Permits - Permit# 22SP-00035 - 4608 West Arm Road - 10/5/2022 City of Spring Park Plumbing Replacement -
Single Fixture (Residential)
4349 Warren Ave, Spring Park, MN 55384
PR►NG PARK 22SP-00035
Lake%inneton a (952)471-9051 (952)471-9160
For Inspections: (952) 442-7520
Date Issued: 10/05/2022 Property Owner: Wendy Shavlik
Expiration Date: 04/03/2023 Mailing Address: 4608 West Arm Road
Job Site Address: 4608 West Arm Road, Spring Park, MN
55384 Spring Park, MN 55384
Category: Residential Miscellaneous Phone:
Permit Type: Plumbing Replacement-Single Fixture Email:
(Residential)
Valuation:
Description of Work:
Replace bathroom vanity
Subdivision: Required Setbacks:
Parcel ID:
Filing:
Lot: Actual Setbacks:
Block:
Total Sq Ft:
Contractors: Fee Items Amount
State Surcharge(Fixed) $ 1.00
Residential Mech./Plg. Replacement Permit $50.00
Total Fees: $51.00
NOTICE
Signature of Applicant/Date Building Department Signature/Date
10/05/2022
MUST BE POSTED ON JOB SITE
INSPECTION CARD
City of Spring Paris
SPRING PARK
OnGakfWinnetonka 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.
Plumbing
PERMIT NO.: 22SP-00035 PERMIT TYPE: Replacement- ISSUED DATE: 10/05/2022 EXPIRATION DATE: 04/03/2023
Single Fixture
(Residential)
PROJECT ADDRESS: 4608 West Arm Road,Spring Park,MN 55384 PARCEL NO.:
OWNER: Wendy Shavlik CONTRACTOR: CONTRACTOR PHONE:
DESCRIPTION OF WORK: Replace bathroom vanity
CONSTRUCTION TYPE: OCCUPANT LOAD:
DATE DATE
INSPECTION INSP PASSED COMMENTS INSPECTION INSP PASSED COMMENTS
Plumbing Final
Fire Approval: Date: Engineering Date:
Approval:
PW Approval: Date: Other( ): Date:
To request an inspection:(952)442-7520
Paoe 1 of 1
• 1 R
I CITY OF SPRING PARK PAGE 1 BUILDING PERMIT
4349 Warren Avenue 1949 �Q'jjs
Spring Park, MN 55384 El Handout Given
Phone: 952-471-9051 Fax: 952-471-9160 El Lead Handout Given Routed to MNSPECT
SITE ADDRESS: y 6 0121 A(w) PID:
1)Was the home constructed before 1978?(YES o,continue with line 2,NO o continue without completing EPA Section)
2)Will the work disturb?6 sq it of interior painted surfaces or a20 sq it of exterior painted surfaces?(YES o go to line 4,NO)tline 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)
5)EPA Contractor Certification Number. NAT- (applies to contractor only)
• PROPERTY OWNER: WerI&M havI I L Address: q eS*- Y tin
Ci ' State: Zi : S53� Email: (0 i o v l k- 6? fit,koo. Cc"
r' Contact Name. Phone; Z - S - S�SD
CONTRACTOR:
Address:
City: State: Zip: Phone: Fax:
Contractor License No: Contact Name: Phone:
Email:
ARCHITECT: Address:
City: State: Zip: Phone: Fax:
• Email: Contact Name:; Phone:
TYPE OF WORK:
❑New Construction c Deck ❑Pool ❑Re-Roof
❑Commercial X Residential o Change of Use o Retaining Wall,!,n Porch n Reside
EST.VALUATION OF WORK ❑Finish Basement 0 Demolit►ori o Fence
$ L4 CIO o Remodel n Fire Sprinkler c Shed
Square feet: in Addition ❑Fire Alarm o Window/Door Replacement
❑Garage-Attached/Detach.<M 4'P16mbing-provide detail on Page 2 #being replaced
Detailed Description of W rk: ❑'Accessa ' tructure o Mechanical-provide detail on Page 2 o Misc Other
Signature of this application by the legal roperty 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 t 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.1 her agree that at work performed will be In accordance with approved plans,specifications and conditions and to abide by at ordinances of the Municipality
and the laws of the State of Minnesota r gardmgactions 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
.r Is not commenced within 180 days from ate_of Perm 4,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 ffect:iMONDAY-FPoDAY Before 7 a.m.and after 10 p.m.Weekends/Holidays before 7 a.m.and after 8 p.m.
SIGNATURE OF APPLICA T: DATE: a(
PRINTEl3.NAME:,, A;1,1i2r This is the signature of: ❑Owner or )(Owner's Representative
OCCUP.TYPE: CONST.TYPE: CODE: BLDG SPRINKLED Yes/No
VALUATION:$
ermit Fee: $ G • WAC Charge: $
Plan Review Fee: $_ Sewer&Water Hook-Up: $
State Surcharge: $ - Sewer&Water Disconnect: $
Site Insrection Fee, $ Water Meter. $
3.E.C-Fee: $ Muni SE/WA Fee: $
Investigation Fee)Other Fee: $ *2016 SAC Escrow: $24m
>- Copy Charge($.25 per 8.5 x11 page) $ Other. $
QLicense Chock($5)1 Lead Chock($5)$ TOTAL DUE: $ A a�
W S B TOTAL $
y `NOTE:Commercial plans will be submitted to the Met Council Environmental Svcs
=1 Plumbing Fee(fr)m Page 2) $ for SAC determination. Escrow payment will be required when permit is issued. If
W Mechanical Fee fr m Page 2 $ after Met Council review no SAC is determined,escrow will be refunded in full.
U
IL Special Conditions/Requi Setbacks:
LL
Building Approval By: DATE:
Printed Building Appr val Ity ❑ License Verification❑ Lead Verification-Checked By:
City Approval By: 5 as
DATE:
Paid. Date: q a3 ova Receipt No.5�j(p rJ ( By: �-,
CITY OF SPRING PARK ❑ MECHANICAL PERMIT
KPLUMBING PERMIT
P GE 2 FOR PERMIT ISSUANCE
PAGE 1 and PAGE 2 should be complete
INFORMATIONMECHANICAL
Mechanical Contractor: Address:
City: St e: Zip: Phone: Fax:
State Bond No: Contact Name-
Email: Contact Phone:
Detailed Description of Work:
Indicate type of project,fi ures, and Gas Lines you will be installing or replacing (include count for eaeh ty f fixture):
MECHANICAL FIXTURES GACN
Quantity Quantity Quantity
Furnace Kitchen Fan Furnace
Air Conditioning Systerr Bath Fan Fireplace
Air Exchanger Grill Unit Heater
Fireplace Water H
Unit Heater Grill
In Floor Heat er
Gas Log
KTotal
❑Replacement(one fixture only,no piping or vent changes) hanical ermit Fee: $
LiAddition/Remodel s Line Permit Fee: $
❑New Construction State Surcharge: $
ElOther Other- $
echanical Permit: $
FORMATION
Plumbing Contractor: 1 Vi0:61W Address: ay( S UC rI CY14'ek
Cit : S te: Zip: Phone: Fax:
Plumbers Licens o: Pei M5 1 Jee3 State Bond No:
Contact Name: t CIS,:, Contact Phone: ot)- 3 ( -,->"-7
Email e6hd _k, 1204 0. QnaakCDY�
Detailed Descrip ion of Work
re- 19 al-ha byyi- 441 ILl
Indicate type of pro I ct 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 Rough4n 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
Offike Use Only:
1)4 Replacement(one fixture only, no piping or vent changes) Plumbing Permit Fee: $ 50 -
❑Addition/Remodel State Surcharge $ .
❑New Construction Other: $
❑Other Total Plumbing Permit: $ 5�'�
Payment Confirmation
Payer Information:
Payment Made By: Rick Brainer
Payment Made For: Rick Brainer
Email: infoperfectionplumbing@gmail.com
Permit Address: 4608 West Arm Rd
Address: 24185 Denmark Ave
Farmington, MN 55024
Payment Description: Permits
Payment Date: 9/23/2022 9:55:11 AM
Business Name Payment Payment Confirmation Amount Convenience Total
Method Account Number Fee
City of Spring Park VISA ****2926 56684671 $51.00 $2.25 $53.25
(Permits)
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RECEIPT
City of Spring Park �^
4349 Warren Ave, Spring Park, MN 55384
(952)471-9051
SPRING PARK
22SP-00035 I Plumbing Replacement-Single Fixture (Residential) On Gale Minnetonka
Receipt Number: 72
Payment Amount: $51.00 October 5, 2022
Transaction Method Payer Cashier Reference Number
Credit Card Precision Plumbing Jamie Hoffman 56684671
Comments
Assessed Fee Items
Fee items being paid by this payment
Date Fee Item Account Code Assessed Amount Paid Balance Due
09/23/22 State Surcharge(Fixed) $1.00 $1.00 $0.00
09/23/22 Residential Mech./Plg. Replacement Permit $50.00 $50.00 $0.00
Totals: $51.00 $51.00
Previous Payments $0.00
Remaining Balance Due $0.00
Permit Info
Property Address Property Owner Property Owner Address Valuation
4608 West Arm Road Wendy Shavlik 4608 West Arm Road
Spring Park, MN 55384 Spring Park, MN 55384
Description of Work
Replace bathroom vanity