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Electrical Permit - Permit# 24SP-00053 - 4742 West Arm Road - 7/10/2024City of Spring Park 4349 Warren Ave, Spring Park, MN 55384 Phone:(952) 471-9051 Fax: (952) 471-9160 For Inspections: (952) 442-7520 Electrical Permit 24SP-00053 Date Issued: 07/10/2024 Property Owner: DEREK SELLNOW Expiradw Date: 01/06/2025 Mailing Address: 4742 WEST ARM RD Job Site Address: 4742 WEST ARM RD, SPRING PARK, MN 55384 SPRING PARK, MN 55384 Category: Other Phone: (405) 535-6241 Permit Type: Electrical Permit Email: sellnowl8@gmail.com Valuation: Description of Work: Move exiting A/C unit to a new location Subdivision: SETON VILLAGE TOWNHOUSES Required Setbacks: Parcel ID: 1811723320005 Filing: Lot: 5 Actual Setbacks: Block: 1 Total Sq Ft: Contractors: Fee Items Amount Primary MILOW ELECTRIC INC (952) 475-2270 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 07/10/2024 MUST BE POSTED ON JOB SITE INSPECTION CARD City of Spring Park SPRING IR On La(g rytinneto* 4349 Warren Ave, Spring Park, MN 55384 POST THIS CARD IN A SAFE CONSPICUOUS LOCATION. PLEASE DO NOT REMOVE THIS NOTICE UNnL ALL REQUIRED INSPECTIONS ARE MADE AND SKMED OFF BY THE APPROPRIATE AUTHORITYAND THE BUILDNG IS APPROVED FOR OCCUPANCY. STAMPED APPROVED PLANS MUST BE AVAILABLE ON THE JOBSiTE. APPLICATION NO.: 24SP-00053 TYPE Electrical Permit ISSUED DATE: 07/10/2024 EXPIRATION DATE: 01/06,QD25 1811723320 PROJECTADDRESS: 4742 WEST ARM RD, SPRING PARK, MN 55384 PARCEL NO.: 005 OWNER: DEREK SELLNOW CONTRACTOR: MILOW ELECTRIC INC CONTRACTOR PHONE (952) 475-2270 DESCRIPTION OF WORK: Move exiting A/C unit to a new location CONSTRUCTION TYPE: OCCUPANT LOAD: DATE DATE INSPECTION INSP PASSED COMMENTS INSPECTION INSP PASSED COMMENTS Electrical 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 #01W— Date Issued. Receipt I PLEASE PRINT OR TYPE ALL INFORMATION AND COMPLETE ITEMS ON BOTH PAGES Quantity DESCRIPTION OF WORK FEES Sub/Total U f IN,Sk�EC'1`QI�'i` ~ ~Includes up to 4 circuits if more than 4 see Sec. D below $ 40.00 per Q" Additional Inspection trips for Reinspection/Bonding/Equipotential Plane/etc. $ 40.00 per I>r ,a �07!ling, U , 1t# 3 I� I 1. New Dwelling Unit, up to and including a 200 amp service $ 125.00 per unit E _ 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 : -FEESOR N9W,dR IiPGRAQEI] S) 17VICE5. TEMP. SERVICES, GENEII ATORS; OTHERSUP Y. SOUREES..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 _ ,T 4. 801 am�rvice 00 each and above T . _ $ 300. —._ ._ .. _ - D. FEES'Ft3ft QIRCUI'C$!iF>(1 ©ERS.$ TF INSFORMERS 0 to 200 amp _ $ 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 _ ._y L . ANIiI�If MalLITMdA Each dwelling unity $ 50.00 per unit A-[,U M, COMMUNICATION, SIGNALING CIRCUITS, OF LESS THAN SOVOLTS Each System Device or Apparatus @ $ .50 each _ State Surcharge .0005 of the permit fee (minimum of $1.00) TOTAL AMOUNT DUE (Do not forget State Surcharge Fee) 1.00 l Describe Proposed Work: ✓10vs' � Lr'VA ' U ►-� -M 01- /Ij eJ 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: 1 yL u*r Art^, 14wl spring Park. Zip: 6S3g4 OR Legal Description: Lot: Property ID (PIN No): Block: Applicant is: Contractor:* Or Owner: ❑ Subdivision: Contractor/Company Name: tA � t't �UL License #: Ck WZ Address: LLXas 2.G1t&1- 001 City/State: 0K) Zip-. Telephone: Oflice:'Home: ( 67— ) Ll-)5 - -� � Mobile: (____J - E-mail: �� j-,)�5e.k e ,tii �oj C,14,LtKc.. Cowes Fax: ( -- Builder/Owner Name: Dwt;V .5 e-, IDLj Address (if diff. from Site): `i)NZ wear lLD City/State: 66' `4� Zip: Ry $Y Telephone: Office/Home: (Y�?) r�� - �`/� Mobile: E-mail: Je-11 N>'wj !B e54-I.'w; � . cow, Fax: 1 HEREBY APPLY FOR AN ELECTRICAL PERMIT. AND I ACKNOWLEDGE THAT THE INFORMATION ABOVE IS COMPLETE AND ACCURATE; I UNDERSTAND WORKISVOT TO START WITHOUT A PER)PER)djT I UNDERSTAND AND HEREBY AGREE THAT THE WORK FOR WIIICI I 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 BUILDINGIELECTRICAL CODE. I UNDERSTAND THAT THE PERMIT WILL EXPIRE AND BECOME NULL AND VOID IF WORK IS NOT COMPLETED WITHIN 12 \"rHS OF VALIDATED DATE AND, THAT I AM RESPONSIBLE FOR ENSURING THAT ALL REQUIRED INSPECTIONS ARff<1EQUES INC ORMANCE WITH THE STATE BUILDINGIELECTRICAL CODE. ley Signature: �"'\. Date: z6 , EMAIL COMPLETED PERMIT APPLICATION TO: jkhofflnanCci.spring-park.mn.us. PAYMENT CAN BE MADE AS FOLLOWS: Y Online at www.paymentscrvicenctwork.com; Y By calling 1-877-885-7968; Downloading the PSN Payments app from the Apple AppStorc or Google Play; y 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: Address: Payment Description: Payment Date: Dan Russek Dan Russek danrussek@milowelectdc.com 2065 W Wayzata Blvd Long Lake, MN 533 Licenses 7/9/2024 12:35:40 PM Business Name Payment Payment Confirmation Amount Convenience Total Method Account Number Fee City of Spring Park VISA ****8105 82474600 $41.00 $1.96 S42.96 (Licenses) This notice confirms that the above payment was successfully submitted to our payment processor, PSN, and is currently being processed. Thank you for using PSN. 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YOU ARE HEREBY NOTIFIED THAT, IF YOU ARE NOT AN INTENDED RECIPIENT LISTED ABOVE, OR AN AUTHORIZED EMPLOYEE, OR AGENT OF AN ADDRESSEE OF THIS COMMUNICATION RESPONSIBLE FOR DELIVERING EMAIL MESSAGES TO AN INTENDED RECIPIENT, ANY DISSEMINATION, DISTRIBUTION, OR REPRODUCTION OF THIS COMMUNICATION (INCLUDING ANYATTACHMENTS HERETO) IS STRICTLY PROHIBITED. IF YOU HAVE RECEIVED THIS COMMUNICATION IN ERROR, PLEASE NOTIFY US IMMEDIATELY BYA REPLY E-MAILADDRESSED TO THE SENDERAND PERMANENTLY DELETE THE ORIGINAL E-MAIL COMMUNICATION AND ANYATTACHMENTS FROM ALL STORAGE DEVICES WITHOUT MAKING OR OTHERWISE RETAINING A COPY. RECEIPT City of Spring Park 4349 Warren Ave, Spring Park, MN 55384 (952) 471-9051 24SP-00053 I Electrical Permit Payment Amount: $41.00 Transaction Method Payer Credit Card Milow Electric Comments Assessed Fee Items Fee items being paid by this payment SPRING PAR Mw On Lake Minnetonka Receipt Number: 323 Cashier Reference Number Wendy Morrissey 82474600 July 10, 2024 Assessed Fee Item On Account Code Assessed Amount Paid Balance Due 06/24/24 State Surcharge (Fixed) $1.00 $1.00 $0.00 06/24/24 Single Inspection (Up To 4 Circuits) $40.00 $40.00 $0.00 Totals. $41.00 $41.00 Application info Property Address Property Owner 4742 WEST ARM RD DEREK SELLNOW SPRING PARK, MN 55384 Desaiptilon of Work Move exiting A/C unit to a new location Previous Payments $0.00 Remaining Balance Due $0.00 Property Owner Address Valuation 4742 WEST ARM RD SPRING PARK, MN 55384