3746 Burgundy DrDate:
/xiild -*
City of Eapll
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #: 1(312
Permit Fee: 36c
Date Received:
Staff: l %e )
013 RESIDENTIAL BUILDING PERMIT APPLICATION
3 Site Address::T7W— 374 y37y t/id fir Unit #:
Resident/
Owner
Name:.ge-%i e CQ' l.e.hS Phone:
Address / City / Zip:37 1 , 7 y6— j 7r/c• ,&/-0404, apr--
Applicant is: Owner Contractor
I Type of Work
Description of work: TPt.y ( j' `'
Construction Cost: ,g®1 ` c t2 Multi -Family Building: (Yes / No )
Contractor
Company: 2i // i/l0jn./0/ne,le C, Contact: &JJ SQfC.' M
Address: .)d° SC/h?77C r -Si SJ RC City: "17/2151'
State: M/% Zip: 575-// 3 Phone: 4 z'32%- Wok
License #: Re26-a Jel Lead Certificate #: ,/j,4 -=379'/ -(
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
In the last 12 months,
Yes No If
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has the City of Eagan issued a permit for a similar plan based on a master plan?
yes, date and address of master plan:
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
Phone:
, NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.qopherstateonecall.orq
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota Sta e Building Code must be com
days of permit issuance.
x `sr LL V1
Applicant's Printed Name
k
Applic. nt's Signature
Page 1 of 3
City of Eagan
PERMIT
411' CityofEaan
Permit Type: Mechanical
Permit Number: EA134107
Date Issued: 11/24/2015
Permit Category: ePermit
Site Address: 3746 Burgundy Dr
Lot: 2 Block: 07 Addition: Seneca Hills
PID: 10-67125-07-020
Use:
Description:
Sub Type: Residential
Work Type: Replace
Description: Furnace & Air Conditioner
Comments: Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Fee Summary:
ME - Permit Fee (Replacements) $59.00 0801.4088
Surcharge -Fixed $1.00 9001.2195
Total: $60.00
Contractor:
Angell Aire
12253 Nicollet Ave S
Burnsville MN 55337
(952) 746-5200
- Applicant -
Owner:
Jerry W Pottorff
3746 Burgundy Dr
Eagan MN 55122
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Applicant/Permitee: Signature
Issued By: Signature
Cpei;�.;� EA )(31-1109-
AA
3`I109-Ad ��5 P3 7 Ll L. (J lArr.
APPLIANCE
PERFORMANCE T
Attach to gas line adjacent 10 regulator
Heating Contractor 0,,1,-//4
Name of Tester
Date
Job Address
Heating Contractor
Name of Tester
Date
Percent
Percent CO2 ' 7 Av"
Percent CO C3
Stack Temp. /.r?'
E
PRODUCT DATA SHEET `.
Metacaulke 1000 Firestopping Sealant i
Clusifea System Numbers 1RCIPIJ80. 3. TRC/FY 120.13, TRCIpV 120.15. 111CJFv 120.17, MC/FM 120.09, CN1320. CM 2112, CAJ 2113. CAJ
3068, CM 3067, CAJ5134, CJU 5070, CM 5077, CM 5x178, CAJ 1221, CAJ 2120, CM 2119, CIU 2122, CAU 5095, CA19047, CM 90510, CM 2134,
CAJ 1260. CAJI281, 09.11263. CAJ1296, CA11262, CAJ51a11, CAJ 1329, CMJ 1327. 02.22245, 029222.47, CM6025.YIL 5057. WL 5059. WI.50a1,
WL 5063, WL5064, 1ML5092, At. 2102, WL 3104, WI 210x1, 4N 1999, WL 1159, W1.1199. WI. 1104, WL 1102, WL 1108, WI. 1106,1M. 2101L WI 2239,
W1.2192. WL2190, WL2201, WL220A, WL215G, WI 31.52, wt.: Ar6,WL1120, WL 1110, WL 1118, WL1114. WL1181, WL1177, WL 1179, WI.1181.
V8.5127, WL7034, WL7039. WI.6000, WJ 50111, W.I 5010, WJ 2020, WJ 5022, WJ 2023, WJ 2025, WJ 2027, WJ208S, WJ2083, WJ2072,
WJ 1036, WJ 1038. WJ3056. W,130511, WJ:4129, W,2 33. WJ11,M5. WJ1043. WJ1OS1, WJ1059, WJ1061, WJ1079, WJ 5059, WJ7010, WJ7014,
WJ5039, FC 1030, FC 11X12,110 2085, FC 5020. FC 5022, IC 20Vt. FC 2075. lC 2076, 1.02190, F02192. F02132, FC2130. F01055. FC1041,
l4 2146, FC1061, FC 035, FC1085. FC1083, rats I, HWD 11014, HWD 0119. HWI)0056
1. Product beicription
Metacaulk° 1000 is a one component,
general purpose fire rated sealant
and smoke seal for construction
joints and through -penetrations.
Metacaulk° 1000 is a water based,
extremely intumescent, non -sag
caulking grade sealant that is easy
to apply as well as to retrofit. It cures
to an olastomoric seal that is suitable
where dynamic movement is expected.
In the event of a fire, Metacaulke
1000 will prevent the spread of
flames, smoke, hot gases and water
through joint openings and through -
penetrations. No dilution or mixing is
required for use. No special skills are
necessary for installation. MetacauIke
1000 is applied with a conventional
caulking gun, bulk loading gun or
can be troweled from the pail_ For
large applications, it can be pumped
directly from the pall. Metacaulke 1000
systems are rated for 1, 2.3 and 4 hours
in accordance with the ASTM E914
(UL1479).UL 2079 and ULC -5115-95
test standards. Metacaulk° 1000 is
protected in a wet stage as well as
in a dry stage against mold growth
with a combination of biocides.
Use Metacaulke 1000 for various
applications:
September 2013
Top of the Wall Construction Joints
Deflection Track Wall Systems
Up to 2" (51 mm) PVC\CPVC (Open)
Up to 3' (76 mm)PVC\CPVC & ABS
(Closed)
Crosslinked Polyethylene (PEX)
tubing
Steel, Copper, Cast Iron and
EMT Pipe
Flexible Conduit
Fiberglass Insulated Pipe
Armaflex Insulated Pipe
Telephone, Communication and Power
Cables
HVAC Ductwork
For a complete list of product
applications orfor additional technical
information, call RECTORSEALforthe
latest updated information,
Metaeceulk* 1000 Features
• Water Based
• Excellent Freeze -Thaw
• Flexible Set
• Highly Intumescent
• Paintable
• VOC Compliant
• Safe and Easy to Use
• Minimum 3 Year Shelf Life
2. Material Properties
Asbestos Fillers None
Solvents None
Hazardous Ingredients None
Application
Caulking
Gun or
Trowel
Activation of Intumescence:
Expansion Begins 375 F (190°C)
Expansion Greatest 575' (3021 to
1100° F(593° C)
Color
Cure Time
weeks
Density
Elastomeric
Freeze -Thaw Excellent
Skin Over Time 30 min.
(at 77- F/
25°C)
pH Value 6.5to7
Volume Coverage:
for 10.3 oz. tube
Red
3 to 4
(at 77"F/
25°C)
10.5 +/-
0.5 lbs./gal.
1.25 kg/L
Yes
(304m1) 18
cu. in.
(295 co)
for 5 gallon (18.9 liter) 1155 cu. in.
(5000 cu. cm/L)
VOC
Negligible
ASTM E 84, UL 723TunnelTest
Flame Spread
Smoke Index
5
10
Sound Transmission Class
STC 62'
Minted in S 121.411 wpl14S54m171yIS0Gtgn 14 ASTW E90
3., Applications
Metacaulke 1000 can be used in
interior applications as a general
purpose fire rated sealant and smoke
seal for construction joints on both
vertical and horizontal surfaces.
MetacaulkW 1000 is also an excellent
fire rated acoustical sealant and can
be used in areas under constant
.T
•
METACAULKe1000
vibration or movement. Metacaufke
1000 can also be used on various
penetrations such as EMT, telephone
& power cables, insulated pipes, etc.
in concrete floors and walls , gypsum
walls as well as wood floors, Use
Metacaulksl 1000 to prevent the spread
of fire and smoke through joints in fire
rated gypsum wallboard partitions,
concrete block or concrete walls and/
or concrete or corrugated steel deck
floor/ceiling assemblies.
4. Installation Data
Install Metacaulke 1000using standard
caulking techniques or trowel from
pails. Metacaufke 1000 may also
be pumped from the pails. When
damming materials are needed,
use only materials approved for the
specific application.
TYPICAL TOP OF WALL
INSTALLATION
Step 1)
Cut and fit the gypsum wallboard to the
contour of the steel decking leaving a
maximum 3/4° (19 mm) relief gap.
Step 2)
Pack the flute openings and relief gap
with required amount of fiberglass
insulation and recess to required
depth.
Step 3)
Gun, trowel or pump the sealant
as required to the specified depth,
Properly tool sealant surface flush
with the wall.
Consult UL Directory for complete
instructions and system listings.
5. Testing Data
For specific test criteria, refer to the
UL's Fire Resistance Directory or
Warnock Horsey International Listing
Directory or call RECTORSEAL
Metacaulkw 1000 was tested et positive
pressure with a minimum 0.01 (2.5 Pa)
10. LIMITED WARRANTY
Reclor5ual makes the Liinited Express warranty [hal whin the instruction: for musette and Ilarxlting ul 4ur prOduets are feelCwed we warrant Ow productt t0 be tree Nam detects. THIS LIMITED
EJ(PNE,SS WAHRANTY IE EXPNE5SLY IN LIEU 01' ANy UTNtH EXPHESS UH IMPULD WANNAURES, INCLUDING ANY IM%.ItD WAtiIANa1Y Of MtNCHANIARII ITV OR FITNFS: FOR A PAR-
TICU1 AR PIJRPQ$F, ANO OF ANY OTHER OBt IOATION ON THF. PART OF RECTORSE/U.. Thr sola remedy lir broach el the Limited Express warranty stall he ale Irked Of the putohaea piton.
AI! Olr:or liability is negated and disclaimed, and nectodlea! shall WA be liable for incidental or consequential damages.
inches water and in accordance with
ASTM E814 (UL 1479), UL 2079 and
ULC -5115-95.
Complies to Required Environmental
Exposure Testing of Accelerated Aging
and High Humidity as per UL 1479 Fire
Test of Through-Penotration Firestops.
FBC System Compatible indicates that
this product has been tested, and is
monitored on an ongoing basis, to assure
its chemical compatibility with FlowGuard
Gold®, BlazeMaster® and Corzane pipe
and fittings.
FBC. F!OwGuard GOlde, lileteMesluide and COrsarte Bra
Ilccr*0d trattcmarxe tN the Lubrizol corporation.
6. Storage & Handling
Metacaulk'° 1000 should be stored
between 35°F (2°C) and 120.F (49' C), to
obtain a minimum 3 year shelf life. NOTE;
Do not dilute, no mixing is required. Best
if protected from freeking. If freezing
occurs, Thaw completely before using.
Keep products stored under protective
cover in original containers.
7. Availability
Metacaulk" 1000 is available In 10.3 oz.
(304 ml), 30 oz.(887 ml) caulking tubes
and 20.2 oz. (597 ml) sausage pack
and in 5 gallon (18.9 L) pails.
8. Limitations
Metacaufke 1000 is not designed to
be used in areas under continuous
immersion or in areas which would
be continuously wet. Metacaulk°i
1000 should not be used against hot
uninsulatcd surfaces above 300" F
(149" C).
9. Cautions
FOR CHEMICAL EMERGENCY, SPILL,
LEAK, FIRE, EXPOSURE OA ACCIDENT,
CALL CHEMTREC-DAY OR NIGHT 1-800-
424-9300. •
PRECAUTIONS: Do not take internally. May
be harmktl if ewsNdwP.d. May Causie eye and
skin irritation if prolonged or repeated contact
occurs. Wash alter handling. FIRST AID:
For any overexposure, get immediate medical
0119ntion alter tiro aid 14 given. eye*- Flush
15 minutes with clean water. Skin -Wash with
soap and Water. Inh10Ia0o/141ert+ove to fresh
air. Ingestion -Only if conscious, give Targe
arncunts of water and INDUCE VOMITING.
FIRE AND SPILLS: Use water log, CO, foam,
or dry chemicals, Wipe up spills to prevent
footing hazard. Clean up with scrapers and
water. STORAGE AND HANDLING: Stom
away from heat molars. Keep container closed.
00 not reuse empty container, KEEP OUT OF
REACH OF CHILDREN.
For oedemata! mlprrrmpan, rotor to Malone! $atety Data
sheet
For additional technical service,
call: 1-800.231-3345
fax: 1400-452.2824
www.rectorseal.com
www.mettacaulk.com
Corrugated Steel Baca
fibs Gs Irlaulariarl
l4rirlflrlfNAI
Itlt tAri tint,
'4'4'PCa/r4r' 404 4 0 4 4 44
Opium Wallboard
2 Layers of 5/8- (lam.
Type le
UL Lts1 System: HWC0014
Tasted as Per UL 2079 0 2S0 Compression or extension for 500 cycles
%quosenns and recommtsxtalial:: covering the use dike produCls are based de Our pea experience and laboratory findings. However, 00 we have n0 control as t0 the methods and ConptlOoS
01 apptknatiren„wv Orly esiturue respo se:i1N 104 the urilormltY 01 our products Warm manufacturing t0Wranerm,
•1111011111111111111wxwerww
41,