Permits - Permit# 23SP-00037 - 2258 Hazeldell Avenue - 5/5/2023'rl I City of Spring Park I Mechanical (Residential
A� 4349 Warren Ave, Spring Park, MN 55384
~� 23SP-00037
!ARK Phone:(952) 471-9051 Fax: (952) 471-9160
For Inspecdons: (952) "2-7520
Date issued:
05/05/2023
Property Owner: Robin Sherman
Expiration Date:
11/01/2023
Mailing Address: 2258 Hazeldell Avenue
Job Site Address:
2258 Hazeldell Avenue, Spring Park,
MN 55384
Spring Park, MN 55384
Category:
Residential Miscellaneous
Phone: (952) 4864776
PerrnitType:
Mechanical (Residential)
Email:
Valuation:
Description of Work:
Replace Air Conditioner
Subdivision:
Required Setbacks:
Parcel ID:
Filing:
Lot:
Actual Setbacks:
Block:
Total Sq Ft:
Contractors:
Fee Items
Amount
State Surcharge (Fixed)
$ 1.00
Residential Mechanical Permit
$ 75.00
Total Fees:
$ 76.00
NOTICE
Signature of Applicant/Date
Building Department Signature/Date
05/05/2023
MUST BE POSTED ON JOB SITE
INSPECTION CARD
City of Spring Park
SPRING BARK
On Lake9l4innetonk; 4349 Warren Ave, Spring Park, MN 55384
POST THIS CARD IN A SAFE CONSPICUOUS LOCATION. PLEASE DO NOT REMOVE THIS NOTICE UNnL ALL REQUIRED MSPECTIONS ARE WADE AND SIGNED OFF BY THE APPROPRIATE
AUfHORITYAND THE BUILDING IS APPROVED FOR OCCUPANCY. STAMPED APPROVED PLANa MUST SE AVAILABLE ON THE JOBSITE.
Mechanical
PERMIT NO.: 23SP-00037 PERMIT TYPE: (Residential)
PROJECT ADDRESS: 2258 Hazeldell Avenue, Spring Park, MN 55384
OWNER: Robin Sherman CONTRACTOR:
DESCRIPTION OF WORK: Replace Air Conditioner
OOCUPANT LOAD:
ISSUED DATE: 05105/2023 EXPIRATION DATE: 11l0112023
PARCEL NO.:
CONTRACTOR PHONE:
DATE DATE
INSPECTION INSP PASSED COMMENTS INSPECTION INSP PASSED COMMENTS
lechanical Rough -In Air/Hydrostatic Test
ieports Mechanical Final
Fire Approval: Date: Engineering
Approval:
PW Approval: Date: Other {
To request an inspection: (952) 442-7520
Date:
): Date:
Pew 1 of 1
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CITY OF SPRING PARK PAGE 1 BUILDING PERMIT
4349 Warren Avenue
Spring Park, MN 55384 El Handout Given
Phone: 962-471-9051 Fax: 9552-471-9160 ❑ Lead Handout Given Routed to MNSPECT
.;ITE ADDRESS: 2258 HAZELDELL AVE PID: 17-117-23-33-0067
1) Was the home constructed 1`efcre 19751' (YES X continue with ime 2 NO continue without completing EPA Section)
0 Will the work disturb L>6 sq ft of interior painted surfaces or z20 sq ft of exler:er painted surfaces? (YES ❑ go to line 4, NO dine 3)
3) Are thete any windows being replaced' tYES �_, go to Ikne 4. NOX continue without completing EPA Section)
4) Has this home been Certified Lead Free7 tiYES you MUST Attach Certif;cation Information, NO o complete line 5)
;f) EPA Contractor Certification Number NAT - (applies to contractor only)
ROBIN SHERMAN
SPRING PARK State_ MN ZiD_ 55384
_mail:
rOR:CENTERPOINT ENERGY
N VALLEY StateMN Zi :55422
License No: MB003503
OF WORK:
EST. VALUATION OF WORK
i 5600.00
iquare fbet
Descrlp#on of tlikark:
: New Construction
Change of Use
a Finish Basement
Remodel
Addition
Garage-Attached/Detach
2258 HAZELDELL AVE
Phone- 952-486-8776
A161 GOLDEN VALLEY RD
763-512-2765 Fax:
Name:JOANN ZINKEN Phnl
❑ Deck z Pool
Retaining Wall Porch
a Demolition
Fire Sprinkler
FireAlarm
Plumbing -provide detai on Page 2
Mechanical -provide detail on Pace 2
Re -Roof
- Re -Side
❑ Fence
o Shed
= i�lindow/Door Replacement
# being replaced
— serer-. rue.,.,
3trimum or this application by the legal propertyowaer cr a Amsed cWhacror as the owners mpresentat ", is required and authortme the Zoning Administrator or deWWeee and the auWbtg Oflk3a
iz designee to enter upon the property to perform needed Inspections. Entry may be, vaout prior notice. I hereby eckro fledge that I have read M application and state that all Irnfermalbn Is trip and
romect to tha bast of my knowledge. I fuAter agree that all work perromned will be In "accordance with approved plans, specMcallons and conditions and to abide by al ordinances at the Munkipalky
iatd the lanes of the State of Mlnnesole regardrtg actions taxer pursuant to this permti. I agree to pay all plan rwlewfaes awn If 1 choose not to prnewd with tM work. Permti axpltw when wok
is not commenced within 180 days from date or petmd, or If work Is suspsnde4 abandoned. or not Inspected for 180 days. work beyond the scope of this perch. or work wftout a permit or Inspection,
lath be subject to a penalty.
Noise Ordinance In Effect: NDAY - FRIDAY Before 7 a.m. and after 10 P.M. WeelandolHolidays before 7 a.m, and after 8 p.m.
SIGNATURE OF APPLIC"T DATE, 05/03/2023
PRINTED NAME: .loAnn L.tke Ln This is the signature of: :: Omer or jq Owner's Representative
OCCUP- TYPE: CONS . TYPE: CODE: BLDG SPRINKLED Yes 1 No
S
Permit Fee. $ .�
Plan Review Fee: $
State Surcharge: $ •
Site Inspection Fee: $
S.E.C. Fee: $
Investigation Fee 1 Other Fee: $
Copy Charge ($.25 per 8.5 x11 page) $
Liconsa Chock ($5) l Load Chock ($5) $
SUB TOTAL $
Plumbing Fee (from Page 2) $
I Approval By:
Building Approval By:
City Approval B
Paid: _ Date:
Setbacks:
Receipt No.
WAC Charge: $
Sewer & Water Hook -Up: $
Sewer & Water Disconnect $
Water Meter $
Muni SElWA Fee: $
•2016 SAC Escrow: S2_485
Other. $
TOTAL DUE: $ Pl
Commercial plans will be submitted to the Met Council Environmental Svcs
for SAC determination. Escrow payment will be required when permit is issued. K
after Met Council review no SAC is determined, escrow will be refunded In full.
DATE:
❑ License Verification ❑ Lead Verification - Che ked By:
DATE:
11 MECHANICAL PERMIT
CITY OF SPRING PARK
❑ PLUMBING PERMIT
PAGE 2 FOR PERMIT ISSUANCE
PAGE 1 and PAGE 2 should be complete
_ MECHANICAL INFORMATION
Mechanical Contractor: CENTERPOINT ENERGY Address:6161 GOLDEN VALLEY RD
City- GOLDEN VALLEY State:MN Zi : 55422 Phone:763-512-2765 Fax:
State Bond No: MB003503
lContact Name.JOANN ZINKEN
Email: - rm' s int n
Contact Phone: 763-512-2765
Detailed Descrt n 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 OAS LINES
Quantity Quantity Quantity
Furnace Kitchen Fan Furnace
Conditioning System Bath Fan Fireplace
Air Exchanger Grill Unit Heater'
Fireplace _ ` Water Heater
Unit Heater Grill
`b
In Floor Heat Dryer
Gas Loa. Stove
Ofte We Only.
Ip Replacement (one fixture only, no piping or vent changes) Mechanical Permit Fee:
❑ Addition/Remodel Gas Line Permit Fee: $ 1 `
❑ New Construction State Surcharge: $
❑ Other , $ `
Total Mechanical Permit: S
PLUMBING . a
Plumbing Contractor: Address:
City: State: Zi : Phone: Fax:
Plumbers License No:
ISUte Bond No:
Contact Name:
lContact Phone:
Email:
Detailed Descripflon 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 SAC.
Water Heater Shower Laundry Tub
❑ Gas ❑ Electric Dishwasher Rough -In Future Fixture
Water Softener Clothes Washer Sump
Lawn Sprinkler System lee Maker Line Water Piping System
Water Closet (Toilet) Hose Bib Floor Drain
Lavatory ash Basin Bathtub
Office Use Only. -
Replacement (one fixture only, no piping or vent changes)
Plumbing Permit Fee: $
Addition/Remodel
State Surcharge $
❑ New Construction
Other: $
11 Other
Total Plumbing Permit: $
Payment Confirmation
Payer Information:
Payment Made By:
Payment Made For:
Email
Permit Address:
Address:
Payment Description:
Payment Date:
Business Name
City of Spring Park
(Permits)
JOANN L ZINKEN
CENTERPOINT ENERGY
HSP-
PERMITS@CENTERPOINTENERGY.COM
2258 HAZELDELL AVE
6161 GOLDEN VALLEY RD
GOLDEN VALLEY, MN 55422
Permits
5/4/2023 8:08:40 AM
Payment Payment Confirmation Amount Convenience
Method Account Number Fee
MC ****9294 87055105 $76.00 $2.99
Total
$78.99
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City of Spring Park
4349 Warren Ave, Spring Park, MN 55384
(952)471-9051
23SP-00037 i Mechanical (Residential)
Payment Amount: $76.00
-idol
� � �, f �, '✓
On Lake Minnetonka
Receipt Number. 182
May 5, 2023
Transaaon Methad Payer
Cashier
Reference Number
Credit Card Centerpoint Energy
Jamie Hoffman
87055105
Comments
Assessed Fee Items
Fee items being paid by this payment
Date Fee Item
Account Carle
Assessed Amount Paid
Balance Due
05/03/23 State Surcharge (Fixed)
$1.00 $1.00
$0.00
05/03/23 Residential Mechanical Permit
$75.00 $75.00
$0.00
Tom:
$76.00 $76.00
Previous Payments
$0.00
Remaining Balance Due
$0.00
Permit Info
Property Address Property Owner Properly Owner Address Valuation
2258 Hazeldell Avenue Robin Sherman 2258 Hazeldell Avenue
Spring Park, MN 55384 Spring Park, MN 55384
Description of Work
Replace Air Conditioner