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P - 60354Building E►`C�Y�.IyIN�+� Inspections �SID�NTIA�r. APPI.YCATXt�►N ��3�s�z-��a4 CIT� OF F1t�DLE�' 7b3-502-4�?7 FAX �Nr•LCrivE i-►-z0i� �...� . . SITEAUA�ESS�� ��� �.4�i• �r '1'I-iIS Af'PLCCP.N7' IS: CI OWAlEft ��.OPER�f'V' OWNEii/ ��ME: ; `C�1�EANT AQPRESS: ' PHC�NE:S€',1, � -. �O1V'ii�AGTOR �iAMk:: fA S[�L�MP�' A Cc��'Y a� srA�TE LiGE E Y�UE� STATF LICENSE n�a ccRTlFr�aTE o� np�RES�:� PER;MiT TYPE TYPE DESCit1 R1F 512E OF iM 0 5ChIGLE• FhMll: Q TW� FAM1l.YfF o BASf;MCNT FINiSH ❑ DtGt� N4}MBER Uf SQ[JARES G�1l2A4 F.S r�a�ra5�;� stzE: �ItC1ROSEy71-tF_1GFi7;._„ S'�y1 Cl Alu�»inu�n ❑ Ottwr _�_ 4ti'INT? \V IN F.XISTINGaPEhlll�tC1S 0'Ycs C]No E)R FOR NLW pPENiNGS-D�SCR[SE 512E Of C�l'F.1VlNG CtiANGE5 R ALb FEES AR� P#an Review Fsre Surchar$C Surclyar�e L.icense �urcharge SAC Chacge Curb Cut Escrow Erosion Control 1'ark Fee Setver Main Char�e . �� YOUlt �-MA11. �,,�, � #x t��;* ctmv�,� �_� 6�! �nx ,t '� U RUC'1'if3t+1 SIZE,,.,,_ C7a�N 5'I'�RI ES� � GAW�GE/SHf.D � WINDClWS ❑ Roor ❑ �Ra��a r�t.�: �stDlN4 C10'i�1ER p $VVIMMING PAt1L. CI A�UfI`CdN C1 RFMOL��.ENG LJ I IUl1UL Ul���!! � [] FIOUS� & C,ARAGC ❑ ATTRCHFC7 GARA(iE D (�ETACHEp GAI�AGE ��c S�ITINGISQ�'�'yTlr'xSCIA CI Tri,n R�A�10i�ED? fl YE5 ❑ 1�0 ❑ l=�.sCia LOCAt14N QF W1N��YS T�Y� 1997 U.B:C FEE SC�EDULE} Pennit �teceived _ S7'AT�,w,_?;[P'�.,�„�t �rt�►'� .z��, FiL• IGHT $Q FT �HSL'��ItIV! RL'141�J1JLLtuU.lt�lllllll. i. Gxis[ing Floor �18n 2, i't4pased itoor gisn 3. List of struotural rnembers to be uscd EO1R AlEW C.ONSTIttJCTlC?I�F TNGLL3DINC }?ECKS, All ITYt3NS & P t€C1±�5 SUE# 11" l. 5iu pian/Survey shawing t!x exiStmsSsttuctures and propoSbct ptttl�. 2. 'iWO Stts ofcGnSUUGtion p1anS 3. Energ,y Galculations COR w[NCtOWS � PRC)'YIDE tJ-VP.�-uG,0.ND MANLfFACTl3RP STICK�� AN W[NT�'t�U. - — -- $ _ See �ack Page for �'ee Sch�dute $ 65%af L�uildin� Permit �ec � � --- _001 times the�total j4b vaiu�tion $ .4405 x Permic'�Ialuatian Iwinimum or ,50 $ $5.Q0 (State I�icensed Residentiat ContrflctoYS) $ $2�G5 per SAC Un�t (Plans ta MWCC far determination) $ i�+bfi= ttx$�5=$ $ $454 ConServation i'lan ltevi�w $ F�e l�etcrmined by Etiginoering � _ Agrterrsent neccssary ( ) Non NeGessaty� ( ) TH]S tS AN AP�L1CAil4N FOR A PCCilN1T-NU'C VAL1DtJN'1'IL PRO�E95tiD { h�reby appty for a buildit�� permit �nd l acknowledge that the inf4rmation atao've is compfete and �ceurate; that tbe work Will be in conform�nCe with the ordinances and codes of thc City of �'ridley and with t�e MinncsotA ConstruC[ion �oci�s; th�t [ understand this is not a permit but anly an ap�lie�tion f a it and rk is not t4 st2trt wiihout a permxt on site; th�U tht wc�rk will be i� accnrd�n�e with the e�pproved �lan in the case,,faf , ich r v' w and �PPraval of plan.r,�;����� ,/ � SIGNAT[TRi OF APPC.ICAl`� �` _ PT{INT NAME lsi� �va ! �ATG_'T l�- r.L� Wd LZ�6S�ZL ZI�OZ/L4/b �a��o Z/Z :a6�d' 866£998ZL9 :�o��