HomeMy WebLinkAbout2014-00472 - doors « �� CITY OF ORONO _
2750 KELLEY PARKWAY * � 0 1 4 0 0 4 7 2 *
DATE ISSUED: OS/27/2014
ORONO,MN 55356-
(952 249-4600 FAX: 952 249-4616
ADDRESS : 1770 SHADYWOOD RD
PIN : 17-117-23-21-0023
LEGAL DESC : SHADY-WOOD
: LOT 018 BLOCK 000
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : DOORS
ACTIVITY : O/S BUILDING-UNDEFINED
VALUATION : $ 2,908.00
NOTE: REPLACEMENT OF(1)PATIO DOOR INTO EXISTING OPENING.
APPLICANT PERMIT FEE SCHEDULE 88.50
STATE SURCHARGE(VALUATION) 1.45
THE HOME DEPOT A.H.S. MAIL-IN FEE 2.00
2690 CUMBERLAND PKWY, STE 300 TOTAL 91.95
30339-
(763)542-8826 Payment(s)
Minnesota State License#: BUIL-20268257 CHECK 68112 91.95
OWNER
O'DONOGHUE,DANIEL&SUE
1770 SHADYWOOD RD
WAYZATA,MN 55391-
AGREEMENT AND SWORN STATEMENT
The work for which this pertnit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires sepazate
permits. All provisions of laws and ordinances goveming this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of I80 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
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Applicant Permitee Signa e ate Issue B Si nature Date
Y g
05/19/2014 12:36 9522494616 CITY OF ORONO PAGE 02/02
M�Y '19/2014/MON 12;56 AM Elder Jones Building �Ak No. 952 854 4909 P, OQ2
, �.
Cifiy of +Orono
Building Permit Appl�cation for Internai Vllork
(windows, doors, siding, re,roof, etc.)
Me11�+s�aaress: � �
"�"��T PO eox 66 Permit number: � —
�, (� Crystal Bsy,MN 5532�Opfi6 Dete received: � -�j/
''� ��� � Str9et Address: R9ceived by:
��-, ' G�' 2750 Kelley Parkway Alan review fee:
�s8o�' Orono, MN 55366
Ma��� 95�-249-4800 Fax: 952-249-461 e Total�ee: 9i �l-'l�r
i�OK Ci.otono.mn_us
7"his application form must b�complatad in full and aU r�equired inforr»atlon must be submitted,
Incorraplete app�ic$tions will be return•d. (P/easo prir�t)
GENERAL INFORMAT1oN:
Job Site Addiress: � �7 0 �/�(� � � RO Q
Will this be a Parade ofi Homes, Remedelers Sho e Home or other�isplay yome? Yes No
!f yes,s Speclel evllnt p�mNt ia ngaul�gd�i�ry pppce Depenment and CKy Gbunpl!4pp�qyp�60 d� �ror �
�ear+ired unfass epp/lcznt demonstra�as m,/fiolenl evr,oi�e p�ing�s avallabla. Non-eimpitte m���/��np�b�,t�o�dervlQ°w'I!Ae
CONTRACTOR�APPLICANT IN�ORMA'fION:
Name: 9S� 3yS- G e
State I.icense# THD At-Home Se�tv�j�e,�c, 7'
Phone: 2690 Cumberland Pk�ovy, Ste 30a ceii
Mailing Address: Atlanta,GA 30339-3913 ZlP:
Contact Person: Lic#CR268257�1�. 763/542-8826
Email end/or Fax- lomeowner ��,�o„a�
PROPER7Y OWIYER INF� �ON 1 b Q n a
Name: � � �{ � �
Phone(day): s� y 2 � . p � 'I
Address: / v R C' : �Q 7 Q�6 Zlp; "J�'S 3 j
Email and/or Fax
PROJECT INFORMAT�ON:
Fype ot P►oject:
Any opr[�h movement may require
Door{s) �Remodel �W�a�Q�age MCWD review b p4e��
❑Window(s) �epA�� ❑StOfm DamOgA Minnehah2 Geek W�ershed Dly�flct(MCWO)
18202 MirlfletOnka Blvd
❑Siding ❑Regtpr�ticn ❑pther. s � ��P����MN 55391
� p �� Phone: 952-471-0590
❑Re-roof ❑Fre Damage ��� 952-471-0662
���II�Po'ect DesCtiplion: Q �w.minn
�stimabed Constructfon Valuation af F'ro'ect(excluding land $ �X�� � A �
Q O '�
APPLICANT�ACKf�OWLEDGEMENT;
• AGrees to provide all informaGon�qyired or r�equested by tho BUilding Departmer�t;
• Certifies that the infonnatlpe au�rpl(ed is true and con�to the best of his/he��a�Atl9e, 7k�e applicani recognl�aa that they
are solely�p�Sibl2 for submifting a•opmplete application being aware tilat upon failure to do so,tha s�aff'h�,�a��„p
but to�ejact jt until It is Co�tplete;
• 'Some or all of the info►matlon thet ypu 8�e asked to provldo on thig appliCation 1s dslssifietl by State law as elthor pry'�te or
confider►tial. Private dpta is irtformation whlch gena,�ly cannot be given to the public but cen be gfVpn ;o the sub)ect of the
data_ Confidential data fs Informado�vvhtch generally cannot be Qiv�to etther the pubiic or the subjec! et the data. our
purpose end lotended use of this iretorrnE,t;on Is to annually upaate our re�rqs and reoords oF other govemmental agencies
requireC b law, �f ou refuse to su I the Irrfo��q� the a lic¢qOn ma not pe issued.
APP�icaret's Sigr2ature: � � �ate� ��l q ���
� -�_'_ �_
i-ast UpdOted: 06-04-2009
DATE TI
CITY OF ORONO CALLED IN
INSPECTION NOT CE SCHEDULED
PERMIT NO. ' COMPLETED �t-�4:�5
ADDRESS /�� ���w� ��
OWNER TELEPHONE NO.
CONTRACTOR �� �G��
� DESCRIPTION �Q�' ���•
t~N ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q �►VAL ❑ WATER HOOK-UP �bLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL
J ❑ DEMO-SITE ❑ SEPTIC INSTALL ❑ FOUNDATION/REMOVAL
2 OWNERICONTAACTOR TO MEET 11�U:_YES_NO ,,,
y COMMENTS:�/..�•'� /�o��Q.- �.S�l�� r`d <�!/ �r 4
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� ❑VIiORKSATISFACTORY:PROCEED ��JECTCOMPLETE
W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� O CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COA/ERING PERMANENT
❑CORRECT UNSAFE CONDIT�ON WRHIN HOURS. ❑pH0T0 TAKEN
INSPECTOR WILL REZURN ❑CITATiON ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REWIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-460�
Owner or on site:
Inspect
White CopyAnapectoPs File Canary CopylSfte Notiee