P - 48028Inspections
7b3-572-3604
763-SQ2-497? FAX
From: unknown Page: 3/7 Date: 12/5/2011 10:27:06 AM
MECHANIC�I. �ermit iva.;,_
RES�DENTIAL APPL�CATIUN R��"'�a By:
CITY OF FRIDLEY
DATE YOUR G-MAf.L ADDftF.SS dgVe(a�davesheating�rydalr.com
STfL ADDIiESS 1504 Wfndemere Dr(ve
Ti-IIS APPI,ICAN7' 1S• Cl aWIVFR �ICON"1'RACTOR
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ROPF.RTY Nq�; JlmKnoMauch
OWNER/ Ap���s�, 150A Windemare Drive C�y Ftidley STATE MN �ip 55432
T�NANT ounUr, 612-710-6411
CONTRACTOR �()MPANY T[AME� DAVE'S liEATING AND AIR
SUDMIT A COPY OF
CQNTACT PBRS�N: AMY MAdVIG
YOUIt S"fATE STATP. LICENSE # EXPDATE
LTCENSE WITH ADD3tESS: 1601 37Tti AVE tJE CtTY COLUMBIA HEICiHTS STATR MN �IP 55421
APPLiCATION �H�� 783-761-6801 F�X 763 789-B605
PERMIT TYPE �iNGLR FAMIT.Y �WO FAMIL,Y
TYPE OF WORK: I � � �PLACEMENT
�OWNHOUSG
❑ ALTE1tATI0N/REMODEL
DETAILED DESCRIPTiON �F WaRK Replece fumace w! Ilsted equipment beiow
FEES ARE BASEI3 01V S10.00 PER �IXTURE, F,XCEPT WFIBRE NOTFI). FIXTURES: (1NAiCATF. TOTAL NUMB�R:O� �ACFt BEl,O�
PROVLVE WTAT 1.OS5 GA I.C'S PER iVTANUAL J 2006 ASI�RA� aAIVDBO(1K. ��M��e� gg,� gp,�p e.fU
Fquipmentlnstalled MF(3: �n+� MADEG: SIZFlB7U
MFG: MODEL:
siz�ru
MFG: MOpEL: SFZEIBTU
�4/C $25.00 ,�TTREPLACE (GAS) $}5.00 QAS RAN(iE/OVEN $IQAQ
_AtR TO A[I� EXCHANGEER $ I5 FIREALACL� (WOOT)) $35.00 N�W GAS GR(LL $10.Q0
�BQILER $35,00 �FURNACT :C3S.00 �CsAS UN1T HTIt 510.00
_CH[MNEY LINER $IO,UO GAS DRYER SlU.WI PQUL HEATER 535.00
ni7CT WORK SIQ.00 GRS PIPTNCr S1A.00 VE[VTTLATOR 515:00
Nurriber of fixtures (u� $1.0:�10 � S] p.00 =$
Numb�r oFfixtures Q$t'S.QO x$15.00 r$
Number af fixtures � .$25.00 x �25.(}0 = $��,
Number of fixtures Q$35.OU 1 x$35.Off =� 36'.00
State Surcharge =
$ 5;QC1
r � y�.vv
TNIS.{'S AN APPLICATlON rdR A RERMiT-NpT VALiD UNTI4 PROC�55ED
I hereby apply far a building permii and I acknow[edge that thE information above is campteto and accurate; that the work will be in
conformance with the ordinances end codes of the Ci of Frid}ey and with the Minnesota Construction Codes; that f understfuid this is
not a permit but only plication f a perm � ork's no start wi#hout a permit; that the work will be in accordance with the
approved plan in the �f�ll �erl�v �h i� proval af plans. ,, _ _ � _ _ _ � ..
STrNATUKE OF APPLICANT
City of Fridley
ilding Inspections Department
1 Unive�ity Avenue NE, Erid#ey, MN 55432'
763-572-3604 FA3�.: 763,502-4977
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