1449 Kings Wood Rdr _ . rv
? • i
wemfica#e of cccuvanc?
W" o f Cfagan
baeat oF 13uiibixg 3a#0cction
This Cenif:cate issued pursuani to the requirements of the Uniform Building Code
certifying that at the trme of issuance this strueture was in compliance with the various
ordinances of the City regulating buildeng construction or use. For the foJlowing:
SF Q„G 1278
Use Classification: - - DI Bldg. Permit No. _? Tna
Occupancy Type Zoning Distritt ao.?
Owcer of Buildi BITIIm ng Address
SAFARI P , .
sw naarc? i.ocalicy
11r25/92
Date:
suilaing orrkiai,
POST IN A CONSPICUOUS PLACE
" INSPECTIQN REC4RD
' CIT-Y .OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road Permit Number:
Eagan, Minnesota 55123 Date Issued:
(612) 681-4675
? SITE ADDRESS: LoI'z0 eCOCh ;1 _ APPLICANT:
? 1449 KIMaS 1iooQ Ro aZMlisti "EORs iN+C
? KIM16S Wl)Op 2MD (612) 431-6000
PERNIIT SUBTYPE:
'?? f OWt,
TYPE OF WORK:
Control No. 0996
13it i t 10 1 N ri
1104 34:
110 /?8 / 91
MEW
INSPECTION
F 1101A MIQ-- r. •
t 1,: AM1 rtC, .A
{
TH%U! A t fnN
F IiyAt I
f' a!7 ! ` i' 4 A C U
RF b1ARi4ti a fii JM W C[1NTRACTOR -- PE IMF i'i BB
?'.?. ?R ?_?.., . . M . ??
? ' " . ? ? . . ? . ? - i J;i""?_ . y`•". ??? _ _
._ .. . , . _ .. _ . - ?. _ _?` w?• _t,? 7F
?aaar? - - -
- ? ? - - - - - ` - _? - - - - _? - - -.-
Permk No. Permit Hold9r Date Telephorn #
SNY
PLUMBING
HVAC ?'? //! gpd 3?.,
ELECTRIC
ELECTRIC
inspect}on Dabe Insp. Cuanmena
Footings I /?19? . ?
Foundation
Framing !?`l 43! Z L
Roofing Z
Rough Pibg.
Rough Htg.
1
lsul.
Fhaplace o- r3-9 z
Final Htg.
1- - "
orsac rest 04
Final Plbg. / Z. Ptbg. Inspectar- Notify Plumber
Cortst. J4feter
ErtgrJPian
Bldg. Final
Deck Ftg.
peCk Fnsi
Well
Pr. Disp.
o .? ? o -' ?
?
Address: 1449 KiNGg WOOD rZpAp Lot g Blk z Sec/Sub KINGS wCpD M
These items were/were not complete at the time of the f1na1 inapection.
Date: 11 2 92 Yas No iiisppctnr, 46,
Final grade (6" from siding) ?,?
Permanent steps - garage t/
Permanent staps • main entry ?
Permanent driveway
Permanent gas ?
Sod/seedad graas '?
Tra11/curb damage
Porch
Basement finiah l?
Deck ?
Pleasa varify vith tha buildar tha removal of rooP tast caps from the plumbing
system and the shut-off of vatar supply to tha outsida lawn faucet before
freeze potential axists. ?
.a,uewa
White - City copy Yellow - Resident copy Pink - Contractor copy
/7J REQUEST FOR ELECTRICAL INSPECTION ,,:!-?`-, ee-ooooi-oe
? Seemstmdions for compleMg this brm on back ol yellow copy ?',?YF,?F?a ?s:
44-?27 - - ° "
"X" Below Work Covered by This Request +'?'
ew Adtl Rep Typeofeuiltlmg ApphancesWiretl EqmpmentWved
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Bwlding Dryer Other (Speah/)
Comm.llndustnal Fumace
Farm Av Conditioner
Other (speciM Comractor5 Remerks
Compute Inspection Fee Be/ow-
# Other Fee # SerwceEntranceSize Fee # Circwts/Feetlers Pee
Swimming Pool 0 ro 200 Amps ?3-b 0 to i00 Amps
Transformers Above 200 _ Amps Above 100 Amps
SiynS Inspei Use Ony TOTAL -
Irngation Booms
/ p'O A
? f U
SpeGal InspeCtion
AlarmlCommunication THIS INSTALLATION MAY BE ORDEHED DISCONNECTED IF NOT
Other Fee COMPLETED WITFIIN 18 MONT S.
I, the Eledncal Inspector, hereby Aou9n-m
.- oaW
certifythattheaboveinspectionhas
been made. F,nai oaie
?
OFFICE USE ONLY
This repuesl void 18 months Irom
K44227
? v
dn
?
a-8 0-
Request Dale Fi No. Roug1+n Inspectmn
Requ, redP
? flefltlY Now ?<ill Nohry Inspector
n R
Wh
tl
?
No
u
e
ea
y
14 licensed contractor p owner hereby request inspection of above electrical work at:
Job Atltlrass IStreet Box or qaute No)
! Y7 ?J s,Vo,.f ,e? City
F
SecLOn No Taxnship Name or o Rarge N0. County
P.4r'?? -!e A y
a
OccupaJnll(?PFIN?T)j
V
eJ 1F Phon`e /No
?
Y Jl' J'a D G
Power Sopplier
,94 AEtlress
Electncal Conbactor ICOmpeny NamB)
? ov? tri'jc-c?`wCc c 8• ConVettor§ Licenx No.
C,4-a a l?/
MaiLngp ArW ss IConVactor aor Owner MaLking Installanon)
(
?
,
? K. /i2?' dR 'J CJ'?? L(J?' / /C- ,v C
Author etl nat une i onhacrpr,Owner M g In tallatan1
Phone N mber
1
3
-
?
MINNESOTR $TATE BOARD OF ELECTBICITY THIS INSPECTION REOUEST WILL NOT
Griggs-MlOway BIAg. - qoom S173 BE ACCEPTED BV THE STATE BOARD
iBS1 UnlverNty Ave., SI. Vaul. MN 55104 UNLESS PROPEF INSPECTION FEE IS
Phone(6/2)66R-0800 ENCLOSED
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
L?L.f 3830 PILOT KNOB RD, EAGAN MN 55122
651-681-4675
Naw Construdion ReauiremenM
• 3 registered sde surveys showing sq ft of lol, sq. ff. of house; and ell roofed areas
(20%macimumlotwveragealbwed) .
• 2 copies of plan showirg beam 8 window s¢es; poured Found desyn, etc.)
. 1 sei of Eneryy Calculalians
• 3 wpies oF Tree Preservahon Plan if bt plaked after 771/93
• Rim Joat Det2il OpGons selection sheet (Wdgs with 3 arless units)
DATE ?- (5 ` 0 z-
SITE ADC
TYPE OF
iULTI-FAMILY BLDG _ Y _ N
FIREPLACE(S) _ 0 _ 1 _ 2
APPLICANT SELA qOOFlNG & REMODELING, INC
STREET ADDRESS ST. LOUIS PARK, MN 55416 CITY STAtE_ZIP
TELEPHONE #QZ T23-qid?d CELL0PH0NE # FAX #
PROPERTYOWNER J2(f ?--?25 TELEPHONE# `fSZ- S-762
-------------- -------------------- -................ --------- -...................... --------°--
COMPLETE THIS SECTION FOR KNEW°' RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESOTA RULCS 7670 CATEGORY 1 MINNESOTA RUL,ES 7672
(q su6mission type) . Residential VenGlatlon Ca[egory 1 Worksheet Suhmitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculatlons SubmiUed
Plumbing Contractor: __
Plumbing system includes:
Mechanical Conhactor:
Mechanical system includes:
Sewer/Water Contractor:
_ Air Conditioning
_ Heat Recovcry System
Phone #
Fee: $90.00
Phone AUG 1 5 2002
?
----------°----------------------°-------------------------------------------°°------° ley ---------------
I hereby acknowledge that I have read this application, state that the information is coY?ect; an agree o comply
with all appiicable State of Minnesota Statutes and City of Eagan Ordinances.
Stgnature of Applicant ?, Q? ?? ,L-??!r Jt?
--------- __.--___--__......r...._.._........_---------- --------------- -----------_ _ __-------- _
OFFICE USE ONLY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
UpdateG 4102
_ Water Softener
_ Water Heater
_ No. oF Baths
RemodeVReoair Reauirements
• 2 copies of qan
• 1 set of Eneigy Calcula6ons for heated addilions
• 1 site survey for ezterior additions 8 tlecks
. IMicate R hane served by septic sysiem for additions
VALUATION W?- C CoC . "
Phone #
_ Lawn Sprinkler
No. of R.I. Baths
OFFICE USE ONLY
? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OS 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 (screened) ? 36 Multi
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plhg_Y or _ N ? 25 Miscellaneous
O 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 WindowslDoors
? 34 Replacement •Demolition (Entire Bldg only) - Give 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 Width
REQUIRED INSPECTIONS
_ Footings (new bldg) FinaUC.O.
_ Footings (deck) FinaUNo C.O.
_ Footings (addition) _ Plumbing
Foundation FIVAC
Drain Tile Other
Roof _ Ice & W ater _ Final Pool _ Ftgs _ Air/Gas Tests _ Final
_ Framing _ Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ _
Final Windows (newlreplacement)
_ Insularion _
_ Retanung 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
Total
Building Inspector
INSPECTION RECORD Cantrol No. 0996
CITYOFEAGAN PERMITTYPE: BuzLoaNG
3830 Pilot Knob Road Permit Number: 001347
Eagan, Minnesota 55123 Date Issued: 0 S/ 2 8/ 9 2
(672) 681-4675
SITEADDRESS: LoT: s aLocK: 2 APPLICANT:
1449 KINGS W000 RD OZMUN 9LDRS INC
KINGS W00D 2ND (612) 431-5000
PERMIT SUBTYPE:
SF DWG
TYPE OF WORK:
NEW
INSPECTION
FOOTING D. .
FRAMING .•
INSULATION FINAL
FIREPLACE
REMARKS: S& W CONTRACTOR - PEINE PLBG
? ?
PE1?n MTrr
11 Control No. o[? 9c
? v
CITY OF EAGAN
3830 Pilot Knob Road PERMITTYPE: auxLozNG
Eagan, Minnesota 55123 Permit Number: 001342
(612) 681-4675 Date Issued: 9 8/ 2 8/ 9 2
SITE ADDRESS:
1449 KIN6S WQQD RD
LO7: 8 BLOCK: 2
KINGS W000 2ND
DESCRIPTION:
Buildi"hg Permit 7ype SF DWG
` Bui];da.ng Work Type NEW
xU8C Qccupancy R-3 M-1
CansCructian'Type v-N
Zoning R-1
Build3ng Length ? 64
Building Width 44
,<-
,?, y
-`l ,?.':iSi??a :4l 1?:"fz? ` ?:?•? L„;`°`-;ft..`?l?tJ ?.i
REMARKS: C (f a C(ri ?"j
5& W CONTRACTOR - PEINE PLBG
FEE SUMMARY:
VAIUATIqN
Base Fee
Plan Review
Surcherge
SAC
SAC t
SAC Units
Subtotal
$853.00
$554.45
$80.50
$700.00
100
1
$2,187.95
$161,000
MISCELLANEOUS $1,610.50
Total Fee $3,798.45
CONTRACTOR: - Applicant - sT. Lz OWNER:
OZMUN BLpR3 ZNC 14315000 000104 OZMUN BLORS
15196 GALAXIE AVE 15136 GALAXIE AVE
APPLE VALLEY MM 55124 APPLE VALLEY MN 55124
(612) 431-5000 (612)431-5000
I hereby acknnwledg.e that I have read this appliaatlon and state that t'he
information is carre'cC and agree to cam.ply with ail appJ,icahle State o'F Mn.
StaGutes and CiCy af Eagan Ordinances.
{-. -
C
P2PLICANT/PERMITEE ATURE ISSUED EIY. GNATU E
_... _ ?W _ .
PERMIT k
REACTIVdTE ?1!W2
CITY OF EAGAN
1992 BUILDING PERMIT
681-4675
$.9, Iffe,
APPLICATION
A?? 1 ? RECo
MUITI-FAMILY 2 sets of plans, 3 registered site surveys, 1 capy of energy
17 calcs.
MERCIA L
co? 2 sets of architectural 8 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 mon h in which re uest is made or lot chan e is re uested once ermit is issued.
Date Valuation of work
Site Address:
STREET SUITE k
Tenant Name: (commerclal anly) I"/u(
LOT BIACK SUBD.
l P.I.D. 1f
,
Descri tion of work: ( w
The applicant is: Owner 0 Contractor ? Other (oes«ibe)
Name - M Phone
Property LAST FIRST
Owner Address ? ? ?P ??aXl?° tCV'?
S EET STE M
City UG? State ? Zip
Company Z Phone `?
Contractor Address l & (551 k ?2 A1W License #? Exp ?J113
City `Q- V61 State N,Iv ZiP
Company Phone
Architect/
Engineer Name Registration #
Address
City State Zip
Sewer 6 water ticensed plumber Processing time for
sewer & water permits is two da s once area ha een approv d.
I hereby acknowledge that I h re is app ication and state that the information is
correct and agree to comply th al plicabl 5tate of Minnesota Statutes and City of
Eagan Ordinances.
Signature of Applicant:
OFFICE USE ONLY
BUILDING PERMIT TYPE
O Oi Foundation
g 02 SF Dwg.
O 03 SF Addition
O 04 SF Porch
? 05 SF Misc.
? 06 Duplex
? 07 8-Plex
? 08 S-Plex
? 09 12-Plex
? 10 Multi. Add'1
WORK TYPE
0 31 New
? 32 Addition
? 33 Alterations
? 34 Repair
GENERAL INFORMATION
?
11
Apt.(Lodging
EM' A
9asement Finish
? 12 Multi. Misc. ? 17 Swim Pool
? 13 Garage/Accessory ? 18 Comm./Ind. ,
? 14 Fireplace ? 19 Comm./Ind. Misc.
? 15 Deck ? 20 Public Facility
O 21 Miscellaneous
O 35 Tenant Finish O 37 Demolish
O 36 Move i
Const. (Actual) V- N Basement sq. ft.
(Allowable) ?,j-N lst F1. sq. ft.
UBC Occupancy R-3 M-t
_ 2nd F1. sq. ft.
Toning R_-7_ Sq. Ft, total
# of Stories
_ Footprint Sq. ft.
Length Tr On-site well
Depth c 6L On-site sewage
APPROVALS
Plannirig Building
Engineering Yariance
REQUIRED INSPECTIONS
Q Site
? Mallboard
? footing
? final
.
MWCC System I'-5
City Water YF-,s
PRV Required
Booster Pump
Fire Sprinkler
Census Code O/
5AC Code o f
Assessments
? Framing ? Insulation
? Draintile ? Fireplace
Permit Fee v.imcion: g /6f Ot)O'
Surcharge lp
Plan Review GAR?E? ?sT ?LOp?z
;
License .
MWCC SAC ?1?fZxy2 -- 6?3 BSMT: ?2ti?
Cit
WaterSConn.
AX/ 2?
(a4?
??ZXUZ= I I
Nater Meter .!p k X/i ; ("???
? Y. i 'J2? ID?r
Acct mp?sit --? ? I 235 A53- G$455
S/W
S/w Surcharge GH4 x!6 ? Jp 3bL,
Treatment Pl.
R
d ?
oa
Unit
Park Ded.
,O
q(
L}z -Y 3 I: 13 oZ
'
Trails Ded,
Copies y Y
K 13
5 z
f??3 = `3??
Other ?I x f o= 2 ? p
K
Total: (0) Kb3
Li
- sz
sac % Ioo Iarux rs= I$Z10
?
3AC Units ?_ J258x53= (o(,(7c.(
/ O 4-4-
' 2?2? Enlxp?lsa 4riva
,?,`? ?' ? tAendotn Hslqh4t. ? 65126
* plomomp ? ? ? • (e?x) e!l1-1814•F4x OEt-94d9
?....----?-
i? uWO ?ns • tclemm-n"lcls eae r,l9n.ay 10 Natneosi
* ?np nr.ear nQ S,n,ne, MN $5134
* * ?t (etx) 7e3-1ee0•Vax 7ea-1853
?
Certificate of Survey for: dz ??M 6Q(LpER5 rN??AT?
House Address: 1L49 ?Ms Woad
Model Nnme: ?.?---•--
? •.?
O?
?
?
?
?
?
M "
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-1- A
? r
,`
v
v` ^
g 1 .,? un `? I d'
th
8N
?9 N ? ? ? •
a? ? ? I l
\'?I $9y?ll
?
Q NO r
O ?
Q M
a p
?
W
? ?O ?- ? ?v
30.o L
oM? I ``k
a, ?v
245
ti
?
87"!7° SO% 00
Dc
I sd • 60
Nj
'0
?•?. ?
,o ,v o
f`M1
1?! ? N U N
o?
I ?
L 1'?.?1 (
o.o -4 x 996,5
,,o YfF? q ?
M
8Ba°? 988.1
I 4 &.91 .?
N09°
• wo.o ptinates Exibting Elevallon
• oo? Denotes Proposed Elewtion
Denotes Dratrtage dt tJtllity Eaaement
penotea Oralnege Flow Direction
---0-- Denotee Monument
r 'Y? g
?
I
?
? I
.T - --- j
882
t
? 7T
. r? 4a ??k 1
'?
????g ? ?'i7NE?uR1NG DEP
paoPas?a?s?.?kvArn
l,oweat Floar Elewtion: 9661.
7ap of BIaCk Elevptlon: $94,')
Garaqe Slab Elevotion: 914.1
-19- isenates Difaet Nub gepringa afiown ore oaeumad
L.OT 8, BLOCK 2._, Kr?? WCaoD _2AlD ADDITlC
ap, Koz-q CpUNty, MINNESOTA
t he.*v c.ruly tMt this .m•sY. OIM a 1e15al vm wevor.A b7 me a v-dr mw dir", ? r?Mlen ond tMf f wn dulv hhNnrM t? furv+ra
?neM ?M Iw.? el tM l?n? el M1nnowrH. DrtM t?+?. IS T.,. dw o1 AtA A.P. if :?=.
Rev. 8-2D-92: Add C-x64 Elevs j1 ?
IaWPV Pvoe EIPVS. •° \T. ?.?
S-21• qZ: NeWCs?QIIO?) ?oJSC '
? .CI{P.'' t14?1.30f!!!I noNen?h, iKi .ncnnn
? N ?.
fi N
?
... 0
?
?? 9t55a,o3
ozMUN BuiUDERS, iNC.
DESIGNERS AND BUILDERS MNL(c.0001044 ME
15136 GALAXIEAUENUE, APPLE VALLEY, MN 55124 (61 2)431-5000
Job Site Addres
Maa.n Level
Lineal' tt of
3econd level:
Lineal ft of'
Vaulted Area
Lineal ft of
Rim Joist Arta.
'Lineal ft of
Lower 1eve1
Lineal ft of
Lineal ft of
Lineal ft of
Legal Descripti
Lot_:_) BT.ock 2: Addition
Date?_
AVERAGE LINEAL FEET OF •
EXPOSED WALL AREA ABOVE GRADE
•
tramed wall above grade[g?x height of wall I=??
framed wall above gradeOx height of wa11LJ
framed wall above gradeq& x height of wall?= ??(J
rim ?x height of rim ??)3 = e;?J'?5
framed wall above grade 3 xheight of wall ?_ ?
?
(? f
framed wall above grade x height of wall
masonry wall above grad O x hgt..aboirevqrgde-=
ar.ea.above qrade including windows and doors
Tptal Qall
?
Il .
flll
11
l -l?tt N+I.
1 I
WINDOWS: Brand and Type -MOC.. 00(_'CI?YWiA*,
.Lt
t.-
ilj .ft
.ft
.ft
.Et
.tt
ft
.ft
.ft
.ft
.£t
.ft
' sq,ft._
OPAQUE WALL•CONSTRUCTION:,Area
Frami.ng members Framed wall
Rim Joist Area
Masonry wall .
DOArea• va?u
d' ?t? UfGt?2'?. ?1+?J sq. ft ?x
l?Q d) [ri . sq.ft x /PSI sq.ft. -? x
e sq.ft. 2 , x
. . ry
Total wall area including '
Windows and•Doors
Total ( U ) VeLlties
Divided by, total wa 1 area
__L2LLLU_
x"U" va ue-.
sq.ft `c?' ???J X
sq. ft,?x
sq.ft %•,?_5 x
sq.ft 7C? x
a.
OU11 ? 1 ( a
nVo _
nVn o
uVa =
nUn _
nUu _
nUn a
nUn ?
uUu ?
uUn ?
uUu ?
uVu a
uV?? _
uVu =
r: U e,
:IV u?a
?
uVu ? ? _
nUu ,?
„?„ , O? I =
nVu
nVu =
slU.90 ??
b",It)
Avg. "U" 't "
AVERAGB "U" Minimum .ll:or less.for 1& 2family dwellings
.
?
?
.
J WALL
t'K'rER10?7- p.Irz FILM
hl bl l-i[o
SFFEltiTH I NCs
5??2? SoPT VIOOD
V2' v?tP. ?? INTER.IOIZ ?i? F I ?._},/I , ?S
_? rora. _ = 1D??o?
u
F-R,&,Mp-p WaL-?
rF-R1oR- &I?- r-ILM
71 NLs
M?kThft N6-
154&N I NgUI..
° vYP• e?v
? -?fa u.? E A
z
.17
2,0[0
!o . 8'75
.45
.17
2. oCo *
!
i
rerziorz ? z- Fi t?1 .?P
`t'OTAL 2= Z?.O?
6
R? M Jo15T
. 1-7
, 4,rl
2. OCa
I,88 '
14) 'UO .
, (p8
CU_CAL 2 w
u-
.17
2.48
VVJL rz = °? .33
u_ lo-I ?
?
F-RIOP- NR FILM ,Col ,
=I eq?? I t??Ls?Tica?.l 460 • ?
G*I P 13- p. 15&
4-1 r7ep
/?. u
w
G
?
•
r
>
? ?2 ?t'?? s? `??'h?? •
EX-rE.fLlo?,?.lfz ?II-M ,Col ?
12 ? F L>. I{-J5U i..P,"Y'lol-1 ?7i?• ? ?
?a? GyP? ?D• ,5[ri
II-1-I'ERIvR? Pifz ?ILM ,tpl
-ro-rA?. {z = y5,-18 ?
uu= ,n22
.
>
_ •
t-,I-_,BL .21 CITY OF EAGAN
f ?l , /? PLUMBING PERMIT
SUBD. ?..wEO A9rt-D? (612) 681-4675
PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS
WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
CITY USE ONLY
RECEIPT #
DATE
AISO, FOR TOWNHOMES AND CONDOS
WORK
NEW CONST _
ADD ON
REPAIR _
OWNER NAME: (ruEMT? " 3U-"-e?
SITE ADDRESS:
INSTALLER:
ADDRESS: U/ U`(- J -?
CITY: 2IP:
COMPLETE THE FOLLOWING:
N0. FIXTURES EA. TOTAL
REPAIR/ADD ON 15.00
r SHOWER 3.00
? WATER CIASET 3.00
BATH TUB 3.00 'GO
IAVATORY 3.00
KITCHEN SINK 3.00 Ls-t}
? LAUNDRY TRAY 3.00
HOT TUB/SPA 3.00
? WATER HEATER 3.00
? FLOOR DRAIN 3.00
? GAS PIPING OUT.
(MINIMUM - 1)
3.00 ?
?
_ ROUGH OPENINGS 1.50
_ OTNER
WATER SOFTENER 5.00
PRIVATE DISP. 15.00
U.G. SPRINKLER 3.00
W. TURNAROUND 15.00
STATE SURCHARGE .50
0
TOTAL: -?
? COMMERCIAL
PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL SUILDINGS. ALSO FOR MULTI-FAMILY
BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT.
WORK DESCRIPTION:
OWNER NAME:
SITE ADDRESS:
TENANT NAME: _
SOITE #:
INSTALI.ER:
ADDRESS:
CITY:
YHONE j{ :
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)
CITY OF EAGAN
CTI'Y OF EAGAN
L C? MECHANICAL PERMIT RECEIPT # a?C%S 0
SUBD. ' ?'•`? (612) 681-4675 DATE a-14, 4:?
RESIDENTIAL
PLEASE COMPLETE UPPER PORTION ONLY FOA SINGLE FAhIII.Y DWF.LidNGS. ALSO, COMPLEI'E FOR
TORNHOMES/CONDOS R'HEN SEPARATE PERMTfS ARE REQUIRED FOR EACH DR'ELLING UNTf.
OR'NER: ...t,?? ADD-ON A/C ADD-ON Ft1RNACE ?
S ADDRFSS:
' ADD ON/REMODEL (EXISTING
CONSTRUCI'ION ONM $ 13.00
INSTALLER: ,?,?wyf 1 HVAC: 9-100 M B1'U 24.00
PHONE #: L-i-
? T 6, F3 2.
ADDTCIONAL SO M BTU
6.00
ADDRESS: GAS OUTLET5 - MINIMUM 1@ $3 EA.
CT11': ZIP: 'GVS SURCHARGE $ .SO
SIGNATURE: ,? ,??? TOTAL: $ p? ?
- - -- ?
NO PE?tMIT REQUIRED FOR DUCTWORK ONLY!
COMMERCIAL
PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAUINDUSTRIAL BUILDINGS. AISO COMPL?.'TE FOR
APARTMENT BUILDINGS OR OTHER MULTI•FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR
EACH AR'ELLING UNIT.
WORK DFSCRIPTION: CONTRACT PRICE
196 OF CONTRAGT FEE. FEES
' STATE SURCHARGE IS $.50 FOR EACH
$1,000 OF PERMIT FEE.
$
PROCESSED PIPING - $25.00
1?iINIMUM FEE • S25.00
$
OWNER: TOTAL: $
SI1'E ADDRESS:
TENANT:
SUTfE
INSTALLER:
ADDRESS:
CTl'S': ZIP:
PHONE #: CITY SIGNATURE:
SIGNATURE:
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Use BLUE or BLACK Ink
I For Office Use
Permit#: J
rEaRd City OT 1 ll
I
I Permit Fee: 0 5_a5
'
3830 Pilot Knob Road I
Eagan MN 55122 Date Received: 1~ I
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 Staff:
I I
_ 29J4 RESIDENTIAL BUILDING PERMIT APPLICATION
Date:/cam Site Address:
!tow
Name: Phone:
Resident/
Owner Address / City / Zip:
Applicant is: Owner Contractor
Y
Type of Work Description of wor _ 4_1
~
Construction C Multi-Family Building: (Yes / No
Company: 27/' el, ntact:~
Address: G City:
Contractor
I State: Zip: Phone: ~
License #:Lead Certificate
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
i
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:
s
Licensed Plumber: Phone:
Mechanical Contractor: Phone: j
Sewer & Water Contractor: Phone: 1
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of f
the information may be 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.
x C zne_
x
Applicant's Printed ame Applic is Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA139853
Date Issued:11/14/2016
Permit Category:ePermit
Site Address: 1449 Kings Wood Rd
Lot:8 Block: 2 Addition: Kings Wood 2nd
PID:10-42001-02-080
Use:
Description:
Sub Type:Fireplace
Work Type:Wood Burning Fireplace
Description:
Census Code:434 -
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Improvements to the home may require smoke detectors in all bedrooms. Chimney / flue must be inspected prior to
concealing.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Valuation: 3,000.00
Fee Summary:BL - Base Fee $3K $88.50 0801.4085
Surcharge - Based on Valuation $3K $1.50 9001.2195
$90.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Jeffrey Iles
1449 Kings Wood Rd
Eagan MN 55122
Fireside Hearth & Home
2700 Fairview Ave N
Roseville MN 55113
(952) 985-6675
Applicant/Permitee: Signature Issued By: Signature