HomeMy WebLinkAbout2015-01284 - doors a�
CITY OF ORONO
� 2750 KELLEY PARKWAY * 2 0 1 5 — 0 1 2 8 4 *
DATE ISSUED: 10/OS/2015
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 3059 FARVIEW LA
PIIV : 04-117-23-33-0008
LEGAL DESC : EARVIEW
: LOT 006 BLOCK 001
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTIOIY TYPE : DOORS
ACT[VITY : O/S BU[LDING-LINDEFINED
VALUATION : $ 1,859.00
NOTE: 1 PATIO DOOR REPLACEMENT[N EXISTING OPEN[NG
APPLICANT PERMIT FEE SCHEDULE 73.99
STATE SURCHARGE(VALUATION) 0.93
THE HOME DEPOT A.H.S. TOTAL 74.92
2690 CUMBERLAND PKWY, STE 300 Payment(s)
ATLANTA,GA 30339- CREDIT CARD 0174 74.92
(763)542-8826
Minnesota State License#: BUIL-CR268257
OWNER
WANG& LING SHANG, LIXIAO
3059 FARV[EW LA
LONG LAKE,MN 55356-
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 gran[permission for additional or related work which requires separa[e
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
revoked at any time for due cause. �
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Applicant Permitee Signat re Date [ssued By Signature Date
���T'�'� �.� �Ri D4 �'� Al'� Elder Jones Building �n� �i� ��r� 8'�4 79�i � G:.
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City of Orono
Building Permit Application for Mainfienance / Replace�nen# 1 Remodei
�i,�� �rrindaws, doors, sidin�, reWrca�f, �tc, — N� STRtJCTt1R�oL �XP,4NSI�N}
MarlingAddress: P�rmit number.- L'�'f `�-- �' I c: � ��
��� PO Box 66 I
Crystal Bay, MN 55323-0066 , Date received: � � :�� I_�
E � � StreetAddress: � Received by: C� 2
y� G� 275�Kelley Parkway Plan review fee: /�
�XFs�[o�� Orano; MN 55356
Total Fee� �]�-� �I �--
Maln� 952-249-4600 Fax: 952-249-4616 www_ci.orono.mn.us F
This appiication form must be completed in full and all required information must be submitted,
h�complete applications will be returned. (Please print)
GEHERAL INFORMATION: o
Job Site Address. � � � t �G �` V l C W � � �
Will this be a Parade of Hon�es, Remodelers Showcase Ncme or other Display Hame? ❑ Yes ❑ Mo
!f yes,a Specfa!event permit is r�quired v✓ith Polrce Department and City Cocrncil app�`oVa!60 days prior to fhe evenE. Shuttle bus service Will be
required unless applicant demonstrates Sufflclsrrt onslte parking Is avallabla. Non-permiited events wfl!not be allowed_
CQNTRACT012/APPLICANT INFORMATION:
Name: T��7 At-Hoine Service, Inc, gS?�3�l S ' �b 4 � .l a Cl�
State �icense#� 2690 Cu�xiberland Pkwy, Ste 3Q0 �xpiration Date:
Lead Certification Number_ . Atlanta, GA 30339-3913 � Expiration Date:
(torwork on homes thatwe+ �ac#CR26$257 Ph. 763/542-8826
Phone: (cell) �e)
Mailing Address: City: �Ip�
Cont�Ct Person: Applicant is= Gontracto / H�meowne�- (circ�e one)
Email and/ar Fax�
Pi20PERTY OWNE INFORMATIQN�
Name: � ( f�
Phone (day): � 5 a • � 5 3
Address: 3 0 S R o P Y t c r,��4 n C c�ty: �P o � o ziP: S 5 3 x �
Email�nd/or Fax:
PRO�JECT INFORMATION: Overall praject description: C l`r�/b C'�o �l' /'e !d /'? 4 n /"
! Type of Project: Any earth movement may also raqulre
I MCWD revlew S�permlts:
��Door(s) l-PG �J o � Remodel ❑ Fire DamaQe
❑Re-roof,asphalt �tepair ❑Storm Damage Minnehaha Creek Watershed District(MCWQ)
18202 Minnetonka Blvd
� Re-roof,cedar ❑ Restorat;on ❑Water Damage Dsephaven,MN 55399
❑ Re-roof,other(specify) ❑ Siding ❑Other: (specity) Phone: 952�71-0590
Fax: 952�71-0682
I V ❑Window(s) www.minnehahacreek.crc�
Estimated Construction Valu�tion of ProjecE(excludtng land) $ �J
APPLICANT ACKNOWI��I7GEMENT:
• Agrees to�rovide all information required or requested by the 6uildiny Pepartment;
I • Certifies that the information supplied is true and correct to the best of his/her knowledge. 7he applicant recngnizes that thay ara I
SoE91y responsibl�fpr submitting a complete appfication being aware that upon failure to do so, the Staff has no alternative but to
rejBCt it until it is complete;
I . Some or all of the Information that you 2re asked to provide on this application is classtfied by State law as eifher private or
confdential. Private data is informaflon whlch generally cannot be glven to tt�e public but cari be given to the subject of the data.
Confldential data is information which generally cannot be given to eifher the public or the subject of the data. Our purpose and
fntended use of this information is to annually upd�te our recards and records of othe;r governmental agencies required by taw. If
oU refUse to Su I the infnrmation,the ap licafion ma not be issued.
Applicant's Signature: Date� � � � �
Owne�s Signature: Date�
Last Updated:January 2015
--5 �j�--
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DATE TIME
CITY OF ORONO CALLED IN J'� ---,2� �7"
INSPECTION IC n/�� SCHEDULED /
PERMIT NO. � � OMPLETED
ADDRESS ��s� ��
OWNER � n-� TELEPHONE N0�3-3�" ��53
CONTRACTOR
� DESCRIPTION �v! ��/ C`/'�
� ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
O ❑ 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
v ❑ DEMO-SITE ❑ SEPTIC INSTALL
WNE ONTRACTOR TO MEET YOU:�YES_NO
� COMMENTS: ;
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GW ❑WORKSATiSFACTORY:PROCEED Q�PRO.{€CT COMPLETE
� ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
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� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECWERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. �pHOTOTAKEN
INSPECTOR WILL REfURN
❑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. �""�
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White Copyllnspector's File Canary CopylSfte Notice