HomeMy WebLinkAbout2014 - 00406 - windows CITY OF ORONO 1111 111111 II 11 .1111 II i i II
204 - 00406 *
2750 KELLEY PARKWAY DATE ISSUED: 05/12/2014
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 1110 WILLOW DR S
PIN : 10-117-23-24-0011
LEGAL DESC : UNPLATTED 10 117 23
: LOT 000 BLOCK 000
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WINDOWS
ACTIVITY : 0/S BUILDING-UNDEFINED
VALUATION : $ 4,520.00
NOTE: REPLACE 8 WINDOWS WITHIN EXISTING OPENINGS
APPLICANT PERMIT FEE SCHEDULE 118.00
STATE SURCHARGE(VALUATION) 2.26
THE HOME DEPOT A.H.S. MAIL-IN FEE 2.00
2690 CUMBERLAND PKWY, STE 300 TOTAL 122.26
30339-
(763)542-8826 Payment(s)
Minnesota State License#: BUIL-20268257 CHECK 67989 122.26
OWNER
GLASER,ROBB
1110 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 he
revoked at any time for due carie.
' / do, a.
Applicant Permitee Signature Date Issued By 'ti ature Date
MAY/05/2014/MON 11 : 29 PM Elder Jones Building FAX No, 952 854 4909 l P. 002
City of Orono 5 (a—
Building Permit Application for Internal Work
(windows, doors, siding, re-roof, etc.)
Mailing Address: Permit number: c;t9ON oeg0,6
PO Box 66
K.:37;7°,.,
Crystal Bay, MN 55323-0066 Date received: 54 -/4
�' Received ti,�x"' a, Street Address: by: MS
il. r" 2750 Kelley' ^�" f G yParkway Plan review fee:
�9sIp$k� Orono,MN 55356
Total Fee: ;aa . a W
Main: 952-249-4600 Fax: 952-2494616 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: , y�
Job Site Address: 1/ /d [/'I lb0 t.J Of/V 4.
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Li 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 I APPLICANT INFORMATION:
Name: si 04h Q6P/VI5••41: Y7
State License# THD At-Home Service, Inc,
Phone: 2690 Cumberland Pkwy, Ste 300 Scell)
Mailing Address: _ _ Atlanta, GA 30339-3913 ZIP:
Contact Person: Lie#CR268257 Ph. 763/542-8826 lomeowner (Circle one)
Email and/or Fax:
PROPERTY OWNER INFORMATION:
Name: f4 r 31& 5 o 6
Phone(day): yoY �(p9. r
Address: l ( 0 a Dr r re. City: LaO y 7 444 ZIP: 16 3
Email and/or Fax
PROJECT INFORMATION:
Type of Project: Any earth movement may require
❑ Door(s) ❑ Remodel MCWD review& permits
❑Water Damage •
Minnehaha Creek Watershed District(MCWD)
Windows) '-L1 Repair Q Storm Damage 18202 Minnetonka Blvd
Deephaven, MN 55391
❑Siding ❑ Restoration
❑Other:(specify) Phone: 952-471-0590
Fax: 952-471-0682
❑ Re roof
❑Fire Damage __ www.minnehahacreek,ora
Overall Project Description: 8 PI 10 u plii is //7 1 t!J //A a op . A (.0 91
Estimated Construction Valuation of Project(excl ding land) $ 15 a ! Z
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 the information,the application may not be issued.
. X Applicant's Signature: Date: 6C ` l
Last Updated: 05-04-2009
MAY/05/2014/MON 11 :29 PM Elder Jones Building FAX No. 952 854 4909 P, 001
1120 East 80th Street,Ste.#211;Bloomington,MN 55420 Elder Jones Bldg.
952-345-6047-Direct 952-8154-4909-Fax
Permit Service, Inc.
Fa)(
To: Orono,City of Attn: B[dg, Dept. From:
Fax: 952-249-4616 • Pages:
Phone: 952-249-4600 Date:
Re: Building Permits) CC:
❑Urgent ❑ For Review ❑Please Comment X Please Reply Cl Please Recycle
• Comments:
Please call when the permit fees):have been figures. So I can cut a check, _
Thank You,
CJ�Cd I
952-345-6047
/y $SK -grip ti
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICESCHEDULED '
PERMIT NO. 24'050-0o4d6 COMPLETED 6-/-/S )j
ADDRESS /MO UJ /64.) - S..
OWNER ,,cc.am,! "� TELEPHONE NO.
CONTRACTOR /�wte /debt
DESCRIPTION
W ❑ FOOTING 0 DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL 0 PLUMBING RI 0 EXCAV/GRADING/FILLING
H 0 FOUNDATION WATERPROOF ❑ PLUMBING FINAL 0 TREE REMOVAL
Z ❑ RADON SLAB 0 MECHANICAL RI 0 SITE INSPECTION
Q 0 FRAMING 0 MECHANICAL FINAL 0 PROGRESS
❑ INSULATION ❑ WOOD BURNER/FIREPLACE 0 COMPLAINT
Q INAL 0 WATER HOOK-UP OW-UP
W ❑ AS BUILT-SURVEY 0 SEWER HOOK-UP HARD COVER REMOVAL
. ❑ DEMO-SITE 0 SEPTIC INSTALL 0 FOUNDATION/REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
v) COMME5 TS:
IQ i'G/wt:C `tdi,2 ✓ �r�,/. ' C46� fig/
o ,.•taL /n5,Pc-tho:
cc
o
W I✓)N00 1.3 (e/a/- sic 5 lee./ St.v(e 5
Q Iry �,)CtSe1'tS Dfrt,s.
z
14.1
k/o r 64 a�gs/3 f /frt f/s h e_
cc i.m. ieta
a
WQ 0 WORK SATISFACTORY:PROCEED e?BOJECT COMPLETE
W 0 CORRECT WORK&PROCEED 0 ISSUE CERTIFICATE OF OCCUPANCY
0 0 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. 0 PHOTO TAKEN
INSPECTOR WILL RETURN
0 CITATION ISSUED
0 STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contractor on site:
Inspector. t .-- II"-
White opyllnspector's File Canary Copy/Site Notice