HomeMy WebLinkAbout2017-00712 - doors CITY OF ORONO * z 0 1 7 — 0 0 7 1 z *
� � 2750 KELLEY PARKWAY DATE ISSUED: 06/29/2017
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2765 PHEASANT RD
P[N : 21-117-23-23-0025
LEGAL DESC : PHEASANT LAWN
: LOT O10 BLOCK 000
PERMIT TYPE : MINOR ALTERATIONS
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : DOORS
ACTIVITY : O/S BUILDING-UNDEFINED
VALUATION : $ 3,850.00
NOTE: REPLACE(1)PATIO DOOR
APPLICANT PERMIT FEE SCHEDULE 108.38
PELLA NORTHLAND STATE SURCHARGE(VALUATION) 1.93
15300 25TH AVE N. -SUITE# ]00 MAIL-IN FEE 2.00
PLYMOUTH, MN 55447- TOTAL 112.31
(952)345-6047 Payment(s)
Minnesota State License#: BUIL-BC645090 CHECK 78300 112.31
OWNER
BAKKE, STEPHEN
2765 PHEASANT RD
EXCELSIOR,MN 55331-
AGREEMENT A1vD 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 additiona)or related 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 l80 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.
i
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Applicant Permitee Signature Date Issued By S gnature Date
- � City of Orono
, Building Permit Application for Maintenance / Replacement / Remodel — Residential ONLY
(i.e. windows, doors, siding, re-roof, etc. - NO STRUCTURAL EXPANSION)
�Q� ������ Permitnumber: �- �/ "'()U7�c�
Q Crystal Bay, MN 55323-0066 Date received:
`���� � �` ��� � Received by:
� � Street Address:
ti�, Gti 2750 Kelley Parkway Plan review fee:
�qkf S H o�� C�Tl(J��ro�`$Ci�6
Total Fee: /�a �l
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. (Please print)
GENERAL INFORMATION:�� �S ����Q�� � A
Job Site Address: �'
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
reauireo unless aoolicant demnn.Grrara.c.cufiic�en�nn-site parking is available. Non-permitted events wil!not be allowed.
CONTRAC Pella Northland
Name: 15300 25th Ave N. Ste 100
State Licer P1}nnouth, MN 55447 Expiration Date: 3- J-/
Lead Certii Lic # BC645090 Ph. 763/745-1400 1517 Z-� Expiration Date: y-?-7�
(for worl B
Phone: (cell) (office) cj�Z, -�(��,.,(�0 7
Mailing Address: City�__ _ ZIP:
Contact Person: Applicant is Contractor� Homeowner (Circle One)
Email and/or Fax: � �. ,
PROPERTY OWNER INFORMA ON:
Name:
Phone (day): "Z_. _- '7
Address: City: ZIP:
Email and/or Fax:
PROJECT INFORMATION: Overall pro'ect description:
Type of Project: Any earth movement may also require
❑ Door(s) ❑ Remodel ❑ Fire Damage MCWD review 8 permits:
Minnehaha Creek Watershed District(MCWD)
❑ Re-roof,asphalt [�Repair ❑ Storm Damage 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) ��(,�,'���f� www.minnehahacreek.orq
Estimated Construction Valuation of Project(excluding land) $ _3�_�7
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 information,the lication ma not be issued.
Applicant's Signature:� Date: �p�'���� 7
Owner's Signature: Date:
Last Updated:January 2016
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�- �'
-�"` DATE TIME'✓
CITY OF ORONO CALLED IN � —� ___��
INSPECTION N TICE ��/„ �CHEDULED � —
PERMtT NO. -` �i 7 � ���COMP��E�ED
ADDRESS ���_ ����
OWNER T�LEP ONE NO. � �`�g� 7�"�
CONTRACTOR � ' �GL L'Y��'L(�y"� �t a�
� DESCRIPTION ���� � ���
4�j ❑ FOOTING ❑ DEMO-FINAL ❑ SEPTIC FINAL
Q ❑ POURED WALL ❑ PLUMBING RI ❑ EXCAV/GRADING/FILLING
"j ❑ 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
_ ❑ AS BUILT-SURVEY ❑ SEWER HOOK-UP ❑ FOUNDATION/REMOVAL
SITE ❑ SEPTIC INSTALL
�MIN�ERIC��RACTOR TO MEET YiOU:�YES_NO
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� COMMENTS:
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W O W'ORK SATISFACTORY:PFiOCEED OJECT COMPLEfE
� ❑CORRECT WORK 3 PROCEED ❑I E CERTIFlCATE OF OCCUPANCY
W
O O CORRECT NfORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE CONERINO PERMANENT
❑CORRECTUNSAFECONDITiONWRHIN HOURS. O PHOTOTAKEN
INSPECTOR WILL RETURN
❑CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPEC710N REUUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
OwnerlContra site:
Inspector:
WINb CoPYAnspector's FlN C�nary Copr/Sib Notk�