4646 Bristol Blvd?
` C17'Y OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
PECTIQN RECORD
PERMIT TYPE:
Permit Number:
Date Issued:
i SITE ADDRESS:
i;j.•i1•.Ciil 61.V'rE
:FI '? f ??il ;I i 9 I
,.
' PERMIT SU6TYPE:
APPLICANT:
ltl.rat'? ?..?.
,
? TYPE OF WORK:
/
It Cd+?
I
I.t 1'f
!
I 1 I I;) !'1 i1? ?
? I " _._I-.. I I I I II
? Ihti:; i?
?
" •C1? - ? ?- ?
I
ilL
?,
permit No. Permft Hofder Dete Telephone #
S/W
PLUMSING
HVAC
ELECTRIC
ELECTRIC ?
Inspectlon Date Insp. Comments
Footings I (/ c/l?, ,)d
Foundation ??, ( Q-3 , _ 1 !f
?Cy
Framing k l P g?
Roofing
Rough Rlbg.
?
Rough Htg.
Isul. f ?
r^- ?
IvA
Fireplaca ;2 J? dJ(?S
Final Htg. ?z4rf3 ? I
Orsat Tesi
Final Pibg. Q?7 Plbg. Inspector - Notify Plumber
Const. Meter
EngrJPlan
Bidg. Final
Deck Ftg.
Deck Final
Well
Pr. Disp.
?
?
f'-P I
. l
CITY 4F EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 6$1-4675
? SITE ADDRESS:
4 { 7 ? .
i:.ali. 61i L"1i,k( f4t.vP
PERMIT SUBTYPE:
. , ; ?-ii i,;; ? lr1r ;I1
(JN RECORD
PERMIT TYPE:
Permit Number:
Date Issued:
t," . 'a W ? V' 0 - , APPLICANT:
TYPE aF WORK:
ni r 11rA s rra14
( N k'i 8k': a.? W)C! ?q `i )
INSPECTION
> > ,????>++,.? r• ON TYPE
a ,fII! ?Vf D
I
Permit No. Pennit Holder Oate Telephone #
ELECTRIC ?J ?? Q ?
PLUMBING
HVAC
Inspectlon Date Insp. Comments
FOOTINGS
FOUND
FRAMWC.,
l D
ROOFING
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
eSMT R.I. -
BSMT FINAL
DECK FfG
DECK FINAL
?. ? .
?• :-3 .?ar
.
Wtrtificate of cCClipRliC4
wiim vt Cfagan
This Certifcate issaed pursLartt to ihe requtremerets of the Uniform Building Code
certifying that at the time of issuanee this struclun was in compliance with the various
ardiaances af the City reguluting buildiag corr.stnection or use. For the following:
use classiscauon: SF M Bwg. PeFmit No. 21335
Occup-Y TYPe R3 ' 7unieg Disorict R Type Consc
Owner of Building SMS rJMMMMQJ ?ress 4600 1''M-%W ?? ?, EW-AN
Building Address 4646 MISIC7L H[.W [.acaliry I2, B3, WMW l,I,S / Date-
' ' Suild'mg Official
P09T IN A CONSPICUQUS PLACE
Address 4646 SR7St»i. TtfAp Zip 5512 3
Lot. .' 2 Blk 3 Sub wES'mrr HaIs
THESE ITEMS WERE ! WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECTION.
Date: ? 9 ?-I- Yes No Inspector:
Final grade (6" from siding)
Permanent steps (garage)
Permanent steps (main entry) ?
Permanent driveway
Pertnanent gas V/
Sod/Seeded grass
TraiUcurb damage
Porch ?
Basement finish
Deck ?
Please verify with the builder the removal of roof test caps from the plumbing system and the shutoff of water supply to
the outside lawn faucet before freeze potential exists.
Contad engineering division at 681-4645 before working in righ[of-way or installing underground sprinkler system. ?
Wtiite - City Copy Yellow - Resident Copy Pink - Contractor Copy
Wy?J OFFlCE USE ONLY This request wid 18 monthv (ran wlidaKon dole prinled in Ihis bw?.
/ .?f s? 6/7 /
I1IIIIII?III?IIIIIIIIIIIIIIIIIIIIIIIIIIU1.;2/6.// O-," ' //
* 400
?
0 4 1 6 1 7 8 2* pLEASE PRINT OR TYPE
Requesl
JI 7 RaugFin inspecfion requiredz Y. ? W
? ou
muat mll the inspecmr when neady) Inspecflon dher Thon RauqMn. ? Rmdy N .II Call
Dab Reody.
I, ? licensed conhoctor difewner hereby request inspecfion of the above electricol work at:
Job Addr G epy ' RaegT?y
/? • Ciy Zip Code
Section No. Township Noma n No Rmge No. Fire No. Couny
Occupant ; /
C?VI /?l+ Nvna No.
Power S.pp r /ddross
Ekchiml Con ( po?ry Namel
o rn?e o wh e't, Conhacbr Ixenu W. Maakr lic. No (Plam Eled. OnJy)
r.bii,, ndd cemm?a r re.r«mina mwution)
ov
Mdhorized S re vo r o Owner PerFormng I ?
c 'oe Ph/one No.
(0/2 " 7.? Z ??%/!1
EBOOOOIA 1 8/96 STYTF 9f1GRO MPY - CFF IN.¢Ti11MlNNC llN BACN OF VELLOW COW
3/?/? 7? REOUEST FOR ELECTRICAL INSPECTION
-'? Minnesota State Board W Elechicity
0' 1621 Universiry Ave., Rm. 5-128, St. Paul, MN 55104 ?
Phone (612) 642-0800
e Duplex A 1. Bldg. (ine . Naw Addn
Commercial Indushial Farm SM ' Remod Re ir
Air Cond. Htg. Equi . WaMr Hh. Load Mgmt. Other:
D er Range Elec. Heat Tem . Service
"X" obove the work covered by this request Enfer remorks in this space and on fhe back of fhe whik copy only.
Calculaie InspecFion Fce - This Inspection Requesf will nof be accepted wifhoul fhe correct fee:
Ofher Fee M Service Entrance Size Fee # Circuits/Feeders Fee
Mobile Home Park Sfall 0 l0 200 Amps 0 ro 100 Amps
Sheet Ltg./ira((ic Sig. A6ove 20Am s Above 100_Amps
Transkrmer/Generotor msPecroRS use onLY T
Sign/Oudine L . Xfinr.
Alarm/Remote Canhol
Swimming Pool
I hereb ce ' that I in the d«nical insmAation described herein on ihe dores bd
Imigotion Boom RwgMn r Daro
$
eciallns
ech
on ?
p
p
Invesfigofive Fe
e Fi o?
3
THIS INSTALLATION MAY 6E ORDERED DISCONNECTED IF NOT COMPLETED WITHIN 1B MONTHS.
/C2 1 d'Co
a aa ? ? s ?`'
Requ t Oate ?
7/ 16 / 9 3 Fire o Rough-in Inepection
ReqWratl?
? Reetly Now ?`.j Will NoGy Inspector
&Vas ? No When RBatlY?
IX hcensed contractor ? owner here6y requesl inspection of above electrical work at:
Jo0 Atldress (Street Box or Rome No,) Ciry
4646 Bristol Ea an
SMion No TownsM1ip Name or No Range No. CAUnry
Dakota
Occupant(PRINT) Phone No.
Sons Construction 452/5855
PowBr Suppber Atltlres3
Dakota Electric 4300 220th St. W., Frmington
Elecincal Conlrenor(ComOany Name) ConVector5 Lkense No
Joos Electric Co. AM01895
MeJmg qOtlress ICOntractor Or Owner MeMing Instellation)
2104 Great Oaks Drive, Burnsville, MN 55337
AWhonzea Signelure iGonVactoriOwner Making Ins ry Phone Number
431-4755
MINNESOTA STA7E 60AHD OF ELECTRICITV THIS INSPECTION REOUE3T WILL NOT
GrIggs•Mltlway BIEB. - poom S173 BE FCCEPTEO BY THE STATE BOARD
1821 Universlly qve., St. Paul. MN 55106 UNLES$ PROPER INSPECTION FEE IS
Pho" (811) 642-0800 ENCLOSED
REQUEST F?_.. ____-...._-.._ ...SPECTION
? Sae mstrucbons br completing this brm on back M yenow copy.
_ 'X" Below Work Covered by This Request
N% , ee-00001-08
A$„?.?'
e Atltl Rep 7ypeolBwlding AppliancesWired EqulpmeniWired
X Home X Range Temporary Service
Duplax Water Heater Electric Heating
Apt. Builtling Dryer O[heo-(Specity)
Comm./Industnal X Fumace
Farm Air Conditioner
Otnm (syeciry) CaMrector5 Ramerks
Compute Inspection Fee Below:
# Other Fee # ServiceEntrenceSize Fee # Circu1lsiFeeders Fee
Swimming Pool 0 to 200 Amps 0 to 700 Amps
Transformers Above 200 _ Amps Above IDO _ Amps
Sgns Insoecwr§ use Oniy. TOTAL
Imgation Booms
Special Inspechon
Alarm/COmmunication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WRHIN 18 MONPK
I, the Electrical tnspector, hereby
tif
h
th
6
i Rough-in J o 7„'?
F?w
cer
y i
at
e a
ove
nspection has
been made. F;nei ?a
?C
OFFICE USE 3NLY
This roquasi mitl 18 monihS irom
? CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
SITE ADDRESS:
PERMIT
PERMIT TYPE:
Permit Number:
Datelssued:
4646 BRISTOL BIVD
LOT: 2 BLOCK: 3
WESTON HILLS
rk
i/?/?
BUIL NG
021335
07J14J93
DESCRIPTION:
B ldi Permit Type SF DWG
uilding rk Type MEW
BC Oc'c?lpanc" R-3 M-1
? tonstr•uction "i` e V-N
' ZOning • R-1
? Bu3liling Le?gth . 56
Buil,di.ng Width •, 37
B
REMARKS:
S& W PLBR - R C PL66 PRV
FEE SUMMARY:
Base Fee
Plan Review
Surcharge
SAC
SAC %
SAC Units
Lic. Search Fee
Subtotal
$161,000
VAIUATION
MISCELLANEOUS $1.744.50
Total Fee $3,987.95
$653.@0
$554.45
$88.50
$750.00
100
1
$5.00
$2,242.95
CONTRACTOR: - APPlicant - sT. Lic. OWNER:
SONS CONST 14525355 0002608 SONS CONST CO
1091 TIFFANY OR 4600 FAIRWAY HILIS OR
EAGAN MN 56123 EAGAN MN 55123
(612) 452-5355 (612)452-5355
? I herehy.aaknowledge thet.I F}aus.read .this applIcatipn and s!tate th`a.t the
?- information is currect and a,gree,t9 gpmply with, a11 ap611cab4e- State of An:
? Statutes and Gity of eagata ,Qesfinances.. , - ' ?-- _ _ - -- ?
-_-
APPLICANT/PERMREE SIGNANRE ISSUED BY: IGN RE ?
INSPECTION RECORD
CITYOFEAGAN PERMITTYPE: eutLoiNs
3830 Pilot Knob Road Permit Number: 021335
Eagan, Minnesota 55123 Date Issued: 8 7/ 14 J 9 3
(612) 681-4675
SITEADDRESS: Lor: 2 BLOCK: 3 APPLICANT:
4646 BRISTOL BLVD SONS CON3T
WE3TpN HILLS (612) 452-5355
PERMIT SUBTYPE:
SF DWG
TYPE OF WORK:
NEW
FOOTING .. .
FRAMIN6 .A
INSULATIOM FINAL
FIREPIACE
REMARKS: S& W PLBR - R C PL66 PRV
? -- - --. - - - - -- - --- - `---- -- - - - - _. _- -_ __ __? _._ _ . . ' ^ __ - . - • -- -?
REACTIY_ ---'""""""' GITY OF EAGAIV
P.ERMIT1993 BUILDING PERMIT APPLICATION $3,Q??•4.?'`
If; 681-4675
M303U rl..?,?(, ?-zQ
SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs.
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.
Date ??? /?' /!? Yaluation of work f?6TCzf )0
Site Address: '1-M 46 Rvisjm
STREET SUITE #
Tenant Name: (commercial only)
LOT d- BLOCK= SUBD.?Q?/J NII`S P.I.D. ?f
Descri tion of work: AX?"t-V n'o
The applicant is: X Owner Contractor O Other (Deaertbe)
Name.? nJS C'rJ5'F' C::?o ? Phone
Property LAST FIRST
Owner /J
kl
l
oe
2v'
c
l
cr , vW-) 12? s
-
Address
STREET . STE N
_
r_
City ? nJ State &,ll c Zip
Company Phone
Contractor Address License # I?_ Exp.
City State Zip
Company Phone
Architect/
Engineer Name Registration #
Address
City State Zip
Sewer & water licensed plum6er Processtng time for
sewer & water permits is two days once area has been appr ed.
I hereby acknowledge that I have read this application and state that the information is
correct and agree to comply with all applicable 5tate of Minnesota 5tat tes and City of
Eagan Ordinances.
Signature of Applicant:_C__?nl 0J C/ ?? '
OFFICE USE ONLY
BUILDING PERMIT TYPE ? 4a . _: .?
? Ol Foundation ? 06 Duplex ? 11 Apt./Lodging ? 16?Ba;ejgntjFipi
? 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc. ? 17 5wim Pool
03 SF Addition ? 08 8-Plex ? 13 GarageJAccessory ? 18 Comm./Ind.
? 04 SF Porch 13 09 12-Plex ? 14 fireplace ? 19 Comm./Ind. Misc.
O 05 SF Misc. ? 10 Multi. Add'1. ? 15 Deck ? 20 Public Facility
? 21 Miscellaneous
WORK TYPE
d 31 New ? 33 Alterations ? 35 Tenant finish ? 37 Demolish
? 32 Addition ? 34 Repair O 36 Move
GENERAL INFORMATION
Const. (Actual) V-N Basement sq. ft. MWCC System yFs
(Allowable) V-N lst F1. sq. ft. City Water ?
UBC Occupancy R_3 M_i 2nd F1. sq. ft. PRV Required
Zoning ,R -1 Sq. Ft. total Booster Pump
ri of Stories Footprint Sq. ft. Fire Sprinkler
Length 6 On-site well Census Code / oi
Depth ?Z On-site sewage SAC Code _e.3 4
APPROVALS ol
Planning Building Assessments
Engineering Variance
REQUIRED INSPECTIONS
0 Site
? Wallboard
? Footing
0 final
? framing
? Draintile
? Insulation
? Fireplace
Permit Fee
Surcharge
Plan Review
License
MWCC SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
Copies
Other
Total:
SAC % lDO
SAC Units _L
Yetuation: s (fol, 0 o oa
C7AR 4 (9V1„X•ZS= '/68 X16 =
SS_,??.24x3y=
13x1o=
3'$ x 13Y4;
IS'h x ? =
2xaU2=
Isr F?oo ,
85rv?T= Io4(p
2 XZxCI7 .36-_
'It3Zx54=
L N o F'c.,, oaa„ :
aA X53'?Z =1552s??
57tx 2.0 _ ( i u )
w K r-7 = ?6S)
lo'/y ' . _?_ ?..
7gU3
r
?ky•
130
4Ib
31
S'
...-??
?oq?,x ?5 = 16,440
6 y/ZS
_ rIS,ov6
I b ol 3 V7
JUN 22 193 12:40 TO 4525355 FROM PROBEIHNGINEa2IWG 7-161 Pi02
AO(3E VLRN 4 s one qP iUpVdY08f
. ENQrIN6EA1Nt3
COMPANY, INC.
.?,?.. 1000 EAbT I461h STR[47, BUIINSWLLE, MIHNL{OiA 0633 7. PN1?432-11000, ,
CERTIFI.GATE OF"SURV'EY
Legal Description:
sca.e i r = an
pGNOmE
(955,0 ) DENQTE
INDIIMAIT
955, 3 3 Q FINIBME
q 4-9 •33 = BASEME
956,33 a TOP PJF
.EIEVATION
D E1.EVATION
M (6R SURf?A
It
)*NoTE : S7RaT NOT OAV6TiPr/C76o, OROPWD g7R6aF7''
EL6t?.qT/G4!S S46wW A"-A7HOW ORO.4FAC7'CioG4TFW7JYw/^4
30 Fr. FKanrr 8v11An?6
SETBACK LIN6 --?,
pRA/NA6E AND
vM-irY EAAWENr,
,
I hereby aertify that tliie ig a tru.e' and correct
land as ahown and deseribed liers9n:?Aw prepa
„ ?.
??NE r ? ? ' . " ;?`
1100
LOP
•s•Oreeentation oP, a. traoti of
oetiy ?na thi+e „ia day of
oe `Minn. Reg. No. /GoM
,.,. LOT BURVEY CHECKLIBT FOR RESIDENTIAL
? BUILDINO,PERMIT APP ICATION
W ? PROPERTY LEOAL:
? w
m Date of Burve§: aa Lc
pOCUMENT BTANDARDB
W 0 0 • Reqistered Land Surveyor sfgnature and company
{??? 0 • Building Permit Applicant
:C3" O ? • Leqal description
0 Er ? • Addresa
0 0 • North arrow and bar scale
?? 0 • House type (rambler, walkout, split w/o, split
lookout, etc.)
Cr?'?? • Directional drainage arrows with slope/gradient 8.
0['l" 0 • Proposed/existing sewer and water services
{J3 0 D • Street name
G ? ? - Driveway
Exisiinq
D M"?D • Sewer service
? 0 ? • Lot corners
I? 0 • Top of curb at the driveway
? 0 • Elevations of any existing adjacent homes
Proooeea
?O 0 0 • Garage floor
?f ? D • First floor
it 0? • Lowest exposed elevation (walkout/window)
?-/0 0 • Property corners
C? 0 0 • Front and rear of home at the foundation
PONDINti AREAS (if apDlicabl-ol
0 0`?- 0 • Easement line
0 L? ? • NWL
0 ? • HWL
0 E/ 0 • Pond # designation
0 Q 0 • Emergency overflow Elevation
0 ? •
p' ? 0 •
E' D 0 •
o' ? 0 •
0 0,,,? .
Rev
October 1992
entry,
Lot lines
Right-of-way and street width (to back of curb)
Proposed home dimensions including any proposed decks,
overhangs greater than 21, porches, etc. (i.e. all
structures requiring permanent footings)
Show all easements of record and any City utilities within
those easements
Setbacks of proposed structure and setback of adjacent
EXTEMoa.$xvBr.op$:axBaciY coD&coxRvme+rtarawoRcsbs$,r
Project
Site
1. EXPOSED WALL CALCULATIONS
AM "D" WJM AREA x 'U"
A. Opaque Wall .
1. Masonry/Concrete
a. Y ?
b. x ?
c. x ?
2. Foundat-icn Wa
a. „
b.
3. WoW Fraae' WRU ?.
a. Insu]atad 1?rea x. •,04 .. ' ?
b. Fraa?ing Are?; (
A
vq. 150 at ?6". x) j, '
I
a
C.. ?$?Qi? ?? ?sV@. 3b
_
?
??
4• ?L' i .?1? ?//p? ?
? ? . , •
a.
?.. b•
B. Glazing
1. Windows
a. x> .?.° 3?,,,, ' ?1? • :? _
b. 4b: x
2. DOOts • 7t ?
C. Doors
l. Wood
a. Solid
b. With atacm x •
2. Metal „ .?_;x' '_?"`•
3. Overhead x ?
4. Othes
D. WTAL MIL aRFA, sq. f t . . . . .. : :. ..... .. . .... 2-',1 ,
E. TDMI: of ARFJ1 Y"U" . .....................................:............ 2LoZ . ? G
II. ROOF/CFilLINf3 CALCULATiONB
A. Roof/Ceiling Insulated Area ?- x ,D L ¦ 2•2
8. Aoof/Ceiling Framirg p?ve. 150,a! 16" ,oc) ¦?'C. Rmf/C:ei].ing Framirg (Ave. ,10% at 24" x) .'.1?,9a` ,:,, Y!??? =-?'°•=?
0. Skylight ? ,x
,•- .
E. TO'1'AL AOCIF/C:EI7+ItG ARFA sq. ft...........,.•.. ." ' F. 'DOV!L CF AREA x"U" ......... a............:.......?..-.?........ «..<......... v•?7
Z+o Determine Qmpliance with the,MinnesotaEnergy Oode
(Section. 502 of the Ststie -kaenw'19&3 ?lo" aww'Cccie) .
' •,:
Ill. BU[LDING 8NV8LOPS.RBQUIR8INSNT6 ,
,.
ALI:AWABLB
(?rea x, "D') ,
. .?I? l?? rI • ,
A. FScposed Wa]1 t ? 7c "? ? •. e)
8. Roolfieilirg: ;^L??,`x? , -` z''• •? ,
._.?.
C. ' TO'lAI. ALLOf+II+= 8U7LDIIG FNVE[OPE ('lbta7: of A',BA";..-.
IV. ACTUAL SUILDiIIN4 8NV8LOPS
ACTUAL
(At? x
A. Exposed Wall (Fmrt I.E) b6
8. 1?oof/Ce?1in9 (Fram I?.? _ ?,?. ?'1
C. TOTAL ACl[IAL 8U'bD?'i WMPB, Ci'CW of A i$),.. ..........
. .'
*(Neu coft esqrieraau tf las Wr iII.C) ' '
. a' . . u ..
V. REQUiBED "U" VA1:UB8 .
?,LS? I?OF/t?II.IN?G
Detached ore dtld twD Eatai]y dwellirgs .11 :026 ?
* Malti-Family liesidential euildirgs .236 :033
(3 stories a lees in height)
* All Other Qxastruction %ypes (3 stcries or lese) .238 .06
• A]l Other Constructicn Typea (Moc'e tMan 3'ftociqs)
. . .Z8 • :06
• aama on eoo7 a..sioa myne ars ("PhAs. vwr)
AOiust 'Y• ralws ueordlqyJY tolC oeler louti,ppi -
.
CER'1YFICATION
I heceby certify that I have
Minnesota State Ei7ergy CocIB.
-,
M#0?44w •Ojae it, FW4s. wlth t
the, a¢we ic40
. , , ?.
BCSD 3-89
CC/SA'i/6574
r R
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
SITE ADDRESS:
P.I.N.: 10-83750-020-03
PERMIT
PERMITTYPE:
BuxLorNG
Permit Number: 029571
Date Issued: a g /g 7/g 7
4646 BRISTOI BLVD
LpT: Z BLOCK: 3
WESTON HILLS
DESCRIPTION:
(NO BEDROOMS)
ermit Type BASEMENT FINISH
6 Type ALTERA7ION
?-?? 434 ALT. RESSDEN7IAL
A A
H
...
W, ' ' ' Eron
REMARKS:
A SEPARATE PERMTT IS REQUIRED FOR ANY ELECTRICAL QR PLUMBIN6 WORK
FEE SUMMARY:
Base Fee $50.00
Surcharge $.50
Total Fee $50.50
CONTRACTOR: OWNER: - qpplicant -
? ARTH RICH
4646 BRIS70L BLVD
? EAGAN MN 55123
(612)452-5990
? F '
J?NI I?
?. ..? he.r- b? acknowfedc?e?,th?ot?j h?s?ve r0 ? d appl?c?Ci?e??r??f 6tate ?h&t
.,
a, ??e'b," tw'??"L
? ?inf9rmat'$on ?rrr-?e4? si?
? •? -=?t????e??,??•d?`'`Cx??i ?a mceg"??f??°
. ?i.
.
m, ??C_ _
PPLICANT/PERMI IGNA7URE ?SSUED :SIGN E
Xqf 897 BUILDING PERMITAPPLICATION (RESIDENTIAL)
? CITY OF EAGAN
3830 PILOT KNOB RD - B6122
sammag 681-4675
HeR7odeVRenair ReoufremeMs
• 3 regiatered ake suneys a ycopies of plan
* Z coDbs W plans (induda beam b window sim; poured fid, tlesign; etc.) ? 2 site suneya (extarior eddldons 6 dedcs)
? 1 energy celculffiiona ? 1 errorgy eakulations for heated edtlttions
? 3 wpiea M tree preseivation plen B bt pleried eRer 711/93
requhed: _Yea _ No •
DATE: coNSrnucnoN cosr: -?S ?• ? S°a ?
DESCRIPTION OF 1NORK:
STREET ADDRESS:
LOT I BLOCK ?J SUBD./P.I.D.#: 1???? e''?,?Q??
PROPERTY NBRte: Phone #: 452- s°rgo
OWNER Street Address: 4?`l
City: State: A-kl-) Zip: S?? Z3
CONTRACTOR Company: SE-t-+` Phone #:
Street Address: License #:
City: State: Zip:
ARCHITECTI Company: 5 E- k-f Phone #:
ENGINEER
Name: Registration #:
Street Address:
City:
State: Zip:
Sewer & water licensed plumber (new construcdon onty): . Penally applies when address change
and bt change are requested once permit is issued.
I hereby acknowiedge that 1 have read this application and state that the informaNon is correct and agree to comply with all applicable
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant
OFFICE USE ONLY
Certificates af Survey Received _ Yes _ No
Tree Preservation Plan Received _ Yes _ No _ Not Required
" . !
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. AI50, FOR TOWNHOMES AND
CONDOS WHEN PERMTTS ARE REQUIRED FOR EACH UNIT.
i0. FIXTURES EACH TOT?
3 E.HnuEg 3.39 3. --
WATER CLOSET 3.00 27 -
a BATH TUB 3.00 (1. -
LAVATORY 3.00 /.Q- -
L KITCHEN SINK 3.00 3 ,
_
1 LAUNDRY TRAY 3.00 31
-
HOT TUB/SPA 3.00
= WATER HEATER 3.00 3 -
L FLOOR DRAIN 3•00 3- "
_ GAS PIPING OUTLET • minim»ro - i 3.00 3_ -
3 ROUGH OPENINGS 1.50 ?lst>
WATER SOFTENER 5.00
PRIVATE DISP. • nerc,y. uc. 15.00
U.G. SPRINKLER • tome under oo?t. 3.00
AL'I'ERATIONS • to exisuog 15.00
WATER TURN AROUND 15.00
STATE SURCHARGE .50
ii-D
?
TOTAL: •
3IT'E ADDRFSS: 4646 Bristol Blvd.
OWNER NAME: Sons Construction
INSTALLER: R C Plumbing
ADDRESS: 5910 (`heeter AvP
CTTY: Northfield STATE: mn ZIP CODE: 55057
PNONE#:( 61 ? 461-2096
SI NATURE OF PE ITTE
1993 PLUMBING PERNIIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
FAGAN MN 55122
(612) 681-4675
PLEASE COMPLETE FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND
CONDOS WHEN PERMITS ARE REQUII2ED FOR EACH UNTI',
? NEW CONSTRUCTION
ADil-OIv A/C
ADD-ON FURNACE
DATE 11 /?17J
FEES
HVAC: 0-100 M BTU
ADDITIONAL 50 M BTU
4L OUTLETS (MINRvtuM 1 @ S3.oo EwCH)
$ 24.00
6.00
6.60
ADD-ON/REMODEL (ExisTING coxsMucrtoN)
STATE SURCHpRGE
TOTAL
$ 15.00
.50
.5
STTE
OWNER N
TF-LEPxorrE #: '? - .635§1
INSTALLER: GIIVZ-RYAN PLUNIDING & HEATING C0.
ADD::ESS: 14745 South Robert Trail
CTT'y; Rosemount STATE: M ZIP CODE: 55068
TELEPHONE #: (612) 423-1144
0
MECHANICAL PIItMIT (RESIDENITAL)
CITY OF EAGAN
3830 PILOT KNOB RD
FAGAN MN 55122
(612) 6814675
L? BL ? CITY U3E ONLY RECEIPT#: _/ OO570
SUBD. W'J?.v I.XXX?? RECEIPT DATE: 12
1997 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: . single tamily dwellings
? townhomes and condos when permits are required for each unit
? backflow preventer for underground sprinkler system
FIXTURES
Shower
Water Closet
Bath Tub
Lavatory
Kitchen Sink
Laundry Tray
Hot Tub/Spa
Water Heater
Floor Drain
Gas Piping Outlet • minimum - 1
Rough Openings Water Softener * for dwellings under conawctlon
Water Softener ` for existing dwelling
U.G. Sprinkler ' for dwelling under const.
U.G. Sprinkler ' for existing dwelling
AIter2tions " to euisting residence
Water Turn Around
Private Disposal System ' Dak Cty lic.
(new and refurbished systems)
Private Disposal Systems "nnandonment
9ACU NQ. TOTAL
3. ° x ? _
o nn X _ 3
3.00 x =
("T x = 3
3.00 x =
3.00 x =
3.00 x =
3.00 x =
3.00 x =
3.00 x =
1.50 x =
5.00 x =
20.00 x =
3.00 z.00 ' _
0
65.00 =
20.00 =
STATE SURCHARGE .50
TOTAL DC7. S o
I heraby edcnowledge that 1 have read this applicadon, state that the iMormadon is coeed, and agree to comply with ell appiieable City
of Esgan ortlmances. It is the epplicanPs responsibillty to nMi/y the property owner Nat the City of Ea98n assumes no Ilability for any
damages caused hy the City during its noimel operati0nal and maiMenence ectivkies to tlie faaliities conahudad under this pertni[ within
Ciy propertylrigMof-way/easemeM.
SITE ADDRESS: ??0 A) ??-
OWNER NAME:
INSTALLER NAME:
STREET ADDRESS:
cirr:
fNC. TELEPHONE #:
` ---. • ? ZIP: SIGNATURE OF PERMITTEE
OFFICE USE ONIY
2004 RESIDENTIAL BUII,DING PERNIIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122 7'1 () 06
(D Telephone # 651-675-5675 FAX # 651-675-5694
NewConsWCtionReauirements
RemotleVF2eoairReauirements . =--..?,.
Zee;FJs+I g
3 registe2d site surveys shaving sq. ft ot lot sq. ff. of house; and all roofed areas 2 copies of plan CeR of ?13rveylHeait
• Yx_ a
(20%
maximum lotcove2ge allowed) 7 set of Energy Calculations for heated additions (
?e.PrkPlap .
?,,;1f?.,wyt?
2 copies of plan ahowing beam & window sizes; poured (ound design, etc. 7 site survey for additions 8 decks 'Eice Fies R uired
?
? - Y°;_ N
i set of Energy Calculations Addition - indicate if arsfte septic sysfem ,
,6n
,-"?g?
3 copies of 7ree P2servation Plan if lot platted aNer 7/1193
Rim Joist Defail Optbns selection sheet (61dgs with 3 or less unBs
Date ?y ??-
Construction Cost y?dD? sz e
Site Address UniUSte #
?
DescripHon of Work l/L - tru s?
Multi-Family Bldg _ Y?N Ftireplace(s) _ 0 _ 1 _ 2
Property Owner c? Telephone #
Contractor
Address </Ci ?/ ?j?? ,? ?'t? ? _ ? City
Sta[e Zip Telephone # oq2 ) 5!2?
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
- Mirmesota Rules 7670 Cateaorv 1 Minnesota Rules 7672
Energy Code Category . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheet
(Jsubmissiontype) Submitted Submitted
• Energy Envelope Calculations Submitted
Have you previously constrvcted a building in Eagan with a similar plan? _ Y _ N If so, 25% plan review
fee applies.
Licensed Plumber
Mechanical Contractor
SewerlWater Contractor
Telephone # (
Telephone #(
Telephone # ( F
I hereby apply for a Residential Building Permit and aclrnowledge that the inform ? n is
that the work will be in conformance with the ordinances and codes of the City ?
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 e of work wh' requires a review and
approval ofplans.
%/f?v.'d
? Applicant's Printed Name A plicanYs Signature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA113566
Date Issued:09/05/2013
Permit Category:ePermit
Site Address: 4646 Bristol Blvd
Lot:002 Block: 003 Addition: Weston Hills
PID:10-83750-03-020
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Scott Follese
5182 West Broadway
Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088
Surcharge-Fixed $5.00 9001.2195
$60.00 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 -
Paul N Goren
4646 Bristol Blvd
Eagan MN 55123
Golden Valley Heating & Air
5182 West Broadway
Crystal MN 55429
(763) 535-2000
Applicant/Permitee: Signature Issued By: Signature
I For Office Use I
Permit
WCS~
Clt of ~a a~ I ~ I
Y I Permit Fee: I
3830 Pilot Knob Road I I
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff: I
-----------------I
2013 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: .4C> `OZZ `r-: Site Address:
Tenant: Suite
Resident/Owner - Name: Phone:
Address / City / Zip:
Name: 1~,4 WCgnse
Address: _
Z--
Contractor•~ ~r-- City:
State: Zip: 70 Phone: -
Contact:Email
Type of Work -New ✓Replacement -Repair _Rebuild _ Modify Space _ Work in R.O.W.
Description of work:
RESIDENTIAL
V Water Heater
Water Softener
Lawn Irrigation RPZ PVB) ~
Permit Type Add Plumbing Fixtures Main / Lower Level)
Septic System _
New Water Turnaround
I Abandonment
RESIDENTIAL FEES:
$60.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge)
$60.00 Lawn Irrigation (includes $5.00 State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnaround* (includes $5.00 State Surcharge)
"Water Turnaround (add $189.00 if a 5/8" meter is required) ,
$105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 State Surcharge)
TOTAL FEES $
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.qopherstateonecall.org
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.
Applicant's Printed Name Applicant's Signature
FOR OFFICE USE Reviewed By: - Date:
Required Inspections: _ _Un_der G_r_ound_ __Rough-in _Air Test _Gas Test Final--
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA145405
Date Issued:09/08/2017
Permit Category:ePermit
Site Address: 4646 Bristol Blvd
Lot:002 Block: 003 Addition: Weston Hills
PID:10-83750-03-020
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 - Residential Additions, Alterations
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 within 10 feet of all sleeping room openings in residential homes (Minnesota State
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 -
Paul N Goren
4646 Bristol Blvd
Eagan MN 55123
Craftsmans Choice Inc
5680 Quam Ave NE, Suite A
St. Michael MN 55376
(763) 276-7465
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA153411
Date Issued:12/18/2018
Permit Category:ePermit
Site Address: 4646 Bristol Blvd
Lot:002 Block: 003 Addition: Weston Hills
PID:10-83750-03-020
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 - Residential Additions, Alterations
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 within 10 feet of all sleeping room openings in residential homes (Minnesota State
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 -
Paul N Goren
4646 Bristol Blvd
Eagan MN 55123
Craftsmans Choice Inc
5680 Quam Ave NE, Suite A
St. Michael MN 55376
(763) 276-7465
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA166806
Date Issued:02/05/2021
Permit Category:ePermit
Site Address: 4646 Bristol Blvd
Lot:002 Block: 003 Addition: Weston Hills
PID:10-83750-03-020
Use:
Description:
Sub Type:Windows/Doors
Work Type:Replace
Description:Two or More Windows/Doors
Census Code:434 - Residential Additions, Alterations
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 within 10 feet of all sleeping room openings in residential homes (Minnesota State
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 -
Paul N Goren
4646 Bristol Blvd
Eagan MN 55123
Craftsmans Choice Inc
5680 Quam Ave NE, Suite A
St. Michael MN 55376
(763) 276-7465
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA166808
Date Issued:02/05/2021
Permit Category:ePermit
Site Address: 4646 Bristol Blvd
Lot:002 Block: 003 Addition: Weston Hills
PID:10-83750-03-020
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 -
Paul N Goren
4646 Bristol Blvd
Eagan MN 55123
Craftsmans Choice Inc
5680 Quam Ave NE, Suite A
St. Michael MN 55376
(763) 276-7465
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA172113
Date Issued:09/15/2021
Permit Category:ePermit
Site Address: 4646 Bristol Blvd
Lot:002 Block: 003 Addition: Weston Hills
PID:10-83750-03-020
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Standard Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
Surcharge-Fixed $1.00 9001.2195
$60.00 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 -
Paul N Goren
4646 Bristol Blvd
Eagan MN 55123
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature