4637 Summit Pass PLUMBING (RESIDENTIAL)
Permit Application
City Of Eagan ~
3830 Pilot Knob Road, Eagan Mn 55122
~ ` ` Telephoue # 651-675-5675 FAX # 651-675-5694 3~ ~ `J
Please complete for: Single Family Dwellings
Townhomes and Condos when permits are required for each unit
vece ~ 1 , ay , ~
Site Address VV.~,I ~ Unit #
Property Owner ~Q.~,~/1.~.~Y LVQ,V~ Telephone # ( ~°+~I ~ y ~ ~ ~-f
Con[ractor 1Jt-i~-V~-11)
Address l~ ~ y 3`~ ~v-e S ~,ty l-~
State rn'v Zip ~~~~d Telephone# O~ )
The Applicant is _ Owner Contractor _ Other
Septic System New _ Refurbished Su6mit 2 sets of plans and MPC license $ 100.00
Includes County fee. Additional cansulWnt fees may apply.
Alterations To Existing Dwelling Unit, Including $ 50.00
_ Adding fixtures to lower levels or room additions, excluding water softener and water heater
_ Abandonment of septic system
_ Water turnaround 5/8" meter if needed -$121.00)
Other:
_ RPZ _ new installation _ repair _ rebwld $ 30.00
Lawn irrigation system
r-
_ Water softener _ Water heater $ 15.OD
_ replacement _ additional
~
~ D I_ G I~ I I ls $ eo
State Surcharge ~ S E n 2 ~ I~
~ ~~5v
To~ai I , ~
!
I hereby appty for a Residential Plumbing Permit and acknowledge that the information is comp ete an accurate; that the work will
he in conformance with the ordinances and codes of the City of Eagan and with the f'lumbing 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 rhe
approved plan in the case of work which requires a review and approval of lans.
~v. ~ a ~L/C.~a
Applicant's Printed Name ApplicanYs Signature
, ~ B. P- s~a~~ Ssoy. ~
L--~ ~ \ RESIDENTIAL ~r,,P s ~c~-5~Z
BUILDING PERMIT APPLICATION a• .~a ~ 9~~'
~,~y_ Qo. ~ CITY OF EACAN
3830 PILOT KNOB RD, EAGAN MN 55122 S~W S~a yy
651-681-4675 ~ ~
NewConstruMionReoufrementa RamodeNteoairReauirements ~
• 3 registered s~te surveys showirg sq. fl. of lot, sq. ft. of house; aM all roofed areas • 2 copies of plan ~
(20%mazimum lol caverage allowed) . 1 set of Energy Calculahons far heated additions
• 2 copies ai plan showing beam & wiMow s¢es, paured found design, etc.) • 1 site survey for extenor additions & decks
• 1 5et o( Energy Calculations . Indicate if home served 6y septit system for additions
• 3 copies of Tree Preservation Plan i( lot platted after 7l1193
• Rim Joist ~elail OpUons selectlon sheet (bldgs with 3 ar less units)
DATE ~~-a-~~ ~~a~~ALUATION
SITE ADDRESS '`~G,~J 7 e q~y~.~G~J MULTI-FAMILY BLDG _Y N
TYPE OF WORK S~-v FIREPLACE(S) _ 0~1 _ 2
APPLICANL
STREEf ADDRESS ~S CITY ~ STAT~ZIP ~J~7J°II
• TELEPHONE # ~I -O ELL PHONE # PAX #~~~7~- J~
PROPERTY OWNER TELEPHONE#
COMPLETE THIS SECTION FOR ~NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ ~INNESO'PA KULES 7670 CA1'GGORY 1 _ ~IIVNEB`OT:\ RULLS 7672
(J submission type) • Residential Venfilation Category t Worksheet u6mitted New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted ~ ~ _ ~ ~ ~ ~
Plumbing Contractor: ~ /l'°~\A~c Phone ~_~Z' =7-~O ~ 2
Plumbing system includes: _ ~Vater Softener wri-' nnkler Fee: $90.00
Water Heater No. of R.I. Baths
No. of Ba[hs
Mechanical Conhactor: ~~L'~ir~p72~Q ~,~Vil],I ~ Phone #%5~Y `Y 7 S r`~o~~
Mechanical system includes: Air Conditioning Fee: $70.00
_ Hcal Rccovery Systcm
Sewer/Water Confractor: i~~ ^ Phone # g^ ~7
I hereby acknowledge that I have read this application, state that the information is correct, and agree to comply
with all appiicable State of Minnesota Statutes and City of Eagan Ordinances.
Signature of Appltcant
------°~~J~ ~L!~...__._..
OFFICE USE ONLY
0
Certificates of Survey Received ~j5 Tree Preservation Plan Received ~ Not Required _
SvC~~ ~ GiQ~~ ' Updated 4102
OFFICE USE ONLY ~
? 01 Foundation ? 07 OS-plex ? 13 i6-plex ? 20 Pool ? 30 Accessory Bldg
~ 02 SF Owelling ? OS O6-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 EM. Alt - SF
? 04 02-plex ? 10 OS-plex ? 18 Deck 0 23 Porch (screened) ? 36 Multi
? OS 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
~ 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (FOUndation) ? 45 Fire Repair
? 33 Alteration ? 37 ~emolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement *Demolition (Entire Bldg only) - Give PCA handout ta applicant
Valuation / 9 V~vO~ Occupancy MC/ES System
Census Code r7 / Zoning ~ City Water
SAC Units (7! Stories ~ Booster Pump
Nbr. of Units Sq. Ft. 2,~y3 PRV I~
g Fire Sprinklered
Nbr. of Bldgs Len th j ~
Type of Const Width c~(4~ ,
REQUIRED INSPECTIONS
~ Footings (new bldg) ~ FinaUC.O.
_ Footings (deck) _ FinallNo C.O.
Footings (addition) _ Plumbing
~C Foundation _ HVAC
Drain Tile Other
Roof _ Ice & Water _ Final _ Pool _ Ftgs _ Air/Gas Tests _ Final
~C Franung Siding Smcco _ Stone
~ Fireplace ~ R.I. ~Air Test ~Final _ Windows (new/replacement)
~ Insularion ~ Retaining Wall
Approved By T Z , Building Inspector
_ /
Base Fee ~ 2
Surcharge (~j 's ~ > ~ ~ ~
Plan Review 1 U
MC/ESSAC rb~~'' ;o. ~ ~ ~ 3 " D 0~~~ / ~
City SAC
Water Suppiy & Storacz ~ ~ I ~ ~ O ~i S 1.1 _ ~ ~i(~
S&W Permit 8 Surcharge
Treatment Plant
Plumbin Permit ' - ~ • ~ ~ ~ ~ ~
f'` a~
Mechancal Permit ` ~ U ~ ~ + ~
license Search
Copies ( ~
/ v ; ' 9
Other ~`r(7~ ~P ~ ~1
Total ~ r~~ ~
• LPnda D'ralte
From: Gregg Hove
Sent: Wednesday, December 04, 2002 7:41 AM
To: Linda Dralle
Subject: Pine Tree Pass 7th Lot 7 Block 1
Linda, I don't need a tree preservation plan for Lot 7 Block 1 of Pine Tree Pass 7th (4637 Summit Pass).
~ ~~~i
7
Supervisor of Forestry
C`it}• of Pagan
3S~J1 Coaclunan Paint
F..agan, MN SSt22
Phonu: 651-681-4300 (throuah Docember 9 t3n1y}
Note New Phone Number: 651-675-5319 (After Decemher 9)
Fax: b5 L-~bS I -4360
Note New Fax Number: 651-675-5360 (After December 9)
E~naiL ~horc;;a,ci.ea~an.mn.us
~~'WW'; www.cityofeagan.com/forestry/forestry.hYm
i
LOT SURVEY CHECKLIST FOR RESIDENTIAL
' . BUILDINGPERMITAPPLICATION
PROPERTY LEGAL: LU~ / ~ID~R I ~n~~~L~Q~'S~ ~-~~n
DATE OF SURVEY: If
~/GI ~ D 2
LATEST REVISION:
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O~ Q DOCUMENT STANDARDS
~n ? • Registered Land Surveyor signature and company
~Ft ? • Building Permit Applicant
[u~ ? • Legal description
~ ? • Address
? • North arrow and scale
. House type (rambler, walkout, split w/o, split en4y, lookout, etc.)
4~/ • Directional drainage arrows with slope/gradierK %
• Proposed/existlng sewer and water serviCes & inver[ elevation
p`~~ ? . Street name
&f/ ? n • Driveway
d/ 0 ? • Lot Square Footage
GY ? ? . Lot Coverage
ELEVATIONS
/ Existin~c
p~ 0? • Sewer service (or Proposed)
? • Property comers
IX?? • Top of curb at the driveway and property line extensions
? • Elevations of any existing adjacent homes
? I~/ ? • Adequate footing depth of structures due to adjacent utility trenches
? ~f ? • Waterways (pond, stream, etcJ
/ PfODOSed
Fd'/ ? ? • Garage floor
? ? . Basement floor
FX ? ? • Lowest exposed elevation (walkouUwindow)
ra~/ ? ? • Property corners
C~ • Front and rear of home at the foundation
/ PONDING AREA (if aoqlicable~
? ? • Easement line
? fd~ ? • NWL ~
? ~ ? • HWL
? GV ? • Pond # designation
? Cfy/ ? • Emergency Overtlow Elevation
? L9' ? • Pond/Wetland buffer delineation
/ ~IMENSIONS
g/?? . Lot lineslBearings 8 dimensions
H?? • Right-of-way and street width (to back of curb)
i 7 . Proposed home dimensions induding any proposed decks, overhangs greater than 2', porches, etc.
(i.e. all structures requiring permanent footings)
? . Show all easements of record and any City utilities within those easements
? . Setbacks of proposed structure and sideyard setback of adjacent existing structures
i] . Retaining wall requirements, if any
Reviewed: ~ ~ - 3 ~D ~
Name Date
G'/FORMSlBUilding Permit Applicatiat
REVISIONS
, 30 15 0 15 30 60 ~
~ ^ r, ~ SCALE IN FEET
~~o'~ ~o
~o ~ DEC o 2 REC'D
LEGEND
~ OO DENOiES SANITARY MANHOLE
I DENOTES ITYDRANT
i~ DENOTES CATCH BASIN ~j $
~ 5 DENOTES SANITARY SEWER ~ µ
W DENOTES WATERMAIN ~
N89°19'27"E 155.51 M~ sr DENOTES STORM SEWER ~ F°
(9 70.6) sss.z~ 56.00 sss 5t 30 0 ~ ~ DENOTES STORM MANHOLE
~ ~rq n DENOiES STORM APRON ~ ~
~ - - - ss4j,x 2o.s d{ ~1 ~
a 5 ~ w~ " o,~ vj SETBACKS a~
~ ~ ; f I o M W~<
p~ I 9 X B 9sx.a x ess.a ~ Q 2 5.-2_y ~j ~ MIN. FRONT YARD SETBACK = 30' ;
rn J3.5 rn o I,ap ~1 MIN. SIDE YARD SEiBACK = 5(GARAGE), 10' (HOUSE) W S
I n~/~ v~ n~ M I N. R E A R Y A R D S E i B A C K = 1 5' o
J ~ 22 A~' ~
4 Z~ ss3 3 x w PROPOSED TOP OF FOUNDATION ELEVAiION= 956.8
~ I ~ ~ w~~ ~ I i~ ~ PROPOSm GARAGE FLOOR ELEVATION= 955.8
i„~ a a w N M o m I M ~ PROPOSED ~OWEST FLOOR ELEVATION= 948.0
n ° u~ I O ~ ~ps
(V ' r' ~ a~ ~ ~
N DRAINAGE & a a ~ I ai ~ .
1~
o I UTILITY 9sus 9s2~~y °i 34 ~ ~ ~ ALL OFFSET IRONS ARE MEASURED TO HUN~RED7HS µ
~ EASEMENT X X~~ X~ ~ OF A F00T AND CAN BE USED AS BENCHMARKS. ~
Z ^ •~~si ~ 952.5 x ~5i.i ~ 10
5 ~ - - ~ - ~ ~ a ~ ~ ~ O DENOTES IRON ~gb
~ 63.9 949.027 rj(~'.~~ 5.54- $Q.QD xmm m X DOp.O DENOTES EXISTING
~ (sss.s) gg~~g'27"E 155.96 x~so.o 5 ~vnnoN
pp~~ ~000.0~ DENOiES PROPOSED ~
HW~ 3 ELEVAnON ~.1 •
a S+~ L, ~p CqR, ~2 DENOTES DIRECTION ~ ~
~FEiIlG~ 9~~8 OF SURFACE DRAINAGE ~ O~ o
m O DENOTES SANITARY ~ P~17 w
0 945•Q SEWER SERNCE ELEVATION o(~ R Z
~ A TITLE OPINION WAS NOT FURNISHED TO THE ~ i° ZiN
~ Z
~ 3 I ~ ~ ~
~ SURVEYOR NOR WAS A SPEqFlC iliLE SEARCH FOR W¢~I r+ ~
iHE EXISTENCE OR NON-EXISTENCE OF RECORDED OR ~ a~ a
~ UNRECORDED EASEMENTS CON~UCTED BY iHE Q~(y ~ w
~ b SURVEYOR AS PART OF lHIS SURVEY. U a ~
~ - _ ; ~ : L~ ~0 0
4 ; ~ V ~
~ , J~ 1 ~:9 R~~t6F~i I hereby certify that this is a true and correct representation ~ a ~
~ of a survey of the boundaries of: U
~ pP ~a4~inin~ LOT 7, BLOCK 1, PINETREE PASS 7TH ADDITION
~ /2- 3 - ~ ~ Requir~
~ i „ ' ~ DAKOTA COUNTY, MINNESOTA
Q . . ' ._.v.-~...?~•._~SI.~VitJ~~~~ ' \
~ r And the location of all buildings, if any, thereon, and all visible DRAWN
k ' encroachments, if any, from or on said land. As surveyed by RS
a me this 19th day of November, 2002. CHECKED
~ GRG
a HARDCOVER ,~~,ti,h ~ ti~2o~Jo2
~ LOT AREA = 13.za~ s.F. TREE SUMMARY ~ scA~
~ HOUSE AREA = 2,342 S.F. ExISTING 1REES = 0 Gary R. Germond AS SHOWN
~ covERnce =».ssx TREES REMOVED = o Licensed Land Surveyor, Minn. Lic. No. 24764 JOB N0.
5402-701
9
3
i i
NIlQCheck COMPLIANCE REPORT ~ I ~
Minnesota Energy Code ~ Permit # ~
MNCheck Software Version 3.0 ~ ~
~ ~
~ Checked by/Date ~
~ ~
COUNTY: Dakota
STATE: Minnesota
ZONE: 2
CONSTRUCTION TYPE: Single Familti
DATE: 1-29-2003
DATE OF PLANS: 01-29-03
TITLE: An and Jenny Tran
PROJECT INFORMATION:
407071
4637 Summit Pass
Stonecliffe
COMPANY INFORMF~TION: ~
Lundgren Bros. Canstruction
NOTES:
Devonshire "C" Base Plan
~CZSN1'P~LIANCE: PASSES
Required UA = 567
Your Home = 480
15.3% Better Than Code
Area or Cavity Cont. Glazing/DOOr
Perimeter R-Value R-Value U-Value UA
CEILINGS 1632 44.0 0.0 44
WALLS: Wood Frame, 16" O.C. 112 19.0 2.0 6
WALLS: Wood Frame, 16" O.C. 2302 19.0 2.0 129
WALLS: Wood Frame, 16" O.C. 328 11.0 2.0 27
BSMT: Conc. 8.3' ht/7.8' bg/8.3' insul 1254 10.0 0.0 73
GLAZING: Windows or poors, Above Grade 538 0.350 188
DOORS 38 0.350 13
HVAC EQUIPMENT: FuTriaCe, 90.0 AFUE
COMPLIANCE STATEMENT: The proposed building design described here is
consistent with the building plans, specifications, and other calculations
submitted with the permit application. The proposed building has been
designed to meet the requirements of the Minnesota Energy Code.
Builder/Designer 1 V v - Date I-~~~~
LOT SURVEY CHECKUST FOR RESIDENTIAL 'n~r
BUILDING PERMI7 APPLICATION S t n v~ti vn a_`"S-~
I PROPERTY LEGAL: ~ D t 7 Q~v~ I -~'r~_,P~
~t c~ 1~in /i ~+(.~~'l' I a'rw
DATE OF SURVEY: a ~
LATEST REVISION:
m
m
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m
t
U
9
a
O ~ Q DOCUMENT STANDARDS
~o ? . Registered Land Surveyor signature and company
fid~ ? ? • Building Permit Applicant
? • Legal description
Fd~ ? ? • Address
q~/? ? • North arrow and scale
l9' • House type (rambler, walkout, split w/o, split entry, lookout, etc.)
? • Directional drainage arrows with slope/gradient %
~v/ . Proposed/existing sewer and water services & invert elevation
[3"/ ? ? • Street name
C3" ? ? • Driveway
~ ? ? • Lot Square Footage
~ ? ? • Lot Coverage
ELEVATIONS
/ Existin
0 ? • Sewer service (or Proposed)
C~ ? ? • Property comers
~ G G • Top of curb at the dnveway and property line extensions
Ya~/ • Elevations of any existing adjacent homes
• Adequate footing depth of structures due to adjacent utility Venches
? q~ C~ • Waterways (pond, stream, etc.)
Prooosed
~~I7 ? • Garage floor
d G n • Basement floor
? • Lowest exposed elevation (walkouUwindow)
~jy ? ? • Property comers
~[1 ? • Front and rear of home at the foundation
PONDING AREA (if aoplicablel
? ~o • Easement line
? • NWL
? p~ ? • HWL
? d~ ? • Pond # designation
? f~/ C • Emergency Overflow Elevation
? p~ ? • Pond/Wetland buffer delineation
/ DIMENSIONS
B' ? ? • Lot lineslBearings & dimensions
~,Ll ? • Right-of-way and street width (W back of curb)
q/ CI i.t . Proposed home dimensions including any proposed decks, overhangs greater than 2', porches, etc.
(i.e. all structures requiring permanent footings)
r~p n • Show all easements of record and any City utilitles within those easements
~1~ ? • Setbacks of proposed structure and sideyard setback of adjacent existing structures
• Retaining wall requirements, if any
Reviewed: r ' 7
Name Date
G:/FORMS/BUilding Permit Application
REVISIDNS
M LL
30 15 a 15 30 60 n/2e/az es
SCALE IN FEET
LEGEND
v p
~ ~ ~ OO DENOTES SANITARY MANHOLE ~ ~~fC~D
- I ~ DENOTES ITYDRANT
q ~ ~ DENOTES CATCH BASIN V §
~ ~~J
~ Q~ 0 ~a 3 S DENOTES SANITARY SEWER
W DENOTES WATERMAIN ~ °
rua (970.6) N89°19~27~~E 155.51 s,~ ST DENOTES STORM SEMfER ~ F a
g7t~ 9`~77(g56.7)56.00(956.2) 95551 3~.00 ~ ~D DENOTES STORM MANHOLE
~n ~ " a ~ DENOTES STORM APRDN
s x za.s ,
~o _
o° s~ ~ ^ ~ ~ o „ SETBACKS P~', <
~ I 9..9,8 9`a6t3 x9S54 v~ ^2 R'~ ~ I';V~~ ~ 's ~ s
~ X X~ 33.5 ~ a'~ ~~2~ 4~ ~ ~ MIN. FRONT YARD SETBACK = 30~ ~ r
x ~ O1 o h 00 ~ MIN, SIDE YARO SETBACK = 5~ (GARACE), 10' (HOUSE) ~ 3
~ M ~ r~ ~ t3a~~=,",- ~:;''I~. ('1' MIN. REAR YARD SETBACK = 15~ S
~ / o Q 2z ` t :'r rrti,~ &
~ / v ~~a 953?# W m
o w~ ~ P R O P O S E D T O P O F F OUN DA TION ELEVATION= 957.3 E~
- I a ow~ I ( ~ ry PROPOSEO GARAGE FLOOR ELEVATION= 956.38 d o
~ N~nN o"> r7 PROPOSED LOWEST FLOOR ELEVATION= 948.5
N om n ~ N
C D O M I ~ ~ a~{
t
T
N I DRAINAGE &,~r y 1~ a~ I a ~
~ UTIUTY "qs `~~..t~9 I~ 3a ~ I rn ~ ALL OFFSET IRONS ARE MEASURED TO HUNDREDTHS ~
~ EASEMENT X x A '-I ~ OF A FOOT AND CAN BE USED AS BENCHMARKS. ~ ~
O 5~ r~ 953 x 55~ i 1
If
Z ~ - - - ' O ^ 1 ~410 ~,so
5 ~ - ~ - ~L ~ " ~ ~ ~ O DENOTES IRON
MONUMENT
fi3 9 449 2 F 6.QQ 5.54- 30.00 °i ~ ~
~ , x~F~ ~ X OOD.D OENOTES EXISTING
(963.6) Ngg°1g 27'E 155.96 5o e~EVnnoN
E70S71N6 ~000.0 DENOTES PROPOSED r
~p 3 ~ ELEVATION W •
S I L. / 7pp
~ ~ z 4- DENOTES DIRECTION > ~ ~ F
FDN.~0.'S0.6 OF SURFACE ~RAINAGE ~ O(~ o
~~~/C DENOTES SANiTARY ~ ~y
I 945.0 SEWER SERVICE ELEVATION ~ p~~ z
~n 3I ~ ~ ~
I A 11TLE OPINION WAS NOT FURNISHED TO THE O o ;
~~_~g$ e~~~~ SURVEYOR NOR WAS A SPECIFIC TITLE SEARCH FOR w Q~ QI ~
S~~'~ ~~~A THE EXISTENCE OR NON-E7CISTENCE OF RECORDED OR ~ a~[-~ ¢
~ ~a~ t~1`~g
g UNRECORDED EASEMENTS CONDUCTED BY TtiE Q~ V1 w
1~~~~n~~~ . V l7 SURVEYOR AS PART OF THIS SURVEY. U a~ Z a
3•
o~ R~ ~~ied~ K-^7 ~ ~ C >
r
Re4 , . , ~ _ ~ ° ~ V ~
~S r~ i~ C~ ;1' ~ ~ ~ _3 I hereby certify thot this is o true ond correct representotion ~ ~
f` ` , of a survey of the boundories of: U a
` t~;,,~.'.~_
' ` ~ Y~ LOT 7, BLOCK 1, PINETREE PASS 7TH ADDITION
- ~ DAKOTA COUNTY, MINNESOTA
, j':~,i ;?,;.5_"ta~r3~a~b?. And the location of oll buildings, if ony, thereon, and all visible DRAWN
= encroochments, if ony, from or on soid lond. As surveyed by RS
me this 19th day of November, 2002. CHECKED
GRG
HARDCOVER ~ o~Jo2
~or nREA = ia,za~ s.F. TREE SUMMARY
HOUSE AREA = 2,342 S.F. EXISTING TREES = 0 Gary R. Germond AS $f{QI~
COVERAGE = 17.69~ rnEES rtEMOVED = o Licensed Land Surveyor, Minn. Lic. No. 24764 JOB N0.
5402-701
Address:: 4637 3ummit Pass F~ Zip: 55122
Lot: 7 Block: 1 Subdivision: Pinetree Pass 7th
THE FOLLOWING ITEMS WERE/WERE NOT COMPLETE AT FINAL INSPECTION ON
Yes No Comments
Final grade - 6" from sidin
Permanent ste s- ara e
Permanent ste s- main entr
Permanent driveway
Permanent gas
Sod/Seeded lawn
TraiUcurb damage
Porch ? .
Lower level finish
Deck
Fireplace
• Verify with your builder that roof test caps from the plumbing system have been iemoved.
• Tum off water supply to the outside lawn faucets before freeze potential exists.
• Call the City's Engineenng Department at 651-681-4645 prior to working in right-of-way or installing
u-rigation system.
CIUILDING INSPECTOR ~ L
~J
cd/bldgmsp/fomis/2002/Fnal inspection checklist
~
Sile address: Lof 2 Block ~ Subd.f L~?~ Q-~
On April 15, 2000 the Minnesota Energy Code, Category I Building Requirements for insulation protection, air
tightness, and ventilation, was atlopted. As a result, the City of Eagan is requiring that the following information be
su6mittetl prior to issuance of a Certificate of Occupancy.
_ This struclure: is cons(ructed to meet minimum requirements of the Mn Energy Cotle, Chapter 7670
V OR
This structure: will 6e cons(rucfed to meet more restrictive requiremenls of Chapters 7672 or 7674
APPLIANCE GAS ELEC MANUFACTURER MODEL BTU'S VENTING TYPE
Water Heater O~
DDU V C~
Furnace ~ ~ T U 2 f~ p(~
Dryer
4ENTED
El(HAUST SYSTEM LOCATION TYPE MODEL CFM's ves No
Kitchen kitchen
8athroom 1 N ~
Bathroom2
Bathroom 3 ~ ~ ~ ~
5-rE~ a J ~ -G '~~j ~
Bathroom 4
Other
VENTING
FIREPLACE S LOCATION GAS WOOD MANUFACTURER MODEL BTU'S DIHECT ATMOS
~ X FS 1 '0p
MAKE•UP AIR MODEL TYPE CFM's
~ f1'2 2 2, a LA n~C r
I hereby acknowledge that ihe above intormation is correct and agree to comply with the Minnesota Energy Code antl City o( Eagan
requirements. r
~n,(1 ~ n~~ ti~JCP.~/~ /r~ -~2-C)~
ture ~ Date
~ r A~l , ~ifYln~n ~icY7 U~
CompanyNa
' This torm is the responsibiliry o( the General Contractor.
City of Eaton
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
MARpg1016
Use BLUE or BLACK Ink
For Office Use
Permit#: l?v Uq
Permit Fee: ( 10 1(- I
Date Received: 6-) / `P
Staff:1
2016 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 3/7/2016 site Address: 4637 Summit Pass
—3_f()I)
4
Unit #:
Name: Jenny Tran
Address City / zip: 4637 Summit Pass
Applicant is: Owner 1 Contractor
Description of work: Finish basement
Construction Cost: 26000.00
Phone: 651-231-1011
Multi -Family Building: (Yes / No ✓ )
Company: My Contractor Inc Contact: Gene Patnode
Address: 11133 Quinn Ave S City: Bloomington
state:MN zip: 55437 Phonst/2 - 51° e5/4mail:
License #: BC520307 Lead Certificate #: NAT -F118394-1
If the project is exempt from lead certification, please explain why:
Built in 2003
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:
Fire Suppression Contractor: Phone:
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.orq
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to start without a permit; that the work will be in
accordance with the approved plan in the case of work which requires a review and approval of plans.
Exterior work authorized by a building permit issued in accordance with the Minnesota State wilding Code t be completed within 180
days of permit issuance.
x Gene Patnode x
Applicant's Printed Name Applicant's Signature
Page 1 of 3
4-/(P � ,,.,. ss
DO NOT WRITE BELOW THIS LINE
13ss'
SUB TYPES
Foundation _ Fireplace
Single Family _ Garage
Multi _ Deck
01 of _ Piex Y Lower Level
WORK TYPES /\
_ New _ Interior Improvement
Addition Move Building
Alteration _ Fire Repair
Replace _ Repair
Retaining Wall
DESCRIPTION
Valuation
Plan Review �j
(25%_ 100% 7j)
Census Code
# of Units
# of Buildings
Type of Construction v 3
210, obi . vel
REQUIRED INSPECTIONS
Footings (New Building)
Footings (Deck)
Footings (Addition)
Foundation
Roof: _Ice & Water _Final
)0 Framing
Fireplace: _Rough In Air Test
Insulation
Sheathing
Sheetrock
Fire Walls
Braced Walls
Shower Pan
Porch (3 -Season)
Porch (4 -Season)
Porch (Screen/Gazebo/Pergola)
Pool
Siding
Reroof
Windows
_ Egress Window
Exterior Alteration (Single Family)
Exterior Alteration (Multi)
_ Miscellaneous
Accessory Building
_ Demolish Building*
_ Demolish Interior
Demolish Foundation
_ Water Damage
*Demolition of entire building - give PCA handout to applicant
Occupancy A.= (
Code Edition f\ 201
Zoning '12' —1
Stories
Square Feet
Length
Width
Final
Reviewed By: —TO / k fy , Building Inspector
7°
MCES System
SAC Units
City Water
Booster Pump
PRV
Fire Suppression Required
Meter Size:
Final / C.O. Required
Final / No C.O. Required
HVAC _ Gas Service Test Gas Line Air Test
Pool: _Footings Air/Gas Tests _Final
Drain Tile
Siding: _Stucco Lath _Stone Lath _Brick
Windows
Retaining Wall: _ Footings _ Backfill _ Final
Radon Control
Fire Suppression: _Rough In _Final
Erosion Control
Other:
RESIDENTIAL FEES
Base Fee
Surcharge
Plan Review
MCES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
Copies
TOTAL
h 2�,O
51 Pr
Page 2 of 3
City of ban
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #: /cam V0,
Permit Fee: 6' 0 - 00
Date Received:
Staff:
2016 RESIDENTIAL PLUMBING PERMIT APPLICATION
Date: 3/11/2016 Site Address: 4637 Summit Pass
Tenant:
J
Name: Jenny Tran
Address / City / Zip: 4637 Summit Pass
Suite #:
Phone: 651-231-1011
Name: License #:
Address: City:
State: Zip: Phone:
Contact: Email:
_ New _ Replacement _ Repair _ Rebuild ✓ Modify Space _ Work in R.O.W.
Description of work:
RESIDENTIAL
Water Heater
Lawn Irrigation ( RPZ / _ PVB)
Septic System
New
Abandonment
Water Softener
IAdd Plumbing Fixtures ( Main / 1 Lower Level)
Water Turnaround
RESIDENTIAL FEES:
$60.00 Water Heater, Water Softener, or Water Heater and Softener (includes State Surcharge)
$60.00 Lawn Irrigation (includes State Surcharge)
$60.00 Add Plumbing Fixtures, Septic System Abandonment Water Turnaround* (includes State Surcharge)
"Water Tumaround (add $280.00 if a 3/4" meter is required)
$115.00 Septic System New (includes County fee and State Surcharge)
TOTAL FEES $ $60.00
CALL BEFORE YOU DIG. Call Gopher State One CaII 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.
Jenny Tran
Applicant's Printed Name
Applica s Signatire
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA144809
Date Issued:08/10/2017
Permit Category:ePermit
Site Address: 4637 Summit Pass
Lot:7 Block: 1 Addition: Pinetree Pass 7th
PID:10-57666-01-070
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Allow an 18" minimum radius clearance to the water meter from all appliances (i.e. furnace, water heater, water softener).
Fee Summary:PL - Permit Fee (WS &/or WH)$59.00 0801.4087
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 -
An A Tran
4637 Summit Pass
Eagan MN 55122
(651) 271-8619
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA172143
Date Issued:09/16/2021
Permit Category:ePermit
Site Address: 4637 Summit Pass 1
Lot:7 Block: 1 Addition: Pinetree Pass 7th
PID:10-57666-01-070
Use:
Description:
Sub Type:Reroof
Work Type:Replace
Description:Does not include skylight(s)
Census Code:434 - Residential Additions, Alterations
Zoning:
Square Feet:0
Occupancy:
Construction Type:
Comments:Please print pictures of ice and water protection and leave on site.
If water damage is encountered, please call (651) 675-5675 to schedule a site visit to verify the extent of the damage. Any
repairs must be inspected prior to covering. The inspector will determine if an additional permit will be required to repair the
water damage.
Valuation: 5,000.00
Fee Summary:BL - Base Fee $5K $118.00 0801.4085
Surcharge - Based on Valuation $5K $2.50 9001.2195
$120.50 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 -
An A Tran
4637 Summit Pass
Eagan MN 55122
(651) 231-1011
Kaufman Sheet Metal Roofing
2521 24th Ave S
Minneapolis MN 55406
(612) 722-0965
Applicant/Permitee: Signature Issued By: Signature
