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Home My WebLink About2013 - 01219 - addn/remodel/repair CITY OF ORONO 1111111011110111111111111111111111101111111111111111 * 20 1 3 - 0 1 2 1 9 2750 KELLEY PARKWAY DATE ISSUED: 11/25/2013 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 960 WILLOW DR N PIN : 27-118-23-33-0011 LEGAL DESC : UNPLATTED 27 118 23 : LOT 000 BLOCK 000 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 2,150.00 NOTE: SEPARATE PERMITS REQUIRED: PLUMBING,MECHANICAL,FIREPLACE,ELECTRICAL(STATE) REPAIR WATER DAMAGE IN BASEMENT APPLICANT PERMIT FEE SCHEDULE 88.50 GREEN CLEAN RESTORATION STATE SURCHARGE(VALUATION) 1.08 7229 UNIVERSITY AVE.NE FRIDLEY,MN 55432- TOTAL 89.58 (763)789-9600 PAID WITH CC# 7705 Minnesota State License#: BC631450 OWNER BODE,KATHRYN 960 WILLOW DR N 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 revoked at agy time for due Tfl / Applica rmite Signature Date (FAA-� i---ak-4-11 11 2 ssues ignature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. , 'cil`' 41, 9 Vi°5 City of Oronb ,,i Building Permit Application for Maintenance / �teplacement / Renovation (No structural expansion. Only windows, doors, siding, re-roof, etc.) �O'V Mailing Address: Permit number: 620(3-01 V.q PO Box66 Crystal Bay, MN 55323-0066 Date received: I(-14 -(3 Street Address: Received by: S y 2750 Kelley Parkway Plan review fee: c7O(3—01 ZI g Fe C� Orono, MN 55356 X57 S3 kfsHo 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:INFORMATION:, Lu\lkocY1;,C\ CL. LOQ Long, LAK( )1Y\ eto Will this be a Parade of Homes, Remodelers Showcase Home or other DisplHome? ❑Yes [q 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: CI( ' .(1 a(\ i �(at G\g. `0 n1 State License# U 3�( j2j 1 �j3 Expiration Date: (5(t ay 14 Lead Certification Number: 1,4AT s%A1g- I Expiration Date: 6:70c1 a015 (for work on homes that were constructed prior to 1978 Phone: (cell)-iO3 .aa-j -q 505 (office) 103 -7 gc.3 --qtobd Mailing Address: -,Wag 0/ ` (c�/jk C,4 P' 416E City: ZIP: 6643a- Contact Person: R (A`( "RoTAIX Applicant is: ntrac O Homeowner (Circle One) Email and/or Fax: fh4-�te, w-ec 1 'UQd(N G6CQ- , g.,dr ei iGoS " 1Q1e) " 4'4)3 PROPERTY OWNER I`N�FORMATIONN:_^�,� Name: N-€1"1,( (1 .CXX�ct, Phone(day): toW -'3o q - 'i aQ Address: c.: y3 (.,S0,`6(1,`-)Cl g'-. KOCth City:LO(\aL Q. ZIP: 46366Email and/or Fax: KinA, ja.0 Yee ,(pm ( ,C OS6-- C.((��,,t,c Q-01-A.,- i+15J14k,o(l 1-o(Q.,AtcS�ocu.w .. w 5 , cwk6c AtiN 4" Rt3 OnF L� tote, PROJECT INI RMATlON: Overall project description:tMi)L t'.Oo -ike41 �C. ono6 ['l_C4j t( ‘cvt r OC t- Type of Project: An earth ovement may also require(4-k0( ❑ Door(s) ❑ Remodel 111Fire Damage MCWD review&permits:`, k u)&'...) El Reroof, asphalt El Repair ❑ Storm Damage Minnehaha Creek Watershed District(MCWD 18202 Minnetonka Blvd ❑ Re-roof, cedar ❑ Restoration KWater Damage Deephaven, MN 55391 El Re-roof, other(specify) ElSiding ❑ Other: (specify) Phone. 952-471-0590 Fax: 952-471-0682 LI Window(s) www.minnehahacreek.orq Estimated Construction Valuation of Project(excluding land) $di I_SO 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 supply • .• ormation,the application may not be issued. > Applicant's Signature: " I . r _Aka,.. Date: '/" /d — 13 Owner's Signature: Date: Last Updated:03/06/2013 PLAN REVIEW CHECKLIST FOR NEWnnSTRUCTURES / ADDITIONS Address/Permit Number: C((6 C W t 1,L.-0 l� az Description of work: W pc-flag- .0R(MA-axe �' IQ-(R Septic review by: NI A Date Approved: Zoning review by: NIA Date Approved: Building review by: C1 Date Approved: I J—I aL)1'3 Grading review by: MO Date Approved: Zo ing District: Zoning File#: Reso#: Reso Date: Zoning. Lot Area: SF/AC Width: Lot Coverage: SF % Survey Su emitted: D Yes 0 No Date of Survey: Revised date(? . Proposed Se •acks: Front(Lake) Rear(Street) ( N S E W ) ( N S E W ) Other Build'/ gs Wetland Side Side , Defined Height: Peak Height: FFE: FFE minus feet= (Existing Contour) Perimeter(linear feet) = 50% = #of Stories Ok? 0 YES FOR A BUILDING WITH A BASEMENT OR C WL SPACE: The distance between the lowest FOR A B ILDING ON A SLAB FOUNDATION: START WITH proposed floor(of th basement or crawl space)and the highest oint of the roof. START WITH The distance between the top of slab and the highest point of the roof. If you have a... If you have a... • GABLE OR HIPPED ROOF(no • GABLE OR HIPPED ROOF(no windows): Subtract half the windows): Subtract half the distance distance between the highest'oint between the highest point of the roof of the roof to the low point of the ,/ to the low point of the corresponding SUBTRACTION corresponding gable or hipped roof\ SUBTRACTION gable or hipped roof (BASED ON ROOF • GABLE OR HIPPED ROOF(with (BASED ON • GABLE OR HIPPED ROOF(with TYPE) windows): Subtract half the ROOF TYPE) windows): Subtract half the distance distance between the top of the between the top of the highest highest window and the highe window and the highest point of the point of the roof roof • ALL OTHER ROOF TYP S(flat, • ALL OTHER ROOF TYPES(flat,mansard,etc):No subtraction. mansard,etc):No sub action. ADDITION Add the distance between the top of slab Subtract the distance be.,een the N (BASED ON and the highest existing grade adjacent to SUBTRACTION '� (BASED ON EXISTING basement/crawl spac- oor and the EXISTING the foundation. GRADES) highest existing gray adjacent to theRADES) foundation OR 1# eet(whichever is less). E1gU\ALS Defined building height EQUALS Defined buil' g height Shoreland District MCWD Permit Received Average Lakeshore Setba4 Met? Bluff 0 Yes 0 No 0 N/A 0 Yes 0 No 0 Yes 0 No 0 Yes 0 No 0 N/A Permit Number: Setback: �` Stormwater Quality Existing Proposed Overlay District Tier Hardcover Hardcover Variance Required CUP Required 0 Yes 0 No 0 Yes 0 No Type(s): Type(s): Updatd: January 2013 v:\forms\plan review checklist 2013.docx REMARKS (in-house): 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 = $ 1St Floor X = $ 2nd Floor X = $ Garage X = $ Estimated Construction Value: $ 2, ) 5 0 Orono Inspections Required Work Requiring Separate Permits Required State Permits ❑ Site ❑ Plumbing ❑ Grading/ Filling ❑ Well ❑ Hardcover Removal ❑ Mechanical ❑ Fire ❑ Electrical ❑ Footing ❑ Septic ❑ Water Connection ❑ Poured Wall ❑ Fireplace ❑ Sewer Connection ❑ Foundation Survey ❑ Masonry ❑ Lawn Irrigation ❑ Radon Rock Bed 0 Mfg. O Framing 0 Other(specify) ,Insulation O As-Built Survey /12'Final O Wetland Buffer O Other(specify) REMARKS (in-house): Other Review: Reviewed by: Date Approved: Access: Existing: 0 YES 0 NO New: 0 YES 0 NO OFFICIAL REMARKS -TO BE NOTED ON PERMIT AND INITIALLED Updated: January 2013 v:\forms\plan review checklist 2013.docx Kathryn Bode 960 Willow Drive North Long Lake, MN 55356 - Water Damage Restoration, basement *Existing rigid foam insulation on exterior walls to be pulled and replaced with 4" R13 unfaced batt insulation and poly vapor barrier H y X 4. , , , &e_b , ,q \\ trcic (0 / 1 x - i (.) 1 / s ,/ X , 1- XX X X X X ... , 1 3 • 1 D o 77 1 , u 0 r\0+-CL) (S(.,„At,.06 (,,' c D 2‘01,.--.. c i . — ,Up 1 1 1 H 0 I 0 1 1 I b 0 1 0 00 0 • 0 • ik ( c) n 0 0 c) c) o 0 6 —r-- , i ., . ORONO COPY REVIEWED for CO E'dE CC747PLZAN'CE PLAN CHECKED BY4F,(Q,vt, DATE //- /co 2413 c,1 07 Minnesota Department of Labor and Industry Construction Codes and Licensing Division Licensing and Certification Services 443 Lafayette Road N Phone: 651.284.5034 Saint Paul, 55155 Email: DLI.License@state.mn.us MWebsite: www.dli.mn.gov/ccld.asp NOTICES NOT TRANSFERABLE CHANGE YOUR BUSINESS STRUCTURE SUBMIT A NEW APPLICATION FOR NEW ENTITY GREEN CLEAN RESTORATION RENEW OR REPLACE INSURANCE POLICY 7229 UNIVERSITY AVE NE FRIDLEY, MN 55432 SUBMIT NEW CERTIFICATE OF INSURANCE NOTIFY THE DEPARTMENT OF A CHANGE IN YOUR BUSINESS. Failure to do so, subjects you to administrative penalties of up to$10,000. 15-Day Notice Requirement—Forms available online at www.dli.mn.gov/CCLD/LicUndatP asn • Change in business'physical address,mailing address,phone number,or email address • Change in control,owners,officers,directors,members,partners • Change in business'legal name and/or assumed name • Loss of or change in QUALIFYING BUILDER • Change in general liability insurance or workers'compensation insurance coverage immediate Notice Requirement—Notification to DLI in writing • Judgmen�t pebtor. A licensed contractor has 15 days to provide written notice of the finding that it is found to be a judgment debtor based upon conduct requiring licensure. • Bankru tc Petition Filed. A licensed contractor has 15 days to provide written notice that it filed a petition for bankruptcy. • Conviction Notice. A licensed contractor has 10 days to provide written notice that it has been found guilty of a felony, gross misdemeanor, misdemeanor or any comparable offense related to the license, including convictions of fraud, misrepresentation,misuse of funds, theft, criminal sexual conduct, assault, burglary, conversion of funds, or theft of proceeds in this or any other state or any other United States jurisdiction. YOUR CERTIFICATE IS BELOW THE PERFORATION. SHOW CERTIFICATE WHEN OBTAINING PERMITS. 15Z- MINNESOTA DEPARTMENT or iLABOR & INDUSTRY RESIDENTIAL BLDG CONTRACTOR Construction Codes and Licensing Division Website: www.dli.mn.00v/CcId.as0 Licensing and Certification Services 443 Lafayette Road N St.Paul,MN 55155 Email: dii Iicensetaastat m c This is to certify that the certificate holder is licensed as a RESIDENTIAL BUILDING CONTRACTOR in the state of Minnesota is nesota and651.284.5034 in compliance with Minnesota Statutes 326B.805,and may build residential real estate,contract or offer to contract with an owner to build residential real estate,and contract or offer to contract with an owner to improve existing residential real estate;provided the responsible individual is at all times a QUALIFYING BUILDER and the certificate holder maintains compliance with the required general liability insurance,and workers'compensation laws. License : RESIDENTIAL BLDG CONTRACTOR I Lic Number : BC631450 GREEN CLEAN RESTORATION Effective Date : 04/01/2012 7229 UNIVERSITY AVE NE Expiration Date : 03/31/2014 E, FRIDLEY, MN 55432 t r, VERIFY UP-TO-DATE STATUS, BOND,AND INSURANCE INFO AT www.dli.mn.Qov;ccldLicVerifY.asp (ENTER NUMBER). • t ,, i '. tr,a ` .rye :11''',.:S141"‘„ 1 �N. ii 5;s ` u 3a ct 1 . ' ,.., t ,0,,,,,,,_,.' 0 4, ... .‘„ .,,,,,,...,,,,,,I : ,,,:__,,, ,,..,„ „..,,.., ,,, *m+ O �' ,fir .. , i (s r i f O 11` • - ' I-1 ft11„,.., 430= uz �� ,... .t,„....,„ a; . o _ ....- iii,00 1 . , tbi ct) ., -- logo -- nary sa jot Loma trt • � ,... to, joyit it, + •4 C 4,011. '64*Ail , , ctittittts#%'"'' L_..,... .' .. .., .. ...___ ,, ,. .. rti) pli zi v _ ... . .. ,,,.. _ ,.., :::::...7-i 1.... ..; 74111: 4 . . . * o . . . .. .. c .....,_ ii _ 4 R= is...„ „.., , ,. .... .4101 -lit ' ..,,,,,' ...,,..;,,,,..„,,'14',‘'.,'.„ ' ..,,1'„` 4 - ' ‘-- , , _ ... ........, ,......,... . ,=7; ,.. , ,. . 49 f .. 4 4.4., ,,,,,.,- ...0, .„,...:'-- ..-: - -,,..4:k,„p::, .,..,',,,, - VA ,-,' '''.00.41,;,,,,:: cam,= p� ' m Ar _ ,Y` � / I / V D E �� TIME V CITY OF ORONO CALLED IN /3 BMW J -”_.L- INSPECTION NOT cE , SCHEDULED r:'y:��t�:��>,) PERMIT NO. ��13 " C'L) �l COMPLETED /) /r''O i ADDRESS Cr u c l,\ 11, �� U. i)ZZ Kt . j OWNER TELEPH 0 NE NO. 7([ J 7 q �/ �Cr'C, CONTRACTOR i „-7 ( ; f. DESCRIPTION ��;�L,t _\CI --t— \ C-:-/'_1 I ('( , IQ i❑ FOOTING ❑ PLUMBING FINAL i A [1EXCAV/GRADING/FILLING ❑ POURED WALL ❑ MECHANICAL RI y ❑ LAKESHORE/WETLANDS ” ❑ FRAMING 0 MECHANICAL FINAL 4-(/fl /iO-TREE REMOVAL • ❑ INSULATION ❑ WOOD BURNER/FIREPLACE `� SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP 0 PROGRESS ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT r 0 DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP LU ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL v 0 PLUMBING RI ❑ SEPYI%4INAL 0 FOUNDATION/REMOVAL IT OWNERICONTRACTOR TO MEET YOU:}/YES_NO / c c.) COMMENTS: cc W 0- CC CC O N.. cc O 4. W CC Q I.. W WO RK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY OO ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY C) 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 nex r spection 24 hours in advance. (952) 249-4600 Owner/Contra r,, f I e: Inspecto . i 1 White Copyllnspector's File Canary Copy/Site Notice