HomeMy WebLinkAbout2010-01033 - roofing CITY OF ORONO PERMIT NO.: 2010-01033
2750 KELLEY PARKWAY
J
ORONO, MN 55356- DATE ISSUED: 10/20/2010
952 249-4600 FAX: 952 249-4616
ADDRESS : 591 NORTH STREAM RD
PIN : 25-118-23-34-0004
LEGAL DESC : NORTH STREAM
: LOT 001 BLOCK 001
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ROOFING-ASPHALT
ACTIVITY : O/S BUILDING-UNDEFINED
VALUATION : $ 17,000.00
APPLICANT PERMIT FEE SCHEDULE 295.00
FOSS EXTERIORS LLC STATE SURCHARGE(VALUATION) 8.50
1891 SANDBAR CIRCLE
WACONIA,MN 55387 MISC FEE 0.00
(612)229-8619 TOTAL 303.50
Minnesota State License#:20438042
OWNER
PEARCE,DAVID&SUSAN
591 NORTH STREAM RD
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 separate
permits. All 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 permit may be
revoked at;=a e.
Applicata Pe ee 942a Date Issued By Ahature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
City of Orono
Building Permit Application for Internal Work
(windows, doors, siding, re-roof, etc.)
Mailing Address: Permit number:
Og,D,�O PO Box 66
Crystal Bay, MN 55323-0066 Date received:
Street Address:
Received by:
2750 Kelley Parkway Plan review fee:
t`�kEsso4`� 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.
Incomplete applications will be returned. (Please print)
GENERAL INFORMATION:
Job Site Address:
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 Aille
required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed.
CONTRACTOR/APPLICANT INFORMATION:
Name: x5 LAX{BIZ l o/L S LLC.
State License# 2a�/3`6b�2_ Expiration Date: ,2.9/i
Phone: 612- 222 9-G(I (office) (cell)
Mailing Address: C—IL city: sf ZIP: 5S 3
Contact Person: T;:-,?.- Applicant is: ontra r ! Homeowner (Circle One)
Email and/or Fax: j,2z- Fb &k461z.r6C6u,_
PROPERTY OWNER INFORMATION:
Name: .L lq /� -t,-'
Phone (day): L( 7
Address: ��l�z City: ZIP:
Email and/or Fax
PROJECT INFORMATION:
Type of Project: Any earth movement may require
MCWD review&permits
❑ Door(s) ❑ Remodel ❑Water Damage
Minnehaha Creek Watershed District(MCWD)
❑Window(s) ❑ Repair ❑ Storm Damage 18202 Minnetonka Blvd
Deephaven, MN 55391
❑ Siding ❑ Restoration ❑ Other: (specify) Phone: 952-471-0590
Fax: 952-471-0682
Re-roof ❑ Fire Damage www.minnehahacreek g
Overall Project Description:
Estimated Construction Valuation of Project(excluding land) $
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 you refuse to supply the information,the application may not be issued.
Applicant's Signature: 6 Date:
Last Updated: 05-04-2009
TIME
CITY OF ORONO 40 / 0 33 CALLED IN l�
INSPECTION NOTI SCHEDULED
PERMIT NO. COMPUTED
ADDRESS
OWNER TELEPHONE N0
CONTRACTOR Q S 7C
DESCRIPTION A rv �
tu El FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHOREIWETLANDS
h ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL
Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
v ❑ PLUMBINGRI SE IN L ❑ FOUNDATIOWREMOVAL
OWNER/ NTRACTOR TO MEET YOU: YES NO
y COMMENTS:
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UjDg IMRK SATISFACTORY:PROCEED 11 PROJECTCOMPLETE
W ❑CO ECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contractor on site:
Inspector. AI
White Copyllnspector's File Canary Copy/Site Notice
t�D TIME
CITY OF ORONO CALLED IN /d
INSPECTION Q E 33 SCHEDULED
PERMIT NO. lJ COMPLETED
ADDRESS e -
OWNER TELEPHONE NO.
CONTRACTOR SSfei(2t
DESCRIPTION
16.
❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ElPOURED WALL ❑ MECHANICAL RI El LAKESHORENVETLANDS
h ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL
❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATIOWREMOVAL
OWNERICONTRACTOR TO MEET YOU:_YES_NO
cam., COMMENTS:
W
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W
W
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Q
W
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4j ❑WORK SATISFACTORY:PROCEED 9OJECTCOMPLETE
W ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contractor on site:
Inspector. 4lm
White Copylinspector's File Canary Copy/Slte Notice