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1636 Oakbrooke DrAddress Lot Blk , "? ""777 Zip 5512 .. . ? Sub THESE TTEMS WERE / WERE NOT COMPLETE AT THE TTME OF THE FINAL INSPECTTON. Date: ;_? t Yes No Inspector: Final grade (6" from siding) ? Permanent steps (garage) ?- Permanent steps (main entry) )V a ? Permanent driveway ? Permanent gas ? Sod/Seeded grass h- ' Trail/curb damage k ' Porch ? ? Basement finish x ? Deck a Please verify with the builder the removal of roof test caps from the plumbing system and the shut-off of water supply to the outside lawn faucet before freeze potential exists. Cantad engineering division at 681-4645 before working in right-of-way or installing underground sprinkler system. ? White - City Copy Yellow - Resident Copy Pink - Contractor Copy _ ?._. - , , RESIDENTIAL ? BUILDING PERMIT APPLICATION /? ?? ???,?f ? 7? CITY OF EAGAN I 3830 PILOT KNOB RD - 55122 651-681-4675 ?,Q?I? ??1q.a1 NewConstrucfionReauiremeMS RemodeVReoatrReauiremenls - ? • 3 regislered sile surveys showirg sq. ft at WC sq ft. of house: snd aii roofad areas • 2 copies of plan (20% maximum bt coverage allw/ed) . 1 set of Energy CaLulatiore for heated addNOns • 2 copies d pan showing beam 8 window sizes, poured faM design, etc.) • 1 site survey br erierlor addi6ons & decks 1.eYI?V ? . 1 set of Energy Calalauons • 3 copies of Tree Presenation Plan d bt pla8ed after 7l1193 • Rim Joist Detail Options selection sheet (61dgs with 3 w less unit) I f? ec: v- -Pe rrn '? f Ca /V, DATE I/ f D 1 VALUATION (EXCLUDING IAND) jJB 51TE ADDRESS I ?C 3?-P D??b(? ??? L'?f , Je, IF MULTI-FAMILY BUILDING, HOW MANY UNITS? PROPERTYOWNER PI-_A-k tiC1V0c5 TYPE OF WORK APPUCANT ADDRESS PAGER # FIREPLACE(S) _U _7 _2 _3 PHONE # ZIPCODE t?l?-3t?y-at?o7 Fax# ?sl-99y-?S?7 NEW RESIDENTIAL BUILDING ONLY - FILL OUT COMPLET Energy Code Category _ MINNESOTA RULFS 7670 CATEGORY 1 (check one) - Residential Ventilation Category t Worksheet Submitted - Energy Envelope Calculations Submitted _ MINNESOTA RULES 7672 - New Energy Code Worksheet Submitted Piumbing Contractor: _ Plumbing System Includes: Mechanical Contractor: Mechanica3 System Includes: Sewer/Water Contractor: _ Water Softener _ _ Water Heater _ No. of Baths Air Conditioning Heat Recovey System Phone # Phone # Fee: $90.00 Fee: $70.00 Ali 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 compiywith all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant Certificates of Survey Received _ Tree Pre5ervation Plan Receive _ Not Required _ Phone #: Lawn Sprinkler No. of R.I. Baths Updated 1101 OFFICE USE ONLY ? 07 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Owelling ? 08 06-plex ? 16 Fireplace O 27 Porch (3-sea.) O 31 Ext. Alt- Multi ? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 Ext. Alt - SF ? 04 02-plex ? 10 08-plex 1?7 78 Deck ? 23 Porch (screened) 17 36 Multi ? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Stortn Damage O 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous ? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding T'l 32 Addition ? 36 Move Bldg. ? 42 Demolish (FOUndation) ? 45 Fire Repair ? 33 Alteration ? 37 Demolish (Bldg)' O 43 Reroof ? 46 WindowslDoors 0 34 Replacement 'Demolition (Entire Bldg only) - Give PCA handout to applicant Valuation Occupancy ? MC/ES System Census Code ? Zoning City Water SAC Units 0/" Stories Booster Pump Nbr. of Units ? Sq. Ft. PRV Nbr. of Bldgs ? Length Fire Sprinklered ? Type of Const Width Footings (new bldg) ? Footings(deck) _ Footings (addirion) Foundation Drain Tile Roof Ice & Water Final _ Framing - _ Fireplace _ R.I. _ Au Test _ Final _ Insulation REQUIRED INSPECTIONS FinaUC.O. FinaUNo C.O. _ Plumbing I-NAC Other _ Pool _ Ftgs _ Air/Gas Tests _ Final _ Siding Stucco Stone _ Windows (new/replacement) Approved By 6,-6 , Building Inspector Base Fee Surcharge Plan Review MC1ES SAC City SAC Water Supply 8 Storage S8W Permit 8 Surcharge Treafinent Plant Piumbing Permit Mechanical Permit License Search Copies Other Total OFFICE USE ONLY ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessary BIQg p 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - MuIG ? 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 Plbg_Y or _ N ? 25 Miscellaneous 00 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 Windows/Doors ? 34 Replacement •Demolition (Entire B ldg only) - Give PCA handout to applicant Valuation Occupancy ?- 3 MC/ESSystem Census Code L(? / Zoning ? City Water 4662? - SAC Units Stories Booster Pump Nbr. of Units l Sq. Ft. 71-0 (?hd+tf ?-, pRV ? Nbr. of Bidgs l Length 5-c7r Fire Sprinklered Type of Const Width REQUIRED I NSPECTIONS ? Footings (new bldg) J, FinaUC.O. _ Footings (deck) FinaUNo C.O. Footings (addition) ? Plumbing ?O Foandation ? HVAC Drain Tile Roof Ice & Water F inal O[her ? Framing Pool Ftgs Air/Gas Tests Final Fireplace X R.I. )(Air Test X Final Siding Stucco Stone ?j Insulation _ Windows (new/replacement) Approved By 16-,.J , Building Inspector ease Fee Surcharge 7do K tS = CO/ ()?GU Plan Review Le? U) -e- .p- LL- as'f5-L- r? ? MC/ES SAC G Y -? ???xsY= City SAC Water Supply & Storage r- S&W Permit & Surcharge 7a 6?C s? Treatment Plant °" Plumbing Permit - g?BXSf = ix7-2 Mechanical Permit License Search Copies -,o ° ?- Other ? ? Tatal ??? H '_? ':? 3 0 a Es Di EN AL ' z° ? ? ? . SUILDING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD - 55122 651-681-4675 NewConstructianRequirements RemadellReoairReauirements . 3 registered site surveys showing sq. h. of lot, sq. ft. of house; and all ropfed areas . 2 copies of pian (ZO% maximum bt coverage allowed) . 1 set of Energy Calculations tor heated addiUOns • 2 copies of plan showing 6eam & window srzes: poured found desqn, effi.) . 1 site survey (orex[enor addi6ons & decks • 1 set of Energy Calculations • 3 copies of Tree Preservation Plan if lot plalted aKer 7/1193 . Rim doist Detail Options selection sheet (bkigs with 3 or less uni4s) DATE a_/6 h I VALUATION (EXCLUDING LAND)_110I 115'3 JOB SITE ADDRESS I636 6J4K)3JP-03KE ,Dl IF MULTI-PAMILY BUILDING, HOW MANY UNITS? PROPERTY OWNER? )?(!- ]) Sm e 5 U? JaI TYPE OF WORK RC1 & APPLICANT pU IrC J}d?hcs PAGER # CELL PHONE # ?I 2-3jcj"7)), FIREPLACE(S) v YES _ NO PHONE # 40" `?b.3'`???5^ FAX # 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. yAIlF3 ,P1-1wWG Phone Plumbing System Includes: Waeer Softener Lawn Spnnkler Water Heater 1 No. oF R.I. Baths .3 No. oFl3aths Mechanical Contractor: OW/8U0,0? I1Z NY? d-f}lfi Mechaiical Systciii Includes: Air Conditioning Heat Rccovcry Systcm Sewer/Water Contractor. Ntl(D GCRClh ? 5??1?1?-?S ge12-j 721 Fee: $90.00 Phone# /?Z` ge/?°ODD'? P'ee: $70.00 Phone# 763'?'4 8, -?1m All above information must be submitted prior to processing of application. D? ?Uj T Ll CI T I hereby acknowledge that I have read this application, state that The information is correct, agree to comply all applicable State of Minnesota Statutes and City of Eagan Ordinances. ? SignaTure of Applican} -4,w ?J Certificates of Survey Received ? Tree Preservation Plan Received _ Not Required ? Updated 1101 Address k (Irr! ae C'r Zip 5512L L.ot ? Blk % Sub (""'l>>?Yo" k,? THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECI'ION. Date: 6:_27 _p j Yes No Inspector: ? Final grade (6" from siding) Permanent steps (gatage) X Permanent steps (main entry) Permanent driveway Permanent gas Sod/Seeded grass ? TtaiUcurb damage k Porch Basement finish X Deck X Please verify with the builder the removal of roof test caps from the plumbing system and the shut-off of water supply to the outside lawn faucet 6efore freeze potential exists. Contact engineering division at 681-4645 before working in right-of-way or installing underground sprinkler system. ? White - City Copy Yellaw - Resident Copy Pink - Contraclor Copy &&3?? 3e?-s--?6 2004 RESIDENTIAL PLUMBING PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Please complete for modifications to existing residential dwellings. Datecl??/ Site Street Address J??J ?((,Q fla(GL .fJ /L Unit # J 1/ Property Owner N' L-! t ?(-G S T.S C?e- Telephone #?/ ),?k-? Contractor Telephone #( Address ?City F'??A A!;'? ? State M Zip D_2Y The Applicant is: _ Owner YContractor ' _Other Alterations to existing dwelling _Add fixtures to rooms, excluding water softener and water heater _Septic System Abandonment _Water Turnaround (add $121.00 if a 5/8" meter is required) Other: $ 50.00 Water Softener Water Heater _ replacement _ additional $ 15.00 Lawn Irrigation System RPZ_ new _ repair _ rebuild $ 30.00 State Surcharge $ .50 Total 7 h3? $? I hereby apply for a Residential Plumbing Permit and ackn and accurate; that the work will be in conformance with 1 Eagan and the plumbing codes; that I understand this is permit, work is not to start without a permit and work will the eqenk a plan is required to be reviewed and approveq. ?, that the i formation is complete 7tntcc s codes of the City of u ly an application for a ith the approved plan in AJ A,1f VJolq ? ApplicanYs Printed Name Appli anY: NOU-20-2660 03:13 PULTE HOMES 651 452 5727 P.02i02 MNcheck COMPLIANCE REPORT Minneaota Energy Code MNcheck Software Version 3.0 COUNTY: Dakota STATE: Minnesota ZONE: 2 CONSTRUCTION TYpE; Single Family DATE: 11-20-2000 DATE OF PLANg; 8/14/00 TITLE; TYI,ER ELEVATION #4 PROJECT INFORMATION: OAKaROOKE SINGLE FAMjI,y COMPLIANCg: pp.SSES Re4uired UA = 520 Your Home = 442 15.0$ Better Than Code Permit # C ecke by Date Area or Cavity Cont. C3lazing/DOOr ________ Perimeter R-Value R-value U-value ----- -------------- ---------------------- ---------- CEILTNGS WALLS: Wood Frame, 16" O.C. 1656 44.0 ?.D 49 19.0 2,0 1 WALLS: Wood Frame, 16° O.C. 20243 BSMT: ConC. 8.01 ht/7_31 bg/7,3' ineul 640 9.0 2•0 SSMT: Conc. 7.0' hC/7.0' bg/7.0' insu2 224 11.0 0.0 GLAZING; Windows or poozs, Above Grade 378 DOORS 0.350 1 FLOORS: Over Unconditioned Space 38 0.350 SLAB FLOORS: Unheated, 42_01, insul. 372 38.0 0.0 .0 HVAC EQUIpMENT; Furnace, 92.0 AFVE ------------- ------- ---------------- COMPLIANCE STATEMENT: The proposed building design described here is - consistent with the building plans, speci£icatione, and other calculations submitted with the permit application. The proposed building has been deeigned to meet the requirements of the Minnesota Energy Code. Builder/Designer -?'Ht(XA -e- MA G eS Date? J TOTRL P.02 . ??? PULTE HOMES OF MINNESOTA CHANGE ORDER 2,, DATE: 10121100 JOB NO: 0320-201-04 LOT: 1 BLOCK: 4 COMMUNITY: Oakbrooke Single Family ADDITION: Phase 2 BUILDING ADDRES 1636 Oak6rooke Drive CITY: Eagan STATE: MODEL NAME: Tyler MODEL#: 18281 ELEVATION 2 GARAGE: eav:? 0 MN ZIP:55122 0 LEFT BUYERS NAME: Krishna & Padmaja Vedula CURRENT ADDRES 4444 Woodgate Ct CITY: Eagan STATE: _ HOME PHONE: 651-686-5021 BUSINESS PHONE: 612-727-6139 BUSINESS PHONE: 0 SALES REPRESENTATIVE: JMA PHONE: 651-686-2862 TOTAL FROM PREVIOUS JIO OR CHANGE ORDER $0 1 18281 Tyler $219.990 1 18023 Elevation #2 $3,100 1 14007 1ST CARPET PAD UPGRADE $245 1 14084 1ST CARPET UPGRADE $1,475 1 17083 RI Electric-Microwave $100 1 21020 GAS FIREPLACE - CERAMIC W/SH.ROCK $3,825 4 17024 CEILING ELECTRIC OPENING $400 1 32020 ADD'L PHONE JACK $54 1 23007 3 TON AIR CONDITIONER $2,350 7 99952 Base Price Reduction ($2.000) $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 $0 TOTAL MTI) QC ^ $229,535 THIS CONSTITUTES A CONTRACT BETWEEN T SELLE ND THE PUCHASER (S) FOR THE ABOVE ITEMS. APPROVED BY BUYER APPROVED BY BUYER APPROVED BY SUPERI APPROVED BY SALES: i q-L `f MN ZIP:55122 Builders License # 0001371 ? . ? PROPERTYLEGAL L l? Q ? e? ? ? ? 0 ? L? ? ? ca? n o B?/ ? ? C-3/ ? ? ?a ? ? ? ? 6/ ? ? V ? ? r4// ? n C??' ? 0 LOT SURVEY CHECKLIST fOR RESIDENTIAL 9UILDING PERMIT APPIICATION DATE OF SURVEY: /?.- LATEST REVISION: DOCUMENTSTANDARDS • Registered Land Surveyor signature and company • BuildingPertnitApplicant • Legaldescription • Address . North arrow and scaie . House type (rambler, walkout, split w/o, split entry, lookout, etc.) • Directional drainage arrows wdh sbpeigradient % . Proposed/existing sewer and water services & invert elevation • Street name • Dmeway • Lot Square Footage • Lot Coverage ELEVATIONS Existina / J ? • Sewer service (or Proposed) I? Li p • Property comers G7?/ ? ? • Top of curb at the driveway fa' ?/ " ? • Elevations of any existing adjacent homes Venches nt utilit d ad th f t t t i d p? ? • y ruc ures ue o jace s Adequate foot ng ep o Proposed / LY o ? • Garage Floor ? ? • Firstfloor ? • Lowest exposed elevation (waikouUwindow) i? ? . Property camers ? ? . Front and rear of hame at the foundation PONDING AREA (if aoolicable) / ? d 0 • Easement line ? /p • NWl ? ? . HWL ? ? • Pond # designation ? VO • Emergency Ovefiow Elevation DIMENSIONS ? • Lot lines/Bearings 8. dimensions /?7? V • Right-of-way and street width (to back of curb) ' ?A? 7? • , porches, etc. Proposed home dimensions including any proposeG decks, overhangs greater than 2 / (i.e. all structures requiring pertnanent footlngs) i?3'/ U? • Show all easements of record and any City utiikies wilhin those easements ilf ? CI ? • Satbacks of proposed structure and sideyard seffiack of adjacent existing structures 11 11 • Retaining wall requvements, rfany _ Revewed' Name 5' ' 4?2 - / Date March 1999 f ReVvPl Of.ORMT LM • ? ? Surveyor's Certificate SURVEY FOR :PUL-tE DESCRIBED AS : reeerGing??ecaementeBo??ecord? AD01110N, City of Eagan, Dakolo County, Mfnneote ond ? - -vi. - . iR! ? ? ? ? ? Q ? ?a ,j I, ?J 's. lqqS1J 280.4 ?qqq,0 • -?- 3 a ,,-- sr ?-r ?E? c C - i I aaa o cOMw Exlst Mome TOB - 941.7 Prapeead I $ 2-Sto ? p ry ew Unew -------------- o N89'42'35"E 69.33 •-i? t.. 1 , 5 ? LOT SQ. FOOTAGE = 8 085 ,:. , 1 !7,jr , ?` "% i'? HSE. SQ FOOTAGE = 9 788 ; ?? . , . , LOT COVERAGE = 22% Plon 111 18281 1 PROPOSED ELEVATIONS ' Y` BENCHMARK, TMN? ?q Top of Foundation = q451 Garcge Floor = q44.I ereu.qq503 Basement Floor =937,( Aprox. Sewer SerVice =q3i.2' Q Proposed Elev. = MIN. SETBACK REQUIREMENTS Exlsting Elev. _ Orainage Directions = Front -25 Hause Side - Denotes Offset Stake m• scALE: I a,eh .'30 feat Reor -75 Garcge Side- ,ae Na t HFAEBV CERAfY THAT MIS iS A fRUE AND CORRECT REPRESENTA110N OOR- (e0b H?D???? OF iF1E BOUNOARIES OF 7HE ABOYE DESCRIBED PROPERTY AS SURVEYED BY IdE OR UNDER MY DIRECT SUPERNSION AND DOES NOT PURPORT TO BOOK: PACE: PLINNINC dNGlN66RlNG SDRVSYING SHOW IMPROVEMEN75 OR ENOROACHMENTS, E1(CEPT AS OWN, Eaqan,iMNb9?22 DAfE L?.r/-00 CAO flLE: Phone; (Bb1) 408-6600 Fax: (861) 408-6608 EY D LINDqtE?N. UND S EY?R OAKBROOKE NES A UCEnSE NuMBER 14376 3-/-ei -- - - LDa.ezoo7 % ? cr>ys,- oe 64WCG ' Surveyor's Certificate SURVEY FOR :PUL1E DESCRIBED AS : Lot 1, Block 4, OAKBROOKE 41H ADDI110N, City of Eagan, Oakoto County, Mlnneoto ond reserving eoeemente o} record, Exlt! Home T09 - 947.7 LOT SQ. FOOTAGE = 8)085 HSE. SQ. F40TAGE = 1, 788 LOT COVERAGE _ .22% Plon M 18281 PROPOSED ELEVATIONS Top of Foundation = qq5.1 Garoge Floor = 944,1 Basement Floor =937,t Aprox. Sewer Service = q31,2t Proposed Elev. Existing Elev. Orainage Directions = Denotas Offset Stake @ . SCALEf 7 Mch - 30 }"t 9ENCHMARK, TWMe V4 Eleu . qqg.a3 MiN. SETBACK REQUIREMENTS Front -25 Houae Side - Reor -Tg Garoge Side- i HEREBY CER7IFY THAT fli15 IS A TRUE ANO COIIRECT REPRESENTATON OOR- 06 HEDL?tlND OF TME BOUnOARIES OF TNE ABOVE OF.SCRIBEO PROPERfY AS SURVEYEO BY Mf OR UNDER MY DIIIECT SUPERNSION AND DOES NOT PUftPORT TO BOOK: PAGE: PLINNINC dNG1N3'BR1NC BpRVSY/NC SHow IMPNOVEMENTS OR ENaROACHMENTS. ExcEPT as s ovm, 2006 Pin Oak OHvs Eaqan. MN 59122 OATF (ZY27/00 ? CAD flLE: Phone; (651) 408-6800 EY 0 LINOCREX. IAND SU EYOR OAKBROOKE fmr. (Bb1) 408-6B06 N A LICENSE NUMBER 1437E - - CDa?eYo7 / ? ct>yd-?- vC? r,?CL ? , 1 CITY USE ONLY L ? BL `C I` RECEIPT#: SUBD. RECEIPT DATE: I I'7?I U? PERMIT# 2000 PLUMBING PERMIT (RESIDENTIAL) CITY OF EAGAN 3830 PILOT IINOH RD EAGPN, MN 55122 651-681-4675 Please complete for: D single family dwellings D townhomes and condos when permits are required for each unit ? backflow preventer for underground spnnkler system FIXTURES EACH N TOTAL Alterations to existing dwelling - minimum fee Describe: $ 30.00 Bath tub $ 3.00 x = $ - Floor drain 3.00 x = S ? Gas piping outlet ' minimum -1 3.00 X = $ Hot tub/spa 3.00 x = $ Kitchen sink 3.00 x Laundry tray 3.00 x Lavatory 3.00 x = $ Z - Septic System new/refurbished ' requires MPC lic. 75.00 X = $ SeptiC SyStem abandonment 30.00 X = $ RPZ new instailation/repairlrebuild 30.00 X = $ Rough opening Shower 1.50 3.00 x x 3 = = $ $ 3 ? Undergroundsprinkler if dwelling is under construction 3.00 x = $ Undergroundsprinkler rfexistingdwelling 30.00 x = $ Water closet 3.00 x = $ - Water heater 3.00 x = $ 3? Water softener If dwelling under eonstruction 5.00 x = $ Water softener if exiatlng dwelling 30.00 X = $ Waterturnaround 30.00 x $ State Surcharge Total 50 -> -> -> -> $ .50 Reminder: Call for inspections of alterations, i.e. water heaters, water softeners, etc. --------------------•---------------•--•-------------._.._----------------------------------•----------•------------------------- I hereby adcnowledga that I have read this application, state that the information is cortect, and agree to compty wdh all applicable City of Eagan ordinances. It is the applicanYs responsibility to notify the property owner that the City of Eagan assumes no liability for any damages caused by the City during its normal operational and maintenance activities to the facildies constructed under thisArmit within City property/right-of-way/easement. SITE ADDRESS: OWNER NAME: : TELEPHONE #: (AREA CODE) INSTALLER NAME: (/Q (/? ? ?/.NIQ• (?/J ? ,P A TELEPHONE #: (AREA CODE) STREET ADDRESS: CITY: STATE: /°C.f(i I ZIP: SIGNATURE OF PERM Site address: AO ? (%kiRaD1W- Uf i?a- Lot ;2- Block / Subd. (.CiL42CIOt-- On April 15, 2000 the Minnesota Energy Code, Category I Building Requirements for insulation protection, air tightness, and ventilation, was adopted. As a result, the City of Eagan is requiring that the following information be submitted prior to issuance of a Certificate of Occupancy. _ iThis structure: is constructed to meet minimum requirements of the Mn Energy Code, Chapter 7670 ? OR _ 7his structure: will be constructed to meet more restrictive requirements of Chapters 7672 or 7674 APPLIANCE GAS ELEC MANUFACTURER MODEL BTU'S VENTINGTYPE WaterHeater ? ff p- C)B Furnace xp 70DE1? Q%ttef Dryer EXHAUST SYSTEM LOCATION TYPE MODEL CFM's VENTED YES NO Kitchen kitchen Bathroom 1 1041n ?M iG Bathroom 2 AA;d f-V -bS l/ ? a ? Bathroom3 s* V° O5vQ Fjb t?/ Bathroom 4 other ?ug eric ¢'v - DS 1/ 5Q t/ ? FIREPLACE S LOCATION GAS WODD MANUFACTURER MODEL BTU'S VENTING DIRECT AiMOS T'aW:,% !?-r ?`rZ a? oo v MAKE•UP AIR MODEL TYPE CFM's I hereby acknowledge that the ahove information is correct and agree to comply with the Minnesota Energy Code and City of Eagan requirements. Signature CompanyName ?p 1 -"1:7 1? / Date ' This form is the responsibility of the General Contractor. ï þ ý ÿÿ þýüøüû ùþþÿÿúøúñíí ðá þùð ñëëð ÿõ ÿþýüûòùøâùÿýüû úùýüûòû ùûíÿ âÿâðëðáÿû ü Ü àÿ ùé øùûùûûùùø ù ùóÿóûùöæ ù ø þ ùî ÿ ÿù ù û þÿøûî â ùþóãù ùùàÿùþü öø óüóî éäëÞäììîñìîðìñ ôù ÿù ù ß ÿ äëÞäîñêîêñ ß ÿ ë î óò õñ÷ ûû ù Þòÿ ñëðìùëá þùù ú ù õ÷ññ õ÷ññ èåëì ùþü ö ù ûû øùó ùù ùóûüö ûû þ øõ ÿ âüø áù î ûû æ ÿü ÿù Use BLUE or BLACK Ink 4,11` (j For Office Useyo City of Eaali Permit#: ! 16 t3 3830 Pilot Knob Road _ E. Permit Fee: 60 > \J .,. Eagan MN 55122 Date Received: a'ci "1 Phone:(651)675-5675 FEB 0 9 2U18 Fax:(651)675-5694 Staff: 1 2017 MECHANICAL PERMIT APPLICATION El Please submit two(2)sets of plans with all commercial applications. Date: 02/07/2018 Site Address: 1636 Oakbrook Drive Tenant: Suite#: I Patricia Rutske 612-961-3586 Resident/Owner Name: Phone: Address/City/Zip: 1636 Oakbrook Drive Eagan, MN 55122 I Name: Metro Heating & Cooling License#: 20090002249 Contractor I Address: 1220 Cope Avenue East City: Maplewood g € State: MN Zip: 55109 Phone: 651-294- 79g Contact: Carley Email: carleYmetroheatin 'corn t New Replacement Additional Alteration Demolition i i Replace existingfurnace i Type of Work Description of work: p 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. I R RESIDENTIAL COMMERCIAL i 1 Furnace t New Construction Interior Improvement Conditioner Permit Typeg _Install Piping Processed i Air_Air Exchanger _Gas _Exterior HVAC Unit .. _Heat Pump 1 _Under/Above ground Tank ( Install/_Remove) Other RESIDENTIAL FEES $60.00 Minimum Add or alteration to an existing unit, includes State Surcharge $100.00 Residential New, includes State Surcharge =$60.00TOT AL FEE COMMERCIAL FEES Contract Value$ x.01 $60.00 Permit Fee Minimum $75.00 Underground tank installation/removal,includes State Surcharge -,-$ Permit Fee Surcharge=Contract Value x$0.0005 '$ Surcharge If the project valuation is over$1 million, please call for Surcharge =$ 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 ; at the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. x Carley Ferrie x Applicant's Printed Name Applicant's Signature FOR OFFICE USE Required Inspections: Reviewed By: Date: Underground Rough In Air Test Gas Service Test In-floor Heat Final HVAC Screening -4 1N7('Lo • Metro Heating & Cooling 255 Roselawn Avenue E Ste 41 St, Paul MN 55117 • 651-294-7798 Address: 111-3C C kbice bt-% ' Date:3/ 1 l g Owner: OCs ,t.4 ry L' / _� Type of Heat: Gravity Air_ Forced Air K Gravity Hot Water_ Forced Hot Water Steam Unit Heater Space Heater_____ Other Type of Fuel: Gas Oil_ Other Cas Design Conversion _ Make of Burner _ "t" qn l Make Model ig Cp roti,2p(9Ove 4 Model ' Serial (s21%/4 y'i t-i 1 Max. BTU Rating Input 600 Make of Furnace Equipment venting type: Atmospheric Induced Fan Other Total BTU input of all vented gas appliances per chimney: 60, 60 0 Type of Chimney: Masonry Class B Other W4.- 2 if - Type of Liner: None i,r- Metal Clay Tile Combustible Air Supply Required:': Yes No 3C Installed?: Yes x Nei Safe Unrati enrt '-nncrol Ttc - Yes No Fuel Analvsis/F7ut Gas Analysis: Yes No Pilot/Flame Safeguard Operating Properly Vents Properly without Spillage Limit(s)Operating Properly )( Flame Stays Inside/Doesn't Roll Out -- Operator(s) Operating Properly Low Water Cut-Off Operating Properly Burner Lights Smoothly --- - gri All Controls Operating Properly -- - Wig' Final Visual Inspection Stack 'Temperature 17/Net -- es No .Stackygn /0/ F/Net Duel Piping System—Okay A % 741 % Vent Systems---Drafthooci, Carbon Dioxide 7 b Connector. Vent Chimney-- Okay Carbon Monoxide plc �—' _______ n t ppm %! Heating Unit Okay _� Carbon Monoxide Detector(tube type) Positive Negative,__ Look At Total Heating System Before You Leave: Does system operate safely and properly? Yes No COMMENTS: ,_.--- • Name er Licensed Contractor: Metro Heating&Cooling T„-___--_ Address 255 Roselawn Ave P.St.Paul 55117 Phone# 651-294-7795 . --- .„e• -Persnn Doing 1e,t(Print) ` `7 � / ,r .�—•--- .__ (signature)_ "'-.. Certificate of Cu -"'�""r'--- --'----�--•---------._ 'npetency Number horn City of Saint Paul for Appropriate Fuel: SAFETY TEST REPORT Fire Men i2on Divas on 6�Z Fire Preverttisyn Division