HomeMy WebLinkAbout2017-01297 - doors t �•, CITY OF ORONO * 2 0 1 7 - a 1 2 9 7 *
2750 KELLEY PARKWAY DATE ISSUED: 10/1U2017
ORONO,MN 55356-
(952)249-4600 FAX: (952 249-4616
ADDRESS : 2695 SHADYWOOD RD
PIN : 21-117-23-24-0056
LEGAL DESC : CHAPMAN ADDN
: LOT 002 BLOCK 001
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : DOORS
ACTIVITY : O/S BUILDING-UNDEFINED
VALUATION : $ 2,515.00
NOTE: REMOVE AND REPLACE(1)PATIO DOOR
SAME SIZE-NO STRUCTURAL CHANGES.
APPLICANT PERMIT FEE SCHEDULE 92.89
STATE SURCHARGE(VALUATION) 1.26
HOME DEPOT USA,INC. IvIpIL-IN FEE 2.00
2455 PACES FERRY RD
ATLANTA,GA 30339- TOTAL 96.15
(763)542-8826 Payment(s)
Minnesota State License#:BUIL-BC147263 CREDIT CARD 7660 96.15
OWNER
PAULSON,STEPHEN&BOTHAINA
2695 SHADYWOOD RD
EXCELSIOR,MN 55331-
AGREEMENT AND SWORN STATEMENT
1'he work for which this permit is issued shall be perfortned according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and dces
not grant permission for additional or related work which requires separate
pertnits. All provisions of laws and ordinances goveming tt►is 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 conformance 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 ignature Date
Fror�andr�8eryt Fax:(888)4455845 To: Fax:.(952j 249-4616 Page 2 of 2 10l10l2017 1:17 PM
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Buildi�g Perrnit Appi�cation far:Mafntenanc�/Re.placem�n#/R�mod�l �3�sideni�al �?�Y.
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Rf�Box:86 �rta�it[ruta�har � .� � �
. 'GegstBF Bay MN 55323-0066. DBk�.t'�o@�+��d ;� ��"" `«- ;� .
Street Ar1a!ress: . �ec�v�d by
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, �, Orora.MN.5�3�6
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, Main: 952-249-4600 Fax: 952-249-4616 www.ci:arono.mn.us <;. .. ; : :
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; � ?his aPplication:form must:be completed in ful!and_all r�q.uir�d.inf4[mation i�nust he submitted.
M.c4mal�e applications.will qe returfled (Piea�e print) '
GENEl3A�L IN�.OFtMAT1..O.N:
�o�s�.e,Aaaress: �&�'s' .5k�cd r�rd ,�'d
wiil thes.be a:P.arada of:F#oime�e;Fiemocle�a `Sh�►case;Hc�n�or oth�'`piaplay Harie2. Yes ... Na �
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ltYa�e.a apeFia!e�ent pemth te re�uired tv�tl�.HoflCa DaparfineCrf�nd.Cdy:Eoun(,�l approvai 6R ci4Y+�A�r to tho 4r�drtL .Shuf�lo bus S
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, requlced uNess a�plicant derrwnstrai�st(1fJple�on�eite paddn,g is avaitable. hlon-pem+lttecl events wW notbe albwad. ,
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CONTRACTQR l APPLICANT INFORM41TIOt�F: -
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Name: >.
_ / 3 _ . . Expi[atio.n Uate: . . .�3/
State License#
Lead Cert�cation�turober:
/�/�T-3/.xfi�i-�?— Fxpir�t�on Date. .
(forwprk o»trom�s thstwena.�ottarfrocGad Rrioc:#o 1978
PhOnB: (ceN} �(y-Q�'Z- / 2... (OfFtce)
Mailing Address:. _ City: : ZIR:,. . 0.. .: . _..
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Contact P.erson: ��"? _ . APPlu�nt is: : .
rrt. o .! Mameawner . �c�rae o.�s�
Email andlor.Fax:. � Otov /lt.tit . .. °.` . p�6r _,Q
PRflPERI'Y�WNER>INFQF�AAATION:
Name: ��1 �Sfl
Phone(daY)� 2-8'S71 —5a�1 . _. - -
Addcess: `. _. . CitY,�CC.Qa�St'oi"" /l� �IP:,��3
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PRUJECTINFORMAT10A1: Overall ro'ec�desGn tion: , :d[I`�x [!} .�e.t�ddl";�Si�� /
7'Ype of Proj�ct:. _ . _ , _ . _ . Any:earth'mov�nt may aiso reguirR �,..
❑Door(s) �Fxemodel p Fir.e Damage .
� MC1ND rsvteur$�peri»its:
Minnehaha.Greelc:Mlatershed:Disttic�(MGWD)
Q Re-roof,a�aphalt. []Repair . []&torrn Dameg� 15320 Minnatonka;Blvd ..' .
p Re-Foof,'cedar (�Resto[&Uon �]Wster:,Dama� MinnetQnka,'MN 553� :
. _ • Phone: 952-471=059p
�Re-[oof;other.(�Ra�1v) CI Sid'u1g {]Other.�specify} F.aX. �52-471=0682, '
'._.._.,-._ ��ndow(S) �nnnu:minneh�hacLrsek:org
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Estimated,Construc#lon Val.uation ot Project{excluding l�ncp.. : ..S
APPLICANT ACKNOWLEDGEAAENT:
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• +4qt!�s to pravi�s..al1�nfo►matlati..requlCed.or r.eguested by:th�Budd�g t�epacGmen�. .
• Certifies that the information supplied Is tcus end correct fo the faes#.of hislhe[.knowledc�e. The;aRpbcant r�cognizes khak:thQy:ace
solely respons�le�nr submilting a�mplete�pplicai'ion�k�ing�re that upon.failure to:da so,:the sta..ff has.na aNemative but io
rejec#it until it ig complete; _. ` _ �
• Some or a{taf the informa�an tha#.you are.asked tu provide on thi� �ppaicakicn is.clas��fi�d::by.Staie law:as:Qitlie.r:priv�te ar
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cDrtfidential. Private deta is'infotrnatian which generslly cannpt be given.to the pubtic but.can be givan to the;s�j.ect.of:the da1a.
Gonfidentia(d.ata is informa�..o.n wtiich.gecrera{ry•cannot be given to�dbecthe.pt�lic.orthe subject.Rf.the:data.,�Dur purposa..and
iritertded use of this.i . rmatiQn.:�s tp annuatly update our►e�cords�d recQrds fl#other:govetnmenxal�gRndes cequlred:by law_ If
Cu ref�to su I in t� a lieafion ma not be issu�.
Applicant's Signa#ut'e' � Date:. I������
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owne�'s Signatute; Date:
Last Updated:Janusry 2018 .: _
INSPECTION NOTICE
DATE TIM
CITY OF D��'v CALLED-IN
SCHEDULED :GC�
PERMIT NO. a��ll�•D/a9T COMPLETED a• '!�
ADDRESS ! -
OWNER/CONTR. t e
❑SITE INSPECTION ❑MECHANICAL RI ❑REINSPECTION
❑COAIC SLABS ❑MECHANICAL FINAL ❑FOLLOW-UP
❑FOOTING ❑INSULATION ❑COMPLAINT
❑POURED WALL ❑RATED ASSEMBLY ❑FIREPLACE
❑FRAM NG RAINAGE O SEPTDIC WSTALL �S�INIC� RySYS�Elujr.� �
� ❑SHEATHING ❑SEPTIC FINAL 6� �` ��' ��l��
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❑PLUMBING RI ❑S&W HOOKUP ❑
� ❑PLUMBING FINAL ❑GAS LINE MANOMETER ❑
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� FURTHER CORRECTIONS MAY BE REGIUIRED �P�MIT FINALED
� 0 WORK SATISFACTORY: PROCEED ❑ PHOTO TAKEN
p �CORRECT WORK&PROCEED �
V O CORRECT WORK.CALL FOR REINSPECTION BEFORE COVERING
❑CORRECT UNSAFE CONDITION IMMEDIATELY.
❑ STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
TO SCHEDULE YOUR INSPECTIONS
PLEASE CALL: (763) 479-1720
Metro West Inspection Services Inc.
Owner/Contr. site:
.
Inspector: /