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HomeMy WebLinkAbout2013-02-05 MN State Ltr to OPH Re Health Partners Clinic @ SAHS 443 Lafayette Road N. MINNESOTA DEPARTMENT OF (651) 284 -5005 St. Paul, Minnesota 55155 1 -800- DIAL -DLI www.dli.mn.gov L ABOR & INDUSTRY TTY: (651) 297 -4198 PROJECT JURISDICTION NOTIFICATION COPY TO BUILDING OFFICIAL: ; City of Oak Park Heights Bldg Official Julie Hultman PO Box 2007 Oak Park Heights, MN 55082 Project Title: ISD 834 /Stillwater High- Healthpartners Well @Work Clinic Location: OAK PARK HEIGHTS, MN 55082 Address: 5701 Stillwater Blvd N Enc This information can be provided to you in altsnative formats (Braille, large print or audio). An Equal Opportunity Employer 443 Lafayette Road N. MINNESOTA DEPARTMENT OF (651) 284 -5005 St. Paul, Minnesota 55155* p R Q,, i �i, IN+�+ �,�r 1 -800- DIAL -DLI www.dli.mn.gov LABOR 4�4 DU7I I TTY: (651) 297 -4198 Ad lk PERMIT REQUIREMENTS ARCHITECT /ENGINEER: Date: 2/5/2013 David Kippen HGA - Mpls 420 5th St Ste 100 MINNEAPOLIS, MN 55401 Project: ISD 834 /Stillwater High - Healthpartners Well @Work Clinic Location: OAK PARK HEIGHTS, MN 55082 County: Washington Address: 5701 Stillwater Blvd N State Plan Review Number. BLD1302 -00015 Date Received: 2/4/2013 We have reviewed your Initial Application for Plan Reviewand determined that the project is located in a jurisdiction that that does not have a Municipal Delegation Agreement with the Minnesota Construction Codes and Licensing Division. Therefore: BUILDING PLAN REVIEW AND BUILDING INSPECTIONS WILL BE DONE BY THIS DIVISION Please refer to our website: http://www.dli.mn.qov/CCLD/PlanConstruction.aspfor the Application for Plan Review and the Plan Review Fee Calculator. The application must be completed, signed and submitted along with the appropriate fee, plans and specifications. Since this division will be doing the plan review and issuing the building permit, please use the 100% Plan Review Fee on the Plan Review Fee Calculator. Once reviewed and approved, a permit may be issued. Refer to our website for the Building Permit, Mechanical Permitand Sprinkler Permit applications as applicable. A state regional building official will be assigned to this project to verify compliance with the requirements of the Minnesota State BuildingCode. Please note that land -use zoning permits may be required by the local jurisdiction before beginning construction. Please be advised that plumbing plans, specifications, and appropriate fees must be submitted to the DLI Plumbing Plan Review and Inspection Unit or the appropriate local jurisdiction identified at www.dli.mn.qov /CCLD /PDF /pe planreagree.pdf For additional information concerning DLI plumbing plan reviews and inspections, please visit www.dli.mn.gov /CCLD /Plumbinq.asp Sincerely, CONSTRUCTION COD S & LICENSING QIVISION Jerry Norman � ' "���� 0/4 2 Supervisor Building Plan Review GN:mw C: Regional Building Official Plumbing Unit Municipal Building Official (if applicable) This information can be provided to you in altenative formats (Braille, large print or audio). An Equal Opportunity Employer 443 Lafayette Road N. MINNESOTA DEPARTMENT OF (651) 284 -5005 St. Paul, Minnesota 55155 D �,,�r 1 -800- DIAL -DLI www.dli.mn.gov LABOR INDU T I TTY: (651)297 -4198 REGIONAL BUILDING OFFICIAL Date: 2/5/2013 Paul Heimkes 443 Lafayette Rd N ST PAUL, MN 55155 Project Title: ISD 834 /Stillwater High- Healthpartners Well @Work Clinic Location: OAK PARK HEIGHTS, MN 55082 Address: 5701 Stillwater Blvd N Enc This information can be provided to you in alternative formats (Braille, large print or audio). An Equal Opportunity Employer \234 56 1 -000k5 Minnesota Department of Labor a�i 4 Industry , 9, Construction Codes and LicensingDivision 0 > Building Plan Review /Inspections MINNESOTA DEPARTMENT OF 443 Lafayette Road North r< N Illr ABOR & INDUSTRY St Paul, MN 55155 �c 4 0'13 w Phone: (651) 284 - 5068, _ CPR" A Fax (651) 284 -5749 v Ihnitial Application for Plan Review www.dli.mn. v ' CODES & LIO v www.dli.mn. Pleas plete this application and return it to the Construction Codes and Licensing 4 c c;, D' ' p nor to your expected plan review submittal date. This will help us expedite your IN I N IN o r TYPE your responses. G G' i Z OT.sj ct while we determine where you will make application for plan review. PROJECT TITLE PROJECTED CONSTRUCTION VALUATION HEALTHPARTNERS WELL @WORK CLINIC - STILLWATER HIGH SCHOOL $100,000.00 ADDRESS ANTICIPATED START DATE 5701 STILLWATER BOULEVARD NORTH FEBRUARY 18, 2013 CITY OR TOWNSHIP WHERE LOCATED ***PLEASE VERIFY*** COUNTY OAK PARK HEIGHTS WASHINGTON OWNER (OR STATE AGENCY IF APPLICABLE) CONTACT PERSON STILLWATER AREA PUBLIC SCHOOLS .1.5vz,3ik TONY WILLGER ADDRESS PHONE 1875 SOUTH GREELEY STREET (651) 351 -8374 CITY STATE ZIP CODE FAX STILLWATER MN 55082 DESIGN FIRM PROJECT CONTACT HAMMEL GREEN AND ABRAHAMSON, INC. DAVID KIPPEN ADDRESS PHONE 450 5TH STREET NORTH, SUITE 100 (612) 758 -4312 CITY STATE ZIP CODE FAX MINNEAPOLIS MN 55401 (612) 758 -9312 E -MAIL dkippen @hga.com PROJECT TYPE El Public (state- owned) building paid for by the state or other state agency for: ❑ National Guard ❑ Historical Society ❑ MN Zoo ❑ D.O.T. ❑ D.N.R. ❑ Iron Range R ❑ MNSCU (State College or University) ❑ State Hospital ❑ State Home ❑ Capitol Complex 0 Public school district building of $100,000 or more in construction cost ❑ State Licensed Facility licensed as a: ❑ Hospital ❑ Nursing Home ❑ Correctional Facility ❑ Boarding Care Home ❑ Supervised Living Facility ❑ Free- standing Outpatient Surgical Center ❑ Residential Hospice CLASS OF WORK ❑ New Building Construction ❑ Addition i A Remodeling Sprinklers © Yes ❑ No ❑ Partial IBC OCCUPANCY CLASSIFICATION(S) IBC TYPE OF CONSTRUCTION EDUCATIONAL 'E' OCCUPANCY 1B PROJECT DESCRIPTION Remodeling of an existing classroom area into a clinic space which includes 2 exam rooms, patient toilet room, lab., and storage room. Upon receiving this completed initial application, we will confirm proper jurisdiction for the project, assign a project number, and determine who will do plan review and inspections. Within a few days we will notify you in writing of the project number, where to submit your documents for review, and how inspections will be handled. If delegated to the municipality, you will need to follow their procedures and fee schedule. Otherwise our standard application process will need to be followed. I completed the information on this application and understand that it does not authorize the start of construction. APPLICANT NAME (PRINT) • • T SIG), • '�j ' DATE DAVID S KIPPEN 4 r A-----2*-- FEBRUARY 4, 2013 This material can be made available in different forms, such as ge print, Braille or on 0 tape - To request, call 1 342 - 5354 (DIAL - DLI) Voice or TDD (651) 297-4198. BCS 01 (5/12)