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PRE 2010 DOCSCity of Fridley, Minn. N® 9728 BUILDING PERMIT Date: May 10, 1968 Owner: --John Miskowiec Builder Western Construction Address X09 24 S t . N. E. Address 3 017 Lyndal a Ave. South LOCATION OF BUILDING No. 4709._.._.._ Street 24 Street _ part of Lot Lot 18 & 19 _ Block 7 Addition or Sub -Division . _ Plymouth Addn. Corner Lot —_ Inside Lot — Setback _ _ Sideyard Sewer Elevation — Foundation Elevation DESCRIPTION OF BUILDING To be Used as: Garage Front _.._1V Depth 22' Height 10, Sq. FL 396 Ca. Ft 3960 Front Depth Height -- Sq. Ft. Cu. Ft. Type of Construction ____ game Fast. Cost _ $1200.00 _.__To be Completed In consideration of the issuance to me of a permit to co#tr the *pli cribed above I agree to do the proposed work in accordance with the description abovethanance with a'll provisions of ordinanoEs of the city of Fridley. / In consideration of the payment of a fee of x____6.00 , permit is hereby granted to Western Construction to construct the building or addition as described above. Thisperaut 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 within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said ordinances. Building Inspector Clarence Belisle NOTICE: This permit does not cover the construction, Installation for wiring, phunbing, gas heating, sewer or water. Be erre to neo the Building Inspector for separate permits for these items. APPLICATION FOR BUILDING PERMIT <."t a OF` MDLRY y M MIVASOTA OWNERS' N101E t BVILD19- ADDRESS.'., `L '/ D� ✓ o� � TV ��,..+ _ ADDRESS % LOCATION OF' BU�I,ni1+tG N0. STREET- I.OT' •f. BZOCFC� '`~ 'ADAfTT.-OR SUBDIVISION. CORNER LOT INSIDE LOT^'SIDEYAI SEWER ELEVATION TOP OF FOOTING Applicant attach to this form Two Cert -.Ai Atex of Survey—of Lot and proposed ;.-building location drawri'on these Certificates.: WSCRIPTION OF'BUILDING:: To Be Used As t Depth ; ..Height__ &: .,.,..._...._. - ..-.-o..z �- S Square feet � y Cubic Feet . i�x'ont Depth < Height Square feet Cubic Feet Type of Construction Estimated Cost /A Ue To Be Completed 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 Depa , t of Buildings, and hereby declares that all the facts and represe atio s stated this application are true and corre _. t. DATE J- D 77 SIGNATURE pyt�iLC/� (Schedule of Fee Costs can be found on the Reverse Side). J �y City of Fridley Applicelon for mtd Gas Fh#kq Pennit 52-8.4-879.01 Dept. of Bldgs. Phone '.i®0-3450 DESCRIPTION OF WORK Number. Kind and Location of Fixtures Location 4709 NE . 2;9 S t ® nm. nmln�M�Mmmmmmmlli INEEMMENEENNEW g ' Future coanedson Openings I w= + New Fixture. Old Openings 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 Clydinance and ruling of the Department of Buildings, and hereby declares that aR the fact and representations stated in this application are true and correct Owner Fridley, Minn -L-O 180 1979 18, John Miskowic Kind of Building frame Sawn 0 Used as residence Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ................ x $200 $ Future Fixture Opening ............ x $1.50 $-- New _New Fixture Old Opening .......... x $1.50 $ Catch Basin .................... x $3.26 $ Water Heater (Up to 88.000 BTU) • • • • x $3.00 $ New Ground Run Old Bldg......... x $3.25 $ Electric Water Rester .............. : $200 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures x $200 $ Additional Fixtures ................. x $ .75 $ Gas Range to 199,000 BTU ................ x $6.00 $ Replace (1) gas range 3.00 REPAIRS & ALTERATIONS—Rain to Code To be completed about July 21, 1972 Estimated Cost, $--19.020 OldX-New. Building Permit No. Permit No. �0-4 Signed: e By -- Business Phone NNEGASCO ROUGR Description ..............................:............... TOTAL FSE $ 3.00 CIM NIP surcharge .50 915.51 ° City Of Fridley APP10'QQ1v-®,@ Dept. of Bldgs. Phone 9W-3490 DESCRIPTION OF WORK Number, Kind and Location of Fixtures Loea8ni709 IdE. St, PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...... SF $ Future Fixture Opening ........ ...... x $1.50 r New Fixture Old Opening ...... . .. x $1.50 U Q Z x $3.25 $ Water heater (Up to 99,000 BTU) ...... I . N WATER HTR. GAS EIEC Base x $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... 1 x $2.00 $ 2,00 Additional Fixtures . .......... , ....... x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ lite and grill 6.00 PAIRS & ALTERATIONS—Refer to Code lot Description ................................................$ ' to & ri 11 2nd 3rd -- 4th ®PONCoasecBen finings * Now Fixture.Old Openings Connect" with sower Cesspool0 PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL Number Fixtures ...... x $2.00 $ Future Fixture Opening ........ ...... x $1.50 $ New Fixture Old Opening ...... . .. x $1.50 $ Catch Basin ... x $3.25 $ Water heater (Up to 99,000 BTU) ...... x $3.00 $ New Ground Run Old Bldg. x $3.26 $ Electric Water Heater x $2.00 $ GAS FITTING FEES: NO. RATE TOTAL 1st 3 Fixtures .......................... 1 x $2.00 $ 2,00 Additional Fixtures . .......... , ....... x $ .75 $ Gas Range to 199,000 BTU .............. x $5.00 $ lite and grill 6.00 PAIRS & ALTERATIONS—Refer to Code Description ................................................$ 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 application are true and correct Fridley, Minn Oct. 15, 1969 19_ Owner John Vi . lrowi e o Kind of Building f rams Used as resiAA-CA To be completed about Octe 20, 1969 Estimated Cost, $ 20.00 OldMNew. Building Pe amat By o� Business Phone No 1148 649 ROUGH FINAL • ® m" l ld WELL OR BO"G LOCATIONINNESOTA Screen from U. to DEPARTMENT OF HEALTH Minnesota Well and Boring Sealing No. H County Name Mailing Address if different than property address indicated above. WELL AND BORING SEALING RECORD Minnesota Unique No. SEEN Anoka. COLOR Minnesota Statutes. Chapter 1031 or W -series No. TO - - Set in oversize hole? Annular space initially grouted? Yes No ❑ Unknown ❑Yes to ❑� ❑-Yes ❑ No ❑ Yes ❑ No El Unknown ❑ Yes ❑ No ❑ Yes ❑ No ❑ Unknown - (Leave blank d not known) - - Township Name Township No. Range No. Section No. Fraction (sm. Ig.) Date Sealed Approximate Date Well 1114 ita ria 3/31% or Boring Constructed �' 945 2 CASINGS, OR CASING AND BORE HOLE: ft. ❑ Perforated _ ❑ Removed ft. El Perforated ' ❑ Removed Numerical Street Address or Fire Number and City of Well or Boring Location ra0 eP 60 Depth Before Sealing ft. Original Depth ft. Show exact location of well or boring Sketch map of well or boring Static Water Level Accurate in section grid with -X". location, showing property lines. ElApproximate N roads. and buildings. W MEME Screen from U. to ft. Open Hole from to ft. OBSTRUCTION/DEBRIS/FILL Obstruction ❑ Debris ❑ Fill Drop pipe Type of debris/obstruction Obstruction/Debris/Fill removed? ❑ Yes ❑ No MEMO PROPERTY OWNER'S NAME John & Ilaze . Niakowiac Mailing Address if different than property address indicated above. PUMP ❑ Removed [Not Present ❑ Other SEEN GEOLOGICAL MATERIAL COLOR HARDNESS OF FORMATION MEME TO CASING Diameter Depth in. from �� to rid? ft. in. from to ft. in. from to ft. Set in oversize hole? Annular space initially grouted? Yes No ❑ Unknown ❑Yes to ❑� ❑-Yes ❑ No ❑ Yes ❑ No El Unknown ❑ Yes ❑ No ❑ Yes ❑ No ❑ Unknown � t "Single Aquifer ❑ Multiaquifer ft. X below above land surface CASING TYPE E Nmire $ . ;.Steel F-1 Plastic ❑ Tile 11 Other _ d . { S I mile - C ' Screen from U. to ft. Open Hole from to ft. OBSTRUCTION/DEBRIS/FILL Obstruction ❑ Debris ❑ Fill Drop pipe Type of debris/obstruction Obstruction/Debris/Fill removed? ❑ Yes ❑ No and jet PROPERTY OWNER'S NAME John & Ilaze . Niakowiac Mailing Address if different than property address indicated above. PUMP ❑ Removed [Not Present ❑ Other GEOLOGICAL MATERIAL COLOR HARDNESS OF FORMATION FROM TO CASING Diameter Depth in. from �� to rid? ft. in. from to ft. in. from to ft. Set in oversize hole? Annular space initially grouted? Yes No ❑ Unknown ❑Yes to ❑� ❑-Yes ❑ No ❑ Yes ❑ No El Unknown ❑ Yes ❑ No ❑ Yes ❑ No ❑ Unknown If not known, indicate estimated formation log from hearty well or boring. Drift - METHOD USED TO SEAL ANNULAR SPACE BETWEEN 4NoAnnular Space Exists ❑ Annular space grouted with tremie pipe . ❑ Casing Perforation/Removal in. from to in. from to Type 2 CASINGS, OR CASING AND BORE HOLE: ft. ❑ Perforated _ ❑ Removed ft. El Perforated ' ❑ Removed of perforator ❑ Other GROUTING MATERIAL Grouting material :� 'rtld from from from from r� 60 to _ �+ ft. yards bags to ft. yards bags to ft. yards bags to ft. yards bags - REMARKS, SOURCE OF DATA, DIFFICULTIES IN SEALING is well located6�'' eamernt off jet 'Jest side of houae' :'I3Wpresent, q..g L1t from well 42f io lin, dropUNSEALED tp�pe t_ jet,, ;�� a depth 0 Sc . sS t it is viater 'Lr WELLS AND BORINGS Other unsealed well or boring on property? ❑ Yes Flo LICENSED OR REGISTERE6 CONTRACTOR CERTIFICATION This well or boring was sealed in accordance with Minnesota Rules, Chapter 4725. The information contained in this report is true to the best of my knowledge. I t Dr1-11 ing-275i - Contractor Rusin es5 me License or Registration No _ Authorized Representatwo Sigrratufe Date LOCAL COPY DO= 3/3/94 HZia Name of Person Sealing VYall or $ont>gr =, A J i Y OF FRIDLEY INSPECTION DIViSION - 6431 University Ave NE Fridley, MN 55432 APPLICATION FOR POWER PLANTS"AND HEATING, COOLING, VENTILATION, (763) 572-3604 REFRIGERATION AND AIR CONDITIONING SYSTEMS AND DEVICES Effective On January 1, 2002 JOB ADDRESS "-109 1- RATES0' ED{ULE OWNERS u Residential Rate TOTAL Furnace Shell and bunt Work, Burner - Also Replacement Furnace $ 30.00 (Side Vent Fif dut Back) Gas Piping (Neededwith ;new furnace, $ 10.00 but not;replacement) Gas Range $ i0.00 Gas Dryer $ 10.00 *Air Conditioning - All Sizes $ 25.00 All Others/Repairs—t't Alterations (LIST ON BACK) 1% of Value of Appli6nce or Work Commercial/ Iridust>i? al' 1.25% of Value of Appliance or Work State Surcharge TOTAL FEE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50=STATE SURCHARGE REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without written permission from adjoining property owner. a BUILDING USED ASd—�� r ESTIMATED COST PERMIT NO. DESCRIPTION OF FURNACjAND 911 BURNER No. of Heating Units_ Circle One (Steam) (Hot Water) arm Ai Trade Name 7 ® Size No. 77 n(\C o BTU HP EDR Fuel Total Connected Load Burner Trade Name Size No. BU HP EDR T;he undersigned hereby makes application for a ipermit for the work herein specified agreeing to do all work in strict accordance with the City Codes an rulings of the Building Division, and hereby declares that all, the facts and representations stated in this application are true and correct. DATE HEATING CO � r; � :.� � �\ u. s .�,, = Approved By/-_ Rough -In Date Final `Date THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED When re la _ing an exkfing furaney, 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 N No( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. 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. The existing cnmeu_stinn air is sized and installed to meet the current codes and manufacturer's specifications. When required to install a new nnmhustinn air it will be sized and installed to meet the current codes and manufacturer's specifications. Yes ( ) No ( ) Yes( ) No( ) Yes No( ) Yes( ) No( ) When installing a new v antic gyystam, the undersigned hereby verifies that itis 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 O 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 #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 Lengthft Diameter in Type HEATING CO: /! - Date: f2L�t: � I p i 9.11 S 25H f0 Tj J9L Z'LZA 1�®ice m0�C O OD C ro M ' F' 1. O n� 0 r QJ a s gf>L;t7® N T ay €€ I Mill � LU �3r C SO � V? Y�h Ooocoa ® oocaoc® " � - tW KL „�� o� 000ao® o :a•- gg gR g � � � o 00000 o®aoao 000007 ®ao93 aaots�® oo®c _o a o0 P � ~ ora ♦p �9€ �p g ��p d®CQiO CO ^F Q'000 aDB®t oa9OOOtS 16 gt gg yy !t 1 1 1Hgg ®`^ s gg L ®®GOOD ti teCOO�� qg rg }}ii yi'p[_ a 3 �OG OOC O b rt:N a .n mill � V`-. 000 TOO O0O NCsaNO �O ad o h�rC®® �CCDt F C w RER t0 CD UJ '® r�oao crts�ae o D � F aO Nrsoc dna- q _ N®O OCOOG9 C ppq� C 'a tom$ pe 3: S 's g.g9 =� C F �P to -6-6c; L i $ i $ mo»�®-� �ti�rsma moo ct:®ea ms+om®o vi�o�®o woa ocSc. 006 vLtp �GOOC At?9 my �.J �A � r7CM�Ota C�OOe?6O P:O6 t ao Ofl V iiz U50— 69.9 p i 9.11 S 25H f0 Tj J9L Z'LZA 1�®ice m0�C O OD C ro M ' F' 1. O 0 ' i r- n� 0 r QJ a s gf>L;t7® N T ay y � LU �3r C {��—n►rr� � V? Y�h Ooocoa ® oocaoc® " � - tW 000ao® o :a•- gg gR g � � yam' o aoocao _o 0 omO�g � P � ON9O¢Do�O ora ♦p �9€ �p g ��p GA oa9OOOtS 16 Off ® RI ®`^ s gg L ®®GOOD ti teCOO�� qg rg }}ii yi'p[_ a 3 �OG OOC O b rt:N a 0 ' i r- Vi 0 r QJ a s gf>L;t7® N T p�q�{ ao v � ® �3r C {��—n►rr� � V? Y�h � 4 JJd8C�4 � - tW 0 ' i r- a 1 SUBJECT City of Fridley 2 719 6 AT THE TOP OF THE TWINS BUILDING PERMIT t R i __ _ COMMUNITY DEVELOPMENT DIV. r � PROTECTIVE INSPECTION SEC. 1 � � NUMBER REV DATE PAGE OF APPROVED BY CITY HALL FRIDLEY 55432 612-571-3450 910-F15 81498 JOB ADDRESS 4709 NE 2 1/2 St 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 18, 19 7 1 Plymouth SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Linda Skoog 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Viking Home Improvement Co 4832 2 1/2 St NE Minneapolis MN 55421 572-1820 4772 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO, 8 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION ❑ ALTERATION Rl REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE 'PoRK [louse Reroof UNWt and garage (14 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with State Building Code. 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 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 $1167 AWyIM $.58 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 - ION OR THEPE F ANCE OF CO STRUCTION. $40.25 Fire C $1.16 MW ff. = 144C z'® ' LAN CHECK FEE Lice C 5.0 TOTAL E $4 .99 SIG ATURE CON' CTOR ORAUTHORIZED AGENT (DATEI EN RO ALIDAT IS V UR PEFjdp T - BLDt IP SP 4ATE SIGNATURE OF OWNER pF OWNER BUILDER) IDATEI a 1 NEW [ ] ADDN [ ] CITY OF FRIDLEY ALTER [) SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION ConstructionAddress: Z-470 Legal Description: Effective 1/1/98 9� Owner Name & Address: Z -1 -41M S leo 0 cl--- Tel. # Contractor: �(� 1 � rj yl �r p u U C i} MN LICENSE # �/ 7 7 Address: LW 3 2 ®Z Ste— Z%%JAz/ JOWL( Tel. # 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: Construction T e� 7 glUd1UU-��"� \ YP Driveway Curb Cut Width Needed: Ft. + 6 Ft = _ ►tima ed Cost: $ (Fee Schedule on Back) Ft x $ _ $ DATE: -°�APPLICANT: Tel. # �_( 7Z �� r Permit Fee $ Fire Surcharge $ %- State Surcharge $ SAC Charge $ License Surcharge $ 00 Driveway Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ TOTAL STIPULATIONS: CITY USE ONLY Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1000 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 [ J