HomeMy WebLinkAbout2012-01146 - roofing IINIA I I I I III II II III I 111 1I 11111111
CITY OF ORONO
* 20 1 2 - 0 1 1 46 *
2750 KELLEY PARKWAY DATE ISSUED: 11/09/2012
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 850 WAYZATA BLVD W
PIN : 35-118-23-44-0004
LEGAL DESC : UNPLATTED 35 118 23
: LOT 000 BLOCK 000
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : INSTITUTIONAL-SCHOOL
CONSTRUCTION TYPE : ROOFING-OTHER
ACTIVITY : 0/S BUILDING-UNDEFINED
VALUATION : $ 50,758.00
NOTE: REMOVE AND REPLACE TPO ROOF AND METALS
APPLICANT
PERMIT FEE SCHEDULE 689.25
SIMON CONSTRUCTION STATE SURCHARGE(VALUATION) 25.38
12366 RIVER RIDGE ROAD
BURNSVILLE, MN 55337- MAIL-IN FEE 2.00
(612)861-7000 TOTAL 716.63
Minnesota State License#: 20593656 PAID WITH CC# 1521
OWNER
Montessori School
OMS PROPERTIES LLC
760 HUNT FARM 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
revo at any time for dug cause.
0411,fr 414A-11-AA- 11/ 9 / 2__
Applicant Permitee Signature Date IssuekBy Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
11/09/Z012 9:49 AM FAX 16125736615 SIMON CONSTRUCTION 0001/0001
City of Orono
Building Permit Application for Maintenance / Renovation
(windows, doors, siding, re-roof, etc.)
O \ Ma!!!�Box 66 Address: Permit number: O/
$(46 " '1 Crystal Bay.MN 55323-0066 Date received: //-q 2-
, , - Received by.
Street Address:
'7� 4 ,its/ 2750 Kelley Parkway Plan review fee:
v^mr� /� Orono,MN 55356 ,0
ko$ Total Fee: l Tr -r- —
Main: 952-249-4600 Fax: 952-249-4616 www,ci.Q OJ19,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: X S-0 k q,lt $i 4. &NU, . It4 J
Will this be a Parade of Homes,Remodoters Showcase Home or other Display Home? Q Yes i'No
! if yes,a special event permit is required with Police Department and City Council approval 50 days prior to the event Shuttle bus service will be
required unless applicant demonstrates sufficient on-site parldng la available. Non-permitted events will not be allowed.
CONTRACTOR/APPLICANT INFORMATION:
Name: S
State License# 13c-515(056 Expiration Date: 2/P(
Lead Certification Number: Expiration Date:
(for Ivor*on homes that ware constructed prior to 1978
Phone: (0g6l boo (office) (cell)
Mailing Address: (23 6(o Ikkaa" fLicL t e,1vrA City: ,r 4 Lg. ZIP: 33
Contact Person: Applicant is: •66- ctg. / Homeowner (ctrl.on.)
Email and/or Fax: W.P S►vim,✓►Cori si✓dc-+Loo . c. w.
PROPERTY OWNER INFORMATION:
Name: M. c.1its 14.3A-Vv-‘A‘• •(;1/4.
Phone(day): qS2. 1.104_ ip 1[(e
Address: f 5O LA. City. 004,01,0 ZIP: SS 3q i
Email and/or Fax
PROJECT INFORMATION:
Type of Project: Any earth movement may require
[]
Door(s) 0 Remodel 0 Fire Damage MCWD rovlew 8 permits:
Minnehaha Creek Watershed Dlabict(MCWD)
❑Re-roof,asphalt 0 Repair Storni Damage 18202 Minnetonka Blvd
❑Re-roof,cedar 24estoratiorl ❑Water,Damage Deephaven,MN 55391
Phone: 952-471-0590
( "Re-roof,other(specify) ❑Siding Q Other:(specify) Fax: 952-471-0682
fu...k Teo ❑Wlndow(s) www.rninnehehacreek.org
Overall Project Description: ia.a-rx j . S `f 'rr �p r o,,,, -
Estimated Construction Valuation of ProJecti uding land) $ �, 15%.
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 end 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 ply_the Information the application may not be issued.
Applicant's Signature: � Date: �� la/
Last Updated: 08-09-2011
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION ROTI E , , SCHEDULED 1``f
PERMIT NO. — COMPLETED `~
ADDRESS 25— 4.` ,, ,),..3,4„,' '. lo
- II
OWNER T PHONE NO.
CONTRACTOR „)...-411,4-7 j, C--e)". ••
DESCRIPTIONL'h->' 476
4, 0 FOOTING 0 PLUMBING FINAL ElEXCAV/GRADING/FILLING
0 POURED WALL ❑ MECHANICAL RI 0 LAKESHORENVETLANDS
y
Q 0 FRAMING 0 MECHANICAL FINAL 0 TREE REMOVAL
0 INSULATION 0 WOOD BURNER/FIREPLACE 0 SITE INSPECTION
ADON SLAB 0 WATER HOOK-UP 0 PROGRESS
FINAL 0 SEWER HOOK-UP 0 COMPLAINT
Q 0 DEMO-SITE 0 SEPTIC MAINTOLLOW-UP
i 0 DEMO-FINAL ❑ SEPTIC INSTALL 0 HARD COVER REMOVAL
v 0 PLUMBING RI 0 SEPTIC FINAL 0 FOUNDATION/REMOVAL
Z OWNE TO MEET YOU:_YES_NO
276. MENTSi ' ,
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U IIWORK SATISFACTORY:PROCEED ROJECT COMPLETE
LU ❑CORRECT WORK&PROCEED ❑ UE CERTIFICATE OF OCCUPANCY
CZI ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
C.1 BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ID CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hou in advance. (952 ' 9-4600
Owner/Contractor on site:
Inspector. / 'l t
r
White Copyllnspector's File - Canary Copy/Site Notice