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HomeMy WebLinkAbout2016-00057 - addn/remodel/repair , CITY OF ORONO * 2 0 1 6 - 0 0 0 5 7 * , 2750 KELLEY PARKWAY DATE ISSUED: OU29/2016 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 3444 NORTH SHORE DR PIN : 08-117-23-43-0022 LEGAL DESC : LYDIARDS PARK LAKE MTKA : LOT 017 BLOCK 000 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 25,000.00 NOTE: SEPARATE PERMITS REQUIRED: PLUMBING,MECHANICAL,ELECTRICAL(STATE) FINISH BASEMENT&LAUNDRY ROOM,BATHROOM&BEDROOM APPLICAI�IT PERMIT FEE SCHEDULE 433.67 LEE LUMENDAL,DEBORAH PLAN REVIEW 281.89 3444 NORTH SHORE DR STATE SURCHARGE(VALUATION) 12.50 WAYZATA,MN 55391- TOTAL 728.06 Payment{s) CHECK 6509 728.06 OW1vER LEE LUMENDAL, DEBORAH 3444 NORTH SHORE DR WAYZATA, MN 55391- AGREEMENT AND SWORN STATEMENT The work for wnich 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 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. �� 7 �''Li �1��_.�b�� l L C � / � /(� Applicant Permitee Signature Date Issued By Signature Date City of Orono Building Permit Application for Mait�tenance / Replacement / Remodel (i.e. windows, doors, siding, re-roof, etc. — NO STRUCTURAL EXPANSION) �O�O Mailing Address: Permit number. `�(� t�� -- {;,�- J PO Box 66 Crystal Bay, MN 55323-0066 Date received: f •- `� -f(_-, � Street Address: Received by: ' � � ,,��} ti�, � 2750 Kelley Parkway Plan review fee: �;.Ul ZQ .`t'+.- �„i��+?r� f�l t�kESHO �"G Orono, MN 55356 � . R Total Fee: � ' `-�� f�'�,' 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 b,e submitte�l. Incomplete applications will be returned. (Please print) �-���ti-� ;° � �'�������_ GENERAL INFORMATION: , I , Job Site Address: ���1 (� , ��'�c%,(� C Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes o If yes,a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus rvic will be required un/ess applicant demonstrates su�cient on-site parking is availab/e. Non permitted events will not be allowed. CONTRACTOR/APPLI�INF0�2MATION: Name: �f,�.,�q—� ,,.,,�,. 1 State License# � Expiration Date: Lead Certification Number: Expiration Date: (for work on homes that were constructed prior to 1978 Phone: (cell) (office) Mailing Address: City: ZIP: Contact Person: Applicant is: Contractor / Homeowner (Circle One) Email and/or Fax: PROPERTY OWNER INFO RMATION: Name: �yjlit'��1 1.�1�n� ( Phone (day): U . — Address: � � v e City: ZIP:�53� � Email and/or Fax: � �. �� PROJECT INFORMATION: Overall pro'ect descri tion: ` 11 � ( — � KL��' ti ' f M Type of Project: Any earth movement y also require ❑ Door(s) �emodel ❑ Fire Damage MCWD review 8�permits: ❑ Re-roof,asphalt ❑ Repair ❑ Storm Damage Minnehaha Creek Watershed District(MCWD) ❑ Re-roof,cedar 15320 Minnetonka Blvd ❑ Restoration ❑Water Damage Minnetonka, MN 55345 ❑ Re-roof,other(specify) ❑ Siding ❑ Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 ❑Window(s) r� yyWniv mi.,..,.�_�-- ' •� J Estimated Construction Valuation of Project(excluding land) $ ,�r, - - "' _ f - C,; ✓`l`' - - , a ��� : 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 inforrnation 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 information is to annually update our records and records of other governmental agencies required by law. If ou refuse to su I the information, the a lication ma not be issued. ApplicanYs Signature: Date: � `' Owner's Signature: " Date: � —��� —��'� Last Updated:January 2015 ��;r/� ��� / /�� /� `_ �- � � / � cu i��Lf-a� �-�f�.�°E��,� ��-�[=�E������' ��[� ����C��� �>�[�;����;����� � f�'-����E�GC�C�� ������: ,3��� �l��i �'�i��� ,�i�iv� ������ ��.: ��scri�tioe� �#���4ortr: --- D��� ��c'c@: ��ptBc rebie�+by: J (�(/'�o^ �Y f�r/�• /( �ate�ppr�v�ae�: ZonE�� r��si�e�b�+:,� �ag�Approv�d: �ui6e�st�g revi�w€by: �ate e�pprov�d: , �l f �r�e�6erg re�ie�s by: _- Da�e�,ppro���€: �ac�Era� �?is�cEc�: �oroi�� FE6��: 6�e�o�: �eso D�t�: Z�nir��: t�o��.rea: SF/AC tR�ie6�h: �.c��Cav���e: SF ��re0y Su�sr�Et�ec9: �Yes � No ����m4'Sucvc��: / Revised date(?)� ��c�d�c��a��ia�subm��tecR? � Yes � No 9..a�ec�g���r: � E�ro o�ed �e��scP�ss: �eonf�i�at��j 6t�ar�Stre�t� � � � � �,' ) �� � E �p � �ther�u`Ed�n�s lff�'etl�r��i �ide � �ic�e ���n�i�eEght: �e�:��ieigh�: F�E: F��enir�u� 6$e�t= (�x€€�i�g Ca��t� ,, F��e@cnefiee�(€inear feet�� 0% L.�. be6ow�gr�d� Basennen�? f�Yes � No, Stor6 �OR Et BUiLDIPEG Ih�ITFi�►BASENiEMT OR CItAWL SPA : FOR�►BUILDtPIG OPi Ae SLA$FOUAlDATIOW: The dfstanca the I west proposed Slab at or above grade— START WlTH fleor(of the ba or cr wJ space)and measuie from htahest exlstlna the highest point the roof. START WITH �tO�highest poirrt of the roof even if fill was brought in to lf you have a.. elevate home. SUBTRACTION a GABt R HIPPED R OF"(no glab belo�sr grade,_measure (BASED OM w(ndo ): Subtract ha the distance from fiighest existinp prade to the ROOF TYPE) n the highest po of the roof hi hest int of the roof. to th low point of the rtesponding B you have a... ga or hipped roof SUBTRACTION ° ��E OR HIPPED ROOF � G LE OR HIPPED R F(with (BASED ON (��ndows): Subtract half wi dows): SubVact half distance ROOF TYPE) �e distance between the tween the top of the h hest highest polnt of the roof to ndow ar�the highest .M of the tl�e low point of tt►e f correspondtng gable or a lL OTHER ROOF TYP S(flat, ����� F GABLE OR HIPPED ROOF ansard,etc):No subt ' n. (with avindows): Subtract SUBTRACTION Su the distance between half the distance between (BASED ON base ent/crawl space floor a the tha top ef the highest EXISTING high st existing grade adJacent o 4�e window and the highest GRADES) foun ation OR 10 feet(whichev r is less). pofnt of the roof o ALL OTHER ROOF TYPES EQUALS D�ff eci buitdtng height (flat,mansard,etc)�Np subVactioo, DefEned building heigM E�UALS i Updated: October 2015 a:\forms\plan review checklist 10-2015.docx Avera�� f aE:e��°mcs:^����i�acE: �,l�aff Shorela�c� �istr'sc�: €�RG�D E�e�rrtit hRet� � Yes I� � Yes � �o Permit I�umber: � Yes � i�o � N/A �o � N/A-see attached Setback: Stor-mw�ter���fity ���sting Propased Overlay Distri�t�'ier E�arcEco�s�r E�arcic�v�r �fariance i2ege�ired C�lP R�auired circle one %and s % and s CP Yes C� No � Yes � No 1 2 3 4 5 jYPe�S)� Type�s�: Fee�to be Char ed �'�� �� Perm9t �iar� Re��iew � Sta#e S�abcharge �/' �RN@S�1$8tlbt'1 F@8 S1�C-I��rr�ber of S��t��its 1/' Otiner(specify) S uar� Fo�ta e � er S uare Foota e Basement X - � 1�Fioor X � $ Z�d FI00� X = $ Garage � - $ Estirna�teci Censtruction l4�lue: � ��s��V Orone tnspections itequireci �'Joric Requieing Separa4e Pecmits 0 Footing � Site Plumbing , � Grading/Filling [� Poured Wall 0 Silt Fence/Erosion Control Mechanical � Fire � Foundation Survey Q Hardcover Removal i� Septic Q Water Connection � Foundation Waterproofing � Other(specify) C� Fireplace � Sewer Connection Framing � IVlasonry � Lawn Irrigation �insulation Qi Mfg. t� Landscaping � As-B�uFlt Survey � Other(specify) Finai 6 Lathe Reauired State Per�nits � Other(specify) Q Weli �Electrical REII�IARl4S (in-house): Sy��'IC!/�L R�F�l��tt��-'f0 �E td0`���I O� P�E��,�E�',�6Pl� E�ETff�.�LLC�: � Se�E��itc�er�cK:�o�+tee�g�mert�ForrvQ � Prior to release of escrow money an as-built survey and hardcover calculations must be submitted and approved. 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G /ec-f �'�c•G /Q�. �— /��9Pc Z�� �. r � _ ���d� 7a �l�,ni�Gc � C/►/� 'Tdr � �`� r -CS��'�`o � W � Q � 2 W � W � J d W� ❑WORKSATISFACTORY:PROCEED ❑ PROJECT COMPLETE W O CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY � ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN INSPECTOR WILL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED ��PEC,�ION REQUIRED.CALL TO ARRANGE ACCESS. Call forthe next inspection 24 hours in advance. (g52) 249-46�0 OwnerlContractor on site: Inspector.<��,� � �;/ ' White Copyllnspector's File Canary CopylSite Notice �_ � � � 7 TE TIME CITY OF ORONO cnLLED IN � INSPECTION HEDULED 7� � PERMIT NO. �� �OMP EfE ` ADDRESS OWNER TELEPHONE NO. � �/� CONTRACTOR � DESCRIPTION / �-t-L ty ❑ FOOTING ❑ DEMO-FI L ❑ SEPTIC FINA Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRAD G LLING O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q RAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP _ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL v ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 OWNERlCONTRACTOR TO MEET YiOU:_YES_NO «� COMMENTS: a� r � �/�t�17 ' �"�!��+a — G4ci1 S��t o .Prta� 7c Cd�r��1�- - T�.� Q K � ¢ ° 6� � Ga r�e,/ Lo r�c c� -� W � Q � 2 � W aC J O W� ❑WORKSATISFACTORY:PROCEED ❑PROJECT COMPLEfE W ECT W'ORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECONERING PERMANENT ❑C�RRECT UNSAFE CONDITION WRHIN HOURS. ❑pH0T0 TAKEN INSPECT�t WILL RETURN ❑CITATION ISSUED ❑STOP OR�ER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call forthe next inspection 2a hours in advance. (952) 249-4600 OwneHContractor on site: Inspector: � / �"' � White CopyAnspector's Flb Cenary CopylSite Notice DATE TIME CtTY OF ORONO cnLLED IN " INSPECTION NOTI E ��f SCHEDULED PERMR NO.���— '^"` COMPLEfED __a.�� ! ADDRESS�, �l�� . �S�o�e I1 r � OWNER TELEPHONE NO. CONTRACTOR ��-+�a��h L�'��'T�� '' DESCRIPTION Z/1,S kLt'��,�. ' � ❑ 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 _ ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � : NSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP 41 ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL _ v ❑ DEMO-SITE ❑ SEPTIC�NSTALL 2 OWNFRICOI�IiRACTOR TO MEET 1NOU:_YES_NO h COMMENTS: � a � ��saG. �r � .L. - a c�.f�� — o �.� iir�r. o.t .3 cvQ i/s - i"esb a-� � w a <�� ��� �/'!o� ' Jj4►�Nev�•[��/ C!�� ° 6�,�s �� �D�., e%r ���vt � �a•z�ta� �a ac. Q .�i�c.b/ _ l�, �- ' �,e �- Cb v�� - � � W � j � �NORK SATISFACTOHY:PROCEED ❑PROJECT COMPLETE � ❑CORRECT WORK�PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECONERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pH0T0 TAKEN INSPECTOR W{LL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cail forthe next inspection 24 hours in advance. (952) 249-4600 OwnerlContractor on site: Inspector: VYhite CopyAnapector's Flle Canary CopylSiM Notke �.� • �(,�'�� f�`> �.�'`�-�' DATE TIME �� CITY OF ORONO CALLED IN f INSPECTION NOTICECCL:�� �HEDULED __��� � PERMIT NO. ZC I�C COMPIEfED ADDRESS ��; �� `t `� / �/ �� ��l �''/'� ,D/2 . OWNER —��2����rn���'f�LEPHONE NO. ��`�1�/��C' CONTRACTOR �-' '' DESCRIPTION �����E�f � �/f�� / � ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL � ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLINO 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 ��INAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL _ v ❑ DEMO-SITE ❑/�E�IC INSTALL 2 OMINEAICOI�ITRACTOR TO MEET YOU:;�L YES_NO � � COMMENTS: � � C`e�� F���L ��al� /� � E�•-e�s- oK o - S. C�. � L •d ��s�<<��✓s - ��' �. � ° �� Lc�ivr!< Gbw�,����� • �sr L .L.. �,.�I�s•C — W � Q � � � � .Dl�i'Y! �i �/��/o�" J � O VMORK SATISFACTORY:PFiOCEED �iiGL1ECT COMPLEfE W ❑CORRECT WORK a PROCEED ❑ISSUE CERT1F1G1TE OF OCCUPYINCY O ❑CORRECTYMORK,C/►LL FOR REINSPECTION TEMPORARY V BEFORECOVERINQ PERMANENT ❑OORRECT UNSAFE OONDITION WITHIN HOURS_ p pH0T0 TAKEN INSPECTOR WILL RETURN ❑8TOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REWIRED.CALL TO ARRAN(iE ACCESS. CsM tor the next inspectfon 24 hours in advance. (952) 249-4600 Owne�IContrector on site: Inspector: �ti^�' Whits CaPY�nspectors Fil� c.na►1��PrfSFb Nales Carbon monoxide detector � � �� A � ���S�O ���� required within 10 Et. of ' �� ,��Q�,,���� � � ,; �.,i�E � � u ' all sleeping rooms. �" ' ' s F - A1� "rQ ����r��� rte'�a� a�K( �..� �y�r r� :�C�t I-' � � ��c� ��v������,.�� �`��`� �'����rc:� 1�1�; �, . forCo�e SM01�DETEC70R CONNECTED TO A SouNc- ) �,E �t R,���eWed of Orcno 1NCi OEVtCE OR OTHER DEfECT�R AUDlt3LE 1N C e y�k�'��,,� '� � � .-� . Comp�«��e C�� SIEEPING AREAS.�� ,��S 6 f ��: � �� F �,,. 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