P - 40840Building
Inspections
763-572-3604
763-502-4977 F
S[TE .�DRESS -
THIS �PPL[CANT IS
PROPERTY N.�,¢: �
OWNER/ ?.DDRESS:
TENANT
PHONE:
MECHANICAL
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
EFFECTTVE Z-19-09
0�1NER �
YOUR
�
Permit No.:
Received By�:
Date Rec'd:
STA
CONTRACTOR � onm.a�. N.��_ Standard Heating & Air L;ondmornng
COI�iT.�CT PERSON: Ym0
SUBMIT A COPY OF --(t�jjfl�iea�e�;s-Po�P�5�4�� 1 344�
YOUR STATE STATE LICENSE t# F 1 �_R7d_7� DATE
LICENSE WITH �DRESS: CITl' STATE ZIP
APPLICATION -
PHONE FAX
PERMIT TYPE
TYPE OF WORK: I � ��z
F.aI�IILI" ❑ T�'O F.AI�ffLI'
�REPLACEA-tENT
DETAILED DESCRIPTION OF WORK
❑ TO�INHOUSE
❑ .aLTER:\T[ON%RErfODEL
FEES ARE BASED ON $10.00 PER FIXT'URE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBII2 OF EACH BELOVI�
Equipment Installed MEG: MODEL: SIZFJBTU
MFG: MODEL: ` � SIZEBTU �b0�
MFG: MODEL: SIZFJBTU
A/C 525.00 _FIREPLACE (GAS) $15_00 GAS RANGE/OVEN 510.00
_AIIt TO AIR EXCHANGEER $15 _FIREPLACE (WOOD) $35.00 NEW GAS GKII,L 510.00
_BOII ER 535.00 �FURNACE $35.00 GAS UNTI' HTR $10.00
_CHII�IIQEY LINER S 10.00 GAS DRYER $10.00. POOL HEATER S35.W
DUCT WORK 510.00 _GAS PIPING $10.00 VENTII.ATOR 515.00
THIS IS AItl.0
I hereb_y apply for a building perniit and I
conformance �cith the ordinauces an es o
not a perniit bu an p cati for a pemi
approved p in th , of 11 work ch reqi
;ATTON FOR A FERNffT-N83` VALID i.7N"I'II. PROCESSED
le ge e uifonnation above is complete and accurate; that the ti�'ork �vill be in
Gity of Fridley and «-ith the Ivfinnesota Construction Codes; that I understand this is
id vvork is not to start «-ith t a perniit; that the wo - t��ill be in acco ance with the
s review and approval of p �
�� ERIN"I� N_�fE
City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 763-502-4977