Loading...
AF - 45640Date: - �����'�P i�69 Owaer: �l�����, T�,� , City of Fridley, Mirm.. BUILDING PERMIT Builder ��e �� �11 C�tetr�.1 �nre . lq. E . Address ��'e N�� 1034 '' LOCATION OF BUILDING No. %�'28 8treet - ��$3��� ��re�t' N. E. Part of Lot Lot 1 .� Black 3 Addition or Sub-Division .r ��on' ���h '_e3.t?b�a . Corner Lot 7n�itde Lot —�- Setback 3� � � Sideyard 15 ' Sewen IIevation , 886 .32 � ��c�� �� �p�� . Top a� F�ot3.�n� DESCRIPTION OF BUILDING To be Used as: �a�e1? in,;; �nt 45' Depth � 2 Height �Q` Sq. F't. 11i5 �, � 2�.,500 Gs�a�e Front 20' Depth 24' I�eight �o' Sq. Ft �Q Cn. F't. Type of Constrttction 61'e�'� F�t Cost _. �'2i,�C�t). ��C� To be Completed �Ei�IEA i3OC:�TI�� - 8 o South of ��aniaol� WF:�'C� L�4�1'IC+14 - 2' Nortl± of RL��.t�o? e In con�lderation o4 the issuance to me of a permft to construct the building described above i agree to 80 the proposed work in accordauce with the descript3on above set Porth and in compliance with e� provisfona oP ordinaaces oE the dty of Fridley. =� s _ ,f� - �> ,.;:: �'�: _� �O` s S!,(10.00 �er��t� C6fanect�.c�r� Ch�r�e Ia considerat[on of the payment of a fe� of $ 37 ��� , permit is hereby granted to C� gr`����"• ��e . to construct the buildfng or additton as described above. Tl�i��rmi t is granted upon the express condition that theperson to whom it is granted and his agents, employees an� worl�en, fn all work done in, around and upon said building, or any part thereof, shall conform itt all reapecta to the ordinancee of FrirIIey, Minnesota regarding local3on, construction, alteration, maintenance, rega3r and moving of buildings within the dty limits and this pernnit may be revoked at aqy time upon violatfon of any of the proviaions of said ordinancea St�ilding Inspector fle�: y k' . R��t. st�i�.c13 NOflCEa 'I�is psrmt! d�s aof eevee �6s eee�sfion, imlall�lon �o� vrWnp, plambieg, �a hsMi�, ssw�� or wmr. B� sQ» to � �e Bnildio8 Insptcror io� apsnb pormNs for thas iiw�, � �- - � -� 0 ;� �;- =- .. ., APPLICATION FQR BUII,�INC P�MIT CITY OF F&IDLEY, PqINNESOT9 0� �S NAME BTJILD� Clamrnn . I�n� _ •--- -- � Lot l. Blk � ADDRESS l�Li.�.l Ceatral ��e. N.E. LOCATION OF BIIILDING N0. '�� .�` STBE'aT LOT 1 BLOCK i; �DDITION OR SIIBDIVISiOAT Don T s�th Add. COR'C� LOT INSIDE LOT�_SEI'BAE.'��_SIDEXASD,� SEW� ELEV�TION TOP OF FO(3'i'ING C�r4� - 2�-6 Appliaant attach to thie for� 'I'�wo Certificateg of SurvQy of Lot and propoaed building locatio� drs.ara on thea� Ce�tificatesa DESCRIFTION OF BtIILDING To Be IIsed Aa: _ Dw� lli]�$ Front 1�.5 Depth 25 Height �� �- �� Square feet 1125 Cubic Feet ' � � „� , �;� � � -� Gar�ge 3n Bsmt. Front 20 Depth 21.� Height 7�btT Square feet �,t80 Cubic Feet Type of Conetruction Frame Estimated Coet 27,500•00 To Be Completed 10/1/69 The undereigned hereby makes application for a permit for the work herein epecified, a,greeing to do all work in strict accordance with the City of Fridley Ordines�.cas and rulinge of thr� Depar Building�s, and he�eby declares that alI the facts and �.ti:�re .tations s ated in thie applieation are true and correcto DATE Tr�l ��� . lA 9 � (Sehedule of Fee Coete can be fourid on the Reverse � � � ra � � LL�"�� r � ;�- �� � � �,-1 � _ �. �.. =a -�- .g � � � � ,+�, � C ;� �-� ; �� � � ,r".� �, _ d 3ideo) � , �� '�" ' � ,� � _ � � • . . BTTILDING PEI�MIT F�EE SC�IILE SF,CTION 2 o The Inspector of Buildinga� shall, before iaauing perraita for the erection of sny building or �tructure, or for �.ny addition to aay exiating structure or building9 or for any alteration or repaire to �ary eaieting bnilding-or etructure9 upon application therefore, require the payment.by the applicant for such permi� of feea to the amount herein 4° k�eiow eet forth and in the mann�r herein provided to-wit: IIniform Buildix� Code: Type 19 2, 8� 4-=1 ,75 for each one thousaad cubia feet, or fraction thereof, in auch ct�bical Qontente. Type 3& 5- �1050 fo� each one thoueand cubio feete � . � For the puxpose of computing feea for building permite, the cubical contente of any bu3ldi_ng or addition to a uniform height throughout by multiplying the ground area covered from a point sig (6) inches below the ,floor line of the baaement or the cellar to the average height of the upper eurface or to the avere.�e height of the roof surface of the main g�,ble of a pitched roof . �'ox re�aixs or alterations to an existing structure, the fee ehall be at the rate of $3.00 per each iive hundred dollaxs (=500°00) or fraction thereof in the cost of all proposed worko In no case shall the fee charged for any permit as set forth in Section 2 be leae than $50000 _ r NSSSD Connection Chasges based on location - Area 1 or 2. a � �'� � � �.� ��- �-- ,, - „ �3 - _ __�: ,_ ���_ ��/� � � " � H r i. .. �� �.��' � `� I ��--y�� � � , _., � n n r-°'y "- Z� � � � � d,` i. � � � [�Pl�rninr� C873-h�'�GS N.E. cQ�es�y;� �►�/��2, .�''STS��9 ENGINEERING, iNC. ���o Civ,� fr iur�wpc� std�eid-0066 � ��� — En9ineers � �Su� veyo�s �-- ces*i�scate o� . s�ttire Fo: c� �'��`�'��`` �'��' . T --�- ?I �, � i_: =, r----____.__- _ . _. ��.�,--____._.� _..�y �__ , �. . � , � i` .�.�.,...a.._�, � � %� . � .. .,� i,l"_ ! I � � � �� L ( � �� �d/ � i� � , ..3 j � .__ _, . ' � �..__ �� i � - L3J i_. �... �. ..,. _ ..,.�— - - 1 a I e' j., I � �� t25 , NCi�TH 0 � OAAINAGE qN� UTIL�TY E ASEM�1��°T ' L O7 �� L� C K � D O N'S� S r" A�DITIaI� �r���a r;�:�•���� � lf�dy urfr�y f�t /his a a fi�e afd mr+rtct npr�w�fof�avr o�'o su�et� �'!I r ba,,,�s �('� ai6s�r �w+b�d laid, md ��Q�� 9r� ��s , fltrea►� .�yd d/ ris'�ddt o�arfimmfs , r�'aAy, � ar nt�id /and. As sr�r-►ryrd d� r� 11$�,=_ � 4 il� LST A.D. l9�. SUBUR$Alll EIV6lNEER1NG, 1NC. �� � A L E� 1k 4t� �, E_�� � ,��'� ..�°F.: �,; _�.�� n ° - , �. . , - .a., � , -6 . ;� � _ - _ � ---- - -� - - -r,,��_-,_� . , ;_. _ ,.. �,. _ ` F� � I � r � '' �1� '� � c� a H d � � n s ►� �; �'' � , � u n. .� S � p� �. ,^• r� .x ��. : y .� f.L. t�) ; �' � :�� i� �� f: �'. 4� �r : 1" ) � i �/ ; . �!� � � (.) �ii ��! rD ��l . �� Il � � y1 �j R .1. ::� :� '� �� �d �., n � �o � � � �i "' �. !; ;� �? � ' i� o ",,,I`. w G° ,e� °' ,�,� `° � Se . ; . .,� � x � a „ . �y ~ ~tp V � � • C � A � � t0 M .l �7 O H- r �!: j � • ` � iJ � '� � `� . � � � ' : Gtl `� : � � . � -,=,.1 s � ., � : . � r�- t ; M . . 00 � . � . \ � .. : o : ' � : � � ' ' ' � . � ° � : : . � : � : : : m ; • • . . . , t/i : • . . • . . . . . � :�. �� , m • ' ' � v � . o c i-- y; � �a a� N� oe k x x �e m �y � , � :�i � �i W � W h�+ . h�+ � � �: s��8�8�8�$0$� � �� �a��� ' "� � H H � `� I�- — -- - r � o � x � ' • �� a . . a � � � � Ey' a � �^ p a " � Storles m � d s WA11� , �a M S C105! 7 5 plS' /[�� �• IIMI��I���. p p �1 � A�t�� iun, O pr p �, �, e�iru V b S�NRS 4 �b i/ � M�•.�� s� �a ,.... d � � �. d � 8 N 7Q � � �' o y � a � c a 'c. � rZo �' n �i .�. ~ � E. � � -- - i i � DP,INR, f W NT. �� s��wu. s i1004 DRAINS U��� ���- w�� w1SMER G�y MvL G.�� RAkGE c�� poENirrCS — .. — — ; ►f N I y �� a r I p ' li ��ti n aa` ,� � 7� ,.�„ '� o A » M .��j' d � 1� ��n� :i � o � a a ��� � A � r, 5 ' y �e °a � o�a � � y°oa .� w a p, � a. ��o; � � �� � ��--� ��' � .°. o � 0 N � Ti � � � E. 5 6� � �' •°: � _ mo,�.� � =� .�. d O � (� m a' �^'v G.n � � � S '�i p � '�+ � � � � � A � � I � n £ � n '� o•wi�� � ,� S o rj Ip '1 � N w 7'n„�S r r' � � � � o � G DC' �o w � . y1� / .. x % � $� °� n � � g y Q ~ O x � �� p � »� �! � �. � h s � . s li �• o' � � . � \ / . � � � o � � � T r �,. �- R d A b � � w ��i. m � � �. �...�'� `o r 0 �t e A � � �. �W $ i� � 2 � t- �_ � + ,,_:. ,- i t �� � S�,y � 3 i � � � s� �, � � � � � � � � � 0 x � � � � � � � b ����� b � � � v�', ��'y�'s� � O � � �• `t�'. ci �� ��,�. � ��� � ��;��� C O+ � � � � �� �� � tY � � �y' R � ��+ � � � �, �'' co' � ��o�a �• � A `�• �, "�'' H. b ° R oF� � � � y n, � . � � c0 � ti � � s� � A n. �'��� �' � � � � � � A o � A. � � ���,s� o�.��;' ob��;�� ior � � C °• � n. O � s:��,�'o � O n � �' � b �. �' yyc�.�� � � � O � O O �j��� � N� � � � • � �. �' �' �' � �• � ��� �. � Q o. �N+, A � .�' R, o�a �. R, O � � � � b � � z 0 � 0 � � � � � 8 M O � � � � tr4 O ri � �• � W � � �x "a+ �, �- � � � �. � I I � � ICLOS TS � o y � ti �, � � � � � o � �. o � � � �. � � � � � � � � 0 � � � �� e �' � �. BATH b �- Tues � �O � BASINB � 0 � I ISINKS � �• z ,� \ WABH h G � �G�J � I ITRAYS � � ty p' � SD DRtNK a {�pp7'�� p �� I IFOUNT. � � .r-r � � r� �� o 0 ISNOWERS � �: ° g 1gy °i IQ � FLOOR O o p"y �l �� �� � DRAINS M � � ' ICATCH ^�' �,+ � BASIN9 � � 6 IRAINW. � � � LDRB. � � � �+ ' MISC. P. �+. � �' FIX. �' �„� � GAS �-�1 �a � A �APPL. � �-t IGAS �+ � RAN6E K ro � � � � ` I � i w �' V� � �w I m .z, � O � � qy, � �• � '�j ag � O n �� Z � � °� o �' � � �. � �� �� �� :o M �� � � �, •o � � �, � � � �� �� � � � . � � i � � m A o+ � � � _ � C 1� � � � ao �a � ���� O � � � � O PI" � � � ���Q � r�,,,�. i S 0 � � '�� '� z � �!r m � � � Z � a � � ee � � � � �����p C�! ✓�. � A � �k! N h7 S' ►�+ 5 �,c� o � � �x � � � �. . �� : : � � : � . $ ; m. � °° � ° ��s� � , 0 � w a � � � �� �� � � � O r � C � M I w � oa " �� �� M �� C p � � M- � � :- �� �: � � 's 's � � � � � � � � a � � � � � � � � � �' � �.�, � � ;� ,+. ; � � � ��� � \ i �� . ��,� ��V.� 6�_ � � � � �,� �, 's � �� �� � � �; �` .°+ O � ��� � "� �� � O �� � � � �' � � '� Q � � �a � '\ x - � � � � \\+� g\� � �" � � � � � � � � � � o G Qa. � � O N � � � a o g � Cr � � �? R° R° i� ��� �� ���� 3 � � � � � � � � �. : : � � . : , � . � : : � : : � . W�ao s�g� � �� � ' e� � � A � s� � � � � o ,. ,,; t� � e�'i O � I � � �o. � ff �. �:_,i, � �° ,� � � � � 0 � � � R° �'° � � � iti � � o � � � ~ W � �o��� ����� ��; pio� c. � � d � . . ~ � � . � $ �� o o ; : : ,,�,� : : : : Q � �� m � � � y � � � ��°� � �a�.� � � o C � � � 00 �� � �4 � � � x � � � � CA . . � g : : o $ : : � : : : - ����o w��o� 8"sg�$ ssgs� �. � I � �� � � ��a � � o� a `. w � � �. a� � � ��� � ��� � �� � \ � `,\ o �� � � �ro �� �� °� � �, � ���� � �~~ � �� a+ bd °r � �' b �5'm ���� o��� ���� �°'op ��� ���m o�a.� � � �� � ��� SP�` � � � y � ���� �� � a� �� eo y �C�o a" � m � id � ��� ��, � � r � � � m Q � � � '� � � � �i � � �� � � � �e �w � � e . � ��%O � �� - . � \ �, � A 3 � � ro � �' �, � � oa y 0 � ��'�o �. �: � o���b `� O � � i �,���� r.� � � �: F�o' � °�''� �. �°°����. �' � � � �, s.. �.� �o � ��,��•A � o �.� � b����. oo�,�s �.�° A� �� �� �.��.� ���'�. o�`�a b ,n '� Q�� � � �: o �, � � �, o � � � �: � � � � �. c�. �' �' r. "' � � �� �'�.� �� ��`°� e � �� � A � � „ a� 10 � R.f1.� O �" �ii' � p��•q O � � � r. � 0 ��A� ��'�� `�ti�� ��� � � ���� O �, � �, � � � �' 0 � �`�' c�' � 'C � A A b��„� 0 ��°o�. A'�pi.�r. q � n b �� � �' C� �'• 0�" A �'• � c� �'�ti3 ti� + n. �00 o "s1F�o'R' ��o �. �' � � ot'� � � 0 � � � � �� � � O � � b � O A o �' o �0' °. � � �' �, b Q" �I � � � y y 0 � � � n R. o o b � � � � � � ti �0 4\ � � � � � �, o co b o � � R� � � � ti W � [� � � �, � . iJ � � O � a �' � � w c0 �. � -�i, , � �' � � � e�'o � a Z° y 0 a O O � � A � � n m � � � � � A Q� � � , � '� C �� � Q� � � . n � -o s =� � � < � — �• � —1 ��:-�. � = -�e � O � H � O . � � � 3 � � �, � �. � , � i � � � N �D L�7 Q. A� � _ � y � � ... ' a � 0 O �� � ro � � � � • Q , , i �\ � �� � � � � Q. �' � � w t" � � : � : � . � � M . � : � • � : � : � � . O � � �i � � � p x �' � � � z � � � W e� �� C n � � n G� � � �,! e� � .� � �g ?� „ � � � m4 o � a ° � � � � � � = �� a o� � . '° °' o � '� � 0 b �' �y a � tA � : : w � : �• � . . � � � . , � o x � W � a M M iQ aC ii id k g a� S y g � � � �i � $ �° � ��� � � � � � � � o O I � �,,� O � II� � O � � 1 � � � c � � A O � fz0 � � � � � � z 0 a, IH � � �: I , d i I � I'o I' � � x 0 � � �r D � � � (i _ � � rC d17 �{. o t. w I n, .+ � '�i ts� � I a �° � � O �� �• � �' � � � � � �I I � � � �o H Q ��a� d � � � r� � 0 � y � a ~ � � 6� � g � I� .. �,. � �� �AiER � usia��s aTM � �� SINKS WASM TRAY$ DRINK. FOUNT. ��. FLOOR DRAINS GTCM ��� �wro WA� GAS MFL 6AS RANGE GAS OiENINOS . • _. �, � m� n � �a� ti � ��p 1-�+ Op a C m � a r� M � O fp � � ��°q� � � �� o � � �. � � m � ���� � � ��� � fA � CA � ���� �� � p- :* � U p�,�°� � o 5. 'O .. A � �°, � � o. w O � � ����. �. � � � � M .�i � � � � �oo vr .. eo � I » eo 3 '� w � M � � � h � � � � � � �i p � M �°y � � � � n � �, � � � � .y, � 'q� M � 1 � � � � � � � eF • � � . O F-� HOU E HEATING TEST RECORD ADDRESS r Y� �� APT. FLOOR CITY SUBURB ''��� OCCUPANT OWNER HEAT LOSS DATE HTG. INST. ^AS C0. METER BADGE # �' SOLD BY INSTALLED BY ° '- ` Eleetricol Work By Gaa Lfne By '' TYPE OF HEAT GA FA HW STEAM SPACE HTR. UNIT H . OTHER � /� �A,�D�IGN ' CONVERSION MAKE /� 1`Z-%'>�+-i �� � �• - _ � � :�.• MAKE OF BURNER Model �'', �' ' Model Serial „' �, f@� `-� Max. BTU Rating INPUT ,� �--��r MAKE OF FURNACE Model CONTROLS � �� THERMO AT Ha t Plug Vent Size Valve � � KIND OF LINER SIZE NONE Limit g �r��,,� Droft Hood Regulamr Limff Setting E7'��A� � Fi Iters Size �� � �� mber � Fan Sattine � Chimnoy Location n id Outaide Pilot TYPe `r ��'� Chimney Construetion � -� Pilot Maka Pilot Model Smoke Bomb Wiring Pilot Timing— �� -o Droft Test Ta �-G'� e L.W. Cut Off � Door Pressure Lighting Inst. s� .--� Pressure �` � d% Pareent CO2 �� J' Date Tasted �' -�� �� Input CFHr � `� F°ereent OZ 7 � Company Testing ��� Staek Temp. --_���(� Pereen! CO �� � Name of Tester Form 235 � A � � < �, � � b � R. A ���o �. �; f0 cCo o��yb �oa"�`� �y��� � �. r.oa � � �. n, C �' � � � �. � � �. �' �. � � � � �a�,�� ��~„�E'i'A ti S, �.Q� � ��b�a 0 0 � �. aF'o'. �' o � `�� by Q a. � � � r. r« � �« � �• ot'� �b�pb y A � � _ �'�:o �, o � ��� `���' C �. � M �p PI. �C �' �i • � �.�� � � \.��•� �� � . �' S o �1��� 0 0 �, �. �Y ��� �Q� ���,�. �� �.y g'� � A �. Q �' � �� � �"h�'� r. b � c�o � '� � `° � o� � b � N� �� (0 `�I t�q i"• � � �b ���A . b � � , � �o o �+ 1�. � � C bto�0°. �,�' C'� r. ��� O � A � �� o 'zJ co R' �. R. � `y� �„��p y �tti+. �o' `C �S" (0 � b � "' o � � C � A � � �I ti I � � 0 Q y � � � � o� � N• � � � � � �y � � 1 O � O A. ,.. � � � � � ,.. � �� . : � �� � a� � o � � � � � � � � A � � q � � ti � q O o� o � , � \� � � 3 � � �e . �°. � � �. � � � � . � c'ro � � � y � Z O O � � m �, =: � � ; � � "�1 0. � � � � Oo C� � O� � � d. � 3 � � • 7p —• � � 3 ° O � "'� � � O � •S � 0 � � � � ep e� 'i y � Q '"'� � eD � �rt� e� � � � � ; � y �' 0 ��: � � O O ■ � � ro � �, � � O � '� � 0 ! SuBJECT City of Fridley AT THE TOP OF TME TWINS g U I L D I N�G P E R M I T i � � � ' • COMMUNITY OEVELOPMENT DIV. � �V �'��� , r � � PROTECTIVE INSPECTION SEC. i---•��� "' �,; CITY MALL FRIOLE� SSIJ2 Nu�ABE11 REV L 612-571-3450 910-F/5 J08 AODRESS 7528 Hayes Street NE t LEGAL �07 NO. BLOCK TRACT OR ADDITION oescp. 1 3 Don's 5th Addition 2 PROPERTY OWNER MAIL AOORES$ Julie Ampe 7528 Hayes Street NE 3 CONTRACTOR MAIL AODRESS Master Remodeling Inc 32 10 Ave S, Hopkins, MN a AiiCF11TECT OR DESIGNER MAIL AODRESS 5 ENGINEER MAIL ADDRESS 5/23/00 5343 21P VAGE OF � / kl• . �� O� AVPROVEO BY SEE ATTACMED SHEET PMONE 780-4634 PMONE LICENSE NO 269-9525 20012916 PMONE LICENSE NO. PHONE LICENSE NO 8 USE OF BUI�DING Residential 7 CIASS OF WOFiK ❑ NEW O AODITION O ALTERATION � REPAIR O MOVE ❑ REMOVE 8 DESCRIBE WORK Soffit & Fascia; replace one window 9 CHANOE OF USE FqOM TO STIPULATIONS Provide smoke detectors in all sleeping rooms and on all levels of the dwelling per Section 310.9.1.2 of the 1997 Uniform Building Code. SEPARATE PEIiM17S ARE REOUIREO FOR ELECTiiICAL, PLUMBING, HEATING, TYPE OF CONS�f. VENTILATING OR AIR CONDITIONING. TMIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING AUTHpqIZED IS NOT COMMENCED WITHIN 80 DAYS. OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANOONED fOR A PERIOD OF 12p DAYS AT ANY 71ME AFTER WORK IS COMMENCEO. NO DWLG. UNITS I HEREBY CERTIFY THAT I MAVE REAO AND EXAMINED THIS APPLICATION 1 ANO KNOW TME SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS yp�UATION AND ORDINANCES GOVERNING TMIS TYPE OF WORK WILI BE COMP�IED WITM WHETHER SPECIFIED MEREIN OR NOT. TNE GRANTING OF A pERM1T �2 � OOO DO�S NOT PRESUME TO GIVE AUTMORITY TO VIOLATE OR CANCEL THE pERMIT FEE PqOVISIONS OF ANV OTNER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $69.25 PLAN CHECK EE Lice S S�GN4TUAEO�CONCRACTOAOA4UTHONijEDaGENT IDAiE� , _� � �D�iEi OGCUPANCVGROUP IOCCUPANCVLOAD SQ.FT CU FT OFFSTREET PARKING STA�LS GARAGES SURTAX y�1.0� SAC CMARGE Fire SC $2.00 70TALFEE $5.0 $77.25 EF1 �� IOAT 7MIS �S �pUR P�RMIT !Uf•1-1b-17'y�i 11�3y FkUln C11Y uF FR1ULEr TU HEW i J ADDN [ l CITY pF FRIDLEY �-T� [ l SINGLE FAMILY AND DUPLEXES R-1 Al�'D R-Z BUILDING PERMIT APPLTCATION C o nstructionAddress : 7 .�o� Legal Description: 93?5�1b P.bl�b� Effective I/1/98 4�E3/ r/N�r�a: � ,� w� ��.;� � �' � �.oa�0 �.� Owner Name & Address: T� ���,P S�-Q- _ - Tel. # 412, 7 PO ♦�(, � c� Contractor: .����Y� �I��D �� �� �.'�?�, �'1��, 141IV I.ICENSE # Z�0 / 2 9i Li �� ����h A����� ����6a Address:_ r�,�,„�a�o�,� - � - lw������6 � ���a.�� Tel. � �� ��'�� �'`� �pplication, a Certificate of Survey of the lot, with the proposed coastruction drawn on it to scale. LIVING ATtF.A: GARAGE AYtEA: AECK AREA: OTI�R: DESCRYPTION OF YMPRO`'EMENT �n8� W idth Height �Ag� Width Height �� Width Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft. Construction Type: �j �- F I ,4roQa�v�l Estimated Cos�: $ ��% (Fee Schedule on Back1 Driveway Curb C�t Width Needed: Ft. + F� Ft x$ _$ �� GcZ DA'TE: S- 1`) � APPLICANT: �i"' Tel. �.� Ge'! ° 9�"L S" Permit Fee Fire S�trcharge State Surcharge SAC Charge Licease Surcharge I}riveway Fscrow Erosion Concrol Park Fee Sewer Main Chazge TOTAL CITY USE ONLY $ ��� Z r Fee Schedule on Reverse Side $ �� °'� .001 of Permit Valuation (1/lOth�ol $ (� � $.50/$1,000 Valuation $ 51000 per SAC Unit $_ S � � $5.00 {State Licensed Residential Gontractors) $ Alt. °A" or Alt. "B" Above $ $450.00 Conservation Plan Review $ Fee Determined by Engineering $ Agreement Necessary [] Not Neressary [ J $ �7.2� STTPULATIONS: `���Y�D� ��i�� ������"c�T�� / � /�-v� o� �LL .��1/�"G�- r��=' 7`/��=" f��-�. �"�. �3�0� � r � . f jy7 � �, c . O'" ii—W L s: = �u���s� �t � � M AY 19 2000 � 4 . _;5 .. �j,J1 9Kc�nt 'a �.kisl.�...tiyt7 :�'J. � � � 2 �� .c! /�LG �LC�-�p�,,.l� lJ�/�1�/.�'�: ri O W C � -i O Z D � � _ A r r W m -D z O O m v -� m � c z n � m � O z cn 0 A D D z v � w r rn rn ,D n O � 0 Z m Z � z � O O z � n � � v m � d � � c � � � D �° r � � m rn a � .� �m � °� v m �, 2 a � m 3 � � � o Z m -^ v �o � c � o � o o m = �D �� °� D �v rD- � m � O z � � �� � � o � c� 'o -o < � a W � 0 � m s � � d � . �� �i � ,/ � � � � z m 0 m r Z O w � � � `G � N t�A G G G C 61, N � � O� n� d d� 9 �° a �o�c�u m c�� � O.n � � O O a o � � 2 2 -� � � ao � N � � N � N N � �D .+ y W -p � � � � � rt N (np � � p) � � �D m m = � -, � <_: r y. �n - rJ> � � � co � � � � Z m co � N � � � m � � * � — � -n � � � � � � c � N.. � c �D m � � ... z 0 I I(�I I I I( I I I I � ���r��r��Enr�r�c�n� cr o 0 0 � o y;•� v ti cn �. � 0 0 0 0 0 0 0 0 0 0 0 o c 0 0 0 0 0 0 0 0 0 0 0 0 0 c � W m � °' � � � rt D Z � -< � : $ � � �� � Q m � � � � � z � o � 4 � o � � n - �/`� � � � � a � � W C N � a N G M � N J ? 1 l� 0 N lO @ � N 01 N Q C. f�D I S A � m 2 �;�c � �a m �N y tG y .�. -O+� �D � 7 O m � ,, S W �/► � � c� � a c. � a c° m � v — � n3, .� � ? pl. � N us o N > > '�o -v � � -a �• a c'' �i � " = -�►. � d o � m � �, � � � o m c. c�i � c�Di � -° m m d �-, � p_ � ? -�w �. �, o o � � � � 0? A �D � � � o m °-' � y y (� �� -� r C � � Z � � C � m �, m � z O � m O D r L W a v v � m � � � M N 1 � � THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNiNG APPLIANCES OR THE APPUCATION WILL BE RETURNED �pII�ILnpl` <�I�T� t/GI�T CC)IIf�FGTnR AA!D CDIl�Hl1STIC)I� AIR VFRIFICATI�N When !r �a � an eYictin0 �ran __, the undersigned hereby verifies that the vendng has been examined and is free from rust, deterioration, obsbvctions, and is securely supported and firestopped where required. Yes (;► No () The venting system is plasticJPVC and meets all current codes and manufacturer speafications including sizing, length, number of elbows and termination. Yes ( 1 No () The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturers speaflcations. This does indude AGA-GAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. me o,.i •��eme ��en air is sized and installed to meet the current codes and manufacturers specifications. When r@qUl�d t0 ����� a new cemb��ctien air it will be s�:ed and installed to meet the current codes and manufacturers specifications. Yes ( ) No ( ) Yes ( ) No ( ) Yes ( ) No ( ) When it�stallia: � ne�' �'entin��y�gm_, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturers spec�f"tcations. 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 () • � • , 1 M' I � ' , � � Y ' • 11 11 • 1 ' � . � • ' � • � � ' M • � • / 11 . � • � AppGance #1 Type BTU Input _ Fan Assisted or Nat _ Appliance #2 Type BTU Input Fan Assisted or Nat _ qppr�ance #3 Type BTU Input _,._ Fan Assisted or Nat -- °Fr�a1 �►p�,tiartt�s---- - - Total �tuJn,r�ut � Common Vent Type Vent Height � Diameter _ inct�es Appliance #1 Vent Connector Height ft Length ft Diameter in Type Appliance #2 Vent Connector Height ft Length ft Diameter in Type qppliance #3 Vent Connector Height ft Length ft Diameter in Type � I � • ► �:- . .�- HEATING CO: �9�� g� Date :