HomeMy WebLinkAbout2012-00693 - chimney repair � ► CITY OF ORONO
2750 KELLEY PARKWAY * 2 0 1 2 - PJ 0 6 9 3 *
DATE ISSUED: 07/20/2012
ORONO,MN 55356-
(952) 249-4600 FAX: 952)249-4616
ADDRESS : 1600 LONG LAKE BLVD
PIN : 26-118-23-33-0032
LEGAL DESC : ALBEES LONG LAKE ADDN
: LOT 001 BLOCK 000
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : CHIMNEY-REPAIR
ACTIVITY : O/S BUILDING-UNDEFINED
VALUATION : $ 8,490.00 .
NOTE: CHIMNEY REPAIR
APPLICANT pERMIT FEE SCHEDULE 177.00
JACK PIXLEY SWEEPS INC. STATE SURCHARGE(VALUATION) 4.25
4179 149TH AVE.NW TOTAL 181.25
ANDOVER,MN 55304
(763)422-0011
Minnesota State License#:20183369
OWNER
CAJACOB,CAROL
1600 LONG LAKE BLVD
LONG LAKE,MN 55356-
AGREEMENT AND SWORI�i 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 separate
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not speci£ed hereia 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
revok at any ti�he for due caus
7� a�� / � `�� O /
App icant Permitee Signat Date Issu y Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
- • City of Orono
Building Permi# Application for Ma�ntenance / Renovation
windows, doors, siding, re-roof, etc.
MalUng Address: permit number. —��9
O�,O.�O PO Box 68
Crystal Bay,MN 55323-ooss pate received; -o�f>/ �
.. Streef Address: Reoeived by:
� o$ 2750 Kelley Parlcway Plan review Eee:
� Orono,MN 55356
T�al Fse: ,� O I. I�
Main: 952-2d9�600 Pax: 952-249-d616 www.G.orono.mn.us
This applica�on form must be completed in full and all required information must ba submitted.
Incomplete applieations will be returned. (Please print)
GENERAL INFORMATION:
Job Site Address: '�t,J�.
Will this be a Parade of Nomes, modelers Showcase Home er other Display Home? Yes No
I►yes a speaal ev+enf permh is n�qulRed Polior Depa►tme�and Gity Councll app�oval 60 days pr9or to the event. Shutde bus sarvlce will be
ieyulred unless appllcant onsMdtes sul�ident on-sita pa�irtng is evailable. Non pennieted evsnts wiill not be allow�d.
CONTRACTOR I AP UCANT INF RMATION:
Name: '�� � I5T ��c.6 (:.+�.� Co.
State License# � �, Expiratlon Date: M�A�N 31 ,aDl3
Lead Certification Number � 7.� Expirstion Dete: � �.�30.�p�
(for w�ork on homes at wer�can trucEed pria to 1978
Phone: �.a� � (office). ��Q$5� (cell)
Mailing Address: � ��q�t� City: ZIP: SS
Contact Person: $„e.. Applicant is: Con ractor / Homeowner (Grcb 0�)
Email and/or Fax: '��,k ,
PROPERTY OWNE INFORMATI N: �K �� "-V� I S38S � 0�71 F1cP. (� � C�%7�I
Name:
Phone(day)� GJ .Epi.�._
Address: L, � -i�,�, Ciiy: (,�y,�, �� ZIP: `jsJ.S�o
Email and/or Fax
PROJECT INFORMATION:
Type of Project: Any eaRh movement may require
❑Door(s) ❑Remo el ❑Fire�amage MG���eW�`��'��
❑Re-roof,as hak Minnehaha Creek Watershed Dislrict(MCWD)
p ❑Repai ❑Storm�amage 18202 Minnetonka Blvd
❑Re-roof,cedar ❑Resto tion ❑Water Damage ��Phaven,MN 55391 - - -
Phone: 852�71-0590
❑ Re-roof,other(speciry) ❑Slding �Other:(speCity) Fax: 952-471-0682
❑Wind s) �u,��,J�,q�� �•minnehahacxesk.ora
Overall Project Descr�ption: a� �
Estimated Construction Valuatio of Pro)ect(excluding land $ O'
APPLICANT ACKNOWLED�3E ENT:
• Agrees to provide all infortnatio required or requested by the Building Department;
• Certifies that the information s pplied is true and correet to the best of his/her knowledge, The applicaM reoognizes th�t they
are solely responsible for sub itting a complete application being aware thet upon failure to do so,the staif has no altemative
but to reject it uMil it is complet ;
• Some or all of the infortnation that you are asked to provide on this application is Gassified by State law as either pnYate or
confidential. Private data ia i rmation which generally cannot be givsn to the pubilc but can be given to the subjed of the
data. Confidentisl data is in rmation which generaly cannot be given to etthsr the public or the subject of the data. Our
purpose and intended use of rmafion is to annualy update our records a�d records of other govemmental agencles
re uired b law. If u refus ths ir�formabon,ths a lication ma not be issued.
ApplicanYa Signature: .Z. Date: �,It,�l G�� ,��ol
Last Updaled: OS-09-2011
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� Specisic�t�ons a�od�stlmmte
'T7iie I�lame You Can Trust' J�p��y�
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�� "� £� 963-4 -Ob81 (�
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1
Jack PWey Chimney-Sweeps and IViasonry 4179 - 149th Avsnue N.W. Andover, MAi 55304-31355
Tel: 1-763-422-Q4�1 Fax: 1-763•421-020B IMN Contractor License#a0183369 www.jackoixleYsweeps.com
Carol Cajacob ]uly 16,2012
1600 Long Lake�lvd. (952)404-9659
T..ong Lake,MN 55356 (612)807-0703
'We 6ereby propose to iutoL�h materials and labar nax�ary to:
Remove all tlue t1k liners aad relline chi�nney fo�fireplace using 10" stainless steel liner system
(U.I.. listed with manufaceuer's lifetime limiced wananry); remave conerete wash and top 14 eourses of brick; re-brick 14
course of ehimeey brickwork(best manch),Pro'�'ide eoncre�be crown with overi�ang and drip ledge as outlined in ardcle "Tops eo
Larr a Lrjetime"by Jack Pixley;install a st�inless steel rain cover/screen with life�time wananty.
Ynclades:
�Omund 8c roof protect3on
�Scaffold selup&removal �--�
�Roof scaffold setup&removal �''� � • �
�Equipment sehtp j ..
�Concr�ete wash,brick 8c tile breakout '�� l
�Access into chimney �;:;•w. .
� ,_ �: :, ` •:.�
Carry debris to trailer .. �.;�;�..=f .
..•.;
✓Install stal�r�less steel liuner dt instllate - - .
✓Retile chimneY(�P) '�'��'� - �' ' �
- - >•
✓eut�redo access to chimney _
�Re-brick top of chimney
�Concreu crown at top "'�
�/Install s.s.rain cover/screen
�Equipment teer-d�wrn&removal
�Cleanup •
��.andfill/Recycle,�avel,unload , � ` �
�/Remova forms �-'-- �-�—
�Building permit 8c lnspection
TOTAL OF BID:S 8,490.00
pLEASE N07'E:]'f during breaknue,we frnd n code vfolarinn...we�esern the opdon to stop eire job;.thow owner and/or consult wfth the buildtng
i�tspector.The extra repatrs necessary may r,csult in�tn added priee for the jo6.
WE PROPOSE hereby to furnish material and labor-complete in acco�dance with above spec�ication,
for the sum of: dolla�s($ ),
rA��ro aE tww�as�oL�.ows: 25% at acceptaAce �nd remainder at m letion af,�ob
��m ts po�a�e�w be as�cdi�a�e wani m w oe�e�ee a..ee�d.�rt�e�a acmdlne ro AuOiodma
�doisau0a�0.oerarMrdpa�r�s.An/tl�tia�adMalfonhomaDoreapeeifm�farunoNiiOsmeatmv� 55gnah�re
Ee txeaiIDA my�n�aa0�4 end+�ill Oeapro an pOi MesBs orv an0 aoove Na ecWr�eot NI�unr�oora�n
won saiva aoaaena or a�oamna aa mnna.arr�b m�,rtre,mnmea.�a od�tr�rr�nAram»,an xor�na Notr.This I may be
w�r��r��a�moa�I�, �tlldrerm b�l us 1(not acoopted wilhin. 30 days.
ACCEPTANCE OF PROI'OSAI. The abo've priees,specificationa and
condtao,u are satisfactay and are haeby accepud.You are auchorized to do
d�e w�ork as spxifitd.Payment will be made as outlined abbve. s�AO�+^s
Unrt ojAcae�pmnce: Sigrrarons
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DATE TIME ` /
CiTY OF ORONO CALLED IN ��
INSPECTION�NOTICE SCHEDULED 7 l Z �Q ; QZ�
PERMIT NO�'����-�O LG� COMPLETED
ADDRESS
OWNER T H NO. - ��'� a/
CONTRACTOR
a DESCRIPTION , �-�
� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXC V/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL
Q ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLA�NT
J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
y COMMENTS:
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W� ❑WORK SATISFACTORY:PROCEED �'JiOJECT COMPLETE
W ❑COflRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFOREC�IERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ppHOTOTAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
�STOP ORDER POSTED.CALL INSPECTOR
�INSPECTION REQUtRED.CALL TO ARRANGE ACCESS.
Cail for the next inspection 24 hours in advance. (g52) 249-4600
OwnerlContractor on site:
Inspector. (l 0 A-Z
White Copyllnspector's File Canary CopylSfte Notice