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Home My WebLink About2016-01418 - windows R CITY OF ORONO * Z PJ 1 6 — PJ 1 4 1 8 2750 KELLEY PARKWAY DATE ISSUED: 11/14/2016 ORONO, MN 55356- (9.52) 249-4600 FAX: (952)249-4616 ADDRESS 245 OLD CRYSTAL BAY RD N PIN 33-118-23-31-0012 LEGAL DESC CLAIRE ADDN LOT 002 BLOCK 001 PERMIT TYPE MINOR ALTERATIONS PROPERTY TYPE RESIDENTIAL CONSTRUCTION TYPE WINDOWS ACTIVITY O/S BUILDING-UNDEFINED VALUATION $ 4,970.00 NOTE: WINDOW REPLACEMENT APPLICANT PERMIT FEE SCHEDULE 123.87 STATE SURCHARGE(VALUATION) 2.49 PELLA NORTHLAND TOTAL 126.36 15300 25TH AVE N.-SUITE# 100 Payment(s) PLYMOUTH,MN 55447- I CHECK 76501 126.36 (952)345-6047 Minnesota State License#:BUIL-BC645090 OWNER WELLS FARGO BANK MN N A THOMAS C ALDRICH RE0043993 6TH&MARQUETTE MAC N9305 MINNEAPOLIS,MN 55479- 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 time for due cause. 'k ) 4 Applicant Permitee Signature Date Issued ByoSignature Date City of Orono Building Permit Application for Maintenance / Replacement / Remodel — Residential ONLY (i.e. windows, doors, siding, re-roof, etc. – NO STRUCTURAL EXPANSION) Mailing Address: _D� l Permit number: p� � O PO Box 66 r RECEIVEaystal Bay, MN 55323-0066 Date received: ' Street Address: Received by: ti NOV 1 4 ZGJE 750 Kelley Parkway Plan review fee: tgkESti04'� — G Orono, MN 55356 Total Fee: Main: 952-2, tTMIDF ORQN052-249-4616 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 4i j Ofd ^r v S / 8Q y RO Q / Job Site Address: (. .-�C Q ( V Will this be a Parade of Homes, Remodelers Sho case Home or othet 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 will be required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: State License# Pella Northland Expiration Date: Lead Certification Numbe 15300 25th Ave N. Ste 100 Expiration Date: (for work on homes tha Plymouth, MN 55447 Phone: (cell) Lic# BC645090 Ph. 763/745-1400 ffice) Mailing Address: ZIP: Contact Person: Applicant'&, Contractor / Homeowner (Circle One) Email and/or Fax: �, p �f�'s ca e d t E go /) t5 . ( OM PROPERTY OWNER INFORMATION: Name: —Fp M (' j ( (, Phone (day): QS'9 117 S . 10 7 j Address: 2 y S 0j Y b4 G ` ,Ba y /Qd N . City: 6`o A U ZIP: Email and/or Fax: PROJECT INFORMATION: Overall project description: Type of Project: Any earth movement may also require ❑ Door(s) ❑ Remodel ❑ Fire Damage MCWD review&permits: ❑ Re-roof,asphalt ❑ Repair ❑ Storm Damage Minnehaha Creek Watershed District(MCWD) 15320 Minnetonka Blvd ❑ Re-roof,cedar ❑ Restoration ❑Water Damage Minnetonka, MN 55345 ❑ Re-roof,other(specify) ❑ Siding ❑Other: (specify) Phone: 952471-0590 Fax: 952-471-0682 Window(s) www.minnehahacreek.org 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, t application may not be issued. Applicant's Signature Date: /1 /7 It Owner's Signature: Date: Last Updated:January 2016 1 C/ DATE TIMf/ CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED PERMIT NO. L `lL ' COMPLETED r ADDRESS y� OWNER TELEPHONE NO. 7 CONTRACTOR �—�� Dry►/ate DESCRIPTION W ❑ 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 ❑ RATED WALLS ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL ❑'6EMO,-SITE ❑ ?EPTIC INSTALL OMIN NTRACTOR TO MEET YOU- r YES_NO r.� C�' OMMENTS: QC QC OO W W W ❑WORK SATISFACTORY PROCEEDPROJECTCOMPLETE Qr. ❑CORRECT WORK 3 PROCEED ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 Owner/Contractor on site.. Inspector. L 4 'A1 White Copy/Inspector's File Canary Copy/Site Notice