HomeMy WebLinkAbout2007-P10820 - addn/remodel/repair PERMIT
CITY OF ORONO
2750 Kelley Parkway- PO Box 66 Permit Number: P10820
Crystal Bay, Minnesota 55323 Permlt Type: Addition/Remodel/Repair
(952) 249-4600 Date Issued:
3/23/2007
SITE ADDRESS: 2650 Countryside Dr W Unit#
Long Lake,MN 55356
P��� 04-117-23-12-0014
DESCRIPTION: UBC Occupancy R3
Construction Type VN
Proposed Use: Residential
Census Code 434
Permit Class: Building
Permit T e: Addition/Remodel/Repair Permit Sub-type(s): Addn/Remodel/Repair
YP
DETAILS:
Approved per resolution#:
Separate permits required: Mechanical Fireplace Electrical(state)
NOTICES/REMARKS:
12x17 extension of Sun Room
FEE SUMMARY: Permit Fee: $ 853.75 valuation: $ 80,000.00
Plan Review Fee: $ 554.94
State Surcharge Fee: $ 40.00
TOTAL FEE: $ 1,448.69
APPLICANT: Wood Smith Builders OWNER: Robert Jorgenson
6640 Cherokee Trail W 2650 Country Side W
Eden Prairie, MN 55344 Long Lake MN 55356
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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PLICANT PERMI E SIGNATURE ISSUED BY SIGNATURI;
Copies: 1-File(Signatures Reguired), 1-Applicant, i-Monthly Reports, 1-Assessing,(If Septic, 1-Septic) Page 1
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Total Fee: $ �� � ' � �� ,�� ��`�i Date Received: � )� �
Entered By: � �,� - '� � Permit#: � ) �g�0
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CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
THE APPLICANT IS: (circle one) OWNER OR CONTRACTO
JOB SITE ADDRESS: 2 G Sv ���„�,��i�_�i�_ z�p: 55 3 5G
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 Counci!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.
NAME OF OWNER:�( p�3� ���j2,Gg�.�C,p�.� PHONE: (home) S -415" ��v�4
(work)
MAILING ADDRESS: �, O . ��TY:�, �Ip ZIP: !is�jSG
CONTRACTOR: � �����I '�� -�' - �f�'�j�� P�ONE: `�52 -��]- �'f9GC?
CONTACT PERSO : � ' MOBILE/PAGER: (�I1�70'�3 -
MAILING ADDRESS: ��(U CN'C�c�L��� �2,,�IL LU. CITY:�1��iZA�R,�� ZIP: ss 3y4
STATE LICENSE: # Zp21�S15� EXPIRATION DATE:���
ARCHITECT/ENGINEER: ���,�..�y ,/�j1_(�l�-I . PHONE: (P11-�p�'Jl- �Sb
MAILINGADDRESS: 2�2 ��a� j��,�CITY:,j�j„�,4�.y_�S ZIP: �S�o/
NAME: i M �,����t REGISTRATION: #
TYPE OF WORK: New Home Addition C Accessory Structure
Move Home Remodel/Alteration (ie: Siding, Windows)
Any earth movement may requirejMCWD review and permits!
PROPOSED WORK(describe in detai�: `�MA�I. � Il, ����uo�l c�
'�X 1L;T7�•i(� l-v�] ►�.�M
STORIES: I SQ.FEET OF EACH FLOOR: Z��
NO. OF BEDROOMS: -- GARAGE STALLS: ATTACHED — DETACHED—
ESTIMATED CONSTRUCTION VALUATION(excluding land): $ c�U ��
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City and with the State Building
Code;that I understand this is not a permit and work is not to start without a permit;and that the work will be
in accordance with the approved plan.
APPLICANT'S SIGNATURE: �- - DATE: 3
31
,- . � -
I � �
Sec.13.Od RIGHTS OF SUBJECTS OF DATA
Subd. 1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this section.
SuUd.2. Information required to be given individuaL An individual asked to supply private or contidential data concerning himselfshall be
informed of: (a)the purpose and intended use of the requested data within the collecting state agency,political subdivision,or statewide system;(b)
whether he may refuse or is legal(y required to supply the requested data,(c)any known consequence arising from his supplying or retiusing to supply
private or confidential data,and(d)the identity of other persons or entities aud�orized by state or federal law to receive d1e data. This requirement shal I
not apply when an individual is asked to suppiy investigative data,pursuant to sec[ion 13.82,subdivision�,to a la�v enforcement officer,
The coinmissioner of revenue mayplace the notice rec�uired under this subdivision in the individual income ta�or properry tax reYund
instructions instead of on those forms.
Subd.3. Access to data by individuaL Upon request to a responsible authority,an individual shall be informed whether he is die subject of
stored data on individuals,and whether it is classitied as public,private or contidential. Upon his further request,an individual�vho is the subject of
stored private or public data on individuals shall be shown the data without any charge to him and,if he desires,shall be infonned ofthe content and
meaning of that data. After an individual has been shown dte private data and informed of i[s meaning,the data need not be disclosed to him for si�
months thereafter unless a dispute or action pursuant to this section is pending or additional dafa on the individual has been collected or created The
responsible authority shall provide copies of the private or publ ic data upon request by the individual subject of the data. The responsible authoriry
may require the requesting person to pay the actual costs of making,certifying,and compiling the copies.
The responsible authority shal I comply iinmediately,if possible,with any request made pursuant to this subdivision,or within tive days of
the da[e oFthe request,esduding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. [fhe cannot comply�vith the request
within that time,he shall so inform the individual,and may have an additional tive days within which to comply�i�ith the request,exduding Saturdays,
Sundays and legal holidays.
S ubd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private data
conceming himself. To exercise this right,an individual shall notity in writing the responsible authority describine the nature ofthe disagreement.The
responsible authority shall within 30 days eithec (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipients of
inaccurate or incomplete data,including recipients named by the individual;or(b)notify the individual that he believes the data to be correct. Data in
dispute shall be disclosed only if the individual's statement of disa�reement is induded�vith the disclosed data.
The determination of the responsible authoriry may be appealed pursuan[to the provisions of the administrative procedure act relating to
contested cases.
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04,Subd.2,"Rights of subjects of data",we would like to inform you that your request
for a pem�it or license from the City of Orono or any of its departments may require you to furnish certain private or
confidential information.
You are notified that:
1. The information you furnish wi(l be used to detern�ine your qualification for the permit or license
requested.
2. You may refuse to supply data,but refusal may require that the City deny the permit or license.
3. 1,he information may be shared with other local, state or federai agencies to the extent necessary to
process the permit or license.
4. If your requested permit or license requires Council action to approve,some information may become
public.
5. You have certain rights under M.S. 13.04(available upon request)to review private data on yourself.
6.. Your full name is ' ed to process this application or pern ' .
'l.!i �n��I � 1
First �liddle Last
/�i
Address
City Statc Zip Phone
I b derstand y rights as stated above.
�___. _ " �� �
Signature
� � Reset Form 32 �+.� - ]
�
� ! {
Total Fee: $ Date Received:
Entered By: Permit#:
CITY OF ORONO - BUILDING PERMIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all inforniation)
------------------------------------------------------------------------------------------------------------------------
THE APPLICANT IS: (cif•cle one) OWNER OR CONTRACTOR
JOB SITE ADDRESS: ZIP:
Will this be a Parade of Homes,Remodelers Showcase Home or other Display Home?
❑ Yes ❑ No lf yes, n specral event peri��i�is re9uired tii�r�th Police Departmext and City Cozmcrl approva!
60 days pr•ior to the event. Sl�z�ttle bars se�vice lvil/be��equired ttnless applicant demonstrates
sufficiervt on-site parking is available. rVoh-pei•n��itted events rvill not be a/lowed.
NAME OF OWNER: PHONE: (home)
(work}
MAILING ADDRESS: CITY: ZIP:
CONTRACTOR: PHONE:
CONTACT PERSON: MOBILE/PAGER:
MAILING ADDRESS: CITY: ZIP:
STATE LICENSE: # EXPIRATION DATE:
ARCHITECT/ENGINEER: PHONE:
M_AILING ADDRESS: CITY: ZIP:
NAME: REGISTRATION: #
TYPE OF WORK: New Home Addition Accessoiy Structure
Move Home Remodel/Alteration (ie: Siding, Windo�vs)
' � Any earth movement may require MCWD review and permits !
PROPOSED WORK(describe i�:detai�:
STORIES: SQ.FEET OF EACH FLOOR:
NO. OF BEDR001�15: GARAG� STALLS: ATTACHED DETACHED
ESTIMATED CONSTRUCTION VALUATION(excluding land): $
I hereby apply for a building permit and I acknowledge that the information above is complete and accurate;
that the work will be in coniuemance with the ordinances and codes oi the City and with the State Building
Code;that I understand this is not a permit and work is not to start���ithout a permit;and that the work will be
in accordance with the approved plan.
APPLICANT'S SIGNATURE: DATE:
` .�, 31 � .
. ( G�20
CHECiK pFF i�IST FOR TSSUANCE 4F �'E�'VITTS
FOR OFFICE USE ONLY'
A.DpRESS ORLEGAL: �: (��� ��xan�'� S .dc� i�(�. ; , �
PID: .
I7ES CRTP'I.'TON OF W ORK: /�vr�q Sn�nc�-
__--�-----
- ----------____--------------------------�d,_ �'-----------------
ZOti�i IG REVIE�V 73Y: �(- DATE APPROVED: Z C1�
BU�LDING RE'YIE�V SY: " D.A.TE APPROVED: 3� Zz-a�
FEES TO BE CHA.RGEA: ! Misc. Fees Calculated By:
PER�.�I.IT Yes c� No
PLAN REVIE`V � Yes i/ No SE�YE.R CO�INECTION
STATE SURCHARGE Yes l/ No �VATE.RCONNEC�'ION
INVESTIGATION FEE Yes No s/ PARK FEE
SAC Yes No � STTEINSPECTTON
Number of SAC�Units OTHER (specify)
---------------------------
----------------------------------
ZON.7��IG CT:�E.CK LIST Zoaing Discricc: � � I� •
Fite Departs.ent:
Post Office: Schaol District:
I.ot Area: Sq.ft. Acres Widch Depth
Survey Submittecl: Yes ✓ No Da[e of Survey: �� ' R� ( �
F��� ' .
Proposed Setbacks: �Q � Side; �� '
Front(L�kc): f/lR �
Rear(S[reet): __�_�___ Left Side: n�
�`�.��3CP�r CrnlCh�r�:; �/'� tivPE���: /�� �
Building Hei�t: Def. Hgt. /1I� Peal`Ho�'
Lot Coveraje: h/�__
GradL-�g: Scaff Approval Date: /Uv G[��xnt BY:
c� Council Approval Date: '
Szp�ic: S�af�Approv3! Date: �f� j �'LJ� �Y� ��-`
Zoa�n� File: �`__. Resolutioa: n _ Resolution Date:
Sho�eland Districc: //1�
Avg. Setbac�:: gl,�F`Serback: Lc�Cove2ge;
Ecistino P;oposed
H�c�over; G-7�'
'l�-2�0�
2�C-�GG'
��JV-1C�C�J�
<, �;v �_.., o` Co�c� .`,� �. =':
�a•���,��,•er `Y�Z'.��^.�2 Z'GU'.:2�: '2i . - -
F.r�L�-�� (Ln ho',;�l; J�cfC(��twl. !s /to F f try�C [,M ou�'r� -�u �v►c{2/
,G��2hd ../-C�-�'' �Nt ra��,•�n/- � �u�t��
SUII�DING� REYLEtiV CHECK LIST
�C- __ IZ• 3 � CONSTRUCTION TYPE: �//`�
Sq Footaoe $ Per Sq Fcg
Basement . x =
lst Floor x � _ .
2nd Floor x _ �
Garage x =
x —
TOTAL
Estimated Construction Value: $ �Q���0 ��
Inspections Required: tiYork Requiring Separate Permits:
5 ue Plumbing Fire
Hardcover Removal aC Mechanical Water Coanectioa
_Lc Faoting ' Septic Sewer Coanection �
� Framing �_Fireptace Lawn Inigation
_�Insulatio❑ (Masoary) Oc'ner
�Wal1 Board __� (Nlfg.) Wetl (State Permit)
F�� Grading/Fillin� _� Electricai (Scate Percnit)
O[he r
RENIARK.S (IN HOUSE):
-----------------------------------------------------------------------------------------------------------------
REVIEW SY OTHERS: �A�:
Access: Existing New
Access Approva:: Datz gy;
-------------------
REI�IARKS (TO EE NOTED ON PER11�lIT):
8
�
;� . � . . :���+�"� �
Pernvt Number
REScheck Compliance Certi�cate Checked ByNate
2000 Minnesota Energy Code
REScheckSoftware Version 3.6 Release 1
Data filename:Untitled.rck
PROJECT TITLE:Jorgenson Addition and Remodel
COUNTY:Hennepin
STATE: Minnesota
ZONE: 2
CONSTRUCTION TYPE: Single Family
WINDOW/WALL RATIO: 0.14
DATE: 03/12/07
DATE OF PLANS:March 6th,2007
PROJECT DESCRIPTION:
12'x 17'extension off of existing sun room
DE SIGNER/CONTRACTOR:
Quigley Architects/WoodSmith Builders
COMPLIANCE: Passes
Maximum UA=79
Your Home UA=78
1.3%Better Than Code(UA)
Gross Glazing
Area or Cavity Cont. or poor
ri r -R Value R-Value U-Factor �$
Ceiling 1: Cathedral Ceiling(no attic) 400 38.0 0.0 11
Wall 1: Wood Frame, 16" o.c. 108 18.0 1.0 5
Window 1:
Above-Grade:Metal Frame with Thermal Break:Double Pane with Low-E
23 0.320 7
Wa112: Wood Frame, 16" o.c. 161 18.0 1.0 8
Window 2:
Above-Grade:Metal Frame with Thermal Break:Double Pane with Low-E
30 0.320 10
Wall 3: Wood Frame, 16" o.c. 36 18.0 1.0 2
Wa114: Wood Frame, 16" o.c. 27 18.0 1.0 2
Wa115: Wood Frame, 16" o.c. 147 18.0 1.0 8
Window 3:
Above-Grade:Metal Frame with Thermal Break:Double Pane with Low-E
8 0.320 3
Window 4:
Above-Grade:Metal Frame with Thermal Break:Double Pane with Low-E
8 0.320 3
Wa116: Wood Frame, 16" o.c. 27 18.0 1.0 2
Crawl 1:Masonry Block with Empty Cells 157 1.0 13.0 17
Wall height: 5.0'
Depth below grade: 3.0'
Insulation depth: 3.0'
Furnace 1:Forced Hot Air, 80 AFUE
Proposed and Maximum U-Factor Averages
Proposed Maximum
Average U-Factor Allowed U-Factor
Above-Grade Windows and Glass Doors 0320 0.370
Includes Foundation Windows>5.6 ft2
COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans,
specifications,and other calculations submitted with the pernut application. The proposed building has been designed to
meet the 2000 Minnesota Energy Code requirements in RES checkVersion 3.6 Release 1 (formerly MECchecl� and to
comply with the ma tory r irements li n the RES checkInspection Checklist.
Builder/Designer Date 3/ 2,
11}l 1 1 � � ��u��yL. ..�. � �---- r• — t�Fp���vv
County , Minnesota ���� � .
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CITY OF ORONO CALLED IN
INSPECTION N TI(� SCHEDULED -07 // ,'UD
PERMIT NO. U � COMPLETED
ADDRESS �
OWNER CO R.�t�'�.����
TELEPHONENO. 6�Z-�gD " ��S
� DESCRIPTION /��������
l4 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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V BEFORE COVERING PERMANENT
❑ CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
"i CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next i�spection 24 hours in advance. (J52� 24J-46O0
OwnerlContrac�si e:P �
Inspector.
White Copyllnspector's File Canary CopylSite Notice
� , alC�l DA�E TIME V,
ITY OF ORONO ��CALLED IN G�
INSPECTION N TICE � �1 SCHEDULED � < <
PERMIT NO. /D �'�/ COMPLETED
ADDRESS caZ O
OWNER CO R. LC�d8C1����ti��L�
TELEPHONE NO. IP�Z �B4 7Z�I.SI
� DESCRIPTION �arn ��'(,,
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 P�UMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOH TO MEET YOU:_YES_NO
� COMMENTS:
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V BEFORECOVERING PERMANENT
❑ CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN '
❑ CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
C INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �952� 249-46QQ
OwnerlContrac e:
Inspector.
White Copyllnspector's File Canary CopylSite Notice
� � DAT TIME /
CITY OF ORONO CALLED IN �� �g D �
INSPECTION�OTICE SCHEDULED 3 � "�o
PERMIT NO. (C�$�C� COMPLETED
ADDRESS �-1�o� �Ou+r�'!Y'�I 5�cle, ��;�, l.ve,5'�'
OWNER CONTR. vt-C,L'��I,Sm.� �!d�S
TELEPHONENO.��I�- `��Ih � `�3qS -��U�
� DESCRIPTION �--CX��t�1��5 .�Y1S�.
lL 01 FOOTING 11 MECHAf�1 AL RI 18 EXCAV/GRADING/FILLING
� 02 FR,4MING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
�
O 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q OS FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FO�LOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUM8ING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. �, pHOTO TAKEN
INSPECTOR WILL RETURN ❑ GTATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
C INSPECTION RE�UIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. �952� Z49-46QQ
OwnerlContractor on site:
Inspector. W //��.1���C'�
White Copyllnspector's File Canary CopylSite Notice
�� AT TIME /
CITY OF ORONO c�iN �
�
INSPECTION N0��O8� SCHEDULED ;S- /-(,�7 �
PERMIT N0. �`� COMPLETED
ADDRESS a�SD c�Q �
OWNER C NTR.C���tS�'`y�'
TELEPHONE NO. � ��- �DO 7a9�
� DESCRIPTION
� 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT /
J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
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