HomeMy WebLinkAbout2014 - 01199 - roofing CITY OF ORONO �� I IN N III 111111111111 111
2750 KELLEY PARKWAY DATE ISSUED: 10/15/2014
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS / : 1115 WILLOW DR S
PIN : 10-117-23-24-0017
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 : $ 6,900.00
NOTE: VALUATION OF PERMIT:$6900.00
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 147.50
STATE SURCHARGE(VALUATION) 3.45
SELA ROOFING& REMODELING, INC. MISC FEE 0.00
4100 EXCESIOR BLVD
ST. LOUIS PARK, MN 55416- TOTAL 150.95
(952)915-7227 Payment(s)
Minnesota State License#: BUIL-BC 1050 CHECK 35235 150.95
OWNER
GABRIELSON,TODD& SUE
1115 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 goveming 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 at any tithe-€ar-due .• e.
/D/ /.5/ /
'N ant 'ermitee Signature Date lssuSignature Date
r By
City of Orono
Building Permit Application for Maintenance 1 Replacement / Renovation
e
(No structural expansion. Only windows, doors, siding, etc.) p
Mailing Address: Permit number: /V�/1 C 9
V-O V PO Box 66 Date received: la-/5—/�
Q Crystal Bay,MN 55323-0066
Received by: �.
Street Address:
*:".S.*
t 2750 Kelley Parkway Plan review fee:
�F ." Orono,MN 55356 . ��
tRkESHO1t 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: 1 1 \M \ I Q\iU o r . �S.
Job Site Address: 1
Will this be a Parade of Homes, Remodelers ShowcaseHomeor other
aDi Display
ys prom Home?
event.1Shutt sous service ill If yes,a special event permit is required with Police Department andCity
Council required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed.
CONTRACTOR 1 APPLICANT' IN_ FORMATION:
Name: VV 0t)(
State License# A00D 0G7: Expiration Date: 0
AT.j r Zt-7))4
Lead Certification Number: 7v� � Expiration Date:
(for work on homes that were constructed prior to 1978 (office) 0 02. • a ' • ZZ
Phone: (cell)
49
LIP
Mailing Address: uo ,,
L WY give City: sr Ig plc ZIP: Varrit1
Contact Person: A A Applicant is: ontracto / Homeowner circ)
�. �. -V1( . cowl A • q22 .4111
Email and/or Fax: e1�P,S� ,�'.t 1A1/1H�
Name: )
ERTY OWNER I Ot111�1AT1 V: 1 , tISO k
j .
Phone (day): / AIM • c�! r I--��/�A Q7IP: '
' t 1 DA) r, J ' City: J A J..- IV l ✓4
?��.
Address: l (
Email and/or Fax: p�� ..(� 1(0.0.1)-f kiOu
PROJECT INFORMATION: Overall project description:T '14)I 1 [
AIA-Elk
Any earth movement may also re ire
Type of Project: MCWD review&permits:
❑Door(s) 0 Remodel 0 Fire Damage
Minnehaha Creek Watershed District(MCWD)
Re-roof,asphalt 0 Repair 0 Storm Damage 18202 Minnetonka Blvd
Deephaven,MN 55391
o Re-roof,cedar 0 Restoration 0 Water Damage g Phone: 952-471-0590
❑Re-roof,other(specify) 0 Siding 0 Other:(specify) Fax: 952-471-0682
0 Window(s)
min h �acreek.orq
Estimated Construction Valuation of Project(excluding land) $
� ct Du . L �
APPLICANT ACKNOWLEDGEMENT:
• Agrees to provide all information required or requested by the Building Department; recognizes that they are
• Certifies that the information supplied is true and correct to the best of his/her knowledge. The applicant
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 u•date our records and records of other governmental agencies required by law. If
you refuse to supply opation,th,rPIik
on • ay not be issued. D lk
��
] 1 Date:
Applicant's Signature: ...- •_a_
Date:
Owner's Signature:
Last Updated:03/06/2013
v DAT • TIME
CITY OF ORONO CALLED IN `� 10,1,111s
INSPECTIOIWTI En SCHEDULED Mena
PERMIT NO - G COMPLETED
ADDRESS t t 15 LADd`.) br S
OWNER TELEPHONE NO.c&- - qL3- "1142
CONTRACTOR • t!4__ P.-1)c)Al
DESCRIPTION tir P_
W ❑ FOOTING 0 PLUMBING FINAL 0 EXCAV/GRADING/FILLING
U. 0 POURED WALL 0 MECHANICAL RI ❑ LAKESHORE/WETLANDS
y
Q 0 FRAMING 0 MECHANICAL FINAL 0 TREE REMOVAL
• 0 INSULATION 0 WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q 0IIII��-RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
I INAL ❑ SEWER HOOK-UP ❑ COMPLAINT
v ���� DEMO-SITE 0 SEPTIC MAINT. 0 FOLLOW-UP
LLJ 0 DEMO-FINAL 0 SEPTIC INSTALL 0 HARD COVER REMOVAL
• 0 PLUMBING RI 0 SEPTIC FINAL 0 FOUNDATION/REMOVAL
si
2
OWN ERICONTRACTOR TO MEET YOU:_YES_NO
• COMMENTS:
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"S amort (4604"dec—
LU ❑WORK SATISFACTORY:PROCEED BQJECT COMPLETE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V 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
Owner/Contractor on site:
Inspector. �'"'` �
White Copy nspector's File Canary CopylSite Notice
� DATE
`
CITY OF ORONO CALLED IN V I I5I L s%it
INSPECT: N WISE I rn SCHEDULED �C L `� 35
PERMIT `� `) COMPLETED
ADDRESS 1 l 1-S t t LVDLID 0r S .
OWNER �_� TELEPHONENO.° St 1-3
CONTRACTOR \
. DESCRIPTION •0..-
LULU ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
U.. CI POURED WALL CI /W
MECHANICAL RI 0 LAKESHOREETLANDS
y
Q CI FRAMING CI MECHANICAL FINAL ❑ TREE REMOVAL
0 INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
'
0 RADON SLAB 0 WATER HOOK-UP ❑ PROGRESS
E=, 0 FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
tij ❑ DEMO-FINAL 0 SEPTIC INSTALL ❑ HARD COVER REMOVAL
J ❑ PLUMBING RI ❑ SEPTIC FINAL 0 FOUNDATION/REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
LI COMMENTS:
Lu 7;".4r - - 6",e. .t55 roar �S/`Q4dr.rty 4
j /"xl a' .' /4o .w /II "—'i `�!/eV vB%gf k
7.
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Lu
Q 14)(74 r,� t./0-1/ 7.0/s — /fl4 e_ $4/ a /CG `I_
2 Li.,a•v ftOt'G(to A, cJDCDIGS , f015edQ Cu4 tr,44
W 1
cc ,coviraGI0 / '//6er'G f, 4r`'es
IQK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W ❑CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contractor onsite: /
Inspector. 9_►,.__. Rv
White Copy/Inspector's File Canary CopylSite Notice
CITY OF ORONO I IlIl����I�II1111�111111�
2750 KELLEY PARKWAY * 2 1 S 1 1 9
DATE
TE IssuEv: 10/15/2014
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 1115 WILLOW DR S
PIN : 10-117-23-24-0017
LEGAL DESC : UNPLATTED 10 117 23
: LOT 000 BLOCK 000
PERMIT TYPE : MINOR ALTERATIONS
I'ROI'ERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ROOFING-ASPHALT
ACTIVITY : 0/S BUILDING-UNDEFINED
VALUATION : $ 6,900.00
NOTE: VALUATION OF PERMIT:$6900.00
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.
lihoQ,00
sPaCr , cYO )v,
APPLICANT PERMIT FEE SCHEDULE 147.50
SELA ROOFING& REMODELING,INC. STATE SURCHARGE(VALUATION) 3.45
4100 EXCESIOR BLVD MISC FEE 0.00
ST. LOUIS PARK,MN 55416 TOTAL 150.95
(952)915-7227 Payment(s)
Minnesota State License#: BUIL-BC1050 CHECK 35235 150.95
OWNER
GABRIELSON,TODD&SUE
1115 WILLOW DRS
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.
OM" �— Ctt /O/ i /-
Applicant Permitee Signature Date Issued ty Sign ature Date
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