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4360 Andromeda WayDate: CityofEaaau 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 Use BLUE or BLACK Ink For Office Use '] 2L, Permit #: Permit Fee: Date Received: Staff: 2014 RESIDENTIAL BUILDING PERM ITAPPLICATION 22' 1 Site Address: k7LLP 0 rklapiniqtal V✓' Unit #: J Resident Owner Name: avviaw vaGv Address / City / Applicant is: Owner X Contractor Description of work: I -"-W, V 1 e/ , Construction Cost: vJ) ` 0 Multi -Family Building: (Yes / No/ ) %d �PJ e: 47jj r skyltU v��• Company: wli. v . 0-11Wt "[ 1`/O 1 Contact: �1(2 tlil Address: r/ !� tc t At/ 4 City: St Lou( f vic. State: MN Zip: 'J"J' k i l.f Phone: 02.. 410- -1221P License #: 0(0 0 \ OR Lead Certificate #: N — 1 If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) A\\A ICri vl 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: Phone: Sewer & Water Contractor: 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 onclude that they are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.orq 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. x0(70,WW1 i 1W s Applicant's Printed Name Applic?" ure Page 1 of 3 îü ûù þýýüûûúùúøû ÷üüýýöùü üï íå÷ ú ú íïíå þý ÿþýü ì ø úþýü ÷úþýü ì ü ä ùÜú ø ø íåíæüý Û óú û çò ú üú ü üúúçò úúô ô ò ü úã úçÿúê ý ú ú üÿ ç ü ê øúÿôé ú ú ú óú ÿý çôýòô ê û ëêïêíï ô÷ úòú ëêïêï ßåê óò ñð üü ì ô ñò ßú ôûú íåâúô ÷ý ôñöïïí ñöïïå ðïîïïï ò ú ÿý òòè ú ò üü òò çúô úú ú ôüýòüüÿ çñ øýç æú ê üüã úô ú ý ú INSPECTIQ CITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: I . ;iJi'Ft3ilt+11 ilfti IJA`1 tl'!; !il I;Ni , ? l`F11tR :'Nil ' PERMIT SUBTYPE: ft I I 1 I0 1 ly (i v3W .322 G!b/2Rf97 TYPE OF WORK: Fsl ff RA1'1'ON . , ' ,.; t ? V t; i:. RCt fc F i=iNAI 94 1CORD PERMIT TYPE: Permit Number: Date Issued: p 1 . .. p -4 w ? B1.0„ ? APPLICANT: ? k; ( F: ) 4 .:' h - :3 f? .! 8 Permit No. Permit Holder Date Telephone # ELECTRIC PLUMBItVG FlVAC InapecHon Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING 7 ? ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL BSMT R.I. BSMT FINAL DECK FT'G DECK FINAL CITY OF EAGAN Remarks Addition NIILDERNESS PARK 2ND ADDITION Loc 4 eIk S Parcel 10 84251 040 03 Owner,KLtuv',?n ' ,r;c?1ccE (,6,rj_ -Street 4360 Andromeda Way state Eagan, NW 55123 Improvement Date mou Annual Years Payment Receipt Date STREET SUR F. STREET RESTOR. GRADING R SAN SEW TRUNK 1973 7. t 2 107.95 A006486 8-11-78 SEWER LATERAL WATERMAIN ? WATER LATERAL * WATEFIAfiEA Q 1979 631.00 63.10 10 504.80 C005650 , * STORM SEW TRK 1979 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. tv - 71 BUILDING PER. tt SAC PARK . ? ` CASH RECEIPT ? CITY OF EAGAN 3795 PILOT KNOB ROAD EAGAN. MINNESOTA 55122 DATE 19 REC6IVED . _ ` ? FROM AMOUNT $ I 8 OOLLARS ?oo ? CASH ? CHECI{ --<- FOR f ? PUNO COOE AIdOUNT . r . - . I ,. ` ' ' ---r- - -- ` ? 7G1 I 1? ?w? I cf? S ? / Thank You= 0- , / BY ? J -2 White-Payers CopY Yellow-Posting CopY Pink-File Copy cirr oF EAcaN WATER SERVICE PERMIT 3795• Pilot Knob Road PERMIT NO.: E}gon, MN 55122 DATE: ' i /Loning: - No. of Units: Owner. Address: $ite Address: Plumber: a- Meter No.: Connection Charge: Size: _ Account Deposit: Reader No.: Permit Fee: 1 agree to eompfy with the Cify of Eogon Surcharge: Ordinunces. Misc. Charges: ? Totql: BY Date Paid: Date of Insp.: Insp.; ciTY oF EaGaN SEWER SERYICE PERMIT 3793 flilot Knob Rood PERMIT NO.: Ea jan, MN 55122 DATE: Zoning: _ No, of Units: Owner: Address: 5ite Address: Plumber. I agree to comply with the Ciry of Eagan Connection Charge: 7-Ordiaances. Accounr Deposit: By Date of Insp.: PermiY Fee: Surcharge: Misc. Chorges: - Total: Dote Paid: ? 1 t,r ` rc CITY OF EAGAN ?' • 3793 P11of Knob Rood Eegan, MN 56122 N2 5322 PHONE: 454-6100 BUILDING PERMIT Receipt # Te be ursd for Est. Value Date , 1_9 Site /Wdress Erect ? Occuponcy Lot Block Sec/Sub. Alter ? Zoning pQrcel # Repoir p, Fire Zone 0: z0 °u4 f- Eniaroe ? Type of Const. N1nr?+e Move p # Stories Address Demolish ? Front ft. City Phone Grode ? Depth fr. Nome Approvols Fees Address Assessment Permit City phone Water & Sew. Surcharge Police Plen theck Nome Fire SAC Address Eng. Water Conn. aW I City Phone Plonner Woter Meter Council I hereby ocknowledge thct I have reod this opplication and state that Bldg. Off. the information is correct and agree to comply with oll opplicable APC Totol Stote of Minnesoto Stotutes and City of Eagan Ordincnces. Signature of Pertnittee A Building Permit Is issued to: on the express condition thot all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinonces. 8uilding Officiol \ Pomk # Dah lawd ? ??nkfN Plumbing f`t Z ^ 20 -Z ?-L-k- Mechanical LS 4-4- - t 5-e.? ,1 0 9 -.2.t- INSPEGTIONS DATE INSP. Rouph-In Finol Footings Date Insp. Date Insp. Foundation Frome /lns. Plumbing Mechonical ? -c6G Final -$ Remarks: , . . CITY OF EAGAN ?-,-P ..."TIRET: 3795 Pilot Knob Road Eogon, Minnesoto 55122 Phone: 454-8100 PERMIT No. -- c?--13--79 Dote: Site Address: _ Lot Block ' Sub/Sec. 15745 Receipt No.: Single I Residential ? Multi Res., Comm./Ind. ` Name .'z'?R31 TNxkwsm L^.r. - New%Aiter./Repoir d c,x - 3 Address 235 --- Cost of Instailation O R 5( ?"'? •,?i; ?- ??- ?n City 'TV,: " Ahone: - Permit Fee ' - Name P--'1? Plbg ? Ftri 5urchorge ? E Address e 0 City Phone: Total ? This Permit is issued on the express condition thot oll work sholl be done in accordonce with all opplicable State of Minnesota Statutes ond City of Eagan Ordinances. Building Officiol cinr oF EAwN 3795 Pilot Knob Rood EagOe, MinnemM 55122 Phone: 454-8100 PII?ffi.NG PERMIT Date: Receipt No.: ? •r . r'IM?Lt2't'?3<"?. ?'';?• ing e Sife Address: Residential 3 R-r.il.<? ?-x?s ra?c ?nr' Lot Block 5ub/5ec. - Multi Res., ( C?.s? '? ro? "+-N`wn-qcn Irice 1472 No. 1E745 IX Nome New/Alter. / Repair ; Address Cost of Installotion 0 City 55024 Fl.bg. 6 Htg. 4 6?-45 Phone: Permit Fee Surcharge 20.00 .50 $ -? r• .f . ddress 2-- ' ti"_ • _.._ . . ? - City Phone: Total This Permit is issued on the express condition thot oll work sholl be done in accordonce with all appliwble Stnte of Minnesota Statutes ond City of Eogan Ordinances. Building Official V•, K? ?i Ptt ?ltt tYtg 3tt6}7Ptftlttt ;,°•- i % =a This Crrtifiratc,?istuul purtHant to tbe uquirements of Seraon 306 0f fhe Uni for+d Buiklriigi ;_. . C?e-tntifyiag thai'at the limc o/ irruana tbis structare wut in compliarue witb the'.varioier :.ordrnaruuof.°{heCuyrcgulatingbuild:ngcannructionorure. For'the following:r ?'- ? SF DN[6/GAR 5322 ? - ? . _ umcnm?unm? ?" ams-remuHo. g, V R. I,.,.. . 3' ? = zo?s w??: "Oza?una Pederson Inc Box '235rVa t n Mn ?? a.;?otemaNS naa. „_IOGn>n,..a.....,..,.AL. 1Ai....d`. :..^•T l n0 dnt4AuD .> v y„uw? CITY OF EAGAN 3795 Piloe Kno6 Raad Eagan, MN 53122 N2 5322 ' VHONE: 454-8700 BUILDING PERMIT APPLICATION Receipt # ro be uma fo.SF Dwlg & Garage Est. Volue 58,000. oare 7-23 ,1979 SiM Address 4360 Andm meda Wav Erxt [?} Occupancy R3 - i.or 4 siook 3 5el/sub. Wilderness Park 2ryAte, 0 Zon;,,g ? Parcei .# 10 84251 040 03 Repoir ? Fire Zone E l f C t T U n arge ? ype a ons . z Name OZ[[e.lIl Pede rson Inc. Move ? # Stories X Z AddressBoX 235 Demolish ? Front 70 ft. ? Cit Far[ttingtOn 550?&ne 463-4555 Gwde ? Depth 36 ft. o Nome Sdm Approvals Fees a? Address Assessment Permit 152.50 V? Water & Sew. Surcharge 29.00 Cit Phone Police Plan check 76.25 ? Fw Name Fire SAC 525.00 ?? Address Eng. ? Wofer Conn. 270.0 aw w Cit Phone Plonner o WaterMeter 60.0 Council ?• '?'?? ?S.?Q I hereby acknowledge that I have read ihis opplication and state tRat gldg. Off. the information is correct Qnd agree t comply State af Minnewto StatuYc?oncf?City?f gon with oll opplicable Ordinanwf APC l li?-87•75 Toto Signature of Permittee?K"f ?? `? r A Building Permit is issued to: OZillllil-ff SOll IRC. on the express condition thot all work shall be done in ucco elte 'th I op icable State of innesota Statutes and City of Eogon Ordinances. Buildirtg ONiciol --- / , ?,?? a?oT 3p 53aa .? CITY OF EAGA.9 Include 2 sets of plans, 1 site plan w/elevations ? BUILDING PERMIT APPLICATION 1 ,31 1 set of energy calculations. f „, (" ? To be used for e-,'?/4 /?,Valuation =6= ??? Date Site Address 41?u/) OFFICE USE ONLY Lot Block 3 Sec./Sub. Erect Occupancy Alt er 2oning Parcel 8/? p? Repair Fire Zone 3 Owner. Enlarge Type of Const. 1/ ? Move 0 Stories Address: Demolish Fron[ 70 ft. Grade Depth 36 ft. ? Phone 0: Approvals Fees I Con[ractor: Assessment 7a3 ermit lSo2 ? Address: ?dX .?'i 3 J Water/Seaer Surcharge oZ 9? Police Pl-an Check a 7 G? • Fire SAC Phone N: 45,? -3 Eng. Water Conn. ? Planner Water Meter (?p Arch/Eng.: 7/pl'/C - Council Road Unit 7S'? ? ' Bldg. Off. ? Address: APC , Phone A: ? TOTAL ° Minnesota State Board of Electricity 19544Jniversity Ave., St. Paul, Minn. 55104-Phone 645-7703 -REQUEST FOR ELECTRICAL INSPECTION CHEfK BELOW WOffK COVERED BY THIS REOUEST / 'lL R 941.90 Type oi Building New Add. Rep. Check Appliances W"ved For Check Equipment Wired Fm Home 0 ? ? Rangc 0 Tempoiaxy Wving ? Duptex ? ? ? Water Heater ? Lighting PirzW[es 19 Apt. Bldg. ? ? ? Dryer 0 Electric Heating ? Commeccial Bldg. ? ? ? Fumace [m Silo Unloadei ? Industriai Bldg. ? ? ? Air Conditioner ? Bulk Milk Tank ? Farm ? ? ? List ) List Other ? ? ? o } HeierSf Hehexs? COMPUTE INSPECT[ON FEE BELOW ?_. T? 'V' to fee "'...""' I TOTALFEI'.SQOOAS0-S0I I, the Electrical Inspector, hereby certif -that the?bdve pection has been made. u- 6-7 f" (Rough-in) cn Date q - /.i - 79 (Final) ? Date l- 3o-?f' G This request void 18 months from /?' -u!A=?,-t,Q) This request void 18 months from i?,e!; - -ye?4 R 94190 Date of this Request_9-10-79 I, as K] Licensed Electrical Contractor ? Owner, do hereby request inspection of the above electri- cal wuing installed at: WSlderness parR 2nd Addn, Street Address or Route No. 4360 AndTOIDed9 Wav-I,ot 4.B.3 City Eastan Section Township Range County DakOta Which is occupied by ()Zmun-PedeTSOn (Name af Occupant) Is a roughin inspection required on this job? No ? Yes C$ Ready Now ? Will Call od PowerSupplier 7}Etkota F',lectric Address Farmington, Mn. Electrical ContractorJEMM EIECTRIC Contractor's License No.A-35761 (COmpany Name) Mailing Address nve, W. Mn. Authorized Signature_ 7,?? ?:k. Phone No. 469-493B (Eloctrlcai Gontractor or Ownsr Makinq 7t nstallatlon) ?? ,(??`?,?[ j 2 6 O?rpj? V ??} (/'???(J This inspection request will not he accepted hy the 1? }J State Board unless praper inspection fee is enclosed. i .- ANDf?OMEL7A WRY 4 3 N ? 0o? r??? , ? -0 Z -9 z ,`A? z ? ? 1 a1 ? L ? ?. ?-- I d: ? ` 1-I , J' Lc1r 4N? - ?O4.oQ _ ? T VS r 0 Q 0 ? C: iY 6F E'Ai=F:1< ?AWK'. :I;; 1'IlRMTNAl., NO: t;a I)AfF:: OF,I24I97 '1TMl:c 1.:i,;:!.`;:(:)2 NpME: JngiFr;H J FIJNF; 3'r.?'I.q '°rp(l! 49bb ANDR(JMi=X:q", ;3'i'.25, ';.`:t; 900i 436n AR'•,RnT9Fr?A P.On Tot.'.:l R.._..cgiDt i'?n7oi.tritn 09„01n CR075;36 i..iSe-R r.D: inN E>'TF.P.IC)K ENVrLOPE AVERACE °It" C(1M1'UTA'fION -ner ?- ' Address Phone --?P?- --- --- -- -- - - ---- ---- •ga1 Description of Froperty: Lot_a,,_BlockAddition\L\IR?K Date ~/-? te Address + AVERAGE LINEAL FEET OF E?CPOSED WALL AREA AROVE GRADE iin level ].ineal ft. of framed wall above gradeV,_4 x height of wall im jcist atea Lineal ft. of rim x height of rim ,wer levei Lineal ft. of framed wall above grade L2 x height of wall A-!Q =?/?.O Lineal ft. _ ___ of masonry wall above grade_AL4to2 x height above grade3p .NF S. = 1? ?y,•C? __ TOTAL wall area above grade including windows $nd doors x "U" value Ih?Ok'S: Are a ll ll ake ? 't 6 type ' No ?r?l?l"N sq. ft. X U - sq. ft. 1 ?-?---- X - $fUl. ,? ?Q- sq. --?- .s-I x ft. 1-7 ?i ft. d l.(oS' g nU•, .4?13 ° .t.oo sq. ft. I O.c?o x i?U Q?7 sct. ft. `r!cA O x ??U sq. ft. 17_.s-?o x ?pU?? }_ 1114?i 1? S Q b s q. f t. o0 ]C nUn n n - ???h T . ,. ? S•'?S sq. ft. 3•?S x nUn _ _ , sq. ft. X llUll. - sq. ft. X "U" -- ,. u , sq. ft. ' x ?tun =. n n eq. ft. 'K nUn - sq. ft. X "Ull _- sq. ft. X _ l.u,. °. ft. ? X ?lull .? ?? --- sq, ft. x f X 'lUll _ _ AloZ?3 • 00 (L) (A) (u)(A) (tl) (A) (U) (A) (L') (A) (U) (A) (D) (A) (U) (A) (u)(A) (L') (A) (U)(A) (ll)(A) JL) (A) + (LI) (A) (L3 (A) (U)(A) ?(C) (A) (L') (A) 11, ? ?----- sq. t. i 4( , _ ulORS: Area x "U" value lake & type 1?vF $ M+?nfa?.. 1?}5??L I?z?,oos9• ft. 7?.66 x ur_•?? (U) (A) „ „ ?? ? „ _, ?r?.,., r?,? sQ. fc. r?.?2 .---X u• c??) cn) sq. ft. X (U) (A) sq. ft. X nUn = (II) (A) "??•77 z? )PAOUE WALL CONSTRUCTION; Area x"U" value sq. ft. I7n-.Zb X"tr"??? = 11,?2 (i?)(4) x L - U A sq. ft. letail refet ,W ? ? sq. ft. fc?67.o4 X U?? (A) 2nee f.rom ?g Sy, ft.-,_.?-------X "Un - (t') (AZ ittached ?,,,? a?c- 9cac sq. ft. 4. X??U•? 041 =??.?Z ?(l')(A) ?hee[s sq. ft. X nUn - (t') (A) Sq. ft. 1_f`t . O g nUll?"?= __ (U) (A) i ?4•??_ l?1,02& T''JTAL Wall Area Including ? _- - Windows & Doors --, ,r-- ' ? TOTAL (U) (A) Z'???,_. . - ..o-???---- .5? 4- Hh7'AL (U) (A) VALllF.S AVG. "U" ?_,? -- --- _ t7IVIDED $Y T'0'PAL WALL AREA AV[:RAGE "l7" Minimum .ll or less for 1& 2 family dwellings Minimum .22 or les.s for all other huildings ?? ? NoTF.: ]f average U' values as calculated above do not meet the Energv Code reauirements, the "Alernate Envelope nesign" as indicated on Page 5 may be used. , Tup View L(?'i'a: o?e l?? ,1 oyakue 11 ? -<-, xGli areu i'or_ fran,in ??y €y ceu.Lers i? Iq . a FKAMING MEMBERS IN WAI.LS Exterior air film Sidinf=...T,- _.__----•-------- ?- Sheaihing IV-2'? ? ? soft wood `-g" dr.y wall • Inte?r ,,.ior TOTAL R U = 1/R U nq ? FRAMED WALL ? .: , :. .. (2) -r a Exterior air film Siding r Sheathing ? - AW-batt insulat3on _ dry wall Interior air film R-V al ue _.._ , .17 - - -- -- . ?o / .45 68 ? 67 ,45 68 Tf1TAi R = ZZ ? ?!^ U = 1/R U = ? o?4 _ RIM_ JOIST ARLk- _ Exterior air film Siding ?i Sheathin 111" soft wood - In Interior air film r 6 [ _ ---- 1.88 ' . I n! .68 TOTAL H = 7 i U = 1/R U MASONRY WALL Exterior air film 12"_concrete block .- Insulation Interior air film .17 .?g TOTAL R = Z, • _ _.._ _ _ .. _.--- U = 1/R U = . ?r0 l • ROOF CFILING • r?-` -' ?l.9SS?7? ?F1,?11?? ?. ?? `? Outside air film .61 - `` ' - ---- - - ---------- ?Js-f -" ' -- -°---- - If?f ?:-- Insulation u )+ hV - - ? ? - - -- Drywall Interior air film II a L/H U= Outside air film Insulation 9 ? ?C? • __ _? ._ _. _ _ .45 - --- --- 61.-- - TOTAL R C? 7 'g" Drywall Iaterior a1r film .61 ??.. .45 .61 -- ---- ------ --TOTAL- R - ??.•.(n? 0=1/R U=. ?O`'? _ Outside air fi1ffi •17 Rni 1 t lip rnofjng ___ . ? i :00FfCt•:ILTNG: GTAI:-AREA: sq . Et. )etail re£erence "U" . a Z x sq. f£,?,'?b° (U) 6) ` rom above. sq. ft.,a? = ZI?Od (L')(A) lescTihe apenings "U" x sq. ft. _ (U) (A) ' . n YoOf ••II-, . X Sq. ft. _ (IJ) (A) --- , Ilull x sp. ft. Q') (A): . npn x 'Sq;.'ft.' - ,lun. x sq. ft. TOTALS sa. ft. ?C.?Z (11) (A) 'OTAL (U) (A) VAL IIES ?Z )IVIDED BY TOTAL [:UOF/ 35' _ . tjZ AVG. °li" :CILIt:f; ARF.A ?A`s? ,VEItAGE "1:" .^5 for ventilated roofs .10 for all other construction :o'CF.: lf aver:+ye "I"' va]uES as calculated above do not mee[ the Engersy Code requirements, the "Altcrnate Gnvelnpe Design" as indicated on Page 5 may he used. (3} __1t__6ITY OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 SITE ADDRESS: PERMIT PERMITTYPE: BurLorrvG PermitNumber: 030,322 Date Issued: m 6/ 2 4/ 9 7 4360 ANDROMEE3A WAY LOT: 4 BLOCK: 3 WTLDERNESS PRRK 2N0 P.I.N.: 19-84251-040-03 DESCRIPTION: REROOF B d A?f ?Permit T'ype rk Type /"Cinsu s. G od?,. ? - fi r, . SF.(MISC.) ALTERATTON, 434 ALT• RESZDENTIAL sr ? ? •? ? kc-,) . REMARKS: FEE SUMMARY: Base Fee Surcharge Total Fee i i $4,000 CONTRACTOR: - Applicant - S1'. LIC. OWNER: J J EX7ERIOR CONCEPTS 14253638 0003389 VRAA ' KEN 12579 95,TN AVE N 4360 ANDRQMEDA WAY MAPLE OROVE MN 55369 EAGAN MN (612) 425-3638 (612)454-8795 I herebyr ackfnowt_edge thatAl hsurgad t#?s ;?rplsta't3 info rma?i?v?7,:?? cs?0 r& - SCatutes _and"Citg= of'-I agatr' VAIIlATIQN $87.25 $2.00 $89.25 ??1e APPLICAN7/PEPMITEE SIGNATURE ISSUED BY: SIGNATURE . 1997 BUILDING PERMIT APPLICATION (RESIDENTIAL) j$q ?6 CITY OF EAGAN 3850 PILOT KNOB RD - 55122 B81-{675 HemodeUReoair Reauiremenb ? 3 registered site surveys ? 2 copies of plan ? 2 coples of plans (inGude beam S window saes; poured fitl. design; etc.) ? T sfte aurveys (ex[erior aECitions 8 dedcs) • 1 energy celculations ? 1 energy ealwlatlons for heated addiGOns • 8 eopiea of tree preservation pWn H lot platte0 after 7/1/93 qulred: _ Yea _ No - DATE: re _ =RSTRUCTION COST: DESCRIPTION OF WORK: G STREET ADDRESS: 'ro "t `n Ql UOA? LOT L BLOCK ? SUBD./P.I.D. Z- PROPERTY Name: ? ?' ?'? ? v '? Phone #: L( 71 le OWNER r Street Address: y? 6? ?? r.f V' r w a ?) q ? at c? City: State:Zip: ? CONTRACTOR Company: ? &S -R-'??? Phone#: ?+ r o a _ Street Address: t Z S?) C? \ S License #: City: State: Zip: ARCHITECT! Company: Phone #: ENGINEER Name: Registration #: Street Address: Ciry: State: Zip: Sewer & water licer.aed plumber (new construction onty): . Penalty applies when address change and lot change are,equested once permit is issued. I hereby acknowledge that I have read this application and state that the inTormation ' correct a?r1 agree?mply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. // Signature of Applicant: OFFICE USE ONLY Certificates of Sunrey Received _ Yes _ No Tree Preservation Plan Received - Yes _ No _ Not Required OFFICE USE ONLY BUILDING PERMIT TYPE 0 01 Foundation ? 06 Dupiex ? 11 Apt./Lodging ? 0 02 SF Dwelling o 07 4-plex o 12 Multi Repair/Rem. ? ? 03 SF Addition o 08 8-plex n 13 Garage/Accessory o ? 04 SF Porch o 09 12-plex o 14 Fireplace n 0 05 SF Misc. 0 10 _-plex o 15 Deck WORK TYPE a 31 New o 33 Alterations o 36 Move ? 32 Addition o 34 Repair ? 37 Demolition GENERAL INFORMATION Const. (Actuai) (Allowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS Planning 16 Basement Finish 17 5wim Pool 20 Public Facility 21 Miscellaneous _ Basement sq. ft. MC/WS System _ Main level sq. ft. City Water _ sq. ft. Fire Sprinklered _ sq. ft. PRV _ sq. ft. Booster Pump _ sq. ft. Census Code. _ Footprint sq. ft. SAC Code Census Bldg Census Unit Building Engineering Variance Permit Fee Surcharge Plan Review License MCNVS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit SNV Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies Total: Valuation: $ % SAC SAC UnRs ??(,a 4cl/ 2004 RESIDENTIAL MECHAIVICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for: single family dwellings & townhomes/condos when permits are required for each unit ,36 - S-Z) C'??CC. Date D J / r2o Site Address '73 (ao Rn dr o med b Unit # Pro ert Owner r Telephone #(?? )!V,511- 91791 p y ConMactor / Ot ? • Cit Jl? SVeetAddress y ... St t (( 1 IV • -5?& Telephone# (YJ5') 0" O Zi a e p Bond #• Expires: The Applicant is _ Owner -?-Cbntractor _ Other Add-on or altera[ion to existing dwelling unit l ment Additi l ? -f k $ 30.00 urnace c - ona p ace _ air exchanger air conditioner _New _Replacement other U ? statesnrcharge ? SEP 2 3 2004 $ so u By $ C30 ISV Total I hereby apply for a Residential Mechanical Perntit and acknowledge that th : ormati n is complete and accurate; that the work will be ' ormance with the rdinances and codes of the City of Eagan an wrth the chanical Codes; that I understand tlils is not a ernut, b only an applicatioon For a pemut, and work is not to start wi e't; that the wor be in ccordanc with the app jov plan in the case?efw?prk ?hich ryquire?s a review and approval of plans. ? _ ? ? ? A ?v 2004 COMMERCIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for. commercial/industrial 6uildings multi-family 6uildings when separa[e permits are not required for each dwelling unit Date Site Street Address Unit # Tenant Name (if applicable) Previous Tenant Name Property Owner Telephone # ( ) Contractor Stree[ Address City State Zip Telephone # ( ) Bond #: Expires: The Applecant is _ Ov+ner _ Contractor ` Other Work Type New Construction _ Underground Tank _ Install _Remove'"see below Interior Improvement _ Install Piping _ Processed _Gas Nature of Work: *'When installing/removing underground tank, call for inspection by Fire Marshal and Plumbing Inspector Permit Fees: $70.50 Underground tank ins[allatioNremoval $50.50 Minimum (includes State Surchazge) or ContractValue $ x 1% PermitFee • If perrttit fee is $1,000 or less, add $.50 => $ State Surchazge If permit fee is over $1,000, add $.50 for every $1,000 ne rmit fee $ Total Fee 1 hereby apply Yor a Commercial Mechanical 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 Mechanical 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. Applicant's Printed Name Applicant's Signature Approved By: , Inspector :? ( I 00 2005 RESIDENTIAL BUILDING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New ConsWCtion ReauiremenGS RemodellReoair Reouirements Office Use Onlv 3 registered site surveys showing sq. ft. of lot, sq. ft of house; and all roofed areas 2 wpies of plan Cert of Suney Recd _ Y_ N (20% maximum lot coverage allowed) 1 set of Energy Celculadons (or heated additions Tree Pres Plan Recd _Y _ N, 2 copies of plan showing beam 8 window sizes; poured found design, etc. 1 site survey tor additions & decks Tree Pres Required _ Y_ N lsetaFEnergyCalculations Addrtion-indicafeilon-sttesepG'csystem On-siteSeptic5ystem _Y _N 3 cropies of Tree Preservation Plan'rf lot platled after 711193 Rim Joisl Detail Optbns selection sheet (buildings with 3 orless umts) Date -Z,2_//2/ 6 S Canstruction Cost Site Address 6 19 __ r&pt?Z; Md q 04 y UniUSte # Description of Work ZLA Multi-Family Bldg _ Y?' N n i 1r? i Fireplace(s) _ 0 _ 1 _ 2 l? '`= r9 l? /1 ? l/ i,/ n., A vTc 4G c 1.' "l! A ????1 ?I III? PropertyOwner , ?ui t ? Telephane#( ) Contractor 6CC KlVhlY L.X?C? i'of5 ?C?i Address C2?3/ Godc?v; eW ?v ? y 5. City CA 4A 5c ?T Z?`e State Zip 916 Telephone#( ESI) HSY Saaa 2A Lt64S3H COMPLETE THIS AItEA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672 Energy Code Category , Residential Ventilation Category 7 Worksheet • New Energy Code Worksheel (Jsubmissiontype) Submitted Su6mitted • Energy Envelope Calculations Submifted In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master planZ _ Y _ N If yes, date and address of master plan: Licensed Plumber Mechanical Contractor Sewer/Water Contractor Telephone #( Telephone #( ? Telephone #( I hereby apply for a Residential Building 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 the State of MN Statutes; I understand tkus 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 requues a review and approval of plans. ?? ?r 61,0K(v)d Applicant's Printed Name Applic n ignature OFFICE USE ONLY Sub Types ? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? OB OB-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garege ? 22 Porch/Addn. (4-sea.) ? 33 Eut. Alt - SF ? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screenlgazebo) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 LowerLevel ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous Work Types ? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding ? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 Alteration ? 37 Demolish Building` ? 43 Reroof ? 46 Windows/Doors ? 34 RepleCement •Demolition (En[ire Bldg) - Give PCA handout to appliwnt Valuation Occupancy MCES System Plan Review 100% or 25% Census Code Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const Width _ Footings (new bldg) _ Footings (deck) _ Footings (addition) Foundation Drain Tile Roof Ice & Water Final _ Framing _ Fireplace _ A.I. _ Air Test _ Final Insulation REQUIRED INSPECTIONS _ FinaUC.O. _ FinaUNo C.O. _ Plumbing HVAC Other _ Pool _ Ftgs _ AidGas Tests Final _ Siding _ Stucco _ Stone _ Brick _ Windows _ Re[aining Wall Approved By: , Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total PERMIT City of Eagan Permit Type:Building Permit Number:EA156596 Date Issued:07/09/2019 Permit Category:ePermit Site Address: 4360 Andromeda Way Lot:004 Block: 003 Addition: Wilderness Park 2nd PID:10-84251-03-040 Use: Description: Sub Type:Reroof Work Type:Replace Description:Includes Skylight Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State Building Code). Valuation: 5,000.00 Fee Summary:BL - Base Fee $5K $118.00 0801.4085 Surcharge - Based on Valuation $5K $2.50 9001.2195 $120.50 Total: 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. Contractor:Owner:- Applicant - Russel T Otzenberger 4360 Andromeda Way Eagan MN 55123 All Season Remodeling & Exteriors Llc 17344 Puma Street NW Anoka MN 55303 (763) 444-1373 Applicant/Permitee: Signature Issued By: Signature