P - 39802Building
Inspections
�163-572-3604
763-502-4977 FAX
DATE / U ` O�iC. `
SITE ADDRESS I
THIS APPLICANT IS:
MECHANICAL
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
❑ OWNER
PROPERTY NAME: -
OWNER/ p�DRESS:
TENANT
PHONE:
ADDRESS
CITY
Permit No. � � ��f�. `�i � -
Received By:_�!(�____
Date ��: ��$ E�' �N� '� ��� � �
ATE /IN ZIP
CONTRACTOR COMPANY NAME: SHARP HEATING & A. C.
SUBMIT A COPY OF CONTACT PERSON: FLOYD JOSWICK
YOUR STATE STATE LICENSE # EXP DATE
LICENSE WITH pDDt�ss:7221 UniversitY Ave. N, E. CITY Fr1C�i12V STATEMN ZIP 55432
APPLICATION pHONE 763-572-0459 Fax763-572-0164
PERMIT TYPE
TYPE OF WORK: � � NEW
FAMILY ❑ TWO FAMILY
❑ REPLACEMENT
DETAILED DESCRIPTION OP WORK
� TOWNHOUSE
� ALTERATIONIR.EMODEL
FEES ARE BASED ON $10.00 PER FIXTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACft BELOW).
PROVIDE HEAT LOSS CALC'S PER MANUAL J 2006 ASHRAE HANDBOOK.
Equipment Installed MFG: MODEL: SIZEBTU
MFG:
MODEL:
SIZE/BTU
MFG: MODEL: SIZEfBTU
^A/C $25.00 _FIREPLACE (GAS) $15.00 GAS RANGEJOVEN $10.00
AIR TO AIR EXCHANGEER $15 `FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00
$OILER $35.00 FURNACE $35.00 _GAS UNIT HTR $10.0�
CHIMNEY LINER $10.00 GAS DRYER $10.00 POOL HEATER $35.00
�DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00
� THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
�,,.y�.
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 ordin ces and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is
not a permit but only an app cation 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 1 work whi qu' review and approval of plans.
SIGNATURE OF APPLICANT PRINT NAME v 7P� S DATE / ^� —
APPROVAL INSPECTORS SIGNA RE DATE
City of Fridley
Building Tnspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 763-502-4977
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