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AF - 43575City of Fridley, Minn. - BUILDING PE�T N� � 7� s�� Date: � ��-� �� � ''�" � �9 �r Owner: �F��;:� • �+a�`.� .,,�"�``_� !�'° Builder ..� ' °` '._.,�5:.�� �__._..� _ f� Address _._.. __.� .�` �.—_ Address — —_..----- -- a LQ�ATI�1+1 p� BUILD9NG 1��. �` � '� � � i �`, �'. i` r�* ' Part � Lot ' �,f,� I No. �.���_ Street �� .�... _� -�— � ��� .. Lot __.�...�.__ Block _ � �....,� Addition or Sub- 'vision,�'���� �"�--�_u'� -��.-�`���� �f " P /f � Corner Lot __.._.V._._.._._ Inside Lot _��_ Setback —_ Sideyard ._ ��_�.�.;�_._ Sewer Elevat3on _._.._ �___._...—....._ Foundation IIevation DESCRIPTION OF �UILDIiVG To t, Used,g/�� � ,�,,, ;� ,,•� .�� ,.3 ��':'� �' '�" • '�� Frant � ' Depth �' ��Height "�. Sq. F� ..�.�.='���`Cu. Ft . _ � : ��"'`' �� � a�.�� �— ,�t Depth Height �.,.�... Sq. Ft � Cu. Ft _ ,�, , .. t ,�'�� �a" " ,r '',rr^'� ` Tyge of Construction �c,,,,�.'_-�'"`- '� � � _ F�� Cost��..� � '� �–�To be Completed ..._ In consideration of the fssuance to me of a permit to construct the building described above, I agree to do the proposed work in accordance with the description above set forth and in compliance with all provisions of ordinances of the dty of Fridley. • '�` :�� �+ � :� In conslderatioa of the payment of a fee of $�.� , permit is hereby granted to to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and worl�nen, in all work done in, around and upon safd building, or any part thereof, shall conform in all respects to the ordinances of FrYdley, Minnespta regarding location, construction, alterxtioa, maintenance, _rePair and moving of �buildings within the dty limits and �Chis pez�mit ma.y be revoked at any time upo� 'ola.tio�° of any of the provisions of said oTdiIISIIC23. -"` _ � J� � •, � �„'°� ..+� .f ?� `. " � � -".''! _. .'�'! � •�- � ». ..' BUildin8 InsPectOP NOTICE: This perroit does not eover f6e wnatrucHoe, inatallalloe fo� wGing, plumbing, gas 6eatieg, aewer er water. Be sure ro aee ths Bulldla8 Inspee�ar for seperate pare�ifs for these Items. � 4 � •;: �.�,>, - _ � . �. � _ s� v� �iPPLICATIOV FOl@ BUILDING PERMIT CiTY 0�' i�RID�EY, MiNNESOTA Owner's Name �� ��� �`'��L � -a° Bu�.lder �-'• �. /F'`7��� �� � ��� - .— ,...�.... Address� Addrees /���/ �i�'-,e�c :�� ��E, LOC�ITZUN OF HUITfDING �To. Street �Part of Lot � ��' �E�v q r°'G� c �t�� �/�',�'s�H �o Lot •.�� 81ock � Addition or S�divis�.on r� Cornar Lot inaide Lo� �� 3etback�3ide-Yard �—`� SEVdEIi ELEVAT�ON �'OUNDATION ELEVATIOi�T Applicant attach to this �orm Certi��cate o� Susvey oiE Lot a�c� proposea building� location. �o be used aso � DE�CI�IPTION OT� $UILDING 0 � �� Sq • Ft • _�/ 7�s�� , .,, Cu • Ft ._ 2'�, � � o Front______ Dep• �_ �3eight Sq. Ft. Cue Ft. Type o�E Construction_ Et-�-�Es�amated Cos� � �° ° To be Comp ,� / �.� . _ / The undersigned he�ceby makes application �Eor a�ermit �or the work harein specified, agree�.ng to do a11 work 3n stric� accordarice with �he City of Fridloy D�d�.nances and ruliag o� the Departmeat of euild- ings � and hereby declares that a11 the faefis and represea'r�tions stated in this apg�lication are true and correct. �: � � � v nAS� � 1 � � szcn�� v� , � (Schedule o� �ee Costs can be �ound on the Reverse �icle). �"', �"� .. . . � . �_--. �i73LD�NG PERi�T F`EE SC�DUI�E Sec�:ion 2. The Inspector of Sufidings shall, be�o�e 3ssuing any pe�aii: io� the e�ec�3on of any bu�.lding or s�ructure, or �or any add�.�ioa to any ox�.stjn� build�.ng or s�ructure, or �Eor an� alterations o� repa�=s �o any exis�c�a�j build�nc,� or s�ruc�u�e, upon application �hore cor, �equire �he pay�nent by the a�p�.icant £or such pe�nnit of rees �o the ainount herein belova set �orth ancl in �che manner herein pgovlded to wito 2.1. �or any auch p�sc�nit �or the erection o� any fire-proo:� building� o�he�c than a garago, wa�cehouse, �actoxy or grain elevator, or �ox the e:rec�ion or any f�ge-p�oo� addit3ora, �or similar occupar►cy, �to any exis� �ing buildi.ng shall be a�t the ra�ce of $1.40 for each on� thousand cubic �eet, or �rac�cion �hereof, ir� such cubical contenics. 2e2. For any such perm�.�t �or the erec�cion o� any firo-proof garage, warehouse, �ac�tory or grain elevator, or �or tTne erect3on or ar�y f�.re� psoo� ado�ition, ior si�.lar occupancy, �co any oxiating bu�l.ding shall be at tl�e ra�e of $1.25 �or each one thousand cubic feet, classified as '°�i�eprooi" by Sec�ion 502 oF the Minneapolis Building Code. FTOZ7'SE S 2.3. For any such pe�m�.� for the erec�ion of �.ag oi:har than a garage, warehouse, fac�ory or �on-��.reproo� addiicion, £or siYailar occupancy, PerYnit $1.00 �o�c each on� thousand cubic feet. GaRAG�S , any non-f3reproo� build- grair► elevator, or any to any exis�ting bu�.lding . 2e4. For any such �e�mi� �or �ha erecfiion oi any aoa�-fireproo� garage, warehouse, yac�o�y or g*-aa.n eZeva�or, or for the erection of any non-�Eireproo�E ad�it3.on, ior sim.i.iaY occug�ancy, to any existing building or ior each such building or additione Ninoty Cenics for each one �,ousand eubic �eet or graction �hereoi, 3n the cubical coa�ents �ereof wi�ch a minimwm oi $4,00 a � �or �he pur�ose oc compu�ing fees fo�c building pegmi.ts the cubical con- ten�s o� any builaing or addition �to a uni corm height throug�hou� 1oy multiplying the grour�a area covered �rom a point six (6) �.nches Zoelow 'r.he cloor lino o� �he�basement or cellar �o the average height of the upp�r sur�ace or �co 'che averag� heigh� of the roof surface of the mairi ga:ble of a pitched roo�. 2_.5, For �epa3rs or alterations ta an existing structure, the fee sha].1 be at the rate o� $3.00 per each Five Hundred Doliars ($500,00) or �:actSon �hereo:� in �tha cos� o� al]. proposed worke 2_.6e 3n no case ahall th0 ree charged �or aay permit as set gorth in Section 2 be less tl�a�n $4,Qp, ^ �. y � � S ; � HARVEY A. CARTWRIGHT ANOKA COYNTY SURVEYS NENN6PIN COUNTY SURVEYS MINNEAPOLIB SURVEYB 8410 PALM STR@ET N.W. SUNBET 4-7885 OWM�R INDUBTRIAL - JUDICIAL BUSlNE55 - TOPOGRAPHICAL CITY LOT6 - PLATTING ��in Ter�zplin F— -- _— CARTWRtG�T & Ol�SON LAND SURVEYORS RLdIST6R80 UNDHR LAWO OF STAT6 OF ININN680TA �.ICBNO60 BY ORDINANC6 OF CITY OF MINNEAPOLIB 326 PLYMOUTH BUILDING FEDERAL 6-8721 HENNEPIN AT SIXTH • MINNEAPOLIS 3. MINNESOTA $►�rbepor'g �ertiftcatc GOMBINfNG �THE RECORDS OF J. E. HILL, CtYIL ENGINEffR EBTABLIBN6D 18a6 C. F. SANDHOFF CIVIL ENGINEER ESTABLIBMED /B08 JAMES NELSON $URVBYOR ESTABLiBNEO tY82 METROPOLITAN LAND SLRVEYORS. ESTABLI8ME0 �t+e+ /O � _ __ _ _ _ __ _ __ _ _ ___ _ _. _ _ 1 _-_ :� _ __ _ __ _� v �',�����"�1i',� ���� s I h�reb� cer�ify th<<t this is c.. trua � nca corr=:�ct re�r�s::nt��tion of � su._rvey o_�: �ot ��, Blocic 2, C�- ra;:n�. i��lol�n�a G�.rlens ��s surveycd b� r�e tlzis 8th day oi l�TOV�r��ber, 1961. !" 1 � � ,• - 4� � � . ^ ,, _ . SIGNHO - ' G�$TWRIGHT wND OL90N F � �a �,3 � d y � � �o �+ � y p � . M : '�, :� : �, : � : o � a . m �7 . � : � • � ,� :A�, � � �+ !'� �'7 � � F1j 1n � �' � m � G W � � � o • o • o�: o . . Gd : : � : : � aa ia �a � ►�+ � o p O � � � � H H 1� Q � t% � � � � � � z �i 8 � � � � � � "'� � � � � N a� ��� � M � � � � � � � � � o � � o a � � � � � �.N:���:� bd _°c : : a g ' � ' : qn o : . : . ' W : : : : ; � . . . . p7 >: >C p4 aC N O ta t� W r r r � 6�i� p C�7� O O 9 � ffl i!i EA � � � �a _' . H � � � � � O � x � � � � � � D � r � m N n 2 m C r m O � a. � 8 � � � � � � � � �= - ■��:�� • _ ..��1 , ■���� . . ■■��� �, �. ■�„ : ���r► ����� � � oa 8 ►+ N o � � g a� w a. �� WATER CLOSETS ualwas enrH �� BASIt�S SINKS W� ranYs DRINK. wu�vr. sr+wa�. FLOOR DRAINS �� B/�SINS nuro WASHER GAS APPL 43A5 RANGE GAS OPENINGS � • 2 � � � � A � � n �aa� � � � a��� � ��� �o � �� � o ��� � ��o�, � � ��°� �' � �'� � ��� �. �� � � � �,� � � � ��� �� p � � o �a°p p" M o � � � y � � � � b a'� � �. o�a�" �$� �o � ro ;+�'n� �� � w � � N � � � � M ��„ � f� flj � c• q �' d � w ¢ro w� Rx &� p � M � M i� � m � � � � �i � � � � � � � � � � G 0. �' � � � � � M � �. o � � A A �. � � - '� �� � � � 0 � x � z z � �r��� x � � o ���z � � � � � � �� �� � � � _ � `' o � � � E � � �� �s sA � m � � D m � N � � t � G� N i � � �� � � � � � �� �� � E' � � � m y � � � � � W x � ~� �' R9 � k � � � � y o � ii y N � o � c ' °o � � � : : x „ �a ,e o N � °c o � � {n v� {n � m y �� W � � � w n � p I � � � � � z � � � � b � � � � � � � o � � ro � � � � � b 0 � 0 0 0 0 0 � 0 r � � z °c � n I � � W m � :' w � �x � � � � �o . �: �: �� �: �. cn 0 0 sn 1� � � � � 0 � � I �� en 0 0 � �' a' ,a�''. a 00 � � ',� ',� � � x� � � � � ti • � z^ M/ ►�! � O � d � � �� � x Jo 0 ��� A� � 1 ZM 1 � . � � � � � � � x ts' y � � �� � � � � o�0 � � � � � � � N � � 2n cn o 0 0 0 0 0 � � � R+ � � � � � � � � � � 0 m � z 0 � 6� I� ,�!� i l� �� 0 6� � 0 � � g � � � ,� � � � �. �. � ` � � � � R° R° ' � � `� � ��"'�'� � � �°��°� 0 0 � � � � � ° � � � �'� �,�� �yo W v ; G " � o . . � o: o 4 � ; : ' � w en oen w o0 o °o °o °o °o � � 0 � 1� � � � tA y ° � � � � � � � � � %9 � e 4 l m � � � b � � m w, m � � � � � � � � � � � � � m � � o � y ti bt�� � � � � � d �o � �, b � o � � : � ¢ � : : � . . w ° : : 0 0 . . o . . s::: N en ca oo � 'v� o 0 0 p o 0 0 � O � O�. p. � `.�''"' �'! H ���� ° M �y � m � �� � � O �� � � � � 1�+ �, d �. �� � ��° � � d��� ��� �. ,°,, o a' ���� o��� p��o �O.�p �l�D G,O M y ���� b � �' �. ��j��� liy�y '��A�"r �� �o � a �,. � �' � �� ��� � -_I D r � � m � 2 m C m � ro M � � 1+ � a '6 �: . � � �� � � 0; �j � .�:. _ �o� '��'- �, w v� �° �. � � � 70 � 0. c � � c� ��� � _ /��/ ���'�e�/q � � � A��p IYS6 �u � s ��' � �� ! � �� � V f�(� I HEAT LOSS CALCULATIONS �Q'�j � DEPARTMENT OF BUILDINGS .�• I i Weatherstrips A.S.H.V.E, Construction No. Insulation Guide Windo Door Reference Out. Wall Int. Wall Ceiling Roof F7oor Kiad How E Y No No 19_ Fl.� Room � Length Width Height Fl.� Room Length Width ..; Windows an Doors—Crackage and Area Windows and Doors—Crackage and Area �Vfdth Helght No. ot Llneal f. Area Wldt6 Helght No. o[ Lineal it. Aeea No. o[ pane of pane llghta of crack aq. ft. No. ot pane ot pane llghta - ot crack eq. tt. �' �.4 d'. Coef. Btu ( Infiltration �� �` Infiltration �i r Glass � � Glass . Exp. wall Esp. wall � z� Net exp. wall .,�� Net esp. wall Int. wall Int. wall __ _ Ceiling � � �. � Ceiling �( Floor � � °1. Floor t 1'otal Btu. Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Required sq. k. E.D.R. or sq. ins. W.A. Leader area F7.� Room ( Length �/idth Height �,� t r �Room ( Length �2 Width Win ows and Doors—Crackage and Area Windows and Doora—Crackage an Area Wldth Helght No. of Llneat tt. Area Wldth HetBht Na. of Lineal Pt. Area No._ o[ pane of pane Ilghte of crack e4. tt. In6ltration � � Glass � /2 Q Exp. wall � j(' Net esp. wall Qr 8'� � Int. wall Ceiling � Floor B1 /� Total Btu. /a, Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Fl. Room � Length Width �j�feight Windows an Doors—Crackage and Area Wldth Helght No. ot Lineat ft. Area No. of pane of pan llghta ot crack eq. ft. o � sJ F Coef. Btu Infiltration � �j a / ' c,ass 9 I` �p. Wau � Net eap. waU ('g ` Int. wall Ceiling '�T/' /� Floor / � Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area �� ������ 's �' � > / r���C+ � � f t��:Si � rI/�.1 /L� � _-��� � ' � � ��- Glass Eap. wall Net esp. � int. Wau Ceiling Floor �: '�� Btu ' �� /� r �'i`�,� �L-ir� - - -- ---- - — - � Required sq. k. E.D.R. or sq. ins. W.A. Leader area Fl.� Room I Length Width Height Win ows and Doora—Crackage and Area Wtdth Height No. of Lineal ft. Area No. of Dgne oL pane ttghte ot crack eQ. it. �• p' •6 � s i ''ii" �c �� � 2 Coef. Btu Infiltration �„ �; � �"� c�asg Eap. wall � �( Net exp. wall Int. wall Ceiling �' Floor � , Total Btu. J t � ft. E.D.R. or sq. ins. WA. Leader area L �� '��. Ci�rene� .T, �a��o� 124i ��,re�e�r�� �.�r�. ��i�l�r, ���,�sxte����. ���r F�'� . T��.r� �ar� s `i�i.� Citg► �f �'r�.�i�� 3.� enfvrc�.n� t'�e C�.tq �nd ��*� ��ste of Rr'ir�cee�ot�. In f�� c���aZa3�ti, t�i� �14�rd �d� � s�vgy �f f�llo���.azg eoad3.t�.c�as t,�e:ce u�n�e� wriic� �ar� s�� in�rov�e��. �`'8rC1'i 18, 19G% t�� �e�lt� l�ws of thi� c�nneetion �nd �r�vr �r�n�.�e� and t�a� in n�ee� s�f cc�rr�et ior� Gasba�� �ci debr�� c�es� li�teracl �rc�u�d tt�e �arbage can� artd tra�?� burn�r, T2�is i� n�� on�,y un�i��tly, but magr �r��ide exeelL�a�t ?��rb����e fnr r�den�s �nd c�th:�r ver��.a�. �18. �arba�e si�a�.I be c�s�3�e+d, s�r��p�d c�ad �r4pelcip �t�►red i� tightly Cr�vereci ��tal c���t�.inr�rs u�atiZ c�11e�c��. �a�ri��e :�hail he c�'1lectec? at L��.st or�ce a��ek. �E�e t�u�in$ of garb��e �.rl the citq �►f �'ric�ley i� �rc�hib�.�C�ci. �iCy 1�� r�qu�.reffi t°��t ,�arba,ge �r�d refuse can� 'be �tc3red �.n ��� ��ars�e or �n► �o rear of t�e pr�a�i�e� �.n a xack� el�v�tin� t�c� raa�� at le��t 1��� abc�ve ��.e �,zAVnd sur�aca. T�E �����e ec�a�d�,t�4n� �se �c�t corrected by ����rc1� 2S, i9�7, ��i� �Aarc� ta�i11 �±ave n� �1na��.oe bu�t tc� c�.use eaid nu3.�ance �e� be ai�a�e�S .�,�e Z���+e, �lC1�•rE�qBL" � t�.�t c�uth �.��ien �a�.1L bc� wr�teee���zy' aad that yc�u c��.Zl v�luxzt�ril�r cr��ul� w��h tI� Lau�. '�� e'��.11 b� �lad t� di�cu4� �r►� que�tic�n� �r d3.f�ievitieg y�u ��q. �av� �.t� co�et�lpi�►� �.��.t?�+ e'�e �,is�3.rmi�: '�ealtlz 1��a� , cc � C3'�y* t�:gr. J�7jh �h Ve�y �ru�p yottr�, Jgme� I3. �en�ley �i�y af �'ridl�q Buard �f '���,1�� � \ .� _� _ -- - : � . . . . _ _ -- Y � ^ Y r N �` ` _s = � _ e � __ —� ---� ` p � ___�'� � L �--_-_� -�� '�,.'�, � � " • V R P 4 R � t�� �L� �� n.• i' v S � � �' L � n t r !+ —' ! 8 � • II 1 � _ � ._ .. f: c a f� _ ,' 4 � � � � I i � .1C�^_9 .- r .. .- r C� ^� �- � r. -r � � l' r G w � G v� O� C b 5 ^ � L � , ' . I I I � � a i. > � � � .. c � Q ..' 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G. r ^ � �, o � rt n D tt. ¢ �'( ' W 1- - .:, a � � a C� �. O r. '-' � � ro n, r. v O [i rZ µ � `C C f� r � G `. _ _ � ..- ,^. G v r-� C � � o � n � ' � p r U .� - r u rn y G. A ac ' � U •< r r ' _ � � a U n _ 7 r 7r a r, r. _� .� � o 0 .t .+ .n n v r u x � � � m � 1-� G L 1-- Y � G r a '- -< r h � �- IL N W � .- r. rn 7 M '' � n u r U . - v� n o _ � m h o n• I� c r� n •+ - u �� -- r, v . ., � .- � c_ n n t. c. rt - � n [+ n 'n � �, a - ti r .-� r.. S r. v c. �+ [� n r 'T n o � n r �" n �9 '� i L _ _ � � O I� n i .T r � F+ D � r � �p � r �c x � G 6 (; ' t; -� C� n n ^ C '� • r. G ¢ n [G 4 m rt rt m n� 4 O c 3 � r R v Iw ''i Q+ W 1'� W � � �� C a c`, r 0 � > v T. � � C %'o � . _ � SuBJFCT c�ty of Fridley AT THE TOP Of THE TWINS g � I L D I N G P E R M i T � S � � ; y __��� COMMUNITY DEVELOPM�NT DIV. r � � PROTECTIVE INSPECTION SEC. � . , � Z �"'1 � CITY NALI FRIOLE� SS�32 NuMBEp pEv �"""'� � �'' 612-571-34b0 s�aF�S ,oe nooaess 1247 Gardena Avenue NE 1 LEGAL LOT NO. BIOCK � TFiACT OR ADOITION DESCii. rj 2 Gardena Meloland G 2 PROPERTY OWNEFi MAIL ADpR�$$ Patty Scott 3 CONTRACTOR MAIL AODRESS Midwest Cedar Timberoof 1001 E Cliff Rd. Burn d ApCHITECT OR OESIGNER MAI ADDRESS 5 ENGINEER MAIL ADOfiES3 8 USE OF BUILDING Residential 7 CLASS OF WORK 8 DESCRIBE WORK Reroof hous O�TE 9/23/99 ZIP PAGE OR / / �RMIT NO. 302�8� ECEI� O. �� � vppvEO Br SEE ATTACMED SFIEET PNONE 571-8928 PMONE LICENSE NO 8-1149 20147336 PFIONE LICENSE NO PFIONE LICENSE NO � NEW O ADOITION O ALTERATION 1S8 REPAIR p MOVE O FiEMOVE 9 CHAN(3E OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. [��rmit Inspec��Qn ��r�s WIII ge Mall�d � To Homeo�rner To Po�� SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAI, PLUMBING. HEATING. �'r� v. w••�. VENTI�ATING OR AIF CONOITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK Oii CONSTRUCTION ZONING AUTMORIZED IS NOT COMMENCED V�IITHIN 80 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONEO POR A PERIQD OF 120 DAYS A7 ANY 71ME AfTEF WORK IS COMMENCED. NO DWLG. UNITS I HEFiEBY CERTIFV 7NAT I MAVE READ AND EXAMINEO THIS APPLICA710N AND KNOW TME SAME TO BE TAUE ANO CORREC7. ALL PROVISIONS OF LAW$ yp�UATION ANO ORDINANCES GOVEqNING TMIS TYPE Of WORK WI�L qE COMPlIEO WITN WHETHER SPECIFIED HEREIN OR NOT. TME GRANTING Of A PERMIT ��.66�. DOES NOT PRESUME TO GIVE AUTHOFiITV TO VIOIATE OR CANCEL T►iE pERM17fEE PROVISIONS OF ANV OTNER STATE OR �OCAL LAW REGULATING CON- STRUCTION OR TME PERfORMANCE OF CONSTRUCTION .�GO. �.O PLAN CHECK FEE Licens C S�GN4TUAE O� CON'AACTOp Op 4UTMOQ�ZED OGENT iO�TEi EN P( S�GNniUFE O� OWNEAa� OWNEpBU4DERi ip�1Ei e� n....en � OCCUPA STA��S � OCCUPANCVLOAD CU FT ' PARKING GARAGES �.8� SAC CNARGE Fir SC $1.66 TOT EE $ .59 ° � � N�w [ `� - Effective 5/10/99 �� ADDN [ l CITY OF FRIDLEY nb� �_��j�I ALTER �J SINGLE FAMII.Y AND DUPLEXES R-1 AND R-2 'i� �� BUII,DING PERNIIT APPLICATION � �� U" d Construction Address: � ��� ��UfQ�� � ��, � � � � � Legal Description: Owner Name & Address: �j �' r�}-� (�'� �{' ���s . (� �, Tel. # � p ��- 'rj' � �- ��Z � Contractor. ��(..�j-° CPr( c� fil�ar C�G� _MN LICENSE # Z� ��} 1�� Address: _�(�(�I �, Gi �� Rd. Te1. #(:o IZ- ��— I 1`iq Attach to this application, a Certificate of Survey :of the lot, with the proposed construcdon dra�vn on it to scale.: ..: _ LIVING AREA: GA.1?.AGE AREA: DECK AREA: Length Length Length �ESCItT�TION �F �'RO .�1�1'A' "" `-. . ; . _ Width Height Sq. Ft. Width I3eight Sq. Ft. Width Hgt/Ground Sq. Ft. 01'HER: I q �'S � Construction Type: Estimated Cost: $_ '�j ��(Q, lp� ��(. �Dl` I Driveway C�rb Cut Width N�eded: Ft. + 6 Ft = Ft x$ _$ . DATE: e`1 APPLICANT: (1�, �,, ��� Tel. #(� � Z�� - � ��°f � U Permit Fee Fire Surcharge Sta.te Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sew�r Main Charge TOTAL STIPULATIONS: � I� .� $ � � ��P $ .� $ $ �• � $ $ $ $ $ � � �� CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/lOth%) $.50/$1,000 Valuation $1050 per SAC Unit $5.00 (State Licensed 1�esidential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] 1 �� /r , �� ` � ! _� a ` BUII..DING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing �rmits 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 application theref�r�; rec}u.ire.:the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: TOTAL VALUE $1 to $500 $501 to $2,000 $2,OU1 to $25,QQU $25,001 to $SO,Q00 $50,001 to $100,000 , $100,Q01 to $500,000 $500,001 to $1,0�,000 $1,000,001 and up FEES $23.50. $23.50 for first $500 plus $3.OS for each additional $100 or fraction thereof, to and including $2,000 $�9.25 f.or fir�t $?_,(_N10 �lus $14.CKJ for ea�h additio�al$1,000 or fraction thereof, to and including $25,000 $391.25 for first $25,0{� plus $10.10 for each additional $1,000 or fraction thereof, to and including $50,000 $643.75 for first $50,000 plus $7.00 for each additional $1,000 or fraction thereof, to and including $100,000 $993.75 %r .first $100,000 plus $5.60 for each addiuonal $1,Q�(R3 or fraction thereof, to and including $SG0,000 $3,233.75 for the first $500,000 plus $4.75 for each additional $1, 000 or fraction thereof, to and including $1, 000, 000 $5,608.75 for the first $1,000,000 plus $3.15 for each additional $1, 000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets flnly) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50. Alteriate "B": Removal-and; replacement_ of :curb and �utter aud �stall a 3%ot wide - approach with 6 inch depth - Driveway width plus 6 feet times $23.25. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow �or proper review of the proposed structure and of the construction site. � A Certificate of 5urvey of the lot, showang the location of the foundation once it has it has been co�truct�d �aiLri be required before proceeding with the framing. sue�Etr � PEA,AAJ�I_ . City of Fridley �� AT TME TOP OF TME TWINS g � I L D I N G P E R M I T 3 2118 r ! �` COMMUNITY OEVELOPMENT DIY. �����,6�4 R ,��� r � v � PROTECTIVE INSPECTION SEC. i . , l--_. A��'�'�•� CITY FIALL FRIOLE� 55132 NUMBEN REV OATE VAGE Of A VROVEO BY t �� 612-571-3450 9t0-F15 8/28/O1 / / JOB ADORESS 1247 Gardena Avenue 1 LEGAL �OT NO. BLOCK TFACT OR ADOITION SEE ATTACMEO DESCR. 5 2 Gardena Meloland Gardens SFIEET 2 PROPERTY OWNER MAIL AODRES$ ZIP PMONE Patty Scott, 1247 Gardena Avenue, Fridle , MN 55432 3 CONTRACTOR MAIL ADDRESS Z�P PHONE IICENSE NO D.J.'s Remodelin , 11207 Ma nolia St. NW Coon Ra ids, MN 55448 763-5%$757-8521 a ARCNITECT Oii OESIGNER MAIL AODRESS ZIP PMONE LICENSE NO. 20053769 5 ENGINEER MAII ADDpE33 21P PMONE LICENSE NO 8 USE OF BUIIDING Residential 7 CIASS OF WORK � NEW ❑ ADD�TION O ALTERATION p REPAIR O MOVE O FiEMOVE 8 DESCRIBE WOiiK Reside 9 CHANGEOFUSEFROM TO STIPU�ATIONS Per Section 1402, 1997 Uniform Building Code requires that a weather resistive barrier be placed over exterior sheathing to protect the interior wall covering. Exceptions for this provision would be if sheathing is an approved weath�rproof panel or when the siding 3s an approved weather barrier. Vinyl siding is not a weatherproof covering unless the manufacturer states this in the application guidelines. Call for inspection of wrap before covering. SEPARATE PERMITS ARE FiE0U1RED FOR ELECTRICAL, PLUMBING. HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCV �OAD VENTILATING OR AIR CONDITIONING THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION 20NING SO. fT CU FT. AUTMOqIZED IS NOT COMMENCE� V�IITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENOED OR ABANDONEO FOR A PERI00 OF 120 DAYS AT ANY TIME AFTEfi WORK IS COMMENCED NO DWLG. UNITS OFFSTREET PARNING I HEREBY CEiiTIFV THAT I HAVE READ ANO EXAM�NEO THIS APPLICA710N STALLS GARAGES AND KNOW TME SAME TO BE TRUE AND CORREC7. ALl PFOVISIONS OF LAWS VALUATION SUR7AX AND ORDINANCES GOVERNING TMIS TYPE OF WORK WILL BE COMP�IED WITH WMETHER SPECIFIEO MEREIN OR NOT. TNE GRANTING OF A PERMIT ��1�000.00 �Z.00 DOES NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OR CANCEL THE pERMIT fEE SAC CMARGE PROVISIONS Of ANY OTHER STATE Ofi LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $9%.25 Fire SC ��F.00 PLAN CNECK FEE TOTAL FEE Li nse 5.00 $108.25 S�GNGTUpE OF CON'AACTOp ON AUTHONi2E0 OGENi iO�iE� HEN ROPEpLY VALIDAIEO TMIS IS YOUR PERMIT S�GNnTUAE Oi OWNEA��� OWNEA BU4DEpi �O�T6� � G"�NS ph NEw [J ADDN [] , ALTER [ ] Construction Address: / �i7 Legal Description: Owner Name & Address: � 7 , Contractor: � , s �� Address: / /��1 � v�-rr�-�� LNING AREA: GARAGE AREA: Effective 1/12001 CITY OF FRIDLEY (763) 572�604 Bidg Insp SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION MN LICENSE # # Rt �0 3- �S'7- �S�/ �D ��Q Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft Length Width Height Sq. Ft DECK AREA: Length OTHER: Width Hgt/Ground Sq. Ft. Construction Type:_��2�� Estimated Cost: $ y��l�, % Driveway Curb Cut Width Needed: Ft + 6 Ft = Ft x$ _$ ,-,�..� DATE: 4 ��O � � % APPLICA(�T: � � Tel. #7� � � 75 �7 ��5 � I �,. CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: Call (763) 572-3604 for Permit Fees if mailing in application $ .�,sl Fee Schedule on Reverse Side $ • Oa .001 of Permit Valuation (1/10th%) $ � � $.50/$1,000 Valuation $ $1150 per SAC Unit $ �dU $5.00 (State Licensed Residential Contractors) $ Alt. "A" or Alt. "6" Above $ $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [ ] Not Necessary [ ] $ /oS.� _ BUII.DING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addidon to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to-wit: TOTAL VALUE $1 to $500 $501 to $2,000 $2,001 to $25,0� $25,001 to $50,000 $50,001 to $100,000 $100,001 to $SOU,000 $500,001 to $1,000,000 $1,000,001 and up FEES $23.50 $23.50 for first $500 plus $3 .OS for each additional $100 or fraction thereof, to and including $2,000 $69.25 for first $2,000 plus $14.00 for each additional $1,000 or fraction thereof, to and including $25,000 $391.25 for first $25,000 plus $10.10 for each additional $1,000 or fraction thereof, to and including $50,000 $643.75 for first $50,000 plus $7.00 for each additional $1,000 or fraction thereof, to and including $100,0� $993.75 for first $100,000 plus $5.60 for each additional $1,000 or fraction thereof, tc, and including $500,000 $3,233.75 for the first $500,000 plus $4.75 for each additional $1,000 or fraction thereof, to and including $1,000,000 $5,608.75 for the first $1,000,(�0 plus $3.15 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway widtli plus 6 feet times $15.50. Alternate "B" : Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $23.25. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum 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 once it has it has been constructed will be required before proceeding with the framing. New Houses Onlv � v� n� O� �v Wrn -�'i c O ,.N.� Z � a n., �T <� �rn -r, v D z -� o' � Z Z < � fV rn � D .-•�r► -� 7 O � c�D �: � o N� � � � O� y � n � � o � � � a� o„o � �• o� QQ � fD .o a � _. � � .� a c� � � � a . � � O C .+ D 'o � 0 < m a W �� 0 c ov � � � N f�D � � � 0 N � 1 � � m z CA -v m � O z � rn m � .A V 0 0 � 2 � �m� N�3 C m�3 � �D-I m oom Z � DD� r�*t�Z n� N � Z v =-�-_Di r�*1ZA� L/ Q I � Q � r 3� �� < Nm �Z � � O -� N o� � m a � w N � W � m r � 2 D � z G) c� 0 r p � 3 � A O� A oi � � � a �. vCi v °1 N� � � m 0 1 0 � � � "'� � � `° � c m -� m � � d c�o �f! b9 � � � � � � ror o� �� � IT4 � � � Z � C �� Z �� � � � 2 � � N "1 � N ��,�� � � � fD � fD � fl. ?.�, �- m _,, dh�N o�°��' ' oo c�, m � � � � a .� ' ov d °- .+ m � j� O -� a � o. o. ��oo� -+5•°-' � � v� ° w `"'o � m � � O y v °� '�' � A Q � � � � A. � � �' �' O � � A � m a � -^ � A ° o c � �- a� � � w � � -v _ '^ m c�o a�� � � d � ° rt �' o -� °1 .+ -. � —�..« �.?m s cD C� � �� o y n � O �. d �" N N � -�a a '" m � �. � � O o. � G � � o� �^ c�o � °, d D �� � nr' D � .-► � � �� o �•; �o � N �i � "'{ � Z W D n � ... D C') 0 a 0 7 �' 00 D N � � � d N � m � � G� D�1� CE N N „Ci N N v� O . � C. o�i � " � c°1'f � � �. v_' `° co « m � � �o► cn or � � < � c_?u � � � � 7 o � ' .�+ a � �-��� =c � � � � � r► � < m � pp m o � � � � � C � � � � C � � 1 +�► �? _- � .(NJ1 O O O O O 69 b�1 6H <A �°1 . � C W 7 �o � -i� d a c� Z d � 2 "D N N� m z 0 m' 0 � -*� ao -+ z �-a�,o _ C � o z= m � � �' �o =� �' � C � N -� - _ - --- - � � f� � A <i � O Q � � � fp (D � ^ � �- (n hD . �, �m`°3 Qoz �o� 2 0 � � m ..�i � d 1 � � ... � � O O � O O "' cD Ef! {fl � 0 � m � _1 D -a m v c� O N � 'o m � � � Z O t � � � � C r- v Z c� c � rn 0 �. � � m N � x m v c r m a • .. . � ,� v�rnn WQ.W� N� 7 O GJ � <' ,1 p�Z� � � �� m w D � N � Z zN m� m -�-I 0 z � D O � Z '9 � �� �O m� � � '.'� � O� Z� Z � v� D � �Z vD z .� v o= Zm D Z —1 � Z N (�i �n 0 m 3�r N Z a Z � vm vZ <� � � NO z m � m � < c� 0 � � d � c d � 1--F N 0 0 r COMMON VENT VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When repiacing an existin� furance, the undersigned hereby verifies that the venting has been examined and is free from rust, deteriorataon, obstructions, and is securely supported and firestopped where required. Yes () No () The venting system is piastiGPVC and meets all cuRent 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 cuRent codes and manufacturers specifications. This does include AGA-GAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. The existinsa combustion air is sized and installed to meet the cuRent codes and manufacturers specifications. When required to install a new combustion air, it will be sized and instalied to meet the cuRent codes and manufacturer's specifications. Yes ( ) No ( ) Yes ( ) No ( ) Yes()No() When installing a new ventin� svstem, the undersigned hereby verifies that it is a listed assembly and meets the cu�rent codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliance�. 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 Tvpe and Size/Common Vent and Vent ConnecYar 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 i ype Appliance #2 Vent Connector Height ft Length ft Diameter in Type Appliance #3 Vent Connector Height ft Length ft Diameter in Type ALTERATIONS• (Describe) - �OYALi(7N MEATING & COOLING 4120 - 85th AVENUE NORTH HEATING CO:��,�LyN �A�K.�N 55443 — Signed By: 763'�424-�333 Date : �–.f5°�2- �'•-� ���!� C� � � O z < m z � � O� Z � D c� � � v m �� m � �o � -� o = � � m j .Z1 � � D m o Z m � � H� � O ,��'i � cn `D m = w O � � � D� � �. � D O � � 0 co r � � � m m � m � O z � � � 0 'O � D 'n cn � Z � � �i fll � � � m -� � ai ai !2 �� c o�i_ ai W�� m �� o� c� d� 5 ��� a' f � -n v � m c�n c�u � � �' o v, -v �! � � � � m m � m � nWi � � � � w f�D �.d,. 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N.E. FRIDLEY, MN 55432 •(763) 571-3450 • FAX (763) 571-1287 April 20, 2004 Ms. Patty Scott 1247 Gardena Ave NE Fridley, MN 55432 Re: Final Inspection at 1247 Gardena Ave NE Contractor: Gavic & Sons Plumbing Dear Ms. Scott: A plumbing permit was issued on March 6, 2003 to install a water heater at your address. According to Section 4715.2800 of the State Plumbing Code, a final inspection shall be conducted on the work authorized by this permit. As of this date the inspection has not been requested. The permit fee that was paid covers the inspection to make sure the work was completed according to the Codes. We will keep your permit open for another 30 days and if we do not hear from you within this time to set up the inspection, we will mark the permit "no inspection called for by homeowner after notifica.tion" and take no further action. To set up the inspection or to have any questions answered, please contact the Building Inspection Division at (763) 572-3604. 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' � W � � �° G, _ � t7 in � � � ��� ; �-�,— � t� ��o� � � �� � � � . m °� �'a d 4e� � � ~' �i � � _S%1 � (� a N' � (/j @ � i� ^► � � � � � � 6� � O N � � rn ,�y � � '�o' .o p � vm Z 4. � �� � y � � �� � � � � � � ��� � � � � � P �-�► � -�i. � � � � (/l7 ,,,� ; � a.. � ' � �0 �3t�� �� s��,, �/� so C� � � � t,1 T � ��� � i�, � � `'� O � � o � � � � � � �� i � m �, � � � F� h �� 0 a � m � � m � � � �J6.� v�r �.r..._. -- •_ _ _ .�' .i_ "1? �. � ..� ' � �' � „ � � �: . . . ., .. � :.. � � � .� �.'; K �s\.. ' :�. � ' � , _ ��.:�_ 1����. • �.�.:i+ �,.\ �� ] . � . ■�. .. ��i> > ni_ ;, :_ \ ... �. . . � . ... ��e� A�� ��+� p���*+��, tt� urrd�rsig��cd heeeby v��f�s tl�rat th� � ver�ting !i� be�n �x�ritir�d ��� fr�ae graa� ru�� deterior��Or►, o�SttuCtia�ts, Yes i f�lo and f� s�au�eljll s�pRarted �r�d firostapped �Ct�r� r�ufr�d. � (} itt� �nt�g syst�nn ts pla�tic/PVC ar�t9 �ts all current c�des �d nnanufactu�er specifl��a�s inciud�g siaing, tengt�, numt�r �f el� �sd t�rtnina��. 'Yss ( No () Ttte a�r�ign�i �I� v�rifi�s that �� �plae�cnent urut;s � IisUed a�mbN astd meets tt� cu�nt c���s and manufsc�rer's s�Ciflc.etions. '� doe� i�lude A�A-GAIVaA Ca�gc�y i Centr�l Furn�ce V�n�n� Ta�les for fen as�I�ted a�r�d �r�l dr�ft app�ianc�s. Y� ? No () The Yi�� � r_�,,,n�• �4idvti �ir `8 si��[ �nd ic9sta118d �o m�t tt`i� �uft�eit C.odeF ar�d man�f�#urers �pec.itic��s. � r�quit�d ta �..�°�Qt - �.� •++ � °�±:�� �tP�,it wfU b� s�.:ad �n� inst�il�d to meet t�e aarr�t ca�des and manu�ac�u�� �pecittcatbng• Ye�s� No ( ) Ye�sjj �o ( ? vVh�t �p�r*e� q���a �;�t�en_ �°t� und�r�ig��d Ptereby v�r�9�s that it is a�%a1 �ssembiy �nd tv�ets the s.urt+�rrt cod�� �rtd manufa�tr�r°s s�C�tit�s. TI1is do8s i�t68ud� A�A CategOry I Centr�i Fcama� V�ntir� T�bles forf�n �ss6st�d and naturai draft �ppll�nce�. Y�s�No { Is tt� c7o+mm�rt v�nt �nd ver�t c�ne�tars s�� �nd installed c�redly ai#er �n appn�� h�s ta�en rernov�a from ti�e oaranenon vQr�t ar�d v�ne�d Yes 6�io ( ) �ep�tely a� p�r c.earren4 codes, t s . . .�.:.,. - _ __- ._.�. _ =,r , rti�-�-s . . �• �.,�� ����•�r. V � �.ila esda�aei Of �S� Appli�no� �� igap� � �fy1'✓' �ii! InPu4 � �,pp9l�r�c�e �Z i'Y� .w.,_„ ��c _, _m �TiJ lnput G�CJ � F�� RssiStet4 � .�,� a�p0��� � Ty� � 8TU lnput Far� Assisted or N2t %#al Appli��e� Tot�i B�a En�ut / � �om�o� V�nt Typ�s �- PA� _... Verrt Heighf �_ Di�re�eter � Enches Appllar�ce #� V�nt GOre�'t�s�r 1°�etght 2 ft Length ,�,� ft [33ameter in Type L�/��'S � pp #2 ��nt Connec:Per Fieigh# ft l.engf�h ft Diaa't'►eter in Typ� Appl(�c� �i 19ent �onat�c.%r Height it L�rtgth � Di�meter in Typ� .— ,� , ra_ ., .r •:, :-,� ,,;•�: _ . HEi0.�l�lC"a G�: -- p� a'�i68i!@d �l: "' ��tr `�;; ..���e ��i$ V '" �� >�' �.. . — y- .'=?,�'�,� ����Li�r� ���ili�� � �s������`a 4120 - �5th AV��1�� ��RTF� �Fi001�LYN E�/���, V�� 55443 763-424-�333 TOTfiL P. �� �r wss r,�t�ccn�►rtoNs W�,:herurips � v'?lv,r� Wiada�n [)ooa Rriereace Out W�I] ''4—' l�o ea o 19 F7.( Raow L.eagt6 Width R/'mdows aad Doon---C.nel�age � Arca �v�a�A 1t�l�s� 7Va ot uuaf n. wna Ma e[ ws� ot a.e� ur6a� of cr�cY .s_ t� �VUWo Class EYp. ++►�11 Ne! ocp, asB In� wall Ceiliag Floor Tot.l Btu. Ftequirc�i a4• ft E.�.fd. o� � �OOm •Wiadows and Doors—�i atb lt.tRra 7 Na a! n�e� e[ e�a. l lII���:�0� �����.. C.aI�Y �� �. wall Net esp. �val1 IA�. Mi�I �Glll�$ Fioor Tota1 Btu. No. lofiltratiop Glass F�p. waU �� Net ezp, w�J) Iat. w�li -�-__�_._._. Ceiling -..r....-..._._�. Nloor —_...�.r TotsJ &u. ..r�. a.�ea aroe� �� aad Area fe. E.DR or �q. iw. W.A L�eader arei► Rooa� �l.eo�th Widti: and Door+---Csuksse Rad Area pEPABTMENT OF iNSPEC?!ON ; c� N0. i� W.li CeiIi�a� Roof �-loot aii� 2.%� � Bto C�o Fs�►. '..� �� Iat. waQ 'a�al �t. �e�iID'� aq. �4. �4�. 08 i�, iro6. F7.� i�oom � (� Wmdo►rs a�ad Doo�s�-.Cau1� Clsa �P•' N�c � � M bCa1ld tal8tu. � w• fe. �D.[�t or �q. m.. R�oon� ( La�st� Wmdo� �od Dbo��—�Crulra,� �:ia�1t Esp. �+s1) IVet ccp. wall �b � M 11+ID�II�A .... �. ..-- � Width aad Ace�► are. �r .o. .ea. w�►. a�.ae� .�ea � TOTAL P.04 :� � , _. .' �+ M HOUSE HEATING TEST RECORD ADDRESS l i� f C "'� r `F�� �,��n `5;� d°°, �•� �a �,� �� G ' '�,t' . , =� ��,. � �. �...�—APT. FLOOR CITY 7�R. �� - '�'°SUBURB___, QCCUPANT _� � a° � P. , e� ! s,�,r `�- 01MNER —� HEAT LOSS DATE HTG. INST. SOLD BY INSTALLED BY El�chicol Work' Br Gas Lin� Br TYPE OF HEAT GA FA,��H1M STEAM SPACE HTR. UNIT HTR. OTHER MAKE ���`-���{ ' ( GAS DESIGN CONVERSION AAAKE OF BURNER Mod•I �'�� � �' _ ��` !'"! �� �' �+ s ,° � IAod•I S«iol � ��- � � �•' � `� �. Max. BTU Ratino INPUT � ri�; ,����n������'� MAKE OF FURNACE Mod�l -� � CONTROLS � �, �,�� THERMOSTA�T {� --�' H�at Pluy r' �-�' V�nt Sizf�' VO�"• ���`� �" �, � KIND OF LINER � SIZE � d �Limit � o � ��"' � ' NONE �� �MT. �.� D.ah Hood p 9 Rpulowr Limit S�ttiny �'�'�� �'` Fllhrs Si:� "'�� ��� umb�► ° Fan Ssttinp � Chimn�r Loeafion Insid�. OW�id� Pilor TrP.�° "�`.�'�` Q�imn�y Construefio� � �..�� �h Pilot Maks Pilot Modsl Snnok� Bomb -- Wirino --�y��� Pilot Timing Draft e�� '°` �_ P`°/� +`�y.�� T�st Too L.W. Cut Off Door Pnssur� Liqh�inq Inst. � �� �,r e � • Pnssuro �—' � -� P�re�nt C0� °-°j �" Dot� T�st�d �a -' '� � t � � I�ut CFH �P�►e�nt 0 �� ° � '�`" � � 3'�"----- Stack T�m `"�''� / F.i� 2 � C°mponr T�sting � + � " ( �":�•r_� -i�,.:-� f a � P• —�,,a--.a P�rc�nt CO �� Nann ef T�stn � � � �` �' � ° Fwm 235 ...A-° °� �` "'���