P - 45116; � lding
I pections
63-572-3604
763-502-4977 FAX
DATE S ' �Q —
SITE ADDRESS _�
THIS APPLICANT IS:
PROPERTY
OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE
LICENSE WITH
APPLICATION
PERMIT TYPE
MECHANICAL
RESIDENTIAL APPLICATION
CITY OF FRIDLEY
EFFECTIVE 7-1-2010
OUR E-MAIL ADDRESS
�P h. o� S-�. �. �.
❑ OWNER �(CONTRACTOR
NAME:
ADDRESS: / 3 �
nvnwro. 71.2 � r1 �%� � � Q� �
Permit No.:
Received By:
A
COMP.4NY NAME: SHARP HEATING & A. C.
CONTACTPERSON: FLOYD JOSWICK
STATE LICENSE # EXP DATE
ADDRESS: %22� University AV2. N. E. CITY Fr1.C�l.ey STATEMN ZIP 55432
PHONE 763-572-0459 F�c763-572-0164
TYPE OF WORK: � � NEW
FAMILY O TWO FAMILY
❑ REPLACEMENT
DETAILED DESCRIPTION OF WORK
❑ TOWNHOUSE
�ALTERATION/REMODEL
FEES ARE BASED ON $10.00 PER F[XTURE, EXCEPT WHERE NOTED. FIXTURES: (INDICATE TOTAL NUMBER OF EACH BELOW)
PROVIDE HEAT LOSS CALC'S PER MANUAL J 2006 ASHRAE HANDBOOK.
Equipment Installed MFG: MODEL: SIZEBTU
MFG: MODEL; SIZEBTU
MFG: MODEL: SIZEBTU
_A/C $25.00 _FIREPLACE (GAS) $15.00 _GAS RANGE/OVEN $10,00
_AIRTO AIR EXCHANGEER $15 FIREPLACE (WOOD) $35.00 NEW GAS GRILL $10.00
BOILER $35.00 FURNACE $35.00 GAS UNIT HTR $] 0.00
CHIMNEY LINER $10.00 GAS DRYER $10.00 POOL HEATER $35.00
)C DUCT WORK $10.00 GAS PIPING $10.00 VENTILATOR $15.00
THIS IS AN APPLICATION FOR A PERMIT-NOT VALID UNTIL PROCESSED
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 ap 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`vv "ch rec �r s review and approval of plan .
SIGNATURE OF APPLICANT = � � PRINT NAME �iH't� / ( � /. JtI e�l �� DATE ✓ ^
APPROVAL
DATE �-� J �
�; City of Fridley
Building Inspections Department
6431 University Avenue NE, Fridley, MN 55432
763-572-3604 FAX: 763-502-4977