Permits - Permit# SP-2021-00051 - 4228 West Arm Drive - 6/3/2021INSPECTION RECORD
2020 MN State Building Code
City of Spring Park Permit Number: SP-2021-00051 Issue Date: 6/3/2021
SITE ADDRESS: 4228 WEST ARM DRIVE, SP, MN 55384
PERMIT TYPE: MAINT - Window Replacement
ZONE/USE TYPE: RESIDENTIAL
APPLICANT: Renewal By Andersen
OWNER: GARY BENDICKSON & MARY JANE PRICE
1 window
Description:
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.
Permit Card
Re -Window In -Progress
DO NOT COVER ITEMS TO BE INSPECTED.
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
C I I Y Of
.SEA k NUPPAI R K
To Schedule an Inspection Call: 952-442-7520
Details
Permit Number: SP-2021-00051
Issue Date: 6/3/2021
Zoning Type: RESIDENTIAL
Use Type:
24 HOUR NOTICE REQUIRED FOR ALL INSPECTIONS • MON-FRI: 8AM-4:30PM ♦ NO HOLIDAYS
Site Address: 4228 WEST ARM DRIVE, SP, MN 55384
Description:
1 window
Permit Granted To: Renewal By Andersen
Homeowner's Name: GARY BENDICKSON & MARY JANE PRICE
Phone Number:
Parcel #: 1811723440045
Permit Type: MAINT - Window Replacement
Permit Exp: 11/30/2021
Valuation: $0.00
Fees
Receipt# Product Sale Date Quantity Date Paid Status Pmt Info Amount
12598 Residential - Re -Window 6/3/2021 1.00 6/3/2021 Paid Check: per City email $50.00
12598 State Surcharge Flat Fee - $1.00 6/3/2021 1.00 6/3/2021 Paid Check: per City email $1.00
Total: $51.00
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 02021
RECEIVED JUN 03 2021
CITY OF SPRING PARK
BUILDING PERMIT
PAGE 1
d51
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4349 Warren Avenue
Handout Given
Spring Park, MN 55384
Routed to MNSPECT
Phone: 952-471-9051 Fax: 952-471-9160
❑ Lead Handout Given
— - CA
wD 'P%< m% -` V-R PID:
SITE
ADDRESS: l Of W •
_
1) Was the home constructed before 1978? (YES ❑, continue with line 2, NO o continue without completing EPA Section)
2) Will the work disturb a6 sq ft of interior painted surfaces or a20 sq ft of exterior painted surfaces? (YES ❑ go to line 4, NO ❑ line 3)
3) Are there any windows being replaced? (YES o, go to line 4, NO o
continue without completing EPA Section)
4) Has this home been Certified Lead Free? (YES ❑, you MUST Attach Certification Information, NO o complete line 5)
5) EPA Contractor Certification Number: NAT -
(applies to contractor only)
• PROPERTY OWNER: -e- -Ti . G-.
Address: ; }c
City: State: Zip:
Email:
•� Contact Name:
Phone:
CONTRACTOR: A (S-eYV
1
Address:-Iqzo Co. Ind "C,�• w� ST
Ci S • -e— State: h "Zip: S S 113
Phone: (p S I - a(D y - vo F 8 Fax:
Contractor License No:?0 C, (Pq 51 a 3 7
Contact Name: Phone:
Email: W SC-� riajd C 7 Ce) f ,.e f- Cf-)
ARCHITECT:
Address:
City: State: Zip:
Phone: Fax:
• Email:
Contact Name: Phone:
TYPE OF WORK: ❑ New Construction
❑ Deck ❑ Re -Roof
❑ Commercial )LResidential o Change of Use
❑ Pool ❑ Re -Side
EST. VALUATION OF WORK o Finish Basement
❑ Retaining Wall ❑ Fence
$ H . yti{q -- ❑ Remodel
o Porch ❑ Shed
Square feet: o Addition
❑ Demolition Window/Door Replacement
❑ Garage-Attached/Detach
❑ Plumbing -provide detail on Page 2 # being replaced
•� Detailed Description of Work: ❑ Accessory Structure
❑ Mechanical -provide detail on Page 2 o Misc Other
Va Cq 1 w; N4�o w L A-n i _er? 1
Signature of this application by the legal property owner or a licensed contractor, as the owners representative, is required and authorizes the Zoning Administrator or designee and the Building official
be 1 hereby acknowledge that I have read this application and state that all information is true and
r designee to enter upon the property to perform needed inspections. Entry may without prior notice.
correct to the best of my knowledge. I further agree that all work performed will be in accordance with approved plans, specifications and conditions and to abide by all ordinances of the Municipality
H I to with the work. Permit expires when work
nd the laws of the State of Minnesota regarding actions taken pursuant to this permit. I agree to pay all plan review fees even choose not proceed
.. is not commenced within 180 days from date of permit, or if work is suspended, abandoned, or not inspected for 180 days. Work beyond the scope of this permit, or work without a permit or inspection,
•
'II be subject to a penalty.
Noise Ordinance In Effect: MONDAY - FRIDAY Before 7 a.m. and after 10 p.m. Weekends/Holidays before 7 a.m. and after 8 p.m.
SIGNATURE OF APPLICANT ��
DATE: a
PRINTED NAME: yt-A( 0. -%-2 n S
This is the signature of: ❑ Owner or 290wner's Repres ntative
OCCUP. TYPE: CONST. TYPE: CODE:
BLDG SPRINKLED Yes / No
VALUATION: $
Permit Fee: $ 56,00
WAC Charge: $
Plan Review Fee: $
Sewer & Water Hook -Up: $
State Surcharge: $ 00
Sewer & Water Disconnect: $
Site Inspection Fee: $
Water Meter: $
S.E.C. Fee: $
Muni SE/WA Fee: $
Investigation Fee / Other Fee: $
12016 SAC Escrow: $2,485
>.
Co Charge ($.25 per 8.5 x11 page) $
Copy g
Other: $
$ �- n�
0
License Check ($5) / Lead Check ($5) $
TOTAL DUE:
W
SUB -TOTAL $ _!fLy'
�NOTE; Commercial plans will be submitted to the Met Council Environmental Svcs
N
Plumbing Fee (from Page 2) $
for SAC determination. Escrow payment will be required when permit is issued. If
w
Mechanical Fee from Page 2 $
after Met Council review no SAC is determined, escrow will be refunded in u .
t)
Ii
Special Conditions/Required Setbacks:
L
O
Building Approval By:
DATE:
Printed Building ro By: A OR
ElLicense Verification ❑ Lead Verification - Checked By:
City App al
DATE:
Paid: Date: Receipt No. 9 $ BY:
RECEIVED SUN 0 3 2021
re
®• al
BY ANDERSEN'
window realacemenr
W S & D Permit Service
P.O. Box 250
Scandia, MN 55073-0250
Phone: 651-433-4250 Fax: 651-433-3539
To Whom It May Concern:
I am an authorized agent by Renewal by Andersen to pull, pay for, and obtain their building
permits. - -
• If there is a problem with this please feel free to give me a call at
651-433-4250.
Thank you for you assistance,
Kara Benson
WS&D Permit Service
651-433-4250
Thank you for your Payment!
Transaction ID: 12598
Transaction Number.
Transaction Type: Payment
Recipient:
Notes:
1 C:1IY Ot
�[) R Cj"*VA RK
City of Spring Park
4349 Warren Avenue
SP MN,55384
Ph:952-442-7520
$51.00
Date: 6/3/2021
Method: Check: per City email
Address: 4228 WEST ARM DRIVE, SP, MN 55384
Reference: Permit Number: SP-2021-00051 Type: MAINT - Window
Replacement for Renewal By Andersen
Fees
Product:
Residential - Re -Window Paid 1.00 $50.00 $50.00
State Surcharge Flat Fee - $1.00 Paid 1.00 $1.00 $1.00
Total Amount: $51.00
Page 1 of 1 Printed on: 6/3/2021