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Home My WebLink About2015-00038 - addn/remodel/repair CITY OF ORONO * z 0 1 5 - 0 0 0 3 8 * . ' 2750 KELLEY PARKWAY DATE ISSUED: O1/15/2015 ORONO, MN 55356- 952 249-4600 FAX: 952 249-4616 ADDRESS : 635 FERNDALE RD N PIN : 36-118-23-11-0009 LEGAL DESC : UNPLATTED 36 118 23 : LOT 000 BLOCK 000 PERMIT TYPE : ADDITION/REMODEL/REPA(R PROPERTY TYPE : RESIDENTIAL CONSTRUCTIOi�t TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 30,000.00 NOTE: (INTERIOR KITCHEN REMODEL&WINDOWS) SEPARATE PERMITS REQU[RED: PLUMBING,MECHANICAL,ELECTRICAL(STATE) APPLICANT PERMIT FEE SCHEDULE 490.10 PLAN REVIEW 318.57 THOMAS MUELLER CONSTRUCTION LLC STATE SURCHARGE(VALUATION) 15.00 3815 SARATOGA LN PLYMOUTH, MN 55441- TOTAL 823.67 (612)590-1980 Payment(s) Minnesota State License#: BUIL-637729 CHECK 9178 823.67 OWNER O'NEILL-JACOBSEN, LARRY JACOBSON& VICTORIA 635 FERNDALE RD N WAYZATA, MN 55391- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according[o the approved pians and specifications,applicable City approvals,and the Sta[e E3uilding Code. This permit is for only[he 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 expirc and become nuii 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 conformaq�with the State Building Code.This permit may be revoked at any time fqr'due cause. � � '� � � - ��/ /s//�� / ,,�5 ,-� �� I' ant Permitee Signature Date Issu y Signature Date City of Orono • B�ailding Permit Application for Maintenance / Replacement / Remodel (i.e. windows, doors, siding, re-raof, etc. — NO STRUCTURAL EXPANSION) OA' MailingAddress: Permitnumber: ('i(5 •- tYZ%.� � •VO PO Box 66 � Crystal Bay, MN 55323-0066 Date received: i " f 3 / `_, a � Street Address: 'I i�lj� Received by: �-' 1� ti�,! ` 2750 Kelley Parkway Plan review f : -- qK�sr��%� Orono, MN 55356 Total Fee: � �3 . `p� 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) GENERAL INFORMATION: Job Site Address: C.�3S V1 �-�� '�c�. `�JS .3�� Will this be a Parade of Homes, Remodelers Showcase Home or other D�splay Home? ❑ Yes �No /f yes,a special event permit is required with Police Department and City Counci/approval 60 days prior to the event. Shutt/e bus service wi//be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: ��-�� 'u'�,`1-�\\�,� C.��s��v c:�� ;; .-.. State License# '��, (�^�"� �C,� Expiration Date: � 3 j Lead Certification Number: �G-f-- ��j'"�o-- Expiration Date: a�3G f � S (for work on homes that were constructed prior to 1978 Phone: (cell) C�12-S`!�%�l�� (office) " l Z., -S�O � (�� Mailing Address: �g ` � �yY4 _ �„� City: � ,J�l,� ZIP: SS y�/ Contact Person: 6,.,,� I�"1/�� Applicant is� ontractor Homeowner (Cirde One) Email and/or Fax: ��.^V,,��`�'�t,�tio��o�.��GF,`� L.�;,,,tC� 5-�-� V1 ct PROPERTY OWNER INFORMATION: � t Name: �G�r� S�--a�.io�'� � � ��c. ; ��'1,�� 1 Phone (day): (p `2, - �j� �2 -(p 2 S Z Address: (�� 3�" (� �� .r„�l�,�.�� City: CJ✓o.�r.> ZIP: S-S� cf � Email and/or Fax: PROJECT INFORMATION: Overall project 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) 18202 Minnetonka Blvd ❑ Re-roof, cedar ❑ Restoration ❑Water Damage Deephaven, MN 55391 ❑ Re-roof, other(specify) ❑ Siding ❑ Other: (specify) Phone: 952-471-0590 ,/ Fax: 952-471-0682 C��'�-��✓� �,Window(s) www.minnehahacreek.orq Estimated Construction Valuation of Project (excluding land) $ �6 APPLICANT ACKNOWLEDGEMENT: • Agrees to provide all inforrnation 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' tion,the a ' tion ma not be issued. Applicant's Signature: li,�i Date: � Owner's Signature: Date: Last Updated:January 2015 PLAN REVIEIIV CHECKLIST FOR 11�EVIl STRUCTURES / ADDITIONS Addeess/Permit Number: �� =�� x' Description of work: �� Y��»� L- � Septic review by: N� ✓3 Date Approved: Zoning review by: i°�'�� Date Approved: Building review by: � Date Approved: � - D��" ,� Grading review by: d� l�4 Date Approved: oning Distric�: Zoning File#: fte�o#: Reso Date: Zo ' g: Lot Area: SF/AC Width: Lot Coverage: SF _% ;' ' Surve Submitted: 0 Yes � No Date of Survey: Revised date(?j: �` 3 Pro ose etbacks: Front(La Rear(Street) ( N S E W ) ( N S E W ) Other Buildings Wetland Side Side i � Defined Height: Peak Height: FFE: FFE minus 6 fe, _ (Existing Contour) S Perimeter(linear feet) = 50%_ #of Stories Ok? � YES FOR A BUILDING WITH A BASEMENT CRAWL SPACE: The distan between the lowest FOR A BU DING ON/A 3LAB EOUNDATION: START WITH proposed floo of the basement or crawl � space)and the hest point of the roof. START WITH The distance between the top of slab and If you have a... the highest point of the roof. { • GABLE OR HIPP ROOF(no :f you have a... windows): Subtract If the GABLE OR HIPPED ROOF(no windows): Subtract half the distance distance between the hest point between the highest point of the roof of the roof to the low poi of the � to the low point of the corresponding SUBTRACTION corresponding gable or hip d roof �, SUBTRACTION gable or hipped roof (BASED ON ROOF o GABLE OR HIPPED ROOF(w (BASED ON . GABLE OR HIPPED ROOF(with TYPE) windows): Subtract half the ROOF TYPE) windows): Subtract hatf the distance distance beriveen the top of the between the top of the highest highest window and the highest window and the highest point of the point of the roof roof . ALL OTHER ROOF TYPES( � � • ALL OTHER ROOF TYPES(flat, mansard,etc:No subtrac4ion. ; mansard,etc):No subtractyp�i ADDITION Add the distance between the top of slab SUBTRACTION Subtract the distance between, e (BASED ON and the highest existing grade adjacent to (BASED ON EXISTING basemenUcrawl space floor d the EXISTING the foundation. GRADES) highest existing grade adj ent to the GRADES foundation OR 10 fee4( ichever is Iess). EQUALS Defined building height EQUALS Defined building h ht � � � � _ �.� s � Shoreland ��str6ct CH16D Permit Received Adera e L�keshore tl�ack Met? �luff Yes 0 No � N/A � � Yes 0 No 0 Yes 0 No Q Yes 0 No 0 /A �; Permit Number: Setback: � � Stormwater Qu #�ty Existing Proposed ��riance Required CUP Re�ired �: Overla Di�tr' t Tier hiardcover liardcover � � Yes � No 0 Yes 0 No � Type(s): Type(s): �: Updated: January 2013 v:\forms\plan review checklist 2013.docx � �.�"w'G..r. F"s`.�+.�aE...t�:�.^3 `' .+i��:. ' . . ...n . .s a , . �...... . . . ....�. ,.... .,.. ._,... . . ... . ......:_.... .. _1. . .� __ . - . $1.. ..a�a-, a.u.._�_�G":�:c,_...._vE .:.� �. >��..w:L , ..�.� F ......�.. ._.:.� ;... ....... . .::: REMARKS (in-house): Fees to be Char ed YES NO IPermit �� Plan Reveevv �``"� State Surcharge �°" Investigation Fee �AC-Number of SdAG Un6ts Other(specify) S uare Foota e $ er S uare ��ota e Basement X - $ 1St Floor X = � 2"d FlOor X = $ Garage x - � s, Estimated Cons�ruction Value: $ ��'�,� �`�`�� `��`` Orono inspections Required Work Ftequiring Separate Permits Required State Permits 0 Site ��Plumbing � Grading/ Filling � Well 0 Hardcover Removal �Mechanical � Fire ,� Electrical � Footing � Septic Q Water Connection 0 Poured Wall � Fireplace 0 Sewer Connection 0 Foundation Survey � Masonry � Lawn Irrigation 0 Radon Rock Bed � Mfg. . ,� Framing 0 Other(specify) �lnsulation 0 As-Built Survey �`^Final 0 Wetland Buffer � Other(specify) REMARKS (in-house): Qther Review: Reviewed by: Date Approved: Access: Existing: � YES 0 NO New: 0 YES 0 NO OFFICIAL REMARKS -TO BE NOTED ON PERMIT AND INITIALLED Updated: January 2013 v:\forms�plan review checklist 2013.docx �� , �� DATE T#� �CITY OF ORONO C f/ cALLED IN INSPECTION NO/TI E � SCHEDULED -� �-�a�-� PERMIT NO. �( COMPLETED ADDRESS �� '"`s�c�c� C� �� /(/ . OWNER TELEPHONE NO.._.CfL�� CONTRACTOR �j�—�u-e �er � DESCRIPTION u � � W ❑ 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 ❑ PROGRESS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT J�. :��.___ _... Q �FINAL "� ❑ WATER HOOK-UP ❑ FOLLOW-UP �U ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL _ v ❑ DEMO-SITE SEPTIC INSTALL ❑ FOUNDATION/REMOVAL 2 OWNERICONTRACTOR TO MEET YO�YES_NO . � COMMENTS: j� i�I r'�� fiSC-'✓YICr�( $ � ) �►'1rI(51�t)� a �/�. �.�� - 3 — 6� /5— o �/►'!airC� -�- Ga �e�e��s �/'ov�a.� ' � � ° �� !�a�!� C�w►,ol�� - W � Q Z /nG�✓w��" t /K�i(e� — W � W � � � ❑WORKSATISFACTORY:PROCEED `�\ROJECT COMPLETE W ❑CORRECT WORK 8 PROCEED �� I5SUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REtNSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call forthe next inspection 24 hours in advance. (952) 249-46�� wnerlC tractoronsite: �a�'' � - Inspector. ` • � �� White Copyllnspector's Ffle Canary CopyfSfte Notice DATE TIME � CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED � PERMITNO..�U/S -L�p6� COMPLETED �,9 ADDRESS � ��rN ��- • l� OWNER TELEPHONE NO. � CONTRACTOR ��-� s Ynu e,�c V C�6�St • >: DESCRIPTION J�-��'-ti ��'''L�+2 l � tl� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS � Q �EAAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z J�JSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q�� ' ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL O SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL Q OWNERlCONTHACTOR TO MEET YOU:_YES_NO �z r 3G ' /u COMMENTS: L" �� Q"�� - � � a �✓!�w�►vi r ✓ � eu t �sje cJ s '� o /-I-Q�_ .��' — .rJl�✓ .h f�H .. �. � W —,.j,n,�� f� ��,s`.�1. , n, c��l� �/ Q 1l• ha. �r�� 2 � U/� �8 ��U e ✓ �_ w � j d W� �VV6RKSATISFACTORY:PROCEED ❑ PROJECT COMPLEfE � ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pH0T0 TAKEN INSPECTOR WILL REfURN ❑CITATION ISSUED ❑STOP ORDEH POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED_CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (J52� 249-4600 OwnerlContractor on site: � Inspector_ White Copyllnspector's File Canary CopyfSite Notiee