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4616 Black Wolf Run (fit )al~F(S 8363 a 1`- i !O0 Use BLUE or BLA ' ----------6----- a 0 For Office Usre~' j Permit « I , City of Eap r , 5 c~ a I 1 501 I Permit Fee.: 3830 Pilot Knob Road PIE E~V I I Eagan MN 55122 1 Date Received: ~IpR 2~1~ Phone: (651) 675-5675 Fax: (651) 675-5694 S 1 Staff: 1 - - - - - - - - - - - - - 2014 RESIDENTIAL BUILDING PERMIT APPLICATION Date: Site Address: Unit 17 Name: Dr P, r-7ZAJ I/J Phone: Resident/ Owner Address / City / Zip: Applicant is: Owner -,,Ar Contractor C, 4's_ lOc. Description of work: Type of Work ~ q-11, ~7,d 1/~ E"~t! i//-~. f 5'//Ut~ r~ FA-MIL--r Construction Cost: 4 q7o Multi-Family Building: (Yes / No Company: /l. r lv sttr/,A+`c~_ Contact: P-7j _g- I Contractor rte 1 Address: &g92 XhIU13e:11266 City: State: N Zip: 550 4t Phone: '752. -,7,f . 73 G License >6P0,5 Lead Certificate M If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) 41,41 C,0A)~"'7r0&r10, COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In t7Ye st 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? s N o If yes, date and address of master plan: _ Licensed Plumber:/ Phone: Mechanical Contractor: Phone: 713 ° x"7,3 '®2-2-&! Sewer & Water Contractor: Phone: i 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 the are trade secrets. GALL 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.oopherstateonecall.org 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 State Building Code must be completed within 180 days of permit issuance. X Loa &Cc- x Applicant's Printed Name Applicant's t&jtfature Page 1 of 3 Li 6 a-~ Ins ` j a M5 DO NOT WRITE BELOW THIS LINE SUB TYPES _ Foundation _ Fireplace _ Porch (3-Season) _ Exterior Alteration (Single Family) Single Family _ Garage _ Porch (4-Season) _ Exterior Alteration (Multi) Multi _ Deck _ Porch (Screen/Gazebo/Pergola) _ Miscellaneous 01 of - Plex _ Lower Level _ Pool _ Accessory Building WORK TYPES New _ Interior Improvement _ Siding _ Demolish Building* Addition _ Move Building _ Reroof _ Demolish Interior _ Alteration _ Fire Repair _ Windows _ Demolish Foundation _ Replace _ Repair _ Egress Window _ Water Damage Retaining Wall *Demolition of entire building - give PCA handout to applicant DESCRIPTION Valuation 31 Occupancy MCES System Plan Review Code Edition erk . " SAC Units (25%4 100%-_) Zoning 90 City Water Census Code Stories Booster Pump # of Units Square Feet PRV # of Buildings Length Fire Sprinklers Type of Construction Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final / C.O. Required Footings (Addition) Final / No C.O. Required Foundation HVAC _ Gas Service Test Gas Line Air Test T Roof: -Ice & Water -Final Pool: -Footings Air/Gas Tests -Final Framing Drain Tile --,..,,r„ Fireplace: Rough In _YAir Test Final Siding: Stucco Lath Stone Lath Brick Insulation Windows Sheathing Retaining Wall: _ Footings _ Backfill _ Final Sheetrock Radon Control Fire Walls Erosion Control Braced Walls Other: Reviewed By: , Building Inspector RESIDENTIAL FEES rp o~ "}~I ~j Base Fee ti V` Surcharge Plan Review MCES SAC K4 15 City SAC / G Utility Connection Charge 7d , S&W Permit & Surcharge / e , 2 Treatment Plant J Copies V f, TOTAL 'j f Page 2 of 3 i'DNis New Construction Energy Code Compliance Certificate JURROMINE Per N1101.8 Building Certificate. A building certificate shall be posted in a permanently visible location inside Date Certificate Posted #t 'Elrr the building. The certificate shall be completed by the builder and shall list information and values of components listed in Table NI 101.8. Mailing Address of the Dwelling or Dwelling Unit 4616 Black Wolf Run Eagan Name of Residential Contractor MN License Number DRHorton BC605657 Community Plan ID THERMAL ENVELOPE RADON SYSTEM Type: Check All That Apply X passive (No Fan ) o ° Active (With fm and m)nomeler or H d y a ~ other sttrtcm monitaing device ) V y~ wo d PG fA v U ~ b > o Z ~ in ° a w Insulation Location a c V Oqq w c N o A-2 o O 9 moo E~ a z w w w w ii! f Other Please Describe Here Below Entire Slab X Foundation Wall R-5 X Type in location- exterior Perimeter of Slab on Crade Rim Joist (Foundation) R-12 X Type in location_ interior Rim Joist (In floor+) R-12 X Type in location interior Wall R-19 X Ceiling, flat R-44 X Ceiling, vaulted R-44 X Bay Windows or cantilevered areas R-32 X Bonus room over garage R-33 X X Describe other insylafed areas ting or Cooling Ducts outside Conditioned Spaces Windows & Doors DIR-value Average U-Factor (excludes skylights and one door) U: 0.31 Not applicable, all ducts located in conditioned space Solar Heat Gain Coefficient (SHGC): 0.28 MECHANICAL SYSTEMS Make-up Air Select a Type Appliances Heating System Domestic Water Heater Cooling System X Not required per mi code Fuel Type NAT GAS NAT GAS R-41 DA Passive Manufacturer CARRIER AOSmith CARRIER Powered Interlocked with exhaust device. Model 598SC2610OS21 GPVH-50 CA13NA036 Describe: Input in 100000 Capacity in 50 Output in 3 Other, describe: Rating or Sicc BTUS: Gallons: Tons: Ilc3tI.ss: 77,395 Heat 26,838 Location of duct or system: Structure's Calculated Gain: AFUE or 92 SEER: 13 HSPF% Calculated 32696 Efficiency coolie load: Cfin's roue uc Mechanical Ventilation System "metal duct 2- Panasonic WhisperGREEN fans set at 50 cfin continuous (one with a light). Fans ramp up to 80 cfm upon motion Combustion Air Select a Type sensing for 30 minutes. Toilet Room FV08VSL 80 cfin switched Not required per mech. code Select Type X Passive Heat Recover Ventilator (HRV) Capacity in cfins: Low: High: Other, describe: Energy Recover Ventilator (ERV) Capacity in cfins: Low: High: Location of duct or system: 1-Panasonic FV08VKM3 & 1- FV08VKML (w/lite) Continuous exhausting fan(s) rated capacity in cfins: 80 efin set @ 50 efm each furnace room Location of fan(s), describe: Master bath & full bath (respectively) Cfin's Capacity continuous ventilation rate in cfins: 100 6 " round duct OR Total ventilation (intermittent + continuous) rate in cfins: 240 " metal duct 4616 Black Wolf Run Eagan HVAC Load Calculations for DRHorton Lakeville, MN Prepared By: Todd Boyum Sabre Plumbing & Heating 15535 Medina Rd Plymouth, MN 55447 763-473-2267 Monday, March 17, 2014 Rhvac is an ACCA approved Manual J and Manual D computer program. Calculations are performed per ACCA Manual J 8th Edition, Version 2, and ACCA Manual D. Rhvac - Residential & Light Commercial HVAC Loads Elite Software Development, Inc. Sabre Plumbing & Heating ' 4616 Black Wolf Run Eagan Plymouth, MN 55447- Page 2 Project Report General Project Information Project Title: 4616 Black Wolf Run Eagan Designed By: Todd Boyum Project Date: 3/17/2014 Client Name: DRHorton Client City: Lakeville, MN Company Name: Sabre Plumbing & Heating Company Representative: Todd Boyum Company Address: 15535 Medina Rd Company City: Plymouth, MN 55447 Company Phone: 763-473-2267 Company Fax: 763-473-8565 _ T DesignData Reference City: Minneapolis, Minnesota Building Orientation: Front door faces West Daily Temperature Range: Medium Latitude: 44 Degrees Elevation: 834 ft. Altitude Factor: 0.970 Outdoor Outdoor Outdoor Indoor Indoor Grains Dry Bulb Wet Bulb Rel.Hum Rel.Hum Dry Bulb Difference Winter: -15 -12.38 n/a 30% 70 27.02 Summer: 88 73 50% 50% 75 35 Check Figures Total Building Supply CFM: 1,257 CFM Per Square ft.: 0.265 Square ft. of Room Area: 4,752 Square ft. Per Ton: 1,744 Volume (W) of Cond. Space: 39,498 Building Loads Total Heating Required Including Ventilation Air: 77,395 Btuh 77.395 MBH Total Sensible Gain: 26,838 Btuh 82 % Total Latent Gain: 5,858 Btuh 18 % Total Cooling Required Including Ventilation Air: 32,696 Btuh 2.72 Tons (Based On Sensible + Latent) -Notes _T Rhvac is an ACCA approved Manual J and Manual D computer program. Calculations are performed per ACCA Manual J 8th Edition, Version 2, and ACCA Manual D. All computed results are estimates as building use and weather may vary. Be sure to select a unit that meets both sensible and latent loads according to the manufacturer's performance data at your design conditions. C:\ ...\DRH 5341- West front door- 4616 BW Run.rh9 - Monday, March 17, 2014, 5:38 PM Sabre Plumbing 55447at nq ht Commercial HVAC Loads - Elite 4Software 6 6 Black Wolf Run Eagan 3 Ly Load Preview Resort Net ft: Sen Lat Net Sen Hts SCyls yt Duct Scope Ton Iron Area Gain Gain Gain Loss CFM CFM CFM Size Builduxq2.72 1,744 4,752 26,838 5858€ 32,696 77,395 1,036 1,257 1,257: System 1 2.72 1,744 4,752 26,838 5,858 32,696 77,395 1,03C 1,257 1,257 12x18 Duct Latent 279 279 Humidification 3,591 Zone 1 4,752 26,838 5,579 f 32,417 73,804, 1,03E 1.257 1,257 12x18 . _ 1-Basement 1,482 4,290, 606; 4,896 21,4371 301 201 201 2-6 2-Main floor 1,4821 14,491. 3,770 , 18,261 27,656 388 679 679 7-6 3 -2nd floor 1 788 8 056: 1 203 t 9,259 24,711 347 77 377 4-6 „ CA ...QRH 5341- West front door- 4616 BW Run.rh9 Monday, March 17, 2014, 5:38 PM Rhvac - Residential & Light Commercial HVAC Loads Elite Software Development, Inc. 11 Sabre Plumbing & Heating r 4616 Black Wolf Run Eagan Plymouth, MN 55447 Page 4 System 1 Summary Loads Component Area Sen Lat Sen Total description _ Quan Loss Gain Gam Gain DRH LowEE 2929: Glazing-DRH Windows, u-value 0.29, 80 1,972 0 2,470 2,470 SHGC 0.29 DRH LowEE 3328: Glazing-DRH Windows, u-value 0.33, 132 3,704 0 3,270 3,270 SHGC 0.28 DRH LowEE 3228: Glazing-DRH Windows, u-value 0.32, 196 5,332 0 4,791 4,791 SHGC 0.28 DRH LowEE 2930: Glazing-DRH Windows, u-value 0.29, 30 740 0 954 954 SHGC 0.3 DRH LowEE 3031: Glazing-DRH Windows, u-value 0.3, 8 204 0 144 144 SHGC 0.31 DRH LowEE 2924: Glazing-DRH Windows, u-value 0.29, 12 296 0 314 314 SHGC 0.24 DRH LowEE 3028: Glazing-DRH Windows, u-value 0.3, 18 459 0 541 541 SHGC 0.28 11J: Door-Metal - Fiberglass Core 20 527 0 149 149 1 U Door-Metal - Fiberglass Core 17.8 907 0 256 256 12E-Osw: Wall-Frame, R-19 insulation in 2 x 6 stud 3314.2 19,156 0 3,470 3,470 cavity, no board insulation, siding finish, wood studs .15130-5sf-4: Wall-Basement, , R-5 board exterior 96 734 0 0 0 insulation to footing, no interior finish, 4' floor depth .15130-5sf-8: Wall-Basement, , R-5 board exterior 976 5,974 0 0 0 insulation to footing, no interior finish, 8' floor depth RJ-12.2: Wall-Frame, Custom, Rim Joist- interior R-12.2 522.7 3,644 0 662 662 spay foam 11613-44: Roof/Ceiling-Under Attic with Insulation on Attic 1788 3,344 0 1,888 1,888 Floor (also use for Knee Walls and Partition Ceilings), Vented Attic, No Radiant Barrier, Dark Asphalt Shingles or Dark Metal, Tar and Gravel or Membrane, R-44 insulation 21A-20: Floor-Basement, Concrete slab, any thickness, 2 1482 3,401 0 0 0 or more feet below grade, no insulation below floor, any floor cover, shortest side of floor slab is 20' wide C20P-33: Floor-Over open crawl space or garage, 348.3 888 0 83 83 Custom,.._R.-33 blanket_insulatio 1 _any._cover_.......... Subtotals for structure: 51,282 0 18,992 18,992 People: 6 1,200 1,380 2,580 Equipment: 1,041 3,976 5,017 Lighting: 0 0 0 Ductwork: 2,117 279 495 774 Infiltration: Winter CFM: 225, Summer CFM: 144 20,405 3,338 1,995 5,333 Ventilation: Winter CFM: 0, Summer CFM: 0 0 0 0 0 Exhaust: Winter CFM: 100, Summer CFM: 100 Humdfcation...(Winter ._9..79... al/da 3 591 1)._._............................................. 0 . . . . . . . . . System 1 Load Totals: 77,395 5,858 26,838 32,696 heck Figures Supply CFM: 1,257 CFM Per Square ft.: 0.265 Square ft. of Room Area: 4,752 Square ft. Per Ton: 1,744 Volume (ft") of Cond. Space: 39,498 SystemLoads _ _ s - L _ Total Heating Required Including Ventilation Air: 77,395 Btuh 77.395 MBH Total Sensible Gain: 26,838 Btuh 82 % Total Latent Gain: 5,858 Btuh 18 % Total Cooling Required Including Ventilation Air: 32,696 Btuh 2.72 Tons (Based On Sensible + Latent) Notes Rhvac is an ACCA approved Manual J and Manual D computer program. C:\ ...\DRH 5341- West front door- 4616 BW Run.rh9 Monday, March 17, 2014, 5:38 PM Rhvac - Residential & Light Commercial HVAC Loads Elite Software Development, Inc. Sabre Plumbing & Heating 4616 Black Wolf Run Eagan Plymouth, MN 55447 Page 5 System 1 Summary Loads (cont'd) Notes _ Calculations are performed per ACCA Manual J 8th Edition, Version 2, and ACCA Manual D. All computed results are estimates as building use and weather may vary. Be sure to select a unit that meets both sensible and latent loads according to the manufacturer's performance data at your design conditions. C:\ ...\DRH 5341- West front door- 4616 BW Run.rh9 Monday, March 17, 2014, 5:38 PM Site address 4616 Black Wolf Run Date 3-17-14 Contractor Sabre P & H Completed Todd B. Section A Ventilation Quantity (Determine quantity by using Table N3104.2 or Equation 11-1) Square feet (Conditioned area including Basement -finished or unfinished) 4752 Total required ventilation 190 Number of bedrooms 5 Continuous ventilation 95 Directions - Determine the total and continuous ventilation rate by either using Table N1104.2 or equation 11-1. The table and equation are below. Table N1104.2 Total and Continuous Ventilation Rates (in cfm) Number of Bedrooms 1 2 3 4 5 6 Conditioned space (in Total/ Total/ Total/ Total/ Total/ Total/ sq. ft.) continuous continuous continuous continuous continuous continuous 1000-1500 60/40 75/40 90/45 105/53 120/60 135/68 1501-2000 70/40 85/43 100/50 115/58 130/65 145/73 2001-2500 80/40 95/48 110/55 125/63 140/70 155/78 2501-3000 90/45 105/53 120/60 135/68 150/75 165/83 3001-3500 100/50 115/58 130/65 145/73 160/80 175/88 3501-4000 110/55 125/63 140/70 155/78 170/85 185/93 4001-4500 120/60 135/68 150/75 165/83 180/90 195/98 4501-5000 130/65 145/73 160/80 175/88 190/95 205/103 5001-5500 140/70 155/78 170/85 185/93 200/100 215/108 550176000 150/75 165/83 180/90 195/98 210/105 225/113 Equation 11-1 (0.02 x square feet of conditioned space) + [15 x (number of bedrooms + 1)] = Total ventilation rate (cfm) Total ventilation-The mechanical ventilation system shall provide sufficient outdoor air to equal the total ventilation rate average, for each one-hour period according to the above table or equation. For heat recovery ventilators (HRV) and energy recovery ventila- tors (ERV) the average hourly ventilation capacity must be determined in consideration of any reduction of exhaust or out outdoor air intake, or both, for defrost or other equipment cycling. Continuous ventilation - A minimum of 50 percent of the total ventilation rate, but not less than 40 cfm, shall be provided, on a con- tinuous rate average for each one-hour period. The portion of the mechanical ventilation system intended to be continuous may have automatic cycling controls providing the average flow rate for each hour is met. GASAFETYUMVent-makeup-comb air submittal (2).docx Section B Ventilation Method Choose either balanced or exhaust only) Balanced, HRV (Heat Recovery Ventilator) or ERV (Energy Recov- ✓ Exhaust only ery Ventilator) - cfm of unit in low must not exceed continuous venti- Continuous fan rating in cfm lation rating by more than 100%. Low cfm: I I High cfm: Continuous fan rating in cfm (capacity must not exceed 00 continuous ventilation rating b more than 100%) Directions - Choose the method of ventilation, balanced or exhaust only. Balanced ventilation systems are typically HRV or ERV's. Enter the low and high cfm amounts. Low m air flow must be equal to or greater than the required continuous ventilation rate and less than 100% greater than the continuous rate. (For instance, if the low cfm is 40 cfm, the ventilation fan must not exceed 80 cfm.) Automatic controls may allow the use of a larger fan that is operated a percentage of each hour. Section C Ventilation Fan Schedule Description Location Continuous Intermittent Panasonic FV08VKML WhisperGREEN Master Bath 50 80 Panasonic FV08VKM WhisperGREEN Full Bath 50 80 Panasonic FV08VSL Toilet Room- master bath 80 Directions - The ventilation fan schedule should describe what the fan is for, the location, cfm, and whether it is used for continuous or intermittent ventilation. The fan that is chose for continuous ventilation must be equal to or greater than the low m air rating and less than 100% greater than the continuous rate. (For instance, if the low cfm is 40 cfm, the continuous ventilation fan must not exceed 80 cfm.) Automatic controls may allow the use of a larger fan that is operated a percentage of each hour. Section D Ventilation Controls (Describe operation and control of the continuous and intermittent ventilation) JNJ and Master bath WhisperGREEN fans run at 50 cfm constant- ramp up to 80 cfm upon motion sensing for 30 minutes Toilet room fan has wall switch Directions -Describe the operation of the ventilation system. There should be adequate detail for plan reviewers and inspectors to verify design and installation compliance. Related trades also need adequate detail for placement of controls and proper operation of the building ventilation. If exhaust fans are used for building ventilation, describe the operation and location of any controls, indicators and legends. If an ERV or HRV is to be installed, describe how it will be installed. If it will be connected and interfaced with the air handling equipment, please describe such connections as detailed in the manufactures' installation instructions. If the installation instructions require or recommend the equipment to be interlocked with the air handling equipment for proper operation, such interconnection shall be made and described. Directions - In order to determine the makeup air, Table 501.3.1 must be filled out (see below). For most new installations, column A will be appropriate, however, if atmospherically vented appliances or solid fuel appliances are installed, use the appropriate column. For existing dwellings, see IMC 501.3.3. Please note, if the makeup air quantity is negative, no additional makeup air will be re- quired for ventilation, if the value is positive refer to Table 501.3.2 and size the opening. Transfer the cfm, size of opening and type (round, rectangular, flexor rigid) to the last line of section D. The make-up air supply must be installed per IMC 501.3.2.3. Table 501.3.1 PROCEDURE TO DETERMINE MAKEUP AIR QUANITY FOR EXHAUST EQUIPMENT IN DWELLINGS (Additional combustion air will be required for combustion appliances, see KAIR method for calculations) One or multiple power One or multiple fan- One atmospherically vent Multiple atmospherical- vent or direct vent ap- assisted appliances and gas or oil appliance or ly vented gas or oil pliances or no combus- power vent or direct vent one solid fuel appliance appliances or solid fuel tion appliances appliances appliances Column C Column D Column A Column B 1. a) pressure factor 0.15 0.09 0.06 0.03 (cfm/sf) b) conditioned floor area (sf) (including 4752 unfinished basements) Estimated House Infiltration (dm): [la 712 x 1b] 2. Exhaust Capacity a) continuous exhaust-only ventilation 100 system (dm); (not applicable to ba- lanced ventilation systems such as HRV) b) clothes dryer (dm) 135 135 135 135 c) 80% of largest exhaust rating (dm); Kitchen hood typically 240 (not applicable if recirculating system or if powered makeup air is electrically interlocked and match to exhaust) d) 80% of next largest exhaust rating (cfm); bath fan typically Not (not applicable if recirculating system or if powered makeup air is electrically Applicable interlocked and matched to exhaust) Total Exhaust Capacity (cfm); 475 [2a + 2b +2c + 2d] 3. Makeup Air Quantity (cfm) a) total exhaust capacity (from above) 475 b) estimated house infiltration (from 712 above) Makeup Air Quantity (dm); [3a-3b] -237 (if value is negative, no makeup air is needed) 4. For makeup Air Opening Sizing, refer Not Rer~~d to Table 501.4.2 M A. Use this column if there are other than fan-assisted or atmospherically vented gas or oil appliance or if there are no combustion appliances. (Power vent and direct vent appliances may be used.) B. Use this column if there is one fan-assisted appliance per venting system. (Appliances other than atmospherically vented appliances may also be in- cluded.) C. Use this column if there is one atmospherically vented (other than fan-assisted) gas or oil appliance per venting system or one solid fuel appliance. D. Use this column if there are multiple atmospherically vented gas or oil appliances using a common vent or if there are atmospherically vented gas or oil appliances and solid fuel appliances. Makeup Air Opening Table for New and Existing Dwelling Table 501.3.2 One or multiple power One or multiple fan- One atmospherically Multiple atmospherically vent, direct vent ap- assisted appliances and vented gas or oil ap- vented gas or oil ap- Duct di- pliances, or no combus- power vent or direct pliance or one solid fuel pliances or solid fuel ameter tion appliances vent appliances appliance appliances Column A Column B Column C Column D Passive opening 1-36 1-22 1-15 1-9 3 Passive opening 37-66 23-41 16-28 10-17 4 Passive opening 67-109 42-66 29-46 18-28 5 Passive opening 110-163 67-100 47-69 29-42 6 Passive opening 164-232 101-143 70-99 43-61 7 Passive opening 233-317 144-195 100-135 62-83 8 Passive opening 318-419 196-258 136-179 84-110 9 w/motorized damper Passive opening 420 - 539 259 - 332 180 - 230 111-142 10 w/motorized damper Passive opening 540 - 679 333 - 419 231-290 143-179 11 w/motorized damper Powered makeup air >679 >419 >290 >179 NA Notes: A. An equivalent length of 100 feet of round smooth metal duct is assumed. Subtract 40 feet for the exterior hood and ten feet for each 90- degree elbow to determine the remaining length of straight duct allowable. B. If flexible duct is used, increase the duct diameter by one inch. Flexible duct shall be stretched with minimal sags. Compressed duct shall not be accepted. C. Barometric dampers are prohibited in passive makeup air openings when any atmospherically vented appliance is installed. D. Powered makeup air shall be electrically interlocked with the largest exhaust system. Sections F Combustion air Not required per mechanical code (No atmospheric or power vented appliances) Passive (see IFGC Appendix E, Worksheet E-1) Size and type 4" Rigid, 5" Flex Other, describe: Explanation - If no atmospheric or power vented appliances are installed, check the appropriate box, not required. If a power vented or atmospherically vented appliance installed, use IFGCAppendix E, Worksheet E-1 (see below). Please enter size and type. Combus- tion air vent supplies must communicate with the appliance or appliances that require the combustion air. Section F calculations follow on the next 2 pages. Directions - The Minnesota Fuel Gas Code method to calculate to size of a required combustion air opening, is called the Known Air Infiltration Rate Method. For new construction, 4b of step 4 is required to be filled out. IFGC Appendix E, Worksheet E-1 Residential Combustion Air Calculation Method (for Furnace, Boiler, and/or Water Heater in the Same Space) Step 1: Complete vented combustion appliance information. Furnace/Boiler: Draft Hood ❑ Fan Assisted ✓QDirect Vent Input: Btu/hr or Power Vent Water Heater: 42000 ❑Draft Hood 0 Fan Assisted DDirect Vent Input: Btu/hr or Power Vent Step 2: Calculate the volume of the Combustion Appliance Space (CAS) containing combustion appliances. 1298 The CAS includes all spaces connected to one another by code compliant openings. CAS volume: ft' LxWxH L W H Step 3: Determine Air Changes per Hour (ACH)1 Default ACH values have been incorporated into Table E-1 for use with Method 4b (KAIR Method). If the year of construction or ACH is not known, use method 4a (Standard Method). Step 4: Determine Required Volume for Combustion Air. (DO NOT COUNT DIRECT VENT APPLIANCES) 4a. Standard Method Total Btu/hr input of all combustion appliances Input: Btu/hr Use Standard Method column in Table E-1 to find Total Required TRV: ft' Volume (TRV) If CAS Volume (from Step 2) is greater than TRV then no outdoor openings are needed. If CAS Volume (from Step 2) is less than TRV then go to STEP S. 4b. Known Air Infiltration Rate (KAIR) Method (DO NOT COUNT DIRECT VENT APPLIANCES) Total Btu/hr input of all fan-assisted and power vent appliances input: 42DOO Btu/hr Use Fan-Assisted Appliances column in Table E-1 to find RVFA: 3375 ft3 Required Volume Fan Assisted (RVFA) Total Btu/hr input of all Natural draft appliances Input: 0 Btu/hr Use Natural draft Appliances column in Table E-1 to find RVNFA: ft, Required Volume Natural draft appliances (RVNDA) Total Required Volume (TRV) = RVFA + RVNDA TRV = 3375 + 0 _ 3375 TRV ft' If CAS Volume (from Step 2) is greater than TRV then no outdoor openings are needed. If CAS Volume (from Step 2) is less than TRV then go to STEP S. Step S: Calculate the ratio of available interior volume to the total required volume. Ratio = CAS Volume (from Step 2) divided by TRV (from Step 4a or Step 4b) Ratio =1298 /3375 =.38 Step 6: Calculate Reduction Factor (RF). RF =1 minus Ratio RF =1- .38 =.62 Step 7: Calculate single outdoor opening as if all combustion air is from outside. 42,000 Total Btu/hr input of all Combustion Appliances in the same CAS Input: Btu/hr (EXCEPT DIRECT VENT) Combustion Air Opening Area (CAOA): Total Btu/hr divided by 3000 Btu/hr per in2 CAOA = 42,000 / 3000 Btu/hr per in2 = 14 inZ Step 8: Calculate Minimum CAOA. Minimum CAOA = CAOA multiplied by RF Minimum CAOA = 14 x .62 = 8.68 in2 Step 9: Calculate Combustion Air Opening Diameter (CAOD) CAOD =1.13 muldplfed by the square root of Minimum CAOA CAOD =1.13 V Minimum CAOA = 3.3 in. diameter o up one inch in size if using flex duct l If desired, ACH can be determined using ASHRAE calculation or blower door test. Follow procedures in Section G304. IFGC Appendix E, Table E-1 Residential Combustion air (Required Interior Volume Based on Input Rating of Appliance) Input Rating Standard Method Known Air Infiltration Rate (KAIR) Method (cu ft) (Btu/hr) Fan Assisted or Power Vent Natural Draft 1994 to present Pre-1994 1994 to present Pre-1994 5,000 250 375 188 525 263 10,000 500 750 375 1,050 525 15,000 750 1,125 563 1,575 788 20,000 1,000 1,500 750 2,100 1,050 25,000 1,250 1,875 938 2,625 1,313 30,000 1,500 2,250 1,125 3,150 1,575 35,000 1,750 2,625 1,313 3,675 1,838 40,000 2,000 3,000 1,500 4,200 2,100 45,000 2,250 3,375 1,688 4,725 2,363 50,000 2,500 3,750 1,675 5,250 2,625 55,000 2,750 4,125 2,063 5,775 2,888 60,000 3,000 4,500 2,250 6,300 3,150 65,000 3,250 4,875 2,438 6,825 3,413 70,000 3,500 5,250 2,625 7,350 3,675 75,000 3,750 5,625 2,813 7,875 3,938 80,000 4,000 6,000 3,000 8,400 4,200 85,000 4,250 6,375 3,188 8,925 4,463 90,000 4,500 6,750 3,375 9,450 4,725 95,000 4,750 7,125 3,563 9,975 4,988 100,000 5,000 7,500 3,750 10,500 5,250 105,000 5,250 7,875 3,938 11,025 5,513 110,000 5,500 8,250 4,125 11,550 5,775 115,000 5,750 8.625 4,313 12,075 6,038 120,000 6,000 9,000 4,500 12,600 6,300 125,000 6,250 9,375 4,688 13,125 6,563 130,000 6,500 9,750 4,875 13,650 6,825 135,000 6,750 10,125 5,063 14,175 7,088 140,000 7,000 10,500 5,250 14,700 7,350 145,000 7,250 10,875 5,438 15,225 7,613 150,000 7,500 11,250 5,625 15,750 7,875 155,000 7,750 11,625 5,813 16,275 8,138 160,000 8,000 12,000 6,000 16,800 8,400 165,000 8,250 12,375 6,188 17,325 8,663 170,000 8,500 12,750 6,375 17,850 8,925 175,000 8,750 13,125 6,563 18,375 9,188 180,000 9,000 13,500 6,750 18,900 9,450 185,000 9,250 13,875 6,938 19,425 9,713 190,000 9,500 14,250 7,125 19,950 9,975 195,000 9,750 14,625 7,313 20,475 10,238 200,000 10,000 15,000 7,500 21,000 10,500 205,000 10,250 15,375 7,688 21,525 10,783 210,000 10,500 15,750 7,875 22,050 11,025 215,000 10,750 16,125 8,063 22,575 11,288 220,000 11,000 16,500 8,250 23,100 11,550 225,000 11,250 16,875 8,438 23,625 11,813 230,000 11,500 17,250 8,625 24,150 12,075 1. The 1994 date refers to dwellings constructed under the 1994 Minnesota Energy Code. The default KAIR used in this section of the table is 0.20 ACH. 2. This section of the table is to be used for dwellings constructed prior to 1994. The default KAIR used in this section of the table is 0.40 ACH. C Physical Properties and ASTM Specifications Page l .of 4 CertiAvm Physical Properties and ASTM Specifications 1. Typical property values are based principally on most recent product audit and sampling data. For specific property ranges and bounds, contact you DiversiFoam Products representative. Typical pro erties of CertiFoam brand inusulationl 2. Because of ongoing ASTM ertiFoam CertiLit technical discussions test ertiFoam 25 System CertiFoa regarding the complete method 15 SE SL Board 40 application of test Insulation methods C117-76 and C518-76, traditional Properties C 177- industry methods for Thermal 762 determining the thermal Conductivity or conductivity of low (Btu/hr. sq. ft. density insulations are °F) C 518- 0.178 0.178 0.178 0.178 used. test uncertainty 5-Year Aged 762 0.185 0.185 0.185 0.185 of thicker foam (Design) 0.200 0.200 0.200 0.200 insulations is expected Values3 to be less than 5 percent (cry, 25° F mean 0.192 0.192 0.192 0.192 from listed values. @ 40° F mean 3. Recommended typical @ 75° F mean design values after five- 6-Month Aged year aging at 751F. Values4 4. Partially aged values 75° F mean after six-month aging at Water 75°F or three-month Resistant D 1.0 1.0 1.0 1.0 aging at 140°F. These Properties 2842- <0.1 <0.1 <0.1 <0.1 values are not Water G96 recommended for use Absorption C272- 1.0 1.0 1.0 1.0 in design calculations. by volume 767 They are included for Water Vapor comparison with Permeance E 96- published values for (perm s polyisocyanurafe and Maximum 80 polyurethane foams Mechanical measured after aging Properties D for these periods Compressive 1621- according to http://www.diversifoam.com/cfproperties.htm 12/4/2013 z Physical Properties and ASTM Specifications Page 2 of 4 Strength 73 209 409 409 Soto RIC/TIMA procedure (lb./sq. in.) 281-1. Minimum 15 25 25 40 5. (specification) 6. Test precision is plus or Value minus 1.0 percent by Miscellaneous volume. Properties 7. Values will be between Maximum 165 165 165 165 0.0 and the values Recommende shown. Use 8. Desiccant method. For Temperature D696 3.5x10'5 3.5x10'5 3.5x10-5 3.5x10'5 all CertiFoam products (OF) one inch or greater in Linear thickness. Coefficient of 9. Vertical compressive Thermal strength at 10% Expansion deformation or yield, in./in. °F whichever occurs first. Structural applications involving high continuous loads, high temperatures, or non- uniform loads may require higher safety factors based on minimum specification values. Thermal Resistance (R-value) of live-year aged 10. Vertical compressive CertiFoam strength at 5% deformation or yield, whichever occurs first. To minimize Nominal @ 25°F Mean @ 40°F Mean @ 750F Mean viscoelastic Thickness (in.) Temperature Temperature Temperature deformation with time 1/2 2.8 2.7 2.5 in load-bearing 3/4 4.2 4.1 3.8 applications, higher 1 5.6 5.4 5.0 safety factors are 1 1 /2 8.4 8.1 7.5 recommended: 3:1 for 2 11.2 10.8 10.0 dead loads, and 5:1 for 21/2 14.0 13.5 12.5 live or combined loads. 3 16.9 16.2 15.0 Elevated temperatures may also require higher safety factors. ASTM C 578-10 specifications for rigid cellular polystyrene thermal insulation Tlusstandard supersedes Federal Specifications HH-1-524 B. HH-1-524 C. and ASTM C 578-08 Type 1 ype Type Il Type Type Type Type Type Type Vlll IX XIV X IV VI VII Insulation Material littp://www.diversifoam.com/cfpropeities.htin 12/4/2013 Physical Properties and ASTM Specifications Page 3 of 4 Expanded polystyrene (EPS) EPS EPS BPS EPS EPS Extruded polystyrene - XEPS XEPS XEPS XEPS XEPS Physical Properties Density, minimum lb/fl3 0.9 1.15 1.35 1.8 2.4 1.3 1.55 1.8 2.2(35) (kg/m3) (15) (18) (22) (29) (38) (21) (26) (29) Thermal resistance of 1.00 in. (25.4 mm) thickness, minimum °F- 4.0 4.2 4.4 4.6 4.6 5.4 5.4 5.4 5.4 fl2h/Btu (k-m2/W) (.70) (.74) (.77) (.81) (.81) (.95) (.95) (.95) (.95) at mean temperature: 3.6 3.8 4.0 4.2 4.2 5.0 5.0 5.0 5.0 40°F (4.4°C) (.63) (.67) (.70) (.74) (.74) (.88) (.88) (.88) (.88) 75°F (23.9°C) Compressive resistance at yield or 10% 10.0 13.0 15.0 25.0 40.0 15.0 25.0 40.0 60.0 deformation, whichever (69) (90) (104) (173) (276) (104) (173) (276) (414) occurs first (with 25.0 30.0 40.0 50.0 60.0 40.0 50.0 60.0 75.0 Skins intact), minimum, psi (173) (208) (276) (345) (414) (276) (345) (414) (517) (kPa) Flexural strength, minimum, 5.0 3.5 3.5 2.0 2.5 1.5 1.5 1.1 psi (kPa)por permeance of (287) (201) (201) (115) (143) (86) (86) (63) 1.1(63) ater 1.00 in. (25.4 mm) 4.0 3.0 3.0 2.0 2.0 0-3 0.3 0.3 0.3 thickness, max, perm (ng/Pa- s-m) 2.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 2.0 Water absorption by total 24,0 24.0 24.0 24.0 24.0 24.0 24.0 24.0 24.0 immersion, maximum, volume % Dimensional stability, (change in dimensions), maximum, % Oxygen index, minimum, volume % Product meets or exceeds Type: X CertiFoam 15 X ertiFoam 25 SE, SL X CertiLite System Board X CertiFoam 40 X CertiFoam 60 CertiFoam Product Guide - Home, Products;:Contact Info, Locations, Company-Info, Literature littp://\Yww.diversifoam.coin/cfproperties.htiii 12/4/2013 Physical Properties and ASTM Specifications Page 4 of 4 Corporate 17~ 1'Si M Regional Office Headquarters pRODf1= Chicago/Milwaukee/St. Minneapolis/St. Paul Louis 9091 County Road 50 1101 Lori Lane Rockford, MN 55373 Phone: 763-477-5854(@ Mendota, IL 61342 Fax: 763477-5863V Reguest Information http://www.diversifoani.com/cfproperties.hini 12/4/2013 3 1 EVALUATION REPORT UN! Report Number. 0272 ` Originally Issued: 12/2012 Valid Through: 12/2013 DIVISION: 07 00 00 - THERMAL AND MOISTURE 3.0 DESCRIPTION PROTECTION Section: 07 21 00 - Thermal Insulation 3.1 QuadFoam® 2.0 Insulation: REPORT HOLDER: QuadFoam®2.0 is a spray applied, closed cell Quadrant Urethane Technologies polyurethane foam plastic insulation having 1 nominal 200 Industrial Blvd. density of 2.0 pounds per cubic foot (32 kg/m McKinney, TX 75069 3.2 Surface Burning Characteristics: (972)542-0072 www.QuadFoam.com 3.2.1 The QuadFoam® 2.0 insulation, at a maximum EVALUATION SUBJECT: thickness of 4 inches (102 mm) and a nominal density of 2.0 pounds per cubic foot (32.0 kg/m3), has a flame QuadFoam02.0 spread index of 25 or less and a smoke-developed index of 450 or less when tested in accordance with ASTM E 84. 1.0 EVALUATION SCOPE: 3.2.2 Thicknesses of up to 11 '/2 inches (292 mm) for 1.1 Compliance with the following codes: ceiling cavities and 7 1/ inches (191 mm) for wall • 2009 International Building Code@ (IBC) cavities are recognized based on testing in accordance with NFPA 286, when covered with a • 2009 International Residential Code® (IRC) minimum inch thick gypsum board or an equivalent thermal barrier complying with, and installed in • 2009 International Energy Conservation accordance with the applicable code. Code® (IECC) 3.3 Thermal Resistance: • 2006 International Building Code® (IBC) • 2006 International Residential Code@) IRC QuadFoam® 2.0 insulation has a thermal resistance, ( ) R-value, at a mean temperature of 75 F (24' C) as • 2006 International Energy Conservation shown in Table 1. Code® (IECC) 3.4 Intumescent Coating: 1.2 Evaluated in accordance with ICC-ES AC 377, dated October 2010 DC 315: intumescent coating is manufactured by International Fireproof Technology Inc., and is a water- 1.3 Properties evaluated: based coating supplied in 5-gallon (19L) pails and 55- gallon (208L) drums. The coating material has a • Surface-burning characteristics maximum shelf life of 24 months when stored in • Physical properties factory sealed containers at temperatures between • Thermal Resistance 50°F (10eC) and 90oF (32°C). • Use in attics and crawlspaces • Air permeability 4.0 DESIGN AND INSTALLATION 2.0 USES 4.1 General: QuadFoam® 2.0 is a closed-cell spray foam is used as QuadFoam®2.0 spray-applied foam insulation must be a nonstructural thermal insulating material in Type VB installed in accordance with the manufacturer's construction under the IBC and dwellings under the published installation instructions and this report. A IRC. copy of these instructions and this evaluation report must be available on the jobsite at all times during installation. Page 1 of 4 Copyright 02012 by International Association of Plumbing and Mechanical Officials. All rights reserved. Printed in the United States. No part of this publication may be reproduced, stored in an electronic retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the publisher. Ph: 1-877-41ESRPT - Fax: 909.472.4171 -Web: wwyr.iapmoes.om • 6001 East Philadelphia Street • Ontario, Califomia 91761-2816 --USA - . i EVALUATION REPORT i Report Number. 0272 Originally Issued: 12/2012 Valid Through: 12/2013 4.2 Application: IRC Sections R316.5.3 and R316.5.4, as applicable. The ignition barrier must be consistent with the QuadFoam® 2.0 must be applied using spray construction type of the building. equipment specified by Quadrant Urethane Technologies. 4.4.2 Application without a Prescriptive Ignition Barrier: Where the spray-applied insulation is installed 4.3 Thermal Barrier: in accordance with Section 4.4.2.1 or 4.4.2.2, the following conditions apply: 4.3.1 Application with a Prescriptive Thermal Barrier: QuadFoam® 2.0 spray foam insulation with a) Entry to the attic or crawl space is only to maximum nominal thicknesses of 11.5 inches (292 service utilities, and no storage is permitted. mm) in ceiling cavities and 7.5 inches (190 mm) in wall b) There are no interconnected attic or crawl cavities must be separated from the interior of the space areas. building by a thermal barrier. The IBC and IRC specify c) Air in the attic or crawl space is not circulated an approved thermal barrier of %-inch thick (12.7 mm) to other parts of the building. gypsum board wallboard or equivalent 15-minute d) Attic ventilation is provided when required by thermal barrier complying with IBC Section 2603.4 or IBC Section 1203.2 or IRC Section R806, IRC Section R316.4, as applicable. except when an air-impermeable insulation is permitted in unvented attics in accordance 4.3.2 Application without a Prescriptive Thermal with Section R806.4 of IRC. Under-floor (crawl Barrier: QuadFoam®2.0 spray foam insulation may be space) ventilation is provided when required installed without a prescriptive thermal barrier when it by IBC Section 1203.3 or IRC Section R408.1, has been coated on all surfaces with 18 mils dry film as applicable. thickness of DC 315 intumescent coating as described e) The foam plastic insulation is limited to the in Section 3.4 of this report. The maximum thickness maximum thickness and density tested. of the spray foam insulation is limited to 7.5 inches f) Combustion air is provided in accordance with (190 mm) on vertical surfaces and 11.5 inches (292 Sections 701 and 703 (20061MC) and Section mm) on overhead surfaces. Coating must be applied 701 (2012 and 2009 IMC). in accordance with International Fireproof g) The installed coverage rate or thickness of Technology's installation instructions and this report. coatings, if part of the insulation system, shall Surfaces to be coated must be dry, clean, and free of be equal to or greater than that which was dirt, loose debris and other substances. The coating is tested. applied in one-coat with low-pressure airless air equipment. 4.4.2.1 Attics and Crawl Spaces: QuadFoam® 2.0 spray foam insulation may be spray-applied without an 4.4 Attics and Crawl Spaces: ignition barrier to the underside of the roof deck to ® thicknesses not exceeding 11.5 inches (292 mm) When installing QuadFoam 2.0 in attics and/or crawl and/or vertical surfaces to thicknesses not exceeding spaces and a thermal barrier is omitted in accordance 7.5 inches (190 mm), as described in this section with IBC Section 2603.4.1.6 or IRC Sections R316.5.3 When QuadFoam® 2.0 is installed as described in this or R316.5.4, installation must comply with either section, no ignition barrier or a coating are required. Sections 4.4.1 or 4.4.2 below. QuadFoam® 2.0 spray-foam insulation qualifies as an As an alternative QuadFoam® 2.0 insulation may be air-impermeable insulation and, when installed in covered with DC 315 intumescent coating as accordance with Sections 4.4.1 or 4.4.2.1, may be described in Section 3.4 and installed with the manufacturer's installation instructions. The foam used insulate unvented attics in accordance with plastic must be covered on all exposed surfaces with IRC Section R806.4. an application of DC 315 as described in Section 3.4 4.4.1 Application with a Prescriptive Ignition of 18 mils dry film thickness. Surfaces to be coated Barrier: When QuadFoam® 2.0 insulation is installed must be dry, clean, and free of dirt, loose debris and within attics and crawl spaces where entry is made other substances. The coating is applied in one-coat only service of utilities, an ignition barrier must be with low-pressure airless air equipment. installed in accordance with IBC Section 2603.4.1.6 or Page 2 of 4 3 EVALUATION REPORT H v ss Report Number. 0272 Originally Issued: 12/2012 Valid Through: 12/2013 4.4.2.2 Use on Attic Floors: 5.8 Use of QuadFoam® 2.0 insulation under this report QuadFoam® 2.0 insulation may be installed exposed is limited to Construction Type VB. (no coating), without an ignition barrier up to a maximum thickness of 11 inches (292 mm) between 6.0 EVIDENCE SUBMITTED and over the joist in attic floors. The insulation must be separated from the interior of the building by an 6.1 Data and test reports submitted are from approved thermal barrier. The ignition barrier required laboratories in compliance with ISO/IEC 17025 and in by IBC Section 2603.4 and IRC Section R316.5.3 may accordance with the ICC-ES Acceptance Criteria for be omitted in this case. Spray-applied Foam Plastic Insulation, (AC377), dated October 2010, including reports of tests in accordance 5.0 CONDITIONS OF USE with Appendix X of AC 377. The QuadFoam® 2.0 spray foam insulation described 7.0 IDENTIFICATION in this report complies with, or is a suitable alternative Containers of QuadFoam® 2.0 components are to what is specified in those codes listed in Section 1.0 identified with a label bearing the Quadrant Corp. of this report, subject to the following conditions: name address; the product trade name (QuadFoam® 5.1 The product must be installed in accordance with 2.0, Grade S, W, AS or AW); the lot number; the flame the manufacturer's published installation instructions, spread and smoke developed indices; mixing this evaluation report and the applicable code. The instructions; density; the shelf life; the expiration date; instructions within this report govern if there are any and the IAPMO Uniform ES Evaluation Report number conflicts between the manufacturer's published (ER-0272). installation instructions and this report. 5.2 QuadFoam® 2.0 insulation must be protected by a 1A p U E 15 minute thermal barrier in accordance with Section MO S 4.3.1 of this report except when installation complies with Sections 4.3.2 (Application without a Prescriptive Thermal Barrier) and/or 4.4 (Attics and Crawl Spaces) TM of this report 5.3 The A and B components of the insulation are IAPMO UES #0272 produced under a quality control program with inspections by IAPMO Uniform ES. 5.4 QuadFoam® 2.0 insulation must be installed by contractors certified by Quadrant Urethane Technologies. Amir Zamanian, PE 5.5 When QuadFoam® 2.0 insulation is used in areas Technical Director of Evaluation Service wherein the likelihood of termite infestation is 'very heavy," it must be installed in accordance with 2009 IBC Section 2603.8 or IRC Section R318.4, as [ applicable. 5.6 Jobsite labeling and certification of the insulation must comply with IRC Sections N1101.4 and GP Russ Chaney N1101.4.1 and IECC Sections 303. 1.1 and 303.1.2 as CEO, The IAPMO Group applicable. 5.7 Where applicable, QuadFoam® 2.0 must be installed with a vapor retarder in accordance with the applicable code. Page 3 of 4 EVALUATION REPORT viw ORION E Report Number. 0272 Originally issued: 12/2012 Valid Through: 12/2013 Table 1-Thermal Resistance (R-Values)' Thickness inch R-Value OF-ft-hr/Btu) 1.0 6.5 2.0 13 3.0 19 4.0 25 7.5 47 11.5 71 SI: 1 inch = 25.4 mm; 1 °F-ft •hr/Btu = 0.176 °K•m •hr/W 'R-values are calculated based on tested k-factors at 1- and 3.5-inch thicknesses. Page 4 of 4 t LOT SURVEY CHECKLIST FOR RESIDENTIAL BUILDING PERMIT APPLICATION PROPERTY LEGAL: Lt' + 1 DATE OF SURVEY: LATEST REVISION: as a~ c ca s U 0 z Q DOCUMENT STANDARDS ❑ ❑ • Registered Land Surveyor signature and company '0 0 0 • Building Permit Applicant JY 0 0 • Legal description ❑ D • Address 0 ❑ • North arrow and scale ❑ ❑ • House type (rambler, walkout, split w/o, split entry, lookout, etc.) ❑ ❑ • Directional drainage arrows with slope/gradient % ❑ 0 • Proposed/existing sewer and water services & invert elevation ❑ ❑ • Street name 0 0 • Driveway (grade & width - in R/W and back of curb, 22' max.) 0 0 • Lot Square Footage e' D ❑ • Lot Coverage ELEVATIONS Existing 'z ❑ ❑ • Property corners ,,Er 0 ❑ • Top of curb at the driveway and property line extensions ❑ ❑ • Elevations of any existing adjacent homes A5 0 0 • Adequate footing depth of structures due to adjacent utility trenches ,a ❑ ❑ . Waterways (pond, stream, etc.) Proposed ❑ ❑ • Garage floor ❑ ❑ • Basement floor 0 ❑ • Lowest exposed elevation (walkout/window) ,D' ❑ 0 • Property corners '0 ❑ 0 • Front and rear of home at the foundation PONDING AREA (if applicable) 0 D • Easement line 0 ❑ • NWL ❑ D • HWL 0{ 0 • Pond # designation 0 ~z D • Emergency Overflow Elevation ❑ a ❑ • Pond/Wetland buffer delineation Y' • Shoreland Zoning Overlay District Y LN • Conservation Easements DIMENSIONS ❑ 0 • Lot lines/Bearings & dimensions ❑ 0 . 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(0 _ -i J ° 1 ; (WALKOUT) 1 co ` 0w L` II Q CO (n 0 r O~ , DD 0 0 Q II _ o Io °ot~ 1 GARAGE d 0 (WALKOUT) N, in r 0 to Lo PROPOSED ° ° -W o° ; N w t HOUSE " I° X CaL. / , GARAGE 1 ~ a' N O e-- - -i - ` ° pt10.33iN2 .0 PORCH 0 ~ GA RA E in 9.6 0 0 (~1033 BENCH MARK N .7 V LL ` °i O _ PROPOSED ° I TOP OF SPIKE PORCH I (1033.7) WALK DRIVEWAY r ° ELEV.=1031.84 Q 1 ~ N Q BENCH MARK J V N TOP OF SPIKE a°) / ° (1032.6 "'T- o ELEV.~1031.19 5 t ' rn 1 .4 i t t~ l 1032.0tc N D 1030.Q 4 i 5 2 . 2 031.5tc o 3-7 15 o al 1 Q N z Q Z. f u N w - II C X16', J L oLF w < 0 0 BLACK 0 M _ Q o~' •L ~t4 ~ ~ m t _ � Clty of��a� Address: 4616 Black Wolf Run Permit#: 121415 1 �� The following items were/were not completed at the Final Inspection on: �� T �� Z� � � -�n, A-d -«�, �� ,�� : " �'�° � �a t`� � ' � `; � �r ;�� i�k�'rC� m =�� < � �� '� �� '� t�1 ��.'11�� - g� �" - r ��; � �� i�.� ',��i�� ' �r� ,r ��iV'- �'a,:� ��.- ��` �ila�: ��i7�'�`. �� Final grade - 6"from siding s Permanent steps—Garage Permanent steps— Main Entry Permanent Driveway Permanent Gas ✓ Retaining Wall or 3:1 Max Slope Sod / Seeded Lawn � �Z� J��'�-=Y Trail / Curb Damage Porch � r� �`�� Lower Level Finish y„G�;�e� �� Deck � y� � j�C�L-� Fireplace � ��; � �—� �� i� • Verify with your builder that roof test caps from the plumbing system have been removed. • Turn off water supply to the outside lawn faucets before freeze potential exists. • Call the Engineering Department at (651) 675-5646 prior to working in the right-of-way or installing an irrigation system. Building Inspector: . G:\Building Inspections\FORMS\Checklists . Use BWE or BLACK Ink �----------------- � For Office Use . � � j Permit#: � �� I � 6 I � I 1� O� �� permit Fee: � � 3830 Pilot Knob Road ,, „ I I Eagan MN 55122 ""�`k' � � •�.�� Date Received: �� j � Phone:(651)675�675 I I Fax:(651)675-5694 %',x i��, �� I Staff: I I I '-------- ' - �------- 2014 RESIDENTIAL BUILDING PERMIT APPLICATION � ,��/�� l Date: ^ 2 ��i{ SiteAddress: `��CP �C.�4�-K�L� �.�--� " �unit#: . � � Name: ��'L }-��:L�Y-�T� $��N Phone: �� -� 31 Z- ��3 1� Resident/ OW 11eP Address/City/Zi p: �l��lG� Q l.s��.1L �..�i;�..� �t� �Ff(�� N S-S i 2 � Applicant is: Owner �Contractor ' � . Type Of Work Description ofwork: ��L �- Construction Cost: ' J�� Multi-Family Building: (Yes /No�) Company: T�-�c. �E�..K-- � �c�,.�... �.ci.��.' Y Contact: �'�c>R.� ��n,r��trv�l c �.� s� Contractor Address: �S i�-v i.�� S{' r..� $��,�= (�� ciry: ��'�-� ��-+-�Y _4�,z , , State:lM� Zip:S"s'IZ�-/ Phone: �iS Z-`1:3 Z Email: �r.�s^�-c�Ta-��l�r��s;r.�c.N�rt � � � p �,_�_ 3�3 S f5 - �c'� �-�fS-s" t License#: GF-��'� `-� `'�� }' Lead Certificate#: N 1 If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) �;� �`� �I� � COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months,has the City of Eagan issued a permit for a similar plan based on a master plan? " _Yes _No If yes,date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer&Water Contractor: Phone: NOTE:P/ans and supporting docum�nts that�u submit are cansidered to be publ4c information. :Portions of the information may be c/assified'as non:pc��rlic if you pro�lale speci�c reasons that wou/d permit;the Cify to conc/ude fhat the are trade secrets. - � CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground u4ility damage. Ca1148 hours before you intend to dig to receive locates of underground utilities. www.aooherstateonecall.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 State Building Code must be completed within 180 days of permit issuance. . , _ x 1��=�r' h'l.t.r.s��i rJ�� X . ApplicanYs Printed Name Applica Signature , Page 1 of 3 , � �l�l� I�l��- Z�'�/� ��i l�77�d� DO NOT WRITE BELOW THIS LINE SUB TYPES Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Family) � Single Family Garage _ Porch(4-Season) _ Exterior Alteration(Multi) _ Multi � Deck Porch(Screen/Gazebo/Pergola) Miscellaneous `� . _ 01 of_Plex _ Lower Level _ Pool _ Accessory Building WORK TYPES � � `X New _ Interior Improvement _ Siding _ Demolish Building* _r_� _ Addition _ Move Building _ Reroof _ Demolish Interior _ Alteration _ Fire Repair _ Windows _ Demolish Foundation _ Replace _ Repair _ Egress Window _ Water Dam�ge _ Retaining Wal) *Demolition of entire building—give PCA handout to applicant DESCRIPTION / Valuation �� Occupancy ��- MCES System- � Plan Review Code Edition W�S.�C SAC Units W (25%_100%�C ) Zoning D City Water Census Code Stories Booster Pump #of Units Square Feet PRV ' � #of Buildings Length Fire SprinkFers - Type of Construction y�� Width � REQUIRED INSPECTIONS � � Footings(New Building) Meter Size: . � Footings(Deck) Final/C.O. Required Footings (Addition) � Final/No C.O. Required Foundation HVAC Gas Service Test � 6as Line Air Test Roof:_Ice&Water _Final Pool:_Footings Air/Gas Tests , Final � Framing Drain Tile T Fireplace:_Rough In Air Test _Final Siding:_Stucco Lath _Stone Lath _Brick Insulation Windows � - � Sheathing Retaining Wall:_Footings_Backfill_Final Sheetrock Radon Control Fire Walls Erosion Control Braced Walls Other: - Reviewed By: ��'7 , Building Inspector � � . RESIDENTIAL FEES � Base Fee � '� `� Surchar �� t � �� ` � ge Plan Review � -- f� � MCES SAC CP �C � �� / � _ City SAC Utility Connection Charge , ,� � S$W Permit$Surcharge L' �2 . � x � � . 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