HomeMy WebLinkAbout2011-00881 - roofing �
CITY OF ORONO PERMIT NO.: 20��-ooss�
� 2750 KELLEY PARKWAY
ORONO,MN 55356- DATE IssuEn: 08/18/2011
952 249-4600 FAX: 952 249-4616
ADDRESS : 583 PARK LA
PIN : 06-117-23-41-0047
LEGAL DESC : MINNETONKA SUMMIT PARK
: LOT 013 BLOCK 006
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ROOFING-ASPHALT
ACTIVITY : O/S BUILDING-UNDEFINED
VALUATION : $ 13,064.00
NOTE: VALUATION OF PERMIT:$13,064.00
ROOFING PERMITS ISSUED WITHOUT ENOUGH NOTICE FOR TEAR OFF INSPECTIONS. (WE REQUIRE 24-48 NOTICE,PRIOR TO
WORK BEING STARTED) MUST PROVIDE COMPLETE SET OF PICTURES OR A FINAL INSPECTION MAY NOT BE ISSUED.
SIGNS-ADVERTISING SIGNS MAY ONLY BE ON THE PROPERTY DURING THE TIME THE ROOF IS BEING DONE.
ONCE WORK IS COMPLETED THE SIGNS MUST BE REMOVED.
APPLICANT pERMIT FEE SCHEDULE 250.75
THE HOME DEPOT A.H.S. STATE SURCHARGE(VALUATION) 6.53
2690 CUMBERLAND PKWY,STE 300
30339- MAIL-IN FEE 2.00
(763)542-8826 TOTAL 259.28
Minnesota State License#:20268257
OWNER
HANSEN,GINA AND STEWART
583 PARK LA
LONG LAKE,MN 55356-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be perfortned 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 sepazate
permits. All provisions of laws and ordinances goveming 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.
`�,(,� /'fl'� / / l l
Applicant Permitee Signature Date Issued By gnature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB E.
AUG/16/2011/TUE 04; 40 AM Elder Jones Building FAX No, 952 854 4909 P. 002
.
City of Orono
Building Perm�t Application for Internai Work
(windows, doors, siding, re�roof, etc.)
Mai�ing Address: Permit number: D//�d� 8g�
O,¢Q�,� PO Box 66
Crystal Bay. MN 55323-0066 Date received: 8 �
� Received by:
St�esf Address:
� � 2750 Kelisy Paricway Plan review f :
�,�° Orono,MN 55356 �+
Total Fee: ���f', �O
Main: 852-249-4600 Fax: 9`a2-249�46�6 www.ci.orono.mn.t��
This application form must be completed in full and all required information must be submitted.
, Incomplete spplications will be returned. (Please print)
GENERAL INFORMA710N: � D 3 �Q ` � / � n �
Job Site Address: � ��
Will this be a Parade of Homes� Remodei�rs Showcase Home or other Display HaFne? ❑ Yes ❑ No
If yes,a spedal event permif is fequlfed with Pdlce DEpa�bnenf end C�y�CounG�approva!80 deys prior to the event. Shutde bua seivlce will be
required unless appllcant demonstrales sulticient on�ite parking is avellab/e. Nan-permitted events w!lI rwt be allowed.
CONTRACTOR/APPLICANT INFORMATION: , 1 b�f� �q £T ���l�I y�
Name: x�At-�Tome Serviees, Ina `�
State License# y69p �,�mbexland Pkwy, Ste 300 5� �y 5 - o��
Phane: (cell)
Mailing Address: Cumberland Office Paz'k ZIP:
Contact Person: Atlanta, GrA 30339-3913 lomeowner �c��i.o�)
Emai1 and/or Fax: Lic#20268257 Ph. 763/ 542-8826
PROPEI2TY OWNER 11]�ORMA7'�ON:�a � j� n
Name: C� 4
Phone(day): 3 � Q A n� . �� : Lbn q La�� Z,P: s's 3 s �
Address:
Email andlor Fax 'S� ? S ' 7
PROJECT INFORMATION:
Type of Project• Any earth movement may requfre
' MCWD review 8�.permits
❑Doo�(s) ❑ Remodel ❑Water Damage .
Minnehaha Creek Watershed DistricC(MCWD)
❑Window(s) �Repair ❑Storm Damage 18202 Minnetonka Blvd
Deephaven,MN 55391
❑Siding ❑ Restoration ❑Other.(speclfy) Phone: 952-471-0590
Fax: 952-471-0682
Re-roof ❑�ire Dama e 'nne h reek.o
verafl Pro ect Descri tion: � - O , v /
Estimated Construction Valuation of Pro'ect(excluding land $ 0 6
APPLICANT ACKNOWLEDGEMENT:
. ABrees'CO provide all information required or requested bythe Building Departrnent;
. CerBYes that the iriformation supplied is true and correct to the bs�t of his/her knowledge. "fhe appliqnt recognizes that they
are solely responsibla for submitting a complete application being aware that upon fallUl'A to do so,the staiT has no eltemative
but to reject it until it is�mplete;
. Some or all of the information that you 8re asked to provide on ihis application is classified by St2te law as either private or
conffdential. Private data is ir�formation which generally cannot be given to the public but can be gtv�n to the subJed of the
data. Confidentiaf data is information which generally cannot be glven to either Che public or the subject of the dsta. Our
purpose and intended use of this information is to annually update our records and recor'ds of other govemment�l agencies
re uired b law. If u refuse to sup I the information, e a Ifcation ma not be issued.
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ApplicanYs Signsture: � Date:
�
� .../��J���J. /fC MA �IflA/� �
� TIME �/
cinr oF oRONo CALL� ,
INSPECTION NOTICE SCHEDULED -� - /Z
PERMIT NO. a 0/!-dG 8'�'/ COMPLETED
ADDRESS '-��3 ��`�'�' �-
OWNER TELEPHONE N0.7�.3 ��� ��-S�
CONTRACTOR p��'e ��t ,
� DESCRIPTION �� �� ���
� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORENVETLANDS
y ❑ 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
� � PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL
2 OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFOREC�IERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN
INSPECTOR WlLL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (g52) 249-4600
OwnedContractor on site:
Inspector.
White Copyllnspector's File Canary Copy/Site Notice
CITY OF ORONO DATE TIME �
CALLEDIN
INSPECTION NOTICE SCHEDULED
PERMIT NO. 0�0//- �O ggi COMPLEfED �- y-jf.
ADDRESS S$�3 Pai k L�..
OWNER TELEPHONE NO.
CONTRACTOR ?�1 e �•+�c� CJ�Oat I
y, DESCRIPTION ��- �'ad� re�.�.5,�c���.-
�
� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING
y ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WEfLANDS !
Q ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL �
� ❑ INSULATION ❑ WOpD BURNER/FIREPLACE ❑ SITE INSPECTION I
❑ RADON SIAB ❑ WATER HOOK-UP ❑ PROGRESS I
���INAL ❑ SEWER HOOK-UP ❑ COMPUUNT
Q ❑ DEMO-SITE ❑ SEPTIC MAINT. �FOLLOW-UP �
_ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
J ❑ PLUMBING RI 0 SEPTIC FINAL ❑ FOUNbATION/REMOVAL
2 OWNERICONTRACTOR TO MEET YOU:_YE3_NO i
� COMMENTS• _ , , • �
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� ❑WORKSATISFACTORY:PROCEED �CiOJECT COMPLEfE
W ❑CORRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECT WORK�►LL FOR REINSPECTION TEMPORARY
V BEFORECOWERING PERMANENT
❑CORRECT UNSAFE CONDITION WRHIN HOURS. p pHOTO TAKEN
INSPECTOR WILL RETURN p CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Ca11 for the next inspection 24 hours in advance. (g52) 249-4600
OMmerIC or on site: _
Inspector. ��--� _
White CopyllnspectoPs Ffle Canary CopyfSfts Notke