HomeMy WebLinkAbout2013-00657 - roofing 111111111111111111111111 1111111M
CITY OF ORONO * 2013 - 00657 *
2750 KELLEY PARKWAY DATE ISSUED: 07/16/2013
ORONO, MN 55356-
(952)249-4600 FAX: (952)249-4616
ADDRESS 315 TONKAWA RD
PIN 06-117-23-14-0021
LEGAL DESC REG. LAND SURVEY NO.0540
LOT 000 BLOCK 000
PERMIT TYPE MINOR ALTERATIONS
PROPERTY TYPE RESIDENTIAL
CONSTRUCTION TYPE ROOFING-OTHER
ACTIVITY O/S BUILDING-UNDEFINED
VALUATION $ 19,300.00
NOTE: EPDM FLAT ROOF
APPLICANT PERMIT FEE SCHEDULE 339.25
LES JONES ROOFING INC. STATE SURCHARGE(VALUATION) 9.65
941 W 80TH STREET
BLOOMINGTON,MN 55420- TOTAL 348.90
(612)881-2241 PAID WITH CC# 9068
Minnesota State License#: 6560
OWNER
Waycrosse,Inc.
MACMILLAN,MARTHA E
15407 MCGINTRY RD W
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 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
re ed at any time for due ca se.
7/ / 7/ /3 7/ &.l
plicant Permitee Signature Date Issue y Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
+ e7/16!2013 13:30 Les Jones Roofing,Inc. fW)52M170 P.0021002
City of Orono
Building Permit Application for Maintenance / Replacement / Renovation
(No structural expansion. only windows, doors, siding, re-roof, etc.)
Mailing Address: Permit number aV +490
PO Box 86
Crystal Bay,MN 55323-0066 pate received: 7—) b-t3
Street Address: Received by:
2750 Kelley Parkway Plan review fee:
`�ttK SHo��G Orono,MN 55358
Total Fee: Ll 0.
Main: 852-248-4800 Fox, 962-2494816 www.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: MA WA ROAP
Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home? Yes No
Nyes,a special event pem*/s requprd with Police Department and Co Council approval 60 days prior to the event Shuttle bus servk a w1N be
ragtdrsd unbar applk ant demonstrates sur►gc/ent on-site parking Is avexable, Nw9emdtled events w9t not be Mowed,
CONTRACTOR/APPLICANT INFORMATION:
Name: p
State License# (4560 Expiration Date: 3 3r
Lead Certification Number: Nq-T 40372-1 Expiration Date: �� g f /�^
(for work on homes that were consfrucfed prior to 1978
Phone: (cell} & 7. - 231- L C(o$ (office) q S,t- 7 111
Mailing Address; k( 8pvk S City: zip: rf- 20
Contact Person: Applicant is: &�/ Homeowner (creone)
Email and/or Fax: ca
PROPERTY OWNER INFORMATION:
Name:
Phone(day):
Address: City: ZIP:
Email and/or Fax:
PROJI=CT INFORMATION, Overall project description:
Type of Project: Any earth movement may also require
❑Door(s) ❑Remodel ❑Fire Damage MCWD review&permits:
❑Re-roof,asphalt [I Repair ❑Storm Damage Minnehaha Creek Watershed District(MCWD)
18202 Minnetonka Blvd
[]Re-roof,cedar ❑Restoration ❑Water Damage Deephaven,MN 55391
�Re-roof,other(specity) ❑Siding []Other.(specify) Phone: 952471-0590
Fax: 952471-0682
2 LCPOM F'la4"r ❑Window(s) www.minnehahacreek.om
Estimated Construction Valuation of Project(excluding land) $ l°It my—
APPLICANT ACKNOWLEDGEMENT:
Agrees to provide all Information required or requested by the Building Department,-
Certifies
epartment;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 date Is Information which generally cannot be given to the public but can be given to the subject of the data.
Confidential data Is infarmaDI�StD
generally cannot be given to either the public or the subject of the data. Our purpose and
Intended use of this Info tionnnuallyupdate our records and records of other governmental agencies required by law. If
ou refuse to su I Informaea lostion mg not be Issued.
Applicant's Signature: Date:
Owner's Signature: Date:
last Updated:03IM013 7-7 t ,?�
CI ` DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTI E SCHEDULED _
PERMIT NO. o�� 'AS 6S'T COMPLETED
ADDRESS 3 45- le-) trAO
OWNER TELEPHONE NO.
CONTRACTOR </ GS JG_ q:�S (!,?-$8t'Pow
DESCRIPTIONLt
tjj ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
O ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
X INAL SEWER HOOK-UP ElCOMPLAINT
J ❑ DEMO-SITE ❑ SEPTIC MAINT. XFOLLOW-UP
❑ DEMO-FINAL El SEPTIC INSTALL ❑ HARD COVER REMOVAL
v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDAT10N/REMOVAL
Z OWNERWNTRACTOR TO MEET YOU:_.YES_NO
COMMENTS:
d ,,0e-r Ns�t ✓10 �.�agL idt.S,A�.�,,;�. �e�►u 45j
j
O � _
Iffr4 l B • S' - i3
o --
W
CC
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W� ❑WORK SATISFACTORY PROCEED PRejECT COMPLETE
❑CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANC)'
C) ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING
❑CORRECT UNSAFE CONDITION WITHIN HOURS. PERMANENT
❑ PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours In advance. (952) 249-4600
Owner/Contractor on site:
Inspector. t w..
White Copy/Inspector's File Canary Copy/Site Notice
<-�CALLEDIN
DATE TIME
TY OF ORONO
INSPECTION NOTICE �_SCHEDULED
PERMIT NO. 22 L�-,l-'S__WOE kOMPLETED
ADDRESS ct-f�> (A V_cl-
OWNER TELEPHONE NO.(r kA�
CONTRACTOR 19
DESCRIPTION S Inn-
❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHOREIWETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL
Q ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
r ❑ DEMO-SITE ❑ SEPTIC MAINT ❑ FOLLOW-UP
❑ DEMO-FINAL ❑ SEPI INSTALL ❑ HARD COVER REMOVAL
v
El PLUMBING RI El SEPT,f FINAL ❑ FOUNDATION/REMOVAL
2 OWNER/CONTRACTOR TO MEET YOU:P
YES_NO
COMMENTS:
cc
W
QC
a
W
cc
Q
2
W
W
J
❑WORK SATISFACTORY:PROCEED .+ROJECT COMPLETE
Qz
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
Cj BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contractor on site:
Inspector. — -
White Copy/Inspector's File Canary Copy/Site Notice