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P - 35802Building MECHANICAL Permit No.: Inspections RESIDENTIAL APPLICATION Received By: � 763-572-3604 CITY OF FRIDLEY ��Re�� 763-502-4977 FAX �cTtvEi-i-zoii '� DATE I' I L� " 1 I YOUR E-MAII, ADDRESS J S`m��Ylh�i t1. C� Q(`(1(,�i �. ��l1 si�nnn�ss �!�a�'I �. � j_C�.,C`.��r��,,� Pc�� THIS APPLICANT IS: ❑ OWNER �CONTKACTOR PROPERTY NAME:i�`(�Ci� M��C�(leA �� ZZ\ OWNER/ nDD�ss: '�S�°I C_.�C�-�C��C�0.t1 �ChS�� i-t i\�� STATE M�II' �SII �j TENANT PHONE: �1 UJ �� L} �j�I ",3S t� � CONTRACTOR cohrnnrrY NnME:� � Sm�� i-'�0� �� C, ,\ r�C - SUBMIT A COPY OF CONTACT PER50N: _�(��l C� { c��'�C YOUR STATE STATE LICENSE # EXP DATE LICENSE WTTH ADDRESS:��Jq�S �'n ��'C� S�G ��C E CITY �1 �IY1 �K.� STATEMI�.�IP SS3� APPLICATION PHONE �]SQ�j� �'1 q'c�- '� �LQ �� FAX � 1lA 3� �1 \�1 — 3°l �� PERMIT TYPE �SINGLE FAMII.Y ❑ TWO FAMILY ❑ TOWNHOUSE TYPE OF WORK• � �W �P�CEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK FZfa L.EL.U�1 ��vv.»i1 O� J—I� , DO(� �j 11� �� C.� u�I F_C�M �\C�U,��C C�j�C • FEES ARE BA5ED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOR� PROVIDE HEAT LOSS CALC'S PER MANUAL J 2006 ASHRAE HANDBOOK. Equipment Installed MFG: �V�U G, MODEL: C� L �) ERM�� SIZE/BTU �1S � � O MFG: MODEL: SIZE/BTU MFG: MODEL: SiZE/BTU A/C $25.00 FIREPLACE (GAS) $15.00 �GA5 RANGE/OVEN $10.(� AIR TO AIR EXCHANGEER $15 FLREPLACE (WOOD) $35.00 _NEW GAS GRII.L 510.00 BOILER $35.00 �FURNACE $35.00 _GAS UNTT HTR �10.00 CHIl�IlVEY LINER $10.00 C,AS DRYER $10.00 POOL HEATER 535.00 �DUCT WORK $10.00 GAS PII'ING $10.00 VENTILATOR $15.00 � �� F� r r� � � � ,u,; + � : k r 5 M L m� � � � _g k- �s ^�. '�. P, S 3' , �:, � S., s+: �z ,�,� , � � � �� ,`� s 4 i�E s a ;cJ' .� W��r�; r� `� � � , t ia �3 c�, �:f a�- y a � �� $ � �" �'z � � � �° � "'^t�y,.�`. M1 a� �''S .3 Y'�`. ��"'Yh °": " y 4� x£: '� �` �s$�'w�. 'M !.. �d F 3"� A :;q x.' f ��'' S�?�„Ae� +Y?��h' ' 3.fl�. ..... �� ! N� � .# . 4 � 'Y 4 . # :3 }�',z � $r .k d, 'i �� s`+ t '�' �.�..:, s zt.� � " ;�a �'r,,.; �' ! � r e��i�-fi a �.r i�� w ,C � � "� � r� s��t �^�ua " ��.�� '� �"�� '� r=" r t� � f i� r r � ,�+"'k� � �r �'j �r 4 3 �.-� v: � �� "'' �, x3' .� ,�ai*�i"�,��r ,�'x i„*t�+- � i w.ra .. � v"St..�q*�`�'�;. �,�'�3��'u"�er„`�,� � �� , "� � k : s�' � „"� ,: , � "C�, »�,+.�.M. v �' � �- '� �� : � z '�; :: �, � ,� � � �,v� � a,z,� %' t _ y� � � 3 � s �t a � �:� a� , r� '�..� � �i ��a ,�. � d : : < <" ' �. �' ;..y. st �+. ��',��f'��e�;� �;,�,,;� X�`�.�'� �� _;� . � I'+It�iilfi7e�' +�f #�Ctll��s � �3S.i�1 � 7F, ��S:i�U � � �i� .'i� Q �t��e,>Srirehar�e — � ' 5:UU lYi k`�E �40.�i!' `�'oCa�, � $,, b� `. THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED I hereby apply for a building 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 pernut but only an application for a pennit and work is not to start without a permit; that the work will be in accordance with the approved plan in the ease of all work which requires review and approval of plans. SIGNATURE OF APPLICANT' �.CIL a PRINT NAME i \ C. � \ DATE �' I�' �, APPROVAL INSPECTORS SIGNATURE DATE � � L �`��. "" �'�K�� ' �� '`y' ,�j ''`4 „ � �„ .a �- , n � . �� ' ,'� � � , , � � � � .. �.. „w Y � �� , r' '�� ,., City of Fridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977