Permits - Permit# 08-04M - 2437 Black Lake Road - 1/1/2008�a� eb 'I_I). 'UWi 1" ;'1PH r i f.!' of prig P'1rI; I�I��.'1�'1I) f'. I
as ,
FEB 2 5 200g
CITY OF SPRING PARK
4349 WAItKEN AVENUE
SPRINGI VARK, MINNI SOTA 55384
952-471-905.1
APPLI.CNXION FOR MECHANIC'Ai., PI;RIMIT
Li rVl—
GENERAL INIT O1tNIATION
1. You Islay apply for mechanical pernd(v by mail or in person at the City offices. Applications will be
reviewed and it permit will be immed rvilhin 2 working days.
2. Permit cm da will be senf by return 11111il alter :r reviery is comple(ed. PER.MJ•.I S AIM NOT VA1,11)
UNTIL YpU REf-J;1VE A 1.'1'',.Itjvll'I'. WORK MUSTNOT BEGIN ANTI' TIDE PERMIT CARD i5
POSTED ONTHE HE JOlI SI'I'L, -- -- - --- - -
3. Mechauienl D signs - Complete calculations, details and speciliealious ere rcqui►•ed for each
heating, vcu(Ilatiols, b.till►Idilica(ion-dchruuidllication, and air conditioning inst.allsstioll islclitclinl; be -.if
lost/heist g rill c:dcnls.l.ion, design temperataret, ecpiipnlen( ratings and Identification as to type,
manrrfsrcturer end model, Uala shall be pretienl.cd un form provided. Identification of :usd
specifications for water heat.hsg cgidpincut Shall also be provicled,
4. When any new coustructioll or remodeling is Involved, a separate baildhig permit unr;:t be oh(ained.
5. All wort: Intivi be done in accordance wills (he Uniform Mechnnlcal Codc/Stat.c Building Code
regrure►uen(v.
6. All vvor-k.:mist he isaspec.f.e..d (vorrl;h-in ausl lirrll). Call 95.2-2,19-4600. A 24 hour notice Is rcxlrrircd.
7. house Heating Test Record nnrst fie Submitted before fin:sl.
1NSTRUC_7.'IONS Complete all Items on this elsplicsst.ion. Compute the permit fec. Sign 111)cl (Int.e the
cerlil'ication.:I:1VC'Ol�'fl'.[,T1'7+' Al'PLICAI'JON8 WILL NOT. BEE PROCESSED. If you lsave questions,
call.952-249-4600 or 951-471-905.1.
I'lease check one: New/ _ Addil.iou - _ - Repair -- Replace
Residcnt.ial Commercial ---
Owner's Na►ne --N,S. •� IA _. �_t `_ Phone Number r C
. - - ..--- -
Mailing Adclresv --��� — i, _1 S
Conlr ac(or't Naure� :�1�4� -�— -- -p —='phone Nu she►
INlailing Addre,gc r—i--.�1-1�`�-c���_
-SYS'1EM DLSCIUl"FION
HEATING' NVN•IEMIN
Q11autit.y
1
Make
_
Model
Fuel
N_ —
Flue Size
Pd -----
Input 11'l'Us--
Ou(put B'.CUs
--
chid
l r�i
COOLING SYSTEMS
Quantify ------- --- — - --
f!1) L0 llu 1 1PM CI tY 0t :1) r III= P3P
Mechanical Pamit
Make
Model
'1 o119
11. Power
WOOD BURNING YQUIVIVIE.NT
Wood stove 1011 floc
Wood Combination or ndd-ou
Factory fircplace wilb flue
Factory firelrlace(s) --- --
Wood Stove (s) --_ -
Brand nature _
Mrgr•'s Mill., (aearnuces, side
VEN'1 MATION
No.
No.
Freestanding
Franklin, other
-- 1'enr
Masonry
___-- Model No
----- - ----------------
mill. flue dill. -------- ._.. -----
Total
Kitchen exbnust - dueled A --recirculating
. ROI exhaust (must be ducted outside)
Other fall.9: Locatlous
ICURI.. STORAGE (l1?17S'I' IlE A.PPROVE.0 BY FIRI, MA.IZST-jA'1,1,)
Installation Removal
Fuel Oil _--_- kaflow; _—_ underground inside outside
cl'ru �v�
ci'm
__ cfln
'I'ot:n1 --
LY Gas
Other ____ _ _ �----.---- --------____-- —__--- gas opcuiug
1�1()NU5
2002 State S01_111te -- Xes, 1111e Section Applies
The repla.eelncllt of it ltcsidculial fixture o1•--wollance flint meets sill three of the following Ierluiveutcllts:
1) Hoes ttrot rellulre Inudiflcatiou to electrical or gas service.
2) Dias a total cost of $500.00 or less exeludipy the cost of file lixttre or applinllce; anti
3) Is improved, installed or replaced by the bujileowiler or licensed coutractor.
Skip Heat scetioll; Cost of Permit $ $1.5.00
State Surcharge $ .50
Mail Tn Tee 1.50
J. 1..25% of Contr:lct Price * or Mininyunihee Cp5,O
(Contract Price)
2. State Surcb:u'ec ** Add the State Hul(Qsk Code Division
Snrcbargc to cacti perndt. gO V � x .000S
(Contract Price)
or.1.50, wbichever is greater
3. Postage and HanalillA (Only Instil-iu applications)
2
$� 1.50
b- 2 0.? (10 8 f' f�A City o f ;; n r III E' •-I r If
Mccha.tlical Perldlil
4. '.CO'I'At. NJAMIT F EE (Adel lines 1-3 above)
A C'ON' RA.CT PRICE or .►pll COST nlcnng the nctuill or estirllnt.cd dollar• auwuul: charged for (Ile
permitle d w•orlc includiuy lonlerials, labor, profit, and other fixed costs. It is I'lle alilonlll. to be charged
to the enston,er Cor the work done. If any material, equipment. labor, or illslallatioll are furilished by
the owner, tenant, or silly other psirty, the reasonable market value of Such lte.11ls 11111.0 be ;e.eieicd to the
estimated cost or contract price for permit fee purposes. In the event there is a dispiou on the s1111ouut
of the job cost, Idle CIIV luay regl.resi the submission of a signed copy ol'the actual contract.
ww The STATE SIIRCILXRCtiJ?, is .()11(15 of the contract price undo S1.,000,000 or $.ill, whichever is
greater. For valuations over $1,000,000 call file Department of ]uspectioual Services for the,
price.
The undersigned hereby applies to the City for issuance of a Medulnicnl Permit, agrees to do all work
lu strict accordance with the ordinances of the City and the I-Cruintious of tile Minllcsota Slate 111111ding
Code, and certifies lllat. sill statements nslule on t.ilis application arc complete, true and correct.
Applicant's Signa
Approved By
Permit: $110.00 Valuation $8,800 Ao. OS -0401
P & H: 1.50
State: 4.40
Total: $115.90
SWe of Ainnleosta City of Spring Park
County of Hennepin } Office of Building Inspector
Oletbniml Permit
IN CONSIDERATION OF The statements and representations made by Metro Air
in application therefore duly filed in this office, which application is hereby made a part hereof, PERMISSION IS HEREBY
GRANTED To said Roxanne Rockvam as owner
to install to a building described as follows: kind of construction
(build, erect, install, add to, alter, repair, move, wreck, as the case may be)
Mechanicals for new construction per application dated 02-20-08
Front of width in feet ; side or length in feet ; height in feet ;
number of stories ; contents cubic feet; square feet, upon that
tract of land described as follows: Lot Block ; plat or addition
2437 Black Lake Road 19-117-23-12-0028
which tract is of the size and area specified in said application.
This permit is granted upon the express conditions that said owner and their contractors, agents, workers and
employees, shall comply in all respects with the ordinances of the City of Spring Park ;
that it does not cover the use of public property, such as streets, sidewalks, alleys, etc., for which special permits must
be secured; and that it does not cover the following: none of the following
(Electrical work, plumbing, heating, plastering, etc., if such there be.)
for which special permits must be secured.
Given under the hand of the Building Inspector of said City and its corporate seal and
attested by its Clerk this 4th day of March Year 2008
Attest:
Sarah Friesen, Administrator
Clerk
Lyle Oman
Building Inspector