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P - 35403l3uildi,x�g Inspec��ons 763-572-3604 753-502-4977 �,A.� r�n� c� -1-- d. SI"hE AT)DRESS � THIS AppLiCAtJT IS: TENAN�' SUBMi7' A COPY 4� xouR sxAr� �r�NSE AND �$.ATIFiCA'� QF INSUR�,IVC'.E DESCt�tB� WOR?t B�fN� T) From: 7635020227 Page: 1i2 Date: 7/22/2011 10:29:15 AM SUI�D��G �ES����T�'IA� AP�'��C,A.TIt��`�t �I'�'X U� �"R,��LEX YC1UR �-MAIL AbbRE,55 !.'�. J� li�r�` (� � % � r-A� '.�D1r% S' C10WN&R ONTRA.CTOR l�lA.ME:�„(�t� �"� , ADnR�45:�.,�,�� �-.�L�c-b=-: CITY_��� z�ioNC� � tv�nEr�; , r ���� STATB l..tCEN3B # �' x,EAD E�uit?' NUMARf A1DtJRP.3S:� fip ��-IrG,��l.►�..,�;./ �L,% C[TY� pt�o�v� .�' �S' y- S" rnx - �S :lN�#:G£s FJIMILY �� � AMI W CONS'P'RUCTION S'f`C}WAS ^" � ALlT}TfiO1V O t�l�R.A� FI�T3 LT WINDOWiS tl HAl5�3Mt3NT 1�tN�SH Cl Rfyf3� G I3RAtN TILG G11�FsCZC CI SIDING �j�R 0 SWIMMING i�pL D ttiLW HOI� Ci?N�TSiUC7f4N C� Ai7T�iTIQN NTBNANCEIi�''PAI1t CI FtEh2aI1�LiNd �LOI?Il"�G Ni1MB6R QF 3Q�A�F�ES __.. � f�ttlPb�6DSiZA: F'R4P{7�}13t3I3QGH7"; . � � GI Vittyl O Aiuminun� d 13�r = W�ws t1V 13�5'f1NC# f?1'ENlNGS OYcs DNo dR POR T1BW t]FF.RIiNGS�D6SCRiHE SfzB pF p}�liNG CFIAN(3$�fi ek Ci�il Plari R�+iew Fitc Stu�cb� Sw�ct�rge Lic�scY 3urch�rgo SAC Cl�arge Cuxb Cut 8scrvw Fx�osiun C�ntrol P�'Ic ��e Se�uvetie M�in Charg+� Cf HdUSE OI�ILY �} Ht3U5� & Ci�IRACrF 0 ATT�H�p CiARA�'rF. D I}Ei'ACI3ED GARAQE OSofftt G! Trim ❑ Faseia LfJCATIaN f}F Vs�IN1�OW� sa...,,� �u.�.,.r.rvlvll��u .L 'c� ��� u.s.c r~�� �crmit No,: �y : � 8E1�EM�3N7' ii1�MC3t�xE,nu� l. 8xi�t3s$ Fi�t Pl� 2. Fropaa�d floof pltut �. Li�at of suut�tur�l mcmbcrs t0 be uscd Tt7R NRW CONS'i'RUC970dd 1TVCLiJI��iTtG 13P.Cif3, t. Sihs Planl3ttrs�,y ��cswia� �he atiati� gtructt�ss end proyu►scd pt�Jeet 2. '1'aro sets af consttucfiotf plana FC?R WiNT�JW�S -P OVibi3 U•YALUE ANQ MANUPAGTURF3 9'1�CKER t7N WiNA�fW. �e� B�ck page �or Fee sched�e --- - .—� 65%0 o£T3uilding Permit Fe� .dQ l tiines tha tatal job v�uation .OQOS x k'e�7nit Vai.uation Mituixnurn $S.UO $5.4t� (3tate Li.censed R�s�dential Contract�rs) $2230 per SAC t3nit {�]ans to MWCC far detcrm�natian) �_____ft �• 6 � = ft x $2S� ���.._._. $a5o eanserv�on Ptan Revfcw Fee ]��t�m�ned by F.,�ginaerir� Agrcem�ent n�cessarY ( ) Nan Necessary ( ) 'rt�iS JS h,N APPLfCAT10N FOR A t�sR�vrtT.NC�'r VnT,� u�v77L FROCES3�0 I hereby epply for a building pernn' and 1 acicn.owledge that the in%rmat�on sbove is �omplete arxd accurate; t�at t�e work will be in conf�rmra�r►co with the ardinances e� a£the 'ry of Fridley �nd with tiho Minnesote Cox�struction Ccrdes; tihat I understand ttais is not a pctrnit bt,t c�nly an applecativn fnr a it a�ad i,a nat tcr wtart without s pennit on �it�; that the �,vc�C yy�1j �� a�q�.��� ��j the �pProv"rd p�an in the case af al i `�►nd approva:l of pl ,, a St(3NATU�tF� pF APALiCANT PRiNT Tiq� I�'/Gt t I l'�/"� DATE ��� �%�..�?I. l APPR�!'VISl.1NSPF.(''TnR C1r:Fn[ rnn _ — � � 2Z-�°