HomeMy WebLinkAbout2014-01422 - addition to home � CITY OF ORONO * Z 0 1 4 — 0 1 4 Z 2 *
' 2750 KELLEY PARKWAY DATE ISSUED: 12/22/2014
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 3399 CRYSTAL BAY RD
PIN : 17-117-23-44-0021
LEGAL DESC : WALLACES ADDN TO VIL OF MTKA B
: LOT 018 BLOCK 000
PERMIT TYPE : ADDITION/REMODEL/REPAIR
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR
ACTIVITY : 434-RESIDENTIAL
VALUATION : $ 250,000.00
NOTH;: SGPARAI'I: PI?RMI"I�S RI:QIiIRI�D: PI,UMBING, MECHANICAL.L:LFC"I'RICAL(S"I�A"I�{�;)
APPLICANT PERMIT FEE SCHEDULE 1,956.75
STATE SURCHARGE(VALUAT[ON) 125.00
COMMAND BUILDING SERVICE TOTAL 2,081.75
15405 N EDEN DRIVE
EDEN PRAIRIE, MN 55346- Payment(s)
(612)708-6085 CHECK 22706 �,081.75
Minnesota State License#: BUIL-BC636753 City of Or�.�����
21�G Kellcy Nai kwdy
Orono MN `�53`�6 �5[ �24y-46UU
OWNER Receipt No: 3.012500 Dec 22, 2014
V MCKINNEY, STEVE SOBIENIAK/ Commercial Building Service, Inc.
339 CRYS'rAL BAY RD Previous Balance: .00
WAYZATA, MN 55391- Fermits
2014-U1422 3399 Cryst�l 1,956.75
Bay Rd
101-3251G
Building Permits
AGREEMENT AND SWORN STATEMENT Fermits
2U14-01422 3399 Cr;st�l 125.00
The work for which this permit is issued shall be performed according to Bdy Rd
the approved plans and specitications,applicable City approvals,and the 101-2G802
State Building Code. This permit is for only the work described and does D118 10 yOVtS—StBte
_ _
not grant permission for additional or related work which requires separate J,081.75
permits. All provisions of laws and ordinances governing this type of work T�tal: _______________
shall be compied with whether or not specified herein.l�his permit will Check
expire and become null and void if construction authorized is not ('h��k NU: 22706 z.�81•75
commenced within 180 days o��fli�e dat�'�a�issuance,or if construction is FeyOY:
suspendedforaperiodof 180days�Y'�arSytimeafterworkhascommenced. COmmBYC121 E�ulldlfly SeIv1CO3 Inc.
I he applicant is responsible for uring all required inspections are Total Appl ied: 2,081.75
requested in conformanee wit � tate[�uilding Code.This permit may be ---__ _-----u0
revoked at any time for due ay e� Ch�flye Te�id@I'Ed:
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12/22/2U14 U2:31PM
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Appli ant Pcrrri�tee Signatui � Dale Issued 3y Signature Date
CITY OF ORONO
BUILDING PERMIT APPLICATION
FOR NEW STRUCTURES OR ADDITIONS
f��C1 Mailing Address: D —D ,/
i ��� PO Box 66 Permit number. 5R-
Crystal Bay, MN 55323-0066 Date received: /.� //—/
Street Address:' Received by:
.� a. --
�yF �� 2750 Kelley Parkway _/ � lan review fee: ��/ �— /
�,q �,�/ Orono, MN 55356 �`u ��Z� � /
kcsrto�. �-L__s �7.�
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Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us �) % , )-r',
This application form must be completed in full and all required information must be submitted.
lncompiete apptications wiil be returned. (P/ease print)
GENERAL INFORMATION: - �� �� � r
Job Site Address: � � � / � � /2
Will this be a Parade of Homes, Remodelers Showcas ome or o er D� lay Home? ❑ Yes No
/f yes,a special event permit is required with Po/ice Department and City ouncil approval 60 day prior to the event. Shuttle bus service will be
required un/ess applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed.
CONTRACTOR/APP CANT INFORMATI N/: • /
Name: �� '� / , [ �,.�;.%��
State License# Expiration Date: �3 � -
Phone: cell _ _ p ---' office � o p, ' �
Mailing Address: ' � / Cit : � ZIP:
Contact Person: � Applicant is: ontr�/ Homeowner (Circle One)
Email and/or Fax: / - - � �.�,�
PROPERTYOWNERI R ION: , /� ,� � 2��0
Name: �F-� � ��
Phone (day): , , _ ��� �I
Address: ��,J ��t�'��C/�, ,�� City: ZIP:
Email and/or Fax
ARCHITECT/ENGINEE INFORMATION:
Name: f-��y ,,� ,.,_
Phone (day): 1�._- _- �v 7
Address: Cit : � /� ZIP:
Email and/or Fax:
PROJECT INFORMATION: Description of pro�ect:
1.Type of Project 2.Proposed Use 3.Structure Type 4.Sewage Disposal 8
Water Supply
❑ New Construction �ingle Family with �-Residence
�-Addition attached garage ❑Garage/Accessory Bldg. �ublic Sewer
❑Accessory Building ❑ Single Family with ❑ Deck
❑ Relocation detached garage ❑ Office/Commercial
❑Other: (specify) ❑ Multi le Famil /Condo ❑ Private Sewer
p y ❑Warehouse
❑ Public ❑Storage ❑ Public Water
**Any earth movement may also require ❑Commercial ❑ Other(specify)
MCWD review&permits. ❑ Industrial ❑ Private Well
Minnehaha Creek Watershed District(MCWD) ❑Other: (specify)
18202 Minnetonka Blvd
Deephaven,MN 55391
Phone: 952-471-0590
Fax: 952-471-0682
www.minnehahacreek.or
/
Estimated Construction Valuation (excluding land) $ �Q' �2j v ��
STRUCTURE INFORMATION:
1.Structure Dimensions 1.Structure Dimensions(continued) 2.Type of Construction
a. Length(ft.)= �� Number of bedrooms= � �.ap/ood/Frame
b.Width(ft.)= � d Number of garage stalls: � ❑ Masonry
Areas in sauare feet Attached= l ❑Metal
c. Basement= � Detached= ❑ Pole Bldg.
d. 1S'Story = ��8 ❑ICF
❑On-site Prefab
e.2nd Story= ��Z ❑Off-site Prefab
f. 'h Story =
� ❑Other(piease specify):
g.Total Area= Z...
REQUIRED SUBMITTALS:
All of the information must be submitted in order for our ap lication to be rocessed:
Not
Enclosed A licable
❑ Permit A lication
e0— ❑ Pro osed Buildin Plans
� MN State Ener Code Calculations and Mechanical Code Re uirements Form
`�1-- ❑ Surve meetin all re uirements
❑ c�- Stormwater Pollution Prevention Plan
c�"` �-- Hardcover Calculation s
� �-- Se tic S stem Site Evaluation Re ort
� �-- Access Permit
� �-- Wetland Buffer Im rovement Plan
� �— En ineered Plans for Retainin Walls 4 feet or above
� �-- Minnehaha Creek Watershed District Permit s
� ❑ Plan Review Fee
❑ V'�--- Application Escrow&Agreement
� ❑ Other:
APPLICANT/OWNER ACKNOWLEDGEMENT:
• Agrees to provide all information required or requested by the Building Department;
• Agrees to pay the City of Orono for engineering consultant review costs in excess of$500;
• 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;
• Acknowledges the Escrow Agreement is completed and signed;
• Understands 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,the application may not be issued.
+ Ag�s that in th�e,vsnt that�ther or oth�r conditinns preve�nt�compte�an cf a�n a�-buit�sur�y at the ttme�e
Certific�te of Glccupan e+eq ts ,a t�e ra rf�cat�c�f t'�ccupancy may t�issuerf�pon receipf of a 510,�Dt��
escrow#o ensar+e. Plei�or� su and+�II ai��Rro�m�nt�.
r���� � _ i ` � l /
ApplicanYs Sig�ature: Date: � f ` � � <
�
Owner's Signature: y � - Date: f� — ��
,�
� � PLAN REVIEW CHECKLIST FOR NEW STRUCTURES / ADDITIONS
Address/Permit Number: 33 q q C r
Description of work: � ' V CA
Septic review by: �/VV Date Approved: �—
Zoning review by: V�. ��S Date Approved: � 2. ' ZZ'�'1'
i>
Building review by: <- Date Approved: /2 -- 2--Z— l`(�
Grading review by: N � Date Approved:
Zoning District: Zoning File#: Reso#: Reso Date:
Zoning: Lot Area: SF/AC Width: Lot Coverage: SF _%
Survey Submitted: �es � No Date of Survey: 12-' � ( ' ��' Revised date(?):
Proposed Setbacks:
F nt(Lake) �(Street) ( N S � W ) ( N S E W ) Other Buildings Wetland
Si Side
I ' 14.g'
Defined Height: Peak Height: FFE: FFE minus 6 feet= (Existing Contour)
Perimeter(linear feet) = 50% _ #of Stories Ok? � YES
FOR A BUILDING WITH A BASEMENT OR CRAWL SPACE:
The distance between the lowest FOR A BUILDING ON A SLAB FOUNDATION:
START WITH proposed floor(of the basement or crawl
space)and the highest point of the roof. START WITH The distance between the top of slab and
If you have a... the highest point ot the roof.
If you have a...
• GABLE OR HIPPED ROOF(no . GABLE OR HIPPED ROOF(no
windows): Subtract half the windows): Subtract half the distance
distance between the highest point between the highest point of the roof
of the roof to the low point of the to the low point of the corresponding
SUBTRACTION corresponding gable or hipped roof SUBTRACTION gable or hipped roof
(BASED ON ROOF . GABLE OR HIPPED ROOF(with (BASED ON • GABLE OR HIPPED ROOF(with
T�'PE) windows): Subtract half the ROOF NPE) windows): Subtract half the distance
distance between the top of the between the top of the highest
highest window and the highest window and the highest point of the
point of the roof roof
• ALL OTHER ROOF TYPES(flat, • ALL OTHER ROOF TYPES(flat,
mansard,etc):No subtraction. mansard,etc:No subtraction.
ADDITION Add the distance between the top of slab
SUBTRACTION Subtract the distance between the (BASED ON and the highest existing grade adjacent to
(BASED ON EXISTING basemenUcrawl space floor and the EXISTING the foundation.
GRADES) highest existing grade adjacent to the GRADES
foundation OR 10 feet(whichever is less). EQUALS Defined building height
EQUALS Defined building height
Shoreland District MCWD Permit Receive Avera e Lakeshore Setback Met? Bluff
� Yes 0 No N/A / � Yes No
Yes � No � Yes 0 No � N/A
Permit Number: Setback:
Stormwater Quality Existing Proposed Variance Required CUP Required
Overla District Tier Hardcover Hardcover
N� � Yes No 0 Yes No
� Type(s): Type(s):
Updated: January 2013
v:\forms\plan review checklist 2013.docx
REMARKS (in-house):
Fees to be Char ed YES NO
Permit
Plan Review I�
State Surcharge
Investigation Fee
SAC—Number of SAC Units
Other(specify)
Square Foota e $ er Square Foota e
Basement X = $
1S�Floor X = $
2nd FIoOP X = $
Garage X = $ ______
Estimated Construction Value: $ z 5(�,(�40��
Orono Inspections Required Work Requiring Separate Permits Required State Permits
� Site �lumbing 0 Grading / Filling 0 Well
� Hardcover Removal �llechanical 0 Fire ,� Electrical
0 Footing � Septic � Water Connection
� Poured Wall � Fireplace 0 Sewer Connection
� Foundation Survey 0 Masonry 0 Lawn Irrigation
� Radon Rock Bed 0 Mfg. �
Framing 0 Other(specify)
�Insulation
� s-Built Survey
Final
0 Wetland Buffer
0 Other(specify)
REMARKS (in-house):
Other Review: Reviewed by: Date Approved:
Access: Existing: � YES 0 NO New: 0 YES � NO
OFFICIAL REMARKS -TO BE NOTED ON PERMIT AND INITIALLED
Updated: January 2013
v:\forms�plan review checklist 2013.docx
� �� DATE TIME �
CITY OF ORONO CALIED IN �-� ls ��
INSPECTION NOTICE ,/ SCHEDULED c�-.� � /��
PERMIT NO. - �""�COMPLETED
ADDRESS 3 3 Ql .S oC�
OWNER TEL P NO. ���D$'-(pO�j
CONTRACTOR t
� DESCRIPTION �
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4~j ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FIN
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS
� ❑ IN ULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
i ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL
J ❑ DEMO-SITE ❑ SEPTIC INSTALL ❑ FOUNDATION/REMOVAL
2 OWNERICONTRACTOR TO MEET YOU:_YES_NO
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0 ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECONERING PERMANENT
❑CORRECT UNSAFE CONDITION WffHIN HOURS. p pHOTO TAKEN
INSPECTOR WFLL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
NSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
C xt inspection 24 hours in advance. (952) 249-4600
orrtractor on site:
Inspe�tor:
It IlnspectoPs Flle Canary CopylSite Notice
DATE TIME V
OF ORONO C� ALLED IN
INSPECTION N TIC SCHEDULED
PERMIT NO. � —���Z�OMPLEfED
ADDRESS � � �f � ��15� � /�,�/_____��
OWNER TELEPHONE NO. ���� �z p
CONTRACTOR �m� `
� DESCRIPTION
4~j ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
Q ❑ FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
Z ❑ RADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
Q �FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
Q ❑ FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
_ ❑ AS BUILT-SURVEY ❑ ER HOOK-UP ❑ HARD COVER REMOVAL
� ❑ DEMO-SITE ❑ �TIC INSTALL ❑ FOUNDATION/REMOVAL
Z OMfNERlCOI�fTRACTOR TO MEET YOU:_YES_NO
y COMMENTS:
� �/�. �Z ` 02�� 7•/�
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O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECONERING PERMANENT
❑CORRECT UNSAFE CONDITION WRHIN HOURS. ❑pHOTO TAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
ron 2a taurs in advance. (952) 249-4600
wnerfContractor on site: ��/
inspector: �
White CopyflnspectoPs File Canary CopylSke Notiee
�� �i�k� DATE TIME � �
CITY OF ORONO CALLED IN �,��
� INSPECTION N, TICE SCHEDULED L-�.L_
PERMIT NO. cOMPLETED
ADDRESS �
OWNER TELEPHO N0.��3 �2�Z_K2�Z
CONTRACTOR � �w�VY�C�C 1 i`1 � �I c�
� DESCRIPTION v \��� ���� ( � fi� �� •`� ��+�+J
tl� ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑,�OURED WALL ❑ PLUMBWG RI ❑ EXCAV/GRADING/FILLING
y FOUNDATION WATERPROOF ❑ PLUMBING FINAL ❑ TREE REMOVAL
ZRADON SLAB ❑ MECHANICAL RI ❑ SITE INSPECTION
FRAMING ❑ MECHANICAL FINAL ❑ PROGRESS
� INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
� FINAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
_ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL
v ❑ DEMO-SITE ❑ PTIC INSTALL ❑ FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU: YES_NO
��., COMMENTS:�
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O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hou in advance. (J 49-46��
OwnerlContractor on site:
Inspector.
White Copyllnspector's File Canary CopyfSite Notiee
�aDATE �IME
` CITY OF ORONO CALLED IN
INSPECTION NOTICE ��y�sCHEDULED �Jp� 1�/i�?
PERMIT NO. �l� COMPLETED
ADDRESS � �� � � ��7� ��'`� �
OWNER —TELEPHONE O.Lo I Z-70$-(�RS
CONTRACTOr — �
� DESCRIPTION� �/l�l�I ���� �
tt� ❑ 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 ❑ PROGRESS
� ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
��,F1NAL ❑ WATER HOOK-UP ❑ FOLLOW-UP
_ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL
J ❑ DEMO-SITE ❑ PTIC INSTALL ❑ FOUNDATION/REMOVAL
Z OWNERICONTRACTOR TO MEEf YOU: YES_NO
� COMMENTS: �c�'_'• /=e�1.�L ' �' `7 r �J�
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W ❑CORRECT WORK&PROCEED L.4 K fa.� - ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION �►'►���''� TEMPORARY
V BEFORE CWERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN
INSPECTOR WILL REfURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
JSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for t ion 24 hours in advance. (952) 249-4600
Own ontractor orLsite: ����—
Inspector. ��^^�
White Copyflnspector's File Canary CopylSfte Notice
DATE TIME
CITY OF ORONO CALLED IN �
INSPECTION NOTIC iL SCHEDULED
PERMIT NO. " ��a� COMPLETED
ADDRESS � y
OWNER TELEPHONE N
CONTRACTOR ��
/ .
�. DESCRIPTION � �� � '"`�� j'
4~j ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
�Q ❑ 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
41 ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
_
v ❑ DEMO-SITE ❑ E TIC INSTALL
Z 01NNERlCONTRACTOR TO MEET Y�U: YES_NO
y COMMENTS: �� ��CC - �� n �G " 6" 7 `" �S
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W ❑CORRECT WORK 3 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY
0 ❑CORRECTVYORK,CALL FOR REINSPECTION TEMPORARY
V BEFOREC04/ERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. p pF{OTO TAKEN
INSPECTOR WFLL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED
❑INSPECTION REQUIRED_CALL TO ARRANGE ACCESS.
Ca11 for the next inspection 24 hours in advanoe. (952) 249-4600
OwnerlContra�toron site: �sl�
Inspector: � � �
Whits CopyAnapector's File Canary CopylSite Notics