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P - 44376� 10�7. a9 I3uilding Ins��ct�ons ��3-s�z-��o4 BU ILDI�TG RESIDENTIAI. A�PLICATIU�1 �IT� OF FRID�EY U�.�,� L! a�J �" �_ . - _ Y(>UR E•MA[L AL1DRtiy5 •- 51'1'� AllUI(ESS �. �� �_ � � n.�0. » •... . �_ . _.. . 'THtS AFALIC;ANT LS� O OWNF'1t ONTRA41"c)R _ „ . .. . _ ��op�x�cY owNERi Nan�a: -� �� .a-�l�.�reh Bour ea u. ... T��A1�tT ,�DDRESfi:..L".r? O Yf o h�Q�?��Nc�:1�rY.... F�rid Je�.. PHUN�:?C�p 3 � �.�! �A• — ,_ CONTRACTt�R �IIbMIT A COPY (}h' YOUR STAT� LICF..WSL w,•�x ,�Pi..ica�rc�� PRUP�RTY TYPE pEItMIT TYPE TrnE aF wo�rc: r�ntv�: t��„I �naow ��.« . ._ srn�r� ucENSt�: a. 020 I G�3 �/9 ,.,. c� na•��� auu�u?ss:990 Lont AaK J�2�t�(f� PIIONF. �51 90 5'' O l 05 rnx CQ 5 �� SINci1:F: RAIvIILYlNEW CUNS'�RUCTION . SI� p'I'WO FAMII.Y/NEW C:t)NS'�1ZUC:1'ION ST d AUl')ITIOAI �- CI GARAC►EJSFfEU ❑ f3A,gAh�B�1T FiNISH ❑ RQOE p p�� ❑ 3IDINt; O SWIMMENC3 POOL l7 NCW t7 All1�IT]ON �.,C,� .. _----..-•_•-----.:_ _ ...�nn.tr_ UESCRIB� WUItK S�iNti DON%+: r�� aee W,Snd�W 5' �h Q SIZE Ul' iMPKOY�MLNT ��:NGTFi W K � t:' � HUU5G QNt.YT NUMk3ER OE SQUART'S �,.� CI 1!IOUS� dc �1ARACiFi , A� C7 A I'T'ACtIEU t:, aRACi� PRO!'F7SEDSIZ�:._. G tAE'['ACHFDGhAA(iE YRQPhStl1] iIEIGH7 : ,. . �'�'—�'� 17Salrit ❑ Yinyl ❑ Aiun�nura ❑ Triu� I�ni j� rNt`Ci8 Q nt{pf _ . � IN h'i� �t—��ST�INCi ciPL'TVIN(i5 �'Ce ONo LU(:ATfOl�t UF WiND(�WS �O`. �..� Utt PQR N�W Ol'L'NINGS-1?FSCRISl: STZG OF � . - I� - or�r.mrc cnAxGrs a� do �.bl� h u�-Q ..... ..,.,., ,..- ,��,�,,,.,..,fi zYpE oF W n�mow Ta sa �HST�t�[,k:� ALL �EES ARE BASED Or1 �'ALITA' (US[1VG Permit Fee Plan i�eview Fixe 5un:herge gurcfiarge Lice�se Surcharga SAC Cliarge Curb Cut Escrow Erasion Control Paz� ree Sev�er Main Char,�� P�rmit No.: R.�c:ei . 9� ,��3a 3 " s._�.. _CITY., . �EC1 g STA�'fE 41f j-q��6 17y�' � �_ I21h:S _ , � INDUWS CI DKAfN TiLE ❑ U'I'��x �a�c ..�r. ( i $ f % �O�/7 / -S LUDING Tk�B COST OF U.S,C �'EE SCIiEDULE) �sial �. e•.x�sungrMO i•�an x, Fropoacd flo p�dn 3. List nf inembav to'be esed g(?K NL•y1' (,`ONSTRU fIOI�' WCI`i1DINti 1)�.(�GS, l eaCist.ia� sir�cW� and propnr�xl projc�l- 2. �NQ }i�'1S 01 SIJ�Cfl011 �Siat16 3. F.nnr�y C�1c a�ions , AND JU� VALIJA'fION � acd'� .,�,.��r�,.... - --- � Ses Sack P�e for Fee Schedule � b49�p of Buildin� Pennit Fee S �.UOt times the tatal job valuation � UU05 x Permit V�luation Minimum �.54 �'� ',�� �S.UO (St�te Liccnsed Residential Contraa�ars) �' $�G75 per SAC [Init (Plans ta MWCC for d�ternr � _ft+6 fl�-- _ftx�21 =�—,.— $ $450 Cons�tion Ptan Rcview � $ F'ee Aetermined by Enginearing $ A�reemettt necessa�'Y ( ) Non Necess�rY ( ) -�--r_ � _ �. ,.._ud ..�a..�� .,�..,Ae►le tn_ Citv Of FCidley_. i ow� „u� - _ __ 'i'iilS iS AN APPI.ti.tlTlt�l P�It A PFs[�Ml'C-NOT VALII) [!N'�'{L Pitf1CG5SEU I hereby apply For a building permit and � acknowled�� that the information abvve is com�lete and accur ��rtforrnancC with tlae ordinanc�� aud code� flt rhe Citv ai� k1ridley and » ith the MiYanesot� ��onstruction Godes; per�'tt but enly aa application for a permic and work is not tc� start withcwt a Perrnit; tttat thc woric wi11 be in � pla:t is� the case of af! wark which requires revi e apprc�val c�F plans. �anC�s,G� �%�S�n�a,7 �'t'NAML.—.�-• = SiC�dAl't�L OF APPLiCAN'C �_,—, , �' _�_��, Ld Wd90 : b0 ZO�Z €Z '��0 ZB�ti tiLS�9L :'ON SCd� that the work wf11 be in 1 uuderstand this �s not a xdarice with tha approved �-aq-�c? fiaGpta� ,�oi Fi�t�: 4�.12�