Permits - Permit# SP-2019-00070 - 2478 Black Lake Road - 1/1/2019CITY OF SPRING PARK PAGE 1
BUILDING PERMIT
4349 Warren Avenue
Spring Park, MN 55384 *Handout Given
5� ayjq-D6p-7Z�
Phone: 952-471-9051 Fax: 952-471-9160 ❑ Lead Handout Given
Routed to MNSPECT
"[ 7 �C �U I �i� 3 / Xt 49-7
SITE ADDRESS: �f 5l i�` PID:
1) Was the home constructed before 1978? (YES ❑, continue with line 2, NO ❑ continue without completing EPA Section)
2) Will the work disturb 26 sq ft of interior painted surfaces or Z20 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 ❑, you MUST Attach Certification Information, NO ❑ complete line 5)
5) EPA Contractor Certification Number. NAT - (applies to contractor only)
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PROPERTY OWNER: I%t f t! )TULL Address:
City: State: Zip: Email:
Contact Name: Phone:
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CONTRACTOR: SSA otr- 25 L L Address: 6 O rti /-\
Ci : c G. t a State: 5 Phone: gS-9/3'S 55 G Fax: ':
Contractor License No: /'t 6 S d Z I Contact Name: Se ssL 0hone:,1n 2 I'3 f$S 6
e— v Email: �S c gyp' cs �- C 0
ARCHITECT: Address:
city- State: zip: Phone: Fak:
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Email: Contact Name:" % ,,Phone:
TYPE OF WORK: KNew Construction ❑ Deck �' ❑ Re -Roof
❑ Commercial esidential ❑ Change of Use ❑ Pool' �, � ❑ Re -Side
EST. VALUATP,N OF WORK ❑ Finish Basement o RetairiinglNall ❑ Fence
$ t 2 S 00 --' ❑ Remodel d Porch ❑ Shed
Square feet: ❑Addition ❑ Demolition -, j ❑ Window/Door Replacement
❑ Garage-Attached/Deta'ch'Plumbin"rovide detail on Page 2 # being replaced
De fled Description of Work: Accesso Structure ❑ Mechanical -provide detail on Page 2 ❑ Misc Other
❑
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signature of this application by the legal property owner or;a licensed contractor, as theowriers representative, Is required and authorttes the Zoning Administrator or designee and the Building oftlel
or designee to enter upon the property to perform needed Inspections. Entry may be wlgeut prior notice. I hereby acknowledge that I have read this application and state that at Information Is true and
cared to the best of my knowledge. I further agree that all wotic pei ronne wll tie In accordance with approved plans, speclacatbns and conditions and to abide by all ordinances of the Municipally
and the Ism of the state of Minnesota regarding actions taken pursuant to Mb permt. I agree to pay at plan review fees even It I choose not to proceed with Me work. Perot expires when work
.
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Is not commenced within 180 days from date of.pem_ iI[ orlfworkls suspended, abandoned, or not Inspected for 180 days. Work beyond the scope of this permit, or work without a perms or inspection,
11 be subled to a penalty. �'
i A ' -- zl
Noise Ordinance In Etieat: MONDAY - FRIDAY Before 7 am. and after 10 pm. Weekends/Holidays before 7 a.m. and after 8 p.m.
SIGNATURE OF APPLICANT: DATE: 9' 6
PRINTED NAME: _ �SS� e -r This is the signature of: ❑ Owner or Owners Representative
OCCUP. TYPE: --,_ CONST. TYPE: CODE: BLDG SPRINKLED Yes / No
VALUATION. $: 12 S O d
Permit Fee: $ WAC Charge: $
Plan Review Fee: $ Sewer & Water Hook -Up: $
State Surcharge: $ Sewer 8 Water Disconnect: $
Site Inspection Fee: $ Water Meter. $
S.E.C. Fee: $ Muni SE/WA Fee: $ I
)
Investigation Fee / Other Fee: $ *2016 SAC Escrow. l-
>-
Copy Charge ($.25 per8.5 x11 page) $ Othe . $
CLicense
Check ($5) / Lead Check ($5) $ TOTAL DU $ L' ; 6 DLiu
W
SUB -TOTAL $
Plumbing Fee from Page 2 $ / %/• �*CU NOTE: commerelal plans will be subm to the Not coundl En Aronmerrfal
9 ( 9 )
for SAC determination. Escrow paymarR ell required when Permit Is Ise it
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\
Mechanical Fee from Page 2 $ after Met Coundl review no 8AC Is determined; escrow will be refunded In fu
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: OID Date: Receipt No. Cj � By.
CITY OF SPRING PARK ❑ MECHANICAL PERMIT
❑ PLUMBING PERMIT
PAGE 2 FOR PERMIT ISSUANCE
PAGE t and PAGE 2 should be complete
MECHANICAL•' •
Mechanical Contractor: Address:
City: State: Zip: Phone: Fax: .
State Bond No:
Contact Name:
Email:
Contact Phone:
Detailed Description of Work:
Indicate type of project, fixtures, and Gas Lines you will be installing or replacing (include -count fore each type of fixture):
MECHANICAL FIXTURES GAS LINES \\
Quantity Quantity Quantityv
Furnace Kitchen Fan Furnace
Air Conditioning System Bath Fan Fireplace
Air Exchanger Grill Unit Heater
Fireplace Water Hea a
Unit Heater Grill
In Floor Heat Dryer
Gas Log /.Stoves
015;e Use Only. �v
❑ Replacement (one fixture only, no piping or vent changes) echanical Permit Fee: $
❑ Addition/Remodel Gas Line Permit Fee: $
D"ew Construction State Surcharge: $
❑ Other � Other. $
Total Mechanical Permit: $
PLUMBING INFORMATION
Plumbing Contractor: cSSep cJ ��L �J Address: S Z 6 O i ✓ L v
C' Lt State: `� Phone: of S 2 -91) -S 8 E Fax:
Plumbers License No: u10\6
IState Bond No:
Contact Name: sS cl I ` k L.A c S
Contact Phone: 2 - 1 J - S 8S 6
Email: �aSe p C-S 1b7k 0+,— 0-) c- O
Detailed Desc4l�n of Works: Se
Indicate type of project and fixtures you will be installing or replacing (include count for each type of fixture):
PLUMBING FIXTURES
Quantitv QuantityQuantity
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
3 i
Water Closet (Toilet) Hose Bib Floor Drain
Lavatory ash Basin Z Bathtub
❑ Replacement (one fixture only, no piping or vent changes)
Ofllee Use Only: D v
Plumbing Permit Fee: $
in Addition/Remodel
State Surcharge $ G
VNew Construction
Other. $
❑ Other
Total Plumbing Permit: $
Poor Quality Document
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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.
LICENSE/CERTIFICATE/REGISTRATION DETAIL
PLUMBING
Class Type: CONTRACTOR Number: PC659021
Application 295195
No:
Expire Date: 12/31/2019
Orig Date: 11/9/2012
Enforcement NO
Action:
Workplace N/A
Experience:
Status: ISSUED
Effect 1 /1 /2018
Date:
Print 2/26/2018
Date:
Name: JESSE TOUTGES LLC
Address: 5260 CLAYTON DR
MAPLE PLAIN, MN 55359
Phone: 952-913-5856
Business Relationship Requirements
Name:
TOUTGES, JESSE E
Lic/Reg No: PM084068
Application
Status:
ISSUED
135802
No:
Expire
12/31/2020
Effect Date: 1/1/2019
Date:
Orig Date:
4/1/2011
Another Lookup?,
INSPECTION RECORD
x 2015 Minnesota State Building Code
City of Spring Park Permit Number: SP-2019-00070 Issue Date: 9/16/2019
SITE ADDRESS: 2478 BLACK LAKE RD, SP, MN 55384 Description:
PERMIT TYPE: PLG - General (residential) New home construction - plumbing =19 flatures (1 gas water heater. 3 toilets.
ZONE/USE TYPE: Residential 4 lavatories, 2 showers,1 dishwasher,1 clothes washer. 3 ice makers. 2
APPLICANT: 3esse Toutges LLC bathtubs, I rough4n flature.1 floor drain)
OWNER: AMIN 8: LUCILLE EMAD
No inspection will be performed, and a re -inspection fee will be charged, if this "Inspection Record", the "City of Spring Park Permit", and, when applicable, the
approved plans are not available to the inspector. This permit expires if construction activity does not commence within 180 days from obtaining this permit; when
construction activity has been suspended or abandoned for at least 180 days; or the work has not been inspected within 180 days from the last documented activity.
IF SEPARATE PERMITS ARE REQUIRED, REFER TO THE "SEPARATE PERMITS REQUIRED FOR:" STAMP ON YOUR APPROVED
PLANS/CONSTRUCTION DOCUMENTS TO IDENTIFY WHAT SEPARATE PERMITS ARE REQUIRED.
ALL REQUIRED ROUGH -IN INSPECTIONS, NOTED ON SEPARATE PERMITS, MUST BE COMPLETED PRIOR TO SCHEDULING A FRAMING
INSPECTION.
ALL REQUIRED FINAL INSPECTIONS, NOTED ON SEPARATE PERMITS, MUST BE COMPLETED PRIOR TO SCHEDULING A BUILDING FINAL
INSPECTION.
DO NOT COVER ITEMS TO BE INSPECTED.
Permit Card (4)
Inspection Inspector's Response Approval Date Comments or Corrections Required
UndergroundPlumbing
Plumbing Above Ground R. I. Required
Gas Line Certification Required
Plumbing Final Required
MUST CALL TO SCHEDULE NO LATER THAN THE BUSINESS DAY PRIOR TO THE INSPECTION DAY: 8:00 A.M. TO 4:30 P.M. MONDAY THRU
FRIDAY. PHONE NUMBER TO CALL: 952-442-7520
When a Certificate of Occupancy Is needed, return this card and the approved final inspection notice to
the City of Spring Park office.
City of Spring Park Permit
� CITY OF
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NA IN6*4ISO _11A
Permit Number: SP-2019-00070
Issue Date: 9/16/2019
Zoning Type: Residential
Use Type:
To Schedule an Inspection Call: 952-442-7520
24 HOUR NOTICE REQUIRED FOR ALL INSPECTIONS • MON-FRI: 8AM-4:30PM NO HOLIDAYS
Details
Site Address: 2478 BLACK LAKE RD, SP, MN 55384
Description:
New home construction - plumbing = 19 fixtures (1 gas water heater, 3 toilets, 4 lavatories, 2 showers, 1 dishwasher, 1 clothes
j washer, 3 ice makers, 2 bathtubs, 1 rough -in fixture, 1 floor drain)
Permit Granted To: Jesse Toutges LLC
Homeowners Name: AMIN & LUCILLE EMAD
Phone Number.
Parcel #: 1911723120021
Fees
5567 State Surcharge Flat Fee - $1.00
5567 PIG - $10 per Fixture over Min
- - -- — --- -- - ---------- -- _ --
Permit Type: PLG - General (residential)
Permit Exp: 3/14/2020
Valuation: $12,500.00
9/16/2019 1.00 9/16/2019 Paid Cash $1.00
9/16/2019 19.00 9/16/2019 Paid Cash $190.00
Total: $191.00
Notes
• This permit is issued in accordance with and subject to all provisions of Ordinances and policies governing building and zoning in City of
Spring Park.
• Permit Holder/Contractor/Owners Agent is responsible to call for the inspections!
• Permit Packet, including approved plan, and this inspection record must be posted in an accessible location before calling for inspection.
Maintain this inspection record until work is complete.
• No deviations from the approved plans are allowed without prior consent from the building inspections department.
• To Owner, Occupant, or Contractor: It is ILLEGAL TO OCCUPY this area/building until all required final inspections have been made,
approved, signed, and certificate of occupancy issued!
Scott Qualle, Building Official
City of Spring Park $4349 Warren Avenue ♦ 55384 Copyright 02019
Thank you for your Payment!
e, CITY OF
Transaction ID: 5567
Transaction Number
Transaction Type: Payment
Recipient: contractor
Notes: TS recd cash @ 191.00 on 9/16/19
Fees
City of Spring Park
4349 Warren Avenue
SP MN, 55384
Ph: 952-442-7520
$191.00
Date: 9/16/2019
Method: Cash
Address: 2478 BLACK LAKE RD, SP, MN 55384
Reference: Permit Number: SP-2019-00070 Type: PLG - General
(residential) for Jesse Toutges LLC
Product: btatus: -tuantity: &rice: I aX AMOunt: I otal Arnount:
Slate Surcharge Flat Fee - $1.00 Paid 1.00 $1.00 $p.00 $1.00
PIG - $10 per Fixture over Min Paid 19.00 $190.00 $0.00 $190.00
Total Amount: $191.00
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Page lofl Printed on: 9/16/2019