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HomeMy WebLinkAbout2015-00353 - addn/remodel/repair " � � CITY OF ORONO * 2 0 1 5 - 0 0 3 5 3 * 2750 KELLEY PARKWA►Y DATE ISSUED: 04/03/2015 ORONO,MN 55356- 952 249-4600 FAX: 952 249-4616 ADDRESS : 4215 NORTH SHORE DR PIN : 07-117-23-43-0006 LEGAL DESC : ORCHARD BEACH : LOT 002 BLOCK 000 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTMTY : 434-RESIDENTIAL VALUATION : $ 80,000.00 NOTE: SEPARATE PERMITS REQUIRED: PLUMBING,MECHANICAL,ELECTRICAL(STATE) (KITCHEN REMODEL) APPLICANT PERMIT FEE SCHEDULE 952.24 STATE SURCHARGE(VALUATION) 40.00 MALESKA CUSTOM BUILDERS TOTAL 992.24 10282 HAWTHORNE RD NW Payment(s) RICE,MN 56367- CREDIT CARD 4031 992.24 (320)251-7898 Minnesota State License#:BUIL-BC109531 OWNER WALDOCH,DOUGLAS&DIANE 4215 NORTH SHORE DR MOLTND,MN 55364 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. 1'his 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.l'his 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. 1'he appiicant 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. � /� J/� Applicant e itee Signature Date ssue y Signature Date � . �ga , �-� City of Orono Building Permit Application for Maintenance / Replacement / Remodel . �. ;� . .:� .�,_ . . � _ :.� �s'i.a 4..��.';.st,L ,.:�..e •e � ` -_-, : - . _. � . �. _ �. �. - _ . � . . _�.... . �.� ..__. � O Mailing Address: lr` 7 Permit number: ``' — � �TO PO Box 66 L� ��\ 1 __ Crystal Bay, MN 55323-0066 Date received: � � Street Address: �� e�� ti� � 2750 Kelley Parkw y� L � r,-1 Plan review fee: 9C�� • t � Orono, MN 55356 Z�< < �KfSH��� Total Fee: Main: 952-249�600 Fax: 952-249-4616 ��:�r u= This application form must be completed in full and all required information must be submitted. Incomplete applications will be returned. (Please print) GENERAL INFORMATION: , ,� l Job Site Address: ����' °V '7�1���G �'�C ��v�� V� 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. Shutt/e bus service will be required unless applicant demonstrates sufiicient on-site parking is availab/e. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFOR�ATION: _, Name: r� ��'�� c� v����-t.h -,���i ��C�r-S State License# L �' "�3 ' Expiration Date: .3 --�) —) �� Lead Certification Number: Expiration Date: (for work on homes that were constructed prior to 1978 Phone: (cell) (office) �� "�>) - �`� � Mailing Address: � �j'� ,�;, ,�� ,��� City: '' : ZIP: � '� � Contact Person: ' Applicant is�__Contractor:�/ Homeowner (Circle One) Email and/or Fax: � ��-,r� � �✓ :j� t-�,��� PROPERTY OWNER INFORMATION: � �,�c ` A 1�'� Name: ; r:, . ;;1,� , V� Phone(day): � — � Q " � 2.� n Address: ��) `~j U�-�'h S��(. /�,�, ✓�P City: �����,,�yil ZIP: �S �J(-�� Email and/or Fax: PROJECT INFORMATION: Overall ro�ect description: Type of Project: � Any earth movement may also require ��'�'��'��►"'� MCWD review&permits: ❑ Door(s) �.Remodel ❑ Fire Damage ❑ Re-roof,asphalt ❑ Repair ❑ Storm Damage Minnehaha Creek Watershed District(MCWD) 18202 Minnetonka Blvd ❑ Re-roof, cedar ❑ Restoration ❑Water Damage Deephaven, MN 55391 ❑ Re-roof, other(specify) ❑ Siding ❑ Other: (specify) Phone: 952-471-0590 Fax: 952-471-0682 ❑Window(s) ^;�rr�v.m�nnenahacreek.orq Estimated Construction Valuation of Project(excluding land) $ ? 7� 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 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: 63� � �/5 � � 1 � Owner's Signature: �Ll 1-,! �,�(i�i ,�(�(:�Y'1 Date: ;l�(i��/`) Last Updated:January 2015 : _ ; r . . ��� ��v��w ���c��'��r ��� ��� ���uc����� � �����on�s � Adc6res�: `�� !,� ������3'S'�� ��a� Permit No.:_��� m ����'� : � . I Descri�sti�n of v�ork: �� t; �, Da#e R�c'd: �����l�' _ , . S�p�ic revi�wr b�►: 6�� D�t��lppr�ved: : _ Zon6n�r�view by. � � ,�,_' D�4e Appraveci. Builc�ing redie�nv I�y: Date�Pr�v�d: � f �� - � o��. , �r�dfng"review bY: ��'� � D�te Approved: ; _ � ; Zanie�g Disfirict:, Zoni�ng �il�#: R�so#; Reso Dat�: �' Z�n g:Lot l�r�: �F!AC Width:��� ; Lot Coverage: SF `% ; ' �urvey ubrriiif�: 0 Yes : � No Da�e cef'Survey: Revised dat ? : Pro osee� b�cicsr. _ : � �ront(��6s� F2ear(�treet) � :�d � E W � f; A1 S E W ) 0�her.�uildin �letl�nc9 Sid� ,- . S1d� ' �ef�n�d Height: Peak He6ght:�, .;F��: - F�IE minua�fee; = (F�ci$�in�Corstoa�r � E�erprn�ter{lin�a°f�t)m 50°l0= r l� . belaw gr�d� �of 5tories ` �OR A BUILDI6VG V►11TH/A��EAIIEId'I'OFt W�SPA.CE: �OR A'BUILDIRIG 0(� SLL�F011IdD,�Tl0�1: The dfstan een the lowest proposed - The dfstance tietvreen the top of START W ITH 'floar(of the b� ment or crauuF.space)and START W ITH stab ar�d the highest polnt o'f the � , #he Mfghest polnt the roaf. . : roof. < ', ff you have a... tf'you have a... GABLE OR HI�'P RAOF(no ' • 'GABLE OR HtPPED ROOF � � wiritlows): Subtra alf the tlfstance (no windows): Subtract haff betweert the highest nt of the roof fhe distance ltetw8en t�te W the;Ipw poini of�e co.espondirtg hlghest,point of the roof to flte lowi potnt of the SUg'fRACTI�N gabte or hipped-rAof corresponding gabie or (BASEE)ON . GABiE OR HIPPED ROOF( ' SUBTRACTION hipped roof i ROOF TYPE) windows): Su6tract haif the dis ce {BAS�D ON �� GABLE OR FffPPED ROOF =i between#he'top of fhe Mighest � ; ` ROQF TYPE) (w3tfi wfrtdows): Subtract ;- wlndow and 3he hfghest point of , heif the distance between . , roof ; - tl�e tnp�of the highest , • ALL OTHER ROOF-TYPES windovr ar�c9 the highest mansard,etc}:No subtra n. ' Point of the roof + ALL 0'T'HER ftOOF TYPES , SUB7RACTION SubVacf the dis#a��betw the (flat,mansard,etc):'No ' (BASED OM basement/erawl space r and the ' ` ' subhaa on. EXISTING hl9hest e�sthtg grade jacenf to the AUDITION Adc1 the dlstance between t�1e fop: ' GRADES) ` four�daUon OR 10 f (wfiich�ver is fes�). ,: (BAS�D QN ` of slab anrl the highest existlng, EQU/1L3 ` peflned'bu01d1 heigMt EXISTING grade adJacent to the foundaUon. . ,. ;:: ; . GRADES , , = ':; ELIUJILS Defined building�aeight s�hore9and D#stric� tdIC1�YD�'en�ei:t �►verage L�Ic��hore tbaa� �IufF 119�t? ,: � Yes � N Perntit hlumb�r. � Yes � 'No '[] q Yes � 'No , ` � N/A-see a�tached ' ` ; Setbaak: .. 3taemarater C� lit�r �isfile�g iiarticover Prapo��d f)verlay D rict o F9�rd�over Vaeianc�r R�talre¢d, �Requir�d ! Ti�r ci e one (/°an�� °/a and : � � Yes � No C� Yes � No i - , , ! 1 ' 2 3 4 5 : ;. , T Y P e{s}: ' T y p e(s); . , ( lipdated: January20�5 � z:\forms�plan revieRw checklist 2015.docx I ' . _ ! f�"�;: '� r'�x�:{,,�4�' a�'�a�`"'�",.� ri uy }b �=c ..n4i���R""�'��i"f�'76a`�F,a4>"G �a�„+��� � �:;s�'�`�9�,f,;�a 'rv�%``F A� �"-, ac.t�L.S �(•,S+'t a .jr�{�n,t-S w',�1i �j� �' �. �,'� �`^�� ;��� � '� ,. s +�.,���; „�Y a� y n rT,a� s�ti f :� f :. :� tz �� � t -�' �.a .:,� '��;� F t �,. �; r i � a �.:�4 5 �., �,�;yf"��� 2 �.s. u,� s !� � kr�,� � a'��.�,�"'�t� 7 � s t- X�'i.�j a �t�: r�a % ti � . v�,. -�� z�: *AG r�c t t�# i �4' V3°zi� }}�,��e�" �c; �,,�„� -. ��'�+� 'C {t `�� €»I^i M, r�Cr�ak � 3. F � � , �" 1 "- �f p �'j.v t x I �� L4� A � -z"H � � � {F�"^'z1 l � '� /yy y,�,,w � t U + � f�s ai�,���S+:.�a°��i`.�f;°I y � 5 i 4� r, �*�� 'fi:. 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W � Q 2 �j K 7,J C'�c./ W � W � 1 � GW �QRK SATISFACTORY:PROCEED �PROJECT COMPLETE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W � ❑CORRECT WORK,CALL FOR REtNSPECTION TEMPORARY V BEFORE CWERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN INSPECTOR WFLL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (952� 249-46�� OwnerlContractor on site: Inspector. Q i� White Copyllnspector's Ffle Canary CopylSite Notice �/" I ���t DATE `�E: �CITY OF ORONO CALLED IN / — � V INSPECTION NOT�I�C„E SCHEDULED 7-! �O-� � PERMIT NO. O�J�S-��S.�OMPLETED ADDRESS �T�� / v � J -DV� I/�-�- OWNER ���� �E��PHONE N� '�- '7 CONTRACTOR l��'�� � DESCRIPTION ��C�T.C� � %���-C lL ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING O ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL J ❑ DEMO-SITE ❑ SEPTIC INSTALL ❑ FOUNDATION/REMOVAL 2 OWNERICONTRACTOR TO MEEf YOU:_YES_NO c�.� COMMENTS: � LC �G.-� !�jYl G�'� Sa��-' � � a � � O �. � O � W � Q � 2 W � W � j a W O WORK SA7ISFACTORY:PROCEED PROJECT COMPLEfE � ❑ CORRECT WORK 8 PROCEED O SUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECWERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p PHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Cail for the next inspection 24 hours advanc 9 Z -46�� OwnerlContractor on site: � Inspector. White Copyflnspector's File Canary CopylSite Notice