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HomeMy WebLinkAbout2016 - 01331 - roofing f t CITY OF ORONO 11 zl III 1111 1111111111113 31111 2750 KELLEY PARKWAY DATE ISSUED: 10/19/2016 ORONO,MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 1099 WILLOW DR S PIN : 10-117-23-24-0016 LEGAL DESC : UNPLATTED 10 117 23 : LOT 000 BLOCK 000 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : 0/S BUILDING-UNDEFINED VALUATION : $ 8,500.00 NOTE: VALUATION OF PERMIT:$8500.00 TEAR OFF REROOF HOUSE AND GARAGE ROOFING PERMITS ISSUED WITHOUT ENOUGH NOTICE FOR TEAR OFF INSPECTIONS. (WE REQUIRE 24-48 NOTICE,PRIOR TO WORK BEING STARTED) MUST PROVIDE COMPLETE SET OF PICTURES OR A FINAL INSPECTION MAY NOT BE ISSUED. SIGNS-ADVERTISING SIGNS MAY ONLY BE ON THE PROPERTY DURING THE TIME THE ROOF IS BEING DONE. ONCE WORK IS COMPLETED THE SIGNS MUST BE REMOVED. APPLICANT PERMIT FEE SCHEDULE 185.83 STATE SURCHARGE(VALUATION) 4.25 DERCON CONSTRUCTION SERVICES INC. MAIL-IN FEE 2.00 727 170TH LANE NW ANDOVER,MN 55304- TOTAL 192.08 (612)276-6006 Payment(s) Minnesota State License#:BUIL-BC51296 CREDIT CARD 4495 192.08 OWNER RODER,ROGER&GLORIA 1099 WILLOW DR S WAYZATA,MN 55391 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 any time for due cause. ( d)�cc r 'moi 76,/91 Applicant Permitee Si ature Date Issu d By ignature Date 10119/2016 09:53 Dercon Construction (FAX)7639513019 P.002/003 City of Orono Building Permit Application for Maintenance / Replacement / Remodel -ResSidentiatl-OI SLY (i.e.windows, doors, siding, re-roof, etc. - NO STRUCTURAL EXPANSION) oW Mailing Address: Permit number. C I(o-6.13 5 I PO Box 66 Crystal Bay, MN 55323-0066 Date received: Street Address: Rece1V6d by: . G 2750 Kelley Parkway Plan review fe [� Orono,MN 55356 tEsrtot� 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: 06119 LO\.\\C L ) , Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑Yes o If yes,a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus se ice will be required unless applicant demonstrates sucient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: 72112.AteiNeN. ;UJ) State License# cl,C,r31a4't i� Expiration Date: 3 -3 Lead Certification Number: )-C 3CAS Expiration Date: 1 - :_( (for work on homes that were constructed prior to 1978 Phone: (cell) a") \-g � j j (office) fQ 1 �- o�`Z k2^1000/-0 Mailing Address: -1-3.1 i-)o-_ Lew, �; City: fid)ti,eA ZIP: 5 5,3,E zj Contact Person: v.e.,x,cx. fywort, e Applicant is: o ctor / Homeowner (Circle one) Email and/or Fax: Sr-z_vr\ekVlCs2 . u :� `4'c , 5•�. 1 Q3-ci S i-'.311 Il i PROPERTY OWNER INFORMATION: Name: r DO t.__Yr.mow. Phone (day): 44;1 - id3 rt gin'3 Address: Octc\ \-.1,5 \IDA . _ City: 4 ZIP: 5-536t I Email and/or Fax: nc4c,nom-c, e PROJECT INFORMATION: Overall project description: ,,1� - t`c?_;D� )��}� �� T Type of Project: Any earth mover t may also require` ' ❑ Door(s) ❑Remodel 0 Fire Damage MCWD review&permits: ORe-roof,asphalt Minnehaha Creek Watershed District(MCWD) p Repair LI Damage 15320 Minnetonka Blvd ❑Re-roof,cedar ❑ Restoration ❑Water Damage Minnetonka, MN 55345 El Re-roof,other(specify) ❑Siding CIOther: (specify) Phone: 952-471-0590 Fax: 95271-0682 0 Window(s) www_minnehahacreek.orq Estimated Construction Valuation of Project(excluding land) $ 9a 5 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 rno efuse to supply/the Information,the a ['cation may ppt be 4 issued. / Applicant's Signature: 'r //� t e• Date: -/q-e(, Owner's Signature: Date: Last Updated:January 2016 C2E TIME / CITY NO CALLED IN INSPECTION N TIC SCHEDULED Of2f'r? PERMIT NO. t COMPLETED ADDRESS /(- 7 } L( / / I ©(�� /9/? ,s , OWNER TELEPHONE NO. lel 2-2-47 -'—, ( CONTRACTOR DESCRIPTION C70"/ -a j W ❑ FOOTING 0 DEMO-FINAL 0 SEPTIC FINAL c ❑ POURED WALL 0 PLUMBING RI ❑ EXCAV/GRADING/FILLING Q ❑ FOUNDATION WATERPROOF 0 PLUMBING FINAL 0 TREE REMOVAL ❑ RADON SLAB 0 MECHANICAL RI 0 SITE INSPECTION Q ❑ FRAMING 0 MECHANICAL FINAL 0 RATED WALLS • ❑ INSULATION 0 WOOD BURNER/FIREPLACE 0 COMPLAINT • 0 FINAL 0 WATER HOOK-UP 0 FOLLOW-UP ❑ AS BUILT-SURVEY 0 SEWER HOOK-UP 0 FOUNDATION/REMOVAL ❑ DEMO-SITE 0 SEPTICIN TALL 2 OWNER/CONTRACTOR TO MEET YOU: YES—¢�}/NO • COMMENTS: /K ) h4qtcc Q. 7?T)7 ( c,L cc /T-cr /2 ,t„:„ ce ace", W / cc J W ❑WORK SATISFACTORY:PROCEED PROJECT COMPLETE CC ❑CORRECT WORK 8 PROCEED ❑ SSUE CERTIFICATE OF OCCUPANCY OO ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY C.1 BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN [3STOP 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 op site: Inspector. 13 White Copyllnspector's File Canary Copy/Site Notice