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Home My WebLink About2015-01411 - windows CITY OF ORONO * 2 0 1 S - 0 1 4 1 1 * . 2750 KELLEY PARKWAY DATE ISSUED: 1UO3/2015 � ORONO, MN 55356- (952) 249-4600 FAX: 952) 249-4616 ADDRESS : 85 FERNDALE GREEN PIN : 36-118-23-44-0024 LEGAL DESC : ALLO-RAE TERRACE : LOT 000 BLOCK 000 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENT[AL CO1vSTRUCTION TYPE : WINDOWS ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 2,196.00 NOTE: REMOVE AND REPLACE 2 WINDOWS APPLICANT PERMIT FEE SCHEDULE 92.93 STATE SURCHARGE(VALUATION) 1.10 SELA ROOFING&REMODELING, INC. TOTAL 94.03 4100 EXCESIOR BLVD ST. LOUIS PARK, MN 55416- Payment(s) (952)915-7227 CHECK 36467 94.03 Minnesota State License#: BUIL-BC1050 OWNER POWERS,JOHN&ROXANNE 85 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 sepazate permits. All provisions of laws and ordinances governing this type ofwork 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 wnstruction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsib(e for assuring all required inspections aze requested in conformance with the State Building Code.This permit may be revoked at any time for due cause. , .� ` �,� f�/ � ��`�\�� -�f�� ' � � � � r� plicant Permitee Signature Date Issued By Signature Date � City of Orono Building Perrnit Application for Maintenance / Replacement / Remodel (i.�v �i�dow�, �1��, �ic�i�g, �°e��of, e��, � �� Rl9C�'IJR�� ii�S19P�) �ONMailing Address: Permit number: � �,� C_:, � o PO Box 66 Crystal Bay,MN 55323-0066 Date received: StreetAddress: Received by: � �r � 2750 Kelley Parkway Plan review fee: � t � Orono, MN 55356 9KE5 H�� 2 Total Fee: (� , b J 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. (P/ease print) GENERAL INFORMATION: � � � /� A , Job Site Address: ��/(/ --- - -- _ _ __ _ - -- - - - 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 s ni e will be required un/ess applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be a/lowed. CONTRACTOR/APs�i�AN��II�F��A�ION: Name: �` �� 11 �l State License# �b[�`p�� Expiration Date: �J��—� Lead Certification Number: N �'�� d�-� Expiration Date: �.�Zy j� (for work on homes that were constructed prior fo 9978 Phone: -tc�la� GI/�Z ' �j'��`��Q (office) ��'� '�J � ��"� Mailing Address: � "��((,� oV \ / C�ty� G�.L 1�I,IS GtVi< ZIP:�",�"�!�-�,�() Contact Person: ��, Applicant is: ontractor / Homeowner (Circle One) Email and/or Fax: �j�_OI��. PROPERTY OWNER NFO ATION: �� Name: Phone (day): Address: � � City: ZIP: �f I Email and/or Fax: PROJECT INFORMATION: Overall project description: VJl/ � 1 V1,W � � � b�j�,,��Vv". 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) 18202 Minnetonka Blvd ❑ Re-roof,cedar ❑ Restoration ❑Water Damage Deephaven, MN 55391 ❑ Re-roof,other(specify) ❑ iding ❑Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 Window(s) www, in ehahacreek.or Estimated Construction Valuation of Project (excluding land) $ � 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 gen rally cannot be given to the public but can be given to the subject of the data. ' �entiat--data-is-infomratrotrwhi 1tq't:��t"b�"'gTv�'rl"T6�itl'i�1'tfi�`pUb`ti"c'�ai'tlie s�l7b�`��t`25f`ttle data ur rpose and` intended use of this inf r a ann al p�ate our records and records of other governmental agencies required by law. If ou refuse to suppl e i rma�om the plica Qn a �ot be issued. Applicant's Signature: . , , �,'�� Date: .��-9" Owner's Signature: Date: Last Updated:January 2015 �_3 �� , � > DATE TIM�� cinr oF oRONo t �«�:�_ -�o-� INSPECTION NOJIC�_b� SCHEDULED �_��—/ Cv ��.' PERMIT NO. �� COMPLEfED ADDRESS �� 5��'u-�� `h� OWNER TELEPklONE N�I a—a� -777"�l CONTRACTOR � DESCRIPTION U ��'� �'S ly ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RAD,�O,N,�SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q�nnnirvG ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT �q -fj"f1TVAL ❑ WATER HOOK-UP ❑ FOLLOW-UP r ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL J ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 OWNERIC CTOR T EET YOU:�YES_NO c�., COMMENTS: � a a w � M b ow s �- �D��.P , .�, o � +e � 5�r.�n� b/ie — i'l�� a.wt�.<� � � /' /�L.1.1 S o-S' O � � ��c��o % ' �K Q � � GJ D/'K Gp--� ,� �,�.�-C � � ` n j ,�A�,,r..o�i �'.?l!l.Bl/ d W ❑WORKSATISFACTORY:PROCEED ROJECT EfE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECTVYORK,CALL FOR REtNSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cail for the next inspection 24 hours in advance. (952� 249-46�� OwnerlContractor on site: Inspector. ; ' � f''"�'`�_ � White Copyllnspector's File Canary CopyiSfte Notice L 3 �� - � ; -- DATE TIM� CITY OF ORONO CALLED IN -� -� INSPECTION NO�IC�_b� SCHEDULED ��-/ (o !D.' PERMIT NO. �'�U COMPLETED ADDRESS �� 5z��-�� "�� OWNER TELEPkiONE NO�, a�a� "77�� CONTRACTOR � DESCRIPTION � �L� a�S tL ❑ 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�PSA1�fITIG ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT q� �f�"�1TVAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W- ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL Z J ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 OWNERIC CTOR T EET YOU:�YES_NO y COMMENTS: � � . � a � � M b ow s � �o��d.� , �, j Gy� +B � S�wt� b/ze - i�i� ��a�nt��t� �. o ---� � r �K�d�— 0 � Q �ocf��o � ' �l� � �� O/'K �.t� GD-'� ✓,� l� � � a .�� "�Y��V � � ❑WORKSATISFACTORY:PROCEED ROJECT�Sllb?tETE w ❑CORRECT VYORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECWERING PERMANENT ❑CORRECT UNSAFE COND�TION WITHIN HOURS. ❑ pHOTO TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALI INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Ca11 forthe next inspection 24 hours in advance. (952) 249-4600 OwnerlContractor on site: . �_.; Inspector. �} i'� �"'"" White Copyllnspector's File Canary CopylSite Notice