HomeMy WebLinkAbout2011-00692 - roofing CITY OF ORONO PERMIT NO.: 2011-00692
2750 KELLEY PARKWAY
ORONO,MN 55356- DATE ISSUED: 07/21/2011
952 249-4600 FAX: 952 249-4616
ADDRESS 645 TONKAWA RD
PIN 05-117-23-33-0019
LEGAL DESC AUDITOR'S SUBD.NO.207
LOT 000 BLOCK 000
PERMIT TYPE MINOR ALTERATIONS
PROPERTY TYPE RELIGIOUS
CONSTRUCTION TYPE ROOFING-ASPHALT
ACTIVITY O/S BUILDING-UNDEFINED
VALUATION $ 50,000.00
NOTE: REPAIR AND REROOF DUE TO HAIL AND STORM DAMAGE.
APPLICANT
PERMIT FEE SCHEDULE 681.75
J INC. STATE SURCHARGE(VALUATION) 25.00
524499 OGREN AVE NE
MN 55376-
TOTAL 706.75
(763)497-4444 PAID WITH CC# 8377
Minnesota State License#:20593845
OWNER
MINNEAPOLIS,TEMPLE ISREAL OF
645 TONKAWA RD
LONG LAKE,MN 55356
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
rcvn at any time for a cause. I
A pli t Pe Si ature Date Issu By Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
.� City of Orono
Building Permit Application for Internal Work
(windows, doors, siding, re-roof, etc.)
Maung Address: Permit number.
iD PO Box 66
O L Crystat Bay,MN 55323-0066 Date received: 11
1 Received by:
A Street Address:
2750 Kelley Parkway Plan review fee:
Orono,MN 55356
Total Fee: 76(to `7 s
Main. 952-249-4600 Fax: 952-249-4616 o.vvrr.cLorong.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: 645 Tonkawa Road
Jab Site Address:
Will this be a Parade of Homes,Remodelers Showcase Nome or other Display home? Yes No
If yes,a special event permit is required with Police Department and Obt Council approval 60 days prior to the event shuttle bus service will be
required unless applicant demonstrates suftent on-site parking is available. Non-permitted events will not be allowed
CONTRACTOR f APPLICANT INFORMATION:
Name: J Zac Inc.
State License# 20593845 Expiration Date: 3-31-2012
Lead Certification Number. NAT 106196-1 Expiration Date: 3-16-2012
(for work on homes that ware constructed prior to 1978
238-4051 (cell)
Phone: (763) 497-4444 (office) Jerrys-(763)
Mailing Address: 5249 Ogren Avenue NE City:St.Michael ZIP:55376
Contact Person: Jerry Z a c hm a n Applicant is: Contractor / Homeowner (cirde one)
Email and/or Fax: i erre i zacinc colli Fax – (763) 497-4454
PROPERTY OWNER INFORMATION:
Name: Temple Israel and Myra Giesener
Phone(day): ( 6.12) 377-8680
Address: —' l Emerson Avenue South City Minneapolis Z1P:55405
Email and/or Fax
PROJECT INFORMATION:
Type of Project: Any earth movement may require
MCWD review&permits:
❑ Doors) ❑Remodel ❑Water Damage Minnehaha Creek Watershed District(MCWD)
M Window(s) []Repair ❑Storm Damage 18202 Minnetonka Blvd
Deephaven,MN 55391
Siding ❑Restoration ❑Other.(specify) Phone: 9521171-0590
Re-roofFax: 952-471-0682
❑Fire Damage
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Overall Project Description: Repair & Reroof due to Hail and Storm dama
Estimated Construction Valuation of Project(excluding land) . Btu
APPLICANT ACKNOWLEDGEMENT:
Agrees to provide all information required or requested by the Building Department;
cuppiiad is trio 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
connaennai. Pnvate care is InrbrmaUOn 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 9ttqis information is to annually update our records and records of other governmental agencies
required by law. If you refute to ly the i ion,the application may not be issued.
Applicants Signature: Date:
Last Updated: 03-01-2011
Z-AC TEMPLE ISRAEL / MYRA GIESENER
I N C c rrnNu n W n ROAD
n
5249 Ogren Ave. • St. Michael, MN 55376
T. 763-497-4444 • F. 763-497-4454 ORONO, MN 55405-2635
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a DESCRIPTION 7F' r S R J
❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAWGRADING/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
i ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
v ❑ PLUMBING RI ❑ SEPTOC INAL ❑ FOUNDATION/REMOVAL
OWNERICONTRACTOR TO MEET YOU:-4YES_NO
COMMENTS:
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❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
OO ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR El CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contractor on ite:
Inspector.
White Copy/Inspector's File Canary Copy/Site Notice