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P - 48618„,,,, From: 9529425550 Page: 2/2 Date: 311 5/201 2 1 1:04:37 AM Building BU.TLDING ���t No.:� I�spections �i ��ENTIA� APPI,�C�T�UN Received By: �7�3-�72-3604 CITY O�+' FRIDLE� Date lt��'� ��3-sa�-a���� F� �C� �-�-�o�z _ _ .� '1 � t C' _ t r'� r� - - - -r-. - - - - 9ITE ADDRFSS �, TH1S Ai'PLICANT IS; G�i1.� 1 FRQ�,ERTi' QW1VEj�J �'�+'N�11�rI' s�.� car�r a� Y'dC1It STATE LIC�NS� ANb CEItTi�ICl�TE O� INSUIUINCB �'�QPERTY TYI'E PERM�' �'YP'E T� o� wozzz�: UESCRi��'Wt7�C BF«T�iG YOUR E-MAIL ADDR�SS , d (SWN�R NAMF.• � (^� 0 BTATE LICEISSE PHONE ' � ❑ STIV�T,� FAMILY/NEW GONSTRL1CirO1V � 'ltii�0 FAMII.Y/Iv'EW CRNS'I'RUCTION ❑ ADI7T"PIOAt O t3ARAG ❑ �t�.9�MENT FIIVISFI LI RQD�' ❑ DECK C7 SIDINO ❑ TV�VV HQ3rtE CONSTRUCTION OR OFING h1UMBER.OF SQUARES �� PRQPOSP,n 57ZE: �RIQPOSED FIEICrH'1'_ SIDING �� ❑ v;nyi O AI►�minum ❑ bthcr R'II�TDOW3 7I� �CI51')N� OPENINCTS �YGs �1Vo OR PpR TI�W OPENIN(39-DESC�� SIZE OF OPENIlV� CIiANG�S & �YPE OP W 1NDp't� �O HE II+TSTALLLD � 0 ' � �"�' �� � �'r ���''`�'�� r�nn ��.�T r�r�m����� �~T,?,��..��� ;�rrY vr FAY - ( �.T SIZE STpRTBS �/SY�b - _ OWS DRIiIN Ttr x � QTHER NG PO[7L o .wn�azax ❑ T-TOTJS� �NI.Y ❑ HOUSE 8c GARAG� Q A'2TAG'�3ED GARt1GE ❑ DETACH�D GATtACB bSoi�c SiptNG1SOFFTT/FASCIn D'�ina REMOVED? C] `YIES C! lv4 � Fastia LpG,AIION OF WINDOWS ����� � �1��� �`-: . r� AT��'�� E;111 RASFMi'NT_REMODE�I1VCr 5iJ$M['L”: 1. Eaci�tiRg Ftoor �'lan 2. Propased floor ptan 3. I.ist of 6wchual membcre tp bC usCd FOR NEVJ CONSTItU�TTd1V' TN'C.C.t1D[NG DECKS, .�.nnrnaxs. � roRr.r�s strnn,rcr: 1. Sire P1baJSurvey showing thc eziRting s�uctures and propoacd pmi cct. Z• Itm+�ofcorstruct�onplans 3. Energy C¢lculaiians T4R WIl�ibO'UJS - PIiqVIDE U-:rAL� p1VD MANUFACCURS STi[CI{ER ON WITIDOW. AT��, ���5 A,RE BASED ON'�'ALUA,'�IpN INCL[T�IN'� THE �CQS'� pI� LABOR tlND M.�1TE17TA�,S- TQ�'A�., ,TpB VALi Femut Fee Plan Review �irc Surcharga 5urchargv Licexise Surcharge S1�,C Charge Curb Cut Escrow �rasioi� �ontrp� Pa�lc k'ee Sewer Msiin Charge Total bue � . ,�y�, �jSING fi�T� 199? U.B.0 b'EE SCHF.�?CrT.,�) (,' �C.� QCCUPAN�CY TYpE �---- �. Z.�_ See Back Page far Fee Schcdulc � 65% of $uilding pernait Fee $ -C� ° ,Obl times the total job valuation $ !.( .0005 x Permit Va(uat�an. N[inim��um or .50 � $5_00 (State �icensed Residen#ial Cantractors) � �23b5 pex S�C Unit (F'lans to MWCC for Qet�runationj � �ft -� 6 ft = ft x �25= $ � �450 Conservation Plan R�vicw � S _ _ . Fee Determined by �nginccring � Agteement necessary ( ) Non Necessaxy ( ) _� J1 ,� �j 117ake checlt� pay�ble to: Citv of F�idtev Attach T�-lI5 IS AN APP'LICATION FOR A pL�hfxT.X+iO'� VAL1D UNTIL PItOCESSED I hereby apply For a 1�uildiing pezmit a�d I acknowledge r�at the iuformatioB above is complete and aecurate; i1�ae the work wilt bc in conformance w,ith the ardinanccy arad codes of the City of Fridley and wi�h thc Ma�esata Gons�uction Codes; that I understand this is not a permit but only sn appli for a permit and work i�a'aot to st vvithaut a pormit Qn site; that the woa-lc will be in accordance wida the a�proved plan in tYie case }�� 1y� � ew and approva� of pl ans. SIGNATCTItE OF APPLICANT_ 1� /l�/ PRTNTNAMF? ,�ili a-rt f ik�Fr'n v1 ��.c,r naTU �i �1.� - i.� 0212412011 15:48 . FEB-24-2011 1�:17 i , 7637542908 CENERPOINT ENER RIUER CITV D2te' 2l2412Q11 R�visian Date: 2124/2�1 � ExiSting Construction: Pr� 199�4. Site Informat�on � Addr'ess 9: 171 Rickard Raad Project #: Address 2. L.ot: Black: City: Fridley Cdurlty: Subdivision: Appll�ation, lnformation Rusiness fV�me: MN Contr�ckor Licertse #: �ontaCt Rerson: �ffice Ph' �ax_ Geil Ph: Address �: Glt�: State: Zip Code: Combustian AQqli�n�e W�ter Heater; Natur�l Draft Inpu# BTUs: 36,000 Independently Ventsd �urnacelBoiler: Direck VenUSeal�d Combustian lnput BTUs: 6Q,400 Independently Vented Maxe-up Air Np Ma�ke-Up Air Required by CoC1E Combusti4rt Air Minimum Cornbus#ion Air Requirements Met. Applicant Name (prirtt):_ Signature/pate�� Cod� Officlal (print): Signature/oat�: �.- � �� �,� L f, �� :,�L1�(�) `- C.rv` � .� � �.� ',f- � ��, � , ,� � � ��� � � �� 2004 CcntcrPoint Efiergy Minneg,accp. 2(}U4 M�chNr,icxl C otic: Guidelines. PAGE 03/03 P.00i�oai f�n�r i TOTAL P.001