Permits - Permit# 23SP-00038 - 4317 Channel Road - 5/15/2023 City of Spring Park Plumbing (Residential)
4349 Warren Ave, Spring Park, MN 55384
PRING PARK 23SP-00038
Phone:(952)471-9051 Fax:(952)471-9160
n Lake Winneton a
For Inspections: (952) 442-7520
Date Issued: 05/08/2023 Property Owner: Berry
Expiration Date: 11/05/2023 Mailing Address: 4317 Channel Road
Job Site Address: 4317 Channel Road, Spring Park, MN
55384 Spring Park, MN 55384
Category: Residential Miscellaneous Phone:
Permit Type: Plumbing (Residential) Email:
Valuation:
Description of Work:
Install new water heater
Subdivision: Required Setbacks:
Parcel ID:
Filing:
Lot: Actual Setbacks:
Block:
Total Sq Ft:
Contractors: Fee Items Amount
State Surcharge(Fixed) $ 1.00
Residential Plumbing Permit $75.00
Total Fees: $76.00
NOTICE
Signature of Applicant/Date Building Department Signature/Date
OS/15/2023
MUST BE POSTED ON JOB SITE
INSPECTION CARD
City of Spring Park
SPRING PARK
OnGakf%innetonka 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.: 23SP-00038 PERMIT TYPE: (Residential) ISSUED DATE: 05/08/2023 EXPIRATION DATE: 11/05/2023
PROJECT ADDRESS: 4317 Channel Road,Spring Park,MN 55384 PARCEL NO.:
OWNER: Berry CONTRACTOR: CONTRACTOR PHONE:
DESCRIPTION OF WORK: Install new water heater
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
Spring Park, MN 55384 ❑ Handout Given
Routed to MNSPECT
Phone: 952-471-9051 Fax: 952-471-9160 ❑ Lead Handout Given
SITE ADDRESS: ! ` C/ Itk 17 n Rr� r TP�1 Par12 PID:
1)Was the home constructed before 1978?(YES o,continue with line 2,N6 ❑confinue without completing EPA Section)
2)Will the work disturb a6 sq ft of interior painted surfaces or z20 sq ft of exterior painted surfaces?(YES o go to line 4,NO o line 3)
_ 3)Are there any windows being replaced?(YES o,go to line 4,NO c continue without completing EPA Section)
4)Has this home been Certified Lead Free?(YES o,you MUST Attach Certification Information,NO o complete line 5)
6)EPA Contractor Certification Number. NAT- (applies to contractor only)
• PROPERTY OWNER: TROlilr SAAddress: y 31-- hJ Rd
Cl -.nQ State: NZi : �613Rq Email:
if
r Contact Name: Phone:
CONTRACTOR: S' � Address. X ir•r ,42 T
Cit : State: Zi L .e1_-5' Phone: -3 0 q- T Fax:
r
Contractor License No: PC Contact Name: Phone -
Email: NcLbf "I
ARCHITECT: Address:
City: State: Zip: Phone: Fax:
• Email: Contact Name: Phone
TYPE OF WORK: ❑New Construction c Deck ,Pool o Re-Roof
❑Commercial esidential c Change of Use o Retaining Wall ❑Porch ❑Re-Side
EST.VALUATION OF WORK c Finish Basement ❑Demolition o Fence
$ c Remodel c Fire Sprinkler ❑Shed
Square feet: c Addition a Fire Alarm o Window/Door Replacement
c Garage-Attached/Detach NTIumbin"rovide detail on Page 2 4 being replaced
r Detailed Description of Work: ❑Accessory Structure o Mechanical-provide detail on Page 2 o Misc Other
•
n
Signature of this application by the legal property owner or a licensed contractor,as the owners represerta!ive.Is required and authorizes the Zon;ng Administrator or designee and the 8uildmg OffWal
or designee to enter upon the property to 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 beet of my knowledge.I further agree that all work performed will been accordance with approved plans.specifications and conditions and to abide by as 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
rr is not commenced within 180 days from data ofpermit,or If work is suspended,abanooned.or not inspectad for 1,00 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: ON -FRIDAY Before 7 a.m.and after 10 p.m.Weekend slHolidaya before 7 a.m,and after 8 p.m.
SIGNATURE OF APPLICANT:T: DATE: 51.S.a
PRINTEikAA s.,; This is the signature of: = Owner or Owner's Representative
OCCUP.TYPE: CONST,TYPE: CODE: BLDG SPRINKLED Yes/No
VALUATION:'$
Permit Fee: $ "��•�� WAC Charge: S
Plan Review Fee: $ Sewer&Water Hook-Up: S
State Surcharge: $ ` Sewer&Water Disconnect: S
Site Inspection Fee: $ Water Meter. $
S.E.C.Fee: $ Muni SE/WA Fee: S
Investigation Fee/Other Fee: $ '2016 SAC Escrow: S .485
�- Copy Charge($.25 per 8.5 x11 page)$ Other. $
Z Licensc Check($5)f Lcad Check($5)$ TOTAL DUE: $
W SUB-TOTAL $ rJGTE:Commercial plans will be submitted to the Met Council Environmental Svcs
D Plumbing Fee(from Page 2)$ for SAC determination. Escrow payment will be required when permit is issued. If
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:
U.
C•
Building Approval By: DATE:
Printed Building Approval By: ❑ License Verification❑ Lead Verification-Checked By:
City Approval By: DATE: 5 tJ><=j a
Paid: Date: g Receipt No. By:
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:
Cit : State: zip: Phone: Fax:
State Bond No: Contact Name:
Email: Contact Phone:
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
Furnace Kitchen Fan Furnace
Air Conditioning System Bath Fan Fireplace
Air Exchanger Grill Unit Heater
Fireplace Water Heater
Unit Heater Grill
In Floor Heat Dryer
Gas Locl Stove
Oft Use Only:
Replacement(one fixture only,no piping or vent changes) Mechanical Permit Fee: $
u Addition/Remodel Gas Line Permit Fee: $
❑New Construction State Surcharge: $
❑Other Other: $_
Total Mechanical Permit: $
PLUMBING INFORMATION
Plumbing Contractor: rS1 0701,71 7' 7 Address:g F10
Cit : Paro State:JAVZip Phone: 7 - - ax:
Plumbers License No: PC / State Bond No:
Contact Name, Contact Phone: -
Email: /iY Q
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
Quanti 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: $
CITY OF SPRING PARK MECHANICAL PERMIT
PLUMBING PERMIT
PAGE 2 FOR PERMIT ISSUANCE
PAGE 1 and PAGE 2 should be complete
MECHANICAL • ' •
AkchdniwlConudclw; Address:
Coy State Zip Phone Fax:
State Bond No Contact Name:
5
Email lConlact Phone.
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
Furnace Kitchen Fan Furnace
Air Conditioning System Bath Fan Fireplace
Air Exchanger Grill Unit Heater _
g Fireplace Water Heater
Un4 Heater Grill
In Floor Heat Dryer
Gas Log Stove
OfIke Use only:
Repiacement(one fixture only,no piping or vent changes) Mechanical Permit Fee: $
Addlton/Remodel Gas Line Permit Fee: $
New Construction State Surcharge: $ _
G Other Other. $
Total Mechanical Permit: S
/ PLUMBING INFORMATION
Plumbing Contractor: C'i G .' Address g STF f
CA Pbrb State A4V Z, Jf- S Phone - ax:
Plumbers License No State Bond No. 3
Con tat Name Contact Phone qS - 9 -
a Email /ii✓ 2
Detailed Descri tion of Work:
Indicate type of project and fixtures you will be installing or replacing(include count for each type of fixture):
PLUMBING FIXTURES
a i Quantity uanti
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: S
o Addition/Remodel State Surcharge $
New Construction Other. S
n Other Total Plumbing Permit: S •
RECEIPT
City of Spring Park
4349 Warren Ave, Spring Park, MN 55384
(952)471-9051
SPRING PARK
23SP-00038 i Plumbing (Residential) On Lake Minnetonka
Receipt Number: 183
Payment Amount: $76.00 May 8,2023
Transaction Method Payer Cashier Reference Number
Credit Card Contractor Christy James
Comments
Assessed Fee Items
Fee items being paid by this payment
Date Fee Item Account Code Assessed Amount Paid Balance Due
05/03/23 State Surcharge(Fixed) $1.00 $1.00 $0.00
05/03/23 Residential Plumbing Permit $75.00 $75.00 $0.00
Totals: $76.00 $76.00
Previous Payments $0.00
Remaining Balance Due $0.00
Permit Info
Property Address Property Owner Property Owner Address Valuation
4317 Channel Road Berry 4317 Channel Road
Spring Park, MN 55384 Spring Park, MN 55384
Description of Work
Install new water heater