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PRE 2010 DOCSVillage of Fridley, Minn. BUILDING PEBMIT 0 N . 7 74 Office of INSPECTOR OF BUMDINGS Owners Archite / Builder Fridley, Minn. LOCATION F BUILDING No.rk street f '^* x u Part of Lot Lot Block Addition or sub -Division DESCRIPTION OF BUILDING Front_+ Depth ..'- °-Height-2 stories' ' saner of Construction To be used as "" To be completed Estimated Coat p" Permit is hereby granted to_,,. the building ' t. -" described in the above statement. This permit is granted upon the express condition that the person to whom it is granted, and his agents, employees and workmen, in all the work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordi- nances of Fridley, Minn., regarding the 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. Inspector of Buildings. AGREEMENT AND SWORN STATEMENT In consideration of the issue and delivery to me by the Inspector of Buildings of Fridley of the above permit,'' I hereby agree to do the proposed work in accordance with the description above set forth and according to the provisions of the ordinances of Fridley, and, being first duly sworn, I hereby state and say that the facts stated by me and contained in the above permit are true as therein stated. Subscribed and sworn to before me at Fridley, day of ( �I 4&t, wa.s A .D. 19 0 Minnesota,,thi�a r ? • Date; ! `. ,✓ "�. j�ri► r Omer Bufder ... 'rw`"r► .... ... ... Address .. 'sr . r�. Address ......... . '� O TIQN OF 'BUILDING X0..... . st reet ..... .................... ... .. Part of Lot . Lot B k ..... Addition or Sub Division ..... .......................... Corner . Lot Inside Lot Setback ` . Sideyard ..'� ..".... .. .. . DESCRIPTION OF BUILDING To be Used 'j Front Depth 0. .Y . freight° _ Sq. Ft. ....... Cu. Ft.. .... dj# Front Depth . , . Leight Sq. Ft. Ca. Ft. ........ Twpe or Construction I!: d,i + r ..; ..... Est. Cost .... . .. ...... To be Completed ... . w i X ' '" ,► 00 ope pi 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 above- set forth and in compliance' with all provisions of ordinances of the. villag of Fridley.' ...� .. ...LI ...... h' . In consideration of e, payment of a fee of $., 1 ..:. l,- permit is hereby gtanted to ,.to construct the b or addition as desmi , ', c .............:....... . wilding bed above. �'iTh4a permit is granted upon. the express condition t the person to whom it is granted and his agents, employees and workmen, in all work done in, 'around and u said. building, or aril► part thereof,, shall conform in all respects to the .ordinances of Fridley; Minnesota re9f g itxsrtiota, construction,_ alteratioir, maintenance, repair and movig of buildings with -- construction, the village limits ant this permit may be'revoked at any time upon violation of any of the provisions of said ordinances. ..- Building inspector { NOTICE: This permit does not coverthe construction, Installation or alteration for wirlrl'g, plumbing, gas heating, t sewer or water. Be lure to Building Inspector tor, separate permits f ase ,items. j. SUBJECT PERMIT NNe -._ City of Fridley 0 19326 AT THE TOP OF THE TWINS BUILDING PERMIT • COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. ry�/ 1 r / }} CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY L , ` 612-571-3450 910-F15 2/19/88 JOB ADDRESS 5860 - 3rd Street N.E. 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 1 22 Hyde Park SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Roger Vanous 5860 - 3rd Street N.E. 571-5365 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Anerican Remodeling 3700 Annapolis Lane, Mpls. 553-0020 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 Q. REPAIR ❑ MOVE ❑ REMOVE 6 DESCRIBE WORK Reside. Dwelling 9 CHANGE OF USE FROM TO STIPULATIONS 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 1 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 SURTAX AND GOVERNING THIS TYPE OF WORK WILL BE COMPLIED ,ORDINANCES WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $4,900 $2.45 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE ROVISIO ANY OTHERS TE OR LOCA AW REGULATING CON- S R C N O THE P RFO A CE OF UCTION. $50.50 PLAN CHECK FEE TOTAL FEE $52.95 IG TURE OF ONTRACTO AUTHORIZED AGENT (DATEI WHEN PROPERLY VA TE THIS IIS YOUR PE MIT BLDG INSP aTE �� SVGNATURE OF OWNER OF OWNER BUILDERI IDATEI NEW [ ] City of Fridley Effective 4/1/86 ADDN. t R-1 AND R-2 ALTER. [ ] Building Permit Application Constructii Legal Desc, Owner Name Contractor IJ Address: 3 701 AviL/�ed Ze& Gig• 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 [ Type of Construction: ] Ft. Yd. Setback Estimated Side Yard Cost: $ Setback Approx. Completion Date: Alt. A Alt B Proposed Driveway Width If New Opening Is Desired: $ $ See Back Page for Explanation DATE: Permit Fee Plan Check State Surcharge SAC Charge Park Fee Sewer Main Charge TOTAL STIPULATIONS: APPLICANT: Tel. 0 C.'47 .1 CITY USE ONLY Fee Schedule on Reverse Side 25% of Building Permit Fee $.50/$1,000 Valuation $ 525 per SAC Unit Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] G SUBJECT City of Fridley ? 4 1 89 :] AT THE TOP OF THE TWINS BUILDING PERMIT RECEIPT NO. Ir? �4 COMMUNITY DEVELOPMENT DIV �� ------ r i � PROTECTIVE INSPECTION SEC CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED By 612-571-3450 910-F15 5/17/96 JOB ADDRESS 5860 3 Street NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 1 22 1 Hyde Park SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Roger Vanous 5860 3 Street NE 571-5365 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Midwest Restoration 1628 Hwy 10 NE M ls. MN 55432 784-2772 5267 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 x❑ B DESCRIBE WORK Re lace soffit fascia 9 CHANGEOFUSEFROM TO STIPULATIONS Ventilation to meet the 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 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 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 $692 $.50 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACCHARGE PROVISIONS OF ANY OTHER STA E OR LOCAL LAW REGULATING CON- $ $.69 STRUCTION OR HE AN STRUCTION PLAN CHECK FEE TOTALFEE _ p License SC $5.00 $32.69 SIGNATURE OF CONIR OR OR AUTHORIZED AGENT ATE) WHEN PROPEPA VALIDATED THIS IS YOUR PERMIT 8 )NSP r BATE SIGNATURE OF OWNER OF OWNER BUILDER) )DATE) NEW [ ] Effective 3/1/96 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 Building Permit Application ConstructionAddress:t> Legal Description: Owner Name & Address: v ��lp�� Tel. #%/ Contractor: ` ip��s•�' �� /rte—�� MN LICENSE # 5 ; 7 Address: / D Tel.00, 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: Le4gth Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER:'';8�.F� .4eLa=mfg-' Comer Lot [ ] Inside Lot [ ] Type of Construction: Approx. Completion Date: Ft. Yd Setback Side Yard Setbacks Estimated Cost: $ (Cost on Back) dD Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x DATE: 7 9 APPLICANT - Tel. CITY USE ONLY Permit Fee Fee Schedule on Reverse Side Fire Surcharge $ , State Surcharge $ • 150 SAC Charge $ _ License Surcharge $ '57 C Driveway Escrow $ Erosion Control $ Park Fee $ Sewer Main Charge $ TOTAL $� STIPULATIONS: .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $900 per SAC Unit $5.00 (State Licensed Residential Contractors) Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary [ ] 01 SUBJECT City of Fridley =2� AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIPT NO. COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. I NUMBER REV DATEPAGE OF APPROVED By = 1 '0 ... I CITY HALL FRIDLEY 35432 ,'' 612-571-3450 910415 4 /15/99 10B ADDRESS 5860 3 STREET NE 1 LEGALLOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 1 22 HYDE PARK SHEET 2 PROPERTY OWNER MAIL ADORES$ ZIP PHONE Roger Vanous 5860 3 Street NE 571-5365 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Midwest Restoration 6319 Hwy 65 NE, Fridley, MN 55432 502-1082 5267 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 j] REPAIR O MOVE ❑ REMOVE B DESCRIBE WORK Reroof House & Garage (12 Sq) Tear -off 9 CHANGE OF USE FROM TO STIPULATIONS Underlayment must comply with the State Building Code. 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 REOUIRED 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 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 1 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 13E COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1,028 $ •51 DOES NOT PRESUME TO GIVE AUTHORIT TO VIOLATE OR CANCEL THE PERMIT FEE SAC CHARGE PROVISIONS OF ANY OTHER STATE OR OCAL LAW REGULATING CON- $37.50 Fir"C $1.03 STRUCTION OR TH RFO UCTION PLAN CHECK FEE TOT FE L e C $5. $4 .04 SIGNATURE OF CONTRACTOR AUTHORIZED AGENT IDATEI ENR A DAT 5 IS Y PE IT .� 0 SIGNATURE OF OW NER ,If OWNER BUIIDER� IDATEI 9l INSP BATE 01 NEW [ ] Effective 1/ 1/99 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION 0A L ConstructionAddress Legal Description: Owner Name & Address: Contractor: Address: Tel. # ,.��%� ,�3G•/r' MN LICENSE # S-0 G Tel. # 1—� Attach to this application, a Certi icate 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: / C�timated Cost: Construction Type: . hdleonPack) Driveway Curb Cut Widt?- XT--A-A. DATE: (Fee Sc e u (, Ft = Ft x $ = $ CITY USE ONLY Tel. Permit Fee $ C> Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/ 10th%) State Surcharge $ m 2_L $.501$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $ '� r t�l� $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 $ � 9 I C4 STIPULATIONS: e6 6,600+ 2" ft o`N CT-T� WRI-F-6Z WELL OR BORING LOCATION MINNESOTA DEPARTMENT OF HEALTH Minnesotai o Well and Bor)ng WELL AND BORING SEALING RECORD Minnesota Unique Well No. H 1a C G 4 e A 2 7 5 County Name Alwka Minnesota Statutes, Chapter 1031 or W -series No. t a mu a na awn) Township Name Township No. Range No Section No. Fraction (sm. i Ig.) Date Sealed Date Well or Boring ConstructeedT U 30 24 123 I �i 2 ^ ld ®" Numerical treat Adtlress or Fire Number and City of Well or Boring Location � SF- Cr of e Depth Before Sealing 25h. Original Depth 25 ft. Show exact location of well or boring Sketch map of well or boring AGUIFER(S) STATIC WATER LEVEL in section grid with 'X'.location, showing property Nlines, roads, and buildings. N \ \�(�L...(�� ` Single Aquifer ❑ Mult aquifer *easured ❑ Estimated ft. [I below C3 above land surface WELUBORING i),4ater Supply Well [:1Monit. Well E] Env. Bare Hole C3 Other W - T- -T- -i- E�. k�^ CASING TYPE(S) a -i-- -i-- --i-- Aniffe -- - -i-- - I-- --� %SAL t mle �t, �` r Ixfeel ElPlastic ❑ Tile ❑ Other CASING(S) Diameter Depth YSet in oversize hole? Annular space initially grouted? 2 in. from 0 .to 22 ft. ❑ Yes 060 ❑ Yes o ❑ Unknown 7❑` in. from - to ft. [:1Yes ❑ No ❑ Yes No ❑ Unknown PROPERTY OWNER'S NAME ritv ti in. from to ft. ❑ Yes ❑ No ❑ Yes ❑ No ❑ Unknown ProperFjowner's mailing address it different than welllocationaddress indicated above. vmw NE 6431 vn1�N,f•�T SCREEWOPEN HOLE cAt F111�1e�1, NI 55432 �f Screen from 22 to `5 ft. Open Hole from to ft. OBSTRUCTIONS ❑ Rods/Drop Pipe ❑ Check Valve(s) ❑ Debris ❑ Fill XNo Obstruction Type of Obstructions (Describe) WELL OWNER'S NAME Santa Well owners malting address if different than property owner's address indicated above. Obstructions removed? ❑ Yes ❑ No Describe PUMP Type ❑ Removed E)Aot Present ❑ Other GEOLOGICAL MATERIAL COLOR HARDNESS OF FROM TO FORMATION if not known, Indicate estimated formation log from nearby well or boring. METHOD USED TO SEAL ANNULAR SPACE BETWEEN 2 CASINOS, OR CASINO AND BORE HOLE: l�o Annular Space Exists ❑ Annular space grouted with trance pipe 9 & � Gra Gravel 1 22 Jmdan Yellow 216 — ❑ Casing Perforation/Removal In. from to ft. ❑ Perforated ❑ Removed in. from to ft. ❑ Perforated ❑ Removed Type of perforator ❑ Other GROUTING MATERIAL(S) (One bag of cement = 941bs., one bag of bentonite = 60 gam) 1 Grouting Matarial Neat from - 0 to 25 ft yards �2 bags from to ft. yards bags from to ft. yards bags from to ft. yards bags REMARKS, SOURCE OF DATA, DIFFICULTIES IN SEALING OTHER WELLS AND BORINGS `^ No How many? ��� A ko t` CLX Other unseated and unused well or boring on property? ❑ Yes C]l..'I LICENSED OR REGISTERED CONTRACTOR CERTIFICATION Remarks: VGVl From 6431 L AVC. MThis well or boring was sealed In accordance with Minnesota Rules, Chapter 4726. The information contained in this report is true to the best of my knowledge. Water Level in Abm Well: 70 f. Date Wader Lound Taken: 12/17/69 Code:Map SALE D EJL Renner & Sass, Inc. 71015 Contactor Business Name Uoartse or RegtbaWn No. 07I0M Authorized Represents Signature Date TMy S1iqLwXeVn Saheitei%ui According to Mfg State Regulations IM PLR ANT -FI WNTH PR PYERTY H �+ 2 7 Name of Person Sealing Well or Boring CITY OF FRIDLEY INSPECTION D1ViSION 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 RATE SCHEDULE Residential Furnace Shell and Duct Work, Burner - Also Replacement Furnace (Side Vent - Fill Out Back) Gas Piping (Needed with new furnace, but not replacement) Gas Range Gas Dryer *Air Conditioning - All Sizes All Others/Repairs & Alterations (LIST ON BACK) 1%, of Value of Appliance or Work Commercial/ industrial 1.25% of Value of Appliance or Work Effective On January 1, 2001 .SOB ADDRESS S&�e c)i rl OWNER Rate TOTAL $ 30.00 BUILDING USED AS $� ESTIMATED COST PERMIT NO. 15 W $ 10.00 $ DESCRIPTION OF FURNACE AND OR BURNER $ 10.00 $ No. of Heating Units _ Circle One (Steam) (Hot Water)m Air) $ 10.00 $ Trade Name 1.--emY1zE? COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furance, 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 (--f 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 verities 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 existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes (,--rNo ( ) When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes (41"No { ) When installing a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturers 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 (-f No( ) Appliance Type and Size/Common Vent and Vent Connector Information Appliance #1 Type I A A BTU lnput I=an Assisted or Nat Appliance #2 Type BTU Input an 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 C( Signed By: