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P - 48614Building Ins��ct�ons 753-572-3604 ���-saz-a��� FAx narE ° .�A — 5tC� At7TJRESS Tka1S Ak'p11CAN7 I5: TE1�iA,NT $UBMfT A COPY OF YQUR S'f/�'�E LIC�N5� f#NA C��t'I�FtCAT� OF INSiJ,RA�tCk, PRU��'f V TXk� From: unknown Page: 1/1 Date: 3/20/2012 12:08:26 PM �3UILUING R.E��DE�TT.�� A�'��.,��CA.T�[��T CITY OF FR.��I..EX YDLTR �MAIL ADDAE55 ,� '�nrc.a. � 1�.J � — [7 Ol4N�R '�C(3NTRA[,�pR rrA.t+�r�:� luM __g r� Cr� �{fti 1� t� ADDitE58: c �'�' �y PHONE: � NA1NF: � � � ��. u,a STA'E� LICEI+TSB it�,,,�„� ,�,� 1� s�y� ----- vr.. � T � �i:—Tr . Permit Nn.. Rec�ived �y: � I � - � f�Ai� � 0 20 � ��a� c�xr rrun��c N`0.�(—"� �`!OZ � �z�nz+� � �1 '� �►o ��a' "1 �, �n,x �SJNt3I.E F�AMIx.YMEW CDNSTRiJ�71dN ST7.�E IW4 �AMILY/NEW CONSTRUCTION STORIES _ C1 s�►s8l�a�r �n+isx a Koo� Cl D�.CtC �S[L►iN �l'Y� ��''Wl)�: f CI TJSW FIOME �OTiSTltClCTfqM C] ADDiTION � C7 MAIN'['ENANCFJR�PAIR �;REMUDEGI f7F,5CRifiF. WO}L1C RF.ING tXaNF:_ .1'� �d A C� 4J �� Ct'!'1' ❑ UItRIN TIZE � OTIiER �& � lfOUSfi DNLY Nu�R OF SQUARES _ � IdOUSE dE (3ARrAGE rsuar�r,�e � A1iACt�t�.b QAIiACiE PICOPS3SEA SIZ�:�T 17 D�ETACH�A 4ARAQE i'ROPOSED HEiCi}CI'' � �VinYl "�,Snfl3t 51biNG180RN1T/FABC"IA ❑ Afuminum T'rim itBM4�'&D? C) Y�S C) NO L7 qthe[ Fegcis �1�lWS xN EXIS�'11NG dPPNtNd3 e6 C,1f+Td LQCATION OF WINDOWS UR FO$ IY�W OI�iINC�S- CfiU�3$ 56ZE OF or�r�a c�v4�s e� �'-j 9 TYPE OF WINbbW 1'U_i3� tNSTA.[.LED �4.It�tl�� � NUhiDE1t OF"V17�S174WS .. AG[, ���S A1� $ASED 0l�1 VA#..UAT1D�1,1]YCX,,Ubx1VC i'H� COS'f l��' I ,- (USING THE 199'7 U.B.0 FEE SCA�D[1L�) TOTAL d0$ VALI pemuit Fee Plan Review �'ire Surcharge Surcharge License 5urcharge SAC ChgtgC Curb Cut Egcraw ��ras�on Conbral Park Fee Sewer Main Chsrge �i'a R4SRi�fF�VT�,�A►,r[�IIEL.tIQCi SU9M1� � . Fxlswig Rloas PYs� 2, Ps�+oasd �loor pla�d 3. l.ist af shuctural maa�bo!'S W be ufad �QR 1�ffiW C�NSTRUGi20N IriCF.UDEN(3 A�C�&. AT�17,t'�'i0I3S. d4�t�G1�F.5 3z7Etfra7': 1. Siec PIan/Survey s�enwinB ehe exirtit�g s�r�r,ttues and Fxapoeed p�aject. 2. 'M�o eale oEconuruction D�n 3. �agy Galaleriare �OR W'd�R�1WS — YItI7VIt►E U-VAx,i,1� pND MANUFAGTURE S'I'[CiC�R IJN WINbb"W. S '/_ �� .�� See Back �age for Fec Soheclufe S 6S% of Suilding Permit Fee S 1" r .001 timee the trna) jab v�luation S � .00US x Potmit Valuation MinirntYm or .50 S_ __ ��^ � $5.00 (5t�cc Lice�n�od Residcnasf Conn�acWrs) • S 52365 pm SAC UMt (Plat�s tn MWCC far det�tmiYtation) a - - ft+6ft— . ftxS25=S _._ S S4S0 Co�servation Plan Review S ___ _ �ee Uetermined by EnBinee�ir�& S �„ . �.,�, Agreemgnt necessary () Non NecaasnrY () '[7�S �S qN qPFLICATION F4R A PERMTT-NOT VALID UNTIL PROCESSED I htreby apply for a building pezruxt ar�d I aclmowlcdge th�t the 9nforrnation abovc is complcrc uttd eo�ttgtt; that the wQdt wifl be in aonfnrimance wit� the ordinenccs e�1d codes ofthe City oi'Fridley and with the Minnesota Constn�etian Codes; t!►st i understsnc! this is not � pCrlTtti TniL Dniy an appiication fat a ' and work is nat to start without a pesrmit on sito; that the work wi1� bc Ld a�ordance with the SpprovGd �lfiCl �tl UlC CBSC Of 8II W whi roquuc� raview and gpproval of pl�ns. �, 1 I SIGb1A'�'V� PF APPlrfcANr �FWr►'r' NAIMk �aC � tp•U �c. nA�'k, ���1 11 eu�fontrnf rnirecrrnucrrsue�rrmc