HomeMy WebLinkAbout1996-007650 - kitchen addition PERMIT
,� �ITY OF ORONO PERMIT TYPE:
„50 Kelley Parkway- P.O. Box 66
Crystal Bay, Minnesota 55323 Permit Number:
(612) 473-7357 Date issued:
SITE ADDRESS:
DESCRIPTION:
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REMARKS:
FEE SUMMARY:
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CONTRACTOR: ;��;.::�:� � .; �_ <:.,..,: _._ OWNER:
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P ANT-PERMITEE SIGNATURE ISSUED BY:SIGNATURE. �C�C,
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, Total Fee: $ �/f i 7 y DateReceived:��- ;� 7- � s'
Date Approved:
Entered By: ��9-�'J Permit#: '����L'
CITY OF ORONO - BUILDING PERMIT APPLICATION
ALL INFORMATION MUST BE SUBMITTED IN FULL BEFORE PLAN REVIEW WILL
BE STARTED
----------------------------------------------------------------------------------�-.------------------------------
THE APPLICANT IS: (circle one) OWNER OR ONTRACTOR
----____
JOB SITE ADDRESS: �;Zc� /��`�_,� ,;�-���, Z�: Sl 39 �
NAME OF OWNER: �o� � �i����_�Gv���-g PHONE: (home) �.{ 7S"-3���/
' (work)
MAILINGADDRESS: � ,,,.� CITY: Z�:
CONTRACTOR: A/�- �SL'�>_c� C� PHONE: S":�c�--Z�( 7
l+��'�"r�y
MOBILE PHONE/PAGER:
MAILINGADDRESS: k� 3l'y �'�'Jc�,��{,�/�;;�G���-�ITY: i:�,/,-1�:., ���/F,��:, s�.c.<�7
STATE LICENSE: # a z/,c.(
ARCHITECT/ENGINEER: PHONE:
MAILINGADDRESS: CITY: ZIP:
NAMF: REGISTRATION #
TYPE OF WORK: New Addition `� Accessory Structure
Move Remodel/Alteration ,.� Land Alteration
PROPOSED WORK(describe indetail): �(,P� ,�, '��;��( �,���,� �c ,�w�Q ��+`'�'
(,�� .. � � .r�•�� v✓' �� � �s c UP�yC:
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION(excluding land): $ �}� �o D g��
I hereby apply for a bulding 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 �ill be in acc�ordance with the approved plan.
APPLICANT'S SIGNATURE: ��� ,,,y _ ����.G 7����DATE: ���z'7�95—
NOTE! Parade of Homes event�require separate permit approval by Police Department and
City Council 60 days prior to the event. Non permitted events will not be allowed.
9
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,� "" '�'� � 1�� ���' stal Ba '�firu�esota 55323-OOG6
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DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd. 2, "Riahts of subjects oi data , we would like to
,�
inform you that your request for a permit or license from the Ciry of Orono or any of its
departments may require you to furnish certain private or confidential information.
You are notified that:
l. The information you furnish wi11_ be used to determine your qualification for the
permit or license requested.
2. You may refuse to suppl�� data, but refusal may require that the City deny the
permit ar license.
3. The information may be shared with other local, state or federal agencies to th�
exter�t necessary to p:ocess th� permit or license.
4. If vour requested permit or license requires Council action to approve, some
information may become public.
5. I�ou have certain ri�hts under M.S. 13.04 (see fo?lo�*�ing �aQP) to review privzte
data on vourself.
6. Your full name is required to process this application or permit.
PLEASE PRII��
/�✓<�C�'� �
)�v�y � ��[��"
First —�—�ie Last
� ��� ��l���c� �lin ,.�/'��
Address
�'�/� � ��l�� i���� � S��� � �u- Z-�1�
City State Zip Phone
I understand my rights as stated above.
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iQnature
` T'ELEPHONE-473-7357• FAX-473-0510
10
. , .
Sec.13.04 RIGHTS OF SUBJECTS OF DATA
Subdivision l. 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.
Subd. 2. Information required to be given individual. An individual asked to supply
private or conf'idential data concerning himself shall 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 legally required to supply the requested data;
(c) any known consequence arising from his supplying or refusing to supply private or
confidential data; and (d) the identity of other persons or entities authorized by state or federal
law to receive the data. This requirement shall not apply when an individual is asked to supply
investigative data, pursuant to section 13.82, subdivision 5, to a law enforcement officer.
The commissioner of revenue ma�place the notice required under this subdivision in_the
individual income tax or propertv tax refund instructions instead of on those fo_rms.
Subd. 3. Access to data by individual. Upon request to a responsible authority, an
individual shall be informed whether he is the subject of stored data on individuals, and whether
it is classified as public, private or confidential. Upon his further request, an individual who
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 informed of the content and meaning of that data.
After an individual has been shown the private data and informed of its meaning, the data need
not be disclosed to him for six months thereafter unless a dispute or action pursuant to this
section is pending or additional data on the individual has been collected or created. The
responsible authority shall provide copies of the private or public data upon request by the
individual subject of the data. The responsible authority may require the requesting person to
pay the actual costs of making, certifying, and compiling the copies.
The responsible authority shall comply immediately, if possible, with any request made
pursuant to this subdivision, or within five days of the date of the request, excluding Saturdays,
Sundays and legal holidays, if immediate compliance is not possible. If he cannot comply with
the request within that tune, he shall so inform the individual, and may have an additional five
days within which to comply with the request, excluding Saturdays, Sundays and legal holidays.
Subd. 4. Procedure when data is not accurate or complete. An individual may
contest the accuracy or completeness of public or private data concerning himself. To exercise
this right, an individual shall notify in writing the responsible authority describing the nature of
the disagreement. The responsible authority shall within 30 days either: (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 disagreement is included with the disclosed data.
The determination of the responsible authority may be appealed pursuant to the provisions
of the administrative procedure act relating to contested cases.
11
. CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: ��� �' i ��� -z-�-�����,.�< ��c�' /C���-�-/,
PID: 7 4< _ �,i �'_ _;( -7, // C� �Za''%
DESCRIP'TION OF WORK: 'C -L��'��t���- -�`.L�"�1:�, �
----------------------
ZONING REVIEW BY: DATE APPROVED: (-�-4�
BUII.DING REVIEW BY: DATE APPROVED: i-3-9�
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes � No
PLAN REVIEW Yes �' No SEWER CONNEC'TION
STATE SURCHARGE Yes � No WATER COrfNECTION
INVESTIGATION FEE Yes No �' PARK FEE
SAC Yes No �" SIT'E INSPECTION
Number of SAC Units OTHER (specify)
--------------------------------------
ZONING CHECK LIST Zoning District• ��� ��� Shoreland District : N
Fire Department: (,.i A�-�y; Post O�ce: w AT-�Y�__ School District: w�-�-�
Lot Area: Sq.ft. �U �. Acres Width �iv�-���-*C Depth
�
Survey Submitted: Yes � No Date of Survey: �"i�°>
o n.r t=t�
Proposed Setbacks:
Front (L-�ej: ni (�r Right Side: N �r4
r
Rear (Street): /2� � t Left Side: 8 S �
Adjacent Structures: /4r�t-f�"'� Wetland: /'�(/�-
Building Height: Def. Hgt. �•� Peak Hgt. !
Avg. Setback: Bluff Setback: Lot Coverage:
Existing Proposed
Hardcover: 0-75'
75-250'
�r� 250-500'
l 500-1000'
Hazdcover Variance Required: Yes No Date of Council Approval:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: BY�
Zoning File: !i Resolution: # Resolution Date:
REMARKS (in house):
26
BUILDING REVIEW CHECK LIST
UBC: /Z • 3 CONSTRUCTION TYPE: y�
Sq Footage $ Per Sq Ftg
Basement x =
lst Floor x =
2nd Floor x =
Garage X =
x =
TOTAL
Estimated Construction Value: $ y S,�D�O�
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Fire
Hardcover Removal � Mechanical Water Connection
� Footing Septic Sewer Connection
� Framing Fireplace Lawn Inigation
_� Insulation (Masonry) Other
_�_ Wall Board (Mfg.) Well (State Permit)
.� Final Grading/Filling O� Electrical (State Pemut)
Other
REMARKS (IN HOUSE):
-------------------------------------------------------------------------------------------------------
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date BY�
REMARKS(TO BE NOTED ON PERIVIIT):
27
STATE OF MINNESOTA
�TH�.sy; STATE OF MN DEPT. OF COMMERCE
y�;;� 9T�. DEPARTMENT OF COMMERCE
fg� ��; �T�ii s��T
�.�„�",���,K-��:� t 3�S Ea�rt Seventh St I33 East Sevent��St �'�=„� ,��;..
c� f y ! ' St. Paul,MN 55101 �t.Paul,MN 55101 %: ����
�€�:_ !
wv � ���i ..�'�''' f�1212�6-6319 � , s!�
w�`��ls�x`�y� BUll.DING�ONTRACTOR B�UILDING CONTRACI'OR ��i;��1'��
IDts��64 ID#226d
REMODELER REMODELER
CORPQRATION CURPORATIUN
' Expires: 03/31/1995
DAVID l�i PETERSC�N Expir�s: 03l31/1995
7 Hrs CE due by 3I31/4� DAVID M YETERSON
llBA:NEW KOOMS SPACES
�x�c�aUe hy 3r�iis4
E3f r�IE?�1DEL;SSCaI-�i AVE?v
CiC7LDEN VALI�EY MN��d27-(70(}Q DBA:NEW ROOMS SPAGES
636�iENDELSSOHN A�'E N
GOLDEN VALI:EY�15542?-���
CM-00543
S.. _ . __.. ,
' EXTERIOR EHVELOPE AVERAGE "U" COHPUTATION �
. � . • .
01h�E R: �I�c'a W�a--�j �
SITE ADDRESS : l Z�f �Jor`��'1 �-tar"�'��c��':-. K�a�
CONTRACTOR: • 1. 1 t�c�,�w�� � .���H.t:�� DATE : . I Z�LF�, -'Si5'�' rHONE : [', +.�c:*..:.`,�/":% .
�ETERMINE NORKING SOUARE FOOTAGE OF EACH:
) . TOTAL EXPOSED uALL AREA, , , , , , , , �n (o sq f t x "U" •11 . '/, �(�,
2, TOTAL ROOF/CE I L I NG AREA; , , . , , , , �p , sq f t x "U" •OZ6 � �� o
3, TOTAL EXPOSED NALL AREA CALCULATIONS :
Total exposed Nall
area abovc floor, , , , , , , , 9(o sq ft
t
a) Total well window area :
,..�,,,�i� � glazed. . . . . . _ l7, SCa sq f t x ����� �� Z � S ha
glezed, , , , , , .— sq ft x "U"
.
b) Tota) door erea , , , , , , , , , ---- sq ft x "U" a
c) Total s11dlnq qlass door area:
glazed. . . . . . " sq ft x "U" �
qlazed. . . . , . �--- sq ft x "U" �
d) Total ffreplace wall ar�a — sq ft x "U" -
c) Total Nall framing area
;-...
(Averaoe 104) . . . . , . . , �fj , („ sq ft x "U" , �� � ,�-�
f) Total net wall area above. �
floor (Insulated) . . . . . . � s ft x U �^, `'
, ,�-�- q �� �� � � ` 1� ;,�
g)� Total rim )oist arca, . . . . _ �h sq ft x "U" � �:.� � � r� �
Total foundatlon
erea (Exposed) . , . . . . . . . f 0 sq ft
h) Total foundatlon
windo+r erea. . . . . . . . . . . . `- sq ft x "U"
s
i ) Totai net founda[lon
� a �� �� ,. � � r�i�--�
�rea above grade. , . , , . , , sq ft x U , � `�
. �3• TOtAL a) thru 1) D, r
if ( tem fi3 is the same as , or less than item I►� , you h�ve met the inten[ of
2 MCAR 1.16008 A and 0. •
Page 1
_ . . ... ;_ _, , .. . _,-_. _..,_ L�:,: ir._ ..
-- - -----_._.____..�
, . ��►, � : •. �
_ 4.�� TOTAL EXPOSED ROOF/CE I L I Nf CALCULAT I Ot�S : • �
Total exposed '
�oof/ceiilnq area. . . . . . . . SO sq ft
J) Total skyllaht •rea. . . . . . . "'-- sq ft x "U" '
k) Total �oof/ce111nq framing
area (Av�raae 1t19,) . . . . . . s sq ft x "U" + C5 � � r /�
1) 'Total net (nsutated
�oof/ceil (nq area. . . . . . . �s" sq ft x "U" � 0 �... ' � �'d
G TOTAL J) th ru 1 ) , p
If total of d4 Is the same as , or less than �2 , you have met the (ntent of
2 MCAR 1.16008 A and 0.
ALTERt�ATE BU I LD I�IG ENVELOPE �ES I rN
To utilize the total envelop� system method , the values established by the sum
of Items �3 and �`4 shall not be �reater than the sum of items A1 and �`2 . �
1 . + 2 . � ',
3, + 4. �
L E R T I F i C A T I (1 N
I hereby cert► fY that I have calculated the "U" factors and "R"
values hereln and that the bulldfncl here descrlbed meets or exceecls the State
of Minnesota Enerqy ConServa[ I�n Act .
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(Date) Page 2
DATE TIME
CITY OF ORONO CALLED IN �' �--/`<'
INSPECTION NOT CE�,., SCHEDULED � �' ��� <! '.Cc%
PERMIT N0. �-�U COMPLETED Z-av-�` 1 v: 3�
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ADDRESS r'�1 2�-��--�'-� cN�
OWNER �%�Z�� CONTR. -�--'� n-�
TELEPHONE NO. ,q`� `�� �-2�� 7
� DESCRIPTION _/�i����-r�.�-�
� 01 FOOTINC� 11 MECHANICAL RI 18IXCAV/GRADING/FIWNG
y 2 FRAMING 13 MECHANICAL FINAL 19 LAl�SHORENVETIANDS
� 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z p4 Wq�gp. 12 WATER HOOK-UP 17 SITE INSPECTION
� 05 FINAL 14 SEWER HOOK-UO 06 PROGRESS
Z
� 07 DEMO—SITE 27 SEPTIC MAINT. 21 COMPLAINT
J
Q 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
i 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBING FINAL 36 FOUNDATION REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� L CORRECT WOf1K 8 PROCEED ' ISSUE CERTIFICATE OF OCCUPANCY
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Q C CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING PERMANENT
Cl CORRECT UNSAFE CONDITION WITHIN HOURS. - pHOTO TAKEN
INSPECTOR WILL REfURN
❑ STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUEO
i.–i INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnerlContra r on 'te:
Inspecto .
White Copylinspector's File Canary Copy/Site Notice
DATE TIME
CITY OF ORONO CALLED IN � b
INSPECTION NOTICE � SCHEDULED ��;L�� �'�'' �
PERMIT N0. �� OMPLET
ADDRESS �
OWNER ����'Y�2.[-� CONTR. �-�-J
TELEPHONE NO. � ��- J��o Y �/
� DESCRIPTION ,/��a����.�J
� 01 FOOTINO 11 MECHANICAL RI 18 EXCAV/GRADING/FILLINd
y 02 FRAMING 13 MECHANICAL FINAL 19 LAI�SHOREIWETLANDS
� 031NSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
pq yyqLL gp 12 WATER HOOK-UP 17 SITE INSPECTION
= 5 FINAL ' 14 SEWER HOOK-UO O6 PROGRESS
� 07 DEM�SITE 27 SEPTIC MAINT. 21 COMPLAINT
J
Q 07 DEMO—FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
i 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVEF REMOVAL
v 10 PLUMBINCa FINAL 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORAFY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL RETURN
^CITATION ISSUED
❑STOP ORDER POSTED.CA�L INSPECTOR
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
Owner/Contractor site
Inspector.
White Copyllnspector's File Canary Copy/Site Notice
DATE TIME
CITY OF ORONO CALLED IN �' s'
INSPECTION N TICE SCHEDULED / � �Fa ��� 3 l>
PERMIT N0. ���U COMPLETED �_ _�
_�
ADDRESS r' .�°��� ' ���lJ'
OWNER �i/����1-ca CONTR. � ��2C����
TELEPHONENO. c��� "�o � �f �
� DESCRIPTION �,E ��(��.,
� _..r------��
W�01 FOOTINQ � 11 MECHANICAL RI 18 EXCAV/GRADINd/FILLING
y 02 FRAMINO 13 MECHANICAL FINAL 19 LAi�SHOREJWETIANDS
Q 031NSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z pq yyq�(.gp, 12 WATER HOOK-UP 17 SITE INSPECTION
Q
= 05 FINAL 14 SEWER HOOK-UO 06 PROGRESS
� 07 DEM�SITE 27 SEPTIC MAINT. 21 COMPLAINT
J
Q 07 DEM�FINAL 15 SEPTIC INSTALL 22 FOLLOW-UP
W 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAI
2
J 10 PLUMBINO FINAL 36 FOUNOATION REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
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� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � PHOTOTAKEN
INSPECTOR WILL REfURN
❑STOP ORDEF POSTED.CALL INSPECTOR = CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.47�73rJ7
OwnerlContrac o sit :y
Inspector.
White Copyllnspector's File Canary CopylSite Notice
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