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PRE 2010 DOCS
City of Fridley, Minn. BU MING PERMIT Date: .. ; m9...24#.. 934.. ................... Owner....................................... Address ...................................... N® 3965 Builder ... ® a .................... Address ............................................. LOCATION OF BUILDING No.. 6f? ..... Street ... :4e A4 Av . Ae .............. Part of Lot ............................... Lot ........ Block ......5........... Addition or Sub -Division ... W99)RU?. T9;racjes . 3r Corner Lot ............ Inside Lot ..A ....... Setback AVO... Sideyard XQ 4 DESCRIPTION OF BUILDING To be Used as: . D►aT@ ........ Front W0.. Depth ?.5t6!. Height AVOL! Sq. Ft 1054.. Cu. Ft. X.093. .................... Front ........ Depth ........ Height ........ Sq. Ft......... Cu. Ft......... Type of Construction ................... Est. Cost...41.�'�.1.09..... To be Completed ................... In consideration of the issuance to me of a permit to construct the building desribed above, I agree to do the proposed work in accordance with the description ab t forth and in compliance with all provisions of ordinances of the city of Fridley. � � /-/; / . In consideration 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 workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings with- in the city limits and this permit may be revoked at any time upon violation of any of the visions of said ordinances. ..... ...........Inspector NOTICE: This permit does not cover the construction, Installation or alteration for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these items. City of Fridley SUBJECT PERM . AT THE TOP OF THE TWINS BUILDING PERMIT .13035 r RECEIPT NO. • COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. ---1 CITY HALL FRIDLEY 55432 1---'j 1 NUMBER REV. DATE PAGE OF APPROVED BY 612-560-3450 910-F15 6-23-75 JOB ADDRESS 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 1 4 3 BROOKVIEW TERRACE 3RD ADDITION SHEET I 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE SHERIDAN A. BORN 6876 MONROE ST. N.E. FRIDLEYMINNESOTA 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. HANK DUEVEL CONSTRUCTION 9307 - 5TH STREET N.E. MINNEAPOLIS MINNESO 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING RESIDENCE 7 CLASS OF WORK ❑ NEW ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK CONSTRUCTION GARAGE 22.x 24 9 CHANGE OF USE FROM TO STIPULATIONS PROVIDE HARD SURFACED DRIVEWAY �p X00 � FOR WIRING, tg\ 05VA- REQUIRED a���, RATE PEIwITS SSPE Np SIGNS. 8eta� �0��.��-E $1 tEti� y4EpTMG, PL1JN1`BING Qvr��® SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD VENTILATING OR AIR CONDITIONING. FRAME THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. 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 R-1 528 5,280 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 SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED, WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $3,907.20 $1.95 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. $10.00 PLAN CHECK FEE TOTALFEE �3^16 1 $11.95 Ty SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) HEN PROPERLY VALIDAT D THIS IS YOUR PERMIT �o JUNE 23, 197 BLDG INSP DATE SIGNATURE OF OWNER (IF OWNER BUILDERI (DATE) w O 4 - •APPLICATION FOR RESIDENTIAL., ALTERATION, OR ADDITION.BUILDING PERMIT CITY OF-FRIDLEY, MINNESOTA OWNER'S Nle BUILDER: ADDRESS: rI %� �Diol2� �Pc ADDRESS: .? 3 a a STREET• LOT: BLOCK: 3 ADDITION : ,';'- �'V" e aJ CORNER LOT: INSIDE LOT: SETBACK:: SIDEYARD: Applicant attach to this form Two Certificates of Survev.of Lot and.propose building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: �e_ Front :,2 Depth : v2' S` Height: 1710, Square Feet: Cubie.Feet: Front: Depth - Height: .Square Feet; Cubic Feet: • Q� Type of Construction: �/c'c� �I�2_ Estimated Cost: $ 2- 6©0 9 e 7 o2 -el To Be Completed: �e .The undersigned hereby makes application for a•permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances 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: SIGNATURE: (See Reverse Side For Additional Information.) S"A-YnS*' 9 '9Nl4Y.4-9Nl9N3 fvYgdn gns, 'T 71P a' lion --W aw kq pan'-aAjnv sy -ptxl pim.,w -w i=j, 110 pzw,pwl PAVA-,aw wor -v,* -CPiJvp" fiaA.#KV,10 PZA-IM PIIW M -Y 0 R sIqj P*l Aq"Il N0.1 aov r4c)z:j1 s3.LIDN�C3 v X -Lin I -Ln S3,mq ac c;, ,0% =,,I --I --1 Nv.4 rise 91 ONW33NION2 Alvlkauu P4",7 oLf Slut"Id PuD7 uw9jglfllfl owner of the property located at � �� M OIV R6f- :577 A1,/ have no objection to the City allowing 'the construction of a• )G -A ILE to be located at 7 An O W O i '5l /L/E without the required certificate of survey that the City ordinarily requires for all new construction. Sign e _ C q-7(2 ZVO/-/)e 9,5, 5,i-7— A� Address C -;-/ 2,6 Date • � c i witness SUBJECT Cit of Fridle � City Y r?S 0 AT THE TOP OF THE TWINSBUILDING PER T RECEIPT NO, i may_,______, COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. 1 � ; CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY 612-560-3450 910-F15 2/21/78 JOB ADDRESS 6876 Monroe Street N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 4 3 Brookview Terrace 3rd Addn. SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE ` Jim Wells 6876 Monroe Street N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. L. Gudmunsen 10800 Xavis Street N.W. 421-0218 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 6 USE OF'BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION? ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Install fireplace and replace door 9 CHANGE OF USE FROM TO STIPULATIONS SEPERATE PERMITS REQUIRED FOR WIRING, HEATING, PLUMBING AND SIGNS. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. 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 SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED $l, 75O $.88 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE ON- PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $ lO.SO STRUCTION THE P ORMANCE OF CONSTRUCTION. 3R PLAN CHECK FEE TOTALFEE 1!!�*2 $11.38 SIGN AT OF CONTRACTOR OR AUTHORIZED AGENT IDA t I WHEN PROPERLY BLDG. INSP VALIDATED THIS IS YOUR PERMIT null)_ C2 a 17 DATE SIGNATURE OF OWNER IIF OWNER BUILDERI (DATE) — "• - ! , - " - . ��r, l.,iwwl 1-11 " --- ,. - I , ,;�77 ��_ _ M: qp, ,4' 'j; , , �, _ I � , , , "-�,-- , , .: � � � '. 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I -4, . . 4 �_ _ r , - � � *�� + , � . . , � , r � _ ;-,t,, . , + + , � - � . . � * , CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PERMITS (NEW, ALTERATIONS, ADDITIONS, OR REPAIRS) OWNER: e_ I I GUILDER: Address: G g (� - �7�, e®� C> Aj Address: I e $ `400 )C.� v, s AV IA -)7 Tel. No.: Z /— D 2/ No.: Street: LOT: BLOCK: ADDITION: CORNER LOT: INSIDE IAT: SETBACK: SIDEYARDS: Applicant attach 'to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. To Be Used As: DESCRIPTION OF BUILDING Front: Depth: Height: Square Feet: Cubic Feet: Front: Depth: Square Feet: Cubic,Feet: Height: Type of Construction: �i.��4 Estimated Cost: $ To Be Completed:/ �� Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired $ $ (SEE REVERSE SIDE OF SHEET)' The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. See reverse side fob; additional, information. DATE: ��2���_ SIGNATURES✓�/G�sf� 1�z2 Stipulations: i sue,,EtT P City of Fridley 2 8 7 33 AT THE TOP OF THE TWINS BUILDING P E RMI T -' X5/2-_3604INITY DEVELOPMENT DIV. I >r PROTECTIVE INSPECTION SEC. r ��� , NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F1512/8/98 10B ADDRESS 6876 Monroe Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DEscR. 4 3 lBrookview Terrace 3rd SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE James Wells 574-1643 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Owner 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 6 USE OF BUILDING Usidential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION Ek REPAIR ❑ MOVE ❑ REMOVE "DESCRIBE WORK Reroof house and garage (18 S Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must complyO with the State Building Code. SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING. TYPE OFCONST. OCCUPANCY GROUP OCCUPANCYLOAD VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID 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 OWLG. 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 SURTAX AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT 1542 $.77 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL TME PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $51.25 Fire SC $1.54 PLAN CHECK FEE TOTALFEE It 53.56 SGACTOR ORAUTMOAIZEDAGENT 10ATE, WHEN PROPER ALIDATED THIS IS YCIIUR P RMIT Z2 S,GNA RE ii R - SLOOP INSP OAtE NEW [ ] Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ J SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: ; „ �s/ -2 �o /qty b d, vo Legal Description: Owner Name & Address: ; S� �� 1�) 62 Tel. # Contractor: MN LICENSE # Address: LIVING AREA: GARAGE AREA: DECK AREA: OTHER: 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 Length Width Height Length Width Hgt/Ground Tel. # Sq. Ft. Sq. Ft. Sq. Ft. -16-1z Construction Type: Estimated Cost: (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: - APPLICAN : - o Tel. # CITY USE ONLY Permit Fee $ 1 -/ K Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1 / 10th %) State Surcharge $ 77 $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL STIPULATIONS: CIIYOF FRIDLEY FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287 'i. May 17, 1999 James Wells 6876 Monroe St. NE Fridley, MN 55432 Re: Final inspection at 6876 Monroe St. NE Contractor: Dependable Indoor Air Dear Mr. Wells: A mechanical permit was issued on March 25, 1998 for the property located at 6876 Monroe St. NE for a new furnace and air conditioner. According to Section 305(a) of the 1991 Uniform Mechanical Code a final inspection shall be performed on the mechanical permit. As of this date no inspection has been called for. You will be given thirty (30) days from receipt of this notice to respond. If we do not hear from you, we will expire the permit and any inspections on this installation will require a new permit. Any questions can be addressed to myself at (612) 572-3603. Sincerely, ZW,- I /C'-" /'�.` Bary Riesch Building Inspector CITY OF FRIDLEY INSPECTION DIVISION Effective On January 1, 1998 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, �� �✓ �p 572-3604 REFRIGERATION AND w AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS— DDRESSRATE RATESCHEDULE The undersigned hereby makes application for a permit for the work herein Residential Rate TOTAL specified agreeing to do all work in strict accordance with the City Codes and Furnace Shell and Duct Work, Burner — rulings of the Building Division, and hereby declares that all the facts and Also Replacement Furnace $ 30.00 $Ao representations stated in this application are true and correct. (Side Vent — Fill Out Back) ,s , ,1998 Gas Piping (Needed with new furnace) $10.00 $� OWNER Gas Range $10.00 $ BUILDING USED AS Gas Dryer $10.00 $ ® ; ESTIMATED COST ``71� PERMIT NO. *Air Conditioning —All Sizes $ 25.00 $L DESCRIPTION OF FURNACE AND OR BURNER All Others/Repairs & Alterations (LIST ON BACK 1% of Value of Appliance or Work $ No. of Heating Units Circle One (Steam) (Hot Water �armAlr) Trade Name Size No. Commercial/Industrial BTU 15 000 HP EDR 1.25°/a of Value of Appliance or Work $ Fuel y�Gt� �Q.1s Total Connected Load State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLINGNENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE REINSPECTION FEE $42.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. .50 Burner Trade Name BTU HEA Sign Size No. HP EDR Approved ByRough—In Date. FILL OUT BACK SIDE FOR4STAVERIFICATION ON REPLACEMENT FURNACE Final Date NO List List ALTERATIONS Being Done: HEATING CO: Signed By: Date: 15� CHIlV NEY AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes No ( ) 2. Is free from rust or deterioration Yes No ( ) 3. Has no foreign objects lodged within Yes (/) No YQ 4. Is securely supported Yes No ( ) 5. Meets all current Code requirements for size and total BTU's connected Yes No ( ) 6 Has total heating BTU's of C O All other BTU's —g, TOTAL BTU's 7 7. Has a liner been provided for water heater Yes () No ( ) 8. Has combustion air been provided for water heater Yes (/) No 4- List List ALTERATIONS Being Done: HEATING CO: Signed By: Date: 15� CITY OF FRIDLEY INSPECTION DIV. Effective April 1, 2004 1431 University Ave NE =ridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT 'U 763) 572-3604, FAX (763) 571-1287 MARK NUMRFR OF FIXTI IRFS Tn RF IIURT01 I Gn nM Genu 1:1 nnO 'LUMBING FIXTURE RATES: Jew Fixtures )Id Opening, New Fixture leer Dispenser Ilow Off Basin :atch Basin ;ain Water Leader ;ump/Receiving Tank Vater Treating Appliance Vater Heater -Electric NO. RATE TOTAL JOB ADDRESS "Sr n ¢. - a.S aw Ajz, - Vater Heater - Gas** 'as Range** gas Dryer** ;ack Flow Preventer Required ( )Yes () No Type $10.00 $10.00 $10.00 $10.00 $10.00 $10.00 $10.00 $35.00 $35.00 $35.00 $10.00 $10.00 $15.00 reinspection Fee $50.00/Hr .LL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.25% of Value of Fixture or Appliance State Surcharge TOTAL FEE The undersigned hereby makes application for a permit for the work herein specified agreeing to do all work in strict accordance with the city codes and rulings of the Building Division, and hereby declares that all the fads and representations stated in this application are true and correct. DATE: 10 X.Z , 20 06 Linda Wells OWNER 6876 Monroe Street Northeast 11 Fridley, MN 55432 SOc7 BUILDING USED ASST ESTIMATED COST qo 0 O° PERMIT NO. PLUMBING C P O C \k OVA UAA1. IFjt SIGNED TEL 1,10. ((oIZ) 327 - C/o 33 Approved By Rough -In Date Final Date MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 or 5% OF COST $-3 Sb OF THE IMPROVEMENT WHICHEVER IS GREATER PLUS THE SURCHARGE :OMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. -PROVIDE COMMON VENT INFO ON BACK SIDE FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacina an existing furnace, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes () No ( ) The venting system is plastic/PVC 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 manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes ( ) No( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes ( ) No( ) When required to Install a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes ( ) No ( ) When Installing a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This. does include AGA-GAMA Category I Central Furnace 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 O No( ) Appliance Type and Size/Common Vent and Vent Connector 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 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) - HEATING CO: Signed By: Date: