Permits - Permit# 23SP-00046 - 4000 Shoreline Place Condos - 6/13/2023 City of Spring Park Re-Window/Exterior Door
4349 Warren Ave, Spring Park, MN 55384 (Residential)
PR1NG PARK 23SP-00046
Phone:(952)471-9051 Fax:(952)471-9160
n Lake Winneton a
For Inspections: (952) 442-7520
Date Issued: 06/13/2023 Property Owner: Jennifer Clementson
Expiration Date: 12/10/2023 Mailing Address: 5 Shoreline Place
Job Site Address: 5 Shoreline Place, Spring Park, MN
55384 Spring Park, MN 55384
Category: Residential Miscellaneous Phone: (612) 991-4480
Permit Type: Re-Window/Exterior Door(Residential) Email:
Valuation:
Description of Work:
Replace windows
Subdivision: Required Setbacks:
Parcel ID:
Filing:
Lot: Actual Setbacks:
Block:
Total Sq Ft:
Contractors: Fee Items Amount
State Surcharge(Fixed) $ 1.00
Residential Building Maintenance Permit $50.00
Total Fees: $51.00
NOTICE
Signature of Applicant/Date Building Department Signature/Date
06/13/2023
MUST BE POSTED ON JOB SITE
INSPECTION CARD
City of Spring Park
SPRING PARK
OnGakf3finneton(g 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.
Re-Window/Exterior
PERMIT NO.: 23SP-00046 PERMIT TYPE: Door(Residential) ISSUED DATE: 06/13/2023 EXPIRATION DATE: 12/10/2023
PROJECT ADDRESS: 5 Shoreline Place,Spring Park,MN 55384 PARCEL NO.:
OWNER: Jennifer Clementson CONTRACTOR: CONTRACTOR PHONE:
DESCRIPTION OF WORK: Replace windows
CONSTRUCTION TYPE: OCCUPANT LOAD:
DATE DATE
INSPECTION INSP PASSED COMMENTS INSPECTION INSP PASSED COMMENTS
Final/In-Progress
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 C9.v BUI NG PERMIT
4349 Warren Avenue ' -le)
Spring Park, MN 55384 ❑ Handout Given
P 9 Routed to MNSPECT
Phone: 952-471-905511 Fax: 952-471-9160 ❑ Lead Handout Given
SITE ADDRESS: J O�`e 1• PID:
1)Was the home constructed before 1978?(YES❑,continue with line 2,NO❑continue without completing EPA Section)
2)Will the work disturb 4 sq ft of interior painted surfaces or>_20 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 o 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 OWNER: —S' G-C tM{h t So el Address:
City: State: Zip: Email:
Contact Name: Phone: I -L
• CONTRACTOR: Address: Iq ZO GO- RCI "C " L'0•L' S+
City: S •�l I-f— State: (h7\j Zi : SS 11 2) Phone: & -o?i o L10 F3 ii Fax:
Contractor License No: cC,(Pq SIP 3 Contact Name: Phone:
Email: W$Ck d 7'CO " -C-f CQ 0'
ARCHITECT: Address:
city: State: Zip: Phone: Fax:
• Email: Contact Name: Phone:
TYPE OF WORK: ❑New Construction ❑Deck o Re-Roof
❑Commercial 39.Residential ❑Change of Use ❑Pool ❑Re-Side
EST.VALUATION OF WORK ❑Finish Basement ❑Retaining Wall ❑Fence
$ 5 0 y ❑Remodel ❑Porch ❑Shed
Square feet: ❑Addition ❑Demolition )Window/Door Replacement
❑Garage-Attached/Detach o Plumbing-provide detail on Page 2 #being replaced
Detailed Description of Work: ❑Accessory Structure o Mechanical-provide detail on Page 2 ❑Mise Other
VX re LA-) • a • •
•
Signature of this application by the legal property 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 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 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 I choose not to proceed with the work.Permit expires when work
is not commenced within 180 days from date of permit,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,
• 'll be subject to a penalty.
Noise Ordinance In Effect:MPADAY-FRIDAY fore 7 a.m.and after 10 p.m.Weekends/Holidays before 7 a.m.and after 8 p.m.
SIGNATURE OF APPLICANT: DATE &-,t
PRINTED NAME: C 0.'J-t'_rt son This is the signature of: ❑Owner or eOwner's Representative
OCCUP.TYPE: CONST.TYPE: CODE: BLDG SPRINKLED Yes/No
VALUATION:$
Permit Fee: $�' WAC Charge: $
Plan Review Fee: $ Sewer&Water Hook-Up: $
State Surcharge: $ •13 0 _ Sewer&Water Disconnect: $
Site Inspection Fee: $ Water Meter: $
S.E.C.Fee: $ Muni SE/WA Fee: $
Investigation Fee/Other Fee: $ "2DI6 SAC Escrow: $2,485
J Copy Charge($.25 per 8.5 x11 page) $ Other: $
zz License Check($5)/Lead Check($5)$ _ TOTAL DUE: $
W SUB-TOTAL$ :N„z_.;Commercial plans will be submitted to the Met Council Environmental Svcs
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.
0
LL Special Conditions/Required Setbacks:
IL
O
Building Approval By: DATE:
Printed Building Approval By: ❑ License Verification❑ Lead Verification-Checked By:
City Approval By: DATE:
Paid: Date: Receipt No. By:
re - • al
BY ANDERSEN'
window replacement
W S&D Permit Service
P.O. Box 250
Scandia,MN 55073-0250
wsandd@ftontier_com
Phone: 651-433-4250 Fax: 651-433-3539
To Whom It May Concern:
I am an authorized agent by Renewal by Andersen to pull,pay for, and obtain their building
permits. I have enclosed a self addressed stamped envelope for your convenience to mail the
permit back to me. If there is a problem with this please feel free to give me a call at
651-433-4250.
Thank you for you assistance,
C '4-� bu�r"-�
Kara Benson
WS&D Permit Service
651-433-4250
RECEIPT
City of Spring Park �^
4349 Warren Ave, Spring Park, MN 55384
(952)471-9051
SPRING PARK
23SP-00046 ( Re-Window/Extedor Door(Residential) On Luke Yinnetonk¢
Receipt Number: 191
Payment Amount: $51.00 June 13,2023
Transaction Method Payer Cashier Reference Number
Check WS and D Permit Service Jamie Hoffman 34560
Comments
Assessed Fee Items
Fee items being paid by this payment
Date Fee Item Account Code Assessed Amount Paid Balance Due
06/13/23 State Surcharge (Fixed) $1.00 $1.00 $0.00
06/13/23 Residential Building Maintenance 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
5 Shoreline Place Jennifer Clementson 5 Shoreline Place
Spring Park, MN 55384 Spring Park, MN 55384
Description of Work
Replace windows