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Home My WebLink About2011-00001 - addn/remodel/repair ' ~ CITY OF ORONO PERMIT NO.: 2oi�-0000� 2750 KELLEY PARKWAY � , � ORONO, MN 55356- DATE ISSUEn: OU06/20ll 952 249-4600 FAX: 952 249-4616 ADDRESS : 110 SMITH AVE PIN : 02-117-23-21-0026 LEGAL DESC : ORONO ORCHARDS HIGHLANDS : LOT 001 BLOCK 001 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 260,847.42 - NOTE: SEPERATE PERMITS REQUIRED: PLUMBING,MECHANICAL,ELECTRICAL(STATE) FIRE DAMAGE REPAIR, INTERIOR WORK ONLY. PROVIDE SMOKE AND C O DETECTORS TO CODE APPLICANT pERMIT FEE SCHEDULE 2,022.75 LINDSTROM RESTORATION PLAN REVIEW 1,314.79 9621 lOTH AVE N PLYMOUTH,MN 55441- STATE SURCHARGE(VALUATION) 130.42 (763)544-8761 TOTAL 3,467.96 Minnesota State License#; 1087 OWNER FISK,JAMES&JENNIFER 110 SMITH AVE 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 separate permits. All provisions of laws and ordinances governing this type of work shall be compied with whether or not specified herein.This permi[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 fo assuring all required inspections are requested in conformance h e ta uilding Code.This permit may be revoked at any ' e for e c � ( / / < / / ! / pplic t Permitee Signatur Date Iss e y Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. s � City of Orono � � Building Permit Application for Internal Work (windows, doors, siding, re-roof, etc.) (� Mailing Address: ��,0,�.�� n PO Box 66 Permit number '1�JI l � (�:(:�Q //Q �� O�\ �� Crystal Bay, MN 55323-0066 Date received: j ' C� i( �"�:"�,, � R e c e i v e d b : �� l C-,- �o �a ��' - �.�i ' `` Street Address y 1e � F' \ 2750 Kelle Parkwa �� , � ''�L G�� Y Y , Plan review e: � � �� Orono, MN 55356 `�kEsxot'' �- - = � ��, g� Total Fee. Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us This application form must be completed in full and all required information must be ubmitted. Incomplete applications will be returned. (Please print) GENERAL INFORMATION: Job Site Address: !0 5.�•� �-� AV 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. Shuttle bus service will be required unless applicant demonstrates sufficient on-site parking is available Non-permifted events will not be allowed CONTRACTOR/APPLICANT INFORMATION: Name- �;..�2�.L�o....� �e -ag1.�•+�?w.i State License# /o g7 Expiration Date: Phone: 7'�3 — Syy— �7 L I (office) °7L3—a3g— g/ 3� (cell) Mailing Address: �z/ � +•+ �}✓� �1 Cit : ,yQ� ZIP: $'Syy Contact Person: �,Q� L t(....� Applicant is: Contractor / Homeowner (Circle One) Email and/or Fax: �'�41,,�„ p �.•a..e,,�•e?.;�, c.,.,.� PROPERTY OWNER INFORMATION: Name: �.4--.��5 'F'.S � Phone (day): ls�2- �37—�/�/ <i Address: //D 5.,.,,.•��„ A�1,� City: e¢o�n o ZIP: 5S3 y/ Email and/or Fax PROJECT INFORMATION: Type of Project: Any earth movement may require MCWD review 8 permits ❑ Door(s) ❑ Remodel ❑Water Damage Minnehaha Creek Watershed District(MCWD) ❑Window(s) ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd Deephaven, MN 55391 ❑Siding ❑ Restoration ❑ Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 ❑ Re-roof Fire Damage www.minnehahacreek.orq Overall Project Description: Estimated Construction Valuation of Project(excluding land) $ a(�e� �S7, ..�� 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 re uired b law. If ou refuse to su I the information, the a lication ma not be issued Applicant's Signature: ��"��.�� Date: ( -� 3— I � Last Updated: 05-04-2009 � , � Plan Review Checklist for New Structures / Additions Adtlress/ PID/Legaf: �� SYN t T'1-� Av L Description of work: F i 2,� �,q wva�� 2�.�,,q�� Septic review by: I�t/� Date Approved: r- Zoning review by: Date Approved: � Building review by: Date Approved:_ J �6- �� i Grading review by: NIA� Date Approved: '— Zoning File#: Resolution#: Resolution Date: onin District Fire De artment Post Office School District Zoning: t Area: SF /AC Width: Depth: Survey Submitted: 0 Yes � No Date of Survey: Pro osed Setbacks: Front(Lake) Rear(S et) ( N S E W ) ( N S E W ) Other B 'dings Wetland Side Side Building Defined Height: Building Peak Height: FOR A BUILDING WITH A BASEMENT OR CRAWL SPAC . FOR A BUILDIN ON A SLAB FOUNDATION: START the distance between the basement f or/ START the distance between the slab and the WfTH crawl space floor and the highest roof p k, WITH highest roof peak, the top of the comice the top of the cornice of a flat roof, the dec of a flat roof, the deck line of a mansard line of a mansard roof, or the uppermost roof, or the uppermost point on a round or oint on a round or other arch-t e roof other arch-t e ro�f SUBTRACT half the distance between the highest UBTRACT half the distance between the highest window and highest roof peak of a pitched window and highest roof peak of a roof itched roof SUBTRACT the distance between the basement floor/ ADD the distance between the slab and the crawl space floor and the highest exisf g highest existing grade within the grade within the foundation or 10 fe , undation whichever is less. EQUALS D fined buildin hei ht EQUALS Defined buildin hei ht Lot Coverage: SF Shoreland District M D Permit Received Avera e Lakeshore Setb ck Bluff 0 Yes ❑ No � es � No 0 N/A p Yes 0 No p N� 0 Yes 0 No rmit Number: Setback: Hardcover Zones Existin Pro osed Variance Re uired P Required 0-75' 0 Yes 0 No � Yes 0 No 75-250' Type(s): Type(s): 250-5 ' 500- 000' REMARKS (in-house):_ I'v� GH`►9��,f Updated: 07/01/2009 z:\forms�plan review checklist.docx # , i Fees to be Charged YES NO ;P.ecm:ii, _ .. . Plan Review ��tE:S�r.c�ar e Investigation Fee S�►C-:Numbe�r�of'SAC=U;nyts Sewer Connection �Hat�r'�:C�onnection Park Fee ;�ite��nspection Other (specify) ''MiscQlla neous:Fees- Calculated By: � UBC: Construction Type: S uare Foota e $ er S uare Foota e ; Basement X i = � � 15 Floor X � � _ � 2" FlOor X ' _ � Gara e X = g I Estimated Construction Value: � 2 b O,`3 S? �12-- Orono Inspections Required Work Requirinq Separate Permits Required State Permits ❑ Site ,0'Plumbing ❑ Grading / Filling ❑ Well 0 Hardcover Removal .0'Mechanical ❑ Fire }71 Electrical ❑ Footing � Septic Q Water Connection ❑ Foundation Survey ❑ Fireplace ❑ Sewer Connection .� Framing ❑ Masonry ❑ Lawn Irrigation J� Insulation ❑ Mfg. ❑ Wall Board ❑ Other (specify) ❑�4s-Built Survey ,0�Final ❑ Other (specif ) REMARKS (in-house): I�(� j l TZ. � �`�( -}-� ��,,��S'tJ (Z-/� Other Review: Reviewed by: Date Approved: Access:Existing: ❑ YES ❑ NO New: ❑ YES ❑ NO REMARKS (TO BE NOTED ON PERMIT Prw v �;/1� s vvw tc,c� q,v,Q C.a �l--Q-z c�-�CL-5 � c� 2-P Updated: 07/01l2009 z:\forms\plan review checklist.docx USAA � ' Mark Pifer Property Large Loss Operations �� P.O. Box 33490 San Antonio, TX 78265 l 2/30/2010 Insured: }=1SK, CAPT]AMES Home: (952)476-0953 Property: 1 10 SM1TN AVE Other. (612)237-4216 WAYZATA, MN 5539] Homc: 1 10 SM1TH AVE WAYZATA, MN 55391 Claim Kep.: Mark Pifer Business (614)216-7723 I3usiness: P.O. F3ox 33490 San Antonio,TX 78265 Estimator: Mark Piler l3usiness: (614)Z16-7723 I3usiness: P.O. }3ox 33490 San Antonio,TX 78265 Member Number: 001]62627 Policy Number: 001 162627/90A L/R Number: 031 Type oT Loss: FIRE Cause of Loss: Other Coverage Deductible Nolicy Limit Dwelling $500.00 $368,000.00 Date of Loss: 12/27/2010 Date Received: ]2/27/2010 Date Inspected: 12/28/2010 Date Entered: 12/27/2010 llate Est. Completed: 12/28/20J 0 Price l.ist: MNMN7X DEC10 Restoration/Service/Remodel Summary for Dwelling Line ]tem Total 293,46924 Matl Sales Tax Reimb @ 7.275% x ] 16,353.07 8,464.69 Subtotal 301.933.93 Ovcrhead @ ]0.0% x 301,933.93 30,193.39 Protit @ 10.0% x 301.933.93 30,193.39 Cleaning Sales Tax @ 7.275°/o x 12.686.77 92296 Replacement Cost Value $363,243.67 Less llepreciation (102,386.25) Actual Cash Value $260,857.42 Less Deductible (500.00) Net Claim $260,357.42 "Iotal Recoverable Deprecialion 102,38� 25 USAA FISK, CAPT JAMES 12/30/2010 Page:2 Net Claim if Depreciation is Recovered $362,743.67 M ark Pifer "A PERSON WHO FILES A CLAIM WITH INTENT TO DEFRAUD OR HELPS COMMIT A FRAUD AGAINST AN INSURER IS GUILTY OF A CRIME." MN STAT. §60A.955 Please contact our adjuster if you believe a supplement 10 ihis estimate is needed. Before we will consider a supplemem to this estimate,we must have ihe opportUnity to re-inspect Ihe damages prior to the supplemenlal work being done. DATE TIME Y CITY OF ORONO CALLED IN INSPECTION N TICE SCHEDULED - -c l � PERMIT NO. � l l� �� COMPLETED ADDRESS r � o �NL'�� OWNER TELEPHONE NO. CONTRACTOR �_..�� e'� St'rt�/vl >; DESCRIPTION �� S'� �. � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORFJWETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z �VSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT v � DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: a � �'I� �`� �'�''4` nn" (�l� (2� itn�`s � � 0 � � IL � �Z c�c cG 0 � W � Q � Z W � W � � v � WORK SATISFACTORY:PRCCZED ❑ PROJECT COMPLETE W ❑ RRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CANDITION WITHIN HOURS. p pHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cail for the next inspection 24 hours in advance. (g52) 249-46�� Owner/Contractor on site: Inspector. _ White Copyllnspector's File Canary Copy/SHe Notice ��Y \� ATE; TIME ITY OF ORONO �� CALLED IN `��/� � � / NSPECTION N IC� DOO ' -SCHEDULED � �3 � � PERMIT NO. COMPLETED ADDRESS � I�' \ V{�l�G�� OWNER TELEPHONE NO. �� 7�'� CONTRACTOR �' ^ �� ^ �: DESCRIPTION ��-v� � � � � � � � � �� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBI SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNER/�ONTRACTOR TO MEET YOU:�YES_NO � COMMENTS: � W � � � �- �15 ��,� ru� s �7-� �3 r� 0 �.. �� • � ° J� �r- �t W � Q � Z W � W � � d W ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE � �RECT WORK 8 PROCEED G ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALI FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CQRRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WlLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED � INSPECT�ON REQUIRED.CALL TO ARRANGE ACCESS. Cali for the next inspection 24 hours in advance. (952� 249-4600 OwnerlContractor on site•• Inspector. r��' ( � White Copyllnspector's File Canary CopylSite Notice /D /`/ TIME �/ CITY OF ORONO CALLED IN �< � � INSPECTION NOTICE SCHEDULED � PERMIT NO��//— �� COMPLETED ADDRESS �0 D r �� OWNER � TELEPHONE NO. � ` � l CONTRACTOR a DESCRIPTION i��"� � � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Z Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a j I � d O � � � l c�� W - � Q � z W � W � j d W ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE � ,,�ORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W � 0 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITION WITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-4600 Owner►Contractor o site: Inspector. � White Copy/inspector's File Canary CopylSite Notice