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PRE 2010 DOCSCity of Fridley, Minn.. BUILDING PERMIT io Date: ...__....__'"':.._.__ """ __ __._..._......._...._.. Owner: .: - - :_ .:.�.... ........ ...... Builder e"° r Address ....._......._...._..___.____ __ 1? ._ ___ ^ �_ :.._.._ddress ,BLOC • ION OF BUILDING No......... Street _....._..... P #Lot - ___ _ _ .._.._......... ------ ........._.... f - - Lot ........ Block ........_......._........ Addition or Sub -Division ... .. .- -- ` ,- --•• ...... Corner Lot ... Inside Lot ..................._................. Setback ........... Side yard yard....._-•---,t.'.....___......................._............._.-•---...-- SewerElevation....._......................_...._....---•----..........................._....................... Foundation Elevation ........ _.......... .............. _... _........ _............................ _............. ... DESCRIPTION OF BUILDING To be Used as: � r� --... ' ::...... S Ft. --- !... .:._ Front ...:. ... Q Depth .,1 -_-�, Hei ht Cu. Ft , .. A g q• / . ............. .... Fron --- -..4 Depth !' Hei ht �.._.. Sq. � Cu. Ft......�" --...4�� Type Construction :..::.. Est. . To be Completed ........------......... .................. . _ ZE \j', 0 L AT gHI r'Eis _ CJD 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 all provisions of ordinances of the city of Fridley. In consideration of the payment of a fee off.::...:"�..::......, permit is hereby'granted to. .......... _.... ...................... __.__...__........__......__.___..._.___... to construct the building or addition as described above. This permit is granted upon the express condition that the person to whom it is granted and his agents, employees and workmen, in all work done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings within the city limits and this permit may be revoked at any time upon viola ' of any of the provisions of said ordinances. Building Inspector NOTICE: This permit does not cover, the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to see the Building Inspector for separate permits for these items. 4 APPLICATION FOR BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA Address1� -N, �A-��1. Addresses LOCATION OF BUILDING 1 e No. / -,,k b' Street/t-!�� Part of Lot Lot ., Block ,E_ Addition or Sub.Div. Q=Zb4 SAA e L Corner Lot, ✓Inside Lot_Set Back Side -Yard '' SEWER ELEVATION FOUNDATION ELEVATION Applicant attach to this form Certificate of Survey of Lot and proposed building location. To be used as: DESCRIPTION OF BUILDING f I epth ��'.,._ �i4Height Ft. L Front Depth Height Sq. Ft. Cu. Ft.,�� Type of Construction.?�, Estimated Cost ),ge To be 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 representa- tions stated in this application are true an rrect./--�� DATE (A Schedule of Fee costs can be found on the Reverse Side.) BUILDING PERMIT FEE SCHEDULE Section 2. The Inspector of Buildings shall, before issuing any permit for the erection of any building or structure, or for any addition to any existing building or structure, or for any alterations or repairs to any existing building or structure, upon application therefor, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to -wit: 2.1. For any such permit for the erection of any fire -proof building, other than a garage, warehouse, factory or grain elevator, or for the erection of any fireproof addition, for similar occupancy, to any existing building shall be at the rate of $1.40 for each one thousand cubic feet, or fraction thereof, in such cubical contents. 2.2. For any such permit for the erection of any fireproof garage, ware, house, factory or grain elevators or for the erection of any fireproof addition, for -similar occupancy, to any existing building shall be at the rate of $1.25 for each one thousand cubic feet, classified as "fireproof" by Section 502 of the Minneapolis Building Code. HOUSES 2.3. For any such permit for the erection of any non -fireproof building other thana garage, warehouse, factory or grain elevator, or any non - fireproof addition, for similar occupancy, to any existing building, Permit $1.00 for each one thousand cubic feet, GARAGES 2.4. For any such permit for the erection of any non -fireproof garage, warehouse, factory or grain elevator, or for the erection of any non - fireproof addition, for similar occupancy, to any existing building #x' for each such building or addition. Ninety Cents for each one thousind cubic feet or fraction thereof, in the cubical contents thereof with a minimum of $4.00. For the purpose of computing fees for building permits the cubical contents of any building or addition to a uniform height throughout by multiplying the ground area covered from a point six.(6) inches below the floor line of the basement or cellar to the average height of the upper surface or to the average height of the roof surface of the main gable of a pitched roof. 2.5. For repairs or alterations to an existing structure, the fee shall be at the rate of $3.00 for each Five Hundred Dollah ($500.00), or fraction thereof in the cost of all proposed work. 2.6. In no case shall the fee charged for any permit as set forth in Section 2 be less than $4.00. r b / Application for Power Plants and Heating. Cooling. Ventilation. Refrigeration and Air Conditioning Systems and Devices PARTIAL RATE SCHEDULE IL 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 AER Furnace Shell & Duct Work to 120,000 BTU ............ 8.00 $ each add. 80,000 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 hour ........................ 5.00 $ over 3 gal. per hour—See Fee Schedule GAS BURNER (up to 400,000 BTU) 5.00 $ GAS FITTING FEES: NO RATE T70 11'L 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 yENTILATING SYSTEM $ ALTERATIONS & REPAIRS TOTAL FEE $ s REMARKS: Dept. of Bldgs. Phone SII s 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. ey, 1V�9nn MAY 31 196 y 195- Owner 195— Kind of Building Used as To be completed about oU _ Estimated Cost, $ Permit No. &V 6 DESCRIPTION OF WORN HEATING er1RJD77Warm Air—No Trade Name Size No Capacity. Sq. Ft. E.D.R � BTU H.P. Total Connected Load Kind of Fue BURNER — Trade Name Size Capacity Sq. Ft. E.D.BTU H.P. 11 195— 11 POST IM -12-58 HEAT LOSS CALCULATIONS DEPARTMENT OF BUILDINGS ,� MINNEAPOLIS. MINN. Weatherstrips A.S.H.V.E, Construction No. Insulation Guide Windows Doors Reference Out. Wall Int. Wall Ceiling Roo# Floor Kind How Applied Yes—No I Yes—No 19— FI -0 I Room engt � � iI L h Width - Height ' ht II I F1.1 Room I Lenath 9 Width -.7Height , Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area ri.1 1 width Windows and Doors—Crackage and Area Windows and Doors—Crackage and Area 73- 2<D Width Height No. of Lineal f . Area No. of pane oflights of crack sq. ft. pane 3 B oQ+ 33 J) Ze 41 33 Btu Infiltration 1 Coef. Coef Btu Infiltration Btu 2 ID LI) Glass 33 �j'® /6 r' Exp. wall Rl XS 33 �® 16 S' 2 Net exp. wall Net -exp. wall z Int. wall Int. wall Net exp. wall Ceiling Ceiling 1214 Int. wall '4in ? 0 Floor Floor 63 0 Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area ri.1 2, tcoom I Length jA, width 1 nelgnt Windows and Doors—Crackage and Area 73- 2<D D 'Zo Width Height No. of Lineal ft. Area No. of pane of pane lights of crack eq. ft. J) Ze 41 33 Btu Infiltration 1 Coef. Btu 1 Coef. Btu Infiltration ID LI) Exp. wall 9 Glass 0 Glass Net exp. wall 33 �® 16 S' 2 Exp. wall Net -exp. wall z Int. wall Ceiling Net exp. wall Ceiling Floor 1 14"a 1214 Int. wall '4in ? 0 Floor 63 Ceiling Floor Ceiling /6 ,Z Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area P F1.1 2 Room I Length 1A Width Q 14eiaht Windows and Doors--Crackage and Area Width Height No. of No. of pa a 0 paxle lights Width Height No. of Lineal ft. Area No. ofrp�ane of pane lights of crack sq. ft. Fi aCd 6eA dy lLd ITA 73- 2<D D 'Zo Coefj Btu Infiltration 1 Coef. Btu 1 Glass Z2, o ID LI) Exp. wall 9 Glass 0 Exp. wall Net exp. wall Exp. wall gt 13xo a Int. wall Net -exp. wall Xe Int. wall Ceiling Int. wall Ceiling Floor 1 14"a 1214 ` '4in ? 0 Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Windows and Doors—Crackage and Area Width Height No. of No. of pa a 0 paxle lights No. Width. Height No. of Lineal ft. Area of pane of pane lights of crack eq, ft. ITA 73- 2<D D 'Zo Iff 1 Coef. Btu Coef. Btu Infiltration 2,,o--7j Glass 'v,, on Glass 0 Exp. wall o o Exp. wall gt 13xo O 36 Net -exp. wall Xe Int. wall Int. wall Ceiling Net exp. wall;z-1 Ceiling Floor 'i?z X",/ Floor 63 4 6 Total Btu. ZZ, Required sq. #t. E.D.R. or sq. ins. W.A. Leader area t F1.11 -Ad Ad o Room I Length 2,9r" Width / Height Windows and Doors—Crackage and Area Width Height No. of No. of pa a 0 paxle lights Width Height No. of Lineal ft. Area No. of pan of pane lights of crack sq. ft. ITA 23 D 'Zo Iff 1 Coef. Btu Infiltration d Glass 1, x6ZO Glass Exp. wall •� 13xo O 36 Exp. wall 4--o Xe Int. wall Ceiling Net exp. wall;z-1 Floor 'i?z X",/ 16 Int. wall Ceiling Floor14 Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area Room l Length Z Width' , - ,"Height, - Windows and Doo`rs—Crackage and Area Width Height No. of No. of pa a 0 paxle lights Lineal ft. Area of crack Q. ft. ?s 1,0 D 'Zo Coef, Btu Infiltration d Glass Exp. wall •� Net exp. wall 2 Int. wall Ceiling Floor 'i?z X",/ 16 Total Btu. Required sq. ft. E.D.R. or sq. ins. W.A. Leader area City of Fridiey Application for Plumbing and Gas Fitting Pent DepL of Bldgs. Phone SII 4-7470 DESCRIPTION OF WORK Number, Kind and Location of Fixtures yy 47 c � _ �j 7�- Z • • WATER HTR. $CJ �F� ? 3� C� O� a 63 �< 0 F N GAS ELEC. M . t) f Base 1st I } 6 2nd _ 3rd 4th Future Connection Openings witMl- Sewer � New Fixture, Old Openings Cesspool PARTIAL RATE SCHEDULE PLUMBING FIXTURE RATES: NO. RATE TOTAL ell Number Fixtures i -s ...................... x $1.50 $1�.'® Future Fixture Opening ................ New Fixture Old Opening .............. Catch Basin ........................... Water Heater (Up to 200,000 BTU) ..... . New Ground Run Old Bldg . ............ _ x 1.20 $ — x 1.00 $ x 3.25 $ x 2.00 $ a x 3.25 $ GAS FITTING FEES: NO. RATE ,TOTALc 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 $ — /, "- - -, \ d 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. ` 19 6146 Owner Kind of Building Used as TU t To be completed about 0 Estimated Cost, $ /�2 ' Old—New. Building Permit No �` � Permit No... Signe Asr ,a , By 9 Business Phone No.-- tr 4– .7 7 4,2 JUN 9 19�J ROUGH FINAL d z 2M 7-59 Original• • PERMIT for Power tants and Heating. Cool- ing, Ventilation. Refrigeration and Air Conditioning Systems and Devices DESCRIPTION OF WORK No. of j ting Plants to be 'nstalle ® tered---repaired Make Oil fired—, Coal fired—,- Gas fired ; Gas Authorization Remarks Approved Final Inspection 19_ Inspector Permit __ X616, Fee$ N® _ 4455 Office of the Inspector of Buildings City of Fridley City of Fridley, Minn. 7 , 19_ Owner Location s–LAIS�" Kind of Building_ How Occupied Work to be Commenced !�& ®7 ,19_4__J� To be Completed V`' 5e ,19 k_ Estimated Cost, $ % 5-10 Old -New, Building Permit Permission is hereby granted to Y-' W . to install—erect—use the material and devices described in the above statement. This permit is granted upon thg express condition that the person to whom it is granted, and his agents, employees and workmen, in all the work done and materials used under this permit, and in the operation of the devices herein mentioned shall conform in all respects to the ordinances of the City of Fridley relating to or governing the work to be done and the operation of the devices herein named, and to the specifications set forth in the approved application for this permit on file in the office of the Inspector of Buildings. �J &, Inspector of Buildings 42 2M 11.67 V el f/ IV 01 SUBJECT PER City of Fridley 13460 AT THE TOP OF THE TWINS PERMI. . BUILDING R � so • ______ COMMUNITY DEVELOPMENT DIV. •y r , PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER REV- GATE PAGE OF APPROVED BY L•""A'� 612-560-3450 910-F15 4/16/76 JOB ADDRESS 1425 Trollhagen Drive N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 1 Innsbruck Second Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE David Rogosheske 1425 Trollhagen Drive N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Same 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO. 5 ENGINEER MAILADDRESS ZIP PHONE LICENSE NO. 6 USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW ❑ ADDITION 0 ALTERATION 0 REPAIR ❑ MOVE ❑ REMOVE 6 DESCRIBE WORK Reroof 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. D101 AS halt 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 1 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. $1 f 500 .75 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 PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $9.00 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $9.75 SIG NAT URE OFCONTR OR OR AUTHORIZED AO NT (DATE) WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT ��''� 1 T E_OF OWN (BUILDE NER R) IDATEI .BLDG. INSP ``�� `^"' `"��T DATE el f/ IV 01 APPLICATION FOR RESIDENTIAL, ALTERATION, OR ADDITION BUILDING PERMIT CITY OF FRIDLEY, MINNESOTA OWNER'S NAME: ! / BUILDER: ADDRESS: /Z_2�_ L\J,£ ADDRESS : NO:. 15!�?d5� STREET: LOT: g BLOCK: % f 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: 6 ,, e- Front: Depth: Height: Square Feet: Cubic Feet: Front: Depth: Height: Square Feet; Cubic Feet: e of Construction: / ,S`C� .�s.,sl �" Estimated Cost: $ ^ -� Typ" To Be Completed: —% min b� The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in stict 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: %�r / �� S IGNATURE irlt4 r (See Reverse Side For Additional Informa oVq .) 1�7 00 ,pry r �S_ O ; BUILDING PERMIT FEE SCHEDULE SECTION 2. The Inspector of'Buildings shall, before issuing permits for the erection of any building or structure,.or for any addition to any existing building or structure,' or for any alteration or repairs to any existing building or structure, upon application therefore, require the payment by the Applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to -wit: UNIFORM BUILDING CODE: Type 1, 2 & 4 - $2.15 for each one thousand cubic feet, or fraction thereof, in such cubical contents. Type 3 & 5 - $1.85 for each one thousand cubic feet. ADDITIONAL INFORMATION For the purpose of computing fees for building permits, the cubical contents of any building or addition, is determined by multiplying the ground area covered from a point six (6) inches below the floor line of the basement or the cellar to the average heights of the upper surface or to the averageR height of the roof surface of the main gable of a pitched roof. For repairs or alterations to an existing structure, the fee shall.be at the rate of $3.00 per each five hundred dollars ($500.00) or fraction thereof in the cost of all proposed work. In no case shall the fee charged for any permit as set forth -in Section 2 be less than $5.00. VERIFICATION OF FOUNDATION NOTE: Permits for construction will be issued a minimum of 24 hours from the time of application, to allow for proper review of the proposed structure and of the construction site. A Certified Survey of the lot, showing the location of the foundation, once it has been constructed, will be required before proceeding with the framing. CERTIFICATE OF OCCUPANCY Application for a Certificate of Occupancy shall be made ten (10) days prior to the use or.occupancy of any structure for which a building permit has been issued; and said structure shall not be used or occupied until a Certificate of Occupancy has been issued. a CITY OF FRIDLEY APPLICATION FOR RESIDENTIAL BUILDING PERMITS (NEW, ALTERATIONS, ADDITIONS, OR REPAIRS) OWNER: - PUILDER: l_.rT�1s �a Address : �� "'1Z/ Address : // C%a Tel. No. No.:Street: ®�E LOT: I� BLOCK: /___ CORNER LOT: )_ INSIDE LOT: SETBACK: SIDEYARDS: Applicant attach to this form Two Certificates of Survey of Lot and proposed building location drawn on these Certificates. 7-(Xt,14 V,a01,9DESCRIPTION OF BUILDING To Be Used As: ,61 � ,0� Front: Depth: Height: ✓-_2 a Square Feet: T 'Y"Cubic Feet: C) c� Front: PG' d Depth: Height: Square Feet: Cubic Feet: 2 - Type of Construction: (gyp0j YAVAe- Estimated Cost: $ 'ell el, '� To Be Completed: _ ; Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired $ $ (SEE REVERSE SIDE OF SHEET) The undersigned hereby makes application for a permit for the work herein specified, agreeing to do all work in strict accordance with the City of Fridley Ordinances and rulings of the Department of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. See reverse side for additiQonal information. DATE: 3-7 -7i SIGNATURE: ' fes✓,if Stipulations: O 7 2-0 BUILDING PERMIT FEE SCHEDULE SECTION 2. The Inspector of Buildings shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repairs to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to -wit: NEW CONSTRUCTIO14: Single Family Homes and Garages: $4.00/1,000 cubic feet.. PLAN CHECK: 25 percent of building permit fee. DRIVEWAY DEPRESSION: (Concrete Curb Streets Only) Alternate A: Removal and replacement of concrete curb and gutter only; Driveway width plus 6 feet x 41-V6_0 Alternate B: Removal and replacement of concrete curb and gutter and install a 3 foot wide approach with 6 inch depth; Driveway width plus 6 feet x 1'7.20 1 For the purpose of computing fees for building permits, the cubical contents of any building or addition, is determined by multiplying the ground area covered from a point six (6) inches below the floor line of the basement or the cellar to the average heights of the upper surface or to the average height of the roof surface of the main gable of a pitched roof. For repairs or alterations to an existing structure, the fee shall be at the rate of $3.00 per each five hundred dollars ($500.00) or fraction thereof in the cost of all proposed work. In no case shall the fee charged for any permit as set forth in Section 2 be less than $1.50 plus $.50 state surcharge. VERIFICATION OF FOUNDATION NOTE: Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has been constructed will be required before proceeding with the framing. CERTIFICATE OF OCCUPANCY Application for a Certificate of Occupancy shall be made ten (10) days prior to the use or occupancy of any structure for which a buildJng permit has been issued; and said structure shall not be used or occupied until a Certificate of Occupancy has been issued. ENERGY CONSERVATION SUPPLEMENT TO BUILDING PERMIT APPLICATION PLANNING AND INSPECTION DEPARTMENT y CITY OF FRIDLEY, MINNESOTA This supplement is provided to assist the applicant in computing EXTERIOR ENVELOPE AVERAGE "U" FACTOR INFORMATION. This information is required so the BUILDING OFFICIAL can determine that submitted plans comply with the ENERGY CONSERVATION DESIGN CRITERIA of the STATE BUILDING CODE (Section 6000). It is the APPLICANT'S responsibility to accurately compute the data; reflect the proper DESIGN CRITERIA in the plans; submit product specifications, if needed to support the "R" and "U" factors used; and �to�a--ssure construction is per app/roved plans. JOB LOCATION: � � 61o� T_ 5 L-1)(� .� 5:2A C/ OWNER/CONTRACTOR•. ADDRESS: zis- /_ rre, 11 L7Q0 r- r, 19r.. rr-r-9 1 d le ®e PHONE: S 7 /(-"r)I A. Determine the Total Exposed Wall Area as follows: 1. Total wall window area 2. Total door area 3. Total sliding glass door area 4. Total fireplace wall area 5. Total wall framing area (average 10%) 6. Total net wall area above floor (average 90%) g , 7. Total rim joist area,> . Subtotal: Total exposed'wall area above floor 0 re—d 8. Total foundation window area 9. Total net foundation area above grade Subtotal: Total exposed foundation area GRAND TOTAL EXPOSED WALT, AREA ®` B. Multiply the GRAND TOTAL EXPOSED WALL AREA X .17 = Item I C. Determine the Total Exposed Roof/Ceiling Area as follows: 10. Total skylight area 11. Total roof/ceiling framing area (10%)_ 12. Total net insulated roof/ceiling area GRAND TOTAL EXPOSED ROOF/CEILING AREA _ D. Multiply the GRAND TOTAL EXPOSED ROOF/CEILING AREA X .05 = Item II 4 84. Determine the "U" value of each segment (1-9) and multiply by the area as .' follows: 1. _ X nun AP _. _ 2. x null _ 3. x "U" _ 4. X "U'' _ 5.x nun 6. �.t x Hull 7. . �� x "U" 8. X "U" _ 9. x "U" _ ADD 1-9 FOR TOTAL WALL SEGMENTS - ITEM III F. Determine the "U" value of each segment (10-12) and multiply by the area as follows: 10. X 11. X 12./ x nun null D�@ nun e go Ab ADD 10-12 FOR TOTAL ROOF/CEILING SEGMENTS = ITEM IV o60 G. If Item III is the same as, or less than Item I, you have met the intent of State Building Code 6006 (c) 2. H. If Item IV is the same as, or less than Item II, you have met the inter of State Building Code 6006 (c) 1. I. Add Item I ��. �,�® + Item II J. Add Item III !9 + Item IV J,2 -, Me K. If the sum of Items III and IV are less than Items I and II, you have met the intent of the Code for total envelope system. The undersigned, as applicant for a building permit, hereby affirms the above information has been prepared and submitted by himself or under his direction, hereby acknowledges the information to be correct and accurate; and hereby presents the information with required plans in support of the building permit application. By: L DATE: 4 g V V SUBJECT PERMIT City of Fridley N605 AT THE TOP OF THE TWINS BUILDING PERMIT r RECE COMMUNITY DEVELOPMENT DIV. r � � PROTECTIVE INSPECTION SEC. 1 = � CITY HALL FRIDLEY 55432 IL---- NUMBER REV. DATE PAGE OF APPROVED BY ,'j 612-560-3450 910-F15 9 6/78 JOB ADDRESS 1425 Trollhagen Drive N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 55 ]- Innsbruck 2nd Addition SHEET 2 PROPERTYOWNER MAIL ADDRESS ZIP PHONE David Rogasheske 1425 Trollha en Drive N.E. 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSENO. Rich els Bros. Construction Co. 1310 Kendon Lane452-1616 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 a X NEW ❑ ADDITION Ij ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct a 20' x 22' Garage and convert existing garage to living area 9 CHANGE OF USE FROM TO STIPULATIONS Variance granted May 28, 1978. Provide copy of scissors truss design to the City by September 30, 1978. Provide a hard surface driveway. SEPERATE PERMITS REQUIRED F ®R HEATING, PLUMBING WIRING. AND SIGNS. TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING, wood Frame 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 440 4400 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. $14,414 $7.20 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 PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $21.12 NONE STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTAL FEE 5.28 $33.60 SIGNATURE OF CONTRACT AUTHORIZED AGEIT - (DATE) WHEN PRCPE13LY VALIDATED THIS IS YOUR PERMIT BLDG. [N§P DATE 7UNYrORE OF OW ' E NER BUILDER) (DATE) g V V FIRE DEPARTMENT MEMO TO: BUILDING INSPECTION ASSESSING SUBJECT: FIRE -DAMAGED STRUCTURE FIRE HAS OCCURRED AT 1425 NE Troll Dec. 8, 1978 (DATE OFFIRE) >� DATE: Dec. 11, 1978 en Dr., David Rogosheske, 571-8801 �// �� pj"�:�°� �-C./i'//�j/��,, to G: ✓d/� �� / ..- _ �. , �'� �n i0��' S./�YL� FPB -6 CITY OF FRIDLEY 6431 UNIVERSITY AVENUE N.E., FRIDLEY, MINNESOTA 55432 TELEPHONE ( 612)571.3450 October 17, 1979 Mr. David Rogosheske 1425 Trollhagen Drive N.E. Fridley, MN 55421 Re: Final Inspection, Building Permit #14,905, Garage and Alteration Dear Mr. Rogosheske: A final reinspection was made on October 17, 1979 to final out the above noted building permit. It was noted that the handrails for both outside stairways had not been installed. We will expect them to be installed by November 1, 1979 when we will again inspect to determine compliance. If you have any questions on this item, please contact me at 571-3450 before the reinspection date. Sincerely, DARREL G. CLARK Chief Building Official DGC/mh L �j e/ C/ 01 SUBJECT Cityof Fridley72'8 ril AT THE TOP OF THE TWINS BUILDING P E R M I T r `y ______ COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. t Ii ,`� CITY HALL FRIDLEY 55432 NUMBER REV. DATE PAGE OF APPROVED BY ___-� L 612-571-3450 910-F15 7/13/81 JOB ADDRESS 1425 Trollhagen Drs N.E. 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 1 Innsbruck 2nd Add. SHEET 2 PROPERTY OWNER MAILADDRESS ZIP PHONE David Rogosheske 1425 Trollhaclen Dr. N E Fridl - 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Rich els Bros. - 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 t 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. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. FT. CU. FT. AUTHORIZED IS NOT. COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT R-1 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 $3,000.00 .90 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. $18.00 PLAN CHECK FEE TOTAL FEE 4 Q $23.40 SIGNATURE OF CONTRACT_,9RgORAUTHO IZEDAGENT ' (DATE) WHON PRO ER V Ib A THIS IS YOUR PERMIT � p /� a BLDG INSP DATE _ i N R OWNER clF ER BU LDERI (DATE) �j e/ C/ 01 CITY OF FRIDLEY APPLICATIM FOR RESIDENTIAL BUILDING PEIU41TS (New, Alterations, Additions„ or Rcpairs) • OWNER: BUILDER: / ADDRESS: 6, ADDRESS: ft...._.4 iiyA � Q v� •�� TEL NO: 7/ ��O'% TEL 1.10: !.C`.� — %z / r� Construction Location STREET NO: STREET: / a LOT: BLOCS:: / ADDITION: ��1� 1 r .../ n 'J Corner Lot: Inside Lot: Setback: Sideyards: Apvlicant attach to this form two Certificates of Survey of lot and proposed building location drawn on certificates to scale. DESCRIPTION OF CONSTRUCTION { P Front: �---��` � Depth: Iieight: Squane.Feet: Cubic Feet: . �P Q+ Front.: Depth: Height: 'S' 41 hSquare- Feet: Cubic Feet: J " Type of Construction: Reof W� Estimated Cost: $ oo0 To Be ox"pleted: j �2jn �h ' Alt. A Alt. B Proposed Driveway Width If New Opening Is Desired: SEE REVERSE SIDE OF SHEET Ilia undersigned hereby makes application for a permit for the cork' herein specified, agreeing to do .all work in strict accordance with the .City of Fridley Ordinances and rulings of the Departmomt. of Buildings, and hereby declares that all the facts and representations stated in this application are true and correct. DATE: el za — 'z5-1 SICNATM: Stipulations: -477� • BUJLD114G IIER141T FEC SCIIEDULE' v SI3CTION 2. - ThZ' In%;pcctor. of 1luildings : IM11, before i suing permits for the erection of Wiy bui l.dincl or nt ruet:ure, or for any addition to any existing building or structure, sir for any alteration or repairs to •any existing bui.l.ding or structure, upon application thr.,rofor.e, require the payment by the applicant: for such permit of fees to the amount herein below set forth and in the manner herein provided to -wit; I'1EW CONSTRIICTIOIJ: Single Family :fomes and Garages: $4.00/1,000 cubic feet. PLAID CII}:CK: 25 percent of building permit fee. DRIVEWAY DEPRESSIOIJ: (Concrete, Curb Streets Only) ' Alternate A: Removal and replacement of concrete curb and gutter only; Driveway width plus 6 feet x $13.50 Alternate B: Removal and replacement of concrete curb and gutter and install a 3 foot wide approach with ' 6 inch depth; Driveway width plus 6 feet x $15,75 ITIONAL INFORMATIO For the purpose of computing, fees for building permits,. the cubical contents of any building or addition, is determined by multiplying the ground area covered from a point six (6) inches below the floor line of the basement or the cellar to the. average heights of the -upper surface or to the average height of the roof surface of the main gable of a pitched roof. For repairs or alterations to an existing structure, the fee shall be at the rate of $3.00 tier each five hundred dollars --($500.0o) or fraction thereof in the cost of all proposed work. - In•no case shall the fee charged for any permit as set forth in Section 2 be less. than $7.50 plus $.50 state surcharge. _VERIFICATION OF FaMM TION NOTE: Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate ' of Survey of the lot, showing the location of the foundation once it has been constructed will be required before proceeding with the framing. CERT T F I CATE OF � CUPANCY Application for a Certificate of Occupancy shall be made ten (10) days prior to the use or occupancy of any structure for which a building permit has been issued; and said structure shall riot be used or occupied until a Certificate of Occupancy has been issued. ' Main Office 571 6066 UBURBAN 6875 Highway No. 65 N.E. NQINEERINCi Minneapolis, Minnesota 55432 South Oftce 8806510 /'u d 8 M—rtpal Engrnarrmg • Sud r,'atfng • Land Sunvvmg • Land Planning 'u'n Cliff Road Burnsville, Minnesota 55337 Mortgage Loan Survey for DAVID ROGOSHEUE LCAT 5, BLOCK I INN<5BRUCK L`ADDITIDN A NORTH SCale This is a true and correct representation of a survey of the boundaries of the land above described and of the location of all buildings, if any, thereon, and all visible encroachments, if any, from or on said land. This survey is made only in connection with a mortgage loan now being placed on the,,property and no liability is assumed except to the holder of such mortgage or any other interest acquired b the reason of such mortgage. It is understood and agree T�numen have been laced for the purpo�of establishing lot lines or boundary corners. Dated this a of y A. D. 1918;. / SUBURBA GINE' ^ING, INC. LEngine rs Surveyors b r OF FR�IDLEY COMMUNITY DEVELOPMENT DEPARTMENT MEMORANDUM DXTE: October 10, 1990 TO: William Burns, City Manager FROM: Jock Robertson, Community Development Director Barbara Dacy, Planning Coordinator Steven Barg, Planning Assistant SUBJECT: Nuisance Complaint/1425 Trollhagen Drive N.E. On Septembet 20, 1990, I received a copy ,of the attached letter, which was also sent to Councilmembers Dennis Schneider and Nancy J. Jorgenson. Subsequently, I inspected and sent a letter instructing the property owners to clean up debris located near their woodpile. A reinspection on October 9, 1990, revealed that this problem has been corrected and the property is in full compliance. SB:ls M-90-728 SUBJECT PERMIT City of Fridley 2 6 0 :63: AT THE TOP OF THE TWINS BUIL®I MIT ECEIPT I`y ��_�_- COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. d 1 . � NUMBER REV DATE 5/19/98 PAGE OF APPROVED By CITY HALL FRIDLEY 55432 "'j 612-571-3450 910-F15 JOB ADDRESS1425 Trollhagen Drive 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 1 Innsbruck 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE 572-2302 Timothy Duca, 1425 Trollhagen Drive, Fridley, MN 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO. Timothy Duca (same as above) 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 ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Wood shed 12' x 14' 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. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SQ. 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 2 000 00 $1 .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 PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $ STRUCTION OR THE PERFORMANCE OF CONSTRUCTION. PLAN CHECK FEE TOTALFEE $65.25 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI WHEN PROPERL ALIDATED THIS IS YOUR PERMIT 81.0t INS DATE SIGNATURE OF OWNER OF OWNER BUILDERI IDATEI NEW Effective 1/1/98 ADDN [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (� BUILDING PERMIT APPLICATION ConstructionAddress: I ct 2 S % Q 0 G LK R c,- c- f- D P—) N) Legal Description: Owner Name & Address: -y o T `-k `i Tel. #_ Contractor: T , w. '0 c r-\ MN LICENSE # Address: f Lo Z S i a.0 L L 1A CAC- 1, 3 n cZ Tel. # S -1 a 3 0 2 5 -7a -:.30-;" LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Construction Type: Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF IMPROVEMENT Length Width Height Sq. Ft. Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. L--> o a r) S 1-\ 6- D Driveway Curb Cut Width Needed: DATE: 51 N 7- e' zV (z rc i `6 `Estimated Cost: $ 2-1 000 (Fee Schedule on Back) Ft. + 6 Ft = Ft x $ = $ APPLICANT:- Tel. # STIPULATIONS: CITY USE ONLY Permit Fee $ ell �'S' Fee Schedule on Reverse Side Fire Surcharge $ 'yj .001 of Permit Valuation (1/10th%) State Surcharge $ $.50/$1,000 Valuation SAC Charge $ $1000 per SAC Unit .License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ STIPULATIONS: BUILDING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to -wit: TOTAL VALUE FEES $1 to $500 $21 (Minimum Fee is $21 plus surcharge) $501 to $2,000 $21 for first $500 plus $2.75 for each additional $100 or fraction thereof, to and including $2,000 $2,001 to $25,000 $62.25 for first $2,000 plus $12.50 for each additional $1,000 or fraction thereof, to and including $25,000 $25,001 to $50,000 $349.75 for first $25,000 plus $9.00 for each additional $1,000 or fraction thereof, to and including $50,000 $50,001 to $100,000 $574.75 for first $50,000 plus $6.25 for each additional $1,000 or fraction thereof, to and including $100,000 $100,001 to $500,000 $887.25 for first $100,000 plus $5.00 for each additional $1,000 or fraction thereof, to and including $500,000 $500,001 to $1,000,000 $2887.25 for the first $500,000 plus $4.25 for each additional $1,000 or fraction thereof, to and including $1,000,000 $1,000,001 and up $5012.25 for the first $1,000,000 plus $2.75 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $13.50. Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $15.75. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the framing. L I) 6 8m Office 571 6066 ®UOUR®AN _ _ J Mi75 N,qhdvolis, M No. 65 NJ N01N66RIN0 M,nnrapohs, Mmnrsota 55432 �— - 5oolh 111"C" 890 6510 ® fnvl & .Sfanvfpal Fnglnrennp 0 Steel 7'-finR • Land .SurrnmR • /.and Planning 1101 CMf flodit PA 'Burnsville, Minnesota 55337 Mom Mortgage Loan Survey for DAVID ROGOSHE-Ul- no �• ,.. iI re1�1 .� NOP T H LoT--5, BLOCK I-) 5c ale=1°Vic' INN513RUCK 2 ADDITION � ANok A C "I'A -01 'ter y O \ �,'` '; •' P;�, ''.��Ii.,y it � ,, C/ 1-01 A, J 1,1 •'J`��, l `b b p FRIDLEY 0-1 � BOARD OF APPEALS EXHIBIT No MEETING DATE This is a true and correct representation of a survey of the boundaries of the land above described and of the location of all buildings, if any, thereon, and all visible encroachments, if any, from or on said land. This survey is made only in connection with a mortgage loan now being placed on the property and no liability is assumed except to the holder of such mortgage or any other interest acquired bp/the reason of such mortgage. It is understood and agreed nor,:;numen have been I tail for the purpos of establishing lot lines or boundary corners. Dated this I doy of J�� A. D. 19� �4 � SUBURBA GIN•Ef,,RING, INC. L �,y� Engine s p ��f �� SurveyorsIs ryox ruun5neu: Mn nlyms neserveu �6 A NO. SUBJECT PERMIT P City ®f Fraley 3 0022 AT THE TOP OF THE TWINS BUILDING PERMIT r `L __��_ COMMUNITY DEVELOPMENT DIV. r PROTECTIVE INSPECTION SEC. / 1 = � CITY HALL FRIDLEY 55432 NUMBER REv DATE PAGE OF APPROVED BY 612-571-3450 910415 8/6/99 10B ADDRESS 1425 Trollhagen Drive 1 LEGAL LOT NO. BLOCK TRACTOR ADDITION SEE ATTACHED DESCR. 5 1 Innsbruck 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Timothy Duca 572-2302 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Owner 4 ARCHITECT OR DESIGNER MAIL ADDRESS ZIP PHONE LICENSE NO 5 ENGINEER MAIL ADDRESS ZIP PHONE LICENSE NO B USE OF BUILDING Residential 7 CLASS OF WORK ❑ NEW xU ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Construct a 121 x 131 Screen Porch 9 CHANGE OF USE FROM TO STIPULATIONS See stipulations on plan diglllog caii� fot �� locations s30 utility 454.0002 5EQU1RE® LAW. MPMA'T!�' ' REQUIRED FOR PARING. WEATIK PLUM81 AND Sfi; ; 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 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COMMENCED. NO OWLG. UNITS OFFSTREET PARKING 1 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 $2843 $1.50 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. STRUCTION OR THE PERFORMANCE OF CONSTRUCTION $83.25 Fir SC $3.00 PLAN CHECK TOT FEE � � 7.75 SIGNATURE OF CON' ,TOR OR AUTHORIZED AGENT ,DATE, E ALIDAT T S IS UR P IT OMPWIL KS,GNATURE �'L ,Nso QAtf OF OWNERJF OWNER BUILDER, ,DATE, NO. NEW [ I ADDN ALTER Construction Address: Legal Description: Owner Name & Address: Contractor: Address: LIVING AREA: GARAGE AREA: DECK AREA: OTHER: Construction Type: Effective 5/10/99 CITY OF FRIDLEY SINGLE FA HLY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Tel. # Y`,ZZ22 ;?JD� MN LICENSE # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF EWROVEMENT Length Width Height Sq--R.— Length q--R'Length Width Height Sq. Ft. Length Width Hgt/Ground Sq. Ft. Estimated Cost: $ do Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ e DATE: - APPLICANT: OU9 Tel. # CITY USE ONLY Permit Fee $ Fee Schedule on Reverse Side Fire Surcharge $ .001 of Permit Valuation (1/10th%) State Surcharge $ e $.50/$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $ $5.00 (State Licensed Residential Contractors) Driveway Escrow $ Alt. "A" or Alt. "B" Above Erosion Control $ $450.00 Conservation Plan Review Park Fee $ Fee Determined by Engineering Sewer Main Charge $ Agreement Necessary [ ] Not Necessary [ ] TOTAL $ STIPULATIONS: BUILDING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to -wit: TOTAL VALUE $1 to $500 $23.50 MM $501 to $2,000 $23.50 for first $500 plus $3.05 for each additional $100 or fraction thereof, to and including $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 $100,001 to $500,000 $500,001 to $1,000,000 $1,000,001 and up $69.25 for first $2,000 plus $14.00 for each additional $1,000 or fraction thereof, to and including $25,000 $391.25 for first $25,000 plus $10.10 for each additional $1,000 or fraction thereof, to and including $50,000 $643.75 for first $50,000 plus $7.00 for each additional $1,000 or fraction thereof, to and including $100,000 $993.75 for first $100,000 plus $5.60 for each additional $1,000 or fraction thereof, to and including $500,000 $3,233.75 for the first $500,000 plus $4.75 for each additional $1,000 or fraction thereof, to and including $1,000,000 $5,608.75 for the first $1,000,000 plus $3.15 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50. Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $23.25. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the framing. O � ce + I I j i t 0 i I t ' I I ♦}I ' � i I I I � I � I �_.__� J7 Ire - 1 -4 - - --- -- - - - - --Aim- -- -- - - •--- - - -- -. - - - - - -- -.- - + A.0k, - v- ---- _ - - - - d 4k, a Nev a � all Conn et. -1' � a•s �i �I`d weal, ' � h�"t �i y� j--t►�r®m - - - - ---•.. � - -- - �i. AA mow" t i � --- —— = -- —� -� --- — i i t —1 _ .*___y___ __ r—� .—_.._ _ � _.i_._ _ _ .� _�--. _ • __ r _rte__.__! __ � _�- _ _ Mam OftKe 571 5056 itlelJR■AN 6N15 ffice .., No. 11 N.E A N1RWAN RING —JI Mmrwacotts. Mmnrsata 55407 ® --_INC. $nutAOtircr 8906510 ® 1rh 101 if Hoad a' t lux & .1lnnn rpn! F• par nn, • 6n/ rnutne • Land Sarr r�mQ a Land Plamm"4 Btnnw it!. Mmnesnla 55037 DAVID ROGOSPE-Ul- Mortgage Loan Survey for NOR TH LoT-51, BLOC K 1-) GCale INNSBRUCK 2 T ADDITION � ANC*A ; *a illi 7• V C�— 11 r,• i,r • ve4 �i rY O O z. :t• ,�at:r�to'• '_ : �'1 tip 1 O ' O , �+•/ FRIDLEY BOARD OF APPEALS EXHIBIT Nom MEETING DATE This is a true and correct representation of a survey of the boundaries of the land above described and of the location of all buildings, if any, thereon, and all visible encroachments, if any, from or on said land. This survey is made only in connection with a mortgage loan now being placed on the roperty and no liability is assumed except to the holder of such mortgage or any other interest acquired b the reason of such mortgage. It is understood and agreed no pnonumen have been p1 ced for the purpos e! establishing lot lines or boundary corners. Doted thisdoy of av A.O. 197x3 SUdURBA GINING, INC. Engine i• M Surveyors Is f i .d'., . Not Published: All Hlgnts meserveo 17 - - -ts•�-Y.----�(�� @-;L ; ---------- a�.� .Q�'c�'� �=�;�-----. -•- -•- - -. __�.. 714 Cl^. C�1i?•'�r + 3.» �---•--- ----- �`s�ll.��------- -_ _ __ �j.�. . "- - 1..� it , _ -�"f •� ��- .?.h_; �t �� 2 � _ � , - ------ - -- - -- - --- - -- — -- - -4-2--=Qr all n - — — — . t ; To Li 1 i _ y PL4i t f r--f--t--�-I'T"-- rViA ;�.r r SUBJEtT P3 City of Fridley 33 3 AT THE TOP OF THE TWINS BUILDING PERMIT CEIPT NO. __ - __ COMMUNITY DEVELOPMENT DIV. d � � PROTECTIVE INSPECTION SEC. CITY HALL FRIDLEY 55432 NUMBER 11EV DATE PAGE OF APPROVED BY 612-571-3450 910-F15 10/4/99 JOB ADDRESS 1425 Trollhagen Drive 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DescR. 5 1 Innsbruck 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Tim Duca 572-2302 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO New Haven Constr. 4208 83rd Ave N Brooklyn Park 55443 566-5225 2007 950 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 A REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Reroof house and garage (30 Sq.) Tear-off 9 CHANGEOFUSEFROM TO STIPULATIONS Underlayment must comply with the State Building Code. SEPARATE PERMITS ARE REQUIRED 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 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 $2622 WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT $1.31 DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PERMIT FEE SACC RGE PROVISIONS OF ANY OTHER STATE R LOCAL LAW REGULATING CON- $83..25 Fl SG STRUCTI OR THE PERFORMA C F C NSTRUCTION $2.62 PLAN CHECK FEE TO/Af FEE c Pel License $5.0 2.18 SIGNATURE CONTRACTOR O ,AUTM 12ED AGENT I ATE. f EN R P VALI THIS IS YOU PERM 9L INSO ArE S-GNATURE OF OWNER,IF OWNER BUILDER. (DATE. r NEVA [ ] - Effective 5/10/99 ADDY [ ] CITY OF FRIDLEY ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: Legal Description: Owner Name & Address: Tel. Z 3 e Contractor: '4��.z'fj MN LICENSE # Address: �� s��`��J Tel. # Attach to this application, a Certificate of Survey of the lot, with the proposed construction drawn on it to scale. DESCRIPTION OF BIPROVEMENT DIVING AREA: Length Width Height Sq. Ft. GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: Construction Type: Lr -7 Z) /y�?o Estimated Cost: $ Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _ $ DATE: / APPLICANT: Tel. # Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Driveway Escrow Erosion Control $ 5-- an E Park Fee $ Sewer Main Charge TOTAL STIPULATIONS: 11 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 [ ] BUILDING PERNM FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to -wit: TOTAL VALUE $1 to $500 $23.50 FEES $501 to $2,000 $23.50 for first $500 plus $3.05 for each additional $100 or fraction thereof, to and including $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 $100,001 to $500,000 $500,001 to $1,000,000 $1,000,001 and up $69.25 for first $2,000 plus $14.00 for each additional $1,000 or fraction thereof, to and including $25,000 $391.25 for first $25,000 plus $10.10 for each additional $1,000 or fraction thereof, to and including $50,000 $643.75 for first $50,000 plus $7.00 for each additional $1,000 or fraction thereof, to and including $100,000 $993.75 for first $100,000 plus $5.60 for each additional $1,000 or fraction thereof, to and including $500,000 $3,233.75 for the first $500,000 plus $4.75 for each additional $1,000 or fraction thereof, to and including $1,000,000 $5,608.75 for the first $1,000,000 plus $3.15 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50. Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $23.25. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the framing. SUBJEeT PE City of Fridley 0 51 1 AT THE TOP OF THE TWINS BUILDING PERMIT � NO. COMMUNITY DEVELOPMENT DIV. � v � PROTECTIVE INSPECTION SEC. r , ----1 CITY HALL FRIDLEY 55452 %J NUMBER REV DATEPAGE OF APPROVED BY 612-571-3450 910-F15 11/15/99 JOB ADDRESS 1425 Trollha en Drive 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 1 Innsbruck 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADORES$ ZIP PHONE Timothy ft Duca 572-2302 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO New Haven Constr. Co. 4208 83rd Ave N Brooklyn Pk 5544 566-5225 200 7950 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 XC ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE B DESCRIBE WORK Construction of an addition off kitchen C171611 9 CHANGE OF USE FROM TO STIPULATIONS See stipulations on plan. tMAR � WT Before digging tali for 811 utility ODO�tio*�s ]REQUIRED 13Y LAI, �10. yob �d sicNs s SEPARATE PERMITS ARE REOUIREO 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 1 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 $14,500 $7.25 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 $244.25 Fire AC $14.50 a / 1-1.5---9f �/J� PIAN CHECK FEE � TOTAL E SIGNATURE OF CONTRACTOR OR AUTHOR(ZEO AGENT IDATEt HEN ROP ALIDAT IS IS V UR E T INSP rtA E S-GNATURE OF OWNER OF OWNER SUILDERI -,DATE t NEW [' ] Effective 5/10/99 ADDN [ ] CITY OF FRIDLEY 44 ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION'+ �e I Construction Address: t t�) S I f o k i�, a c,. ))r. v Legal Description: (Z ®o,rv�- ck� d k A \ c a. Owner Name & Address: ' 1 vmo+k ,t I v- A Tel. # IQ Contractor: dV g-- v.a H A v & N Q-0 ^ + (� v e-4 ► o .\ MN LICENSE # �)®®-77? ,.S -O 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 1 I Width "l Height GARAGE AREA: Length Width Height DECK AREA: Length 7 Width Hgt/Ground _ OTHER: ��id _� 1�► 0, 41 P 4—C- IP4 _ Construction Type: Sq. Ft. b Sq. Ft. Sq. Ft. Estimated Cost: $ 14 1 S O O Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ DATE: P 1 I L I °( 0) APPLICANT: �� Tel. # CITY USE ONLY Permit Fee $ �I �J �� Fee Schedule on Reverse Side Fire Surcharge $ ,'%, �� .001 of Permit Valuation (1/10th%) State Surcharge $ "7,� $.50/$1,000 Valuation SAC Charge $ $1050 per SAC Unit License Surcharge $ �Sl, $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 $ 00 STIPULATIONS: s '7 a- ) 3 0 1 BUILDING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to -wit: TOTAL VALUE $1 to $500 $23.50 FEES $501 to $2,000 $23.50 for first $500 plus $3.05 for each additional $100 or fraction thereof, to and including $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 $100,001 to $500,000 $500,001 to $1,000,000 $1,000,001 and up $69.25 for first $2,000 plus $14.00 for each additional $1,000 or fraction thereof, to and including $25,000 $391.25 for first $25,000 plus $10.10 for each additional $1,000 or fraction thereof, to and including $50,000 $643.75 for first $50,000 plus $7.00 for each additional $1,000 or fraction thereof, to and including $100,000 $993.75 for first $100,000 plus $5.60 for each additional $1,000 or fraction thereof, to and including $500,000 $3,233.75 for the first $500,000 plus $4.75 for each additional $1,000 or fraction thereof, to and including $1,000,000 $5,608.75 for the first $1,000,000 plus $3.15 for each additional $1,000 or fraction thereof DRIVEWAY DEPRESSION ESCROW (Concrete Curb Streets Only) Alternate "A": Removal and replacement of curb and gutter only - Driveway width plus 6 feet times $15.50. Alternate "B": Removal and replacement of curb and gutter and install a 3 foot wide approach with 6 inch depth - Driveway width plus 6 feet times $23.25. VERIFICATION OF FOUNDATION Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the proposed structure and of the construction site. A Certificate of Survey of the lot, showing the location of the foundation once it has it has been constructed will be required before proceeding with the framing. Tin Duce 1425 TIORMWn Drive Fridley, MN 55421 Roof Plan ;�� -- Plbv�J� PCOPEt Sim s heec�- K, prou'dF, smo v� le �c-bes (n Nt StIECP n dboNtS F1 �tl or\ laIt Lig()i IS Ojp4 n- vlousE. . c / ujo-( ' e S h k,Ft d w tus-� py4e vtc� I a,< pc)s4 t x.10 Q 6 Amos4 bz ,RbIO2;4 'VexW"1Wi&,P) 1JwV K p row!— mrd tiros prtxxa�� • � � �.06�/ T �L�'vZ'/Li9T/moi Awt*le h0if 6es�,as ��ti a,of,�s�//, �a a 40,07 s�o,� ,*421 m sI.r SUBJECT 4919RMIT ND4' City of Fridley 3 3 7 AT THE TOP OF THE TWINS BUILDING PERMIT r RECEIP NO. COMMUNITY DEVELOPMENT DIV. PROTECTIVE INSPECTION SEC. �/ Y® r NUMBER REV DATE PAGE Of APPROVED BY CITY HALL FRIDLEY 55432 763-571-3450 910 -Fl 5 7/31/03 JOB ADDRESS 1425 Trollhagen DR NE 1 LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED DESCR. 5 1 Innsbruck 2nd Addition SHEET 2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE Tim Duca, 1425 Trollhagen Dr NE, Fridley, MN 55421 763-572-2303 3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO Same as above 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 ❑x NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE 8 DESCRIBE WORK Construct addition 9 CHANGE OF USE FROM TO STIPULATIONS See notations on plans. SEPARATE PE RT REQUIRED • WIRING HEATIN LHMSIN6 AND SIG 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 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 $20s 926.00 @ $10.46 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 PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CON- $335.25 Fire SC $20.93 STRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLAN CHECK FEE TOTAL FEE $366.64 SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT IDATEI PROPERLY VALIDATED THIS ISYO R P HE LOG/ -NSP rI q S,GNATURE OF OWNER,IF OWNER BUILDER. IDATEI NEW [ ] CITY OF FRIDLEY ADDN]' 6431 University Ave NE, Fridley, MN 55432 ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 BUILDING PERMIT APPLICATION Construction Address: \H )- 7 r is t ( in c^_ � r Effective 1/1/2003 (763) 572-3604 Bldg Insp (763) 5714 287 Fax ,� 4 Legal Description: ' Owner Name & Address: ► +� c. 0. , 5 a ,�,.x Tel. # -7 6 3 s 1 3 a Contractor: 5-- 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 IMPROVEMENT LIVING AREA: Length I Width i'6 Height Sq. Ft. i„ GARAGE AREA: Length Width Height Sq. Ft. DECK AREA: Length Width Hgt/Ground Sq. Ft. OTHER: arS q Z) 0` Construction Type: r 0, � Estimated Cost: $ C.� a p . Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ =$ DATE: l 3 APPLICANT:O +t,`/ Tel # 3- 7 3 Call (763) 572-3604 for Permit Fees if mailing in application. Fax to 763-571-1287 if using credit card and we will call you for card number. CITY USE ONLY - Permit Fee Fire Surcharge State Surcharge SAC Charge License Surcharge Curb Cut Escrow Erosion Control Park Fee Sewer Main Charge TOTAL $� )o Fee Schedule on Reverse Side .001 of Permit Valuation (1/10th%) $.50/$1,000 Valuation $1275 per SAC Unit $5.00 (State Licensed Residential Contra Alt. "A" or Alt. "B" Above $450.00 Conservation Plan Review Fee Determined by Engineering Agreement Necessary [ ] Not Necessary BUILDING PERMIT FEE SCHEDULE The Chief Building Official shall, before issuing permits for the erection of any building or structure, or for any addition to any existing building or structure, or for any alteration or repair to, any existing building or structure, upon application therefore, require the payment by the applicant for such permit of fees to the amount herein below set forth and in the manner herein provided to -wit: TOTAL VALUE $1 to $500 $501 to $2,000 $2,001 to $25,000 $25,001 to $50,000 $50,001 to $100,000 FEES $23.50 $23.50 for first $500 plus $3.05 for each additional $100 or fraction thereof, to and including $2,000 $69.25 for first $2,000 plus $14.00 for each additional $1,000 or fraction thereof, to and including $25,000 $391.25 for first $25,000 plus $10.10 for each additional $1,000 or fraction thereof, to and including $50,000 $643.75 for first $50,000 plus $7.00 for each additional $1,000 or fraction thereof, to and including $100,000 $100,001 to $500,000 $993.75 for first $100,000 plus $5.60 for each additional $1,000 or fraction thereof, to and including $500,000 es $500,001 to $1,000,000 $3,233.75 for the first $500,000 plus $4.75 for each additional $1,000 or fraction thereof, to and including $1,000,000 $1,000,001 and up $5,608.75 for the first $1,000,000 plus $3.15 for each additional $1,000 or fraction thereof CURB CUT ESCROW (Concrete Curb Streets Only) Removal and replacement of curb and gutter only - driveway width plus 6 feet, times the annually determined rate. Permits for construction will be issued a minimum of 24 hours from the time of application to allow for proper review of the. proposed structure and of the construction site. VERIFICATION OF FOUNDATION A Certificate of Survey of the lot, showing the location of the existing foundation will be required before proceeding with the framing. New Houses Only n. Loa J� Fr�F 1'6875 M ! ro 0thca - 61t bOefS a.. Highway � ` OINfL�LRINtaI ' Min,reepobs ;Minnvs t# 5643ZS v South Office 89Ik8$10 xs Of t 101 Clift Raw y 1 Afuniripal kngunemng a Soil.Treting aLand Surueymg a Land Plaanwg Burnsville INmnesdt6 55337 i GOD AVI ,_ �4 2LLz x 111dprtga,ge ' Laan Survey Por r v • A �- 1>e nde 4 f4f1,N' Uti•lr� fUs�mc?rl 1' �"' NORTH GC ale, 00 K 2 AD D IT 10 N F51. VI i�u « ,tip° 0 si•.r:o�., n,j,� ��s Q � r • r �`1\ , t f �"• jl.�� `r•') `rk t V af'i FRIDLEY BOARD OF APPEALS. r�� u E ,r h ; EXHIBIT No. — Ip - �R ' ;n MEETING D�iTE �LZ?C) oW11— -XA , • r chis is a ,true and correct representation of a *survey of the boundaries of the land above described and of the lo�6tion of. all buildings, if any, thereon, and ail. visible encroachments, if any, from or on said land. this survey is In I in: connection with a mortgage loan now being laced on the property and no liability is assumed 1 y�9 P P Y Y a S t °e><cept, to' the holder of such mortgage or any other interest acquired b the reason of such mortgage. It is understood and agreed' �a► amumenjs hove been I ced for the purpos of establishing lot lines or boundary cof'ners: Dated thisday of P&A A. D. 19 SUBURBA GIN ING, INC. L� ��t/ -� � 3' - 5 —1.� • 3 6 o N Engine s :;�'-T�,'• surveyors r V Sy V_ v Fj� "*P-Iuvnb "E ch ENGINEERED TRUSS DESIGNS AND LAYOUTS SHALL BE MADE AVAILABLE ON THE JOB SITE FOR THE FRAMING INSPECTION THIS JOB COPY SH ,A AVAILABLE ON THEE- 08 SITANDEFINAL I FOR THE SPECTIOU sC- CV4 Fir. T r -s5e� rl0 1 rlam,,)c. Ir IVC ------22-0"--- -- ---- .. -. BUILDING OFFICIAL REVIEW ND AU-1KORiZATION REQUIRED PTtI R TO CHANGES. MODIFICATIONS Oft ALT RAii.iF!'; -17 uq- Attic Ventilation a ,� y 4� 1/300 of horiiontal projection -- of roof area — 1/2 to be in soffit. 1/2 to be in roof near riC�e. A - _._._..--22=0" -_ > o� ec\rtss Windows 1n haS ni 1 3 011 k L10 tl C Cx SRhv�an� W l N� b w r 00 S r, ��azr5u` -- I � •2.. i b�oC�C wc�l(S 15 �elj 1 IrQ t 1c.t bgrI,Iur eX � 1 Lo r,CCc e 13�� ASS int cc nor wy�t I�r.i Pa�lTton ll -gIvMM "ioff,I e. z Z o- Q k c,\ �i St. 06, ..c..ts Ct o.c, a, k (o � C eg\. �c � 5 l � ` � 1 G ILI( I {i o n, a- K 1 0 ' I-� a i� � 2A- 4 ^A -end 9 C).0. ane.hur ;L of v r, x io F\vvt ,o1S� s 1�'1 o.0 . S Mo�c cue �e� "7670--7(aV - is MaSo tA� 10, 5 e) l�S ��1 � + „S s� S iJ at ln7 / G — Ar V J C CISSOr� }rv55es a ni O.0 P, ck cS Y 5t.2 f Al( lU curall �L f� 2'-11" E x15 �p°may tw,a+s av�, av p, 5 C'• I, V,) t n CA 0 9-0 n6'i6+0' �` OV dA 8'-0"--- ►i" Ib'�d'A �A�6•a• 0 M x fo.s u I ! I I I 10'-1 4,r us K t+ � c° �� i IS x53 1' 1w I - IIbM SvrtS X"� al.+c ac} f woJ g s log All, ppf bi X004,-Jowt i 3z-5 �3�:M 3�'?`— \ vh L C 114 � S I t' 0 L I � G Cl T�✓� ►1 � \v � X63-s-7a-)�3o s. REScheck Compliance Certificate 2000 Minnesota Energy Code RES checkSoftware Version 3.5 Release Id Data filename: C:\Program Files\Check\REScheck\house.rck PROJECT TITLE: Addition COUNTY: Anoka STATE: Minnesota ZONE: 2 CONSTRUCTION TYPE: Single Family DATE: 07/09/03 DATE OF PLANS: 7/3/2003 PROJECT DESCRIPTION: Bedroom Addition DESIGNER/CONTRACTOR: Self COMPLIANCE: Passes Maximum UA = 76 Your Home UA = 75 1.3% Better Than Code (UA) Permit Number Checked By/Date Gross Glazing Area or Cavity Cont. or Door Perimeter R Value R -Value U -Factor UA Ceiling 1: Flat Ceiling or Scissor Truss 310 38.0 0.0 9 Wall 1: Wood Frame, 16" o.c. 112 19.0 ' 0.0 7 - 7 Wall 2: Wood Frame, 16" O.C. 112 19.0 0.0 6 Wall 3: Wood Frame, 16" o.c. 162 19.0 0.0 0.280 15 Window 1: Above-Grade:Wood Frame:Double Pane with Low -E 54 Basement Wall 1: Masonry Block with Empty Cells 128 10.0 0.0 9 Wall height: 8.0' Depth below grade: 6.5' Insulation depth: 8.0' Basement Wall 2: Masonry Block with Empty Cells 128 10.0 0.0 8 Wall height: 8.0' Depth below grade: 6.5' Insulation depth: 8.0' Window 2: Basement > 5.6 ft2:Wood Frame:Double Pane with Low -E 8 0.280 2 Window 3: Basement > 5.6 ft2:Wood Frame:Double Pane with Low -E 8 0.280 2 Basement Wall 3: Masonry Block with Empty Cells 144 10.0 0.0 10 Wall height: 8.0' Depth below grade: 6.5' Insulation depth: 8.0' Proposed and Maximum U -Factor Averages Proposed Maximum Average U -Factor Allowed U -Factor Above -Grade Windows and Glass Doors 0.280 0.370 Includes Foundation Windows > 5.6 ft2 COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications. and other calculations submitted with the permit application. The proposed building has been designed to meet the 2000 Minnesota Energy Code requirements in REScheckVersion 3.5 Release Id (formerly MECchecl and to comply with the mandatory requirements listed in the RESchecklnspection Checklist. Builder/Designer Date �1TY OF FRIt)LEY INSPECTION DIVrSiON Effective On January 1, 2000 5431 University Ave NE =radley, IAN 55432 APPLICATION FOR POWER PLANTS AND HEATING, COOLING, VENTILATION, 763} 572-3604 REFRIGERATION AND AIR CONDLTIONING SYSTEMS AND DEVICES JOB ADDRESS RATE NEDULtr OWf1EI rm tesidenval Rate TOTAL Furnace Shell and Duct Work, Burner • BUILDING USED AS Also Replacement Furnace $ 30.00 �.�` (Side Vent - Fig Out Back) ESTIMATED COST, _ PERMIT NO Gas Piping (Needed with new furnace, $ 10.00 $ but not replacement) CbESG TION ®F FURNACE AND OR LIURNER Gas Range $10-00 No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Gas Dryer $ Io.00 $ Trade Name ___ -- - - --- Size No. - - _ BTU HP — EDR— Air Conditioning • APl Silos $ 25.00 $ - Fuel __._ Total Connected Load_ All Others/Repairs & Alterations (LIST ON BACK) 1%® of Vacuo of Appliance or'Nork ooa»mer cial/Indumiraal 1.25% of Value of Afoplia m. or Work State Surcharge TOTAL FEE i 1 K . ., zNMT_ , -- 1INSPECTION FEE $47.00/Nr Air Conciitioners can not be placed in a side yard without rri*ten Permission from adjoining property owner. Burner Trade Name Size Mo.- BTU—.-- o.BTU._— HP --- EDR t 3 The undersigned Hereby ;Hakes application for a permit for the work herein specified agreeing to do all work in strict accordance with the City Codes an rutangs of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct... o DATI _.... - .._.._..._. . s Final Date Z8 ' d -"101 CA1IA, ONi N WNT. VENT CONNr MR ANp C®iYiBt�ISTt®N &IR 3LERIFiCATION When re 1 ging an exist'sng hirance, 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 0-140 ( ) The venting system is plasti4JPVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes ( 4--�I6to ( ) The undersigned also verifws; hist the replacement unit Is a listed assembly and meets the current codes and manufacturer's specifications. 'chis does include AGA -+LAMA Category t Central Furnace Venting tables for fan assisted and natural draft appliances. Yes H440 ( ) The exis#ng combustion at is sized and installed to meet the current codes and manufacturers specifications. Yes (-No ( ) When required to installi a new combustion air, it will be sized and installed To meet the current codes and manufacturers specifications. Yes ("ANO { ) When InEt-a-lift a new ven111L"nam, the undersigned hereby verges that It Is a listed assembly and meets the current codes and manufacturer's specifications. This does Includo AGA-GCategory l Central Fumace Venting Tables for fan assisted and natural draft appliances. Yes (` YWo ( ) . Is the common vent and vent connectors sized end installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes (✓1 No ( ) dip iI„ p arrgeTyin and 5iaelCoennaon Vng�and Vent Cots t9r Infbtrnation Appliance 01 Type A rY,-J nput an Assisted or Not Appliance #2 Type STU Input Fan Assisted or Nat Apgllance #3 Type � _ STU input Fan Assisted or Nat Total Appliances Total Stu Input Common Vent Type Vent Height Diameter inches Appliance 91 Vent Connector Height it Length ft Diameter in Type,,-�d Appliance #2 Vent Connector Height ft Length l Diameter in Type Appliance #3 Vent Connector Height St Length Diameter in Type O r MR 1[ ►r it HEATING M Signed Ely: 2629' d S99868L 01 A3 USA .10 AI T O Wrisd es : Zl 0002-TZ-Aw Effective January 1, 2003 CITY 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 FAX (763) 571-1287 JOB ADDRESS t RATE SCHEDULE OWNER Residential Rate TOTAL Furnace Shell and Duct Work, Burner - BUILDING USED AS Also Replacement Furnace $ 30.00 $ (Side Vent - Fill Out Back) ESTIMATED COST PERMIT NO. Gas Piping (Needed with new furnace, $ 10.00 $ but not replacement) DESCRIPTION OF FURNACE AND OR BURNER Gas Range $ 10.00 $ No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) Gas Dryer $ 10.00 $ Trade Name Size No. BTU HP EDR *Air Conditioning - All Sizes $ 25.00 $ Fuel Total Connected Load All Others/Repairs & Alterations (LIST ON BACK) Burner Trade Name Size No. 1% of Value of Appliance or Work BTU HP EDR Commercial/Industrial 1.25% of Value of Appliance or Work $ 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 an State Surcharge 0 .50 rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. TOTAL FEE $ DATE MINIMUM FEE FOR ANY HEATING/COOLING/VENTILATION HEATING CO REFRIGERATION/AIR CONDITIONING PERMIT IS $25.00 PLUS THE $.50 STATE SURCHARGE Signed TEL # FAX # REINSPECTION FEE $47.00/Hr *Air Conditioners can not be placed in a side yard without Approved By Rough -In Date Final Date written permission from adjoining property owner. FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED When mplaijng an aYi_etinQ ftiranra, 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 (i 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 pY�nnCnmh ,etien air is sized and installed to meet the current codes and manufacturer's specifications. Yes( ) No ( ) When required to Install a now r-nmhi intinn ai ;,itwill be sized and installed to meet the current codes and manufacturer's specifications. Yes( ) No( ) When lnstalllnn a new yantina 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 #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 N V eA\ -i Gin 0 CO I HEATING CO: Signed By. Date Effective January 1, 2003 .�- CITY 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 FAX (763) 571-1287 % JOB ADDRESS f 40 ��9�'n - 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 Rate $ 30.00 $ 10.00 $ 10.00 $ 10.00 $ 25.00 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. OWNER 72l &fC 7 TOTAL ' BUILDING USED AS ��'(70 ESTIMATED COST d�GG, co PERMIT NO. 7)" DESCRIPTION OF FURNACE AND OR BURNER moi' y�I�T, No. of Heating Units Circle One (Steam) (Hot Water) (Warm Air) $ Trade Name1�� /NG �U Size No. 5?- _75�19-f BTU 10 60c HP EDR $ Fuel /Vo- Total Connected Load Burner Trade Name Size No. $ BTU _HP EDR $ 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 an $ .50 rulings of the Building Division, and hereby declares that all the facts and representations stated in this application are true and correct. DATE 1113 �-�aoFerir� �r� HEATING CO ,s s�€ WAI_ i -A R� '� S��►� Signed— TEL # FAX # Approved By Rough -In Date' Final Date FILL OUT BACK SIDE FOR STACK VERIFICATION ON REPLACEMENT FURNACE *114 THE BELOW MUST BE FILLED IN WHEN REPLACING FUEL BURNING APPLIANCES OR THE APPLICATION WILL BE RETURNED When re la _ing,an avicting figannn, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes (:► No The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes( ) No(/) The undersigned also verifies that the replaccment 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 ayisgingsnmb nstrnn air is sized and installed to meet the current codes and manufacturers specifications. Yes( No (�f When required to install a naw cnmbll_etion air,.it will be sized and installed to meet the current codes and manufacturer's specifications. Yes () No 0 When installing a new venting ,,cySam, 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 #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 N HEATING CO: Signed By: Date: CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 572-3604 VAX: (763) 571-1287 ADDRESS : 1425 TROLLHAGEN DR NE PIN : 253024120028 LEGAL DESC : INNSBRUCK 2ND ADD : LOT 5 BLOCK 1 PERMIT TYPE : ELECTRICAL PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION t' PERMIT NO.: 2004-00959 3�u DATE ISSUED: 06/21/2004 VALUATION NOTE: ELECTRICAL PERMIT BECOMES VOID 12 MONTHS AFTER PERMIT ISSUE DATE. CONVERT SERVICE TO UNDERGROUND. # INSPECTIONS 2 APPLICANT DUCA TIMOTHY M & ROBERTA R 1425 TROLLHAGEN DR NE FRIDLEY, MN 55421 OWNER DUCA TIMOTHY M & ROBERTA R 1425 TROLLHAGEN DR NE FRIDLEY, MN 55421 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of wort will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction. Applicant Date Bldg Insp Date. ELEC PERMIT FEE - MIN (RESI) 40.00 STATE SURCHARGE, ELEC FLAT 0.50 ELECTRIC FORM FEE 1.00 TOTAL 41.50 PAID WITH CHECK # 4967 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. CITY OF FRIDLEY INSPECTION DIV. 6431 University Ave NE Fridley, MN 55432 (763) 572-3604, FAX (763) 571-1287 )C -e 3 Effective April 1, 2004 APPLICATION FOR PLUMBING AND GAS FITTING PERMIT MARK NUMBER OF FIXTURES TO BE INSTALLED ON EACH FLOOR C X96 i 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** NO. RATE TOTAL $10.00 $10.00 $10.00 $10.00 $10.00 $10.00 $10.00 $35.00 $35.00 $35.00 $10.00 Gas Dryer** $10.00 Back Flow Preventer Required 66Yes () No Type W1)Ki ^ S '1 :.1) iQS $15.00 iPt•h Reinspection Fee $50.00/Hr ALL OTHERS AND/OR REPAIRS AND ALTERATIONS 1.25% of Value of Fixture or Appliance State Surcharge $ JOB ADDRESS \q3 -S �c61lt-,0,S�e, bG\VE 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. DATE: 6b © , 20 014 OWNER y r, A BUILDING USED AS � 0 ESTIMATED COST PLUMBING COMPANY S -0 - PERMIT NO. �O®�Z - Q012 SIGNED BY TEL N0. Approved By Rough -in Date Final Date MINIMUM FEE FOR ANY PLUMBING/GAS PERMIT IS $15.00 or 5% OF COST TOTAL FEE $ - e —b OF THE IMPROVEMENT WHICHEVER IS GREATER PLUS THE SURCHARGE. -l/S G COMBUSTION AIR SHALL BE PROVIDED PER UMC SECTION 504(A) AND TABLE 6-A. **PROVIDE COMMON VENT INFO ON BACK SIDE . UO FILL IN COMPLETELY FOR REPLACEMENT FUEL BURNING APPLIANCE PERMITS COMMON VENT, VENT CONNECTOR AND COMBUSTION AIR VERIFICATION When replacing an existing furnace, the undersigned hereby verifies that the venting has been examined and is free from rust, deterioration, obstructions, and is securely supported and firestopped where required. Yes () No( ) The venting system is plastic/PVC and meets all current codes and manufacturer specifications including sizing, length, number of elbows and termination. Yes () No( ) The undersigned also verifies that the replacement unit is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No( ) The existing combustion air is sized and installed to meet the current codes and manufacturer's specifications. Yes () No( ) When required to install a new combustion air, it will be sized and installed to meet the current codes and manufacturer's specifications. Yes () No ( ) When installing a new venting system, the undersigned hereby verifies that it is a listed assembly and meets the current codes and manufacturer's specifications. This does include AGA-GAMA Category I Central Furnace Venting Tables for fan assisted and natural draft appliances. Yes () No ( ) Is the common vent and vent connectors sized and installed correctly after an appliance has been removed from the common vent and vented separately as per current codes. Yes () No( ) Anoliance Tvoe 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) [02401fill � Signed By: Date : CITY OF FRIDLEY 6431 UNIVERSITY AVENUE NE FRIDLEY, MN 55432 t07L-36U4 VAX: (763) Z 11-12757 ADDRESS : 1425 TROLLHAGEN DR NE PIN : 253024120028 LEGAL DESC : INNSBRUCK 2ND ADD WATER TREATMENT APPLIANCE : LOT 5 BLOCK 1 PERMIT TYPE : PLUMBING PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDITION/ALTERATION PERMIT N : 2004-00958 DATE ISSUED: 06/21/2004 VALUATION : $ 0.00 NOTE: COMBUSTION AIR SHALL BE PROVIDED PER UMC CHAPTER 6 AND TABLE 6-A. INSTALL A BACK FLOW PREVENTER (WILKINS 720) ON THE IRRIGATION SYSTEM. # ELEC WATER HEATERS 0 VALUE OF FIXTURE/APPLIANCE 0 # NEW FIXTURES (EXIST OPENINGS) # GAS DRYERS # OF NEW FIXTURES APPLICANT DUCA TIMOTHY M & ROBERTA R 1425 TROLLHAGEN DR NE FRIDLEY, MN 55421 3AK ' DUCA TIMOTHY M & ROBERTA R 1425 TROLLHAGEN DR NE FRIDLEY, MN 55421 0 # GAS WATER HEATERS 0 0 # GAS RANGES 0 1 # WATER TRMT APPLIANCES 0 AGREEMENT AND SWORN STATEMENT This permit becomes null and void if work or construction authorized is not commenced witin 60 days or if construction or work is suspended or abandoned for a period of 120 days at any time after work is commenced. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of wort will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law regula' g nstru ion or the performance of construction. Applicant Date Bldg Insp PLBG PERMIT MINIMUM FEE 15.00 PLBG FIXTURES (NEW OPENINGS) 0.00 PLBG FIXTURES (EXIST OPENINGS) 0.00 WATER TREATMENT APPLIANCE 0.00 WATER HEATER - ELEC 0.00 WATER HEATER - GAS 0.00 GAS RANGE FEE 0.00 GAS DRYER FEE 0.00 PLBG REPAIR/ALTERATIONS 0.00 STATE SURCHARGE, PLBG FLAT 0.50 TOTAL 15.50 PAID WITH CHECK # 4967 SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.