The URL can be used to link to this page

PRE 2010 DOCS_ Y// Application for Power Plants and Healing, Cooling, Ventilation, Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE GRAVITY WARM AIR: RATE TOTAL Furnace Shell & Duct Work .......................... 8.00 $ Replacement of Furnace ............................. 5.00 $ Repairs & Alterations—up to $500.00 ................. 5.00 $ Repairs & Alterations each add. $500.00 ............... 2.50 $ MECH. WARM AIR �J Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 each add. 60,000 BTU ....................... 2.00 $ Replacement of Furnace 5.00 $ Repairs & Alterations—up to $500.00 ................. 5.00 $ Repairs & Alterations each add. $500.00 .............. 2.50 $ STEAM or HOT WATER SYSTEM Furnace Shell & Lines—to-400 sq. ft. EDR Steam ..... 8.00 $ Furnace Shell & Line—to 640 sq. ft. EDR Hot Water .. 8.00 $ Each add. 200 sq. ft. EDR Steam ...................... 2.50 $ Each add. 320 sq. ft. EDR Hot Water .................. 2.50 $ OIL BURNER—to 3 gal. per hi#dr . 5.00 $ over 3 gal. per hoiur! m --See Fee Schedule GAS BURNER (up to 400,000 BTU) ....................... 5.00 $ 5 GAS FITTING FEES: NO RATE TOTAL 1st 3 Fixtures ........................ x $1.50 $ Additional Fixtures .............. x .50 $ Gas Range to 200,000 BTU .. ........ x 2.00 $ AIR CONDITIONING $ FAN HEATING SYSTEM See Fee Schedule VENTILATING SYSTEM $ ALTERATIONS &REPAIRS TOTAL FEE $-- 7 -r— ROUGH FINAL Dept. of Bldgs. Phone SU 4-7470 Location City of Fridley: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City Ordinances and ruling of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. Fridley, Minn �� ,�9 Owner 21 as 0 Cd L d_S L"t L) Kind of Building Used as �� S To be completed about 3 Estimated Cost, $ Old ew. uilding Permit No. Permit No. DESCRIPTION' OF WORK HEATING or POWER PLANTS --Steam, Hot Water, Warm Air—No- Trade ir—No Trade Name AFco o Size No Capacity Sq. Fi. E.D.R BTU H.P. Total Connected Load 3,P /?--L— Kind of Fuel ��'` 61A -A BURNER —Trade Name Siz No Capacity Sq. Ft. E.D.R BTU H.P. (REMARKS -OVER) Signed By AI 4 z 2M Business Phone No - � r - •r � r Y'W6 7.01W9 ay5 HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS MIINNEAPOLIS, MINN. Weatherstrips A.S.H. a Construction No. Insulation Guide owsI&NL Reference Out. Wall Int.; 11 _eilm Roof Floor Yes N o 19— ¢' ,7 7-1 mT,1.f lo"N', ,i!Room I Lengt re. Widthle, htFI.) Room Length,//' Wid eight 71 Windows and oors—Crackage ,and Area Windows and Doo rackage and Area Width Height No. of Lineal f . Area , Wid Heigh No. of Lineal ft Area I 1 No o e of pane lfghte of crack e f �' N e D 1 is of crack ir Coef. Btu Coef B Infiltration;�` . � ��""' Infiltration'. Glass / Wass G lass •'`.Jr,' v Exp. wall Exp. `wall 4:x Net exp. wall .„ Net exp. wall :Int. w ll Int. w Ceiling Ceiling FloorAv 4A 47..�•* ,. br ,1.'"'� �, �„.. Toiv Btu. Tota tu. `VquirX sq. ft. E.D.R. or sq. ins. W.A..Jaader area. If of equir ,1 .'or sq. ins. W der are Fl -L i �m ( Length Width ight Fl. 4;Room (Length . °' Width Z Z--Meight fWindows and Doors—Crackage and Area Windows, and Doors-Crackage and Area Width Height No. of Lineal it. Area AOIL N pa of pane lfghte of c Width Helot t No. of Lineal ft: Are N pa of e 1 to of CrA k" e 7. h Infiltration Infiltration +� Glass " Glass t Exp. wall jrt Exp. wall' Net exp. wNet a wall k �• Int. will Int. rCeiling Ceiling o t Floor ''-Floor Tot tu. ' Tot tu. e u' sq. . or sq. ins. W.jt kader'are RequhqhLq. it. Ob.R- or sq. ilia. W.A. Le r ar AL y,r� � oom, I Length t ` 0 Width Height Fl �:,. , Room I Length Width eight indows and Door racka a and Area 8 mdows and ours—Crackage and Area. Width Height No. o! Lineal ft. Area Width Height No. of Lineal ft Area No. of—pavid of—paof p$ fights of ack. sq. ft. i/[ij� No. of a ot.D a lights ' of crac sq. ft. -V— PM71 i Oka Infiltration "�° 'Infiltration Glass Glass . Exp. wall .�.. Oe, Exp. wall �,,. 00 Net exp. waNet exp. wall. t.. Int, wgil Int. wall Ceiling Ceilingj a Floor or AOO& to To Btu. #1 ft Tot u. C Required sq. ft. E.D.R. or sq. ins. W.A. Leader area. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area ti City of Fridley Application for Plumbing and Gas Fitting Permit Dept. of Bldgs. Phone SII 4-7470 DESCRIPTION OF WORK Number. Kind and Location of Fixtures Location �.j 6,2 PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL €� z �Tsi Future Fixture Opening ................ Zai a2r� pZ a�z O,S1� ,� (9 0 z 0 p • F • N WATER HTR. GAS ELEC. Base New Ground Run Old Bldg. ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 % Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ lot 2nd 3rd 4th • Future Connection Openings New Fixture, Old Openings I Connected with Sewer Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...................... 1 x $1.50 $ Future Fixture Opening ................ x 1.20 $ New Fixture Old Opening .............. x 1.00 $ Catch Basin ...... ..................... x 3.25 $ Water Heater (Up to 200,000 BTU) . . . ... x 2.00 $ r New Ground Run Old Bldg. ............ x 3.25 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... x $1.50 $ Additional Fixtures .................... x .50 $ Gas Range to 200,000 BTU .............. x 2.00 $ REPAIRS & ALTERATIONS—Refer to Code Description ................................................$ TOTAL FEE $ L,�"- City of Fridley: The undersigned hereby makes application for a permit for the work herei specified, agreeing to do all work in strict accordance with the City Ordinance and ruling of the Department of Buildings, and hereby declares that all the fact and representations stated in this applicatim are true and correct. Fridley, Owner Kind of Building Used as To be completed about nk 190 Estimated Cost, $ Old New. Building Permit No– #7 Permit No. Cp 4� Signed --_--v==,, ) By Business Phone No ROUGH FINAL 42 '2M 01 SUBJECT P City of Fridley ®122'70 AT THE TOP OF THE TWINS BUILDING P E R M I T r CEIPT NO. . `L -.-_-_ COMMUNITY DEVELOPMENT DIV. INSPECTION I �� e PROTECTIVE SEC. (//�✓' 1 . � NUMBER REV. DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 ,'J 642-560-3450 910-F15 8/8/73 JOB ADDRESS 45 - 62k Way N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 15,16 17 Fridley Park SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE E Swanson 45 - 6232- Way N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. D. F. Vizecky 2659 Dupont Avenue South 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 IX ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reside House 9 CHANGE OF USE FROM TO STIPULATIONS Caulk around all openings TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, VENTILATING OR AIR CONDITIONING. Alum 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 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 $1,000 00 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT .50 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE STAELOCAL LAW REGULATING CON- PROWSIO F HWNCONSTRUCTIO 6.00 STRUC N R FN. PLAN CHECK FEE TOTALFEE 6.50 GNATURE OFC NTR TO OR AUTHORIZEDAGENT IDATEI WHEN PROPERL LI DATED THIS IS YOUR .PERMIT BLDG )NSP DATE SIGNATURE OF OWNER OWNER BUILDER) (DATE) IIF 01 APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA ,Cc ) (�,,,�, . OWNER' S NAME:�j' , _ ,^.� BUILDER: _�e ADDRESS: - _W'ADDRESS: NO:. � ` STREET: LOT • -' , BLOCK • �7 ADDITION • CORNER LOT: INSIDE LOT: SETBACK: SIDEYARD: Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. DESCRIPTION OF BUILDING To Be Used As: �- Front: Depth: Height: Square Feet: Cubic Feet: -Front: —Depth: Height: Square Feet Cubic Feet: f Type of Construction: �2� Estimated Cost; $ To Be Completed: The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in stiict 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: , 3 SIGNATURE: Z_ (See Reverse Side For Additional Information.) - �a i Effective Date May 1, 1988 CITY OF FRIDLEY APPLICATION FOR PLUMBING AND GAS FITTING PERMIT RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures -?2- $ 5.00 $ Is, 00 Future Fixtures K ar $ Water $ v $_�� Beer Dispenser $ 4.00 EH r $4 5.00 $ (d $4 $ w tr Rain Water Leader Heater .roi $ ro $ M m Sump or Receiving Tank aro+ 5.00 $ C �c 7.00 $ Hot Water Heater $ 5.00 $ Gas Range w aim $ Gas Dryer $ � [a Back Flow Preventer Required. 3 g .i Type $ U $ w ro v 19 of Value of Fixture or ao ani $ 3 A w° m Reinspection Fee $ u M 3 U ($15.00) TOTAL FEE o as lec 1st 2nd 3rd 4th (R) = Future Connection Opening Connected with Sewer (*) = New Fixture, Old Opening Water RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures -?2- $ 5.00 $ Is, 00 Future Fixtures $ 3.50 $ Old Opening, New Fixture $ 1.50 $_�� Beer Dispenser $ 4.00 $ Blow Off Basin $ 5.00 $ Catch Basin $ 5.00 $ Rain Water Leader $ 5.00 $ Hydraulic Valve $ 5.00 $ Sump or Receiving Tank $ 5.00 $ Water Treating Appliance $ 7.00 $ Hot Water Heater $ 5.00 $ Gas Range $ 10.00 $ Gas Dryer $ 10.00 $ Back Flow Preventer Required. . . Yes ( ) No ( ) Type $ 5.00 $ ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 19 of Value of Fixture or Appliance $ State Surcharge $ .50 Reinspection Fee $ ($15.00) TOTAL FEE Job Address /oZ Department of Buildings City of Fridley Tel. #571-3450 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 Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct Fridley, Mn. 19�J / OWNER��%Y KIND OF BUILDING USED AS TO BE COMPLETED ABQPT ESTIMATED COST / F)NEW BUILDING PERMIT NO. PERMIT NO. ( (-)3Cq Company�� Signed By Tel. No. ROUGH INSP. Date FINAL INSP. Date APPROVAL FOR PERMIT MINIMUM FEE FOR ANY PLUMBING PERMIT IS $15.00 PLUS THE $.50 STATE SURCHARGE SUBJECT P City of Fridley 20203 AT THE TOP OF THE TWINS BUILDING PERMIT i COMMUNITY DEVELOPMENT DIV. � INSPECTION SEC. 4,�;A r � PROTECTIVE e , � "1 CITY HALL FRIDLEY 55432 NUMBER REV, DATE PAGE OF APPROVED BY j 612-571-3450 910-F15 11/17/8 JOB ADDRESS 45 - 62� Way N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 15,16 17 Fridley Park SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Dick.Svenningsen 45 -- 623-a Way N.E. 571-5759 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Morin Construction Inc. 1210.4 Jefferson Street, Blaine, MN 55434 755-6517 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION? ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Interior remodeling 9 CHANGE OF USE FROM TO STIPULATIONS Bee notations. on plan. SEpARA E PERMITS REQUIRED FOR E -E TMG, pLtj[VLRtmG AND "SLGM9. WIRING, 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 SO. FT. CU. FT. 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. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 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 $6 00.0 $3"Qa WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT F 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 FEE TOTALFEE $84. QO SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI+ . WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT BLDG INSP SAT SIGNATURE OF OWNER IIF OWNER BUILDERI IDATEI I NEW ADEN [ ] R-1 AND R-2 ALTER [ Building Permit Application Construction Address: Legal Descripticn: Owner name & Address: M Effective 5/1/88 TV --l. # 5`7 � S-7 ,� Contractor: _11 u, NO v, f( h2g r-7 j e � �� r Tel. Address: 6 9T, Attach to this application, a Certificate of Survey of the�- lot, with the proposed bion drawn on it to scale. fz LIMO AREA: Inngth e-7 G RAGE AREA: Length EECK AREA: �S , E89M=CK CIF Width Height Width Height Width Hgt/Ground Sq. Ft. Sq. Ft. Sq. Ft. Corner Lot [ ] Inside lot [ ] Ft. Yd Setback Side Yard Setbacks ZjTie of Construction:_,e,, ; Estimated dost: $ Approx. Cmpletion Date: /i. ; - iq Proposed Driveway Width If New Opening Is Desired: Ft. $ $ Width + 6' See Back Page DATE: APPLICANT':,�.� Tel. # �.:`-c- ,i ii 7 MY USE COY Permit Fee $ P / O c) ti Fee Sdmdule on Reverse Side State Surcharge $ S 00 L- $.50/$1,000 valuation SAC Charge $ $575 per SAC Unit Driveway Escrow $ Alt. "A" or Alt. "B" Above Park Fee $ Fee Determined by Emji reeri n Sewer Main $ Agreement Necessary [ ] Not Necessary [ ] TOTAL �j. rte! I I I I I (/ ITI I _ I ' Ar I T I I i I -j-- I I I I ---1----j,�- 1 -t- I ty i ltVl I J I — — —;-- -- opl II I II I i i I 1 I I I ! I I i I I I i -y(- I I i I I I I •, ', I i i '. grill j� I ! 11 T I I I II I� ' SUBJECT City of Fridley 2676 AT THE TOP OF THE TWINS ?, BUILDING PERMIT I RECEIPT NO. ------COMMUNITY DEVELOPMENT DIV.�� ~ PROTECTIVE INSPECTION SEC. NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910415 7/22/98 JOB ADDRESS 45 62 1/2 Way 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 15 & 16 17 Fridley Park SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Dick Svennin sen 571-5759 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Four Seasons Roofing & Remodeling - 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20138780 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO. 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION M REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Reroof (11 Sq) Tear-off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with State Building Code. 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 SO. FT. CU. FT. 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. 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 $500 $.50 DOES NOT PR UME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS ANY TATE OR LOCAL LAW REGULATING CON- STRUCTION OWTHE PE PF R NCE OF CONSTRUCTION.$21.00 Fire SC $.50 PLAN CHECK FEE TOTAL FEE Z�r License SC 5.00 27.00 St. NATURE OF CONT RA TOR OR AUTHOR IZEDAGENT IDA EI O�PEERLY LI DATED THIS IS YOUR PERMIT HEN PROPERLY/11.1 � w ! / ,?2 - BLDG I P DATE S-GNATURE OF OWNER0F OWNER BUILDERI IDATEI NEW [ ] Effective 1/1/98 ADDN [ ] .; ,;, , .. CI*_,OF FRIDLEY ... , ALTER [ ] SINGLE FAMILX-AND DUPLEXES R-1 AND R-2 BUILDINOERNUT APPLICATION ConstructionAddress: Legal Description: _ Owner Name & Address: C,y @.fn in t ing sem Tel. t5'71 9 11a 1,� -MN LICENSE #�f Contractor: Lo Lf r S e�.s on s 'R-0 a-�j� � Rem 0jp � Address: 7G% 3 d L` vi i U e es t 4nu AUS AUE' Er= cl Imo, Tel. # Attach to this 'application, a Certificate of _Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION, OF RUPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq: Ft. RD LQr OTHER: 42,W CJ V 2, 4L P Construction Type: ZM6 4- aL x_e_ 11hc.o . PW V Estimated Cost: $ ISOO' (Fee Schedule, on Back). Driveway Curb Cut Width Needed: Ft.- + 6 Ft = Ft x $ _ $ DATE:.APPLICANT:, Tel. # ., CITY USE ONLY Permit Fee $ D "Fee Schedule on Reverse Side Fire Surcharge $ :.S_D `L'1%001 of Permit Valuation (1/10th%) State Surcharge $ �� $.50/$1;000 Valuation SAC Charge $A per SAC Unit License Surcharge $ $5 60.: (State Licensed Residential Contractors),a k r Driveway Escrow $ Alt: `"A" or *Alt. "B", Above Erosion Control $, $450.00 Conservation Plan review Park Fee $ Fee Determined by Engineering Sewer Main Charge $! [. ] Not. Necessa ;:Agreement Necessary ry. TOTAL... t" STIPULATIONS: SUBJECT City of Fridley 27361 AT THE TOP OF THE TWINS BUILDING PERMIT(13,,,. r COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. `� S r � NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 L 612-571-3450 910415 8/24/98 JOB ADDRESS 45 62 1 2 Way NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 15, 16 1 17 lFridleyPark SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Dick Suennin sen571-5759 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Norlina Exteriors Inc284-8S136 20098700 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 Re lace aluminum soffit, facia 9 CHANGE OF USE FROM TO STIPULATIONS Install soffit ventilation to meet State Building Code. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCYLOAD SEPARATE PERMITS ARE REQUIRED 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 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 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $2100 $1.05 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.- $74.75 Fire SC $2.10 PLAN CHECK FEE TOT L FEE 4/ _ a7 �[) Licens $5. 2.90 IGNATURE OF CONTRACTOR OR AUTHdMIZED AGENT IDATEI EN R P VALID T HIS XUR PERMIT o o o SIGNATURE OF OWNER qF OWNER BUILDERI IDATEI ffLIPG INSP qA E NEW [ ] Effective 1/1/98 ADD'N - [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: : Legal Description: Owner Name & Address: , S �, ��s, <,, o, - s o # !�'2/- 577S - Contractor: r �,,- o MN LICENSE # Address: Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF EMPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: r J `t Construction Type: 11kfd, n fn J�' "�� ' �` " :r"" Estimated Cost: $ o`)�� ®- Go (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ = $ DATE: Sl -4.4> APPLICANT: Tel. # 70 STIPULATIONS: CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge r $ $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit License Surcharge $ CSL $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: CITY OF FRIDLEY INSPECTION DIV. • 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT 572-3604 / MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Effective On January 1, 1998 PLUMBING FIXTURE RATES: NO. RATE TOTAL JOB ADDRESS New Fixtures $ 7.00 The undersigned hereby makes application for a permit for the work herein Old Opening, New Fixture $ 4.00 specified agreeing to do all work in strict accordance with the city codes Beer Dispenser $ 5.00 and rulings of the Building Division, and hereby declares that all the facts Blow Off Basin $ 7.00 and representations stated in this application are true and correct. Catch Basin $ 7.00 Rain Water Leader $ 7.00 �D� �i /�� W , 1998 Sump/Receiving Tank $ 7.00 j 9`opu/' ��y✓IS Water Treating Appliance $10.00 Owner a— 0W) Water Heater —Electric $ 7.00 �— / Water Heater — Gas** $10.00 Building Used AsGas Range" Range** $10.00 �� Gas Dryer** $10.00 Estimated Cost) PERMIT NO. Back Flow Preventer Required ( )Yes () No � Type $15.00 �� -/ PLUMBING COMPANY .CJ/��K lti� �i,> AIA K:Z�— Reinspection Fee $42.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge TOTAL FEE SIGNED BY ? Approved By �l� Rough—In Date $ .50 MINIMUM FEE FSR ANY PLUMBING/ $;L0'�0 PLUS THE $.50 STATE SURCHARGE TEL N0. SY7—fl J 7 Final Date hh ya IINIT IQ 0.2n nn **COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6—A. MINIMUM SIZE 9 SO INCHES. CITY OF FRIDLEY INSPECTION DIVISION�`� / Effective On Janua 1,, sse 6431 University Ave NE )-/ o �9 ry Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES RATE SCHEDULE JOB ADDRESS L.} � 6 Z� "� _ WA Y � P Residential Rate Furnace Shell and Duct Work, Burner - Also Replacement Furnace $ 30.00 (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace) $10.00 Gas Range $10.00 Gas Dryer $10.00 *Air Conditioning - All Sizes $ 25.00 All Others/Repairs & Alterations (LIST ON BACK) 1 % of Value of Appliance or Work Commercial/Industrial 1.25% of Value of Appliance or Work The undersigned hereby makes application for a permit for the work herein TOTAL 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 c r ®uo ,1998 OWNER_►�-� a GOtaCa t� i� ^r c�c ettlC� �� BUILDING USED AS ESTIMATED COST _ 2 -LI: $ PERMIT NO. -/3S,20 350 DESCRIPTION OF FURNACE AND OR BURNER $ No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Trade Name -Tcp(Z, Size No. BTU 5 01 o ® HP EDR $ Fuel Nfkr . 6 t,� S Total Connected Load State Surcharge* $ .50 Burner Trade Name TOTAL FEE $ '50.0 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. BTU Size No. HP EDR HEATINGCOMFtKIY� Signed By Tel No. 7Z -.LA- 0311 Approved By Rough -In Date Final Date FILL OUT BACK SIDE FOR STACK VERIFICATION ON loll (0 A) / REPLACEMENT FURNACE C 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 -3. Has no foreign objects lodged within 4. 5. 6 Is securely supported Meets all current Code requirements for size and total BTU's connected Has total heating BTU's of All other BTU's TOTAL BTU's 7. Has a liner been provided for water heater 8. Has combustion air been provided for water heater Remarks: . List ALTERATIONS Beim Done: HEATING CO: Signed By: Date: Yes () No ( ) Yes () No ( ) Yes () No ( ) Yes ()No() Yes () No ( ) Yes No CRYOF FRIDLEY FRIDLEY MUNICIPAL CENTER - 6431 UNIVERSITY AVE. N.E. FRIDLEY, MN 55432 - (763) 571-3450 - FAX (763) 571-1287 October 17, 2001 Dick & Georgia Svenningsen 45 62 1/2 Way NE Fridley, MN 55432 Re: Final Inspection at 45 62 1/2 Way NE Contractor: Residential Heating & Air and Lindman Plumbing Dear Dick & Georgia Svenningsen: A mechanical permit was issued on February 10, 1999 to install a furnace and gas piping and a plumbing permit was issued on December 15, 1999 to install a water heater at your address. According to section 4715.2800 of the State Plumbing Code and section 305 (a) of the 1991 Uniform Mechanical Code, a final inspection shall be conducted on the work authorized by these permits. As of this date, no inspections have been called for. The permit fees that were paid cover the inspections to make sure the work was completed according to Code. We will keep your permits open for another 30 days and if we do not hear from you within this time to set up the inspection, we will expire the permits and no further action will be taken. To set up the inspection, or to have any questions answered, please contact the Building Inspection Division at (763) 572-3604. DAVE Building DJ/mh L � vt t CITY OF FRIDLEY INSPECTION DIVISION Effective On January IF, 998 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES JOB ADDRESS H,5 67 - RATE SCHEDULE 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 $_"J®representations stated in this application are true and co (Side Vent — Fill Out Back) 1 ggga Gas Piping (Needed with new furnace) $10.00 $ / OWNER c �( t A V L �d !�I 165 Gas Range $10.00 $ BUILDING USED AS H O in � Gas Dryer $10.00 $ _ ESTIMATED COST Z1430-00 PERMIT NO. *Air Conditioning — All Sizes $ 25.00 $ 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) (Warm Ai Trade Name TennFf -r A tZ Size No. Commercial/Industrial BTU --7_5, ®o® HP EDR 1.25% of Value of Appliance or Work $ Fuel N A7-%— : 0��S Total Connected Load State Surcharge TOTAL FEE $ .50 o MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION 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. Burner Trade Name L -11J HP Size No. EDR HEATING MPANY ` — N E R` -ir A (e, Signed By Tel No._ %2—'-1-1811 OApproved By Rough—In Date Final Date FILL OUT BACK SIDE FO11 STACK VERIFICATION ON REPLACEMENT FURNACE CH N4NB3 AND STACK VERIFICATION The undersigned hereby verifies that the existing chimney or stack: 1. Has been carefully examined Yes 91 No ( } 2. Is free from rust or deterioration 3. Has no foreign objects lodged within 4. Is securely supported . 5. Meets all current Code requirements for size and total BTU's connected 6 Has total heating BTU's of All other BTU'sC�� TOTAL BTU's 7. Has a liner been provided for water heater 8. Has combustion air been provided for water heater Remarks: List ALTERATIONS Being Done: HEATING CO: Signed By: Date: Yes -0 No ( ) Yes 1A No ( ) Yes No ( ) Yes ( No i ) YesyNo() Yes(( ) No ( ) ©/-C-1ti 01 SUBJECT P City of Fridley 29332 AT THE TOP OF THE TWINS g U I L D I N G P E R M I T f RECEIPT NO. ______ COMMUNITY DEVELOPMENT DIV. K"OuAf✓1 26 'YW r E - PROTECTIVE INSPECTION SEC. a 1 ; � ", CITY HALL FRIDLEY 55432 ` NUMBER REV DATE PAGE OF APPROVED BY L 612-571-3450 910415 4/28/99 JOB ADDRESS 45 62 1/2 Way NE 1 LEGAL LOT N0, BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 15,16 17 1 Fridley Park SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Dick Svenningsen 45 62 1/2 Way NE 571-5759 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Norling Exteriors 341 79 Way NE, Fridley, MN 55432 784-8936 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 20098700 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO 8 USE OF BUILDING Residential 7 CLASS OF WORK . ❑ NEW ❑ ADDITION ❑ ALTERATION [I REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Install window trim 9 CHANGE OF USE FROM TO STIPULATIONS CONSTRUCTION WORK HOURS: 7:00 am to 9:00 pm, Monday thru Friday; 9:00 am to 9:00 pm on Saturday; No work on Sunday. SEPARATE PERMITS ARE REOUIREO FOR ELECTRICAL, PLUMBING, HEATING, TYPE OF CONST. 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 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. UNITS OFFSTREET PARKING I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 1 I 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 $500 $ .50 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• TR CTION OR THE PERFORMANCE OF CO TRUCTION $21.00 Fire SC $.50 �--� PLAN CHECK FEE TOTAL FEE X07 •- License SC $5.00 $27.00 SIGNATURE OF CON'RACTOR OR AUTHOR[ZED A NT IOATE. HEN PROPERLY (DATED THIS IS Y'O%UaR PERMIT SIGNATURE OF OVVNEROF OWNER BU4DER1 .DATES BLDG NSA MATE 01 NEW [ ] ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: Legal Description: Effective 1/1/99 ILA ly �S 3 Owner Name & Address: L ,r - f �' sy le A Tel. # Contractor: /y Irl �r ��Pv-ror-s MN LICENSE # 9,o6> �-7 ®® Address: �/1 7 � w� c( ��- r �� 012 ArK4f Tel. # 7 3 �- Attach to' this application; a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF E%IPROVEMENT LIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: 14L� rl . ! i -m Construction Type: G�,maa� �„ o� doo,� Estimated Cost: $ tt�� (Fee Schedule on Back) Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: f' 'o�D cI APPLICANT: � -� Tel. #--5- % `a t o� 7e> Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control Park Fee Sewer Main Charge TOTAL STIPULATIONS: $ 'S706 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) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] r CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Effective On Jan 1, 2000 PLUMBING FIXTURE RATES: NO. RATE TOTAL New Fixtures $ 7.00 Old Opening, New Fixture $ 4.00 Beer Dispenser $ 5.00 Blow Off Basin $ 7.00 Catch Basin $ 7.00 Rain Water Leader $ 7.00 Sump/Receiving Tank $ 7.00 Water Treating Appliance $10.00 Water Heater -Electric $ 7.00 Water Heater - Gas** 1_ $10.00 10.0-0 _ Gas Range** $10.00 Gas Dryer** $10.00 Back Flow Preventer Required ( )Yes () No Type $15.00 Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance . State Surcharge $ .50 TOTAL FEE $ ZO.50 JOB ADDRESS c � �iASi�iFi� 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. Z`�� , 200b SVENNINGSEN, GLORIA Owner 45 62ND 1/2 WAY NOR'rHEAST FRIDLEY, MN 55432 (612)571-5759 l Building Used As re S �C&'t4 e_Q' Estimated Cost `7� PERMIT NO. / PLUMBING 9 -ANY C/VVl � iyx SIGNED BYJ/_JTEL N0. 927 - LI033\ Approved By Rough -In Date Final Date ®z) COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furance, the undersigned hereby verges 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( ) 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: CITY OF FRIDLEY INSPE=CTION DIV. 6431 University Ave NE Fridley, MN 55432 763-572-3604 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR Effective On Jan 1, 2001 PLUMBING FIXTURE RATES: New Fixtures Old Opening, New Fixture Beer Dispenser Blow Off Basin Catch Basin Rain Water Leader Sump/Receiving Tank Water Treating Appliance Water Heater -Electric Water Heater - Gas** Gas Range'" Gas Dryer** Back Flow Preventer Required (,J'fes () Nc Type 4--� 12,60 NO. RATE $ 7.00 $ 4.00 $ 5.00 $ 7.00 $ 7.00 $ 7.00 $ 7.00 $10.00 $ 7.00 $10.00 $10.00 $10.00 $15.00 Reinspection Fee $47.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.5% of Value of Fixture or Appliance State Surcharge TOTAL FEE TOTAL JOB ADDRESS _ (D, 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. Owner 2L12---' 20e/ Building Used As Estimated Cost PERMIT NO. / �/ PLUMBING COMPANY —► � SIGNED BY Approved By COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. COMMON VENT INFO ON BACK SIDE COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furance, the undersigned hereby verges 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( ) 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 :