HomeMy WebLinkAbout2015-00588 - roofing �� ' CITY OF ORONO * 2 0 1 5 - 0 0 5 8 8 *
2750 KELLEY PARKWAY DATE ISSUED: OS/13/2015
ORONO, MN 55356-
952 249-4600 FAX: 952 249-4616
ADDRESS : 2700 PHEASANT RD
PIN : 21-117-23-23-0017
LEGAL DESC : PHEASANT LAWN
: LOT 000 BLOCK 000
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ROOFING-ASPHALT
ACTNITY : O/S BUILDING-LJNDEFINED
VALUATI01�1 : $ 18,400.00
NOTE: VALUATION OF PERMIT:$18000.00
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 DUR[NG THE TIME THE ROOF IS BEING DONE.
ONCE WORK IS COMPLETED THE SIGNS MUST BE REMOVED.
APPLICANT PERMIT FEE SCHEDULE 325.28
STATE SURCHARGE(VALUATION) 9.00
TWIN CITY HOMEWORKS TOTAL 334.28
646 EAST RIVER ROAD, SUTIE 3 payment(s)
ANDOVER,MN 55303- CHECK 22667 334.28
(763)746-0860
Minnesota State License#: BUIL-BC045212
OWNER
ETAL, MICHEAL CULLEN
2700 PHEASANT RD
EXCELSIOR, MN 55331-
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 celated 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.
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Applicant Permitee Signature ate Iss By Signature Date
. = City of Orono
Building Permit Application for Maintenance / Replacement / Remodel
(i.e. windows, doors, siding, re-roof, etc. — NO STRUCTURAL EXPANSION)
�O�O MailingAddress: Permit number: �j"�� g
PO Box 66
Crystal Bay, MN 55323-0066 Date received: S��J S
Street Address: Received by:
y ` 2750 Kelley Parkway Plan review fee:
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t �, Orono, MN 55356
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Total Fee:
Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us
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: �.-� '�" ��Le���, � �o�
Will this be a Parade of Homes, Remodelers Showcase Home or other Display Home? ❑ Yes No
If yes, a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service will be
required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed.
CONTRACTOR/APPLICANT INFORMATION:
Name: 'r ; (�. , ' �������r-
State License# � �� � Expiration Date: ��
Lead Certification Number: Expiration Date:
(for work on homes that were consfructed prior to 1978
Phone: (cell) (office) � - 7" - ��, �j
Mailing Address: (�j " � �� � _ � 'u � , City: H ZIP: �3
Contact Person: �,�� -Te��;,S Applicant is: ontractor / Homeowner (Circle One)
Email and/or Fax: �—
PROPERTY OWNER INFORMATION:
Name: /�'��J�� (,c�.�(�ev�
Phone (day): y5�.- "�(� d �
Address: 2'7od P���.�+ ,. City: Q��;--d ZIP: 5�j j�
Email and/or Fax:
PROJECT INFORMATION: Overall project description: 1�'a/-� n � �' -�� I�; ' � -:��'�
Type of Project: earth vement may also require
❑ Door(s) ❑ Remodel ❑ Fire Damage MCWD review&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(specify) ❑ Siding ❑ Other: (specify) Phone: 952-471-0590
Fax: 952-471-0682
❑Window(s) www.minnehahacreek.orq
Estimated Construction Valuation of Project (excluding land) $ ().
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 governmental agencies required by law. If
ou refuse to su I t informa'on li tion ma not be issued.
Applicant's Signature: �� � _� Date: �/�fT��
Owner's Signature: Date:
Last Updated:January 2015
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DATE TI E <�
� CITY OF OR CALLED IN `
INSPECTION NOTICE SCHEDULED
PERMIT NO. �/�--C�Jg� COMPLETED
ADDRESS ��� �`�� ��:'1 f �
OWNER TELE�HON�NO.�rz�������3
CONTRACTO �_
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� DESCRIPTION �Q�
lN ❑ 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 ❑ SE ER HOOK-UP ❑ HARD COVER REMOVAL
J ❑ DEMO-SITE ❑�TIC INSTALL ❑ FOUNDATION/REMOVAL
Z OWNEiUCONTRACTOR TO MEEi YOU: ES_NO
� COMMENTS:
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��/���ATISFACTORY:PROCEED ❑ PROJECT COMPLEfE
��RR£�T WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
� ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE CWERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ pHOTO TAKEN
INSPECTOR WILL REfURN ❑CI7ATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952� 249-46��
OwnerlConVactor on site:
Inspector.� /�
White Copyflnspector's File Canary CopylSite Notice
��L � TE h� TIME �
� CITY OF ORONO CALLED IN �' _/cJ
INSPECTION NOT CE, ��p�CHEDULED ��� f =-���
PERMIT NO. 0 PLETED
ADDRESS ��a� /`%'�������� ,��
OWNER E PHO E NO, "��-��
CONTRACTOR /� ���E�yX'e
� DESCRIPTION
ly ❑ FOOTING ❑ DEMO NAL ❑ 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 ❑ MECHANICAI FINAL ❑ PROGRESS
��ULATION ❑ WOOD BURNER/FIREPLACE ❑ COMPLAINT
v AL ❑ WATER HOOK-UP ❑ FOLLOW-UP
W ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ HARD COVER REMOVAL
J ❑ DEMO-SITE ❑ SEPTIC INSTALL ❑ FOUNDATION/REMOVAL
2 OWNERICONTRACTOR TO MEEf YOU:_YES_NO
c�., COMMENTS:
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W ❑WORK SATISFACTORY:PROCEED PROJECT COMPLETE
� ❑ CORRECT WORK 8 PROCEED ❑ SSUE CERTIFICATE OF OCCUPANCY
W
O G CORRECT WORK,CALL FOR REtNSPECTION TEMPORARY
V BEFORECdVERING 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 urs in adv 2) 249-46��
OwnerlContractor on site:
Inspector. ✓
White Copyllnspector's Ffle Canary CopylSite Notice