Permits - Permit# 07-08M - 2471 Black Lake Road - 1/1/2007$ Permit:
312.50
P & H:
1.50
State:
12.50
Total:
326.50
State of AlinnPgota
Valuation $25,000
County of Hennepin I
-00. 07 -0801
City of Spring Park
Office of Building Inspector
Ajecbaniml hermit
IN CONSIDERATION OF The statements and representations made by Gopher Htg
in application therefore duly filed in this office, which application is hereby made a part hereof, PERMISSION IS HEREBY
GRANTED To said Sue Baker 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)
Ht2 and cooling ner hermit
Front of width in feet ; side or length in feet ; height in feet ;
number of stories ; contents
tract of land described as follows: Lot
cubic feet; square feet, upon that
plat or addition
2471 Black Lk Rd
which tract is of the size and area specified in said application.
Block
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 27th day of April Year 2007
Attest:
Sarah Friesen, Administrator Lyle Oman
Clerk Building Inspector
Poor Quality Document
Disclaimer
The original or copy of a document or page of a document
presented at the time of digital scanning contained within this
digital file may be of substandard quality for viewing, printing or
faxing needs.
CITY OF SPRING PARK
4349 WARREN AVENUE
SPRING PARK, MINNESOTA 55384
952-471-9051
APPLICATION FOR MECHANICAL PERMIT
GENERAL INFORMATION
1. You may apply for mechanical permits by mail or in person at the City offices. Applications will be
reviewed and a permit will be issued within 2 working days.
2. Permit cards will be sent by return mail after a review is completed. PERMITS ARE NOT VALID
UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE PERMIT CARD IS
POSTED ON THE JOB SITE
3. Mechanical Designs - Complete calculations, details and specifications are required for each
heating, ventilation, humidification -dehumidification, and air conditioning installation including heat
loss/heat gain calculation, design temperatures, equipment ratings and identification as to type,
manufacturer and model. Data shall be presented on form provided. Identification of and
specifications for water heating equipment shall also be provided.
4. When any new construction or remodeling is involved, a separate building permit must be obtained.
5. All work must be done in accordance with the Uniform Mechanical Code/State Building Code
requirements.
6. All work must be inspected (rough -in and final). Call 952-249-4600. A 24 hour notice is required.
7. House Heating Test Record must be submitted before final.
INSTRUCTIONS Complete all items on this application. Compute the permit fee. Sign and date the
certification. INCOMPLETE APPLICATIONS WILL NOT BE PROCESSED. If you have questions,
call 952-249-4600 or 952-471-9051.
Please check one: New --�� Addition Repair Replace
Residential __ Commercial
JOB SITE
Owner's Name _
Mailing Address _
Contractor's Name
Mailing Address _
SYSTEM DESCRIPTION
L�
HEATING SYSTEMS
Quantity
r
Make
Model
C- 7 P.
Fuel_
Flue Size
Input BTUs
l/ 0
Output BTUs
/ ot)
CFM
00
COOLING SYSTEMS
f
Quantity
Number
Number
..
Mechanical Permit
Make`
Model r- -6
Tons
H. Power
WOOD BURNING EQUIPMENT
Wood stove with flue
Wood combination or add -on
Factory fireplace with flue
Factory fireplace(s)
Wood Stove (s)
Brand name
Mfgr's Min., Clearances, side
VENTILATION
No.
No. �—
No.
Freestanding
Franklin, other
rear
Masonry
Model No
min. flue dia.
Total
Kitchen exhaust - ducted X recirculating
Bath exhaust (must be ducted outside)
Other fans: Locations
FUEL STORAGE (MUST BE APPROVED BY FIRE MARSHALL)
Installation Removal
Fuel Oil gallons underground inside outside
LP Gas gallons
cfm
cfm
_ cfm
Total
Other gas opening
PERMIT FEE CALCULATION(S)
2002 State Statute Yes, This Section Applies
The replacement of a Residential fixture or appliance that meets all three of the following requirements:
1) Does not require modification to electrical or gas service.
2) Has a total cost of $500.00 or less excluding the cost of the fixture or appliance; and
3) is improved, installed or replaced by the homeowner or licensed contractor.
Skip next section; Cost of Permit $ $15.00
State Surcharge $ .50
Mail In Fee $ 1.50
1. 1.25% of Contract Price * or Minimum Fee 35.00
—mod x .0125
(Contract rice)
2. State Surcharge ** Add the State BuildJi ng�C � e Division
Surcharge to each permit. � , G x .0005
(Contract Price)
or $.50, whichever is greater
3. Postage and Handling (Only mail -in applications)
2
$ _� ) _?, sQ
UsD
$ 1.50
Mechanical Permit
4. TOTAL PERMIT FEE (Add lines 1-3 above)
CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the
permitted work including materials, labor, profit, and other fixed costs. It is the amount to be charged
to the customer for the work done. If any material, equipment, labor, or installation are furnished by
the owner, tenant, or any other party, the reasonable market value of such items must be added to the
estimated cost or contract price for permit fee purposes. In the event there is a dispute on the amount
of the job cost, the City may request the submission of a signed copy of the actual contract.
** The STATE SURCHARGE is .0005 of the contract price under $1,000,000 or $.50, whichever is
greater. For valuations over $1,000,000 call the Department of Inspectional Services for the
price.
The undersigned hereby applies to the City for issuance of a Mechanical Permit, agrees to do all work
in strict accordance with the ordinances of the City and the regulations of the Minnesota State Building
Code, and certifies that all statements made on this application are complete, true and correct.
1 �
Applicant's Signature Date
Approved By Date
3