Electrical Permit - Permit# 23SP-00039 - 2258 Hazeldell Avenue - 6/26/2023City of Spring Park Electrical Permit
4349 Warren Ave, Spring Park, MN 55384
PRIN4 PkIM
23SP-00039
n C e Winneton a Phone:(952) 471-9051 Fax: (952) 471-9160
For Inspections: (952) 442-7520
Date Issued: 06/26/2023
Property Owner: Robin Sherman
Expiration Data: 12/23/2023
Mailing Address: 2258 Hazeldell Avenue
Job Site Address: 2258 Hazeldell Avenue, Spring Park,
MN 55384
Spring Park, MN 55384
Category: Other
Phone: (952) 486-8776
Permit Type: Electrical Permit Email:
Valuation:
Description of Work:
AC
Subdivision:
Required Setbacks:
Parcel ID:
Filing:
Lot:
-T
Actual Setbacks:
Block:
Total Sq Ft:
Contractors:
Fee Items
Amount
Primary Centerpoint Energy (763) 512-2765 State Surcharge (Fixed)
$ 1.00
Single Inspection (Up To 4 Circuits)
$ 40.00
Total Fees:
$ 41.00
NOTICE
Signature of Applicant/Date
Building Department Signature/Date
06/26/2023
MUST
BE POSTED ON JOB SITE
INSPECTION CARD
City of Spring Park
SPRING PARV
On L* 3finnetonka 4349 Warren Ave, Spring Park, MIN 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
AUiHORRYAND THE BUILDING IS APPROVED FOR OCCUPANCY. STAMPED APPROVED PLANS MUST BE AVAILABLE ON THE,IOBSRE.
PERMIT NO.: 23SP-00039 PERMIT TYPE: Electrical Permit ISSUED DATE: 06/26/2023 EXPIRATION DATE: 12/23/2023
PROJECT ADDRESS: 2258 Hazeidell Avenue, Spring Park, MN 55384 PARCEL NO.:
OWNER: Robin Sherman CONTRACTOR: Centerpoint Energy CONTRACTOR PHONE: (763) 512-2765
DESCRIPTION OF WORK: AC
CONSTRUCTION TYPE: OCCUPANT LOAD:
DATE DATE
INSPECTION INSP PASSED COMMENTS INSPECTION INSP PASSED COMMENTS
Electrical Rough -in I I I JElectrII;al Final
Fire Approval:
PW Approval:
To request an inspection: (952) 442-7520
Date: Engineering Date:
Approval:
Date: Other ( ?: Date:
Page 1 of 1
CITY OF SPRING PARK
ELECTRICAL PERMIT
OFFICE USE ONLY
Electric Permit #
Date Issued:1 a6 Receipt #
PLEASE PRINT OR TYPE ALL INFORMATION AND COMPLETE ITEMS ON BOTH PAGES
Quantity DESCRIPTION OF WORK FEES Subrrotai
A. MINIMUM FEE PER INSPECTION TRIP
Includes up to 4 circuits if more than 4 see Sec. D below $ 40.00 per
Additional Inspection trips for ReinspectionlBondinglEquipotential Plane/etc. $ 40.00 per
B. RESIDENTIAL One and Two-family dwelling units Up to 3 trips included in fee
1. New Dwelling Unit, up to and including a 200 amp service $ 125.00 per unit
2. New Dwelling Unit, 201 amp to 400 amp service $ 175.00 per unit
3. Existing Dwelling Unit, additions, alterations, or repairs up to & including a 200 amp service,
fees as per C & D below but not to exceed $ 125.00 per unit
4. Existing Dwelling Unit, additions, alterations, or repairs 201 amp to 400 amp service
fees as er C & D below but not to exceed 175.00 per unit
5. New or Existing Dwelling Unit, 401 amp service or above See C & D below
C. FEES FOR NEW OR UPGRADED SERVICES, TEMP. SERVICES, GENERATORS,
OTHER POWER SUPPLY SOURCES OR FEEDERS TO SEP. STRUCTURES
1. U to and including a 200 amp service $ 50.00 each
2. 201 amp to and including 400 amp service $ 100.00 each
3. 401 amp to and including 800 amp service $ 200.00 each
4. 801 amp service and above $ 300.00 each
D. FEES FOR CIRCUITSIFEEDERS $ TRANSFORMERS
0 to 200 am $ 10.00 per circuit
Above 200 am $ 15.00 per circuit
Transformers up to 10 KVA $ 20.00 each
Transformers over 10 KVA $ 30.00 each
E. MULTI -FAMILY DWELLINGS
Each dwelling unit $ 50.00 per unit
F. ALARM, COMMUNICATION, SIGNALING CIRCUITS, OF LESS THAN 50 VOLTS
Each System Device or Apparatus @ $ .50 each
. WORKIaEGUNOR FMISHED WITHOUT .PERMIT IS ZX THE IEA *.P PMWT-FEE
State Surcharge .0005 of the permit fee (minimum of $1.00)
1.00
TOTAL AMOUNT DUE
Do not forget State Surcharge Fee
rqlpV
You must ca11952-442-7520 when work is ready for inspection!
Describe Proposed Work: WIRE/ RECONNECT DAIKIN AIR CONDITIONER
Separate Permits are required for any building, mechanical, fire, or plumbing work.
PLEASE PRINT OR TYPE ALL INFORMATION AND COMPLETE ITEMS ON BOTH PAGES
Job Site: Street Address: 2258 HAZELDELL AVE
OR Legal Description: Lot:
Property ID (PIN No): 17-117-23-33-0067
Block:
Applicant is: Contractor: 56 Or Owner: ❑
Spring Park, MN Zip: 55384
Subdivision:
Contractor/Company Name: CENTERPOINT ENERGY License #: EA001796
Address:6161 GOLDEN VALLEY RD City/State: GOLDEN VALLEY Zip: 55422
Telephone: Office/Home: 7( 63 } 512 - 2765
E-mail: HSP-Permits@centerpointenergy.com
Builder/Owner Name:
Address (if dill. from Site):
Telephone: Office/Home: (
E-mail:
Mobile:
Fax:
City/State: Zip:
Mobile:
Fax:
I HEREBY APPLY FOR AN ELECTRICAL PERMIT, AND I ACKNOWLEDGE THAT THE INFORMATION ABOVE IS COMPLETE AND ACCURATE; I
UNDERSTAND WORK IS NOT TO START WITHOUT A PERMIT. I UNDERSTAND AND HEREBY AGREE THAT THE WORK FOR WHICH THE
PERMIT IS ISSUED SHALL BE PERFORMED ACCORDING TO THE FOLLOWING: (1) THE CONDITIONS OF THE PERMIT, (2) THE APPROVED
PLANS AND SPECIFICATIONS, IF NEEDED (3) THE APPLICABLE CITY APPROVALS, ORDINANCES, AND CODES, AND (4) THE STATE
BUM DING/ELECTRICAL CODE. I UNDERSTAND THAT THE PERMIT WILL EXPIRE, AND BECOME NULL AND VOID IF WORK IS NOT
COMPLETED WITHIN 12 MONTHS OF VALIDATED DATE AND, THAT I AM RESPONSIBLE FOR ENSURING THAT ALL REQUIRED
INSPECTIONS ARE REQUESTED IN CONFORMANCE WITH THE STATE BUILDING/ELECTRICAL CODE.
'00-1 �q — . l
Signature:
Date: 05/04/2023
❑ Check attached — Check # MAKE CHECKS PAYABLE to MNSPECT
EMAIL: electrical@mnspect.com
FAX: 952-442-7521
MAIL/DELIVER: MNSPECT, 235 West First Street Waconia, MN 55387
9 Visa/Master card — 6n1 riW,
Account Number
Expiration Date CSV
Credit Card Owner Billing Address:
Street Address City, State
Payment Authorization Signature (REQUIRED)
Print Name on credit card (REQUIRED)
Amount to be withdrawn
Zip Code
Payment Confirmation
Payer Information:
Payment Made By:
Payment Made For:
Email:
Permit Address:
Address:
Payment Description:
Payment Date:
CENTERPOINT ENERGY
CENTERPOINT ENERGY
joann.zlnken@CenterPointEnergy.com
2258 HAZELDELL AVE
6161 GOLDEN VALLEY RD
GOLDEN VALLEY, MN 55422
Permits
5/5/2023 12:25:47 PM
Business Name Payment Payment Confirmation Amount Convenience Total
Method Account Number Fee
City of Spring Park MC ****9294 96554107 $41.00 $196 $42.96
(Permits)
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