Permits - Permit# 25SP-00085 - 4601 Shoreline Drive - 11/18/2025I_rl I City of Spring Park I Re -roof (Commerciol)
PARK
4349 Warren Ave, Spring Park, MN 55384
Phone:(952) 471-9051 Fax: (952) 471-9160
For Inspections: (952) 442-7520
25SP-00085
Date Issued: 11/18/2025
Property Owner: PHS/LAKE MINNETONKA LLC / ATTN
Expiration Date: 05/17/2026
CFO
Job Site Address: 4601 SHORELINE DRIVE, SPRING
Mailing Address: 2845 HAMLINE AVE N
PARK, MN 55384
Category: Commercial Miscellaneous
ROSEVILLE, MN 55113
Permit Type: Re -roof (Commercial)
Phone: (952) 471-0211
Valuation: $175,000.00
Email:
Description of Work:
Layover installation of new EPDM roof system by full adhesion
method. see scope discription:
Subdivision:
Required Setbacks:
Parcel ID: 1811723330061
Filing:
Actual Setbacks:
Lot:
Block:
Total Sq Ft:
Contractors:
Fee Items
Amount
Primary PINE CITY ROOFING LLC (612) 876-0173
State Surcharge
$ 87.50
Building PINE CITY ROOFING LLC (612) 876-0173
Commercial Roof/Siding/Window/Door
$ 1,804.50
Commercial R/S/W/D Plan Review
$ 1,172.93
Total Fees:
$ 3,064.93
NOTICE
Signature of Applicant/Date
Building Department Signature/Date
11/18/2025
MUST BE POSTED ON JOB SITE
INSPECTION CARD
*k=:Z City of Spring Park
SPRING PARK
OnGakf%innetonka 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 JOBSITE.
Re -roof
PERMIT NO.: 25SP-00085 PERMIT TYPE: (Commercial) ISSUED DATE: 11/18/2025 EXPIRATION DATE: 05/17/2026
1811723330
PROJECT ADDRESS: 4601 SHORELINE DRIVE, SPRING PARK, MN 55384 PARCEL NO.: 061
PHS/LAKE MINNETONKA LLC / ATTN
OWNER: CFO OWNER PHONE: (952) 471-0211
CONTRACTOR: PINE CITY ROOFING LLC CONTRACTOR PHONE: (612) 876-0173
APPLICANT: Pine City Roofing - Sandy APPLICANT PHONE: (612) 876-0173
DESCRIPTION OF WORK: Layover installation of new EPDM roof system by full adhesion method. see scope discription:
CONSTRUCTION TYPE: OCCUPANT LOAD:
DATE DATE
INSPECTION INSP PASSED COMMENTS INSPECTION INSP PASSED
UnderlaymenUlnsulatio I I I Building Final
n
Fire Approval: Date: Engineering
Approval:
PW Approval: Date: Other
To request an inspection: (952) 442-7520
Date:
Date:
COMMENTS
Page 1 of 1
Read all attached
materials.
Everyone
performing work
to which the code
is applicable shall
comply with the
code.
The field copy of these plans
must be kept on -site and
made available to inspector
during all inspections.
To schedule inspections
call
(952) 442-7520
Please have the permit
number and street address
ready at the time of the call.
Plan Revisions
All construction shall comply
with the approved plans.
Plan revisions will not be
reviewed in the field without
prior approval from the Building
Official. Submit all plan
revisions to the Department of
Building Safety for review, prior
to their construction.
NOTICE
Plan review was done in accordance with the current
Minnesota Building Code. Plan review does not waive
any additional code compliance issues found on site.
e
EFER TO APPROVAL LETTER
ADDITONAL COMMENTS AND
REQUIREMENTS
Reviewed for Code Compliance
This review is limited to the submitted scope of work, is based upon the supposition that the plan
accurately depicts the intended construction and end -use, that the necessary legal authority has
been obtained to construct the project and work is subject to code compliance and field
inspection during construction.
By: Verrickil) man Type of Construction: V-B
Date: 11/3/2025 Occupancy Classification: R-3
Permit #: 25SP-00085 Code Edition: 2020 MN Building Code
Reviewed for
Building Code
Compliance
RltL Commercial
&
Residentiai
� Jotl 4op.q�.r
' 61i•SPSJ8�99KS
T hWWAgD 61t6854495
ss.or p-necatyroofing@gmall.com
Pine City Roofing LLC
3249 Bloomington Ave S. Minneapolis
MN 55407
M- 612-685-4495
Bid/Contract Submitted To:
Name: Gavin Hart
North Lone Star Capital
Address:
Phone: 651-775-7781
Date: 9/24/2025
Total Roof Measure:
ESTIMATE/CONTRACT
Work to be performed at:
Name: Parkshore Apartments
Address: 4601 Shoreline Drive
Spring Park, MN
Pine City Roofing LLC - PM: Jose Rodriguez
Total Cost of project: $175,000.00
Bid/Contract to include material, equipment, and labor to layover the existing roof and install a new
fully adhered .60 Mil EPDM Black roofing system. The job will bid as follows:
Scope of Work
Pine City Roofing (PC) will provide material, equipment, and labor to install a new roofing system
which includes the following actions:
• PC to carefully remove perimeter coping wall metal for reuse.
• Remove loose pebble for disposal.
• PC will then mechanically/manually tear -off and remove existing roofing material from
walls and properly dispose of debris.
• PC to then inspect roof insulation and deck and prepare surface as needed. Shall Pine City find wet or
rotting on the insulation or deck, it can be replaced at $60 per man-hour, plus the cost of materials.
Permission will be requested, and pictures will be taken prior to work commencing.
• PC will then mechanically install a %:" Fiberboard layer by use of metal plates and screws.
Reviewed for
Building Code
Compliance
Commercial
c> &
PFF[STIYIIf
elp;ir
Residential
JJ..6 Ro dgusr
OJECTY44GER
6 •'�"nir
/2.685A898
... ....
612-685- 495
.,. ,. .., pinecilyrooling@gmail.com
• PC will then apply anew .60 Mil Black Ethylene Propylene Diene Monimer (EPDM)
roofing membrane by full -adhesion method; which involves rolling industrial EPDM
bonding agent using roof rolling pins and fully adhering the membrane to the insulation.
For the detail work, PC will use reinforced 6" Seam Tape where sheets of membrane join
(EPDM) to ensure there is a permanent seal. Likewise, all appropriate flashing up to any
wall or HVAC surface will be done. All penetrations, vents and HVAC units will be flashed
and sealed as well. Shall an HVAC unit need to be raised for flashing, Pine City can assist
in lifting and lowering the unit. We only ask that a qualified technician take care of any
needed connection/disconnection.
• Finally, PC will re -install -the existing perimeter wall coping metal to the parapet walls to finish the job.
• Clean-up of Construction Site: Pine City to provide dumpster service and clean-up entire
roof area of all debris and clean grounds daily. Dumpster to be removed upon job
completion.
e Through core cuts, PC has found the average R value of the existing roof to be at about R30 and will
bring it up to just under R32 by adding the fiberboard on top of the existing roof.
• Upon full completion and payment of job, Pine City to offer a 10-Year Warranty on
workmanship.
We hope our bid approximates your project's needs and assure we work to the highest quality
workmanship. Please give us a call to discuss any items which may not be meeting your project's
parameters. We want to earn your trust and become your contracting partner.
Price for Above Roofing Project (Re -Roof Project) $175,000.00
Down Payment $87,500.00
Due Upon Completion $Remainder
Payment of any remaining balance by Buyer-owner/Client is due on completion of project.
Signature
OWNER/BUYER:
Date
Signature
Pine City Roofing —Jose E. Rodriguez
Reviewed for
Date Building Code
Compliance
Commercial Application/Plan Review Submittal Checklist
The following check list has been compiled to assist in expediting the commercial plan review
and permit issuance process. Please take a moment to review these submittal requirements
and to verify all of the necessary documentation prior to submitting your project.
COMMERCIAL ADDITIONS, NEW CONSTRUCTION, REMODELS, ETC.
❑ Provide co pleted permit application including:
Date
ZSite Address
riZ wner
Owner Address
Tcontractor
elephone Number
Information
F
escription of work being performed
aluation of work being performed
signature of applicant
❑ 2 (two) sets of SIGNED Architectural and Structural drawings are required on all
commercial projects unless other arrangements or agreements between the submitting
party and the building inspection department have been made.
❑ Submitted Plans will include, a Code Analysis Including:
❑ Which Code and Edition (i.e.: 2006 IBC, 2007 MSBC)
❑ Occupancy Classification
❑ Fire separation requirement (separated/non-separated)
❑ Fire Sprinkler system requirements
❑ Fire alarm system requirements
['Construction Type
❑ Allowable area
[Proposed actual area
❑ Allowable height
❑ Proposed height
❑ Proposed area and height increases if applicable
❑ Occupant load
❑ Exiting requirements
❑ Plumbing Fixtures Requirements
❑ Provide project manual or; door hardware and window schedules, wall section and wall
construction details
❑ Complete and Sign Special Inspections Worksheet (see attached)
❑ Complete and provide Minnesota Energy Code compliance forms (see attached)
❑ Building Envelope or ComCheck for building envelope; AND
❑ Lighting or ComCheck for lighting; OR
❑ Energy Cost Budget Method; OR
❑ Building Performance Rating Method
❑ Projects must comply with the Minnesota Accessibility Code including:
❑ Parking
❑ Accessible route
❑ Ramps
❑ Door width, swing and hardware
❑ Bathroom requirements
❑ Access between floors
❑ Countertop heights
❑ Provide site plan including parking lots, fire apparatus access roads/lane etc.
❑ Provide Utility and/or Civil plan including fire hydrant locations
Reviewed for
Building Code
Compliance
Structural Testing and Special Inspection
Statement of Special Inspections
Project Name: G t— C ak.4 r c— AeG -- rrsr +nA P-w- r Q G
Location: '`i (a O l 5y, nix n c Za �n ry . ��-lcfir-; S'5-- 5S%-i
Owner: S ILL. C-
This Statement of Special Inspections is submitted as a condition for permit issuance in accordance with the Special
Inspection and Structural Testing requirements of the 2006 International Building Code as adopted by the current
Minnesota State Building Code. It includes a schedule of Special Inspection services applicable to this project and the
identity of agencies to be retained for conducting these inspections and tests. This Statement of Special Inspections
encompasses the following disciplines:
❑ Structural ❑ Architectural ❑ Other:
The Special Inspector shall keep records of all inspections and shall furnish inspection reports to the Building Official, the
Architect and Structural Engineer of Record. Discrepancies shall be brought to the immediate attention of the Contractor for
correction. If such discrepancies are not corrected, the discrepancies shall be brought to the attention of the Building
Official, the Architect and SER. The Special Inspection program does not relieve the Contractor of his or her responsibilities.
Interim reports shall be submitted to the Building Official the Architect and SER.
A Final Report of Special Inspections documenting completion of all required Special Inspections, testing and correction of
any discrepancies noted in the inspections shall be submitted prior to issuance of a Certificate of Use and Occupancy.
ACKNOWLEDGEMENTS
Each appropriate representative shall sign below:
Owner: Firm: Date:
Contract • �• Firm: &4, A':�* �a&R ^c U.G Date: / D
Architect Firm: J Date: _
SER:
SI S:
SIT:
TA:
F:
Firm:
Firm:
Firm:
Finn:
Firm:
Date:
Date:
Date:
Date:
Date:
If requested by engineer/architect of record or building official, the individual names of all prospective special inspectors and
the work they intend to observe shall be identified.
Legend: SER = Structural Engineer of Record
SI-S = Special Inspector - Structural
Accepted for the Building Department By
SI-T = Special Inspector- Technical
F = Fabricator
_ Date _
TA = Testing Agency
Reviewed for
Building Code
Compliance
Commercial Application/Plan Review Submittal Checklist
Changes to original Submittal Documents:
1. Any changes or addendums to the original submittal documents must be submitted to the
Building Inspections Department for review prior to proceeding with the proposed
changes.
2. Changes may be indicated by a single sheet with a clouded area showing the proposed
changes to the particular sheet or area.
3. Full plans may be submitted if there are changes or corrections to multiple sheets. Once
again, the changes to the original should be indicated by clouded areas.
4. If a full set of plans is resubmitted without indication of the changes to the original, a
complete plan review will be performed and another full plan review charge will be
assessed.
5. 2 (two) sets of the changes should be submitted.
Reviewed for
Building Code
Compliance
Structural Testing and Special Inspection
Program Summary Schedule
Project Name tom' -V- S�n DMe-A 'k M c f, } �C —�ofr_r Project No.
Location t (O n I S h IQ a
Jo �1 Permit No. (1)
Notes: This schedule shall be filled out and included in the Structural Testing and Special Inspection Program.
(1) Permit No. to be provided by the Building Official.
(2) Referenced to the specific technical scope section in the program.
(3) Use descriptions per IBC Section 1704, as adopted by Minnesota State Building Code.
(4) Special Inspector - Technical, Special Inspector — Structural, Testing Agency.
(5) Weekly, monthly, per testfinspection, per floor, etc.
(6) Firm contracted to perform services.
Reviewed for
Building Code
Compliance
A,..
ING PARK
Project Name:
Date:
Jurisdiction:
ID:
Applicant Phone:
Jobsite:
Code:
Reviewed:
11 /03/2025
City of Spring Park
25SP-00085
(612) 876-0173
4601 SHORELINE DRIVE
City of Spring Park
4349 Warren Ave
Spring Park, MN 55384
Phone (952) 471-9051
Fax (952) 471-9160
Approval Status: Approved with Comments
Construction Type:
Applicant Name: Pine City Roofing - Sandy
Applicant Email: pinecityroofing@gmail.com
2020 1300, Minnesota Building Code Administration; 2020 1305, Minnesota Building Code
Building
The plans and specifications, for the project named above, have been reviewed for substantial compliance with the
current Minnesota State Building Code. This review is limited to the submitted scope of work; is based upon the
supposition that the data on which the design is based are correct and that the necessary legal authority has been
obtained to construct the project. Although every attempt has been made to identify code issues or concerns for proper
and necessary change, the project designer(s), the building contractor(s) and the property owner(s) are ultimately
responsible for providing complete code compliance and maintaining minimum construction standards for the
safeguarding of life or limb, health, public welfare and property while constructing this project.
Approval is based on the correction of all noted deficiencies and compliance with all items listed below. Any changes from
these documents and/or additional information shall be submitted to the Department of Building Safety for code
compliance review and approval. Written response of approval must be on site prior to implementation of such changes.
The following information is related to the submitted plans/scope or as general information regarding code compliance
Compliance with the stated requirements will be verified during the construction process.
All work shall be inspected. It is the responsibility of the contractor/installer to contact the Department of Building Safety,
when ready to schedule an inspection, at (952) 442-7520 during regular business hours.
If you have any questions or concerns regarding this plan review, please contact me via telephone at (952) 442-7520 or
email at codereview@mnspect.com.
Derrick Wyman
Plans Examiner
dwyman@safebuilt.com
4601 SHORELINE DRIVE Page 1
A-Y-
ING PARK
Miruictonfia
Plan Specific Items:
Building: Approved with Comments - Derrick Wyman, dwyman@safebuilt.com
PLANS DATED:
PLAN SHEETS REVIEWED:
SCOPE OF WORK: As described on the contractor's scope of work.
PLAN SPECIFIC ITEMS (to be completed during the construction process):
City of Spring Park
4349 Warren Ave
Spring Park, MN 55384
Phone (952) 471-9051
Fax (952) 471-9160
• Access shall be provided to the roof by the contractor during all inspections. Access shall be by an OSHA approved
ladder or other approved means.
Minnesota Building Code Items:
1. Roof Coverings shall be installed in accordance with the MN building code and the approved manufacturer's
instructions such that the roof coverings shall serve to protect the building. (MBC 1503.1). All roof coverings and roof
assemblies must comply with performance requirements (MBC 1504) and fire classification (MBC 1505)
2. Flashing: Flashing shall be installed in such a manner so as to prevent moisture entering the wall and roof. Flashing
shall be installed at wall and roof intersections, at gutters, wherever there is a change in roof slope or direction, and
around roof openings. Metal flashing shall be corrosion resistant with a thickness of not less than 0.019-inch galvanized
steel (MBC 1503.2)
3. Coping: Parapet walls shall be properly coped with noncombustible, weatherproof materials of a width no less than the
thickness of the parapet wall. (MBC 1503.3)
4. Roof ventilation: Intake and exhaust vents shall be provided in accordance with Section 1203.2 (MBC 1503.3)
5. Crickets and saddles: A cricket or saddles shall be installed on the ridge side of any chimney or penetration greater
than 30" (MBC 1503.5)
6. Roof replacement shall include the removal of all existing layers of roof coverings down to the roof deck. (MBC 1511.3)
Exception: Where existing roof assembly includes an ice barrier membrane that is adhered to the roof deck, the existing
ice barrier membrane shall be permitted to remain in place and covered with an additional layer of ice barrier membrane.
7. Roof recover: (MBC 1511.3.1) The installation of a new roof covering over an existing roof covering shall be permitted
where any of the following occur:
• The new roof covering is installed in accordance with the manufacturer's instructions.
• Complete and separate roofing systems, such as standing -seam metal panel systems that are designed to transmit the
roof loads directly to the buildings structural system and do not rely on the existing roof covering for support shall not
require the removal of existing coverings.
• Metal panel, metal shingle, and concrete and clay tile roof coverings shall be permitted to be installed over existing
wood shake roofs.
• The application of a new protective roof coating over and existing protective roof coating, metal roof panel, spray poly
foam roof, built-up roof, modified roofing, thermoset and thermoplastic single -ply roofing shall be permitted without tear
off of existing coverings.
8. A roof recover shall not be permitted where any of the following conditions occur:
• The existing roof or roof covering is water soaked or has deteriorated to the point where the existing roof or roof
covering is not adequate as a base for additional roofing.
4601 SHORELINE DRIVE Page 2
'Y— I City of Spring Park
4349 Warren Ave
Spring Park, MN 55384
v� Phone (952) 471-9051
PARK Fax (952) 471-9160
• Where the existing roof covering is wood shake, slate, clay, cement, or asbestos -cement tile.
• Where the existing roof has two or more applications of any type of roof covering.
9. Reinstallation of materials. Existing vent flashing, metal edging, drain outlets, collars, and metal counterflashing shall
not be reinstalled where rusted, damaged, or deteriorated. Flashings shall be reconstructed in accordance with the
manufacturer's instructions (MBC 1511.5)
10. Minimum Slope: (MBC 1511) Reroofing shall not be required to meet the minimum design slope requirement of one -
quarter unit vertical in 12 units horizontal (2-percent slope) in Section 1507 for roofs that provide positive roof drainage if
all of the following conditions are met:
• The minimum required roof slope is infeasible due to existing parapet heights, existing unalterable flashing that requires
positive drainage, or other obstacle.
• Existing structure is demonstrated through structural analysis to be capable of supporting ponding to the level of the
secondary emergency drainage system or point of overflow.
• A secondary (emergency) drainage system is installed
• Where the application of a new roof covering over wood shingle or shake roofs creates a combustible space, the entire
existing surface shall be covered with gypsum board, or mineral fiber fastened in place. (MBC 1511.4)
11. Underlayment: Shall be installed per Table 1507.1.1(1) & 1507.1.1(2)
Roof Type:
1. (MBC 1507.12) (EPDM) Thermoset single -ply roof coverings shall comply with ASTM D4637, ASTMD 5019. Unless
designed for water accumulation in accordance with section 1611.2, roof shall have a design slope of a minimum of 1/4
vertical unit in 12 units horizontal (2%) slope. (MBC 1507.12.1)
2. (MBC 1507.15) (Liquid -applied roofing) Liquid applied roofing shall comply with ASTM C836, ASTM C957, ASTM
D1227 or ASTM D3468, ASTM D6083, ASTM D6694 or ASTM D6947. Unless designed for water accumulation in
accordance with Section 1611.2, liquid -applied roofs shall have a design slope of a minimum of one-fourth unit vertical in
12 units horizontal (2-percent slope).
Skylights:
1. (MBC 2610.3) Dome -shaped skylights shall rise above the mounting flange a minimum distance equal to 10 percent of
the maximum width of the dome but not less than 3".
Minnesota Energy Code Items:
1. Insulation:
• Where the insulation is entirely above the deck) roof shall have a minimum of R-30 continuous insulation.
• Where two or more layers of continuous insulation board are used, the edge joints between each layer of continuous
insulation boards shall be staggered.
• [BF] 1508.2 Material standards. Above -deck thermal insulation board shall comply with the standards in Table 1508.2.
(MN Rule 1305)
2. Insulation requirements for roof replacement. (MBC) For roof replacement on an existing building where the insulation
is entirely above the deck and where the roof slope is less than two units vertical in 12 units horizontal, the insulation shall
conform to the energy conservation requirements specified in Table 5.5-6, Opaque Thermal Envelope Requirements. (R-
30 ci) (2024 Minnesota Energy Code-ASHRAE 90.1-2019)
Exception: Where the required R-value cannot be provided because of the thickness limitations that occur with the
existing rooftop conditions, including heating, ventilation and air-conditioning equipment, low door or glazing heights,
4601 SHORELINE DRIVE Page 3
A-rI City of Spring Park
4349 Warren Ave
Spring Park, MN 55384
V� Phone (952) 471-9051
PARK Fax (952) 471-9160
parapet heights, or proper roof flashing heights, the maximum thickness of insulation compatible with the available space
and existing rooftop conditions shall be installed.
GENERAL ITEMS:
1. Construction or work shall be inspected in accordance with the requirements of Minnesota Rule 1300.0210.
2. It is the responsibility of the contractor/installer to contact the Department of Building Safety, when ready to schedule
an inspection, at (952) 442-7520 between the hours of 8:00 a.m. and 4:30 p.m., Monday through Friday.
3. The approved permit and all related plans and documentation shall be on site and available to the inspector at the time
of inspection.
4. Failure to provide the required documentation to the inspector at the time of inspection may result in a cancelation of
the inspection and additional inspection fees for the additional inspection(s).
5. The field inspector may identify additional code requirements during inspections. (Example of code requirement items
that might be identified are fire sprinkler heads being obstructed by framing, beams, lighting, ceiling configurations,
plumbing pipes, and mechanical system ductwork that will require review by the fire suppression plan reviewer. Additional
work being completed that is not consistent with the project scope of work or the approved plans.)
6. Applicable Codes: 2020 Minnesota State Building Code, 2024 Minnesota State Energy Code
4601 SHORELINE DRIVE Page 4
CITY OF SPRING PARK PAGE 1
BUILDING PERMIT
4349 Warren Avenue
Spring Park, MN 55384 ❑ Handout Given
_
Phone: 952-471//-9051 Fax: 952-471-9160 ❑ Lead Handout Given
R ute to M SP
�(n �� j �! I ��. tj
SITE ADDRESS: C '-D n f !J r'- C �� !? ,/tom^ PID:
1) Was the home constructed before 1978? (YES ❑, continue with line 2, NO o'continue without completing EPA Section)
2) Will the work disturb t6 sq ft of interior painted surfaces or k20 sq ft of exterior painted surfaces? (YES o go to line 4, NO c line 3)
•
3) Are there any windows being replaced? (YES o, go to line 4, NO o continue without completing EPA Section)
4) Has this home been Certified Lead Free? (YES c, you MUST Attach Certification Information, NO o complete line 5)
5) EPA Contractor Certification Number NAT - (applies to contractoronly)
!
PROPERTY OWNER: k S L- ---G Address. h,,-,
'
City 67— P - L State: MIV Zi : Sr' 3 Email-
r•
Contact Name: Phone: 9 S oZ
•
CONTRACTOR: Piri C C; L LC Address: 92-CICIa i o �,r, rya so
City. State: Zip. 0-4 Phone- D Fax:
Contractor License No: - - ntact Name: SGr Phone/2 "o
EmaiL t -+ o.' A r �- C i+-�6, 12--3 ^O 1
ARCHITECT: Address:
City State. Zip Phone: Fax:
•
Email: Contact Name. PhcDe.
7OF WORK:
❑ New Construction ❑ Deck )(Re -Roof
merclal Residential
❑ Change of Use ❑ Pool In Re -Side
o Finish Basement ❑ Retaining Wall ❑ Fence
EST. VALUATION OF WORK
$
❑ Remodel ❑ Porch a Shed
Square feet:
❑Addition ❑ Demolition a Window/Door Replacement
o Garage-Attached/Detach ❑ Plumbing -provide detail on Page 2 # being replaced
-.Accessory Structure c Mechanical -proyde detail on Page 2 _ Misc Other
•
Detailed Description of Work:
Lci o �c
:� Cor ''
GSA S coo t
Sprsmre of In s apptc situ by IK Iepal property vvmr ora Ik enf¢d cmvalor, as Its tits repro enla; e s Tauired and amnor¢es Ins, Zoning Adminermtor or designee anti Ine auznq elfictai
or designee to enter upon the property to perform needed Inspections Entry may be without prior notice- I hereby acknowledge that I have read this application and stale that all information Is true and
cones to the best ormy knowledge 1 further agree that alt work performed will be In accordance with approved plans specifications and conditions and to abide by at ordinances of the Municipality
sno the laws of the stale or Minnesota regarding actions taken pursuant to this permit I agree to pay all plan review fees even if I choose not to proceed with the work. Penult expires when work
•
isnot c onmenced within 180 days from dale of permit cr if work Is suspended abandoned. or not Inspected for 18o days Work beyond the scope or this permit or work without a permit or Inspection
•
.+• be subject to a penalty
Noise Ordinance In Effect: SIONpA FRIDAY Before 7 a.m. and after 10 p.m. Weekends)Holidays before 7 a.m. and after 8 p.m.
SIGNATURE OF APPLICANT: `mac �� DATE: 10-1 - Zs'
PRINTED NAME: OS C_ &T This he signature of: ❑ Owneror zowners Representative
,.-;CC JP. TYPE CONST, TYPE CODE BLDG SPRINKLED Yes / No
VALUATION. $
Permit Fee: $ 11wt • So WAC Charge: $
Plan Review Fee: $ a Sewer 8 Water Hook -Up: $
State Surcharge: $ _$�_. Sewer 8 Water Disconnect: $ _
Site Inspection Fee: $ Water Meter: $
S.E-C. Fee: $ _ Muni SE/WA Fee: $
Investigation Fee / Other Fee: $ '2016 SAC Escrow: $2485
>_
-J
Copy Charge ($.25 per 8-5 x11 page) $ _ Other. $
zO
License Check ($5) / Lead Check ($5) $ A I TOTAL DUE:
to
SUB -TOTALS
y
'NOTE: Commercial plans will be submitted to the Met Council Environmental Svcs
Plumbing Fee (from Page 2) $ for SAC determlnallon. Escrow payment will be required when permit Is Issued. If
ed Mechanical Fee (from Paae 2) $ after Mot Council rovierw no SAC Is dmormin, escrow will be relunded In full.
eWi
LL
Special Conditions/Required Setbacks:
a
0
Building Approval By: DATE:
Printed Building Approval By: ❑ License Verification ❑ Lead Verification - Checked By:
City Approval By: DATE:
�s
Paid: 0& • Date:
Receipt No V 'F By:
Jamie Hoffman
From: payment@thepaymentgroup.com
Sent: Friday, November 14, 2025 9:00 AM
To: Jamie Hoffman
Cc: payment@thepaymentgroup.com
Subject: JOSE RODRIGUEZ Permit Payment to Spring Park, MN - Permits & Licenses from TPG
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Dear Spring Park, MN - Permits & Licenses,
JOSE RODRIGUEZ has made a web Payment through The Payment Group for:
Payment Information
Date Paid: Friday, 14 November 2025 08:59:38 CT
Confirmation: YV7BQE
Credit Card Number (last 4 1255
digits):
Credit Card Type: Visa
First Name Last Name
JOSE RODRIGUEZ
ull Address
ermit or
Business
Name ity, State &
icense
ip
umber
11706 80TH
PINE CITY
4601
AVE, MILACA,
ROOFING
SHORELINE
56353MN
Payment
Amount
$3,064.93
JOSE RODRIGUEZ can be reached at: 612-685-4495 or PineCityRoofing@Gmail.com if there are
any questions regarding this payment.
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1
RECEIPT
City of Spring Park
4349 Warren Ave, Spring Park, MN 55384
(952) 471-9051
25SP-00085 i Re -roof (Commercial)
Payment Amount: $3,064.93
wi=zz
SPRING PARK
On Lake 911innetonkg
Receipt Number: 503
November 18, 2025
Transaction Method Payer
Cashier Reference Number
Credit Card per City
Marcy Miller
Comments
Confirmed received payment per Petria at City
Assessed Fee Items
Fee items being paid by this payment
Assessed Fee Item
On
Account Code Assessed Amount Paid
Balance Due
11/04/25 State Surcharge
$87.50 $87.50
$0.00
11/04/25 Commercial R/S/W/D Plan Review
$1,172.93 $1,172.93
$0.00
11/04/25 Commercial Roof/Siding/Window/Door
$1,804.50 $1,804.50
$0.00
Totals. $3,064.93 $3,064.93
Previous Payments
$0.00
Remaining Balance Due
$0.00
Application Info
Property Address Property Owner Property Owner Address Valuation
4601 SHORELINE DRIVE PHS/LAKE MINNETONKA LLC 2845 HAMLINE AVE N $175,000.00
SPRING PARK, MN 55384 / ATTN CFO ROSEVILLE, MN 55113
Description of Work
Layover installation of new EPDM roof system by full adhesion method. see scope discription: