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P - 48014Building MECHANICAL Permit No.: Z� Inspections RESIDENTIAL APPLICATION Received By;��_ �63-s�2-3604 CITY OF FRIDLEY �''�� 763-502-4977 FAX EFFECTIVE 1-1-201 l �� i �� DATE ' %' "' / -` r% � YOUR E-MAIL ADDRESS _ �j jr-%'�f G�v*j�G <� �,,i1/%f`%'i/, �' �xis�( SITE ADDRESS � �� 'j-� � !i?�`��Gj �� J' (' � THIS APPLICANT IS: � OWNER ❑CONTRACTOR PROPERTY NAME: c j,� s�C �/' f,-�-� Gc �� OWNER/ ADDRESS:_,�}'6S� E/`lS%/f�f(//!�%<1`/'� .i'/I7}S CI`IY ��'Lj�GG�� STATEf��P.�� TENANT PHONE: `� �i �' •- f 7 � — � �7 d °t � CONTRACTOR COMPANY NAME: SUBMIT A COPY OF CONTACT PERSON: YOUR STATE STATE LICENSE # EXP DATE LICENSE WiTH ADDRESS: CITY STATE ZIP APPLICATION PHONE FAX PERMIT TYPE � SINGLE FAMILY ❑ TWO FAMILY ffi TOWNHOUSE TYPE OF WORK: `'�NEw ❑ REPLACEMENT ❑ ALTERATION/REMODEL DETAILED DESCRIPTION OF WORK ��j �. L �iv �>,� ,J�=LG� / �� --�(�� FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: ([NDICATE TOTAL NUMBER OF EACH BELOW) PROVIDE HEAT LOSS CALC'S PER MANUAL 2�R�E HANDBOOK. Equipment Installed MFG: MODEL: SIZE/BTU MFG: MODEL: S1ZE/BTU MFG: MODEL: SIZE/BTU _A/C $25.00 FIREPLACE (GAS) $I5.00 GAS RANGE/OVEN $10.00 _AIR TO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00 _BOILER $35.00 FURNACE $35.00 GAS UNIT HTR $10.00 _CHIMNEY LINER $10.00 GAS DRYER $10.00 POOL HEATER $35.00 _DUCT WORK $10.00 _GAS PIPING $10.00 VENTILATOR $15.00 -� r � ��,�, �� s .r "�' �.: �� .�', � �✓ a� : �n�c�� 3 r� y � � �., �6;. #� �: . �. s�� :,$ �. - �, y' ,� .� �, .a� � � � y�. a �� °`�` , �? � s '� ,� i� r�:. �"�� ,v �.v '� v��.� � r'S"�� r�� +' a a y � : �- �c �� x � s - �� z �.� . x.� �f g t�* >r�; K � Y . �9 Y � i ,, '�' � t y .o* � : y �. - a�`� x � . � . ,w .� � / ' a � ; `� �� r�' .� � �'m� _��,� � �'�, ��p i � .;, . �� ,s .�� f e�3 °� . k .� . +a�c ��,� 3� � � � �� i . �� `� � �v £ b:5 \ �, 3� , �'" r �.< � V : � 7 � a�. �� S � : � a �� €', � x �": � .: .�xfi . ., i i ' � ,a � _ � , . � �, � _ 5 � _� � . � /.: � � .: s, � �"� �� _ ��' '�v ni '�-. � �" ��T1 h+�� n4 �� p � � „y� � �'� �� . � �: `� F � .: ,._ � � y�,. �.�'f . .✓c4 a .� r'- , � z -:"� �� x.'� . �� a2 �� t � 'w� � � �' � � *F� a. ;� 9�f � � �i i :: '�,a;l r 1'��'� , 5 � , �' '�'''` � �� : � � � '� f �,.� ,� n �-�c�' � �'� �� *�£ b � �,� ":. `� � 'e . � � ��' � �� . a � � i .� ,� �, � , �. '_ �� 3� �sz �� s r �'v �� , � � �� n � � `a '�<, �' �+.:. ��, ,� � �:, � ¢�P � � -� �� .�.: ,ar`�,t � ,:� � �,� �?, � �� : �� ' s ,� r � �, r s � � ., i : 3 : z � � �,s , ��*d� �'�'.ss� �,�.: a.a, �§ .� s�,,� � �.� K�� z� `�,� ��c �'� `' * +.� s��. �,. _ "� ��,�",� - �, , � .. �d z ��a '�' �, i � a ��'�'�� 8 � `��'v�. : i�.� _ ��' �;a � � x�4 '� �; .: � `ti�� . .� c� ." � . � F��C� ; h \ �^ -c�` d'�. '� � -. C� � " °a�.� � ., � �S �� , � - � ..� x :. z � .., :. � � v.� �` �` �-� 3 :i �t3�r � `-�� ,� . � � �,� .� $° v�,. -: 7 `�`3��`� AY - � P"�. �k��'. �\� �. j 1. �/. t � ,� :� 3� ',� - � � n A�, 'i�» . ?c? e^ % "�'� ti, '.�`�a. �,s J., e ,'�: /;�., �.,,� ,. , �. \ '�.l '�'� y a;:. , , ..�� _ , ,��. , . _.. ,,,,.,, . . .... , ,.,,,.__ ..-: , .,-.a,., ,r.. .>,. . , •.:= � . _, .. . �,,,F ..��. �,�»,,r i�,�• ..�..-. THIS IS AN APPLICATION FOR A PERMIT-NOT VAL[D LINTIL 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 permit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of all wo which requires review and approval of plans. SIGNATURE OF APPLICANT �'='6-�---- PRINT NAME � � %` �%%'ci�� / DATE I � �� I APPROVAL INSPECTORS SIGNATU DATE .. _ .R,.: _..., ... .. � .:: .. . ,. y :. � �. - �ng . ._, ... . .�,: .. � ; .. ..,� , e..: .. ..��. .. $ �� .�� i"1 i: . , .. _.:,. .. „ .. ......:�. : ' �" �;ity of r'ridley Building Inspections Department 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977