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Electrical Permit - Permit# 24SP-00065 - 4326 West Arm Road - 7/18/2024'r, I City of Spring Park I Electrical Permit PARK 4349 Warren Ave, Spring Park, MN 55384 Phone:(952) 471-9051 Fax: (952) 471-9160 For Inspections: (952) 442-7520 24SP-00065 Date Issued: 07/18/2024 Property Owner: Mairin Brzica Expiration Date: 01/14/2025 Mailing Address: 4326 West Arm Road Job Site Address: 4326 West Arm Road, Spring Park, MN 55384 Spring Park, MN 55384 Category., Other Phone: Permit Type: Electrical Permit Email: Valuation: Description of Work: Install Electrical circuit Subdivision: Required Setbacks: Parcel ID: Filing: Lot: Actual Setbacks: Block: 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 07/18/2024 MUST BE POSTED ON JOB SITE I INSPECTION CAR® City of Spring Park SPRING MRK On Lakr':tirinnetmtkp 4349 Warren Ave, Spring Park, MN 55384 POST THIS CARD IN A SAFE CONSMUOUS LOCATION. PLEASE DO NOT REMOVE THIS NOTICE UNTIL ALL REQUIRED INSPECTIONS ARE MADE AND SIGNED OFF BY THE APPROPRIATE AUTHORITY AND THE BUILDING 13 APPROVED FOR OCCUPANCY. STAMPED APPROVED PLANS MUST BE AVAILABLE ON THE JOBSITE, APPLICATION NO.: 24SP-00065 TYPE: Electrical Permit ISSUED DATE: 07/18/2024 EXPIRATION DATE: 01/1412025 PROJECTADDRESS: 4326 West Arm Road, Spring Park, MN 55384 PARCEL NO.: OWNER: Mairin Brzica CONTRACTOR: MILOW ELECTRIC INC CONTRACTOR PHONE: (952) 475-2270 DESCRIPTION OF WORK: Install Electrical circuit CONSTRUCTION TYPE: OCCUPANT LOAD: DATE DATE INSPECTION INSP PASSED COMMENTS INSPECTION INSP PASSED COMMENTS Electrical Rough -In Electrical Final Fire Approval: Date: Engineering Approval: PW Approval: Date: Other To request an inspection: (952) 442-7520 Date: Date: Page 1 of 1 CITY OF SPRING PARK ELECTRICAL PERMIT OFFICE USE ONLY Electric Permit # atk* Date Issued: Receipt 44Q8197a PLEASE PRINT OR TYPE ALL INFORMATION AND COMPLETE ITEMS ON BOTH PAGES Quantity DESCRIPTION OF WORK FEES Subrrotal pi I�i%�. um -0E kR `INSPEPTIaN TRIP . ; z. Includes up to 4 circuits if more than 4 see Sec. D below $ 40.00 per Additional Inspection trips for Reinspection/Bonding/Equipotentlal Plane/etc. $ 40.00 per B. R'ESMENT14 One and fiia= ath ify dwelling "unlit U} to 3 trips iticJude� tin -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 ..FEES-P R NEW OTt UPOt DED SERVICES TEMP. SER CES, GENERATORS, OTHER -POWER SUPPLY MICE flR FEEDERRS 1bEP.U_t STURt B. I — 1. Up is and including a 200 amp .service $ 50.00 each i 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-71 D.:FEES.FOR +t✓Ii CUNT81FEE1]ERS--k;TRANSIFORMER, 0 to 200 am $ 10.00 per circuit _ _ _ Above 200 am $ 15.00 per circuit Transformers up to 1.0 KVA 20.00 each _ _ Transformers over 10 KVA $ 30,00 each Y Il uLlrGFAIA�Y DWEILLNGS r� Each dwelling unit $ 50.00 per unit — . ALAR11r VCiQMMUNICATION, SIGNALING CIRCUITS, OF I:ESS THM 50 VOLTS. - Each System Device or Apparatus @ $ .50 each -� W State Surcharge .0005 of the permit fee (minimum of $1.00) 1.00 TOTAL AMOUNT DUE Do not forget State Surcharge Fee z 9 I 410 Describe Proposed Work: Separate Permits are required for any building, mechanical, fire, or plumbing work. .6 V2 9,~ PLEASE PRINT OR TYPE ALL INFORMATION AND COMPLETE ITEMS ON BOTH PAGES Job Site: Street Address: `- , (P wep 14 Y411 941 p p: s 5,56`! Spring P�I_Ic, Mtn Zi OR Legal Description: Lox: Block: Subdivision: Property ID (PIN No): Applicant is: Contractor: Or Owner: ❑ Contractor/Company Name: --n'`� iJ �``j'le,C� _ License ##: 64-jjz5z Address:l+ v L) Goalar3kM4 City/State: lcle x"PJ Zip553SYo Telephone: Office/Home: ( ) _ ZZ)0 Mobile: E-mail: S-/ >rU 5CX 6? �5I.3q t 2s-`F�� G • Gp -+ Fax: Builder/Owner Name: I /'; h Address (if dill. from Site): City/State: Zip: Telephone: Office/Home:�) L_ _ �J• 3 Mobile: �) _ E-mail: ; r9 A e-6 io 5i Alc�; (D)'1 Fax: _ I HEREBY APPLY FOR AN ZLEC7RICAL PERMrr, AND I ACKNOWLEDGE TI IAT T1 iE INFORMATION ABOVE IS COMPLETE AND ACCURATE; ; L'NDERSTAND WORK ?SNOT TO ST T W THOUT A PF�MLT. I UNDERSTAND AND HEREBY AGREE TflAT nM WORK FOR WHICH THE PEILMIT IS ISSUED SNALL BE PERFORMED ACCORDING TO TI1E FOLLOWING_ (1) THE CON -Dr -IONS OF THE PERMIT, (2) THE APPROVED PLANS AND SPECIFICATIONS. IF NEEDED (3) THE APPLICABLE CITY APPROVALS, ORDINANCES, AND CODES. AND (4) T;IE STATE BUILDiNGILECTRIC.4L CODE, 1 UNDERSTAND THAT THE PERMIT WILL EXPIRE AND BECOME NULL AND VOID IF WORK IS NOT COMP=- zD WITHIN 12 -NIONTHS OF VALIDATED DATE AND. THAT I ATM RESPONSIBLE FOR ENSURING THAT ALL REQUIRED INSPECTIONS ARE IN CO. ` ORMANCEWITH THE STATE BUILDIN&ELECTRICAL CODE. } �/ Signature: �, "AA— Hate: 6 Z I :_ikhoffmanCei.spring-park.mn.us. PAYMENT CAN BE MADE AS FOLLOWS: y Online at www.paymentscrvicenetwork.com; 9 By calling 1-877-885-7968; i� Downloading the PSN Payments app from the Apple AppStore or Google Play; i- Mailing a chcer to: City of Spring Park, 4349 Warren Avenue, Spring Park, MN' 55384. PLEASE CALL 9-52442-7520 WHEN YOU ARE READY FOR AN INSPECTION Payment Confirmation Payer Information: Payment Made By: Payment Made For: Email: Address: Payment Description: Payment Date: Business Name City of Spring Park (Licenses) Dan Russek Dan Russek danrussek@milowelectric.com 2065 W Wayzata Blvd Long Lake, MN 55356 Licenses 7/18/2024 10:03:29 AM Payment Payment Confirmation Amount Convenience Method Account Number Fee VISA ****8105 62131272 $41.00 $1.96 Total $42.96 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. NOTE: While credit and debit cards generally are immediately approved, the transaction is not considered "paid" until the credit or debit card company has "settled" the payment which occurs most often within 24 hours. If there are any issues with your payment, PSN will send an email to the address you provided. 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RECEIPT City of Spring Park 4349 Warren Ave, Spring Park, MN 55384 (952)471-9051 24SP-00065 I Electrical Permit Payment Amount: $41.00 Transaction Method Payer Credit Card Milow Electric Comments SPRING jar-AW On Gar ,,Vfinnetonkq Receipt Number: 327 Cashier Reference Number Jamie Hoffman 62131272 July 18, 2024 Assessed Fee Items Fee items being paid by this payment Assessed Pee Item Account Code Assessed Amount Paid Balance Due On 07/18/24 State Surcharge (Fixed) $1.00 $1.00 $0.00 07/18/24 Single Inspection (Up To 4 Circuits) $40.00 $40.00 $0.00 Totals. • $41.00 $41.00 Application Info Property Address Property Owner 4326 West Arm Road Mairin Brzica Spring Park, MN 55384 Description of Work Install Electrical circuit Prevlous Payments $0.00 Remaining Balance Due $0.00 Property Owner Address Valuation 4326 West Arm Road Spring Park, MN 55384