P - 48370JUN-03-2011 09:04 AM STANDARD WATER COMTROL T63 537 1882 P.02
�+uuuiii� 13 U 1LDING Pernut No.: �'� ?�� �� C
� Inspections � �i SI�]� i N T� A L A, P F L I C' A T I p N Received B;
763-572-3b04 y
���-soz-4s�7 �Ax CrTY OF F�tIDI�E3� Dgt�:
EF'FgC'[TVE 1-1-2b11
bAT�_ LD i . t
SyY`E ADDRESS ��
t'F�S APPLICAIVT IS; p p�R
T�NANT
&MAIC. ADDRESS —
SUBMI'C A C�PY OF gTATE LICEMSg #__.I_!�� es�* '
YOCI�t STA'f'E L[CLNST Lt�AD �aaT NUM
AND CERTCFIC)A�7}'B dF ADDR833: 5�.3.3' % Ld��� f �t /'� ��.�.�,
. �S V 1V'fl\CT.. 'S[]�M�n �i IA �.Z ��"� �9 yf / / A � i w '-
SiNCC.,� pAMILY/NEW CON'STRUG7'ION
�rwo F:v�s�.vnv�w coxs�rerrcTTrnv
t� $�s�xr �nv�sx o �p '
� DE�CIG ❑ S�1NG
TY�� O�` WORK: — � N�W HOME CONS'[YtUCTiON ❑ ADDITION
0 MAINfSNANCB/REPADt 'R( RBMODELII�G
DE5CR1SI3 WORK B�YNG DONE; 1� ' � � /Yj
SIZE bF IIN�OVF.MEN'f �Q� ��
ROOFING ❑ YYOU9H ONF.Y
D1Y.�M86R OF SQUAR88 0 HOCJS� 8t CiAxtAQE
�
PROPOSED SYZ�:
PROPdSEb HBIGHT:
.1� Vmyt
Q /�(��mim�m
❑ 0lher �_
�
IN EXIS7'YNG aPHNrNQ3 �Yes �lvo
OR FOR NEW �PEN1N43•DESCRY�S SiiLg QF
OPENIlVG CHANCiBS dk.
7"YPB OF WlNDOW TO BE yNST
0 AT7"ACHBb 4ARAGE
� bE'fAGi�D GARp,(ig
OSolFii
❑'rrim
� �ascia
LOCATIdN' OF WIId!)QVY3
�+bRAIN TILfi
� 01'E�BR
�
��
� . �
1. �xiaung Flopt plen
2. Propossd fl000�' plao
3. List of sttuctu�ul eqem6err to ba used
FOR NEW CONS'i°ItUCTtON INCGUDIN+Ci bEGKS,
A�'i'jONR �,�(��t`H � rw�*.T,
i. S� P� �� ;,,g �e o�ciseing atr�cuea
x. Ta�o eets af const�ctlon plaie
3. fintrgy Cakculatiqns
FpR WIIQDOWS — I�ROVIDB U•VALll7 ANp
MANUt�ACTURE S'i'YC�iR qN W1NDp'VN',
ALL �ES ARL BASEb ON VALUATIpN, INCiUDING T�E CO$T OF LABQR AND MATLRIA:L$:
(�J'SYNCr TE� 1997 U.H.0 �'EE SCHEDULE)
'OTAL JOB VA�,UA'1'ION S p��gp��y �,p�
Plan Review
Fire Surcharg�
Surchsrge
Lieense Surcharge
SAG Charge
Gurb Gtit fisorow
Brdsian Cantr�l
Park Fee
Sewer Main Charge
See Ba�1c Page far �'a Schedule
65% of �uilding Fermit Fce
.001 ti,mea the total job valuation .
A005 x Permit Valuaiion Minimum $5,00
$5.00 (State Lioensed �esidenrial Cnnh�actar�)
$2230 per SAC Unit (I'tsns to I�WCC for dctermination)
ft+6ft= ftx$25=$
5450 Conserv�tion Pl$n Roview
Fno Determined by fingi�rir►g
Agreement necesaery ( ) N�n Neces�ary ( )
A�ke cbeclra payable to: Citv of Frldlev Aiiin
'['fD3 I3 AN A�LICA77ON FOR A PEI�IIT. OT VAWD 1J1V'C�L PRpCESSED �
I herebY apply� for a bail�3ing permit I that the. ' stion above is cvmplete and accurate; that the wack will bo in
canfor�aance �+ith tha o�dinancea and c o f F' � and with the Mimtcsots Conatructian Codes; t3�at I underetand thie ie not a
pormli but only an app(iC$tion fpr a pe atart ' a permit on sitc; that the work will bc ia accordane,e v�,;th che
approved platt in the bf ppr�vai of plans.
SI4AiATUR� OF APPLI � x�_112•'r�.��i on nw� /
ar�eovar. �rsrECraa s� �► �r ,
JUN-03-2011 09:05 AM STANDARD WATER CONTROL 763 53� 1$82
;
� �I�N��L BU�tDING CONTRAC'�i�R LIC���
�+-- ___
Le$aF Nalria; !�'1`A�l�RD �111/�"�p C��1'1'ROI, 8Yi3T�NM8 INC
pB�i::
Ad�rees: 533"i L.AK�LAI�J�AVE N ..
�pOOKLYN ���R, 4Wh�: �5�9 �
Llcense Iderrti�catlon Numbsr: �'��xit ..
t�icerf�s�E�plr� I�; .. �151/SQ1S
IDs $37495
SiANDARD WATER�G�ROLS SYSTEMS ING
C�edfAcNelaa, ��a ar Re�wflm
�welfing conlract�r Ca�tnicatlon
Busir�aas 8truature;
CC�RPORAI'ION
t�ualflyfrtp Pereon: MICHAEL W W+p��NSON
Conq�uan� ��duc�tbn; �4 h�urs �ue.Y��r C3131/8012
oeiz� ,
1/�'i�cat.���ic� t�����`tmera� oC Cc�c�nrrt�tc:�
B�u►t�ri:
P.04
tD;837488
MIK� HOC3ENSON ��,•,
' "'- ��,
i � �"
CertlAe�tloa� �.ic�lo�e, or Re$4traelop Ni�e E=pir�s
�welling Gontrsctod�puslitier Certification ;7�;�: � 10/Q9111
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�JVi�rac�r'E�in i:3e���rt���i�nt �fi u.�r��>���;r�.;�
Sipntu�x:
W����' C�N�'IUICTQR REGiSTRATIQN CERTIFICAT�
ORK�'C7RC� srar� oF iow�►
CIEVEL01'M�NT
�.�� n�., :
IOWA WpRKFaRC� D�VELOPM�NT
DiVIS10N QF L,ABQR 3ERVICES
CONTRACTOR REdISTRATIaN
1 pq0 Ea�t Or�nd Ave,
De� Molrtet, IA 60319-0209
Phans (S15) 242 - 5879
STANDARD WATER CpNTROL
sYSr��SiNC
5337 LAKELAND AVE N
CFtYSTAL, MN 6542�
DATE ISSi1ED: 'i0114/2010
DATE �XpiRE$: 10114/2011
REGISTRATION NUMBER; C108197
G�-a�' ¢
aavid Neil, Commiasianer