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Home My WebLink About2011-00829 - bathroom remodel r - - � CITY OF ORONO PERMIT NO.: 20��-oos29 2750 KELLEY PARKWAY ORONO,MN 55356- DATE ISSUED: 08/23/2011 952 249-4600 FAX: 952 249-4616 ADDRESS : 880 PARTENWOOD RD PIN : OS-117-23-43-0001 LEGAL DESC : PARTENWOOD : LOT 006 BLOCK 001 PERMIT TYPE : ADDITION/REMODEL/REPAIR PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : ADDN/REMODEL/REPAIR ACTIVITY : 434-RESIDENTIAL VALUATION : $ 30,000.00 NOTE: SEPERATE PERMITS REQUIRED: PLUMBING,MECHANICAL,ELECTRICAL(STATE) BATHROOM REMODEL APPLICANT pERMIT FEE SCHEDULE 466J5 PARTNERS 4 DESIGN STATE SURCHARGE(VALUATION) 15.00 275 MARKET STREET#109 TOTAL 481.75 MINNEAPOLIS,MN 55402- (612)927-4444 Minnesota State License#:20637776 OWNER GRAY,JERRY&CYNTHIA 880 PARTENWOOD 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 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 consVuction is suspended for a riod of 180 days at any time after work has commenced. The applicant is r ponsible for assuring all required inspections aze requested in confo ance with the State Building Code.This permit may be r o t i e r due cause. NA! / o� / 1 p � � ` Appli ant ermitee gnature Date Issu y Signature Date SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE. � � � 5 ��3 �� (� �� 5 Cit of Orono '� ��' � Y � Building Permit Application for New Structures or Additions Mailing Address: Permit number: p7�//-p(>� 9 O��,�.0 PO Box 66 l Crystal Bay,MN 55323-0066 Date received: �!�a �/ � a ��; ;�, �, StreetAddress:' Received by: �'.�, � y� Gti�' 2750 Kelley Parkway Plan review fee: Q 9 L9x�H0¢'F' Orono,MN 55356 o2G//_pG�a� — Total Fee: Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us This application form must be completed in full and alt required information must be submitted. Incomplete applications will be returned. (Please print) GENERAL INFORMATION: Job Site Address: 8� �'p��t—�{ ►.-,100l� �'D , �3Ze t—►� . �� Will this be a Parade of Homes, Remodelers Showcase Home or ot er Disptay Home? ❑ Yes � No /f yes,a special event permit is required with Police Department and Cify Council approval 60 days prior to the event. Shuttle bus service will be �equired unless applicant demonstrates su�cient on-site parlcing is availa6le. Non-permitted events will not be allowed. CONTRACTOR/APPLICANT INFORMATION: Name: {��{ZTN E.�.�j � ��Sl��.{ State License# OlP 3'"['1'f(� Expiration Date: - 3� - 2012 Phone: C�12 - '(1't - 1}1}-•�}.-�} o�ce l01�.. - `lv� - St�92 Rlc.l-' cell Mailing Address: 'I 5 1-�A►z.IG�'f $T �Q"t City: '��•1r'LS ZIP: 55 �05 Contact Person: rL1G1G SLYL� (�S0 Applicant is: �r / Homeowner (CircleOne) Email and/or Fax: PROPERTY OWNER INFORMATION: Name: TE pc�Y� Gt atn'•( C�'a,�.Y Phone(day): Address: I�{�,•.1eoG jzv c�cy: ��tot.t� ziP: 5535� Email and/or Fax ARCHITECT/ENGINEER INFORMATION: Name: PPa•?Nl�th �(' rJE5t�7� Phone(day): �/12 • 92'I• �{�4� Address: Z 5 M R+►a-`G'f.'� �. ��ty: M�..ti ziP: 56�}-0 5 Email and/or Fax: `Z.((��, � Pp•a•T N E IZS� L�E.St�►� . GO 1'v� PROJECT INFORMATION: 1.Type of Project 2.Proposed Use 3.Structure Type 4.Sewage Disposal 8� Water Supply ❑New Construction ❑Single Family with ❑ Residence ❑Addition attached garage ❑Garage/Accessory Bldg. ❑ Public Sewer ❑Accessory Building ❑ Single Family with ❑Deck ❑Relocation p�1 I I��,e� detached garage ❑O�ce/Commercial ❑Private Sewer �Other:(specify) Ylr�M1-K+� ❑ Multiple Family/Condo ❑Warehouse ❑Public ❑Storage ❑Public Water "`Any earth movement may require ❑Commercial ❑Other(specify) MCWD review 8�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) 5 . Last Updated: 4/26/2011 - 19- � 1 STRUCTURE INFORMATION: 1.Structure Dimensions 1.Structure Dimenslons(continued) 2.Type of Construction a.Length(ft.}= Number of bedrooms= ❑Wood/Frame ❑Masonry b.Width(ft.� Number of garage stalls: ❑Metal Attached= ❑Pole Bldg. Areas in sauare feet Detached= ❑ICF ❑On-site Prefab c.Basement= ❑Off-site Prefab d.1�Story = ❑Other(piease speciiY): e.2"°Story= f. '/�Story = g.Total Area= REQUIRED SUBMITTALS: All of the information must be submitted in order for your application to be processed: Not Enclosed icabls 0 Permit lication � ❑ Pro Buildin Plans ❑ MN State Ene Code Calculations and Mechanical Code R uirements Form ❑ Surve meetin all uirements 0 Stormwater Pollution Prevention Pian O S Hardoover Calculation s ' O Se tic S tem Sfte Evaluation R ❑ Access Permit ❑ Wetland Buffer Im rovement Pian ❑ En ineered Plans for Retainin Walls 4 feet or abave ❑ � Plan Review Fee O Other • APPLICANT ACKNOWLEDGEMENT: • Agrees to provide ali infortnation required or requested by the Building Departrnent; • Agrees to pay the City of Orono for engfneering consulta�rt review costs in excess of i500; • Certifies that the informati�supplied is true and correct to the best of his/her knowledge. The applicarrt rrecognizes that they are solely responsible for submitdng a compiete application being awaroe that upcxi failure to do so,the staff has no altemative but to reject it until it is complete; . Adcnowledges the Escrow Agreement is completed and signed; • Understands sane or all of the information that you are asked to provide on this application is dassified by State law as either private or c�nfidential. 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 tfie subject of the data. Our purpose and intended use of this infortnation is to annually update our records and records of other govemmental agencies required by law. If you refuse to supply the information,the appiication may not be issued. • Agrees that in tl�e everrt that weather or other conditions prevent the completion of an as�uiK sunrey at the time the Certificate of Occupancy is requested, temporary Certificate of Occupancy may be issued upon receipt of a 510,0� escrow to ensure compledon of the as iR survey and all site improvements. ApplicanYs Signature: Date: 0'I d�(I Last Updated: 4l26/2011 -20- . , . Plan F�eview �Che�kl:is�t fc�r ��e�r Strwctures l Additic�ns �da�es5 i Pi�i Lega�: 43�d(� ��nc� C(�i.� �a �t:� Description ofi work: I��f 2t.s�Y�/J C:Z- S�ptic ceview by: /�!//7 Date Appro�ed: .�oning re�riew by: /l�/ Date�Approved: Builcling revie�v by: Date�Qppraved: � " ( 5 —f � Grading>review by: N/�" Date Appro�red: oning File#: Resoluti�n#: Resolution Date. Zonir� District Fic�e De artment Post OfiFice Scho�!District �oning: t:Area: SF/�C Width: Depth: Survey Submitted: �Yes 0 I�o Date of`Survey: Rro osed Setbacks: FroMt�Lake) Rear jS et) � '�N S E W ) ( N S f lN ) er�Buildings �Illetland 'Sic1e ':�ide Buifding Definetl Height:, Building Peak Meight: ' #of Stories Dk?: D YES FDR A-BI]ILDING lMTH;a'4�BASEMENT OR'CRAfNL SPACE: R��BU1L'DING ON 94 SL:AB'ROUNDATION: START UITITH the distance between the basemenffloor/ wl START the distance:between the slab and'#he highest space'floor and,the highest roof peak,3he top- WITH roof.peak;the top nf the.sarnice of a flat roof, : the eomice of a flat roofi the de�k line ofi a the deck]ine of a mansard roofi, or:#he mansard roof,nr the.u;ppermos't point on a r nd uppermost poin�:on a roun8 or other arch-ty�e ' nr other arch-. e roof roof SU.BTBACT halfthe distance;between the t�ighest> mdow and UBTRACT half the distance be�tween.thB highestuvindow . hi hest roof eak of a: itched roof ;and hi hest roof eak Df a `itched roDfi SUBTRAGT : the distance between the basem t floor/crawl ADD �the distance between the'slab.and.the;highest space floor.antl;the fiighest ex ing grade within existin ratie vvithin�the foundation the foundation or 10#eet,w hever is less. EQUALS Defined builtlin '+hei`ht EQIJALS Defined buildin hei ht Lot;Coverage: SF _ �o Shoreland(District MCWD Permit Recei�✓ed Avera e Lakeshoce�et k ` B1uff 0 Yes � 'No G N/A � Yes 0 .No � Yes � 'N D Yes 0 No � =NIA Perrnit Number: S ack: Hardco�er:Z es Existin, Pro osetl V�riance Re uired CUP R vired 0-75' � 'Yes � 'No G Yes No 75 50' TYP�(S)= TYPe(S)� � 0-500' 500-1000' RE ARKS (in-house): Nv G�l'�4�G� Updated: 09/11/2009 z:lformslptan review checkfist.doac Fees to be Cha ed �'�fS ; �IO ; Plan Rewiew - Inves�igation Fee .: Sewrer��onnectia.n :Park F�e ,�ther-(speC'�{Y� ��lculateii>By.: S uare F-�ota e �$: er S uare Foota e Basemerit �(' _ $ _ '1�':Floor X = $ 2"d Finor X = $ �arage :�C = $ , Estimated Canstruction Value: $ ��.040 °'� Orono':tnspections Required `��1York Rsquieing Separate-'Permits Required`State:F.errnits fl Site ;Rlumbing � �rading/�illing G :Welt � Hardr,over R�moval �`�lechanicai � Fire Electrical -i] Footing "G -Septic � Water�onnection fl Poured Wall fl Firsplace ;� Sewer.Connection � 'Foundation�urvey � Masonry � Lawn Irei.gation D Radan f�ock'Bed p IVIfg. �Framing D �)ther(sp�cifY) � insu(ation . � ,�s-�B�iilt`Surv,ey � 'Final � =D.ther:(specifiy) ,REM�f��S (in-house): O.ther R�r�e�nr: Rreviewstl by: Date 1#ppr4vetl: Access:E�cisting:`� �fES ti N0 Ne�nr: 0 YES 0 ND REMAI�KS (TO'BE NOTED ON�C-�fMIT AND 1NITIALLED BY PEI�SDI+A PllLLING PERMIT) 'Updated: 09/11/2009 z:\formslpfan review checklist.docx �_ � �t DAT TIME �/ CITY OF ORONO CALLED IN � �� f INSPECTION NOTICE SCHEDULED � � � L�' PERMIT NO. ��'�� wL,�`�`�(+l COMPLETED ADDRESS ��-��u-�� OWNER TELEPHONE ��`� l�� lc� CONTRACTOR �'�� j � � ��.e c�-�/ �: DESCRIPTION �"v�'� � (�-� �� ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS � ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT � ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SE IC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET Y YES_NO f � COMMENTS: � � cI �C�:� � ( V1 ��1- . W 0. � � O � � O � W � Q � Z W � W � � GW �VORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE � ❑CORRECT WORK 8�PROCEED C ISSUE CERTIFICATE OF OCCUPANCY W 0 ❑ CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �952� 249-46�� OwnerlContractor on site: Inspector. White Copyllnspector's File Canary CopylSite Notice V �..i%�i ' TIME , / V CITY OF O NO CALLED IN �D INSPECTION NOT C SCHEDULED J � PERMIT NO. ��°Z�C PLETED ADDRESS �� -��4� �� OWNER T EPHONE NO. "� �-s � CONTRACTO � � �� >; DESCRIPTION � ly ❑ FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHOREM/ETLANDS y O ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT J ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL � ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COM E TS: a � � o� � - dvCflD �t�� o - ll- �0 `�Z��` �O�.I � � � 5 n�r� �-I-e c�-s (� a.��.rc. � Q —�e,� � reJ -� t`3sz c�C'Oc��.�.. Ac�.L 1 � PQS' � tac� � . c�, �¢�-e C �4-e�r� � 2� �.v �� c,� 3 �-�.�,rv r t� " c.9� � �^c�Pl � Q �G1�0 U •+-� � � a W ❑WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE � ❑CORRECT WORK&PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY W �L�CORRECT WORK,CALL FOR REINSPECTION TEMPORARY U PERMANENT ❑CORRECTUNSAFECONDITIONWiTHIN HOURS. � pHOTOTAKEN INSPECTOR W4LL RETURN ❑STOP ORDER POSTED.CALL�NSPECTOR � CITATION ISSUED ❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-4600 OwnerlContractor on site: tnspector. ��./ � White Copy/l�spector's File Canary CopylSite Notice �� DATE TIME � CITY OF ORONO CALLED IN �� WSPECTION OTICE �J"J� �( SCHEDULED o - — l J �:OD PERMIT NO. �d�� / uZ� COMPLETED ADDRESS �YC�D � Dix�Gr�"1�C� OWNER TELEPH NE NO. ��27 �!�!� "/��'' CONTRACTOR a DESCRIPTION n � � l� ❑ FOOTING � PLUMBING FINAL ❑ EXCAV/GRADING/FILLING � ❑ POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WETLANDS � Q ❑ 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 � OWNER/CONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � W 0. o G, d � :s� � s',�-��S � -�.�5�t,�t c t� � �g Q-e1'` � �� « � W ! � Q � Z W � W � � d W� iB'�WORK SATISFACTORY:PROCEED ROJECT COMPLETE W ❑CORRECT WORK&PROCEED � I SUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECOVERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. � pHOTO TAKEN INSPECTOR WILL RETURN ❑STOP ORDER POSTED.CALL INSPECTOR '�' CITATION ISSUED ❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. �95Z� Z49-4600 OwnerlContractor on sit : � Inspector. � � White Copyllnspector's File Canary Copy/Site Notice