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Home My WebLink About2011-00178 - roofing �J �. CITY OF ORONO PERMIT NO.: 2011-00178 27�0 KELLEY PARKWAY � ORONO, MN 55356- �A7'E �ssuE�: 03/28/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 905 FERNDALE RD W PIN : 02-117-23-44-0010 LEGAL DESC : AUDITOR'S SUBD. NO. 184 : LOT 000 BLOCK 000 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYNE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING -CEDAR ACTNITY : O/S BUILDING - UNDEFINED VALUATION : $ 60,000.00 NO"I'1=,: "fLAR OFI'RI-;ROOI=-CGDAR SI IAKI',S APPLICANT PERMIT FEE SCHEDULE 756.75 ALLSTAR CONSTRUC'I'ION STATE SURCHARGE(VALUATION) 30.00 5145 INDUSTRIAL ST SUITE 103 TOTAL 786.75 MAPLE PLAIN, MN 55359 (763)479-8700 Minnesota State License#: 20631575 OWNER BROOKS,JOHN&JOAN 905 FERNDALE RD W WAYZATA, MN 55391- AGREEMENT AND SWORN STATEMENT Thc��°ork for which this permit is issued shall bc perlornicd according to thc approvcd plans and specifications,applicablc City�approvals,and thc State L3uildinb Code. 'I�his pennit is lor oniti�the work described and docs not grant pennission tbr additional or related work�vhich requires separate , permits. All provisions of laws and ordinances govcrning this type of work � shall be compied�vith��hether or not specified hcrcin.This permit will expire and become null and void if construction authorized is not commenced��ithin I 80 days of the date of issuance,or if construction is suspended for a period of 180 days at any time alter work has commenced. "I�he applicant is responsi If suring all required inspections are requc,� � 'n nfor � � �idi thc State Buildin�Codc.'I�his permi�may bc re� an tim � � ,,� � , �� 5 i :�g i �`i �.i i // ,�"App icant Permitee Signature Date �Iss y Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. �t � City of Orono Building Permit Application for Internal Work (windows, doors, siding, re-roof, etc.) Mailing Address: Permit number: Q –Q��7� g,�,�. PO Box 66 0 ` � Crystal Bay, MN 55323-0066 Date received: � /� � � �'`��-�`��, �, StreetAddress: Received by: �. � �'�, '" �ti�' 2750 Kelley Parkway Plan review fee: l-9kESHp4'�' Orono, MN 55356 � —" Total Fee: �� '7� 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: - - Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes � No If yes, a special event permit rs required with Police Department and Ciry Council approval 60 days prior to the event. Shuttle bus service will be required unless appficant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: State License# ' �-, Expiration Date: .�� ; �� Lead Certification Number: Expiration Date: (for work on homes that were consfructed prior to 1978 Phone: . , �; _ - �.->; (office) � (cell) -�,_.�_. Mailing Address: ��, T�:zust,,, ,�� ; �- ,t� Cit : .�.;,,-:� ��-;, . �� ZIP: <. �- ,, c�� : Contact Person: T�, l�u_��_�.; , Applicant is: ontrac r / Homeowner �c��ie o�e> Email and/or Fax: �, , • _ �. ;�� _ , ; PROPERTY OWNER INFORMATION: Name: � . - �. � Phone (day): �;�� , 7; ��,�> Address: �� ° / ; / City: ,%�, , ZIP: `" � �'� �� s F=� ,�., , - .. Email and/or Fax PROJECT INFORMATION: Type of Project: Any earth movement may require ❑ Door(s) ❑ Remodel ❑Water Damage MCWD review&permits: Minnehaha Creek Watershed District(MCWD) ❑ Window(s) ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd ❑ Siding ❑ Restoration ❑ Other: (specify) Deephaven, MN 55391 Phone: 952-471-0590 [��2e-roof ❑ Fire Damage Fax: 952-471-0682 www.minnehahacreek.orq Overall Project Description: ": :- f� �: �', / �,:;? �,. 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 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 re uired b law. If ou refuse t su I the inf r ation, the a lication ma not be issued. , ApplicanYs Signature: i/ �%:.f, �,-'% �., Date: ; - J;' -� / j Last Updated: 03-01-2011 "" _� DATE TIME CITY OF ORONO CALLED IN 3 INSPECTION NOT CE SCHEDULED PERMIT NO. /�` OC��7� COMPLETED � ADDRESS � OWNER T EPHONE NO. CONTRACTOR �; DESCRIPTION v�� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/F G Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL Q ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W a � J O a � O � W � Q � Z W � W � � d W� �ORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK R PROCEED r ISSUE CERTIFICATE OF OCCUPANCY O ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (g52) 249-46�� Owner/Contractor Inspect . White Copyllnspector's File Canary CopylSite Notice DATE TIME ` / CITY OF ORONO CALLED IN U IIVSPECTION N T E SCHEDULED PERMIT NO. � � COMPLEfED /BDDRESS �E��+-o5(!� �l/� OWNER E E NE NO. COPITRACTOR � � DESCRIPTION � ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING y ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHOREM/EfLANDS ❑ FRAMING ❑ MECHANICAL FINAL p ❑ TREE REMOVAL � ❑ INS LATION ❑ WOOD BURNER/FlREPLACE ❑ SITE INSPECTION ❑ DON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. �FOLLOW-UP ❑ DEMO-FIIdAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OYdMERICONTRACTOR TO MEET YOU:._YES_NO � COINAAE(VTS: � Cg�� ,��wt��' �- rl0 ��tqL �vl5�ec��e.c �e� a,5'1�.� � � O >, - � � O ��- '- W __ � 'Q � --- � W ._ � W -- � ,/ J ._ W� ❑WORKSATISFACTORY:PROCEED ��ROJECTCOMPLEfE w ❑CORRECT WORK&PROCEED ❑ I SUE CERTIFICATE OF OCCUPANC�' � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECbVERING PERAAANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN INSPECTOR WILL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call forthe next inspection 24 ours in advance. (�2) 24g-460� Owner/Contractor on site: Inspector. White Copyllnspector's File Cenary CopylSite Notice