HomeMy WebLinkAbout1996-008444 - bathroom remodel �` PERMIT
� CITY OF ORONO .
PERMIT TYPE:
2750 Kelley Parkway- P.O. Box 66 E,:1 T[_f:j��i�
Crystal Bay, Minnesota 55323 Permit Number: {�{ya;�,���
(612)473-7357 Date Issued: �#}�{y,Y;�,��
SITE ADDRESS: ;
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DESCRIPTION:
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REMARKS:
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FEE SUMMARY:
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CONTRACTOR: — �����1 �r��-�t. — OWNER:
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APPUCANT%PERMITEESIGNATURE SSUEDBY:SIGNATURE �t�C�.IL�
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' Total Fee: $ �/Jp.5% Date Received: � '�� ; g
Entered By: _�-� Permit#: �'������/
CITY OF ORONO - BUILDING PERNIIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
-------------------------
THE APPLICANT IS: (circle one) OWNER OR C CTO �
JOB SITE ADDRESS: '�` � ���� � �����'� ZIP: ��� �O 4-
NAME OF OWNER: �D�}� j l I I� V U� PHONE: (home) ��� -'��Q �
work)
MAILING ADDRESS: 1�`� ���� � �V� CITY: �,�,G��/1 ZIP: C ��
CONTRACTOR: ��,lJ�G V PHONE: �'> 3 .' C'�j�.�"
CONTACT PERSON: G�I��Q � MOBILE/PAGE :
MAILING ADDRESS: � u' �F - � CITY: '' ��,��I�tiS �� � ZIP: ��� � c�'
STATE LICENSE: # ����''
ARCHITECT/ENGINEER: ,1 �1 PHONE:
MAILING ADDRESS: ���}��- _ CITY: ZIP:
I�JAME; REGISTRATION#
TYPE OF WORK: New Addition Accessory Structure
Move Remodel/Alteration ✓ Land Alteration
PROPOSED WORK(describe in detain: � �� V��00�'►� V�'VVlO� � �
STORIES: SQ. FEET OF EACH FLOOR:
NO. OF BEDROOMS: GARAGE STALLS: ATT. DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ ,�� (� . _
I hereby apply for a building permit and I acknowledge that the information above is complete and
accurate; that the work will be in conformance with the ordinances and codes of the City and with
the State Building Code; that I understand this is not a permit and work is not to start without a
permit; and that the work will be in accordance with the approved plan.
APPLICANT'S SIGNATURE: l���;�`_ DAT'E: � � a�- I a,�
NOTE! Parade of Homes events require separate permit approval by Police Department and
City Counci160 days prior to the event. Non permitted events will not be allowed.
6
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Sec.13.04 RIGHTS OF SLJBJECTS OF DATA
Subd. 1. Type of data. The righcs of individual on whom the dara is stored or to be stored shall be as set forth in this secdon.
Subd.2. Information required to be given iadividual. An individuai asked to suppiy private or confidendal data concerniag himself shall
be informed of: (a)the purpose and incended use of the requested dara within the collecting§tate agency,poGdcal subdivision,or sta[ewide system;
(b)whether he may retux or is legally roquired to supply the requested data;(c)any imown consequence arising from his supplying or refitsing to supply
privace or confidenaal data;and(d)rhe idendry of other peaons or enades authorized by state or federal law to receive the data. This requirement shall
not apply when an individual is asked to supply invesdgadve dard, pursuant to secdon 13.82,subdivision 5,to a law enforcement officer.
The commissioner of revenue mav piace the nodce required under this subdivision in the individual income tax or vroaertv tax refund
insaucaons instead of on those forms.
Subd.3. Access to data by individual. Upon request to a responsible authoriry,an individual shall be informed whether he is the subject
of stored dara on individuals,and whecher it is classified as public, private or co�dendal. Upon his further request,an individual who is the subject
of stoced private or public data on individuats shall be shown the data wichout any charge to him and:if he desires, shall be informed of the conten[
and meaning of[hat data. After an individual has been shown[he priva[e data and informed of its meaning,the data need not be disclosed to him for
six months thereafter uniess a dispute or accion pursuant to this section is pending or addidonal data on the individual has been collecud or created.
The responsible authority shall provide copies of the private or pubiic data upon request by the individual subject of the data. The responsible authoriry
may require the requesting person to pay the actual cosu of making,cemfying,and compiling the copies.
The responsible authority shatl comply immediacely, if possible, with any requesc made punuant to this subdivision,or within five days of
the date of ihe request,excluding Saturdays,Sundays and legal holidays,if immediate compliance is not possible. If he cannoc comply with the reques[
within that time,he shall so inform the individual,and may have an addidonal Five days within which to comply with the request,excluding SaNrdays,
Sundays and legal holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private
data concerning himself. To exercise this right,an individual shall notify in writing the responsible authoriry describing the nature of the disagreement.
The responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to nodfy past cecipiena of
inaccurate or incomplete data,including recipients named by the individual;or(b)nodfy the individuat that he believes the data to be correct. Data
in dispuu shail be disclosed only if the individual's statement of disagreement is included with the disclosed data.
The determinadon of the responsible authoriry may be appealed pursuant to the provisions of the administradve procedure act relatiag to
contested cases.
DATA PRNACY ADVISORY
In accordance with M.S. 13.04, Subd.2, "Rights of subjects of data", we would like to inform you that your request
for a pemut or license from the City of Orono or any of its departments may require you to fumish certain private or
confidential information.
You are notified that:
1. The information you furnish will be used to detemune your qualification for the permit or license requested.
2. You may refuse to supply data, but refusal may require that the City deny the permit or license.
3. The information may be shazed with other local, state or federal agencies to the extent necessary to process
the permit or license.
4. If your requested pernut or license requires Council action to approve, some information may become
public.
5. You have certain rights under M.S. 13.04 (available upon request) to review private data on yourself.
6. Your full name is required to process this application or permit.
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Fi t Middie Last
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P���b�nsd��P Ml� �5�-Y 53 3-03��--
City State Z�p Phone
I understand my 'ghts s ted above.
Signantre
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CHECK OFF LIST FOR ISSUANCE OF PERMITS
FOR OFFICE USE ONLY
ADDRESS OR LEGAL: -
PID• , � � _
DESCRIPTION OF WORK: ,' �,� i -
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ZONING REVIEV�J BY: ,i1/ /�'; DATE APPROVED:
BUILDING REVIEW BY: Q��,�,w,,__ DATE APPROVED• � '
-------------------------------------------�--------------------------------------------------------,----3---��--
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERMIT Yes J� No
PLAN REVIEW Yes �' No SEWER CONNECT'ION
STATE SURCHARGE Yes �;,s No WATER CONNECTION
INVESTIGATION FEE Yes No PARK FEE
SAC Yes No SITEINSPECTION
Number of SAC Units OTHER (specify)
------------------------------------------------------------------------------------------------------------------------
ZONING CHECK LIST Zoning District:
Fire Department: Post Qffice: School District:
Lot Area: Sq.ft. Acres Width Depth
Survey Submitted: Yes No Date of Survey:
Proposed Setbacks:
Front (Lake): Right Side:
Rear (Street): Left Side:
� � Adjacent Structures: Wetland:
:
� ���� Building Height: Def. Hgt. Peak Hgt.
�� � Lot Coverage:
Grading: Staff Approval Date: By: Council Approval Date:
Septic: Staff Approval Date: By:
Zoning File: # Resolution: # Resolution Date:
Shoreland District:
Avg. Setback: Bluff Setback:
Existing Proposed
Hardcover: 0-75'
75-250'
250-500'
� 500-1000'
� Hardcover Variance Required: Yes No Date of Council Approval:
�2EMARKS (in house):
10
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BUII.,DING REVIEW CHECK LIST
uBc: ,�.- 3 co�rs�-xucTTo�v �E: ��
Sq Foota�e S Per Sq Ft�
Basement x =
lst Floor x =
2nd Floor x =
Garage x =
x =
TOTAL
fj•.'
Estimated Construction Value: $ r�;�'`�"
Inspections Required: Work Requiring Separate Permits:
Site � Plumbing Fire
Hardcover Removal Mechanical Water Connection
Footing Sep[ic Sewer Connection
u( Framing Fireplace Lawn Irrigation
_� Insulation (Masonry) Other
�_ Wall Board (Mfg.) Well (State Pemut)
,r—Final Grading/Filling �' Electrical (State Permit)
Other
REMARKS (IN HOUSE):
REVIEW BY OTHERS: DATE:
Access: Existing New
Access Approval: Date BY�
RENIARKS(TO BE NOTED ON PERi'�IIT):
27 �
Jo,hn & Nora Sillerud, �. �ate: 9/27/96
� 1415 Park Drive
Mound, MN
"' " � ' 55364
Job# 1059 .
--------------`'-----------�-�---------------------------
[ ] SCOPE OF PROJECT: Bathroom remodei
�� �
1. Remove and dispose of existing bathroom window, frame in opening,
_ . insulate, and patch both surfaces of wall "ilush"with similar
finishing materials. Match existing A.C.A.P.
[ ] Owner to remove%dispose existing vanities, countertops, sinks
&faucets. Owner to remove/dispose sheetrock at walls. ,
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[ ] Owner to remove/dispose of existing shower door, faucets,,&
ceramic tile at shower floor &walls.
2. Existing do,Qrs to re�nain, protect as needed.
3. Cut opening in existing wall for new door. � � �
1'0"x6'8"flush oak prehung door ,
* Rough opening: 1'2" x 6'101/2"
* Jamb size: 4 9/16" due to existing 2x4 walls.
* Door swing per plan � ,
* Hardware: Weiser B-3 "Beverly" passage set
* Trim: Oak ranch casing, stained by OWNER.
[ ] INSULATION — Wall insulation shall be R-13 friction fit fiberglass.
[ ] ' DRYWALL — 1/2" gypsum board over wall studs with taping
process, sanded smooth for owners,' finish.
— 5/8' gypsurrr board for all ceiling/soffit applications
with taping process and "flat skim coat" finish.
[ ] "' CERAMIC TILE per plan�and tbe following allowances for materials:
Floor tile: $4.00/ S.F. �
,
Wall tile: $3.00/ S.F. " ' '
Feature pieces: NONE/ LF.
,; Any changes to the abo�e quantities will be charges or credited.
•. [ ] Supply and install MEDICINE CABINET (Material ALLOWANCE of$150).
[ J TOWEL BARS/TISSUE HOLDER allowance of $50.00 per bath.
[ ] SHOWER DOOR shall be a BASCO pivot w/fixed glass side panel
, made of e�ctruded �luminum chror�e finish with "obscure" safety glass. �
[ ] Install two'�8SF plate glass mirrors with pencil edge & mirror clips
If! i� �� �
. 1
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� � Sillerud SPEC'S pg 2 of 2
. --------------------------------------------------
� ( ] CABINETRY shall be manufactured componets by DESIGN LINE.
Bath cabinets:
* Style: Designer series; "SWEVA"
* Exterior style &finish: Birch, Handwiped "Aspen White", low sheen
* Interior finish: woodgrain vinyl
* Hardware: $3.00 per pull
[ ] CULTURED MARBLE shall be"white—on—white" colored marble w/
3" integral backsplash and "oval" shaped bowl, faucet drill 4" o.c.
[ ] MECHANICAL per contract:
' * Vent exhaust b�th fans " �
[ ] PLUMBING per contract and the following:
� ALL fixtures to be "white"'.
Shower: �
* Faucet: DELTA#1524 chrome single handle
Tub/Shower: -
* Manufacturer: Kohler
* Model: Villager #K-715
* Color: White, cast iron
* Faucet: Delta#1548 Chrome single handle
Lavatories:
* Faucet: DEL�'A#520 chrome single handle
„ ,,
Stools: ,
* Manufa�turer: pCohler '
* Model: Wellworth Lite#K-3420/21 , ,
* Color: White, with chrome lever �
[ ] ELECTRIC per contract:
* ALL FIXTURES, if on job�site at electrical finish are furnished
by owner (UL listed), installed by Sawhorse.
(Sawhorse to supply & install recessed cans.)
* Switch and outlets to be"IVORY" color.
* NO smoke detector is inccluded in this contract, but may have
to be added depending on the condition of your existing detectors.
** Note: you have been charged in this contract for the following:
4 — light fixtures removed
3 — light openings removed
2 — existing outlets converted to GFI
2 — ground fault interrupter"GFI" receptacle
3 — standard switches
1 — recessed light opening (H7—ICAT fixture included)
, ,, � ,
�. ,� �
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, _ Sillerud SPEC'S pg 3 of 3
--------------------------------------------------
[ ] ELECTRICAL CONTINUES...
1 — shower trim
2 — assembled fi�ctures supplied by owner, installed by Sawhorse
2 — NUTONE QT80cfin exhaust fa�
Any changes to the above quantities will be charged or credited.
� '� GENERAL NOTES
[ ] CAUTION:
�; Do NOT remove or tear down anything before building
permit is on job site. -
[] OWNER to protect or move all personal property from in or around
- construction area, both interior and exterior. Please review
area before construction start—up and remove neccessary items.
[ ] OWNER DIRECT"Not Included in Contract" ITEMS:
SAWHORSE to assist in schedule coordination
* All painting, staining and decorating by OWNER.
* LIGHT FIkTURES (excluding recessed fixture) "'
� * SMOK� DETE�TORS in existing spaces '
* Modifications to public utilities
* ABATEMENTS (lead or asbestos) '
* Corrections of existing substandard conditions
(structural or mechanical)
(Owner is responsible for all N.I.C. obligations:,
selections, schedule, costs, liabilities and callbacks).
[ J Clean up of building debris at job completion by SAWHORSE.
Dumpster may be left on job site for building debris.
(No tires, appliances or neighbor's mattress).
[ ] Communication is essential for a successful project.
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CITY OF ORONO CALLED IN � �o� �'T'� /j7
INSPECTION NOTIC (�[J� SCHEDULED �d ' - -'3 Q
PERMIT NO. 7" 7 COMPIETED �l �
ADDRESS /
OWNER i '��� CONT . B'j'
TELEPHONE NO. .��3 —O �.��Z
� DESCRIPTION
� 01 FOOTIN� 11 MECHANICAL RI 18 D(CAV/ORADINC�I/FlWNO
Q�0 FRAMINO 13 MECHANICAL FlNAL 19 IAI�SHORF.lVVE7LANDS
,��OCfiR50 TION 24/2S WOOD BURNER/FlREPUCE 34 TREE REMOVAL
� 04 WALL BD. 12 WA7ER HOOK-UP 17 SITE INSPECTION
� p5 FINqL 14 SEWER HOOK-UO O6 PROQRESS
�
J 07 DEM�SITE 27 SEPTIC MAINT. 21 COMPUUNT
� 07 DEMO—FlNAL 15 SEPTiC INSTALL. 22 FOLLpW-UP
= 08 PLUMBINO RI 23 SEPTiC FlNAL 35 HARD COVER R&MOVAL
v 10 PWMBINO FlNAL 36 FOUNDATION REMOVAL
Z OWNER/CONTRACTai TO MEET YOU: YE8_NO
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❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL REfURN
�STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
❑INSPECTION REWIRED.CAIL TO ARRANGE ACCESS.
Call for ex inspection 24 hours in advance.473-7357
OwnerlCont s
Inspector: �
whit•copynnspectors Fla canary copy�site Noac�
DATE TIME
CITY OF ORONO CALLED IN _3,0
INSPECTION NOTICE �j�a� SCHEDUIED G� •
PERMIT NO. � COMPLETED
ADDRESS f s �a-`r' �'-
OWNER CONTR. W �
TELEPHONE NO.
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� DESCRIPTION 1 Q l VlSfil �o� rr -�6r�
� 01 FOOTINO 11 ME RI 18IXCAV/(�RADIN(i/FIWNO
y 02 FRAMINd 13 MECFIANICAL FlNAL 19 LAI�SHOREJWETLANDS
Q�SULATION 24/25 W000 BURNER/FlREPLACE 34 TREE REMOVAL
� WqLL Bp. 12 WATER Ii00K-UP 17 SITE INSPECTION
ti� OS FlNAL 14 SENIER HOOK-UO 06 PROORESS
v 07 DEM�SfTE 27 SEPTIC MAINT. 21 COMPWNT
W 07 DEMO--FINAL 15 SEP71C INSTALL Yt FOLLOW-UP
= 08 PLUMBINO RI 23 SEP71C FlNAL 35 FIARD COVER REMOVAL
v 10 PWMBINQ FINAL 38 FOUNDATION REMOVAL
Z OWNER/CON7AACTOR TO MEET YQU: YES_NO
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❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL tNSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cali for the next inspection 24 hours in advance.473-7357
OwnerlContra ite:
Inspector:
White CopyMspecto Fik Gnary CopylSite Notke
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DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOT�CE SCHEDULED G�,�� vZ:f"XX�
PERMIT N0. - `��� MPLETED �_ �_
ADDRESS ``�'�� �a-r �r,
OWNER CONTR. � �S�
TELEPHONE NO.
� DESCRIPTION
� 01 FOOTINQ 11 MECHANICAL RI 18 D(CAV/GRADINO/FIWNQ
� 02 FHAMINO 13 MECHANICAL FINAL 19 LAI�SHORE/WETIANDS
Q 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z pq yyqu,gp, 12 WATER HOOK-UP 17 SITE INSPECTION
Q �� 14 SEWER HOOK-UO O6 PROCaRESS
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J DEMO—SITE 27 SEPTIC MAINT. 21 COMPIAINT
W 07 DEMO—FINAL 15 SEPTIC INSTALL 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
v 10 PLUMBINO FINAL 36 FOUNDATION REMOVAL
� OWNER/CONTRACTOR TO MEET YOU:_YES_NO
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� BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. L PHOTO TAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
❑STOPORDER POSTED.CALL INSPECTOR
O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Cali for th xt in ction 24 hours in advance.473-7357
OwnerlCon ct sit :
Inspector.
White Copylinspector's File Canary CopylSite Notice
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