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AF - 46739_ • ; : �. , . , Mam Ol►ice 571-6085 � �B�iR�/1� . -� � � Bfl75 Hi -' NAI/lB�R/!�� . � Mipr�eapo�i�s, Nimnecota�55432 � ?' iMC � ' ' SouthOtfke 8906510 <1tri1 & Motic�ppl Epqenearrnq � 4pB Testmg s Luqd Strturytifg:� Lwqf AlOnr�m$ t 101 CIiN Road ,; • Butnsviile, Minnesota 55337 - . � ' - . . . . _ ^ - . � � . . d� � � .� �S�rtiti,�ate oF l9urvey for � ��'t : �� . r _ r� , _ '''� � ��' 'o--- ' : � _ - �� t ; :��• � � ' � / . __ � � � _ . _ , , _ � � � . , � . , . , �. ` �; � �, . _ � � o i _ �`>�� ) � �?' � _ �� " _ _ � 1._ _,,: . p �, . ' ..� � � � C� �.'[ Q . i v � �� 0 - � d� ��L �' � ' �� °- ° . r . . . � � '� t �� , b 2�.te- . ' . � o..�¢S tVb+�t �v►o v►uw�¢rti� S� "' • w � � �`'°1 . . . , - - � _ . . � . - . : . .� } � � � , . . _ ` �r►�� "' � � �. ' , yic _ � o.. � ` ' d),,Ip � �;: . , � vV , � � ��``°�''' `'' y a � . . . ' . iY'�av� vi+��it�rn�.4�SZ' �"�. , � t�t►v�r� o� tn�✓ �¢c.att:�.:: , . / '� , , o#-' �ai►�le_t� .��""`°�--�-��'` � ' , � � � S � � � _ ��1.. ��..�. �. . � _..�..�� - � � ; �. - 1�' �-°�� .~°�i �`-��.-1 c�' �1�°�"� . �� j�� .1 �` �r �a�,� m ' �� v �cT � �astwttn� . v_� 1�Gcard � 1 � an � • � �_ 1$berebX c�rti/r tha� ►hi� Is a true and eornet r�prtaeefafipe e} o s vsY of the �unda�ies of tbe a6ow d�scribed lond� and ot tAs loca�ioe of all�bqilding th�non� an4 all vi bl• roqch�nenl�l� il anrt from or on �aid land, Ai surwped br �ne tiii•'ZZ�`do�ref 'iL�. :D. 19 '� _ � � � SUSUR AN INEfF�1Nl�'rINC. t�in . .a'�,r Surv�rors - L�R? b -��=�� 9u� e.. ..� ��" �►8 120 , Not Publi;poeb��ts ResBtved � — � � SUBJECT City of Fridley ATTHETOPOFTHETWINS gUILDING PERMIT r � � � • COMMUNITY DEVELOPMENT DIV. �' PROTECTIVE INSPECTION SEC. � __� r ; " -; � . , `-•-.� ��"' �'� CITY HALL FRIDLE� 55432 NUMBER aEV. � 612-571-3450 910-Ft 5 10B ADDRESS 660 Hugo Street N.E. 1 LEGAL �OT NO. BLOCK TRACT OR ADDITION oescR. 42, 43 S Riverview Iiei.ghts 2 PROPERTY OWNER MAIL ADDRESS Michael Johnson 660 Hugo Street N,E. 3 CONTRACTOR MAILADDRESS S.a�me 4 ARCHITECT OR DESIGNER MAIL ADDRESS 5 ENGINEER MAILADDRESS 8 USE OF BUILDING Residentia,l 7 CLASS OF WORK ❑ NEW DATE PAGE OP R/'ld/can � � ZIP ZIP rtnmi - ��20525, \ RECEIPT NO. 3°1 �/� APPROVEO BV SEE ATTACHED SHEET PHONE 784-1166 PHONE LICENSE NO. PHONE LICENSE NO. PHONE LICENSE NO. 0 ADDITION O ALTERATIOId �¢7 REPAIR � MOVE ❑ REMOVE 8 OESCRIBE WORK Rer,00� Dwelling C8 Squares) 9 CHANGE OF USE FROM STIPULATIONS TO On �►� �e�, �oofs Stafe �de °� tear-offs mopl�ed fo$ethe�ireS tnar z laYe sd ��placemenf roofs, up f�0m ext�riQr� 6e �nsralle� to °f 15 �b• felt, BPproved u��erta waN fi�e a point z4 inches Yment rxre�c6can� �Se af other SEPARATE PERMITS ARE REQUIRED FOH ELECTRICAL, PLUMBING, HEATIN(i, VENTILATING OFi Alii CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONINC3 AUTHORIZED IS NOT COMMENCED WITHIN 80 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. UN 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS VALUATION AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $4OQ WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERM1T FEE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- ' $15, QQ� STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. __ TURE� CON f AC� OR AUTH, ORIZED A6EN7 IDATEI ��- � 3CCUPANCY(3ROUP OCCUPANCYLf S0. FT. CU. FT. OFFSTREET PARKING STALLS GARAGES SURTAX $ . 50 SAC CHARGE � TOTALFEE $15.5Q : LY A ID T D HIS IS Y�R PER�T� i � � [ l Effective 1/1/90 � [ ] 1�1 AND R-2 �'� [ ] Building Permit Application Construction Address: � �(� /-/�/GO S7r, �j6 , Isqal D�CY'lpt].o21: Go i� rfz -f C/3 Rccc/t S ,/1 L�/ti2 �� k/ /�6�G/�%S o� r� &�: _�rc NA� c. �� o�.vso,v �. # 7�y//6L coritractor: �e.t. # Addres.s: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DLSCRIPTI�T OF Il�VII�Tr LI�TIIaG AREA: Length Width Height Sq. Ft. GARAGE ARE�,: Length Width Heic�t Sq. Ft. D�CR �,: Length Width � Hgt/G�u�d Sq. Ft. OTf�[t: � � Corner Iat [] Inside Int ] F'�. Yd Setback Side Yard Setbac3cs Zj�pe of Construction: ��c-',-� � LC'�. � Estimated Cest: $ �nC� � Approx. Cbtnpletion Date: - . ; . , ; �J Proposed Driveway Width If New �ening Is Des'irecl: ��•' • Ft. $ $ � � ,, � Width + 6' See Back Page n�: � ��: G .�� - .�: �. # �� i�� CITY USE ONLY P�ezmit Fee $ �� C�� State Surcharge $ �� SAC Criarge $ Driveway E�scrow $ Park Fee $ sewer Main criarge $ . �• sZZ�.rt.AZZOr�s : $ /� , .� C� Fee Schedu3.e� or� R+everse Side $.50/$iyOpO�:ilaluation $600.��pe� _ 5AC Unit Alt.' 'eA" = or Alt. ��B�� Above Fee , Det.�xmined bY II�gin�rincl Agreement Necessaiy [ ] Not NeoessaYy [ ] _� �. • � - :�1 � � � •�]I'�� I]i' : M:151�,IJ :r The Chief Buildir�g Official shall, before issuing permits for the erection of aay building or structure, or for ar�y ac�dition to ariy existirig building or structur�, or for ariy alteration or repair to any PYI�I,� },�ldir�g or structure, upon application therefore, require the paymexit by the applicant for suc� permit of fees to the amount herein below set forth ar�d in the manr�r herein prwided to-wit: TOTAL �11�1IiJE $1 to $500 $501 to $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 $100,001 to $500,000 � �. $15 (Minim�nn Fee is $15 plus suzrhaYge) $15 for first $500 plus $2 for each additional $100 or fraction thereof, to and including $2,000 $45 for fiYSt $2,000 plus $9 for each add.itional $1,000 or fraction thereof, to and including $25,000 $252 for first $25,000 plus $6.50 for each additional $1,000 or fraction thereof, to ar�d including $50,000 $414.50 for first $50,000 plus $4.50 for each additional $1,000 or fraction thereof, to ar�d iricludinq $100,000 $639.50 for first $100,000 plus $3.50 for each additional $1,000 or fraction thereof, to arid including $500,000 $500,001 tfl $1,000,000 $2039.50 for the first $500,000 plus $3 for each additional $1,000 or fraction thereof, to and including $1,000,000 $1,000,001 arid up $3539.50 for the first $1,000,000 plus $2 for each additionai $1, 000 or fraction thereof DRIVE�Y DEPRESSIOI�T FSC[mp (O�ncrete Curb Streets On1Y) Alternate ��A��; Remaval arid replaoement of curb arid guttex only - Driveway width plus 6 feet times $13.50. �t�a� "B" = Remwal arid replace�nent of curb and gutter and i�stall a 3 foot wide aPProach with 6 inch depth - Driveway width plus 6 feet times $15.75. ` �• � v• •� • ° �� i i� • •; Permits for construction will be issued a mininann of 24 hours frc4n the time of application to allow for proppx revieti,r of the Proposed structure and of the c�nstruction site. . A Certificate of SuYVey of the lot, shawinq tiZe location of the foauidation once it has it has been constructed will be requir�ed before pr�dirig with the framing - ` �_.. SUBJECT City of Fridley AT THE TOP OF THE TWINS g � I L D I I� G P E R M I T r � � COMMUNI7Y DEVELOPMENT DIV. y PROTECTIVE INSPECTION SEC. i ` _ � _'_ r ; ' �; � . , � _ �"'1 � CITY HALL FRIDLEV 55432 NUMBER �'-"� � �'� 612-571-3450 910-F15 JOB ADDRESS 660 H.ugo Street NE 1 IEGAL LOT NO. BLOCK TRACT OR ADDITION oescR. 42 , 43 S Riverview 2 PROPERTY OWNER MAII ADDRESS Micha.el Johnson 660 Hugo Stxeet NE _ 3 CONTRACTOR MAIL ADDRESS Same d AHCHITECT OR DESIGNER MAIL ADDRESS 5 ENGINEER MAILADDRESS REV. DATE VAGE OF 7/23/92 � � PER . 21454 RECEIPT NO. �y 7�� APPROVED B� SEE ATTACHED SHEET 784�-1166 ZIP PHONE LICENSE NO Z�p PHONE LICENSE NO. 21p PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK � NEW � ADDITION ❑ ALTERATION ❑ REPAIR O MOVE ❑ REMOVE 8 DESCRIBE WORK Const�'uct � 2Q� x 24' Gaxa,ge ,� � 9 CHANGE OF USE FROM STIPULATIONS �rpyide a, hard s.ux�ace drive�ntay TO TYPE OF CONST. SEPARATE PERMITS ARE REDUIRED FOR ELECTRICAL, PLUMBING, HEATINO, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANV TIME AFTER WORK IS COMMENCED. NO. DWLG. UNI I HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION I, AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS yALUATION AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $��555 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE pERMIT FEE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $�� OO STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. _ _'^„' SlGNATURE OF CON i RACTOR l �� _ % ,�� . %/,� AGENT IDATEi iDATEi s � ' LOAD CU. OFFSTiiEET PARKING STALLS GARAGES SURTAX $3. 78 SAC CHARGE Fire SC $7.56. TOTALFEE $110.34 :F►lY VAy,ID ED THIS IS YOUR PERMIT � � �-Z3`�'�� ATE NEW ( ) ADDN [ J ALTER ( ] CITY OF FRIDLEY SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application Effective 3/ 1/92 Conshvction Address: v' (�� U Gt7 .S� �l/L Lega1 Description: L� 7 s G/� �- � 3 /aL�ic K S �d/v��2 ve��v e-�i=r �� T S Ov�mer Name & Address: `?iJ� CN.R �L /a �� 1 G�f,c%,(e Tel. # 7S � �i G 6 Contractor: Address: MN LICENSE # Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT LI�ING AREA: Length _J� Width � Height GARAGE AREA: Lengt�► "'�� D Width ��/ Height � DECg AREA: Length Width Hgt/Ground OTHER: Sq. Ft. Sq. Ft. � d Sq. Ft. Corner Lot [] Inside Lot [] Ft. Yd Setback Side Yard Setbacks Ty� of Constivction: lii�� ,�> ��1i�r � _ Estimated Cost: $ Approx. Completion Date: _/ 1�I? o� o�- / J�J ' Z� (Cost on Bacic J Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x$ _� DATE: � I APPLICANT: Tel. #°7 S�-� // G� 99.v� Permit Fee $ ,�� Fire Surcharge $ ..� State Surcharge � .� � SAC Charge $ ��—, License Surcharge $ '�"" Driveway Escrow $ �—"' �TY USE ONLY F� Schedule on Reverse Side .00i of Permit Valuation (1/lOth%) $.50/$1,0� Valuation �%(� jlet $�iC Uillt $5.00 (State Licensed Resideutial Contractors) Alt. "A" or Alt. °B" Above Park Fee $ —�—' Fee Determined by Engineering Sewer Main Charge $ Agreement N�essary j] Not Necessary [] TOTAL STIPULATIONS: , ' �,..,.��- � 1� F'�� e BUII.DING PERMIT FEE SCHEDULE The Cluef Building Official shall, before issuing permits for the erextion of any building or structure, or for any addition to any existing bailding or struct�re, or for any alteration or repair to any existing building or structure, upon applic�tion therefore, require the payment by the applicant for such pemut of fees to the a,miount herein below set forth and in the manner herein provided to-wit: TOTAL VALUE $1 to $SW $501 to $2,000 $2,001 to $25,000 $25,(xll ' to $50,000 $50,001 to $1�,� $100,0U1, to .$��(�0 � . $5�,001 to $1,OQ0,� $1,IX1U,001 and up FEES $15 (Minimum Fe� is $15 plus surcharge) $15 for first $500 plus $2 for each additional $100 or fraction thereof, to and including $2,000 $45 for first $2,000 plus $9 for each additionat $1,000 or fraction ther�f, to and including $25,000 $252 for first $25,000 p�us $6.50 for each additional $1,000 or fraction thereof, to and including $50,� $414.50 for first $50,0� plus $4.50 for each additional $1,000 or fracti�ion ther�f, to and including $100,000 $639.50 for first $1�,OD0 plus $3.50 for each additional $1,()00 or fraction thereof, to and including $500,000 $2039.50 for the first $500,�0 plus $3 for each additional $1,(�0 or fraction ther�f, to and including $1,000,�0 $3539.SU for the first $1,�0,000 plus $2 fo= each additional $1,000 or frdction �thereof DRIYEWAY DEPRESSION ESCROW � ' � (Concrete G�rb Streets Only) '� 'x ig Alternate "A": Removal and replacement of curb and gutter only -.� l�rive�vay width plus 6 feet times $13.50. � � �� Alternate "B": Removal and replacement of curb and gutter and irlstall a 3 foot wide approach with 6 inch depth - Driveway width plus .6 feet t�mes $15.75. . VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours ftom the time of application to allow for proper review of the proposed structure and of the constructio,� site. A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will � required before proceeding with the framing. a (� �-�-P�C� c� � y�-�'�. �..-► ��-� ..r 1�' � �" � �� ^ ; @� "�`�`•� � �'_ `�°� '�..�- � ��r �+ ' � .. ,� ,�`�-- � � A � � C� % �! �3 ��GS w�/' QLd�-� �ifl.�io�'t..�- 'a--o�-c.P i��. ��°c�-s �O sC.�'..e �:�:-�'-: �r�� ..�.��c �� r�-� � t� `e o � p�L T� p � ��'� � a�c� � � � G� �^.�� . � ��ti � ��. � �� 1� � �. : � � � �, •sC, � }��,�,�,�n.�- d (i`�f�.r � ��a-�� t�,�a1 , - �/ �� ..._ � � � �.�� -.-�__ �.v�-t-�s �-- ��j L � � 5 I b s �� c._-� ��£� ., � !� � h��.c.`�'° �z�% � ��+�� r �. . - .. � �o�� m � � °�, ,� � 5� � � �--� � ��-... 5��-�- ,�r�-� `� `� � � � � � �' �..� � � �. �°=�� '.-� K�:=� �/ � �� '�; �. � 0 Name i� 1 t� ��'1 YlJ S d � Address �� V�-U � C� 5T , rJ �' � City G� Stat�� Zi � Garage Size � x � A. Removals: oid Garage Nd N� other �- B. Bastc Slabs w/2' apron �� - `f C. Addttional Concrete �] C3� � � `� � `�'�`� �"�`'�°� —� � D. Blocks � �� E. Type: Attached etached Add-on F. Roof Style: `Gabie Hip Rev. Gable G. OverHangs Eave Side " �� Gable Ends " � Roof Sheathing � -� � H. Shingles - Seal Down r ��%'4� 61 I. Manufactured Trusses 2 x 4's �� "o.C. Rafters 2 x 6's -�' "o.c. J. Wall He(ght a t feet �1 K. Studs 2 x 4's ��n "O.C. ,�► lu L. Wall Ties _d� "O.C. M. Wall Sheathing ( J s� N. Siding V � "'�'� O. O.H. Door (size & style) i�`� ��G�uantity� P. Garage Door Opener -�� uantity a. Ranch Windows �uantity � ` R. Service Door � �'� ��--� �uantity S. Electrical �� T. Other -�^ . • • • tr � � Building TI].S�eCtI.OriS 763-572-36 DATE�SITE ADDRES _ THIS APPLICANT IS: PROPERTY OWNER/ TENANT CONTRACTOR SUBMIT A COPY OF YOUR STATE LICENSE WTTH APPLICATION PERNIIT 'I'YPE MECHANICAL RESIDENTIAL APPLICATION CI'T'�' OF FRIDLEY YOUR E-MAIL ADDRESS ❑ OWNER NTRACTOR � S: � � CIT'Y � � �a / g � c��C� / / COMPANY NAME CONTACT PERSOa STATE LICENSE # PHONE °�SINGLE FAMILY ❑ TWO FAMILY TYPE OF WORK: � � �P��T DETAILED DESCRIPTION OF WORK �� 410 WEST L Q1.�, MN 55408 Pemlit No.: Received By: 3 Date Rec'd: � � STATE ZIP FAX ❑ TOWNHOUSE ❑ ,qLTERATION/REMODEL PER MS 16B.665 the permit fee is a minimam of $15A0 or 5% of the total cost up to $500.00, whichever is greater, for the improvement, installation or replacement of a residential fixnue, excluding the fixtures. (This should refleet only the cost of labor ) Labor cost under $300 =$15.00. Labor cost between $300 to $500 = cost of labur x.OS'= � FOR PROJECTS WHE12E LABOR EXCEEDS $5 , FEES ARE BASED ON $10.00 PER FDC1'URE> EXCEI'T WI�R� NflTED' FIXTU�' (�N�ICATE TOTAL I•t[JMBER OF EACH BELOWj � �ODEL: 3,j S-��g, U=--F-f--� Equipmentinstalled . MFG: MFG: MODEL: MFG: MODEL: SIZFJBTU A/C $25.00 FIREPLACE (Gf�.S) $15.U0 GAS RANGElOVEN $10.Q(i —FIREpLACE (WOOD) $35.00 NEW GAS GRILL $10.00 _AIIt TO AIlt EXCHANGEER $15 A� �35.00 G,AS ZJI•I(T HTR $lO.OQ BOILER $35_00 �� RYER $10.00 POUL HEATER $35.00 C�EY LINER $10.00 GAS PIPING $10.� VENTII-A'fOR $15.00 DUCT WORK $10.00 — .. . ` . — b_ � ,T_ �: ,,, . .. . , e.. , . � , � �:.n �:�..�.�-� , �� _ . Permit Fee $ Number of fixtures @$10.00 x$10.00 = Surcharge � .50 Number of fixtur�s @ $15.00 x $15.00 = $ TOTAL DLJE $ Number of fixtures @$25.00 x$25.00 =$ � Number of fixaues @ $35.00 ,� x $35.00 = $� State Surchazge = $ .50 Tota1= $ ��_� TFIIg LS AN APPLICATTON FOR A PER1�9T NOT VALID UNTII. PROCESSID I hereby apply for a building permit and I aclmowledge that the information above is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Fridley and with the Minnesota �Construction Codes; that � understand this is not a permit but only an appli 'on for a peimit an rk is not to start witl�out a Permit; that the work will be in accordan with the approved plan in the case of w7r]'�'�v'�1�1h ' s vi and approval ofR� �� _ „V4 V � _ ' � .,...a.l'�.,�,...d�lqillel/1 �/YIQf�ATE SIGTTpTURE OF APPLICANT � c��y of F�aiey Building Lnspections Department 6431 ilniversity Avenue NE, Fridley, NIN 55432 . 763-572 3604 FAX: 763-502-4977 REQUIRED INFORMATION NEEDED TO PROCESS PERMIT � � RESIDENTIAL PERMIT APPLICATION HVAC ` � � ❑ NEW HOMES/ADDITIONS EXISTtt�G HOME ❑ MAKE-UP AIR REQUIRED FOR NEW/EXISTtNC HQ�IfE� ..�;: . . , . _ :i, . '�:.' �+1' , . rf 1. Combvstion Air (See note belo�v-) �,„ �' � ,� a. Oil or solid fuel IMC Chapter 7 with MN Amendments b. Nat�a1 Gas or Propane/IFGC Chapter 3 with MN Amendments �- 2. Mak�up Air (See note below) a. IMC Cha.pter 5 with MN Amendm.ents 3. Ven.iing a. Gas appliances IFGC Chapter 5 with MN Amendments b. Fuel oth.er than gas IMC Cha�ter 8 with MN Amendments REQUIRED FOR NEW HOMES 4. Heat loss & cooling load per room a. Required on new constru.ction IMC 1346.0312 5. Ventilation a. Per MN Energy Code 7670 or 7672 6. Duct Design Fer Y�IC 1346.0603.2 . �-- a. ACCA Manual D NOTE: Centerpoint Energy Mechanical Code Guidelines software may be used for combustion and make up air calculations 09/19/2006 21:37 FAX 6512075231 ARLA FRIGSTAD � STANDARD C� 004 a ,,• DBte: 9/19/2006 Revision Date; 9l19/200G � Address 1: 660 Hugo St Address ; City; Fridley County: lic�tion infe�rmatioq Business N�m�; �tandatd Heating 8 qir Conditioning Contact Person: oav� Melnick �ffiCe Ph; Fax: Ceil Ph: Addresr, 1; Cit�: Stale: Zip Cede: �xistin� Constructio�; P�� gg; Project #; Lot: 81ock; Subdivision: MN ContractQr License #: o bustipn Aqnl�ce Water Heater� Natural praft Input BTUs: 35,Op0 �ommon Vent Furnacel8oile�: Natural Dtaft lnput BTUs� 44,000 Common Vent � r mbustion ppQ��ances G85 Fited Direct Ve�1t FireplaCe{s): No Oas Fired Power Vent Fireplace(s): No Gas Fired N�tura� OtBft Firepl�ce(s): Nv Solid Fuel App(iance(s): No �chaust_ EQUq�mg��{ C�ntinuous Exha�st Ven�la#ion Capacity (cfm); Nq Clothes Oryer (cfmj� 135 Exhaust Fan Rating (cfm): 135 Make-Up Ai� Nd Make-Up Air Required by Code Combustion qir Round Rigid Required: 5 inches or Insulated Ffex; 6 inches Applicant Name {print): Signature/Date: Code OfflCi�l (print)� Signature/Date: � � �U r na�� rOU� ��lc�. i� � � � (� � � «� 2culd c;�ntcrly�int I�nv�'(t,y MiMeg;i.ycn. ZO(� Mcx:htutic:eil Cc�� Ciuidulilli�v. F'a�u l