4480 Mallard Pl
Use BLUE or BLACK Ink
_
I For Office Use
I
Permit
City of EaV
I Permit Fee: I
3830 Pilot Knob Road
Eagan MN 55122 I Date Received:
Phone: (651) 675-5675
I j
Fax: (651) 675-5694 ,iii Staff:
/ 2011 MEC[HJAN~`ICAL PERMIT APPLICATION
Date: / Site Address: T `'7r o y
Tenant: Suite
~`7L/-
RESIDENT/ OWNER Name: C Phone:
f~
Address/ City /Zip:
Name: CG-)License
CONTRACTOR
1,4
l U u City:
Address: y
k/S v j
y7"
State: _ Zip: ~~~1! Phone:' ~fi J
Contact: Olawvn Email:
TYPE OF WORK New Replacement Additional Alteration Demolition
C' ~j _&In Description of work: L1~ ,
NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City
Code. Please contact the Mechanical Inspector for information on permitted screening methods.
RESIDENTIAL COMMERCIAL
PERMIT TYPE -/Furnace New Construction - Interior Improvement
Air Conditioner Install Piping _ Processed
Air Exchanger Gas _ Exterior HVAC Unit
Heat Pump _ Under / Above ground Tank Install / _ Remove)
" When installing/removing tank(s), call for inspection by Fire
Other Marshal and Plumbing Inspector
RESIDENTIAL FEES:
$55.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge) l~~ f
$95.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) $ " TOTAL FEE
COMMERCIAL FEES:
$75.00 Underground tank installation/removal OR Contract Value $ x1%
$55.00 Minimum (includes State Surcharge)
Permit Fee
- If the Permit Fee is less than $10,010, surcharge is $ 5.00
If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee Surcharge
(i.e. a $10,010-$11,010 Permit Fee requires a $ 5.50 surcharge)
TOTAL FEE
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.or-q
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,under nd 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 apprgvedg a case of rk ich,requires a review and approval of plans.
r
X'' d ~G h X Lh ~1
Applicant's Printed Name Applicant's Signature
FOR OFFICE USE Reviewed By: Date:
Required Inspections: ' Under Ground _ Rough In -Air Test -Gas Service Test -In-floor Heat -Final
Exterior HVAC Screening Inspection
7 ? INSPECTIUN REC4RD Controi No. 0580
.
CITIf OF EAGAN PERMIT TYPE: ?" ? ?• ? ? ?a
3830 Pilot Knob Road Permit Number: 000733
Eagan, Minnesota 55123 Date Issued: 06/00j92
(612) 681-4675 ?
SITE ADDRESS: 1. p Tc t? h t a 1; x: I APPLICANT:
i 4480 MALIARp 1'l. Ot:ROLO eRorNERS COlIST
T H U M A`; ! A VF W[) () Ci C i S T I Ei 121 449-94-?`y
958
PERMIT SUfBTYPE: TYPE OF WORK:
H?u
'?'a.
iA4 .f.`- a.'1 i?l' _l? ? ? - . . _ t, ,??. . . .i_} ?S
_; - i %?' ?u` ?? ?? ? s?.??F ?` i • "? f'?- f -;' - `` ..s- - - 1? ? 4S e? ? ? . ' _ - . . _ - '.
ItF M61teR S: RECf 1 6'T # pHV `+LW P1. "N ,- F'AF3t1N5 PL iiN
Psrmlt No. Psrmk FbIdM Dets TeirpNons #
S/VV
PLUMBING 3 -M
HVAC 2 ? Z 3 -
ELECTRIC 7
ELECTRIC
Inspaeflon Caft Inap. Commems
FooWxp I O?o2-
4m
Fownaan«, ??S Q u?
Framing ?
Roolfrq
?? ?? ??q-?;
Rotgh Htg. -f
Isul.
FimpiWom L
FHi81 FI1Q.
o?sat res?
Flnel wbp. Plbg. lr?spector -?JdiN Pk,mber
Const. Meter
EngrJPlen
Bidg. Finai G Z
Dedc Ftp.
Dedc Finai
Wefl
Pr. Disp.
v
V
L
(Itrftf ttate uf COrru?attr?
? titp of eagan
?
'er#atmrnt of iwding lnsprrtion
Y
This Certificate rssued pursuant to the requiremenu of Section 306 of the Uniform Building
:
Code cert[fying rltat\ at lhe te»te of issuance thrs sduetrrre wu in compliance with tke mrious
-,ordinances oj the City regulating building constructEan or tcse. For the fo!lowing:
u? clustfic"M S F DWG IlIdg. ??t No. 733
OC_p_Y TM R-3 M-1 ??]Dkrict PD R-1 Type Cow V-N
owm alhliw;ng GEROLD BROS CONST Addrea 1204 280TH ST W
?.???? 4480 MALLARD PL ?ty L13, Bi, THOIKAS LAKE ODS
ate: AUG 6, 1992
&Imq ookw
,F
POST IN A CONSPICUOUS PLACE ..
IN
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
, ,.
Ii SITE ADDRESS:
I . ,
i PERMIT SUBTYPE:
,
ON RECORD
PERMIT TYPE:
Permit Number:
Date Issued:
?'?'ii.lii: ; ? ??+V:,iI?1
TYPE OF WORK:
;Ji,'.t ;( I;• i Lifr1
raFw
4 ,F n?NOM Pn1zcN11f+f + V
INSPECTION DA • D
I
I v n.- a ,W7 .
1.3 rit,0r.r
Permit No. Permit Holder Date Telophona #
ELECTRIC
PLUMBING
HVAC
InapeaNon Date Inap. Comments
FOOTINGS
FOUND
FRAMING
c
u?t7
ROOFING
ROUGH
PLUMBING
PLBG
AIR TEST
ROUGH
HEATING
C?
G(l•3
GAS SVC
TEST
INSUL
GYP BOARD
FIREPLACE
FIREPLACE
AIR TEST
FINAL PLBG
FINAL HTG
ORSAT
TEST
BLDG FINAL
0
!?/
BSMT R.I.
BSMT FINAL
DECK FfG
? n
OECK FINAL
?
L?
Ad$ress: 4480 MALLARD PL Lot 13 Blk 1 Sec/Sub THOMAS LAKE WOODS
These items were/were not complete at the time of the final inspection.
Date: AOG 6 1992 Yes No
Final grade (6" from siding)
Permanent steps - garage tl"'
Permanent steps - main antry V_?'
Permanent drivaway
Permanent gas
Sod/seeded grass
Trail/curb damage
Porch ?
Basement finish ?V/
Deck k-11
Please verify wlth the builder tha ramoval of roo£ tast caps from the plumbing
system and the shut-off of water supply to the outside lawn faucet before
freeze potential exists.
R[C1ttE01?RP
White - City copy Yellow - Resident copy Pink - Conti'actor copy
-1 /
ReQUesl Oa? . . Frta No, qoug?-in Inspeclion
' Requir '+ ? ReaOy N. ill Nohiy Inspedor
r' es G N. YJhen Rea0y7
I-?censed contracror ? owner hereby request inspection of above electncal work at:
Job AtlOress (Sheet Box or Fouta No ? City
a N.?
Secuon No Townsni0 Name or No Fenge No Coun
Occupant RINT) w, 1\. /_[Z l /
W'W l:cvb? V hone No.
? • -ji?l ?
Power p AOtlress
?
n
Electncal racmr (COmpany Name) o ctor5 Ucense No
tJ /U Z-6
Mai6ng Atl (GOmraaor or ner Makmg Instanauon)
30 t
AuMOn a ignatpre (ConVan wner Making Installation) Phone Nu _ ?( ,
/
1CJ
MINNESOTA STpTE BOARD OF ELECTflICI THIS INSPECTION REOl1EST WILL NOT
GngBS-Mitlwey Bltlg. - Room 5-173 BE ACGEPTED BV THE STATE BOARp
1021 Universiry Ave.. SI Paul, MN 55104 UNLESS PROPER MSPECTION FEE IS
PROne(6R) 891-0800 ENCLOSED
???? L REDUEST FOR ELECTRICAL INSPECTION
J 2 4 5 8 4 ? See insvutlmns lor complenng this lorm on back oi yellow mpy
? "X; Below Work Covered by This Request
k*,E? E8.OW01-OB
•?' ???
ew Adtl Rep. TypeolBUilding AppliancasWrted EquipmentWired
- Home Range Temporary Serwce
Duplex Water Heater Electnc Heahng
Apt Butlding Dryer Other (Specity)
Comm./lndustrial Furnace
Farm Air Conditioner
Other (syecry) Conhaclar; Remarks
Compufe /nspection Fee Below:
8 Olher Fee # ServiceEniranceSrze Fee # Cimmis/Feeders Fee
Swimming Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 _ Amps A ve 0_ Amps
SignS Inspecbr5 Use Only c' OTAL ?
"
Irriga[ion Booms 7f
SpeCial Inspection
Aiarm/Communication THIS INSTALLATION MAY OR? E DI#CONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 TFi .
I, the Electrical Inspector, hereby Rou9n.n oa?e 7 G ti
T 6
cerhfy that the above inspection has
been made.
OFFICE USE ONq
TM1is requesl void 18 months (rom
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EAGAN MN 55722
651-687-4675
New Conetructfon Reouiraments
• 3 registered Nte surveys showing sq. ft. of bt, sq. N. of house; arM ?II rooted areas
(20°/> mexumum bt coverege ellowed)
. 2 copies ot plan shovring beam & windaw s@as; poured found design, etc.)
. 7 set of Energy Cakuletions
• 3 copias af Tree Preservatan Plen tl bt pmtted afler 7/1 /93
. Rim Jolet Detail Optuns salectbn sheet (bklgs wBh 3 or less uniGS)
DATE CJ (l `O Z
`2s . 2 5
PemodeVHeoalr Neauirements
• 2 copies of pian
• 7setofEnergyCakulafwnsforheatedaddifions
• 1s08surveytorexterioradditWnsBd¢cks
• Indipte tl Fwme served by septic system for a0attions
VALUATION ?& Sf1 ?? • ?
SITE ADDRESS MULTI-FAMILY BLDG _ Y _ N
NPE OF
FIREPLACE(S) _ 0 _ 1 _ 2
SELA ROOFING & REMODELING, INl.
APPLICANT 4100 EXCELSIOR BLVD.
ST. LOUIS PARK, MN 55416
STREETADDRESS _ irN ,.nnn,?rr) CIN STATE-ZIP
TELEPHONE #Ca-12-?dZ3- FSbV/„ CELL PHONE # FAX #
PROPERTYOWNER \W`? vi .. ITELEPHONE#?g?' ? 2-1_5
-------------------- ° ----------°---------------°-----------°---------° °------------------
COMPLETE iHIS SECTION FOR uNEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULES 7670 CATEGORY 1 _ MINNESOTA RULES 7672
(4 su6mission type) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Confractor:
Plumbing system includes:
Mechanical Conhactor:
Mechanical system includes:
Sewer/Water Conhactor:
_ Water Softener
_ Water Heater
_ No. of Baths
Phone #
Lawn Sprinkler
No. of R.I. Baths
Phone #
Fee: $90.00
_ Air Conditioning Fee: $70.00
Heat Recovery System ?n_---
Phone#
JUN 1 1 2002
------------------------------------------------------------------------ uiu
I hereby acknowledge that I have read ihis application, state that the information is orrect, and agree to co ply
wifh all applicable State of Minnesota Statutes and City of Eagan Ordinances. Y .?---
Signafure of Applicant
°-----°.._._._....°--------------°-------------------°....._
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Updated 4l02
OFFICE USE ONLY
? 01 Foundation ? 07 06plex ? 13 16plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace O 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 Porch/Addn. (4sea.) ? 33 Ext. AR - SF
? 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screened) 0 36 Multi
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
O 06 04-plex ? 12 12-plex Plbg_Yor_ N 0 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
O 32 Addition ? 36 Move Bldg. O 42 Demolish (FOUndation) ? 45 Fire Repair
O 33 Akeration ? 37 Demolish (Bldg)' ? 43 Remof ? 46 Windows/DOOrs
? 34 Replacement `Demolition (EMire B idg only) • Glve PCA handout to applicant
Valuation Occupancy 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 W idth
REQUIRED INSPECTIONS
_ Footings (new bldg) FinaUC.O.
_ Footings (deck) FinaVNo C.O.
_ Footings (addition) _ Plumbing
_ Foundadon HVAC
_ Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
- FranunS _ Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ Insulation _ Retaining Wall
Approved By
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Water Supply & Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Totai
Building Inspector
.,?.?i,wy(:'.i;E$:Y:%F%dri:Y?,.t'.Yr'N•$?h?$:Y,,.?Y,tiK??<4t:Mf?)r")XWn:y;;iSA Y,O&iK.F
? !:ITV C)F [:ASON
Q1SH];EFie_ iS TI=G:ii).'!AI. P:O! 796
i'F1'(C;; 05i04?9E3 'f:l3ilii:^ I.°ie0107
1 r,,?,
NAME':: 7-'li ciT'f.L.L!AF.LI. GCrlSiltUi'r,:Op?,?'>li.:
320 `:)IJG:I. 4AE;t1 NiA!.L.ARL` F'L ii'3-r'.i'_`5
3402 9001 4430 MALLAI;U PI._ ±54.2J.
205 ;anp.i. 4480 r1r1Ll._A:iD PI_ 8,00
'ar,_t Recr:i.!-?i. Anour,ty 399..0.
[.F'il^I;'i':l'
USER ?D: :IAt!
PERMIT
` CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612) 681-4675
P.E?RMIT TYPE:
Permit Number:
Date Issued:
BUILDING
031883
05/04/98
SITE ADDRESS:
4480 MAILARD PL
LOT: 13 BLOCK: 1
7HOMp5 LAKE WOODS
P.I.N.: 10-76109-130-01
DESCRIPTION:
s;
ar?
;'6
4-SEASON PORCH/DECK
ermit Type SF ADDITION
4A? Type NEW
?N
Ne;ft
434 ALT. RESSDENTSAL
s,
q?
?
Jr, ?
? ?'?;?t? • mi ? !`? a oq
REMARKS:
A SEPARATE PERMIT TS REQUTRED FOR ANY ELECTRICAL WORK
PLAN REVIEWED BY MZKE BHRCK
FEE SUMMARY:
r
!
Base Fee
' Plan Review
Surcharge
Total Fee
VALUA7ION
$237.25
$154.21
$8.00
$399.46
$16,000
CONTRACTOR: - Applicant - sT. Lzc.OWNER:
STIILWELL CONST INC, TED 19299342 0004138 RUEGG STEVE
2701 YOSEMI7E AVE S 4460 MALLARD PL
ST LOUIS PARK MN 55416 EAGAN MN
(612) 929-9342 (612)681-9233
? h-er?by .a?`knaul?d<gte
° iwrfinrEiiratkran is c4K,r-"r,gc'lq,?,a
Gtig??: ? C3 ty iif 44C
-A-;n
I?V'. S?i-NAT IR? ?
!
1998
?
?
New Construction Reauirements
BUILDING PERMIT APPLICATION (RESIDENTIAL) 3?j!)
CITY QF EACiAN
3830 PII,OT KNOB RD - 55122
681-4675
RemodeUReoair Raquirements
• 3 registered site surveys
? 2 copies of plans (inUuda beam & window sizes; poured fnd. design; etc.)
? 7 energy celwlations
? 3 copies of trea preservation plan N lot plaNed after 7/7l93
required: _Yes _ No
DATE: "y - I.3 - CI ?
? 2 coPies of Plan
? 2 site surveys (exterior addRions & decks)
• 1 energy calculations for heated additions
CONSTRUCTION COST; 3?o0DESCRIPTION OF WORK: °?[ SeGJ?-'L
STREETADDRESS:
LOT: IS BLOCK: SUBD./P.I.D. tm AV?
PROPERTY
OWNER
CONTRACTOR
ARCHITECT/
ENGINEER
Name: A e,4 ? (-?;4 Ue Phone #:
L First
Street Address: '41gtJ ?(Ce C f
City Z-? State: ./"/ ? Zip:
Company: Phone #: 02 - ? ?Z
Street Address: r?7Ol //d1P?h ?? ?5'U; • ? License #
City
Company:
Phone #:
Name: Registration #:
Street
City State:
Sewer & water licensed plumber (new construction only):
and lot change is requested once permit is issued.
Zip:
Penalty appiies when address chang
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicabl
State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant:
OFFICE USE O
Certificates of Survey Received _ Yes _ No
Tree Preservation Plan Received Yes No
rr ?C State: ?I ? Zip: 5-S L1 1 ??
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 06 Duplex
? 02 SF Dwelling ? 07 4-plex
0-03 SF Addition ? 08 8-plex
? 04 SF Porch ? 09 12-plex
? 05 SF Misc. ? 10 = plex
WORK TYPE t-( Fae?.su n
O 31 New ? 33 Alterations
1?1- 32 Addition ? 34 Repair
GENERAL INFORMATION
? 11 Apt./Lodging Cl
? 12 Multi Repair/Rem. ?
? 13 Garage/Accessory ?
? 14 Fireplace ?
? 15 Deck
j?ivr?l W (??ec?
? 36 Move
? 37 Demolition
ti
d?...?."?
16 Basement Finish
17 Swim Pool
20 Pubtic Facility
21 Miscellaneous
Const. (Actual) Basement sq, ft. MC/WS System ?
(Allowable) Main level sq, ft. City Water ?
UBC Occupancy sq. ft. Fire Sprinklered
Zoning sq. ft. PRV
# of Stories sq. ft. Boaster Pump
Length sq, ft. Census Code, y 3 y
Depth Footprint sq. ft. SAC Code o I
Census Bldg ?
Census Unit D
APPROVALS
Planning Building /VLF?> Engineering Variance
Permit Fee Valuation: $
Surcharge Plan Review
License
MC/WSSAC +co xrc.. = 2s? ?? sy= ?3, g2?. -
City SAC
Water Conn.
Water Meter ? ? S n zv",,
Acct. Deposit
S!W Permit
S/W Surcharge
Treatment PI.
Park Ded.
Trails Ded.
Other
Copies ...? . ..,_? -_..- c
Total:
°h SAC
SAC Ui
i
B??$. CCWST.
PlBNpEqS ond LOND SUAVEY005 4?.0/
CONSUlTIN6 ENOINEEIIS. \432-3000
.?rdCsINEERIidG 79
COMPRNY, INC. S 25426
f
000 EAST 1461h STREET, BUftNSVILLE, MINNESOTA 55337 CERTIFICATE OF SIJRVEY
Lega1 Description:
09.eOT9_ COUN7?!__?YJ/NNES'OT<l.
(q_56_o ) DENOTES EXISTING ELEVATION
(957,5 ) DENOTES PROPOSED ELEVA710N
.?. INDICATES DIRECTION OF SURFACE DRAINAGE
957,83 - FINISHED GARAGE FLDOR ELEVATION
950?I2- = BASEMENT FLOOR ELEVATION
958.1(0 = TOP OF FOUNDATION ELEVATION
SCALE : 1' = 30' , , F7-?-cT
FT G"NT BU/GD/NG
TBAGK L/n/E
g56.33+
1nA1-L4QD
/ZA&E
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EX?ST/N6
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UT/L/T y F?JSEn'lEAV1T
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101?
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I hereby certify that this is a true ancl correct representation of a tract of
land as shown and described hereon. As prepared by me this 29-M day oi
MAY , 19?.9- •
??^?• ; /t-?'``? idinn. Rey
No. /6085
! 04/23/98 19:39 0612 627 0625
SCHERER BROS
P6- t e
Zooi
??ISIW AYea z 333.011 .044 14'_E44
Frami Area z 59.280 .094 4.$28
Windows 110.OO0 .370 40JM
_ DOOrs 17,789 ' .200 3.
_ Rtm Joist 280.0D0 .042 10.829
m Flre ece Wall 000
? Above Ofade Faundation Y1Fep ,ppp ,466 .006
Fqundatlon WfnCOVVg pp
? Wano ooors .ooo .sao .ao0
m aner .ono o _aoo
w .90D
0
n _000
x ppp
W .QO0
TOtals E 7710130 F74.667
Ave c U-Fador F 74.55654072 iE 772
Required U-Fador frorn Ene .CoQe :
LVL%VMM G .097
H .114
1) U-Fac[ar for skyllght arq wlndaw muat he tletenmUiM f+Y tlre itatbI PereCq'atlan Ratlng Courcil &Wtldaid 10687
or AsNRAE 1986 Handbo0k of FuntlamenEete, Claptar 27, tM 9.
2) ThenrW 7rerre11dUeme of opdQue mmPonards pmWnB etgra?N UwWaEed maBUnry etM meml ahid frami?-
uae Pert 76701M. aubpmi 4
01/23/98 13:33 $`612 827 0629 SCHERER HRO5
Fo.rrri for use witft Minnesota Rules part 7870.0476. Su6p2
1& 2 Family RpldeMial `COOkbaolC' AAethad
?looz
Minimum Crilorla:
Pom:aoY R-19 iraulptlon Foundelon Wincbna: IneulMad piny. 72'sir Space, vemp or W1ry1 franw
E doa'8: 1.9M irch 6tW vrood wkh ffiarm c[ b[n2r
Total Wintlaw & Door Arsa 8q. Feef 9ox-A (wrndoar 6 door araa)d'rvided ty BmcB(total
wINDOWS (including ioundetion wlndows); ' wau area) 6mes 100 eqnals the window and
DimBnsions Qty Rrea door grea as a percent of walt area (BOxC)
iAVAtUE! Box,A 125289 x100= ? 24_47
J+dE WAU,:
Total VlFmdowAroa
C? •??7?i7
#VALUE
2_687 8.670 1,000 17.789
0,000
Totai Ooors Area 17.789
Totaf Area of Windavs 8 Doors
x2b.2?
BQX.A
Totaf Wall qrea in Sq. Ft.
Wall Total Perimeter Heloht area
4YALUEI
64.OOD 1.Q00 8.000 ' S120oo
0.000
0'.000
$12.000
BE?X B
B
STANDARD FRAMING X
ADVANCEQ FRAMINC9
fiTYINSUTATION R- 99.000
LESS THAN R 8 ?
R-5 aR naoRE
IQOWS(EXCEPT FpUNDATIQN WINDOWS):
U-F/1CTOR U-. 0.37D
n ihe t8ble, delerntine tlie mAXtlpum pem11t
bw & doorarea for the tlesigrt-options selected
aMer the value In hox 0 below:
25.000
BpX D '
Box C must be less than or equel to Box D
2 0d;23/98 19:94 '0812 827 0823 SCHERER BROS U003
Assembly R and U-Factor Forms
ASSEpNBLy ROOF AT FRpM ING
Materlal (Dagodbe) Thickness ' ' R-Valde•
tntenor Fi1m Coelflcia?tt .810 .
Sheet RoGc 0.63 .$gp
Ceili AAember 2X6 6.670
Insulatlon 44.000
ExteriorFilm,CoeffiaeAt .6i0
Total Aesertitil' ' 1'hertnal Resistance 52.850
Assemhl BCtor 1(fotel .079
ASSEMBLY ROOF ATINSULATION
Material' peseribe '[hickness ' R-Value '
Interior. Film Caeffiaent ggp
SHeel Rodc U.93 •.580
Insulafion ".Opa
ExtBFlor FYm C,oeffident 1170
Totel Assemb 7hermal Repganoe 45.410
Assemb U•Feftr 1fTOta1 R ,022
A33ENtBLY kYHLL ATFRAAAING
Material Describe Thiokness R Velue
Irrterior Film CoeffiCieat .650
Sheet Rock 0,60 _450
aw 2X8 6.870
Sheath' 0.44 :gyp .
SidIn 1.820
Exterior Fllm Coeftldeqt .170
Totai Assemhl Thertnal' Resistanea t0.610
AssemGl U-Factor lfratal Ft) .094
ASSEMBLY
Materfal e&cribe Tryiekness R-valne
Interior Film Caelfldetu ,gep
tnsulaHan . 19:000
Rim t.896
9heath :82a
sk-
Exterivr Film Coetfioiert
Tota1 Assem6l Thennal Res"utance 24.010
Assemd U-Factor 1/TOtai R .pqz
ASSEMBLY WALL At INSLJLATION
AAateMal Descri6e Thickness R-Vaiua
"edor Fiim CoefAcieM
Sheet Rack 0.50 .160 '
In'sulatian 19.000
SttCAttf 0.44 820.
&idi 1.820
FaGeriorFilmCaeffideM ,170 .
otai'Assemb Ttiermef ReS13t9liee 22.740
Assembl U-Fac'Wr tlTetal pqq
ASSEaNBLY ? BLOCiC
Material (Describe) Thickn6ss R-Value
InfeMr Fi(m.COeificieM' . ggp ,
Cona'ete Block 1280
O 'anal insulafion
3tud .
Exte[ioF Film CcefFderrt .170
TOt51 As68111D ThCr(1101 RCSiStance 2,130
Assembl u-Fadar 1lTOtal .469
, ITY OFEACIAN
830 Pilot Knob Road
Eagan, Minnesota 55123
(612) 681-4675
PERMIT
PERMIT TYPE:
Permit Number:
Date Issued:
BUILOING
000733
@6/08/92
SITE ADDRESS:
DESCRIPTION:
9480 MALLARD PL
LOT: 13 BLOCK: 1
THOMAS LAKE WOODS 1ST
Huilding Permit Type SF OWG
-" Building 'Work Type NEW
UBC pccupancy R-3 P1-1
Construction'Type VN
2oning -,
` PD R-1
Buildin9 Length 60
Building Width 37
REMARKS:
RECEIPT 11 PRV SSW PLBR. = PARSONS PLBG.
\.?
FEE SUMMARY;
Base Fee
Plan Review
Surcharge
SAC
SAC %
SAC Units
Subtotal
VALUATION _j140,000
;779.60 MISC FEES
$506.68 Total Fee
$70.00
$700.00
100
$2,056.18
$1,610.50
;3,666.68
CONTRACTOR: - Applicant - ST. I.I QWNER:
GEROLD BROTHERS CONST 14453171 000111 GEROLD 8R03 CONST
1704 280TH ST W 1204 260TH ST W
NEW PRAGUE PIN 56071 NEW PRAGUE MN 65372
(612) 445-3171 (612)445-3171
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 Pln.
5tatutes and City of Eagan Ordinances.
? ?'Al?LICANT/?E?MITEE S ATURE
ISSUE Y. SIGN?
Control No. 0580
I_RMIT # cinr oF eaGaN
1992 BUILDING PERMIT APPLICATION
681-4675
"', -MAY29
IOti, ?
?£0
REca. .
SINGLE 8 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 when •typing of permit is requested, but not picked up by last working day
of month in which re uest is made or lot chan e is re uested once ermit is issued.
Valuation of work Z3?dac?
Date J?_ /a2 / q2
/
te Address: 7 yc?? ?a.?(QCQ
STREET STE Y
Tenant Name: (commercial oniv) --
LOT BLOCK 7 'Y`uS Lo??E W?`?S
?
SUEO.,??J P.I.D. N
,
,(
Descri tion of work:
The applicant is: ? Owner [J<ontractor ? Other (Deseribe)
Name Phone
Property uST FIRST
Owner
qddress
STREET STE M
City State Zip
Company Phone yyS 31 7l
Contractor Address 1704 11/'
License #00a5W!h* Exp.
City State
Company Phone
Architect/
Engineer Name Registration #
Address
City State Zip
Sewer 8 water licensed plumber eso? Processing time for
sewer & water permits is two days once area has beei approved.
I hereby acknowledge that I have read this application and state that the information is
correct and agree to compl ith all applicable State of Minnesota Statutes and,City of
Eagan Ordinances.
Signature of Applicant: ?C. ? -
OFFICE USE ONLY
BUILDING PERMIT TYPE
? O1 Foundation ? 05 Apt. Bldg O 09 Basement Finish O 13 Comm/Ind New
ff 02 SF Dwg. ? Ofi 6arage/Accessory ? 10 Swim Pool ? 14 Lomm/Ind Add
? 03 Two family ? 0 1 Fireplace ? 11 Res. Add. ? 15 Comm/Ind Rem
O 04 Multi-fam. T.H. O 08 Deck ? 12 Res. Porch O 16 Public Fac.
. ? 17 Agricultural
WOR K TYPE
M31 New ? 33 Alterations ? 35 Move
? 32 Addition ? 34 Tenant Finish O 36 Demolish
GENERAL INFORMATION
Lonst. (Actual) U-N Basement sq. ft. MWLC System _Yj_-?s
(A1Towable) v-N lst F1. sq, ft. City Water yeL_
UBC Occupancy R-3 rn-I 2nd F1. sq. ft. PRV Required 1/9;
Zoning Pc 2-? Sq. Ft. total Booster Pump
# of Stories Footprint Sq. ft. " Fire Sprinkler
Length &p1 On-site well Census Code /v/
Depth ? On-site sewage SAC Code oi
APPROVALS
Planning Building Assessments
Engineering Yariance
REQUIRED INSPECTIONS
O Site
? Wallboard
? footing
? Final
? framing
O Draintile
O Insulation
? Fireplace
Permit Fee
Surcharge
Plan Review
License
MWCC SAC
City SAC
Water tonn.
Mater Meter
Acct. Deposit
S/W Permit
S/W Surcharge
Treatment P1.
Road Unit
Park Ded.
Trails Ded.
topies
Other
Total:
9 99 50 YBlYBL{011: f'qv? 00 J' .
o u
SO ,(oSd
?-?? ?y X 39 = 72v ?
?lOOOv 16 x 9 ?r2 ? ?ls"z
?
IS? t7a
(o
?r5uo 31-x 2.r.
.30,Do X
3 ll? y.l
y
lbx?i/c- IS
.
3no, o0
38?,0o ??
I 137xi5= ??+ ??`?
IsT F?moa ;
176e
6 x
G' Nb FW D12
PFMA.36;;? 990
SAC % I?
SAC Units
i3 2
q
HY7 x53' 60'1011
?
Tv7.tL
.
Rr11ER:
EXTERIOR ENYELOPE AVERAGE "U" COMPUTATION
:ITE ADDRESS:' 77,YC,) M 1\w-0 0 lG3c:(e c-a?g,yt? ev%ej_ ?of- I.???.U14-1, 1,, ,„?", I'
:ANTRACTOR: (`?eU&C lFSdas_ D,ticL4 _ DATE: ? a.'7(4'Z_?._- PHONF:
. DETEPNINE WORKINf. SO.UARE FOOTAGE OF EACH:
1, TOTAL EXPOSED WALL AREA,,,,,,,, Fj?, 73 sq ft x"U" • I ? aq?i?. ?3
?, TOTAL ROOF/CEILING AREA,,,,,,,, sq ft x"U" SOAD_ m a?•?
), TOTAL E%POSED WALL AREA CALCULATtONS: Total exposed wall
•ree above floor,,,,,,,, ? sq ft
' t
e) Total wall wlrtdaw area:
9lazed...... sq ft x??U" ,.30? • g??
...... sq ft x "U" ?
T_ .
b) Total door area ,,,,,,,,, 3(Y+ ? sq ft x "U"
?
J
?
1-
?
2
?
c) Total stidfng glass daor area:
glazed...... sq ft x"U°
glazed...... zq ft x "U"
d) Total fireplace wall area
sq rc x
.
e) Total wall framing area /?
'r
?
"
?O?
2 ?
¦
C7, sq ft x
U
(Avera9e 10>.)........... o
r o
f) Total net watl area above
floor (Insulated)....... oZa.3(7= ? sq ft x "u" • °yG • T3.?
g) Total rlm Joist area...... i Q, q sq tt x"U" . 6 5! 3 . S, S
Total foundatlon
area (Exposed)......... J 3 6 sq ft
h) Total foundatlon
windoa area ............. sq ft x"U"
{) Total net foundstion •
araa above grade........ sq ft x"U"
TOTAL a) thro t) aa9, ?
tf Item 03 Is the same as, or less Lhan ltem Ri, you have met tha tntent of
2 MCAR 1.16008 A and 0.
J
?
.3
9
X
N
I Page 1
4.," "TbTAL EXP04ED ROdF/CEILING CALCULATIONS:
Tota} exposed
ro.of/cellfng area........ sq ft
J) Total skylloht area....... . sq ft x"U"_ '?- k) Total roof/cetlinq framing
' area (Averane I?h)...... sq ft x"U" ??.3
1) Total net insulated ? .01$ ' q
rooi/cetlinq area....... sq ft x "U" _
4, TOTAL j) thru 1) _ ?2-
If tota) of 04 (s the same as, or less than 02, you have met the intent of
2 MCAlt 1.16008 A aad 0.
ALTERHATE BUILDING ENYELOPE DESIGN
To utiiize the total envelope system method, the values established 6y the sum
of Items 13 and 04 shall not be cjreater than the sum of Items Pi and 02.
1. + 2. '
C E R T 1 F 1 C A T 1 0 N
1 hereby eertlfy that I have caleulated the "U" factors end "R"
values hereln and that the Dulidinq here described meets or exeeeds the State
of Minnesota Energy tonservatlon Act.
Stqnature
????CQZ
(Date) page 2
NALL
SECTION
2
q mD
?
SECTION
?
?
Vn
2
a
?
2ND WALL
?
J SECTi'lt:
g
3
?
N
6Ill
JOISi
?i
n . .?.C.
? :?LI?E CAICULATiONS . .
YALUE U YALUE
Intlde •tr film .66
Lntecior ra:l '`f5 (Wall) l' • ? .
I-tcu:att..n 19 ' pD
y
,?z e olo
Sheathinw Stdtng • eO/
:.uts[de atr fllm .17
Q 70TAL Z(S 3
Instde air tilm .68 .
iMe::or xail .45
4-1 stad R` 4:38- (Framtng)U. F .
G.a7
Sheaching .LZ
5lding ?v?
Outside air i!!c .17 .
ri iOTAL 7 "7
Insttle air film R= .68
Int&rLor vafl
Insu!ation IWall
Sheathing
EaCetior vall covering
Exterlor air filar R.-1i
R 70TA1
Intrrlor air ti ia R' .63
lr.sula;lon I Q.60 ?
T
1k fr.ch soic yuu.t Rv1.88
(Rim
U . j[.
YOiSt)
Sheathing ?(oZ
- ? 64'
3
Exterfor vail cavering , /ol
Extertor •1r film 92 .17. . .
? . aTorAL Z Z• 9!o
? Intertor a:: [:1-, R` .68
? lnsula.ior. 7 , r 1
? FounJa:ion 1 ?2a {fdn.} U
Extcrlor air :iln R` •7 ? ?pz
S roraL 9.1? 3
\
I
'-{xpused Slvck
% - -- • " Pri'oE 3
P.EILIYG KIT1I YENTED ATilt S?ACE ABOYE
? FRAMIyG ' CEIIING
. ?
Air film 0.61
.
0.17
Inside air fitm 0.61
Ceiiinq
Joitt (stud
Insulatlon
Air spate
Rocf de:ktng
Insulatton
Bu11t-up roof
Outslde atr tilm 0.17
Tota7 R
???
lindow infiltraticli .5 ttm/lineal foot of crack -
4nfiltraton 11mO s tfm/lfneal `oot c of CraCkinicurtode requln+nent
?nsidential y door Infiltration
lon
ip 72" concrete block no lnsulation a .41 R 2.1
ip 12" concrece block insulated cores a .26 R 3.8
!b 12" liyhtaeioht block
;p
12
ligntweiiht block insulated cores
.._
12 R 8.3
J single glass a 1.13; xith stom xindow .54
1 double ylass o .55
J tripie glass ¦ .41
k11 exterior walls and teitings a?ust have a vapor barrier (C.10 perm cex•)•
:apor Earrier must De on the lnside (heased side) of wa,i•
sapor barriers of the polyethelene thin film have no aValuc.
. '4
i ,3S
Insulation 5a
.totst
5(o te111nq . 5!0
O.fl Air iitm 0.61
Totai R S 3; 78
u • A . a/S
fiAT ROOF OR CATHEURAL C:ILIyG
a ue R YALUE
FRAMIN6 CEILING
0.61
! l '----'
I '• .
p? e 4
.oz(
GUIDELINE TO (R) FACTORS FROM ASNRAE lIAIiUAL
OF TYPICALLY USED PRODUCTS
AIR FIlMS ? SHEA? 21
Interior Air Film Natls) 0.68 3/4" Hood Subf)oor or SheathTng 0.94
Exterior Air itlm Nalls) 0.17 112" Plywood Sheathing 0.62
Interior Air Film Vented Ceiling) 0.61 1/2" Partlcle Board 0:66
Exteriar A1r f11m Yented Ceiling) 0.61 C,ypsuai or Plaster Board 3/8" 0.32
Interior Air F11m Non Yented) 0.61 6ypsum or Plaster Board 112" 0.45
Exterior A1r film Non Yented) 0.17 6ypswn or Plaster 8oerd 5/8" 0.56
Plywood 3/8" 0.47
Plywood 112" 0.62
BLOWING WOOLS Plywood 3/4" 0.93
Sheathing, Reg, Density 1/2" 1.32
Approx. 3" 900
. Sheathing, Reg. Oensity25/32" 2.06
Approx. 4 1/2" 13
? Nail-Base Sheathing 1/2p 1.14
Approx. 6 1/4" 19.00
Approx. 7 1/4" 24.00
Approx. T4" 30.00 ROOFS
Approx. 18" 40.00 guiit-up Roofs 0.33
Al1 other lnsulation materials must Asbestos-Cement Shingtes 0.21
be verified (R Factor) Asphalt Roll Roofing 0.13
Asphalt Shingles 0.44
1NSULATION
Insulat ton: 2-2 3/4" Flberglass 7.00 SI? G
lnsulation: 3 1/2" Fiberglass 11.00 ptuminum Siding 0.61
Insulation: 6" Flberglass 19.00 Aluminwn with Backer 1.82
Insulation: 3 5/8" Fiberglass 13.00 Aluminum ?vith Backer 8 foiled 2.96
Insulation: 9" Fiberglass 30.00 112 x 8 Lap Siding (dood) 0.81
Insulation: 12" Fiberglass 38.00
' 7/16 x 12 Hardboard Siding 0.67
lnsulation: 8" Cellulose 29.00 Asbestos Sidiogs 1/4 Lapped 0.21
Insulation: 10° Letlutose 37.00 Stucco (Brown and Finish toat) ----
lnsulation: 12" Cellulose 44.00
Insulation: 1 1/2" Thermax 12.00
Insulation: 2" Thermax 16.00 p00RS ?.
1 3/4" Solid Core Door .46
NOODS N/Storm, Wood .31
Fir. Pine 6 Similar Soft Noods
11 w/Storm. Metal
Pease Steel Door Insl/N/GL 7.45R .26
.13
1 1/2
p 1/2° 1,89
3.12 Sliding 61ass Door. Mood .65
3 1/2" 4.35 14etal '72
5 1/2" 6.87 _
CONCRETE BLOCK WINDOWS
8" Concrete Block (S 6 6 Reg.) 1,11 A11 NindoNs
(w/Sto?ms 1" to 4" Space)
.56
(Filled with Yermlculite) 1,93 Removal Double 6lazing (RDG) .55
12" Goncrete Blak (S 8 6 Reg.),. 1.28 Therna or We1deA 3/16" Air Space .69
(Filled with Yermicullte) 3.15
" Air Space
1/4
.65
8" Light 11e1ght 2,18 i/2" Air Space .58
(Filled with YermlculTte) 5.03 (Other windows specifically tested
" Light Meight
12
(F111ed with Vermiculite) y,qg
5.82
tan use better ratings)
pf?o E S
GE?LO B'2??• ?'a/9T.
'=
ie
CpNSUlTIN6 EN61NfE115
ROBf PLflNNE85 ond IAND SUflVEYORS 'C;,,
-f?S07¢•4/ ;
E
BK. 179
NGINEERIP9G .a
F
.,
.
INC?e/?/??`u •?. P6.'S Z5?26
.
???Y{Y'?'9Y?Y :%
X
, .
< ,1000 EAST 1461h STREET, OURNSVILLE, MINNESDTA 55337 PN 432-3000
CERT9FICATE OF S!)RVEY
Legal Description: LOT /3 6Gace? Typir/qs Lqx? wooos
OAKOT9_ COUN?/NNES074. _
DENOTES EX{STING ELEVAl'{ON
(95715 ) DENOTES PROPOSED E4EVATION
--.a---- INDICATES DIRECTION OF SURFACE DRAINAGE
957.83 - FINISHED GARAGE FLOOR ELEVATION
950-1z ? BASEMENT FLOOR ELEVATION
958,16 = TOP OF FOUNDATION ELEVATION
SCALE :
? : 30FT F"NT 6U/LO/NG
ET?G,? G//?E
EX157/N6 (ooj
Na?5E ?°o i
G/-
/YIAL [A2p
9ss.&4
P? v DE? Z? 92
T
0 3y b S.
q .a+.
3
,
^' 7
'?
)0
i
??„? ? ?? ,ya u tiqoY.•oi ??
h / v??'?•/q _ ? , !
A ?G
-
? ?y? ?a• ?, ov o
(i .. IZ,b°
?- ,
\ ?0 ? ? r
?
? ? ?? ?
`
v
q"
p?fl 7 ?Y ??? //7
?F?
S?
?
p.Pfl/N,9GE ANP `? Ca:'lIV GI1VEa;11ING DEPT
UT/G/T y !EF4Sz!5?WEA/T
/M
l?' ?rk P? ? ?iEia
?o o e L-4 [
2 hereby certify that this is a true and correct representatioil of a tract of
' land as shown and describecl hereon. As prepared by me this 29 7V day of
MAY ? 192? •
Minn. Reg. No. do 5
L13 B / CITY OF EAGAN
, J MECHANICAL PERMIT RECEIPT # L
SUBD. (612) 6814675 DATE :L,['g "4
7
RESIDENI'IYAL
PLEASE COMPLEfE UPPER PORTTON ONLY FOR 3WGLE FAMII.Y DWELLINGS. ALSO, COhiPLEl'E FOR
TOWNHOMFS/CONDOS WHEN SEPARATE PERMTfS ARE REQUIRED FOR EACH DWELLING UNIT.
oWNER. T?? e FEES
STl'E ADDRESS: ADD ON/REMODEL (EXISTING
CON3TRUGTION ONLI) $ 15.00
INSTALLER: P
,
/-,I-
HVAC: 0.100 M B1'U
74.00
PHONE #: ADDTl'IONAL 50 M BTU 6.00
ADDRESS: 00 Z.E I S GAS OUTLEfS - MINIMUM 1 ea $3 EA. a. D d
CTiT: ZIP.53Q g SURCHARGE $ .SO
SIGNATURE: TOTAL: $ 6, 520
COMMERCIAL
PLEASE COMPLEfE THIS PORTION FOR ALL COMMERCIAUINDUSTRIAI, BUILDINGS. ALSO COMPLEfE FOR
APARTMENT BUILDINGS OR OTHER MULTI-FAMILY BUILDINGS R'HEN SEPARATE PERMITS ARE NOT REQUIRED FOR
EACH DR'ELLING UNTf.
WORK DESCRIPTION: CONTRACT PRIC&
196 OF CONTRACT FEE. FEES
STATE SURCAARGE IS $50 FOR EACH
$1,000 OF PERMIT FEE.
$
PROCFSSED PIPING - $25.00
hIINIMUM FEE - $25.00
$
OR'NER: TOTAL: $
SI1'E ADDRESS:
TENANT:
SUITE #:
INSTALLER:
ADDRFSS:
CTPY: ZIP:
PHONE #: CT1T SIGNATURE
SIGNATURE.
L r3 eL CITY OF EAGAN
PLUMBING PERMIT
SUBD. (612) 681-4675
PLEASE COMPLETE IIPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS
WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
----°--------
WORK DESCRIPTION
NEW CONST X
ADD ON _
REPAIR
OWNER NAME: S-7:-u t,° R1J _ Cf GI
SITE ADDRESS: ?? ?D ?rA e/?c? Y7c7Ce
INSTALLER:
ADDRESS : ??0? O IS I .S
CITY: l ZIP:
PHONE
OF
CITY USE ONLY
RECEIPT # L' v ? 9 -7 'J L[
DATE ?Z
ALSO, FOR TOWNHOMES AND CONDOS
COMPLETE THE FOLIAWING: /
N0. FIXTURES EA. TOTAZ
REPAIR/ADD ON 15.00
? SHOWER 3.00
?
WATER CIASET
3.00 ?
BATH TUB 3.00
? LAVATORY 3.00
KITCHEN SINK 3.00 ?
I LAUNDRY TRAY 3.00 3
? HOT TUB/SPA 3.00 3
L WATER HEATER 3.00 ;7;?
? FIAOR DRAIN 3.00
GAS PIPING OUT.
L (MINIMUM - 1) 3.00
?
? ROUGH OPENINGS 1.50
OTHER
WATER SOFTENER 5.00
_ PRIVATE DISP. 15.00
_ U.G. SPRINKLER 3.00
_ W. TURNAROUND 15.00
lvy s-0
STATE SURCHP.RGE .50
TOTAL: S J M ' 00
PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILPINGS. ALSO FOR MULTI-FAMILY
BUILI?INGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT.
WORK DESCRIPTION:
OWNER NAME:
SITE ADDRESS:
TENANT NAME: _
SUITE #:
INSTALLER:
ADDRESS:
CITY:
PHONE
FOR:
ZIP:
CONTRACT PRICE:
1% OF CONTRACT FEE. _
STATE SURCHARGE - $,50 FOR
EACH $1,000 OF PERMIT FEE.
$25.00 MINIMUM FEE.
CONTRACT PRICE x 1%
STATE SURCHARGE
TOTAL:
$
$
(SIGNATURE)
CI1'Y OF EAGAN
PERMIT # yy 1
RECEIPTDATE! 1-?-o1
USIDEPTIAL PLIJM$IN6 PERMiT APPLiCATION
crrYoF F-AsM
3830 Paar xxos en
EAaArt, Mx ssiEs
651-681-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
? ,_backflow preventer for irriqation system_
RUEGG,STEVEN ISITE ADDRESS: 4480 MALLARD PLACE '
EAGAN, MN 55122 i
OWNER NAME: : {sei) 681-9233 ? TELEPHONE
- -- -- - -- - - (aaea cooe)
INSTALLER NAME: NORBLOM PLUMBINQ C0. TELEPHONE #:
+3 (AREA CODE
STREETADDRE55: E8?2?E9 AVE827"40'i3
$BBi gAP?1F1?. ene?vu
MINNEAPOLI8, MN 55409
CITY: STATE:
Place a check mark next to the oermit work tvoe
ZIP:
New residential dwelling unit under construGtion and not owner/occupied $ 90.00
V Add-on, modification or alteration to existin dwelling unit, including: $ 50.00
• abandonment of septic system
• new installation/repair/rebuild of RPZ
• lawn irrigation system
• water turnaround
Nature of work: (_e.401 aG2 ? p??? ?711 2axeil?
Septic System, new/refurbished - $ 225.00
• includes County & Consulting Inspector fees '
• requires MPC license
State Surcharge Ff..(S I.I i!/ ?
na?
$ 50
001 ? ' ?. ?
Total
! _? $
e
Reminder: Be sure to schedule inspections of alteration's, i:e: wr eP=treaterh, water softeners, etc.
I hereby acknowledge that I have read this appficafioq state that [he information is correct, arW agree to comply wifh all applicable City of Eagan ordinances. It
is the applicant's responsibility to notity the property owner that the City of Eagan assumes no lia6ility for any damages caused by the City during its normal
operational and maintenance aclivities lo the faciliNes constructed under this permit within City propedy/righbof-way/easemenl.
SIGNAT RE OF PERMITTEE
Updatetl 1f01
;0/10/2011 14:21 6128252303 RAY N WELTER HTG PAGE 02/02
r
~7f.~~~T ,t1 /oG GGO
4L~ `7o C) HOUSE HEATING TEST RECORD _
ADDRESS ` ' ' Q dl f C~ `,51 PT FLOOR CITY SUBURB
OCCUPANT V C' Lk e- OWNER S tI M91
HEAT LOSS D E HTG. INST. D
SOLD BY INSTALLED BY S ' - '
Electrical Work By Gas Line Bye 1_
FA HW STEAM SPACE HTR UNIT HTR OTHER
TYPE OF HEAT GA
GAS DESIGN CONVERSION
MAKE MAKE OF BURNER _
Model Model
Serial - 9 i - Max STU Rating
INPUT MAKE OF FUR AC
Model
f CIL e_~ CONTROLS i'1
THERMOSTAT Heat Plug Vent Size - ~L
Valve w S KIND OF LINER SIZE ONE
Limit 1q,0 4- '3
f Draft Hood Regulator
i
k e319 _ Filters Size t`~x~•~~C ( Number
Limit Setting
Fan Setting l Chimney Location Insl 0
Pilot Type ; - ~ c> Lk (I Q C_c Chimney Construction C
Pilot Make N Q y~ C! %1
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City of Ea�all
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
1
For Office Use
Permit #: DC16/ 3
Permit Fee:
Date Received:
Staff: rJ `7
2013 MECHANICAL PERMIT APPLICATION
❑
Please submit two (2) sets of plans with all commercial applications.
Date: 7/`a- �i Site Address: A#/SD �! (/�x.`J / ligC6
Tenant:
Name:
Address / City / Zip: 4
Suite #:
Phone: .,S1 -6.R1-91,33
-° 8'6 447 ice! SS/A4
Name: A -I id + th/i as License #:
Address: iii‘ 31 l: N 164 &) kg , City: 11)4/44/744 45
State: MX), Zip:__________ Phone: CO- Y9S-- 6C7
Contact: /L %Z./ Email: it /c it 0 tda Ilam, e, t/• - . edM
New ReplacementrAdditional Alteration Demolition
Description of work: I?Y da" (tit/dike 4i l P/aL%0* —7 i60 df%
J
RESIDENTIAL FEES:
RESIDENTIAL
Furnace
Air Conditioner
Air Exchanger
Heat Pump
Other
COMMERCIAL
New Construction Interior Improvement
Install Piping Processed
Gas Exterior HVAC Unit
Under / Above ground Tank ( Install / Remove)
$60.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge)
$100.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) =
TOTAL FEE
COMMERCIAL FEES:
$70.00 Underground tank installation/removal
$55.00 Minimum
*If the project valuation is over $1 million, please call for Surcharge
Contract Value $ x 1%
_ $ Permit Fee
= $ 5.00 Surcharge*
= $ TOTAL FEE
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before
you intend to dig to receive locates of underground utilities. www.gopherstateonecall.orq
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.
;Jam.
Applicant's Printed Name
roup
Use BLUE or BLACK Ink
r
For Office Use I
' Permit
City of Eapn I
I Permit Fee:
3830 Pilot Knob Road
Eagan MN 55122 Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 I Staff: I
I I
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: Site Address: Unit M
Name: STer/e Phone:
Resident/ i
Owner ! Address / City / Zip: V YSa /2R114a e
(l Applicant is: Owner Contractor
Description of work: Y-7 Sti u4& < r o o f
Type of Work
Construction Cost: f , 4J v Multi-Family Building: (Yes / No
_ rMr
Company: ^i.vi✓'eXj~T 1
_`c sr 5 J1-10es Contact:
Contractor Address: 7 ya Si e7 ,.,We A/°/" 2 City: 5 771,42 ve
State: A/ Zip: /0 2 Phone: l /Z 2Z / - 6 3 Gz
{ License D `I g 6 Lead Certificate /✓R 12 0 o / "/490
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
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:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
f the information maybe classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.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.
Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit issuance.
Applicant's Printed Name Applicant's Signature
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