HomeMy WebLinkAbout2015-01220 - roofing CITY OF ORONO * z 0 1 5 - 0 1 2 z 0 *
� 2750 KELLEY PARKWAY DATE ISSUED: 09/22/2015
ORONO, MN 55356-
j 952) 249-4600 FAX: 952) 249-4616
ADDRESS : 1160 HERITAGE LA
PIN : 10-117-23-13-0003
LEGAL DESC : FOXHILL
: LOT 003 BLOCK 001
PERMIT TYPE : MINOR ALTERAT[ONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ROOFING-ASPHALT
ACTIVITY : O/S BUILDING-UNDEFINED
VALUATION : $ 29,300.00
NOTE: VALUATION OF PERMIT:$29,300.00
ROOFING PERMITS ISSUED WITHOUT ENOUGH NOTICE FOR TEAR OFF INSPECTIONS. (WE REQUIRE 24-48 NOTICE,PRIOR TO
WORK BEING STARTED) MUST PROVIDE COMPLETE SET OF PICTURES OR A FINAL INSPECTION MAY NOT BE ISSUED.
SIGNS-ADVERTISING SIGNS MAY ONLY BE ON THE PROPERTY DUR[NG THE TIME THE ROOF IS BE[NG DONE.
ONCE WORK[S COMPLETED THE S[GNS MUST BE REMOVED.
APPLICANT PERMIT FEE SCHEDULE 490.10
STATE SURCHARGE(VALUATION) 14.65
LES JONES ROOFING INC. MAIL-IN FEE 2.00
941 W 80TH STREET
BLOOMINGTON,MN 55420- TOTAL 506.75
(612)881-2241 Payment(s)
Minnesota State License#: BUIL-6560 CRED[T CARD 2821 506.75
OWNER
MITHUN, RAYMOND&SARAH
1160 HERITAGE LA
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 of work
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 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. jr` ,
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Applicant Permitee S�gnature Date Issued By Signawre Date
09/1712015 15:10 Les Jones Roofing, Inc. �W(�528817009 P.002l003
���,�o City of Orono
B�i[ding Permit Application for Maintenance / Replacemen# I Remodel
(i.e. windows, doors, sidin , re-roof, etc. — NO STRUCTURAL EXPANSION)
Mailing Rddress; Permit number: � `"� � �vl 2 �
��� PO 8ox 66
� Crystel Bay,MN 55323-0068 Dafe received: � ���"� I
Street Address; Receiv9d by: ���
� �' 2750 Kelle Parkwa � �
z Y Y Plan revfew fee:
��q� s�o��"G~ arana, MN 5S35fi
Total Fee: .(� �
Mafn: 952-249-4800 Fax; 952-249-4616 w�nn+.ci.o[ono.mn us '�"t
This application form must be campEeted In full and al[requlred inform�tion must be submitted.
Incomplete appllcatlons wlll be returned. (Please pnntJ
GENERAL 1NFORMATIOW:
Job 8ite Address: 1 � �p(] �.�(��f'�q..�� L,��rE
Will this be a Parade of Homes, Remodelers 5howcase Flome or other dlsplay Hame? Yss No
/f yes,G 9peCidl event pemfit!s n9qulrt9d Wlth PoI(Ce Dep&Mment 9nd CIly Councll Approva160 days prlor to fhe event Shuftle bus serviCe wil!be
requll�d un/e99 dpplfCant demOtlstl'&te9 SulffClent On��e parldng!s avallatrle. Non-pennitfed events wll!not be ellowed.
CQNTRACTOR!APP�ICANT INFORM�ION:
Name: IL�S Tvr.��5 a�.�at•��n+�.
State License# (os'�p Expiration Date: �l�,���
Lead Certification Number: N�.-�,c}pg-��.�, Expiratfon Date: S gg ��
(fnr work on homes that were constructed prlor to J978
Phone: (cell) (p�Z• 2g7• ( (�� (office) � �$I• y�,y�
Mailing Address: �' City: ZiP:
Contact Person; C�� �Kp�,y� Applicant is; ontractor / Homeowner �c�.c�.ono�
Email and/or Fax: Ghr�sO.. �s�pr►cs ro v� , Co 9S� � 8�'/- ?uv�I
PROPERTY OWNER INFORMATION:
Name: ��,�4�H /�/c�rtfUAl _
Phone(day): (v!Z. SL(a• lO��
Add ress: City: Z!P:
Email and/or Fax:
PROJECT INFORMATtON: 4verall ro�ect descri tion:
Type of Project: Any earth movement may also requirs
❑ aor(s) � (]Remodel ❑Fire Damage
,MCWD revlew 8�permlta:
�e-roof,asphalt ❑Repalr ❑Storm Damage Niinnehaha Creek Wate�shed District(MCWD)
/�� 18202 Mlnnetonka Blvd
❑Re-roof,cedar ❑Restoration ❑Watsr Damage Deephaven,MN 55391
❑Re-roof,other(epeclfy) [�Slding ❑Other. (specify) Phone: 952-471-0590
Fax; 952�71-0682
�Wlndow(s) www.minnehahacreek.ora
Estimatsd Constructlon Valuatlon of ProJect(excluding iand) $� OQ. o O
APPLICAN7 ACKNOWLEDGEMENT: �� �. � T. '�'z'� �
. Agrees to provlde all Informatfon requlred or requested by the Building Department;
. CeRlFles that the Informatlon supplled is true and correct to the best of his/her knovv�edge. The�ppllcent recognlzea that they are
solefy responsible for subrnitting a complete application b9ing�ware that upon fallure to do so,th�staff has no alternative but to
reJect lt untll lt is complete;
. Some or atl of the lnformatlon that you are asked to provide on this application is Clasalfled by Stats )ew as either private or
conAdential, Private data is informatia�which generally cannot b9 glvgn to the pubBc but cen be given to the subject of the data.
Confidential data is information which generally cannat be gfven to elther the public of the subject of the dat9. Our purpose and
Intended use of this inFormation is to annually update our record8&nd reCords of Oth�r governmental egencies required by law. 1f
ou refuse to su I the ation the a lication ma not be Issued.
Applicant's Signature: r Date: `�I/711�
Owner's Slgnature: Date�
Last Updated:January 2016
�� ��'� DATE TIME �
CITY OF ORONO CALLED IN
INSPECTION OTIGE SCHEDULED
PERMIT NO.��5� �(��� COMPLETED �°�
ADDRESS
OWNER TELEPHONE NO. � - ��-��`
CONTRACTOR S
� DESCRIPTION �`�a / ��
ly ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
y ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
��F_1G1AL ❑ WATER HOOK-UP ❑ FOLLOW-UP
_ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
J ❑ DEMO-SITE ❑ PTIC I ALL
� OWNER/CONTRACTOR TO MEET YES�NO
c�., COMMENTS:
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� ❑WORKSATISFACTORY:PROCEED ��GP$QECT COMPLEfE
W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REtNSPECTION TEMPORARY
� BEFORE CWERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (g52) 249-46��
OwnerlContractor on site:
Inspector. Q �y-- �
White Copylinspector's Ffle Canary CopylSfte Notice