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3273 Black Oak Dr PERMIT City of Eagan Permit Type: Building 3830 Pilot Knob Rd Permit Number: EA083376 Eagan, MN 55122 . Date Issued: 06/04/2008 (651) 675-5675~~~ EPermit Category: ePermit www.ci.eagan.mn.us lflflUl tflflLLL Site Address: 3273 Black Oak Dr Lot: 4 Block: 1 Addition: Bur Oak Hills PID 10-15500-040-01 Use Description: Sub Type: e-Reroof Construction Type: Work Type: Replace Description: House & Garage Census Code: 434- Occupancy: Zoning: Square Feet: 0 Comments: If there is no ice protection inspection prior to final, you must meet inspector with ladder and flat bar. Pictures are not acceptable in lieu of inspections. Fee Summary: BL - Base Fee $3K $88.50 0801.4085 Surcharge - Based on Valuation $3K $1.50 9001.2195 Valuation: 3,000.00 Total: $90.00 Contractor: -Applicant - Owner: Sela Roofing Remodeling Albert Chueng Huen Lui 4100 Excelsior Blvd 3273 Black Oak Er St. Louis Park MN 55416 Eagan MN 55121 (612) 823-8046 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 Issued By: Signature INSPECTION RECORD CITY OF EAGAN PERMIT TYPE;' 3830 Pilot Knob Road Permit Number: '3 Eagan, Minnesota 55122-1897 Date Issued:' (612) 681-4675 SITE ADDRESS: 5406 -040 41 APPLICANT: t it1 3 4 Ltt (ICk 5e V3 141ACU OAJh DR L01 At BENT f 0 t y OM k i l l 1. PERMIT SUBTYPE: TYPE OF WORK: 714 s fu r.~~~~}r23~-I~-}I Permit No. Permit Holder Elate Telephone R ELECTRIC PLU1+1ttNti HVAC Irtstp006M D&te Map. Comments FOOTINGS FOUND FRAWNG ROOFING ROUGH PLUMBING PLBG Alta VEST 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 FTG DECK FINAL -Pid INSPECTIO R CORD- CITY OF EAGAN 3830 Pilot Knob -Road Pam* NuMber: 031 s" Eagan, Minnesota 55122-1897 Clate ls~ueid: N 6 / E3 (612) 681.4675 SITE ADDRESS: x r t o' APPLICANT: 1.€3t 4 rJI.€ CK! "t ACM: 41AK € R k X19 RL#~FR~ HUR ()At* HILL,; PERMIT SUBTYPE: TYPE OF WORK: HA SI: MU N t s czar H AI.T9RATION FftAh1rN' 5M ur AVION € 101 H IN P1,8FTNAi j F014A€YS SEPARATE PFRMJt Rt-Q1.J1R1•`0 FOR ANY P1,01011'06 WORK:- Hoj*E FWHFf# 441ft IHO T"t 1HF €iASUOENT, GALA. 44fi-2840 REAAk0(Wp F.LFr,,:TAIGAI_ FI RMIT AND INSPECTIONS. RI AN f?F%JIE"WFD COY MIXF- HARC19. s-3 7 fhn ft fhL f nif 'Mvlde► . f TaMpAaw EI.~'PFtI~ rou RO"S ROUGH PLUMONOO TEST INS GYPODAFM FFMFLACE FINAL FINAL HTG ORSAT TEST BLDG FINAL BSMT R.1. B 3MT FINAL DECK FTG DECK FINAL OF EAGA14 'Pem • {~~~~$1-4675 , - , SITE A GREW: ra r r APPLIC }ff#fk I1At H f.f t. ` (612) 411 $'l**4 . - ii TYPE OF , P MIT SUBTYPE; UVANIN6 itI',,~" "n"' Fit*# FINAL , At,6 ttE'fWIf 5: '~n#r3 CON#"RA( fORL iit - 6f:po tONS!I?tJ~:Ttl~i~ ~ A h"r~h' III OLLMA OW.- $r i aft. MM6 AM* f I+58R b r CMS. i Rra Oak Final Tm Pr. mw L 2h02'~/' A'at Request Date Fire No. Rough-in Inspection 9 Re wired? ❑ Ready Now ~OJill Notify Inspector / Yes C No e when Ready? I X. licensed contractor D owner hereby request inspection of above electrical work at: Job Address IS' rest. Box or Route No.) City 32-73 '8/4.1 011 1?ie .06,4 6n4w Sectior. No. Township Name or No. Range No. County ,,G X414 Occupant (PRINT) Phone No. Power Supplier . Q Address Electrical Contractor (Company Name) Contractor's License No. Avei iP-4 JC-.-/ edc G'D Cr4 a b rf / Mailing Address (Contractor or Owner MaKrng Installation) f~as eswr..v.i-T` f"~ 4"r4y Authorized Signature (Contractor Owner Maki In lallation) Phone Number MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room S-173 BE ACCEPTED BY THE STATE BOARD 1821 University Ave., St. Paul. MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 842-0800 ENCLOSED. ----REQUEST FOR ELECTRICAL INSPECTION ► See instructions for completing this form on back of yellow copy. 288' 2 `X" Below Work Covered by This Request4 / rf ~New Add Rep. TypeofBuilding Appliances Wired Equipment Wired I Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Other (Specify) I Comm./Industrial Furnace I Farm Air Conditioner 1 (Other (specify) Contractor's Remarks: Compute Inspection Fee Below: t # I Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee !Swimming Pool 0 to 200 Amps < •JD 0 to 100 Amps (Transformers Above 200 Amps I Atmve 100 Amps I Signs Inspectors Use Only' TOTAL Irrigation Booms 7 OU 7 S~ Special Inspection (Alarm/Communication THIS INSTALLATION MAY BE ORDER L IF NOT IOther Fee COMPLETED WITHIN 1 THS. Rough-in ate I G I, the Electrical Inspector, hereby , _ s certify that the above inspection has Final Date been made. OFFICE USE ONLY This request voio 18 months from wemf icate of cccuvanc4 Wit4 of Wagan This Certificate issued pursuant to the requirements of the Uniform Building Code certifying that at the time of issuance this structure was in compliance with the various ordinances of the City regulating building construction or use. For the following: SF DWG 20843 Use Classification Bldg. Pernrit Na I OC-P-CY Type JUREM s in Dis4ict 4639 Owner of Budding L Address BUR CAK FIRM B " g Address l,oa li s s 47 i Date: Building POST IN A CONSPICUOUS PLACE Address 3273 BLS OAK DRIVE Zip 5512 l Lot ' ' 4 ' Blk 1 Sub am oAK IM a s THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION. Date:. Yes No Inspector: _ Final g fade ' from siding) Permanent steps (garage) Permanent steps (main entry) Permanent driveway Permanent gas Sod/Seeded grass t✓ Trail/curb damage ✓ Porch Basement finish Deck 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-of-way or installing underground sprinkler system. White - City Copy Yellow - Resident Copy Pink - Contractor Copy to -7 RESIDENTIAL BUILDING Permit Application City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 0 Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Requirements Remodel/Repair Requirements Office Use OnN 3 registered site surveys showing sq. It. of lot, sq. ft of house; and all roofed areas 2 copies of plan _ Cert of Survey Recd (20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions -Tres Pres Plan Read 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks _ Tree Pros Not Reqd 1 set of Energy Calculations Addition - indicate if on-site septic system _ On-site Septic System 3 copies of Tree Preservation Plan if lot platted after 711/93 Rim Joist Detail Options selection sheet (bldgs with 3 or less units Date / Z Z / OZ- h Construction Cost Site Address 3Z1 3 ~ (C/`CV 0A V- b n yy Unit/Ste # Description of Work S 0 in S 0r) (Ian too (0 L41 Oy^' Multi-Family Bldg _ Y - N Fireplace(s) - 0 - 1 _ 2 Property Owner Telephone # Contractor T AddressAn, ~ q g) U" City p / State Zip Telephone # (0) rp or687 7-O r" COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672 Energy Code Category . Residential Ventilation Category 1 Worksheet New Energy Code Worksheet (4 submission type) Submitted Submitted • Energy Envelope Calculations Submitted Licensed Plumber Telephone # ( ) Mechanical Contractor Telephone # ( ) Sewer/Water Contractor j c fi{~Fiprarr # ( ) I hereby aPP1Y for a Residential Building Permit and `knowledge thatnformation is complete and accurate; that the work will be in conformance with the ordin ~es and codes of the City of Eagan and the State of MN Statutes; 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 an in the case of work which requires a review and approval of plans. OLI ha I . nt Applicant's Printed Name Applicant's Signature OFFICE USE ONLY Sub Types ❑ 01 Foundation ❑ 07 05-plex ❑ 13 16-plex ❑ 20 Pool ❑ 30 Accessory Bldg ❑ 02 SF Dwelling ❑ 08 06-plex ❑ 16 Fireplace W 21 Porch (3-sea.) ❑ 31 Ext. Alt - Multi ❑ 03 01 of_ plex ❑ 09 07-plex ❑ 17 Garage ❑ 22 Porch/Addn. (4-sea.) ❑ 33 Ext. Alt - SF ❑ 04 02-plex ❑ 10 08-plex ❑ 18 Deck ❑ 23 Porch (screen/gazebo) ❑ 36 Multi Misc. ❑ 05 03-plex ❑ 11 10-plex ❑ 19 Lower Level ❑ 24 Storm Damage ❑ 06 04-plex ❑ 12 12-plex Plbg_Y or _ N ❑ 25 Miscellaneous Work Types `e j/1 o ~ r` n goo yk, 31 New ❑ 35 Int Improvement ❑ 38 Demolish (interior) ❑ 44 Siding ❑ 32 Addition ❑ 36 Move Bldg. ❑ 42 Demolish (Foundation) ❑ 45 Fire Repair ❑ 33 Alteration ❑ 37 Demolish (Bldg)* ❑ 43 Reroof ❑ 46 Windows/Doors ❑ 34 Replacement *Demolition (Entire Bldg) Give PCA handout to applicant Valuation Occupancy T2 MC/ES System Census Code Zoning- City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const Width 1 REQUIRED INSPECTIONS - Footings (new bldg) _ Final/C.O. _ Footings (deck) Final/No C.O. Footings (addition) _ Plumbing _ Foundation _ HVAC Drain Tile Other Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests -Final Framing - Siding _ Stucco _ Stone _ Fireplace _ R.I. -Air Test -Final _ Windows (new/replacement) ~Q Insulation - Retaining Wall Approved By Building Inspector Base Fee Surcharge ` 4) Plan Review Y/(./ / MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total s ti 0 C N N 0 0qK N w c E W N W I s • , o x~ o y -mom , V w / ex16Tn+G >aoueE 4 ~lea~oeeo ~ 'P SKIM Room ADDRION D15GL4A1ER TICE: ' ! RYT'nAtftf MCelt 6CMtR RAT 6 WSr L a N4ww to lxaTe ~u swao jQ SRL d gM]tltKf To STYX OR ftabSf aNT •ItlVtlf tSIeS, St°1OUl{lHR to STITRK, am HWSdwm TAMIL GAS OR SLAG 1S'-E"t LOO TWAT SLM To ott{t1 a= Wdmmu aN UL \ M ~j,,,,t _,'Jf1 asNN TO 6T,NT YDIK TInD a NOT N N Hldsele ToR oYUaf 1O YTY W7Mtf0 oR Z 0 tetxrOffp THVAIlIr OSN fYtlCD u1LLmlL turf. ~ OaW IW, Sf NO.D 14lfOTlMIL! t'On aNr patty{ ~ 1f4T M4Y OCQR aLSO ~ ~ T4RC QS PllValf LfC6HMMa~t~alt N :t! Y►lTrd CGTiT, 4 lY-^ A .A S T ; e: \ ID cram Bar ~+pT wa' ~ - ~ TEMV rax, ~ee.iu.ow \ 1 i 51TEPLAN JOB NUMBER : TBD AI SCALE : I" : 30'-0" . I CUSTOMERS NAME : PING 4 ALBERT LUI ADDRESS : 3213 BLACK OAK DRIVE CITY / STATE / ZIP : EAGAN. MN 55121 \ HOME PHONE :651-686-6081 \ WORK PHONE : TBD I CELL PHONE : TBD \ DRAWING DATE : 6/25/03 REVISION DATE : 6/29/03 ~I t REVISION DATE : 1/20/03 ° V co PERMIT# 1-4 l(.o DENTI"numm flaw, 11"Im -`W yy iyy.,,a~ ~ $ rtS ip y Plow oomplete for: single family dsee"s, tavnhomas and aondoe when perrltltl: iNed ~ Poo" badcilaw pnwenter fbr Iftation system SITE ADDRESS: K pY • _ ' OWNER NAME:: INSTAt..LER NAME: Ti: t `r STREET ADDRESS: "I CITY: ~Je STATE SEPTIC SYSTEM, new/refurbished (requires M* Stets of ptsmsi and lih) includes $40.00 Cw* fie { Note: Additional oor l d feeematy appty 4 'JA • M..001FICATICNIALTERATION TO DWELL U1diiT 811011. t , . ,r Adding fbdures b lower levels or mom adalitions, exoludin r sd tw and , Abandonment of septic system. Water turnaround - existing dwelling unit &W meter if r"ded - $118) Other: sm* _ RPZ: new installationlreor/rebuild ✓lam irrigS*m system r Replacement/sdditionel: _ water sofmw _ water heater :d . State Surcharge aAV. TOW Ip 1 , I hweby admovAedge that! have read IJ* applica& n. 900 Matthe Irdbrmatimm it OM W, is the sWcanrs respornibYttyto rsa*the pWWIycwner VW the Ctrof Eager amrbes ho sylsr y; , rte . c ~z opavUenal and n aintww ce adivities-to the bAfts con*udad urn this pWdtwM*Q PERMIT ~CITV OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G Eagan, Minnesota 55122-1897 Permit Number: 031589 (612) 681-4675 Date Issued: 03/16/98 SITE ADDRESS: 3273 BLACK OAK DR LOT: 4 BLACK: 1 BUR OAK HILLS P.I.N.: 10-15500-040--01 DESCRIPTION: ONE BEDROOM BuildingPermit Type BASEMENT FINISH Building Work Type ALTERATION Census Code 434 ALT. RESIDENTIAL REMARKS: SEPARATE PERMIT REQUIRED FOR ANY PLUMBING WORK. HOMEOWNER WIRING THE THE BASEMENT. CALL 445-2840 REGARDING ELECTRICAL PERMIT AND INSPECTIONS. TEWED BY MIKE MARCM'. FEE S A : Base Fee $50.00 Surcharge .50 Total Fee $50.50 CONTRACTOR: OWNER: - A p p l i c a n t LUI ALBERT 3273 BLACK OAK DR EAGAN MN 55121 (612)686-6081 j I hereby acknowledge that I have read this appli'catiPn and state that-the information is correct and agree tea -complywith all appii0able State of Mn. Statutes and City of Eagan Ordinances. PLI NTIPERMITEE SIGNATURE ISS ED Y: IGNA R ~ a . ~ ;~,t 3 ' ...Ir 1 - J'.. k I ~ ..I 1_ r ~ { i 1997 BUILDING PERMIT APPLICATION (RESIDENTIAL) CITY OF EAGAN 3830 PILOT KNOB RD - 55122 G 681-4675 New Construction Renu'srements $emodeUReoair Renuirements - ♦ 3 registered site surveys * 2 copies of plan ♦ 2 copies of plans (include beam & window sizes; poured fnd. design; etc) ♦ 2 site surveys (exterior additions & decks) # 1 energy calculations 4 1 energy calculations for heated additions t 3 copies of tree preservation plan if lot planed after 711193 required: _ Yes No DATE: CONSTRUCTION COST: IF -V . DESCRIPTION OF WORK: - f"f Ajl 'I/IIT- ('CAd& . MAJ STREET ADDRESS: LOT BLOCK ( SUBD./P.I.D. L!,~~ I L~ PROPERTY Name: T Phone #:'S OWNER L4sr ~ .WM Street Address; City: 1~ State: zip: CONTRACTOR Company: Phone Street Address: License City: State: Zip: ARCHITECT/ Company: Phone* ENGINEER Name: Registration Street Address: City: State: Zip: Sewer & Water liceraed plumber (new construction only): Penalty applies when address change and lot change are requested once permit is issued. 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. Signature of Applicant: OFFICE USE ONLY 4ViD"VTA Certiftcates of Survey Received Yes - No ~ I Tree Preservation Plan Received Yes No Not Required OFFICE USE ONLY a BUILDING PERMIT TYPE o 01 Foundation ❑ 06 Duplex o 11 Apt./Lodging( 16 Basement Finish ❑ 02 SF Dwelling o 07 4-plex o 12 Multi Repair/Rem. o 17 Swim Pool o 03 SF Addition ❑ 08 8-plex ❑ 13 Garage/Accessory o 20 Public Facility 0 04 SF Porch o 09 12-plex o 14 Fireplace ❑ 21 Miscellaneous o 05 SF Misc. ❑ 10 !-plex o 15 Deck WORK TYPE ❑ 31 New ❑ 33 Alterations o 36 Move o 32 Addition o 34 Repair ❑ 37 Demolition GENERAL INFORMATION Const. (Actual) Basement sq. ft. tSD w MC/WS System . (Allowable) Main level sq-. ft. City Water UBC Occupancy sq. ft. Fire Sprinklered Zoning sq. ft. PRV # of Stories sq. ft. Booster Pump Length sq. ft. Census Code. Depth Footprint sq. ft. SAC Code Census Bldg Census Unit APPROVALS Planning Building Engineering Variance Permit Fee Valuation: $ Surcharge Plan Review License MCMIS SAC City SAC Water Conn. Water Meter Acct. Deposit S/W Permit S/W Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies Total: - ; o % SAC SAC PERMIT Nee, s /e CITY OF EAGAN S_ 3830 Pilot Knob Road PERMIT TYPE: BUILDING Eagan, Minnesota 55123 Permit Number: 0 2 0 8 4 3 (612) 681-4675 Date Issued: 05/03/93 SITE ADDRESS: 3273 BLACK OAK DR LOT: 4 BLOCK: 1 BUR OAK HILLS P.I.N.: 10-15500-040-01 DESCRIPTION: Building Permit Type SF DWG Building Work Type NEW UBC Occupancy R-3 M-1 Construction Type VN Zoning R-1 Building Length 64 Building Width 44 REMARKS: S&W CONTRACTOR - OL-BERG CONSTRUCTION FEE SUMMARY VALUATION $164,000 Base Fee $863.50 MISC FEES $1,744.50 Plan Review $561.28 Total Fee $4,006.28 Surcharge $82.00 SAC $750.00 SAC % 100 SAC Units 1 Lic. Search Fee $5.00 Subtotal $2,261.78 CONTRACTOR: - Applicant - ST. LIC. OWNER: JOHNSON HOMES INC, DONALD 14560034 0001603 JOHNSON HOMES DONALD L 4639 PARK RIDGE DR 4639 PARK RIDGE DR EAGAN MN 55123 EAGAN MN 55123 (612) 456-0034 (612)456-0034 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 Mn. Statutes and City of Eagan Ordinances. APPLICANT/ RMITEE SIGNATURE ISS EO B NATURE REACTIVATE CITY OF EAGAN PERMIT # ` 1993 BUILDING PERMIT APP 11 44C 681-4675 1 C~oIW 3 A SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, c--~ y talcs. COMMERCIAL 2 sets of architectural & structural plans, I set of specifications, I copy of energy talcs. Penalty applies: 1) when permit is typed, but not picked up by last working day of month in which request is made, 2) address is changed or 3) lot change is requested once permit is issued. 7n D De - / 40 Valuation of work Site Address: STREET SUITE 9 Tenant Name: (commercial only) LOT BLOCK BUBD. L1 4+~ ,+ur crab P . I . D . .v c`: Description of work: The applicant is: ❑ Owner d Contractor ❑ Other (Describe) Name Luz, L T 101y6 Phone X37- /29.3 Property LAST FIRST Owner Address / itm /Mi STREET STE 9 City AL A:A~ State. hdz:z-~v Zipa3.3 Company S/u,4U59AIASoN AmE5../NG Phone :~ZS6-003 Contractor Address -46.a!2 License # /~03 Exp. City Z464AI State l~ lNA/ Zip -OZ SZ -a7z, PketntfA Company Phone Architect/ Registration # ALAAxAk~ Engineer Name 4LL I ~R-cc.r.m Address City State- Zips Sewer & water licensed plumber AEXIJ &64 • Processing time for sewer & water permits is two days once area has been appr ed. I hereby acknowledge that jhh!v 'read this application and state that the information is correct and agree to comp all pp able State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY BUILDING PERMIT TYPE ❑ 01 Foundation ❑ 06 Duplex ❑ 11 Apt./lodging ❑ 16 Basement Finish 02 SF Dwg. ❑ 07 4-Plea ❑ 12 Multi. Misc. ❑ 17 Swim Pool ❑ 03 SF Addition ❑ 08 8-Plex ❑ 13 Garage/Accessory ❑ 18 Comm./Ind. ❑ 04 SF Porch ❑ 09 12-Plex ❑ 14 Fireplace ❑ 19 Comm./Ind. Misc. ❑ 05 SF Misc. ❑ 10 Multi. Add'l. ❑ 15 Deck ❑ 20 Public Facility ❑ 21 Miscellaneous WORK TYPE IK31 New ❑ 33 Alterations ❑ 35 Tenant Finish ❑ 37 Demolish ❑ 32 Addition ❑ 34 Repair ❑ 36 Move GENERAL INFORMATION Const. (Actual) Y- N Basement sq. ft. MWCC System YES ~Allowable) V. 1st F1. sq. ft. City Water ~ UBC ccupancy R - 2nd F1. sq. ft. PRV Required Zoning R-1 Sq. Ft. total Booster Pumpp # of Stories Footprint Sq. ft. Fire Sprinkler Length On-site well Census Code /o Depth 4 y, On-site sewage SAC Code y/ APPROVALS Punning Building Assessments Engineering Variance REQUIRED INSPECTIONS ❑ Site H Footing ❑ Framing ❑ Insulation ❑ Wallboard ❑ Final ❑ Draintile ❑ Fireplace Permit Fee vatust;on: $ 6 ta00 Surcharge GARAGE ; 32x22..70 Plan Review License Z. x 1IL czy MWCC SAC City SAC ~ro x Ic - ~pI $a Water Conn. z$h3~6 Water Meter Acct. Deposit t x 9 2/V'D rLoola, S/W Permit P 130y '35'X30= /b So S/W Surcharge 3 x ►8 5~l 3 X /6 yg Treatment P1. 2 KA1 =!5L 3 x /6 . y Road Unit Park Bed. J 3t6 K 15' l1 yG yc sy- CopTrails es Ded. ~ST C^ LoOR'. / g Other Total: 163 SAC 100 132 xy y= SAC Units Donald L. Johnson Homes, Inc. Energy Code Worksheet Owner - Lui, Albert & Ping Address - 3273 Burr Oak Drive, Eagan Contractor - Donald L. Johnson Homes, Inc. Lic #1603 4639 Park Ridge Drive Eagan, Minnesota 55123, Phone 456-0034 Building Classification: Type A (Single Family & Duplex) General Information: 1. Building Perimeter - See Worksheet 2. Wall Height - See Worksheet 3. Gross Wall Area 2369.17 4. Square Foot Roof Area 1168.00 5. Square Foot of Rim Joist 124.00 6. Doors - Area 34.20 U Factor 14 &.47 7. Total Door's Perimeter 8. Windows - See Worksheet Crestline Insulated Casements 9. Total Square Foot Glass 173.55 10. Fireplace Area -0-- Clearance 11. Exposed Foundation .67* 361 83.08 12. Framing Area = 10% Of Gross Wall Area U Factor 13. Gross Wall Area 2369.17 Window Area 173.55 0.36 62.48 Rim Joist Area 124.00 0.04 5.OB Door Area 0.00 0.14 0.00 Other Door Area 34.20 0.47 16.07 Exposed Foundation 83.08 0.14 11.63 Framing Area 236.92 0.10 22.51 Net Wall Area 1717.42 0.04 73.85 191.62 14. Gross Wall Area 2369.17 0.11 260.61 15. Gross Ceiling Area 1166.00 Joist Area 116.80 Net Ceiling Area 1051.20 U Ceiling 1051.20 0.02 25.23 U Framing 116.80 0.02 2.69 27.92 16. Ceiling Area 1168.00 0.03 30.37 27-Apr-93 Page 1 Donald L. Johnson Homes, Inc. Energy Code Worksheet Owner - Lui, Albert & Ping Address - 3273 Burr Oak Drive, Eagan Contractor - Donald L. Johnson Homes, Inc. Lic #1603 4639 Park Ridge Drive Eagan, Minnesota 55123, Phone 456-0034 Worksheet 28+48*8.33 633.08 28 + 48 + 19 + 32 * 13.67 1736.09 2369.17 Roof 1168.00 Windows 2636 6*5.01 30.06 2046 8*2.18 17.44 2646 7* 10.0 70.00 3040 1 *11.65 11.65 2050 8*3.37 26.96 1636 0*1.83 0.00 2036 8*2.18 17.44 2640 0*8.35 0.00 173.55 Doors atrium 0.00 6'0 Patio 34.20 34.20 1 hereby certify that I have completed the above information and that it complies with the Minnesota State Energy Code. Jeanne M. Johnson Date 27-Apr-93 Pagel APR 29 193 10:59 TO 6124560051 FROM PROBE ENGINEERING T-999 P.02 consul T pv sNV``Nlens pOIJ41D ✓o""QAJ 14oov ; ROBE PL11Nfi~115 And itINR IWIVIVORS 0~ ENGINEERING 0K• I87 COIF PAINM, INC. P'_ 7,09 1000 EAST 1461h SIRE[T, BUANSVILLE, MINNESOTA 50337 PII 43Z-3o00 CERTIFICATE OF SURVEY Legal Description: 4 .I.oCfC / p9~._1118. (355:4) DENOTES EXISTING ELEVATION f e~Q ~o) DENOTES PROPOSED ELEVATION INDICATES DIRECTION OF SURFACE DRAINAGE B94 23, = FINISHED GARAGE FLOOR ELEVATION 886. bZ = BASEMENT FLOOR ELEVATION 814-46 = TOP OF FOUNDATION ELEVATION SCALE 'I'm 3W U,QIl1~ Ile f9 0 io /~O °(O (aglt V~ Q( q 1~ rg 3` ~ 814 ,0 ~ ~ ?9:0~ ~ ~ ~ g4-. 33 X893.7 4. Dfo /,c B9i~, $10.33 $ ~v8sg9 ~r,67 ~ w lz.oo i5, ~2y,37 IQ " 14 r~- (6 aB Z~ I hereby certify that this is a true and correct representation of a~tract of land as shown and described hereon, As prepared by me this Y Minn. Reg. Ho., 16081T V y LOT SURVEY CHECKLIST FOR RESIDENTIAL w w BUILDING PERMIT APPLICATION J m 8 - M PROPERTY LEGAL: J F<- 0- Co w < Date of Survey: o ~ z 2 DOCUMENT-STANDARDS :513 0 Registered Land Surveyor signature and company ❑ Building Permit Applicant ❑600"'D Legal description ❑ Address 0 North arrow and bar scale ❑ ❑ House type (rambler, walkout, split w/o, split entry, lookout, etc.) ❑ Directional drainage arrows with slope/gradient ❑ Proposed/existing sewer and water services 91111 0 Street name B" ❑ ❑ Driveway ELEVATIONS Existing ❑ ❑ Sewer service 0'~ ❑ ❑ Lot corners 0~ ❑ ❑ Top of curb at the driveway ❑ ❑ Elevations of any existing adjacent homes Proposed R~-D 0 Garage floor ❑ ❑ First floor Flo' ❑ ❑ Lowest exposed elevation (walkout/window) 20* 'D ❑ Property corners GY ❑ 0 Front and rear of home at the foundation / PONDING AREAS (if applicable) ❑ 2 ❑ Easement line ❑ go- 0 NWL ❑ 0& 0 HWL ❑ g ❑ Pond # designation ❑ E❑ Emergency Overflow Elevation DIMENSIONS 0 ❑ Lot lines 01 0 ❑ Right-of-way and street width (to back of curb) 0 0 Proposed home dimensions including any proposed decks, overhangs greater than 21, porches, etc. (i.e. all structures requiring permanent footings) 0 ❑ Show all easements of record and any City utilities within those easements ❑ ❑ Setbacks of pr d st cture and setback of adjacent existing h s ❑ Retaini r i ents, if any Reviewed: me / ate October 1992 - PERMIT CITY OF EAGAN 3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G Eagan, Minnesota 55122-1897 Permit Number: 0 2 7 6 2 3 (612) 681-4675 Date Issued: 05/21/96 SITE ADDRESS: 3273 BLACK OAK OR LOT: A BLOCK: 1 BUR OAK HILLS P.I.N.: 10--15500-040-01 DESCRIPTION: Building Permit Type DECK BuildingWork Type NEW Census Code 434 ALT. RESIDENTIAL REMARKS: FEE SUMMARY: Base Fee $45.00 Surcharge $._50 Total Fee $45.50 CONTRACTOR: OWNER: - Applicant - LUI ALBERT 3273 BLACK OAK OR EAGAN MN 55121 (612)686-6081 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 Mn,. Statutes and City of Eagan Ordinances. _I P PLICANT/PERMITEE SIGNATURE ISSUE Y: SI TURF CITY OF EAGAN 3830 PILOT KNOB RD - 55122 i4lL251996 BUILDING PERMIT APPLICATION (RESIDENTIAL) 681-4675 New Construction RggirGments RemodellRepair Requirements 3 registered site surveys ♦ 2 copies of plan + 2 copies of plans (include beam & window sizes; pobred fnd. design; etc.) + 2 site surveys (exterior additions & decks) ♦ 1 energy calculations ♦ 1 energy calculations for heated additions ♦ 3 copies of tree preservation plan if lot platted after 711193 required: _Yes _ No a~ DATE: t-3 I q G, CONSTRUCTION COST: DESCRIPTION OF WORK: as 63 beck STREET ADDRESS: ? ctl- 0* '6k ' &gf21± ' `rte LOT BLOCK I SUBD.IP.I.D. 6 Lo PROPERTY Name: Phone b OWNER LAST FIRST Street Address: 3263 W: 64 City: cfN State: Zip: CONTRACTOR, Company: Phone Street Address: License City: State: Zip: ARCHITECT! Company: Phone ENGINEER Name: Registration Street Address- City: State: Zip: Sewer & water licensed plumber: Penalty applies when address change and lot change are requested once permit is issued. Chpe,reby acknowledge that I have read this application and state that the information is correct and agree to comply with all icable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY I [F C D Certificates of Survey Received Yes No MAY 15 1996 Tree Preservation Plan Received Yes No OFFICE USE ONLY BUILDING PERMIT TYPE ❑ 01 Foundation ❑ 06 Duplex ❑ 11 Apt./Lodgin ❑ 16 Basement Finish t3 02 SF Dwelling ❑ 07 4-plex ❑ 12 Multi Repai Re ❑ 17 Swim Pool ❑ 03 SF Addition ❑ 08 8-plex ❑ 13 Garage/Access ❑ 20 Public Facility ❑ 04 SF Porch ❑ 09 12-plex ❑ 14 Fireplace ❑ 21 Miscellaneous ❑ 05 SF Misc. ❑ 10 - plex JU 15 Deck WORK TYPE 31 New ❑ 33 Alterations ❑ 36 Move ❑ 32 Addition ❑ 34 Repair ❑ 37 Demolition GENERAL INFORMATION Const. (Actual) Basement sq. ft. MC1WS System t (Allowable) Main level sq. ft. City Water UBC Occupancy sq. ft. Fire Sprinklered Zoning sq. ft. PRV # of Stories sq. ft. Booster Pump _ Length sq. ft. Census Code. L? Depth Footprint sq. ft. SAC Code Census Bldg Census Unit APPROVALS Planning Building Engineering Variance Permit Fee Valuation: $ Surcharge ' Plan Review License MC/WS SAC City SAC Water Conn. Water Meter Acct. Deposit S1W Permit S/W Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Other Copies Total: % SAC SAC Units CITY USE ONLY 4/ L BL RECEIPT /]e .3 /ct /p SUED. ~ lJ 0~ lJ[,l'Xil) RECEIPT DATE: / 1996 PLUMBING PERMIT (RESIDENTIAL). CITY OF RAGAN 3830 PILOT KNOB RD RAGAN, M 55122 (612) 661-4675 Please complete for: A single family dwellings ➢ townhomes and condos when permits are required for each unit backftow preventer for underground sprinkler system - - - - - - FIXTURES EACH # TOTAL Shower 3.00 x = Water Closet 3.00 X = Bath Tub 3.00 X = Lavatory 3.00 x = Kitchen Sink 3.00 x - Laundry Tray 3.00 x = Hot Tub/Spa 3.00 x = Water Heater 3.00 X = Floor Drain 3.00 x = Gas Piping Outlet " minimum -1 3.00 X = Rough Openings 1.50 x = Water Softener * for dwellings under construction 5.00 X = Water Softener * for existing dwelling 20.00 X U.G. Sprinkler * for dwelling under coast. 3.00 = U.G. Sprinkler * for existing dwelling 20.00 = 75 7277' Alterations * to existing residence - Water Turn Around 20.00 - Private Disposal System * MPC lie. 75.00 = (new and refurnished systems) Private Disposal Systems * Abandonment 20.00 = STATE SURCHARGE .50 TOTAL - I he-reby acknowledge that I have nsad this application, state that the information is correct, and agree to comply with all applicable City of Eagan ordinances. It is the applicant's responsibility to notify the property owner that the City of Eagan assumes no liability for any damages caused by the City during its normal operational and maintenance activities to the facilities constructs unde is permit within City property/right-of-wayleasement. SITE ADDRESS. / OWNER NAME: q + C- Q INSTALLER NAME: TELEPHONE STREET ADDRESS: CITY: STATE: ZIP: SIGNATURE OF E ITTEE JS/FORMS BLDG/PLBG PERMIT (RESIDENTIAL) 1998 2005 RESIDENTIAL BUILDING PERMIT APPLICATION P City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 00. Telephone # 651-675-5675 FAX # 651-675-5694 New Construction Requirements Remodel/Reoalr Requirements Office Use Only 3 registered site surveys showing sq. ft. of lot, sq. ft of house; and all roofed areas 2 copies of plan Cart of Survey Reod _Y _N (20% maximum lot coverage allowed) 1 set of Energy Calculations for heated additions Tree Pres Plan Recd _Y -N, 2 copies of plan showing beam & window sizes; poured found design, etc. 1 site survey for additions & decks Tree Pres Required _Y _N 1 set of Energy Calculations Addition - indicate if on-site septic system On-site Septic System _Y _N 3 copies of Tree Preservation Planrf lot platted after 711/93 Rim Joist Detail Options selection sheet (buildings with 3 or less units) Date %A / ~ 1 d Construction Cost Site Address ~3 Unit/Ste # Description of Work Multi-Family Bldg Y - N Fireplace(s) - 0 _ 1 - 2 Property Owner Telephone # ( ) Contractor Window Concepts of Minnesota Inc. Address 990 Lone Ouk Rd City State SA 114 Zip Telephone # e/) Eagon, MN 55121 COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Category 1 _ Minnesota Rules 7672 Energy Code Category Residential Ventilation Category 1 Worksheet New Energy Code Worksheet (4 submission type) Submitted Submitted • Energy Envelope Calculations Submitted In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? - Y - N If yes, date and address of master plan: Licensed Plumber Telephone # ( ) Mechanical Contractor Telephone # ( } Sewer/Water Contractor 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 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 k which requires a review and appr al of plans. Applicant's Printed Name Applicant's Signature OFFICE USE ONLY Sub Types ❑ 01 Foundation ❑ 07 05-plex ❑ 13 16-plex ❑ 20 Pool ❑ 30 Accessory Bldg ❑ 02 SF Dwelling ❑ 08 06-plex ❑ 16 Fireplace ❑ 21 Porch (3-sea.) ❑ 31 Ext. Alt - Multi ❑ 03 01 of_ plex ❑ 09 07-plex ❑ 17 Garage ❑ 22 Porch/Addn. (4-sea.) ❑ 33 Ext. Alt - SF ❑ 04 02-plex ❑ 10 08-plex ❑ 18 Deck ❑ 23 Porch (screen/gazebo) ❑ 36 Multi Misc. ❑ 05 03-plex ❑ 11 10-plex ❑ 19 Lower Level ❑ 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 Replacement 'Demolition (Entire Bldg) - Give PCA handout to applicant 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 REQUIRED INSPECTIONS - Footings (new bldg) _ Final/C.O. - Footings (deck) _ Final/No C.O. - Footings (addition) _ Plumbing _ Foundation _ HVAC _ Drain Tile Other Roof - Ice & Water _ Final - Pool _ Ftgs _ Air/Gas Tests -Final Framing - Siding _ Stucco - Stone - Brick - Fireplace _ R.I. -Air Test -Final _ Windows - Insulation _ 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 3~'f~j~4~~JNt'• { N+ k! ~r.f ~ f j p]~ t~(~,i !R i a•.F ~ t y ~ yyYY ah ~ F~, t r % Y- ~ I J ~ i 4gx':v i IM. It~ ` r ~ ai 1J ~ j. q r _ 8t J~' sa ra, `1 t • I I • I PERMIT City of Eagan Permit Type: Plumbing Eagan. Permit Number: EA104543 Date Issued: 05/29/2012 OR Permit Category: ePermit 41 it~ of E3 E Site Address: 3273 Black Oak Dr Lot: 4 Block: I Addition: Bur Oak Hills PID: 10-15500-01-040 Use: Description: Sub Type: e - Water Heater Work Type: New Description: Water Heater Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size Comments: Dayna Gardner 505 RANDOLPH AVE ST PAUL. MN 55102 651-228-9071 Fee Summary: PL - Permit Fee (WS &or WH) $55.00 0801.4087 Surcharge-Fixed $5.00 9001.2195 Total: $60.00 Contractor: - Applicant - Owner: Bonfe's Plumbing & Heating Albert Chueng Huen Lui 505 Randolph Ave 3273 Black Oa: Dr St Paul NIN 55102 Eagan NIN 55121 (61)228-9071 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 Cite of Eagan Ordinances. ApplicantiPermitee: Signature Issued Bv: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA128943 Date Issued:12/17/2014 Permit Category:ePermit Site Address: 3273 Black Oak Dr Lot:4 Block: 1 Addition: Bur Oak Hills PID:10-15500-01-040 Use: Description: Sub Type:Windows/Doors Work Type:Replace Description:Two or More Windows/Doors Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Improvements to the home require smoke detectors in all bedrooms. If altering window openings or installing Bay or Bow windows, call for framing inspection. Call for final inspection after installation. Carbon monoxide detectors are required by law in ALL single family homes . Valuation: 4,000.00 Fee Summary:BL - Base Fee $4K $103.25 0801.4085 Surcharge - Based on Valuation $4K $2.00 9001.2195 $105.25 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 - Albert Chueng Huen Lui 3273 Black Oak Dr Eagan MN 55121 Dhg Consulting Llc 17754 Icon Trail Lakeville MN 55044 (952) 240-6720 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Building Permit Number:EA172232 Date Issued:09/21/2021 Permit Category:ePermit Site Address: 3273 Black Oak Dr Lot:4 Block: 1 Addition: Bur Oak Hills PID:10-15500-01-040 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. If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any repairs must be inspected prior to covering. The inspector will determine if an additional permit will be required to repair the water damage. 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 - Albert Chueng Huen Lui 3273 Black Oak Dr Saint Paul MN 55121--233 Options Exteriors 460 Hoover St NE, Suite 2 Minneapolis MN 55413 (651) 705-6376 Applicant/Permitee: Signature Issued By: Signature