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P - 84350�3ui�dirig �.ta,s�ectxans 7G3-572-3604 �63-saz�97� ��x _ From _6514526925 _ Pag�: 'fl2 __ � Date: 10/23/2012 4:21:47 PM _ �VIEC�IA�TICA,.L ��sr.��N�rr�►L .�FF�,T�.��r�o�v CiT� iDF F��DL�X E��cT,.vFt �-i-zo�z bnrr 1� 0/ 1? 2 D 12 yo� �.�rL A.Dnit�ss SJ.TF, ApDRLSS _� g 1 T RC7��j 'I'f U9 A1�PLICANT J$: l7 OWNFR. �ON'iRACTOR. OWNERI T.ENANT a. su.anm:z� � carvor Y(7U,[� S'�ATfi I,IC,E]VS� VVTTFi A�'P1,iCATTON BOULDER Penn it No.; Receiv�d F3y;, Date Rec'd� nnnl2ESS� 2322 1715�' LAt+7E NE CIT� � LAKE 55304 Pxorr�: 612-3.59-274b srAr� MN� COMPA,NYN��.: AIR MECHANICA,I, I�17C coNI�ACrpF;R,.sRN: AEB$IE. BODNAR STATE LICENSE R � FjCl� DAT� Ann�s�; 1541� A��RD�EN 5T A7E CITr k�AM �� MN 55304 7 6 3-'�6 - 3 7 5 2 s�nTE z1F rHOxE_ r.v Ir1:,RM7TTYPE ��c,r,EFAMII,Y R']-WOFA�fTfY �"�'P.E QI' W�j�: ��'�' !� REPLACFMLIY7 p,r�, DEThiL�D I?.ESCRIPTIQN OF WOR� �'RJWNH�[jUSE FF�� ARF D�tSf;�j dY ij(1.00 PR� FT!C�URF., $XCEPT WAT� 7�p1�D, ,����ES: (i]�(�ICATE TOT,AJ, N�TR�gER p�' EA['�{ $ELpVi� PRibV�pF, x7[EAT 1,055 CA1,C`S P�,ft MA,NIiA J 2006 E{, HRA,E HAN,DBGI�pZ(, lzquipmCntlncfn,ll�c1 MFG; MC)I?EL ��'�',%� -,v ST,ZF/H7'tT �� !'I�f(I MF+f3���.%�,---�` MODEL: rI � �� SIZE?1STT,J �� MFG: �vfODFf,' SiZEIF.i1'U ,�A/C 42,S.Q{I f7RFpLAG'£ (GA$) $15.00 �-`- �1.fR Tp AfR IiXCHANCiEFR S 15 FjREPI,(y,�;E (W(jpD) $3$.00 GAS IiAN�E�UVEhT $IU.OD J30�T..£A S3S,00 �FURNAC.E 3�5.oC1 ,...NEW GAS GR.i,�.L S10.p0 CT; il MNT:y L,]NFR $1 U.00 GA C i�RYETt 5] U.DO CAS L i�T17' 1-17R T� 10.00 rnrcx wowr a�o,o� PaC1L HEAT'FR 335.00 (� ` B+1G510.00 V�NI7[r1,TOR$1SA0 S'�ua�abcr of fxtur�s (r]i, g14.p0 x g1Q_pp =� Nurtxt��r of i',xtures @ $ i 5.00 � x $ ] 5.00 = �_. � � Numbcc of �xturos cr $25.U0 � x $25.00 = �_ p� � Nurnbar v���n;ure� �$35.40 l x�35.Ut� M� �� 3tate Sutcharge = $_ 5.00 ° _, Tf-T� (y AN APPF.ICA,TIpN.CQR A PF��T-NOT VAT„[]) �7), pg,p��SSiD I I�CrCbv ap�aiy 1'or a buildin� peimit and I ackz'iowleQgc that the information above is com.p�et¢ and accurate; tl�at the worJc wi11 be in co�a'F4.rmtl�toe with thc ord'tn�nces and codes of t�e City of Frid�ey nd with he 1Vl�nneSaCa Consiructioti COdes; IhBt I undeYStand tk�is is 1t4t a pc,rni.it bui onl.y flti appliCation for a pertxiit and work is not/�start��out a permit; that the wosk witl bC in aaCqrdai)ce with the appn'ovo6 plan, in the case of�i'i4ork wf�iq}�;�qt�jrrs revic�, and�&bnrov f nlanc SJCNATL1Jt� OF AYPLIC�rTT SEP ` City o1`Fridl�y — $uilding I�aspections Departm��t 6431 [�n�v�rsity �venue NE, Fridley, MN 55432 763-572�3604 FA�: '7�3-5�2-4977