4690 Nicols RdCITY OF EAGAN Remarks
Addition TOUSIGNANT'S lst ADDITION Lot 6 Blk 1 Parcel 10 77000 060 Ol
4690 Cedar Ave. So. EaQan, MN 55122
Street
DUPLEX
Improvement Date Amount Annual Years Payment Receipt Date
STREET SURF, r
STREET RESTOR.
GRADING -
* SAN SEW TRUNK
** SEWER LATERAL
WATERMAIN
** WATER LATERAL
* WATER AREA 1971
STpRM SEW TRK
STORM SEW I-AT
CUFB & GUTTER
51DEWALK
STREET LIGHT
WATER CONN. 540.00 14030 5-1-79
BUILDING PER.
SAC 50.00 140-10 1 - 7
PARK
flF EA6AN
Pilor Knob Road
, MN 55122
No.:
w eomplr wiH+ Fhe City of Eagon
SEWER SERVICE PERMIT
Pilot Kno6 Rood
A,SN 55122
WATER SERVICE PERMIT
PERMIT NO.:
DATE:
No. of Units:
Connection Chorge: "
Account Deposit:
Perrnit Fee:
Surcharge:
Misc. CFwrges:
Total:
Date Paid:
PERMIT NO.:
OATE:
No. of Units:
ess: --
Address:
I agree fo comply with the City of Edgan Connection Charge:
O+'dL+aRees. Account Deposit:
Permit Fee:
$urchorge:
BY Misc. Chorges: ?
Dote of Insp.: Totol:
Insp.: -- Dote Paid: ?
RESIDENTIAL
BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD - 55122
651-681-4675 M
New Construction Reauirements RemodeVReoair Reauirements - CAU C? 2
• 3 registered sita surveys shmving sa. ft o( lot sq. ft ol house; and II roofed areas • 2 mp'ces of ptan ?
(20°/u maximum bt average allaxed) . 1 set of Eneyy Calculations far heated additions
• 2 copies of pian showing beam & window sizes; poured lound design, etc.) . 1 site survey for exlerior additlens 8 decks
• 1 set ol Energy Calalauore
• 3 capies ot Tree Preservation Plan if lot platted aRer 711193
• Rim Joist Detail Options Selection sheet (bldgs with 3 w less unAs)
???I
_HiY +
DATE VALUATION (EXCLUDING LAND)
?
.iJB SITE ADDRESS
IF MULTI-FAMILY BUILDING, HOW MANY UNITS?
PROPERTY OWNER " ?
TYPE OF WORK ?? #XwT A-114 i
APPUCANT _ l, '-'- "-? k
PHONE #
ADDRESS P-0, ed:K-" O`J'.2"_ ZIPCODE 71-E' 74
PAGER # l /- ?_ CELL PHONE #?da 4, .24 7 FAX # 4?5'1 ?? -
NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLETELY
Energy code Category _ MINNESOTA RULES 7670 CATEGORY 1
(check one) - Residential Ventilation Category 1 Worksheet Submitted
- Energy Envelope Calculations Submitted
MINNESOTA RULES 7672
New Energy Code Worksheet Submitted
Plumbing Contractor: _
Plumbing S}•stem Includes:
Mechanical Contractor:
Nleclianical System Includes:
Sewer/Water Conhactor:
_ Water Sohener _
_ Water Heater _
N0. of Baths
Air Conditionino
Heat Recovery System
FIREPLACE(S) _0 _7 _2 _3
Phone #
Phone #
Fee: $90.00
Fee: $70.00
.All a6ove information must be submitted prior to processing of application.
I hereby acknowledge that I have read this application, state that the information is cortect, and agree to comply with
all applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant
Certificates of Survey Received _ Tree Preservation Pian Received _ Not Required _
Phone #:
I.awn Sprinkler
No. of R.I. Baths
UpOated 1/Ot
OFFICE USE ONLY ,
? Ot Foundation
? 02 SF Dwelling
? 03 01 of _ plex
0 04 02-plex
? 05 03-plex
? 06 04-plex
? 31 New
?P 32 Addition
0 33 Alteration
? 34 Repiacement
? 20 Pool
? 21 Porch (3-sea.)
? 22 PorchlAddn. (4-sea.)
? 23 Porch (screened)
? 24 Storm Damage
? 25 Miscellaneous
? 30 Accessory Bldg
? 31 Ext. Alt - MuIG
? 33 Eut. Alt - SF
O 36 Multi
? 35 Int Improvement ? 38 Demolish (Interior) O 44 Siding
? 36 Move Bldg. ? 42 Demolish (Foundatlon) ? 45 Fire Repair
? 37 Demolish (Bldg)` ? 43 Reroof ? 46 Windows/Doors
'Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuation Occupancy
Census Code av-?? Zoning
SAC Units ?f Stories
Nbr. of Units l Sq. Ft.
Nbr. of Bldgs Length
Type of Const Width
_ Footings(new bldg)
Footings (deck)
Footings (addition)
?i Foundation
_ Drain Tile
Roof Ice & Water Final
? Framing
_ F'ueplace _ R.I. _ Air Test _ Final
_ Insulation
_ Other
_ Pool _ Ftgs _ Air/Gas Tests _ Final
_ Siding Stucco Stone
_ Windows (new/replacement)
Approved By t146 , Building Inspector
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
? 07 05-plex ? 13 16-plex
? OS 06-plex ? 16 Fireplace
? 09 07-plex 0717 Garage
? 10 08-plex ? 18 Deck
? 11 10-plex C) 19 Lower Level
? 12 12-plex Plbg_Y or_ N
&,#'R 4 6,!?F
/.c.,ra1-;, ) /oyk1.44 ? `f,-) .2 Tr/? ez?
'p' (,(, MC/ES System
?- / City Watei
_L Booster Pump
?2 6'1 PRV
Fire Sprinklered
REQUIRED INSPECTIONS
FinaUC.O.
FinaVNo C.O.
? Plumbing
I-NAC
RESIDENTIAL
? = BUILDING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD • 55122
651-681-4675
New Construclion Reauirements
• 3 (egistered site surveys showing sq. tt. of l04 sq. ft. of house; and all roofed areas
(20% macimum lot coverage allowed)
• 2 copies of plan showing heam & window sizes; poured found design, etc.)
• t set of Energy Calculatlons
• 3 copies of Tree Preservafion Plan if Iot platted after 711193
• Rim Joist Detail Opfions selection sheet (bldgs vnth 3 or less units)
DATE
JOB SITE ADD
9a N
If MULTI-FAMILY BUILDING, HOW MANY UNITS?
' ! 7/3,7!
RemodeqReoairReauirements Call`-4 J
2 copies ol plan ?
• 1 set of Ener9y Calculatiorrs for heated addiGons
• 1 site survey for extenor additions 8 decks
LAND) '2SU ) o o 0
PROPERTYOWNER
TYPE OF WORK lWy FIREPLACE(S) _0 _7 _2 _3
APPLICANT ?e PHONE #
ADDRESS X ZS'Zk ZIPCODE
PAGER # l-877-591' 9gOSCELL PHONE #?1 FAX # GSI -1/50 -I&YO
0.(W-?- 6s?-ySo -6a?a
NEW RESIDENTI L BUILDING ONLY - FILL OUT COMPLETELY
Energy Code Category 1b1INNESOTA RULES 7670 CATEGORY 1
(check one) - Residential Ventilation Category 1 Worksheet Submitted
- Energy Envelope Calculations Submitted
MINNESOTA RULES 7672
- New Energy Code Worksheet Submitted
Plumbing Contractor. 6?I/? Phone
Phunbing Systecn Includes: Water Softeucr _ I.awn Sprinkler
Water Heater No. oF R.I. Baths
No. of 13adis
Mechanical Contractor: -9-
Vlec6anical Syslem Includes:
Sewer/Water Contractor:
c NcQ-? , ?
tlir Contlitionimt
I-Icat Rccovcry S
N/1
All above information must be submitted prior to processing of application.
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply with
all applicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicanf
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
(9/
6 57 -Lf'SS-3o66
Fce: S90.00
# G S1-Z/51 _87V
-? Fee: $70.00
Phone #
Updated 1/01
OFFICE USE ONLY
? 01 Foundation
? 02 SF Dwelling
? 03 Ot of _ plex
? 04 02-plex
? OS 03-plex
? 06 04-plex
? 07 OS-plex ? 13 16-plex
? OS 06-plex ? 16 Fireplace
? 09 07•plex ? 17 Garage
? 10 08-plex ? 18 Deck
? 11 10-plex O 19 Lower Level
? 12 12-plex Plbg_Y or _ N
? 20 Pool
? 21 Porch (3-sea.)
AO 22 PorchlAddn. (4-sea.)
? 23 Porch (screened)
? 24 Storm Damage
? 25 Miscellaneous
>-,
? 30 Accessory Bldg
? 31 Ext. Alt - Multi
? 33 Ext. Alt - SF
? 36 Multi
?
* 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 (Bidg)* ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement •Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuation Occupancy MC/ES System
Census Code ?!3 Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units ? Sq. Ft. PRV
Nbr. of Bldgs Length e?5 O Fire Sprinklered
Type of Const Width o ?O
?b Footings (new bldg)
_ Footings(deck)
Footings (addition)
? Foundation
Drain Tile
Roof Ice & Water Final
? Framing
Fireplace _ R.I. _ Air Test _ Final
? Insulation
REQUIRED INSPECTIONS
? FinallC.O.
FinaUNo C.O.
;L6 Plumbing
HVAC
Other
_ Pool Ftgs AiriGas Tests _ Final
_ Siding Stucco Stone
_ Windows (new/replacement)
Approved By G??
Base Fee
Surcharge
Plan Review
MClES SAC
Ciry SAC
Water Supply 8 Storage
S&W Permit & Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
i r-zD x)
Building Inspector
EAGAN TOWNSHIP
BUILDING PERMIT
?Q ./.... .
Ownex _"-_......
Address (Prese S) ..!!\.Q.,'_...... ....._ ..... .....__....-`--.....--....."'--
Builder .....................
---------r';".tc: `.----"--'---'--• ...................---...
Address .....
N° 1315
Eagan Townahip
Town Hall
Date ._%"4_.....---•-°-----°--
Stories To Be Used For Fronf Depih Heighf Esl. Cos! Permit Fee Aemarks
?'Y
ar
This pesmil does noi aulhorise the use of sireets, roads, alleys os sidewallcs nor does it give the ownar or his agen!
the sigh! !o creafe any siluafion which is a nuisance oz whieh preseals a hasard !o the healffi, safe2y, convenience and
gene:al welfare fo anyone in the communifp.
THIS PERMIT MUST BE KEPT ON THE PREMISE WHILE THE WORK IS IN PROGRE S.
Thia is !o cexlify, lhat.... rl- . . ..has peimission !o erec! a .................. ........... .. . . . ..... .... upon
. -t . --"-'•--=.._.. .... -' . '•"..
the above deccribed pre ise..subj. ec! !o e provisions of the Building Otdinance !or Eagan ownship adopfed April 11,
1955. D I
........................ ..1?*.:.F? '-- ??'-...__... Per ._..'--.....- .. 1-t.' .t ....
... -....................-
....... fc? ?__
Chairman of .nwn Board Sutldin Ins eetor
4 '.c4
-tt /.3 / s,
7'QUs1? 's
/ st 4.Da
O n/ .
u
CITY USE ONLY
PERMIT #: ! f p 70
RECEIPT DATE: y 1 Y/ 10)
RE5ID?'.'gAL MECHANIC?L PERMIT APPLICA1'ION
crrY oe EAsAx
3830 PILOT KNOB RD
EAHRN bIN 55188
65I-6$1-4675
Please complete for: ? single family dwellings
townhomes and condos when permits are required for each unit
Date: 0 3 - b \
SITE ADDRESS:
?
OWNER NAME: F O ?A 1 ?tC2S? -t?1n\ede? ELEPHONE#: -1 -7 <;-Q i- 90IOS
nC i?_) (AREA CODE)
INSTALLER NAME: ??,eV Hsd1i' ' * ' TELEPHONE #: (AREa,cooe) ?S ? - ??8 I
STREETADDRESS: aaa JJO-rdi"a,? ? Vrl N
CITY: s ?- Pau_\ STATE: vYtN ZIP: SS o-l S
oi"? ' ?ub ...?..b .. . «., t0.e .. .....it . ...4 w..n
New residential dwelling unit under constructionand not ownedoccupied $ 70.00
? Add-on,? odification or alteration to existin dwel{ing unit $ 50.00
• (furna¢e replacement
• air exchanger
• air conditioner
• other
Nature of work: 0?ddJD
?
A-Ctd /a!C for ex"st1'.L5 par ?- eC- l-mme
State Surcharge $ 50
rotal $ SU . s 8
Reminder: Call for inspections.
l/G?'s/? • ?./
SIGNANRE OF PERMITTEE
Updated 1101
PERMIT# H
RECEIPT DATE:
M1DEPTIAL PLUM$lft6 PERM1T ALPPLICATION
crrYoF EAsm
3$30 PILOT KAOB RD
EtsM. MN 551E2
651-681-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
? backflow preventer for irrigation system
SITE ADDRESS: ?6 / O
OWNER NAME: : fo TELEPHONE #:
(AREA CODE)
INSTALLER NAME: tlGcipr r/ky, Lk 5 TELEPHONE #: 6.7' YrJ^` ?0,?y
(AREA
STREET ADDRESS: /?[ Q C(LCp.ti ? COOE)
CITY: Ves ? '5? - Po c(
Piace a check mark next to the ermit work t e
STATE: M
ziP:
New residential dwelling unit under construction and not owner/occupied $ 90.00
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
• waterturnaround
Nature of work:
Septic System, new/refurbished - $ 225.00
• includes County & Consulting Inspector fees
• requires MPC license
State Surcharge $ .50
$ S??S
Total
Reminder. Be sure to schedule inspections of alterations, i.e. water heaters, water softeners, etc.
I hereby acknowledge that I have read this application, stafe thatthe information is correct, and agree to complywilh all applicable City of Eagan ordinances. It
is the appiicanl's responsibilityto notify the property owner ihat the City of Eagan assumes no Iiabifity for any damages caused by the City during its normal
operational and maintenance activities to lhe facili6es constructed under ihis permit within City prop asement.
c
SIGNATURE OF PERMITTEE
Updated 1101
. A
EXTEAIOCi ENYELOPE AYEBAGE "U" CDMPUTJITION
SILEhODftESS L= /L1 /?? /Icp S" /C
CONTRACTO(1 ? ? 6?r'IsS YYb-+?S pAT -3`?z- PHONE
Oclcrmine warking square footage ol each
1. Total expoeed wall orea .... i toA 4- eq. It. - .11 /$Lj . Z, Q,
2. Tolal rool/eetling are __ 21,42 eq. 11. ".029 = SS (09
Tolal exposed wall ares above Iloor = ?to 84'
..........................................................
a. Total wali window area 2 3 2
b. Tolal door aren .................................................................. ?O
c. Tofalallding glasa door area .................................................... ?
d. Talal Itreplace wali area ?
.............................
e. Tolal walllraming aree (everage 10N.) ............................................
f. Total nel wall ares ahore Ilaor .................................................... 2
g. Tolalrlm jolel area .............................................................. a .
Total expoeed laundallon area = C2?
..........................
li. Total loundallon wlndow area ......................... ?
1. Total net foundallon area a6ore grede ............................................ O
Oelermfna "ll" value af each wall segment.
a, 2-32 x-u• 31 -71.92
n. cD0 _ x-u• -7.R
c. d X "U' b
d. x'U' 4=1
?
e. /?g x-u- .08 = ? l3.44
,. l2z x -u-. 04 = 48.9ta
9• ° x .U" o . .
x -u-
i. ? x -u. ? c
• 6
9 . ....................................................... Total = 1 2. 1 2.
II Ilem 09 Is the same ae, or leee Ihan Ilem R 1, yvu hava mel tbe inlent al SHC 006(02. .
Tolal exposed rool/ceiling area 2l a'L
?
?. Tolal sNyllghl area ...............................................................
k. Total rool/celling framing aiee (avenge 10Y 1 .................................... 2
1. Total netlneulaled raal/cellinq aren .............................................. _1 2 '
Oetermine "U" value of each roof/celllnp sagment. ?
O x -U"
k. 21 4 x-u• ,ozg 5.99
.... ,. rIll22> x-U•
4 . ....................................................... Tatal
II (alal ol UAie Ilie 39me ae, or leee than N1, you heva mef Ihe inleni ai 58C 6006(e)1.
Allernale Huliding Envelopa Oesign
t
0 2
9. •
/',CATEGORY 1" ALTERNATE FOR
ONE & TWO FAMILY DWELLINGS
INSTRUCTIONS: Th(s alternative may be used for one- and two-family dwellings built to meet the Category 1 requirements of '
Minoaota Rules, Chapter 7670. Complete Pazu A, B, and C. Clearly mark plans with: insulation R-values; window and skylight U-
values; siu and type of equipmen[; equipment controls; and location of vapor retarder and windwash bartiers. More detailed
information can be found in the Minnesota EnerV Code summary sheets available (rom the Minnesota Department of Commerce.
. i
Part'A. BUILDING ENVELOPE
_. .. ------__._ _. 3
Chak proposed envelope joint seeling option + _? scnptive (caulking, gasketa ctc.) ? Performance (ast per 7670.0470 subp. 7.C.)
Check thertnal energy calculation,op[ion used ? "Cookbook" (complete workshzet below) O MnCheck method (attach report) - ? Performance (attach U-value calculations) 0 Systems Anttlysis method (attach analysis) ?
"Cookbook" Worksheet
tNSrnurnoNs
Step I. ChecA item(s) tha[ design meets on Minrmum Requiiemenrs list
to the right Must mcet all items to use "Cookbook" option.
Step 2. Indicate proposed wall type on ta61e below.
Step 3. [ndicate Window U-value and source.
Step 4. Verify total window (including area oFall tbundation windows)
and door area is equal or less than sllowable percentage.
MINIMUM REQUIREMBNTS .
;(for °Cookbaok" o tion only)
? Ceiling Insulation: Minimum R-38 with 7Y," energy heel: or
Minimum R-44 with low truss heel: or
Minimum R-38 with R-5 sheathing when no attic.
? Entn Doors: Max. U-value of 0.30 or 1'/." solid wood with stortn
? Rim laist fnsulation: Minimum R-19
O Flours over unconditioned spaces: Minimum R-24
? Foundation Insulation: Nlinimum R. 10
? Poundation windows: Y;' insulated glass, wood or vinyl frame
TAB?D}FO"ET
'
'
;
: ER1MNINGMAXI MUMWINDOW.:AN DxDOORsAREA ' , -- `
..
r
,
d . .. ..
CR
:14%,
16"/0
l8?hj..
60% : 22%
24%,
. 26'e
28%
?t}:;: a ;•,
"p?; <MaactmumAyerage. WindowU-value_(dcc gptfoundationwindows)
O ,
2x4, R-13 insulauon, 2 RJ sheathing _ 0 55 ;' :' 0.47 , 0:41 0.36;:t W , 0 33 „ 030 : .23
0 R-IS insulation, 2 R-5 sheathing
2x4 0,520.45 °° 0.34 0:28 '
,
2z6, R19 insulation,<R-5 sheathing 0.48 A.41 : 0.36 0.32, 0.29.. 0.26 R0.24??" 2t
0 R-19 insulazion, Z R-5 sheathing
2x6 0 56 0.48 . 0.42 _034 _ 03'1
,
<R-S sheathing
R-21 insulation
2x6 O S!' : 0.43, 0.38 0.3 `" :.0.30 r 0:28 ' ?0.22
,
, 25
O 2x6, R-2I insulation, 2 R-5 sheathing 0.380.50 0,44 0.347 ' 0.35 0.32 ,- .
Maumum Avwage Window U-veluti tfoundation:windows) '`
R- 9 msulazion, < R-S sheathing
x6 0 52 ,: 0.45 039. 0. . N0 31 ,^ 0.28. 0+2Cr` ?0' •?0,22
'
O ,
R-19 insulation, 2 R-5 sheathing
2x6 0 38.r+,? .. 0.50 0.44 0.391:rM „0 35 ".` 032
.,,
0,29
?!0 27
"
"0?3
,
< R-S sheathing
-21 insulation
2x6 O 55, .. ; 0.47 " 0.41 , 0.3Gi;p 0.33' 030 0l25 0:23
? ,
,
2x6, R-2l insulation, 2 R-5 sheathing 060 0:52 0.46 0.41' 036 0.33 030 0.28 0•26
wrI
' Source: ?NFRC O ASHRAE 1993 Handbook
-
y :af. , r, ?;-?[a,? ?.Y:. • .. ? -O/? < OE
O ,
0
win ow & door area gross exposed wall area DESIGN ALL WABLE (from table above)
MlMNESOTA ENERGY CODE - WHICH RuLES MAY 1 USF ?
.i?;T . E Qff;,, 'I1l1L BUIT,DING APPLICABLE RULES
D?a , R53e
?'?
i*Aw 1- "d 2-family:dwellings
?irt homss; duplexes Chapcer 7672; or
Chapter ?670 "Category I" with statutory depressurization and ventilation requiremcnts
nge
and row:s Chapter 7674; or
CAapter 7670 with either "'Cntegory'l" or "Category 2" provisions
• .??` ? rlea:or,lees
glapaRmerits Chapter7674; or
Chapter 7670 with either "Category l" or "Category 2" provisians
'R+taeBopamy- . . rtg?over3storiwhigh Chapcer7676 ,.
:Exeieples. higfarisb¢bndo3'orapartmencs ?..
Part B. DEPRESSURIZATION PROTECTION
Check option used: ? Fuel burning equipment (complete schedules below) ? No fuel buming equipment
?
INSTRUCTIONS
Step I. Complete the Combustron Equrpment Sched:rle below. Only equipment
with a Y(Yes) may be selected under the "Categgory I" aI[emate.
Step 2. Complete ExhausdMake-up Air Schedule on the right if direci ar power
vented or solid fuel atmospheric 'vent space heating equipment is selected.
EXHAUST / MAKE-UP AFR SCHEDULE'
Exhaust devices over 300 cfm Flow
cfm
cfm
cfin
COMBUSTION EQUIPMENT SCHEDULE
(check all rypes proposed)
Space heating - nonsolid fuel Sealed combustion Y Hearth - nonsolid fuel ? Sealed com6ustion Y
? Direct or power vented Y' ? Direct or power vented' y
Atmospherically vented N Atmospherically vented N
Waterheating - nonsolidfuel ? ealedcombustion Y Spaceheating - solidfuel ? Atmosphericallyvented 1"
Direct or power vented Y Water heating - solid fuel ? Atmospherically vented
Atrnosp6erically vented N Hearth - solid fuel ? Atmospherically vented Y
' if atmospherically; vented solid;fuel or direct or power vented nonsolid fuel space heating is installed, then make-up air, to match
? flow is required foneach individu8l'exhanst device which exceeds 300 cubic feet perminute. '
Part Ci. VENTILATION
VENTILATION QUANTITY
(Mechanical ventifation must be provided per the larger quantity calculated below)
? cubic'feet.;x' 0.00583lminute =,?, cfm ( ? x 15 cfm/bedroom) + 15 cfm cfm
?
vol e of habitable rooms , num r of bedrooms -
.";?..:::.. . . , ;° .'
Check mefhod(s)proposed VENTILATION FAN SCHEDULE
? Exhaust only Balanced (hent recovery ventilator, air exchanger, etc.) -j
faytlescription or tocarion;,? . TOTALS
VENTILATION, ," Intake cfm cfm cfm , cfm cfm
AS;DEStGNED' : Exliaust cfm cfm cfrn cfm cfin
Statement of Compliance: The proposed building desi.-n represented in [hese documen[s is consisten[ with the building plans.
specifications, and other calculations submitted with the pennit application. The proposed building has been designed to meet the
requirements of the Minneso[a Energy Code.
,?! 6s/ - -7,61- aJf?f?/`
Applicant (print name) Signamre Date Telephone number
Part Ca. VENTILATION (Submit Part C2 upon completion of system veri5cationT)
x -----------------------------------------------------------
Job Site Address: Permit Number
Faa description or location TOTALS
MEASURED Intake cfm cfm Cfm cfm cfm
PERFORMANCEt. Exhaust cfm cfm cfrn cfin afln
t.',?Ventilation rate must be measured and verified when the performance option is used in lieu of the prescriptive option forthe;sealing
`of joints in the buiiding'conditioned emelope (from Part A).
Compliance Statemenh Installed ventilatio?n s?y [em is in compliance wi[h MN Energy Code and is sized to provide the desigmair flow.
C1???ze ????? Sl - y> o-6? 9'?__
Applicant (print name) Signature Date Telephone number
Certi_ficate of Building iocation For:
Enal Acoess Homes _
DEI.MAR H. SCHWANZ
, - .. L.M sUPrVE.e«s, tNC
. Rpu?oM thew Lew el iM e?w M Wn1w.a??
14750 SOUTH ROBERT TRAIL pOSEMOVNT, MINNESOTA 5306! 651 /4231788
Addness: 4690 Nichol's Road
Proposed Top of bloclc elev. ?J31, 4rroposed lowest level elev. IZ7 8
Lot are3 = 22,602square feet
New bldg = 2,100 squaxe feet
E?cisting = 1,688 square feet
SURVEYOR'S CERTIFICATE
x01022
Bk:196/44
+
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1 here6y certify ihet thh sanay, plmn, or roporl w$* .,. '
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ihel 1 em a duly ReqblsreA Ln+d Survsyor unW!
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30 feet
?
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA135698
Date Issued:03/30/2016
Permit Category:ePermit
Site Address: 4690 Nicols Rd
Lot:6 Block: 1 Addition: Tousignants 1st
PID:10-77000-01-060
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
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 -
Maryann A Toledo
456 Central Ave W
St Paul MN 55103--222
(651) 353-6200
Haley Comfort Systems
122 3rd St W
Hastings MN 55033
(651) 437-0338
Applicant/Permitee: Signature Issued By: Signature
City of aaau
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #:
X75(
Permit Fee:
60 q7
Date Received: //-
Staff:
i`
Staff:
2016 MECHANICAL PERMIT APPLICATION
❑ Please submit two (2) sets of plans with all commercial applications.
Date:
Site Address: 4-10,z‘v fgy4'3
Tenant: friOt R- SC -4-1A.414.
Suite #:
Reel ent/Owner
Name:Phone:
�r,.ti 4 ��.1.i�s�-
Address / City / Zip: elf4=PatO iNLe-4+.-arv-
j,'(L1c. ZesS j .jGCa+w 1%)
Contractor
Name: Agsd�„ul ei£ f1�4.41/4.v/G^1— License #::^�`
Address: S 1- .A. City:EDINs6
Z3 3 Az t�
State:M Zip: 64t-' gel Phone: 9.5 Z--eg 5 1— en.)
Contact: 1"-1, l e -C- 'i -t2 -t, e s ae-J Email: kt ar-4. C.s.O ,.J & Ate_,, QOM
Type 0f Work
New Replacement Additional-) 'Alteration Demolition
Description of work: APr C3�
t tRr s T -c) oar t
NOTE oof mounted and round mounted
`Code Pleasµe,contact the Mechanical
RESIDENTIAL
Furnace
mechanica `equip' a nt is required to be screened by City
Inspector fornforma# on on permittescreening methods .. .
COMMERCIAL
New Construction Improvement
rm=aT
Peit Type
Air Conditioner
_,?Interior
Install Piping Processed
Air Exchanger
Gas Exterior HVAC Unit
Heat Pump
Under/Above ground Tank ( Install / Remove)
Other
_
RESIDENTIAL FEES
$60.00 Minimum Add or alteration
to an existing unit, includes State
includes State Surcharge
Surcharge
= $ TOTAL FEE
$100.00 Residential New,
COMMERCIAL FEES
$60.00 Permit Fee Minimum
Contract Value $ 4 ito• 0D x .01
= $ CPO `----- Permit Fee
$75.00 Underground tank installation/removal, includes State Surcharge
Surcharge = Contract Value x $0.0005
If the project valuation is over $1 million, please call for Surcharge
= $ a en Surcharge
= $ ( O. of v \ TOTAL FEE
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in accordance
with the approved plan in the case of work which requires a review and approval of plans.
Applicant's Printed Name
FOR OFFICE USE
Required Inspect of
x �
Applicant'
nature
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA162806
Date Issued:07/29/2020
Permit Category:ePermit
Site Address: 4690 Nicols Rd
Lot:6 Block: 1 Addition: Tousignants 1st
PID:10-77000-01-060
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
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 -
Maryann A Toledo
456 Central Ave W
St Paul MN 55103--222
Haley Comfort Systems
4320 Hwy 52 N
West Frontage Rd
Rochester MN 55901
(507) 281-0138
Applicant/Permitee: Signature Issued By: Signature