rrscriv� i-�-zoi� nn� i ��f4 � �otnz �.�v,u. Au''�i�xt,s�' 1l��CoY�S'�YU.0 ' o-n . c o nn si�e nnnaFSS '�''� 0�. ' � t�c^ ���.1r°1 C" r�y~ i .� Y"Y11ri� 5�jt-�- TfiLS APPLICANT IS: ❑ ()WNF:R �(C{}�TRACTOR � .__. _.._. .__ r- PROPERTY OWNEW . : .�.nNt� .. ........... _ S_'.C_�-Ir1__ TFNANT , AD�RESS: I rL iT'Y _ � STA PH(lIVE: � ip�-..^� 2.'-��� CONTRACTllR �;A�: �C. ' $ITT3MTCACOPYOF STA'fELiCEIhSE�i �:.(����J'�'LF�--._._..._.._LPjAUt't:It;� 1�1M(iM.k._:___N�T•- Z---�-ta.I,."" �. � v�ux �rn�rF z�t:H�vsH � ......_ AND CERTTFICATB OF AIlDRESS: ��Z � i, � STATCjI�IP '� TNSURA_VCE PHpNH '^ � � �J" FAX • `� V PROPERTY 'I`YPE srrr�[.� Fan-rtt.Yl1VEW CONST[tUCTTQN SIZE 'TWO NAMILYfNEW' CONSTRUCTION STORIES PE�'�IT TY�E L7 ADDITIDIi O CrARA�Er'SHF.D ❑ W[AID�WS � BASE_r,fEN,T FI?3ISFi KOOF �❑ 111tA[N T[LL ; � QDL'C;K S(DtNG f-� �-"6�'1 O OTHE2 ___.__...__ __...___..._._ S�TJIIvII�fINGPODL 'i'YPE C)F wnRx: ❑��w xor� coNS�ttucTTON o nvvrttcax ' MATNTFNANCF./RF,PA7R Q RFMOi)RTdNC nuscRr�t? war�x �:N�rrc: nou� _.;._!C'�E.�' .�'ot1 �. ._.�-._ �Y...�.� 2t ..... �,. ... �S ,. �+�. `Et?r..+rr._,---C�cYS.� ��t.ble5. on1�f SJ'LE, UF IIvlPROVEMENT L�23GT[I WID'tT� IIL'IGITT S I'T ' ' ROOF7N'G ; .. ; { � \ HOUSE ONLY N[7MAER l�F SQUARFS 1��`' HOVSE & GA1tA(i£ E�ASEMENT I�FMOI]FC jAiG S A�TT- _ � 1. F.xisting Floor Pian t� �.l ATTA(;]fED GARAGIi � rnc�r�s�usr�� �', r praposed.floorpinn �I?ETAC.T3F,D CARAGF. 3, i.ist uf structurx! mctn}�ers ts>be �ucd PROPOSEb FIkiGHT; � FOR NGW C".C+NSTRi7CTiQ1V INCGtJD[NG D.f:('KS, ' Vlhyl : � � �SOffit . _ . .. . _ .. A�DII3QNC R PORCHR ' ct AA�I�'- � : . G Ahwvnum . i � 1. Site P1unlSttrv `� � � Trim ey showing tfie ezisling sirucW[ca . I7 Ckhei �\� �Fascia and pmpoacd pmjxt. W OWS � 2 Two sets of constructiun plans '�D � " F.ncrgy Calcularions � � iNPJCISTINGOYF,NINGS OYcs �No LE)(;A'13UN C31' W1N1JUW5 kOlt WINf?pti31S-I'R(?ViT)EU-VAL.UF.ANf) Eflt x'Cilt N�:W UYL•:NIN(iS-llhS{.:;l2113�:.SL'LE Clk MANUt'AC'T1IItI: STIC:KTR �N 1VINUOW. OP�TlNG CAANGbS � '—' I " TYPL OT WINDOW TQ BL INSTALLCD 'VtJMBLR CYF WP.VDOWS � ALL FEES ARE �A�CED ON VALUATION, INCLUllING Ti� COST �F LASOR AlY!) MATF:RiALS: (USiNG T LY9'7 U.B.0 FEF: SCI3E:DI1i.�) TUTAI� JUB VALCTA'1'lU}V � —�� OCCUpANCY TYPE Permit Fee $ ', See $aek Pabe For Fee Schedule ' , Plan Rcvicw ' $ 65°l0 of BuIld'ui� Pemsst Fcc ` � ' Fir� Si�rcharge $ `' .OU1 Gimes the tota! job valuatian Surcharge �$ �.p�5 x Permit Valuation Minimum $SAO License Surcharge � C�, � $S.Q() (State Lrcensed Residential Contraetors) SAC Charge $ $2230 per SAC Unit (Plaas to MVti'CC for dete�minafion) ' C,� C,`ut Escrow � � i€ + 6 ft= ft x$25= � Erosion Cc>uutrol $ � . . . - $45Q Consetvatinn Plan Review ` P�rk Fee $ Fee Deternuned by Engineering Sewer Main L'harge $ _ Agreement necessary () Non Necessuy () � , , Totai Due ; $ � P1�take checks a able to: Ci of Frtdie Attach Sti ulations ' THIS IS AN A}'PL1CA'FiON i'Oit A PE,ktMl'J'-N0'1' VAI..LU ItNT'LL 1'It0[;F:�'F.i7 T hereby anply far a t�urit�in� �rermit and I acknowied that the intormation abave is complctc aad accurate; that the work w.ill be in � conformance with the ordu�ces and codes of ihe Ci .ty of �di�y and rtii tre Minnc�o#a Ccenstruction Codes; that T understand this is not a permi3 but only an arn�licarioi� for a Pcrmit and n�ock is not start thc�ut a permit on stte; t6at the work will be in acco�dan.ce with th� r�pro�ed plan in the cuse o9 a k whi uires ev' w and 3• val of pla +�,,,� ' S!<<NAY {Jlt�, {7N APYLI(,AN"t ���"'��-���Y Aa'vIL Y�-�5 DATE� 8� I� AP?ROVAL TNSPECTOR SICiN `:FT.�A1 i� �qTE� � fiI�P��°�'C"� PER`MTTS t� �2 �OR PI;U1w�T33D+IG' ELE�`I'RIC�T.. ANt? "M;FCHA�dT�AL i�Qi�K , ' < : , , , •• .. ; _ j