AF - 47046City of Fridley, Minn..
n BUILDING PERII�IIT No _ 6933
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Adaress Address
�, LO ION QP B��NG
No. �� Stceet .� �� � P f �Lot
Lot " Sl�k � Addil3on or Sub-Divisio�n �ad���, �
Corner Lot r Ina�d'e /Lot `�� Setback �:5 __._ Sideyard ����
Sewer IIevation � �" �° � °�� El�. •� � ,7 • 5.
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DESCRIPTION OF BUILDING
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Front —� Depth _�� Hei�ht �� Sq. Ft � Cu. FL �'�%LLZ.�
Front � Depth �.—fTefght � Sq. F't. �� Cu. F`t. _..5� �
E� t�
Zj►�e of ction Faat. Cosi�� �'�To be Completed
In consideration oY the �sauance to me of a germit to construct the bwtlding descrit�d above, I agree to do
the proposed work in accordance with the diescrlption above set Porth 9n carnplian th all provlsions of
or�iinances oP the dty oP Fridley. q �*
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In camafderat[on of the payment of a fee of $� , permit is hereby granted to _
to construct the building or addition as d�crYbed above. Thispe rmft ia granted upon
the eupress condition that thepera�n to whom it fs granted and his ageuts, employees and worlanen, in all work
done in, around and upon satd building, or anypart thereof, shall conform ia all reapects to the ordinance� of
Fridley, Minnesoffi regardiag loc�tion� construction, alteration, maintenaace, Tepair and moving of bufldinga
��e dty limits and this permft may be revvlced at aqy� upon�tion of aay of the Arovisions of safd
Building InsPector
NOflCEa
Thb permk dees eet eerer t6s constraaHoe, InstaWMen fo� rrGie6� P��+m9. 6as hadnA, snrar er wNsr. B� sms to w
t6a Buildio� I�e� M� apar� parmt�a 1or 1k�a iifms.
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HARVEY A. CARTWRiGHT ��G� & a�O� �OMBiP11NG TNE wecoR�a oF
J. E. HILL, GIYIL ENGINEER
ANOlCA GOUNTY. 6ilRViYS esTaeLi6Neo �sae �
HQNNffPIN GOUNTY SUIi VEY6 L A ND � UR VE YO R S.
�e�NNewaoua SuavErs C. F. SANDHOFF
64f0 PALM STR�HT Rt. W. ' RQ018T[RtD UNDHR LA1Nd OF 6TATB OP MINN[BOTA ClVIL ENtdINEER
9UNBET d-78OS EBTABLIBXEG 1008
L1G6NYEQ SY ORDINANCR Qf CITII OF MINNEAPOLIS
owNee • JAMES NEL.SOW
. 326 PLYMbUTN BUILDING FEoERA� 9-B721 SuRVBYOR
� INO1lBTRIAL- - JUDIGIAL H�NNEPIN AT .SIXTM � MINIVEAPOLIS 3. MINNESOTA eBrweuBweu �toas
BUSINESS — TCPOQRAPNtCAL ���en OT'g Certi � atc METROPOLITAN LAN�
G17Y LOT$ — PLATTIN(;, C SURYEYORS. EBTAB118NEG ies+
; �]. ?�371.iams . , � "� ^ �'� • Invoice 21292
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T hereby carti:fy that �his is a true and correct representation of a survty of
' the 'boundaries of : '
Lots 1t8, !�9 and 50, Bl:ock R, Riverviet� H�i�hts
� As surveyed by r�e th3s 25th day o� ��pril, 19�. -
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COMMON VENT. VENT CONNECTOR AND COMBUSTION AIR VERIFICATION
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�� When replacina an existina furance, the undersigned hereby verifies that the
venting has been examined and is free from rust, deterioration, obstructions,
and is securely supported and fire�tQpped v�th�[e required. Yes () fVo (:)_ -
The venting system is plastiGPVC and meets all current codes and manufacturer -
specifications including sizing, length, number of elbows and termination. Yes () No ()
The undersigned also verifies that the replacement unit is a listed assembly
and meets the current codes and manufacturers specifications. This does
include AGA-GAMA Category I Central Fumace Venting Tables for fan
assisted and natural draft appliances.
The existinct combustion air is sized and installed to meet the cuRent codes
and manufacturers specifications.
Yes ( ) No ( )
Yes ( )� No ( )
When required to install a new com�ustion air, it will be sized a�d installed
To meet the current codes and manufacturer's specfications. Yes () No ()
When installin4 a new ventina svstem, the undersigned hereby verifies that
it is a listed assembly and meets the current codes and manufacturers
specfications. 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 ()
A�pliance Tvae and SizelCommon Vent and Vent Connector Information �-
Appliance #1 Type �VUC�r� �'i�i [�a �,�TU Input Fan Assisted o Na
e�
Appliance #2 Type BTU Input Fan Assisted or at
Appliance #3 Type BTU Input Fan Assisted or Nat
Total Appliances Total Btu Input
Common Vent Type Vent Height Diameter inches
Appliarr�e �1 Vent Connector F#ei�ht #t Length ft Diameter � in Type -- �---
Appliance #2 Vent Connector Height ft Length ft Diameter in Type
Appliance #3 Vent Connector Height ft Length ft Diameter in Type
ALTERATIONS: (Describe)
�.l�.P�ld ) ��� �, , `��G�� �� �� � �
�L.AIME HTO. A/C & EL�CT. li�l�e
1�62 C�N AL AVE. N.�.
HEATING CO: AN �� 55304
Signed By: ' Date �: - ' � � — «�� �
HEATING
AIR CONDRIONING
AND ELECTRIC, INC.
ADDRESS � �� �
OCCUPANT
HEAT LOSS DATE � INST.
SOLD BY / � r
Electrical Work By t i ( �
TYPE OF HEAT GA FA_� HW STEAM SPACE HTR.
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'��i�%�?.� .%
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COMROLS
Heat Plua
Umit
Fan;
Pilot Make
Pilot AAode� ? l _
Pilot Timino L� �' � q.!.
L.W. Cut Off
Pressure ° ' Peraent COz p
Input CFH Peraent OZ ��• D
Stack Temp. ���_ Peroent CO r� ��/y
HOUSE HEATING TEST RECORD
\
APT. FLOOR CITY � SUBURB
OWNER n
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INSTALLED BY � r e�,�r' , �
Gas Une By ►Y 1 I
UN�T HTR. OTHER
CONVERSION
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Vent Slze
KIND OF LINER SIZE NONE
� H� Regulator
Fliters Size —�i Number
Chimriey Location Inside �q�de
Chimney Conswction _�i °' �eis
Smoke Bomb wring i�
� � , Test Tag �
Door Preasure Lighting Inst
Date Teated � � — �
Comparry Tesdng ,
Name of Tester �
Pressure Percent COZ
Input CFH Per�nt OZ
Stack Temp. Percent CO