Permits - Permit# 11-02P - 2425 Black Lake Road - 1/1/2011CITY OF SPRING PARR
Noise Ordinance In Effect:
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4349 Warren Avenue Spring Park, MN 55384
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Phone (952) 471-9051 Fax (952) 471-9160
Monday - Friday
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before 7 a.m. and after 10 p.m.
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PLUMBING PERMIT
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Weekends/Holidays
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before 7 a.m. and after 8 p.m.
DATE:
PM No.
Pipelayers Card No.
SITE ADDRESS:41 I •6tK e Ad
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OWNER
PLUMBING CONTRACTOR Name / / City / State / Zip / Daytime Telephone
ESTIMATED VALUE
/Address
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CLASS OF WORK: ( ) New ( ) Addition ( ) Alteration ( ) Replace
TYPE OF WORK: Residential ❑ Commercial
Water Closet (Toilet) 1 Bathtub Roof Leader -Rainwater
Lavatory (Wash Basin) Shower Drinking Fountain
Kitchen Sink & Disp. Dishwasher Lawn Sprinkler System
Water Heater Clothes Washer Water Meter
❑ Gas ❑ Electric Water Softner Water Connection
Ice Maker Line Piping/Treating Equipment Sewer Connection
Rough -in Future Fixture Floor Sink or Drain SAC
Vacuum Breakers Sump
Plumbing Comments: Fixtures @ $5.00 each': $
State Surcharge: $_
'to
__
"NOTE: Commercial plans wil_l be submited__to the Met Council �2011 SAc Escrow _:$2,23! - $2
Environmental Svcs for SAC (sewer availability charge) --- - ----- - - -- —
determination. Escrow payment will be required when permit is $
issued. If after Met Council review no SAC is determined, escrow
will be refunded in full. $
Total PLUMBING Pe t: $
'Minimum Fee f $50.00
Signature of this application by the legal property owner or a licensed contractor, as the owner's representative is required and authorizes the City Zoning Administrat nee and the City Building Official or desig
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 correct to the best of my knowle
further agree that all work performed will be in accordance with approved plans, specifications and conditions and to abide by all ordinances of the City and the laws of the State of 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. Permit expires when work is not commenced with 180 days from date of permit issued. of if building and wo
suspended, abandoned or not inspected for 180 days. Work beyond or wi out a permit or inspection will be subject to a penalty.
Call MNSP, or in wcTon. (952) 442-7520. (24 Hour Notice) 8:00 a.m. - 4:30 p.m.
SIGNATURE OF APPLICAN DATE:
PRINTED NAME: _S L-'J -0 erry III DATE:
For All Rough -In And Final Inspections Call MNSPECT At (952) 442-7520 (24 Hour Notice)
For SewerMater Inspections Call City Hall At (952) 471-9051
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Permit #: 11-02P
City of Spring Park
4349 Warren Avenue, Spring Park, MN 55384
Building Permit
PINS: ADDRESS: 2425 Black Lake Rd
Permission is hereby granted to: Doran Enterprises
To install or construct the improvements applied for. This permit is granted upon the condition that
the person to whom it is granted, and his agents, employees and workmen, shall conform in all
respects to the Ordinances of the City of Spring Park and to the Statutes of the State of Minnesota in
such cases made and provided; this permit may be revoked at any time upon violation of any of the
provisions of said Ordinances, Statutes, or for any misrepresentation in the application.
Approved by MNSPECT, CBO Date: 3-31-11
NOTE: This card must be placed in a conspicuous place at the address which work is to be
performed.
CITY OF SPRING PARK
4349 Warren Avenue, Spring Park, MN 55384
INSPECTION RECORD
PINS ADDRESS: 2425 Black Lake Rd
Building Inspections — Permit No.
Footings
Date
Inspector
Framing
Insulation
Wallboard B-4 taping
Final
Others
Plumbing Inspections — Permit # 11-02P
Date Inspector
Rough -in
Air Test
Final
Permit #
Date
Inspector
Sewer
Water
Electric
Note: Contractor is responsible to call for these inspections. This card must be placed in
a conspicuous place, on the premises on which work is to be performed. 952-442-7520.
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MIN'NESOTA DEPARTMENT OF
LABOR & IND'USTRY
STATE OF MINNESOTA...
MASTER PLUMBER
License # 058224-PM
Expiration Date 12/31/2012 ...............
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Original Issued Date 03/29/1974
THOMAS W DORAN
1440 KELLY DR
GOLDEN VALLEY, MN 55427
Plumbing Bond & Insurance Certificate
Construction Codes and Licensing Division Licensing and Certification Services 443 Lafayette Road N St Paul, MN 55155
Website: www.dii.mn.aov E-mail: 131-I.1-icense0state.mmus Telephone: 651-284.5034
This is to certify that the certificate: holder is in compliance with Minnesota Statutes § 3266.46, Subd. 2 for calendar year 2011 and may
engage in the plumbing trade in all areas of the state of Minnesota.
DORAN ENTERPRISES INC
1440 KELLY DR
GOLDEN VALLEY, MN 55427
2011 Bond ID:
STATE FARM O87663 FIIRE & CASUALTY CO
MINNESOTA DEPARTMENT OF
OR & INDUSTRY
THOMAS W DORAN (58224PM)
Liability Insurance ID: 93BFQ2413
STATE FARM FIRE & CASUALTY
Mechanical Bond Certificate
Construction Codes and Licensing Division Licensing and Certification Services 443 Lafayette Road N St Paul, MN 55155
Website: www.dii.mn.aov E-mail: DLI.1-1cense0state.mmus Telephone: 651-284-5896
This is to certify that the certificate holder is in compliance with Minnesota Statutes.§ 32613.197 for the period 01/01/2011 through 01/01/2012
and may engage in mechanical contracting in all areas of the state of Minnesota.
DORAN ENTERPRISES INC
1440 KELLY DR
GOLDEN VALLEY, MN 55427,
Bond ID: 93J482898
STATE FARM FIRE & CASUALTY CO
Certificate ID: 3927-MB
Effective Date: 1 /1 /2011
Expiration Date: 01/01/2012