Permits - Permit# SP-2021-00085 - 4230 West Arm Drive - 8/18/2021City of Spring Park Permit
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Permit Number: SP-2021-00085
I (��T)Af Z Issue Date: 8/18/2021
Zoning Type: RESIDENTIAL
Use Type:
To Schedule an Inspection Call: 952-442-7520
24 HOUR NOTICE REQUIRED FOR ALL INSPECTIONS ♦ MON-FRI: 8AM-4:30PM ♦ NO HOLIDAYS
Details
Site Address: 4230 WEST ARM DRIVE, SP, MN 55384
Description:
Replace A/C
Permit Granted To: Sedgwick Heating
Homeowners Name: JOHN & MARCIA BRYANT
Phone Number:
Parcel #: 1811723440044
Permit Type: MECH - Air Condition Replacement
Permit Exp: 2/14/2022
Valuation: $0.00
Fees
Receipt•• Date Quantity Date Paid Status Pmt Info Amount
13426 State Surcharge Flat Fee - $1.00 8/18/2021 1.00 8/18/2021 Paid Visa: ****--****-****1741 $1.00
13426 MECH - Fixture Maint 8/18/2021 1.00 8/18/2021 Paid Visa: ****-'***-****1741 $50.00
Total: $51.00
Notes
• This permit is issued in accordance with and subject to all provisions of Ordinances and policies governing building and zoning in City of
Spring Park.
• Permit Holder/Contractor/Owners Agent is responsible to call for the inspections!
• Permit Packet, including approved plan, and this inspection record must be posted in an accessible location before calling for inspection.
Maintain this inspection record until work is complete.
• No deviations from the approved plans are allowed without prior consent from the building inspections department.
• To Owner, Occupant, or Contractor: It is ILLEGAL TO OCCUPY this area/building until all required final inspections have been made,
approved, signed, and certificate of occupancy issued!
Scott Qualle, Building Official
City of Spring Park +4349 Warren Avenue ♦ 55384 Copyright 02021
INSPECTION RECORD
2020 MN State Building Code
City of Spring Park Permit Number: SP-2021-00085 Issue Date: 8/18/2021
SITE ADDRESS: 4230 WEST ARM DRIVE, SP, MN 55384
PERMIT TYPE: MECH - Air Condition Replacement
ZONE/USE TYPE: RESIDENTIAL
APPLICANT: Sedgwick Heating
OWNER: JOHN & MARCIA BRYANT
Replace A/C
Description:
No inspection will be performed, and a re -inspection fee will be charged, if this "Inspection Record", the "City of Spring Park Permit", and, when applicable, the
approved plans are not available to the inspector. This permit expires if construction activity does not commence within 180 days from obtaining this permit; when
construction activity has been suspended or abandoned for at least 180 days; or the work has not been inspected within 180 days from the last documented activity.
IF SEPARATE PERMITS ARE REQUIRED, REFER TO THE "SEPARATE PERMITS REQUIRED FOR:" STAMP ON YOUR APPROVED
PLANS/CONSTRUCTION DOCUMENTS TO IDENTIFY WHAT SEPARATE PERMITS ARE REQUIRED.
ALL REQUIRED ROUGH -IN INSPECTIONS, NOTED ON SEPARATE PERMITS, MUST BE COMPLETED PRIOR TO SCHEDULING A FRAMING
INSPECTION.
ALL REQUIRED FINAL INSPECTIONS, NOTED ON SEPARATE PERMITS, MUST BE COMPLETED PRIOR TO SCHEDULING A BUILDING FINAL
INSPECTION.
DO NOT COVER ITEMS TO BE INSPECTED.
Permit Card
Inspector's Response Approval Date Comments or Corrections Required
Mechanical Final Required
MUST CALL TO SCHEDULE NO LATER THAN THE BUSINESS DAY PRIOR TO THE INSPECTION DAY: 8:00 A.M. TO 4:30 P.M. MONDAY THRU
FRIDAY. PHONE NUMBER TO CALL: 952-442-7520
When a Certificate of Occupancy is needed, return this card and the approved final inspection notice to
the City of Spring Park office.
Thank you for your Payment!
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City of Spring Park
4349 Warren Avenue
SP MN,55384
Ph:952-442-7520
Transaction ID: 13426
Transaction Number:
$51.00
Transaction Type: Payment
Recipient: Contractor Date: 8/18/2021
Notes: Paid Online Method: Visa: ****-****-****1741
Address: 4230 WEST ARM DRIVE, SP, MN 55384
Reference: Permit Number: SP-2021-00085 Type: MECH - Air Condition
Replacement for Sedgwick Heating
Fees
Product:
State Surcharge Flat Fee - $1.00 Paid 1.00 $1.00 $1.00
MECH - Fixture Maint Paid 1.00 $50.00 $50.00
Total Amount: $51.00
Page 1 of 1 Printed on: 8/18/2021
Payment Confirmation
Payer Information:
Payment Made By:
Jon Simonson
Payment Made For:
Jon Simonson
Email:
hollyz@sedgwickheating.com
Permit Address:
4230 West Arm Drive
Address:
1240 Trapp Rd. Suite A
Eagan, MN 55121
Payment Description:
Permits
Payment Date:
8/18/2021 12:47:57 PM
Business Xanle Payment Payment Confirmation Amount Convenience Total
Method Account Number Fee
City of Spring Park VISA ****1741 25161683 $51.00 $2.25 $53.25
(Permits)
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THIS COMMUNICATION IS INTENDED ONLY FOR THE ADDRESSEE(S) AND MAY CONTAIN INFORMATION THAT IS PRIVILEGED AND CONFIDENTIAL.
YOU ARE HEREBY NOTIFIED THAT, IF YOU ARE NOT AN INTENDED RECIPIENT LISTED ABOVE, OR AN AUTHORIZED EMPLOYEE, OR AGENT OF AN
ADDRESSEE OF THIS COMMUNICATION RESPONSIBLE FOR DELIVERING E-MAIL MESSAGES TO AN INTENDED RECIPIENT, ANY DISSEMINATION,
DISTRIBUTION, OR REPRODUCTION OF THIS COMMUNICATION (INCLUDING ANY ATTACHMENTS HERETO) IS STRICTLY PROHIBITED. IF YOU HAVE
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PERMANENTLY DELETE THE ORIGINAL E-MAIL COMMUNICATION AND ANY ATTACHMENTS FROM ALL STORAGE DEVICES WITHOUT MAKING OR
OTHERWISE RETAINING A COPY.
RECEIVED AUG 18 2021 -7S. (A)
CITY OF SPRING PARK
PAGE 1
BUILDING PERMIT
4349 Warren Avenue
t'±OQI-0C t �615
Spring Park, MN 55384
❑ Handout Given
Routed to MNSPECT
Phone: 952-471-9051 Fax: 952-471-9160
❑ Lead Handout Given
SITE ADDRESS: ZO W �S 1 1 �Y� �L
PID:
1) Was the home constructed before 1978? (YES ❑, continue with line
2, NO ❑ continue without completing EPA Section)
2) Will the work disturb >13 sq ft of interior painted surfaces or >_20 sq
ft of exterior painted surfaces? (YES o go to line 4, NO ❑ line 3)
3) Are there any windows being replaced? (YES ❑, go to line 4, NO ❑
continue without completing EPA Section)
4) Has this home been Certified Lead Free? (YES ❑, you MUST Attach Certification Information, NO ❑ complete line 5)
5) EPA Contractor Certification Number: NAT -
(applies to contractor only)
•
PROPERTY OWNER: JOkK4
M"j, W
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Address: 14.)30 wca 7 anp. D n'y It
Cit : State: Zip: lq'5A.4
Email:
Contac Na
Phone:
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CONTRACTOR: St I A kA Lk
suft
Address: L40 V
Cit : State: AAJ Zi : i I
Phone: qSa' k,VI- Fax:
Contract License No:
Contact Name: dbUtJ FlWlk Phone: "7
Email
ARCHITECT:
J
Address:
City: State: Zip:
Phone: Fax:
Email:
Contact Name:Phone:
TYPE OF WORK: ❑ New Construction
❑ Deck ❑ Pool ❑ Re -Roof
❑ Commercial gResidential c Change of Use
❑ Retaining Wall ❑ Porch c Re -Side
EST. VALUATION OF WORK o Finish Basement
o Demolition ❑ Fence
$ Say, a) c Remodel
❑ Fire Sprinkler ❑ Shed
Square feet: E. Addition
❑ Fire Alarm ❑ Window/Door Replacement
c Garage-Attached/Detach
In Plumbing -provide detail on Page 2 # being replaced
tailed Description of Work: c Accessory Structure
Mechanical -provide detail on Page 2 e Misc Other
" L
Signature of this application by the legal property owner or a licensed contractor, as the owner's representative. is required and authorizes the Zoning Administrator or designee and the Building Official
or designee to enter upon the property to perform needed inspections. Entry may be without prior notice. I hereby acknowledge that I have read this application and state that all information Is true and
correct to the best of my knowledge. I further agree that all work performed will be in accordance with approved plans, specifications and conditions and to abide by all ordinances of the Municipality
and the laws of the State of Minnesota regarding actions taken pursuant to this permit. 1 agree to pay all plan review fees even if I choose not to proceed with the work. Permit expires when work
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is not comment ad within 180 days from date of permit, or If work Is suspended, abandoned, or not inspected
for 180 days. Work beyond the scope of this permit, or work without a perm It or inspection.
•
will be subject to a penalty.
Noise Ordinance In Effect: fJONDAY - FRIDAY Before 7 a.m. and
after 10 p.m. Weekends/Holidays before 7 a.m. and after 8 p.m.
SIGNATURE OF APPLICANT:
DATE:
PRINTED NAME.
This is the signature of: ❑ Owner or Owner's Representative
OCCUP. TYPE: CONST. TYPE: CODE:
BLDG SPRINKLED Yes/No
VALUATION: $
Permit Fee. $
WAC Charge: $
Plan Review Fee: $
Sewer & Water Hook -Up: $
State Surcharge: $
Sewer & Water Disconnect: $
Site Inspection Fee: $
Water Meter: $
S.E.C. Fee: $
Muni SE/WA Fee: $
Investigation Fee / Other Fee: $
*2016 SAC Escrow: $2 485
}
Copy Charge ($.25 per 8.5 x11 page) $
Other: $
Z
License Check ($5) 1 Lead Chock ($5) $
TOTAL DUE: $ • �
SUB -TOTAL $
N
Plumbing Fee (from Page 2) $
`NOTE: Commercial plans will be submitted to the Met Council Environmental Svcs
D
for SAC determination. Escrow payment will be required when permit is issued. If
W
Mechanical Fee from Page 2 $
after Met Council review no SAC is determined, escrow will be refunded in full.
U
E
Special Conditions/Required Setbacks:
IL
O
Building Approval By:
DATE:
Printed Building Appr By:
❑ License Verification ❑ Lead Verification - Checked By:
City Approval B • :�
DATE:
Paid: Dat : _ /6 — / Receipt No. d_; 4. / 4.0 3 By:
�� Q
CITY OF SPRING PARK X MECHANICAL PERMIT
❑ PLUMBING PERMIT
PAGE 2 FOR PERMIT ISSUANCE
PAGE 1 and PAGE 2 should be complete
MECHANICAL INFORMATION
Mechanical Contractor: Address:
City: LDAhin St
e: zip: Phone: Fax: 9IQ. I - ai
State Bon o:
Contact Name:
Email:
Contact Phone: 01�9'-921 '
Detailed Desc i tion of Ark.
Indicate type of project, fixtures, and Gas Lines you will be installing
or replacing (include count for each type of fixture):
MECHANICAL FIXTURES
GAS LINES
Quantity Quantity
Qua ntit
_ Furnace Kitchen Fan
Furnace
_L Air Conditioning System Bath Fan
Fireplace
Air Exchanger Grill
Unit Heater
Fireplace
Water Heater
Unit Heater
Grill
In Floor Heat
Dryer
Gas Log
Stove
Replacement (one fixture only, no piping or vent changes)
Office Use Only. O
Mechanical Permit Fee: $ 50
Addition/Remodel
Gas Line Permit Fee: $
❑ New Construction
State Surcharge: $ OC)
Other
Other: $
Total Mechanical Permit: $
PLUMBING
Plumbing Contractor:
Address:
City: State: Zip: Phone: Fax:
Plumbers License No:
State Bond No:
Contact Name:
Contact Phone:
Email
Detailed Description of Work:
Indicate type of project and fixtures you will be installing or replacing (include count for each type of fixture):
PLUMBING FIXTURES
Quantity Quantity Quantity
Water Heater Shower Laundry Tub
Gas ❑ Electric Dishwasher _ Rough -In Future Fixture
Water Softener Clothes Washer Sump
Lawn Sprinkler System Ice Maker Line Water Pipinq System
Water Closet (Toilet) Hose Bib Floor Drain
Lavatory Wash Basin Bathtub
Office Use Only:
❑ Replacement (one fixture only, no piping or vent changes)
Plumbing Permit Fee: $
❑ Addition/Remodel
State Surcharge $
❑ New Construction
Other: $
❑ Other
Total Plumbing Permit: $