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Building MEC�3ANICAL Permit No.: Q
Inspections RESIDENTIAL AP�'LICATION Received By:
763-s�2�36a4 CITY QF FRiDLE�
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763-��2w�g%% �'Ax EFFECTIVE2-19-09
DATE �il24l2010 YOUR L-MAfL ADDRESS deve(d,�davesheatingandeir.com
SIT6 ApAR885 6198 HEATHER PI..ACE
TN1S AAPLICANT (S� ❑ OWNf R OCONTRACT02
PROPERTY NAMi:: �aRVI$ HARO
OWNER/ App�s 6199 HEATH�R PLACE ��Ty FRIDLEY STATG� MN z�p 55432
TENANT 763-571-4313
PfiONE:
CONTRACTOR GOMPANY NAME� DAVE'S HEATING, AIR & ELECTRIC
5UBMIT A COPY OP CONTACT P13R50N� AMY MADVIG T
'SCOUR STATG ST'ATB LIGENSF # fiXP DATH
LICENSE WITH pDDRESS: �601 37iH AVE NE C[TY GOLUMBIA HEIGHTS STATE �� Z1A $�21
APPLICATION pHaH£ 783-781-8901 r� 763-789-fl605 �
PE�6VIST TYPE �NGLT FAMSLY ❑ TWb FAMiLY ❑ i'QWNHOUSE
TYPE OF WORK: � N$W ntEPLACL-'MEN'f � A1.7'ERATIONlREMODGL
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DETAILBD DESCRIATIt�N �F WORIC REPLACE FURtJACE W! LENNOX M#G71MPP-36C-0SO-03 AND CENTRAL AIR M#XC14-038
FEES AItN. BASED ON SIA.40 PCR FIXTURF., F.XCRPT WHERE NOTED. FIXTURC$: QiYDICAT� TqTAL [YUMI3ER ON CACIi BI:1.OW)
Equipment Ins�allad MFCi: MOAGL; � SIZPJBTU
M�G: MOAFLt SIZFJA'i'U
MFQ: MOnEL: SIZFIBTU
C f 2S•00 FI RBPLAC6 (CA S) S I 5.00 ^GA S RANG C(OYE'sN $ i Q.QO
IRTO AIR EXCHANGEER S1S IREPL.ACE (WQOD) $35.00 _„_NEW GAS GRfl,G $t�.00
TBOf4ER 535.00 / RNAC6 $35.00 ___,GAS UNfC HTR $1a.U0
�CHIMIIEY LINFR S 10.00 r AS DRYER $10.00 �PQOL HBATF.R $35.(l0
DllCT WORK $10.W GAS PIPING 510.00 YEN'C[(.ATOR $1 SA�
Number of fixtures c� $] 4.00 .___, x$10,Q0 =�
Number o1'fxtures Q $15.Q0 x $15.OQ = $_
Number of �xtures (n� $25.00 ? x �25.60 = $ Z�•00 �
Number of fixtures Q$35.00 �___ x$35:00 =$ 35.00
State Surcharge � $_ _ ^iS0
M.fNIMUM FE� �35.50 Tota! ° �
THIS IS AN APPLiCATION FOR A PCRMIT-NQT VALID UNTIL PROCESS�D
1 hereby apply for a buiiding permit and t acknowledge that the information above is complete and accurate; that the wock will be in
canformance with the inances and codes of the City ofFridley and with the Minnesota Canscruetion Codes; that I unclerstand this is
not a permit but only plication for a permit and wo�ic is not to start without a permit; that the work will be in accardance with the
approved plan in the ase all work which requires r view and approval oPpla s. ,
S[GASATEIRE QF APPLIC NT R[NT NAME __., _ Q ` r�
PLEASB NOTE: SEPA.RATE P6 TS ARE'RB UI FOR BUILD1N�i �LSCT.R[CAI. ANIj M.B NICAL WORK
�.��y or r r�ueey
Buiiding Inspectians Department
6431 University Avenue NE, Fridley, .MN 55432
7b3�-572-3604 FAX: 763-Sa2-4977
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