HomeMy WebLinkAbout1995 - 006769 - kitchen addition PERMIT
CITY OF ORONO PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66
Permit Number:
Crystal Bay, Minnesota 55323 Date Issued: .
(612) 473-7357
SITE ADDRESS:
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DESCRIPTION:
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REMARKS: ' . -
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FEE SUMMARY: 7:...
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SPECIFIEDWORK iN PRIOT COMPLIANCE WITH ALL C:ITY OF
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APPLICAN •ERMITEE SIGNATURE ISSUED BY.SIGNATURE
, Total Fee: $ 7/VC. DateReceived: / o' 5 9s
Date Approved:
Entered By: .-(',/Z/ Permit#:
CITY OF ORONO - BUILDING PERMIT APPLICATION
ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL
BE STARTED
THE APPLICANT IS: (circle one) OWNER OltCONTRACTO
JOB SITE ADDRESS: /C' COO K %//5 ZIP:
•
NAME OF OWNER: a f t7L-1Ie? PHONE: (home) Y/5- )//96..,
(work)
MAILING ADDRESS: LA.%C,bi r Hi )iSIZC) CITY: /r.z/;L�/ ZIP:
CONTRACTOR: j ( -7/7e. o PHONE: /j 5
MOBILE PHONE/P�R: ,2 7 uo,«'
�,; r � :,�,_7- CITY:�'/) j,. c-rf 4;9- ZIP: :53 ye'
MAILING ADDRESS: � C� �_� i �. �-�
STATE LICENSE: # 'g•-7f)
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION #
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration l/ Land Alteration
PROPOSED WORK(describe indetail): ,:7/ji / 2 • �; �//Me; 'r h -4`
STORIES: ' SQ. FEET OF EACH FLOOR: 6'/
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION(excluding land): $
I hereby apply for a building permit and I acknowledge that the information above is complete
and accurate; that the work will be in conformance with the ordinances and codes of the City
and with the State Building Code; that I understand this is not a permit and work is not to start
without a permit; and that the work will be in accordance with the approved plan.
APPLICANT'S SIGNATURE: 'Or/ DATE: /' _- 73
NOTE! Parade of Homes events require separate permit approval by Police Department and
City Council 60 days prior to the event. Non permitted events will not be allowed.
9
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Municipal Offices
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Crystal Y ta55323-0066
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DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd. 2, "Rights of subjects of data", we would like to
inform you that your request for a permit or license from the City of Orono or any of its
departments may require you to furnish certain private or confidential information.
You are notified that:
1. The information you furnish will be used to determine your qualification for the
permit or license requested.
2. You may refuse to supply data, but refusal may require that the City deny the
permit or license.
3. The information may be shared with other local, state or federal agencies to the
extent necessary to process the permit or license.
4. If your requested permit or license requires Council action to approve, some
information may become public.
5. You have certain rights under M.S. 13.04 (see following page) to review private
data on yourself.
6. Your full name is required to process this application or permit.
PLEASE PRLNT
3,
First Middle Last
✓�/ y
Address
City State Zip Phone
I understand my rights as stated above.
>--
'Signature
TELEPHONE-473-7357•FAX-473-0510
10
Sec.13.04 RIGHTS OF SUBJECTS OF DATA
Subdivision 1. Type of data. The rights of individual on whom the data is stored or
to be stored shall be as set forth in this section.
Subd. 2. Information required to be given individual. An individual asked to supply
private or confidential data concerning himself shall be informed of: (a) the purpose and
intended use of the requested data within the collecting state agency, political subdivision, or
statewide system; (b) whether he may refuse or is legally required to supply the requested data;
(c) any known consequence arising from his supplying or refusing to supply private or
confidential data; and (d) the identity of other persons or entities authorized by state or federal
law to receive the data. This requirement shall not apply when an individual is asked to supply
investigative data, pursuant to section 13.82, subdivision 5, to a law enforcement officer.
The commissioner of revenue may place the notice required under this subdivision in the
individual income tax or property tax refund instructions instead of on those forms.
Subd. 3. Access to data by individual. Upon request to a responsible authority, an
individual shall be informed whether he is the subject of stored data on individuals, and whether
it is classified as public, private or confidential. Upon his further request, an individual who
is the subject of stored private or public data on individuals shall be shown the data without any
charge to him and, if he desires, shall be informed of the content and meaning of that data.
After an individual has been shown the private,data and informed of its meaning, the data need
not be disclosed to him for six months thereafter unless a dispute or action pursuant to this
section is pending or additional data on the individual has been collected or created. The
responsible authority shall provide copies of the private or public data upon request by the
individual subject of the data. The responsible authority may require the requesting person to
pay the actual costs of making, certifying, and compiling the copies.
The responsible authority shall comply immediately, if possible, with any request made
pursuant to this subdivision, or within five days of the date of the request, excluding Saturdays,
Sundays and legal holidays, if immediate compliance is not possible. If he cannot comply with
the request within that time, he shall so inform the individual, and may have an additional five
days within which to comply with the request, excluding Saturdays, Sundays and legal holidays.
Subd. 4. Procedure when data is not accurate or complete. An individual may
contest the accuracy or completeness of public or private data concerning himself. To exercise
this right, an individual shall notify in writing the responsible authority describing the nature of
the disagreement. The responsible authority shall within 30 days either: (a) correct the data
found to be inaccurate or incomplete and attempt to notify past recipients of inaccurate or
incomplete data, including recipients named by the individual; or (b) notify the individual that
he believes the data to be correct. Data in dispute shall be disclosed only if the individual's
statement of disagreement is included with the disclosed data.
The determination of the responsible authority may be appealed pursuant to the provisions
of the administrative procedure act relating to contested cases.
11
CHECK OFF LIST FOR ISSUANCE OF PERMITS
FQR/,OFFICE LIS 1 S NLY
ADDRESS OR LEGAL: /� /JJ jJ,4//,/ /.5 lot
DESCRIPTION OF WORK: AOC('n of
ZONING REVIEW BY: �� ($ --��--_--�--- DATE APPROVED: -
BUILDING REVIEW BY: 11,4��Q __ DATE APPROVED: i_zs-Ss
FEES TO BE CHARGED: QQ Misc. Fees Calculated By:
PERMIT Yes No
PLAN REVIEW Yes — No SEWER CONNECTION
STATE SURCHARGE Yes ' No WAL'ER CONNECTION
INVESTIGATION FEE Yes No '-- PARK FEE
SAC Yes No v Sl•1'h INSPECTION
Number of SAC Units OTHER (specify)
ZONING CHECK LIST Zoning District: (ZQ-1(3 Shoreland District : NIA
Fire Department: WA1/4?-24iv Post Office: tjuA rr} School District: O - ' t
Lot Area: Sq.ft. No c ety+/..J Acres -- Width Depth
Survey Submitted: Yes 7(.. No Date of Survey: t 2-Z3- 9`{
Proposed Setbacks:
Front (hake): 52-2— Right Side: 53! ��
Rear (SrrPet): l`{•'L Left Side: A% 6)
Adjacent Structures: /21-77-77c4ssep Wetland: /V/,9
Building Height: Def. Hgt. O. Peak Hgt. O./
Avg. Setback: Bluff Setback: Lot ' o erage:
Existing P opose•
Hardcover: 0-75'
75-2.0'
250 500'
511-1000'
Hardcover Varianc; Required: -s o D. e of Council Ap•r oval:
Grading: Staff A•proval Date: By: Council App oval Date:
Septic: Staff A,,proval Date: -_ 'y:
Zoning File: • Re • .tion: # Resolution Date.
RE (in house):
26
BUILDING REVIEW CHECK LIST
UBC: g-3 CONSTRUCTION TYPE: \IN
• Sq Footage $ Per Sq Ftg
Basement x =
1st Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
Estimated Construction Value: $ 5 Lf o ea 00
Inspections Required: Work Requiring Separate Permits:
Site o< Plumbing Fire
Hardcover Removal o( Mechanical Water Connection
)( Footing Septic Sewer Connection
A- Framing Fireplace Lawn Irrigation
)C Insulation (Masonry) Other
,i( Wall Board (Mfg.) Well (State Permit)
o� Final Grading/Filling 54 Electrical (State Permit)
Other
REMARKS (IN HOUSE):
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date By:
REMARKS(TO BE NOTED ON PERMIT):
27
4
MINNESOTA STATE BUILDING CODE DIVISION
EXTERIOR ENVELOPE AVERAGE "U" COMPUTATION
OWNER
SITE ADDRESS
CONTRACTOR DATE PHONE
Determine working square footage of each.
1 . Total exposed wall area ;91 sq. ft. x ,/ / _ g)"../.2
2. Total roof/ceiling area ,1/‘q sq. ft. x .02[0 = 6,. ,3L,
Total exposed wall area above floor =
a. Total wall window area f
b. Total door area .2/1
c. Total sliding glass door area .5.�
d. Total fireplace wall area _ O
e. Total wall framing area (average 10%)
f. Total net wall area above floor 4
g. Total rim joist area 4'
Total exposed foundation area =
h. Total foundation window area L�
i. Toal net foundation area above grade y
Determine "U" value of each wall segment.
a L?7 x "u" = , v5
b. „G, X "U" . b/ =
c. _S3 x "U 3_S = j �
R,�._c_S-
d. X "U" =
•
e. Sq X "u" , C7/ = x,9/6
f. Lf93•:.) x "u" ,eV3 = (, /:v?
g. `f,o X "U" .C/ / = t, 64(
h. X "U" =
i. 49. x ,.U„ 083 = 3. &.5-
3
53. Total = F�5/•(0�
If item #3 is the same as, or less than item #1 , you have met the intent
of SBC 6006(c)2.
4,
11
Total exposed roof/ceiling area = d?C�
j. Total skylight area
k. Total roof/ceiling framing area (average 10%) ;(y,, 4/
1 . Total net insulated roof/ceiling area a,37fe,
Determine "U" value for each roof/ceiling segment.
j. X "U
k. � y X "U" 0 , _ . 64;
1. 237.( X "U" 0 -1.3 S4'
4 Total = (,-, /`1
If total of #4 is the same as, or less than #2, you have met the intent of
SBC 6006(c)1 .
Alternate Building Envelope Design
To utilize the total envelope system method, the values established by the
sum of items #3 and #4 shall not be greater than the sum of items #1 and #2.
1 . 07. /L2. + 2. L.,,636,-, _ (/ 9T
3. + 4. (,-, i`-f = 90, •
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CERTIFICATE OF SURVEY FOR
TINA WINT RITCHIE
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fi" f +r .,�r*�,.., Bearings shown are based upon an assumed datum . 3 J`�, r=
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1 + s,,{ , ,j �r n This "survey intends to show the boundaries of the above" described
• "' *�� [;', property , the location of an existing house , and the proposed
'-� 't`"' location of a proposed addition thereon . It does not
,� le ,p.,..:4,7', purport to
T i,4�� ' � x• , show any other improvements or encroachments .
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1 I herebycertifythat this surveywas prepared by me or under m direct su er DATF. 12-23-94
a " COFFIN & GRONBERG, INC. vision, and tht I am a duly reistered Civil Engineer and Land Surveyor under
1.' the laws of the State of Minnesota.
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DATE TIME
I fY OF ORONO CALLED IN . y c.
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INSPECTION NOTICE SCHEDULED /i `/ /6 :C)c>
PERMIT NO. .. . COMPLET D v 'i f
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OWNER1L:_< , CONTR. .,, T-il�i.
TELEPHONE NO. ___57,7 - g."3-0
DESCRIPTION /l& r -k-'
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Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
• 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
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09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
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INSPECTOR WILL RETURN C PHOTO TAKEN
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El INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-7357
Owner!Contra n it :
Inspector.
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DATE TIME
CITY OF ORONO CALLED IN ___3/-3// "
INSPECTION N9TICE SCHEDULED 1//3/9 /60 a
PERMIT NO. 7 _1,,pp COMPLETED t '34
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Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 REE REMOVAL
• 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
i09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
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❑STOP ORDER POSTED.CALL INSPECTOR
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Call for the nextlinspection 24 hours in advance.473-7357
Owner/Contr or onrite:
Inspector.
White Copy/Inspector's File Canary Copy/Site Notice
ATE TIME
CITY OF ORONO CALLED IN 0 c• /i'j-
INSPECTION NOTICE SCHEDULED , 3/'7/%7 /1 LI o
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Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
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Call for the next i pection 24 hours in advance.473-7357
Owner/Contractor it .
Inspector.
White Copy/Inspector's File Canary Copy/Site Notice
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED —3/-s/9
PERMIT NO. COMPLETED 4 K.
ADDRESS / 'O b/ � �> i2�'
OWNER `� CONTR. ✓
TELEPHONE NO. 4/73-/Cv �7
DESCRIPTION (lee�_
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Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
03 INSULATION- � 41 /25 T OD R/FIREPLACE 34 TREE 17 SITE
VAL
04 WALL BD. 12 WARHOOK-UP Q 05 F AL 14 SEWER HOOK-UP 06 PROGRESS
07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
W 09 P I IMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
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INSPECTOR WILL RETURN
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❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the n t in pection 24 hours in advance.473-7357
Owner!Contrac n sit :
Inspector.
White Copy/Inspector's File Canary Copy/Site Notice
DATED. TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED - 9
PERMIT NO. 6'''Az' COMPLETED N
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OWNER CONTR.$/ -1P1'-) ") Cpch7-
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• 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
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= 05 FINAL 14 SEWER HOOK-UO 06 PROGRESS
~ 07 DEMO—SITE 27 SEPTIC MAINT. 21 COMPLAINT
Q 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION REMOVAL
OWNER/CONTRACTOR TO MEET YOU: YES_NO
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❑ CORRECT UNSAFE CONDITION WITHIN HOURS. PHOTO TAKEN
INSPECTOR WILL RETURN
ElSTOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next i pection 24 hours in advance.473-7357
Owner/Contra or n si :
Inspector.
White Copy/Inspector's File Canary Copy/Site Notice