Electrical Permit - Permit# 23SP-00101 - 4349 Warren Avenue - 11/29/202300-- 1 City of Spring Pa, I Electrical Permit
PARK
4349 Warren Ave, Spring Park, MN 55384
Phone:(952) 471-9051 Fax: (952) 471-9160
For Inspections: (952) 442-7520
23SP-00101
Date Issued: 11/29/2023
Property Owner: City of Spring Park
Expiration Date: 05/27/2024
Mailing Address: 4349 Warren Avenue
Job SM Address: 4349 Warren Avenue, Spring Park, MN
55384
Spring Paris, MN 55384
Cafgory: Other
Phone:
Permit Type: Electrical Permit
Email:
Valuation:
Description of Work:
High Service Pump Work - install up to 4 circuits
Subdivision:
Required Setbacks:
Parcel ID:
Filing:
Lot:
Actual Setbacks:
Block:
Total Sq Ft:
Contractors:
Fee harms
Amount
Primary HOLTON ELECTRIC CONTRACTORS LLC
State Surcharge (Fixed)
$ 1.00
(651) 7694110
Fees for Circuits/Feeders S Transformers: 0
$ 40.00
to 200 amp
Total Fees:
$ 41.00
NOTICE
Signature of Applicant/Date
Building Department Signature/Date
11/29/2023
MUST BE POSTED ON JOB SITE
INSPECTION CARD
City c f Spring Park
SPRING PARK
On take Winnetankq 4349 Warren Ave, Spring Park, MN 55384
POST THIS CARD IN A SAFE CONSPICUOUS LOCATION. PLEASE DO NOT REM®VE T}BS NOTICE UNTIL ALL REQUIRED INSPECTION ARE MADE AND SIGNIED OFF SYTHE APPROPRIATE
AUTHORRYAND THE BUILDING IS APPROVED FOR OCCUPANCY. STAMPED APPROVED PLANS MUST BE AVAILABLE ON THE JOBSrrE.
APPLICATION NO.: 23SP-00101 TYPE: Electrical Permit ISSUED DATE: 11/29/2023 EXPIRATION DATE: 05/27/2024
PROJECT ADDRESS: 4349 Warren Avenue, Spring Park, MN 55394 PARCEL NO.:
HOLTON ELECTRIC CONTRACTORS
OWNER: City of Spring Paris CONTRACTOR: LLC CONTRACTOR PHONE: (651) 769-4110
DESCRIPTION OF WORK. High Service Pump Work - install up to 4 circuits
CONSTRUCTION TYPE: OCCUPANT LOAD:
DATE DATE
INSPECTION INSP PASSED COMMENTS INSPECTION INSP PASSED COMMENTS
Electrical Rough -In Electrical Final
Fire Approval:
PW Approval:
To request an inspection: (052) 442-75M
Date: Engineering
Approval:
Date: Other (
Date:
Date:
Page 1 of 1
CITY OF SPRING PARK
ELECTRICAL PERMIT
OFFICE USE ONLY
Electric Permit # 9550— 0010 J
Date Issued: I i Receipt #
PLEASE PRINT OR TYPE ALL INFORMATION AND COMPLETE ITEMS ON BOTH PAGES
Quantity DESCRIPTION OF WORK FEES SubITotat
A. MINIMUM FEE PER INSPECTION TRIP
Includes up to 4 circuits if more than 4 see Sec. D below $ 40.00 per
X
Additional Inspection trips for Reinspection/Bonding/Equ!potential 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 per 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. Up 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 CIRCUITS/FEEDERS TRANSFORMERS
8�
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 Q $ .50 each
i114i`lwtl�a.G.��1iF
State Surcharge .0005 of the permit fee (minimum of $1.00) + 1.00
TOTAL AMOUNT DUE 1$41.00
Do not forget State Surcharge Feed
Describe Proposed Work: high service pump work
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: 4349 Warren Ave
OR Legal Description: Lot:
Property ID (PIN No):
Block:
Applicant is: Contractor: lR Or Owner: ❑
S n
�ng Park MN Zip: 55384
Subdivision:
Contractor/CompanyName: EA685239
Holton Electric License #:
Address:
city/state: Golden Valley, MN zip:
Telephone: Office/Home: t 651) 769 - 4119 Mobile: C�
E-mail:
Builder/Owner Name: City of Spring Park
Fax:
Address (if dill. from Site): 4349 Warren Ave city/state: Spring Park zip: 55384
Telephone: Office/Home:
Mobile:
E-mail: office holtonelectricxom 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
BUILDING/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.
Signature: -� (rCA t"d Date: 11 /16/23
EMAIL COMPLETED PERMIT APPLICATION TO: jkhoffman@ci.spring-park.mn.us.
park.mn.us.
PAYMENT CAN BE MADE AS FOLLOWS:
➢ Online at www.paymentservicenetwork.com;
➢ By calling 1-877-885-7968;
➢ Downloading the PSN Payments app from the Apple AppStore or Google Play;
➢ Mailing a check to: City of Spring Park, 4349 Warren Avenue, Spring Park, MN 55384.
PLEASE CALL 952442-7520 WHEN YOU ARE READY FOR AN INSPECTION
Payment Confirmation
Payer Information:
Payment Made By:
Payment Made For:
Email:
Permit Address:
Address:
Payment Description:
Payment Date:
Holton Electric
Holton Electric
ofrice@holtonelectdc.com
4349 warren ave
8014 Olson Mem Hwy Suite 475
Golden Valley, MN 55427
Permits
11/29/2023 12:02:56 PM
Business Name Payment Payment Confirmation Amount Convenience Total
Method Account Number Fee
City of Spring Park VISA ****0637 52878395 $41.00 $4.21 $45.21
(Permits)
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RECEIPT
City of Spring Park
4349 Warren Ave, Spring Park, MN 55384
(952) 471-9051
23SP-00101 1 Electrical Permit
Payment Amount: $41.00
Transaction Method Payer
Credit Card Holton Electric
Comments
onr-
Ai
SPRING PARK
On Gaff Winnetonka
Receipt Number. 255
November 29, 2023
Cashier Reference Number
Jamie Hoffman 52878395
Assessed Fee Items
Fee items being paid by this payment
Date Fee Item Account Cade Assessed Amount Paid Balance Due
11/20/23 State Surcharge (Fixed)
$1.00 $1.00 $0.00
Fees for CircuitslFeeders & Transformers: 0 to 200
11/20/23 amp $40.00 $40.00 $0.00
Took $41.00 $41.00
Application Info
Property Address Property Owner
4349 Warren Avenue City of Spring Park
Spring Park, MN 55384
Description of Work
High Service Pump Work - install up to 4 circuits
Previous Payments $0.00
Remaining Balance Due $0.00
Property Owner Addrm Valuation
4349 Warren Avenue
Spring Park, MN 55384