3906 Thames Ave
INSPECTI4N RECOR.D IControl
~ ciTr oF EaGAN PERMIT TYPE: B" jo
3630 Pilot Knob Road Parmil Number. *90961
•~/~a/9?;~
Eagan, Minnesoia 55123 Date Issued:
(612) 681-4675
SITE ADDRESS: APPLICANT:
14N6 riiaNr 'c nvf f1iF p.0I Tki1lil] t i+ ll1C
~e?kl€'Nrtiv r?a, f~>>.•~ 4r1 -e1e11
PERU1T %@TYPE: TYPE QF WORK:
7:01,TIaN F1NAL
riR17pLAcr ( a.~..
(
~
I IIUMAFtV5e ti& 4J [tl1iYOAi:TfJR - VAILEY F1oN i?,~
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4
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~ PerwAt "o, aal rwmm 000
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FoutwLtlan 7 ~ I
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21 I
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Dock FkW
vm
F'r. D*.
_ ~y 37 Ps ~ ~.a•~~
,v • .
K 1 0 0
8 /a- 9 ~aa4- 5
ReQUest Date Fue No. Aou ~in Inspactwn
2q Re ireE? .~JReady Now ? Will NoUtyInspector
'J^ ! 2- Yes D No When Reatly?
I.,Zhcensed coNracbr O owner hereby request inspection of above electrical work al:
Job AaOress IStreeL Box or qau• N01 Qty
3 0(0
Sxuon No Township Name or No Ranga No Coyp~y
~
Occupam (PRINTi Phone No
_6
Power SupP,D
i Atltlress
a-P,~
Eiec1rroai vastor (COmpany Name) ConVacror§ License No
~c, c o6 3 g i
Mailing Aa ss IContractor or Owner Maki InslallaLOn)
nwhorrzea Sgnawre IGOn;ractonOwner akinq al aLO~~ P~OnB Num02r
MINNESOTA STATE BOARD OF ELECTHICIT THIS INSPECTION REOUEST WILL NOT
Gng9s-MiEway BIOg. - Room S179 9E ACCEPTEO BV THE STqTE BOAFD
1841 Univorsiry Ava.. St Paul. MN 55106 UNLESS PROPEF INSPECTION FEE IS
Phone (614) 6C24800 ENClOSED.
REUUESTFUR-ECECTHIGALINSPEGTWN ee-ooam-oe
10 9 0 ? Sea inslmcuons lor completmg Ihis lorm on back ol yellow copy
- "X" Be/ow Work Covered by This Request
lew Atld Rep Typeof8mlding AppliancesWired EqmpmenlWired
Home Range 7emporary Serwce
Duplez Water Heater Electric Heating
Apt Building Dryer Other (Specity)
Comm./Intlustnal Fumace
Farm Air Conditioner
Olner(syecdy) Conbeclor5 RemaNs
:ompute Inspec6on Fee Below.
n Omer Fee u SarviceEntrance5ize Fee # Cirouits/Feetlers Fee
Swimmmg Pool 0 to 200 Amps 0 to 100 Amps
Transformers Above 200 _ Amps Above 100 _ Amps
Signs Inspecmrs use Onty: TOTAL
Irrigation Booms / J~ qd S",SU
Special InspecLOn t
Alarm/Communication TMIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electrical Inspector, hereby Roiuen-in oate
cerOty that the above inspection has " Fi°ai
been made, r Dete ~ ~„G
iFFICE USE ONLY
••yI
his r2pue9 voitl 18 monihs trom
K 11 91 £ ri/~'/9 ~v~.~~
-~S~-~
Fepues[ ~a~a Fire No Rou " Inspecian
8 R 7 ? ReaOy Now WAI Notity Inspec~or
'ea ~ No ~aa ae
,
6t~
IXlicAnsed contractor p owner hereby request inspechon of above electrica ork at: ~
Job AtlOress lSVaet Boa or Roule NoJ pdy 00
.3Go~ a,,,
Searon No 'rownsniv Name or No aange No C
Occupan PRINTI PM1One No
Power 6u001ier Atldress
~
ElecvKaEhactor (COmpany~ Conlractors License No
003V
Mailing A aress IComractor or Owner Making Inslalli
Aulnonze0 Sgnahure iConlrac r Ow er kmg Ins~allau ~ Phone Number
3-38ia
MINNESOTA STATE 80ARD OF ELECTRICITY THIS INSPECTION REOUEST WILL NOT
Grigga-MlCway BIOg. - Room 5-173 BE ACCEPTEO 8V THE $TATE BOnRD
1831 Univenny Ave.. SL Paul. MN 5510C UNLESS PROPER INSPECTION FEE IS
Phane(61Y) 6C2-0800 ENCLOSEO.
8/j~' /-r'j,~l._ REQUEST FOR'ELECTRICAL INSPECTION eemom-oe
P= ~
? Sea instmclions lar coroleting this lorm on pack ol yeltow topy
K 110 91 ~
"X" Below Work Covered by This Request 1 U~J^~
ew Atld Rep TypeoiBuiltling ApphancesWired EquipmemWiretl
' Home Range Temporary Service
Duplex Waler Heater Electric Heating
Apt. Bwlding ' Dryer ' Other(Specity)
Comm /Industnal Furnace
Farm Air Conditioner
Olnar (syanly) Contrecmr's Remerks:
Compute Mspection Fee Below:
# Other Fee # ServiceEntranceSize Fee N QrcwtslFeetlers Fee
Swimming Pool 1 0 to 200 Amps 0 co 100 Amps 4
TranSfofiner5 Above 200 _ AmpS Above 100 _ Amps
Signs inspeci«s use onry) TOTAL
Irrigation Booms L 9~, J-o
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORDEREW6ISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 MONTHS.
I, the Electncal Inspector, hereby Rouyn,m ~ j oa~e
certdy ihat the above inspection has F,,,ai oa ~ 1 L,-
been made d'
OFFICE USE ONLY
Thrs reqvest witl t8 monins Iram
~
(kL'tiftCRte Of cCCItpQItC~
. wit~ of Cfagan
Teyartmcnt of 13ui[bing 306yecHoa
r This Certificate issued pursuattt to the reyuiremersts of the Unijoim Burlding CoJe
cenifying that at the time ojissuance this structure was in compliance wilh Jhe various
r ordinances of the Ciry regulaling bui(ding constructran ar use. For the jollowing:
U. Clasaification SF DW Rldg. Pmnil No. Q51
ampmlcr "ha Zomng Dutntt RI Type Cwm. VN
Owcer of Building 1M PDTIIAPID 00 IM AdJmw 5201 E RIVF.Et HIl, FRIAEY
g~7
i Building Addmu 3~ \ il;ty ' '
-</6-- 10/1/42
Dmc
` Building bff'icial
POST IN A CONSPICUOUS PLACE
f
Address: 3906 IHAMES AVEN[7E Lot 4 Blk z Sec/Sub COVENTRY PASS
These items were/were not complete ac the time of the fin 1 inspection.
Date: 1p 1 qz Yes No
Final grade (6" from siding)
Permanent steps - garage
Permanent steps - main entry
Permanen[ driveway
Permanent gas
Sod/seeded grass
Trail/curb damage
Porch
Basement finish
Deck
Please verify vith the buildar the removal of roof test caps from the plumbing
system and the shut-off of water supply to the outsida lavn faucet before
freeze potential exists. t~`p
r
qL2t[OxRR
White - City copy Yellow - Resident copy PSnk - Contractor copy
RESIDENTIAL
BUILDINC PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB RD, EACAN MN 55122 `~/n U
651-681-4675
New Construetion Reauiremenh RemodellReoair Reauirements
• 3 registered site surveys showing sq. R. of lot, sq, fi. of house; and all roofed areas • 2 coDies of Dlan
(20%maximum iot wverage allawed) • 1 sel of Energy Calculations for heated addi6ons
• 2 copies of plan showmg heam 8 wmdow srzes; poured found design, etc.) • 1 sde survey for pxlerior additions 8 decks
• 1 set of Energy Calculations • Indicate d home served 6y septic system for additions
• 3 copies of Tree Presenation Poan if lot platted after 711193
. Rim Joist Detail Options selection sheet (bldgs with 3 orless units)
DATE ~L~ ) 02 VAIUATION 1 1,
SITEADDRESS MULTI-FAMILYBLDG_Y~N
TYPE OF WORK FIREPLACE(S) _ 0_ 1_ 2
APPLICANT
STREET ADDRESS 5~ SR ~ IAGI(S CITY STATE ''`42 ZIP SS o-7(0
TELEPHONE # CELL PHONE # PAX # 49`) - '3 R$
PROPERTYOWNER TELEPHONE#
COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY
Energy Code Category _ MINNESO"1'A RUI.GS 7670 CATEGORY 1 NIINNGSO"f:1 RliLFS 7672
(J submission rype) • Residential Ventilation Category 1 Worksheet Submitted • New Energy Code Worksheet Submitted
• Energy Envelope Calculations Submitted
Plumbing Contractor: ___________Phone #
Plumbing systcm includes: Water Softener _ Iawn Sprinl:ler Fee: $90.00
Watcr Heatcr _ No. of R.I. Baths
No. of Baths
Mechanical Contractor: Phone #
Mech;uiic,il system includes: _ Air Condi[ioning Pec: S70.00
Hcat Rccovcry Systcm
Sewer/Water Contractor: Phone #
---r-~ - - -
I hereby acknowledge ihat I have read this application, state that ihe informatio i{ ~rr~t~2dr~tl~r~e ~ omply
with all applicable State of Minnesota Statutes and City of Eagan Ordinances. IJ
I , I l I 8 2002
Sfgnature of Applicant I '
OFFICE USE ONLY LY
Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _
Uptlated 4/02
I
OFFICE USE ONLY
? 01 Foundation ? 07 OS-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg
? 02 SF Dwelling ? OS 06-ptex ? 16 Fireplace ? 21 Porch (3-sea.) 0 31 Ext. Alt • Multi
? 03 01 of _ plex ? 09 07•plex ? 17 Garage ? 22 Porch/Addn. (4-sea.) ? 33 EM. Alt - SF
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screened) ? 36 Multi
? 05 03-piex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex p 12 12-plex Plbg_Y or _ N ? 25 Miscellaneous
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition O 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)• O 43 Reroof ? 46 WindowslDoors
? 34 Replacement •Demolition (Entire Bldg only) - Give PCA handout to applicant
Valuation Occupancy MCIES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bidgs Length Fire Sprinklered
Type of Const Width
REQUIRED INSPECTIONS
_ Footings (new bldg) FinaVC.O.
_ Footings (deck) FinaUNo C.O.
_ Footings (addition) _ Plumbing
_ Foundation HVAC
_ Drain Tile Other
Root _ Ice & Water _ Final _ Pool _ Ftgs Air/Gas Tests Final
_ Framing _ Siding Stucco Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows (new/replacement)
_ lnsula[ion _ Re[aining Wall
Approved By , Buitding Inspector
-
-
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
W ater Supply 8 Storage
S&W Pertnit 8 Surcharge
Treatment Plant
Plumbing Permit
Mechanical Permit
License Search
Copies
Other
Total
PERMIT Control No. 0776
CITY OF EAGAN
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota 55123 Permit Number: 000951
(612) 681-4675 Date Issued: 07 /08 /92
SITE ADDRESS:
3906 THAME3 AVE
LOT: 4 BLOCK: 2
COVENTRY PASS
DESCRIPTION:
; Build3ng Permit Type SF DWG
Building,Work 7ype NEW
UBC Occupancy R-3 M-1
Construction-Type V-N
Zoning ~ R-1
Building Length ` 70
Building Width ~ 37
i
. r
~
n- r^
~C'i
REMARKS: ~ (~i C) `$5 S
5& W CONTRACTOR - VALLEY PLBG
FEE SUMMARY:
VALUATZON $163,000
Base Fee $860.00 MTSCELLANEOUS $1,610.50
Plan Review $559.00 Total Fee $3,811.00
Surcharge $81.50
SAC $700.00
SAC % 100
SAC Units 1
Subtotal $2,200.50
CONTRACTOR: - Applicant - s7. LICpWNER:
THE ROTTLUND CO INC 15710304 0001335 THE ROTTLUND CO INC
5201 E RIVER RD 5201 E RIVER RD
FRIDLEY MN 55421 FRIDLEY MN 55421
(612) 571-0304 (612)571-0304
I hereby acknowledge that I have read this applicatipn and state that the
information is correct and agree to comply with all applicable State of Mn.
Stat tes and City of Eagan Ordinances.
L ~
~
R~ ~ixf
APPLICANT/PERM E SIGNATURE ISSUED Y GNATUIE .
INSPECTION RECORD I C°n 0776
CITY OF EAGAN PERMITTYPE: euZLoxNe
3830 Pilot Knob Road Permit Number: 000951
Eagan, Minnesota 55123 Date Issued: 0 7/ 0 8/ 9 2
(612) 681-4675
SITEADDRESS: LoT: a sLocK: 2 APPLICANT:
3906 THAMES AVE THE ROTTLUND CO INC
COVENTRY PASS (612) 571-0304
PERMIT SUBTYPE: TYPE OF WORK:
SF DWG NEW
INSPECTION ,
FOOTZNG FRAMING
INSULATZON FINAL
FIREPLACE
REMARKS: S& W CONTRACTOR - VALLEY PLBG
F
~
L
PERMITQj CITY OF EAGAN
' 1992 BUILDING PERMIT APPLICATION
681-4675 UUH 2 9 Rtcu
SINGLE 6 MULTI-FAMILY 2 sets of plans, 3 registered site surveys, I copy of energy
calcs.
COMFIERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs.
Penalty applies when typing of permit is requested, but not picked up by last working day
of month in which re uest is made or lot chan e is re uested once ermit is issued.
Date 42 / 2S / 92- Valuation of work /C-(,~c7
Site Address: _r'+awAcs A-V_-
STREET STE N
Tenant Name:F,4I-I~Hr4 Cv Tvlc_
Lor sLaK Z weo. P.I.D. s
Descri tion of work:
The applicant is: Owner Contractor O Other (Deccribe)
Name T~e- ~:}-!v wa~ Ccq• i KC. Phone s~_
Property LAST F,RST
Owner pddress GZ,c~?i E (ZN vec- Ko1 3° l
STREET STE I
City FyA1PV State AALI_ Zip '5S-q21
Company Sao^4e- Phone
COntt'BCtOP Address License A~o433S' ExpY1M/92
City State Zip
ArchitecU - Company Phone
Engineer Name Registration M
Address
City State Zip
Sewer 8 water licensed plumber P(va,bc'0o. . Processing time for
sewer & water permits is two days oea has btren approved.
I hereby acknowledge that I have read this application and state that the information is
correct and agree La comply with all applicable State of Minnesota Statutes and City of
Eagan Ordinances.
Signature of Applicant: 146&
e
vrriut uat unLr
BUILDING PERMIT TYPE
? Ol Foundation ? 05 Apt. Bldg ? 09 Basement Fin9sh ? 1~3 P.~b ic+Fac.
0 02 SF Dwg. O 06 Garage/Accessory ? 10 Swim Pool 014 Agricultural
? 03 Two family 11 07 Fireplace ? 11 Res. Add./Porch ? 15 Miscellaneous
11 04 Multi-fam. T.H. O 08 Deck 0 12 Comn./Ind.
WORK TYPE
0 31 New ? 34 Repair ? 37 Demolish
? 32 Addition ? 35 Tenant Finish O 99 Undefined
? 33 Alterations ? 36 Move -
GENERAL INFORMATION tonst. (Actual ~i,) 1 Basement sq. ft. 2~ o MWCC System k
(Allowable) l/N lst F1. sq. ft. i2fo O City Water y
UBC Occupancy R=3 1-7-1 2nd F1. sq. ft. /a 1-0 PRV Required
Zoning R-/ Sq. Ft. total Booster PumP
i of Stories footprint Sq, ft. Fire Sprinkler
Length 20 On-site well Census Code ~
Depth 3t,,G~ On-site sewage SAC Code
APPROVALS
Planning Building Assessments
Engineering Variance
REQUIRED INSPECTIONS
O Site p'Footing (KJ Framing 0 Insulation
? Wallboard Tkl Final ? Draintile ? Fireplace
Permit Fee Yalutim: f 163.Oc~c
Surcharge ~g S ~-I-r /St ~
Plan Review x2~: ~o(,y (~q4v 20,1-3p = (opo
License
MWCC SAC
~
City SAC ~ yp yl
Water Conn. ~Z~~x~6~ $S62o ~
Water Meter Z~~ ~DZ~o
Acct. Deposit
S/M Permit
S/M Surchar9e l yx3& s~
Treatment P1.
Road Unit
Park Ded. /-2ox5_3= go
Trails Ded.
Copies / (o Z 94
Other J ~
Total:
SAC %
SAC Units -
~i
2422 Entvpnse Vrive
I1 X ~lr~~ptn Heigh!5_ MN 55120 ~I
I~ y~ aae~a . .^o ~(812) 681-1914•Fox 681-9488
U.r~ PI.A~eJFAS . 1PNOS('.J1CE g2g ui^hxcy 10 Ncrlheesl
I lCf7WTI 1CVi -Cv ald
'Vy ' VVY
1~ * y , 8fo7ne, MN 55434
Ill6i[j 7o3-iociv-i v. ~I
AII a r.r4 ~nmr-t r'1ntI ~nt` ~l
I~ l;efLitlCO[@ Oi JurvCy iur: 1 1 1 c I NvL uvii...1 I i tw~ I
~ Hause Address: Thames Avenue, Eagan. MiV ij
Model Name_ Madison
I! , u1~\ 11 II
11 ' ~ I W II
~ ~I
;
~ II
S"
1 V 11 ~ ~ ~f ~~~•..K ~ ~ ? ~ A.... +
ro
o~
q7
, n..
10.;%
f P
,
II ; ~ f I !k
Il EAGA+V
j~ Vt E V I E W E Q
CO p ~I
v.
f~ DATE
$y
ENGINEE DEpT ~
x soaa uenotes t.xis'ting Eievaiion
. PROPOSED HOUSE £LEVATION
c ~
n ~....._.t_.. I~^
-r%•~ r.........
l Lowest riocr ticvaiion:o77.0~ f
il - Denotes Drainaae & Utility Easement _ i
~ - Denotes 4rainagC Ffow DIfECkIOn iop oi ciocic Eievaiiwr08000.:2
--0- DBf10L29 Monument GUfacje JidU
i ~ iiciiuic3
qearingx siWwn oie ussuvrieci
!I LOT 4. BLOCK 2 GOVENTRY PASS II
RAKnrA rMtu-rv uwKrcnrw !
1 here6y [MINtAat IMs Wrvly, Olal w rlport was prEp3Rd Ey f,1! o/ u-Ger my Qiren iun~slon and thal I om tlulY RVqiswcd Und Surveyor '
II ontlor tFe l~ of N. S[.m of Mi~~u. qiud thrs u°GM dav d`"J NJGr A.P_ 17 1 ~ . ~
^t0.1:391 ~
F.!c7'e.t;ion r:t+vr•.t,rnT. nvi:Nnr,E cut-tritTn•I'in~l
1f7- ~fird,yGy'!.
oWm Ea .
SITE ADD9ESS ~ `
CONTRACTOF _l--v?T(,UNO GD. DATF. PHt)NE
Detex-min vorkini; sqvare footai;c of ench.
1. Total exposed wall area ZpQ~.'Z SR_ ft. x 0.11 _ 318.4
• 2. Total roof/ceiling area sq. ft. x 6.026 ~ 32 q
• .
Total exposed wall arca nbovc flo<ir = Z U`/
s. Total vall vindow area '~PV 7, 5gj
c b. Total door area
c. Total slidin L~. ¢ 2
8 61oss door area
d. Total fireplece wall nrea
e. Total wall framing area (average 10')
f. Total net wall area nbove floor .
....................ZO 3~. Cr •
. e• Total rim joist area 2re 3. 2
Total exposed foi:ndntion arca
h. Total foundetion vindov a:ee ~t7
• i. Tota1 net foundation a-ea above grade -7F
~ . . Deterrt;ine "U" value o: eech wall :,F,ment. ,
. . a. 307.
b. <00. ~j-Z x•,~,~ o,/3a _ 8,33 ~
. ' : c. X
d. x ~V,
x.~~U~~ C) Gj q = 2 5? lq-
.
- r. Zo 37. (.i X.,up. p, 0 43 - 8 7• G(
. e. 2L 3, 2- X..l," 4- 041 - !o . 71 ~
n. / o X„u„ - g~ Z
i~..~ X ..u„ All.8s
3. . . . . . . . . . . . . . . : . . . . . . . . . . rot.::l = 2 77. /
o~
If item'N3 is the seme as, or lesr, LtUM item ML, you have met the intent
or sac 6006(c)2.
, .
Totnl exposed roof/ceiling nrel
, ~ . ~ . . . ,
Total gross rooP/ceilinr, arerti = J. Totel skylight area
.
k. Total roof/ceiling framin3 area / 2~• 7
1. Total net insulated roof/ceilinF area 11 45~. C2 60
Determine "U" vnlue for cnch roof/ccilinj; seFgncnt.
• J. x flUll
.
/Z%o, 7,f- X„U„ 01ax7
k:
1. 840. oL z„U„ o.~zz = 2y,r~~ ' ,
4 . , Total = Z , C/L .
If total of H4 is the same as, or less than N2, you have met ttie intent of
ssC 6006(c)i. .
, To utilize the total envelope system method, the values establi;hed by the sum cf iteas N3 and B4 shall not be greater.thnn the sum of items A1 and b'2.
1. + 2. _
+ 4. _ _ •
~ . •
• .
0
. .
. _ . O . • . "
GAl-GULATIDWi (GoNT).
-rFAMr-- W~tLI. G~ INhI-ILA~I~N
LOMPON~N~ . F2-VALUS
AI(L FIL.M D,I"1 -
16t~ATHIH6o,
~
=5/s lNSU~A'~cti• 19.0
'
l711 ° G,
eD
o, 45
~51rJ~
G
~tai~,° 2 3 . O l. . _
U= Rr' - 0_043 .
jb'(t+L
-~ftMV wRU. @. STLIp °
- GoMPaN~NT~ --VALU5
- J_ 1 o_u"~~~~E Ai(~ Fll.dl.
~ ? i
2 ~ZUh~D INl.. . 7 O:G2::.
~
3' hH~A'jH?N~, 2.oCi _
• ` C' ?Nsiv~ Ml?- Fit-M. _ I'I.f~N• Yl~k~. . u~.r ~ o. 0~9.
r !
~=G~JNP~. ~~U =~0,12 X o.ot~9~ t(o,Sb x o.043> = 4. O~-
~ ~r~?-~Io~T . -
~Q ~-atii~ul.. -._:I9•_o .
~ ~t? ,
; ~='L4;
~
I ! , ! - / 3
o,e~
O
tX=~-~' -
= o, oa
1 ~
~
~
i
~ 2
Zz-
\'1--
2l
40
~ IJ~kif?-Ft~M•. _ ---p,zot.
3 4 5 R =--3-5-g-3----
- - ~ = 0, 027
U ~ 5.83
. :4~~w
~ -o;i1:-~----
,
;
o; 4S- -
- -pz_L
;
0.022
~
l 7 BL CITY OF EAGAN CITY USE ONLY
PLUMBING PERMIT
SUBD. (612) 681-4675 RECEIPT #
DATE .:2y y
REBIDENTIAL
PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND CONDOS
WHEN PERMITS ARE REQUIRED FOR EACH UNIT.
WORK DESCRIPTION COMPLETE THE FOLIAWING:
N0. FIXTURES EA. TOTAL
NEW CONST X REPAIR/ADD ON 15.00
ADD ON ~ SHOWER 3.00
REPAIR ~ WATER CIASET 3.00 a-
~ BATH TUB 3.00
p ,t 3 IAVATORY 3.00
OWNER NAME: ~\O h?14- KITCHEN SINK 3.00
LAUNDRY TRAY 3.00 3-
SITE ADDRESS: L~IU~c ~11nw.~ 1'~?~.•- HOT TUB/SPA 3.00
~ WATER HEATER 3.00
~ FLOOR DRAIN 3.00 J'
GAS PIPING OUT.
INSTALLER: (MINIMUM - 1) 3.00 3
ROUGH OPENINGS 1.50
ADDRESS: OTHER
WATER SOFTENER 5.00
CITY: ZIP: PRIVATE DISP. 15.00
U.G. SPRINKLER 3.00
PHONE W. TURNAROUND 15.00
STATE SURCHARGE .50
SIGNATURE OF PERMITTEE TOTAL: S 00
COMMERCIAL
PLEASE COMPLETE THIS PORTION FOR ALL COIR4ERCIAL/INDUSTRIAL BUILDINGS. ALSO FOR MULTI-FAMILY
BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT.
WORK DESCRIPTION:
OWNER NAME:
CONTRACT PRICE:
SITE ADDRESS: 1% OF CONTRACT FEE.
STATE SURCHARGE - $.50 FOR
TENANT NAME: EACH $1,000 OF PERMIT FEE.
SUITE $25.00 MINIMUM FEE.
INSTALLER: CONIRACT PRICE x 1% $
ADDRESS: STATE SURCHARGE $
CIT7': ZIP:
TOTAL: $
PHONE
FOR: (SIGNATURE)
CITY OF EAGAN
r ' CITY OF EAGAN
L~ B oZ MECHANICAL PERMIT RECEIPT # O~a~ S
SUBD. ' (612) 6814675 DATE 5~id 9~-
~a~Y9 RE5IDENTIAL
PLEASE COMPLEI'E UPPER PORTION ONLY FOR SWGLE FAMIIY DWELLINGS. ALSO, COMPLEI'E FOR
TOWNHOMES/CONDOS WHEN SEPARATE PERMITS ARE REQUIRID FOR EACH DR'ELI.IIVG iTNIT.
OWNER: 75ADD-ON A/C ADD-ON FURNACE ?
STl'E ADDRFSS: ADD ON/REMODEL (EXIST[NG $ 15.00
3 p m~S ~ CONS'fRUCI'ION ONLl)
INSTALLER: flVAC: 0.100 M BTU L2.4.00
PHONE ADDITIONAL 50 M BTU 6.00
ADDRESS: 49363 GAS OUTLEI'S - MINIhiUM 1@ $3 EA. . Oa ~
CI1'Y: Q~ ),kE- ZIP:SS SURCFIARGE:
SIGNATURE: TOTAL: $ 2 7,S0
NO PE?tMIT REQUIRED FOR DUCTWORK ONLY!
COMMERCIAL
PLEASE COMPLEI'E TfIiS PORTION FOR ALL COMMERCIAIJINDUSTRIAL BUILDINGS. ALSO COMPLETE FOR
APARTMENT BUILDINGS OR OTAER MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR
EACA DWELLING UNTT.
WORK DESCRIPTION: CONTRACf PRICE FEFS
1:6 OF CONTRACf FEE
STATE SURCHARGE IS $30 FOR EACH
$1,000 OF PERMIT FE& $
PROCFSSED PIPING • S25.00 a
hurrtMUm FEE . au.oo
OWNER: TOTAL: $
SI1'E ADDRFSS:
TENANT:
, , _ , _ .
SUTI'E
INSTALLER:
ADDRFSS: :
, . . _ . :
, _ . . , . . » . .
CTIl': ZIP: ' . , .
PHONE CTI'Y SIGNATURE:
SIGNATURE:
PERMIT
City of Eagan Permit Type:Building
Permit Number:EA164283
Date Issued:09/24/2020
Permit Category:ePermit
Site Address: 3906 Thames Ave
Lot:4 Block: 2 Addition: Coventry Pass
PID:10-18400-02-040
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.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Building Code).
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 -
Robert Hillegas
3906 Thames Ave
Eagan MN 55123
(651) 492-6704
Premier Roofing By Rusty
243 Mac Street
New Market MN 55054
(612) 202-9723
Applicant/Permitee: Signature Issued By: Signature