PRE 2010 DOCS�� 0 0
BUILDING PERMIT
Village of Fridley, Minn. No
Date l!/! it f 4SY............ .
Owner 1�l�T... Builder ..l�i�!dI1Rr..
Address ........... Address ...
LOCATION OF BUILDING
No. .1.�.... stree't'.'... q ........................ .
�� Part of Lot .............
Lot ..d� 120 ... Block .......... Addition or Sub -Division .. e ....... , ,
Corner Lot ............ Inside Lot Setback ... 3j.. Sideyard ..........................
DESCRIPTION OF BUILDING
Used
.. :. ....... Front DepthSIc'3eight < ;q. Ft. 4400 Cu. Ft. ........
FFr�ront ..A Depth Height ... Sq. Ft.... Cu. Ft.........
Type of Construction :lAA P. Est. Cost . f(PfAPjP ......... To be Completed .. �. 4'. ( ..^ ......
In consideration of the issuance to me of a permit to construct the building described above, I agree to do
the proposed work in accordance with the description above set forth and in compliance with allpraiQns of
ordinances of the village of Fridley. ��
co eration 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
Je expr s 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, sh nform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, altera ' , mainte ance, ep ' moving of buildings with-
in the village limits and this permit may be revoked at a time upon viola ion f of provisions of said
ordinances. _ (-/l _
..wilding 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.
MMM
SUBJECT
PE
City of Fridley
o717 63 3
AT THE TOP OF THE TWINS
B U I L D I N G P E R M I T
r
REC
COMMUNITY DEVELOPMENT DIV.
V
r PROTECTIVE INSPECTION SEC.
-3
' { I CITY HALL FRIDLEY 55432
I'J
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
7/30/84
JOB ADDRESS 5613 4th Street N.E.
1 LEGAL
LOT NO.
BLOCK
TR ACT OR ADDITION SEE ATTACHED
DESCR.
19,20
3
Hamilton's Addition to Mechanicvilla SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Vick Plilhowch same
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO.
X Ray Kreps Construct ion Co. 1676 Chatham Avenue Ardens Hills 631-8543
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
7 CLASS OF WORK -
❑ NEW ❑ ADDITION ❑ ALTERATION X] REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
reroof (tearing off old roof)
9 CHANGE OF USE FROM TO
STIPULATIONS
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
asphalt
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
ZONING
SO. FT.
CU. FT.
AUTHORIZED IS NOT COMMENCED WITHIN BO 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
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT
2.285.00
1.15
DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PERMIT FEE
SAC CHARGE
PROVIS NS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON-
38.50
STRU ON OR THE PERFORMANCE OF CONSTRUCTION.
PLAN CHECK FEE
TOTALFEE
or 3 G
39.65
SO, ATURE OF CONTRA &OR OR AUTHORIZED AGENT ( )
PROP YV,p1 �S IS YOURERMIT
�ry y�
BLDG iNSP DATE
SIGNATURE OF OWNER IIF OWNER BUILDER) (DATE)
MMM
NEMC L ] ,
City of Fridley Effective 4/1/84
ADDN. L ] 1R-1 AND R-2
ALTER..] ��.� rn �^' + � G Building Permit Application
Construction Address.
Legal Description:��t.
Owner Name &Address_ „fir G Ll8��/1 S %+ M % Tel. # -5 !2^ ? ��
Contractor: Tei . # 6 3!- £�Sy 3
Address: ✓3
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 Height Sq. Ft.
DECK AREA: Length ________ Width Hgt/Ground Sq. Ft.
OTHER:
Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback
je,j , " re e' v C _
Type of Construction: Lzip- Te,;A_ a;=;` D� �� /4v� Estimated Cost: $ S
Approx. Completion Date: 5e.2 r 5 0T 0
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: See Back Page for Explanation
DATE: -3 0 TSI- `` -r `✓ APPLICANT: C Tel
CITY USE ONLY
Permit Fee
Plan Check
State Surcharge
SAC Charge
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
�S7.
$ Fee Schedule on Reverse Side
$ 25% of Building Permit Fee
$ $.50/$1,000 Valuation
$ $425 per SAC Unit '
$ Fee Determined by Engineering
Agreement Necessary L ] Not Necessary [ ]
SUBJECTMIT
City of Fridley
193.49
AT THE TOP OF THE TWINS
BUILDING P E R M I T
_
r
RECEIPT NO.
Lu ------- COMMUNITY DEVELOPMENT DIV.
r I PROTECTIVE INSPECTION SEC.
, [�
I
CITY HALL FRIDLEY 55432
NUMBER
REV.
DATE
PAGE OF
APPROVED BY
612-571-3450
910-F15
3/22/88
JOB ADDRESS 5613 - 4th Street N.E.
1 LEGALLOT
NO.
BLOCK
TRACT OR ADDITION SEE ATTACHED
DESCR.
19,20
3
Hamilton's Addn. to Mechanicsville SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Vicki Philhower 5613 - 4th Street N.E. 572-0783
3 CONTRACTORMAIL ADDRESS ZIP PHONE LICENSE NO.
Cedarwood Builders Inc. 6628 Penn Avenue So., Richfield 55423
4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO.
866-6684
5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO.
6 USE OF BUILDING
Residential
7 CLASS OF WORK
❑ NEW ❑ ADDITION] ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Install egress windows; reside dwelling
9 CHANGE OF USE FROM TO
STIPULATIONS
Follow State Code on size/location of egress windows
SEPARATE PERMITS REQUIRED FOR
WIRING, HEATING, PLUMBING AND SIGN&
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
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
l
ISTALLS 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
$4,000
$2.00
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
ANY OTHER OR LAW CON-
oN-
$44. 50
UC ONEGULATING
THE PERF RMANCTE
STRUCT ON ORFE OF CONSTL
STRUCTION
�
CHECK FEE
TOTAL FEE
CILPLAN
27 -Lk -gr".
_
$ 46.50
SIGNATURE OF CONTRkAOR OR AUTHORIZEDAGENT IDAT I
WHEN PROPERLY VA TE.D THIS IS YOUR PERMIT
BLDG W$F ATE
SiGNATURE OF OWNER OF OWNER -BUILDER) IDATEI
NEW [ ] City of Fridley Effective 4/1/86
ADDN. [,] R-1 AND R-2
ALTER. [L],-' Building Permit Application
Construction Address: 6i 1_3 q I <-T ,
Legal Description:
Owner Name & Address:t i GIG 1 121-41 t-14oCOEP, Tel. # 2-
Contractor: T®l. #
Address: etGNl=1 r L -D . K)
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
LIVING AREA: Length
DESCRIPTION OF IMPROVEMENT
Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground r_ Sq. Ft.
OTHER: 11"J 5-0-L-4- lzG t2(zS5 CJll WS,
Corner Lot [ ] Inside Lot [ ] Ft. Yd. Setback Side Yard Setback
Type of Construction: Estimated Cost: $ ��4Q
Approx. Completion Date:
Alt. A Alt B
Proposed Driveway Width If New Opening Is Desired: $ $
See Back Page for Explanation
DATE:/ APPLICANT: Tel. #
CITY USE ONLY
Permit Fee $ �-� Fee Schedule on Reverse Side
Plan Check $ 25% of Building Permit Fee
State Surcharge $ 07 00 $.50/$1,000 Valuation
SAC Charge $ $ 550 per SAC Unit
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $
TOTAL $
Agreement Necessary [ ] Not Necessary [ ]
� - �Z�
STIPULATIONS:
CIlYOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER • 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 • (612) 571-3450 • FAX (612) 571-1287
December 30, 1998
Vicki Philhower
5613 4th St. NE
Fridley, MN 55432
Re: Construction Without Obtaining a Building Permit
(Reroof at 5613 4th St. NE)
Dear Ms. Philhower:
According to Section 106.1 of the 1994 Uniform Building Code as
adopted by the City of Fridley, no building or structure regulated
by this Code shall be erected, constructed, enlarged, altered,
repaired, moved, improved, removed, converted, or demolished unless
a separate permit for each building or structure has first been
obtained from the Building Official.
You have been notified of your need to obtain a building permit and
have failed to comply as of today's date. As a result, a special
investigation fee will now be added to the permit, equal to the
permit fee. The City of Fridley will give you 30 days in which to
comply before turning this matter over to the City Attorney for his
legal consideration.
Please contact me at 572 -3603 -if you have any questions on this
matter.
Sincerely,
A Lzq~
vV
BARRY MESCH
Building Inspector
BR/bk
SuBjEtT
PERMI
City of Fridley
28872
AT THE TOP OF THE TWINS
BUILDING PERMI
T
COMMUNITY DEVELOPMENT DIV.
r � � PROTECTIVE INSPECTION SEC.
1
NUMBER
REV
DATE
PAGE OF
APPROVED BY
i CITY HALL FRIDLEY 55432
612-571-3450
9t0-Ft5
1/26/99
JOB ADDRESS 5613 4 Street NE
1 LEGAL
LOT NO,
BLOCK
TRACT OR ADDITION
SEE ATTACHED
DESCR.
19,20
3
1 Hamilton's Addn, to Mechanicsville SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP
PHONE
Vicki Philhower 5613 4 Street NE
572-0783
3 CONTRACTOR MAIL ADDRESS ZIP
PHONE LICENSE NO
Same
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 ❑R REPAIR
❑ MOVE ❑ REMOVE
B DESCRIBE WORK
Reroof House (2nd Layer) 17 S
9 CHANGE OF USE FROM TO
STIPULATIONS
Roofing can be the 2nd layer but not the 3rd.
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCYLOAD
SEPARATE PERMITS ARE REOUIRED FOR ELECTRICAL. PLUMBING. HEATING,
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 DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
1
ISTALLS
GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
VALUATION
$1A094
SURTAX
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMITthim
$.55
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
PLAN CHECK FE
TOT L FEE
76.64
t'r_1NATURE O`F CCOONTRACTOR OR AUTHORIZED AGENT �J IDATEI
MEN ROP A&IDE�tVYHIS ISS 0 R7PERM
SIGNATURE O�Ow NERVE OWNER BUILOERI IDATEI
-- BL ,NSP'
nArE
NEW [ ] Effective 1/ 1 /99
ADDN [ ] CITY OF FRIDLEY
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2
19"
BUILDING PERMIT APPLICATION c;'?-? 8 % Z
ConstructionAddress: 5 ce l - � Z+t" '�T I V
Legal Description:
Owner Name & Address: V IC -AL. i W -e-r Tel. # ie l --?/ 572" QW -3
Contractor:pp MN LICENSE #
5j
Address: �p l � z-4 ST ,\� cr� Tel. # S o�.tm ,2,
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 Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft.
OTHER:
r7S�,
Construction Type: -Q. L.n" nA �0' Estimated Cost: $
(Fee Schedule on Back)
Driveway Curb Cut Width Needed:
Ft. + 6 Ft = Ft x $
DATE: CN: lC1-
1a VPLti- �Tel. # 572-- 0-7
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
CITY USE ONLY
$ Fee Schedule on Reverse Side
$ / .001 of Permit Valuation (1 / 10th %)
$ �-; ��' $.50/$1,000 Valuation
$ $1050 per SAC Unit
$ $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 $ , C
STIPULATIONS:
errytF FRIDLEY INSPECTION DIV_
6431 University Ave NE
Frldley, MN 55432 l
572-3604 A
APPLICATION FOR PLUMBING AND GAS FITTING PERMIT
MARK NUMBER
ALLED ON EACH FLOOR
Effective On Jan 1, 2000
PLUMBING FIXTURE RATES: NO.
RATE TOTAL
New Fires
$ 7.00
Oki Opening, New Fbdure
$ 4.00
Beer Dispenser
$ 5.00
Blow Off Basin
$ 7.00
Catch Basin
$ 7.00
Rain Water Leader
$ 7.00
Surnp/Receiving Tank
$ 7.00
Water Treating Appliance
$10.00
Water Heater -Electric
$ 7.00
Water Heater - Gas" �_
$10.00
Gas Range"
$10.00
$10.00
Back Flow Preventer Required ( )Yes {) No
Type
$15.00
Reinspection Fee $47.00ft
ALL OTHERS AND/OR REPAIRS AND ALTERATIONS
1.5% of Value of Focture or Appliance
101•
State Surcharge $ "50
TOTAL FEE $.2L
JOB ADDRESS & / 3 — E; 7' 1�3 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 codes
and rulings of the Building Division, and hereby declares that all the facts
and representations stated in this application are true and correct.
/0/a -1/G 1 2Q.—
Owner
0_
owner
Building Used As
Estimated Cos! . X00. CPO PERMIT NO. 13= -
PLUMBING COMPANY
.763
SIGNED BY TEL N0.3 - 3
C
Approved BYZ6 Rough -in Date Final Date
COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE
CIIYOF
FRIDLEY
FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (763) 571-3450 - FAX (763) 571-1287
March 7, 2003
Ms. Vicki Philhower
5613 4 Street NE
Fridley, MN 55432
Re: Final Inspection at 5613 4 Street NE
Contractor: R A Johnson & Son
Dear Ms. Philhower:
A plumbing permit was issued on October 23, 2001 to install a water heater at your
address. According to Section 4715.2800 of the State Plumbing Code, a final inspection
shall be conducted on the work authorized by this permit. As of this date the inspection has
not been requested.
The permit fee that was paid covers the inspection to make sure the work was completed
according to the Codes. We will keep your permit open for another 30 days and if we do
not hear from you within this time to set up the inspection, we will mark the permit "no
inspection called for by homeowner after notification" and take no further action.
To set up the inspection or to have any questions answered, please contact the Building
Inspection Division at (763) 572-3604.
DJ/mh
CITY OF FRIDLEY BUILDING INSPECTION
6431 University Ave NE
Fridley, RAN 55439
763-572-3604 FAX 783-5711287
RATE SCHE
DLU
cikko ial
Furnace Shell and Duct Work, Sumer &
also Replacement Fumace/80,10 j?.e IA -4.,.;t
Gas Pi (New Furnace, Fireplace, Insert)
Fireplace insert
Gas P.ange
ZOOS-o02S,3
Effectifie 4/1/200A
APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION
REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES
Egg
$35.00
$1.0.00
$
$15.00
$
$1.0.00
�
Gas Dryer $10.00 $
*Air Conditioning -All Sizes $25.00 $
All Other Repairs or Alterations (List on Back)
1% of Value of Appliance Or Work $_
Minitmim Fee $15.00 for Residential or 5% of vast of
Improvement whichever is greater an worli less than $500.00
COMMC Ialflndustdal/lnstitutianal ReS r D,'.4,jL
125% of Value of AppGsnce or Work (List on Sack)
Minimum Fee $35.00 for Commerciall/Industrial/Institutional
J08 AIDDRES4 S4 / 3Owner
r
Btelding Used A5 Ids ijoe-& t
ESTIMATED COSY :Oyo, ' PERMIT NO
OMRIPTION OF FURNACE AND BURNER
t of Heating Units 1 circle Onc (Stearn)Hot Wate (WarmAir)
Trade Narne Suem k.+." A 3D3 tYe No._ JP- a-0 3
BTU &.R tau - -- - - HP_ - EDR
Fuel N/ G Total Connected Load
Burner Trade Name S wL As Ba.n... _ Size No.
BTU HP EDR
The undersigned hereby makes application for a permit for the work herein
specified agreeing to do all work at strict accordance with the City Codes
$3 L. w and rulings of the Building Divi, and hereby declares that all the facts
and representations stated in this application are true and correct.
State Surcharge $ 0.50
(if permit fee is over $1,000 multiply by .0405)
TOTAL FEE $ 3 �•
*Air Conditioners can not be placed in side yard without written approval
from adjoining property owner - copy to City
FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE
w
HEATING CO ��A n �19�&.vic.�L „_�m,
4Z Tel #A& -7a9 -S3_16
io�a�s w G�A�tls�-.i
FAX # h r a. - -;V4l-"S6 __ Date /- alo-oto
Approved by Rough -in Date Final Date
FILL IN COMPLETELY FOR REPLACEMENT FUEL 13URNING APPLIANCE PERMITS
Q2N!jQN VENT. VENT C0NNBCTOR al1n GOM1gU5Tl®IV„B�R 10�it�Cq__ TI+�hI
1NhenWina an exists fgMaoe, 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 (kf No(
The venting system is plas1101PVC 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 (y„ No(
The exisstincr comion all Is Sized and installed to meet the current codes
and manufacturer's specifications.
Yes (raj- No
When required to jrtall_a a2W CQp bu$ air it will be sized and ins,alled
to meet the current codes and manufacturer`s specifications.
Yes (✓f No( }
When 1$ a now )anima system, the undersigned hereby verifies that
it is a listed assembly and meets the current axles and manufacturer`s
specifications. This does include AGA -LAMA Category 1 Central Furnace
Venting Tables for fan assisted and natural draft appliances. Yes
No ( 1
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 coder,
Yes (v)' No( }
_Agpjiance a d o on e t sn i/ nt ne In silo
Appliance #4 Typeg '/.,. BTU input 6 00o Fan Assisted or Nat ���
Appliance Type wg �o� hrr fe BTU Inputs Fan Assisted or Not %
Appliance #3 Type _ BTU In —AIAZ:
Total A Put Fan Assisted or Not
Appliances Total Btu Input /o„` & -.,-o
Common Vent Type _ 41... Vent Height � "
9 .�.s..� Diameter ,�� inches
Appliance #f Vent Connector Height __�,ft Length ft Diameter /
Appliance #2 Vent Connector Height _ft Len h -YiR T--- ype - 4
Appliance #3 Vent Connector Height gh ___._._ft Diameter - J Y in Type
9 _ft Length ft Diameter -.In Type _
A61MUONS. ar
HEATING CO: AL
Signed By. _ Date . ✓ aG -46
t�0.%£id ' d A9M I NJ J0 A.1 i ZI £S :9 Z GOOF -SS -6UW