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Home My WebLink About2015-01049 - windows � �� CITY OF ORONO * 2 0 1 5 — 0 1 0 4 9 * 2750 KELLEY PARKWAY DATE ISSUED: 08✓18/2015 ORONO, MN 55356- 952 249-4600 FAX: 952 249-4616 ADDRESS : 2625 NORTH SHORE DR PIN : 09-117-23-42-0003 LEGAL DESC : LJNPLATTED 09 117 23 : LOT 000 BLOCK 000 PERMTT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : WINDOWS VALUATION : $ 2,000.00 NOTE: CHANGE OUT ONE WINDOW APPLICANT PERMIT FEE SCHEDULE 77.44 STATE SURCHARGE(VALUATION) 1.00 ANDERSON-REDA INC TOTAL 78.44 4920 LINCOLN DRIVE Payment(s) EDINA,MN 55424 CREDIT CARD 2712 78.44 (612)308-2722 Minnesota State License#:BUIL-20229198 OWNER MEHBOD,AMIR&ASHLEY 2625 NORTH SHORE DR WAYZATA,MN 55391- AGREEMENT AND SWORN STATEMENT 1'he 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 dces 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 specified herein.l'his perrt►it 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. 'fhe applic nsible for assuring all required inspections aze reque d' conform with the State Building Code.This permit may be rev e any time fo e cause. � �" '1� l� C� g l! � lv Ap ' t Permitee Signa Date ss e B Signature Date � � City of Orono Building Permit Application for Maintenance / Replacement / Remodel (i.e. windows, doors, siding, re-roof, etc. — NO STRUCTURAL EXPANSION) �O� Mailing Address: Permit number: � 5 � O PO Box 66 ��i/ Crystal Bay, MN 55323-0066 Date received: � Street Address: Received by: y �` �, G� 2750 Kelley Parkway Plan review fee: t �, Orono, MN 55356 �kf S H�� ,�7 Total Fee: i � O� �/� Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us � 0 7 This application form must be completed in full and all required information must be submitted. Incomplete applications will be returned. (Please print) GENERAL INFORMATION: Job Site Address: � 6a S /�o2.f� ,S�.oQ� �k,/Ue 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/AP ICANT I FORMATI Name: 1"C!`�1�G'�-�I V Q��cs--Vi-1 1�� S ta te License# Zp�� cy�q� Expiration Date: _ Lead Certification Number: n/,47 (/��3�-� Expiration Date: 9 y � (for work on homes that were constructed prior fo 1978 Phone: (cell) (2- 30$ _ at 2 (office) Mailing Address: ,20 ��vc ,,i ;ve City: a(�,,,� ZIP: S y 6 Contact Person: �ti�I�� Applicant is: Contractor / Homeowner (CircleOne) Email and/or Fax: �N.�y C� a,,,,(Qas�Q P.da , c o.�-i PROPERTY OWNER INFORMATION: Name: G{,.,;/� -t �s� /e� i�'�P�i b o� Phone (day): Address: �Ga s �o2f� $�orce ai✓� City: (,��,�o ZIP: Email and/or Fax: PROJECT INFORMATION: Overall project description: C�a,✓ � ScR pe�✓ T u/%ti�� 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.minnehahacreek.orq Estimated Construction Valuation of Project(excluding land) $_ �,ODC'°" 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 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. Confidential data is infor at' 'ch generally cannot be given to either the public or the subject of the data. Our purpose and intended use of this inf tion is t nnu Ily update our records and records of other governmental agencies required by law. If ou refuse to su f rmation e li tion not be issued. ApplicanYs Signature: Date: Owner's Signature: Date: Last Updated:January 2015 DATE TtME CITY OF ORONO cnLLED IN INSPECTION NOTI E SCHEDULED � PERMIT NO. '�� COMPLETED ADDRESS a6 0�.5� /�/• S�ivre ��`- OWNER TELEPHONE NO. CONTRACTOR ��p�� " �c�`� �� i DESCRIPTION w'K�� ' t~N ❑ 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 v INAL ❑ WATER HOOK-UP ,�FOLLOW-UP W ❑�S BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL _ v ❑ DEMO-SITE ❑ SEPTIC INSTALL i OMINERICOI�ITMCTOR TO MEET 1f�U:_YES_NO , � COMMEN7''� �e�••�� /jo�ei �4'•/ear0 �' ct /� �c.,✓ 4 4 �ir��t L �il s.o �.ta., j ' c�rt e f1UrYt� � �I/'/l(1,�OGc� /��l - �iYle JizG � 6�"S�� l i1. ��5�/n� O�li1S'S - W OC Q � Z � LfJO�/C ��4.P��'S �s�✓��e�e a� j � ❑WORK SATISFACTORY:PFiOCEED �,PROJECT COMPLETE W ❑OpRqECT WORK 3 PROCEED ❑ISSUE CERTIFlGITE OF OC(X/P�ANCY O ❑CORRECT WORK,CALL FOR REINSPEC710N TEMPORARY V BEFORECdVERINO PERMANENT ❑OORRECT UNSAFE CONDITION WITHIN H��• ❑pHpTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �GTATION ISSUED ❑INSPEC710N REQUIRED_CALL TO ARRANGE ACCESS. Csq for the next inspectfon 241aurs in advance. (952) 249-4600 OwnerlContractor on site: Inspector. �'►� wn�a covrn�.v.oeor.FiN C�mry CopylBib Nofk�