PRE 2010 DOCSTO WHOM IT MAY CONCERN:
August 5, 1965
Re: Ellsworth Hinz
384 - 66th Avenue N. E.
Inspection of Garage Floor
At some time during the storm repair inspections, the Insurance
Adjustor for this property requested my presence at this address to
inspect the garage floor. The question was whether the cracks appearing
on the garage floor were caused by the tornado or not.
I made the statement at this time to the adjustor in the
presence of Mrs. Hinz that I could not say that the cracks were caused
by the storm. I did not make the statement that the cracks were not
caused by the storm. I merely said I could not say they were caused
by it.
Sincerely,
ALLEN G. JENSEN
Building Inspector
City of Fridley
AGJ:cks
City of Fridley, Mian..
BUILDING PERMIT
•
Date: AUGUST 172 1965
RLLSWORTH HINZ
361-� %
N? 83'3
Builder H. J. BLOMSTRAND & SONS, INC.
Address 384 - 66th Avenue N. E. Address 1220 Arcade Street
Fridley 32, Minnesota St. Paul, Minnesota
LOCATION OF BUILDING
No. 384 Street 66th Avenue N. E. Part of Lot
Lot 4 _ Block 3 Addition or Sub -Division Rice Greek Terrace Plat
Corner Lot Inside Lot Setback Sideyard
Sewer Elevation
To be Used as:
Type of Construction
Foundation Elevation
DESCRIPTION OF BUILDING
Front Depth Height Sq. Ft.
Front Depth Height Sq. Ft.
Est. Cost —$1, 000. 00 To be Completed
•
REPAIRS DUE TO STORM
•
Cu. Ft.
Cu. Ft.
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. �/ F
In consideration of the payment of a fee of 210.00 , permit is hereby granted to H. J. BLOMSTRAND &
SONS, INC. 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, may
construction,
any time inan�o sial n off anyand
the pmoving
Of ba 41A4 -id
within the city limits and this permit
ordinance.
ALLEN G. JENSEN Building Inspector
NOTICE:
7W pme don not carer the construction, hotaiistion for whing, phwb1no, on hosting, Baru or water. Be an to as
the Butldieg h*utor for apwate pwnshs for thea hmm
53-84-9915051 .
City of Fridloy
ApplictstIcn for Pluwling cma Sin r-111fing Peit .
Dept. of Blda-a. Phone SSO-34W
DESCRIPTION OF 410r.r.
Num'xr, Kind and Locrtion of Fixtures 381s 66th Ave.• North
Futu.ra C =G=4 -u OpQnir_3s `'i7° Y7i°
Seveso
Xow Fixture. Old Opsnings Cc:spool C]
PARTIAL RATE SCHEDULE
,UMBING FIXTURE RATES:
NO. RATE TOTAL
Number Fixtures ................
x $2.00
$
Future Fixture Opening ............
x $1.50
$--
_.vew
New Fixture Oki Opening.....:....
< 3
U
U a
N
IU
$
Water Beater f Up to 99.000 BTU)
wAM MTA.
GAS
ucc.
x $3.25
$
Electric Water Hastor...... ........
a $2.CO
$
LS FITTING FEES:
NO. RATE TOTAL
Ist 3Fixtures ............. • • • • •
x $2.00
$ .
Additional Fixtures ...............
x $ .75
$
Gas Range to 199.000 BTU, ...........
1 x $5.00
$ oo
114 RPLC
1
i
Futu.ra C =G=4 -u OpQnir_3s `'i7° Y7i°
Seveso
Xow Fixture. Old Opsnings Cc:spool C]
PARTIAL RATE SCHEDULE
,UMBING FIXTURE RATES:
NO. RATE TOTAL
Number Fixtures ................
x $2.00
$
Future Fixture Opening ............
x $1.50
$--
_.vew
New Fixture Oki Opening.....:....
x $1.50
b_.._
Catch Basin ....................
x $3.25
$
Water Beater f Up to 99.000 BTU)
x $3.00
$
New Ground Run Old Bldg.........
x $3.25
$
Electric Water Hastor...... ........
a $2.CO
$
LS FITTING FEES:
NO. RATE TOTAL
Ist 3Fixtures ............. • • • • •
x $2.00
$ .
Additional Fixtures ...............
x $ .75
$
Gas Range to 199.000 BTU, ...........
1 x $5.00
$ oo
City of Fridley:
The undersigned hereby snakes application for a permit for the- work herei
specified, aZreeing to do all work in strict accordance with the City Ordirance
and ruling of the Department of Buildings, and hereby declares that all the fart
and representations stated in this application are_true and correct'
Fridley, Mina 3-9-76 M & I9e
Owner Ellsworth Him
Kind of Building frame
Used as res.
To be completed about 3-16-76
Estimated Cost,. $ 10_00
Old—Mm. Building Permit No. Permit No 0
L� �
Signed
MINNEGASCO
By --
Business Phone No
ROUGH
FINAL /0
:PAIRS & ALTERATIONS—Rafer to Code .50 State Sur'Charga
. Description ........................................ �
TOTA,rZE $5. 50 Class "A" S'Lircharge .50¢
City of Fridley
AT THE TOP OF THE TWINS
SUBJECT
BUILDING PERM
P
® 1 45�
r i.
COMMUNITY DEVELOPMENT DIV.
1 � PROTECTIVE INSPECTION SEC.
1 ` �
CITY HALL FRIDLEY 55432
612-560-3450
CEIPT N
�J
NUMBER
910-F15
REV.
DATE
4/16/76
PAGE OF
APPROVED BY
�aVADDaEss .66ath Avenue N.E...
O..
1 LEGAL
DES CR.
LOT NO.,
4
I BLOCK ...... .....TRACT
3
OR ADDITION SEE ATTACHED
Rice Creek Terrace Plat 2 SHEET
2 PROPERTY OWNER MAILADDRESS ZIP PHONE
Ellsworth F. Hinz 384 - 66th Avenue N.E.
3 CONTRACTOR MAILADDRESS 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
Ij NEW ❑ ADDITION ❑ ALTERATION ❑ REPAIR ❑ MOVE ❑ REMOVE
8 DESCRIBE WORK
Construct a 12' x 20' Shed
9 CHANGE OF USE FROM TO
STIPULATIONS
Shed must be permanently attached to g Ound by either a foundation or
ties.
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING, HEATING,
TYPE OF CONST.
OCCUPANCY GROUP
OCCUPANCY LOAD
VENTILATING OR AIR CONDITIONING.
Wood Frame
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUCTION
AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION
ZONING
SO. FT.
CU. FT.
OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT
R-1
240
2400
ANY TIME AFTER WORK IS COMMENCED.
NO. DWLG. UNITS
OFFSTREET PARKING
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION
j
ISTALLS GARAGES
AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS
AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED.
WITH WHETHER SPECIFIED HEREIN OR NOT. THE GRANTING OF A PERMIT.
VALUATION
$$OO.00
SURTAX
- 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.
$5.00
PLAN CHECK FEE
TOTALFEE
$5.50
TE)
GN TUREOFCONTRACT R RAUTHWIZEDAG NT W&76
WHEN PROPERLY VALIDATED THIS IS YOUR PERMIT
1 -1b/ -e7/
y
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APPLICATION FOR RESIDENTIAL, ALTERATION,
OR ADDITION BUILDING PERMIT
CITY OF FRIDLEY, MINNESOTA
OWNER'S NAME•45,1 /N -Z- BUILDER:
ADDRESS: - l06 tff;4 U�5 , /V,L ADDRESS:
NO • . �O STREET • Com(/ � ,4P ef`, I , E ,
LOT: BLOCK: ADDITION :, /Cc- Ce Egg %,ej?1?.4 C z ,2L y r z
CORNER LOT: INSIDE LOT: !s SETBACK: SIDEYARD:
Applicant attach to this form Two Certificat^s of Survey of Lot and proposed
building location drawn on these Certificates.
DESCRIPTION OF BUILDING
To Be Used As:
J & 'ED Front: Depth: Height:
Square Feet: Cubic Feet:
Front: Depth: Height:
Squares �F�eet; Cubic Feet:
Type of Construction: Estimated Cost: $
To Be Completed:Q r
The undersigned hereby makes application for a permit for the work herein,
specified, agreeing to do all work in stiict accordance with the City of
Fridley Ordinances and rulings of the Department of Buildings, and hereby
declares that all the facts and representations stated in this application
are true and correct.
DATE: — Ao - 7(e:7 SIGNATURE: o
(See Reverse Side For Additional Information.)
NEW [ ] CITY OF FRIDLEY
ADDN [ ] 6431 University Ave NE, Fridley, MN 55432 (763) 572-3604 Bldg Insp
ALTER [ ] SINGLE FAMILY AND DUPLEXES R-1 AND R-2 (763) 571-1287 Fax
BUILDING PERMIT APPLICATION
Construction Address: 3 ,Fr Y G G "-/ -x"-
Legal Description:
Owner Name & Address: /Oa ve ',4 CA Tel. #
Contractor: S�e �� MN LICENSE #
Address: sG' 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: . 0 �.
-3. aD
Construction Type: 91r- Estimated Cost: $
Driveway Curb Cut Width Needed: Ft. + 6 Ft = Ft x $ _
DATE: �.s - G>' APPLICANT: 017 �r 61.".1 Tel. # 763- �7/- 6^3 c 7
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
Plan Review
Fire Surcharge
State Surcharge
SAC Charge
License Surcharge
Curb Cut Escrow
Erosion Control
Park Fee
Sewer Main Charge
Fee Schedule on Reverse Side
65% of Permit Fee
.001 of Permit Valuation (1/10th%)
$.50/$1,000 Valuation
$1450 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 [ ]
TOTAL $ O �-S STIPULATIONS:
MECHANICAL �. Permit No.: �
Building Received By:
Inspections RESIDENTIAL APPLICATION ,
7.63-572-3604 CITY OF FRIDLEY
EAD
�' 1 vT� YOUR E-MAIL ADDRESS
APPLICANT IS:
❑OWNER C�2elA TrRACTOR
PROPERTY
OWNER/
TENANT
CONTRACTOR
SUBMIT A COPY OF
YOUR STATE
LICENSE WITH
APPLICATION
PERMIT TYPE
ADDRESS: a 46®, 1 -e-4`4 Av4 CITY
PHONE:,
COMPANY NAME:_
CONTACT PERSON:
STATE LICENSE #_
EXP DATE
effNGLE FAMILY ❑ TWO FAMILY ❑ TOWNHOUSE
p NEW p�LACEMENT ❑ ALTERATION/REMODEL
TYPE OF WORK:
DETAILED DESCRIPTION OF WORK
ATL4kJ ZIP
TE-HNZIP ��
PER MS 16B.665 the permitfee is a minimum of $15.00 or 5% of the total cost up to $500.00, whicbever is greater, for the
improvement, installation or replacement of a residential fixture, excluding the fixtures. (This should reflect only the cost of labor)
X.05
Labor cost under $300 = $15.00. Labor cost between $300 to $500 =cost of labor_
KATE TOTAL
FOR PROJECTS WHERE LABOR EXCEEDS $500, FEES ARE BASED ON $10.00 PER FIXTURE,
EXCEPT WHERE NOTED. FIXTURES:
NUMBER OF EACH BELOW) MFG: ��„ �I,e „� MODEL: M "��
Equipment Installed MODEL: SIZE/BTU
MFG: MODEL: SIZ BTU
MFG: GAB RANGE/OVEN 510.00
A/C $25.00 _FIREPLACE (GAS) $15.00. NEW GAS GRILL $10.00
AIR TO AIR EXCHANGEER 515 FIREPLACE (WOOD) $35.00 GAS UNIT HTR $10.00
—BOILER $35.DO 7;: URNACE $35.00 POOL HEATER $35.00 -
CHIMNEY LINER SIO.OD _GAS DRYER $10.00 —VENTILATOR $15.00
DUCT WORK $10.00 _GAS PIPING $10-00-08 AMR,v
Permit Fee $ Number of fixtures @ $10.00 x $10.00
'5" 5w
Surcharge $ 50 Number of fixtures @ $15.00 x $15.00 = $
TOTAL DUE $ Number of fixtures @ $25.00 x$25.00 = $
Number of fixtures @ $35.00 ✓x $35.00 = $,
State Surcharge = $ .50
Total = ��
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
n Codes; the work will
stand this is
n
conformance with the ordinances and codeseoff the C'rmi wo t k IctIc o start and lwithout th the al permit; that the wesota ork will be in accordance with the
not a permit but only an apple ati P
approved plan in the case of all w c ares review and approval of pl D
PRINT NAME DATE
SIGNATURE OF APPLIC
City of Fridley
Building Inspections Department.
6431 University Avenue NE, Fridley, MN 55432
763-572-3604
r. e v. -7ic2 <W)-AQ77
REQUIRED INFQRMATION NEEDED TO PROCESS PERMIT
RESIDENTIAL PERMIT APPLICATION HVAC
NEW HOMESIADDITIONS ❑
EXISTING HOME ❑ MAKE-UP AIR
REQUIRED FOR NEV11EXISTING HOMES
1. Combustion Air (See note below)
a. Oil or solid fuel IMC Chapter 7 with MN �nendments
b. Natural Gas or propanefTGC Chapter 3 with MN Amendments
2 Make-up Air (See note below)
a. IMC Chapter 5 with MN Amendments
3. Venting
a. Gas appliances IFGC Chapter 5 with MN Amendments
b. Fuel oilier than gas IMC Chapter 8 with MN Amendments
EEQUIRED FOR NEW HOMES
4. Heat loss & cooling load Per room
a_ Required on new construction IMC 1346.0312
5. Ventilation
a. Per MN Energy C6ae 7670 or 7672
6. Duct Design Per IMC 1346.0603.2
a. ACCA Manual D ,
NOTE.
Lente oint Energy Mechanical Code Guidelines software may be used for
coinuu.stion and make up air calculations
Building
BUILDING
Permit No.: Z4D q 01 &
inspections
RESIDENTIAL APPLICATION
Received By
763-572-3604
Date.: AUG
CITY OF FRIDLEY
'JATE 6 (O Jbq
YOUR E-MAIL ADDRESS
SITE ADDRESS 3 a q
L 4K
THIS APPLICANT IS:
❑ OWNER 'BCONTRACTOR
PROPERTY OWNER/
NAME: Kfll J0h/)5on
TENANT
ADDRESS: 3 a q 6(,/,,
AVL M CITY FP/ el[
STATE ZIP Jr'SV 3
PHONE:
CONTRACTOR
NAME:_ THD -At-Home Services, Inc. .Jodi em
Fid i r J d n < S
STATELI(. 2690 Cumberland Pkwy, Ste 300 q sa j a
yrs - c, o u -7
SUBMIT A COPY OF
YOUR STATE LICENSE
ADDRESS Cumberland Office Park CITY
WITH APPLICATION
PHONE Atlanta, GA 30339-3913
❑ SINGLE Lic# 20268257 Ph. 763/542-8826 =E
—STATE—ZIP
PROPERTY TYPE
❑ TWO FA .ORIES
PERMIT TYPE
11ADDITION ❑ GARAGE/SHED –t3 -V NDOWS
❑ BASEMENT FINISH ❑ ROOF ❑ DRAIN TILE
❑ DECK ❑ SIDING ❑ OTHER
❑ SWIMMING POOL
TYPE OF WORK:
❑ NEW ❑ ADDITION
ANCE/REPAIR ❑ REMODELING
1
DESCRIBE WORK BEING DONE:_ y Lo ► /1 & W lit � [i G M 11)4S (,n . Y/
//
S T t t1
0 J21 f 1 I/-)
S . Ft.
'IZE OF IMPROVEMENTHEIGHT LENGTH WIDTH
tOOFIIVG
❑ HOUSE ONLY
7UMBER OF SQUARES
O HOUSE & GARAGE
BASEMENT REMODELING SUBMIT:
;ARAGES
❑ ATTACHED GARAGE
1.
Existing Floor Plan
'ROPOSED SIZE:
❑ DETACHED GARAGE
2.
Proposed floor plan
'ROPOSED HEIGHT:
3.
List of structn -A members to be used
TIDING
FOR NEW CONSTRUCTION INCLUDING DECKS,
vinyl
❑Soffit
ADDITIONS. & PORCHES SUBMIT:
I Aluminum
❑ Trim
1.
Site Plan/Survey showing the existing structures
I mer
❑ Fascia
and proposed project
ilmows
2.
Two sets of construction plans
V EXISTING OPENINGS'SkYes ❑No LOCATION OF )yIN OWS
3.
Energy Calculations
?R FOR NEW OPENINGS -DESCRIBE SIZE OF K, �t h rA /�1 �roo� • �j o ��(�uy /fti
>PENING CHANGES & ]. ..b 4 "&'A t t'
(�w.�n 1
YPE OF WINDOW TO BE INSTALLED
. NUMBER OF VaNDOWS T
ALL FEES ARE BASED ON VALUATION, INCLUDING THE COST OF LABOR AND MATERIALS:
(USING THE 1997 U.B.0 FEE SCHEDULE)
TOTAL JOB VALUATION $ d 10 % OCCUPANCY TYPE
ermit Fee
Ian Review
urcharge
ire Surcharge
icense Surcharge
AC Charge
:urb Cut Escrow
rosion Control
ark Fee
ewer Main Charge
'otal Due
See Back Page for Fee Schedule
65% of Building Permit Fee
(.0005) times the total job valuation — Minimum $.50
.001 x Permit Valuation (1/10%)
$5.00 (State Licensed Residential Contractors)
$1450 per SAC Unit (Plans to MWCC for determination)
ft+6ft= ftx$20=$
$450 Conservation Plan Review
Fee Determined by Engineering
Agreement necessary ( ) Non Necessary ( )
Make checks savable to: City of Fridley Attach
THIS IS AN APPLICATION FOR A PERMIT -NOT VALID UNTIL PROCESSED
hereby apply for a building permit and I acknowledge that the information above is complete and accurate; that the work will be in
mformance with the ordinances and codes of the City of Fridley and with the Minnesota Construction Codes; that I understand this is not a
-rmit but only an application for a permit and work is not to start without a permit; that the work will be in accordance with the approved
:an in the case of all work which requires ie d approval of plans. ^� ; < ` 6 bo /el
GNATURE OF APPLICA153y�PRINT NAME / � � J " /) * 11 C DATE