The URL can be used to link to this page

3218 Black Oak DrAddress 3218 Black Oak Drive Lot 10 Blk 1 Sub Orchard Heights Zip 5512 1 THESE TTEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION. Date: Yes No Inspector: Final grade (6" from siding) ? Permanent steps (gazage) j? Permanent steps (main entry) Permanent driveway Permanent gas ? Sod/Seeded grass Trail/cutb damage x Porch Basement finish i Deck K Please verify with the builder the removal of roof test caps from the plumbing system and the shut-off of water supply to the outside lawn faucet before freeze potential exists. Contact engineering division at 6814645 before working in right-0f-way or installing underground sprinkler system. White - City Copy Yellow - Resident Copy Pink - Contractor Copy w APPLIANCE PERFORMANCE TEST Locate near the furnace manual LP Gas Natural Gas ? JobAddress 37 / ?g ?61,z cJ-Z-- e5. % Heating Contractor Name of Tester J-- Rate 7-9- 0 E-- Percent 02 7 d? ? Percent CO o T? Percent COz Stack Temp. //S" ° ,. Pressure 3 • S C."c- White - City Copy Tag - Site Copy Y • ? ?? ?? ?E r,aL 7 BUILDING PERIYIIT qPPLICATIOly ciTr oR ea"N 3830 P14;OT Klypg RD - 55122 ??? ?GIr t?, 651-d81-467s jr? ?? c??n Reauirsmenc¦ ( • 3 re9aterW site surveya showing sq• fL of K ? ? (20°K ma?imwn lot coverage allo?wo ?• ?' bta '???9Y ?cul?Yor & wlndow sizes; Pmed btaid desipn, e1c,) ' 3 copies d Tree Preseryahan Plan i( bt p1?W a* 7/1/93 • Rim Joisi Detail Oplions selec? 0" (pWp wNh 3 or tess unils) OATE /1-0 JOB SITE ? P- 53b?? g? -- Vzi o Mp`, 1 47;1 q • 2 oapiea a1 piin • 1 aet of EnetW CgmWpa fOt be6Aud ad?fOris .' :• tskswveqlbceavioradddonsddeda 9•r?-o? ON (EXCLUOING !`AND) ?• ` ? . IF MULTI-FAMILY BUILDING, HOW MANY NlTS? PROPERTY OWNER TYPE OF WORK APPUCANT FIREPIACE(S) ? 1fES _ NO ?S PHaI+IE f PAGER # cE« PHONe # _ ?/Z 70I 19f?D FAx # f?._????? .,? IVt1V RESIDENTIAL BUILDING C3N ,Y - Fttl OUT Cp1?7V'-'-- - Ene?gy Envelope Calculaati?o ?Se?tsdheet 3tt g MINNF-SOTA Energy Coda Category MINNESOTA RUI.ES 7670 CA (check one) R e s i d e n tia l Ven t Na? On Cat89?Y T?'?RY 1 ULFS 7672 gy ? , -New EneMy code worksneet s?mnted - Plumbtng Contractor: Plumbing System Includes. Phone Water Softener ?? Sprinkler Fee: Water Heater l? No. of R.I. Batb,c $?-? 4? No. of BathS Mechcnical Conttactor. Mechanica! System Includes: w Air ?????, Phono # ?? ?? ???•? ? ?; Heat Recovery System Fee: $70, 1 Sewer/Woter Contractor, " Phono All above informadon must be submitted prior to processing of application. I hereby acknowledge that I have read this opplication, state that the infrormafian is eorrect, an all aPPlicable State of Minnesota Statutes and City of Eagan Ordinances. d?#o c ?? ?? Slgnature of AppNcant Certificates of Survey Received ? Tree Preservatlon Plan Reoeived IVot Requkicl .' ? ? :?x ? tipdaeed trol QFFICE' USE DNLY p? 20 Pbol ? 30 ?? ?9 ? 01 FoundaUon 0 07 05-plex O 13 16-plex 0 21 ?h t??a.' p 31 Cxt. ? 02 SF Dwelling ? 08 06-plex 0 16 Fireplace '? 33 Ex?. ?1K • SF p 22 Porch/A?ddn. (4?.•1 p 03 01 of _ P?x ?? OT•plex ? 17 Gerege Q 23 ?? (??) O 36 Multj Cj 04 02-plex ? 10 08-plex 0 78 ?3edc - ? 11 10-Plex O 18 t.awer Levet O 24 St°rm Damage 0 05 03-piex P.?bQ Y or _ N O25 ?0?0? -plex p 06 04-plex O 12 12 p 38 DertxoiWh (IntWbr) ' C7 . 44 SicOn9 31 New 0 35 Int Improvement ? Sklg. C] 42 Demofth (Fawfatbn) 0 45 Fire Repair t? O 36 Move ? 32 Add'Rion - O 48 :? Wind? ? 33 Alterabon ;? 37 Demoli? 4?9)` O 43 Reroof ' , w. , ? . *OemdliUo?? (Entiro BWga+h?) ,t;hr*PCahandoutbo?u ? 34 ReplacemeM '. s •?: ? - i .MC/ES SyStem? Valuatlon ZoniFtg C?y ? .----.--- Census Code j scorias _?- ' ?'?np ?- ?• ?V ; . ?! ?; i ? SAC Untts Nbr. of Wtft" ?-? S4 Ft. ? Fire Sprinklered - - Nbr. 0?.:81d9s _-? ? . ?d -? j ? Width Type of Const !? "!V REt1UlREID iNSPEGTIQN3 ? Footings (new bldg) ? Footinga(deck) Footings (additton) Foundation prain Tile Roof _ e & Water Final -t Ic ? Framing ? Fircplace RI. ,?Air Test ??1 ?o Insulation -. ? . r Final/C.O. FiaaUNo C.O. ? Ptumbing , ? HVAC - Othar Pool Ftgs _ Atr/Gas Tests _ Fiaal r Siding Stuceo SWne ^ Windows{newlrejsl*fe;W=t)y vt qPPKye'd e'y r,. Buildin9 Inspec%ta' - Base Fee SUfChatoi,b,. . ? . Plac? Review MC/ES SAC City SaC ' . ` , Water Supply & Storage S8W Permit & Surcharge Treatment Plant Plumbing Permit Mechanicai Permit License Search Copies Other ... 11 ?--- " . « IS F3 r-io? S?- s, ? Total . ? . MNcheck COMPLIANCE REPORT Minnesata Energy Code MNcheck Software Versian 3.0 COUNTY: Hennepin STATE: Minnesata ZONE: 2 CONSTRUCTION TYPE: Single Family DATE: 9-11-2001 COMPLIANCE: PASSES Required UA - 538 Your Home = 531 1.41 Better Than Code Permit # Checked by/Date Area or Cavity Cont. Glazing/Doar Perimeter R--Value R-Value U-Value -------------------------------------------_-----------------_--_- ------------ CEILINGS: Raised Truss 1685 44.0 0.0 WALLS: Wood Frame, 16" O.C. 582 19.0 2.4 WALLS: Wood Frame, 16" O.C. 1522 19.0 2.0 WALLS: Wood Frame, 16" O.C. 1121 19.0 2.0 BSMT: Conc. 8.8' ht/8.2' bg/8.81 insul 1077 10.0 0.0 GLAZING: Windows or Daors, Above Grade 143 0.350 1 GLAZING: Windows or Daors, Above Grade 318 0.350 GLAZING: Windows ar poors, Above Grade 207 0.350 DQORS 42 0.350 ---------------------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specificatians, and other calculatians submitted with the p it application. The proposed building has been designed to meet t reqttir me s of the Minnesota Energy Code. Builder/Designer Dat !'//-d / Minnesota Energy Code MNcheck 5oftware Version 3.0 DATE: 9-11-2001 PLAN REVIEW AND INSPECTION ISSUES This list of items may he helpful for Plan Reviewers and Building Inspector use as a guide for enforcing the Minnesota Energy Code. The items apply to Graup R, Division 3 Occupancies, one- and two-family residential dwellings. The items marked with * apply only to detached one- and two-family residential dwellings. PLAN REVIEW TSSUES FOUNDATION INSULATION - foundation wa11 insulation R-5 minimum - foundation insulatzan extends from top of wall down to top of the footin - exterior foundation insulation is eavered by a protective coating finish CONCRETE SLAB OR UNDER-SLAB INSULATIQN - slab on grade perimeter insulation R-5 minimum - slab insulatian extends from top of slab to design frost Iine or top of faoting - flaors aver unheated space R-30 minimum WINDOWS / DOORS / SKYLTGHTS - average U-value is 0.37 maximum for windows and glass doors (excludes foundation windows) - window U-value eonsistent with buil.ding plan and MNcheck Report - window and door area consistent with building plan and MNcheck Regort MECHANICAL VENTILATIQN ISSUES - residential mechanical ventilation system provides adequate ventilation per code requirements* -furnace efficiency is consistent with MNcheck or buildzng design plan - protection against excessive depressurization is installed per code requirements* EIWELOPE INSULATION FOR PLAN REVIEW - interior basement insulation R-5 minirnum (if na exterior insulation) - ceilings with attics R-38 or consistent with building plan and MNcheck Report - wall framing and insulation level is consistent with building design and MNcheck Report INSPECTION ISSUES CONCEALED INSULATION FRAMING AND SHEATHING - wind wash barrier installecl at attic edge - exteriar wall corners framed so that insulation can be installed after exteriar sheathing is installed - iantersections of interior partition walls and exterior walls are frame that insulation can be installed between the partitivn and extera.ar sheathing after exterior sheathing is installed - gaps between framing less than one-half inch are eliminated by securin framing together or are insulated at the time of assembly - all penetratians batween conditioned and unconditiozzed spaces macle priar to faraming inspection are sealed ? INTERIaR AIR BARRIER -all fire staps are air sealed - gipes, ducts, wires, equipment and flues and chimneys through the inte air barrier are sealed - a sealed continuous interior air barrier is installed on the warm side the building envelope at ceilings, walls, and floor rim joist areas* - air barrier behind tub and shower is sealed and protected - recessEd light fixtures are seal.ed ENVELOAE TNSULATION - basement insulatian R-5 minimum - wind wash barrier on wall separating house and garage is sealed - loose fill insulation is prevented from entering the eaves - insul.ation on skyl.ight shatts and walls exposed in attics is supported on the unconditioned side ATTIC INSULATION - attic access panei insulated to R-38 for ceiling panel and R-19 for wall pane2 - attic card attached ta framing near access opening - notification of attic R--value and date of installation pasted near permit inspectian card This is a summary only. Other requirements may apply. See the Minnesota Energy Code. Questions? Call the Department of Public Service Information Center at 651-295-5175 or 1-800-657--3710. F, m ? c m t U Y ¢ ? O z Q [?'/ ? ? ? ? rs? p ? ? Q// ? ? [9?/ ? ? C?}' ? ? ?? ? 1+7/? ? [?? ? C3?/ ? ? C9' ? ? ?? ? LOT SURVEY CHECKLIST FOR RESIDENTIAL r BUILDING PERMIT APPLICATION / RROPERTYLEGAL: L-I` /P BIP,•,K DATE OF SURVEY: LATEST REVISION: DOCUMENT STANDARDS • Registered Land Surveyor signature and company • Buiiding Permit Applicant • Legal description • Address • North arrow and scale • House type (rambler, walkout, split w/o, spiit entry, lookout, etc.) • Directional drainage arrows with slope/gradient % • Proposed/existing sewer and water senrices & invert elevation • Street name • Driveway • Lot Square Footage • Lot Corerage • Benchmark ELEVATIONS Existina ?Y ? ? • Sewer service (or Praposed) ? ? ? . Property comers ?I/ ?? • Top of curb at the driveway and property line extensions r? o/U • Elevations of any existing adjacent homes ?[?' ? • Adequate footing depth of structures due to adjacent utllity trenches ? u/ 0 • Waterways (pond, stream, etc.) Pronosed ? ? • Garage floor ? o ? • First floor ? ? ? • lowest exposed elevation (walkout/window) ? O ? • Property comers ?? ? • Front and rear of home at the foundation PONDING AREA (if applicabfe) ? ? • Easement I'ine ? d 0 • NWL 11 C? ? • HWL ? C?jt7 • Pond # designation ? ?? ? • Emergency Overflow Elevation - S h •- DIMENSIONS [Y ? ? • Lot Iines/Bearings & dimensions ?? • Right-of-way and street width (to back of curb) v? n • Proposed home dimensions including any proposed decks, overhangs greater than 2', parches, etc. / (i.e. all structures requiring permanent footings) C?',/ u ? • Show all easements of record and any City utilities within those easements p/?? • Setbacks of proposed structure and sideyard setback of adjacent existing structures C? ? n • Retaining wall requirements, if any ? Reviewed: Name ! Date N TIFICA TE OF OUR VEY ? EP o 5 REcB G ON YEA HOMES SA Bohlen Surveping & Engineering 31452 Fofiage Avanue 4819 123rd Street W. rorn,naa. ?rN 55057 B E Savor- LtN 5537$ ??(soi)'s?Ti? ??(s62))s s?s U A <? O ? U m o a ?Yi ° W U~ ? ?a a av? ta ?----_ ? ? t °i! I I ORIV'EWAY 1.30.3 I S ? 0 F. 0 O .? ,o S a,3010' i3" E 156.18 - M,,7 GARAGE i I t i ? °o, ? i , ? mo ? ? o r _________Q ?Q ? x 1 ^ o !! ? QM! p ? ?Y ? Z = I ? ? ? • •- , ? N a ?O ..o W°n o icl; Q O ? x ra =aI ? ________________ ? ? q.9 ?S 890'tJ2' ?'JJm W 155.02 sMv wv-aea.7e aaR ? Ei ou?G ? SI L? f?N G?-' LOT AREA = 12283 SQ FT HOUSE AREA = 2236 SQ FT PROPOSED GARAGE FLOOR QEV.-89&5 PROPOSED TOP OF BLaqC ELEV.=898.8 PROPOSED BASEIdtENT FLOOR ELEV.=889.5 T'r DESCRFTION ? o DENOTES APPROX SERVICE LOCATION LOT 10. BLOGC t, ORCHARO HEIGHTS AOdTtON. -...? DENOTES PRQPOSED ORAWAGE D?tECT10 qT'f OF EAG1W. DAKOTA COUNT'(, h11?ANESOTA. ? DENOTE,,c PROPOSED EE.EVATION ADORE55 OOOXO DENOTES DCISTING ELEVATION 3218 BV1qC OAK DRIV5 0 DENOTES W000 HU8 o DENOTES IRON PIPE MONUMENT DENOTES S£RVtCE IOCAT(ON I HEREBY CERTIFY THAT THIS SURVEY WAS PREPARED BY ME OR UNDER MY DIRECT SUPERVf510N AND THAT I AM A DULY REGtSlTERED LAND SURVEYOR UNDER THE LAWS OF THE STATE OF MINNESdTA. DATE• $-30-01 LEROY 4 . BOHLEN, LANO SURVEYOR MINNESOTA LICENSE N0. J0795 ru ['?Inu['. G47-2-0100nYGa 1"=3d' L RESIDENTIAL BUII.,DING Permit Application ? City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Reauirements R air Re uiremenls 3 registered site surveys sFwwing sq. ft of bt, sq. ft of house; and all roofed areas co ies o( (20% maximum lot coverage allowed) , ?q?y ?alr??atio foed additions 2 copies of plan showing beam & windov'sizes; poured found design, etc. site survey for additions & dec 1 set of Energy Calculations Add'rhon - in rcat21"?tarr'S7O'si iFc system 3 copies of Tree Preservation Plan if bt platted after 711193 Rim Joist Detail Optlons selection sheet'(bidgs with 3 or less units ? Office Use Onlv Cert of 5urvey Recd Tree Pres Plan Recd _Tree Pres Not Reqd _ On-site Septic System 51 a r 14? 0-\k??, - Date 5 / j 5 Pd ' Construction Cost Site Address 3? ? g g l a C k ? a? f)?. Unit/Ste # Description of Work I?e- r,K Multi-Family Bldg _ Y ZN Fireplace(s) _ 0 2 Property Owner HoSIQ, r?rt?s"? -?eI? Sa ki2aje,? Telephone # (bS Contractor ?? ? . ? Lr ? ? Address Cih' State ' Zip Telephone L F S COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Energy Code Category Minnesota Rules 7670 Cate?ry 1 • Residential Ven6lation Category 1 Worksheet (4 submission type) Submitted . Energy Envelope Calculations Submitted Licensed Plumber Mechanical Contractor Sewer/Water Contractor Minnesota Rules 7672 . New Energy Code Worksheet Submitted 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 thrs is not a pernut, 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. feS'a.k??P? f s-. Applicant's Printed Name Applicant's Signature Sub Types OFFICE USE ONLY 13 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool 0 02 SF Dwelling ? OS 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 04 02-plex ? 10 08-plex x 18 Deck ? 23 Porch (screen/gazebo) ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex O 12 12-plex Plbg_Y or _ N ? 25 Misceilaneous Work Types ,1 31 New ? ? 32 Addition ? ? 33 Alteration ? ? 34 Replacement Valuation Census Code ? SAC Units Nbr. of Units ? Nbr. of Bldgs Type of Const Footings (new bldg) ? Footings (deck) _ Footings (addition) Foundarion Drain Tile Roof Ice & Water _ Framing 35 Int Improvement ? 38 Demolish (Interior) ? 44 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 37 Demolish (Bldg)* ? 43 Reroof ? 46 `Demoli8on (Entire Bldg) - Give PCA handout to applicant Occupancy MC/ES System _ Zoning City Water _ Stories Booster Pump _ Sq. Ft. PRV Length Fire Sorinklered Width Final _ Fireplace _ R.I. _ Air Test _ Final Insulation i 4 O 30 Accessory Bldg ? 31 Ext. Alt - Multi ? 33 Ext. Alt - SF ? 36 Multi Misc. Siding Fire Repair W indowslDoors REQUIRED INSPECTIONS FinaUC.O. FinaUNo C.O. _ Plumbing HVAC Other _ Pool _ Ftgs _ Air/Gas Tests _ Final _ Siding Stucco Stone _ Windows (new/replacement) _ Retaining 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 . 0 -)`? __ ER rE OF OUR VEY S ? ?E"-D GONYEA ?DM?'?5' 0 Bohlen Surveying & Engineering 31462 F61og. ave,w. 4819 123ra so-met w. Plortt+feid. AN 55037 Savoge, wV 55378 an«,c(so7 ) e..s-r?a B E a+or+c(s,z) 8e5-9212 F= (so7) s4s-n9s F? (s?2) 895-9259 •?,? ? ? r`r, f )? ??•{?, ,,.1, ,. , ?..',, • - .. .????M?]?'^?w?rr+wc?....? -Ywr_?, :-? W O U A a? 0 ?a m 0 NI ? W UQ d' a • O 0 0 O r? t I 1 F;1 ORIV'EWAY ? 30.3 I 10 °10' f3" E 156.18 ;?; ao,:7 s8 - •?o? - - - --'?+?. 6ARAGE i " ? 1 ?• ???! ? ? L29. 10 1 ? X , ?'?` • ? ? 1 ? / r t z i ? ... ? I U a ? . +,o ? x ? ? I L- ? ?y??? i •----r ------------------ - - - m n A ? W = N m O O ?lJ Q V? x ???? ?? S 89°52' 55" 1K 155.02 094x4 ??? S + L7 fEN G ? lOT AREA = 12283 SQ FT • • HOUSE AREA = 2236 Sq FT PROP45ID GARAGE FLOOR ELEV.-898.5 PROPOSED TOP OF BLOCK ELEV.-898.8 • PROPOSED BASEaAENT FLOOR ELEV.-889.5 PROPERTM DESCRIPTION 4 DENOTES APPROx SERVICE L4CATION LOT 10. BLOqC 1. ORt?iARD Ff1GHTS AOOITION, GTY OF EAGAN. DAKOTA COIJNTY. NNPESOTA. -" DENOTES PROPOSED DRAUVAGE DIREC' ? OENQTES PROPBSED E1.EVATiON ADDRESS OOOXQ OENOTES D(ISTING ELEVATION 3218 euac OAc oRIvG O DENOTES WOOQ HUB o DENOTES IRON PIPE MONUMENT DENOTES SERVICE LOCATION I HEREBY CERTIFY THAT THIS SURVEY WAS PREPARED BY ME OR UNDER MY DIRECT SUPERVISION AND THAT I AM A DUIY REGISlTEREO LAND SURVEYQR UNDER THE LAWS OF THE STATE OF MINNESOTA. OATE• $-30-01 LEROY i . 80HLEN, LAND SURVEYOR MINNESOTA LICENSE N0. ] 0795 sa+rea 1 so = 306 MAKE-UPAIR IIIODE!. ? - ,. _: , vu?? 2047 RESIDENTUL BUILDINGPERMIT APPLICATIUN -City Of Eagan 3830 Pilut Knob Raad, Eagan NIlV 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Canstructian Requiremenls 3 registered site surveys showing sq. ft, of lot, sq. ik of house; and all roofed areas (20°,6 maximum lot co4age allowed) 1 Soils Repad ff proposed buildireg is ta be plaoed an disturbed sail 2 copies of plan showing beam & window sizes; paured faund design, etc. 1 Set of Energy Calcula6ons 3 copies af Tree Preservation Plan if lot platted aftet 711193 Rim Joist aefail Opdons selecction sheel (buildings wifh 3 ar Ies:, units) Minnegasco mechenical venUlatinn form RemadeURepair Reauiremenls 2 copies of pEan showing footings, 6eams, joists 1 set of Energy Calcu(ations fbr Eeated additions 1 site survey for additions & decks Addffion - indicate iionsite sephe system Telephone # ( Plans are considered nublic information unless vou state '#hev are trade secret and the reason. ? Date Construction Cost F-CJao . C) U Site Address 3 UnitlSte # Description of Wvrk T D? Multi-Family Bldg _ Y?4,N Fireplace(s) ? 0 _ l 2 P t O p ! /G ' ) ` U O Telephane G r 0 wner roper y , Contractor Address City e 7 4 _ State d-7. Zip Telephoiae ff407} Q COMPLETE THIS AREA t?NLY IF CONSTRUC'pING A NEW BUiLDING - Minnesota Rules 7674 Gategorv 1 Minnesota Rules 7672 Energy Code Categnry . Residential Ventilation Categary 7 Worksheet T • New Energy Code Worlcsheet (4 sabmissian rype) Submitted Submitted • Energy Envelope Caloulations Submitled In the last 12 months, has the City of Eagan issued a permit for a sirnilar plan based on a master pkan? _ Y ! N If yes, date and addrsss of master plan: Licensed Plumber Mechanacal Contractor Sewer/Water Contractor Telephone # ( 4 J-1-a . 00 ? Cc .-a??q Qffice IJse 0ntv Y .:_N Ger#aFSiiryey? _ Sals Eteport . ?Y. '` N Tre.ePtes P1an Recd Y,N, 7'tee Pres,Reqtnred Y ; _ N On Ae 5epbc,Systeiit "f Telephone # ( I I hereby apply for a Residential Buiiding Perrnit and acknowledge that the infortnatton is compiete ana accuraFe; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN S#atutes; I understand this is not a permit, but only an application for a permit, and worlc is not to start without a pernit; tha# the wark will be in accordance with the approved plan in the case of work which requires a review and approVal o lans. r A t's Printed Name licant's Signature DO NOT WRITE BELOW THIS LINE Sub TVpes O 01 Foundation ? 07 05-plex C1 13 16-plex C] 20 Poo9 ? 30 Acoessory Bldg ? 02 SF Dwelling ? D$ 06-plex ? 16 Fireplaee ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi ? 03 01 oF_ plex ? 09 07-plex ? 17 Garage ? 22 PnrchlRddn. (4-sea.) ? 33 Ext. Alt- 5F 0 04 02-p6ex E] 10 08-plex ? 18 Deck 0 23 Porch (screen/gaxebolpergala) ? 3E Mvlti Misc. ? 05 03-plex ? 11 10-pfex 0 19 Lower Level ? 24 5torm Damage ? 06 04-plex ? 12 12-piex ? 25 Miscellaneous ' Work Tvpes 0 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 BuiEding" ? 43 Reroof ? 46 WindowslDoors ? 34 Replacement "Demalition (Entire Hldg) - Give PCA handout to applicant DeSCI'I010n: Wader pamage Yes Valuation Occupancy MCES Systerrt Rlan Review 100°/a or 25% Gensus Cade Zoning City Water SAC Units Stories Boos#er #'ump # of Units 5q. Ft. PRV # vf Bldgs Leng#h Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS - Footings (new bldg) A Sheetrock - Footings (deck) _ Fina1/G.O. - Eaotings (additian) _ Fina]!No C.O. Foundatian HVAC Dra.in Tile Other Roof _ Ice & Water _ Final _ Pool Ftgs Air/Gas Tests _ Framing _ Siding ` Stucco Lath _ 8tane Lath _ Fireplace _ R.I. _ Air Test _ Final ? Wirtdows . _ Insulation ? Retaining Watl Approved By: , Building lnspector Base Fee Surcharge Plan Review MC1ES SAC City SAC Utility Connection Charge S&W Permit & Surcharga Treatment Plant Lieense Search Capies Other Total Final Brick � Use BLUE or BLACK Ink r_________________ • I For Office Use � � /� Q� I Clt of �� a� � Permit# ` LS r� � Y � � �o. 00 � � Permit Fee: � 3830 Pilot Knob Road � Eagan MN 55122 j Date Received:�� I Phone: (651)675-5675 � I Fax: (651)675-5694 I Staff:�'� � �----=------------� 2014 COMMERCIAL PLUMBING PERMIT APPLICATION ❑ Please submit two (2)sets of plans with all commercial applications. Date: II'��'�Site Address: � ` �j� r ,�'-� �,/c.c;��- ��, Tenant: Suite#: Property s OWneC Name: Phone: ' Name: F � License#: �� Contractor ' Address: C�� (fv` UtiYI �� 1rnG. L City. � �� State: Zip: Phone:�Q� ��, �]�-��Emai�:� bl� a�1 .� Type of Work �-New _Replacement _Repair Rebuild _Modify Space _Work in R.O.W. Description of work: � 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 pickinq up meter. Domestic:Size&Type Fire: 1 Avg.GPM High demand devices? Yes No Flushometers Yes No COMMERCIAL FEES � Contract Value$ � • x.01 $55.00 Permit Fee Minimum _$ Permit Fee `If contract value is LESS than$10,010,Surcharge=$5.00 =$ Surcharge" "'*If contract value is GREATER than$10,010, 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 _$ 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 approva�la_s 1n � •--� � x Y V 1�5� ,L�QC.0 �.�CA X � ApplicanYs Printed Name FOR OFFICE USE ' Approved By: Dates Required Inspections: _Under Ground Rough-In _Air Test Gas Test :Final , PRU Required: Yes No Meter Related Items: Meter Size : Radio Read Manometer Staff: Page 1 of 3 Use BLUE or BLACK Ink � For Office Use � � tr.,...,k j3, :$'", j Permit#: I�v� ° � j Cl�� of Ea�� ,.� ... ..A u �� ' y` i , � � Permit Fee: � 3830 Pilot Knob Road ��;'v� `� `� ��s'� Eagan MN 55122 � Date Received: � I l �� I Phone:(651)675-5675 I ` I Fax:(651)675-5694 I Staff: I � ------� �,� 2014 RESIDENTIAL BUILDING PERMIT APPLICATION �`"i �`� Date: �'� -1 y Site Address: 3�� I� C� r un�t#: �\/�1'�� c,� � Q Name: 1��I�c�� 7�1h, Z�C�� Phone: �I`��')�� u Address/City/Zip: 3�� c�� C�o��. (�r� ��c�a✓� v�� 5�1�1 Applicant' � Owner Contractor Description of work: �� •.�n�5� — 1 n C- � ��+ �1''�� C1� Construction Cost:�,��d� Multi-Family Building: (Yes /No � Company: �n� " �wc.. �� Contact: 1.��'.� 1�1�d��"1 Address: �l��O �Ge�S 1�f' 1,�� !J City: �7cA�v��` �it1�� Qec�+�- State: i�'�1''� Zip: '�5�� Phone:�S�-��'�b Email: Ce�.�'�'+��'1��n:`i��10`��°�a License#:�j�� Lead Certificate#: � � `� /d� � If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) ��.J.1� ',n a�� 1 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months,has the City of Eagan issued a permit for a similar plan based on a master plan? _Yes _No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer&Water Contractor: Phone: 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.aoaherstateonecall.orq I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building C must be completed within 780 days of permit issuance. x �.h�' S Cn,�f�c�'1 X `.�•. � ' ApplicanYs Printed Name Applicant's Signature Page 1 of 3 . r �a�� 3�QG� �Q k `p� 1 � DO NOT WRITE BELOW THIS LINE I o �-/ �� SUB TYPES Foundation _ Fireplace _ Porch(3-Season) _ Exterior Alteration(Single Family) � Single Family _ Garage _ Porch(4-Season) _ Exterior Alteration(Multi) Multi Deck Porch(Screen/Gazebo/Pergola) Miscellaneous 01 of_Plex Lower Level Pool Accessory Building WORK TYPES _ New _ Interior Improvement _ Siding _ Demolish Building* �_ Addition _ Move Building _ Reroof _ Demolish Interior x Alteration _ Fire Repair _ Windows _ Demolish Foundation J� _ Replace _ Repair _ Egress Window _ Water Damage _ Retaining Wall *Demolition of entire building-give PCA handout to applicant DESCRIPTION s � Valuation ( Occupancy y��I-- MCES System Plan Review Code Edition .p,�[��v� SAC Units (25%_100%� Zoning ��-- City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Sprinklers Type of Construction Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: Footings (Deck) Final/C.O. Required Footings (Addition) � Final/No C.O. Required Foundation HVAC Gas Service Test Gas Line Air Test Roof:_Ice&Water �Final Pool:_Footings Air/Gas Tests _Fina! � Framing Drain Tile � Fireplace:�Rough In Air Test �Final Siding:_Stucco Lath _Stone Lath _Brick Insulation � Windows Sheathing Retaining Wall:_Footings_Backfill_Final Sheetrock Radon Control Fire Walls Erosion Control Braced Walls Other: Reviewed By: � f/ , Building Inspector RESIDENTIAL FEES 9 � ��`,�� Base Fee �''� Surcharge Plan Review � � `� �� '` / � � MCES SAC ' City SAC Utility Connection Charge S8�W Permit 8�Surcharge Treatment Plant Copies TOTAL Page 2 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA128563 Date Issued:11/19/2014 Permit Category:ePermit Site Address: 3218 Black Oak Dr Lot:10 Block: 1 Addition: Orchard Heights PID:10-54500-01-100 Use: Description: Sub Type:Fireplace Work Type:Gas Fireplace (new) Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to concealing. Carbon monoxide detectors are required by law in ALL single family homes . Valuation: 3,000.00 Fee Summary:BL - Base Fee $3K $88.50 0801.4085 Surcharge - Based on Valuation $3K $1.50 9001.2195 $90.00 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 - Amir Hosseinipour 3218 Black Oak Dr Eagan MN 55121 Hearth And Home Technologies 2700 N. Fairview Ave Roseville MN 55113 (651) 638-3309 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA166719 Date Issued:01/29/2021 Permit Category:ePermit Site Address: 3218 Black Oak Dr Lot:10 Block: 1 Addition: Orchard Heights PID:10-54500-01-100 Use: Description: Sub Type:Reroof Work Type:Replace Description:Does not include skylight(s) 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. We encourage you to retain an electronic copy of photos until the project passes a final inspection. *Roof permits issued between December and March will be inspected in the spring or when weather warms up. 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 - Amir Hosseinipour 3218 Black Oak Dr Eagan MN 55121--233 (651) 245-2696 Capital Construction Llc 416 Gateway Blvd Burnsville MN 55337 (952) 222-4004 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA173364 Date Issued:11/09/2021 Permit Category:ePermit Site Address: 3218 Black Oak Dr Lot:10 Block: 1 Addition: Orchard Heights PID:10-54500-01-100 Use: Description: Sub Type:Siding Work Type:Replace Description: Census Code:434 - Residential Additions, Alterations Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please leave printed pictures of house wrap on site for the final inspection. When installing ventilated soffit material, remove existing material (i.e. debris that could block vents) and take steps to ensure maximum ventilation to attic. Call for final inspection after installation. When a weather barrier is installed or 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 - Amir Hosseinipour 3218 Black Oak Dr Eagan MN 55121--233 (651) 245-2695 Krech Exteriors Inc 5866 Blackshire Path Inver Grove Heights MN 55076 (651) 688-6368 Applicant/Permitee: Signature Issued By: Signature