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P - 44556From: 612 822 5408 Page: 2/2 Date: 3/18/2011 11:59:05 AM r�� 1� Bui�d�itlg PLITIVIB�N� Permit No.'— Inspections RESIDENT7AL APPLXC�'X"YO1�T Rec�i�e� sy: 763-572-36Q4 �jTy pFi FRIDLEY Date Rec'd:� 763-502-4977 FAX �,..,,,,�, , ��,� YOUR E-MnII. nDDRGSS 51TE ADDRF.55 _ �� 3,� f7GCs%t Ef.+N G�J"1l« 'CHIS APPLIC.ANT TS: Q OWNER �pNTRACTOR �W1V�ER/ T�NANT � �.�1'/ S1'ATE�yLlP� �..va. a aw�. a vn NAME: 8MV SUBMIT A CDPY OF 51'A'I'B LtCENSe � �/�iM 1'sXP DAT� L YOUR STATE ./ 1,IC�VSE, BOND AIVD liTATB B()M) # I`� i E?CP DA'1'� �� r CCRT[FTCAT6 OF ADDRBSS: r4 +r � T,CITY /fJ,�J STA'fI'it/�e/ Z1P�[ IIV5URAIVCE PHONE �+� 9"�. FAJL ��r��..��%r/�� PERMIT TYPE '�sWCr.� ranai�Y ❑ TWq FAl�LY Q TQWMiOUSE TXPEU�'WQRic: �NEw �ltEPLACEMENT DETAILED DESCRIPTTON OF WORK FEE3 ARE B/15�D ON SIO_00 PHR FIXT[JRE, EXCETT WIIERi NOTCD. FL7C!'UItES_ (INDICATE'TnTAL NUMBERUF EACH LiL�L.OW}. MIDiD�2UM FEE S3S.50, HATlI SIIdK/LAV FLOOR D1WNS SHpWRR ,_ WA'1'F:1! E�INC PA1TTfU[i CsAS PIPING (IYCI?D CPfY UG7 SWIMMING POAf. WA'1'Y,'R 50f1N�R (S35} Cl.O'TI�IL+S WASH�R KITC3�I S1NK � WA'1'�R C.f.I�SFT �� BACICrLOW PR�V. (SIS) _ DISIIWASHIiIt ! LAUNDRY TRh1Y WATP.R HF.ATRR (Ti35) k�'UR lki!lJGAilON �WATP.R M!?TF.R t71'HEI! �,,,��,��,�y�{�y1�, ,�'� p��, � �,yA� k+ ��, �,��4y,�i, , ��a , , ��f� pn�}�' ,t� � (� ��x�i, ' P � , +u ?`r,`„ � .` "�w��'�It�'153��F .. . ��Ff�t��/ �` . ��'�iKN'+�`�f� . , '�,_ �� .«�,r .�i�i;�r" ' ��: ;��I;i�ituR ��i1N� , !I��',"� '� ��y� � R��y'�`:' � ; . :� `..t�" �' � :•�. •.;:• . . .'''i�,i .7 � c��'{,.�,cr:!'I �r,;' ,.r�p. � , i , ,,,.�„ � f"��. . �$�� (� � �. �. � Srr ��{� ��;, �� r.. r'� '� + r�a a � � q�r,' `'., i�'� p � d�t . n (�E �, �`"'� � 4 �;; ��'�;.. � i k ' ' ...'d 1 •'�•••�'�.•':�.�'�"'�"�� t_ ; � � .;.;..�� i::.....;.•:%�i� �:�:� ��`•,'',''' ,�; � � :�a;;,T �'f;;.�:::�;:>�, ,a. ��::::�:;::,`;>g x,�' .�r•,.;;,•. , �. � if�'�": :.�r;%{r �".; .�:i'• !; � lSA. ��' :'•t�;,, ;,:.tia,':; ::Xt� .:�ix :' m i *•+.'•:;+' ,�la �{�r.•x;:�."::"�' � � ::�,�, �? :W'�r�y �..:•�. i,�; � � . . • :::.•.:• .•.•., •� , ;:;N,y,, � Y 'A+'� a'>1 , r •: � :: r. . , i � � .11�:'S�� .�a� F�� T�i�f :;';f ,� � `. � TIQS I$ AN AYPLICAf1UN FUR A PERMIT-NOT V,q�,jD tJNTQ,1'I�OCES$EA I hereby apply for b plumbing permit and I acknowleclgz that lhC inforin��ttion abovc is completc and accurate; ihai th� work will be in conformance with thc ordinances and codes of the Ciry of Fridley and with thc Minnesota Consrruction Ccrcies; that I uaderstand this is not a permit bu� only an application a per ' a,pd woi'k is not to sttut without a permit on itc; that thc work will be in accordance with the opproved plan in thclp e- �� ich requires rovi�v and apprv�ofplans.� �/�pr/+� SIC�NATURF. OR qPPLICANT ,+�'�' ll e i PRWTNAME! �NdR'. ��_ �=-13 y A a( City of Fridley Building �nspections Department 6431 Uaiversity Avcnue NE, Fridley, MN 55432 763-572-360Q FAX: 763-502-4977