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P - 35506BU11C�1T1� Inspections 763-572-3604 763-502-4977 FAX DA� 3•aK-►( SITE ADDRESS _ THIS APPLICAN'I' IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOURSTATE LICENSE WITH APPLICAT'ION PERMIT TYPE MECI�ANICAL RESIII�ENT�AL APPLICATION CITY OF FRIDLEY ❑ OWNER E-MAIL ADDRESS V CITY F' Y" 1'� Permit No.: Received By: !�:.-;- A"f��IP PHONE: %(e 3- S�% I" S� '� co�arrYrr�: CENTERPOINT ENERGY corrrACrPExsorr: JOANN ZINKEN sTA� r.icErrsE # BOND #22013346 EXp DATE 08/20/2011 nDDx�ss: 9320 EYERGREEN BLVD SUITE � B crTY COON RAPIDS sTa�NIN z�55433 PHONE 763-757-6202 F� 763-757-6701 FAMILY ❑ TWO FAlvIILY TYPE OF WORK: I � �' ��PLACEMENT ❑ TOWNHOUSE ❑ ALTERATION/REMODEL DETAILEDDESC IPTdONOFWORK 3ins�n.\l I�L°� IOtL+C �k-I.�..r✓1��.�� 0.r1� G].ir -� � � :�� �e�' FEES ARE BASED ON S10.00 PER F�TLiRE, EYCEPT WHERE NOTED. FI?�'TURES: (Il��ICATE TOTAL lv'L7A�ER OF EACH BELOVI� PROVIDE HE�.T LOSS CALC'S PER MAi�UAL J 2006 ASHRAE HANDBOOK Equipment Installed MFG: '�Q �,l.ue� MODEL: ��,�i�m "�e S BN �'�i0 MFG: �y,�_ MODEL: u 1'iPM • Oa� SIZEBTU O"'Z' �-o:I i S�c+' MFG: NIODEL: SI�E/BTU �A/C $25.00 TFIREPLACE (GAS) $15.00 �GAS RANGEIOVEN $10.00 _AIR TO AIlt EXCHANGEER $15 _FIREPLACE (WOOD) $35A0 _NEW GAS GRILL SI0.00 _BOILER 535.00 �FURNACE $3�.00 _GAS tJNIT HT'R �10.00 _CHIhINEY LINER $10.00 _GAS DRYER $10.00 POOL HEATER $35.00 DUCT WORK $10.00 GAS PIPING $10.00 ^VENTILATOR 515.00 Number of fixtures' @ $10.00 ' x $10.00 = $ ' = , Number of fixtures @ $. Number of fixtures @ $. i --, a ac�.w 1 :X $35.�0 . �� �W State Surcharge = $ 5.00 SMINIMUM FEE $40.00)' Total = $ ��3ii �� THIS IS AN APPLICATION FOR A PERNIIT-NOT VALID UNTIL PROCESSED I hereby app3y 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 a permit d work is not to start without a permit; that the work will be in accordance with the approv�d plan in the case of tl w rk w i r ire r view and approval of plans. SIGNATUREOFAPPLICANT�'i�//ylNj � PRINTNAME JOANN� ZINKENL -, �_ DATE 3����'`� APFROVAL INSPEC'f01 PLEASE NOTE:' City of Fridley , ilding Inspections Departmen# 6431 University Avenue NE, Fridley, MN 55432 763-572-3604 FAX: 763-502-4977