HomeMy WebLinkAbout2013-00760 - roofing ` ' � CITY OF ORONO
2750 KELLEY PARKWAY * 2 0 1 3 - 0 0 7 6 0 *
DATE ISSUED: 08/OS/2013
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 1170 LYMAN AVE
PIN : 35-118-23-43-0028
LEGAL DESC : WOOD END ACRES
: LOT 001 BLOCK 001
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ROOFING-ASPHALT
ACTIVITY : O/S BUILDING-UNDEFINED
VALUATION : $ 7,500.00
NOTE: VALUATION OF PERMIT:$7500.00
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 DURING THE TIME THE ROOF IS BEING DONE.
ONCE WORK IS COMPLETED THE SIGNS MUST BE REMOVED.
APPLICANT pERMIT FEE SCHEDULE 162.25
THOMPSON HOMES STATE SURCHARGE(VALUATION) 3.75
90 MYRTLEWOOD RD
WAYZATA, MN 55391- TOTAL 166.00
(612)414-2335 PAID WITH CC# 8895
Minnesota State License#: BC4209
OWNER
STOESZ,ASHLEY&SHELLY
1170 LYMAN AVE
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 goveming 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.
_ � -- , � � �5 � /
App icTant Perm��ee�5'�ignature Date Issued Signature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
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: Building Permit Application for Maintenance / Replacement / Renovation �
� ` (No structural expansion. Only windows, doors, siding, re-roof, etc.)
O Mailing Address: Permit number: O l��� � �
? � �O PO Box 66
�� Crystal Bay, MN 55323-0066 Date received: S� `` `
� ' Received by: �
�.' � � StreetAddress: k .
,�-,., yF G� 2750 Kelley Parkway Plan review fee: fr�
�, Orono, MN 55356 �
`�'�ESH�� Total Fee: ��/��, � ;�
Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us `C �
This application form must be completed in full and all required information must be submitted.
- Incomplete applications will be returned. (Please print) '
� GENERAL INFORMATION: V
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Job Site Address: j� �c> L�/{'�I� �1�� ��
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 service will be
required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed.
CONTRACTOR/APPLICANT INFORMATION:
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Name: �7 �.�, ��•� v
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State License# �� ' Expiration Date: 3 - 3 � -1��
'';;;,; Lead Certification Number: Expiration Date:
4,� (for work on homes that were consfruc ed prior fo 1978
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Phone: (cell) (.e f - �I� - � 3 3 S (office)
Mailing Address: v ry� �f ��,,;..� City: � � ��z ZIP: S� �z /
� Contact Person: �',��,� � Applicant is: ontract r / Homeowner (Circle One)
�: Email and/or Fax: �TO�M y ��,�S�Y��QH2 cJ� �'U��
PROPERTY OWNER INFQRMATION:
Name: ,��(il �j f u e S Z
1: Phone (day): (�(� � �S/ � �� (e o
`�': Address: `/ � L���� �ve— City: C�/���irU ZIP: S���� l �,�
� Email and/or Fax:
PROJECT INFORMATION: Overall pro�ect description: �'
Type of Project: Any earth movement may also require
� ❑ Door(s) ❑ Remodel ❑ Fire Damage MCWD review 8�permits: `
� Minnehaha Creek Watershed District(MCWD)
f�:, �e-roof, asphalt ❑ Repair ❑ Storm Damage
18202 Minnetonka Blvd �
' ' ❑ Re-roof, cedar ❑ Restoration ❑Water Damage Deephaven, MN 55391 =,m
❑ Re-roof, other(specify) ❑ Siding ❑ Other: (specify) Phone: 952-471-0590 �
Fax: 952-471-0682 N
❑Window(s) www.minnehahacreek.orq `��
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Estimated Construction Valuation of Project(excluding land) $ S� . �J �
�� 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 hislher knowledge. The applicant recognizes that they are
k�� • solely responsible for submitting a complete application being aware that upon failure to do so, the staff has no alternative 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.
I 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 information is to annually update our records and records of other govemmental agencies required by law. If �
�,� ou refuse to su I the information,the a lication ma not be issued. �
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�`� ApplicanYs Signature: Date: �
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,; Owner's Signature: Date: LL�.
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`° i Last Updated: 03/06/2013
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CITY O ONO CALLED IN
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INSPECTION NOTICE SCHEDULED �(Q—► �
PERMIT NO. d 7 COMPLETED
ADDRESS ��
OWNER TELEPHONE 0.6��'
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Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORFJWETLANDS
y ❑ FRAMING ❑ MECHANICAL FINAL
Q ❑ TREE REMOVAL
2 ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
v ❑ DEMO-SITE O SEPTIC MAINT. O FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
v O PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDAl10WREMOVAL
2 01NNERICONTRACTOR TO MEET YiOU:_YES._NO
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❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑pH0T0 TAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Ca11 forthe next inspection 24 hours in advar�e. (952) 249-4600
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v� DATE TIME V;
CITY OF ORVIYV CALLED IN �' ,—�—��
INSPECTION NOTICE SCHEDULED �� �
PERMIT NO. ��/3-GYJ 7� COMPLEfED �����
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OWNER TELEPHO NO
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� DESCRIPTION ,��� �'�"
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Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS
y ❑ FRAMING 0 MECHANICAL FINAL
Q ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� O FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
= O DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVA�
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0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COYERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 4 hours in advance. (g52) 249-460�
OwnerlContractor on si :
Inspector.
White Copyllnspector's Ffle Canary CopylSite Notice