HomeMy WebLinkAbout2011-00779 - roofing CITY OF ORONO PERMIT NO.: 2011-00779
2750 KELLEY PARKWAY
F ' � ORONO, MN 55356- DATE ISSUED: 08/02/2011
952 249-4600 FAX: 952 249-4616
ADDRESS : 4460 NORTH SHORE DR
PIN : 07-117-23-31-0039
LEGAL DESC : BERGQUISTS 2ND ADDN TO SAGA HI
: LOT 000 BLOCK 000
PERMIT TYPE : M[NOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ROOFING-ASPHALT
ACTIVITY : O/S BUILDING-UNDEFINED
VALUATION : $ 5,200.00
NOTE: ROOFING PERMITS ISSUED WI'I'HOUT 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 132.75
TERRANCE E[D CONSTRUCTION, INC. STATE SURCHARGE(VALUATION) 2.60
3977 GOLFVIEW DRIVE
JORDAN,MN 55352 MISC FEE 0.00
(952)492-2772 TOTAL 135.35
Minnesota State License#: 20514566
OWNER
LOMA,JOSEPH& LISA
4460 NORTH SHORE DR
MOUND, MN 55364
AGREEMENT AND SWORIv 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 separa[e
permits. Ali provisions of laws and ordinances governing 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 permi[may be
revoked at any�xne for due cause.
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A plicant P rmitee Signature Date Issued By S'g ature
SEPARATE PERMITS REQUIRED FOR WORK OTHER HAN DESCRIBED ABO E.
City of Orono
Building Permit Appiication for Internal Work
� ' � (windows, doors, siding, re-roof, etc.)
Mailing Address: Permit number:
O�v�,�0 PO Box 66
Crystal Bay, MN 55323-0066 Date received:
I.� �' ^�+'' �, Street Address: Received by:
�:.
�'�n ' ^°�� ���' 2750 Kelley Parkway Plan review fee:
L�ESH04'� Orono, MN 55356
Total Fee:
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 be submitted.
fncomplete applications will be returned. (Please print)
GENERAL INFORMATION: �
Job Site Address: �- � � G' /L� , G�c..-u. . �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 Polrce Department and City Counci!approval 60 days prior to the event. Shuttle bus service will be
required unless applicant demonstrates sufficient on-site parking rs available. Non-permitted events will not be allowed.
CONTRACTOR I APPLICANT INFORMATION:
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Name: T���r.�i.L, �. r � �„c,..�'l (s--�-yR,..,�t.�.,.����` �� n.r,
State License# ,Z � .�r-�-1 �f��(� Expiration Date 3 � �/,�
Lead Certification Number: Expiration Date: ' r'
(for work on homes thaf were constructed prior fo 1978
Phone: (office) (cell)
Maifing Address: �� 7 � ',� r' . �,�,,�. `') City: :4y. ,,,4 � ZIP: �5-�
Contact Person: � � � �' Appficant is: Contrac�o7�1 Homeowner �c�r�ie o�e�
Email and/or Fax: G� �-:�y�S- - ,�-/S G'+ ` �
PROPERTY OWNER INFORMATION:
Name: _ ;�.`,..-t ���.,v�.a..�t �.�c.-.-,�t,GA
Phone (day): �, � Z - '�.,� � _ d�=7 ct
Address: t�, � '^-r
� l�;'�% � � ,,c�..h...::��.t���.-.P..l� {�../►..t�;,wi City: � �..y,�.,.- ZIP: �_�-j (� y
Email and/or Fax �� ,�—� 1- y� �- - �,! ,��-Z,'
PROJECT INFORMATION:
Type of Project: Any earth movement may require
❑ Door(s) ❑ Remodel ❑Water Damage MCWD review&permits:
Minnehaha Creek Watershed District(MCWD}
❑Window(s) ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd
❑ Siding ❑ Restorafion ❑ Other: (specify) Deephaven, MN 55391
'�Re-roof Phone: 952-471-0590
❑ Fire Damage Fax: 952-471-0682
www.minnehahacreek.orq
Overall Project Description: J ,� ,,,,,��,
Estimated Construction Vafuation of Project (excluding land) $ -�"'�C C�
APPLICANT ACKNOWLEDGEMENT:
• Agrees to provide all information required or requested by the Building Department;
• Certifies that the informafion suppfied is true and correct to the best of his/her knowledge. The applicant recognizes that they
are solely responsibfe 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 ctassified by State law as either private or
confidential. Private data is informafion which generally cannot be given to the public but can be given to the subject of the
data. Confidential data is information which generalfy 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
re uired b law. If ou refuse to su I the information,the a fication ma not be issued.
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Applicant's Signature: "'""���Z,,��,,.�,,,� �,:��� � Date: cS� ,f/ ,�" / f
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LastUpdated: 03-01-2011 "
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CITY OF ORONO CALLED IN � Z
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PERMIT NO. 9 COMPLEfED
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OWNER TELEPHONE NO. 9�Z ��� ����
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Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
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CITY OF ORONO caLLED IN �/
INSPECTION NOTICE SCHEDULED
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Q0 FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL
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Q ❑ DEMO-SITE ❑ SEPTIC MA1NT. �OLLOW-UP
? ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER HEMOVAL
v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNbATION/REMOVAL
� 011bMER/CONTRACTOR TO MEET YOU:_YES_Np
� COAAMENTS:
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❑CORRECTUNSAFECONDITIONWITHIN HOURS. P�MANENT
INSPECTOR NRLL RERJRN �PHOTO TAKEN
❑STOP ORDEH POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANCiE ACCESS.
Cali for the next inspection 24 hours in edvance. (952) 249-4600
�wnerlContractor on site:
Inspe�t�r. _ Ca i.-- �
White CoPYAnapectoNa Flle Canary CoPY/8(te Notke