HomeMy WebLinkAbout2015-00293 - roofing CITY OF ORONO * 2 0 1 5 - 0 0 2 9 3 *
2750 KELLEY PARKWAY DATE ISSUED: 03/11/2015
r , ORONO, MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS : 2775 SHADYWOOD RD
PIN : 21-117-23-24-0009
LEGAL DESC : REG.LAND SURVEY NO.0358
: LOT 000 BLOCK 000
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ROOFING-ASPHALT
ACTIVITY : O/S BUILDING-LTNDEFINED
VALUATION : $ 22,931.00
NOTE: VALUATION OF PERMIT:$22,931.00
ROOFING PERMITS ISSUED WITHOUT ENOUGH NOTICE FOR TEAR OFF INSPECTIONS. (WE REQUIRE 24-48 NOTICE,PRIOR TO
WORK BEING STARTED) MUST PROVIDE COMPLETE SET OF PICTURES OR A FINAL INSPECTION MAY NOT BE ISSUED.
SIGNS-ADVERTISING SIGNS MAY ONLY BE ON THE PROPERTY DURING TI-IE TIME THE ROOF IS BEING DONE.
ONCE WORK IS COMPLETED THE SIGNS MUST BE REMOVED.
APPLICANT PERMIT FEE SCHEDULE 402.73
STATE SURCHARGE(VALUATION) 11.47
LEGACY RESTORATION LLC MISC FEE 0.00
14000 25TH AVE N#110 TOTAL 414.20
PLYMOUTH,MN 55447- Payment(s)
Minnesota State License#:BUIL-BC647213 C�DIT CARD 4094 414.20
OWNER
LITTLE,RICHARD&DELORIS
2775 SHADYWOOD RD
EXCELSIOR,MN 55331-
AGREEMEIVT A1vD SWORN STATEMENT
T'he 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 dces
not grant permission for additional or related work which requires separate
pertnits. All provisions of laws and ordinances goveming this type of work
shall be compied with whether or not specified herein.This pertnit 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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�pplicant Permitee Signature Date Issu By Signature Date
City of Orono
� Building Permit Application for Maintenance / Replacement / Remodel
(i.e. windows, doors, siding, re-roof, etc. — NO STRUCTURAL EXPANSION)
�O�O Mailing Address: Permit number:
PO Box 66
Crystal Bay, MN 55323-0066 Date received:
Street Address: Received by:
Z � 2750 Kelley Parkway Plan review fee:
`� L Orono, MN 55356
`1KFSN0�� Total Fee:
Main: 952-249�600 Fax: 952-249-4616 www.ci.orono.mn.us
This application form must be completed in full and all required information must be submitted.
Incomplete applications will be returned. (Please print)
GENERAL INFORMATION: _7 (� \
Job Site Address: �`T�r� ��) 1 � ��f\l`�`'�._�'� ������;
Will this be a Parade of Homes, Remodelers Showcase Home o ther Display Home? ❑Yes No
If yes,a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service will be
required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed.
CONTRACTOR/APPLICANT INFORMATION:
Name: ����',�` ` ��E';-�C-�I-�, �i Z�Y> �-��
State License# ��j� , �,L�-�� �� Expiration Date: -3 �3 i ��1 �
Lead Certification Number: ��I� �, 7C J _ � Expiration Date: �� ��� ��;
(for work on homes that were constructed prior to 1978
Phone: (cell) �,j� �j��Z`- )Z`Z� � (office) �E•�-��� `� - �E, C� �'
Mailing Address: � �-v S-t�� ���r� City: �I �,�,�1 � ZIP: S;�-�l�
Contact Person: (��;k_,�X(c���i� � �..�_ Applicant is: Contracto / Homeowner (CircleOne)
Email and/or Fax: (`���,i r_�1�L cti�L��')I� r�.�)��.���� Y2�S E���'����i�e� � �`L , Ls.+�
PROPERTY OWNER INFORMATION:
Name: �i c�L ����:��� -
Phone(day): G)�� _ �-I�-� -' L�y �-�`c': I�
Address: �`�� ��h�,�,�� ln�-r>�i �G(�' City: �X Cc�5,���- ZIP: �� �' -
_�_�_-�3 )
Email and/or Fax:
PROJECT INFORMATION: Overall project description:
Type of Project: Any earth movement may also require
❑ Door(s) ❑ Remodel ❑ Fire Damage MCWD review 8 permits:
�Re-roof,asphalt ❑ Repair ❑Storm Damage Minnehaha Creek Watershed District(MCWD)
18202 Minnetonka Blvd
❑ Re-roof,cedar ❑ Restoration ❑Water Damage Deephaven, MN 55391
❑ Re-roof,other(specify) ❑Siding ❑Other: (specify) Phone: 952-471-0590
Fax: 952-471-0682
❑Window(s) www.minnehahacreek.orq
Estimated Construction Valuation of Project(excluding land) $ <�:�, �3 i � �(?
APPLICANT ACKNOWLEDGEMENT:
. Agrees to provide all information required or requested by the Building Department;
• Certifies that the information supplied is true and correct to the best of his/her knowledge. The applicant recognizes that they are
solely responsible for submitting a complete application being aware that upon failure to do so, the staff has no alternative but to
reject it until it is complete;
• Some or all of the information that you are asked to provide on this application is classified by State law as either private or
confidential. Private data is information which generally cannot be given to the public but can be given to the subject of the data.
Confidential data is information which generally cannot be given to either the public or the subject of the data. Our purpose and
intended use of this information is to annually update our records and records of other governmental agencies required by law. If
ou refuse to su I the infor ati ,the a lication ma not b$issued.
Applicant's Signature: .� � ;=r;-,� � ��'�� Date: �� �� ��
Owner's Signature: Date:
Last Updated:January 2015
� � `��� DATE TIME �
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED -1 -�`N�1�L-
PERMIT NO�-�-S-bD2� COMPLETED
ADDRESS � �
OWNER PHONE NO Z�?j!3S'fi"7�D
CONTRACTO � �--
� DESCRIPTION l
W ❑ FOOTING ❑ DEMO-FINA ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL
� ❑ DEMO-SITE ❑ SEPTIC INSTALL ❑ FOUNDATION/REMOVAL
2 OWNERICONTRACTOR TO MEET Y'OU:_YES_NO
h COMMENTS:
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� �ISFACTORY:PROCEED ❑ PROJECTCOMPLEfE
� CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALI FOR REINSPECTION TEMPORARY
V BEFORECONERING PERMANENT
❑CORRECT UNSAFE CONDITION WRHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Ca11 forthe next inspect`�%�C/lhours in advance. (952) 249-4600
OwnedContraator on site: r! �
Inspector: �/�-'
White Copyllnapecfor'k File Canary CopylSffe Notice
� � TE TIME�
CITY OF ORONO CALLED IN �`
INSPECTION TICE CHEDULED —��
PERMIT NO. — PLEfED
ADDRESS � 77S
OWNER TEL ON NO. � � ���-
CONTRACTOR �
� DESCRIPTION �
lL ❑ FOOTING ❑ DEMO-FI ❑ SEPTIC FI AL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z�N SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q RAMING ❑ MECHANICAL FINAL ❑ PROGRESS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL
v ❑ DEMO-SITE ❑ SEPTIC INSTALL ❑ FOUNDATION/REMOVAL
2 OWNERlCONTRACTOR TO MEEf YOU:_YES_NO
c�., COMMENTS:
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W RKSATISFACTORY:PROCEED �PROJECT COMPLEfE
� O CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
W
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE CWERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN
INSPECTOR WILL REfURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 t�ours in adv 52� 249-460�
OwnerlContractor on site:
Inspector. -
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White Copyllnspector's File Canary Copy/Site Notice