EA180959 - Building - Single Fam - Issued Date 01/13/2023 PERMIT
City of Eagan Permit Type: Building
3830 Pilot Knob Rd '.' % ®.' Permit Number: EA180959
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Eagan,MN 55122 •-•- •--• EAGAN
(651)675-5675
www.cityofeagan.com * E R 1 8 0 9 S 9 *
Date Issued: 1/13/2023
Site Address: 3939 Thames Ave
Lot: 21 Block: 3 Addition: Coventry Pass
PID: 10-18400-03-210
Use: * 10 — 18400 - 03 — Z 10 *
Description:
Sub Type: Single Fam Construction Type: V-B
Work Type: Alteration
Description: Bathroom Remodel
Census Code: 434-Residential Additions,Alterations Occupancy: IRC-1
Zoning: R-1
Square Feet: 0
Comments: Improvements to the home may require smoke detectors in all bedrooms.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes(Minnesota
State Building Code).
Fee Summary: BL-Base Fee $83.50 0801.4085
Valuation: 2,000.00 BL-Plan Review 65% $54.28 0720.4222
Surcharge-Based on Valuation $1.00 9001.2195
Total: $138.78
Contractor: - Applicant - Owner:
Minnesota Rusco Louis E&Judith A Gibbons
5010 Hwy 169 N 3939 Thames Ave
Brooklyn Park MN 55428 Saint Paul MN 55123--390
(952)935-9669
This permit shall be null and void if work does not start within 180 days of issuance,or if work is suspended for 180 days or more after
started.
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Applicant/Permitee: Signature ssued B . Signature
Ills
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r For office use
I Building Permit#:
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EAGAN #:
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Permit Fee:*Ise.
3830 PILOT KNOB ROAD I EAGAN,MN 55122-1810 EC ��Pty~ 1 Date Received: I
(651)675-5675 1 FAX: (651)675-5694 1 Date Issued: 1
build inainsoectionscMci ofea ag n.com JAN I________________
RESIDENTIAL BUILD APPLICATION
Date: 1/12/23 Site Address: 3939 Thames Ave Eagan, MN 55123 ` Unit#:
Applicant is: ❑ Owner 14 Contractor
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Name: Judith Gibbons
Homeowner Address: 3939 Thames Ave City: Eagan
State: MN Z; : 55123 phone: 651-687-0660 Email: bagboy66@comcast.net
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Description of work:
Type of $10,803.00
Work Construction Cost:
Type of building: 14 Single Family ❑Townhome, of units ❑ Twin Home
Company: MN Rusco Contact: Kelli Gugisberg
Building Address: 5010 Hwy 169 N City: New Hope
Contractor MN 55428 952-935-9660 kelli@minnesotarusco.com
State: Zip. Phone: Email.
License#: CR002173 Expiration Date: 3/31/24
Se*r Company: Contact:
Water
Contractor Address: City:
Required for State: Zip: Phone: Email:
new construction
License#: Expiration Date:
1 understand that Plumbing, Mechanical, and Fire Suppression work require separate applications.
NOTE:Plans and supporting documents that you submit are considered to be public information. Portions of the
Information Wray be classified as hors-public If you' provide specific reasons that would permit the City to conciude that they
are trade secrets.
CALL BEFORE YOU DIG. Contact Gopher State One Call at(651)454-0002 or www.aooherstateonecall.om for protection against underground utility
damage. Contact Gopher State One 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.
x Kell! Gugisberg x Ke• 0uR4&
Applicant's Printed Name Applicant's VbnaWure
FOR OFFICE'USE QNLI
Site Address: 3939 Thames Ave Eagan, MN 55123 Permit#: /670?ST
SUB TYPES
(Single Family _ Fireplace _ Lower Level
01 of Plex _ Foundation _ Porch
Deck _ Garage _ Pool
WORK TYPES
New _ Repair _ Siding _ Retaining Wall
_ Addition _ Fire Repair _ Reroof _ Move Building
_✓Alteratlon _ Water Damage _ Windows _ Demolish Building*
Replace _ Egress Window _ Solar *Demolition of entire building-give PCA
handout to applicant
DESCRIPTION
Calculated Valuation dim Occupancy Vie-\ MCES System
Plan Review 132511gA 100% Code Edition !`INRC-Q e;Q0 SAC Units
Census Code Zoning 12- l City Water
#of Units Stories Booster Pump
#of Buildings Square Feet PRV
Type of Construction YZ Fire Suppression Required
Separate Stormwater Management Permit Required
REQUIRED INSPECTIONS
Footings: New Addition Deck Meter Size:
Foundation: Before Backfill Poured Wali Siding:_Stucco Lath _Stone Lath _Brick
✓ Framing: 1 Hour Residential Alteration Roof:_Ice&Water _Final
Braced Wall Framing/Blocking Erosion Control
Braced Wall Sheathing(prior to house wrap) Pool:_Footings Air/Gas Tests _Final
Interior Braced Wall Panel(s) Retaining Wall:_Footings_Backfill_Final
Firewalls Fire Suppression:_Rough In_Final
Insulation Windows
Fireplace:_Rough In Air Test _Final Other:
HVAC: Rough In Final
Radon Control ✓Final/No C.O.Required
Drain Tile Final/C.O.Required
Reviewed By: -S-.Ale ka-. , Building Inspector t
FEES `ne C.e,nn ade.\
Calculated Valuation 2,
Base Fee
Plan Review
State Surcharge
Met Council SAC
City SAC
Treatment Plant
Water Supply&Storage
S&W Permit&Surcharge
Meter
Radio Read
Other:
TOTAL $ 0.00