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AF - 45933,� �1 � Caty of Fridley, Minn. BUILDING PERMIT Date: - - AIIGUST 24, 1965 Ovvaer: �LAREENCE E . KGIIENDER �� SAME �a� 6961 H3ckory Place N'. E. A� Fridley 32, Minnesota N° LOCATION OF BUILDING No. 6961 g�t Hickorp P7.ace N. E. Part of Lot Lot 22 Bi�k 1 Addition or Sub-Division _ OSTMA..N' S, 3R� AnnTmrp1Q Coraer Lot _ 7nside Lot Setback Sideyard SeWer ne�atian — ' Fo�mdat3on IIevation 3� 3 � �� 8403 DESCRIPTION OF BUILDING To be vsea es: GARAGE Front � Depth ?� Height � Sq. FL ._5�6�� Cu. F't 5��+6 0 Front Depth F�Teight Sq. Ft (;u, Ft, Type Of Conatruction F�t. Cost $.? ,,.�. �� TO be Completed In canslderation oP the iesuancae to me of a permit to constcuct the building described above I agree to do th� proposed work in acc;�rdance with the description above set forth and in c�amplian with a'll proviaion� of ordinancea oP the dty oP Fridley. ��!, .��' �/' � G In c�mafderation oP the Payment of a Pee of 5$ • 00 , Permft ia herel�Y granted to CJ�AREN'CE E. RLUEIVDER to conatruct the buflding or addition as described above. Thia permit ia grented upon the exPress �ndition that the peraon to whom it is granted aad his agent�, employees and worl�►en, ffi all work done in, arotmd and u�n said building, or anypart thereof, shall coffiorm 9n all respects to the ordinanc� of wlt�bin the d�l�its�and location� construction, alteration, maintenance, repair and mov3ng of bufldings o�� t3► �s permit may be revoked at ar�y ti�ne upon violation of aay of the Provisiona op eaid ALLEN G. JERSEN 8�� NOTICEs 'Ilds peeedf doa eo� cever t6s coeshveHee, Mshlbllon hr wieiee, pivm6tee, 6a h�tlln8. swru er watsr. B� ama to sse �6° &dWinB I�se ier aP�►+b porm6s �or �has k�ma. . g APP'LICATION FOR BOILDfNG PERMIT CI�Y OF FRTDLLY, MI1�Il�TESQTA OWNER' S NAME�k .� :Lc' s�,t.� ��t t�° � �c�� . BUrLDER , r�_ �� ADDRESS � / � � � '� ;?,s�� ADDRESS j� . l ., �oCA�rnv oF Bua.DINc Nt?. STREET PART OF LOT LOT ��- BLOCR / ADDiTION OR SIIBDIVISION .��,,� �,, ��.�� CORNER LOT INSIDE LOT SETBACK SIDE YARD �� SEWER ELEVATION FODNDATION ELEVATIQN Applicant attach to this form Two Certificatea of Survey of Lot and proposed buildiag location drawn on these Certificates. DESCRIPTION OF BUII.DING To be used as; _ ./" ��s Front �, ' � Depth �; (ne Height � � Sq. Ft. � � � Cu. Ft. '��C Front Depth Seight Sq. Ft. Cu. Ft. Type of Conetruction � ,�,�-.,� �,�, Eatimated Cost� � Q�, a� To be completed_ y�s , a� The undersigned hereby makea application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinancea and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE � ., ol '� � 3 SIGNATURE ( t, •� /�,1��/ . (Schedule of Fee Costs can be found on the Reverse Side). ' 1 � �� ,,. G �c,:-�_a.-r _ __ . - � ' BII�DIl�TG PERMIT FEE SCHEDULS SECTION 2. The Inspector of�Buildings shall, before issuing any permit for the erection of any�building or etructure, or for any addition to any esisting building or structure, or for atcy alterati.ons or repaira to aay exiseing building or etructure; upon application thexefore� requi�e the paymeat by the applicant for such pesmi.t of fees to the amount herein below �et foreh and in the manner herein provided to-wit; � 2.1. For any such permit for the erection of any fire-proof building, othei than a garage, warehouee, factory o� grain elevatory or for the �rection of any fire-proof addition, for similar occupancy, to any esisting building, shall be at the rate of.$1.40 £or each one thousand cubic feet, or fraction thereof, in such cubical contents. 2.2 For any such permit for the erection of any fire-proof garage, warehouse, factory or grsin e�evator, or for the erection of any fire»proof addition, for similar occupancy, Co any exieting buildiag ahall be at the rate of $1.25 for each one thousand cubic feet, classified as "fireproof" bq Section 502 of the I�Ii.nneapolie Building Code. flOIISES 2.3. For any such permit for the erection of any non-fireproof building, other than a garage, warehousa, factory or grain elevator, or any non-fireproof addition, for eimilar occupancy, to aay esiating bui�.ding - perm�it $1.00 for each one thousand cubic feet. GARAGES 2.4. For any such permit far t�e erection of aay non-fireproof garage•, warehouse, factorq or grain elevator, or for the erection of any non-fire-proof addition, for similar occupancq, to any egisting builditzg or for each such building or additioa - ninety centa ($0,90) for each one thous.and cubic feet or fraction thereof, in the cubical contenta thereof with the miaimum of $4.00. For the purpose of c�nputing fees for building permite,�the cubical contents of any buildtag or addition to a uaiforin height throughout by multiplying�•Che ground�area covered from a poinC si�x (6� iaches below the £�oor line of the ' basement or cellar to the average h��tght of the upper aurfaae or to the average height of the roof aurface of the main gable of a pitched roof. 2.5. Fo= repairs or alterationa to�a� existing structure, the fee ahall be at the rate of $3.00 per each Five ��andred Dollara ($SOO.G+O) or fraction thereof in the cost of all proposed'work. 2.6. In no case sha11 the fee charged for any permit as set forth in Section 2 be less than $4.00. S�ORM REPAIR DAMAGE �EES: Residential; Estim�.ted Cost of work up to $50�.00 -$5.00 Estimated Cost of wo�k over $S�Oo00 -$i0.00 Commercial; Estimated�st of wo�k up 'to $�i��.00 -$10� �— ,<� 8stimated �st of work over �yG�.00 - $2G. .1 _ , ,�, SUBJEC7 City of Fridley pERM1T AT THE TOP OF THE TWINS g U I L D I N G r i �• COMMUNITY DEVELOPMENT OIV. � � ti' �� PROTECTIVE INSPECTION SEC. � �. i � � i�"1 % CITY HALL FRIDLEv 55432 NUMBER REV. �'-•'� � �`' 612-571-3450 910-F15 JOB ADDRESS 6961 Hickory Place N. E. t LEGAL �OT NO. BLOCK TRACT OF ADDITION DESCR. $ 3 Ostman` s 3rd Addi.tion 2 PROPERTY OWNER MAIL ADDRESS Geraldine Kluender 6961 Hickory Place N.E. 3 CONTRACTOR MAILADDRESS S 3IIle 4 ARCHITECT OR DESIGNER MAIL ADDRESS 5 ENGINEER MAIL ADDRESS 8 USE OF BUILDING Residenti.al 7 CLASS OF WORK � NEw ❑ ADDITION ❑ ALTERATION 8 DESCRIBE WORK Gonstruct a 12' x 20" Boat Shelter 9 CHANOE OF USE FROM STIPULATIONS Us.e treated posts. � TO SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION Zp� AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OH ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPUCATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VAL 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 AUTHORITV TO VIOIATE OR CANCEL THE pEF PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. Q SIGNA7URE OF CONTRACIOR OR AUTHOR12ED AGENT (DATE� - �.,.� � 4- o Q a�- ��-� �I'�- iDATEi DATE PAGE OF 86 / � PE IT _ 18393 RECEIPT NO. � �� APP40VED BY SEE ATTACHED SHEET 571-5909 ZIP PHONE LICENSE NO. Z�p PHONE LICENSE NO. ZIp PHONE LICENSE NO. � REPAIR ❑ MOVE ❑ REMOVE OF CONST. oaourn NG SQ. FT. DWLG. UNITS STALLS IATION $400 AIT FEE $15.00 dROUP OCCUPANCYLOAD CU. FT. OFFSTREET PARKING GARAGES SURTAX $ . 50 SAC CHARGE TOTALFEE $15.50 N� [�] City of Fridley Effective 4/1/86 ADDN. [ ] R-1 AND R-2 pLTER. [ ] Building Permit Application Construction Address: �� Ry P� Legal Description: �T � ��-�` 3 �S"iMRN� �� Owner Name & Address : ��-o Tl� � A - �LV END �R Tel . � �1�- � ��9 Contractor• Tel. � Address• Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Hei�ht Sq. Ft. DECH AREA: Length Width Hgt/Ground Sq. Ft. OTHER : �� t� � Yt E 1-TE � '�'�� x . �(�� Corner Lot [] Inside Lot [] Ft. Yd. Setbaek Side Yard Setback Type of Construction: Approx. Completion Date: �uN� � Proposed DriveWay Width If New Opening Is Desired: Estimated Cost: $ ��• Alt. A Alt B $ $ See Back Page for Explanation DATE: �21� ��'�Ca APPLICANT: ��i10 .-� Tel . � '�'7��9 Permit Fee Plan Check State Sureharge SAC Charge Park Fee Sewer Main Charge TOTN. STIPULATIONS: CITY IISE ONLY $ �e� � Fee Schedule on Reverse Side $ — 25� of Building Permit Fee $ �.,z,�f� $.50!$1,000 Valuation � e�' �475 �et� SAC Urait $ � Fee Determined by Engineering $ Agreement Necessary L � Not Necessary [] � l S�1 ��Z. °"1' � ��p'l"�,I� '�]�S 1 0 � � � BUII.DING PERMIT FEE SCHEDIILE The Chief Building Offieial shall, before issuing permits for the ereetion of any building or structure, or for any addition to any existing building or strueture, or for any alteration or repair to any existing building or strueture, upon applicatio n therefore, require the payment by the applicant for sueh permit of fees Lo the amount herein below set forth and in the manner herein provided to-wit: Total 9aluation $1.00 to $500.00 �501.00 to $2,000.00 $2,001.00 to $25,000.00 $25,001.00 to $50,000.00 $50,001.00 to $100,000.00 $100,001.00 and up Fees $10.00 (Minimum Fee is $15.00) $10.00 for the first $500 plus $1.50 for each additional $100 or fraction thereof, to and including $2,000. $32•50 for the first $2,000 plus $6.00 for each addi-tional $1,000 or fraction thereof, to and including $25,000. $170.50 for the first $25,000 plus $u.50 for each additional $1,000 or fraction thereof, to and including $50,000. �283.00 for ti�e first $50,000 plus $3.00 for each add�tional $1,000 or fraction thereof� to and ia�cluding $100,000. $�33.00 for the first $100,000 plus $2.50 for each additional $1,000 or fraction thereof. DRIt/EHAY DEPRESSION ESCROY (Concrete Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13•50 Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 ineh depth - Driveway width plus 6 feet times $15•75 VERIFICATION OF FOONDATION Permits for construction will be issued a minimum of 24 hours from the time of application t� allow for proper review of the proposed strueture and of the construction site. A Certificate of Survey of the lot, s�e�wing t�ae locat��a� of the foundation onee it has been c:onstructed will be required before proce�edi�g �aith the framing. 9 0 � V ,�\� � � � �� .-. �4, Y � 0 � s ��,i0 �� -, � � ,, , a � �`Z �,,� o 0 �� rYr � � �� r�`� � ,� � � � � � L �r r- _. '` � , .� 1 C� � 1 l�1 � , Z L ��. �, ,,> �:. ` � � �,-_� � , , �� J X � � , �� 'C � _ ' �_ � �,. � _ ' •� . � ^� � _� ,_ �� -� �, e• _ i� � sue�ecT P IT . c�ty of Fridley o 19596 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T r � � R IPT NO. COMMUNITY DEVEIOPMENT DIV. r � L •� PROTECTIVE INSPECTION SEC. � a(� � � .J T 1 = � ' /"'1 � CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY �'""'� � ,�� 612-571-3450 910-F15 / / 7 19 88 J08 ADDRESS 6961 Hickory Place N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. $ 3 Ostman's 3rd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS 21P PHONE Geraldine A. Kluender same 571-5909 3 CONTRACTOR MAILADDRESS ZIP PHONE LICENSENO. S am.e 4 ARCHITECTORDESIGNER MAILADDRESS ZIP PHONE LICENSENO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK � NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Construct 14' x 10'.5" deck. 8 CHANGEOFUSEFROM TO STIPULATIONS SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TMPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAO VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOIO IF WORK OR CONSTRUCTION ZONING SO. FT. CU. FT. AUTHORIZED IS NOT COMMENCED 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. DWLG. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION STALLS GARAGES AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION SUHTAX AND OFDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIfIED HEREIN OR NOT. THE GRANTING OF A PERMIT $SOO . OO y� . SO DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. ZS . OO PLAN CHECKFEE TOTALFEE � ^ 25.50 SIGNATURE OF CONTFACTOR OR AUTNOR12ED AGENT IDATEI WHEN PFOP RLY A� DATED THIS IS YO R PER I � ��i �l �� ` �� S ATUFEOFOWNER�IFOWNERBUILDER� I ATEI BLDG iNSP npTE � �� City of F�idley EEfec#,ive 5/L68 � � � R-1 ArID R-2 ALTER [ ] �nstructian Addr� Legal Descriptiai Building Peaait 1�plication Owr�er Nane & Address :_ ��► L� i � � � - i�LU �J'��I� Tel. # �71-5�i O�ntr actor : __ � � � Tel. # Addr'ess : Attach to this appl ication, a Certif icate o� S1�rvey of the lat, with the proposoed v�nstructian dra�m on it to scale. �S(R�70N � I!�'RWH� r.TVns: Au�a. �� Wiclth Beic�t --- ---- St1. Ft. (�iRAGE ARFA• �qth W,�.,►, � B�C�t . Stl• Ft- D�t AR�, • Lenc,�h �_ Width �� egt /Grota�d f 513. Pt. f � � �� ' �� ,,.`'�� ..e?p� � ,�^'� Y^ � ' �, �rner Lot I] Inside Lot �C ]� Ft. � Yd 7.j�pe of Q�nstruc�iasi: Approx. Gbmpl etion Date : ?�� f �,�e''�1„�+.�o`� fi��'�-e �� siae Yara setbacks rstimatea Cost : s � - �- �� . Alt. A Alt. B Prop�sed Drive�vay Width If New Opening Is Desired: S $ Width + 6'� See Back Page DATE: I �l- �� L.� Fi8 APPLICAI�: ��R`/ �L�JEIJ ��. Tp1. # ��1' �`��%� CL'I'Y OSE Qa�Y wo�K ��O -�co�'�9 Ae�i.t Flee State Snrc�arge SAC Cbarge Drfveway Fscrvw Park Ppe Sewer !lain �arge � Sr�(1i�IQZS: � S �� S , �� K� S S S � $ '+� ��"?! �� , Fhe Schedule on Reverse Side 5.50/51,000 Valuation 5550 per SAC Onit At� �i• or Att. 'B" Above F1ee Deteanir�ed by Fhgir�eering Agreenent Neaessary [ ] Nat Nea�essary [ ] � �' �; �; r-_� � y �� .� �� '�`� �..�{�� f=:U � ,. ' �;�� Y :�� :i��. 1 �e �ief Building Official shall, before issuing permits for the erection of any building or structure, or for a�y addition 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 belaw set forth and in the mann�er herein prwided to-wit: ZOTAL VALDE �1 to 5500 5501 to 52,000 S2, 001 to $25, 000 525,001 to $50,000 550,001 to 5100,000 5100,001 to 5500,000 �:,�;�,001 to 51,000,000 51,000,001 and up � --�� Sl5 �iiriimun Free is $15 plus surcharge ) S15 for first 5500 plus S2 for each aadi.tional �100 or f raction therea�, to arx3 including 82, 000 845 for first 52,000 plus S9 for each additional $1,000 or fractian thereof, to and including 525,000 5252 for first 525,000 plus 56.50 for each ar3ditia�a]. 51,000 or f raction thereof r to anc] incl�iing 850, 000 5414.50 for first 550,000 plus 54.50 for each additional $l, 000 or fractian thereof, to and including 5100,000 5639.50 for first 5100,000 pl� S3.50 for each additional 51,000 or fractian thereof, to and including 5500,000 52039.50 for the firs� 4500,000 plus S3 for each additional 51,000 or fraction thereof, to and including S1,000,000D 83539.50 for the first 51,000,000 plus S2 for each add�tional Sl, 000 or f ractian thereof D�V� DEPR�S�ON �w (Concrete (�rb Streets Only) Alternate "A": R�noval a�d replaoement a� curb and gutter anly - Driveway wiclth plus 6 feet times $13.50. Alternate "B°: Renwal and replaaement a� curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus b feet times �15.75. 1�+; y ; �1 �� " i�.�l � � : � �;� Permits for construction will be issued a minimtua of 24 hours f rom the ti applicatian to allow for proper review a� the proposed structure and of the aonstr site. A Certif icatre of Sluvey of the lot, et�awing the location of t,he foundation once it been wnstructed will be req�ired before prooeeding with the frmming. � �. � � of � n O � � C � '-�I � Z D � � _ D r r � m v � O v m v � m � c � n � m c� � O z � A D ... D Z � D W r m � ,D n � � O Z � m z � Z 0 Q Z D n � � v m � o� m � C -� � s D t° r � � m m � 0 �° D � ��m � �O � -� cD � 2 c� N � � C � -n o Z m -^ v � �O � � o m = � D � � � -� °� D m v D � m � O z � D � (� � � Z � m � d � � � o i c m � 7 v n� � � � �, 0 � m � Vo ' N � � ,c � N N`� � 2 3 � � W m � m n� m a� r. � n� � � Tv�� -, -,� �� O,� � � � � tD (D � fD .�i� C1 �' v j �' �� N t11 � f� N , W'C C N � � � � � � � � � N j � fD '� � -� 7 <, r y. N N � � i �C � � � N Z m co � w � v -� m � � � � � m �* 4 � � � � � � c � m m o. m � � z 0 � I��I � I � I I I I� � r C � W Z � �1'I � c � m D -� m � z O � � � � � � � � � � � � � � fJ� O O O v O V V V V(!� �1 V m 0 0 0 0 o c o 0 0 0 0 0 0 0 0 0 0 o a o 0 0 0 0 0 0 C y W � a � W °��' � � Gi � N n � c. � - �. � � �� , � T. a � � �� 'V � � � � �' � O D r � � O �7 7 'O � � Q. C. A (p � m c -=i c D �m`° °-cu ° N y � � � � 7 �, � tQ I'il � ;,' � 7 Cn � p � � o. � � � W � � � � � � � o- °' Q a �° d � � � � � < � �7�' U1, � N N > > 'II 'd � rt 'O � � � = n � �i Q, � � l = � � s � 1 � � � � � � '_, � � Q 0 m c, o� ni � .-. m � -a m d � � � y � � � 3 0 a 3 rt � o °: � '► `�J � � n � � 3 � o � � o i� d_� � . N (/J - � � O � � � � � n w°��v (p U1 `_� C Q N � �• T' w Z � T; � �Zl A A� �. r N � ,,,�� Z � m� � n �J O � G� < THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPUCATION WILL BE RETURNED ^^••••^" "r"T "r"'T CnI�I�EGTnR �4f`D COIL�Bl1STl01` IR RIFIGATI�N � - When pee1� acing an _xic�in0 furance, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, �nd is securely supported and firestopped where required. Yes ( 1 No O The venting system is plastic/PVC and meets all current codes and manufacturer specifications including s'izing, 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 manufacturers specifications. This does indude AGA-GAMA Category I Central Fumace Venting Tables for fan assisted and natural draft appliances. Th8 pY��me ��nen a�r is sized and installed to meet the current codes and manufacturers specifications. Whet1 reqUlred t0 �� a new cem6�ctien air it will b� si�:ed and installed to meet the current codes and manufacturer's specifications. Yes ( ) No ( ) Yes ( ) No ( ) Yes ( ) No ( ) �g� jpg�j�jp0 a ne�:+ ver�tineyy�m, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's s�fications. 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 cutrent codes. Yes () No () .. ._ _ . . _ __ ._ _. ._ _. . ._. _. _ . . .__ . ... ... .... �. .. . .r ..., . . ;� �• ' .�. . a .!_A.: K .4 . . J.. .�. .y.f.�. .. ll ,� �_i�l-�li�.-Y�(F�=Y�-�.�-i'.��.r��.��..�.-...�. ��_' �" ' ____' ' -_ _- � : �3F::;!38?'-f-'�'� � �4;� AppGance #1 Type BTU Input Fan Ass��ead� AI� `�,_ Appliance #2 Type BTU Input Fan Ass� d or Nat;; '�_ AppGance #3 Type BTU Input Fan Ass�s�ed or f�at� %tal Appliances �otal Bfiu Ir�put m' '� k �. �t�:. K,' k� � � Common Vent Type Vent Height Diameter ��;�� fi�hes , �— w 1 i �.� ' � . . . �. �� Appliance #1 Vent Connector Height ft Length ft Diameter S�` in T�p� � Appliance #2 Vent Connector Height ft Length ft Diameter T�;irt T�p� T_ Appliance #3 Vent Connector Height ft Length ft Diameter ,�_in_; Ty'pe � Y ;�, -. ,��,. ...:��:u;.� �I T RATInNS° (�i HEATING CO: Signed By: • Date :