Permits - Permit# 22SP-00026 - 4467 Lafayette Lane - 8/23/2022 City of Spring Park Mechanical (Residential)
4349 Warren Ave, Spring Park, MN 55384
WRING PARK 22SP-00026
n e9Ninneton (952)471-9051 (952)471-9160
For Inspections: (952) 442-7520
Date Issued: 08/23/2022 Property Owner: ROLAND GROTH
Expiration Date: 02/19/2023 Mailing Address: PO BOX 316
Job Site Address: 4467 LAFAYETTE LANE, SPRING
PARK, MN 55384 SPRING PARK, MN 55384
Category: Residential Miscellaneous Phone:
Permit Type: Mechanical (Residential) Email:
Valuation:
Description of Work:
Install A/C, furnace, air exchanger, garage heater, 25 supplies, 12 returns,4 bath fans, 1 kitchen vent hood, 7 gas lines
Subdivision: Required Setbacks:
Parcel ID: 1911723210056
Filing:
Lot: 9 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 $442.50
Total Fees: $443.50
NOTICE
Signature of Applicant/Date Building Department Signature/Date
08/23/2022
MUST BE POSTED ON JOB SITE
INSPECTION CARD
*k=z� City of Spring Park
SPRING PARK
On Lake Yinnetonkp 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-00026 PERMIT TYPE: (Residential) ISSUED DATE: 08/23/2022 EXPIRATION DATE: 02/19/2023
1911723210
PROJECT ADDRESS: 4467 LAFAYETTE LANE,SPRING PARK,MN 55384 PARCEL NO.: 056
OWNER: ROLAND GROTH CONTRACTOR: Angell Aire Inc, CONTRACTOR PHONE: (952)746-5200
DESCRIPTION OF WORK: Install A/C,furnace,air exchanger,garage heater,25 supplies,12 returns,4 bath fans,1 kitchen vent hood,7 gas lines
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
r,
CITY OF SPRING PARK PAGE 1 BUILDING PERMIT
4349 Warren Avenue d.?SP- 61>151Q?
Spring Park, MN 55384 El Handout Given
Phone: 952-471-9051 Fax: 952-471-9160 ❑ Lead Handout Given Routed to MNSPECT
SITE ADDRESS: 01 L -,4 PID:
1)Was the home constructed before 1978?(YES o,continue with line 2,NOXcontinue without completing EPA Section)
2)Will the work disturb>_6 sq ft of interior painted surfaces or Z20 sq ft of exterior painted surfaces?(YES c go to line 4,NO❑line 3)
3)Are there any windows being replaced?(YES o,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 o complete line 5)
3)EPA Contractor Certification Number: NAT- (applies to contractor only)
• PROPERTY OWNER: Address-
City: State: Zip: Email.
Contact Name: Phone:
• CONT CTOR: _LcAddress:
Cit : State: Zip: 3 Phone: 95�' -5�2.0 Fax:
Contractor License No: Contact Name Phone 1�-Z 7,VK S-7_e5p
Email:
ARCHITECT: Address:
City: State: Zi : Phone: Fax:
• Email: Contact Name: Phone:
TYPE OF WORK: o New Construction Deck ❑Pool o Re-Roof
❑Commercial XResidential ❑Change of Use Retaining Wall ❑Porch ❑Re-Side
EST.VALUATION OF WORK ❑Finish Basement ❑Demolition ❑Fence
$ M 007 ❑Remodel Fire Sprinkler ❑Shed
Square feet: ❑Addition c Fire Alarm ❑Window/Door Replacement
❑Garage-Attached/Detach ❑Plumbing-provide detail on Page 2 #being replaced
Detailed Des ripti of Work: c Accessory Structure Mechanical-provide detail on Page 2 o Misc Other
Signature of this application by the legal property owner or a licensed contractor,as the owner's representaKe,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 acknowleoga 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 at work performed will be M accordance with approved plans.specifications and conditions and to abide by al 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 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 penally.
Noise Ordinance In Effect:MONDAY-FRIDAY Before 7 a .and after 10 p.m.Weekends/Holidays before 7 a.m.and after 8 p.m.
SIGNATURE OF APPLICANT: DATE:4
PRINTED NAME: s 0 -,'n.0 V This is the signature of: ❑Owner or jN Owner's Representative
OCCUP.TYPE: CONST.TYPE: CODE: BLDG SPRINKLED Yes/No
VALUATION:$
Permit Fee: $ 1f44.50 WAC Charge: $
Plan Review Fee: $ Sewer&Water Hook-Up: $
State Surcharge: DO Sewer&Water Disconnect: $
Site Inspection Fee: $ Water Meter. $
S.E.C.Fee: $ Muni SE/WA Fee: $
Investigation Fee/Other Fee: $ *2016 SAC Escrow: S2 485
>- Copy Charge($.25 per 8 5 x11 page) $ Other $
J
O Liconsc Chock($5)/Load Chock($5) $ TOTAL DUE: $
W SUB-TOTAL $ f7
En 'NOTE:Commercial plans will be submitted to the Mel Council Environmental Svcs
M Plumbing Fee(from Page 2) $ for SAC determination. Escrow payment will be required when permit is issued. tt
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:
O
Building Approval By: DATE:
Printed Building Approval By: ❑ License Verification❑ Lead Verification-Checked By:
City Approval By
Paid: Date: Receipt No. y: 13
p l = -L__
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:/ZZ53 v!i
Cit !/ State: Zip: 5.33-7 Phone: -7- -rZ00 Fax:
State Bond No: 3� Contact Name: �-*Wl
Email: G Contact Phone: -,rZO
Detailed Descri tion of Work: l'i
ZS L
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 uanti Furnace / Kitchen Fan Furnace _ a l in
/ Air Conditioning System --�71—Bath Fan Fireplace
_L Air Exchanger Grill Unit Heater
Fireplace Water Heater
Unit Heater Grill
In Floor Heat l 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: $
,6New Construction State Surcharge: $_
❑Other Other. $
Total Mechanical Permit: $
PLUMBING INFORMATION
Plumbing Contractor: Address:
C State: Zip: Phone: Fax:
Plumbers License No: State 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: Angell Aire
Payment Made For: Angell Aire
Email: angellaire@angellaire.com
Permit Address: 4467 Lafayette Lane
Address: 12253 Nicollet Ave
Burnsville, MN 55337
Payment Description: Permits
Payment Date: 8/17/2022 11:48:22 AM
Business Name Payment Payment Confirmation Amount Convenience Total
Method Account Number Fee
City of Spring Park VISA ****2425 83434384 $443.50 $13.08 $456.58
(Permits)
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RECEIPT
City of Spring Park
4349 Warren Ave, Spring Park, MN 55384
(952)471-9051
SPRING aL M
22SP-00026 I Mechanical (Residential) On Lake Winnetonkg
Receipt Number: 51
Payment Amount: $443.50 August 23,2022
Transaction Method Payer Cashier Reference Number
Credit Card Angell Aire Jamie Hoffman 83434384
Comments
Assessed Fee Items
Fee items being paid by this payment
Date Fee Item Account Code Assessed Amount Paid Balance Due
08/17/22 State Surcharge(Fixed) $1.00 $1.00 $0.00
08/17/22 Residential Mechanical Permit $442.50 $442.50 $0.00
Totals: $443.50 $443.50
Previous Payments $0.00
Remaining Balance Due $0.00
Permit Info
Property Address Property Owner Property Owner Address Valuation
4467 LAFAYETTE LANE ROLAND GROTH PO BOX 316
SPRING PARK, MN 55384 SPRING PARK, MN 55384
Description of Work
Install A/C,furnace, air exchanger, garage heater,25 supplies, 12 returns,4 bath fans, 1 kitchen vent hood, 7 gas lines