AF - 44821SUBJECT
City of Fridley
AT THE TOP OF THE TWINS g U I L D I N G P E R M I T
r
� �
� �
� • COMMUNITY DEVELOPMENT DIV.
� �y------ �
r � � PROTECTIVE INSPECTION SEC.
1 �
� � �"'1 � CITY HALL FRIDLE� 55432 NUMBER iiEV DATE PAGE oF
�----�•� ,•' 612-571-3450 9� 0-F� 5 6/2 5/86 � �
JOB ADDRESS 6576 Anoka Street N. E.
1 LEGAL LOT N0. BLOCK TRACT OR ADDITION
oescR. Parcel A, Lot 4, Pt. 5, Block 4, Oak Grove Addition
2 PROPERTY OWNER MA�L ADORESS Z�P
Terry Ba.rrett
3 CONTRACTOR MAIL ADDRESS Z�P
Vista Construction 961 Hillwirid Road N.E., Fridley 55432
4 ARCHITECT OR DESIGNER MAIL ADDRESS SEPARAiE PERM�TS Z�C�EJ�
5 ENGINEER
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW 0 ADDITION ❑ ALTERATION ❑ REPAIR O MOVE ,❑ REMOVE
X
MAIL ADDRESS
PHONE
PERM O.
� 18514
-
REGE
�? //.3 0
APPROVED BV
SEE ATTACHEO
SHEET
PHONE LICENSE NO.
571-920d
PHONE LICENSE NO.
C ��� NO.
i7
8 DESCRIBE WORK
Construct 30' x 30' Foundation for House t�o be Moved in fram New BrightAn.
Construct a 20' x 20' Garage
9 CHANGE QF USE FROM
TO
STIPU�ATIONS � not move house until bond is submitted to the City or bond is waived
by the City Planning Department. Park Fee of $750.00 paid previously. ��-?b�86
All electrical wiring to meet the present Electrical Code. Provide new roof
jack on all plumbing & heating. All base�nent plumbing to meet present Plumbing
Code. Pxnvide new stack (heating vent). Provide new furnace. Provide
egress windows. Reroof dwelling. Provide soffit vents. House to meet the
State energy code. Provide fire/smoke alarms in dwelling. Repaint outside
of dwelling. Provide sill plate. Provide header for basement stairs.
SEWER LOCATION: 133' North of Manhole "Y" ELEV: 884.15
WATER LOCATION: 15' North of Sewer. TO P OF FOOTING: 887.15 Minimum�
_ �,.
,,,.. ,
w������
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK, OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERI00 OF 120 DAYS AT
FT R
TYPE OF CONST. I OCCU
ING
ANY TIME A E WORK IS COMMENCED. NO. DWLG. UNITS
I HEREBY CERTIFV THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 STAL�S
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF �AWS VALUATION
AND,ORDINANCES CaOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OF NOT. THE GRANTING OF A PERMIT $43, 900
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOIATE OR CANCEL THE pERMIT FEE
PROVIS�ONS OF ANY OTHER STATE OFi L CAL LAW REGULATING CON-
STRUCTION O �� AN E STRUCTION. yS`ZS6.00
PLAN CHECK FEE
%
on
SIGNATUFEOFCONTRACTOFlORAUTHORIZEDAGENT IDATEI WHEN ROPE Y
* . , �,
SiGNATUREOF OWNERIIF OWNER BUI�OERI IDATEI , w5P
� FICi
f PARKING
GARAGES
$21.95
SAC CHARGE
$475.00
TOTALFEE
$752.95
D THIS IS YOUR PERMIT
� _� �
tC.
N�,' [ J
ADD27. [ ]
ALTER. [ ]
Construction Addre
Le�al Description:,
City of Fridley
jY R-1 AND R-2 �
Building Permit Application
�C I�.,, r .�.a _ (��.
Effective 4/1/8G
Owner Name & Address : � �'�� y ���� E �� Tel . �
5 y `�
Contractor: l�>� �/� �o,�vs�,2u��.ds�c� Tel. #� S 9vto 0
Address: i� /- /�eLLcvi�✓� �� `'.�i,�L£,�,Y, ,SS%31
LIVING AREA:
GARAGE AREA:
DECR AREA:
OTHER:
Attach to this application� a Certificate of Survey of the
2ot, With the proposed consLruction draxn on it to scale.
DESCRIPTION OF IMPROVEMENT
Length ,�! Width �O _ Height � Sq. Ft. 4O
Length �Q � Width �?0 � Height _�_ Sq. Ft. �l'�d�
Ler,gth � Width _1j[�_ Hgt/Ground ��- Sq. Ft. �.4
Corner Lot [] Inside Lot [� Ft. Yd. Setback �� �
�_ Side Yard Setback /Jr
Type of Construction: Estimated Cost• $ C o d
Approx. Completion Date: �/3����0
Alt. A Alt R
ProposeC Driveway k'idth If New Opening Is Desired: $ $
� See Back Page for Explanation
Q
DATE: G� � a� APPLICAI;T: �--- - N G/i.-���G�c�..I�..L�e.. Tel. �����
Perciit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sexer Main Charge
TOTAL
STZPULATIONS:
CITY IISE ONLY
�—�,��,�� Fee Schedule on Reverse Side
� ��w 25� of Building Per�it Fee
$ 1 �� ' $.50/�1,000 Valuation
���� z �:..� � . % .S
3 ��i S4 5 per AC Unit
� Fee Determined by Engineering
�
v-�—� ��$, Agreement Necessary [ J Not' Necessary []
�i
1�0 �vet
;,,_ Sva �, �i� O�l.
�� ���s�D
(�` ��u�� � �-
Mowt lyo�
G►,�.�►it �'b i t
� w� � c�c,«� � 0�.,��� Q�P'r.
. 3y
�4�i� �e2�t��bus .
� . . �/
BU II.DING PERMIT FEE SCHEDIILE
The Chief Building Official shall, before issuing permits for the erection of any
building or structure, or for any addition to any existing building or•structure, or
for any alteration or repair to any existing building or structure, upon applicatio n
therefore, require the pa}►ment by the applicant for such permit of fees to the amount
herein belox se.t forth and in the manner herein provided to-Wit:
Total Valuation
a1.00 to 5500.00
Fees
�10.00 (Minimum Fee is �15.00)
�501.00 to $2,000.00 $10.00 for the first a500 plus �1.50 for each
additional :100 or fraction thereof, to and including
�2,000.
�2,001.00 to $25,000.00
�25,001.00 to 550,000.00
�50�001.00 to $100,000.00
�100,001.00 and up
�v32•50 for the first �2,000 plus $6.00 for each
additianal �1,000 or fraction thereof, to and
including �25�000.
$170.50 for the first �25,000 plus $4.50 for each
additional �1�000 or fraction thereof, to and
including �50,000.
3283•00 for the first �50,000 plus $3.00 for each
additional �1,000 or fraction thereof, to and
including $100,000.
�433•00 for the first �100,000 plus $2.50 for each
additional �1,000 or fraction thereof.
DRIVEWAY DEPRESSION ESCROH
{Concrete Curb Streets Qnly)
Alternate "A": Removal 2nd replacement of curb and gutter only - Drivexay width plus
6 feet times $13•50
Alternate "B": Renoval and replace�ent of curb and gutter and install a 3 foot wide
approach r:ith 6 inch depth - Driveuay Width plus 6 feet times $15.75
VERIFICATION OF FOUNDATION
Per�its for construction r;ill be issued a mir,imum of 24 hours from the time of
application to allow for proper revieW of the proposed structure and of the
construction site.
A Certificate of Survey of the lot, shoWing the location of the foundation onee it
has been constructed will be required before proceeding �rfth the framing.
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SUBJECT PER .
City of Fridley Mo�ING 18 515
r ' AT THE TOP OF THE TWINS X���� p E R M I T
, � RE .
� ; y _ COMMUNITY DEVEIOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC. ,����D
I � �
� � /"'1 � CITY HALL FRIDLE� 55432 NUMBER REV. OATE PAGE Of APPROVEO BV
�""'� � ��� 612-571-3450 9to-F�5 6/25/86 / /
JOB ADDRESS 6576 Anoka Street N. E.
t LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. ,4, Pt. 5 4 Oak Grove ACIC�ltlOri SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Ter Barrett
3 CONTRACTOR MAIL ADORESS 21P PHONE UCENSE NO.
Dale Movers Inc. 7816 Central Avenue N.E. Fridle 784-4269 29 STA
4 ARCHITECT OR DESIGNER MAIL ADDRESS 21P PHONE LICENSE NO.
5 ENGINEER MAILADDRESS ZIP PHONE LICENSENO.
6 USE OF BUiIDING
Residential
7 CLASS OF WORK
O NEW ❑ ADDITION ❑ ALTERATION O REPAIR � MOVE ❑ REMOVE
8 DESCRIBE WORK
Move house frcm �iew BrightAn into Fridley tA above legal description.
9 CHANGE OF USE FROM TO
STIPULATIONS
Route: 29th Avenue (New Brighton) to Mississippi Street to Anoka
Street tx� site.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
VENTILATING OR AIF CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OFi CONSTRUCTION ZONING SQ. FT. CU. FT.
AUTHORI2ED IS NOT COMMENCEO WITHIN 60 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. OWLG. UNITS OFFSTiiEET PARKING
I HEFEBY CERTIFY THAT I HAVE FEAD AND EXAMINED THIS APPLICATION ]_ STALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMITFEE SACCHARGE
PROVISIONS OF ANY OTHER STATE OR LOCAI LAW REGULATING CON-
STRU� OR THE PERFOFMANCE OF CONSTRUCTION. $HO. OO
PLAN CHECK FEE TOTAL FEE
�Li�Z%�J�°v" ���J �`$�. ��
slGn�niva CONiRACTO� �� � GENT �DnTEi WHEN PROPER�Y VALIDATED THIS IS YOUR PERMIT
/J'"� � � %�
� d � ��,�.� �—l�����
SiGNATUAE OF OWNER�IF OWNER BUILDERI IDATEI ^ G�NSP qATE
Effective Aug. 1, 1981
p��[CT
c�ty of F��a�ey Pe��t No.
•T *�T�°'TM�TM'"" MOVI�VG PERMIT APPLICATIOi�
i�� Receipt To.
� rL-------� cowruN�r. a��oi..EMT av.
, ; M�«� �..��.� .�. a � � � a
� � �. . ; arr �c.� r�ou� Mw�
�....�.I �.� Ni'NO�iNO M�WO� . O�TE E' OR A►�110v Dir
910-F21 0 2/15/73 1 �1 800
property Owner Address one
- ,� 5��2� � � 33� -� � ��
re�ent Lot No B oc No Tract or tion �� -
gal . /(v ;�c � 5 `" � �„� nJ, �✓/G'Fw/,�.�', ��'�
To Be �
wed To -;; %lj C,G�l�`�
�er, ress one icense o.
�
. • ' �t� <�t� =-� � j.� - �a:� =.�z� r: = ���! 1 � � �
.,� ° � , � �-��° �" z_
Expecte une n oz ru r ey Eet mate Cost Ty of Building
$ 11L%C� � ,���t���--c
Rvuting �� , / 4�
,� l �xc , - �%�/�,,��/✓�� .� ��i�!i�'..�- ,�,1;. %- _
Approved By: •
IItilities � be l�otified and aate Servfces �isconnected
llpls. Gaa Oo. ti.S.P. Northwestern Hell Tel. Co.
Snqr. Dep� C1�st. 8us. Ofc. Bus. Ofc.
372-4850 330 554Q 332-4112
Date Date Date
l�iavinq Fees: Movinq PYinciple Suilding Into Fridley $ 80.00
Mcvinq 14ccessory Suildi�g Into Pridley $ 20.00
1�toyinq tiiznuqh, vith.in or cut o� City S 15.0.0
No State surcI�arqe on lla�vinq PeYmits
Apprwed By Water � Sewer Department:
•All Bills Are Paid Services Are Disconnected
The•undersigned hereby makes applicaticn for a permit to move the building
descsibed abave, agreeing to do all work in strict accordance with the City
Ordit1ances and xv lings of the Department of Buildings, and hereby declares that
all facts and representations stated in this application are txue and correct.
`��? ��L� - ,��!����t � � t= -
U � � � � Con tractor
i
.._---..�.-----`-_._.--- �, I y �
-- �-�: ��. � � e
\
s • `
C1TY OF FRIDLEY
APPLICATION FOR PWMBIN6 AND �AS FITTING PEf�1IT
ay. � a u • x y Water
�A an � w c a m � u p, �a�, °� Heater
N m° �.�+ " �c'�a i �M'��gs � u� a�i
v�i u � oo a� v�i a O w v�i t�.o, u m 4 3 � � c� O as lec
� ,�
lst � �
2nd
3rd
4 th
(R) � FuWra Connaction Opening Connected with Sewer
(�) � New Fixtura, Old Openinq Miates
RATE SCHEDULE
PLUMBING FIXTURE RATES: N0.
Mew !1=tur��
lutur• rixtura�
Old Op�ninq, N�v li:tur�
e�er Di�p�na�r
81or Off ea�in
C�tch Basin
R�in Ylatar Lsad�r
Nydraulic Valv�
Su�p or R�ceiving Tank
Mat�r Tse�tinq Appli�nce
Hot ilater tleater
Ga� Renqe
Gas Dryer
�
�
RATE
S 5.00
S 3.50
S l. 50
S 4.00
S 5. 00
$ 5.00
S S.OU
S 5.00
S 5.00
$ 7.00
$ 5.00
$ 10.00
S 10. 00
ALL OTHERS AND/OR REPIIIRS AND ALTERATIONS
ls ot Valus o! ti:tur� or llppliance
� State Surcharge
Asinapection !ee $
(515.00) . TOTAL PEE
TOTAL
S ,��
S
S
S
S
S
S
S
S
S
S ���
S
S
S
"5 Q, � V
Etfective Aug. 1, lyal
Job Address �/., �(/ /y+,rf-��y. S�°
�_�j.._�_.:.
Department of Buildings
City of Fridley
Tel. M571-3450
The undersigned hereby makes application for a paroit !oz the work herein
specified agreeinq to do all work in atrict accordanc� with the City Codes
and rulings of the Departaient of Buildinga, and hsreby declarea that all
the facts and representatio�s etated in thia application ara true and correct
Fridley, Mn. � lg
OWNER �'�� � S� � �- �'C�.r s� I
KIND OP BUILDING �— /Z /9,M 1.
,` /
USED AS % � `- S
TO BE COI�LETED 11BOUT I � - � �j °- � �
ESTIMATED OOST /� m d
_�
OLD - NEW BUILDING PERMIT NO. PERMIT NO. `7 ���
OowPanY `) W �. � I� I•-R.nn /��' `f'�
Siqned By c�--
Tel . No ��'/ �% Tj
RO(1Gt1 I NSP .
nate
FINAL INSP. ec `�"��
nate
11PPR0'VAL FOR PERMIT --��
HININUM FEE FOR ANY PLUMBING PERMIT IS 510.00
PLUS THE S.50 STATE SURCHARGE
� _
UTYOF
FRIDLEY
CI�'IC CF:tiTf-:K • 6-131 UNIVERSITY AVE. N.E. FRIDLEY, MINNESOTA 55432 • PHONE(612) 571-3-�SO
February 9, 1987
Vista Construction
961 Hillwind Road N.E.
Fridley, MN 55432
Re: Final Inspection at 6576 Anoka Street N.E., Fridley, MN
De ar S i rs :
A final inspection was conducted on February 9, 1987 of the above address and
the following ite�ns were noted which must be completed before the structure
can be finaled:
1. Provide house number on structure by February 19, 1987.
2. Provide a handrail on the basement stair by Februaxy 19, 1987.
3. Insulate rim jois t by February 19, 1987.
4. Head off floor joist by February 19, 1987.
5. Pay Double Fee on iieatirig Permit by February 19, 1987.
6. Provide sod in tne front and side yards by June 15, 1987.
7. Provide a hard surf ace driveway by June 15, 1987.
8. Paint the exterior of structure by June 15, 1987.
We will expect the above items to be completed by the scheduled dates when
reinspections will be made to determine compliance. If you have any ques tions
on these items, please feel free to contact me at 571-3450.
Sincerely,
DARREL G. CLARK
Chief Building Official
DGC/mh
CC: Mr. Terry Barrett
C11Y OF FRIDLEY
APPLICATION fOR P011ER PlANTS AND HEATING, COOLING, VENTILATION, REFRIGERATION AND
AIR CONDITIONING SVSTEMS ANO DEVICES
RATE SCHEDULE
�csto��r u►�
/urn�ce Shell •nd �uct Mork,
6u[net IAI�o tpl�cwnt Iurn�n)
C�� Plptnq
(P�p��9 M�� vltll Mr turNC�)
C�• II�n9e
G�• Drr�r
• Air CondLtioniny (�ll �ls��)
MTE
S 20. 00
S 10.00
S 10.00
s io.00
S 10.00
Al1 OtAer�/Ilep�/r• •nd Aiter�tion•
l� o[ V�lue ot Appli�nce or Mork
C01�1 LRC I A L/ INDUSTR I AL
l� ot V�lu• ol Appll�nc• os Mosk
St�t• Surcharqe
rarur. ne
R�ln�p�cttoe It� Ii1S.001
Rouqh Ie�p. '
D�te
PLaal Insp.
�te
Approval toc P�rw1t � d'�
MINTMUM PEE FOR ANY HfJ►TINC PERN[T IS 510.00
PLUS S.SO STATE SURCIIARG�
.......���• w�ry. � �'Yn{
TO'fAL J�b Ackfre.s � ✓ /�/�� O.C!'� ��
�o,�/y a`
s C�� t►r�.artment of 6ulldlnqs b111 Unlverslty Av�. N.L., �r/dl�r, MM SS�)2
,�7 O� Clty o( F(/dley
s �l/ � tel. �S71-]�SO
s
s
S
Tf�� unders/qned h�reby w�k�� �ppllc�tlon to� � perwlt (O[ tM wrk A�[�ln
��clfled �qre�lnq to d� �11 wrk t� �trlct �ccordanc� �ItA th� Cltr Ood�•
�nd rul�nq� of th� Dep��t�e�t of su/ldlnq�, �nd htceby d�cl�r�• th�t •ll th�
f�cta •nd ceprt�ent�tlon� • uted ln thl� �ppl/c�tlon �r• ttu� �ed eo�r�ct.
• ►r/dl�r. Mlon. _,_ ��„/�3 _. l��
Q/NF.R
s
RINO OF �UILDlNG
S
S .50
S
s �
�o-.��
�-0'-
Att�eA �t�et ver/tiaat�oe [oes v� N r�ptec.wene (urnace pocwles
.
•A�r t:�wdlt�onesx c�n �u�� lw• {�Isccd io •:�.1.• yard �ttlwut
rr�u�n p�rw�ivwn fr�w ndin�n��q rr��1���x.
USEO AS
�o �e eawtiteo �sour
% 6 0
PSTIIY►TEO C06T G!� � �_
OW - Mtll W1l�IMG /EIMiT q0. ���IIT NO. / �
oescurria� os ruaN�ce/�uw�c�
eu►rtuc o� vare� ruKrs, se..., Noc wc.r, wr+� �i�- i+o.
n�e� ww� ��i�/✓o jC sis� No. �� ��'� ��_
c.p.��cy sy. rc. co� nv _,,,,.�....,.. er ----
lbtai Connected Io�d It1nd ol IWl 5- R�
su101ER - Tr�de N� s�s� �•
Ca���clty Sq. Ft. EOR 01v N� r
Cow{+�ny
��'��6 � �
Slqn�d !y
T� 1 . IN� . � 4�/ �
��
�
��'" •'s
CITYOF
FRIDLEY
CIVIC CENTER • 6431 UNIVERS[TY AVE. N.E. FRIDLEY, MINNESOTA 55432 • PHONE (612) 571-34$0
April 28, 1987
Ztierry G. Barrett
1463 Wi.ndc�ere Drive N.E.
Fridley, A�I 55421
RE; Non-CaY�liance of the Fridley City Code at 6576 Anaka Street N.E.
Dear r;r. Barrett:
On April 22, 1987 it was confirn�d by an on-site inspection that the PropertY
at 6576 Anoka Street N.E. dces not meet the mini�u.aY► standards necessary to
maintain a pleasant and prosperous subu�.'�an environment. While major code
requirements are satistied, the follawing items do not co�nply with the
perf ozn�ance standards of the City Cod.e:
1. It was stipulated when you were granted a lot split in 19ti6 that a paved
driveway be installed to the n�a 9ara3e• This stipulatian has yet to be
ccx�letg3. In addition, the Yard has rwt y�et been sa3aed and tree txunks
and branches have not been ranwed trccn the site.
I understand that there may have been same extenuating circi.unstances for this
to have occurred, havever, yaur quick action to correct this situation would
be a great itrq�rov�r�ent for your proPertY arui the entire cac�nu�ity as well.
An inspection will be conducted on or about May 14, 1987 to determine
ca�l iance.
If you have any questians or concerns, please feel free to contact me at the
Fridley Civic Center, 5'/1-3450.
S ' erely,
��
Daryl Mc�
ptanning Assistant
I�`�/lu�
C-87 -191
_ _ � _ 5�12� �� -- _
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_ Dry � v�,� � 5 a -� �ac�.� ow v� i �� �` � � . �; � �� � v'e h _ _ _. _.
Y� tAv� �' 1 � % S(o 2�it� jLa�.
5 � �� w¢.- � . _ _ _ _ - - _
• st'
b�-v-E-i�.,►- �, s�-� w; l l b�. (�u�; �� �; �� I�,��, a�- � N�..e. 1-
t�w.-�� �� 1� U�e. � v` ,
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CI�iYOF
FR( DLEY
�
CIUIC CENTER • 6�331 UNIVERSITY AVE. N.E. FRIDLEY, I�1INNESOTA 55.�32 • PHONE (612) 571-��t50
June 18, 1987
Glen and Gail Ahlgren
6562 Anolca Street
Fridley, rf� 55432
F,E: Seoond t:otice of Non-�c,mpliance af the Fridley City Code at 6576 Anoka
Street N.E.
Dear r.r. and M.rs. Ahlgren:
On J�e 17, 1987 s seoond inspection of your property at 6576 Anoka Street
1�. E. rev�led that it still does not c�omply with the perf ormance stanciards
established within the Gity CAde. �he following items still do not comply
k i rh ttie Ci ty Gode :
1. Tne rear yarci needs to be sodded and the driveway to the garage neeas to
be paved.
iZegardless of extenuating circu��stances, this situaticn must be corrected
pronptly to naintain a gleasant and healthy environment. A thirc inspection
will be conducted on or about J�e 29, 1987 at w�hich time it is expected that
this iter� wi11 be in wmgliance. If corrective action cannot be �mplEteci b�
this tin�e, please sutrait a schedule indicating when this deficiency will be
oorrectea If you nave not oontacted me before the inspection date or abatea
L'ne problc-si� then I�ill st�mit all reoords regarding this m�atter to the City
Council ht►o can apprave legal action.
If you tiave any questi�ns �ncerning this matter please contact me at the
Frinley Civic Center, 571-3450. �ank you for your prampt attention to this
n�atter.
�. � ...�c.�.......,_.....,,..�
Sincerely,
Datyl rArey
Planning Assistant
Lri/lmn
C-S7-261 (C-87-191)
Inspection: October 6, 1988 by Darrel Clark,
Chief Building Official, noted that the sod,
driveway, and garage were completed and
ap ro d. ,00 bo d should be rel�.eased.
c`����
.
.
: �. "' •
�,
�"''
C�TY OF
FR[ DLEY ..
Cl�'IC CENTER •(�3?t UNIVERSITY AVE. N.E. FRIDLEY. A1INNESOTA 55�3;2 • PHONE (61?) i7�_3.�$p,
Apri1 28, 1987 ��
Terry G. Barnett
1463 4�'indc�ere Drive N. E.
Fridley, I��1 55421
RE: NorrCa�liance of the Fridley City dode at 6576 Andca Street N.E.
Dear Dir. Barrett:
On April 22, 1987 it was confi�nc.�d by zn on-site inspection that the property
at 6576 Anoka Street N.E. does not meet the mini�.an standards necessary to
�intain a pleasant and prosperous suburban environment. While major code
requirements are satistied, the follawing items do not co¢nply with the
perf o�nance standards of the City Oode:
1. It was stipulated when you were granted a lot split in 19�6 that a paved
driveway be installed to the new 9ara9e• This stipulation has yet to be
camplete�3. In addition, the yard has not yet been saiaed and tree trunks
and branches have not been rar�oved trcm the site.
I understand that there m�y have been sane extenuating ci�ianstances for this
to have occurred, haaever, your quick action to correct this situation would
be a great imprwement for yaur propertY and the entire carnauiity as well.
An inspection will be conducted on or about Ma.y 14, 1987 to determine
ca�liance.
If you have any questians or concerns, please feel free to contact me at the
Fridley Civic Center, 5'/1-3450.
S' erely,
1 ��1,
Daxyl
P2anning Assistant
� , i.
C 8%-�1.
_
_'
�.pl �I �I i�NF
FIV LJLGI
CIVIC CENTER • 6431 UNIVERSITY AVE. IV.E. FRIDLEY, MINNESOTA 55432 • PHONE (612) 571-3450
October 14, 1988
Terry Barret
1463 Windemere Circle West N.E.
� Fridley, 1�T 55432
RE: Performance Bond for 6576 Anoka Street N.E.
Dear Mr. Barret:
Chief Building Official, Darrel Clark, inspected the above
referenced property for compliance to the City Code. Apparently,
a personal check was issued for comgleting outside improvements at
the site. The improvements have been completed, therefore, the
check is being released.
Thank you for your cooperation.
Sincererly,
Kathlyn Castle
Planning Assistant
KC/dn
C-88-513
�
.� _.
SUBJECI
City of Fridley
AT TNE TOP OF THE TWINS g � I L D I N G P E R M I T
r
� .
� �
� ; y__.��_ COMMUNITY DEVEIOPMENT DIV.
r � � PAOTECTIVE INSPECTION SEC.
� �
� � �"'1 � CIFY NALL fRIOLE� SS�J2 NUMBEfi AEv
�""�� �'� 612--571-3450 9t0-F15
JOB ADORESS 6576 Anoka Street NE
t LEGA� LOT NO. BLOCK TRACT Op ADDITION
oesca. 4, Pt. 5 4 Oak Grove Addition
2 PROPERTV OWNER MAIL ADDRESS
Dale Meyer
3 CONTRACTOR MAII ADORESS
Owner
4 AiiCHITECT OR OESIGNER MAIL AODRESS
5 ENGINEER MAtI AOORESS
6 USE OF BUILDING
Residential
7 CLASS OF WORK
O�TE
9/15/99
ZIP
ZIP
ZIP
v�GE Of
/ /
PERM17 NO.
3022
RECEIPT NO.
��/7�
►PPROVEO 0�
SEE ATTACHEO
SMEET
PNONE
586-6911
PHONE LICENSE NO
PHONE LICENSE NO.
PHONE IfCENSE NO
O NEW ❑ ADDITION O ALTERATION � REPAIR p MOVE O REMOVE
8 DESCRIBE WORK
Revlace 6 windows
9 CHANGE OF USE FFiOM
STIPULATIONS
Provide smoke detectors in all sleeping rooms and on all levels of the
dwelling.
TYPE OF CONST.
SEPARATE PERMITS ARE RE�UIREO fOR EIECTRICAL, PLUMBING, MEATING.
VENTILATING OR AIR CONOITIONING
THIS PERMIT BECOMES NULL AND VOIO IF WORK OFi CONSTRUCTION 20NING
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS. Oii If CONSTpUCTION
OR WORK IS SUSPENOED OR ABANDONEO FOR A PERIOD OF 120 �AVS AT
ANY TIME AfTER WORK IS COMMENCED. NO OWLG. UNI
I HEREBY CEFiTIFV TMAT I MAVE READ AND EXAMINEO THIS APPLICA710N
ANO KNOW THE SAME TO BE TRUE ANO COfii;ECi. ALL PROVISIONS Of �AWS yq�UAT10N
AND ORDINANCES GOVERNING THIS TVPE OF WORK WILI BE COMPLIED
WITM WHETMER SPECIFIED MEREIN OFi NOT. TME GRANTING OF A PERMIT ].ZOO
OOES NOT PRESUME TO GIVE AUTMORITV TO VIOLATE OR CANCEI THE pERMITfEE
PROVISIONS OF ANV OTHER STATE OR LOCAI LAW REGUTATING CON-
$TRUCTION OR TME PERFORMANCE OF CONSTRUCTION 44.HS
PIAN CMECK FE
SiGNyupE OF CON'p�f,i0a Op �UiNORrZED �GENT
iOAiEr
� � ��
�o•rE�
SO. fT
STALLS
�ROUP OCCUPANCVLOAp
CU FT.
OFFSTREET PARKING
IGARAGES
SUfiTAI(
$.60
SAC CMAAGE
Fire 8'C $1,20
�►+rS i O R E M�
' �' r
�cTE
�l
NEW`r ] `
ADDN
ALTER
Effective 5/10/99
[ ] CITY OF FRIDLEY
[] SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2
BUII.DING PERMIT APPLICATION
Construction Address:
Legal Description: _
a
,�� `�a � �� �
� ��,�� � �
Owner Name & Address: ? !� Tel. # ��� �� 7 � �
Contractor: _ MN LICENSE #
Address: Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA:
GARAGE AREA:
DECK AREA:
QTHER:
Construction Type:
Length
Length
Length
Driveway Curb Cut Width Needed:
DESCRIPTION OF IMPROVEMENT
Width
Width
Width
Height
Height
H�Ground
Sq. Ft.
Sq. Ft.
Sq. Ft.
Estimated Cost: $ I b'' � v
Ft. + 6 Ft = Ft x$
_$
DATE: 6� 6� f�- 7 I APPLICANT: Tel. #
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
I.icense Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
CITY USE ONLY
$ �� �~ Fee Schedule on Reverse Side
$ f, a C� •001 of Pemut Valuation (1/lOth%)
$ . �(� $.50/$1,000 Valuation
$ $1050 per SAC Unit
$ �5.00 (State Licensed Residential Cor�tractors)
$ Alt. "A" or Alt. "B" Above
$ $450.00 Conservation Plan Review
$ Fee Determined by Engineering
$_ _ Agreement Necessary [ ] Not Necessary [ ]
$ J
CITY OF FRIDLEY INSPECT{ON DiV.
6431 University Ave NE
Fridiey, MN 55432
572-3604
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR
Effective On Jan 1, 2000
PLUMBING FIXTURE RATES:
New Fixtures
Old Opening, New Fixture
Beer Dispenser
Blow Off Basin
Catch Basin
Rain Water Leader
Sump/Receiving Tank
Water Treating Appliance
Water Heate� -Electric
Water Heater - Gas"
Gas Range"'"
NO. RATE
�_
Gas Dryer"" _
Back Flow Preventer Required ()Yes () No
Type _
$ 7.00
$ 4.00
$ 5.00
$ 7.00
$ 7.00
$ 7.00
$ 7.00
$10.00
�V %.�0
$10.00
$10.00
$10.00
TOTAL
�
JOB ADDRESS Co �? Lo �/� z f� r'� �T lU �
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the city codes
and rulings of the Building Division, and hereby declares that all the facts
and representations stated in this application are true and correct.
�-- /�-/ / c � , 20_
Owner �� /t% J a � � v ° .1�
t. /-i J T
Building Used As ��' �
Estimated Cost J G o� PERMIT NO. ��f��/��
$15.00 PLUMBING
Reinspection Fee $47.00/Hr
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Fixture or Appliance
State Surcharge
TOTAL FEE
SIGNED`B�;
�
�c .
Approved By
$ .50
MINIMUM I
$ :�2-c .5 � PLUS THE
�i . A . �o Fl �i s c: � a. � � �'
a�n�ayL/ TEL N0. �� 3"�� 3�
Rough-Iri Date Final Date l-� "�-� %
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE
COMMON VENT. VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
When re�lacinq an existing furance, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required. Yes () No ()
The venting system is plastic/PVC and meets all current codes and manufacturer
specifications including sizing, length, number of elbows and termination. Yes () No ()
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufacturer's specifications. This does
include AGA-GAMA Category I Central Furnace Venting Tables for fan
assisted and natural draft appliances.
The existinq combustion air is sized and installed to meet the cuRent codes
and manufacturer's specifications.
When required to install a new combustion air, it will be sized and installed
To meet the current codes and manufacturer's specifications.
Yes()No()
Yes ( ) No ( )
Yes ( ) No ( )
When installina a new venting svstem, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturer's
specifications. This does include AGA-GAMA Category I Central Fumace
Venting Tables for fan assisted and natural draft appliances. Yes () No ()
Is the common vent and vent connectors sized and installed correctly after
an appliance has been removed from the common vent and vented
separately as per current codes. Yes () No ()
Appliance Tvae and Size/Common Vent and Vent Connector Information
Appliance #1 Type BTU Input Fan Assisted or Nat
Appliance #2 Type BTU Input Fan Assisted or Nat
Appliance #3 Type BTU Input Fan Assisted or Nat
Total Appliances Total Btu Input
Common Vent Type
Vent Height Diameter inches
Appliance #1 Vent Connector Height ft Length ft Diameter in Type
Appliance #2 Vent Connector Height ft Length ft Diameter in Type
Appliance #3 Vent Connector Height ft Length ft Diameter in Type
ALTERATIONS: (Describe)
HEATING CO:
Signed By: Date :
�
m
rCITY OF FRIDLEY INSPECTION DIViSION Effective On January 1, 2002
6431 University Ave NE
'hridley, MN 55432 APPUCATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION,
(763) 572•3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
' Co5%'!� f1�VD,e.4 57 NC ;
JOB ADDRESS
RATESCHEDULE
Residential
Furnace Shell and Duct Work, Burner -
Also Replacement Furnace
(Side Vent - Fill Out Back)
Gas Piping (Needed with new furnace,
but not replacement)
Gas Range
Gas Dryer
*Air Conditioning • All Sizes
All Others/Repairs & Alterations (LIST ON BACK)
1% ofValue of Appliance or Work
Commercial/Industrial
1.25% of Value of Appliance or Work
Rate TOTAL
$ 30.00 $ �• °O
$ 10.00 $
$ 10.00
$ 10.00
$ 25.00
State Surcharge
TOTALFEE
MINIMUM FEE FOR ANY HEATlNG/COOLING/VENTILATION
REFRIGERATION/AIR CONDITIONING PERMIT I� 25.00
PLUS THE $.50 STATE SURCHARGE
REINSPECTION FEE $47.00/Hr
*Air Conditioners can not be placed in a side yard without
written permission from adjoining property owner.
OWNER ���D ���0
BUILDING USED AS 1���//��/��
ESTIMATED COST I1 �7� PERMIT N0. /����
DESCRIPTION OF FURNACE AND OR BURNER
$
No. of Heating Units__j__ Circle One (Steam) (Hot Water) ( arm Ai
$ Trade Name <�P - 9�l P VSa Size No. �D� f,�
BTU HP EDR
$ 2S � Fuel N!-}T. �AS Total Connected Load
$
$
$ .50
$ SS-�
Burner Trade Name Size No.
BTU HP ED
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work in strict accordance with the City Codes an
rulings of the Building Division, and hereby declares that all the facts and
�tion are true and correct.
Home Energy Center
15200 25`h Ave N #128
Plymouth MN 55447
763-476-1990 fax 763-476-1143
DATE � ' �' ��
Signed �'�'�� TEL #
FAX #
;
Approved By_ Rough-In Date
1
�
Final Date -/� y�`f �
FILL OUT BACK SIDE FOR STACK VERIFICATICN ON REPLACEMENT FURNACE
�.,�s, �a I ,' /
' THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE
APPLICATION WILL BE RETURNED
•uu•► ► ► •►► •: �►� •�i: •► ! : : ! �►
When r�- I(La -ing an Pxic in� furanrP, the undersigned hereby venfies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and firestopped where required.
The venting system is plastiGPVC and meets all current codes and manufacturer
specifications including sizing, length, number of elbows and termination.
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufacturers specifications. This does
include AGA-GAMA Category I Central Fumace Venting Tables for fan
assisted and natural draft appliances.
The PYi� �ng comh�st�on air is sized and installed to meet the current codes
and manufacturer's specifications.
When required to install a new cemb �� ien air�it will be sized and installed
to meet the current codes and manufacturer's specifications.
When inc alling a new ventinq cy_etPm, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturers
specifications. This does include AGA-GAMA Category I Central Fumace
Venting Tables for fan assisted and natural draft appliances.
Is the common vent and vent connectors sized and installed correctly after
an appliance has been removed from the common vent and vented
separately as per current codes.
Yes (✓� No ( )
Yes (,�j No ( )
Yes � No ( )
Yes (,� No ( )
Yes (�/j No ( )
Yes (✓j No ( )
Yes (✓j No ( )
•.. .. - .- .�. - .����.. -� .�. -. .��- . . ..��. ..
Appliance #1 Type �uR�/AG� BTU Input �,ovv an Assiste r Nat
Appliance #2 Type BTU Input Fan Assisted or Nat
Appliance #3 Type BTU Input Fan Assisted or Nat
Total Appliances Total Btu Input
Common Vent Type
Vent Height Diameter inches
Appliance #1 Vent Connector Height ft Length ft Diameter in Type
Appliance #2 Vent Connector Height ft Length ft Diameter in Type
App(iance #3 Vent Connector Height ft Length ft Diameter in Type
' 1 :' •► �- r.-
Home Energy Center
15200 25th Ave N #128
Plymouth MN 55447
763-476-1990 fax 763-476-1143
HEATING CO:
Signed By: Date : � • � - D-� .
�a � I�i ��
���4�
RIGHT-J LOAD AND EQUIPMENT SUMMARY
Entire House
Home Energy Center
15200 25th Avenue North, Plymouth, MN 55447 Phone: 763.476.1990 Fax: 763.476.1143
� • ' • •
For: Rondo
6576 Anoka St. NE, Fridley, MN
Notes:
Desi n Information
Weather: Minneapolis-St. Paul, MN, US
Winter Design Conditions Summer Design Conditions
Outside db
fnside db
Design TD
Heating Summary
Building heat loss
Ventilafion air
Ventilation air I�ss
Design heat load
Infiltration
-22 °F Outside db
70 °F Inside db
92 °F Design TD
Daily range
Relative humidity
Moisture difference
91
75
16
M
50
29
�F
�F
�F
%
gr/Ib
Sensible Cooling Equipment Load Sizing
41120 Btuh Structure 18331 Btuh
0 cfm Ventilation 0 Btuh
0 Btuh Design temperature swing 3.0 °F
41120 Btuh Use mfg. data n
Rate/swing multiplier 0.96
Total sens. equip. load 17598 Btuh
Method Simplified
Construction quality Average
Fireplaces 0
Heating Cooling
Area (ftZ) 1224 122�i
Volume (ft3) 9792 9792
Air changes/hour 1.0 0.5
Equiv. AVF (cfm) 164 82
Heating Equipment Summary
Make
Trade
Efficiency
Heating inpu;
Heating output.
Heating temp rise
Actual heating fan
Heating air flow factor
Space thermostat
80.0 AFUE
0 Btuh
0 Btuh
0 °F
980 cfm
0.024 cfm/Btuh
Latent Cooling Equipment Load Sizing
Internal gains
Ventilation
Infiltration
Total latent equip. load
Total equipment load
1380 Btuh
0 Btuh
1595 Btuh
2975 Btuh
20572 Btuh
Cooling Equipment Summary
Make
Trade
Efficiency 0.0 EER
Sensible cc�o[ing 0 Btuh
Latent cooling 0 Btuh
Total cooling 0 Btuh
Actual cooling fan 980 cfm
Cooling air flow factor 0.053 cfm/Btuh
Load sensible heat ratio 86 %
Printout certified by ACCA to meet all requirements of Manual J 7th Ed.
,�, wr�ghtsoft Right-Suite ResidentialT"" 5.0.28 RSR20001 2003-Aug-06 1428:17
AC� C:\WrightsoR HVAC12003�AABasicLoad.rsr Page 1
RIGHT-J WORKSHEET
Entire House
Home Energy Center
75200 25th Avenue North, Plymouth, MN 55447 Phone: 763.476.1990 Fax: 763.476.1143
�MANUAL J: 7th Ed.
Name of room Entire House Rondo
� 2 � Length of exposed wall � 140.0 ft � 140.0 ft � � �
3 Room dimensions 36.0 x 34.0 ft
4 Ceiings Condit.Option 8.0 ft heat/cool d 8.0 ft heaUcool
TYPE OF CS HTM Area Load (Btuh) Area Load (Btuh) Area Area
EXPOSURE NO. Htg Clg (ft� Htg Clg (ft� Htg Clg Htg Clg Htg Clg
5 Gross a 12C 8.3 1.8 1120 "" "" 1120
Ex osed b 0.0 0.0 0 ***' '*** 0
( I walPlsand Icl O.OI O.OI pl .... I.... I �I .... I.... I I.... I,... I I ... I.... I
� � partitions � d � � 0.0 � 0.0 � 0 � "" �"" � 0 � *"` �"" � I"'." �.." � � � �
e 0.0 0.0 0 ..., .... � ,... .... .... ,�., .... ....
f 0.0 0.0 0 ...< .... p .... .... .... .,,,. .,., ,...
6 Windows and a 2A 43.7 "* 162 7079 **** 162 7079 *"' ""�` ""�
glass doors b 0.0 ** 0 0 "" 0 0
I I Heating I c I I 0.0 I" I o I o �.~. I o I o �,". I I I"" I I I�" I
I I I dl I o.ol �• I ol ol •_•% I ol ol ""� I I I"" I I I•"' I
e o.o •• o o~" o o`•" "" ""
f 0.0 .. � �.... 0 0.... ,x.. ....
7 Windows and North 0.0 0 ""' 0 0'*" 0 "" �""
glass doors NE/NW 0.0 0 "" 0 0 "*' 0
� � Cooling � E/W � 52.8 � 120 �""" � 6336 � 120 �"" � 6336 � � '** � � �'"'�� � �
SE/SW 0.0 0I "" 0 0 "" 0
I I I South I 44.8 I 42 J'*" 1882I 42 I"" 1882I I�"" I I I'"`�� I
Horz 0.0 0 "** 0 0 "" 0 '_" `�"�
8 Other doors a 10F 29.4 6.3 42 1236 263 42 1236 263
b 0.0 0.0 0 0 0 0 0 0
c 0.0 0.0 0 0 0 0 0 0
9 Net a 12C 8.3 1.8 916 7584 1616 916 7584 1616
I I exposed I b I I o.o I o.o I o I o I o I o I o I o I I I I I I I
walls and c 0.0 0.0 0I 0 0 0 0 0
I I partitions I d I I G.0 I O.O I 0! O I p I o 0 I 0 I I I I I I
I I I el I o.ol o.ol ol ol ol ol ol ol I I I I I I
f o.o o.o 0 0 0 0 0 0
10 Ceili�gs a 16D 4.9 2.1 1224 5968 2595 1224 5968 2595
I I I bl I o.ol o.ol ol ol ol ol ol ol I I I I I I
I I Icl I o.ol o.o oI ol ol ol ol ol I I I I I I
d 0.0 0.0 0 0 0 0 0 0
I I I el I o.ol o.ol ol ol ol ol ol ol I I I I I I
f 0.0 0.0 0 0 0 0 0 0
11 Floors a 21A 2.2 0.0 1224 2703 0 1224 2703 0
I I(Note: room I bl I o.ol o.ol ol ol ol ol ol ol I I I I I I
I I isedi P�ter I c I I O.O I O.O I 0 O I O I O I O I O I I I I I I I
d 0.0 0.0 0 0 0 0 0 0
� � forslab �e� � 0.0� 0.0� 0� 0� 0� 0� 0� 0� � � � � � �
floors) f 0.0 0.0 0 0 0 0 0 0
12 Infiltration a 81.1 7.1 204 16549 1439 204 16549 1439
13 Subtotal loss=6+g +11+12 '*'* 41120 ***` *'*' 41120 *'*` ""`* m�`
I I Less extemal heating �;;;; I o I•*'• I•"` I o I"'*• I"" I I*`"' I"*' I I*'� I
� � Less transfer ���� ,,,,
14 DuCt loss po� � .... �o� Q .... o� . .... �� ....
15 Total loss = 13+14 '**' 41120 **** **" 41120 "'* *"' '�"'
i6l int. gains: People cLD 300 6 ""* 1800 6 "" 1800 "" ��
Appl. � 1200 2 "'"* 2400 2 "" 2400 "'« �
� 17 � Subtot RSH gain=7+g„+�Z+16 �"`*' �"'" � 18331 �"" �*"' � 18331 �*'"`* �"" � �`�" ��"" � �
Less extemal coolin "" ""` 0="' `*"* p
I I Less transfer 9 I..,. I,.,. I D I .,,,. I.... I � I ,.. I.... I I.... I.... I
I� a I Duct gain I o�id "" I o I o°id •*•' I o I °id •"' I I °id "" I I
� 19 � Total RSH gain=(17+18)'PLF � 1.00 �*"' � 18331 � 1.00 �""' � 1 8 3 3 1 � �`*"" � � ��"` � �
I 20I Air required (cfm) I""' I 98� I 980I `"`• I 98� I 98� I`••• I I �"'• � � �
Printout certified by ACCA to meet all requirements of Manual J 7th Ed.
,� wr�ghtso%t Right-Suite ResidentialT" 5.0.28 RSR20001 2003Aug-06 14:28:17
ACCR C:\WrighlsoR HVAC�20031AABasicLoad.rsr Page 1
-
_
C! l l Ol
FR[DLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287
March 23, 2004
Mr_ David Rnndn
HOUSE HEATING TEST RECORD
/�s� ��
ADDRESS ���G `'Na�A ST �� APT. FLOOR CITY ���� L��
OCCUPANT OWNER ���0
HEAT LOSS DATE HTG. INST.
SOLD BY HOME ENERGY CENTER INSTALLED BY HOME ENERGY CENTER
Electrical Work By HARRISON ELECTRIC Gas Line By
TYPE OF HEAT GA FA X HW STEAM SPACE HTR. UNIT HTR. bTHER
MAKE � � �
Model � �'1
Serial �-- �
INPUT
THERMOSTAT � He t ug _
Valve __T
Limit
Limit Setting
Fan Setting
Pilot Type
Pilot Make
Pilot Model
Pilot Timing
L.W. Cut Off
Pressure 3• 9 Percent CO2
Input CFH S� Percent 02_
Stack Temp. Percent CO .
Form 235
Builc� Inspector
DJ/mh
MAKE OF BURNER _
Model
Max. BTU Rating _
MAKE OF FURNACE
Model
Vent Size
KIND OF LINER SIZE NONE
Draft Hood Regulator
Filters Size Number
Chimney Location Inside Outside
Chimney Construction
Smoke Bomb Wiring
Draft Test Tag
Door Pressure Lighting Inst.
Date Tested
Company Testing HO GY CENTER
Name of Tester
0