Permits - Permit# 22SP-00002 - 4308 West Arm Road - 5/26/2022 ''" City of Spring Park
Re-Window/Exterior Door
4349 Warren Ave, Spring Park, MN 55384 Residential
SPRING PARK 22SP-00002
On Lake 9ftncton a 1 (952)471-9051 Fax(952)471-9160
For Inspections: (952) 442-7520
Date Issued: 05/26/2022 Property Owner: Keegan Shoutz
Expiration Date: 11/22/2022 Mailing Address: 4308 West Arm Road
Job Site Address: 4308 West Arm Road, Spring Park, MN Spring Park, MN 55384
55384 Phone:
Category: Residential Miscellaneous Email:
Permit Type: Re-Window/Exterior Door(Residential)
Valuation:
Description of Work:
Replace 1 window and 1 sliding door
Subdivision: Required Setbacks:
Parcel ID:
Filing:
Lot: Actual Setbacks:
Block:
Total Sq Ft:
Contractors: Fee Items Amount
Primary Pella Northland, (763)745-1400 State Surcharge (Fixed) $1.00
Contractor License Look-up $5.00
Lead Certification Look-up $5.00
Residential Building Maintenance Permit $50.00
Total Fees: $61.00
NOTICE
Signature of Applicant/Date Building Department Signature/Date
5/26/2022
MUST BE POSTED ON JOB SITE
INSPECTION CARD
*k=::Z City of Spring Park
SPRING PARK
On Lake9Ninnetonka 4349 Warren Ave, Spring Park, MN 55384
POST THIS CARD IN A SAFE CONSPICUOUS LOCATION.PLEASE DO NOT REMOVE THIS NOTICE UNTIL ALL REQUIRED INSPECTIONS ARE MADE AND SIGNED OFF BY THE APPROPRIATE
AUTHORITY AND THE BUILDING IS APPROVED FOR OCCUPANCY.STAMPED APPROVED PLANS MUST BE AVAILABLE ON THE JOBSITE.
Re-Window/Exterior
PERMIT NO.: 22SP-00002 PERMIT TYPE: Door(Residential) ISSUED DATE: 05/26/2022 EXPIRATION DATE: 11/22/2022
PROJECT ADDRESS: 4308 West Arm Road,Spring Park,MN 55384 PARCEL NO.:
OWNER: Keegan Shoutz CONTRACTOR: Pella Northland CONTRACTOR PHONE: (763)745-1400
DESCRIPTION OF WORK: Replace 1 window and 1 sliding door
CONSTRUCTION TYPE: OCCUPANT LOAD:
DATE DATE
INSPECTION INSP PASSED COMMENTS INSPECTION INSP PASSED COMMENTS
Final/In-Progress
To request an inspection:(952)442-7520
Page 1 of 1
r#
CITY OF SPRING PARK PAGE 1 BUILDING PERMIT
4349 Warren Avenue c9asto &r)rOC �
Spring Park, MN 55384 El Handout Given
Routed to MNSPECT
Phone: 952-471-9051 Fax: 952-471-9160 ❑ Lead Handout Given
SITE ADDRESS:4308 W ARM RD PID:
1)Was the home constructed before 1978?(YES❑,continue with line 2,NO o continue without completing EPA Section)
2)Will the work disturb z6 sq ft of interior painted surfaces or>_20 sq ft of exterior painted surfaces?(YES o go to line 4,NO Id line 3)
_ 3)Are there any windows being replaced?(YES t6,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 16 complete line 5)
5)EPA Contractor Certification Number. NAT-NAT-F151782-2 (applies to contractor only)
• PROPERTY OWNER:KEEGAN SHOUTZ Address:4308 WARM RD
Ci :SPRING PARK State:MN Zip: 55384 Email:KSHOUTZ GMAIL.COM
rr Contact Name: Phone:320-282-7045
CONTRACTOR:PELLA NORTHLAND Address:15300 25TH AVE N STE 100
Cit :PLYMOUTH State:M Zip:55447 Phone:763-516-0115 Fax:
Contractor License No: BC645090 Contact Name:MEGAN GEHLHAUSENPhone:763-516-0115
Email: GEHLHAUSENMM@PELLAMN.COM
ARCHITECT: Address:
City: State: Zip: Phone: Fax:
• Email: Contact Nam Phone:
TYPE OF WORK: ❑New Construction ❑Deck ❑Pool ❑Re-Roof
❑Commercial esidential ❑Change of Use ❑Retaining Wall :�i Porch ❑Re-Side
EST.VALUATION OF WORK ❑Finish Basement ❑Demolition ❑Fence
$ ❑Remodel ❑Fire Sprinkler ❑Shed
Square feet: ❑Addition ❑Fire Alarm Vvindow/Door Replacement
❑Garage-Attached/Detach ❑Plumbing-provide detail on Page 2 #being replaced 2
rr Detailed Description of Work: ❑Accessory Structure ❑Mechanical-provide detail on Page 2 ❑Misc Other
REPLACING 1 WINDOW AND 1 SLIDING DOOR WITHIN THE SAME SIZE OPENINGS
•
Signature of this application by the legal property owner or a licensed contractor,as the owners 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 permA 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 permft,or If work Is suspended,abandoned,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 Effect:MONDAY-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:MEGAN GEHLHAU N This is the signature of: L Owner or Owner's Representative
OCCUP.TYPE: CONST.TYPE: CODE: BLDG SPRINKLED Yes I No
VALUATION:$
Permit Fee: $ ��•I� WAC Charge: $
Plan Review Fee: $ Sewer&Water Hook-Up: $
State Surcharge: $ DIU Sewer&Water Disconnect: $
Site Inspection Fee: $ Water Meter. $
S.E.C. Fee: $ Muni SE/WA Fee: $
Investigation Fee/Other Fee: $ SAC Escrow: $2.485
Copy Charge($.25 per 8.5 x11 page) $ Other. $
ZO Liconcc Check($6)I Lead Check($5) $ fro
TOTAL DUE: $
w SUB-TOTAL $ (0 ••9'L7
N 'NOTE: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
v Mechanical Fee(from Page 2) $ after Met Council review no SAC is determined,escrow will be refunded In full.
U- Special Conditions/Required Setbacks:
tL
O
Building Approval By: DATE:
Printed Building Approva)By: ❑ License Verification❑ Lead Verification-Checked By:
City Approval gi2i DATE:
Paid Date: 5 as Receipt No.535,�35 By.
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:
City: State: Z W. 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
Offxe Use Only:
❑Replacement(one fixture only, no piping or vent changes) Mechanical ermit 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: $
Payment Confirmation
Payer Information:
Payment Made By: CHAD WITTMER
Payment Made For: MEGAN GEHLHAUSEN
Email: gehlhausenmm@pellamn.com
Address: 15300 25TH AVE N, STE 100
PLYMOUTH, MN 55447
Payment Description: Licenses
Payment Date: 5/25/2022 12:54:21 PM
Business Name Payment Payment Confirmation Amount Convenience Total
Method Account Number Fee
City of Spring Park VISA ****8445 53535411 $61.00 $2.55 $63.55
(Licenses)
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RECEIPT
City of Spring Park
4349 Warren Ave, Spring Park, MN 55384
(952)471-9051
SPRING PARK
22SP-00002 I Re-Window/Exterior Door(Residential) On Lake.911innetonka
Receipt Number: 17
Payment Amount: $61.00 May 26,2022
Transaction Method Payer Cashier Reference Number
Credit Card Chad Wittmer Jamie Hoffman 53535411
Comments
V last four 8445
Assessed Fee Items
Fee items being paid by this payment
Date Fee Item Account Code Assessed Amount Paid Balance Due
05/20/22 State Surcharge(Fixed) $1.00 $1.00 $0.00
05/20/22 Contractor License Look-up $5.00 $5.00 $0.00
05/20/22 Lead Certification Look-up $5.00 $5.00 $0.00
05/20/22 Residential Building Maintenance Permit $50.00 $50.00 $0.00
Totals. $61.00 $61.00
Previous Payments $0.00
Remaining Balance Due $0.00
Permit Info
Property Address Property Owner Property Owner Address Valuation
4308 West Arm Road Keegan Shoutz 4308 West Arm Road
Spring Park, MN 55384 Spring Park, MN 55384
Description of Work
Replace 1 window and 1 sliding door