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4282 Moonstone Dr Use BLUE or BLACK Ink r For Office Use Permit j City of EaEd I 9~ I Permit Fee: 3830 Pilot Knob Roadi I J I Eagan I VIN 55122 r f t? D Date Received: Phone: (651) 675-5675 ~5✓j start: Fax: (651) 675-5694 JUL G 2011 Co - ~ 2011 RESIDENTIAL BUILDING PERMIT IPPLICATION L Date: Site Address: Unit M Name: 'd J ~►~S en Phone: C-t~j 2 ' Y L 7 RESIDENT / F /2_ ~2- 5 ~9 ~ OWNER Address /City /Zip: U Applicant is: Owner ~ Contractor TYPE OF WORK Description of work: ` 106 Construction Cost: Zzp Multi-Family Building: (Yes / No ) Company: C Orr le n(Qr'n'qQct: e4-z~ 57,1/'o 4-2, CONTRACTOR Address: `~ZZ Y4(S'Lj by- DQ city: State: l" Zip: ~ Phone: •y",l- - -~FT W 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 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 the information may be classified as non-public if you provide specific reasons that would permit the City to conclude that the 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.gopherstateonerall.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 accord an a with the approved plan in the case of work which requires a review and approval of plan . x 2A" ~2 vo ~ x 11 Applicant's Printed Name plic nt's Signature Page 1 of 3 DON T RITE LO HIS SUB TYPES Foundation _ Fireplace _ Porch (3-Season) _ Storm Damage Single Family _ Garage _ Porch (4-Season) _ Exterior Alteration (Single Family) Multi Deck _ Porch (Screen/Gazebo/Pergola) _ Exterior Alteration (Multi) _ 01 of Plex Lower Level _ Pool Miscellaneous Accessory Building WORK TYPES _ New _ Interior Improvement _ Siding _ Demolish Building* Addition _ Move Building _ Reroof _ Demolish Interior Alteration Fire Repair Windows Demolish Foundation Replace _ Repair _ Egress Window _ Water Damage Retaining Wall *Demolition of entire building - give PCA handout to applicant DESCRIPTION Valuation Occupancy MCES System Plan Review Code Edition 04 p~Z SAC Units (25%_ 100% Zoning City Water Census Code Stories Booster Pump # of Units Square Feet PRV # of Buildings Length Fire Sprinklers Type of Construction Width REQUIRED INSPECTIONS Footings (New Building) Meter Size: y~ Footings (Deck) Final / C.O. Required T Footings (Addition) Final / No C.O. Required Foundation HVAC Gas Service Test Gas Line Air Test Drain Tile Other: Roof: -Ice & Water -Final Pool: -Footings -Air/Gas Tests -Final Framing Siding: -Stucco Lath -Stone Lath ^Brick Fireplace: -Rough In Air Test -Final Windows Insulation Retaining Wall: _ Footings - Backfill - Final Sheathing Radon Control Sheetrock Erosion Control Reviewed By:Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant 1 Copies r TOTAL Page 2 of 3 ap K C~~t~rr iarr on .r i { 2 k ~-']l 01 SM 17002 ousb # Street Scrl E 1016701 81 w , 172 --:ICEDAR,GRC 130 i"Mi Bch PID. w~:h M .4282 1 N5 TONE DR V' r MINE ~IZ2 ✓~1nS_ /~~U-~ ODD. AMM IL c a IPL M ~ 4dkmL i } i,, ~75- it l 7,1 T C ' /1 l 3 Cc) CITY OF EAGAN Remarks Ceda'C' Grove Acquisitian Addition Cedax' Grove #2 Lot 17 RIk 2 Parcel 10 16701 170 02 Owner ???" J f i' _ A(ii Street 4282 Moonstone Dr. State Eagan? MN 55122 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. 8s 1985 1266.95 84.46 1 STREET RESTOR. GRADING SAN SEW TRUNK SEWER LATERAL 1272 1 52,16 2 Paid WATERMAIN # WATER LATERAL 1972 WATER AREA STORM SEW TRK STORM SEW LAT CUFB & GUTTER SIDEWALK STREET LIGHT WATER CONN. BUILDING PER. SAC PARK INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55123 Date Issued: (612) 681-4675 SITE ADDRESS: PERMIT SUBTYPE: APPLICANT: .141 TYPE OF WORK: , . i ,. , 1 t ,, 1 F f'!1 I f' o kt)1?t l N+i t INSPECTION D• • DA Permit No. Permit Holder Data Telephone # S/IN PLUMBING HVAC ELECTRIC ELECTRfC Inspectlon Date Insp. CommeMs Footfngs I . Foundation ' Framing Roofing 7,//(l?l?G? Rough Plbg- Rough Htg. Isul. Fireplace Final Htg. Orsat Test Final Plbg. Plbg. Inspector - Notify Plumber Const. Meter EngrJPlan ? Bidg. Final Deck Ftg. Deck Final Well Pr. Disp. EAGAN TOWNSHIP m BOJILDING PEFtMIT Ownea __l/r? ._ W...____ Address (Presen!) ....... 41.....__ - -_----------- .____.__'.........____._.. Builder _.._..._......? .____..----- ............. Address .__------- --------------- ._ _._..... __............_. .. DESCRIP.TIaN N° 702 Eagan Township Town Hall Dafe ._7...._--_ cZ..__...Y / SSoriesl To Be Used For - Front Depih Heighi Esi, Cos! Permii Fee Remarks _ .O.Qr.c-cf?/1 CS?o?o ?vD.cro? I . LOCATION - Sireef, Aoad x oi er escrspiion o oca ioa o . oc AddLTion or Traci j,-.- This permiY doas nof aufho?ize the use of slreefs, roads, alleys or sidewalks nor do¢s if give the owner I or his ageni . the righf fo creale any siSUafi nwhich is a nuisar.ce or which presetlfs a hazard !o the healih, safefy, convenlence and geneial welfare fo anyone in ihe communiTy. -THIS PERMIT MUST BE KEPT ON THE PREMI5E WHLLE THE WORK IS IN PROGRE59. - This is 2o cexfity. 3hak-------- -..--.... ------------- ........... _._._...__has permission Yo ereci a--....... ,__._.----.------------_.__..... upon the above described premise subjecf !o the provisior.s of !he Building. Ordinance Sor Eagan Township adopied April 11, 1955. --------------..._..----------------___.------------------- _..._... Per ---- -------------- -------------------------------------------- :.-------'---------_---- Chairman of Tnwn Board Suilding Inspecior ? .1-? (?0 X ? 48 ? A Requeal Date `l(y - Fire o. Rough-In nspection Requlretl (VOU must cell inapector when reetly) Ina edion er Than Raugh-ln atly No g Wil Noti Ins or ? ? . ? V '- 7 ? Yes o ? L Oate Reatl I QTcensed contractor ?owner hereby request Inspection of above electrical work at: Job'Atltlress (Street, Box ar Rou[e No) Clty /vL ? '5;0T ? 'P1 N Section No. Township Name or No. Rangs No. Caunry D" 4 rC6 f !'J Occu/p?a t(PFINT) 1 / /?- Q?S V G-'C!`a ? fll P?ho/ne No.?I 7 c? ^ 7 Power Suppller ,-qpc oZ4 Atltlress Electrical Coniracror (COmpany Name) Conlradora License No. / 7? Mailing Atltlress (Contractor or Owner Ma ng Inetalletlon) ! e Z ? c?'RC! ? NLtL S?'S ?7 Aut orize gn ure (Contradod0 ar akin8 Instellatlon? Phone Number (mINIV€SOTA $TATE B044D OFr ELECTPICp` THI$ INSPECTION REOUEST WILL NOT Grlgga-Mitlway Bltlg. - f(oom 5-140 Q BE ACCEPTED BY THE 3TATE BOARD 1821 Univsr8lry AVe., St. Paul, MN 55100 UNLESS PROPER INSPECTION FEE IS Phone(61P)612-0800 ENCLOSED. "115 F REOUEST FOR ELECTRICAL INSPECTION ?d?%? ee-ooooi-o / O o 2 4 8io- See inatrucHOns for completing this brm on back of yeilow coOY. ? X" Selow Work Covered by This Request ?r:?,?:, Ne Add Fib p. -7ype of Building Appliances Wired Equlpment Wired Home Range Temporary Service Du lex Water Heater Electric Heating Apt. Building Dryer Load Management Comm./Industrial Adf umace Other Specify) Farm Air Conditioner Olher (specdy) ContrectoYS Remarkn: Compute Inspection Fee Below: # Other Fee # Service Entranca Size Fee # Circuits/Feeders Fea Swimmin Pool 0 to 200 Am s 0 to 100 Amps Trensformars Above 200-Am s Above 100,-Am s Si ns Inspeclors Ufle Only: s I' TOTAL ?C Irrigation Booms S ecial Ins action Alarm/Communication THIS INSTALLATION MAY BE ORDERE SCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. I, the Electrical Inspector, hereby ceAlfy that the above inspection has been made. Aough-In ' ? Finel oete Daie ' OFFICE IISE ONLY Thig requeflt voltl 18 monNS from 9 797 /O 7,?5`2 S.;2, 9a Request t I ire No. I Rough-in Inspection Requiretl? ReaEy Now ? Wtll Notlly Inspecbr 9 Wh R tl ? ld o ?Yes en ea Y I Iice:Sed contractor ? owner hereby request inspection oi a6ove electrical work at : Job Atld ress (SVeet Bax or Roule N ? U City ? . ? ns a-"D Satlion No. Township Name or No. Range No. Cou ? OZPl RIN TI nc.a PM1One No. PowerSuOPlier Atltlress Eled c Contractor(CO pany Nam , ? Con rector's License No i4 a Mading Addre IGOmreomr or Owp¢r Making I?ation)? ? ?? livv P.mho izeQSign Wra ICo ra tor,Owner Mazing Innallalion, ' . D Pho Nu o ,355? MINNESOTA STpTE BO PD F LEC HICITY TMIS INSPEQION REOl1EST WILL NOT Griggs.Mltlway 8149 . fio 1]3 BE ACGEPTED BY THE STATE BOARD 1821 Ilnivenity Ave., S, ul. M O< UNLESS PROPER INSPEGTION FEE IS Phone(fi12) 642-0800 ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION Q7 ? See insimctions tor completing Ibis lorm on back of yellow copy uU O_2?01 "X" Below Work Covered by This Request i°`"seaooooi-oe ?o,-?-: ?e+ ?,. e Atl ep. _-TypeofBuilding AppliancesWired EquipmentWired Home Range Temporary Service Duplez Water Heater Electric Heating Apt. Building Dryer Olhec(Specify) Commllndustrial Fumace Farm Air Conditioner Other ?specHyl Contrectar5 R marks' n ?II^ L on ?/n ? `?j???t.? U? l? Compute Inspection Fee 8e/ow: # Other Fee # ServiceEniranceSize Fee # Circuits/Feetlers Fee Swimming Pool 0[0 200 Amps 0 to 100 Amps Transformers Above 200 _ Amps Above 100 _ Amps SignS Inspector5 Use Onry: TOTA ? Irriqation Booms ?J^ pd ?? Special Inspection Alarm/Communication THIS INSTALLATION MAY BE OROERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. I, the Electrical Inspector, hereby Rougn-In oate certify that the above inspection has 6een made. F;,,ei oa? OFFICE USE ONLY This repuesl voitl 18 monihs Vom This reque5t void ./J ._.? ? ?e 18 months from + v A 079f;66 Nuw Q Will Notify. Inspec- tor When qgatly ? Licensed Electrical Contrxctor I herebY reQUest iaspection of above NOwner eieeviwl rark installed al: SVeet Ad?dress, Box o?r fl/oute No./ ?°yl?e+' /°?J7:n?.Y?i..? pC', /? City ,GC'?. Ey ecuc.? o. - Township Name or No. Fange No. Co/vy/??y ,(?a-? a-? o /-cc OccupanJt(PRINT) • hOt/?GtfKC ?•'I.SE'sy Ph/on?e/N?a.7 /7U 77J- Powe,r/ ?SupOiiw / AdAress Elecvical Contracror tCompany Name) - Conbactor's License No. Mailing Address (Contractor ar Owner Meking InsfailaHon) AuMoriz SiBnature (ConVactor Ow r Naki"g Iastallation) Phone Number -ir s2- yJ: r b71NNE50TA STATE BOARO OF el?ECTNICI7Y THIS INSPECTION flEQUEST WIIL NOT Griqgs-Midwav glde- - Ruom N-191 gE ACCEWIEO BY THE STATE BOARD VNLESS PROPEN INSPECTION FEE IS 1627 University Ave.. SL Paul, MN 65104 Phnme 18121 297.2111 ENCLOSED. REQUEST FOR EL,r CTlON /? , See iristrections far cu. . -ehia fmm on back of Vellow copY. K . /? n??n'/ow Work Covered by This Request ??' ? , ?Add Rap. Type ot Builtlinp AppliaMas Nired Eqmoment Wved. Air p Fee ServicaEnt gime k fee Feedars$ebteeAers N Fae Cirwits %jJ Oto200A AnlI?s Oto30Am s A Above 200 31 N 700 Amps 31 to 100 A Swimmin Above 100_ Ab100_Am s Transtorme Irrigation 8ooms Partial%Other Fee I Signs I I jSpeciai lnspections G ITO7ALfEE emerks ?"p ? Finel I, tha ETocMCal Inspeetor, heroby lertify that Ihe above Ip3pBttioO ha5 El00 Thbrepuastvdtll8montlm r m f??9 ?a.,pi>,? S c? ? ? tc u rc?••. 0/,?..t? zo /OlI PERMIT ? Al q-° -? ? CIT4 OF EAGAN 3-95 --9? 3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G Eagan, Minnesota 55123 Permit Number: 023159 (612) 681-4675 Date Issued: 0 3/ 2 5/ 9 4 SITE ADDRESS: 4282 MOONSTONE DR LOT: 17 BLOCK: 2 CEOAR GROVE 2ND P.I.N.: 10-16701-170-02 DESCRIPTION: SF (MISC.) REPAIR C? Crcl' (ROOFING) ; ?..? Blu'ilding'-Permit Type Building Work Type .\ ,.. REMARKS: FEE SUMMARY: VALUATION Base Fee Surcharge Total Fee $41.00 $.96 $41.90 $1,800 CONTRACTOR: OWNER: - Applicant - ENSEN RONALD 282 MOONSTONE DR AGAN MN 55122 612)452-4394 I hereby acknowledge that I hive read t'his infiormation is correct and agree to comply Statutes and City of Eagan Ordinances. ? a APPLIC T/P MITEE SIGNATURE application and state that khe with all applicable State of Mn. " J ,vA/ 2?2 ISSUED 13Y. IGNAT RE I 2315Q CITY OF EAGAN 1994 BUILDING PERMIT APPLICATION 681-4675 14110 SINGLE & MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy CdlCS. 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 Valuation of work ?fS? r Site Address: 1-7lVfid'1S"k'i['_ 1o.? STREET SUITE # Tenant Name: (commercial only) LOT I rl SIACK ? SUBD. inn ?,,,fx ?nm& P.I.D. # Descri tion of work: 4 t?_ vco lGC Ckd- ?.? ?`?-*x= The applicant is: Owner ? Contractor ? Other (Oescribe) Name u_i Phone Lis?`LI?C??l Property LAST FIRST owner Address STREET STE # City State Zip Company ?crc? Phone CO ntractor Address License # Exp. City State Zip Company Phone Architect/ Engineer Name Registration # Address ' City State Zip Sewer & water licensed plumber Processing time for sewer & water permits is two days once area has been approved. I hereby acknowledge that I have read thi application and state that the information is correct and agree to comply w' 11 appl able State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY BUILDING PERMIT TYPE 0 01 Foundation ? 06 Duplex ? il Apt./Lodging 0 02 SF Dwg. ? 07 4-Plex ? 12 Multi. Misc. ? 03 SF Addition ? 08 8-Plex ? 13 Garage/Accessory ? 04 SF Porch ? 09 12-Plex ? 14 Fireplace ? 05 SF Misc. ? 10 Multi. Add'1. ? 15 Deck WORK TYPE ? 31 New ? 33 Alterations ? 35 Tenant Finish 0 32 Addition ? 34 Repair ? 36 Move GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS Planning Engineering REQUIRED INSPECTIONS ?.Site ? Wallboard Basement sq. ft. lst F1. sq. ft. 2nd Fl. sq. ft. Sq. Ft, total Footprint Sq. ft. On-site well On-site sewage Building Variance ? Footing ? Final ? Framing ? Draintile ? Insulation 13 Fireplace Permit Fee Surcharge Plan Review license MWCC SAC City SAC Water Conn. Water Meter Acct. Deposit 5/W Permit 5/W Surcharge Treatment P1. Road Unit Park Ded. Trails Oed. Copies Other Total: vatuae;m: $ A* ?. ? ., r!1 •rR'tJlF 0 16 Bas'ement?fjnish O 17 Swim Pool ? 18 Comm./Ind. ? 19 Comm./Ind. Misc. 0 20 Public Facility 0 21 Miscellaneous ? 37 Demolish MWCC System City Water PRV Required Booster Pump Fire Sprinkler Census Code SAC Code Census Bldg Census Unit Assessments 5AC % SAC Units 2004 RESIDENTIAL BTJII..DING PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 ?C5 `I 3 1 Telephone # 651-675-5675 FAX # 651-675-5694 New Construd'ron ReauUemeMs 3 registered sile surveys shaxUg sq. R of IoL sq. ft of house; and a9 roofed areas (2(I%mazimum btcoverage alloxxd) 2 copns ai plan showing beam 8 window sb.ea; poured fanW dcsign, efc. 1 set W Energy Calculations 3 copies of Tree Pmservatlon Plan ff bt platted after 711r33 Rim Joist Oetail Optiais seiection sheel (bldgs wilh 3 or less units RemodeUReoair Reouire men4 2 apies of plan 1 set of Eneigy Calculations for heated addNOru t sde survey for add'iiats & dedcs Addition - indkete Ban•sAe sepUc system Date Site Address y Z IZ 40tij n Construction Cost ` )? j,.?? ,Ort, UnitlSte # Descriptlon of R'ork S .,. . ?I..)•.? n Multi-Family Bldg _ Y? N Fireplace(s) _ 0 _ 1 _ 2 Property Owner ? ?ON Telephone#(65( ) Y52- -'i'34v Contractor Address State City Zip Telephone # ( ) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Tvlinnesota Rules 7670 Cateeorv 1 Minnesota Rules 7672 Energy Code Category . Residendal Ven8lation Category 1 Wwksheet • New Energy Code Worksheet (J submission type) Submitted Submitted • Energy Envelope Calwlations Submitted Have you previously constructed a buiiding in Eagan with a similar pian? _ Y _ N If so, 25% plan review fee applies. Licensed Plumber Mechanical Contractor Sewer/Water Confractor Telephone #( Telephone ? I hereby apply for a Residential Building Permit and aclmowledge that the info on i, e-azfc?accurate; that the work will be in conformance with the ordinances and codes of the City aganand the State of MN Statutes; I understand this is not a pernut, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. ApplicanPs Printed Name ZUA?'.' Applicant's Signa e OFFICE USE ONLY -, Sub Types ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bidg ? 02 SF Dwelling ? OB 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Aft - Multi ? 03 01 of _ plex ? 09 07-plex O 17 Garage ? 22 Porch/Addn. (4sea.) ? 33 6ct. Att - SF ? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screen/gazebo) ? 36 Multi Misc. ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscelianeous Work Types ? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding ? 32 Addition ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair ? 33 AlteraUon ? 37 Demolish Building• ? 43 Reroof .p 46 WindowslDoors ? 34 Replacement 'Demolition (Entire Bldg) - Give PCA handout to applicant 09-0 Valuation Occupancy MCES System Census Code ? Zoning City Water SAC Units Stories Booster Pump # of Units Sq. Ft. PRV # of Bldgs Length Fire Sprinklered Type of Const ? Width _ Footings (new bldg) _ Footings (deck) _ Footings (addition) Foundation Drain Tile Roof Ice & Water Final Framing Fireplace _ R.I. _ Air Test _ Final ?L Insulation _ y' Approved By: REQUIRED INSPECTIONS FinaVC.O. ?C FinaUNo C.O. _ Plumbing HVAC Other _ Pool Ftgs _ AidGas Tests Final Siding _ Stucco _ Stone _ Brick ?C Windows _ ReWining Wall Building Inspector Base Fee Surcharge Plan Review MC/ES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total 2?Lg &z-a $ 70- d? \ ??? f D? `'• 4?• ?. t / L v I • ? F°° ? fi ?3 '?? ?c _ ? ? I _ Zv °O u? , ?0 ?• 6 ? ? , d= rs ° I WO lMN IV ? i% ? ? a? y - ? D?% N ? • c 9 . ? I V 6 ? p r 8 ?20 u• 0 00 ? ??do S ? b?j ( ? ??' `? r, ? ? ??o. . ?? ? ?' ? 2' i - r ? . ?- . i tR•87 13 0 ' > , ? A? \\ ?0 ?.? v? \ O ?_1?.? ? ?-3 3o d` /??. „? ?T? ? ? # .•+ ??\c? ? ? ? / ia ? ? IZo `I zo f 5 ILo 2006 RESIDENTIAL BUILDING PERMIT APPLICATION ? City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 FAX # 651-675-5694 New Constmction Reouiremenis 3 registered site suNeys showing sq, fl. of lot, sq. fl. of house; and all rooFed areas (ZO°k maximum lot coverage allowed) 2 copies of plan showing beam & window sizes; poured found design, etc. 1 set of Enwgy Calculations 3 copies of Tree Preservation Plan if lol platled afler 7l1193 Rim Joist Detail Options selection sheet (huildings with 3 or less units) Minnegasco mechanical ventilation form RemodeVReoair ReouiremeNs 2 copies of plan showing footings, beams, joists 1 set of Energy Calculations tor heated additions 1 site survey for additions & decks Addifion - indicate i( onsite septic system 35k. 1(° OEFice Use O?dv Czrtd&urneqRecd ?Y N. Fte6 Pt2S PtBO RCCd _ Y.? N FIBEPre3Requited ._Y _fV On-siteSeplicSysiem .v:Y ,.,..N. Date '3 / 2-' ( l )-00 (o Canstruction Cost 6d d Site Address q )-$)' ?nop,/ y?e- 02 Unit/Ste # ?escriptionofWork 011TQG?ei G-Wuye- MulYi-Family Bldg _ YN Fireplace(s) /? 0_ 1 _ 2 Praperty Owner ko v ?f e" 5ed Telephone # (6S/ 2, tr,d ?e ? u u r Contractor 00,rr ar L?N 5?(Uc-/?; or? ?,?' ? Address 113 60 r c;cy Z-e4 t'v?? ? State M i? Zip q Telephone # ( 6[j_) 5 5/ yq COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING - Minnesota Rules 7670 Cateeoiv 1 Minnesota Rules 7672 Energy Code Category , Residential Ventilation Category 1 Worksheet • New Energy Cade Worksheet (Jsubmissiontype) Submitted Submitted • Energy Envelope Calculations Submitted In the last 12 months, has the CiTy of Ecrgan issued a permit for a similar plan based on a master plan8 _ Y /-- N If yes, date and address of master plan: Licensed Plumber Mechanical Conhactor Sewer/Water Contractor Telephone #( Telephone # ( (D [E 0 v a D Telephone #( ) MAa2 1 2006 I hereby apply for a Residential Building Permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN Statutes; I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. Y? 1G./??W !? (dl??'I, 00.?/ 19'7 CCl ???? Applicant s Printed Name Applicant s Signature DO NOT WRITE BELOW THIS LINE Sub Tvpes ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pooi ? 30 Accessory Bldg ? 02 SF Dweliing ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. AH - Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garege ? 22 Porch/Addn. (4-sea.) ? 33 Ext. Alt - SF O 04 02-plex ? 10 08-plex ? 18 Deck ? 23 Porch (screenlgazebo) ? 36 Multi Misc. ? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage ? 06 04-plex ? 12 12-plex ? 25 Miscellaneous Work T es 31 New 0 35 Int lmprovement ? 38 Demolish lnterior 0. 44 Siding ? 32 Addition ? 36 Move Building ? 42 Demolish Founda6on ? 45 Fire Repair ? 33 Alteration ? 37 Demolish Building` ? 43 Reroof ? 46 Windows/Doors ? 34 ReplaCement 'Demolition(EntireBldg)-GivePCAhandouttoapplicant D@SCrIptiotl: WaterDamage_Yes `? Valuation Occupancy MCES SYstem - Plan Review, . 100% or _ 25 % Census Code A/ 31 Zoning City Water SAC Units Stories / Booster Pump -' # of Units Sq. Ft. ? PRV - # of Bldgs ` Length 3 oZ Fire Sprinklered ? Type of Const ? Width AC ` REQUIRED IN5PECTIONS Footings (new bldg) _ Sheetrock Footings(deck) FinaVC.O. Footings (addition) ? FinaUNo C.O. Foundation _ HVAC Drain Tile Roof Ice& Water Final Other Pool Ftgs Final ? Framing _ Siding _ Stucco Lath Stone Lath _Brick Fireplace R.I. Air Test Final Windows Insulation _ Retaining Wall Approved By: Building Inspector ? -a ° /# de I y , ?? goo ? Base Fee " Surcharge Plan Review MClES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant License Search Copies Other Total W 2006 RESIDENTIAL MECHANICAL rERMiT APrLicaTiorr City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephoue # 651-675-5675 Please complete tor. single family dwellings & townhomes/condos when permits are required for each unit 3p,S0 Date 7 / // / 0O Site Address o n j/-uH e. Unit # PropertyOwner /?v"7 ?Ze- --I Sfv7 Telephone#(?S?) Y39 ANGELL AIRE INC Contractor , . Stree[ Address Burnsville, MN 55337 w T , n 46,U&n j c;ty state F87C 952-748-5202ZiP Telep6one # ( ) d# B irer 67 Ex 9 Z'`/o f. : on p . The Applicant is _ Owner ? Contractor _ Other Add-on or alteration to existing dwelling unit $ 30.00 furnace. _Additional _Replacement _ New air exchanger air condi tioner heat pump / C?J/C/ 4 tcA-r? ottier e -Y State Surc6arge $ .50 -30 Total $ 1 hereby apply for a Residential Mechanical Permit and acknowledge that the information is complete and accura[e; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; that I understand this is not a permit, but only an application for a permit, aad work is not to start without a permit that the work will be in accordance with the approved plan in [he case f work which requires a review and approval of plans. /Z /? ?,p /??I 7 ve/e/YfCi n ^ ApplicanC's Printed Name Applicant' ignafure Li 2006 COMMERCIAL MECHANICAL rExMiT nrrLicaTioN City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Pleaze complete for. commercial/industrial buildings multi-family buildings when separate permits are not required for each dwelling unit Date Site Street Address Unit # Tenant Name (itapplicable) Previous Tenant Name Property Owner Telephone # ( ) Con[ractor P . .. i , ,.. , •? ? ??-?<< -? - •? p °^;i1?;,;? Street Address 'it}'^" -1 S -- • + ?'+ ._,,.. ,'.. 'uT State Zip r ' ?:;-T.elai?llqRe,#:,Q ) Sond #: Expires: The Applicant is _ Owner _ Contractor _ Other Work Type New Construction , Underground Tank _ Instafl _Remove **see below Interior Improvement _ Install Piping _Processed _Gas Nature of Work: "When installing/removing underground tank, cali for inspeciion by Fire Marshal and Plumbing lnspector Permit FeeS: 570.50 Underground [ank installation/removal $50.50 Minimum (includes State Surchargc) or ConVac[Value $ x I% _ $ PermitFee $ State Surcharge If oermit fee is lese than $1,000, add $.SD If e?mit fee is more than $1,000, surchazge is $.50 for every $ 1,000 owed. $ Total Fee I hereby apply for a Commercial Mechanical Permit and acknowledge [hat the information is complete and accurate; that the work will be in conformance with the ordinances and codes of t}ie Ciry of Eagan'and •with the Mechanical Codes; 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 io the case oFwork which requires a review and approval of plans. .. ApplicanPs Printed Name Applicant's Signature Approved By: , Inspector Date: Required Inspeaions: - U.G. _ R.I. - Air Test - Gas Service Test _[nfloor Heat - Final ? Rhvac - ResldeMial 8 LigM CommerGal HVAC Loads Elke Software.6evelopment, lnc. [=d A ire sville MN 55337 -- - P?e3 System 1 (Imported) Summary Loads Cflmponent:: P,re? ? Sea?? ???otat? DescripYion G2uan ? Ga#'n "vS , ??. . . 11 P: Door-Polyurethane Core 186 3,236 0 0 D 12E-0sw: Wall-Frame, R-19 insulation in 2x6 stud cavily, 1206 4,921 0 0 0 no board insulation, siding finish, wood studs 16644: Roof/Ceiling-Under attic or knee wall, Ventetl 832 1,098 D 0 Q Attic, No Radiant Barrier, Dark Asphalt Shingles or Dark Metal, Tar and Gravel or Membrane, R-44 insulation 2213-5pm: Floor-Slab on grade, Vertical board insulation 116 3,125 0 0 0 covers slab edge and extends straight down to 3' below grade, any floor cover, R-5 insulation, passive, heavy dry or light wet soil____ Subtotals for structure: 12,380 0 0 0 People: 0 D 0 0 Equipment: D 0 0 Lighting: 0 0 0 Ductwork: 0 0 0 0 Infiltration: Winter CFM: 33, Summer CFM: 0 2,131 0 U 0 Ventilation: Winter CFM: 119, Summer CFM: 119 3,048 1,918 1,168 3,086 Humidification (Winter) 7.55 gal/day _ -- 2,768 - 0 0 -- 0 ---___- System 1(Imported) Load Totals: 20,327 1,918 1,168 3,086 Suppiy cFM: 231 CFM Per Square ft.: 0.278 ' Square ft. of Room Area: 832 Square ft. Per Ton: 0" Volume (fr) of Cond. Space: 9,984 Air Turnover Rate (per hour): 1.4 (h(q.} ' Based on area of rooms being heated or cooled (whichever governs system) rather than entire floor area. " Based on area of rooms being cooled. Total Sensible Gain: 1,168 Btuh 38 % Total Latent Gain: 1,918 Btuh 62 % Total Cooling Required With Outside Air: 3,086 Btuh 026 Tons (Based On Sensible + Latent) 0.69 Tons (Based On 77% Sensible Capacity) + Notes a s s "e 'r1,'. y i a?+ '4 3•%xi:': Calculations are based on 8th edition of ACCA Manual J. All computed results are estimates as building use and weather may vary Be sure to select a unit that meets both sensible and latent loads. ?' . City of EapIl 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675•5675 . _.-,?.__._,.. .._ - .-. . Fax: (651) 675-5694 ------------------ _.m ? Fo'i?Offi'ce;Use ? j Permit#: ? Permit Fee: Date Received: j I ? I Staff: ? I 2008 RESIDENTIAL BUILDING PERMIT APPLICATION ry / \ Date: Site Address: j/?/ ?7L?dr?STUaI° U. Tenant: lK ndl V / O?',? C ( Suite #: RESIDENT / OWNER Name: Phone: Address / City / Zip: Applicant is: _ Owner Y Contractor TYPE OF WORK Description of work: ze? (f Construction C.osk q2j::rj? Multi-Family Building: (Yes _/ No ? CONTRACTOR Name: ?r2vh?cr 4:nqb?" rCUP,? License#: Address: ?,?3 /?k/ S ,? City: State:/7& Zip: Phone: Contact Person: ?Mkw COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING Minnesota Rules 7670 Cateaorv 1 Minnesota Rules 7672 Energy Code . Residential Ventilation Category 1 Worksheet • New Energy Code Worksheef Category Submitled Submitted (4 Submission type) • Energy Envelope CalculationsSubmitted 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 Conirector: Phone: Sewer & Water Contractor: Phone: NOTE: Plans and, supporting documents that you subm/t.are consldered fo b@ public information. Portions of the lnformatlon ma'y be, classifted as non-pub/lc,H you provlde speclflc reasons that would permit the City to ' ' condude that the are tiade:secrets. I hereby acknowledge that this informatlon is complete and accurate; [hat the work will be in contormance with the ordinances and codes of the City of Eagan; that nderstand this is not a permit, 6u1 only an application for a permit, and work Is not to start without a permit; ihat ihe work will be in accor e ? h the approved plan in [he case of work which requires a review and approval oi plans. x - X Applica Ys Printed Name Applicant's Signature Page 1 of 3 PERMIT City of Eagan Permit Type:Building Permit Number:EA121389 Date Issued:03/28/2014 Permit Category:ePermit Site Address: 4282 Moonstone Dr Lot:17 Block: 2 Addition: Cedar Grove 2nd PID:10-16701-02-170 Use: Description: Sub Type:Reroof Work Type:Replace Description: Census Code:434 - Zoning: Square Feet:0 Occupancy: Construction Type: Comments:Please print pictures of ice and water protection and leave on site. Carbon monoxide detectors are required by law in ALL single family homes . Amy Jilk 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 - Ronald A Jensen 4282 Moonstone Dr Eagan MN 55122 Lindus Construction 879 Hwy 63 Baldwin WI 54002 (715) 684-4647 Applicant/Permitee: Signature Issued By: Signature PERMIT City of Eagan Permit Type:Mechanical Permit Number:EA148340 Date Issued:03/21/2018 Permit Category:ePermit Site Address: 4282 Moonstone Dr Lot:17 Block: 2 Addition: Cedar Grove 2nd PID:10-16701-02-170 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. Please call Building Inspections at (651) 675-5675 to schedule a final inspection. Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088 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 - Ronald A Jensen 4282 Moonstone Dr Eagan MN 55122 Angell Aire 12253 Nicollet Ave S Burnsville MN 55337 (952) 746-5200 Applicant/Permitee: Signature Issued By: Signature