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P - 44991Building ��Spectlb�l5 763-572-3604 763-502-4977 FA.� � �� S1Tk /W�KESS _, THiS APPL1CATit IS: From: 763 444 5629 Page: 2/5 Date: 1l4/2011 2:57:36 PM PLiJ�B�� R.�S��TTIAL APP��CA,'�'�ON CITY OF FR.��LEY YVUR k�MA1L ADDILES5 � OwNF.R �'ONTRACT�R ' _ � r�r' f . � - - - . : .�r,i � , �i� � r�w�r`w�■� acVR'�..KA F NAME:__�L��lf � -� }C�i/'C/1_—M .,„_, _._..._..__......__.._. �, �wN�'R/ Ap,RRFSS' :4'-�7 �CL1I�J'�/I .Lr�,' ._..C�i`1��t•1 3TAr�rZ1P T��t.f��l'� —'=T—,—' �---�........ FH4NF.:_. -- c."Vlr i KAC. A i,�RC NAMk: YYIf'� 1'" ►�� F#��.. G+. $UBMI'1' A CUPY OF g�•ATE LiCENSF +� G11..�'�LC�,f�� /3'i . . .. - — EXV bA7'�' �-�,'�/ �/� YOUR S'�A'�'E _.. __ .. .. L3CBNSE, BON�.1 AT1A $TAiE 90NPi # .+ � --•--_....� EXP ARTF; /•� '"� � cxttnFtcax� a�' ann�ss: (,�,��a..77 r� .,�,/�'�� C:17'Y .�`��ex.�,� 9'TA'1'E�[z« INSU�iA,NCE PHONE�„(�� '�....�{"4�t zd 9�, �AX ;-� .......�_ FEAiM,lT TYPE �1(� OF WORK: f�31NGR,� PAMILY o t�w DETAILED DEa^�RIPTIC}N CfF WfJ12,K Q TWO FAMILY �EP�AC�MENT ❑ TU�NNHOUSE F�ES A2L• BASBA ON St0.00 P1:R FIXTtJYtE, �XCBPT WHFRB NO'rTsla. F1X'fUlt}'sS: (1ND�CATb TU'fAL NUM��R OF BACH BSLOW}. MTNIMUM FP.B �35.30. $AT1� S�NlC1LA►Y FLOOR DRAINS 5}ip�y�� WA7ER PIPING �pE'1'klTUB ^ CiAS P1piNG (NEfD C)TY �.lC) � S�YiM1u�iN4 PQOL � W+0.TFR SU�TN�R i�5) CLOTHES WAISk�FR ^ KITCH�N SINK WATER CLOS�T _~ $A.CKF}AW PREV. {SI S) DT5}i�r,�„s�� LAUNDRX TlU.X WA't'ER HEA'I'FR (S35) ROR IRRlGAT1bSV "— "M' �, WATER ME'1'��t �07�NER ��fEl'��1Q.1i0 R�IQ.�Q=� -- i�1iffibQO��i�S.ai _X��QO=� IJiu�' Od' flXpneB �,�iS.OQ ,,,,,,,_ X$35.O11 '■ S St�te Su�lurge s„ �.� �lMI]j�il.11i1,3]1� �} '1�1= � - '�HiS IS AN AFFLI(:ATION FOR A pFsRMCi'-r[U'T VAL1.(S UN'1'1L FRC7Ck,SSfSU � i k��xe� spPly for a plumbing pecmit and 1 aCknawledge tltat the information above is comp�ete and accureue; that the wark wi!! bo in ooqfprq�,ence Hrith khe ptdinanccs �ft of the City of Frid)cy aund with Eho Ivainnesota Con�st;�uction Codcs; tha� 1 undcrstand this is not a pernn��t but only an a�+plication for a it d work is no! to start witlwut a perniit on site; that the work wiU be in &ccordas�ce witk� t�e approved �l�n in the o all quires reviaw and approvaf of p1 a�s_ „,� _� 5IGNAiU[tE'i pfi APPl.1CANT RTii�FNAM��.t,' .I�ttC�_._AA'i'E — r�w•rc U �liy U� �I'l��B� �uilding �napections Department 643i University Avenue NE, Fridley, MN 55432 763-572-36t�4 FAX: �s3-saz-�9��