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P - 37126
From: 7634752566 Page: 2/5 Date: 3/1 Q12011 8:30:06 AM Bui.lding �'Z,UM��NG I�.spection.s ��+ S�DEN'�C'�.A�L A.�'��.,ICA'z'�ON ��3�5��-3�04 �T'�'� OF F.�t.��]LE� 763-502-4977 FAX _ r-.r.Fr-c-TrvF �_i_���� DATE � � --.,�! SI7'f �nnRESS _, TFff5 nl��t..iC�NT IS: NROPERTV OWNER/ Tr�raNT SIJBMI'C A COFY pr YOIlR STA.TE LICEN�G, a�Nn �ND cr•.r�Tir[CA"fL OF 3NS17RANCT; P�N�1V[iT TVPT 'rv�� a�r woRk: DET,�I[LED T�ESCRir .:.y � UWN&� � vcnlrr r.M�I.L A.Uf5Rr5S nr�r�rr•.: Ch.�_�t�t°/_( ,'r7c AnpRT'S5:_ ��� ,. CI�t'r pttorrr: �` NnMG'_!eG!�,J r"'�v► r� ..�+ol_),.'� STATT LICE1JSi: # � '.��j a.���� 9Tn'TT: RONf) # ,f��$"� J� ADDRT:SS:_��fj �i'Lr��- .�r.,..r+� N ciTV_ PHON E �� j '"'t/ �'�� �? �� I: �y� L �SINGLG fAMTf.Y [_INfW WORK C! TWO FAMfI,Y 1_1 TpWNitOU5L �Rmr,��EMt3NT Perm it Re�ei�ea f3y.''� ������!� ��� � , �� ,,, 4TATT;_7]p , Fxp nnT� / Z- � � - Exr nnTE _ �' - �„6' � r''4O�i STATC I' �I7.T.! J' - ��.� .��� ��3 ARl? DASi:D C1N �i1D,(10 PA,R F1XT(]R$, rXCEPT WT•Ii:Rfi NOTL'n. C'IxtuRPS; (�Nn�r,.nTr•, TQTnT NUM�rR 0)? l:ACF•I L�ELOW ). MINTMUM Ff:f R $.5(1, DA'Tld 51NK/LAV f f.(J02 DR�IINS gHl]WT,:R, WATTR PIPT.NG ➢ATN7U13 CrAS PIPTNG (NG�'D CI1'Y l�IC) �$WTMMINp PqOL WATER SOITTNER ($35) CL01'H�9 WASHETt KiTCFiC1�I SiNK tl �+qTFR CLOSGT � BACiU'f.OW PRCV. ($15) _ 15tST-[WA$H�R � LAU]VpR'Y fi1tAV Wn7�R �t�AT.r:.R (�35} FOR iRR.tC�TION _ , W wnTrrc MrTra. p7�°[rtt TH14 IS AN APPC,TCATION FOR A PF..RMIT-NQT Vn1,.TD 1 JNTi�,. �'ROCr9g�D I[�ereby �pnty for a. plurnbing permit and [�ekn�wl�d�e tI��C the informa�ion fl.bc�vc is complccc and accurt�Cc; tl�at Cha work will be in cnnformance with the ordina.nces �.ni� cocles of Che City c�,f 1"ridley an�i wiCh che .Minnesata Conscr��ceion Codes; ch�l 1 untle�rstand thi5 is nat a permit but oply on npplica.cion for a permit ancl �vork ia not. tt� sCs�rt w#thout� a permit on site; thAt t'Ite wortc will be in accordance witlr the approved plfln in �he o�s I a urh'oh uires review �ntl fl.pprav�tl a:F lans. SiC;NA"CUTtr OF APPl.iCANT � 1.� 7� : �^?. PRfNT l3AML•__�.l /. �+t !'�O _ I"" 1�AtL �,.._ C1 APFR(]VAi. IIVSPf:('.Tpity yf4:jVATt1Rf; �2i� pATr 5/ I� `� ' �'ity of F�-idley Building Inspectio�s Ae�aa�tz�e�t 6�31. University Avenue NE, Fridley, MN 5�432 7G3-5'12-3G04 FAX: 7G3-502-4977