Permits - Permit# 23SP-00040 - 4590 West Arm Road - 5/22/2023 or, City of Spring Park Plumbing (Residential)
4349 Warren Ave, Spring Park, MN 55384
PR 23SP-00040
'WRING PARK
Phone:(952)471-9051 Fax:(952)471-9160
Lake Yinneton a
For Inspections: (952) 442-7520
Date Issued: 05/22/2023 Property Owner: Jill Ties
Expiration Date: 11/18/2023 Mailing Address: 4590 West Arm Road
Job Site Address: 4590 West Arm Road, Spring Park, MN
55384 Spring Park, MN 55384
Category: Residential Miscellaneous Phone:
Permit Type: Plumbing (Residential) Email:
Valuation:
Description of Work:
Install 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
05/22/2023
MUST BE POSTED ON JOB SITE
INSPECTION CARD
City of Spring Park
SPRING PARK
On Lakf Jfinnetonla 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-00040 PERMIT TYPE: (Residential) ISSUED DATE: 05/22/2023 EXPIRATION DATE: 11/18/2023
PROJECT ADDRESS: 4590 West Arm Road,Spring Park,MN 55384 PARCEL NO.:
OWNER: Jill Ties CONTRACTOR: CONTRACTOR PHONE:
DESCRIPTION OF WORK: Install water heater
CONSTRUCTION TYPE: OCCUPANT LOAD:
DATE DATE
INSPECTION INSP PASSED COMMENTS INSPECTION INSP PASSED COMMENTS
Underground Plumbing Plumbing Rough-In
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 cp?d&!�_bOD�I-CJ
Spring Park, MN 55384 ❑ Handout Given
Phone: 952-471-9051 Fax: 952-471-9160 ❑ Lead Handout Given Routed to MNSPECT
SITE ADDRESS: / f 1�' r y PID:
1)Was the home constructed before 1g78?(YES❑,continue with line 2,NO o continue without completing EPA Section)
2)Will the work disturb z6 sq ft of interior painted surfaces or>_20 sq ft of exterior painted surfaces?(YES❑go to line 4,NO❑line 3)
_ 3)Are there any windows being replaced?(YES❑,go to line 4,NO❑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)
5)EPA Contractor Certification Number: NAT- (applies to contractor only)
• PROPERTY OWNE • i Address:
Ci tate: Zi : Email: C
Contact ame* Phone:
• CONTRA TO : / ddress: Ir/
city: Sta : Zi
Phone:
Contractor Licen No: Contact Name:
Email
ARCHITECT: Address:
City: State: Zip: Phone. Fax:
• Email: Contact Name: Phone:
TYPE OF WORK: ❑New Construction n Deck ❑Pool o Re-Roof
n Commercial ❑ijksidential ❑Change of Use ❑Retaining W .El Po h ❑Re-Side
EST.VALUATI N OF WORK ❑Finish Basement ❑Demolition ❑Fence
$ o Remodel ❑Fire Sprinkler ❑Shed
Squa a feet o Addition ❑Fire Alarm ❑Window/Door Replacement
1.1 Garage-Attached/Detach 7--plumbing-provide detail on Page 2 #being replaced
rr Detailed sc i tion o W k: ❑Ac esso Structure ❑Mechanical-provide detail on Page 2 ❑Misc Other
•
Signature of this application by the legal property owner or a licensed contractor,as the owners representative.Is required and authorizes the Zoning Administrator or designee and the Building OFAcial
or designee to enter upon the property to perform needed inspections.Entry may be without prior notice.1 hereby acknowledge 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 all work performed will be in accordance with approved plans,specifications and conditions and to abide by all 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 1 choose not to proceed with the work.Permit expires when work
rr is not commenc ad within 180 days from date of permk,or If work Is suspended,abandoned,or not inspected for 180 days.work beyond the scope of this permit,or Wok without a permit or inspection.
• vrill be subject to a penalty.
Noise Ordinance In Effect: >14PAY-FRIDAY BOW 7 a.m.and er 10 p.m.Weekends/Holidays before 7 a.m.and a er 8 p
p.
SIGNATURE OF APPLICANT: f DATE:
PRINTED NAME: This is the signature of: ❑ Owner or ❑Owne s RVees�en�tative
OCCUP.TYPE: CO TYPE: CO. E: BLDG SPRINKLED Yes/No
VALUATION:$
Permit Fee: $ ! WAC Charge: $
Plan Review Fee: $ Sewer&Water Hook-Up: $
State Surcharge: $ Sewer&Water Disconnect: $
Site Inspection Fee: $ Water Meter $
S.E.C. Fee: $ Muni SE/WA Fee: $
Investigation Fee/Other Fee: $ 2016 SAC Escrow: $�485
Copy Charge($.25 per 8.5 x11 page) $ Other. $
ZO Liccnsc Check($5)/Lcad Chock($6)$ TOTAL DUE: $
w SUB-TOTAL $ p
Plumbing Fee(from Page 2) $ 'NOTE:Commercial plans will be submitted to the Met Council Environmental Svcs
tJJ for SAC determination. Escrow payment will be required when permit is issued. If
Mechanical Fee(from Pa e 2)$ after Met Council review no SAC is determined,escrow will be refunded in full.
Lt. Special Conditions/Required Setbacks:
O
Building Approval By: DATE:
Printed Building App val By. ❑ License Verification❑ Lead Verification-Checked y
City Approval By: DATE: a
Paid: Date: Receipt No.
a gy; �'
CITY OF SPRING PARK ❑ MECHANICAL PERMIT
1442LUMBING PERMIT
PAGE 2 / FOR PERMIT ISSUANCE
PAGE 1 and PAGE 2 should be complete
Mechanical Contractor: Address:
City: State: Zi 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 QuantityQuantity
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 Log Stove
Office Use Only,
❑Replacement(one fixture only,no piping or vent changes) Mechanical Permit Fee: $
❑Addition/Remodel Gas Line Permit Fee: $
❑New Construction State Surcharge: $ _
El Other Other: $
Total Mechanical Permit: $
PLUMBING INFORMATION
Plumbin C tractor: v
ress:
C IA" tate: zi :505i Phone:
x
Plumbers Licens No: r'( State Bond No:
Contact Name: Contact Phone: '. d
Email:lowkv ' 1
Detailed Descri tion of
Indicate type of project and fixtures you will be installing or replacing (include count for each type of fixture).-
PLUMBING FIXTURES
quaptity Quantityuantity
Water Heater Shower Laundry Tub
as ❑ 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: $ t(o • -
INVOICE I May 15, 2023
City of Spring Park
4349 Warren Ave, Spring Park, MN 55384
(952)471-9051 SPRING PARK
23SP-00040 I Plumbing (Residential)
On Lake Winnetonka
Fee Item Account Code Assessed Outstanding
Date Balance
State Surcharge(Fixed) 05/15/2023 $1.00
Residential Plumbing Permit 05/15/2023 $75.00
Total Balance Due $76.00
Permit Info
Applicaton Date: 5/15/2023
Property Address Property Owner Property Owner Address Valuation
4590 West Arm Road, Spring Jill Ties 4590 West Arm Road, Spring
Park, MN 55384 Park, MN 55384
Description of Work
Install water heater
RECEIPT
City of Spring Park
4349 Warren Ave, Spring Park, MN 55384
(952)471-9051
SPRING PARK
23SP-00040 I Plumbing (Residential) On Gale.911innetonkg
Receipt Number: 186
Payment Amount: $76.00 May 22,2023
Transaction Method Payer Cashier Reference Number
Check Appliance Connections Jamie Hoffman 13527
Comments
Assessed Fee Items
Fee items being paid by this payment
Date Fee Item Account Code Assessed Amount Paid Balance Due
05/15/23 State Surcharge (Fixed) $1.00 $1.00 $0.00
05/15/23 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
4590 West Arm Road Jill Ties 4590 West Arm Road
Spring Park, MN 55384 Spring Park, MN 55384
Description of Work
Install water heater