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Home My WebLink About2016-01558 - addn/remodel/repair CITY OF ORONO * z 0 1 6 - 0 1 5 5 S * t � 2750 KELLEY PARKWAY DATE ISSUED: 12/28/2016 ORONO, MN 55356- (952) 249-4600 FAX: (952) 249-4616 ADDRESS : 425 OXFORD RD PIN : OS-117-23-41-0023 LEGAL DESC : STIELOWS 2ND ADDN : LOT 002 BLOCK 001 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 70,000.00 NOTE: SEPARATE PERMITS REQU[RED: PLUMBING,MECHANICAL,FIREPLACE,ELECTRICAL(STATE) CONVERT OFFICE INTO MASTER SUITE APPLICANT PERMIT FEE SCHEDULE 873.52 GORDON JAMES CONSTRUCTION PLAN REV[EW 567.79 5159 MAIN STREET E STATE SURCHARGE(VALUATION) 35.00 P.O. BOX 306 TOTAL 1,476.31 MAPLE PLAIN, MN 55359- Payment(s) (763)479-3117 CHECK 13407 1,476.31 Minnesota State License#: BUIL-20531961 OWNER WITHROW,JOHN&JESSICA 425 OXFORD RD LONG LAKE, MN 55356- 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. / 1 L'�'1'�1� �� f �/ ��S/)b p�' ant Permite ignature Date Issued By S' ture Date � � City of Orono Building Permit Application for Maintenance / Replacement / Remodel - Residentiat ONLY (i.e. windows, door�, siding, re-roof, etc. — NO STRUCTURAL EXPANSIOIV) O MailingAddress: Permitnumber: JC-'�lr —C t�;1._�<; PO Box 66 � � Crystal Bay,MN 55323-0066 Date received: �� '- f � �� Street Address: Received by: �� y� ��C' 2750 Keiley Parkway Plan review fee: ` C'��< <{ ��ti�c � t�kESHO��G Orono,MN 55356 � _ Total Fee: / / J/ ;�/ Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us �t /�!'� This application form must be completed in full and all required information must be submitted. Incomplete applications will be returned. (P/ease print) GENERAL INFORMATION: ` ' ' � ' Job Site Address: �7 Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? Yes No If yes,a specia/event permit is required with Police Department and City Council approva160 days prior to the event. Shuttle bus service will be required unless applicant demonstrates sufficieni on-site parking is availab/e. Non-permitted events will not be al/owed. CONTRACTOR/APPLICANT INFORMATION: Name: �7l�Ut�� `AIMrS Ct��>j'�i't:.T?-�i�� State License# ��C.��,� Expiration Date: 'y�1q� �r"}. Lead Certification Number: �; �� Expiration Date: �`t'4,... (for work on homes that were consfructed prior to 1978 Phone: (cell) �S Z-�„��--Z,-�,"� (o�ce) Mailing Address: � i�X� 51�� ,�µ � �-�� .- ;� � City:g�{� ��.�� ZIP:� ��`�c� Contact Person: -T��y Applicant is: Contract r�/ Homeowner (Circle One) Email and/or Fax: ��E�`f c�,� (.�C7K>t��i -- ;y-iq.µ,«-�S. G�,'k PROPERTY OWNER INFORMATION: Name: _�'�jHt� � ti7�"�S�.�c�a 4�1' ?Nr2��J Phone(day): Address: ��"J��-�� , City: p �� ZIP:�. Email and/or Fax: PROJECT INFORMATION: Overall project description: ��,i��~f O�c'�t ,y+� ��1�r— S`��`tt, �-�'t� f�a�, Type of Project: Any earth movement may also require ❑Door(s) ,�(Remodel ❑ Fire Damage MCWD review 8�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(spec(fy) ❑Siding ❑Other:(specify) Phone: 952-471-0590 Fax: 952-471-0682 ❑Window(s) www.minnehahacreek.orq Estimated Construction Valuation of Project(excluding land) $_'�_�.s�� -- 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 govemmental agencies required by law. If ou refuse to su I the information,the a lication ma not be issued. ApplicanYs Signature: t '� Date: ��/-'��/�� Owner's Signature: Date: Last Updated:January 2016 PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS Address: `� �� /�/�C ��'� OC�C�i Permit No.: Description of work: Date Rec'd: Septic review by: �i r?��" � � ,E� �� Date Approved: ��7 l Zoning review by: Date Approved: ,,�� _ l� Building review by: Date Approved: l L � Grading review by: Date Approved: Zoning District: Zoning File#: Reso#: Reso Date: Zoning: Lot Area: ; SF/AC Width: Lot Coverage: SF % Survey Submitted: � Yes ' � No Date of Survey: __ Revised date(?): Landscape plan submitted? 0 Yes O No Landscaper: Proposed Setbacks: Front(Lake) Rear(Street) ( N S E W ) (/N S E W ) Other Buildings Wetland Side � Side Defined Height: Peak Hei�ht:�� FFE: FFE minus 6 feet= (Existing Contour) Perimeter(linear feet) = 50%6f L.F. below grade , Basement? 0 Yes 0 No, S�ories A +� FOR A BUILDING WITH A BASEMENT OR CRAWL SP,AaE: FOR A BUILDING ON A SLAB FOUNDATION: The distance between tl-�lowest proposed Slab at or above grede— START WITH floor(of the baserrment or'�rawl space)and measure from hiqhest existinq the highest point of the robf. rq ade to the highest point of the i START WITH roof even if fill was brought in to 1 elevate home. If you have a... SUBTR,4CTION • GABLE OR HIPPED R�OF(no Slab below grade—measure (BASED ON windows): Subtract hal the distance from highest existing grade to the ROOF TYPE) between the highest poi�of the roof hi hest oint of the roof. to the low point of the cor sponding If you have a... gable or hipped roof � SUBTRACTION ' GABLE OR HIPPED ROOF • GABLE OR HIPPED ROOF`(with (BASED ON (no windows): Subtract half windows): Subtract half the distance ROOF TYPE) the distance between the between the top of the highest` highest point of the roof to window and the highest point o�he the low point of the roof corresponding gable or hipped roof • ALL OTHER ROOF TYPES(flat, '� . GABLE OR HIPPED ROOF mansard,etc):No subtraction. 1 (with windows): Subtract SUBTRACTION Subtract the distance between the ` half the distance between (BASED ON basemenUcrawl space floor and the `� the top of the highest EXISTING highest existing grade adjacent to the window and the highest GRADES) foundation OR 10 feet(whichever is less). �'1. point of the roof • ALL OTHER ROOF TYPES (flat,mansard,etc):No EQUALS Defined building height �� subtraction. Defined building height EQUALS � �� 1 t Updated: October 2015 'i i z:\forms\plan review checklist 10-2015.docx I � Shoreland District MCWD Permit Average Lakeshore Setback Blufif ' Met? 0 Yes � No Permit Number: 0 Yes 0 No 0 N/A � Ye No � 0 N/A—see attached Setback: Stormwater Quality Existing Proposed Overlay District Tier Hardcover Hardcover Variance Required CUP Required circle one % and sf % and sf 0 Yes � No � Yes 0 No 1 2 3 4 5 Type(s): Type(s): Fees to be Char ed YES NO Perm it � Plan Review l� State Surcharge Investigation Fee SAC—Number of SAC Units U Other(specify) Square Foota e $ per Square Foota e Basement X = $ 15� Floor X = $ 2nd FIOo� X = $ Garage X = $ m �� Estimated Construction Value: $ �ly� �� Orono Inspections Required Work Requiring Separate Permits 0 Footing � Site Plumbing 0 Grading/Filling � Poured Wall ❑ Silt Fence/Erosion Control Mechanical 0 Fire � Foundation Survey 0 Hardcover Removal 0 Septic 0 Water Connection � Foundation Waterproofing 0 Other(specify) 0 Fireplace � Sewer Connection Framing � Masonry � Lawn Irrigation Insulation � Mfg. 0 Landscaping � As-Built Survey 0 Other(specify) Final � Lathe Required State Permits ❑ Other(specify) � Well Electrical REMARKS (in-house): OFFICIAL REMARKS -TO BE NOTED ON PERMIT AND INITIALLED: 0 See Builder Acknowledgement Form 0 Prior to release of escrow money an as-built survey and hardcover calculations must be submitted and approved. Updated: October 2015 �•\fnrmc\nlan rovic�ei rharlrliet 1f1_9(11F rinrv �� . . � � �- ,, � ��j _ -,� ..-�� y,' - OATE TIME ' CfTY OF ORONO CALL D IN INSPECTION NOTICE _CI�gSCHEDULED � ��-�� PERMR NO. %1 L I IG COMPLETED ADDRESS �--E'F� �:> � ; X:-��r�l" �,—�s� OWNER TELEPHONE NO. � `- �-7�� -�� . ��. _.. CONTRACTOR l . _ �_,i� ��C� �'� --Syc ►�:7 ^� , � DESCRIPTION `.i ^ < -y-L�i"�C-� I ty ❑ FOOTING ❑ DEMO-FINAL SEPTIC FINAL Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL 2 ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT Q ❑ FINAL ❑ WATEFI HOOK-UP ❑ FOLLOW-UP W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL _ ❑ DEMO-SITE ❑ EpTIC INSTALL v 2 OWNERlCOKTRACTOR TO EAA ET YOU: ' YES_NO -��_ ��- � � COMMENTS: L�.�c�c � �_ ' � b� �.o�� e''f � �- l� I � — ►� i�s�.L. � 0 Q �C �i ✓��w�o o��L — � � Qla��s 6do s�k� 5/,,Ja�c�s � ��c]s�� c�e/,��, � � Q J n k�C�I k i.n. C�os�e� - 2 — �C�S� �� w� — Q � W � � LD�'rcG� �-( r�� i �`?S�cL� J 4�j ❑WORK SATISFACTORY`.PROCEED O PROJECT COMPLETE ��F99RRECT WORK�Pt�OCEED ❑ISSUE CERTIFICATE OF OCCUPANCY 0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE COVERINO PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pH0T0 TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REWIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (g52) 249-4600 OwnerlCartractor on site: Inspector: ,,....�-� � '""� � `r' yyhiM CopyAnspeetor's File C�nary CopyiSlts Notfce � �� r �� / �-` � TIME � DATE CITY OF ORONO CALLED IN INSPECTION N TICE SCHEDULED L � � PERMIT NO. �-� - ^ ' � � COMPLETED ADDRESS �-� ��--_' �-�,X.��:�!'c�l i �d OWNER TELEPHONE NO. ��'� �� CONTRACTOR � , C c� c'� ��r�YVI�'�J / �/�' � DESCRIPTION c 1.�8`�� ,. � ( �-�� % ��' ty ❑ 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 _ ❑ FRAMING ❑ MECHANICAL FINAL ❑ RATED WALLS � INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT v FI AL ❑ WATER HOOK-UP ❑ FOLLOW-UP W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL _ J ❑ DEMO-SITE ❑ S�P-T1I�- INSTALL 2 O'MINERICONTRACTOR TO MF�YiOU:—1�F�_NO � COMMENTS: �� --��\ �' '�1'/G � � //��o r- �� - I'j9lsSL�s✓ .6i�f ` o — �u�s��e ex cs�� s — � - �P .6�- �' 1 rl��rC - - r�r.�: — � `v ��/ � 0 � o — W �C Q 2 � �i �5� 5cw�i�u �'Yl�/� -�- ./J�4� .dCrteL�rt�r� � �� D�- p�v�on'C .a�.f�S �/6 R �v�G 6ati � �.PG, �c;�_�J ��(�.� 6 ..d.� — 6� � �p v�r� w�+o•�l !f.,.tp ,.t� W O WORK SATiSFACTOR�F PROCEED ❑PROJECT COMPCEfE � �RRECT NfORK 8 PROCEED ❑ISSUE CERTIFlCATE OF OCCUPANCY W 0 ❑CORRECT NfORK,CALL FOR REINSPECTION TEMPORARY V BEFORE CONERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pHOTO TAKEN INSPECTOR WFLL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED �INSPECTION REWIRED.CALL TO ARRANGE ACCESS. Ca11 for the next inspection 24 hours in advance. (g52) 249-4600 OMrnerlContra on site: < � Inspector: � yyhl CopyAnspecto�'s File C�nary CopylSfte Notke .� --S ��-- ,� CITY OF ORONO cnLLED IN d� �r�l7 TIME INSPECTION OTICE � C�� SCHEDULED �' ' � PERMIT NO �" � co e ADDRESS OWNER E HONE NO. 9 -��5�� CONTRACTOR ��j � DESCRIPTION � � / �y ❑ 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 WAILS � ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT � ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP �Y ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL _ J ❑ DEMO-SITE ❑ SEPTIC INSTALL 2 dWNERlCOMTRACTOR TO MEET YW:_YES_NO y COMMENTS: � - �� e- r-�v � � 0 - e �'n �, �vl� v c.i �� O r' � G!/ � S 4• �� h � / � � /"� S -�-5 t�/� G 1.., G � Q � . /'o �l f-� /`li �� ` � � v � � � � W � J � O VMORK SATI.SFACTORY:PROCEED �PROJECT COMPLETE W ❑CORRECT WORK 3 PROCEED ❑ISSUE CERTIFlCATE OF OCCUPANCY O ❑CORRECTYIbRK,CALL FOR REINSPECTION TEMPORARY V BEFORE COMERING PERMANENT ❑CORRECT UNSAFE CONDITION WRHIN HOURS. p pH0T0 TAKEN INSPECTOR WFLL RETURN ❑STOP OROER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REWIRED.CALL TO ARRANGE ACCESS. Cal1 for the next inspection 24 hours in advance. (952) 249-4600 OwnerlContractor on site: Inspector: !� �� ' Mmns co�rn��r:Fn. C�n�ry Copyl5lts Notice . . � �t.� ,r�.•�� C L�"`�'`� �lrs-�4� ex,�}+� 1..r1 � . � �t1 f s�.�+�„�•�. ►� tJ�.t�^ N� �� r[��S LASELEC� �NO H�0411 �A'�� MA�UFF�CTU?L�, R��iVE� S�.F�TY CLA.Z�� „�. „�.16. �EQUIRED ,o�,. DEC Z � ZUt6 � sv- c• svxie� ro ir . '� 331N' � esve• C��QF�R�N� To Deck -� ..., �,� o �G � �s vr, o ' . � ��'.z�� .:�E �<�`:<°,.. IFreestnndl ' p .. . � �' ti+ ,<�� GoffeeStetion t Tub � : �.;f.�e�f�li�.�rl�i ��i�y� �� .,Y�.•'+,� � l O ��,�r, Z Z I I Flooring: ^ , ��i� Floor Transition r � i �, 2'-B"daor Tlle �'- '�Y"��`._ • : 3 __ 6 2'��' +' a•r'a e,. Y ,��i .`- �.;C_ PborTrenskion ��.�� "�`"�'�� , 5hauerdoor A i� Hinged at wall ( I 2'-8"door 2'-8"door All Glass 5hau�er ^a�b � Main Level ,,,,r ,�;. � � s : �, Walk-In G�oset �� Master 5uite � - ��°�:� ��`�`�� i .��'��.��.' - � � . �. Bedroom a Flooring:Gzvpet o �'- a+�°� , �• I I 103 SID•— Sl 15116' � � Flooring:Garpet _� P 5tairway to � ,� !Y_471Y 1341Q' Lower Level , �9�,�� - ��_� „�9„- ��,� ( � � Flooring: Garpet I I Floor Transftion 3'-0"door To Foyer r _ DESIGNED FOR lntithrow Residence Bathroom 5uite SHEET# ■ John 8 Jess Withrow A�II Measurements & 5co e of Work 5cale: , i H 1 L L D E S I G N «� 425 Oxford Road Plan � p ev To Be Yerified By Gontractor 1/4" = 1'-0" 1 Kristin Gabriel, P�KBD Orono, MN 2016-12-13