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HomeMy WebLinkAbout2015-00872 - addn/remodel/repair CITY OF ORONO *� 5 — 0 0 s 7 z * 2750 KELLEY PARKWAY DATE ISSUED: 07/17/2015 � ' ' ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS � : 315 HOLLANDER RD a PIN : 25-118-23-43-0014 LEGAL DESC : HOLLY ACRES : LOT 001 BLOCK 002 PERM[T TYPE : ADDITION/REMODEL/REPA[R PROPERTY TYPE : RESIDENTIAL COIYSTRUCTTON TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RES[DENTIAL VALUATION : $ 6,900.00 NOTE: SEPARATE PERMITS REQUIRED: PLUMB[NG,MECHANICAL,ELECTRICAL(STATE)-HOMEOWNER MUST PULL&PAY FOR MECHANICAL&PLUMBING PERMITS AT SAME TIME AS THIS PERMIT. MASTER BATHROOM REMODEL APPLICANT PERMIT FEE SCHEDULE 154.89 PLAN REVIEW 100.68 FAZENDIN,ANDY&ELIZABETH STATE SURCHARGE(VALUATION) 3.45 315 HOLLANDER RD WAYZATA, MN 55391- TOTAL 259.02 Payment(s) CREDIT CARD 2747 259.02 OWNER FAZENDIN, ANDY&ELIZABETH 315 HOLLANDER RD WAYZATA, MN 55391- AGREEMENT AND SWORN STATEMEi�TT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the S[ate Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires separate permits. All provisions of Iaws 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 c ance wi the State Building Code.This permit may be �r,.-� revoked at a ti or du c use. � /J � ��- � � � �_�.-i��� �� � ` � � , l, Ap 'cant Permit Signature te Issued By Signa e Date ► City of 4rono Building Permit Application far Maintenance/ Replacement/ Remodel (i�e. windows, doors, siding, re-roaf, etc. -� NO STRUCTURAL �XPANSION) Mailing Address.� Permit number. ZO l S ^ (�V Z.. �—Q�IO PO Box 66 Crystal 8ay,MN 55323-0066 Date received: '' 4—�S StreetAddress: Received by, �� y� ti 2750 Kelley Parkway Plan review fee: �� `�� �`� Orono,MN 5535fi � p . Q� "�KE�SH��' Total Fea: � � Main: 952-249�600 Fax: 952-249-4516 www.ci.ofoil4,mn.us This applic2tion form must be completed in full and all requir�d information mu be su mitkQd��. � Incomple�te applicetions will be returned. (Please prinf) ���� / -� GENERAL INFORMATION: � +, �f�� m � ���� I �l�/ J Job Site Address: (� ' Cf' (�G � Will thls be 8 Parade of Homes,Remodeler,s ShowCase Home or other Ispiay Home? Yeg No n yes,a specJa!avenf permit is requir,�d with Police bepaRment and Ciry Council approva�6o days prior to tne evenG Shuttle bus service will be ' requlred unless appllcant damonstrates sufficient on-sr7e pa�king is avalfable. Non-pelmitted e�ents will no(Ge allowed. CONTRACTOR/APPLICANT INFORMATION: , Name: �\Zct.�pQ`�'1n �-CV1Gl.1.IrJ State License# Expiration Date� Lead Certification Number. Expirativn Date: (for work on i►omCs thaf We►'e Constructed prlor M f 978 Phone: (cell) _ _ s (office) Mailing Address: '3 'S r- City: Q�Y�o ZIP:55 Contact Person: AppliCant is: Contractor / omeowne �ci«ie a�e) Email and/or Fax: ��� 2.,-Fa 2�,�C�n � QM cu�� C0� (/� PROPERTY OWN�R INFORMATION: � Name: � `1 7.�r�-� cQ � �d 2��✓1 =— Phone(day): - zIP: � -�j�.r Address� � t �, � City: �-ryy,p �mail and/ar Fax� � " �h � , PROJECT INFORMATION: Overall ro ect descn tion:M ✓ a'� ���� Type of Project: Any earth movemerrt may aleo require ❑Door(s) �emodel ❑Fire Damage MCWD review&permlts= ❑Re-roof,d8phalt ❑Repair ❑Storm Damage Minnehahs Creek Waf,�rshed DisfiCt(MGWD) 18202 Minnetonka Blvd ❑ Re-roof,cedar ❑Restoration ❑Water Damage Deephaven,MN 55391 PhOne: 952�7i-0590 ❑Re-fo0f,other(speclry) Q Siding �Qther(specify) Fax: 952-471-0682 ❑Window(s) .minneh& Estimsted Construction Va1uaC�on of Prolect(excluding I�nd) � I O ` ,�,.ti�� APPLIGANTACKNOWL�dGEMENT: ' �f1c{ �' ` � � � �"�� � • Agrees to provide all information requirgd or�equested by the Building DepaRment; _ 1 `�i„� Cerkifies that the information suppli�d is true and correct to the best of his/her knowledge. The applipnt recognizes thdt�iey ar� � • solely responsible for Submilting a compiete application being aware that upon failure to do so, the staff has no alternative but to � reject it until it is complel�; I�' • Some o�dll pf the information that you �re 85ked to provide on this applicati0n i6 ClaSsifiBd by 5tate law as either privat� or � �'� confidentfal, Private data is information which generally cannat he given to the publiG but can be given to the subjeCt Of th2 data. Confident�al data is informatior�which generally C2nnot be given to either Che publiC or the subject of the data. Qur purpose and irltended use of this infnrmatib is to annually update our records and reCoMs of other governmental�genGie6 required by law. If I ou refuSe to su I th � ati�on the IiC2tion ma not be issu2d. � AppliCant's Signature: Date� `� Owner's Signature: ^ Date: �I�`�� I� Last Updated:January 2015 T00�j S2II�d �'A S'Idi� 59TTL9bZi9 X�3 IS�i'T STOZ/fiT%LO � cs � ,, ��= ��y� � � > : �=a, � r. .� . �, - 6' ' �; _ *�`k, � .:��"7��'/y� �i t� � �!� � �� �S�' "`Y, P I `S� � ; �) �" .Z�Tr y �, e. fi ?� s.. .� -..' S.SY_ E��' ti _ "ti= Py'1�.h;� �, d . �r I .� , �s'< ;' „',8 ';��� ` 1t� --� ���� �'rL�:�„s �� �< 3,�•� a.x`"� i i�. ���fl�,� � �.. }f t v �' �';t f q f � r ��4;��.�,-,.. �, `� , ;,�.��'� ..v ;,c'-,'�����, �xsc�"',t .. 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" ��� C NTRACTOR �� � � DESCRIPTION � � ty ❑ 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 ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL _ v ❑ DEMO-SITE [� �EPTIC INSTALL Q OWN ONTRACTOR TO MEET YOU�YES_NO c�.� COMMENTS: � � � W a � J O ). � O � W � Q � 2 W � W � j W �WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLEfE � CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN INSPECTOR WILL REfURN ❑STOP ORDEH POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 rs in advance. � 2 9-46�� OwnerfContractor on site: Inspector. White Copyllnspector's File Cenary CopylSfte Notice o� �� I � DATE TIM CITY OF ORONO CALLED IN /O/a�� INSPECTION NOTICE SCHEDULED /� - i 5/-/S �� � PERMIT NO.oZD/S DO87�OMPLETED ADDRESS ��S � "��`Q�� OWNE� L �q- ELEPHONE NO.fP��9����� CONTRAC R � DESCRIPTION ��'���� ���� lL ❑ 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 ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT �L ❑ WATER HOOK-UP ❑ FOLLOW-UP _ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL v ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 OWNERICONTRACTOR TO MEET YOU:_YES_NO c�., COMMENTS: a �t'� YQO� �/'ewto�.�' O ��'<c. �r''i'4L - �� ' �4- /,S - � � � ✓C yNd/�� J Gai6o ti r�ti�ce- �Q�e��o is 1�/E,'— W � ' o ID�a. Ca . r«��,.is — Q 2 R c s� o� cJ o r�(c. co ...�.�p/�Z`� • � Ga r /`t c�1[ G ci<C �� r���sD�6�i�v W � J d W ❑WORKSATISFACTORY:PROCEED ❑ PROJECT COMPLETE � ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALL FOR REtNSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN INSPECTOR WFLL REfURN ❑STOP ORDER POSTED.CALL INSPECTOFi �CITATION ISSUED ,�{WSPECTION REQUIRED_CALL TO ARRANGE ACCESS. f� all forthe next inspection 24,hours in advance. (952) 249-46�� Ownerl ntractor on site: ��'6��� Inspecto White Copyllnspector's File Cenary CopylSfte Notice