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Home My WebLink About2011-01282 - doors CITY OF ORONO PERMIT NO.: 2011-01282 2750 KELLEY PARKWAY ORONO,MN 55356- DATE ISSUED: 10/25/2011 952 249-4600 FAX: 952 249-4616 ADDRESS 3760 NORTHERN AVE PIN 17-117-23-34-0051 LEGAL DESC SOUTHVIEW ESTATES LOT 003 BLOCK 001 PERMIT TYPE : MINOR ALTERATIONS PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : DOORS ACTIVITY : O/S BUILDING-UNDEFINED VALUATION : $ 3,096.00 NOTE: REPLACE 1 ENTRY DOOR APPLICANT PERMIT FEE SCHEDULE 103.25 PELLA WINDOWS&DOORS STATE SURCHARGE(VALUATION) 1.55 15300 25TH AVE N.-SUITE# 100 PLYMOUTH,MN 55447 MISC FEE 0.00 (952)345-6047 MAIL-IN FEE 2.00 Minnesota State License#:20165884 TOTAL 106.80 OWNER QUAM,MR.&MRS.JOHN 3760 NORTHERN AVE 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 any ttiime�for due cause. � Applicant Permitee Signature Date Issued By 91n &V&Ilate SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED O . City of Orono Building Permit Application for Internal Work (windows, doors, siding, re-roof, etc.) Mailing Address: Permit number: Q PO Box 66 Crystal Bay, MN 55323-0066 Date received: z. a Received by: Street Address: GtiF 2750 Kelley Parkway Plan review fee: tyEsxogw Orono,MN 55356 Total Fee: Main: 952-249-4600 Fax: 952-249-4616 www.cLorono.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: '�l 77��3 7 d o t /1-e f n A V'? /� uc Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes _0N o 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. felon-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: J G C/! Name: J State License# Pella Windows &Doors ;5 3 S • 4 0 y Phone: 15300 25th Ave N. Ste 100 (cell) Mailing Address: Plymouth, MN 55447 ZIP: Contact Person: iomeowner (Circle One) Email and/or Fax: Lic#20165884 Ph. 763/745-1400 PROPERTY OWNER INFORMATION: Name: 0 U 4 01 Phone(day): y 7 l 7-1 (" / Address: 31 6 0 lV of / !`A � Y L City: 6)a Y7 ZIP: S 53 9/ Email and/or Fax PROJECT INFORMATION: Type of Project: Any earth movement may require MCWD review&permits oor(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 ElRe-roof El Fire Damage minnehahacreek.or Overall Project Description: Q n O n IOU /T7 0 Estimated Construction Valuation of Project(excluding Ian ) $ 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 re uired by law. If you refuse to supply the information,the application may not be issued. Applicant's Signature: -/� Date: Last Updated: 05-04-2009 OCT/19/2011/WED 02:23 AM Elder Jones Building FAX No, 952 854 4909 P, 002 City of Orono Building Permit Application for Internal Work (windows, doors, siding, re-roof, etc.) hh', Mailing Address: Permit number: O/�•' I 0`rte Crystal Say,MN 55323-0066 PO BOX 66 Date received: Street Address. Received by: Gwti 2750 Kelley Parkway Plan review fee: o�fn Orono,MN 55356 Total Fee: Main: 962-249-4600 Fax: 962-249-4616 M.U21 This application form must be completed in full and all required Information must be submitted. Incomplete applications will be returned. (Please print) GENERAL INFORMATION: �'� Nor r 1 t /i A r f /) U-C Job Site Address: 'V 7irl Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ElYes No If yes,a speolal event pennif is required with Police Department and City Council approval 60 days prior fo the event shuffle bus service will be required unless applicant demonstrates sufficient onsife parking is available. Non-pennitled events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: /p U Name: •J State license# Pella Windows&Doors 9 5� 3 y S • � o V y Phone: 15300 25th Ave N. Ste 100 cell ZIP: Mailing Address: Plymouth,MN 55447 Contact Parson: icmeow+ner ictal.anal Email and/or Fax: Lio#20165884 Pia. 763/745-1400 PROPERTY OWNER INFORMATION: Name: c,/a A n ® u A M 11 Phone(day); V 7 7 Ci : (J 4 p T ZIP: $$ g Address; 3,14 o of !`A Ir A, Email and/or Fax PROJECT INFORMATION: Type of Project: Any earth movement may require MCWD review&permits oorts) ❑ Remodel ❑Water Damage Minnehaha Creek Watershed District(MCWD) ❑Window(s) Repair Storm Damage 18202 Minnetonka Blvd Deephaven,MN 55391 ❑Siding ❑Restoration C(Other. (specify) Phone: 952-471-0590 Fax: 952-471-0682 ❑Re-roof ❑Fire Damage mi nehaha eek.or Overall Project Description: Q n d a/� a CA /114 4 Estimated Construction Valuation of Pro act(excluding Ian ) $ O L 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 appiloant recognizes that they are solely responsible for submitting a complete application being aware that upon failure to do so,the staff has no altemative 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 date 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 theapp ication ma not be issued. Applicant's Signature: -/�-� Date: ,--i nK nn--7nno OCT/19/2011/WED 02: 24 AM Elder Jones Building FAX No, 952 854 4909 P, 003 Construction Codes and Licensing Division MINNIMOTA DEPARTMENT OF Phone: (651)284.5034 Email" a.MryseOstale mn.us LABOR & ISNDUSTRY waeke: wwwA . macyvfccid.Qso ! CONSTRUCTION CODFS AND WCElNSING f PO BOX 64217 ST.PAUL,MN, 55164.0217 NOTICES LICENSE IS NOT TRANSFERABLE PELLA WINDOWS& DOORS TWIN CITIES INC CHANGE OF BUSINESS STRUCTURE 15300 25TH AVE N YOU MUST GET A NEW LICENSE STE 100 A CHANGE 1N INSURANCE POLICY PLYMOUTH, MN 55447 (REQUIRES A NEW CERTIFICATE OF INSURANCE TO BE FILED YOU MUST.NOTIFY THE DEPARTMENT OF CHANGSS IN YOUR LICENSED BUSINESS, Failure to doso, subjects you to administrative penalties of up to$10,000. 15-Dare Notification Recluirentent. licensed contractors must notify DLI in writing vaithtn 15 days of the date that any of the follomdnq changes to the license occur during the license period. Information and forms to make changos to the license are available onlino at wv_of.dfi.mn.uov/ccld/LicUodnie.asp. • Licensed business'physical street Address,phone number,and mailing address. • Change in licensed contractor's control,ownership;officers or directors. • Change in iicermed contractor's legal name and/or assumed name. • Loss of or change in Qualifying Person. Judament Debtor Notice, Licensed contractors must notify DLI in writing within 16 days of the finding that the contractor is found to boa judgment debtor based upon conduct requiring licensure per Minn.Stat.§§SWO,802 to 3266.885. r gankg:12tcy Petition_Fil'na Notice. Licensed contractors must notify DLI in writing within 15 days of filing a petition for bankruptcy. Conviction Notic¢. Ucensed contractors mustinotify DLI in writing within 10 days if the licensee has been found,guilty of a Felony, gross misdemeanor,misdemeanor,or any comparable offense related to residential contracting,including convictions of fraud, misrepresentation,misuse of funds,theft,criminal sexua;conduct,assault,burglary,conversion of funds,or theft of proceeds in this or any other state or any other United States jurisdiction. Your license certificate is below the perforation. Show license certificate to when obtaining building permits Construction Codes and Licensing Division • ,Py, ealNrvy'R E pgtoA�g7T ST Or Telephone: (651)2845034• '•' LABOR 8c INbUST�i.Y' cbrWAUC1'ION 40ow^NO ucraNumo E-mail address: di,Iicense@state,mn.us t vo max 64217 .o. gr.pwuL,MN, Sol 64 oats Website address: WW%1V.dl1,MrI,72v/Cqld-092 RESIDENTIAL BUILDING CONTRACTOR LICENSE Lo-gal Name: PELLA WINDOWS& DOORS TWIN CITIES INC Business Structure: DB,k- CORPORATION Addross: 15300 25TI-I AVE N STE 100 PLYMOUTH, MN 5544.7 License Identification Number: 20165884 License Expiration Date: 03131/2013 Qualifying Person: DOUGLAS L PALMER OCT/19/2011/WED 02: 23 AIS Elder Jones Building FAX No, 952 854 4909 P, 001 1120 East W Streak Ste•0211;Bloomington,MN 55420 Elder Jones Bldg. 852-345-6047--Dired 952.8154.4909-Fax Inc.Permit Service, Fax Toa Orono, City of Attn: Bldg. Dept From; Faic 952-249-4616 Pages! Phone 952 24900 Dater IRe: Building Permits) CC: ❑Urgent ❑ For Review ❑Please Comment X Please Reply ❑Please Recycle •Commentsi Please call when the permit fee(s)'have been figures. So I can out a check and coa city to pick up the permits). Thank You, do r1 I ell 952-345-6047 �SJOZ �pG I L DATE TIME L CITY OF ORONO CALLED IN INSPECTION NOTI E SCHEDULED -- r1 PERMIT NO.o1D/ D/,2R 2-COMPLETED ADDRESS 3aO OWNER TELEPHONE No 2 CONTRACTOR P�2� DESCRIPTION � ❑ FOOTING El PLUMBING FINAL ElEXCAV/GRADING/FILLING Q El POURED WALL ❑ MECHANICAL RI ❑ LAKES HORE/WETLANDS ❑ FRAMING ❑ MECHANICAL FINAL O ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS I ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP Q ? ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL OWNERICONTRACTOR TO MEET YOU:_YES_NO COMMENTS: CC W Q_ CC J O cc O W W C Q Z W W CZ j d WW [IWORK SATISFACTORY:PROCEED PROJECTCOMPLETE W ❑CORRECT WORK&PROCEED IS UE CERTIFICATE OF OCCUPANCY ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY U 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. White CopylInspector's File Canary CopylSite Notice