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HomeMy WebLinkAbout2016-01100 - addn/remodel/repair CITY OF ORONO * 2 0 1 x - 0 1 1 0 0 2750 KELLEY PARKWAY DATE ISSUED: 09/12/2016 ORONO,MN 55356- (952)249-4600 FAX: (952) 249-4616 ADDRESS 200 TRUFFULA TR PIN 33-118-23-44-0039 LEGAL DESC MEADOW WOOD POND LOT 005 BLOCK 001 PERMIT TYPE ADDITION/REMODEL/REPAIR PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE ADDN/REMODEL/REPAIR ACTIVITY 434-RESIDENTIAL VALUATION $ 10,000.00 NOTE: SEPARATE PERMITS REQUIRED: PLUMBING,MECHANICAL,ELECTRICAL(STATE) BASEMENT BATHROOM&WET BAR APPLICANT PERMIT FEE SCHEDULE 201.32 LECY BROS HOMES STATE SURCHARGE(VALUATION) 5.00 15012 HWY 7 TOTAL 206.32 MINNETONKA,MN 55345- Payment(s) (952)944-9499 CHECK 46076 206.32 Minnesota State License#:BUIL-20325555 OWNER ADAMS,DONALD&SHEILA 200 TRUFFULA TR 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 revok d at any time for due cause. A plicant ertnitee Signature I Date Issued By Signature Date City of Orono Building Permit Application for Maintenance / Replacement / Remodel - Residential ONLY (i.e. windows, doors, siding, re-roof, etc. - NO STRUCTURAL EXPANSION) Mailing Address: Permit number: PO Box 66 Crystal Bay, MN 55323-0066 Date received: Street Address: _ Received by: yA, 2750 Kelley Parkway Plan review fee: j �lgkFSHo�`�`G Orono, MN 55356 , 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 submitted. Incomplete applications will be returned. (Please print) GENERAL INFORMATION: Job Site Address: �,k 00 Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? EI 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-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: 1 e_% , State License# Expiration Date: Lead Certification Number: Expiration Date: (for work on homes that were constructedrlor to 1978 Phone: (cell) - ,-} - ��`� (office) Mailing Address: 5C)(a City: ZIP: Contact Person: Applicant is' ontractor / Homeowner (Circle One) Email and/or Fax: PROPERTY OWNER INFORMATION: Name: Phone (day): Address: City: ZIP: Email and/or Fax: PROJECT INFORMATION: Overall project descripti n: Type of Project: &",PA'kkAti �Jt h/,Damage 1�+- kxi f- Any earth movement may also require ElDoor(s) Remodel ❑ Fir MCWD review&permits: ❑ Re-roof, asphalt ❑ Repair ❑ Storm Damage Minnehaha Creek Watershed District(MCWD) 15320 Minnetonka Blvd ❑ Re-roof, cedar ❑ Restoration ❑Water Damage Minnetonka, MN 55345 ❑ Re-roof, other(specify) ❑ Siding ❑ Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 ❑Window(s) www.minnehahacreek.org Estimated Construction Valuation of Project(excluding land) $ ©CXR r 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 you refuse to su hq,information,the application may not be issued. q Applicant's Signature: Nub Date: I D Owner's Signature: Date: Last Updated:January 2016 rJ��— /� !�� PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS Address: 20© 7-za 'C& / f Permit No..z'a*— d ( 10 0 Description of work: Date Rec d: Septic review by: Date Approved: Zoning review by: Date Approved: Building review by: Date Approved: Grading review by: Date Approved: Zoning District: Zoning File#: Reso#: Reso Date: Zoning: Lot Area: SF/AC Width: Lot Coverage: SF % Survey Submitted: 0 Yes 13- No Date of Survey: Revised date(?): Landscape plan submitted? 13 Yes 0 No Landscaper: Proposed Setbacks: Front(Lake) Rear(Street) ( N S E W ) ( N S E W ) Other Buildings Wetland Side Side Defined Height: Peak Height: FFE: FIFE minus 6 feet= (Existing Contour) Perimeter(linear feet) = 50% = L.F. below grade Basement? 0 Yes 0 No, Stories FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE: FOR A BUILDING ON A SLAB FOUNDATION: The distance between the lowest proposed Slab at or above grade— START WITH floor(of the basement or crawl space)and measure from highest existing the highest point of the roof. START WITH rade to the highest point of the roof even if fill was brought in to elevate home. If you have a... SUBTRACTION GABLE OR HIPPED ROOF(no Slab below grade—measure (BASED ON windows): Subtract half the distance from highest existing grade to the ROOF TYPE) between the highest point of the roof highest point of the roof. to the low point of the corresponding If you have a... gable or hipped roof SUBTRACTION GABLE OR HIPPED ROOF • GABLE OR HIPPED ROOF(with (BASED ON (no windows): Subtract half windows): Subtract half the distance ROOF TYPE) the distance between the between the top of the highest highest point of the roof to window and the highest point of the the low point of the roof corresponding gable or hipped roof • ALL OTHER ROOF TYPES(flat, GABLE OR HIPPED ROOF mansard,etc):No subtraction. (with windows): Subtract SUBTRACTION Subtract the distance between the half the distance between (BASED ON basement/crawl space floor and the the top of the highest EXISTING highest existing grade adjacent to the window and the highest GRADES) foundation OR 10 feet(whichever is less). point of the roof • ALL OTHER ROOF TYPES (flat,mansard,etc):No EQUALS Defined building height subtraction. Defined building height EQUALS Updated: October 2015 z:\forms\plan review checklist 10-2015.docx Shoreland District MCWD Permit Average Lakeshore Setback Bluff Met? Cl Yes No Permit Number: 0 Yes 0 No 0 N/A 0 Ye No 0 Cl N/A—see attached Setback: Stormwater Quality Existing Proposed Overlay District Tier Hardcover Hardcover Variance Required CUP Required circle one % and sf % and sf 0 Yes 0 No 0 Yes 0 No 1 2 3 4 5 Type(s): Type(s): Fees to be Charged YES NO Permit Plan Review State Surcharge Investigation Fee SAC—Number of SAC Units Other(specify) Square Footage $ per Square Footage Basement X = $ 1 st Floor X = $ 2nd Floor X = $ Garage Soo = $ Estimated Construction Value: $ f 64 o Orono Inspections Required Work Requiring Separate Permits 0 Footing 0 Site Plumbing 0 Grading/Filling 0 Poured Wall O Silt Fence/Erosion Control Mechanical 0 Fire 0 Foundation Survey 0 Hardcover Removal 0 Septic 0 Water Connection 0 Foundation Waterproofing 0 Other(specify) 0 Fireplace 0 Sewer Connection Framing 0 Masonry 0 Lawn Irrigation Insulation 0 Mfg. 0 Landscaping 0 As-Built Survey 0 Other(specify) Final 0 Lathe Required State Permits 0 Other(specify) 0 Well XElectrical REMARKS (in-house): OFFICIAL REMARKS -TO BE NOTED ON PERMIT AND INITIALLED: 0 See Builder Acknowledgement Form 0 Prior to release of escrow money an as-built survey and hardcover calculations must be submitted and approved. Updated: October 2015 7•\fnr c\nInn rauiaw rharle ict 1n-9rN5 rinry V/5 DATE TIME CITY OF ORONO CALLED IN INSPECTION T _ D (/ SCHEDULED /1n "/ PERMIT NO. OMPLETED ADDRESS— OWNER DDRESS OWNER EPHONE NO — 97-3��� CONTRACTOR DESCRIPTION N VJ ❑ FOOTING ❑ DEMO-F AL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBI GRI ❑ EXCAV/GRADING/FILLING C ❑ FOUNDATION WATERPROOF ❑ PLUMBI AL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q [I FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL ❑ DEMO- ❑ SEPTIC INSTALL 2 OMIN ONT MEET M "YES—NO COMMENTS: ,O (� ; Gi /'��`' -ten �!�2•� 0 W f W 'LORK SATISFACTORY:PROCEED ❑PROJECT COMPLETE cc 4❑CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V 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 OwnerlContractor on ite: Inspector•. 43 y L W1Nte CopyAnspectoes File Canary CopyM38e Notice DA TIME CITY OF ORONO CALLED IN � INSPECTION NQljCE SCHEDULED PERMIT NO. _ ` "`� COMPLETED ADDRESS �00 , OWNER T L PHONE NO-61133�7 CONTRACTOR / S DESCRIPTION G� ty ❑ FOOTING ❑ DEM CGINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT QZj �INAL ❑ WATER HOOK-UP ❑ FOLLOW-UP ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL v ❑ DEMO-SITE ❑ SEPTIC INSTALL Z OWMERICONTRACTOR TO MEET YOU:_YES_NO COMMENTS: E'lee- /JQL -52' L- Z, 0 cc 0 LuatQ All A)oe"K W W W ❑WORK SATISFACTORY:PROCEEDPROJECT COMPLETE uj W ❑CORRECT WORK A PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑PHOTO TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 Owrrer#CoMractor on site: Inspectorf yµ� While CapyAnsWUw%FIM Canary CopylSib Notice lie -CaXbM samaxii5e detector regnired within 10 ft, of all sleeping rooms. , p TOA SOUNfl- �EG�O� CONNEO� SMOt�E R OTHER�D�EC;OR AUDIBI� ►N ING ©EVtGE O SLEEPING RR PUS oUSXV 1 �4 FAI p tea: PRO COPY Reviewed for Code Compiian Ci of On Date Reviewergc��-n-� 10 V- s - �r :r- r r - y,r • - i