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Home My WebLink About2016-01096 - roofing CITY OF ORONO * Z 0 1 6 - 0 1 0 9 6 * � � � ' 2750 KELLEY PARKWAY DATE ISSUED: 09/08/2016 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 1040 LOMA LINDA AVE PIN : 08-117-23-23-0028 LEGAL DESC : LOMA LINDA : LOT 036 BLOCK 000 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ROOFING-ASPHALT ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 9,500.00 NOTE: VALUATION OF PERMIT:$9500.00 TEAR OFF REROOF HOUSE AND ATTACHED GARAGE 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 DURING THE TIME THE ROOF IS BEING DONE. ONCE WORK[S COMPLETED THE SIGNS MUST BE REMOVED. APPLICANT PEEZMIT FEE SCHEDULE 201.32 STATE SURCHARGE(VALUATION) 4.75 SELA ROOFING&REMODELING, INC. 4100 EXCESIOR BLVD TOTAL 206.07 ST. LOUIS PARK,MN 55416- Payment(s) (952)915-7227 CHECK 37370 206.07 Minnesota State License#: BUIL-BC1050 OWNER SHAPIRO,CINDY 5704 DEVILLE DR EDINA,MN 55436 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 separa[e 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 1 SO days of the date of issuance,or if construction is suspended for a period of l80 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. . �/�/(� � �,'/� A plic Permitee Si re Date Issued By Si�nature Date � City of Orono Building Permit Application for Maintenance / Replacement/ Remodel — Residential ONLY (i.e. windows, doors, siding, re-roof, etc. — NO STRUCTURAL EXPANSION) �O� Mailing Address: Permit number: O PO Box 66 Crystal Bay, MN 55323-0066 Date received: Street Address: Received by: �y� ��C" 2750 Kelley Parkway Plan review fee: G Orono,MN 55356 `9k�SH�� Total Fee: 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. (P/ease print) Job SiRe Add eOSMATION: ��11 � �M/�' � � � .�/n , ll r f )ld, /1 r u� Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes No If yes,a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus se i will be required unless applicant demonstrates su�cienf on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFO ATION: Name: State License# Expiration Date: Lead Certification Number: Expiration Date: (for work on homes that were cons ructe prior to 1978 � Phone: (cell) (office) � Mailing Address: Cit : �, s ZIP: Contact Person: Applicant is: tracto / Homeowner (Ctrcle One) Email and/or Fax: :� PROPERTY OWNER�N�FOOR�AT,�O-1�� Name: V t ��l�/�� Phone(day): � Address: � City: ZIP: Email and/or Fax: PROJECT INFORMATION: Overall project description:� � � �� Type of Project: Any earth movement may also require ❑ Door(s) ❑Remodel ❑ Fire Damage MCWD review&permits: Re-roof,asphalt ❑Repair ❑Storm Damage Minnehaha Creek Watershed District(MCWD) 15320 Minnetonka Blvd Re-roof,cedar ❑Restoration ❑Water Damage Minnetonka,MN 55345 ❑ Re-roof,other(specify) ❑Siding ❑Other:(specify) Phone: 952-471-0590 Fax: 952-471-0682 ❑Window(s) www. 'n hahacreek.or 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 altemative 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 i is to annually update our records and records of other govemmental agencies required by law. If ou refuse to su the nfoRn i ,the lication ma not be issued. Applicant's Signature: Date: �_��.� �-1' Owner's Signature: Date: Last Updated:January 2016 ✓ DAT TIME CITY OF ORONO CALLED IN ✓� �� INSPECTION NQZICE �1�D�O SCHEDULED — PERMIT NO.�'�� COMPL D ADDRESS � ��-- OWNER T PHONE NO. yS �—c�S- �"G CONTRACTOR � DESCRIPTION t~y ❑ FOOTING ❑ DEMO-FIN ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLIN(3 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 � ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP _ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL J ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 OWNEAICOKTRACTOR TO MEET Y�U:_YES_NO v�, COMMEN'T'S: � ' �i c �L cG rc.t,.�t�— i � � � � 3 /'.� � — (i��.,�e,� �.► .s�� ,.� r«��/��. 0 � � Q , n�c,� !'ao � z � W � j � ❑VMORKSATISFACTORY:PROCEED L�ROJECT COMPLEfE W ❑CORRECT VMORK�PROCEED ❑ISSUE CERTIFlCATE OF OCCUPANCY O ❑OORRECT NfORK,CALL FOR REINSPECTION TEMPORARY V BEFORE CONERIN(i PERMANENT ❑CORRECT UNSAFE CONDITION WRHIN HOURS. O PHOTO TAKEN INSPECTOR YVFLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR O CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advanoe. (952) 249-4600 OwnerlContractor on site: Inspector: �I?� �� White CopyAnspector's Fil� C�nary CopylSib Notfcs