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P - 42099Building Tnspections 763-572-36p4 763-502-4977 FAX �rv � SITE ADDRESS! THIS AP?LICANT IS: From: 7635720164 Page: 1/2 Date: 5/18l2011 10:05:14 AM ��C�ANICAL RES��►ENTIAL APFLICATION O dWNP1R �I'�'X Q� �'1iII��E� �-MAIL ADA�855 QWN�R/ ADDRESS: . ^ i'�I�iANT PHONE: , Perm�t No. _ R�c��ved By: Date �tec'd: �i�� ;����; � ti.vA��au+a..xv[� G'QN�ANYTl/1i�E: raw,ru�i uycaa�.a.L�v a ra.ti.. St)814tCC A COpY dF cOivTAGT P�RSON: FLOYD JOSWICK Y�UR STATE STA,'I'L' LiC81�5E # EJO� DATE ��sfi� :a,n�n.FSS;72�t Un3.versitv Ave. 1�.�, ct�r�r F�a.d�,ev �,STATEMN Z1F 55432 ,4�P�.ICATIQN �� 7��_5.72-0459 FAX763-572-0764 � . PERMIT TY�'E � o� wQ�: �SINGLE �AMILY D TWO FAMILY o r��w d �rLacE�rrr UETAILED I�ESCRIPT70N OF WO1ZK C] TOWNHOUSE ��rxow�e�a��L F�+E9 A� BAS�A ON S1G.00 PER Pl'�iiJRL. �CG'�PT WHERE NO'C6D. FucTURESe (1,NDIC,#7'E TOTAL CvuMBE[t OF �AC� 6EL0'W) Y�OVIDE HEA'a' Lp6S CA�.C'S F�lt MANUAL J 2006 ASFIRAE Y�IA.NDB40k. Equipnt�t Inatalle� NifG: MODEL: �� SIZE+rBTU 1�FG: MODEL: MFG: MODfi[.; A/C 525.00 _FTREPL.ACE (OAS) 315.40 AiR'PO AIIt EXCI�WI�F,.�R �IS _F3ItEPLACE (WO�D) 534.00 $OxI.�Ct �35.Od _FL1TiNACE S#5.00 CFi1MNEY LINER SiO.Od GAS DRY6R SIU.OQ DUC'f WORK Sl0.00 �(3AS PIPMG S10.OQ SIZF�B�1J GAS RANGFJ�VEN tl0.0( TtEW GAS GR LSlO.DO GAS UNIT H 5�0.00 POOL HEAATF,� 535,00 _VETITIG.ATORi515.Q0 �HIS [S AN APFLICATION FOTt A P��IT-NOT VAL[L� UNTIL PROCESS�[} I her�by apply for a buiiding permit and l acknar�►+ledge that the information above is cor�aplete and aocurat$; that the wark wi31 be in co�formance with the ordiz�aACes and eodes o� thc City o� F�idley and with thc Iviinnesota Cons�ructian CodQs; that I understand this is z�ot a permit but only a», eppliCati for a permiy�a�qd work is not to start wirh t a permit; that thc wa�k will! bc i� accordance with che $pproved plan in the cgse of all wark hich re `� cs review and approval of p1 s. � SIGNATLfRE 4F APPLZCANT . �'Q�! __ PRINT NAME 1�I i, �� �n�� ����� I APPROVAL INSPEC?Ok$ SIGTIATURE c�ry �f ��a��y �uil,ding Inspec�ions Aepartment 6�431 University Avez�tue NE, Fritlley, MN 55432 7�3-5'72-36Q4 FA,�: 763-502-497'7. �