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1255 Timbershore LaneDate: City of Eaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 RECEIVED APR 2 1 2011 Use BLUE or BLACK Ink Permit Fee: Date Received: ,`2011 RESIDENTIAL BUILDING PERMIT '`' PLICATIO �-0 R- / r Site Address: F 2 S S 1 'wvr be1-sit otime- Name: / idle RESIDENT / OWNER Name: 1 l b` , Lk5c,Ltrwti.G-.C. Phone: 05 )-- 73Z2 - Address / City/ Zip: 12.S 5 / tt n k„ J2riti) - L tAe, r rel., et..t ., A) .5-.92-3 Applicant is: -Owner VContractor TYPE OF WORK Description of work:Rep JO is+ 1A0, in e'S o) s 4t+. at -r +P>et gQ,J,i', j ina P s � ,t a' .¢p te.rs.., ('u, %fny is r0.4-12.4.-45 -4.1.,.a.4- t btokeeN Construction Cost: P 3 0 0 , 0 03 Multi -Family Building: (Yes / No ) CONTRACTOR Company: z, j -)&A4 .AJC_ Contact:r, r3 i, 2j//iS,I ..I 7 Address: 3'736 7 3 1 Ave City: f l + /AAeoi/s State: mi Zip: 3314°7 Phone: Lei Z-3, a .6 87 2 -.014V -79d1 License #: Lead Certificate #: Does this project require Lead Remediation? E Yes o (see Page 3 for additional information) If no, please explain: In the last 12 months, _Yes _No If Licensed Plumber: Mechanical Contractor: Sewer & Water Contractor: COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING has the City of Eagan issued a permit for a similar plan based on a master plan? yes, date and address of master plan: Phone: Phone: Phone: NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of the information maybe classified as non-publiclf you provide specific reasons that would permit the s i tou - conclude that they are trade secrets. CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.00pherstateonecali.org I hereby acknowl Eagan; that I u accorda X Appli ge that this information i complete and accurate; that the work will be in conformance with the ordinances and codes of the City of tand this is not 3t, but only an application for a permit, and work is not to start without a permit; that the work will be in + . se of work which requires a review and approval of plans. ex. pv iv, ame x Applicant's Signature Page 1 of 3 sk ss — ►mfrs ta DO NOT WRITE BELOW THIS LINE g88(01 SUB TYPES Foundation Single Family Multi 01 of Plex _ Accessory Building WORK TYPES New Addition Alteration Replace Retaining Wall Fireplace Garage Deck Lower Level Interior Improvement Move Building Fire Repair Repair DESCRIPTION Valuation 0 0 Plan Review (25%_ 100% x) Census Code # of Units # of Buildings Type of Construction Porch (3 -Season) _ Porch (4 -Season) _ Porch (Screen/Gazebo/Pergola) Pool Occupancy Code Edition Zoning Stories Square Feet Length Width REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Drain Tile Roof: Ice & Water Final Framing Fireplace: __Rough In Air Test _Final Insulation Meter Size: Reviewed By: 1 Z.. Siding Reroof Windows Egress Window Storm Damage Exterior Alteration (Single Family) Exterior Alteration (Multi) Miscellaneous Demolish Building* _ Demolish Interior _ Demolish Foundation _ Water Damage *Demolition of entire building — give PCA handout to applicant MCES System SAC Units City Water Booster Pump PRV Fire Sprinklers Sheetrock Final / C.O. Required Final / No C.O. Required HVAC Other: Pool: _Footings Air/Gas Tests _Final Siding: _Stucco Lath _Stone Lath Brick Windows Retaining Wall: _ Footings _ Backfill Final Radon Control Erosion Control Building Inspector RESIDENTIAL FEES Base Fee Surcharge Plan Review MCES SAC City SAC Utility Connection Charge S&W Permit & Surcharge Treatment Plant Copies TOTAL 114P ye90 Page 2 of 2 CITY OF EAGAN 3795 Pilot Knob Read Eagan, MH 55122 N! 5763 PHONE: 454-8100 BUILDING PERMIT Receipt # To be 0191941 for Est. Value Date 19 Site Address Erect ? Occupancy Lot Block Sec/Sub. Alter ? Zoning 7( Repair ? Fire Zone Parcel # Enlarge ? Type of Const. De Name ?7P'yr- .. c>ore Move [3 # Stories Address Demolish ? Front ft. City Phone Grade E] Depth ft. Approvals Fees Name _ Address Name _ Address 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. Assessment Water & Sew. Police Fine Eng. Planner Council Bldg. Off. APC Permit Surcharge Plan check SAC Water Conn. Water Meter Road Unit Total Signature of Permittee I A Building Permit is issued to: on the express condition that all work shall be done in accordance with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Building Official Same Ave. So. ?erwM # Deb Irue/ ?en•Mtee Plumbing Mechanical INSPECTIONS DATE INSP. Rough-In Final Footings -$f7 Date Insp. Date Insp. Foundation Plumbing Frame/ins. Mechanical Final ??W j Remorks: i/p r A,- RESIDENTIAL r BUILDING PERMIT APPLICATION CITY OF EAGAN Al ywy 3830 PIL 51 68 -467 R5 -55122 Now CoMWC1iw RwWnmonte . 3 registered site surveys showing sq. ft. of bt sq. ft. of house; and L roofed areas (20% maximum lot coverage allowed) . 2 copies of plan stewing beam d window sizes; poured bind design. etc.) . 1 set of Energy Calculations . 3 copies of Tree Preservation Plan it lot platted alter 7/193 . Rim Joist Detail options selection sheet (bidgs with 3 or less units) 47C,00 RamodWRwair Rwuirwrnb ?`II{ r? ?'b . 2 copies of plan . 1 set of Energy Calculations for heated additions . 1 site survey for exterior additions d decks . Indicate ff horns served by septic system for additions DATE / VALUATION JOB SITE ADDRESS l a S S Tr i4 Z eel Grate { L m IF MULTI-FAMILY BUILDING, HOW MANY UNITS? PROPERTY OWNER a ? r.,s AdA4 t? 9L >?< 4 ?w { Q v /?eu 1?.., GS/- qv? - PYgd TYPE OF WORK Wec-K t-C/4 APPLICANT L/r 9",- ADDRESS vow/ PAGER # CELL FIREPLACE(S) _ 0 _ 1 _ 2 3;t_5,7 v PHONE# 6);Z-4%30;,867 ZIP CODE SS/; Y # S¢ r FAX# 72"IS-2 79,2i? 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 -I New Energy Code Worksheet Submitted Plumbing Contractor: A Phone #: Plumbing System Include Water Softener Lawn Sprinkler Fee: $90.00 Water Heater _ No. of R.I. Baths _ No. of Baths Mechanical Contractor: )( Phone # Mechanical System Includes: _ Air Conditioning Fee: $70.00 _/? Heat Recovery System EQ M Sower/Water Contractor: / A Phone # All above information must be submitted prior to processing of application. I hereby acknowledge that I have read this application, state that the informa ' ' o ct, and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordina Signature of Applicant Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated trot OFFICE USE ONLY ? 01 Foundation ? 02 SF Dwelling ? 03 01 of_ plex ? 04 02-plex ? 05 03-plex ? 06 04-plex ? 07 05-plex ? 13 16-plex ? 08 06-plex ? 16 Fireplace ? 09 07-plex ? 17 Garage ? 10 08-plex ) V 18 Deck ? 11 10-plex ? 19 Lower Level ? 12 12-plex Plbg_Y or_ N ? 20 Pool ? 21 Porch (3-sea.) ? 22 PorchfAddn. (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 (Bldg)' ? 43 Reroof ? 46 Windows/Doors [ 34 Replacement •Demolifion (Entire Bldg only) - Give PCA handout to applicant Valuation 0000? Occupancy R-3 MC/ES System Census Code Zoning P-1) City Water SAC Units ?L Stories Booster Pump Nbr. of Units z_ Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const Width _ Other Pool. _ Ftgs _ Air/Gas Tests _ Final _ Siding _ Stucco _ Stone Windows (new/replacement) Approved By 147 . 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 REQUIRED INSPECTIONS Footings (new bldg) Final/C.O. Footings (deck) Footings (addition) Foundation Drain Tile Roof Ice & Water Final Framing- - Fireplace _ R.I. -Air Test -Final Insulation FinsUNo C.O. _ Ptrrmbing HVAC CITY OF EAGAN Remarks Addison • •RgtMRF T.ANF Lot 4 Blk A Parcel In 715502 040 04 Owner ? ?zt) -v?Street 1255 Timbershore lane State Eagan, MN 55123 Improvement Date Amount Annual Years Payment Receipt Date STR EET SUR F. 1974 321.03 64.20 5 Paid STREET RESTOR. GRADING SAN SEW TRUNK 1971 72.25 3.61 20 Paid # SEWER LATERAL 1973 432.19 28.21 15 Paid SW LATS ST SEW 1974 452.93 90.58 5 Paid WATERMAIN ? WATER LATERAL 973 15 WATER AREA 1979 3.57 20 Paid ¦ STORM SEW TRK 1973 15 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 1z. 00 6966-B6 12-11-72 BUILDING PER. SAC _ _ PARK CITY OF EAGAN Addition TtMFIRRSHORR Ira Lot 3 Rlk 4 Parcel In 716507 030 nn Owner CnYOl Rilbick; Street 1257 Timbersbore Lane State Eagan. MN 55123 Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. 1974'. 321.03 64.20 5 Paid STREET RESTOR. GRADING SAN SEW TRUNK 1971 72.25 3.61 20 Paid SEWER LATERAL 1973 432.19 28.21 15 Paid SW LATS ST SEW 1974 452.93 90.58 5 Paid WATERMAIN • WATER LATERAL 1973 15 WATER AREA 1972 71.46 3.57 20 Paid * STORM SEW TRK 1973 15 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. _J'Zn- on '31 12-11-72 BUILDING PER. SAC 2ka-M rg6r 12 PARK - . 11 72 CITY OF EAGAN Remarks Addition TYMBERSHORE 3rd Lot 2 Blk 4 Parcel 10 76502 020 04 Ownerl.?.2I mo- 1l -?OhIn?nY, 6&Yft' Street 1259 Timbershore Lane State Eagan. MN 55123 fhn.lvs A.: TijahiTo. Y?plFt ?g,, iU `I Lzr.n; i? li,/. Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. 974 321.03 64.20 5' Paid STREET RESTOR. GRADING SAN SEW TRUNK 1971 72.25 3.61 20 Paid • SEWER LATERAL 1973 432.19 28.21 15 Paid SW LATS ST SEW 1974 452.93 90.58 5 Paid WATERMAIN * WATER LATERAL 1973 15 WATER AREA 1972 71.46 3.57 20 Paid t STORM SEW TRK 1973 15 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 110.00 6966 .3 12-11-72 BUILDING PER. SAC 26D.00 t 6966 7 I 12-11 -72 PARK CITY OF EAGAN Addition T!MMERSHORE 3rd Lot 1 Blk 4 Parcel 10 76502 010 04 Owner "o u H 5 / !l n j -I- MA real 1261 Tinlbershore Lane State Eagan, MN 55123 eh Improvement Date Amount Annual Years Payment Receipt Date STREET SURF. 1974 321.03 64.20 5 Paid STREET RESTOR. GRADING SAN SEW TRUNK 1971 72.25 3.61 20 Paid *SEWER LATERAL 1973 432.19. 28.21 15 Paid SW LATS, ST SEW 1974 452.93 90.58 5 Paid WATERMAIN * WATER LATERAL 1973 15 WATER AREA 1972 71.46 3.57 20 Paid * STORM SEW TRK 1973 15 STORM SEW LAT CURB & GUTTER SIDEWALK STREET LIGHT WATER CONN. 13LO.00 6966 7510 12-11-72 BUILDING PER. SAC 2 .00 69667 11 IZ-::l -72 PARK EAGAN TOWNSHIP BUILDING PERMIT N° 2812 Owner .II,a?l.. .. -. ....... 51---Y S^^wQi........... Eagan Township Address (present) .......... Town Hall Builder .......................................................... Dale .................. Address Stories T o Be Used For Front Depth Height Est. Cost Permit Fee - - Remarks w `?..?cd \ 3 o op{?13 or V' % 2.4 Va.50k LOCATION " " a1a-s-l a.or MAOCK noouicn or Graf 3 =? n. r n This permit does not authorise the use of streets, roads, alleys or sidewalks nor does it give the owner or his agent the right to create any situation which is a nuisance or which presents a hazard to the health, safety, convenience and general welfare to anyone in the community. THIS PERMIT MUST BE KEPT ON THE PREMISE WHILE THE WORK IS IN PROGRESS. This is to certify, fhah.. t.Y.?.u ..?4?has permission to erect .. .......... ... ..... ........upon the above described premise subject to tWe provisions of the Building Ordinance for Eagan Township adopted April 11, 1955. .................... -.\ -11 ?........... Per .C?,.511.a..,.P ........................ Chairman of Tnwn Board 0 Building ector l3 CITY OF EAGAN 3795 Pilot Knob Rood Eagan, MN 35122 0 1113 PHONE: 454-8100 BUILDING PERMIT APPLICATION Receipt # To be used for Deck Est. Value 700. OO Date 4/21 19-aQ Site Add ess 1255 Timbershore Lane r E7 Occupancy R3 Timbershore 3rd R3 Lot Block Sec/Sub. Alte Alter ? Zoning 10 76502 o4o o4 Repair ? Fire Zone III _ Parcel # ` Enlarge ? Type of Const. X Name Jaryes W. Moore Move ? # Stories z 1255 Timbershore Lane Address Demolish ? Front 20 ft. o Eagan,MN 1 454-2849 h Gmde ? Depth 6 ft C P one . 0 Name enniS Nesbitt Approvals Fees 8354 Dupont Ave. So. OU Address t ,_. Bloomington,O__ Name same Address 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. Signature of Permittee ame oore A Building Permit is issued to: all work shall be done in accordance with al??,a li;,b Assessment Water 8 Sew. Police Fire Eng. Planner Council BIdg.Off. 4 18 80 APC Permit J.UU Surcharge • 50 Plan check SAC Water Conn. Water Meter Rood Unit Total 5.50 an the express condition that Minnesota Statutes and City of Eagan Ordinances. Building Official CITY OF EAGAN Include 2 sets of plans, 1 site plan w/elevations & BUILDING PERMIT APPLICATION ?Set of energy c lculations. To Be Used For ?0 K• valuation`% ?Tjp` Date 3 0 Site Address ( Z$S ?; M?02YSj?ar? LaF ?. Lot Block _!Q_ Sec./Sub. ,,4r Erect Parcel #: i (D - - So L -0q U - O 9 Alter 1 n Repair Omer: Enlarge Address: City/Zip Phone #: Move ZS `(?i r? 1a2rSkea l a?? Demolish _ Code: ?G Hg (? ; & n? . S'S I z 3 Grade OFFICE USE ONLY Occupancy Zoning X131 Fire Zone Type of Const. # Stories Front azc ft Depth 6 ft APPROVALS FEES Contractor: U!2-k) KD (? £ 7 f Assessments Permit Address: City/Zip Code: 8 S 1 v IJ?Uc3 m i 1v ?&1f+ RRR0j?? -(e -) Water/Sewer ?G 4. Pclice ire Surcharge ?y Plan Check SAC Phone # : - g 8 4 - 8`r? q mac) D Eng. Planner Water Conn. Water Meter rch./Eng• : Arch./Eng.: C J c? w? z ? 1 S R ?JO U ?Cougci0ff Road Unit . Address: APC City/Zip Code: Phone #: TOTAL 0` >s-- VILLAGE OF EAGAN 3795 Pilot Knob xoad Eagan, Xinriesota 55122 PMUIIT N0. 313 The Village of Eagan hereby grants to Seasonal Qontrol Inc. ?)f 7620 IyndalOe .Ave. So., Mpls. 55123 a A/C Permit for: (Owner) R. Waldeland at 1255 Timbershore Lane , pursuant to application dated 2/14/73 Fee Paid: $5,00 dated this 15thday of February, , 19 73 (billed e/c of $.00) Building Inspector Mechanical Permits: Bid Total: VILLAGE OF EAGAN 3795 Pilot Knob ttoad Eagan, Minnesota 55122 ?o G? sU c? D tZd 6 fL T -?b,Prshore 3?// PERMIT NO. 280 The Village of Eagan hereby grants to Thompson Plumbing co. of 12201 Minnetonka H1vd.9 Minnetonka 55343 a PLUMBING Permit for: (Owner) New Horizon Homes 1239-47-43 5, 1247;-49-51-53s at 1255-57-59 1- Timbershore L4ngoursuant to application dated 10/25/?2 Fee Paid: $240.00 dated this 30th day of October 19 72 .00 s o ' - hechanical Permits: riid Total: Building Inspector (1 io 7G5oa o30 °? 'i i?,?ershore ??? VILLAGE OF &AGAN 3795 Pilot Knob Road Eagan, Minnesota 55122 PFIUgIT WO. 280 The Village of Eagan hereby grants to Thompson Plumbing Co. of 12201 Minnetonka Blvd.. Minnetonka 55343 a PLUMBING Permit for: (Owner) New Horizon Hones 1239-4-1-4315, 1247-49-51-539 at 1255-57-59 1 Timbershore Lgngoursuant to application dated 10/25/72 Fee Paid: $240.00 dated this 30th day of October 19 72 .00 s c -- Building Inspector hechanical Permits: bid Total: VILLAGE OF EAGAN 3795 Pilot Knob xoad Eagan, Minnesota 55122 7, ? a X16 0¢ TmbersriorS 3rd// DM MIT NO. 280 The Village of Eagan hereby grants to Thompson Plumbing Co. of 12201 Minnetonka Blvd., Minnetonka 55343 a PLUMBING Permit for: (Owner) New Horizon Homes • 1239-41-43 5,"1247-49-51-53, at 1255-57-59 1" Timbershore Langoursuant to application dated 10/25/12 Fee Paid: $240.00 dated this 30th day of October 19 72 .0o a c -- Building Inspector Mechanical Permits: slid Total: 11 io ??5oa aio u? 7;mb Priori 3r01` VILLAUE Ole hAGAN 3795 Pilot Knob itoad Eagan, Minnesota 55122 `&UIIIT NO. 280 The Village of Eagan hereby grants to Thompson Plumbing co. of 12201 Minnetonka Blvd., Minmetoaa 55343 a PLUMBDO Permit for: (Owner) Now Horizon Homes • 1239-41-43- 5;-1247-49-51-53, at 1255-57-59- 1 'Timbershore L?goursuant to application dated 10125172 Fee Paid: $240.00 dated this 30th day of October 19 72 .00 s c -- Building Inspector mechanical Permits: lid Total: /1: J VILLAGE Or' EAGAN 3795 Pilot Knob Road Eagan, Minnesota 55122 PEM41T N0. 275 The Village of Eagan hereby grants to Geo. Sedgwick Heating & A/C of 1001 Xenia Ave So. Mpls 55416 a HEATING Permit for: (Owner) New Horizon Homes 0255=57-59-61 & at 1963.65.67.62 TlmharaherA n», pursuant to application dated 10/25/72 Fee Paid: 160.00 dated this 7th day of November , 19 72 .00 a/c Building Inspector Mechanical Permits: Bid Total: 7 VILLAGE OF' t;&GAN 3795 Pilot Knob Road, Eagan, Minnesota 55122 _ PERMIT NO. •S rl ??<qE ;,445 . ' '_, .,:... ?. ;.:.: K . A-e The Village of Eagan hereby'grants toGii,'' $?dlrSpltH?abltl=i i/C of 1001 Xenia Ave So. Mille 55416 a HEAPING Permit for: (Owner) Now Horizon Homes 1255=57-59-61 & at 1263-65-67-Ag 'Mmhwrshora rle, pursuant to application dated 10/25/72 Fee Paid: .160.00 dated this 7th day of November 19 72 .00 s c Building Inspector hechanical Permits: did Total: C? 1 Z TILLAGE OF' r:AGAN 3795 Pilot Knob Road Eagan, Minnesota 55122 PERMIT NO.__.''4T5'' :-n The'Village of Eagan hereby grants to Qjp: B SOIe Hfat ng 4 A/ ., of 1001 Xenia Ave So, Mpls 551416 a HEATING Permit for: (Owner) New Horizon Homes 1255-57-59-61 & at 1 b3..G2 5-a-669 `Mmharvhern pursuant to application dated 10125/72 Fee Paid: 160.00 dated this 7th day of November , 19 72 .00 e c Building Inspector Mechanical Permits: raid Total: VA ` VILLAGE OF LLGAN 3795 Pilot Knob ttoad Eagan, Minnesota 55122 I PERMIT NO. 275 , The'Village of Eagan hereby grants to GAO: 8?dQ1rSOk HeIItiii4 ?0 of 1001 Xenia Ave 90, Hpla 55416 a HEATING Permit for: (Owner) New Horizon Homes 1255-57-59L-61. & at 1963-65-67-6 Amharshnre ,j,,, pursuant to application dated 10/25/72 Fee Paid: 160.00 dated this 7th day of November , 19 72 .00 e c Building Inspector Mechanical Permits: i3id Total: 7 This request void 18 months from Al 7650¢ eao i ??qN Date of his Request I, as j?Licensed Elec ' Co ractor ? Owner, do hereby request inspection of the above electri- cal tring installed at: _ Street Address or Route No. Section Which is occupied by Is a roughin inspection Power Supplier Zc- Electrical Contractor- Mailing Address Authorized Sipnature Range : County this job? NOV Yes ? Ready NO.W Will Call ? - Contractor's icense NO. v-, o. Installation) U Phone No.?? Minnesota State Board of Electricity I -4 O -a 1954 University Ave., St. Paul, Minn. Phone 645-7703 REQUEST FOR ELECTRICPECTION CHECK BEL43W WORK COVERED BY THIS REQUEST Type of Building New Ad d. Rep. Check Appliances Wired For Check Equipment Wired For Home ? ? Range ? iTemporary Wiring ? Duplex ? ? Water Heater ? Lighting Fixtures ? Apt. Bldg. ? ? Dryer ? ('Electric Heating ? Commercial Bldg. ? ? ? Furnace y??s Silo Unloader ? Industrial Bldg. ? ? ? Air Coditjpner , Bulk Milk Tank ? Farm ? ? ? List List Other ? ? ? Others Here (Others Here COMPUTE INSPECTION FEE BELOW II Service Entrance Size: # Fee Feeders&Subfeeders: # Fee Circuits: # Fee 0 to 100 Amps. 0 to 30 Amperes 0 to 30 Amperes 101 to 200 Amps. 31 to 100 Amperes 31 to 100 Amperes Above 20a_Amps. Above 100 Amps. Above 100_Amps. Transformers Remote Control Circ. Partial or other fee Signs Special Inspection Minimum fee $5.00 Remarks TOTALFEE I, the Electrical Inspector, hereby certify that the above inspection has been made. (Rough-in) Date (Final) 1 ?? (Jute ;;?7 `? 7 oc? This request void 18 months from e RESIDENTIAL BUILDING PERMIT APPLICATION CITY OF EAGAN I 3830 PILOT KNOB RD, EAGA AGAN MN 55122 651-681.4675 New construction Requirements • 3 registered site surveys showing sq. ft. of lot, sq. ft. of house; and all roofed areas (20% maximum lot coverage allowed) • 2 copies of plan showing beam & window saes, poured found design, etc.) 1 set of Energy Calculations • 3 copies of Tree Preservation Plan if lot platted after 711193 • Rim Joist Detail Options selection sheet (bldgs with 3 or less units) DATE S I D' ox SITE ADDRESS lasjjj-&l , 1-1 TYPE OF WORK 12 i 1 A?A_ APPLICANT STREET ADDRESS TELEPHONE # 95i,t •fill -3Y 00 CELL PHONE # PROPERTY OWNER Water Softener Water Heater No. of Baths ----------------------------------------------------------------------------------------------- COMPLETE THIS SECTION FOR "NEW" RESIDENTIAL BUILDINGS ONLY Energy Code Category _ MINNESOTA RULES 7670 CATEGORY I _ MINNESOTA RULES 7672 (J submission type) • Residential Ventilation Category 1 Worksheet Submitted New Energy Code Worksheet Submitted • Energy Envelope Calculations Submitted Plumbing Contractor: -- Plumbing system includes: Mechanical Contractor: _ Mechanical system includes: Sewer/Water Contractor: Phone # Phone # Fee: $90.00 Fee: $70.00 -------------------------------------------------------------------------------------------------------------------------- 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 Applicant OFFICE USE ONLY TELEPHONE # VALUATION k 18 1 11 . I Phone # Lawn Sprinkler No. of R.I. Baths Air Conclitioning Heat Recovery System d RemodellReoair Requirements • 2 copies of plan • 1 set of Energy Calculations for heated additions • 1 site survey for exterior additions & decks • Indicate If home served by septic system for additions LTI-FAMILY BLDG/ Y N FIREPLACE(S) _ 0 _ 1 _ 2 V STATE M"-'ZIP 9 SI/ FAX #75Z 7qJ-q?2S-0 Certificates of Survey Received _ Tree Preservation Plan Received _ Not Required _ Updated 4102 OFFICE USE ONLY I,.-, ? 01 Foundation ? 07 05-plex ? 13 16-plex ? 20 Pool ? 30 Accessory Bldg ? 02 SF Dwelling ? 08 06-plex ? 16 Fireplace ? 21 Porch (3-sea.) ? 31 EM. Alt - Multi ? 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 ? 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 Bldg only) - Give PCA handout to applicant Valuation Occupancy MC/ES System Census Code Zoning City Water SAC Units Stories Booster Pump Nbr. of Units Sq. Ft. PRV Nbr. of Bldgs Length Fire Sprinklered Type of Const Width REQUIRED INSPECTIONS Footings (new bldg) - Final/C.O. _ Footings (deck) - FinaVNo C.O. Footings (addition) - Plumbing _ Foundation _ HVAC _ Drain Tile Other Roof - Ice & Water _ Final - Pool _ Ftgs _ Air/Gas Tests _ Final Framing - Siding _ Stucco _ Stone Fireplace _ R.I. - Air Test -Final _ Windows (new/replacement) Insulation _ Retaining Wall Approved By 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 Building Inspector MASTER CARD LOCATION /ju A??tAdroO. 01 t- t-- (-'7 - S9- STRUCTURE AND Permit No. Issued Issued To Contractor Owner BUILDING Q'• 7 L PLUMBING CESSPOOL - SEPTIC TANK WELL ELECTRICAL HEATING GAS INSTALLING SANITARY SEWER OTHER OTHER Items Approved (Initial) Date Remarks Distance From Well FOOTING SEPTIC FOUNDATION ? CESSPOOL FRAMING FINAL ELECTRICAL OW 7r/- ? ??- 'L TILE FIELD FT. HEATING DEPTH OF WELL GAS INSTALLATION SEPTIC TANK CESSPOOL DRAINFIELD PLUMBING -??'?Y WELL SANITARY SEWER FA.r ??- Violations Noted on Back COMMENTS. COMPLIANCE INSPECTION REPORTS TO BE USED ONLY IN EVENT OF OBSERVED VIOLATIONS PERMIT NO. CONDITIONS OF CONSTRUCTION AT THIS INSPECTION ? NO EVIDENCE OF NON-COMPLIANCE OBSERVED. 11 ACCEPTABLE SUBSTITUTIONS OR DEVIATIONS. DATE OF INSPECTION ? NON-COMPLIANCE. BUILDER WILL COMPLY WITHOUT DELAY. ITEMIZED AND DESCRIBED NON-COMPLIANCE. BUILDER DOES NOT INTEND TO COMPLY. COMPLETION OF CERTAIN IMPROVEMENTS WILL BE DELAYED BY CONDITIONS BEYOND CONTROL. ? REINSPECTION REQUIRED DATE OF REINSPECTION REINSPECTION REVEALED CERTI FI CATION -I certify that I have carefully inspected the above in which I have no interest present or prospective, and that I have reported herein all significant conditions observed to be at variance with ordinances of the Town of Eagan, approved plans and specifications, and any specific require- ments for off-site improvements relating to the property inspected. ? ALL IMPROVEMENTS ACCEPTABLY COMPLETED BUILDING INSPECTOR DATE %!? 23 I EAGAN TOWNSHIP -? p 3795 Pilot Knob Road -"? St. Paul, Minnesota 55111 Telephone 454-5242 ? f PERMIT FOR SEWER SERVICE CONNECTION DATE: October 30, 1972 NUMBER 1191 1-3 OWNER: New Horizon Homes Address 27a ?-59-61 Timbershore Lane PLUMBERThompson Plumbing Co. TYPE OF PIPEHeavy Cast Iron DESCRIPTION OF BUILDING Industrial Commercial Residential Multiple Dwelling No. of units I I I xx 1 4 townhouses Location of Connections: Connection Charge 960,00 pd 12/11/72 10.00 Permit Fee 2; paid 1o131117;> Street Repairs Total Inspected by: Date Remarks By. Chief Inspector In consideration of the issue and delivery to me of the above permit, I hereby agree to do the proposed work in accordance with the rules and regulations of Eagan Tocroship, Dakota County, Minnesota By Thompson Plumbing Co. Please notify when ready for inspection and connection and before any portion of the work is covered. 4 u° EAGAN TOWNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454-5242 PERMIT FOR WATER SERVICE CONNECTION Date: October 30, 1972 Number 1029 Billing Name: New Horizon Homes Site Address; 255'1257-1259-1261 Timbershore Lan, Owner: same Plumber: Thompson Plumbing Co. 1255 - 22351350 - 368695 1257 - 22351351 - 368696 1259 - 22351352 - 368697 1261 - 22351353 - 368698 Assn- 22351355 - 368699 Meter 12/11/72 Meter No. Permit Fee 10.00 pd 10/30/72 .50 pd J U/ TO/72 s/c Meter Reading Meter Dep. Meter Sealed: Yes_ 1Add'l Chg. 300.00 meters NO Total Chg. Building is a: Residence Multiple roc No. Unit Commercial Industrial Other Inspected by Date Remarks: Billing Address es By: Chief Inspector In consideration of the issue and delivery to me of the above permit, I hereby agree to do the proposed work in accordance with the rules and regulations of Eagan Township, Dakota County, Minnesota. By: Thomason Plumbing nn_ Please notify the above office when ready for inspection and connection. EAGAN TOTINSHIP 3795 Pllot Knob Road St. Paul, Minnesota 55111 Telephone 454-5242 PERMIT FOR SEWER SERVICE CONNECTION DATE: October 30, 1972 OWNER: New Horizon Homes PLUMBERThompson Plumbing Co. i J NUMBER 1191 q.q Address 125559-61 Timbershore Lane TYPE OF PIPEHeavy Cast Iron DESCRIPTION OF BUILDING IndustrialI Commerciall Residential I Multiple Dwelling I No. of units xx I 4 townhouses Location of Connections: Connection Charge 960,00 pd 12/11/72 Permit Fee 59 aid 1 /31/7 Street Repairs Total Inspected by:_ Date Remarks: By Chief Inspector In consideration of the issue and delivery to me of the above permit, I --hereby agree to do the proposed work in accordance with the rules and regulations of Eagan Totmship, Dakota County, Minnesota By Thompson Thompson PlumbingCo. Please notify when ready for inspection and connection and before any portion of the work is covered. EAGAN TOWNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454-5242 PERMIT FOR WATER SERVICE CONNECTION Date: October 30, 1972 Billing Name: New Horizon Homes Owner: same Plumber: Thompson Plumbing Co. Number 1029 Site Address: 1255/f2- 1-1259-1261 Timbershore Lars Billing Address Location of Connection Meter Size Connection Chg. 0,0.00 no 12/11/72 1255 - 22351350 - 368695 Meter No. Permit Fee 10.00 pd 10/30/72 1257 - 22351351 - 368696 Pu 730/72 s/c 1259 - 22351352 - 368697 Meter Reading Meter Dep. 1261 - 22351353 - 368698 Meter Sealed: Yes Add'l Chg. 300.00 meters Assn- 22351355 - 368699 _ NO Total Chg. Inspected by Date Building is a: Remarks: Residence Multiple aoc No. Units 4 pfownhouses ?h?Yi Jri' L 1S1r+ ' „.IETERS. Commercial 11,11,LLEO , ? r Industrial By: Other Chief Inspector In consideration of the issue and delivery to me of the above permit, I hereby agree to do the proposed work in accordance with the rules and regulations of Eagan Toomship, Dakota County, Minnesota. By: Q Thompson Plumbing Cn Plea:;e notify the above office when ready for inspection and connection. f,tl , EAGAN TOWNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454-5242 PERMIT FOR SEWER SERVICE CONNECTION DATE: October 30, 1972 NUMBER 1191 y.?l yy y.. -?1 ; N ) ? 014NER: New Horizon Homes Address 1255=57F59?61 Timbershore Lane PLUMBERThompson Plumbing Co. TYPE OF PIPEHeavy Cast Iron DESCRIPTION OF BUILDING Industrial) Commerciai+ Residential Multiple Dwelling No. of units I I I xx ( h townhouses Location of Connections: Connection Charge 960,00 pd 12/11/72 Permit Fee 10-20, paid 1nl3'I 72 Street Repairs Total Inspected by:_ Date Remarks By. Chief Inspector In consideration of the issue and delivery to me of the above permit, I hereby agree to do the proposed work in accordance with the rules and regulations of Eagan Township, Dakota County, Minnesota By Thompson Plumbing Co. Please notify when ready for inspection and connection and before any portion of the work is covered. EAGAN TOWNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454-5242 4 3 PERMIT FOR WATER SERVICE CONNECTION Date: October 30, 1972 Number 1029 Billing Name: New Horizon Homes Site Address; ? 1255-125742551261 Timbershore Lan Owner: same Billing Addre ss Plumber: Thompson Plumbing Co. Location of Connection Meter Size Connection Chg. (L 0,00 no 12/11/72 1255 - 22351350 - 368695 Meter No. Permit Fee 10.00 pd 10/30/72 1257 - 22351351 - 368696 X0/12 s/c 1259 - 22351352 - 368697 Meter Reading Meter Dep. 1261 - 22351353 - 368698 Meter Sealed: Yes Add'l Chg. 300.00 meters Assn- 22351355 - 368699 _ NO Total Chg. Inspected by Building is a: Remarks: Residence Multiple roc No. Units4 Xownhouses Commercial Industrial By: Other Chief Inspector In consideration of the issue and delivery to me of the above permit, I hereby agree to do the proposed work in accordance with the rules and regulations of Eagan Township, Dakota County, Minnesota. By: .- Thompson P>>mbina Cn Plea:3e notify the above office when ready for inspection and connection. r EAGE;N TOWNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454-5242 PERMIT FOR SEWER SERVICE CONNECTION DATE: October 30, 1972 OWNER: New Horizon Homes PLUMBERThompson Plumbing Co. 1 ? NUMBER 1191 Address 1255-57-5 -61 bershore Lane TYPE OF PIPEHeavy Cast Iron DESCRIPTION OF BUILDING IndustrialI Commercial Residential I Multiple Dwelling I No. of units I I 1 xx 14 townhouses Location of Connections: Connection Charge 960,00 pd 12/11/72 Permit Fee 10:42 maid Street Repairs Total Inspected by:_ Date Remarks: By Chief Inspector In consideration of the issue and delivery to me of the above permit, I hereby agree to do the proposed work in accordance with the rules and regulations of Eagan Tocroship, Dakota County, Minnesota By Thompson Plumbing Co, Please notify when ready for inspection and connection and before any portion of the work is covered. P __ EAGA.N TOWNSHIP 3795 Pilot Knob Road St. Paul, Minnesota 55111 Telephone 454-5242 PERMIT FOR WATER SERVICE CONNECTION Date: October 30, 1972 Number: 102 1 ? X3,2/ Billing Name: New Horizon Homes Site Address: 1255-1257-1259 261 Timbershore Lan( Owner: same Billing Address Plumber: Thompson Plumbing Co, on 1255 - 22351350 - 368695 1257 - 22351351 - 368696 1259 - 22351352 - 368697 1261 - 22351353 - 368698 Assn- 22351355 - 368699 Building is a: residence Multiple xx No. Units Commercial Industrial Other Meter Size 12/11/72 Meter No. Permit Fee 10.00 pd 10/30/72 Meter Reading Meter Dep. pa 10/70/72 s/c Meter Sealed: Yes_ IAdd'l Chg. 300.00 meters Inspected NO Total Chg. Date Remarks: By: Chief Inspector In consideration of the issue and delivery to me of the above permit, I hereby agree to do the proposed work in accordance with the rules and regulations of Eagan Township, Dakota County, Minnesota. By: Thompson Plumbing cn Plea3e notify the above office when ready for inspection and connection. Timbershore Homeowners Association Eagan, MN 55123 City of Eagan Eagan, MN 55123 To whom it may concern: We understand that a signed letter must be submitted to the City from the Association in order to obtain a building permit. We are giving a blanket approval to Noble Building CO. for replacement of privacy walls and other work that may be necessary. If there are any problems or additions questions, please call. Sincerely, Ph # (o??l N7, , \ •-- • / M ?? ? 36173616 \ \? ? `? \\ 21T`4 a 1? 3619 ?...1. ` 3618 ? OF s?EA;GAN i ....................... , ..................:..,..: ? .:::.. , ......,,, . i4 0 t` f ? I 4 N I N I Y N U?L ?3 1 1 • r • I • I I I 1 1 / ? •?' ?G in All N 0a I orb I Jcl r b? 2 // ;1/ I I I ? ?ry / ? ter.` 9 3 *t ?? 41 1245 ' 124' ? 4 ( 1 T? AD, - 1 03 .'( ' I • , -- - FI - - - - x235 __ I x237 r 41 N I :I: 20 1 *3 (1 U_-'?f"1. /^ I '•R• 1233 I 12?{ ?? CITY USE ONLY PERIMIT #: ?6Z095 RECEIPT DATE: -114-01 RESIDENTIAL M£CIIAMCAL PERMIT APPLICATION crrY of Emm 3850 PILOT KNOB RD EAGM MN 55122 651-681-4675 Please complete for: ? single family dwellings townhomes and condos when permits are required for each unit Date: ig _0? SITE ADDRESS: Iar,-5-7 TimYerShyc/ Lh. OWNER NAME: brl an Heil nfZ INSTALLER NAME: Wohlers Southside Htg. & A/C, Inc. 6950 West 146th Street, Suite 106 STREET ADDRESS: -Apple Valley, MN 55124 CITY: Place a check mark next to the permit work tVDe TELEPHONE #: SI 905- 15gq (AREA CODE) TELEPHONE #: 15, q3I_- cl (AREA CO E) ZIP: New residential dwelling unit under constructionand not owner/occupied $ 70.00 Add-on, modification or alteration to existing dwelling unit $ 50.00 • furnace replacement • air exchanger • air conditioner • other Nature of work: 1't°1 to u ,- 14,vIYY prc, ?z C{? L IL State Surcharge $ .50 Total $ S-D Reminder. Call for inspections. &6vt.ti.-Q 12 . 14/lj /&:Q SIGNATURE` OF PER.YIITTEE Updated t/01 CITY USE ONLY PERMIT #: APPROVED BY: INSPECTOR RECEIPT DATE: COMMERCIAL MECHANICAL PERMIT APPLICATION CITY OF EAGAN 3830 PILOT KNOB RD EAGAN, MN 55122 651-681-4675 Please complete for: all commercial/industrial buildings multi-family buildings when separate permits are not required for each dwelling unit DATE: SITE ADDRESS: OWNER NAME: PHONE #: (AREA CODE) TENANT NAME (IMPROVEMENTS ONLY): WAS THERE A PREVIOUS TENANT IN THIS SPACE? Y N. NAME: INSTALLER: ADDRESS: CITY: PHONE #: - (AREA CODE) STATE: ZIP: WORK TYPE: New construction . Install U.G. Tank Interior Improvement Remove U.G. Tank Processed Piping Specify Nature of Work When installing/removing underground tank, call 651-681-4675 for inspection by Fire Marshal and Plumbing Iinspector. Fees: 1% of contract price OR $50.00 minimum fee, whichever is greater. Underground tank removaUinstallation = minimum fee Contract price: $ x 1% (Base Fee) State surcharge calculate at $.50 for each $1,000 Base Fee TOTAL $ SIGNATURE OF PERMITTEE Updated 1/01 #b"dtVoFaagan May 18, 2001 PtVrRICIA E AWADA Mayor PAUL BAKKEN MR. SOU-HSIUNG CHID 1261 TIMBERHORE LANE PECCYCARLSON EAGANMN 55123 CYNDEE FIELDS MECTILLE.Y RE: DECK FAILURE NOTICE Council Members Dear Mr. Chiu: THOMAS HEDGES At the request of the Timbershore Homeowners Association, the City of Eagan 's City Admimstntor Protective Inspections Division inspected your deck for safety. Our findings are as follows: • Joists are rotted Municipal Center. • Beams and supports are failing 3,930 Pilot Knob Road For safety reasons, the City is requesting that you block off and discontinue use of your Fagan, ININ 55122-1897 deck immediately until it is repaired, replaced, or removed. For your convenience, we Phone: 651,681.4600 are enclosing an informational handout on deck construction, as well as a current building Fax: 651.681.4612 permit application. I DD 651.454 8535 Please contact me at 681-4679 within 10 days of this letter so we can discuss your plans to ensure safety at your residence. Your cooperation is greatly appreciated. Maintenance Facility: 3501 Coachman Point Sincerely, Eagan, MN 55122 Phone: 651.681.4300 Terry Zelenka Fax. 65L681.4360 Building Inspector 'I DD: 651.454.8535 TZ/jb w .cityofeagan.com Encl. cc: Dale Schoeppner, Chief Building Official THE LONE OAKTREE The symbol of strength and growth in our community 0 ì ý ú þýüýû ÿþþ ýüûùïûúù øýýþþùúüü þ÷ö ÿ ÿþõ úù ø÷ öó é á ùø÷ öø÷ öó é ô óéï ÷ý õù á ù íù÷ýø Üü úÞùý ì ÷â Þù ý æðý üóó÷ ü ûýððýü þ ÷ æáýððý ÷ ýð ýýæ áý ä ý Þù øýó ü ðýø æ ý çååæ åæå ôø úù ýü ý çæ ãæã Ûýùýûæ óò õñð ÷÷ý á óò ú ùý ò ý ýâ ý ò ý÷ þýüýòô ëèå øýó ü ý ýâ ý ý÷÷ýý ý ý ðý ýýü ÷øó ýý÷÷ý úý ðò ýúýù ýáøðþýüýíý æ ÷÷ýé úüýù ù øúüýù þýüýû ÿÿ þýýü ûþþÿÿü ÿúù ÿ ÿø úùø÷ öý õ ý ö ø÷ ô ó ÷öý õ ý ò úñ ò ø÷ òýùðýù ú ýôù ï ôù úñ î òíù ÿ úô ò ý÷ûòô ì é èöúçæ öõåäêìêì ÷û úù äêâê â ëýùýû ê öõ øôó ÷÷ý Þýé ýùüò ú ùý ô úê ý ò ý÷òôþýüýòô è å ìÝ øýó ü ý ýá ý ý÷÷ýýý ý ð ý ýýü ÷øó ýý÷÷ý úý ðò ýúýù ýàøðþýüýß ý ê ÷÷ýæ úüýù ù øúüýù Use BLUE or BLACK Ink I 14111~ I For Office Use ' ~l9 l U City of Eap ; Permit I I 3830 Pilot Knob Road i Permit Fee: ; Eagan MN 55122 I 1 Phone: (651) 675-5675 Date Received: i I Fax: (651) 675-5694 Staff: L-----------------~ 2013 MECHANICAL PERMIT APPLICATION ❑ Please submit two (2) sets of plans with all commercial applications. Date: ~`oC r Site Address: f t~ L % ` t ,t'f J b( t/t' Tenant: Suite r Name: a Phone: Resident/Owner Address l City / Zip: a!_Q?f / Name: K (fu, f E'Y4,' eC Ce License ,I Contractor Address: Y[ S )Q6Pk07 'J~1 -City:UJCV _ f State: zy /f// Zip: V _ Phone: 0o) Contact l- mail: l~~j C l CiC'PJ~'HCca, Y e,7 New replacement Additional Alteration Demolition Type of Work Description of work: ~r ace PE'-ot 6cC-'i4e F)e %'P? ~ . m. a _ - NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City r, Code. Please contact the Mechanical Inspector for information on permitted screening methods. r I RESIDENTIAL COMMERCIAL ir'Fur ce New Construction _ Interior Improvement Permit --Ai Conditioner Install Piping Processed Type _ 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 $5.00 State Surcharge) $100.00 Residential New (includes $5.00 State Surcharge) = $ TOTAL FEE COMMERCIAL FEES Contract Value $ X.01 $55.00 Permit Fee Minimum $70.00 Underground tank installation/removal Permit Fee "If contract value is LESS than $10,010, Surcharge = $5.00 Surcharge" ""If contract value is GREATER than $10,010, Surcharge = Contract Value x $0.0005 ""`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 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 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