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3460 Promenade Ave Use BLUE or BLACK Ink ('1114 For Office Use ,ry I Permit#: City of EaedIl ; (� G Permit Fee: P4� -7- �"/ J 1 3830 Pilot Knob Road Eagan MN 55122 i o� /iC Phone: (651)675-5675 I Date Received: Fax: (651)675-5694 j //.,, I Staff: 0 KNIN1 2 4 2016j ------------------- 2016 COMMERCIAL BUILDING PERMIT-APPLICATION � /� Date: & - 24- 1L0 Site Address: 34,60 &vM e."o-ri F Awe � Fa rLy� lv Lrj Tenant Name: C �P V V IF MI L t t,I LA t nJ(A (Tenant is: Jt New/ Existing) Suite#: C on t'l l) Former Tenant: r4 f A r Name: Tb fin)fl C2►r1 Mehrt.l il;J imA .U CPhone: &5-1-'45 2-3 3 0� Prope , he Address/City/Zip: + 1..r o. ri # Mnl 631 Z Applicant is: Owner Contractor Type ofWo.rk Description of work: EAyucll. bt,161cC+m 51^el) to►� Yv►ed�Ca� c-l��►�G Construction Cost: , ( 46 1 g d o.oo "4 Name: GM C4aY%S+fucU0A 6M%CeS#, LLC License#: 13C 443346 Address: b��rtq--hin by- 0, 1 00 City: Eaga*i Contractor State: 1'' Zip: S51 ZZ Phone: 4,51 C-A-10 (01 j-,7q fi•5 Contact: Ci%G-d 50^cte.:y Email: C-50-v+de Name:.AYcJ t T e f+UW'0.t Uyi 5vA i y m l Registration#: Ar t/E Address: 9 01 t-J cf' In '3 rct 5+reet, 4-M City: Mi lA �ee-p0 S ' State: 14 Zip: 56 0) Phone: (o 12— '514'/43 Z Contact Person: C'ti rf5 Mue[te y' Email: CAv%\k-C 9r a c�,rc�•,c-~`��'� ' Licensed plumber installing new sewer/water service: V I i Phone M.q r I NOTE:Fans ands ""i 's 1) oe�>1af#o mforma ' n m asses;` ub ale t►�t : µ .r 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,aopherstateonecall.oro 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 w hich requires a review and approval of plans. X (!,1„cA E. 5d-V\-&4q y V)ct oet si 4*0C� x Applicant's Printed Name Applicant's Signature Page 1 of 3 DO NOT WRITE BELOW THIS LINE j SUB TYPES _ Foundation _ Public Facility _ Exterior Alteration-Apartments ✓ _ Commercial/Industrial _ Accessory Building _ Exterior Alteration-Commercial Apartments _ Greenhouse/Tent _ Exterior Alteration-Public Facility Miscellaneous Antennae WORK TYPES _✓ New _ Interior Improvement Siding _ Demolish Building* Addition _ Exterior Improvement Reroof _ Demolish Interior Alteration _ Repair Windows _ Demolish Foundation Replace _ Water Damage Fire Repair _ Retaining Wall Salon Owner Change *Demolition of entire building—give PCA handout to applicant DESCRIPTION Valuation 11 1471066 Occupancy MCES System ✓ Plan Review ✓ Code Edition 7-ca MBG SAC Units 5-L (25%_100%—V) Zoning City Water Census Code Stories l Booster Pump #of Units Q Square Feet I 2,c PRV #of Buildings / Length 42 Fire Sprinklers Type of Construction V• 13 Width 731 REQUIRED INSPECTIONS ✓ Footings(New Building) Sheetrock Footings(Deck) ✓ Final/C.O. Required Footings(Addition) Final/No C.O. Required ✓ Foundation Other: Drain Tile . Pool: Footings Air/Gas Tests _Fi�I ✓ Roof: -"'Decking ✓Insulation _Ice&Water Final Siding:_Stucco Lath _✓Stone Lath ✓Brick Framing Windows /Fireplace:_Rough In Air Test _Final �✓ Retaining Wall Insulation ✓, Erosion Control Meter Size: v' Concrete Entrance Apron Final C/O Inspection: Schedule Fire Marshal to be present: V Yes No Reviewed By: 4�4' , Building Inspector Reviewed By: 5 -" 7', , Planning COMMERCIAL FEES Base Fee y 1520V y 75Storm Sewer Trunk Surcharge 5S$.So Sewer Trunk Plan Review 1XV 4.09 Water Trunk MCES SAC 1 49' -e -v Street Lateral City SAC 55-0. aw Street S&W Permit&Surcharge /?-q. &�O Water Lateral Treatment Plant 4,312- .S"e Other: Treatment Plant(Irrigation) Park Dedication Trail Dedication Water Quality TOTAL: Z817-7,41 Page 2 of 3 MCES USE:Letter Reference: 160715A2 Address ID:705675 Payment ID:394231 Date of Determination:07/15/16 Determination Expiration:07/15/18 Greetings! Please see the determination below. Project Name: CityVue Medical Building Project Address: 3445 ProOmenade Avenue Suite#/Campus: CityVue Medical Building City Name: Eagan Applicant: Chad Sandey,CMS Construction Services, LLC Special Notes: The Council understands this building has speculative o ice. At the time the finishing permits are issued, if the use changes from its speculative use to a different use,the SAC assignment needs to be reviewed based on that change. Charge Calculation: Office(Speculative): 11,912 sq.ft. @ 2400 sq.ft./SAC=4.96 Total Charge: 4.96 Credit Calculation: none Total Credit: none Net SAC: 4.96 —or— 5 SAC Due The business information was provided to MCES by the applicant at this time. It is the City's responsibility to substantiate the business use and size at the time of the final inspection. If there is a change in use or size,a redetermination will need to be made. If you have any questions email me at:toni.janzig @metc.state.mn.us. Thank you, Toni Janzig SAC Program Technical Specialist Please visit our SAC website by going to: http://www.metrocouncil.org/Wastewater-Water/Funding-Finance/Rates-Charges/Sewer-Availability-Charge.aspx 390 Robert Street North i 1 Phone . METROPOLITAN An EoOa� 0 0 u N c I c s � � � t • i C9 Q O _ IG!�i'iCr�7i111iC�©C``�ilui�►���F.�7P_ ; . � I',�'+�1 �tirr�li V!!� f NMI ii O i I� 411 IN iii r■` ��`� fy �lftttt Nttt•� t R NNiir♦iQ\ pp ke�uv f ° : Ila sit, I oil �L ;. 1 � k _ 7 1„ Gill mil ��IhC i I w O '�lJ�C����11[J�9�Co�9l�� � I �; rtitl•: �ui{iiiiirt a o 41'. City or Eaaali 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 so) 2')ti U Use BLUE or BLACK Ink For Office Use Permit #: Permit Fee: I I Be 41 Date Received: Staff: 5gcD(.0g qui {� 2016 COMMERCIAL BUILDING PERMIT APPLICATION Date: 0 ' 1- 1 1( Site Address: 3 V -/K o ivenutai Tenant Name: d j 4 (Tenant is: New / Former Tenant: Existing) Suite #: Name:144in etAhrez /1lkd>C4L Ga/z.k. 5, tic . Phone: 6767-g/-6 2 - Address / City / Zip: JPO it f%n y,i,ti 1>e, 74E01 /W, %rI 6-6/ 2-Z- Applicant is: Owner Contractor Description of work: ,e,em t/1n1 Construction Cost: T" �i 0 00 •0 0 Name: 1 /..3 t7Un r/Lt! ci/t7IJ .cif? ✓1C�5 License #: Address: 3`f'if a )(AI!/1j WAS v City: rAigAi State: /hit) Zip: 5 6) Z Z Phone: I, 61-452-- 3340_3 Contact: "fz Sfirib Ej Email: Name: If/ 04 lel 6ijrag&nn t eabilani Registration #: )-'TZfl{ 6 - Address: / ,LL L / i I t -U9 t Woks bi24 )CL City: 1.61 -Al Peicil al— state: i —State: ill i` Zip: 6 6 3+7 Phone: 46 -2 --"hi � D Z12_ Contact Person: 1,e a / 1tpofejEmail: Licensed plumber installing new sewer/water service: /` Ai Phone #: 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. 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. Lm+ 'irwc-41\w n Sera, k ; LLQ, x cAudt. t. sa.vagi xe v,i Applicant's Printed Name Applicant's Signature Page 1 of 3 -31-16,0 erA ..n Ave-- DO v _DO NOT WRITE BELOW THIS LINE V'sz-thei SUB TYPES /Foundation ✓ Commercial / Industrial Apartments Miscellaneous WORK TYPES New Addition Alteration Replace Salon Owner Change DESCRIPTION Valuation Plan Review (25% 100%) Census Code # of Units # of Buildings Type of Construction _ Public Facility Accessory Building Greenhouse / Tent Antennae Interior Improvement _ Exterior Improvement Repair Water Damage 0/ ova Z - O V• /9 Occupancy Code Edition Zoning Stories Square Feet Length Width REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Foundation Before Backfill Drain Tile Roof: _Decking _Insulation Ice & Water _Final Framing 30 Minutes 1 Hour Fireplace: _Rough In _Air Test Final Insulation Sheetrock Windows Final CIO Inspection: Schedule Fire Marshal to be present: CSG Reviewed By: , Building Inspector _ Exterior Alteration -Apartments _ Exterior Alteration -Commercial Exterior Alteration -Public Facility Siding _ Demolish Building* Reroof _ Demolish Interior Windows _ Demolish Foundation Fire Repair ✓ Retaining Wall *Demolition of entire building — give PCA handout to applicant u ZIC A46 Z. MCES System A!A SAC Units City Water Booster Pump PRV Fire Sprinklers Final / C.O. Required Final / No C.O. Required v Other: geheir-- -1-- Pool: Footings _Air/Gas Tests _Final Siding: _Stucco Lath _Stone Lath _Brick -.7 Retaining Wall Erosion Control Concrete Entrance Apron Meter Size: Electronic Plans Required Yes ✓ No Reviewed By: •' , Planning COMMERCIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC S&W Permit & Surcharge Treatment Plant Treatment Plant (Irrigation) Park Dedication Trail Dedication Water Quality Storm Sewer Trunk Sewer Trunk Water Trunk Street Lateral Street Water Lateral Other: TOTAL: 7i / 1/ 3 • Lf/ Page 2 of 3 City of Eaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 19� c` Use BLUE or BLACK Ink For Office Use Permit#: i Permit Fee: Date Received: 9'" lG L Staff: 2016 COMMERCIAL PLUMBING PERMIT APPLICATION Please submit two (2) sets of plans with all commercial applications. Date: 9/28/16 Site Address: 3460 Promanade Ave Tenant: City Vue Medical J Suite #: Name: Town Centre Medical Building, LLC Phone: 651-452-3303 Name: Wenzel -Plymouth Plbg, LLC Address: 1959 Shawnee Rd. #130 City: Eagan Phone: Email: License #: PM061555 State: MN Zip: 55122 New _ Replacement _ Repair _ Rebuild _ Modify Space Work in R.O.W. Description of work: Shell Plbg per Plan COMMERCIAL X New Construction Modify Space Irrigation System ( yes / _ no) ( RPZ / _ PVB) • Rain sensors required on irrigation systems • Avg. GPM (2" turbo required unless smaller size allowed by Public Works) Meters Call (651) 675-5646 to verity that tests passed prior to picking up meter. Domestic: Size & Type Fire: 1 Avg. GPM High demand devices? _Yes _No Flushometers _Yes _No COMMERCIAL FEES $60.00 Permit Fee Minimum $60.00 PVB/RPZ Permit (includes State Surcharge) Surcharge = Contract Value x $0.0005 If the project valuation is over $1 million, please call for Surcharge Contract Value $18600 $ 186 _ $ 9.30 _ $ 195.30 x .01 Permit Fee Surcharge TOTAL FEE Following fees apply when installing a new lawn irrigation system Contact the City's Engineering Department, (651) 675-5646, for required fee amounts. $ Water Permit $ Treatment Plant $ Water Supply & Storage $ State Surcharge =$ TOTAL FEE CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. \ 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. xCarl Michels Applicant's Printed Name x Applicant's Signature /-,o c/7a-/6 2 Page 1 of 3 Date: Use BLUE or BLACK Ink 2016 SEWER AND WATER CONNECTION AND AVAILABILITY CHARGES EXISTING COMMERCIAL PROPERTY (if applicable) Property Owner: Address: Plumber: Phone Number: Contact Name: Sewer Service Sewer lateral charge Sewer trunk City SAC @ $110/unit MCES SAC @ $2,485/unit Receipt #: , Date: Permit Fee, including State Surcharge $65.00 TOTAL: Water Service Water lateral charge Water trunk Water supply storage Receipt #: , Date: Treatment Plant @ $862.50/unit Permit Fee, including State Surcharge $65.00 *Plumbing Permit Required — water meter to be acquired with building permit TOTAL: Sewer Service Water Service Sewer lateral charge Water lateral charge Sewer trunk Water trunk City SAC MCES SAC Receipt # , Date Water supply & storage Receipt # , Date Treatment plant Permit Fee, including State Surcharge *Plumbing Permit Required — water meter to be acquired with building permit TOTAL: $129.00 Number of SAC units is determined by the Metropolitan Council Environmental Services (651) 602-1000. Sanitary Sewer Trunk Connection Charge applies if not charged sewer trunk by assessment in the past. 1-5 SAC units 1,915.50 per SAC unit 6-10 SAC units 9,579.70 plus 445.00 per SAC unit over 5 11+ SAC units 11,980.60 plus 178.00 per SAC unit over 10 L Permit #: Permit Fee: Date Received: Staff: J Cc: City of Eagan Finance Department Page 2 of 3 City af ekoao 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Staff: e� OCT 17 2016 S,, ,c9 Use BLUE or BLACK Ink For Office Use Permit #: Permit Fee: Date Received: '31311 colo UP 2016 COMMERCIAL PLUMBING PERMIT APPLICATION I.V Please submit two (2) sets of plans with all commercial applications. Date: /10 -/7/d Site Address: &V4‘6) 6D /gyp 'o ,t/V,q p,e hi - Tenant: Suite #: Name: Town Centre Medical Building Phone: 651-452-3303 Name: Wenzel Plymouth Plbg, LLC License #: Address: 1959 Shawnee Rd City: Eagan State: MN Zip: 55122 Phone: 651-319-4137 Email: cmichels@wppmn.com .X New Replacement _ Repair _ Rebuild _ Modify Space _ Work in R.O.W. Description of work: vdAt / .?4t ✓S COMMERCIAL X New Construction Modify Space _ Irrigation System ( yes / no) ( RPZ / _ PVB) • Rain sensors required on irrigation systems • Avg. GPM (2" turbo required unless smaller size allowed by Public Works) Meters Call (651) 675-5646 to verity that tests passed prior to picking up meter. Domestic: Size & Type 1" Fire: 1 Avg. GPM High demand devices? _Yes _No Flushometers Yes No COMMERCIAL FEES $60.00 Permit Fee Minimum $60.00 PVB/RPZ Permit (includes State Surcharge) Surcharge = Contract Value x $0.0005 If the project valuation is over $1 million, please call for Surcharge Contract Value $ 28800 _ $ 288 $ 14.40 _$302.4 x .01 Permit Fee Surcharge TOTAL FEE Following fees apply when installing a new lawn irrigation system Contact the City's Engineering Department, (651) 675-5646, for required fee amounts. $ cl% Ari l $ -]t0 $ Water Supply & Storage $ State Surcharge _$ '01 TOTAL FEE CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. \ 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. x [ l AheL / eJS Applicant's Printed Name Page 1 of 3 411,1I City of Eaali 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 r Use BLUE or BLACK Ink For Office Use Permit #: 151g‘5' / g‘5 I q Permit Fee: av A Date Received: ' .-LL—"(1‘ 1 Staff: /'n'A. I II 2016 MECHANICAL PERMIT APPLICATION Please submit two (2) sets of plans withi alll c-ommercial applications. Date: // —7 ` /60 Site Address: 113Ma/t1 eiV Tenant: /14 .)We -DT E&T vOC-(' /1. Suite #: 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. xJen-I/\ 5- D E�rt-cv� Applicant's Printed Name FOR OFFICE Required In it Name: Tow n ( v -e filed, cA-1 &ad 00) 11-e. Phone: (051 -33o3 4ovm t �"_ e. X) ,C' ' U¢A.)I MA) Address / City / Zip: old WA�'1,lvCi ,. � � & Name: Joe 4 So j+- to C License #: City: i Address: 11Z- 1 Si- 5+, WeS4 .✓iT�`I State: /14A) Zip: 5535-2_ Phone: e7 5 -z- 17z.- 030 Contact r 6V'w'V> Email: pP(" Joe Gttn-ok Se3t/ S • r1 -e4 Type of A " XNew Replacement Additional Alteration Demolition Description of work )0.)k) # 5 4. Pc- IPL % < NOT • •� • i and ground mounted echa a • • rit is die m a - add Cod Pi • tact the Mechanical Inspector .® • n on perrn ype RESIDENTIAL Furnace COMMERCIAL `, 1� New Construction Interior Improvement Air Conditioner Install Piping Processed Air Exchanger V Gas Exterior HVAC Unit Heat Pump Under/Above ground Tank (_ Install / Remove) Other RESIDENTIAL FEES $60.00 Minimum Add or alteration to an existing unit, includes State includes State Surcharge Surcharge = $ TOTAL FEE $100.00 Residential New, COMMERCIAL FEES'18/ $60.00 Permit Fee Minimum i[DU I Contract Value $ D x .01 o- = $ Permit Fee $70.00 Underground tank installation/removal Surcharge = Contract Value x $0.0005 If the project valuation is over $1 million, please call for Surcharge = $ �4)Surcharge 3-3 = $ U ;-1, TOTAL FEE 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. xJen-I/\ 5- D E�rt-cv� Applicant's Printed Name FOR OFFICE Required In Use BLUE or BLACK Ink For Office Usehf ,,tt��g� ::::: ° q /Oil° Cit of Ea au � ITd" 3830 Pilot Knob Road �� 0 Eagan MN 55122 �P '''� -� Date Received: Phone: (651)675-5675 Fax: (651)675-5694 Staff: J 2016 COMMERCIAL BUILDING PERMIT APPLICATION Date: 9 - 13 ' ) IP Site Address: 34toO Prom PincLc e. A'ri6 Tenant Name: )-1 ipw s'r ENI T. 5 P�GA�t 63'S (Tenant is: )( New/ Existing) Suite#: Former Tenant: VsliA Name.1 j Cetri1tr2 Mer i at gu'.k�11 l.-L_L Phone: (te t Z-33 >3 PrOpe er Address/City/Zip: 34V kiJe1/43`�/iv IA be - 100, , IAA) 531 2-2 xti - Applicant is: Owner X_Contractor T of Work • Description of work: 1n1-er^for 6..nuini #1; 51, O'1' i)►'1ec{.iCrl.1 Cti'n YRe / (. 0 G?c c u Construction Cost: cb � Name: t.(Y1 S Cow,strIc.i o,1 5"ary 1cr y LLC License#: GC 44 33 Contractor Address: �y�C W�.yL..►..o-i}O%, 171r 100 City: ate, State: Zip: SJ` ('ZZ Phone: Co 12.. 1 ci r c6109_, Contact: L. w.4 Sokv4ci'¢.9 Email: C-5&ra F I%4 c '✓«*el' PSS" Name: tS P ArC�`t�@t4' Registration#: j Architect/Engineer Address: $4—.1 Lold O Mllwit Sr-rtes t City: KiyoNesx.to i 5 State: Zip: 44i3 -1331. Phone: (012. - 6—J—I - 11 O 0 gases,(O12'a7I;72J Contact Person: BAia."-, Hai" rtim`r Email: ba5a+,r.,inannrv+ctt�ntCC "�"SPcarC(-,.W.+-� Licensed plumber installing new sewer/water service: rs/N Phone#: 1' IA NOTE:Plans an• ® ;arming documents >�� it are con ,- ed toe,• � � i` • •° x • • the information • classified as non ublic cf you provide: fic . • °°• permit • ." - wtrade 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,gooherstateonecallorq 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. C N'5 c.v ,,n'a'1"v,+,,C-4i Cvi Sec\is b S, LLC, Q ---� x CiiAa.c4 �r 5�h�� x C Applicant's Printed Name Applicants Signature Page 1 of 3 �0 g9.0„-, j 2 qCk At/6 . DO NOT WRITE BELOW THIS LINE 7800011 SUB TYPES _ Foundation _ Public Facility _ Exterior Alteration-Apartments _VCommercial I Industrial _ Accessory Building _ Exterior Alteration-Commercial _ Apartments _ Greenhouse I Tent _ Exterior Alteration-Public Facility Miscellaneous Antennae WORK TYPES New /Interior Improvement Siding — Demolish Building* — Addition _ Exterior Improvement Reroof _ Demolish Interior Alteration _ Repair Windows _ Demolish Foundation Replace _ Water Damage Fire Repair _ Retaining Wall Salon Owner Change *Demolition of entire building-give PCA handout to applicant — DESCRIPTION Valuation / ,'gai 6O3 a . Occupancy 0 MCES System ✓ Plan Review ✓ Code Edition Za/s 11184. SAC Units 6/11-rre 1_ (25%_100% ✓) Zoning (.1 City Water ✓ Census Code Stories / Booster Pump #of Units D Square Feet /2/ 4k3 PRV / #of Buildings / Length Fire Sprinklers t/ Type of Construction a• fj Width REQUIRED INSPECTIONS Footings(New Building) ✓ Final I C.O. Required Footings(Deck) Final I No C.O. Required Footings(Addition) Other: f/,ems' 9T0PP/Nl. Foundation Foundation Before Backfill Pool:_Footings _Air/Gas Tests _Final Drain Tile Siding:_Stucco Lath _Stone Lath _Brick Roof:_Decking _Insulation _Ice&Water _Final Retaining Wall V Framing 30 Minutes 1 Hour Erosion Control Fireplace:_Rough In _Air Test _Final Concrete Entrance Apron ✓ Insulation Meter Size: ✓ Sheetrock Electronic Plans Required Windows Final CIO Inspection: Schedule Fire Marshal to be present: '/ Yes No Reviewed By: C6 , Building Inspector Reviewed By: _ , Planning COMMERCIAL FEES Water Quality Base Fee t i G71 •Ts''Storm Sewer Trunk Surcharge 5 72 •' Sewer Trunk Plan Review Ti 339• 89 Water Trunk MCES SAC Street Lateral City SAC Street S&W Permit&Surcharge Water Lateral Treatment Plant Other: Treatment Plant(Irrigation) Park Dedication Trail Dedication TOTAL: // 4"88 •G j/ Page 2 of 3 MCES USE:Letter Reference: 161010A1 Address ID:705675 Payment ID:3 / °06 Date of Determination: 10/10/16 Determination Expiration: 10/10/16 Greetings! Please see the determination below. Project Name: Midwest Ear Nose&Throat Specialties Project Address: 3460 Promenade Avenue Suite#/Campus: 100,CityVue Medical Building City Name: Eagan Applicant: Chad Sandey,CMS Construction Services, LLC Special Notes: The City will be charged no additional SAC Units for this project, as determined below. *The rules allow for this 1 net credit where SAC was actually paid to either be taken city-wide or left site-specific. Any net credits taken city-wide can only be taken if the project is reported to MCES at the time the permit is issued. Otherwise,the net credits remain site-specific. Charge Calculation: Office: 9660 sq.ft. @ 2400 sq.ft./SAC=4.03 Retail: 379 sq.ft. @ 3000 sq.ft./SAC=0.13 Total Charge: 4.16 Credit Calculation: CityVue Medical Building(SAC 08/16)=5.00 Total Credit: Net SAC: -0.84 —or— 0 SAC Due The business information was provided to MCES by the applicant at this time. It is the City's responsibility to substantiate the business use and size at the time of the final inspection. If there is a change in use or size,a redetermination will need to be made. If you have any questions email me at:toni.janzig@metc.state.mn.us. Thank you, Toni Janzig SAC Technician Please visit our SAC website by going to: http://www.metrocouncil.org/Wastewater-Water/Fu nding-Finance/Rates-Charges/Sewer-Ava ilability-Charge.aspx 390 Robert Street North St.Paul, MN 55"01 1805 Phone 651 602.1000 Fax 65" 602 1550 ! t I Y 051.29'.0904 I rnetrecounc Lorca METROPOLITAN COUNAft Eq ii )npc7rn JF7l1y` '77{)irJYt- e-- }.....•,, ? g ,,t g133",-iz !, I z r...- c_ = 4 ,1- F'. F ! i ,-2 v 2 ill s im..1 I 1 ! Li g • A Pil ,5 §L. 1 _ 10i ; 0 0 g 1 ..DI R % . 1 t. k ---- 1 ,..,.=_r_, 1 'g g4 ‘,1 2,, i ; N iEr 4 0 0 i ?; = I ku E . 08g il 8 g 5 ? 5 ; EL' ig . I e-.. 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' 1 Lu3 Zirz rl a i rr.,1 IE. .- 1 gi'l g g2 '''s `2 g D. . 1 1, O 1 !' 9 q, 2g ,1 2s if, 2 2m i t e gp lo Illoi ® g i 1 C p ��L Use BLUE or BLACK Ink For Office Use / 2 City (* Cty of E a� Permit#: Permit Fee: 6 l.�., 3 3830 Pilot Knob Road NOV 1 7 2016 Eagan MN 55122 Date Received: //`17- I t" Phone:(651)675-5675 Fax:(651)675-5694 Staff: J 2016 FIRE SUPPRESSION SYSTEMS PERMIT APPLICATION Date: (� LL Site Address: 3i'h o Pry r'"evo.a -- 40e- Tenant: t,e- Tenant: C( flY Viite..., Med(C.k,‘ R1A1 1citi 4 Suite#: Name: C.i'r s S CO1i5Tvo-i ser ces Phone: C25"1— LICA® %So3 Property Owner t S dot T - 1 OO eR art Address/City/Zip: ���® '$� ✓tv�� �+�-• , 9 i Applicant is: Owner Contractor Description of work: IUec...) sI t°1 u . .s s w (Fte.) Type of Work Construction Cost: fa� 1(00 ®l) Estimated Completion Date:_'I /RCA)__ Summit Fire Protection _ - _ 0075 --- -- - Name: License#: ' 575 Minnehaha Ave 1/1/ St. Paul Contractor Address: City: State: MN zip: 55103 Phone: 651-251-1860 Contact SLeft r I -E Email: SSe •!'r" weli'i ; CO Cow FIRE PERMIT TYPE — WORK TYPE Sprinkler System (#of heads,) New _Addition _Fire Pump _Standpipe _Alterations _Remodel Other: Other: — DESCRIPTION OF WORK: ( Commercial _Residential _Educational FEES $60.00 Permit Fee Minimum Contract Value$ iaa;1 6 0 x.01 Surcharge=Contract Value x$0.0005 =$ Ol aLI.60 Permit Fee If the project valuation is over$1 million, please call for Surcharge =$ it .ig 3 Surcharge $100.00 Residential New(includes State Surcharge) _$ 2 35.'63 TOTAL FEE 3/4" Fire Meter-$280.00 =$ a'60.00 Fire Meter =$ S'Ic. (63 TOTAL FEE **Requirements: 2 complete sets of drawings and specifications,cut sheets on materials and components to be used I hereby apply for a Fire Suppression System permit and acknowledge that the information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Minnesota Building/Fire Codes;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. x SC Cfrr yen x Applicant's Printed N e App _, • ature 1 IL / / :a}ea / :Aq pemeineu;lwJed I i l f� i4 6 :eouenssl4o suoglpuo3 i l uol;e S lea;ua� ;sal dwnd d•ul ul g5no�l Isal Melo fwelynnold of•;e}soip�ly -1 SNOI103dSNI03ZII1103I 1 _ e 3Sf130I��O�O �4t Use BLUE or BLACK Ink For Office Us RECEIVED ltio-se3_City of Eaall :::ee : 3830 Pilot Knob Road DEC 12 2016 : I Eagan MN 55122 Date Received: I2 s -- 6 Phone:(651)675-5675 Fax:(651)675-5694 Staff: '°11i 2016 COMMERCIAL PLUMBING PERMIT APPLICATION ❑ Please submit two(2)sets of plans with a I commercial applications. Date: 12/7/16 Site Address: i Promenade Ave Tenant: Midwest ENT Suite#: Property MFC Properties 6514523303 Owner Name: p Phone: Name: Cool Air Mechanical License#: 59249PM Contractor Address: 1544 134th Ave NE City: Ham Lake State: MN Zip: 55304 Phone: 612 644 3813 Email: jon@coolairmechanical.com Type of Work ' New _Replacement Repair _Rebuild _Modify Space _Work in R.O.W. Description of work: Medical vacuum piping COMMERCIAL New Construction _Modify Space Irrigation System(_yes/ no)( RPZ/_PVB) • Rain sensors required on irrigation systems Permit Type . Avg.GPM (2"turbo required unless smaller size allowed by Public Works) Meters Call(651)675-5646 to verity that tests passed prior to picking up meter. Domestic:Size&Type Fire: 1 Avg.GPM High demand devices?_Yes_No Flushometers_Yes_No COMMERCIAL FEES Contract Value$8,200.00 x.01 $60.00 Permit Fee Minimum82.00 $60.00 PVB/RPZ Permit(includes State Surcharge) _$ Permit Fee _$ 4.10 Surcharge Surcharge=Contract Value x$0.0005 86.10 If the project valuation is over$1 million,please call for Surcharge =$ TOTAL FEE Following fees apply when installing a new lawn irrigation system $ Water Permit Contact the City's Engineering Department,(651)675-5646,for required fee amounts. $ Treatment Plant $ Water Supply&Storage $ State Surcharge =$ TOTAL FEE CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. \ 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. xJon Nickelson x Applicant's Printed Name Appl' a�Signature FOR OFFICE USE - Approved By:, ='"e Date: Required Inspections: Under Ground Rough-In ` Air Test Gas Test Final PRV Required: Yes ..` No Meter Related Items: Meter Size Radio Read , Manometer Staff: Page 1 of 3 i Use BLUE or BLACK Ink in-LCt For Office Use Cityof Eaaii J� L/� Permit#: i �1 0 Permit Fee: I 3830 Pilot Knob Road DEC 0 5 2016 Eagan MN 55122 Date Received: to' 'I 1 Phone:(651)675-5675 Fax:(651)675-5694 Staff: 2016 FIRE SUPPRESSION� SYSTEMS PERMIT APPLICATION Date: I I �3o f 1_4 Site Address: 3110 k/G edr 551x3 Tenant: ►V I;d -' s4 Eh Suite#: Name: (filcACkdn 54(iyjGCS Phone: M-rys2- 3303 g / - ,77; Address/City/Zip: 3yt v toiksitI4A Dr.. S v;k r Wlld 551422 � ., Applicant is: Owner X Contractor • Description of work: '1441 reimi4.4 on tears 40 to.,fa," •+'o 4ev mall/ee 1 lu 6u4" ,4fi 4 Construction Cost: $1%, °I5 Estimated Completion Date: I.2/15/fit; Name: ✓41,-4 ComIp,.,%Cs License#: C- 63-5 // Address: 5 in,GA Ac. 41/C LA City: ' 57• Pe; 1kr State: yt✓)N Zip: _ SS!O 3 Phone: g*✓r1 r c Iv2 3a rq Contact:• c(7 ,90,ter Email: Q .� A 4tf �. +.•-t: Co(4 • to FIRE PERMIT TYPE WORK TYPE x Sprinkler System (#of heads 01) _New _Addition _Fire Pump Standpipe X Alterations Remodel Other: Other: DESCRIPTION OF WORK: X Commercial _Residential _Educational FEES Qb $60.00 Permit Fee Minimum Contract Value$ it �f 55 x.01 Surcharge=Contract Value x$0.0005 =$ I$q .q5 Permit Fee If the project valuation is over$1 million, please call for Surcharge 4 =$ ` 5 Surcharge $100.00 Residential New(includes State Surcharge) =$ 19'1 .45 TOTAL FEE 3/4"Fire Meter-$280.00 =$ rt'A Fire Meter =$ I � 45 TOTAL FEE ""Requirements:2 complete sets of drawings and specifications,cut sheets on materials and components to be used I hereby apply for a Fire Suppression System permit and acknowledge that the information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Minnesota Building/Fire Codes;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. n5 e(1 Cper/eie x ze_Ad_e Applicant's PriMited NIme Applicant's/.ignatu ' �«• k=• � j: .�k, �f i'".':�:.=w<r•.rs'bp'^,� sK,s� .u a.. FOR OFFICE USE .. ». r REQUIRED INSPECTIONS • f~l drostat�o '• Izjw Alarm Oram Tes# , i. ' Rough In "i s• t x n: .j._.fk mr.7 i < AA.y_asP'G"l1 rlp » Pump Test: 'Central Station "; , �� rte„ - t .� 7£• � _. 3� k �. Conddions of Issuance r; • ." • * . I : j y . '• ''-''f. „" ��,,: «" y.,�,„ K Lit'. y.'.•" wr'�},�`ih 4 Pe#rrt�It Re �,«, • ,�.t/ 4: f 4 Ta 'x.'�'•' _t��.t.. ,�.5 r.^�§' a» r�:-..•.•� .s5'?"+ � i c jr) c C K._ Qi....„ Use BLUE or BLACK Ink s 0/411`' 6C10 ForO fice taeX00 Cityof Eaaau Permit f ,_7 Pernnit Fee: a e-" 3830 Pilot Knob Road �—) /17 FAN 55122 RECEIVED Received: Phone:(651)575-5875 i Fax:(851)875-5324 MAR - 22017 ,fit. L a 2017 COMMERCIAL FIRE ALARM PERMIT APPLICATION Date: : h--7 Sits Acklre..: a 9 G f Pe-o 01-e.V\cti. cl°e 4 v e, - c3...vt °'I✓ ,,S 5/v ..3 Tenant: e k _( ! c ,I suite 5: j ., d - .. Name: l � t� t � �[fir,? ;'((k.1 �• ( 1 Phone: `– . Preewity ownerAddress/City/Zip: 3 I(.e fJ ir. c.."7 k i v' ,$1 0;F`" L 'cu t. b4 vi S I? lent is: Owner . Contractor Description of wort: i J`1 ,` 1'Cn..11 .0 i'Y , ,r� / 4 (x.41 C O l`1'i i- 1(, f,v`C c . 1:%�' Type of Work Construction Cost: Estimated C. •;etion Date: JIT 0 vl Name: v ck-v'. ' 4 v.K License#:— TS C)0()(0,P-77 Address: S 1 ;Si tJ LAT i c,, rQCity: k ?° Contractor State: 1 Zip: S-cS , 1 Phone: Q l `� – i r* '.ryas �. .7`J V1 V` Contest: 4 061„0,i ,e Pi, i 0 - Email: ,..i ) , i v I. c?•,._v-6,,ur;5 /4 c' u', 0 0 11,E _New _Remodel WorkTYps Addition _meter: _ Alterations DESCRIPTION OF WORK: Commercial Residential _Educational / FEES Contract Value$ /I 3 .�/..q'7x.oi $50.00 Permit Fee Minimum =$ Le tr) Permit Fee Surcharge=Contract Value x 50.0005 =$ to Surcharge* If the project valuation is over$1 million,please call for Surchargetot =$_ lit D`" "' TOTAL FEE **Requirements:2 complete sets of drawings and specifications,cut sheets on materials and components to be used I hereby apply for a Fire Alarm permit and acknowledge that the intimation is complete and accurate;that the work Will be in conformance With the ordMences and codes of the City of Eagan and with the Minnesota Building/Fire Codas;that 1 understand this is not a permit,but only en 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. x S i`ki E.- 1/A ---/Ti i Li Applicant's Printed Name cant's gnature FOR OFFICE USE Reviewed By:; /)ce-- 4.011.1..01.10111•10DOAK 3^o?'E 7 Required MspqctfOnsc Roto.in 7,i (Finid FinaAkinnTest Use BLUE or BLACK Ink For Office Use L�City of Evan � i Permit#: L , `-r' Permit Fee: 3830 Pilot Knob Road Eagan MN 55122 L`re-" 1 Date Received: Phone:(651)675-5675 \'-iii 4VY Fax:(651)675-5694 Staff: 2017 COMMERCIAL PLUMBING PERMIT APPLICATION ❑ Please submit two(2)sets of plans with all commercial applications. Date: 5115/17 Site Address: 3460 Promnade Ave Tenant: /4174c>.4✓ ,.g,VT Suite#: Property Yankee Doodle Commercial, LLC 651-452-3303 Owner Name: Phone: Name: Wenzel-Plymouth Plumbing License#: PM061555 Contractor Address: 1959 Shawnee Rd.,#130 City: Eagan State: MN Zip: 55122 Phone: 651-319-4137 Email: cmichels@wppmn.com New Replacement —Repair Rebuild V Modify Space Work in R.O.W. Type of Work;; — — — Description of work: Irrigation Water Meter COMMERCIAL New Construction Modify Space V Irrigation System( yes/_no)( RPZ/_PVB) • Rain sensors required on irrigation systems PermitType M1 ' • Avg.GPM (2"turbo required unless smaller size allowed by Public Works) Meters Call(651)675-5646 to verity that tests passed prior to picking up meter. Domestic:Size&Type Fire: 1 Avg.GPM High demand devices? Yes_No Flushometers_Yes_No COMMERCIAL FEES Contract Value$ x.01 $60.00 Permit Fee Minimum $60.00 PVB/RPZ Permit(includes State Surcharge) =$ Permit Fee =$ Surcharge Surcharge=Contract Value x$0.0005 If the project valuation is over$1 million,please call for Surcharge =$ TOTAL FEE Following fees apply when installing a new lawn irrigation system $ Water Permit Contact the City's Engineering Department,(651)675-5646,for required fee amounts. $ Treatment Plant $ Water Supply&Storage $ State Surcharge _$ 7'/ TOTAL FEE CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. \ 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 x (.�/qL x Applicant's Printed Name Applicant's Signature FOR OFFICE I SE `� AST 'a`. Ap rQV�i `. n a s Rif Required Inspections ,; ;,Under Ground Rough In _ est h Gas Test Final ' PR Required Yes No Meter Related Items Ill ter"S a Radio- eac. , tlanor eter Page 1 of 3 Use BLUE or BLACK Ink 2017 SEWER AND WATER CONNECTION AND AVAILABILITY CHARGES EXISTING COMMERCIAL PROPERTY (if applicable) OFFICE USkONLY Date: --- >; PPV"requires y Property Owner: C 1R-OWP 3rnit Address: Phone Number: 1 unty R O ermit Plumber: Contact Name: Plttr bangPert? t 7 Sewer Service Water Service Sewer lateral charge Water lateral charge Sewer trunk Water trunk City SAC @$110/unit Water supply storage MCES SAC @$2,485/unit Receipt#: , Date: Receipt#: ,Date: Treatment Plant @$891.80/unit Permit Fee,including State Surcharge $65.00 Permit Fee,including State Surcharge $65.00 TOTAL: *Plumbing Permit Required—water meter to be acquired with building permit TOTAL: Sewer Service Water Service Sewer lateral charge Water lateral charge Sewer trunk Water trunk City SAC MCES SAC Receipt# , Date Water supply&storage Receipt# , Date Treatment plant Permit Fee,including State Surcharge $129.00 *Plumbing Permit Required—water meter to be acquired with building permit TOTAL: Number of SAC units is determined by the Metropolitan Council Environmental Services(651) 602-1000. Sanitary Sewer Trunk Connection Charge applies if not charged sewer trunk by assessment in the past. 1-5 SAC units 1,980.50 per SAC unit 6-10 SAC units 9,904.90 plus 445.00 per SAC unit over 5 e-o=tteiva 11+SAC units 12,387.20 plus 178.00 per SAC unit over 10 f ;'""'o I Permit#: Permit Fee: Date Received: Staff: L Cc: City of Eagan Finance Department Page 2 of 3 Peggy Fleck From: Abby Decker Sent: Wednesday, May 10, 2017 10:50 AM To: 'Lauri Lundquist; Peggy Fleck; Brent Massmann Subject: Irrigation plans approval Address:3443 Promenade Ave (City Vue medical) Contact: Laurie 651-452-3303 LLundquist@mfcproperties.com Meter:Approved for a 3/4" meter. Housed: Housed inside building Lauri- please contact Peggy(651) 675-5675 to make sure your permit and funds are in order to have the meter distributed. Once Peggy approves that the meter is set to be disbursed You or one of your staff can come to 3419 Coachman Pt Eagan MN 55122 (Utility department) M-F 0700-1530 to pick up the meter. Thank you, Abigail N Decker Clerical Technician IV Eagan Utility Department 3419 Coachman Point Eagan, MN 55122 Phone: (651) 675-5210 Fax: (651) 675-5211 1 5LPG. Petot`r /382-05 4,1b° City of au WoMb # 37 TO: ill Hutmacher, Community Development t/Mike Ridley, Planning .arrin Bramwell, Fire Marshal cott Peterson, Building Inspections. Russ Matthys, Engineering John Gorder, Engineering /Aaron Nelson, Engineering Dave Westermayer, Engineering Leon Weiland, Engineering Joe Gibbs, Finance Jared Flewellen, Parks&Recreation On Eaton, Utilities ✓Josh Wilske, IT ./uric Macbeth,Water Resources Gregg Thompson,Water Resources Gregg Hove, Forestry Lt. Mike Fineran, Police FROM: Craig Novaczyk Date: 7/5/16 Project Name: City Vue Medical Building Sub Type,Work Type: New shell building Address: 56Promenade Ave 3460 The plans are located in the Plan Review area in Community Development. Please review and indicate any concerns you have with these plans and resolve these issues with the affected parties. If you are requesting that issuance of the building permit be held, please submit the proper"hold request"form. Please submit a response within 7 days. Comments: Indicate below any fees that are to be collected with the building permit. Amount ❑ Yes ❑ No Landscape Security Required Zoning: ❑ Yes El No Water Quality Dedication Meter Size: ❑ Yes ❑ No Park Dedication El Yes ❑ No Trail Dedication ❑ Yes ❑ No Tree Dedication ❑ Yes El No PRV Required ❑ Yes ❑ No REF Reconciliation between Engineering &Finance Signature Date G:\Building Inspections\FORMS\Commercial Bldgs Final&Plan Review Letters City of EaQall Memo # 37 TO: Jill Hutmacher, Community Development Mike Ridley, Planning Darrin Bramwell, Fire Marshal Scott Peterson, Building Inspections Russ Matthys, Engineering John Gorder, Engineering Aaron Nelson, Engineering Dave Westermayer, Engineering Leon Weiland, Engineering Joe Gibbs, Finance Jared Flewellen, Parks&Recreation Jon Eaton, Utilities Josh Wilske, IT Eric Macbeth,Water Resources Gregg Thompson, Water Resources Gregg Hove, Forestry Lt.Mike Fineran, Police FROM: Craig Novaczyk Date: 7/5/16 Project Name: City Vue Medical Building Sub Type,Work Type: New shell building Address: 3445 Promenade Ave 314 The plans are located in the Plan Review area in Community Development. Please review and indicate any concerns you have with these plans and resolve these issues with the affected parties. If you are requesting that issuance of the building permit be held, please submit the proper"hold request"form. Please submit a response within 7 days. Comments: A/ 01/N lo1/N Indicate below any fees that are to be collected with the building permit. Amount ❑ Yes ❑ No Landscape Security Required Zoning: ❑ Yes ❑ No Water Quality Dedication Meter Size: ❑ Yes ❑ No Park Dedication ❑ Yes ❑ No Trail Dedication ❑ Yes 0 No Tree Dedication ❑ Yes 0 No PRV Required ❑ Yes 0 No REF Reconciliation between Engineering& Finance 1 % _moi 7- 7- lb Signature Date G:\Building Inspections\FORMS\Commercial Bldgs Final&Plan Review Letters 411' City of EaQafi M # 37 TO: Jill Hutmacher, Community Development Mike Ridley, Planning Darrin Bramwell, Fire Marshal Scott Peterson, Building Inspections Russ Matthys, Engineering John Gorder, Engineering Aaron Nelson, Engineering Dave Westermayer, Engineering Leon Weiland, Engineering Joe Gibbs, Finance Jared Flewellen, Parks&Recreation Jon Eaton, Utilities Josh Wilske, IT Eric Macbeth,Water Resources Gregg Thompson,Water Resources Gregg Hove, Forestry Lt. Mike Fineran, Police FROM: Craig Novaczyk Date: 7/5/16 Project Name: City Vue Medical Building Sub Type,Work Type: New shell building Address:45 Promenade Ave 3,40 The plans are located in the Plan Review area in Community Development. Please review and indicate any concerns you have with these plans and resolve these issues with the affected parties. If you are requesting that issuance of the building permit be held, please submit the proper"hold request"form. Please submit a response within 7 days. Comments: Indicate below any fees that are to be collected with the building permit. Amount ❑ Yes ❑ No Landscape Security Required Zoning: ❑ Yes No Water Quality Dedication Meter Size: ❑ Yes ❑ No Park Dedication ❑ Yes ❑ No Trail Dedication ❑ Yes El No Tree Dedication ❑ Yes ❑ No PRV Required ❑ Yes ❑ No REF Reconciliation between Engineering &Finance Eric Macbeth RN'°°rEp°M°mee E4g==Pom,aC=11s Dater 20160712112004-05'00' 7/12/2016 Signature Date G:\Building Inspections\FORMS\Commercial Bldgs Final&Plan Review Letters City of EaQali Mello # 37 TO: Jill Hutmacher,Community Development Mike Ridley, Planning Darrin Bramwell, Fire Marshal Scott Peterson, Building Inspections Russ Matthys, Engineering John Gorder, Engineering Aaron Nelson, Engineering Dave Westermayer, Engineering Leon Weiland, Engineering Joe Gibbs, Finance Jared Flewellen, Parks&Recreation Jon Eaton, Utilities Josh Wilske, IT Eric Macbeth,Water Resources Gregg Thompson,Water Resources Gregg Hove, Forestry Lt. Mike Fineran, Police FROM: Craig Novaczyk Date: 7/5/16 Project Name: City Vue Medical Building Sub Type,Work Type: New shell building Address: J Promenade Ave 3444 The plans are located in the Plan Review area in Community Development. Please review and indicate any concerns you have with these plans and resolve these issues with the affected parties. If you are requesting that issuance of the building permit be held, please submit the proper"hold request"form. Please submit a response within 7 days. Comments: No comments. Indicate below any fees that are to be collected with the building permit. Amount ❑ Yes ❑ No Landscape Security Required Zoning: ❑ Yes ❑ No Water Quality Dedication Meter Size: ❑ Yes ❑ No Park Dedication ❑ Yes ❑ No Trail Dedication El Yes ❑ No Tree Dedication ❑ Yes El No PRV Required ❑ Yes ❑ No REF Reconciliation between Engineering & Finance Josh Wilske 64.).44/442016.07.11 13:16:56-05'00' Signature Date G:\Building Inspections\FORMS\Commercial Bldgs Final&Plan Review Letters 41,11116 City of Eaali Memo # 37 TO: Jill Hutmacher, Community Development Mike Ridley, Planning Darrin Bramwell, Fire Marshal Scott Peterson, Building Inspections Russ Matthys, Engineering John Gorder, Engineering Aaron Nelson, Engineering Dave Westermayer, Engineering Leon Weiland, Engineering Joe Gibbs, Finance Jared Flewellen, Parks&Recreation Jon Eaton, Utilities Josh Wilske, IT Eric Macbeth,Water Resources Gregg Thompson, Water Resources Gregg Hove, Forestry Lt. Mike Fineran, Police FROM: Craig Novaczyk Date: 7/5/16 Project Name: City Vue Medical Building Sub Type,Work Type: New shell building Address: 4445 Promenade Ave 194 D The plans are located in the Plan Review area in Community Development. Please review and indicate any concerns you have with these plans and resolve these issues with the affected parties. If you are requesting that issuance of the building permit be held, please submit the proper"hold request"form. Please submit a response within 7 days. Comments: / /' Indicate below any fees that are to be collected with the building permit. Amount ❑ Yes ❑ No Landscape Security Required Zoning: ❑ Yes ❑ No Water Quality Dedication Meter Size: ❑ Yes ❑ No Park Dedication ❑ Yes ❑ No Trail Dedication ❑ Yes 0 No Tree Dedication ❑ Yes ❑ No PRV Required ❑ Yes ❑ No REF Reconciliation between Engineering & Finance /117‘1140 Signature Date G:\Building Inspections\FORMS\Commercial Bldgs Final&Plan Review Letters 41111111 City of EaQali memo # 37 TO: Jill Hutmacher,Community Development Mike Ridley, Planning Darrin Bramwell, Fire Marshal Scott Peterson, Building Inspections Russ Matthys, Engineering John Gorder, Engineering Aaron Nelson, Engineering Dave Westermayer, Engineering Leon Weiland, Engineering Joe Gibbs, Finance Jared Flewellen, Parks&Recreation Jon Eaton, Utilities Josh Wilske, IT Eric Macbeth,Water Resources Gregg Thompson, Water Resources Gregg Hove, Forestry Lt.Mike Fineran, Police FROM: Craig Novaczyk Date: 7/5/16 Project Name: City Vue Medical Building Sub Type,Work Type: New shell building Address:-35-Promenade Ave 3314. The plans are located in the Plan Review area in Community Development. Please review and indicate any concerns you have with these plans and resolve these issues with the affected parties. If you are requesting that issuance of the building permit be held, please submit the proper"hold request"form. Please submit a response within 7 days. Comments: c'c.-M s. Indicate below any fees that are to be collected with the building permit. Amount ❑ Yes ❑ No Landscape Security Required Zoning: El Yes El No Water Quality Dedication Meter Size: El Yes El No Park Dedication El Yes ❑ No Trail Dedication ❑ Yes El No Tree Dedication El Yes No PRV Required 1:& 4, 0 No REF Reconciliation between Engineering &Finance A —1 (Dia ko E Si•nature J Date G:\Building Inspections\FORMS\Commercial Bldgs Final&Plan Review Letters **. City of Eaall Mello # 37 TO: Jill Hutmacher, Community Development Mike Ridley, Planning Darrin Bramwell, Fire Marshal Scott Peterson, Building Inspections Russ Matthys, Engineering John Corder, Engineering Aaron Nelson, Engineering Dave Westermayer, Engineering Leon Weiland, Engineering Joe Gibbs, Finance Jared Flewellen, Parks&Recreation Jon Eaton, Utilities ' Josh Wilske, IT Eric Macbeth, Water Resources Gregg Thompson, Water Resources Gregg Hove, Forestry Lt. Mike Fineran, Police FROM: Craig Novaczyk Date: 7/5/16 Project Name: City Vue Medical Building Sub Type,Work Type: New shell building Address:444€ Promenade Ave !V6 • The plans are located in the Plan Review area in Community Development. Please review and indicate any concerns you have with these plans and resolve these issues with the affected parties. If you are requesting that issuance of the building permit be held, please submit the proper"hold request"form. Please submit a response within 7 days. Comments: ( LIULA21 l ''t 01--k ..") ri -- -- tiAcAe t Pulls 'y eft P ka- MO U: .. --. Indicate below any fees that are to be collected with the building permit. Ve_vi q ( HOC Amount \ F()A.� - , Yes ❑ No Landscape Security Required ��1 5-00.06 `0,op Zoning: p ❑ Yes E No Water Quality Dedication Meter Size: ❑ Yes 'No Park Dedication ❑ Yes AI No Trail Dedication ❑ Yes ❑ No Tree Dedication ❑ Yes ❑ No PRV Required ❑ Yes El No REF Reconciliation between Engineering & Finance c (\)..kfiktit, ° '04-- -----1\Al .Vi 11(111 iLf ignature Date G:\Building Inspections\FORMS\Commercial Bldgs Final&Plan Review Letters 401' City of Eaaafl meso Jill Hutmacher, Community Development TO: Mike Ridley, Planning Dale Schoeppner, Building Inspections Scott Peterson, Building Inspections Craig Novaczyk or Mike Grannes, Building Inspections Sarah Thomas, Planning Pam Dudziak, Planning Joe Gibbs, Utility Billing Darrin Bramwell, Fire Department John Gorder, Engineering Aaron Nelson, Engineering Paul Graham, Parks Eric Macbeth, Water Resources Gregg Thompson, Water Resources Jon Eaton, Utilities FROM: Craig Novaczyk Date: 2/28/17 SUBJECT: Final Inspection for: Project Name: City Vue Medical Bldg Address: SittEMPromenade Ave The Inspections Division will be performing a final inspection at the above referenced property on 3/7/1 7 If you have cause for not granting the Certificate of Occupancy, please submit a "hold request"to my attention. The person/department requesting a hold is responsible for notifying and resolving problems with the affected parties. 411' City of Eaali memo Jill Hutmacher, Community Development TO: Mike Ridley, Planning Dale Schoeppner, Building Inspections Scott Peterson, Building Inspections Craig Novaczyk or Mike Grannes, Building Inspections Sarah Thomas, Planning Pam Dudziak, Planning Joe Gibbs, Utility Billing Darrin Bramwell, Fire Department John Corder, Engineering Aaron Nelson, Engineering Paul Graham, Parks Eric Macbeth, Water Resources Gregg Thompson, Water Resources Jon Eaton, Utilities FROM: Craig Novaczyk Date: 2/28/17 SUBJECT: Final Inspection for: Project Name: City Vue Medical Bldg Address: 3445 Promenade Ave The Inspections Division will be performing a final inspection at the above referenced property on 3/7/17 If you have cause for not granting the Certificate of Occupancy, please submit a "hold request"to my attention. The person/department requesting a hold is responsible for notifying and resolving problems with the affected parties. 1" Craig Novaczyk From: Craig Novaczyk Sent: Wednesday,July 06, 2016 8:47 AM To: Chad Sandey(CSandey@mfcproperties.com) Cc: 'cmueller@archconsort.com' Subject: Proposed shell building plans for City Vue Medical Bldg. Good morning Chad, We have started our building permit plan review for the above mentioned project. Please provide the following required submittal documents/information so that we may complete our review. A SAC determination from the Met Council. A completed Special Structural Testing& Inspection Program Summary Schedule (the submitted schedule has only two of the seven required signatures). 73- Completed Energy Code compliance documents for Btri, g-.En lepe and M�rvteeh nicer±(hvac). An Emergency Response Site Plan. Reference : http://www.cityofeagan.com/images/CommunityDevelopment/Buildinglnspections/2016Handouts/Handout E mergencyResponseSitePlanExample2016.01.pdf for an example of this required site plan. 5. Plumbing, electrical, hvac,and fire suppression plans shall be submitted with their respective permit applications Thank you in advance for your attention to these items, Craig Craig Novaczyk I Senior Building Inspector I City of Eagan401' City Hall 1 3830 Pilot Knob Road 1 Eagan,MN 55122 1(651)675-5683 1(651)675-5694(Fax)I cnovaczykAcityofeagan.com LI Iy of a a THIS COMMUNICATION MAY CONTAIN CONFIDENTIAL AND/OR OTHERWISE PROPRIETARY MATERIAL and is thus for use only by the intended recipient. If you received this in error,please contact the sender and delete the e-mail and its attachments from all computers. 1 Craig Novaczyk From: Craig Novaczyk Sent: Tuesday, July 19, 2016 7:25 AM To: Chad Sandey(CSandey@mfcproperties.com) Cc: cmueller@archconsort.com Subject: Proposed City Vue Medical Building (shell) @ 3445 Promenade Ave Good morning Chad, I have completed my Building Code plan review for the above mentioned project. Please address the following Building Code issues: //The accessible parking access aisles shall be marked with the designation " NO PARKING". Provide details showing compliance with Section 502.4.4 of the 2015 Minnesota Accessibility Code (MAC). Provide engineered details for the proposed retaining walls shown on the Site Plan.The retaining wall may be part of the overall building permit,or it may be permitted separately. Vestibules will be required per the 2015 Minnesota Energy Code. Reference Section 5.4.3.4 of the ANSI/ASJRAE//ES Standard 90.1-2010 for the requirements. 'Wall type 1 separating the fire suppression riser room from the rest of the building shall be framed to the deck, or sprinkler coverage shall extend above the ceiling for a distance of 25' in all directions as well as below the ceiling. 5. An intermediate landing will be required if the ships ladder exceeds 18' in height above the finished floor. Thank you in advance for your attention to these items. Please revise the plans accordingly, and submit the revisions for our review, Craig Craig Novaczyk I Senior Building Inspector I City of Eagan , n City Hall 13830 Pilot Knob Road I Eagan,MN 55122 1(651)675-5683 1(651)675-5694(Fax)I cnovaczvk(a�cityofeagan.com i y[t ofEkon THIS COMMUNICATION MAY CONTAIN CONFIDENTIAL AND/OR OTHERWISE PROPRIETARY MATERIAL and is thus for use only by the intended recipient. If you received this in error,please contact the sender and delete the e-mail and its attachments from all computers. 1 ( r From: Craig Novaczyk[mailto:CNovaczyk©cityofeagan.com] Sent: Tuesday,July 19, 2016 7:25 AM To: Chad Sandey Cc: cmueller@ archconsort.com Subject: Proposed City Vue Medical Building (shell) @ 3445 Promenade Ave Good morning Chad, I have completed my Building Code plan review for the above mentioned project. Please address the following Building Code issues: The accessible parking access aisles shall be marked with the designation"NO PARKING". Provide details showing compliance with Section 502.4.4 of the 2015 Minnesota Accessibility Code (MAC). Per Exception 1 to said rule,the no parking designation will be provided on the surface of the access aisle so as not to obstruct the pedestrian route. 2) Provide engineered details for the proposed retaining walls shown on the Site Plan.The retaining wall may be part of the overall building permit,or it may be permitted separately. This is typically provided by the contractor or wall supplier. +k +trvle 0`1' v%1' fiesr i`- 04p. x Vestibules will be required per the 2015 Minnesota Energy Code. Reference Section 5.4.3.4 of the ANSI/ASJRAE/IES Standard 90.1-2010 for the requirements. Vestibules would be part of the interior build out. We should communicate to RSP that Vestibules are required per the above referenced section. They show vestibules at the front doors per the last plans I have seen from them. Any entry doors opening in to a space over 1000 sf would require a vestibule. �.4." Wall type 1 separating the fire suppression riser room from the rest of the building shall be framed to the deck,or sprinkler coverage shall extend above the ceiling for a distance of 25' in all directions as well as below the ceiling. Arch Consortium will show the wall to deck. X An intermediate landing will be required if the ships ladder exceeds 18' in height above the finished floor. The ships ladder will be approximately 16' in height. No intermediate landing will be required. Thank you in advance for your attention to these items. Please revise the plans accordingly,and submit the revisions for our review, Craig MED GAS MEDICAL GAS VERIFICATION NFPA 99, 2012 Midwest ENT For: MFC Properties Eagan, MN 55122 Medical Gas Verification - 1 - MED I February 27th,2017 Cool Air Mechanical Midwest ENT Eagan, MN 55122 Re: MEDICAL PIPE GAS VERIFICATION Project ID#: 16602 Service Completed: 2-27-2017 Description of Service: David Alsop of Al Medical Gas, Inc. arrived at Midwest ENT in Eagan, MN to perform the verification of the installation of new medical vacuum source equipment, master alarm, and terminal station inlets in Procedure Room and Exam Rooms 1-14. All brazing meets NFPA standards. Brazing performed by Cool Air Mechanical. This system is considered a Category 3 facility. Zone valve boxes are not required. All testing was performed by a credentialed medical gas verifier. Thins system.t s e for patientruse uniess Otherwise i 0 It ° Al Medical Gas, Inc. is committed to providing superior services paralleled with client satisfaction. All of our services are performed thoroughly, by knowledgeable and friendly professionals in a timely manner. If at any time you feel you have received less than superb service, please call us at 1-919-227-4728. Respectfully submitted, A .e:- .4,1 :7 David Alsop Technical Director Medical Gas Verification -2- A 11 MED GAS Report Summary The following notations are brought to your attention regarding corrective action as per your Safety Compliance Management Program's policies and procedures. See Reports for Details: Reason for Verification: Location of work performed in facility: New Construction Entire Facility Note: All aspects of the Medical Gas Verification comply with NFPA 99, 2012 and other applicable standards, except where noted below: Corrective actions required: NO RECOMMENDATIONS AT THIS TIME. Definitions: Corrective Actions: Denotes items or findings that did not meet the minimum requirements as set by NFPA 99,2012 Verification Performed by: David Alsop • ASSE 6020 Medical Gas Inspector • ASSE 6030 Medical Gas Verifier • ASSE 6040 Medical Gas Maintenance Personnel Respectfully submitted, David Alsop President-Al Medical Gas, Inc. Medical Gas Verification -3 - MED GAS Recommendations Note: All aspects of the Medical Gas Certification comply with NFPA 99, 2012 and other applicable standards, except where noted below: CORRECTIVE ACTION REQUIRED: NO RECOMMENDATIONS AT THIS TIME. Medical Gas Verification -4- liMED GAS Medical Gas Inlet/Outlet Summary All aspects below are tested based on NFPA 99, 2012 4 } Procedure Room MedVac - >3.0 26 in 3 in 23 in 21 in Exam 1 MedVac - >3.0 26 in 3 in 23 in 21 in Exam 2 MedVac - >3.0 26 in 3 in 23 in 21 in Exam 3 MedVac - >3.0 26 in 3 in 23 in 21 in Exam 4 MedVac - >3.0 26 in 3 in 23 in 21 in Exam 5 MedVac - >3.0 26 in 3 in 23 in 21 in Exam 6 MedVac - >3.0 26 in 3 in 23 in 21 in Exam 7 MedVac - >3.0 26 in 3 in 23 in 21 in Exam 8 MedVac - >3.0 26 in 3 in 23 in 21 in Exam 9 MedVac - >3.0 26 in 3 in 23 in 21 in Exam 10 MedVac - >3.0 26 in 3 in 23 in 21 in Exam 11 MedVac - >3.0 26 in 3 in 23 in 21 in Exam 12 MedVac - >3.0 26 in 3 in 23 in 21 in Exam 13 MedVac - >3.0 26 in 3 in 23 in 21 in Exam 14 MedVac - >3.0 26 in 3 in 23 in 21 in *Inlets/outlets are identified on this page from left to right as entering the room. NFPA 2012 Requirements for Operational Pressure Flow Rate Minimum Requirements: 3.5 SCFM with a pressure drop of no more than 5 psig and a static pressure of 50 PSIG for oxygen, nitrous oxide,and medical air 6.0 SCFM for 3 Seconds for all Critical Care areas for oxygen, nitrous oxide, and medical air 5.0 SCFM with a pressure drop of no more than 5 psig and a static pressure of 160 PSIG for nitrogen 3.0 SCFM without reducing vacuum pressure below 12 In Hg at an adjacent Station Inlet Medical Gas Verification -5- MED GAS Medical Gas Area Alarm Summary All aspects below are tested based on NFPA 99, 2012 Nursing Medicine MedVac Line in./Hg Low Pass Pass 12 in./Hg Pass Room Medical Gas Verification -6- A 11 MED GAS Vacuum Source Equipment Facility/Hospital: Midwest ENT Vacuum Pump Inspection Check List General Data 1. Inspection date: 2-27-2017 2. Location of vacuum pump: Vacuum Pump Room 3. Facility served by vacuum pump: Entire Facility 4. Vacuum pump configuration: Simplex 5. Vacuum pump system manufacturer: Powerex 6. Vacuum pump system Model Number: I0VS030221 Serial Number: (H)01/17/17—6011103-394 7. Motor horsepower each pump: 3 8. Is the vacuum system dedicated to medical vacuum? Yes 9. When medical vacuum system is also used for laboratory use, is the laboratory connection in conformance with NFPA 99 or NFPA 99C requirement. NA 10. Are there flexible connectors on the inlet and outlet pipes? Yes 11. Are there isolation valves to permit servicing each pump? Yes 12. Are there check valves installed between pumps and receiver? Yes 13. Lead vacuum switch#1 (inches mercury): Cut-in: 20 Cut-out: 25 Lead vacuum switch#2(inches mercury): Cut-in: na Cut-out: na 14. Lag vacuum switch settings(inches mercury): Cut-in: na Cut-out: na Medical Gas Verification -7- MED GAS Vacuum Source Equipment Facility/Hospital: Midwest ENT Vacuum Pump Inspection Check List Components 15. Is there a lag alarm installed? NA 16. Functionally tested lag alarm? NA 17. Is there automatic alternation between pumps? NA 18. Are there manual electrical disconnect switches installed? Yes 19. Is the system on emergency electrical power? Yes Verified by whom? Maintenance Receiver 20. a. What is the drain type? Manual b. Is there a vacuum gauge present? Yes c. Can the receiver be isolated from the system? Yes Source Valve 21. a. Is there a source valve installed? Yes Is it properly located in the system? Yes b. Is it properly labeled for gas? Yes c. Is it labeled for areas served? Yes d. Is it labeled "DO NOT CLOSE EXCEPT IN EMERGENCY"? Yes Medical Gas Verification -8- A 11 MED GAS Vacuum Source Equipment Facility/Hospital: Midwest ENT Vacuum Pump Inspection Check List Components Vacuum Main Line Gauge and Switch 22. Is there a low vacuum alarm switch installed? Yes Is it in the proper location? Yes a. Is there a vacuum gauge visible from a standing position? Yes b. What is the vacuum gauge reading (inches mercury)? 27 In. Hg c. Is alarm connected to the master panel? Yes d. Does vacuum switch have gas specific demand check? Yes 23. Are the vacuum lines labeled properly? Yes 24. Is the correct piping used to connect all components? Yes 25. Is piping ioined by acceptable methods? Yes Exhaust 26. Does vacuum exhaust meet NFPA 99 or NFPA 99C requirements? Yes a. List exhaust location: Outside Location b. Is exhaust remote from door,window,air intake and other openings? Yes c. Is there a muffler installed in exhaust pipeline(optional)? Yes d. Is there a drip leg installed? Yes e. Is discharge protected from precipitation? Yes g. Is the discharge screened? Yes 27. Is the pump located separately from gas cylinder storage(level 1)? Yes Medical Gas Verification -9- 11 MED GAS VERIFIERS PERFORMANCE TESTING RECORD 1. STANDING PRESSURE TEST-NFPA 99,2012 Piping systems shall be subjected to a 10-minute standing pressure test at operating line pressure with Nitrogen or gas of system designation. Medical Gas System Date Tested By Pass/Fail Notes Oxygen Medical Air Nitrous Oxide Nitrogen Vacuum 2-27-2017 DA Pass Evacuation Vacuum Carbon Dioxide Nitrogen(High Pressure) 2. CROSS CONNECTION TEST—NFPA 99, 2012 After closing of walls and completion of installer performed tests, it shall be determined that no cross connections of piping systems exist. Medical Gas System Date Tested By Pass/Fail Notes Oxygen Medical Air Nitrous Oxide Nitrogen Vacuum 2-27-2017 DA Pass Evacuation Vacuum Carbon Dioxide Nitrogen(High Pressure) Medical Gas Verification - 10- A 11 MED GAS VERIFIERS PERFORMANCE TESTING RECORD 3. VALVE TEST—NFPA 99, 2012 Valve installed in each medical gas and vacuum piping system shall be tested to verify proper operation and area of control. Medical Gas System Date Tested By Pass/Fail Notes Oxygen Medical Air Nitrous Oxide Nitrogen Vacuum 2-27-2017 DA Pass Evacuation Vacuum Carbon Dioxide Nitrogen (High Pressure) 4. ALARM TEST—NFPA 99, 2012 Not Applicable Each alarm shall be tested to ensure that all components function properly prior to the system being placed into service. Please refer to Medical Gas Alarm Summary within this report. Medical Gas System Date Tested By Pass/Fail Notes Oxygen Medical Air Nitrous Oxide Nitrogen Vacuum 2-27-2017 DA Pass Evacuation Vacuum Carbon Dioxide Nitrogen (High Pressure) Medical Gas Verification - 11 - MED GAS VERIFIERS PERFORMANCE TESTING RECORD 5. PIPING PURGE TEST—NFPA 99, 2012 In order to remove any traces of particulate matter deposited in the pipelines as a result of construction, a heavy, intermittent purge of the pipeline shall be performed. The appropriate adapter shall be obtained from the facility or manufacturer and high purge rates of at least 8 SCFM shall be put on each outlet. Medical Gas System Date Tested By Pass/Fail Purge Rate Oxygen Medical Air Nitrous Oxide Nitrogen Carbon Dioxide Nitrogen(High Pressure) 6. PIPING PARTICULATE TEST—NFPA 99, 2012 A minimum of 1000 L of gas shall be filtered through a clean,white 0.45 micron filter at a minimum flow rate of 100 Ipm. 25%of the zones shall be tested, downstream of the pipeline breach, at the furthest outlet in each zone. The filter shall accrue no more than 1mg of matter. This test shall be performed with oil-free, dry nitrogen Medical Gas System Date Tested By Pass/Fail Notes Oxygen Medical Air Nitrous Oxide Nitrogen Carbon Dioxide Nitrogen (High Pressure) Medical Gas Verification - 12- MECO - GAS VERIFIERS PERFORMANCE TESTING RECORD 7. PIPING PURITY TEST—NFPA 99, 2012 For each positive pressure system, the purity of the piping system shall be verified. The test shall be for dew point, total hydrocarbons(as methane), and halogenated hydrocarbons(as methane), and halogenated hydrocarbons, and compared with the source gas. Medical Gas System Date Tested By Pass/Fail Notes Oxygen Medical Air Nitrous Oxide Nitrogen Carbon Dioxide Nitrogen(High Pressure) 8. FINAL TIE-IN TEST—NFPA 99, 2012 Each connection shall be leak tested immediately upon final tie-in by means of an approved leak solution safe for oxygen use. Operational pressure shall also be verified at this time. This test shall be performed using the gas of system designation at normal operating pressure. Medical Gas System Date Tested By Pass/Fail Test Pressure Oxygen Medical Air Nitrous Oxide Nitrogen Vacuum 2-27-2017 DA Pass Line Evacuation Vacuum Carbon Dioxide Nitrogen (High Pressure) Medical Gas Verification - 13 - A 11 MED GAS VERIFIERS PERFORMANCE TESTING RECORD 9. OPERATIONAL PRESSURE TEST—NFPA 99, 2012 Operational Pressure shall be performed at each station outlet/inlet or terminal where the user makes connections or disconnections. Please refer to the Medical Gas Inlet/Outlet Summary Page within this report. Medical Gas System Date Tested By Pass/Fail Notes Oxygen Medical Air Nitrous Oxide Nitrogen Vacuum 2-27-2017 DA Pass Evacuation Vacuum Carbon Dioxide Nitrogen (High Pressure) 10. MEDICAL GAS CONCENTRATION TEST—NFPA 2012 After purging each system with the gas of system designation, each pressure gas source and outlet shall be analyzed for concentration of gas, by volume. Analysis shall be with instruments designed to measure the specific gas dispensed. Medical Gas System Date Tested By Pass/Fail Notes Oxygen Medical Air Nitrous Oxide Nitrogen Carbon Dioxide Nitrogen(High Pressure) Medical Gas Verification - 14- MED GAS VERIFIERS PERFORMANCE TESTING RECORD 11. MEDICAL AIR PURITY TEST(Compressor System)—NFPA 99, 2012 The medical air source shall be analyzed for concentration of contaminants by volume. Sample shall be taken for the air system test at a sample point as specified in 4-3.1.1.9(j)3. Medical Gas System Date Tested By Pass/Fail Notes Medical Air 12. LABELING—NFPA 99,2012 The presence and correctness of labeling required by this standard for all components(e.g., station outlets, shutoff valves, and signal panels)shall be verified. Medical Gas System Date T By d Pass/Fail Notes Oxygen Medical Air Nitrous Oxide Nitrogen Vacuum 2-27-2017 DA Pass Evacuation Vacuum Carbon Dioxide Nitrogen(High Pressure) Medical Gas Verification - 15- MED GAS MEDICAL GAS SYSTEM INSTALLERS PERFORMANCE TESTING RECORD 1. INITIAL BLOW DOWN—Piping in Medical Gas and Vacuum distribution systems shall be blown clear by means of oil-free,dry Nitrogen NF NFPA 99,2012 Medical Gas System Date Test Performed by: Notes Oxygen Medical Air Nitrous Oxide Nitrogen Vacuum 2-27-2017 Cool Air Mechanical See Installer Report Evacuation Vacuum Carbon Dioxide Nitrogen (High Pressure) 2. INITIAL PRESSURE TEST—Before attachment of system components, but after installation of the station outlets,with test caps in place,each section of the piping system shall be subjected to a test pressure of 1.5 times the working pressure with oil-free dry nitrogen. This test pressure shall be maintained until each joint has been examined for leakage by means of soapy water or Nitrogen(High Pressure)equally effective means of leak detection safe for use with oxygen. NFPA 99,2012 Medical Gas System Date Test Performed by: Test Pressure Notes Oxygen Medical Air Nitrous Oxide Nitrogen Vacuum 2-27-2017 Cool Air Mechanical See Installer Report Evacuation Vacuum Carbon Dioxide Nitrogen(High Pressure) Medical Gas Verification - 16- A 11 MED GAS MEDICAL GAS SYSTEM INSTALLERS PERFORMANCE TESTING RECORD 3. CROSS CONNECTION TEST—It shall be determined that no cross-connection of piping system exists. The presence and correctness of labeling for all components shall also be verified at this time. NFPA 99,2012 Medical Gas System Date Test Performed by: Label Present Oxygen Medical Air Nitrous Oxide Nitrogen Vacuum 2-27-2017 Cool Air Mechanical Yes Evacuation Vacuum Carbon Dioxide Nitrogen (High Pressure) 4. PIPING PURGE TEST—The outlets in each medical gas system shall be purged using an intermittent high flow purge into a clean white cloth until no sign of discoloration is present. Purging shall start at the closest Outlet/inlet to the zone valve and completed at the farthest outlet/inlet. NFPA 99,2012 Medical Gas System Date Test Performed by: Notes Oxygen Medical Air Nitrous Oxide Nitrogen Vacuum 2-27-2017 Cool Air Mechanical See Installer Report Evacuation Vacuum Carbon Dioxide Nitrogen (High Pressure) Medical Gas Verification - 17- A 11 MED GAS MEDICAL GAS SYSTEM INSTALLERS PERFORMANCE TESTING RECORD 5. STANDING PRESSURE TEST FOR POSITIVE PRESSURE MEDICAL GAS PIPING—After all of the manufactured assemblies have been installed completely(valves,outlets, alarms), a 22-hr test using a pressure 20%above normal operating pressure shall be performed with no visible drop in pressure Nitrogen(High Pressure)than that attributed to ambient pressure. NFPA 99,2012 Medical Gas System Date Test Performed by: Test Pressure Oxygen Medical Air Nitrous Oxide Nitrogen Carbon Dioxide Nitrogen (High Pressure) 6. STANDING PRESSURE TEST FOR VACUUM PIPING—After all of the manufactured assemblies have been installed completely (valves, outlets,alarms),a 22-hr test using a pressure no less than 12 in vacuum pressure shall show no visible drop in vacuum Nitrogen(High Pressure)than that attributed to ambient pressure. NFPA 99,2012 Medical Gas System Date Test Performed by: Test Pressure Medical Vacuum 2-27-2017 Cool Air Mechanical See Installer Report Waste Anesthesia Gas Disposal Medical Gas Verification - 18- (000. N T ITM NORTHERN 6160 Carmen Avenue East Inver Grove Heights,MN 55076 P.651.389.4191 F:651.369,4190 Unearthing confidence'"" isitimmoge TECHNOLOGIES,LLC www.NTlgeo.com March 3,2017 Mr.Chad Sandey CMS Construction Services, LLC 3460 Washington Drive,Suite 100 Eagan, MN 55122 RE: Special Inspections Summary Letter City Vue Medical Building Eagan, Minnesota NTI Project No. 16.61593.200 Northern Technologies, LLC(NTI) is providing a special inspection summary letter for the above referenced project. The 2012 International Building Code(IBC)Section 1704.2.4 requires this document. NTI was present at the above referenced project,on a periodic basis according to 2012 IBC Section 1702.1, during the construction phases of the building, beginning in August, 2016. During that time NTI was present to perform special inspections, routine materials testing and site observations. CMS Construction Services'on-site representative contacted NTI and coordinated our site visits. NTI performed special inspections/observations of the construction and materials in general accordance with project specifications and as directed by CMS Construction Services'on-site representative. The special inspections performed by NTI at the project included: IBC Section Number Description 1705.2 Steel Construction 1705.3 Concrete Construction 1705.6 Soils The individual tests and observations performed during our work were submitted previously under separate cover. Refer to the individual reports for specific details and observations. It is our opinion that the work we observed to date was completed in general accordance with the project plans and specifications. ,1 Eft �� f� i: ,',f� Special Inspections Summary Letter City Vue Medical Building %%Noe Eagan, Minnesota NTI Project No. 16.61593.200 Our work was performed with the level of care ordinarily exercised under similar circumstances by other professionals practicing in the area. NTI makes no other warranty,express or implied. If you need further information or have any questions, please contact me at(651)389-4192. NORTHERN TECHNOLOGIES, LLC Curtis L.Johnson, P.E. Project Engineer/Project Manager