HomeMy WebLinkAbout2017-01567 - windows � r � CITY OF ORONO
2 7 5 0 K E L L E Y PA R K W A Y * 2 0 1 7 — 0 1 5 6 7 *
DATE ISSUED: 1 U28/2017
ORONO,MN 55356- �
(952)249-4600 FAX: (952) 249-4616
ADDRESS : 1800 SHADYWOOD RD
PIN : 17-117-23-21-0026
LEGAL DESC : SHADY-WOOD
: LOT 021 BLOCK 000
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WINDOWS
ACTIVITY : O/S BUILDING-UNDEFINED
VALUATION : $ 6,990.00
NOTE: REPLACE(3)WINDOWS WIHTIN EXISTING OPENINGS
APPLICANT PERMIT FEE SCHEDULE 154.85
STATE SURCHARGE(VALUATION) 3.50
RENEWAL BY ANDERSON MAIL-IN FEE � 2.00
1920 COUNTY RD C.WEST
ROSEVILLE,MN 55113 TOTAL 160.35
(612)502-4777 Payment(s) •
Minnesota State License#:BUIL-BC130983 CREDIT CARD 8788 160.35
OWNER
SEABOLT,DOUGLAS
1800 SHADYWOOD RD
WAYZATA,MN 55391-
AGREEMENT AND SWORN STATEMENT
The work for which this permit 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 separate
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 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in confortnance with the State Building Code.This permit may be
revoked at any time for due cause.
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Applicant Permitee Signature Date Issued By gnature Date
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� (�1�/ O� �f�110
Buiiding PeR-mit Applica�ion #or Maintenance / Renovatian
(windows, doors, sidmg, re�raof, etc.
Mailing Addrese: Perm{t number- ��/�� l 5�
�` p0�Qx 66
�'a`v Cryst�l gay.MN�i3s3-0066 Date received. , 7 � � . .
� � �{�by:�
� � Streat Add►ess:
2750 Kelley Parkway Plan•rev9ew iee� �
$,a OronO,MN 55356
TptBi Fee-' .
/1�, 3 �. .
iu��,,: es2-aa�eoo �� asz-2�s-ae�s . � o .us
This�ppEicatiton#orm must be comple�ted in'fuli erx�all required ir�formaiidt'�must be submitt,ed.
lncnmplete appllcatians v�iN be retumed. (Please print)
GENERAL kN�ORMATION: ,��d � �d
Job Site Address: a�C]
No
Wiil this be a Parade of Harnes, Remodelers Show se Home ar other Dlsplay.Home? Y�
lPy�,a spec%I event permTt!s►e4uired with Police�epsrbrient and GllY C�n�����fJony��d e�vente wi!!n�be alla►�ed. �wiN be
reqUired unless applfcant demonstrat9s su�P+cle�►f on�Ite PaM�i�9
CONTRACTOR/APPL{CANT tNFORMATION:
Name: l� � '0.r���se�N
State License# G1�a0�3 3 6cpiration Date: �l 3
L,ead Certificatlon Number. � —�� a��83 �' �xpiration Date: y
{f�r wark on homes thaE wrr+e cor+sVtrcted prfor to 79r� toffice) (cell)
Phone: Ze5�� o� ^�Q�" C• �lP: 5S 3
Maifing Address� 19 C. . � "C" wes+ �Y� v.11�
���i PersoR: Applicant is: ontra r /. Homeowner �ci«�e oro�)
Emai!and/or Fax'
PROPERTY OWNER 1N�ORMA710�JN'.���t 'v
Name: T
Phone{day): • �"'��� ZIP:
Address: City:
Emaii and/ar Fax
PR�JECT INFORMATlON: ������,y�qui�
Typs of I'ro}ect: AACWD review&permlbs:
�p��s� ❑Rensodei Q Fre Damage Minnehaha Creek Watershed DistrfcE(MCWD?
18202 Minnetonka Bivd
Q Re-raof,asphalt Q Repeir Q Storm Dameg� Deephaven.MIV 55391 .
❑Re-raof,�edar ❑Restoration ❑Water�ama9e Phorte: 952-471-0590
���.�sp��� FaX: 852-471-0682
�]R�roof,other(spec►f�►? Cl Siding ❑ ,nnnruv,m'nneh ha .or
�1Nindow(s) -
Qverai! ProjeCt D�scription: �
:�► �� ' a .
�stlmated Construct�on Valuatlan of Project excluding land) S (p 990. d
APPLiCANT ACKN4WLEpGEMENT:
. p�c}nees to provide etl infio►mstion tequired or requested by the BuElding Departmer►t;
Certlfles that the information supplied is irve and correct�the best qf his/her Imowledge- The appitcant reoagn�ss that they
• ere gple�y responsible for submi#ing a compiete aPP�ic�lon being aware that uPan fa�ure ta do so,the smtf has na alte�native
but to reject it un�tl 1t is complete;
. Same or all of the infortn�t�n#hat you are ask�d ta pro�[de On th�8ppfic�fion is Class� bY�� �eW� s'�8t��e or
c4tlttdetiGgl. PrnrBte dat$ is infnrmetion r�A'tidt getleraliy canr�ot be given t0 the publiC but C� be 9iv9h tn th8 subjeCt of th�
�
data_ Confidentlal dats fs informa�on which genersfly cannot be gi�en tn either the publlc or the subject of the data. ur
putpc�se and Entended use o�this informat'°n {s to annuaEEq update our records and rer.ords a�f ather govemmenta! a�endes
uired b Isw. If u se fo su I the tnforn�atlor�,the s licsttom m �ot be issued.
AqnficaClt's SiqnatutA:
p�--� Date: o?�Nau 1�
�-� �
DATE TIME
CITY OF ORONO cnLLED IN ������• ��
INSPECTION OTICE SCHEDULED �—
PERMIT NO. —�� �COM LETED
ADDRESS
OWNER TE E NE NO. � ' �
�
CONTRACTOR
/
� DESCRIPTION ���I ��� �a �7�7
4~j ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
� ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
O ❑ FOUNDATION DRAIN TILE ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ LATHE ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
v�AL ❑ WATER HOOK-UP ❑ FOLLOW-UP
?% ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
J ❑ DEMO-SITE ❑ SEPTIC INSTALL
Z OWNERICONTRACTOR TO MEET Y�OU:_YES_NO ' .
� COMMENTS: � , D/Z e. �0�� - �"�t�'o�!L�/��
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W ❑WORK SATISFACTORY:PROCEED ❑PRW ECT COMPLETE
� ❑CORRECT Y1fORK 3 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
W
0 (:ORRECTYYORK,CALL FOR REINSPECTION TEMPORARY
Cl C' PERMANENT
❑CORRECT UNSAFE CONDITION WRHIN HOURS. ❑pH0T0 TAKEN
INSPECTOR WILL RETURN
❑STOP OROER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Ca�l for the next inspection 24 hours in advance. (g52) 249-4600
OwnerlCartraator on site:
Inspe�tor: `
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