Permits - Permit# 22SP-00019 - 4469 Lafayette Lane - 8/2/2022 City of Spring Park Mechanical (Residential)
4349 Warren Ave, Spring Park, MN 55384
PRING PARK 22SP-00019
Ga a 5ilinneton'a (952)471-9051 (952)471-9160
For Inspections: (952)442-7520
Date Issued: 07/27/2022 Property Owner: ROLAND GEORGE GROTH
Expiration Date: 01/23/2023 Mailing Address: PO BOX 316
Job Site Address: 4469 LAFAYETTE LANE, SPRING
PARK, MN 55384 SPRING PARK, MN 55384
Category: Residential Miscellaneous Phone:
Permit Type: Mechanical (Residential) Email:
Valuation:
Description of Work:
HVAC for one unit of duplex
Subdivision: Required Setbacks:
Parcel ID: 1911723210058
Filing:
Lot: Actual Setbacks:
Block:
Total Sq Ft:
Contractors: Fee Items Amount
Primary Angell Aire Inc, (952)746-5200 State Surcharge (Fixed) $ 1.00
Residential Mechanical Permit $ 667.50
Total Fees: $668.50
NOTICE
Signature of Applicant/Date Building Department Signature/Date
08/02/2022
MUST BE POSTED ON JOB SITE
xjyz:��a
INSPECTION CARD
City of Spring Park
SPRING PARK
On L*9winnetonb 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.
Mechanical
PERMIT NO.: 22SP-00019 PERMIT TYPE: (Residential) ISSUED DATE: 07/27/2022 EXPIRATION DATE: 01/23/2023
1911723210
PROJECT ADDRESS: 4469 LAFAYETTE LANE,SPRING PARK,MN 55384 PARCEL NO.: 058
OWNER: ROLAND GEORGE GROTH CONTRACTOR: Angell Aire Inc, CONTRACTOR PHONE: (952)746-5200
DESCRIPTION OF WORK: HVAC for one unit of duplex
CONSTRUCTION TYPE: OCCUPANT LOAD:
DATE DATE
INSPECTION INSP PASSED COMMENTS INSPECTION INSP PASSED COMMENTS
Mechanical Rough-In Air/Hydrostatic Test
Reports Mechanical Final
Fire Approval: Date: Fire Approval: Date:
PW Approval: Date: Other( ): Date:
To request an inspection:(952)442-7520
Page 1 of 1
CITY OF SPRING PARK PAGE 1 BUILDING PERMIT
4349 Warren Avenue
Spring Park, MN 55384 El Handout Given
Routed to MNSPECT
Phone: 952-471-9051 Fax: 952-471--L9160 ❑Lead Handout Given
SITE ADDRESS: 4w�9 'C '(+_VC' [ (X✓ X / PID:
1)Was the home constructed before 1978? YES o,continue with line 2,NO 96continue without completing EPA Section)
2)Will the work disturb Z6 sq ft of interior painted surfaces or Z20 sq ft of exterior painted surfaces?(YES o go to line 4,NO Reline 3)
_ 3)Are there any windows being replaced?(YES o,go to line 4,NOpacontinue without completing EPA Section)
4)Has this home been Certified Lead Free?(YES o,you MUST Attach Certification Information,NO o complete line 5)
5)EPA Contractor Certification Number. NAT- (applies to contractor only)
• PROPERTYOWNER: Address:
Cit : State: Zip: Email:
ra Contact Name: Phone:
CONTRACTOR: t Address: ZZ ,t f
City: State: Zi Phone: s2 7 41 6- 20O Fax.
Contractor License No:MA 331fb Contact Name: Phone 52 7gb6 5-WO
Email:Ot t
ARCHITECT: 01 Address:
City: State: Zip: Phone: Fax:
• Email: Contact Name: Phone:
TYPE OF WORK: ew Construction ❑Deck ❑Pool ❑Re-Roof
❑ Commercial ii.Residential ❑Change of Use Retaining Wall b Porch ❑Re-Side
EST.VALUA ION OF WORK o Finish Basement ❑Demolition ❑Fence
$ ❑Remodel ❑Fire Sprinkler n Shed
Square feet: ❑Addition ❑Fire Alarm ❑Window/Door Replacement
❑Garage-Attached/Detach ❑Plumbing-provide detail on Page 2 #being replaced
r Detailed D cription of Work: ❑Accessory Structure chanical-provide detail on Page 2 ❑Misc Other
LI r SAC
• t
d r
Signature of this application by the legal property owner 6r a licensed contractor,as the owners e. asenta e,Is required and authorizes the Zoning Administrator or designee and the Building Official
a designee to enter upon the property to perform needed Inspections.Entry may be without prior notice.I hereby ackrowledge that I have read this application and state that all information is true end
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 of ordinances of the Municipality
and the laws of the Slate 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.Per id expires when work
u is not commenced within 180 days from dale 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 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: 7 ,
PRINTED NAME: This is the signature of: ❑Owner or ❑Owner's Representative
OCCUP.TYPE: CONST.TYPE: CODE: BLDG SPRINKLED Yes/No
VALUATION:$
Permit Fee: $ (Col. 50 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. $
OLicence Check($5)/Lcad Chock($5) $ TOTAL DUE: $
W SUB-TOTAL $ NOTE:Commercial plans will be submitted to the Met Council Environmental Svcs
rn Plumbing Fee from Page 2 $
� 9 ( g ) for SAC determination. Escrow payment will be required when permit is issued. N
w Mechanical Fee from Page 2 $ after Met Council review no SAC Is determined,escrow will be refunded In full.
U
li Special Conditions/Required Setbacks:
LL
O
Building Approval By: DATE:
Printed Building Approval By: ❑ License Verification❑ Lead Verification-Checked By:
City Approval DATE: �D a
Paid: Date. ? 0�5 a�. Receipt No.5$,5&Lf7 I By:
CITY OF SPRING PARK X MECHANICAL PERMIT
❑ PLUMBING PERMIT
PAGE 2 FOR PERMIT ISSUANCE
PAGE 1 and PAGE 2 should be complete
MECHANICAL • ' •
Mechanical Contr ctor: Address: j
City: &r&SvJ State: Zip: Phone: 7 G SWO Fax:
State Bond No: 003 Contact Name: ll
Emai �i�/ C.6 Contact Phone: GT S—Z7 4/ S-Z b0
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
Z Furnace / Kitchen Fan Z Furnace
Air Conditioning System —7 Bath Fan Z. Fireplace
2 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: $
Ei Addition/Remodel Gas Line Permit Fee: $
A New Construction State Surcharge: $
Opp
❑Other _ 011.1
.. 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 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: $
Payment Confirmation
Payer Information:
Payment Made By: Angell Aire
Payment Made For: Angell Aire, Inc
Email: angellaire@angellaire.com
Permit Address: 4469 Lafayette Lane
Address: 12253 Nicollet Ave
Burnsville, MN 55337
Payment Description: Permits
Payment Date: 7/25/2022 9:03:03 AM
Business Name Payment Payment Confirmation Amount Convenience Total
Method Account Number Fee
City of Spring Park VISA ****2425 58564791 $668.50 $19.72 $688.22
(Permits)
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RECEIPT
City of Spring Park •i''
4349 Warren Ave, Spring Park, MN 55384
(952)471-9051
SPRING PARK
22SP-00019 I Mechanical (Residential) On Lake.Minnetonka
Receipt Number: 38
Payment Amount: $668.50 July 27,2022
Transaction Method Payer Cashier Reference Number
Check Contractor Christy James
Comments
Per Mike
Assessed Fee Items
Fee items being paid by this payment
Date Fee Item Account Code Assessed Amount Paid Balance Due
07/20/22 State Surcharge (Fixed) $1.00 $1.00 $0.00
07/20/22 Residential Mechanical Permit $667.50 $667.50 $0.00
Totals. $668.50 $668.50
Previous Payments $0.00
Remaining Balance Due $0.00
Permit Info
Property Address Property Owner Property Owner Address Valuation
4469 LAFAYETTE LANE ROLAND GEORGE GROTH PO BOX 316
SPRING PARK, MN 55384 SPRING PARK, MN 55384
Description of Work
HVAC for one unit of duplex