P - 41792Building
Inspections
763-572-3604
763-502-4977 FAX
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SITE ADDRESS _��
T'HIS APPLICANT IS:
PROPERTY rJp
OWNER/
MECI�ANICAL
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
EFFECTIVE 1-1-2011
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O OWNER �CONTRACTOR � , . .-� �� I e Y ��( ,
TENANT �DRESS:
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Permit No.: �
Received By:
Date Rec'd:�
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CONTRACTOR co�ArrYrr�: _ENTERPOTNT ENER �Y
SUBMIT A COPY OF corrTa.cT PExsorr: JpANN ZINKEN
YOUR STATE sTA� LicErrsE # BOND #22013346 �{p DATE OB�ZO�ZO11
LICENSE WITH �D�ss: 9320 EVERGREEN BLVD SUITE' B` . crrY COON RAPIDS sTa,rEMN z�55433
APPLICATION PH�� 763-757-6202 F,� �63-757-6701
PERMIT TYPE I�SnvGLE Fa,MILY ❑ TWO FAMILY
TYPE OF W ORK: I��w %�.REPLACEIvIENT
DETAILED DESCRIPTION OF WORK �v�4t rw.�
❑ TOWNHOUSE
❑ ALTERATIONlFLEMODEL
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FEES ARE BA5ED ON 510.00 PER F�TURE, EYCEPT WHERE NOTED. FIXTL'RES: (IIVDICATE TOTAL NU1�ER OF EACH BELOV�
PR04"IDE HEAT LOSS CALC'S PER MANU �2�0�06� �A�S� ,�iE HAIKDBOOK
EquipmentInstalled MFG: �3���,S�y�,a,— MODEL: ��03Q SIZEBN �� t�h
MFG: MODEL: SIZEBTU
MFG: MODEL: SIZEBTU
1A/C $25.00 FIREPLACE (GAS) $15.00 _GAS RANGEJOVEN $]0.0d
_AIR TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 _NEW GAS GRILL $10.00
BOILER $35.00 FURNACE $35.00 GAS UIJIT HTR S 10.00
_CHIhiNEY LINER � 10.00 _GAS DRYER $10.00 _POOL HEATER 535.00
DUCT WORK $10.00 GAS PIPING $10.00 V ENTILATOR $15.00
Number of fixturesl@ $10.00 !x $10.00 = $
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'I'HIS IS AN APPLICATION F T-NOT VALID UNTIL PROCESSED
I hereby apply for a buildin� permit and I acknowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is
not a permit but only an application for ermit and ork is not to start without a permit; that the work will be in accordance with the
approved plan in the case of orl hic eq ir ie and approval of plans.
SIGNATURE OP APPLICANf PRINf NAME JOANN ZINKEN / D�k`i,T-� �' I7 '/I
SEPARATE
DATE �7 �
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City of Fridley
, uilding Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 763-502-4977
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