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P - 48202't• �� Building BUILDING Inspections ��i �I�����AL APPLICATION 763-572-3604 C�'�'�' O�+" �'�Y�r,�+ �Y 763-502-4977 Fl�►,X rr•rr•.cTivr �.�.zoi i a�T� ni,a�. �� SPfL•' nn[�e�SS ��J ThfIS APPLICANT 15; 1'R�FCRTY OWNC�i TENANT YOUFt E•MA[L ADDRC55 M�c�t�r�iorn J� F . N L10WNCR pCON'1'RpC'I'(7R NAME:�'��t±� ( OC�.VIY�.Q nnr�r�r•.ss: �J� ��1�� WICd H�iYl�1dS��1 �,-►�N�:.� ��1a »-�� � � � R� SU13M1'I' A CCII'Y Uf� gq•AT� LICGNSL'• ff �i O Y�UIt STATG LlCGNSE ANi? C�RT►PICA'�G Qf nlllStiL'SS:�� __� INSU[tAT�iCL•" numtar. PitOP�it7'Y �I'YFE �SINGI.I: FAMf1.Y/Nf:W CUNS'I'RUCTfON 0 TWO FAMtLY/NGW CONSTRUCTION P�RMIT TYPC � AD�ITfON ❑ GARAG � [3ASEMCNT FINISF[ � R001� ❑ DGCK � SIUING TYPE OI� UL"•SCitl1�L WOItK l�EING ttaorrrvc NUMD�R Of SQUARGS _ �AC HAGFti r�torosen sirr:; PROPOSGD IIGIGI IT� Pennit No�:� ' ,' Reccived By: � Date I��C�l,�^,a-'F" � § �I—�1 t � ��s Tr:�'r.ir, LLAD CERT NUMQER � �'�' - - --C! 1 Y�.?��Q�],l�S'I'AT�%Ih�— r•nx SI%li . il tiWIMMING 1'OC]L � NGW I�IOMG CQNSTRUCTIQN 0 ADDITIQN � MAtN'P�NANClJI2EI�Afft ❑ RI:MQDf�L1NG � t�Ur h . � ��! S � � , Cl�t� I � LGNGTI•f WIDT1-1 ❑ I fOUSC ONLY _ C! I IOUSE S GARACC 0 ATTACI•!ED GARAGC D DGTACI-(GD GARAGC MI(11�I � (] Viny1 � Alurninum CI OUSer wii�w�; IN Lix14TING �P�NIN(iti Y�y I]N� OK I�UR NLW C)PtiNING',S-DI?ti�RtEiE tiI%f pr OPLMING Cl-fANGGS d2 TYPC Of WINDOW T� CiC INSTALLE�I��� ALL rC�S A[t� I�ASEU ON V, TQTA[,,.JQS VAL(i Pcrrr�it Fcc Plan Review Firc Surchargc $urch�rgC Licensc Surchnrfir SAC C'hnrg� Curb Cut Cscrow �,rosian Cantrol f�ark Fcc Scwcr Main �hargc Tatnl Duc C15olyit � Trim � �u:iviu l.001�'flpN Ql' WiNn4WS aYWINQOWS Q DItAIN TILE 0 OTf IL'•R �/1�YNUMBER�I'WINDOWS__�� _ U T14N, INCL[JD1NC THC COST d�' NG.THF�1�97 U.S.0 FEE SCHEDULE} [3ACEMr-NT f�MOD�LING �UBn?IT: l. G�isting P1oor P1nn 2, Propo�cd tloor plan 3, I.ist ot'structuml mcmlxr:+to bc uscd I�pR NLW CONS'I'RUC'I'ION INCLUDING DECKS. ADDI'I'ION�.I� POI�CI•II�S SUIiLkLIT' 1, Si1c P{an/5urvcy showing thc cxi�ting ytruccurey and proposcd project. 2. Two �a4�t oi'constructio�i plans 3. Energy Cul�;ulntiori.r r•c�R wiNOaws - i�iiaviu� u-vnLUC nNa MANll1�AC'1'URL•:5'CECICL'RON WlNDOW. LA[34R AND MA' .�y� �fQ� , U(� _ O�CU_RANCY TYPE $ ;,? �'7 ,.� � Sce Buck Pn�e for Fee Schcdule � GS%of (3uilding Permit Fee $ j �j t� iJ .QO 1 times t}ic total job vuluation $ '?C ��� ,QU05 x Pcrtt�it V�lu�tiott Minimum $5,00 $ c;� $5,00 (5tatc Liccn;�cd Rcsidcntia) Con�r�►ctors) $ $2230 per SAC Unit (Rlans to MWCC for determin�stion) � it•+-Gft° ftx$25°� $ $450 Conscrvltion Pla�i Rcvicw $ Fec Dctcrmincd by �nginccrin� $ A�rccment ncccssary ( ) Non Nmccssa�'y ( ) � i; n�, .'�. �. Mnkc cljccks ns�vflblc to: Citv of �'ridlc.y Attnch "i7�IIS IS AN nrPI.ICA'�'1UN PQR A PE:RMtT.NUT VAl.lf� UNTII, PIiOCLtiSLD t hertby �pply for a 6uildinb permit and I� knowlcdgc that thc information abovc is complctc and accuratc; tliat thc work will b� in confprmancc with khc ordinances and codes of ie Ciry of Fridley nnd with the Minnesota Construetion Codes; thtst ! understznd d�is is not a permit but anly an lpplicnt;on for � p ork i;; npt to stai't without a permit on Sito; that thc work will bo in aC�ordanec with the npprbvcd pi�n irr tho casc of`a rk whi rev' w, Approvnl of plan L� r!��, ��_ I�r ./z SIGNn'I'URi; 0[+ A1'ri.ICANT PRINT NAMC ��TN'1rG1 �J7� DAT - APPROVAL INSPCCTOR SIGNA fURG c/I a n��c+,_�nr. �co�1 fr c�i v a� a6e a.�a�aawo utoa a� �7i �n_tn_�in� Wd O� LS 6 6 Z 60Z/S/6 � a £/ l d S H� �