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Permits - Permit# SP-2021-00113 - 2463 Black Lake Road - 11/2/2021INSPECTION RECORD 2020 MN State Building Code City of Spring Park Permit Number: SP-2021-00113 Issue Date: 11/2/2021 SITE ADDRESS: 2463 BLACK LAKE ROAD, SP, MN 55384 Description: PERMIT TYPE: PIG - General (residential) Rough in plumbing for toilet, sink, DW, Washer, & Ice Maker - Addition plans ZONE/USE TYPE: RESIDENTIAL on Building Permit #SP-2021-00090 APPLICANT: J S Plumbing Inc OWNER: GREGG & CAROL STEIGER 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 (4) Inspection Inspector's Response Approval Date Comments or Corrections Required Plumbing Underground R. I. Required Plumbing Aboveground R. I. Required Gas Line Certification Required Plumbing 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. City of Spring Park Permit -, CITY OF Q XU *A►!N!�tS0.fA To Schedule an Inspection Call: 952-442-7520 Details Permit Number: SP-2021-00113 Issue Date: 11/2/2021 Zoning Type: RESIDENTIAL Use Type: 24 HOUR NOTICE REQUIRED FOR ALL INSPECTIONS • MON-FRI: 8AM-4:30PM ♦ NO HOLIDAYS Site Address: 2463 BLACK LAKE ROAD, SP, MN 55384 Description: Rough in plumbing for toilet, sink, DW, Washer, & Ice Maker - Addition plans on Building Permit #SP-2021-00090 Permit Granted To: J S Plumbing Inc Homeowner's Name: GREGG & CAROL STEIGER Phone Number: Parcel #: 1911723120026 Fees 14217 PLG - New Fixture - $75 Min 10/29/2021 14217 State Surcharge Flat Fee - $1.00 10/29/2021 Notes Permit Type: PLG - General (residential) Permit Exp: 4/27/2022 Valuation: $0.00 1.00 11/2/2021 Paid Visa: **** ****"***6110 $50.00 1.00 11/2/2021 Paid Visa: **** `*** '***6110 $1.00 Total: $51.00 • 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 ©2021 CITY OF SPRING PARK PAGE 1 BUILDING PERMIT 4349 Warren Avenue St_ r�0� I-~tcf Spring Park, MN 55384 ❑Handout Given Phone: 952-471-9051 Fax: 952-471-9160 ❑ Lead Handout Given Routed to NSPEC /D 2—q3 i� -12 (1 ctci_ Lff�, SITE ADDRESS: PID: 1) Was the home constructed before 1978? (YES ❑, continue with line 2, NO ❑ continue without completing EPA Section) 2) Will the work disturb 2:6 sq ft of interior painted surfaces or 2:20 sq ft of exterior painted surfaces? (YES ❑ 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) 3) EPA Contractor Certification Number. NAT - (applies to contractor on • PROPERTY OWNER: J'� ' l'I ress: 7, t' ' City. ►') Stdtw.AAAi Zip: Email: Contact Na Phone: • CONTRACTOR: :1'6 Address: y �� City: h State:Akv Zi Phone: Contractor License No: 03 Contact Name: C,vr Phone: 61,p -Email: J5 4,W lblez Owl ARCHITECT: Address: City: State: Zip: Phone: Fax: • Email: Contact Name: Phone: TYPE OF WORK: ❑ New Construction ❑ Deck ❑ Pool ❑ Re -Roof ❑ Commercial esidential ❑ Change of Use ❑ Retaining Wall ❑ Porch ❑ Re -Side EST. VALU IWF WORK ❑ Finish Basement ❑ Demolition ❑ Fence $ %'R-emodel ❑ Fire Sprinkler ❑ Shed Square feet: ❑ Addition ❑ Fire Alarm ❑ Window/Door Replacement ❑ Garage-Attached/Detach elumbing-provide detail on Page 2 # being replaced Detailed De sc iptio of Work; ❑ Accesso Str ctu ❑ Mechanical -provide detail on Page 2 ❑ Misc Other >✓�� 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 Offlclal 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. I agree to pay all plan review fees even if I choose not to proceed with the work. Permit expires when work u Is not commenced within 180 days from date of permit, or Ifwork is suspepoed.Aandoned. or not inspected for 180 days. Work beyond the scope of this permit. or work without a permit or Inspection, • will be subject to a penalty. - Noise Ordinance In Effe -. MOND - F A B re 7 a.m. and er 10 p.m. Weekends/Holidays before 7 a.m. and after 8 p.m. SIGNATURE OF APPLICANT: f DATE: PRINTED NAME:' Gf t r G�' This is the signature of: E Owner or ❑ Owner's Representative OCCUP. TYPE: CONST. TYPE: CODE: BLDG SPRINKLED Yes / No �+^ VALUATION:$ `7 _ Permit Fee: i ) WAC Charge: $ Plan Review Fee: $ Sewer & Water Hook -Up: $ State Surcharge: $ 1, Sewer & Water Disconnect: $ Site Inspection Fee: $ Water Meter: $ S.E.C. Fee: $ Muni SEfWA Fee: $ Investigation Fee / Other Fee: $ •2016 SAC Escrow: $2.485 } Copy Charge ($.25 per 8.5 x11 page) $ _ Other: $ " Z Liconco Check / Lead Chock TOTAL DUE: "- - ($5) ($5)f W 51• O� SUB -TOTAL $�— 'NOTE: Cn Commercial plans will be submitted to the Met Council Environmental Svcs Plumbing Fee (from Page 2) $ 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 LL Special Conditions/Required Setbacks: LL O Building Approval By: DATE: Building Approval By: ❑ License Verification ❑ Lead Verifica io - Che ked By: 4rinted proval B DATE: Date: IbkJ Receipt No. By: I ep'o \1_3'✓ 1 ' _J CITY OF SPRING PARK ❑ MECHANICAL PERMIT ❑ PLUMBING PERMIT PAGE 2 FOR PERMIT ISSUANCE PAGE 1 and PAGE 2 should be complete MECHANICAL INFORMATION Mechanical Contractor: Address: Cit : State: zip: Phone: Fax: State Bond No: Contact Name: Email: Co tact Phone: Detailed Description of Work: 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 uant' Furnace Kitchen Fan Furnace Air Conditioning System Bath Fan Fireplace Air Exchanger Grill Unit Heater Fireplace Water Heater Unit Heater Grill In Floor Heat Dryer Gas Log Stove Office Use Only: ❑ Replacement (one fixture only, no piping or vent changes) Mechanical Permit Fee: $ ❑ Addition/Remodel Gas Line Permit Fee: $ ❑ New Construction State Surcharge: $ ❑ Other Other. $ Total Mechanical Permit: $ PLUMBING INFORMATION Plumbing Contractor: Address: City: State: zip: Phone: Fax: Plumbers License No: IState Bond No: Contact Name: I 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 Piping 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: $ CITY OF SPRING PARK ❑ MECHANICAL PERMIT 41*P"LUMBING PERMIT PAGE 2 FOR PERMIT ISSUANCE PAGE 1 and PAGE 2 should be complete MECHANICAL INFORMATION Mechanical Contractor: Address: City: State: zi: Phone: Fax: State Bond No: Contact Name: Email: Contact Phone: Detailed Description of Work: 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 Quantity Furnace Kitchen Fan Furnace Air Conditioning System Bath Fan Fireplace Air Exchanger Grill Unit Heater Fireplace Water Heater Unit Heater Grill In Floor Heat Dryer Gas Log Stove Office Use Only: ❑ Replacement (one fixture only, no piping or vent changes) Mechanical Permit Fee: $ ❑ Addition/Remodel Gas Line Permit Fee: $ ❑ New Construction State Surcharge: $ _ ❑ Other Other: $ _ Total Mechanical Permit: $ PLUMBING INFORMATION Plumbing Contra r: S pillnPlq9 Address: �]] City: '�2 �ti State: Zi v i I Phone: P ^ qC �' -2 Fax: Plumbers License No: QQ 0 State Bond No: Contact Name: (ze Contact Phone: ✓Z �� w� ? Email: i.26 J4 iA 64/ " L air" Detai a Description of Work: (' �,;✓ .v�� �� GIB- � � �' �v� � > !�.-<�• f- 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 awn Sprinkler System Ice Maker Line Water Pipinq System Jt L 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: $ ,I'Addition/Remodel State Surcharge $ ❑ New Construction Other: $ ❑ Other Total Plumbing Permit: $ Payment Confirmation Payer Information: Payment Made By: Payment Made For: Email: Permit Address: Address: Payment Description Payment Date: Business Name City of Spring Park (Permits) JS Plumbing Inc JS Plumbing Inc jsplumbingmn@gmail.com 2463 Black Lake Road 19701 261 ST AVENUE BELLE PLAINE, MN 56011 Permits 11/1/2021 4:32:40 PM Payment Payment Confirmation Amount Method Account Number VISA ****6110 26754230 $56.00 Convenience Total Fee $2.40 $58.40 This notice confirms that the above payment was successfully submitted to our payment processor, PSN, and is currently being processed. 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City of Spring Park 4349 Warren Avenue SP MN,55384 Ph:952-442-7520 $51.00 Date: 11/2/2021 Method: Visa: ****-****-****6110 Address: 2463 BLACK LAKE ROAD, SP, MN 55384 Reference: Permit Number: SP-2021-00113 Type: PLG - General (residential) for J S Plumbing Inc Fees Product: PLG - New Fixture - $75 Min Paid 1.00 $50.00 $50.00 State Surcharge Flat Fee - $1.00 Paid 1.00 $1.00 $1.00 Total Amount: $51.00 Page 1 of 1 Printed on: 11/2/2021