HomeMy WebLinkAbout2017-00239 - roofing � CITY OF ORONO * Z 0 1 7 — 0 0 2 3 9 *
2750 KELLEY PARKWAY DATE ISSUED: 03/17/2017
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 3333 SHORELINE DR
PIN : 20-117-23-11-0024
LEGAL DESC : REG. LAND SURVEY NO. 1422
: LOT 000 BLOCK 000
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : COMMERCIAL-BUSINESS
CONSTRUCTION TYPE : ROOFING-METAL
ACTIVITY : O/S BUILDING-UNDEFINED
VALUATION : $ 83,357.00
NOTE: WHEN CALL[NG FOR INSPECTIONS,NOTE THAT THIS[S A COMMERCIAL PROJECT.
APPLICANT PERMIT FEE SCHEDULE 983.84
STATE SURCHARGE(VALUATION) 41.68
ALLWEATHER ROOF
9211 PLYMOUTH AVE TOTAL 1,025.52
GOLDEN VALLEY,MN 55427- Payment(s)
(612)721-2545 CHECK 500078 1,025.52
Minnesota State License#: BUIL-8035
OWNER
Lunds Food Holding Inc.
4100 W SOTH STREET#2100
EDINA, MN 55424-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed acwrding 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 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 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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3��� � ` �7 ��% c�% � /'.�_` t-�.,�. -� l / `Il i
pli ant Permit Si re Date [ssued By Signature Date
� C ity of O ro n o ����c;r���y���.� ,�<�_�'
Building Permit Application for Maintenance / Replacement / Remodel — Resi tial ONLY
(i.e. windows, doors, siding, re-roof, etc. - NO STRUCTURAL EXPANSI N)
�O�O Mailing Address: _ ,,�,
PO Box 66 Permit number. �;�t, / ;% � �-';` - �,
Crystal Bay, MN 55323-0066 Date received: �'-i`F!%�;'
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Street Address: Received by: './,�
ti�, G� 2750 Kelley Parkway Plan review fee: /Vc�� /�/�.� � -�
�qkESHO�@, Orono, MN 55356 /"_
Total Fee: � �1 �L� ��--
Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us i
This application form must be completed in full and all required information must be submitted. �J��� �_���7
Incomplete applications will be returned. (Please print)
GENERAL INFORMATION:
JobSiteAddress: 333.3 S�o�<<��e. J,�r:�c N���crc , r� N
Will this be a Parade of Homes, Remodelers Showcase Home or other 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. Shutt/e bus service will be
required unless applicant demonstrates sufficient on-site parking is availab/e. Non-permitted events will not be allowed.
CONTRACTOR/APPLICANT INFORMATION:
Name: AIIvc�.-M�c-r (�oo�
State License# �(�3S Expiration Date: 3�3 1 - 1 '7
Lead Certification Number: Expiration Date:
(for work on homes that were constructed prior to 1978
Phone: (cell) L! S5 - 9�/ (office) G/� -�a 1 �as�/�'
Mailing Address: P` w,�,,,,{.�, /�,,� N. City: G..•( �,� V�� � ZIP: S s"ya 7
Contact Person: $c�{�- Sfcryk,�,� Applicant is: ontract Homeowner (CircleOne)
Email and/or Fax: Sco.f-4.Lo 4,1 I aea�'�cr rod • ca•�►1
PROPERTY OWNER INFORMATION:
Name: �,c,,•�,R Foo� F�vl���.gs rnc.
Phone(day): y s, _5 /s--_r.��pS
Address: y�pv v�s� ,$"D SF City: � ,-�,� ZIP: ,$"s`�d 5�
Email and/or Fax: U c,t 1.�, �;�,l�,,,,��,h � ���.j I- , �,,,�
PROJECT INFORMATION: Overall project description:
Type of Project: Any earth movement may also require
MCWD review& ermits:
❑ Door(s) ❑ Remodel ❑ Fire Damage p
❑ Re-roof,asphalt ❑ Repair ❑ Storm Damage Minnehaha Creek Watershed District(MCWD)
❑ Re-roof,cedar 15320 Minnetonka Blvd
❑ Restoration ❑Water Damage Minnetonka, MN 55345
[� Re-roof,other(specify) ❑ Siding ❑ Other:(specify) Phone: 952-471-0590
�jnMMG<G;q Fax: 952-471-0682
� ❑Window(s) www.minnehahacreek.ora
Estimated Construction Valuation of Project(excluding land) $ �3,3S7•
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 information,the a lication ma not be issued.
ApplicanYs Signature: / Date: 3I�N I � `�
Owner's Signature: Date:
Last Updated:January 2016