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P - 36963�uilding ��.spectic�ns 763-572-36�4 763-502-4977 F,A,X DATE 1"� SI"�� A1DA� S � THIS APPLICAN'� SS: �RO�ERTY OW�i�l.2/ �v,�,�r carrrx�c7�o� StJ.��' A GOPY OF YOUR 5TATE S.ZC�15� WITH a���.zc�.�oz� ���' '�'X�'E From: 7637537540 Page: 2/2 Date: 12/15I2010 4:54:00 PM �VIECHANICA.� , P��i���.: RE�ID��TTIAL AP�'L�CATICa►N �eceived $y:,�_ CIT�Y C�F FRIDLE� ����� � � _ � � EFFBCTIVE 7-1-2Q70 YOY7�t E-M.A��. A,�FJ�SS � V 1 GL�-�r�-a'l� i''►'1 � i'..1..!. �� 0�.. L.6�� CrY1. �7� I�li°' . czxx ca�v�p,4asx' tv.a,�oe: !-� i � COI�tTAGT PERSfJIJ: � ��I �, sz���'1�P STATE LIC�NSE # �T ��p ppi� r�n�ss: lr'[ ��C3 [� e.�� �S't' CITY C!�-�'L. sT�z�1�`-z�x PHONE"11,p 3-7�'�--- iF' �P�Ax �l,p 3— `i 5�J-' "�%'�� Ci TYPE OF WORK: I � �w FAM4X ❑ TWO FAMILY ��tEFLACi?MENT p��r,A.z� z��sc�r�orr �F wo�, 0 TOW3VHOUSE ❑ Ax.'�I2A.7'ION/REMODEL k�E3 A� �A,SED ON 510.00 FER FiXit3A�, ��C�.P7' WHE� NOiEn. ��'1.'eJl.tk:S; (.INUlCATE i'OTAL Vl.�i�x��R Ok' �ACH gELOR� �t.OY�A� �AT LOSS CALC'3 PER MAMJ 2046 ASHItAE HANA�UU�,. E�uipmet►t It�stalled MF�r: MODEL: �� �'i�� � SIZE1�'�'U �s� f� C� O MFG: _,.,� MODEL: MFG: _ _ MOD�L: _AJC 523,00 _FI1tEpLACE (G,A.S) $15.OU _A1R. 70 AIIt EXGHANGEER Si5 FIREpLACE (WQcJD) 535,00 BOILER 535.00 �FURNACE $35.00 _C��NEY LINER 510.00 „_GAS DRYER S 10.04 DUCT WORK SX0.0(► GA,S �'S��TG $10.00 SZZ�TTJ SLZE/BTU GAS RANGE/OVkN $x0.00 NEW GAS GRIL,L �1.0.00 _GAS LTNIT H'!'R $10,00 POO�. kIFA.TER 535.00 �VENTTL,A,�'pR �15.00 TfTTS 1S Ah! A,P�.L�C.A,�'fON FOR FL PER�IT-�10�' VA,�.Ip TJNTfL PROC�SS�ZJ Z�ez�by apply far a builrling parnnxt a,zzd I aclalowiedge t,kxat tkAe informatian abov� is complet� anc� accurate; tl�at tl�e work wi�� be iz�. cozzfvznaance with the oxdinences and codes of t�Ze C�ty of Frid]ey and wi.tkx tkae Minnesota Corastructao� Codes; tt,at Z uxadeXStand this is not a permit but o;q1�y ar� applicatian for a pe;r�xt abd work is not to statt wztfaout a permit; that t�e work will be in accrnrdazzce with the a��xoved �lan in the case af alX woxk , bi�c�: requires review a�i,d a��z�oval of pl is_ SZGNATUREOFAPPLZCt�•s FRIN'�'�i,A.M� � ��t�TE ��"'� jS �! C� ri c��y of ��ai�y Building Z.�spections De�pa,xt�e�tt 643� Uzuivezsity Avenue NE, k'xidley, MN 55432 763-57�2-3604 FA;�:7�3-502-4977 , ��,� �` r�