HomeMy WebLinkAbout2014-00985 - roofing 4� �
r' CITY OF ORONO �c z p1 1 4 — 0 0 9 8 5 *
� 2750 KELLEY PARKWAY nAT� lssuEn: 09/03/2014
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 1700 SHORELINE DR
PIN : 10-117-23-14-0014
LEGAL DESC : UNPLATTED 10 1 17 23
: LOT 000 BLOCK 000
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ROOFING -ASPHAL"i'
ACTNITY : O/S BUILDING -UNDEFINED
VALUATION : $ 17,850.00
NOTE: VALUA"l�[ON OF PERMIT: $17850.00
ROOFING PERMITS ISSUEU Wl'I'HOUT ENOUGf I NOTICG FOR"1'F,AR OPP INSPF.CTIONS. (WE REQUIRG 24-48 NOTICE,PRIOR"I�O
WORK E3EING STARTED) MUST PROV[DE COMPLETE SGT OF PICTURGS OR A PINAL INSPF,CTION MAY NO'1'BE ISSUF,D.
SIGNS-ADVERTISING SIGNS MAY ONLY E3t?ON"I�HE PROPERTY DURING TH�TIME THE ROOF IS BEING DONE.
ONC}-: WORK IS COMPLG'I'LD THG SIGNS MUS"I�F3E REMOV�D.
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APPLICANT PERMIT FEE SCHEDULE 309.75
STATE SURCHARGE(VALUAT[ON) 8.93
LES JONES ROOFING INC. TOTAL 318.68
941 W 80TH STREET
BLOOMINGTON, MN 55420- Payment(s)
(612)881-2241 CREDIT CARD 2821 318.68
Minnesota State License#: BUIL-6560
OWNER
ETAL, IRWIN JACOBS
1700 SHOREL[NE DR � �
WAYZATA, MN 55391-
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AGREEMENT AND SWORN STATEMGNT
,
The work for which this permit is issued shall be performed according to ��
the approved plans and specifications,applicabie City approvals,and the �
State Suilding Code. 'I'his permit is for only the work described and does
not grant permission lor additional or related work which requires separate
permits. All provisions of laws and ordinances goveming this type ot�work
shall be compied with whether or not spccitied hereia This permit will
expire and become null and void if construction authorized is not
commenced within I 80 da��s of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applican[is responsible for assuring all required inspections are
requested in conYormance with the State Building Code.This permit may be
revoked at any time for due cause.
�"___ � / / � //
Applicant Permitee Signatw�c Date Issue By Signature Date
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Orono MN 55356 952-249-4600 "4�
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R�r,eipt No: 3.011693 Sep 3. 2014 • - , r��1;A��,
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I'revioi�s Balance: .�� ��
Permits
2014-OOy86 364 Westlake 268.45
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Street
101-34410 ��'��' � �
F�lan Check/Site Exam Fees � ""�
Tutal: 268.45
Cradit Card c:r'r oF oKur;o
�;hECk N0: 5252 �6�.45 �i�El �tFLLEY PAkK�IfiY
PtiyOY: tONI� LRKE. MN 55'356
Valley Pc�ls
(otal Appl ied: 268.45 �r���.'�,����! a�� �,+�'-['
Rrf t: 4JtJF1;
�hanye fandered: .00
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� 09l0212014 13:17 Les Jones Roofing,Inc. �A��528817009 P.002t002
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��s�a,� C�ty of t�rano
Building Permit Application for IUlalntenance / Replacement/ Renovatlon
(No structural expansion. Only windows, daors, siding, re»roof, etc.)
' Malling Address: permlt numb6r;
�01�T� P4 gox 88 -
CrystaE Bey,MN 65323-0066 Dete recelved: q-3-/
Stre9t Addr6Ss: Received by:
y`�t �� Orono,MN 55356 Y Plan review fee:
''k SKo�-�' ,ro�i F�: � �(g,�$
Meln: 952-249-R600 Fax: 952-248-4616 vwvw.ci.orono.mn.us
1"his application form must be completed in full and all requlred Inform�tldn must be submitted.
Incomplete applications wlll be returned. (P/ease print}
�ENEFiAL IN�ORMATION:
Job 31ts Address: / S#O,QEZI Dl�l
WIII this be a Parade of Homes,Remodelers Sh�wcase Home or other Dlsplay Home? Yes No
If yee�e apecee!event perm�Is ropulrod wlth Rolka Department enar City Cowu�epprova!ep deya prlor M the evsru Shuttle bua serv/ce w�l be
requlreed uMess appNcarN demanatratas aufRdent oo-sita pa�ldng/s evalbb�s_ Non-pannitted evanta wll!not be allowed.
CONTRACTOR I APPLICANT INFORMATION:
Name: ��S
Stete License# f���p Expiration Date: 3/3 i�/�
Lead Certification Number: ,��-__yp 3-��_� Explratfon Date: _s-�ap��s- �
(for work on homes that were constructed pHor to 7878 � �—
Phone: (cell) (�1,�����t �q/p g (o��) �Se?- 7G 7- d7 S/7
Malling Address: 9yr W- '�S &r ��tY- �3cc�r��v�;-zv✓ Z�P� S'sy�d
Contact Person: y�rS �4�ro�72suN Appllcant is: on raa or / Homeowner (Grclo Ono)
�maiE and/or Fax: � o� . 4
PROp�R'1'Y OWN�R IIVFORMATION:
Name: I,21rJ�a! ,T�ea/3S
Phone(day)� �I�•�,/9.. 7 a a�
Address: City: ZIP:
Em�il�nd/or Fax
PROJECT INFORMATION: Overall ro'sct descri tlon:
7ype of Projec�: Any earth movement may alsp requl�e
❑D��(s) ❑Remodel ❑Fire Damege �C�p��ew&permlts:
Re-roof,asph�lt ❑Repair ❑Storm Damage Mi�nehaha Creek Wat�rshed Distr�t(MCWD)
❑Raraof,cedar ❑Restoratlon ❑WBter Damage D ephav`en,�MNk55391
❑Re-roof,other(9poclfy) ❑Stding ❑Othor.(spocify) Phone: 9b2-471-0590
Fex: 952-471-0882
❑Windaw(s) www.minnehahecdsek.or,�
Esttmated Constru�t(on Valuation of ProJect(excluding land) $ !7�, S�O• -
APPLICANT ACKNOWLEDGEMENT:
. Agre�s to provlde ell InformaHon required or requested by the Bullding Depertment;
• Ce�tifies that the Informatlon suppUed Is truQ and o0rrecc:t to the�st of his/her knowladge. The appllcerrt recognizes that they are
solely responslble for submitfing a completa eppllcaHon being awsre that uppn failure to do so,the s#aff has no eRemaUve but to
�ect it until it le c�mplete;
. Some or all of the Informabon that you are asked to provide on thls appI�8U0n IS dassified by State law as either pm�ate or
con�ide�tial. Private data ie informaUon whlch generally Cannot be�iven to the public but c�n be glven to the subjed of tY�e data.
Confider�Usl date Is Inipmrta6on which generally cannot be given to efther the publiC or thA subject of the data. Our purpose end
inte�ded use of this i�torm on is to annustly update our records and records of other governmer�tal agencles required by law. If
ou refuse to Su th ' atlo e a Ilcstlon ma not be Igsued.
Applicant's Signature: � Dete: `����/�{
Ownar's Sig�ature: Date:
Last Updeted:03/06/2013