HomeMy WebLinkAbout2017-01106 - re-roof � ' - CITY OF ORONO
2750 KELLEY PARKWAY * � 0 1 7 - 0 1 1 PJ 6 *
DATE ISSUED: 09/12/2017
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 1442 SHORELINE DR
PIN : 11-117-23-22-0005
LEGAL DESC : LINPLATTED 11 117 23
: LOT 000 BLOCK 000
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ROOFING-ASPHALT
VALUATION : $ 3,500.00
NOTE: VALUATION OF PERMIT:$3500.00
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 THE TIME THE ROOF IS BEING DONE.
ONCE WORK IS COMPLETED THE SIGNS MUST BE REMOVED.
APPLICANT PERMIT FEE SCHEDULE 10838
STATE SURCHARGE(VALUATION) 1.75
SJ FISHER CONSTRUCTION
70 FLORENCE DR TOTAL 110.13
TONKA BAY,MN 55331- Payment(s)
(612)221-5509 CREDIT CARD 6600 110.13
Minnesota State License#: mech-BC626515
OWNER
EOF INVESTEMENTS
10 S STH STREET #110
MINNEAPOLIS,MN 55402-
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 [he
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 governing 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 I SO ys of the date of issuance,or if construction is
suspended for a p i d o l80 days at any time after work has commenced.
The a icant i resp ns le for assuring all required inspections are
req in nform n with the State Building Code.This permit may be
re at a time f r e cause.
i
, � 9 , i�--��7
icant rm' ee Signature Date Issued ignature Date
�� . i . City of Orono
Building Permit Application for Maintenance / Replacement / Remodel — Residential ONLY
(i.e. windows, doors, siding, re-roof, etc. — NO STRUCTURAL EXPANSION)
�O�O Mailing Address: Permit number: o�(� _ d�
PO Box 66
Crystal Bay, MN 55323-0066 Date received: /07-�7
� �,
Street Address: Received by:
ti�, G� 2750 Kelley Parkway Plan review fee:
� Orono, MN 55356
R'�ES H���
Total Fee: //a• �3
Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us
This application form must be completed in ful► and al► required information must be submitted.
Incomplete applications will be returned. (P/ease print)
GENERAL INFORMATION:
Job Site Address: ��-f�2— s�Qr� (z'„� ��'�/�. .
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes 'No
/f yes, a specia/event permit is required with Po/ice Department and City Council approval 60 days prior to the event. Shutt/e bus service wi//be
required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed.
CONTRACTOR/APPLICANT INFORMATION:
Name: S��t F►'S i,.�1r �� ���'S ltiev� �.C�w Str G-f-i"�; v. ��1 C..
State License# ��,�,ZL 5 �� Expiration Date: � 1 �� ��
Lead Certification Number: Expiration Date:
(for work on homes that were consfructed prior to 1978
Phone: (cell) (�i Z- Z Z� _ �'�-�1� (office) ��S Z-- L�"1� --�4'j�p
Mailing Address: City: ZIP:
Contact Person: 5��j� �r'��nC�-- Applicant is: ontractor / Homeowner (Circle One)
Email and/or Fax:
PROPERTY OWNER INFORMATIQN:�
Name: �`a (,[/uc���y�,
Phone (day): �,�j _ 3�j(�_ C3�� t n
Address: �p��._ �,+.�� G� �y,�� City:��(,vr� ZIP:
Email and/or Fax:
PROJECT INFORMATION: Overall project description:
Type of Project: Any earth move�ment may also require
❑ Door(s) ❑ Remodel ❑ Fire Damage MCWD rE:view&permits:
�Re-roof,asphalt ❑ Repair ❑Storm Damage Minnehaha Creek Watershed District(MCWD)
❑ Re-roof,cedar 15320�Ainnetonka Blvd
❑ Restoration ❑Water Damage Minnetonka, MN 55345
❑ 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) $ ,�S`7�? '
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 infor ation i annually update our records and records of other governmental agencies required by law. If
ou refuse to su I ' formati n, e lication ma not be issued.
Applicant's Signature: ` Date: ��12-In
' !
Owner's Signature: Date:
Last Updated:January 2016