Permits - Permit# 24SP-00141 - 2433 Black Lake Road - 1/2/2025City of Spring Park
Plumbing (Residential)
4349 Warren Ave, Spring Park, MN 55384
PAP, "7 ' '\' Phone: (952) 471-9051 Fax: (952) 471-9160
For Inspections: (952) 442-7520
24SP-00141
Date Issued: 01/02/2025
Property Owner: Phillip and Debra Holinka
Expiration Date: 07/01/2025
Mailing Address: 2433 Black Lake Road
Job Site Address: 2433 Black Lake Road, Spring Park,
MN 55384
Spring Park, MN 55384
Category. Residential Miscellaneous
Phone:
Permit Type: Plumbing (Residential)
Email:
Valuation:
Description of Work:
Basement bath remodel - replace several fixtures
Subdivision:
Required Setbacks:
Parcel ID:
Filing:
Lot:
Actual Setbacks:
Black:
Total Sq Ft:
Contractors:
Fee items
Amount
Primary MCDONOUGH PLUMBING LLC (763) 227-
State Surcharge (Fixed)
$ 1.00
4715
Residential Plumbing Permit
$ 120.00
Total Fees:
$121.00
NOTICE
Signature of Applicant/Date
Building Department Signature/Date
01/02/2025
MUST BE POSTED ON JOB SITE
INSPECTION CARD
City of Spring Paris
On Lake91linneumn q 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 JOBSnF.
Plumbing
APPLICATION NO.: 24SP-DO141 TYPE: (Residential) ISSUED DATE: 01/02/2025 EXPIRATION DATE: 07/0112025
PROJECT ADDRESS: 2433 Black Lake Road, Spring Park, MN 55384 PARCEL NO.:
OWNER: Phillip and Debra Holinka CONTRACTOR: MCDONOUGH PLUMBING LLC CONTRACTOR PHONE: (763) 227-4715
DESCRIPTION OF WORK: Basement bath remodel - replace several flxtures
CONSTRUCTION TYPE: OCCUPANT LOAD:
DATE
INSPECTION INSP PASSED COMMENTS
Underground Plumbing
Plumbing Final
Flre Approval:
DATE
INSPECTION INSP PASSED COMMENTS
Plumbing Rough -In
Date: Engineering
Approval:
Date:
PW Approval: Date: Other ( ): Date:
To request an inspection: (952) 442-7520
Page 1 of 1
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CITY OF SPRING PARK PAGE 1 BUILDLNG PERMIT
4349 Warren Avenue a _ M/
Spring Park, MN 55384 ❑ Handout Given
Phone: 952-471-9051 Fax: 952-471-9160 ❑ Lead Handout Given Routed to MNSPECT
SITE ADDRESS:
-- — PID.
t) Was the home constructed before 19787 (YES -, continue with line 2, NO E: continue without completing EPA Section)
2) Will the work disturb t6 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 Gi, go to line 4, NO : continue without completing EPA Section)
4) Has this home been Certified Lead Free? (YES -:i, you MUST Attach Certification Information, NO ❑ complete line 5)
5) EPA Contractor Certification Number NAT -
• r-�-, (aPPlies to contractor only)
PROPERTY OWNER: P
Address
Ci ' S 1R Pc-i k State: y' 1% ZIP 3 Email:
Contact Name: (� f oe; iny.-"� PI., +,� i , Phnrun-
License No: VC
OF WORK:
EST. VALUA'VION OF WORK
$ $" o ✓ o
4uare feet
E tailed Description of rk:
Address: PD. §q
3 JS Phone: 7(- -7 Z7 -'{ 71S Fax-
Contact Name:
c New Construction
I- Deep - Pool
a Change of Use
-_� Retaining Waif _-� Porch
Finish Basement
a Demolrtton
o Remodel
, Fire Sprinkler
n-Addition
_ Fire Alarm
rr Garage-Attaehe&Detech
Whumbmij-p,o:,de detai on Page 2
❑ Aec9ssort Structure
i-, Mechanical-plevide Belau,,n Paoe 2
Re -Rood
n Re -Side
r Fence
v Shed
n VYindow,r cior Replacement
# being replaced
❑ Mist Other
31gnah" of this AW ketbn by the I" property ownat or a tkenead c ftactcr, as the oweWs npreserrtattvs. Is required and di&atzas the Zonl% Ac4t h*ttator Of dasv" and the Bu
wkv cr deslgres to arrter upon the property to perform raided inspections. Entry may be wartotn prior notice. I hereby eduvw Wge tttat I Neva read Nis eppicatlon end stab that all t,formation is ands
9Ind the
to" bast d State of Minns I ragwUAhw agree that ar work psr ion"M Wit es in Rccmtwits W" epprovec plain. apectfkations end conditions and to abide by ar ortftrmnces of the M,nlcipalRy
end dte mint of ftmedMr. of Minnesota frta rdake W aottorts to
or pueusM to the perm It 1 Ngrae ib pay all plan ravtasv feae � If I choose not do proceed wrlth a,a work, Permk expires when work
1, rat commenced wttl,as ifkl days Tian dale otpe,n,lt, or rwak Is suspended, abandoned, or not Inspected for 180 days. Work bayocd the scope of this panne, orwortt withwt a
.0 be subpd to a perelly. permit a Yapactlort,
Nola@ Ordinance in Effect MONDAY - FRIDAY &afore 7 a.m. and after 10 P.M. Weekonds/Holidays before 7 a.m. and after 8 p.m.
SIGNATURE OF APPLICANT: d _DATE: 1 L ZN 2 `(
PRINTEDNAME. ` This is the signature of: Owner or _, Owner's Representative
OCCUR TYPE: CONST. TYPE: CODE: BLDG SPRINKLED Yes / No
TION: $
Permit Fee: $
Plan Review Fee: $
State Surcharge: $
Site Inspection Fee: $
S.E.C. Fee: $
Investigation Fee / Other Fee: $
Copy Charge ($.25 per8.5 xtt page) $
Lieoneo Chock ($6) 1 load Chook ($6) $
SUB -TOTAL $
Plumbing Fee (from Page 2) $
Mechanical Fee (from Page 2) $
pecial Conditions/Required Setbacks:
Building Approval By:
Printed Building Approval By:
City Approval By:
WAC Charge: $
Sewer& Water Hook -UP: $
Sewer& Water Disconnect $
Water Meter. $
Muni SE/WA Fee: $ _
*2016 SAC Escrow. S2485
Other. $
TOTAL DUE: $ a
'NOTE; Commercial plans will be submitted to the Met Council Environmental eves
for SAC determination. Escrow payment will be reoprired when permit is Issued. N
after Met Council review no LAC Is determined, escrow will be refunded In full.
DATE:
❑ License Verification 13 Lead Verification - Checked
DATE:
Date:
Receipt No.
By:
CITY OF SPRING PARK
PAGE 2
anical Contractor;
State: Zip:
Bond No:
Led Description of Work:
❑ MECHANICAL PERMIT
❑ PLUMBING PERMIT
FOR PERMIT ISSUANCE
PAGE 1 and PAGE 2 should be complete
Indicate type of project, fixtures, and Gas Lines you will be installing or replacing (include count for each type of fixture):
MECHANICAL RXTURES GAS LINES
antity Quantity awritity
_ Furnace Kitchen Fart Furnace
Air Conditioning System Bath Fan Fireplace
Air Exchanger Grill Unit Heater
Fireplace
Unit Heater
In Floor Heat
❑ Replacement (one fixture only, no piping or vent changes)
❑ Addition/Remodel
❑ New Construction
❑ Other
Contractor: /Vilt gkA0 h_
1,la �tp/`�-
M.
C - S03 1 '2
&,F
r1rm
Water Heater
Grill
Dryer 4�r PP
Offke lbe Only:
P
Mechanical Permit Fee: $
Gas Line Permit Fee: $
State Surcharge: $
Other $
Total Mechanical Permit: S
0 r5t✓Y b
717 -'Q 15 Fax:
B 1 ) qLJ
Indicate type of project and fixtures you will be installing or replacing (include count for each type of fixture):
PLLOASING FDCTURES
QuantftWQuantity Quantity
ater Heater Shower Laundry Tub
Gas ❑ Electric i Dishwasher RoughAn Future Fixture
Water Softener 1 Clothes Washer Sump
3 Lawn Sprinkler System 1 Ice Maker Line 1 Water Piping System
Water Closet (Toilet) Hosa Bib Floor drain
Lavatory (Wash Basin) 2 Bathtub
❑ Replacement (one fixture only, no piping or vent changes)
❑ Addition/Remodel
❑ New Construction
a Other
Office use only:
Plumbing Permit Fee: $
State Surcharge $
Other: $
Total Plumbing Permit: $
Jamie Hoffman
From: payment3=thepaymentgroup.com@mg.thepaymentgroup.com on behalf of payment3
@thepaymentgroup.com
Sent: Thursday, December 26, 2024 10:41 AM
To: Jamie Hoffman
Cc: payment@thepaymentgroup.com
Subject: DALE MCDONOUGH Permit Payment to Spring Park, MN - Permits & Licenses from
TPG
Dear Spring Park, MN - Permits & Licenses,
DALE MCDONOUGH has made a web Payment through The Payment Group for:
Payment Information
Date Paid: Thursday, 26 December 202410:40:39 CT
Confirmation: XWPG2V
Credit Card Number (last 4
4623
digits):
Credit Card Type: Visa
DALE MCDONOUGH MCDONOUGH BUFFALO $121.00
PLUMBING
DALE MCDONOUGH can be reached at: 763-227-4715 or dale@downloadmn.com if there are any
questions regarding this payment.
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RECEIPT
City Of Spring Park
4349 Warren Ave, Spring Park, MN 55384
(952)471-9051
24SP-00141 I Plumbing (Residential)
Payment Amount
Transaction Method
Credit Card
Comments
Assessed Fee Items
$121.00
Payer
McDonough Plumbing
On Lake Winnetonka
Receipt Number. 405
Cashier Reference Number
Jamie Hoffman XWPG2V
January 2, 2025
Fee items being paid by this payment
Assessed Fee Item
On Account Code Assessed Amount Paid Balance Due
12/23/24 State Surcharge (Fixed)
$1,00 $1.00 $0.00
12/23/24 Residential Plumbing Permit $120.00 $120.00 $0.00
Application Info
Property Address
2433 Black Lake Road
Spring Park, MN 55384
Description of Work
Property Owner
Phillip and Debra Holinka
Basement bath remodel - replace several fixtures
Totals- $121.00 $121.00
Previous Payments $0.00
Remalning Balance Due $0.00
Property Owner Address Valuation
2433 Black Lake Road
Spring Park, MN 55384