P - 40839From: 319-247-7160 Page: 2/2 Date: 9/2312011 9:10:01 AM
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Insp�c�ia�s RE�IDE�V''�ZAL APPL�C.A►.`�xON
�63-s�2-�604 C�'�'X t�� F'RIDLEX
7'63�502�4977 FAX .,���.,,...� . . ____
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t+�BS ARE BASEQ QN �ip.OG PBFL FIXTURII, 6XCEFT WfI$i�8 N(�CfiD. F[lCNRES: {IIVDICAT$ TQ'FpL NUMBBR OF SACH 9�i[AW). M1NIM[iM F86
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_ BATH SINKJLE4Y FLl34R DRAINS _, BHOW&R ` WATSR PIPA'JQ
_ �A�xruB _,,, �3A8 PtPiNG (N�BD CTrY [.[G� _ SWiMMiNG p00L � Wa�r� saFrN�� {s33)
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.,{,�Dt$FIWASiiBR _ LAUNDRY'FRAY WAT6It i3BATBR (�35) NaR ]RRIaATt01d
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_ W/lT6R MSfIIt `QTHER
'PFTi3 IS AN APPLiCATION FOA A I�BRMIT NOT VAI,.IL7 UNTIL PROCE33SD
I hereby apply for a plumbing permit �n�.�a�knowtedge thet the informatian above is camptete �d aaaarate; that tha wark will be in
Gonfbrmance wlth the ordlnances end codes bf the Cf of FridIey and wtth the Minnesota Constructicn Codes; that I undarstand this is
not a permit Dut o�ly an application for a potz'�it F wark is not to stert witl,au# a parmlt on site; that the wa wl11 be in accordancd
with the eppmvad plsn In the asse of ell work ! p�c' �d appravat of pl �(�,t„�� r r
SIt3NATLTR� QF APPLICANT p�� � (
APPROYAL INSPECTttRS 5�r.rvs��R�r � � _ . __
"'° Cfty of F,r�dley
Building Z�specf�ons Depa�ept
6431 University Aven�� N�, �ridley, N�'N 55432
763-572-3 G04
FAX: 7b3�5Q2-4g77
P�EASE SEND PERI�iT
'I'U IY(JME 4�YIV'En.!I