PRE 2010 DOCSJ/= � 7
City ®f Fridley, Minn.. X9 9364
BUILDING PERMIT
Date: July 21, 1967
Owner: _ Dr. Waite Builder Rn n yBillman
Address Address
LOCATION OF BUILDING
No. _1599 Street Trollhagen - Part of Lot
Lot ____ 4 _ Block 2 Addition or Sub -Division . _ Innsbruck 5 th Addn4,
Corner Lot — Inside Lot _ Setback _ Sideyard
Sewer Elevation 959.83 _1 GQMX 962.83
TOP OF FOOTING
DESCRIPTION OF BUILDING
To be Used as:
DWELLING Front 74' Depth 26 '&39' Height --Split Sq. Ft Cu. Ft
Type of Construction
Front Depth Height . _ Sq. Ft. Cu. Ft
Frame Est. Coat __ $29, 000 __ To be Completed Dec, 1,, 1967
SEWER LOCATION - 70' North of Manhole (Service off St. Imier))
WATER LOCATION - 80' North of Manhole
In consideration of the issuance to me of a permit to construct the building described above I agree to do
the grosed work in accordance with the description above set forth and in compliance with aft provisions of
ordinances of the city of Fridley.
S100_00 Sewer Cnnnp-tinn rharga
In consideration of the payment of a fee of $ 58.00 , permit is hereby gated to Rodney Billman
Ina.
to construct the building or addition as described above. Thisreit is granted upon
the express oundition that the person to whom it is granted and his agents, employees ancr workmen, in all work
done in, around and upon said building, or any part thereof, shall conform in all respects to the ordinances of
Fridley, Minnesota regarding location, construction, alteration, maintenance, repair and moving of buildings
within the city limits and this permit may be revoked at any time upon violation of any of the provisions of said
ordinances.
CLARENCE BELISLE Buildbg Inspector
NOTICE:
This permit does not cover the construction, installation for wiring, plumbing, gas heating, sewer or water. Be sure to ase
the Building inspector for separate permits for than items.
r
APPLICATION FOR BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER ' S NAME BUILDER
ADDRESS ADDRESS��
LOCATION OF BUILDING
NO. `� �p STREET ��' �� `� + � s -APART OF LOT
i�
LOT BLOCK ADDITION OR SUBDIVISION,2,,,,,1,7' Z�f__ _
CORNER LOT INSIDE LOT SETBACK SIDE -YARD
SEWER EL VATION C16 TOP OF FOOTING
Applicant attach to this orm two certificates of survey of lot and proposed
building loc ion drawn oJI1th e two certificates.
L w — v ✓ _
DESCRIPTION OF BUILDING
�.
a
To be Use/as:
P
� a
Front Depth (ei 91 Height
S q . Ft.__ �' - �-,,, u. Ft. -
Front
t.Front Dept 'y Height _
Sq. Ft. Cu. Ft. _
Type of Construction Estimated Ca _
To Be Completeds��-�
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 ruling of the Department of Buildings, and hereby declares that all the facts
and representations stated in this applic on are true and correct.
DATE SIGNATURE
(Schedule of Fee Costs can be found oe Reverse Side).
,r _z o
BUILDING PERMIT FEE SCHEDULE
SECTION 2. The Inspector of Buildings shall, before issuing permits for the
erection of any building of 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- $1.75 for each one thousand cubic feet, or
fraction thereof, in such cubical contents. Type 3 & 5 - $1.50 for each
one thousand cubic feet.
For the purpose of computing fees ,for building permits, the cubical contents of
any building or addition to a uniform height throughout by multipluing 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.
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.
NSSSD Connection Charges based on location- Area 1 or 2.
3
CITY OF FRIDLEY
Effective May 1, 1990
APPLICATION FOR POWER PLANTS
AND HEATING,
COOLING, VENTILATION, REFRIGERATION AND
AIR CONDITIONING SYSTEMS AND DEVICES
RATE SCHEDULE
RESIDENTIAL
RATE
TOTAL
Job Address ls4 �g c7a to 'A" &ILS
Furnace Shell and Duct Work,
(Also replacement furnace) $
20.00
$ .1"0. FV
Department of Buildings 6431 University Ave. N.E., Fridley, NN 55432
Burner
City of Fridley
Gas Piping $
10.00
$
Tel. #571-3450
(piping needed with new furnace)
$
10.00
$
The undersigned hereby makes application for a permit for the work herein
Gas Range �
specified agreeing to do all work in strict accordance with the City Codes
Gas Dryer $
101.00
$
and rulings of the Department of Buildings, and hereby declares that all the
facts and representations stated in this application are true and correct.
��ry� �A 01 js- !- /
• Air C n�ning all sizes) $
10.00
Fridley, Minn. 6-7 19 --5b
All Others/Repairs and Alterations
OWNER'
It of Value of Appliance or Work
S
KIND OF BUILDING
COMMERCIAL/INDUSTRIAL
USED AS
It of Value of Appliance or Work
$
t�
TO BE COMPLETED ABOUT
ESTIMATED COST
State Surcharge
S .50
��
OLD - NEW BUILDING PERMIT N0. PERMIT NO.
TOTAL !EE
$
Reinspection Fee (515.00)
S
DESCRIPTION OF FURNACE/BURNER
Rough Insp.
HEATING or POWER PLANTS, Steam, Not Mater, warm Air- No.
Date
7Final Insp.
Trade Name��A� Size No.
Date
Capacity / e2�'&7p-pSq. Ft. EDR BTU Ids- lil HP
Approval for Permit
Total Connected load Kind of Fuel 4-02,9
ff
BURNER - Trade Name Size No.
Capacity Sq. Ft. EDR BTU HP
MINIMUM FEE FOR ANY HEATING PERMIT IS
$15.00
Company
PLUS $.50 STATE SURCHARGE
��
Signed By i�Y✓�
*Air conditioners can not be placed in side yard without
written permission from adjoining neiglibor.
Tel. No.
Fill out back side for stack verification on replacement furnaces
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CHIMNEY AND STACK VERIFICATION
The undersigned hereby verifies that the existing chimney or stack;
1.
Has been carefully examined
Yes (,)
No ( )
2.
Is free from rust or deterioration
Yes ( )
No ( )
3.
Has no foreign objects lodged within
Yes ( )
No ( )
4.
Is securely supported
Yes ( )
No ( )
5.
Meets all current Code requirements for size and
total BTU connected
Yes ( )
No ( )
6.
Has Total heating BTUSs of
All other BTU's
TOTAL
Remarks
Company
Signed By
Date
CITY OF FRIDLEY
APPLICATION FOR HEATING REPLACEMENT
CHIMNEY AND STACK VERIFICATION
THIS FOR14 MUST ACCOMPANY STANDARD APPLICATION FOR IIEATING PERMIT FORM.
LOCATION I DATE
OWNER��� ADDRESS
The undersigned hereby verifies that the existing chimney or stack:
1. Has been carefully examined
2. Is free from rust or deterioration
3. No foreign objects are lodced within
4. TFa t it is securely supported
S. That it greets all current Code requirements
for size and total BTU connected
6. Total Heating BTU 1-A61.Q®0
All Other BTU _-5Q om 0
TOTAL
REMARKS
SIGNED C::--� s lld—'
Licens e
by �
Address
Telephone
HEATING PERMIT #
Fridley City License #
W
4 J
SEDGWICK HEATING & AIR CONDITIONING CO. HEATING JOB N014_�LQ 3 %9
8910 WENTWORTH AVENUE SOUTH - MINNEAPOLIS, MN 55420 - (612) 881-9000 TEST RECORD
ADDRESSCITY isb P_
OCCUPANT OWNER
SOLD BY INSTALLED BY
MAKE L i�- N( (o �(' MODEL G2- () `� 9 IE — I
SERIAL NO. SO 0 O'Zrq INPUT2Dc2c2
I
THERMOSTAT H ol0I e "/ Lj
VALVE- R,oben4 S�&tj
LIMIT— S+e�C-0
LIMIT SETTING f cco
FAN SETTING.
PILOT TYPE G L197 C -T
197C -T RQ t\(d (
IGNITION MODEL go � 42sA S k� ANd
PILOT TIMING Ttr::&t)�
P
PRESSURE 3 * I� 11) C PERCENT C
m
VENT SIZE
TYPE OF LINER
LINER SIZE
FILTERS: SIZE 2-ov 15-.A, NUMBER
WIRING L"o,
TEST TAG Lff/
LIGHTING INST. L
DATE TESTED 77 — IS
INPUT CFH PERCENT 02 %b COMPANY TESTING p G
STACK TEMP. L? PERCENT Co ®N Ir
NAME OF TESTER Le.
FORM 235 (REV. 11/89) FORM DISTRIBUTION: WHITE COPY - JOB FILE YELLOW COPY -CITY
SUBJECT - R
City of Fridley *F�32 14AT THE TOP OF TME TWINS BUILDING PERMIT COMMUNITY gEVELOPMENT OIY. � � yPROTECTIVE INSPECTION SEC. J
1 ;
CITY HALL FRIDLEY 55432 NUMBER REV DATE PAGE OF APPROVED BY
612-571-3450 910-F15 8/28/01
JOB ADDRESS 1599 Trollhagen Drive
I LEGAL LOT NO. BLOCK TRACT OR ADDITION SEE ATTACHED
DESCR. 4 2 Innsbruck 5th Addition SHEET
2 PROPERTY OWNER MAIL ADDRESS ZIP PHONE
Norman Hagfors, 1599 Trollhagen Dr, Fridley, MN 55421 763-571-7645
3 CONTRACTOR MAIL ADDRESS ZIP PHONE LICENSE NO
Western Cedar Supply, 9700 13th Ave N, Plymouth, MN 55441 763-541-0304 20155566
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 CT REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Reroof H & G (tear-off) - 39 sq.
9 CHANGEOFUSEFROM TO
STIPULATIONS
Underlayment must meet State Building Code.
TYPE OF CONST. OCCUPANCY GROUP OCCUPANCY LOAD
SEPARATE PERMITS ARE REOUIREO FOR ELECTRICAL, PLUMBING, HEATING,
VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION ZONING SO. FT CU FT
AUTHORIZED IS NOT COMMENCED WITHIN 80 DAYS, OR IF CONSTRUCTION
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
ANY TIME AFTER WORK IS COMMENCED. NO. DWLG. UNITS OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION 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 $4,180.00 $2.09
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 $111.25 Fire SC $4.18
PLAN CHECK FEE TOTAL FEE
-0/ Li ense Al 5.00 122.52
SIGNATURE OFCON 'RACTORORAUTMORIZEDAGENT "DATE" WH PROPERLY VALIDATED THIS IS Y UR ER IT
_Y
S-GNATURE OF OWNEROF OWNER BUILDER" - "DATE" "NSP - O qAT
NEW [ ] Effective 1/1/2001
ADDN [ ] CITY OF FRIDLEY (763) 572-3604 Bldg Insp
ALTER [ j SINGLE FAMILY AND DUPLEXES R-1 AND R-2
BUILDING PERMIT APPLICATION
Construction Address:
Legal Description:
Owner Name & Address: Tel. # i6 3 _ 7/t-
Contractor: �✓��� CSR•^ Siy MN LICENSE# a�SSS
Address:?C� / 3 fir ti - l� /y 5f > ��/ Tel. #
Attach to this application, a Certificate of Survey of the
lot, with the proposed construction drawn on it to scale.
DESCRIPTION OF IMPROVEMENT
LIVING AREA: Length Width Height Sq. Ft.
GARAGE AREA: Length Width Height Sq. Ft.
DECK AREA: Length Width Hgt/Ground Sq. Ft
OTHER:
Construction Type: ��'G`Estimated Cost: $y /
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ =$
DATE: a APPLICANT: 11"�-c `ao %�` Tel. It -7C S
CITY USE ONLY -
Permit Fee
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Driveway Escrow
Erosion Control
Park Fee
Sewer Main Charge
TOTAL
STIPULATIONS:
Call (763) 572-3604 for Permit Fees if mailing in application
$ 111. c�S Fee Schedule on Reverse Side
$, / .001 of Permit Valuation (1/10th%)
$ ® $.50/$1,000 Valuation
$ $1150 per SAC Unit
$ J. () o $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
BUILDING
Permit No
Inspections
RESIDENTIAL APPLICATION
Received By:
763-572-3604
CITY OF FRIDLEY
Date qtFLU
763-502-4977 FAX
EFFECTIVE 1-1-2010
DATE Sh%- L-
a��� YOUR E-MAIL ADDRESS
SITE ADDRESS
THIS APPLICANT IS:
❑ OWNER CONTRACTOR
PROPERTY OWNER/
NAME:_e"��'ELL-
TENANT
ADDRESS:_l��i �¢yl.L.?hP+C+ri/� �� CITY STATf tUZIP
PHONE:
CONTRACTOR
NAME: ♦ v
SUBMIT A COPY OF
YOUR STATE LICENSE
STATE LICENSE # LAd5''� EXP DATE V o a
AND CERTIFICATE OF
ADDRESS: too `� b� �%CJ t.� CITYC,t1 �,pe'..�.j STATFMI� ZIP 'Cc.f Z7
INSURANCE
PHONE FAX
PROPERTY TYPE
❑ SINGLE FAMILY/NEW CONSTRUCTION SIZE
❑ TWO FAMILY/NEW CONSTRUCTION STORIES
PERMIT TYPE
❑ ADDITION ❑ GARAGE/SHED j ,WINDOWS
❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE
❑ DECK ❑ SIDING 0 OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW HOME CONSTRUCTION ❑ ADDITION
❑ MAINTENANCE/REPAIR. '❑ REMODELING
DESCRIBE WORK BEING DONE:_g�',ey-P �+� ♦ N�yw
SIZE OF IMPROVEMENT
LENGTH WIDTH
HEIGHT SQ FT
ROOFING
❑ HOUSE ONLY
NUMBER OF SQUARES
13 HOUSE
HOUSE & GARAGE
REMODELING SUBMIT:
EMODELING
RPlan
1. Existing Floor
GARAGES
❑ ATTACHED GARAGE
2. Proposed floor plan
PROPOSED SIZE:
❑ DETACHED GARAGE
3. List of structural members to be used
PROPOSED HEIGHT:
SIDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
❑ Vinyl
❑Soffit
ADDITIONS. & PORCHES SUBMIT:
❑ Aluminum
❑ Trim
1. Site Plan/Survey showing the existing structures
❑ Other
❑ Fascia
and proposed project
2. Two sets of construction plans
R'INDOws
3. Energy Calculations
IN EXISTING OPENINGS Yes [No LOCATION OF WINDOWS
FOR WINDOWS — PROVIDE U -VALUE AND
OR FOR NEW OPENINGS -DESCRIBE SIZE OF
MANUFACTURE STICKER ON WINDOW.
OPENING CHANGES &
TYPE OF WINDOW TO BE INSTALLED 4. NUMBER OF WINDOWS
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ -Z �9 , a OCCUPANCY TYPE
Permit Fee $ // ` See Back Page for Fee Schedule
Plan Review $ 65% of Building Permit Fee
Fire Surcharge $ L/ .001 times the total job valuation
Surcharge $ .0005 x Permit Valuation Minimum $.50
License Surcharge $ $5.00 (State Licensed Residential Contractors)
SAC Charge $ $2100 per SAC Unit (Plans to MWCC for determination)
Curb Cut Escrow $ ft + 6 ft = frx $24 = $
Erosion Control $ $450 Conservation Plan Review
Park Fee $ Fee Determined by Engineering
Sewer Main Charge $ Agreement necessary ( ) Non Necessary ( )
Total Due $ Make checks payable to: City of Fridley Attach Stipulations
THIS IS AN APPLICATION FOR A PERMIT NOT VALID UNTIL PROCESSED
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in
conformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a
permit but only an applic icp for a permit and work is not to start without a. permit on site; that the work will be in accordance with the
approved plan in the casew ' requires review d approval of plans.
SIGNATURE OF APPLICANTM=*
PRINT NAME �V—A,t+�Fy� �rLLJATE p Q \ a