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P - 48143From: 7635720164 Page: 1/2 Date: 12/19/2011 12:20:46 PM �►Ltild7(l1g ��j ��:�� errnit l�o.: ��,��j�,��' �anspectians R,��I1��TTIA� AF�IIIC.A,TION Received By: ?53-572-3604 CITY C)F ]C)at� %�� —� �Z�� ' � ' _ EfiFECTI'VE 7-1-28 �� O � � _ _ _ �� O �r �. 3TTE,ADD�S � '�i[5 A�PPLICAt4T tS: awx�nr 'r�,�avx ❑ C7WNER �Af�DRESS ,....M,......r..�... _ ___---- - -_.... SUB�MIT A C(')�Y 4P �C�N"t'AC'C' PERSC��: FLCIXD JOS�TIC� Y41UR ST'ATE 5TA'I'E LiCEIti[SE # E7�P DA7'E t,�t�nrs�w�TH Ann�ss:7221 �Iniv�rsi� AveM N.E. �rr�r c�lev A3'PLtCA7'ION _ � S'tAiE,l,�„ZiP 5.. 5� 3�2 PH�JTt� 763—�?� :��_,_., PR7i i'ER�'' TY�'� 'i"ff�� OF`1�V4�{K; � ❑ rt�t�v FAMILY [3 T�VO FA1vtiLY ❑ Ti7WNHOEi�,� D�Ta,g,�fl ��sc�a�t �� waxxc C� Ai.TER.4;TiONIitEMf3��dL ��s �� or� sio.ea p�ae �ucrrr�, �xc� w� �ro��u►. �crrra�s: (tNDiCAT'E'�'C1�TAL iVUl�BER O�' EACA R�1[.+�Wy PROV�'IfE �I�el,T �.0!BS CA�.aC�S �ER MAt4iJ ASHRAE k�ANL1BdOK. �+NiFmGat instalted k� MFCr: MC�DEL: Siz�`!`ij _�� MFG: �...»_`.. tv�C)I>E1:.: --...y,...�...�_ SIZFJB'Yf 1 MFG: --.....�— MOI?EL: ,..��, S(Z�TU —.�.�.. _.vC S'LS.04 _,FIREPLAC� (c3AS) Sl3.t10 �AS FtAI�iG�/OVEN S10.oq ' ,�,,,,,,AJ#l'FQ AIR:E�CC�AAIGEER Sl5 FiItEPLACE (W'Op�i) 533.04 ,.,TNE1�V'�AS Cr`R1LL SIA.OQ 804LFR 535.00 �FUR,I+tAC� 5�3.'4d ,,,,_„GAS*UNIT }�1TR SlO,�Q �EY t,tr�3t 5�4:�0 ��s ��.�� s�n ea . �.. . _. THIS IS AN APPLICATIaTJ �pR A PEHM�T N(}T VAL[D UNT1L PROCESS�p I hereby appiy for a building permit and I aclanowledge chat ttxe u�farnxation above is cozzaplete and accurata; that the wor�C wiR be in coz�fa�cnance wit�z t6e ordsn cs and cades af tho City af Fridley and witf� the Minncsota Construction Cvdes; that [�derstand this is �at a perrnit but only an appl tian permre az�d wark is nat to start wiehout a��at�} e'�prk w' 1 be in aecordance with et�e appro�+ed plan in the ease of wprk�s revicw and approval of plans. .... ,.. - I_`[ _ I�1...; �� SI(3�lATtIRE? bF"AP�I,��q�'� .�tov,4[. nJSrscTnRS c►r . L/v City ��' FridIey � ��ilding Inspect�ons �.lepartm�pt � 6431 U�iv�rsity ,A.venu� NE, ��dley, �va.N 55432 763-572-3604 �,A�: 75�-5t?2'-49?7 �