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Permits - Permit# 26SP-00099 - 4212 West Arm Drive - 10/28/2026 owl City of Spring Park Mechanical (Residential) 4349 Warren Ave, Spring Park, MN 55384 PRING PARK I 26SP-00099 Phone:(952)471-9051 Fax:(952)471-9160 n Lake Winneton a For Inspections: (952) 442-7520 Date Issued: 10/28/2026 Property Owner: GINA ROBERTS Expiration Date: 04/26/2027 Mailing Address: 4212 WEST ARM DR Job Site Address: 4212 WEST ARM DR, SPRING PARK, MN 55384 SPRING PARK, MN 55384 Category: Residential Miscellaneous Phone: Permit Type: Mechanical (Residential) Email: Valuation: Description of Work: Install gas fireplace with venting, HEAT&GLO, COSM042-IFT(Fireside will not be doing the gas line) Subdivision: WEST ARM TOWNHOMES ON LAKE Required Setbacks: MINNETONKA Parcel ID: 18-117-23-44-0053 Filing: Lot: 20 Actual Setbacks: Block: 1 Total Sq Ft: Contractors: Fee Items Amount Primary HEARTH& HOME TECHNOLOGIES (651) State Surcharge(Fixed) $ 1.00 842-4228 Residential Mechanical Permit $75.00 Mechanical HEARTH & HOME TECHNOLOGIES (651)842-4228 Total Fees: $76.00 NOTICE Signature of Applicant/Date Building Department Signature/Date 10/28/2026 MUST BE POSTED ON JOB SITE INSPECTION CARD City of Spring Park SPRING PARK OnGakf91tinnetonka 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. Mechanical PERMIT NO.: 26SP-00099 PERMIT TYPE: (Residential) ISSUED DATE: 10/28/2026 EXPIRATION DATE: 04/26/2027 18-117-23- PROJECT ADDRESS: 4212 WEST ARM DR,SPRING PARK,MN 55384 PARCEL NO.: 44-0053 OWNER: GINA ROBERTS OWNER PHONE: CONTRACTOR: HEARTH&HOME TECHNOLOGIES CONTRACTOR PHONE: (651)842-4228 APPLICANT: FIRESIDE HEARTH&HOME-Doug APPLICANT PHONE: (651)842-4228 DESCRIPTION OF WORK: Install gas fireplace with venting,HEAT&GLO,COSM042-IFT(Fireside will not be doing the gas line) CONSTRUCTION TYPE: OCCUPANT LOAD: DATE DATE INSPECTION INSP PASSED COMMENTS INSPECTION INSP PASSED COMMENTS Mechanical Rough-In Air/Hydrostatic Test Reports Mechanical Final Fire Approval: Date: Engineering Date: Approval: PW Approval: Date: Other( ): Date: To request an inspection:(952)442-7520 Page 1 of 1 CITY OF SPRING PARK BUILDING PERMIT 4349 Warren Avenue PAGE 1 Spring Park,MN 55384 ❑ Email completed form to City of Spring Park to the attention of; Phone:952-471-9051 jkhoffman@ci.spring-park.mn.us Routed to SAFEbuilt Email:jkhoffmanQci.sprin -park.mmus 11 SITE ADDRESS:4212 WEST ARM DR PID:18-117-23-44-0053 1)Was the home constructed before 1978?(YES❑,continue with line 2,NO❑x continue without completing EPA Section) 2)Will the work disturb Z6 sq ft of interior painted surfaces or:'20 sq ft of exterior painted surfaces?(YES❑go to line 4,NO❑line 3) 3)Are there any windows being replaced?(YES❑,go to line 4,NO❑continue without completing EPA Section) _ 4)Has this home been Certified Lead Free?(YES[3,you MUST Attach Certification Information,NO ❑complete line 5) 5)EPA Contractor Certification Number: NAT- PROPERTY OWNER:GINA ROBERTS Address:4212 WEST ARM DR C; :SPRING PARK state:MN zi :55384 Email: ladygsongbird@gmail.com Contact Name:DOUG CARLSON Phone:651-842-4228 CONTRACTOR:FIRESIDE HEARTH & HOME Address:2700 FAIRVIEW E N City:ROSEVILLE State:MN zip:55113 Phone:651-842-422 Fax: Contractor License No:M B662572 Contact Name:DO EARL one:651-842-4228 Email:MNPERMITS@FIRESIDE.COM r IfIr* ARCHITECT: Address: , City: State:MN zip: Pho Fax: Email: nt e: Phone: TYPE OF WORK: ❑New Construction ❑ ck ❑Re-Roof ❑Commercial OResidential ❑Change of Use of ❑Re-Side EST.VALUATION OF WORK ❑Finish Base Retainin Wall ❑Fence $ 11000.00 ❑Remode ❑Porch ❑Shed sq It Square feet: ❑Additio Demolition ❑Window/Door Replacement ❑G e- ed/D ch ❑Plumbing-provide detail on Page 2 #being replaced Detailed Description of Work: ❑Acce cryS OMechanical-provide detail on Page 2 ❑Misc Other INSTALL GAS FIREPLACE WITH V Lb,COSM042-IFT Signature of this application b. _ gal pro rty r or aff censed contractor,as the owner's representative,is required and authorizes the Zoning Administrator or designee and the Building Official or designee to enter u t e o pe needed Inspections.Entry may be without prior notice.I hereby acknowledge that I have read this application and state that all Information is true and correct to the best of no I further agree that all work performed will be in accordance with approved plans,specifications and conditions and to abide by all ordinances of the - Municipality and the laws of the St f Minn is 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.Permit expires when work is not commence - In 180 del fro data of permit,or If work is suspended,abandoned,or not inspected for 180 days.Work beyond the scope of this penult,or work without a permit or Inspection,will be sub t enal SIGNATURE OF APPLICANT: pv DATE:10/14/2026 PRINTED NAME:DOUG CAR SON This is the signature of: ❑Owner or [R]Owners Representative OCCUP.TYPE: CONST.TYPE: CODE: BLDG SPRINKLED Yes/No VALUATION:$ Permit Fee: $ Park Dedication: $ Plan Review Fee: $ SAC Charge: $ State Surcharge: $ WAC Charge: $ Site Inspection Fee: $ Sewer Hook-Up: $ S.E.C.Fee: $ Water Hook-Up: $ Investigation Fee/Other Fee: $ Sewer Trunk: $ �.I Copy Charge($.25 per 8.5x11 page) $ Water Trunk: $ p License Check($5)/Lead Check($5) $ Water Meter$ N SUB-TOTAL$ SAC or City Fee:$ D Plumbing Fee(from Page 2) $ Other: $ Lu Mechanical Fee(from Page 2) $ TOTAL DUE: $ LL Special Conditions/Required Setbacks: O Building Approval By: DATE: Printed Building Approval By: ❑ License Verification❑ Lead Verification-Checked By: City Approval By: DATE: Paid: Date: Receipt No. By: CITY OF SPRING PARK ❑ MECHANICAL PERMIT ❑ PLUMBING PERMIT PAGE 2 FOR PERMIT ISSUANCE PAGE 1 and PAGE 2 should be complete MECHANICAL INFORMATION Mechanical Contractor:FIRESIDE HEARTH & HOME Address:2700 FAIRVIEW AVE N city:ROSEVILLE State:MN zip:55113 Phone:651-842-4228 Fax: - State Bond No:MB662572 lContact Name:DOUG CARLSON Email:MNPERMITS@FIRESIDE.COM JContact Phone:651-842-4228 Detailed Description of Work: INSTALL GAS FIREPLACE WITH VENTING,HEAT&GLO,COSM042-IFT Indicate type of project,fixtures,and Gas Lines you will be installing or replacing(include co " f ach type of fixture): MECHANICAL FIXTURES G INES Quantity Quantity Quantity Furnace Kitchen Fan Furnace Air Conditioning System Bath Fan Fireplac Air Exchanger Grill Unit ter 1 Fireplace W r He r Unit Heater ill In Floor Heat er Gas Log ove O se ly: 40 ❑Replacement(one fixture only,no piping or vent ch es) M Onechanical Permit Fee: $ El Addition/Remodel Gas Line Permit Fee: $ ❑New Construction State Surcharge: $ 1.00 ❑Other Other: $ Total Mechanical Permit: $ PLUMBING INFORMATION Plumbing Contractor: Address: City: te. i : Phone: Fax: Plumbers License No: IState Bond No: Contact Name: J Contact Phone: Email: Detailed Description of Work: Indicate type of project and fixtures you will be installing or replacing(include count for each type of fixture): PLUMBING FIXTURES Quantity Quantity Quantity Water Heater Shower Laundry Tub ❑Gas ❑Electric Dishwasher Rough-In Future Fixture Water Softener Clothes Washer Sump Lawn Sprinkler System Ice Maker Line Water Piping System Water Closet(Toilet) Hose Bib Floor Drain Lavatory Wash Basin Bathtub Office Use Only: ❑Replacement(one fixture only,no piping or vent changes) Plumbing Permit Fee: $ ❑Addition/Remodel State Surcharge $ 1.00 ❑New Construction Other: $ ❑Other Total Plumbing Permit: $ Jamie Hoffman From: payment@thepaymentgroup.com Sent: Wednesday, October 28, 2026 9:50 AM To: Jamie Hoffman Cc: payment@thepaymentgroup.com Subject: CHRISTA WEGWART Permit Payment to Spring Park, MN - Permits & Licenses from TPG ATTENTION: if you need assistance with this payment, please FORWARD this email to tpgclientsu rt nuvei.com_and include your request. Your client manager will respond. Dear Spring Park, MN - Permits & Licenses, CHRISTA WEGWART has made a web Payment through The Payment Group for: Date Paid: Wednesday, 28 October 2026 09:49:49 CT Confirmation: V76415 Credit Card Number(last 4 4616 digits): Credit Card Type: MasterCard FIRESIDE 4212 WEST ARM G CHRISTA WEGWART HEARTH & PARK,DR, SPRING 26SP-00099 $76.00 HOME 55384 CHRISTA WEGWART can be reached at : 651-842-4228 or MN PERM ITS@FIRESIDE.COM if there are any questions regarding this payment. Click here to login to your The Payment Group admin account Thank you once again for choosing The Payment Group! 1 RECEIPT City of Splring Park A-to", 4349 Warren Ave, Spring Park, MN 55384 (952)471-9051 SPRING PARK 26SP-00099 I Mechanical (Residential) On Gale Minnetonka Receipt Number:617 Payment Amount: $76.00 October 28,2026 Transaction Method Payer Cashier Reference Number Credit Card Fireside Hearth and Home Jamie Hoffman V76415 Comments Assessed Fee Items Fee items being paid in this transaction Assessed Fee Item Account Code Assessed Amount Paid waived or Balance Due On Discounted 10/28/26 State Surcharge(Fixed) $1.00 $1.00 $0.00 $0.00 10/28/26 Residential Mechanical Permit $75.00 $75.00 $0.00 $0.00 Totals. $76.00 $76.00 $0.00 Previous Payments/Waivers $0.00 Remaining Balance Due $0.00 Application Info Property Address Property Owner Property Owner Address Valuation 4212 WEST ARM DR GINA ROBERTS 4212 WEST ARM DR SPRING PARK, MN 55384 SPRING PARK, MN 55384 Description of Work Install gas fireplace with venting, HEAT&GLO, COSM042-IFT(Fireside will not be doing the gas line)