Permits - Permit# 13-09 - 2473 Black Lake Road - 1/1/2013CITY OF SPRING PARK Noise Ordinance In Effect:
4349 Warren Avenue Spring Park, MN 55384 0D
C
Phone (952) 471-9061 Fax (952) 471-9160 Monday - Friday before 7 a.m. X F
and after 10 p.m. 3
Weekends/Holidays before 7
BUILDING PERMIT � '� O
a.m. and after 8 p.m.
DATE CHANGES TO APPROVED BUILDING PLANS MUST HAVE CITY APPROVAL
SITE ADDRESS %13 qtv ,� L % %�i� PID
"Me' /YViUr ,� I
CONTACT NAME - PHONE - EMAIL - FAX
CONTRACTOR Name / Address Zip I Phone
s�' Aj ra 14
CONTACT NAME - PHONE - !T&AjlL -FAX _ _
CONTRACTOR LICENSE #
- TYPE OF WORK _- -
❑ New Home
❑Deck
❑ Re -Roof
❑ Commercial ❑ Residential
04Addition
❑ Fence Height:
❑ Re -Side
EST. VALUATION OF WORK
(
❑ Remodel
❑ Pool
❑ Ret. Wall Height:
❑ Finish Basement
10 Stucco Demo
1 ❑ Window Replacement
$
Building Height: Feet
❑ Accessory Structure
10 Stucco
❑ Other:
# of Stories:
SCOPE OF WORK:
Use of Building:
nuflrme of thft appUCatlDn by the legal progeny owner or a licensed corrtraelor, as the owrlda represmntetwe is bad and author' the City Zoning Adnhbtretor or designee and cite Gy Building Official or designee
enter upon the progeny to penlorm needed trlspegbrm. Entry may be without prior notice. I hereby acknowledge V W I have read this application and state Nat all hlto, atlon Is bue and correct to the best of my
further
e. I agree that all work pai b . d will be in accordance with approved plans. specifications and conditions and to abide by as ordinances of the City and the laws of the State of kthanesote regarding actions
pursuant to this pemdt. I some to pay all pLen review fees even H 1 choose not to proceed with the work. Permit ies
er I when work Is not oornrr� with 180 days from dale of permit Issued. or a bu0rsrrp and
w Is svended. abandoned or not Inspected for 190 days. work beyond or without a penminspection or pection ws be subject to a penalty.
"2-7 (24 Hour Notice) 8:00 a.m. - 4.30 p.m.
Call MNSPECT fo V_'j
SIGNATURE OF APP (CANT: � ,�-- - -
PRINTED NAME: Q DATE: <
------------------ QFRCE USE YBELOWTHISLINE---------------.....--
LEGAL DESCRIPTION: Lot Block Addition Zoning .
Valuation of Permit: $ Lot Area: I
OCCUP. TYPE: - CONST. TYPE: CODE:
/ BLDG SPRINKLED Yes /
SETBACKS: REQUIRED (ft) _ ACTUAL (ftl _______ --
Permit Fee:$
— Front (ROW__
_ _
Plan Check Fee:$
_ Rear -- �—
_
State Surcharge :$ 7
- - - — - — Side _ . - -- ----- -- -- -- - -
— Site lnsp. Fee:$ ---
-- _ -- — Side — -
Muni SE/WA Fee:$
— _Comer
S.E.0 Fee:$�
Lakeshore
_
_ Wetland
w_ACCharge:$
Other
sewer s F120 Hook-up:$
sewer a H2O Disconnect:$
Paid Receipt No.
Water Meter:----
— -
'
- .—_. —
Date B_ --- -
Other.$
TOTAL DUE: is - - `
BUILDING APPROVAL BY.• DATE:
— --- ---- - — TIME:
CITYAPPROVAL BY. 'DATE:
TIME: ; S
All new construction and/or dwelling expansion shall require a certified survey y dated within five years of application.
All new construction and/or dwelling expansion will be subject to corttracted planner review and may add to the review time.
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CITY OF SPRING PARK
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CA4349
Warren Avenue Spring Park, MN 55384
Noise Ordinance In Effect:
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Phone (952) 471-9051 Fax (952) 471-9160
Monday - Friday
Z rn _
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z
before 7 a.m. and after 10 p.m.
3
0 m 4 n
MECHANICAL PERMIT
� 3 � �
Weekends/Holidays
�.
before 7 a.m. and after 8 p.m.
'] h
Date: - 1 L�
V
State Bald No.
��ttOWNER1
Gas Fitters License No.
SITE ADDRESS:
�� �owr� IMB00
)OR
Name / Address / City / State / Zip / Daytime Telephone
MECHANICAL CONTZ211\
O i 1 h We S� oC o Pf' h-'C o �j
J
ESTIMATED VALUE
I
At rn
r 55 10
TYPE OF WORK: 'A Residential ❑ Commercial
New Replacement Other
WARM AIR
AIR CONDITIONING SYSTEM
UNDERGROUND DUCT SYSTEM: Yes ( ) No ( )
Gravity Forced
Tons CFM Ductwork
Input B.T.U. Output B.T.U.
VENTILATION / AIR EXCHANGE
Exhaust Only Air Exchange Unit
No. of Fans Size Type Type -Mixing Box
Heat Recovery Ventilation
C.F.M. Del Static Pressure Recovery Efficiency Net Air Flows
Where ventilation is used/located
WET HEAT
GAS FITTINGS
Baseboard In -Floor
Steam Hot Water
❑ Water Heater ❑ Furnace ❑ Stove o Dryer ❑ Grill
Gross Sq. Ft. Input B.T.U.
o Unit Heater o Fireplace
FIREPLACE
No. of Fireplaces
Mechanical Permit Fee: $ 2eP 00
Fuel Type
Gas Fitting Permit Fee: $
Mechanical Comments:
A d 4
State Surcharge: $ S.00
uc fw
$
n-q-w Ck ) ''DY`
$
Total MECHANICAL Permit: $ y3. o®
Signature of this application by the legal property owner or a licensed contractor, as the owners representedve to required and authodzea the CWJ Zoning Administrator a d9aignee and the City Building Offidel ordesligr I
enter upon the property to perform needed inspections. Entry may be without prior notice. I hereby acknowledge that 1 have reed this epickation and state that ell lnformatlon Is true and correct to the best of my knowbd 6.
further agree that all work performed will be In accordance with approved plans, specifications and conditions and to abide by as ordinances of the City and the IBM of the Stale of Minnesota regarding actions taken a
to thus pemul. l agree to pay all plan review fees even If I choose not to proceed with the woraemdl expires when work is not commenced with 100 days from date of pemul Issued, or If bu0dng and work Is
suspended, abandoned or not Inspected for 180 days. work beyond or without a permit or inspedwn will be subject to a penalty,
Call MNSPECT ro I at f952) 442-7520. (24 Hour Notice) 8:00 a.m. - 4:30 p.m.
SIGNATURE OF APPLICANT: 1 DATE: /
PRINTED NAME: Q S :. DATE:
r yr .,u t.vuyn-lfl r+nu Final nlaPrc1LIvn5 Fran nrtn0rtt. I At (952) 442-7520 (24 Hour Notice)
Gas Line Air Tests Required
CITY of SPRING PARK
PERMIT CARD
(VALID FOR A SINGLE PROJECT)
PERMIT NO. SP13-014 Nature of Work: &jd, /ua i 3_ .gzpa, -
..82'i�Zc�.
Site Address: y7-3 A'?e f- �A AvvL Building:
Applicant Name: /✓,_. i�/L�i%rr�.. �,ocyr4.- Date Issued: '7- i0 !i3
INSPECTION RECORD
THIS CARD MUST BE VISIBLY POSTED, ACCESSIBLE, AND PROTECTED FROM WEATHER AND PHYSICAL DAMAGE
FOR THE DURATION OF THIS PERMIT.
REFER TO HANDOUT FOR INSPECTION REQUIREMENTS :
OFFICE USE
❑ ROOFING ❑ SIDING
❑ WINDOW ❑ DOOR
HANDOUT
INSPECTION:
DATE:
Issued by: Received by:
❑ FENCE
❑ SHED
Front: Back:
INSPECTION:
DATE:
Side: Side:
CR MECHANICAL ❑ FIREPLACE ❑ PLUMBING
COMMENT
_ROUGH -IN:
DATE:
Pressure test for plumbing and hydronic piping
GAS LINE:
DATE:
Air test reauired for new gas line
_FINAL:
DATE:
Gas line fitting test required
MUST CALL TO SCHEDULE NO LATER THAN THE BUSINESS DAY PRIOR TO THE INSPECTION DAY.
PHONE (952).442-7520 ' MNSPECT, LLC TOLL FREE (888) 446-1801
'
RECEIPT
®
RECEIVED FROM
e
10
ADD ESS
LL
FOR
ACCOUNT
AOF
ACCOUNT
UNN T
AMT. PAID
I
BALANCE DUE
DATE 7- 1D /.3 NO. 7 5 4 U
.. w t
HOW PAID
CASH J094.
CHECK
MONEY ORDER
DOLLARS
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