HomeMy WebLinkAbout2016-00313 - roofing CITY OF ORONO * Z 0 1 6 - 0 0 3 1 3 *
2750 KELLEY PARKWAY DATE ISSUED: 03/3U2016
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2345 BLAINE AVE
PIN : 17-117-23-34-0011
LEGAL DESC : TOWNSITE OF LANGDON PARK
: LOT 005 BLOCK 009
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : COMMERCIAL-BUSINESS
CONSTRUCTION TYPE : ROOFING-ASPHALT
ACTIVITY : O/S BUILDING-UNDEFINED
VALUATION : $ 3,871.00
NOTE: ASPHALT REROOF OF THE WATER PLANT GARAGE
APPLICANT PERMIT FEE SCHEDULE
GC BUILDERS INC TOTAL
7170 UNION AVE
MAYER, MN 55360-
(952)457-5303
Minnesota State License#: BUIL-20626549
OWNER
(WELL NO. 3 PUMPHOUSE),CITY OF ORONO
2345 BLAINE AVE
PO BOX 66
CRYSTAL BAY,MN 55323-
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 iY 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.
/ /
Applicant Permitee Signature Date Issued By Signature Date
.
City of Orono
Building Permit Application for Maintenance / Replacement / Remodel
(i.e. windows, doors, siding, re-roof, etc. — NO STRUCTURAL EXPANSION)
�O�O Mailing Address: �-
PO Box 66 Permit number: o�D/ —L� _ 1
Crystal Bay, MN 55323-0066 Date received: �j —3� —�
�
Street Address: Received by: ✓✓� -�
6F G� 2750 Kelley Parkway Plan review fee:
t �, Orono, MN 55356 /
qkESHO� ' 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) ��,�.� ��,¢,� T
GENERAL INFORMATION:
Job Site Address: �3�/� ���� �j,.� ��i`�j/ 2�fr �S�g/ �' �/'�''a3 -rj'�' ,^da i�'
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 approva/60 days prior to the event. Shutt/e bus service will be
required unless applicant demonstrates su�cient on-site parking is available. Non-permitted events will not be allowed.
CONTRACTOR/APPLICANT INFORMATION:
Name: �� bUi �c%'!'S"
State License# 8� (o�� }�� Expiration Date:
Lead Certification Number: Expiration Date:
(for work on homes that were constructed prior to 1978
Phone: (cell) 9g�-(/j7—�3U� (office) `�5;,?- �/S7 - � =3D�
Mailing Address: 7/7� ��� �,y �� City: ,q�/e�^ ZIP: 553�,�;
Contact Person: ����idy Applicant is: ontracto / Homeowner (Circle One)
Email and/or Fax: -
PROPERTY OWNER INFORMATION:
Name: C`, .Fy e� p�^� r�
Phone (day): 95,�-`�? - � �G�
Address: 0?3 yS !� ,w i�� �C,e City: G�i4 yZ� ZIP: �i �`3�
Email and/or Fax:
PROJECT INFORMATION: Overall pro�ect description:
Type of Project: Any earth movement may also require
❑ Door(s) ❑ Remodel ❑ Fire Damage MCWD review&permits:
�Re-roof,asphalt ❑ Repair ❑ Storm Damage Minnehaha Creek Watershed District(MCWD)
15320 Minnetonka Blvd
❑ Re-roof, cedar ❑ Restoration ❑Water Damage Minnetonka, MN 55345
❑ Re-roof,other(specify) ❑ Siding ❑ Other: (specify) Phone: 952-471-0590
Fax: 952-471-0682
❑Window(s) www.minnehahacreek.or4
Estimated Construction Valuation of Project(excluding land) $ e O L
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
ou refuse to su I the information,the a lication ma not be issued.
ApplicanYs Signature: Date: �'� ) � '/
�
Owner's Signature: �� " f (�I""� Date: 7 �'- ��D
Last Updated:January 2015
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DATE TIME
CITY OF ORONO CALLED IN - -!�
INSPECTION NOTICE SCHEDULED �
PERMIT NO.��L�� ��3 COMPLETED
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ADDRESS ��� / l�[�1,�, �''`� - �.l�LLC�C----
OWNER T LEPHONE NO.
CONTRArTOR 9• - �GC!�L��
� DESCRIPTION ��� ��-�
l� ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
� �.FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
_ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
J ❑ DEMO-SITE ❑ SEPTIC INSTALL
2 OWNERlCONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS: T�(/�'-�
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W ❑WORKSATISFACTORY:PROCEED JECT COMPLEfE
� ❑CORRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
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� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTOTAKEN
INSPECTOR WlLL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-46�0
OwnerfContrac n site:
Inspector.
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