HomeMy WebLinkAbout2015-01121 - doors CITY OF ORONO * 2 0 1 5 — 0 1 1 2 1 *
� 2750 KELLEY PARKWAY DATE ISSUED: 09/02/2015
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDI2ESS : 65 FERNDALE GREEN
PIN : 36-118-23-44-0026
LEGAL DESC : FAIRWAY HILLS ADDN
: LOT 001 BLOCK OOl
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RES[DENTIAL
CONSTRUCTION TYPE : DOORS
ACTIVITY : O/S BU[LDING-UNDEFINED
VALUATIOI�I : $ 11,750.00
NOTE: 2 PATIO DOOR REPLACEMENTS [N EXISTING OPENINGS
APPLICANT PERMIT FEE SCHEDULE 232.34
STATE SURCHARGE(VALUATION) 5.88
PELLA NORTHLAND MA[L-IN FEE 2.00
15300 25TH AVE N.- SUITE# 100
PLYMOUTH,MN 55447- TOTAL 240.22
(952)345-6047 Payment(s)
Minnesota State License#: BUIL-BC645090 CREDIT CARD 0182 240.22
OWNER
LAPERRE,TIMOTHY&NANCY
65 FERNDALE GREEN
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 construc[ion authorized is not
commenced within I 80 days of the date of issuance,or if construction is
suspended for a period of 180 days a[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 Signature Date Issued By Signatur�= Date
SEP/01/2015/TUE �10. 09 PM Elder Jones Building FAX No, 952 8�4 4909 P. 002
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' City of Orono
B�ilding Permit Applic��ion for Internal Work
(wi��dows, doars, siding, re-roof, etc.)
--� ivl2ilrngAddres5: Permit number: �=!� ��i ' ( �j���
-�,�,�:' , PO Box 66 �� , ,t:.
' �', a GryStal Bay, V]N 55323-0066 Date r�ceived= _
�� <,;:
-�+�� Recei�ed by: 1�
I ; F;��';ri',;:,.,':., a� Street Address:
``'S' �"�'-•;I��'?�"V ti/ 2750 Kelley Parkway , Pl�n revi�w fee: \
tn %�E?r1„ ,�,. ,Y:� c,
�' � i�:V������� � Or•ono, MN 65356 � � �
;`�rr�si�ot`
I rpt�� Fe2: � ,:. 4G� . 1-�,
V A�ain: 95`'-249-4u"00 Fax: 952-249�4G16 wv�w.ci.orono.n�n.us
1 This application fiorm must be completed in fiul[ and ali required i��formation musi be submitted.
Incomplete applications will be returned. (P/ease prir;f)
G�N�RAL INFORIV�ATIDN: /`
,3ob Site Address_ ' � �' � q, (�
�.Nili this be a Parad� of!-lo���es, RemocJelers Showca5e I-iome or other Displ�y Home? [{ Yes ❑ No
If yes,a spacia!�venl ermil is rc�quired with Police Depar!mertf and Cify Council�pprovel 60 dz?ys/?riol'to fhe ev�nx, $hutt,'e bus s3n�it�wN!be
r'oqwir'ad u�less appl;car7t dsmon�trvfas suff;ciant cn-siis pa�krng(s avallabls. Non-permiftad evPnts will not be allowod.
CON7'FZACTOR/APRLiCAN7' INFQRMATION:
Name: �I `�S� ��►S• 6 e y�'
5'tate License� � - r pella Northland
Phone: 15300 25t1�Ave N. Ste 100 '(ce!I)
�,4ailing Address� ��y1Tlouth, MN 55447 ZfP� _
Contact Person: Lic#�3C6�5090 ph. 763/745-1400 {ameowner �Gircle one)
Email and/or i=ax:
F'R�PERTY OWNERIINF RMATION: ,
'�ame� �..�G /' Q• -w
Pho��e (day}: µ.L.,,�� ,� . Q �( � F l
.4ddre55: � 1' Clty' W Q y Z'a T'a, ZIP: 5 J�_3�1
Email ar,d/or Fax ' ' ,M�,
Pi�OJECT INFORMATION�w� �
; Type of Project: ' Any earth movem�nt rnay require
_ MCWD revie�w&permits
Coo�(s) � ❑ Remodel ❑:Water Damag�, �',�'- - -
• Ninnehaha Cre�k Watershec OistriGt(MCWD)
❑Window(s) � ❑ Repaia- � Storm Damage ` 18202 Minnefonka Blvd
Deephaven, MN 55391
❑Siding ❑ Reetoration ; ❑ Other. (specify) - Phone: 952-471-0590
; F8X' 952-47'f-0682
Q ��-roof ' '� Fire Oamage � vvww.rninnehahacreP�„k.orq _�
Overalt Project �esc�ipEion: � � p C,L I A. ��s�� �n���
�stimated Construct on Vafuation of Project(excluding land) $ �y y j`p
APPLICANT ACKN WLEDG�M�NT:
, • Agrees io provicle all infora-�ation required or requested by the Building Dgp�rtmoizt; � �
• Cei7ifies that tn� informztion supplied is true and correct to the be5t of h�S/h�r knowledge. The applicant reCognizes tha[they
are solely respo�sible for submitting a complete appfication heing aware that upon failure to do so, the StBrr has no altemztive
ii�u:to rEjeot it u til it is complete;
. Spme or al! pf th4e information that yau are asked to provide on this application is classified by State law as either private or
confidenfial. Pri ate data is infcrmation which generally cannot be given to the public but can be given t0 the SUbj9Ct of the
� data. Conf�den��a! data �s informatior which c�er:eralfy cannot ba given #o either the public or the subject of the data. Our
� purpos� and int nded use of fhis information is to annually update our records and records of other governmentcl aqencies
j_ re uired b 'raw. 'If ou refuse to su ol the information,the a IiC21i0n R12 not be issued. �� �
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Ap�licant's Signatur�: ', ��"" pafe� ��3 6 l! �
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Last Updated: 05-D4-2009
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�/ � DATE TIME `
CfTY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED C � __,����
PERMIT NO. �l-l.r-t'a,( �Z� COMPLEfED
ADDRESS �D j F- �_'r ���c Ic�_ L< C���"�-'�'�
OWNER TELEPHONE NO. �''��c���^�C'��
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CONTRACTOR - �=
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� DESCRIPTION �� � � ,'��.
4~j ❑ FOOTING ❑ D MO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
y ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
41 ❑ AS BUILT-SURVEY ❑ EWER HOOK-UP ❑ FOUNDATION/REMOVAL
_ ❑ DEMO-SITE � TIC�NSTALL
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2 OWNEiYCONTRACTOR TO MEET YiOU YES_NO
y COMMENTS:
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� ❑WOIiKSATiSFACTORY:PROCEED �OJECT COMPLETE
W ❑CORRECT WORK�PROCEED ❑ISSUE CERTIFlCATE OF OCCUPANCY
� O CORRECTNfORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE CaVERING PEHMANENT
❑CORRECTUNSAFECONDITiONWITHIN HWRS. p pHpTOTAKEN
INSPECTOR WILL RETl1RN
❑STOP ORDER POSTED.CALL INSPECTOR ��TATION ISSUED
❑INSPECTION RE(]UIRED_CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hou dva ) 249-46�0
OwneNContractor on site:
inspector:
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