HomeMy WebLinkAbout2016-01226 - windows ' ' CITY OF ORONO * 2 PJ 1 6 - PJ 1 2 z 6 *
2750 KELLEY PARKWAY DATE ISSUED: 09/29/2016
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 1680 CONCORDIA ST
PIN : 17-117-23-22-0032
LEGAL DESC : COFFEES ADDN TO SHADY WOOD LAK
: LOT 029 BLOCK 000
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : WINDOWS
ACTIVITY : O/S BUILD(NG-UNDEFINED
VALUATION : $ 24,581.00
NO"I'E: REPLACE(10)WINDOWS WITH[N EX[STING OPENINGS
APPLICANT PERMIT FEE SCHEDULE 433.67
STATE SURCHARGE(VALUATION) 12.29
RENEWAL BY ANDERSON MAIL-IN FEE 2.00
350 73RD AVE NE
FRIDLEY,MN 55432 TOTAL 447.96
(612)502-4777 Payment(s)
CREDIT CARD 8788 447.96
OWNER
WILLIAMS&JUDY FESENMAIER, BRIAN
1680 CONCORDIA ST
WAYZATA, MN 55391
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved pians and specifications,applicable City approvals,and the
State Building 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 speci£ed herein.This permit will
expire and become null and void if construction authorized is not
commenced within I80 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 conformance with the State Building Code.This permit may be
revoked at any time for due cause. �
�
�`-✓LL Gc�-e cE � � � io2Gl� l�
Applicant Permitee Signature Date Is ue y Signature Date
Ci�y of Urono
Building Permit Application for Maintenance I R�novafion
(windows, daors, siding, re,roof, ertc,) �
M�Iling Addr�ss: Permtt number: �� � —��
Q,�Q A ti� PO Bax 66 / _
`r Crystal Bay,MN 553Z3-0066 [3ate received: — � ��
,� �- �, StreetAddness: Recelved by:
� � � . � 2750 KeEley Parkway Plan review fee:
� �.° Orona,MN 55356 � , / �� a�
Total�se: �f /
Main: 952-2a9�60D Fax: 952-249-4616 www.ei orono.rilt�.us
This�pplication form must be corr►pleted in fiufl and all required infnrm$#ion must be br'rritted_
lncomplete app4icatlans wltl be returned. (Please prrnt)
GEPI�RAL INFORMATION: ���Y� �Q� �
Job Site Address: �
Wilf thls be� Parade of Horrtes, R�emodelers Showcase Home or other D1spl�y Home? Yes No
{f ye5,a specle/event permi�is roqulred with�'o1loe Department and CIfY Counc!!app�ova!BO days p�or tn ihe e+rent. Shuttle bus ssrvice+vil1 be
required unleas applicant dBmonsfrafe8 sufficfent on�site p6�fdn8 is avd!!able. Plon-permitt9d events w!!/not 8e&llowed.
C�NTRACTOR f APPUCANT INFORMATtON:
Name: 'C r��a.\ ���'��-'N
Stete Llcensa# C„\'309 3 �xpirat�on Date: 3 j 3
Lead Certificatlon Number: �j�'�-- ��'�-�`�'� �1 �xpiratlan Date: �(
(for wur�c on homes d�at vvere canstructed prior t+�'f978 n E�ejj)
Phone: (n51� �(p -'y 0 S�d' �t�qn (office}
M$iling Address: 19 C. ••G•• l�j�Sk CitY: �1 � �1P: SS I
Contact Person: App[iCailt is: ntra / Homeowner (Cir¢!4 4ns)
Email and/or Fax:
P�tOPERTY OWNER lN� MATION:
Name: E ' ( ��� ,
Phone(day):
Address: City: ZIP:
�mail and/or Fax
F�ROJECT 1N�O�tMATION:
TyP��Prol��: Any earth movement m�y rec{uire
MCWD revlew�permits:
� p�r�$� [� Remode€ []Fine Damage Minnehaha Creek Watershed I�istricf(MCWD)
❑FZe-roof,agphalt �] Repair ❑Sto»r Damage 1$2(l2 Minn�ionlc�Bivd
E]eephaven, MN 55391
� []R�roof,cedar ❑ Restoratian �Wat�r Damage phpne: 952-479-0590
�Ra�roof,othQr(spectfy} ❑Slding ❑Other. (specify) Fax: 952-471-0682
www,minn ehqh ecresk.or�c
[]Window(s)
Ov�era#I Pro e�t Description: � �
Es#imated Cpnstruction Valuatlon Pro ect(excludin `land) $ . �
APPLiCAN7 ACKNOW�EDGEMENT:
. ,q�rees to pt'ovide ail tnformation r9equired or requested by the Building Departm�nt;
• Certt�es that the inforrnation supplied is true and oorreCt to the best af hisJher knoWledge. The appl€csnt r�rcOgnizes that they
are splely responsible for submitting a complet� application being awa�'e that upon failure to do so, fhe staff has no altemative
but to reject it until It is complete;
• Same or all of the Information that you are asked to provlde on thts applicat3on is clsssified by Sfate iaw as either ptivate or '
confidantEai. Private date�3 is tnformation which generaliy cannot l�e given to the public but Can be given fo the subjecf of fhs
data. COnflderstial data is in�formaUvn whlch generalfy cannot be gEven to either#he public or the subf ect of the data. Our
purpose and intended use of ihls informadon is'� ennually update our r�cor'ds and recards of ofher govemmenta! agencles
re uired b law. If ref�.rse to su 1 the(nform�tion,the a lication ma not be issued.
Aflolicarrt's Siansture: pt� � Date: ��
������
�,� �/
� DATE TIME
CITY OF ORONO CALLED IN / / �
INSPECTION O IC �x/-7 2/,SCHEDULED � ` — �
PERMIT NO. �J G`�`COMPLEfED
ADDRESS l � J G'����
OWNER TELEPFIQNE NO��� ��
CONTRACTOR ��� ��
� DESCRIPTION G�%(/ � G�
ty ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTiC FINAL
� ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
� �.FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
_
� ❑ DEMO-SITE ❑ SEPTIC INSTALL
2 OWNERICOPfTRACTOR TO MEET Y�U:_YES_NO
cc� COMMENTS:
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� ❑WORKSATISFACTORY:PROCEED �RWECTCOMPLETE
� ❑CORRECT WORK 3 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERINO PERMANENT
❑CORRECT UNSAFE CONDITION WRHIN HOURS. ❑ pHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call tor the next inspectfon 24 hours in advance. (952) 249�4800
OwnedContractor on site:
Inspector: � �
Whits CopYRnspector's Flls C�n�ry Copyl3k�Notks