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HomeMy WebLinkAbout2011 - 00492 - windows CITY OF ORONO PERMIT NO.: 2011-00492 e 2750 KELLEY PARKWAY ORONO, MN 55356- DATE ISSUED: 06/20/2011 (952)249-4600 FAX: (952)249-4616 ADDRESS : 4665 WEST BRANCH RD PIN : 07-117-23-22-0015 LEGAL DESC : WEST BRANCH HILL : LOT 001 BLOCK 001 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WINDOWS ACTIVITY : 0/S BUILDING-UNDEFINED VALUATION : $ 5,000.00 NOTE: WINDOW REPLACEMENT-SOFFIT AND FASCIA APPLICANT PERMIT FEE SCHEDULE 118.00 SMC HANDYMAN SERVICES STATE SURCHARGE(VALUATION) 2.50 12995 135 STREET TOTAL 120.50 NORWOOD YOUNG AMERICA,MN 55368- (952)688-2800 Minnesota State License#: 20633103 OWNER GROVE,JOHN&CARMEN 4665 WEST BRANCH RD MOUND, MN 55364 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 revoke. . . due se. (/ /JO' / 26 1,1 / � 4,/ .2D / / /,,r Applicant Permitee Signature Date Issue By Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. City of Orono c Building Permit Application for Internal Work (windows, doors, siding, re-roof, etc.) '/G� Mailing Address: Permit number: p.D//'-�e- ‘--1*)(63.4 ) Crystal 66 Cstal Bay, MN 55323-0066 Date received: (eVa-off/ a �,,,. 4, Street Address: Received by: �.�L ' ,^S;P‘: c'' 2750 Kelley Parkway Plan review fee: Esuo4 Orono, MN 55356 Total Fee: 4 ,„zae,,5, 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: `ff (0 C \ki i c, PA F_7(1o+J-z) >M J 55 Iif Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ 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: -jm 6 fbt-No f n - Si )0 f 3 ue State License# '2i (p 10 3 Expiration Date: 43 f 2.1J . Lead Certification Number: M —5'- 88 -IO -D© 19 1Lofs Expiration Date: /Z o& -2.01S— (for 0/S(for work on homes that were constructed prior to 1978 Phone: 'fWZ 6, 'gyp U (office) (cell) Mailing Address: 2�q S i ,--,r.... City:JORM)-o,0 ZIP: 5j3f'i8 Contact Person: • FN 01 ('v t Applicant is: tractor / Homeowner (Circle One) Email and/or Fax: I COt,r ' 6" ttv L w..• Cr • PROPERTY OWNER INFORMATION: Name: (.4f -41Cm IF A40 i.1 12.0t/ Phone (day): ( VZ. ?°1 .µ1S 1 — CAlt-M . Address: 44(05 WW5 ( tv 124 City: O(t0410 ZIP: S-536(i Email and/or Fax PROJECT INFORMATION: Type of Project: Any earth movement may require ❑ Door(s) ❑ Remodel 0 Water Damage MCWD review&permits: Minnehaha Creek Watershed District(MCWD) R Window(s) 0 Repair 0 Storm Damage 18202 Minnetonka Blvd 0 Siding ❑ Restoration ❑ Other: (specify) Deephaven, MN 55391 Phone: 952-471-0590 0 Re-roof ❑ Fire Damage Fax: 952-471-0682 www.minnehahacreek.orq Overall Project Description: Estimated Construction Valuation of Project(excluding land) $ 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 sup•, `rmation •- -•plicati•n may not be issued. Applicant's Signature: • /.‘ Date: q2.0 1/ 'ii Last Updated: 03-01-2011 �-C DATE TIME Si CITY OF ORONO CALLED IN '7 /I INSPECTION NOTICE �j SCHEDULED -l/9 /// - V1 PERMIT NO. L-9011 '00gq; COMPLETED ` ADDRESS /-1-(P (L' (.l ) pa-0C a-0 h 1r"��d OWNER TELEPHONE NO. Q gb &C- CONTRACTOR /il/` , DESCRIPTION ? J W ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING c ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y El FRAMING CI MECHANICAL FINAL El TREE REMOVAL • ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS • ❑ FINAL ❑ SEWER HOOK-UP 0 COMPLAINT ❑ DEMO-SITE ❑ SEPTIC MAINT. 0 FOLLOW-UP _ ❑ DEMO-FINAL 0 SEPTIC INSTALL ❑ HARD COVER REMOVAL ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL OWNERICONTRACTOR TO MEET YOU:_YES NO oy COMMENTS: CC W CC O CC O W CC W W CC LU ❑WORK SATISFACTORY:PROCEED 7EPROJECTCOMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY CZ ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY ✓ BEFORE COVERING PERMANENT ❑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 inspection 24 hours in advance. (952) 249-4600 l Owner/Contractor on site: �/��� Inspector. {/)/ White Copy/Inspector's File Canary Copy/Site Notice