HomeMy WebLinkAbout1997-009407 (remodel) � PERMIT
• CITY OF ORONO PERMIT TYPE: -
2750 Kelley Parkway- P.O. Box 66 �`';:�;':,;��,���"`'
Crystal Bay, Minnesota 55323 Permit Number: _ _ . _
(612) 473-7357 Date Issued: _ -, �, -
SITE ADDRESS:
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DESCRIPTION:
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FEE SUMMARY:
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CONTRACTOR: _ _._ ._._..._ ;. -
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AP ANT/PERMITEE SIGNATURE ISSUED BY:SIGNATURE
' Total Fee: $ �O 7� �--� Date Received:
Entered By: Permit#: 9�l6 �
CITY OF ORONO - BUILDING PERNIIT APPLICATION
All information must be submitted in full before plan review•will be started.
(please print all information)
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THE APPLICANT IS: (circle one) OWNER CONTRACTOR
JOB SITE ADDRESS: � �Q�..� ZIp; .�'�'��� �
NAME OF OWNER:�C) L l�. PHONE: home
. � ( )� (-
(work)
MAILING ADDRESS:�� � CITY: ZIP:
CONTRACTOR: �, �.��.��� PHONE:� /�Z'— I��
CONTACT PERSON: ��} MOBILE/PAGE : �t7� ^�Q�'Z.
MAILING ADDRESS: ���„�1�� CITY: .,- ZIP:fGZ�,�'�
STATE LICENSE: #�a b�-��'j�
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS: CI'Ty; ZIp;
NAME: REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration_� Land Alteration
OPOSED WORK describe in detai�: — � C
STORIES: � SQ.FEET OF EACH FLOOR:
NO. OF BEDR OMS: Z GARAGE STALLS: ATT. DET.
��
ESTIlVIATED CONSTRUCTION VALUATION (excluding land): $ (� �O� "�—
I hereby apply for a building permit and I acknowledge that the information above is complete and
accurate; that the work will be in conformance with the ordinances and codes of the City and with
the State Building Code; that I understand this is not a permit and work is not to start without a
permit; and that the work will be in accordance w' the approved plan.
APPLICANT'S SIGNATURE: DATE:�'r� '� �
NOTE! Parade of Homes events require parate permit approval by Police Department and
City Council 60 days prior to the event. Non permitted events will not be allowed.
5
Sec.13.04 RIGHTS OF SUB.TECTS OF DATA
Subd. 1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this section.
Subd.2. Information required to be given individual. An individual asked to supply private or confidential data concerning himself
shall be informed of: (a)the purpose and intended use of the requested data within the co►lecting state agency, political subdivision,or statewide
system;(b)whether he may refuse or is legally required to supply the requested data; (c)any known consequence arising from his supplying or
refusing ro supply private or confidential data;and(d)the idenUry of other persons or entiries authorized by srate or federal law to receive the data.
This requirement shall not apply when an individual is asked to supply investigative data, pursuant to section 13.82, subdivision 5, to a law
enforcement officer.
The commissioner of revenue mav olace the notice reauired under this subdivision in the individual income tax or propertv tax refund
instructions instead of on those forms.
Subd. 3. Access to data by individual. Upon request to a responsible authoriry, an individual shall be informed whether he is[he
subject of srored data on individuals,and whether it is classified as public,private or confidentiaL Upon his further request, an individual who
is the subject of stored private or public data on individuals shall be shown the data without any charge to him and, if he desires, shall be informed
of the content and meaning of that data. After an individual has been shown the private data and informed of its meaning,the data need not be
disclosed to him for six months thereafter unless a dispute or acUon pursuant to this section is pending or additional data on the individual has been
collected or created. The responsible authority shall provide copies of the private or pubiic data upon request by the individual subject of the data.
The responsible authoriry may require the requesting person to pay the actual costs of making,certifying,and compiling the copies.
The responsible authority shail comply immediately,if possible,with any request made pursuant to this subdivision,or within five days
of the date of the request, excluding Saturdays, Sundays and legal holidays, if immediate compliance is not possible. If he cannot comply with
the request within that time, he shall so inform the individual, and may have an additional five days within which to compiy with the request,
excluding Sarurdays, Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or
private dara conceming himself. To exercise this right, an individual shall notify in writing the responsible authoriry describing the nature of the
disagreement. The responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to notify
past recipients of inaccurate or incomplete dara,including recipients named by the individual;or(b)notify the individual that he befieves the data
to be correct. Data in dispute shall be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The determination of the responsible authoriry may be appealed pursuant to the provisions of the administrative procedure act relating
to contested cases.
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd. 2, "Rights of subjects of data", we would like to inform you that your
request for a permit or license from the City of Orono or any of its departments may require you to furnish certain
private or confidential information.
You are notified that:
1. The information you furnish will be used to determine your qualification for the permit or license
requested.
2. You may refuse to supply data, but refusal may require that the City deny the permit or license.
3. The information may be shared with other local, state or federal agencies to the extent necessary to
process the permit or license.
4. If your requested permit or license requires Council action to approve, some information may become
public.
5. You have certain rights under M.S. 13.04(available upon request) to review private data on yourself.
6. Your full name is required to process this application or permit.
�
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I unde tanc�iny rights as stated above.
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Signature (
6
. CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: . 2 l �0 K C�W OOb w�� �
PID•
DESCRIPTION OF WORS: _ 2r.W�p9c+L. / i?��9t2
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ZONING RE'�lEW BY: (A DATE APPROVED:
BITa,DING REY�W BY: DATE APPROVED: � - �0 - 5 7
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERNIIT Yes v'' No
PLAN REVIEW Yes No �./ SEWER CONNECTTON
STATE SUR�HA1�C� Yes �/ No WATER CONNECTTON
INVESTIGATION-FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
ZONING CHECK LIST zoning District:
Fire Department: Post Office: School Districr.
Lot Area: Sq.ft. Acres Width Depth
Surv�y Submitted: Yes No Date of Survey:
Proposed Setbacks: '
Front (Lake): Right Side;
Rear(Street): Left Side:
Adjacent Structures: Wetland:
Building Height: Def. Hgt. Peak Hgt.
,A``� Lot Coverage: .
Y_• .
Grading: Staff Approval Date: By: Council Approval Date:
� Septic: Staff Approval Date: By; �
Zoning F'�le: # Resolution:#. Resolution Date: �
Shorelaad DisL�ict: � �
Avg. Setback: Bluff Setback: Lot Coverage:
• E��g Proposed
Hazdcover: 0.75'
75-250' . . .
2sasoo� .
soai000�
Hardcover Variance Required: Yes No Date of Council Approval:
REMARBS('in house):
' • 26
BUII.DING REV�W CHECB LIST :
UBC: R'3 CO�TSTRUCTION TYPE: V/J
' Sq Footage $ Per Sq Ftg
Baser�ent x _
� ' Ist Floor � � � X � _ . .
.. � 2nd Floor . x . _ . . -
Gazage x _ :
x —
TOTAL
Estunated Construction Value: $ (p�ppp°� � - -
Inspections Required: • Work Requiring Separate Permits: �
Site ,_�( Plumbiag Fire
Hazdcover Removal Mechanical Water Connection --
Footing Septic Sewer Connection
�Framing Fireplace Lawn Irrigation
Insulation (Masonry) Other
Wall Board (Mfg.) Well (State Permit)
_�F� Grading/Filling _�Electrical (State Permit)
Other
REMARKS (IN HOUSE): �
REVIEW BY OT'HERS: � -- DATE: � ��
Access: Eusting New
Access�Approval: Date gy; � .
REMARKS(TO BE NOTED ON PERII�IIZ�: �
_ _ _ . 27 _ _ .� - - _ :. �;;
� �� = -� �� ���-�a �� ���
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SCOPE OF IMPR411F..�IlENTS AMD WOI�K PRQPOSAL
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PROGRAM: CDBG!City �` ° `��' ��k.���
PRQP'ERTY: Copeland, Zi80 K�nwc�ad Way, Orono MN �5391
CARP�NTR MISCELLANEOUS
7• $ ° ` RepNace ba�ement stairs�od�, includmg hand-raii.
��n�t���l �- �� ��
$ _ If cad tNiard is n�t,achievab! pleas provide a basie cost on ti�e
understarx�ing#iat linal cost unfl be de�rmined follawing cnnsutation
with c�ty buitding officiat when carrtract is 5igned.
2. $ Ftemave wCndow opening and frame in void in ba�room; sheath,
insulai�and anstalt water resistant shEr�tracic space for acceptance
of new shower an�t{see below}. Existing storm window is ta remain�
appty frc�st coating to inside of starm window.
3- � __ Remove tub and tii�and drywall fram shower waiis. 1nst�if new
water-resistant drywall. Dur�ck or equal. lnstati and plumb ta cod�
a n�w ffb�rgt��shawer stait sized ta fi#existing opening, white in
cotor. IGahler.cu equal. tnstall shower doars to fit opening. Anti-
sQ�ld f�ucet fixture shai!be chronw;thermostati�or pressur«?�.
balancin9 tYP�.- Sh�fiead st�alt be 3�pm flcrw control. De�rs oc
approv�+d equai.
a- $ Instalt window repl�cement�� vinyl frames! with we�ded carners end
therma) h�rr�Ar, insutating glass,full screen a�d locking d�vice.
Atcoa� eened�or equaf. S�t new units in exisiing openings.
Insulate c�vities. Haul away akf un�s wrth storms and screens,
Repla�e aU winclav�exc�pt basr�mant windaws. C1n�window
apening in each t�edroam shall comply with �gress code
r�quicrements. Uwne�"s chaice of cofor and type of wind ws.
Speci type of window� tatal#of r+ep{a ments.��� � 4 �,��,��'�
-- � �-�r�� 4�,.A.. '� . , -.�,..
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5. $ tnsiali new n�echanica!exhaust fan in b�thro�m. Nutane. 8ro�n, or
equal. Secure to�Iling, duct to exterior, insulate ta moet cod+�_
Size to 62-1989 ASNfiAE standards tor ventilation. {Wiring itstea
under efectrica!se�tion)
6- $ Instaft new rang�hoodte�auster. mechanicat cooking ventilator,
Ul.listed, mourrt above 000ktop (sfze to fully couer cooictop
surtaoe), duct w�xtPrtar, insulate per cocl�. Siz�to Ga-1 sss
aSHRAE startdards for ventil�fion. Vent A-Hood. Nutone, Broan or
Pqual. Owner's choice of color. �ring I�sted under electrical
section.)
paraQiBt G'orrstruct�vx
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Bid submitted by
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3COPE O�Ill� 1�'S AND�IUQRK � , ���` j�; ��y �
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P�tQt�RAM: Ct3BG1 City
PROPEI�: GopeEand, 21$0 Kenwood Way, OronO MN 55381 rr p t �t I
�' `` �° r �§'�
� *�. � ' r�,_ �
P J�,.,.. , A Ay+',
7. $ lr�stail new e�erior steel insulated dooc, l-3/4"miniumum -
� thickn�s� �ush, pr�ung unit w�h or witho�windvw of owner's ��T``� r" Y,.
choice. Casttegate ar equ�l_ tnstatl new hardvwatze,th�shoid, .�, ''�c���'
�� �h�PP��9 and bdcset�suppiy owner w�h,�k�y�.__�ieuse �
casing and trim_�_...__ :;�. ,,. ., . . _
�.�::..�....-..�..>- � � 10 .'
8. $ InstaN n�rnr stomUsu�en daar,sotid c:ar�, baked enaut�el prafmished�,,.
atuminum. with we�a�q�tersttippir�.Seit-�storn�g storm and screon
inserts. t�rdware and lodcing devioe for oompfete as�mbty.
Benada or equal. Qwr�et'�chaics color. �01 �� �� /I�.�.�
���i i�-- - �
9. � R e p l a o e m i�i n g k i t c t t e h d r a w e�r a n d m��s s i n g fi a l s d r a w e r r
is
2-��'tt,�,���6�3. ¢`f,�i��r�tfl e�ci�ting�s dose as poas��. ( � � � �A �'�" 2 � ��
�"r�.�r�.t � ,/�. ""~��r�.�,,��.� tI� .f�'s�•«► '� R����f�a,.�,"�
�. � � Nau!awa and
y �w' �spose af td eler�ic�e ��en�-
G�Jf-�SH� �" �
Z�- $ ! u i lit�tivrr . ote
: socter r �tion s. it . . "
� ralnt� �ng �4�pot e
rain t g r n 6"vf , d f
�� �P �� ap ho1e�" o crn t n
o i ubm b
. �� p�mP m u p of 18 1 and
cxsver sh�l ha vw d' e li ing
h p s
. bmit s�t sho Q
� n instaned dra�rtile and sump pwnp.
���A Y t �E'. ,S'�l.5?`�/�
Patch and repair wa�ic follawing piumbing work witi be added to the approved virork
whzn c�ast can be properly estimflted.
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SCOP�OF INlRROVFJAENTS AND YlfaRi(I�OpOgq1„
PR0�3RAM: CDBCI CiLy
PRCPERTY: Copeland. Z180 K�nwood Way, Orono MIN 55391
PLUMBING - AII work perfo� shaq be in r.�ampliance wtth the State end Iocai
apptfcabt�pfurnbing cod�requu�m�nt�. The system shall be healt�afe and�proper
w�orking orde�: Contraetor shail!ae nes�wr�ible for abtaining a!1 ne.�essary permits prior to
�tarting v�ork.
1. $ Rewent vu�r-heater to a��s�ecif�r if water he�ter must be moved
to aa;amplish Exoper ver�g.y
2- $_ Irss�tU a n�r, sin9le.comp�rtrnen�f�o�ergias�laundry tub, Mustee cx
eqt�af. Install a new t�aucet fixture, nan�hread or with e#8-8A tested
and appr�ved.or equal.hc�e conr�ion vacuum brealc+er. Install new
hot and cold water hose b�s_ Pf�nb. Vent to c.ode.
3- $ VeM kitchen sink, bathroom sink and batfiroom show�r to u�de.
4. $ Ir�l�U anti-scald f�uo�tfadurorforre�urbtshed s1�aMrer;chnwne in calor,
thermosta�c or pres�ure-balanang type with showerhead of 3gpm
flow control. Deft�or approved equal.
5- $ Plurnb new shon�er drain fio cc�d�, �
6. $ eocle plumbir� sys�em. Spec�fy all other pfumbing code work not
listed�bove and the cost per wnrk item.
paraQis� �tnrctfo�r
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Bid subm�ted by
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DATE TIME
CITY OF ORONO CAL�ED IN ��'/-��
INSPECTION NOTICE L SCHEDULED / v_��_. /.�—
PERMIT N0. �� }� COMPLETED
ADDRESS � �� C
OWNER `�� o-�t�-�-��� CONTR. � G�� �
TELEPHONE NO. � 7 d' -/ 70�
� DESCRIPTION
� 01 FOn FRo�1C�� 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
Q ��tir--� 13 MECHANICALFINAL 19 LAKESHORE/WETLANOS
ti
Q 031NSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q
= OS FINAL 14 SEWER HOOK-UP O6 PROGRESS
~ 07 DEMO—SITE 27 SEPTIC MAtNT. 21 COMPLAINT
J
� 07 DEM�FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBING FINAL Z8 CEDAR SHINGLES �FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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d WORKSATISFACTORY:PROCEED
W� � PROJECT COMPLETE
w C CORRECT WORK 8 PROCEED L: ISSUE CERTIFICATE OF OCCUPANCY
O C CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑ CORRECT UNSAFE CONDITION WITHIN HOURS. — pHOTO TAKEN
INSPECTOR WILL RETUFN
❑STOP ORDER POSTED.CA�L INSPECTOR
" CITATION ISSUED
O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance.473-73�J7
OwnerlContract it •
Inspector. �
White Copyllnspector's File Canary CopylSite Notice
D TE TIME
C1TY OF ORONO CALLED IN / � 3 �' 7
INSPECTION NOTICE SCHEDULED /i/_3/i �7 �,-� � t) c:
PERMIT NO. -��'�G� 7 COMP�ETED bt ✓'
ADDRESS
OWNER CONTR. _2�
TELEPHONE NO. �71 --/ 7 C���
� DESCRIPTION ,�l��c��--C�,�
� 01 FOOTING 11 MECHANICAL fil 18 EXCAV/GRAOING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
p 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q
INAL> 14 SEWER HOOK-UP O6 PROGRESS
~ O—SITE 27 SEPTIC MAINT. 21 COMPLAINT
J
� 07 DEM�FINAL 15 SEPTIC INSTALL. 22 FOLLOWUP
= 09 PLUMBINSAL. , �23 SEPTIC FINAL 35 HARD COVER HEMOVAL
N P�UMBIN(3 FINAL � ��Y��� �$CEDAR SHINGLES
---LQ_ 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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�� WORK SATISFACTORY PROCEED
PROJECT COMPLETE
W ! CORRECT WORK&PROCEED ISSUE CERTIFICATE OF OCCUPANCY
O ,�l CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. - pH0T0 TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
G INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next ir�pection 24 hours in advance.473-73ST
Owner/Cont to n ite�
Inspector.
White Copy/i�spector's File Canary CopylSite Notice