Permits - Permit# 22SP-00053 - 4100 Shoreline Drive - 12/9/2022 City of Spring Park Plumbing (Commercial)
4349 Warren Ave, Spring Park, MN 55384
ING PARK 22SP-00053
�1 inneton a (952)471-9051 (952)471-9160
Ra!
For Inspections: (952) 442-7520
Date Issued: 12/09/2022 Property Owner: GENTLE DENTISTRY
Expiration Date: 06/07/2023 Mailing Address: 4100 SHORELINE DR
Job Site Address: 4100 SHORELINE DRIVE UNIT 4, UNIT 4
SPRING PARK, MN 55384 SPRING PARK, MN 55384
Category: Commercial Miscellaneous Phone:
Permit Type: Plumbing (Commercial) Email:
Valuation: $450.00
Description of Work:
WATER METER INSTALLATION
Subdivision: Required Setbacks:
Parcel ID: 1811723440235
Filing:
Lot: Actual Setbacks:
Block:
Total Sq Ft:
Contractors: Fee Items Amount
Primary DOUG LINDEN INC State Surcharge $0.23
Commercial Plumbing Permit $75.00
Total Fees: $75.23
NOTICE
Signature of Applicant/Date Building Department Signature/Date
12/09/2022
MUST BE POSTED ON JOB SITE
INSPECTION CARD
4i=z City of Spring Paris
SPRING PARK
On CakeYinnetonku 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 JOSSITE.
Plumbing
PERMIT NO.: 22SP-00053 PERMIT TYPE: (Commercial) ISSUED DATE: 12/09/2022 EXPIRATION DATE: 06/07/2023
1811723440
PROJECTADDRESS: 4100 SHORELINE DRIVE UNIT 4,SPRING PARK,MN 55384 PARCEL NO.: 235
OWNER: GENTLE DENTISTRY CONTRACTOR: DOUG LINDEN INC CONTRACTOR PHONE:
DESCRIPTION OF WORK: WATER METER INSTALLATION
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
Paae 1 of 1
CITY OF SPRING PARK PAGE 1 BUILDING PERMIT
4349 Warren Avenue 11 'Owe-pooei
Spring Park, MN 55384O1d "
Routed to MNSPECT
Phone: 952-471-9051 Fax: 952-471-9160 0 Lead Hairodout Gban
ITTEADDRESS: rvl e)D 7)14y _ PID:
1)Was the home constructed before 1978?(YES❑.continue with line 2.NO a continue without completing EPA Section)
?)Will the work disturb a8 sq ft of interior painted surfaces or M sq ft of exterior painted surfaces?(YES n go to line 4,NO❑line 3)
3)Are there any windows being replaced?(YES❑,go to One 4,NO❑continue without completing EPA Sermon)
act)Has this home been Certified Lead Free?(YES❑,you MUST Attach Certification Information,NO o complete line 5)
SZ EPA Contractor Certification Number. NAT- (apples to contactor only)
• PROPERTY OVAMt: Address: d v
r^t 'Q"- C State: zily Email:
ContaciName' Phone:
coNTRACTO D 4r 'd tL� fLL Address: 7 f 7 C5 v/ •fri d" h
R:
:!4 E-ee,"r'c°e'State: •'t Zl '� Phone: /1 _2 7&0�
Af Par,
Contractor License No: I Se- y 4 Contact Name: ✓ pSpne Z--7 S!a
ARCHITECT: Address:
+7 - State: zkx Phone: FaL
• Email: Contact NaM2 Phone:
T O%OF WORK: o New Construction ❑Deck [3❑pool r Re�oof
6Cornmercial p Residential ❑Change of Use ❑RetaAMW Weil. t Porky la Ride
EST.VALUATION OF V ORK ❑Finish Basement r,,.i> io[iMt7l1 ❑Fence
r v o Remodel Fire,Bprutl tf C Shed
:igUafe tise!` ❑Addition ❑VOWAlarm ❑WindowlDoor Replacement
❑Garage-AitsrhedlDe h;' Ptumbing�ovide detar on Page e #being replaced
UoUiled Description of Work: ❑ n3 o M militia deal on Pap 2 ❑Mist Other
n 4� � e e—
sOr,�,re ethic appaeeaon by ttr repel property owns era ,ss tir�aMtara repr�wrta>ws,b ragrbed end au4toRw t!r mdr,0 AdmYMatramr or oalptw and tie autdYfp oiacid
r deaIm to WW WW f v@ pgporq to perfo and atone till et Irrraraa. r hue end
-awe to ttw best d ary bwwiadpe_1 Ndlrr spree lit Y� 4 M aecordwrea war epprorsd Piro.epeelicadorw awn mrrd4iors and to akAde by ar ard of tr mwkow ty
ed the lave of tin stall d bnreaota repur�aQ skews wwn pagxaertta Iae pamR r apwio peyat pin nrImw f m wAn tf t ehoom eat to proceed um sue work Pwmk aja when work
s not commenced wtdrtr 1e0 days from delaafPsadlt M inowt s m4panded.�erWonsd,or na knpattad for 180 days.work beyord cis wope of 101r psmt,or wwk wt hmd a peantt or hapeetlon,
eti be subod to a penety.
Noise ardirwftea in EttiCt DAY am,anti taftsr 10 pan.Waekendahloichrys before 7 a.m.and tdhr tf p et.
SIGNATURE OF APPUCAW, DATE�/�/�'•�2
PRMITEQ Tltfs is#w signature of: o Owner or ❑Owner's
OCCUP.TYPE: CONST.TYPE CODE BLDG SPRIWLED Yes/No
VALUATION:$
PemM Fee: $ WAC Charge-.$
Plan Review Fee:$ Sewer&Water Hook-Up: $
State Surcharge: $ Sewer Water Disconnect $
Site Inspection Fee: $ Water Meter. $
S.EC.Fee: $ Muni SE/WA Fee: $
Investigation Fee f Other Fee: $ *2016 SAC Escrow. &2 4$5
J Copy Charge($25 per 8.5 x1 i page)$ Other$
G Lieonso Check(66)1 Load Gook(66)6_ TOTAL DUE: $
ILI SUB-TOTAL $
j Plumbing Fee(from Page 2)$ *NM'Convnerdsi plan MR to amtonNed to the Yet CO1O1s Envkowre"W Svcs
for SAC deterva whon. Eaerow paymmut wni be r quh when permit is bsusd. tr
W Mechanical Fee from Page 2 $ after Mat Count renew no SAC 6s ddermkuq,searo r win he rsfrsrdsd in fuii.
r% Special Cwditiorts/ReWired Setbacks:
LL
O
Building Approval By. DATE:
Printed Binding AppVd BY ❑ License Verification 0 Lead Verification-C By
City Approval By: DATE:
Paid: Date: Receipt N4 WjQ By.
CITY OF SPRING PARK ❑MECHANICAL PERMIT
14 PLUMBING PERMIT
PAGE 2 FOR PERMIT ISSUANCE
PAGE I and PAGE 2 should be complete
MECHANICALe `
Mechanical Contractior: Address:
car, State: Zx : e: Fax.-
State Bond No: Contact Name:
Email: Contact Phone:
Debikd Descripfim of Work:
Indicate type of project,fixtures,and Gas Lines you will be instating or replacing(include count for each type CO fixture):
MECHANICAL►DfTURFS "S L Ann
Quanft quanLftv Quantity
Furnace ICtchen Fan Furnace
Air Conditioning System Bath Fan Fireplace
Air Exchanger Grill Unit Heater
Fireplace Water Heater --.
Unit Heater _ _ Grill
In Floor Heat Der
Gas Lou
tipMaa(be on¢
❑Replacement(one fixture only,no piping or vent changes) Mechanical Permit Flee: $
o Addition/Remodel Gas Line Permit Fee: $
❑New Construction State Surcharge: $
❑Other Other. $
Total Mechanical Parma $
PLUMBING INFORMATION
PI Contr,dor: DU. 4,1_46tao, Jac, Address: e 7/7 o f r-o A A
city: a e �c�!� e�41 ' '"�2 Pho e: 12-�_YZ -15%0
Plumbers License No: r8'4 r-/ state Bond No: PC4'$0,0 Af
con-tact mm. d� contact Ph x-z T z �c
Enmdt t� a[! 2it ILG iyt Lf�
Detailed Des4tftm ofWbrfx• ✓1 zc.c/ W pd" Mer
Indicate type of project and fixtures you will be installing or replacing(include count for each type of fixture):
PLUMBIM FIXTURES
Quantitv Guanft 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
Lavatocy Mash Basin Bathtub
once use ontr.
❑ Replacement(one fixture,only,no piping or vent changes) Plumbing Permit Fee: $
❑AddiftVRemodel State Surcharge $
❑New Cosrcti Other $
a Other � el- In de Total Plumbing Permit $
RECEIPT
City of Spring Park
4349 Warren Ave, Spring Park, MN 55384
(952)471-9051
SPRING PARK
22SP-00053 1 Plumbing (Commercial) On Lake Minnetonka
Receipt Number: 110
Payment Amount: $75.23 December 9,2022
Transaction Method Payer Cashier Reference Number
Cash Doug Linden Inc. Jamie Hoffman Cash at City
Comments
Assessed Fee Items
Fee items being paid by this payment
Date Fee Item Account Code Assessed Amount Paid Balance Due
11/18/22 State Surcharge $0.23 $0.23 $0.00
11/18/22 Commercial Plumbing Permit $75.00 $75.00 $0.00
Totals. $75.23 $75.23
Previous Payments $0.00
Remaining Balance Due $0.00
Permit Info
Property Address Property Owner Property Owner Address Valuation
4100 SHORELINE DRIVE GENTLE DENTISTRY 4100 SHORELINE DR UNIT 4 $450.00
UNIT 4 SPRING PARK, MN 55384
SPRING PARK, MN 55384
Description of Work
WATER METER INSTALLATION