The URL can be used to link to this page

Home My WebLink About2015-00760 - addn/remodel/repair CITY OF ORONO * Z 0 1 5 — 0 0 7 6 0� * • • 2750 KELLEY PARKWAY DATE ISSUED: 06/26/2015 ORONO, MN 55356— 952 249-4600 FAX: 952 249-4616 ADDRESS : 1910 SHORELINE DR PIIv : 10-117-23-42-0017 LEGAL DESC : REG. LAND SURVEY NO. 0096 : LOT 000 BLOCK 000 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL COI�ISTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 93,500.00 NOTE: SEPARATE PERM[TS REQUIRED: PLUMBING,MECHANICAL,ELECTRICAL(STATE) BASEMENT REMODEL FINISH APPLICANT PERMIT FEE SCHEDULE 1,062.56 STATE SURCHARGE(VALUATION) 46.75 SMUCKLER CUSTOM BUILDERS, INC. TOTAL 1,109.31 7509 WASHINGTON AVE. S. payment(s) EDINA,MN 55439- CHECK 12557 1,10931 (952)828-1908 Minnesota State License#: BUIL-20384253 OWNER & HALIMEH MOUSAVINASAB,MAJID FEHRESTI 1910 SHORELINE DR 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 sepazate 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 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time afrer work has commenced. The applicant is responsible for assuring alI required inspections are requested in conformance with the State Building Code.This permi[may be revoked at any time for due cause. �--- -- �iJ� v`CIG�:c,� C;�ti��E�.in /�CL.�C�,�'�� /��_'�� i � � ,_._ .��1��'� :/j-�?��c�Cti.— �l��/j� ��. �� L a � �) �� ,. /� ,"-'`1 App icant Permitee Signature Date Issued y Si ture � � Date . . l�9. �/ CITY OF ORONO �/ BUILDING PERMIT APPLICATION FOR NEW STRUCTURES OR ADDITIONS �O� Mailing Address: Permit number: l ,`"J ' (/ci � O PO Box 66 � Crystal Bay, MN 55323-0066 Date received: l� Street Address:' I� Received by: y�, G� 2750 Kelley Parkway �j � Plan reviewfe : �,,�Uv 7 lqkESH�� Orono, MN 55356 r � /„ �i�I �� Main: 952-249-4600 Total Fee: �� r� (J Fax: 952-249-4616 �vw�v.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: , Job Site Address: �� / G � Ll G �'��' �-� %u �� 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 Police Department and City Council approval 60 days prior to the event. Shuttle bus service wil/be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: �5��G��/�- cF' iz C'C��h'( o�ul�--D��i'J i-�.. State License# Expiration Date: Phone: (cell)(o�Z� Z � �� office � ;L Y�� G ' Mailing Address: �=l'cj �1..�/.}S6-�� Cit : ��/ �i.� ZIP: S� > � Contact Person: � /,<J�� S�y� � C�c�,G- Applicant is: Contractor / Homeowner (Circle One) Email and/or Fax: C�-�'�c� � Siy�vGr^��, , �� PROPERTY OWNER INFORMATION: Name: fjf�J i�� fi�l72�� I-� Phone (day): Address: %��/n G� l.t /-��L City: C�' f�d��'�% ZIP: Email and/or Fax ARCHITECT I ENGINEER INFORMATION: Name: —�� JC��%' ��G'�L''//��' C�u�� C��'�� Phone (day): lC ` -' Address: v - � � � �-�,; '�-�eii d�/1 Cit : �Z,L%�;�'Z�LF ZIP: �`�� Email and/or Fax: ��` �� L ��-�L�� , ��, PROJECT INFORMATION: Description of project: 1.Type of Project 2. Proposed Use 3. Structure Type 4. Sewage Disposal & Water Supply ❑ New Construction ❑ Single Family with ❑Accessory Bldg./Garage ❑ Addition attached garage ❑ Deck ❑ Public Sewer ❑ Accessory Building ❑ Single Family with ❑ Office/Commercial � Relocation r�ak��n�>t;� i detached garage ❑ Residence ❑ Private Sewer Other: (specify) f6i�r_S</U�'lyl f�Lt ❑ Multiple Family/Condo ❑ Retaining Wall(s) ❑ Public 4-feet or greater ❑ Public Water **Any earth movement may also require ❑ Commercial ❑ Storage MCWD review&permits. ❑ Industrial ❑Warehouse ❑ Private Well Minnehaha Creek Watershed District(MCWD) ❑ Other: (SpeCify) ❑ Other(SpeCify) 15320 Minnetonka Blvd Minnetonka, MN 55345 Phone: 952-471-0590 Fax: 952-471-0682 www.minnehahacreek.or Estimated Construction Valuation (excluding land) $ �,.3, S l`� . `� Last Updated: January 2015 STRUCTURE INFORMA'tION: 1. Structure Dimensions 1. Structure Dimensions(continued) 2.Type of Construction a. Length(ft.)= Number of bedrooms=� �Wood/Frame b.Width(ft.)= Number of garage stalls: ❑ Masonry Areas in square feet Attached = ❑ Metal ❑ Pole Bldg. c. Basement= l�Z S � Detached = ❑ ICF d. 1 S`Story = ❑ On-site Prefab e.2"d Story= ❑ Off-site Prefab f. '/z Story = ❑ Other(please specify): g.Total Area= REQUIRED SUBMITTALS: All of the information must be submitted in order for your application to be processed: Not Enclosed A licable ❑ ❑ Buildin Permit Escrow A reement and Fees ❑ ❑ Plan Review Fee � ❑ Com leted A lication Form ❑ ❑ Pro osed Buildin Plans—2 full size sets,to scale and 1 reduced 11 x 17 or 8'h x 11 set ❑ ❑ Minnesota State Ener Code Calculations and Mechanical Code Re uirements ❑ ❑ Surve —2 full size,to scale meetin ALL surve requirements ❑ ❑ Hardcover Calculations ❑ ❑ Se tic S stem Certification ❑ � Minnehaha Creek Watershed District(MCWD)Permit or Documentation from MCWD statin no ermit is re uired ❑ ❑ Landsca e Walls and/or Retainin Wall Plans ❑ ❑ Stormwater Pollution Prevention Plan SWPPP ❑ ❑ Access Permit ❑ ❑ Data Privacy Advisory Form APPLICANT/OWNER ACKNOWLEDGEMENT: • Agrees to provide all information required or requested by the Building Department; . Agrees to pay the City of Orono for engineering consultant review costs in excess of$500; • 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; • Acknowledges the Escrow Agreement is completed and signed; • Understands 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 you refuse to supply the information,the application may not be issued. • Agrees that in the event that weather or other conditions prevent the completion of an as-built survey at the time the Certificate of Occupancy is requested, a temporary Certificate of Occupancy may be issued upon receipt of a $10,000 escrow to ensure completion of the as-built survey and all site improvements. � ;. Applicant's Signa re: � �� Date: � ! � ��^ Owner's Signature: Date: Last Updated: January 2015 , � . PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS Address: � G1� S�L�!/'e!!l�L� �o"��1�'-� Permit No.: ��i'J�' �z�¢{�/ Description of work: �a5��'�`� !1 2l�'1C9�� / t/��S� Date Rec'd: Septic review by: Date Approved: Zoning review by: Date Approved: Building review by: �Y7 Date Approved: Grading review by: Date Approved: Zoning District: Zoning File#: Reso#: Reso Date: Zoning: Lot Area: SF/ , Width: Lot Coverag . SF % Survey Submitted: � Yes � No Date of Survey: Revised date ? : Pro osed Setbacks: Front(Lake) Rear(Street) ( N S E W ) ( N S E ) Other Buildings Wetland Side Side Defined Height: Peak Heigh . FFE: FFE minus 6 feet= (Existing Contour) Perimeter(linear feet) = 50%= L.F. below grade #of Stories FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: FOR A BUILDING ON A SLAB FOUNDATION: The distance between the lowest p pos The distance between the top of START WITH floor(of the basement or crawl spac nd START WITH slab and the highest point of the the highest point of the roof. roof. If you have a... If you have a... • GABLE OR HIPPED ROOF • GABLE OR HIPPED RO F(no (no windows): Subtract half windows): Subtract h the distanc the distance between the between the highest oint of the roof highest point of the roof to to the low point of e corresponding the low point of the SUBTRACTION gable or hipped r f corresponding gable or (BASED ON . GABLE OR HI ED ROOF(with SUBTRACTION hipped roof ROOF TYPE) windows): S Vact half the distance (BASED ON • GABLE OR HIPPED ROOF between th top of the highest ROOF TYPE) (with windows): Subtract window a the highest point of the half the distance between roof the top of the highest • ALL HER ROOF TYPES(flat, window and the highest man ard,etc):No subtraction. point of the roof • ALL OTHER ROOF TYPES SUBTRACTION Subtrac he distance between the (flat,mansard,etc):No (BASED ON basem nUcrawl space floor and the subtraction. EXISTING highe t existing grade adjacent to the ADDITION Add the distance between the top GRADES) fou ation OR 10 feet(whichever is less). (BASED ON of slab and the highest existing EQUALS D med building height EXISTING grade adjacent to the foundation. GRADES E�UALS Deflned building height Shoreland District MCWD Permit Av rage Lakeshore Setback g�uff Met? 0 Yes 0 No Permit Number: 0 es 0 No 0 N/A � Yes � No 0 N/A—see attached Setback: Stormwater Quality Existing Hardcover Proposed Overlay District o Hardcover V riance Required CUP Required Tier circle one (/o and sfl a/o and s 0 Yes � No � Yes 0 No 1 2 3 4 5 Type(s): Type(s): Updated: January 2015 z:\forms\plan review checklist 2015.docx REMARKS (in-house): Fees to be Char ed YES NO Permit Plan Review State Surcharge Investigation Fee SAC—Number of SAC Units Other(specify) S uare Foota e $ er S uare Foota e Basement X = $ 15t Floor X = $ 2nd Floo� X = $ Garage X = $ Estimated Construction Value: $ �`T'i V'V`� Orono Inspections Required Work Requiring Separate Permits Required State Permits 0 Site lumbing � Grading/Filling � Well � Silt Fence/ Erosion Control Mechanical � Fire lectrical 0 Hardcover Removal � Septic 0 Water Connection � Footing � Fireplace 0 Sewer Connection � Poured Wall 0 Masonry � Lawn Irrigation 0 Foundation Survey � Mfg. � Landscaping � Foundation Waterproofing 0 Other(specify) � Radon Rock Bed � Framing � Insulation � As-Built Survey 0 Final � Other(specify) REMARKS (in-house): Other Review: Reviewed by: Date Approved: Access: Existing: � YES � NO New: � YES 0 NO OFFICIAL REMARKS-TO BE NOTED ON PERMIT AND INITIALLED Updated: January 2015 z:\forms\plan review checklist 2015.docx J� \� DATE TIME r CITY OF ORONO CALLED IN � 3'-5 INSPECTION NOTICE SCHEDULED �O �� PERMIT NO. -�7� COMPLETEp ADDRESS � OWNER TELEPHONE NO i ` � � CONTRACTOR � DESCRIPTION `� l� ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING y ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q �FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT J ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP _ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL J ❑ DEMO-SITE ❑ SEPTIC INSTALL ❑ FOUNDATION/REMOVAL � OWNERfCONTRACTOR TO MEET YOU:_YES_NO � COMMENTS:q l�''� ��C/f�v�� a o (� /'C�V t p e �!y q 1-��i • � ��1 n� � �,3��i►r0 v�1 P �• I�- /n Sp• ' 3e-v4l 7�t1 6 5 � ��• S�4S� `� t-,.��-e�".r.�-� Clea.�sdr�'�S' W � l�/'�s�S�o _.� f6 l�`� Q � cr r✓,c� �4-� GJ a Cl�h. ��lie cQs�co... � VJrLs 10 �Y�/ C� o� �T Y r�--l�TJ �l7`�.f j �� rGc-��n,o 9�/ ��Bcn,G�ia�o�s �-� �1J W ❑WORKSATI6F��PROCEED ❑ PROJECTCOMPLEfE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALL FOR REtNSPECTION TEMPORARY V BEFORECWERING PEFiMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED SPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call forthe next inspection 24 hours in advance. (g52) 249-46�� OwnerlContractor on site: --� Inspector. White Copyllnspector's File Canary CopylSite Notice ��-5 S.�- ; � `---'�— DATE TIME CITY OF ORONO CALLED IN 7 INSPECTION N TICE SCHEDULED � 3-•�1� PERMIT NO. ��5�7� COMPLETED �. ADDRESS ��/ �� OWNER TE EPHONE.NO� � g 7 � CONTRACTO ��-�/L /✓'�� DESCRIPTION l� ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING y ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP 41 ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL _ v ❑ DEMO-SITE ❑ SEPTIC INSTALL � OWNERICONTRACTOR TO MEET YOU:_YES_NO y COMMENTS: � W � � J O � � O � W � Q � W � W � J d W RKSATISFACTORY:PROCEED ❑PROJECT COMPLEfE � ❑ RRECT VYORK 3 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY � BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pH0T0 TAKEN INSPECTOR WIIL REfURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REWIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (g52) 2 -460� Owner/Contractor on site: Inspector: White Copyllnspector's Flle Cenary CopylSite Notke \J DATE TIME CITY OF ORONO CALLED IN � � INSPECTION NOTICEG ��d SCHEWLED � PERMIT NO._�n�"�'� COMPLETED � ADDRESS � OWNER TELEPHONE NO. ��L� � �g� COI�RACTOR �� 'U� � ( -N�'� � DESCRIPTION �-� ��i�� Fi�a� K' 41 ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAWGRADING/FILLING Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FR NG ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ SULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT v FINAL ❑WATER HOOK-UP ❑ FOLLOW-UP _ ❑ S BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL v ❑ DEMO-SITE PTIC INSTALL 2 O'WNERICONTRACTOR TO MEET YES_NO � COMMENI'� � � j � 0 � 0 W �G Q � W W � � J O W O WORKSATISFACTORY:PFiOCEED PROJECT COMPLETE � O CORRECT W'ORK 3 PROCEED D I E CERTIFlCATE OF OCCUPANCY W � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECdNEFtlN(3 PERMANENT ❑CORRECTUNSAFECONDI110NWITHIN HOURS. p p�pTOTAKEN INSPECTOR WILL RETURN O STOP ORDER POSTED.CALL INSPECT�1 ❑dTATION ISSUED ❑IN3PECTION REOUIRED.CALL TO AF�tANGE ACCESS. can ro�a�e��t rnspectio�za �,ea�►a 9 49-4600 owr�rlConrractor on site: Inspector: WINb CuPYMspsctor's FlN Gn�ry CopylSiN Nollee