HomeMy WebLinkAbout2015 - 01358 - windows CITY OF ORONO I 11111 1 1 1 1MM
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2750 KELLEY PARKWAY DATE ISSUED: 10/27/2015
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 1145 WILLOW DR S
PIN : 10-117-23-24-0018
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 : $ 6,680.00
NOTE: 13 WINDOWS REPLACED
APPLICANT PERMIT FEE SCHEDULE 154.89
STATE SURCHARGE(VALUATION) 3.34
PELLA NORTHLAND MAIL-IN FEE 2.00
15300 25TH AVE N.- SUITE# 100
PLYMOUTH,MN 55447- TOTAL 160.23
(952)345-6047 Payment(s)
Minnesota State License#:BUIL-BC645090 CHECK 72795 160.23
OWNER
PERL, BETTE
1145 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. (C)
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Applicant Permitee Signature Date Issued By nature Date
i„ City of Orono
Building Permit Application for Maintenance / Replacement / Remodel
(Le. windows, doors, siding, re-roof, etc. - NO STRUCTURAL EXPANSION)
(rp*Sil4C2:".
� Mailing Address: Permit number: 02-0/ 5-0/3 S 8
PO Box 66
RECEWbstal Bay, MN 55323-0066 Date received: JO - /
Street Address: Received by:
7150`27Kelley Parkway Plan review fee:
t c Orono, MN 55356
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Total Fee:
4G,
Main: 952-249-4600 Fax:"552-249-4616 www.ci.orono.mn.us
This application form must be completed in full and all required information must be submitted--e--' C--
Incomplete applications will be returned. (Please print)
GENERAL INFORMATION: 1
Job Site Address: 11 ‘16 i / b Lf Di J V C
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: 9S /3 45 • 40Y/ Jodi
State License# Pella Northland Expiration Date:
Lead Certification Number: 15300 25th Ave N. Ste 100 Expiration Date:
(for work on homes that Plymouth, MN 55447
Phone: (cell) Lic#BC645090 Ph. 763/745-1400 )ffice)
Mailing Address: City: ZIP:
Contact Person: Applicant is: ( ntractor_) Homeowner (Circle One)
Email and/or Fax:
PROPERTY OWNER INFORMATION:
Name: 8H e PQ t
Phone (day): G / 2 175/ • 153S
Address: //ti s" („J, // b W ()flirt City: t.)a y r 4-1-4 ZIP: 553 `I/
Email and/or Fax:
PROJECT INFORMATION: Overall project description:
Type of Project: Any earth movement may also require
❑ Door(s) ❑ Remodel 0 Fire Damage MCWD review&permits:
❑ Re-roof, asphalt Repair 0 Storm Damage Minnehaha Creek Watershed District(MCWD)
18202 Minnetonka Blvd
❑ Re-roof, cedar 0 Restoration ❑Water Damage Deephaven, MN 55391
❑ Re-roof,other(specify) 0 Siding 0 Other: (specify) Phone: 952-471-0590
Fax: 952-471-0682
Window(s www.minnehahacreek.org
Estimated Construction Valuation of Project (excluding land) $ L V 8 O
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 pplication may not be issued.
Applicant's Signature:y� Date: / 0 1 ?o h S
Owner's Signature: Date:
Last Updated:January 2015
1 ` /
DATE TIME
CITY OF ORONO CALLED IN t V
INSPECTION NOTICE - SCHEDULED ( --f 4
PERMIT NO. `-' l 3 r'=� COMPLETED
ADDRESS k ' L)c
OWNER TELEPHONE NO. % 2 fr-r - `'S 53
CONTRACTOR t ,
DESCRIPTION ` "J t--;
ti, ❑ FOOTING 0 DEMO-FINAL 0 SEPTIC FINAL
Q ❑ POURED WALL 0 PLUMBING RI 0 EXCAV/GRADING/FILLING
❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL 0 TREE REMOVAL
❑ RAD' SLAB 0 MECHANICAL RI ❑ SITE INSPECTION
'IT 0 F' MING 0 MECHANICAL FINAL 0 RATED WALLS
• ❑ SULATION 0 WOOD BURNER/FIREPLACE 0 COMPLAINT
ri FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W • • BUILT-SURVEY 0 SEWER HOOK-UP 0 FOUNDATION/REMOVAL
, ❑ DEMO-SITE 0 SEPTIC INSTALL
2 OWNER/CONTRACTOR TO MEET YOU:_YES_NO
y COMMENTS:
CC
_
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O /
cc
Q
2
W
RK SATISFACTORY:PROCEED 0 PROJECT COMPLETE
CC ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
Cj BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. ! ' ) 249-4600
Owner/Contractor on site: /
Inspector. �'
White Copyllnspector's File Canary Copy/Site Notice