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HomeMy WebLinkAbout2013-00066 (remodel) . - CITY OF ORONO� * z 0 1 3 - 0 0 0 6 6 * 2750 KELLEY PARKWAY �ATE tss[1��: 02/12/2013 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 4495 BAYSIDE RD PIN : 06-117-23-21-0004 LEGAL DESC : UNPLATTED 06 I l7 23 : LOT 000 BLOCK 000 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 17,500.00 NOTE: SEPERATG PERMITS REQU[RFD: PLUMBING, MECI IANICAL,FIRGPLACG, GLECTIZICAL(STATG) P[NISH BASEMEN'I� APPLICANT PERMIT FEE SCHEDULE 309.75 KATHERINE TAYLOR HOMES, INC. STATE SURCHARGE(VALUATION) 8.75 120 RAILWAY STREET W PO BOX 35 PLAN REVIEW 201.34 LORETTO, MN 55357 TOTAL 519.84 (763)479-0301 Minnesota State License#: 4738 OWNER Katherine Taylor Homes, Inc. P.O. BOX 35 LORETTO, MN 55357- AGREEMENT AND SWORN STATEMENT I'hc work for which this permit is issued shall be performed according to the approved plans and specitications,applicable City approvals,and the State Building Code. 'I�his permit is for only the work described and docs not grant pennission for additional or related work which requires separalc permits. All provisions of laws and ordinances goveming this type of work shall be compied wilh 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 t any time for due cause. a �/a � / 2 a�/ � � 13 pplicant Permitee,ignature Daie ssu B��Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. . • • �(�� � . ( � ��� � � ; v Cit of Orono � � � �'" � �. y C�, � �, „�� ; .�`I �. � � ���'� Building Permit Application for New Structures or Additions . ---- Mailing Address: Permit number: pl �� e� " (�7� �jp �:g,�,�:\ PO Box 66 / � �,�, Crystal Bay, MN 55323-0066 Date received: �� �i �' �f � II • Received by: ��i,� � � �,,; StreetAddress: �'�' ��� ����� '� ti%� 2750 Kelley Parkway Plan review fee: �;�.y'����"���;����� Orono, MN 55356 �<<kEsxo4'',- 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: �`-��7 1�-` �t(�, 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: �l��-t'�'���-�== ���[..c..�"7Z'S �riCL��d-e-� State License# �1�:3� Expiration Date: Phone: (,���0 office (cell) Mailing Address: � '" Cit : ZIP: t"-,��-'> �- Contact Person: j � l�N Applicant is: on racto / Homeowner (Circle One) Email and/or Fax: t 4�y cJ PROPERTY OWNER INFORMATION:/," ' Name: f�`�'rC�c,t'l� Phone (day): Gj'�-J �,-7 - Z� �- Address: City: ZIP: Email and/or Fax ARCHITECT/ ENGIN�ER INFORMATION: Name: ���,��C� 5��� Phone (day): ��/- ��J(U - , „ /�� Address: City: ZIP: Email and/or Fax: PROJECT INFORMATION: 1.Type of Project 2. Proposed Use 3.Structure Type 4.Sewage Disposal & Water Supply ❑ New Construction �Single Family with �Residence ❑Addition � attached garage ❑ Garage/Accessory Bldg. ❑ Public Sewer ❑Accessory Building ❑ Single Family with ❑ Deck ❑ Relocation � detached garage ❑ Office/Commercial �Private Sewer Other: (specify) -t'1�,� � ❑ Multiple Family/Condo ❑Warehouse ❑ Public ❑ Storage ❑ Public Water "'Any earth movement may require ❑ Commercial ❑ Other(specify) MCWD review&permits. ❑ Industrial �Private Well Minnehaha Creek Watershed District(MCWD) ❑ Other: (Specify) 18202 Minnetonka Blvd Deephaven, MN 55391 Phone: 952-471-0590 Fax: 952-471-0682 www.minnehahacreek.or Estimated Construction Valuation (excluding land) $ t��l/��d`�� Packet Last Updated: 03-06-2012 -21 - STRUCTURE INFORMATION: 1.Structure Dimensions 1.Structure Dimensions(continued) 2.Type of Construction a. Length (ft.)= Number of bedrooms= ❑Wood/Frame b.Width (ft.)= Number of garage stalls: ❑ Masonry Areas in square feet Attached = ❑ Metal ❑ Pole Bldg. c. Basement= Detached = ❑ ICF d. 1St Story = ❑ On-site Prefab e. 2"d Story= ❑ Off-site Prefab f. '/z Story = ❑ Other(please specify): g. Total Area= REQUIRED SUBMITTALS: All of the information must be submitted in order for your application to be processed: Not Enclosed Applicable ❑ ❑ Permit A lication ❑ ❑ Pro osed Buildin Plans ❑ ❑ MN State Ener Code Calculations and Mechanical Code Re uirements Form ❑ �' Surve meetin all requirements ❑ Stormwater Pollution Prevention Plan ❑ ,.8" Hardcover Calculation(s) ❑ Septic S stem Site Evaluation Re ort ❑ �,� Access Permit ❑ �'' Wetland Buffer Im rovement Plan ❑ En ineered Plans for Retainin Walls 4 feet or above ❑ �❑ Plan Review Fee ❑ ❑ Other: APPLICANT/OWNER ACKNOWLEDGEMENT: • Agrees to provide all information required or requested by the Building Department; • Agrees to pay the City of Orono for engineering consultant review costs in excess of$500; • 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; • Acknowledges the Escrow Agreement is completed and signed; • Understands 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. • Agrees that in the event that weather or other conditions prevent the completion of an as-built survey at the time the Certificate of Occupancy is requested, a temporary Certificate of Occupancy may be issued upon receipt of a $10,000 escrow to ensure completion of the as-built survey and all site improvements. ApplicanYs Signature: �1.L,��l' � �ate: //07�-/�/,3 Owner's Signature: Date: Packet Last Updated: 03-06-2012 -22 - PL/�IV REVIEW CHECKLIST �OR I�EIlV STRlJCTURES / 14DQITIQ�lS Address/PermitNumber: �`��P� ��y�t�L, t2-o,A✓� Description of work: �(�����= '� % ��.+ a S �=� Septic review by: t� '"� Date Approved: ���"4 Zoning review by: �� Date Approved: Building review by: �� Date Approved: �/ -� �C9 � 0 � Grading review by: {v/� Date Approved: oning District: Zoning File#: Reso#: Reso Date: Zon g: Lot Area: SF/AC Width: Lot Coverage: _% Surve Submitted: 0 Yes 0 No Date of Survey: Revised ate ? : ''s Pro ose etbacks: Front(La ) Rear(Street) � � S E W ) ( R! S E 1�' ) Ot r Buildings Wetland Side Side � Defined Height: Peak Height: FFE: FFE inus 6 feet= (Existing Contour) Perimeter(linear feet) = 50% _ #of tories Ok? 0 YES ; FOR A BUILDING WITH A BASEfNE T OR CRAWL SPACE: The tance between the lowest FOR A BUI�DING ON A SLAB FOUNDATION: START WITH propos floor(of the basement or crawl space)an the highest point of the roof. START WITH The distance between the top of slab and If you have a. . the highest point of the roof. If you have a... • GABLE O HIPPED ROOF(no . GABLE OR HIPPED ROOF(no windows): btract half the windows): Subtract half the distance distance betwe n the highes oint between the highest point of the roof of the roof to the w point f the to the low point of the corresponding SUBTRACTION corcesponding gabl or pped roof SUBTRACTION gable or hipped roof (BASED ON ROOF . GABLE OR HIPPE OF(with (BASED ON . GABLE OR HIPPED ROOF(with NPE) windows): Subtr half e ROOF TYPE) windows): Subtract half the distance distance betw the top o he between the top of the highest highest win and the highe window and the highest point of the point of t roof roof • ALL HER ROOF TYPES(flat, • ALL OTHER ROOF TYPES(flat, mansard,etc:No subtraction. m ard,etc):No subtraction. ADDITION Add the distance between the top of slab SUBTRACTION Subt ct the distance between the (BASED ON and the highest existing grade adjacent to (BASED ON EXISTING b menUcrawl space floor and the EXISTING the foundation. GRADES) ighest existing grade adjacent to the GRADES foundation OR 10 feet(whichever is less). EQl1ALS Defined building height EQUALS Defined building height Shorelan District IVI�WD Permit Re�eives9 Avera e �ake hore Setback 111fde�? �luff ' � Yes � No � N/A � Yes � No � Y s � No � Yes � 0 N/A Permit Number: Setback: S�ormwater Quality Existinc� �roposed �ariance Required CU� F�equired Q�erla District Tier Hardco�er liarcicover � Yes Q No E� Yes � No Type(s): Typ ): Updated: January 2013 /� / v:\forms\plan review checklist 2013.docx �{ ,O C I� r—ti�C�� / v � REMARKS (in-house): Fees to be Clnar ed YES NO Perm�t Plan Review State 5urcharge k Investigation Fee SAC—Number mf SAC Units Other(specify) S uare Foota e $per S uare Foota e Basement X - $ � 1S'Floor X = $ 2nd Floo� X - � Garage X - $ Estimated Construction Value: $ i �3. ��� �' Orono inspections Required WVork Requiring Separate Permits Requireci State Permits � Site lumbing � Grading/ Filling 0 Well L7 Hardcover Removal Mechanical 0 Fire �Electrical � Footing ' � Septic � Water Connection � Poured Wall Fireplace Q Sewer Connection Q Foundation Se�rvey 0 Masonry 0 Lawn Irrigation � Radon Rock Bed �f9� Framing � Other(specify) �Insulation � � As-Built Suneey �Final 0 Wetland Buffer � Other(specify) RENiARKS (in-house): > Other Reviewr: Revieweci by+: Dat�Approved: Rccess: Existing: � YES � NO New: Q YES � NO � �FFIGIAL RL�Ni�►RKS -TO BE NOTED Of� PERflAIT AND INITIALLED r r Updated: January 2013 v:\forms\plan review checklist 2013.docx ..:.. ;r .,�•.�. -� � - > ,. ,. ,. . : ..<.. _ ..:-� _ . -, � . . ..,:, .. .:.. . ..- ..�. „� - .��,«��;;�;��r�a ._ z��,� . . . _. . e.:. . ... �. :... __.. � � �_— D E TIME ✓ CITY OF ORONO CALLED IN O� � INSPECTION I� SCHEDULED G��'a� - � PERMIT NO. /� MPLETED ADDRESS OWNER T H NE NO � � �I CONTRACTOR >; DESCRIPTION � � � l� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS h O ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL � ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W � � � � � �� � � � � � � 0 � � ��� �. � � O � W � Q � Z W � W k � d W ❑WORKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE W �;pRRECT WORK 8 PROCEED � ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN �NSPECTOR WILL RETURN O STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours'n advance. (952� 249-46�0 OwnerlContractor on site: Inspector. White Copyllnspector's File Canary CopylSite Notice �� �""�" DATE TIME `� CITY OF ORONO CALLED IN 2- INSPECTION NOTICE /� SCHEDULED o7��.� '�l'.'�D PERMIT NO. ���—�CY��!/� MPLETED _�_ ADDRESS OWNER ' T P NE N .7��7�-�3�� CONTRACTOR � >; DESCRIPTION �� � W ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS h O ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP i ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL v ❑ PLUMB ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OW RIC TRACTO EET YOU:�YES_NO � COMMENTS: � W a o r��� I —v {� G� 1 .� � �',� �, 'c�,� �', o'� �� �l c,� � � ��� � �'- . W � Q � Z W � W � � � ��IW@RKSATISFACTORY:PROCEED ❑ PROJECTCOMPLEfE W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN 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 OwnerlContractor on site: Inspector. � White Copy/l�spector's File Canary CopylSite Notice DATE TIME y CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED PERMIT NO. /3-u COMPLETED ADDRESS OWNER yy TELEPHONE NO. CONTRACTOR �1 a f��%'�''�`� y✓�'� '"'2 1000, DESCRIPTION W El FOOTING El PLUMBING FINAL ❑ EXCAV/GRADING/FILLING El POURED WALL ❑ MECHANICAL RI ElLAKESHORE/WETLANDS h Q El FRAMING El MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � VLAL ❑ SEWER HOOK-UP �❑"C�OMPLAINT ❑ DEMO-SITE El SEPTIC MAINT. f-OLLOW-UP ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL r ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL Z OWNEWCONTRACTOR TO MEET YOU:_YES_NO COMMENTS: cc cc * -1'1I t'cocci ti�fJ✓ 7zt��6 a L L�rtS !'ovn/J/�fe� W 11 nn -� vLSI(Jc� �o,;c� C ©.qL� W� b74r ✓� .0/4107. Q 2 cc QQ rr.c�L` tt a6la- oo g�� AW j W ❑WORK SATISFACTORY:PROCEED PROJECT COMPLETE cc W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑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 next inspection 24 hours in advance. (952) 249-4600 Owner/Contractor on site: Inspector. r-- White CopylInspector's File Canary Copy/Site Notice