4219 Wexford Way
~ y rwW~
C~?`e~t~ 'cate cccupanc
4
This Certificatt issred pwsuant to the requinments of the Uniform Building Code
certifying that art the tine of issrraACC titis structwc was in compliance with the varioWs
v
ordenoreces of rhe City regulating building conrtnection or use. For the foIlawrng:
ux c3asircadw SF m sldg. aat i Na 1583
O-PHY-7 Type Il~ AVE
o~voa o( &uilding ~ , MIUM
I
. ~ Bwi~ Aadvs L-dity LA, isi, KWUM
Do= 01/21/93
. DUUMOMcial .
POST IN A OONSPICUOUS PLACE
INSPECTIQN RECaRD C"Rtr°'
I ~ GITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Rosd Permrt IVumber: Eagan, Minnesota 55123 Dete Issued:
(612) 681-4675 •
SITE ADDRESS. APPLICANT:
4.11 kf ul r fOft n sinr uAlli t 91401 HER$ rNc
Wr-xf(,?,11 ~?,t.~y nnH-~~~s.
PERT ~S'U,BTYPE: TYPE OF W4RK: New i ;
~
t t1(1t IM6 FlIAMIMd
rp~ut.A rt9k frN~??.
7
i'3N#'wl.Al`F
I
I
I
t RPPOAR~'v : ~~fV W CQNTftAC i'OP - 31Att PLDS
f s
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Address 4219 weXFO?tD waY Zip 55122
L,of Blk i Sub wm-oitn
THESE ITEMS WERE / WERE NOT COMPLETE AT THE TIME OF THE FINAL INSPECfION.
Date: 01 27 y3 Yes No Inspedor. ~
Final grade (6" from siding) ~
Permanent steps (garage) ~
Permanenl steps (main entry) 1/11~
Permanent driveway ~
Permanent gas ~
Sod/Seeded grass
TraiUcurb damage ~
Porch ~
Basement finish ~
Deck
Please verify with the builder Ihe 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.
Contad enginccring division at 6814645 before working in right-of-way or installing underground sprinkler system.
Whire - City Copy Yellow - Resident Copy Pink - Contracror Copy ~
~
Fepuesl Oate f~~e Roughm Inspeclion
Raa~~~ad, ? Reatly Now I WAI Notity Inspector
, es C No When Ready?
IX Iwensed contractor E3 owner hereby request inspechon of above electncal work at
Jab Atl ress (SVeet Bo+ or Roure No ) Giry
~'a\Q Qek C a.n
Seciron N. Township Name or No Range No Counry
k~<<
OccupantlPRINT7 Phone No
\.~Q.. a . 6g(~6
Powe: Suppher Mtlress
Elecincal Conva<to,ICOmoany Name) CoMracior's l.sense No
CAo~al
MaJing Adoiess (COnVac;or or Owner Making Installalronl
)S~S " n o k ls~r,. na~~~. ~ ~ o Mn~ rl
Au;horr etl SignaWre ICOnlractorQwner Moemg Installa4on, Ppone Number
MINNESOTA STATE BOAPD OF ELECTRI TY THIS INSPECTION REOUEST WILL NOT
Gtlgga-MlOway BICg. - Poom S473 BE FCCEPTED BY THE STATE BOARO
1021 University Ave.. SL Paul, MN S5104 UNLESS PROPER INSPECTION FEE IS
Vhone(6t2) 642-0800 ENCLOSED,
~ ntQUEST FOR ELECTRICAL INSPECTION
~^99? See mstmcuons mr completmg tms lorm on oack ol yeilow caoY
v
IN S "X" Below Work Covered by This Request "if;
i -
ew Add liep.y TypeofBwitlmq ApphancesWired EquipmentWued
Home Range Temporary Service
Duplex Water Heater Electric Heahng
Apt Buildmg Dryer Other (Specity)
Comm./lntlusirial Furnace
Farm Air Conditi0ner
Omer (specity) Convncror5 RemarXS ~/7 6
Compute Mspection Fee Below: W «e „U~1SQ- f
q Other Pee k Service Entrance Size Fee # QrcuitsiFeetlers Fee hollika Swimming Pool 0 to 200 Amps .00 0 to 100 Amp _ ,
Transformers Above 200 _ Amps Above 100 _ Amps
SIgnS Inspactor5 Use Only TOTAL
Irri9ation Booms
Special Inspection
Alarm/Communicauon THIS INSTALIATION MAY BE ORDERED DISCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 S.
I, the Electncal Inspector, hereby Rouqmin
cerhfy thal Ihe above inspeC[ion has F,nai r Dale ~
been made.
OFFICE USE ONLV ~ ~ j'This reQUesl voiE 18 monlhs Irom
INSPECTION RECORD I C°nt 1157
CITY OF EAGAN PERMIT TYPE: a u z LoIN c
3830 Pilot Knob Road Permit Number: 001583
Eagan, Minnesota 55123 Date Issued: 10 / 0 7 J 9 2
(612) 681-4675
SITE ADDRESS: LoT : a B L OC K: g APPLICANT:
4219 WEXFORD WAY UAHLE BROTHERS INC
WEXFORD (612) 888-6866
PERMIT SUBTYPE: TYPE OF WORK:
SF DWG NEW
INSPECTION . .A
FOOTING FRAMING
INSULATION FINAL
FIREPLACE
REMRRKS: PRV S& W CONTRACTOR - STAR PLBG
. . _ _ -
L
CITY•OF EAGAN PERMIT C°" ° 1157
~
3830 Pilot Knob Road PERMIT TYPE: B U I L D I N G
Eagan, Minnesota 55123 Permit Number: 001583
(612) 681-4675 Date Issued: 10 / 0 7/ 9 2
SITE ADDRESS:
4219 WEXFORD WAY
LOT: 4 BLOCK: 1
WEXFORD
DESCRIPTION:
Building Permit Type SF DWG
~ 9uilding Work Type NEW
U8C Occupanay R-3 M-1
~ ConstrucCion Type V-N
Zoning PD R-1
Building Length , 72
Building Width ~ 38
,
. i
~
, , . ~ . . . . . .
REMARKS: C q I
PRV S S W CONTRACTOR - STAR PLBG
FEE SUMMARY:
VALUATION $141,000
Base Fee $783.00 MISCELLANEOUS $1,610.50
Plan Review $508.95 Total Fee $3,672.95
Surcharge $70.50
SAC $700.00
SAC % 100
SAC Units 1
Subtotal $2,062.45
CONTRACTOR: - npplicant - sT. LI'OWNER:
DAHLE BROTHERS INC 18886866 000164 DAHLE BROS INC
9304 LYNDALE AVE S 9304 LYNDALE AVE S
BLOOMINGTON MN 55420 BLOOMZNGTON MN 55420
(612) 888-6866 (612)888-6866
I hereby acknowledge that I have read this application and state th'at the
infio tion is correct and agree to comply with all applicable StaC'e of Mn.
Statu an C ot Eagan Ordinances.
L
~ ~nz~n R c~r(171i3f
APPLICA T/P MITEE SIGNATURE rSSUED B4 SI NATUR15
-
PERMIT N CITY OF EAGAN vlrj~ I 1,'#r/
REAC71va7E 1992 BUILDING PERMIT APPLICATION
~
513 681-4675 jPjd !!0- q
' 4CT D ~ R~CD
I
SINGLE 8 MULTI-FAMILY 2 sets of plans, 3 registered site surveys, 1 copy of energy
calcs.
I;
COMMERCIAL 2 sets of architectural & structural plans, 1 set of
specifications, 1 copy of energy calcs. I
Penalty applies when typing of permit is requested, but not picked up by last workingiday
of month in which re uest is made ar lot chan e is re uested once ermit is issued.
Date Valuation of work
Site Address: ~ ~G y.
STREET SUITE N I
Tenant Name: (commercial only) II:
IAT ~ BIACK ~ SUBD. P.I.D. M
Descri tion of work: I!
The applicant is: O Owner [d Contractor ? Other (oe8orree)
Name T ~~,~f ~p'j l' C Phone
Property LAST FIRST ,
Owner Address ?-364 .rAL.e. 1/e~, jQ
SiREET STE N ICityi ~~}~11.t~~,D~. State ~JIM Zip
i
Company Phone 806 1C,"
v
Contractor Address ~ L~L..f>&License #0~014W7 Exp. ~
City State Zip
Company Phone
Architect/ Engtneer Name Registration #
Address
City SNM:W(6-z~oxl State AA z;
P~
Sewer 8 water licensed plumber '.!S~k ~ Processing time for
sewer & water permits is two days once area has been approved.
I_
1 hereby acknowledge that I have-rea 'this application and state that the informationliis
correct and agree to comply ialyvappli-able le~ te of Minnesota Statutes and City If
Eagan Ordinances.
Signature of Applicant: 14 i
I
OFFICE USE ONLY
BUILDING PERMIT TYPE
O 01 foundation 0 06 Duplex O 11 Apt./Lodging '15 It BVtAt Finish
202 SF Dwg. ? 07 4-Plex O 12.Multi. Misc. ? 17 Swim Pool
D 03 SF Addition ? 08 8-Plex ? 13 Garage(Accessory ? 18 Comm./Ind.
? 04 SF Porch ? 09 12-Plex ? 14 Fireplace ? 19 Comm./Ind. Misc.
? 05 SF Misc. D 10 Multi. Add'1. ? 15 Deck ? 20 Public Facility
? 21 Miscellaneous
WORK TYPE
,9[ 31 New O 33 Alterations O 35 Tenant Finish ? 37 Demolish
? 32 Addition ? 34 Repair ? 36 Move
GENERAL INFORMATION
Const. (Actual) V- N Basement sq. ft. MWCC System A S
(Allowable) lst F1. sq. ft. City Water
UBC Occupancy 2nd F1. sq. ft. PRY Required yES
Zoning r R-; Sq. Ft. total Booster Pump
N of Stories Footprint Sq. ft. Fire Sprinkler
Length ~T On-site well Census Code ~
Depth ~A On-site sewage SAC Code ~
p,PPROVALS
Planning Building Assessments
Engineering Variance
REQUIRED INSPECTIONS
O Site ? Footing O Framing ? Insulation
O Mallboard ? Final O Oraintile ? Fireplace
Permit fee vaimt;d,: S 14 1, 00 0
Surcharge
Plan Review ~A 9AGE; -'4 K 34= eI C~ P°~ uN~in~~'~)
License
MWCC SAC 2- X 12 =(4FI 2X12= 14 *33 =
c;r,y sAC 4~ Xto= ~yo~ S'~yo
Nater Conn.
Nater Meter
Acct. Deposit 1203~
5/W Permit ;~S)c 38 m 95o c:, ,
S/W Surcharge Z ZY 3108 1"r,Eo
Treatment Pl. ~z ~a ~
Road Unit H X!0 ~ yo
Park Ded. -J x iy _ qg 1 X 4 ~
Trails Ded. 10
% ~
~
Copies I3clfe 715~CX 53
Oer Total: YYIA?N _L~ A/?~l~
y16o5. ~
Bs~~T _ 139 i. 14 < /SC,~. ,
SAC Units a~1o° a t~t71
~ X r~ - I 2 b~ S. 519
_ ri6 il, So
r-t r I u~3 Ha,~a ~
, CERTIFICATE OF SURVEY
M~p+ ~ 8713 DUPONT~AVENUE SOUTH
.k.py ^K BLOOMINGTON, MINN. 65420
f ' 888-]084
>
V
LAN
D SURVEYORS
Survey for:
DAHLE BROS., INC.
1,.a?1
~
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.o
0
.
~
Scale: 1"=30'
l~f al~~ ~ _ \5 N~~
\ p?~
13. DESCRIPTION: \ y53'
~Z~ ~ • ~l Z`~ ~ioP3 ~93~6
lot 4, Blbck 1,
WEXFORD N
()3D
JrVA// '•~j,~~~ ~ c~ 9 ~ 93 ,
_ ~ 9 : " ~ ~ W n ~a 2~ / ~ ' ~~,n?~
J~
p5~r
• ~j
Propos es: /G~ ~\j0' 93' 9~~
rop of .JQ~1oA%N ERING DEp7
Garage floor 933s o L~~5
Basement floor gZ6-0
932 0~ ~ ,
po.-~~?Mo'G~[~`~.;SU~'UUL._,\
NOTE:. Circlgd elevations are proposed, others are
existing.
Arrows denote direction of drainage.
We hereby certify that this is a true and correct representation of a survey of the
boundar•fes of, the land above described and of the location of all buildings, if any,
thereon and all visible encroachments, if.any, from or on said land.
Dated this,29th day of September ,19 92.
bY
innes a icense o. 018 ,
ZS/-¢7
' EX•TERI4R ENVELOPE AJERAGE "U" LOMPUjATION, P'wf iC'1:
SJTE ADnRESS: y
CONTRACTOR: DATE: -~-~Z PHONE:
DETERMINE 410RKINf SO,UARE FOOTAGE OF EACH:
1. TOTAL EXPOSEO L/ALL AREA, , , , . . . , 3~~ kDE> sq f t x "U" .11 2. TOTAL ROOF/CEILINC AREA,,,,.... sq ft x"U" .026
3• TOTAL EXPOSED 1JALL ARE.4 CALCULATIONS:
Total exposed wall
area above floor,,..,,, 2725 sq ft
-
a) 'ioial wal! .ri.^.dow _rea: tt)
4lazed...... sQ ft x ~~U" .4
qlazed...... sq ft x "U"
~..-.~b) Total door area sq ft x"U" ~,21 =-7,43
c) Total sllding qlass door area:
%RENU~t q I a ze d . . . . . . s q f t x "U" - .40 4lazed....., sq ft x"U" e
d) Total ftreplace wall area - sq ft x"U"
e) Total wall framing area
(Averaae 10').....,.... 2~~D sq ft x"U" _ o Qq l 24.00
f) Total net wall area above
floor (Insulated)....... 52,~ sq ft x"U" - ,6~3 = D 5~0
g) Total rim toict area......_ 7qS/05 sy Pt x'U" _oQ = Q-7
Total foundation n
area (Exposed).......... Zy~p sq f[
h) Total founda[lon •
wtndow area............. I sq ft x"U"
I) Total net foundation /
area above qrade........ _ 29VJ sq f[ x"U"
3' TOTAL a) thru i)
IF Item x3 Is the same as, or less than i[em P1, you have met the intent of
2 MCAR 1.16008 p and 0.
Page 1
4. 'TOTAL EXPqSED ROOF/CEILINf CALCUlAT10t15: '
Total exposed
roof/ce111nA area........ sq ft
J) Total Skyllaht area....... sq ft x"U"
k) Tatal roof/ceilinq framing
area (Averaae In9,)...... 71,30 sq ft x"U" > O Z~ ~ SZ,
1) Total net Insulated ,
roof/ce(1'tnq area....... sq f[ x "U"
4. , TOTAL j) thru 1)
If total of 94 fs the same as, or less than N2, you have met the inten[ of
2 MCAR 1.16008 A and 0.
ALTERHATE BUILDItIG ENVELOPE DESIf,r1
To ut111ze the total envelope sys[em me[hod, the values established by the sum
of icems d3 and M4 shall not be 9rea[er than the sum of items Xl and 02.
35q, 33 + 2. A-3, 50
.
3. 1. 41 + 4. 71o~
eE R s+s;crT!oN
1 hereby eertify cha[ I have calculated Che "U" factors and "R"
values hereTn and that the hufldinq here descrj~lfl meets or excee the Sta[e
of Mfnnesota Eneray Lonservation Act.
nature ~
CAV/s k ,
TPrint name
(Oate)
Pi-e 2
. • CQtISTRUCTION, R VALUE
WALL FRAHING SECTION:
I Intertor afr fllm 0.68
Z 1~'L1Y'P JD ~
A 37-_ Inc es so t wood a
4 ._•~13'%" ~.1-4E~IyI1~fC~. 2. Ur~
• 6 Exlor a r m ~1171f~Ca 0.: 7
TOTAL R - J "I'
~~LL~
U~ 1/R- C~91
NALL SECTION (INSULATEO)
1 Interlor alr fllm 0.68
i'A7
'3
~ G "5'r +s` - tl,.l(
F Exterlor air film 0,17
TOTAL R ~ O
u - i/a
RIM J015T SECTION:
1 Interlor afr fllm p,(,$
z=`. ir~ ~'I•:"rr I I~};~_i,~ ~~r ~
4 ,i:_hlT• I.
~
5 ;k(t1~S=Y,ili i
_ h E[erlor air film p,~~
TOTAL R
FOUNDATION INSULATIOP! REQUIRED:
Min. R-5 on entire wall OR U~ 1/R
Q,a•;•,o• Min. R-10 down to frost depth
~
D - FOUNDAT I ON SEtT I ON :
1 Interior alr film 0.68
~'A 2
' 6- 3 17Ccti.IC
L Exterior afr film 0,17
-°•I ~ '•a.• G L (S
,~Q.~;,4'i~~,I~.:/. TOTAL R
U- 1/R
SLAR ON GRADE
4' '•,pi :'4.~. 4'.,a•Q,I
, . :a ~ ~ , . ~ c~ i' . ~ ; ~ • • f
• .o •a-•,41• , A ~ ~ ~ • V ~ °•..d
'u a'•• a ' d• . , . •.•j
u .4;.
' a 4
4 . . ' . . .
Heated Slabs:
~.'a, Minimum R = 85 'q~ Q.,d~ ~
Unheated Slabs: , 4?~ ,~v.d ; • J~ ~
Minimum R = 6.2 • 4; ,
El7Page 3
~ .
a
, . . CONSTRUCTION R VALUC
CEILINf. SECTION (INSULATED): ~
I Interfor alr fflm 0.61
E~ AIR 2 ~ `p
cavxE 3 12- v
3 4 4 Exterlor alr fllm still) 0.61
TOTAL R -
U- 1/R-
' ,Z ~ CEILING FRAMINf SECTION:
F \
1 Interlor air fllm 0.61
2 5, u , . ) -
AIR VENTED 3 , . T 2:.;.,~
FLOW 4 Interior ai r i 1m sti I 1 0.61
5 7 Inches Soft woo
T07AL R - ~
u - i/R -
CEILING SEf,TION (INSULATED):
1 ' I n te r i o r a i r f i 1 m 0. 61
2
4 Fxterior air film still 0. 1
G 3
TOTAL R =
~ - -
' ~ U 1/R =
i' -
~ 2 3 4 5 CEILINf; fRAHl~If; SELTION:
1 Interior air film 0.61
VENTED Z
3
~£xter[e- air ilm s[ill 0.61
5 Inches soft wood
TOTAL R =
U ° IIR =
3 4 5
1 Inslde air film 0•61
- 3 .
~ 4
5 Outside air film 0.17
TOTAL R s _
u = I/R -
Page 4
WINDOWS
1420 x 1.75 sq ft =
1426 x 2.33 sq ft =
1432 x 2.92 sq ft =
1438 x 3.50 sq ft =
111444 2 x 4.08 sq ft = 8 l
1450 X 4.67 sq ft =
1456 x 5.25 sq ft =
1462 x 5.83 sq ft =
1468 x 6.47 sq ft =
1474 x 7.00 sq ft =
2020 x 2.50 sq ft =
2026 x 3.33 sq ft =
2032 I x 4.17 sq ft
II2038 x 5.00 sq ft =
2044 x 5.83 sq ft =
1112050 x 6.67 sq ft
2056 x 7.50 sq ft =
11112062 ~ x 8.33 sq ft =
2068 x 9.17 sq ft =
2074 x 10.00 sq ft =
2420 x 3.00 sq ft =
2426 x 4.00 sq ft =
2432 x 5.00 sq ft =
2438 ~O x 6.00 sq ft =
2444 x 7.00 sq ft =
1/1I2450 x 8.00 sq ft = 00
2456 x 9.00 sq ft =
I'(W 2462 ~ x 10.00 sq ft =(.~D,bO
2468 x 11.00 sq ft =
2474 x 12.00 sq ft =
2620 x 3.25 sq ft =
2626 x 4.33 sq ft =
2632 x 5.42 sq ft =
2638 X 6.50 sq ft =
12644 x 7.58 sq ft = -7. j50
2650 x 5.67 sq ft =
2656 x 9.75 sq ft =
2662 x 10.83 sq ft =
2668 x 11.92 sq ft =
2674 x 13.00 sq ft =
3232 x 6.67 sq ft
3238 x 8.00 sq ft =
3244 x 8.75 sq ft =
iz" sidelite Z- X 6.67 Sq ft =
14" sidelite x 7.78 sq ft =
24" x 24" Octagon x 4.00 sq ft =
24" x 36" Elongated Octagon _ x 6.00 sq ft =
TOTAL
DOORS
2-6 x 6-8 Steel Door x 16.67 sq ft =
~2-8 x 6-8 Steel Door T-x 17.78 sq ft = 1715
I3-0 x 6-8 Steel Door ~ x 20.00 sq ft = 20.Gp
TOTAL
PATIO DOORS
5-0 x 6-8 Sliding x 33.34 sq ft =
116-0 x 6-8 Sliding ~ x 40.00 sq ft
8-0 x 6-8 Sliding x 53,34 sq ft =
9-0 x 6-8 Sliding x 60.00 sq ft =
5-0 x 6-8 Atrium x 33.34 sq ft =
3-0 x 6-8 Atrium x 20.00 sq ft =
6-0 x 6-8 Atrium x 40.00 sq ft =
8-0 x 6-8 Atrium x 53.34 sq ft =
TOTAL = ~O. OU
. . •4'. .
I~ x 150~
Z-7
~
L_, BL CITY OF EAGAN CITY USE ONLY II
/ YLUMBING PERMIT
SUBD. ~ (612) 681-4675 RECEIPT ~ a118d~o
DATE I'3
RESIDENTIAL
PLEASE COMPLETE UPPER PORTION ONLY FOR SINGLE FAMILY DWELLINGS. ALSO, FOR TOWNHOMES AND CONDOS
WHEN PERMITS ARE REQUIRED FOR EACH UNIT. Ii
WORK DESCRIPTION COMPLETE THE FOLIAWING:
N0. FIXTURES EA. TOTAL
NEW CONST ~ REPAIR/ADD ON 15.00
ADD ON SHOWER 3.00
REPAIR _ L WATER CIASET 3.00
BATH TUB 3.00 .3 O O
IAVATORY 3.00 G, ~
OWNER NAME: 47 KITCHEN SINK 3.00
IAUNDRY TRAY 3.00 00
SITE ADDRESS: Y219 I/IlP,V ~O?G9 Wu c/ HOT TUB/SPA 3.00
~ WATER HEATER 3.00 ~
FIAOR DRAIN 3.00
~ GAS PIPiriG uliT. 11
INSTALLER: /`flC°7/7I iP P/ A6_ (MINIMUM - 1) 3.00 Oc7
ROUGH OPENINGS 1.50
ADDRESS : OTHER
_ WATER SOFTENER S.100
CITY:_ GC//ildts ZIP: ~J~ PRIVATE DISP. 15.00
U.G. SPRINKLER 3.00
PHONE
_ W. TURNAROUND 15.100
STATE SURCHARGE .50
SIGNATURE OF PERMITTEE TOTAL: S II 3~~~0
COMMERCIAL II
PLEASE COMPLETE THIS PORTION FOR ALL COMMERCIAL/INDUSTRIAL BUILDINGS. ALSO FOR MULTI-FAMILY
BUILDINGS WHEN SEPARATE PERMITS ARE NOT REQUIRED FOR EACH DWELLING UNIT.
AORK DESCRIPTION: II
OWNER NAME: II
CONTRACT PRICE: r
SITE ADDRESS: 1% OF CONTRACT FEE.
STATE SURCHARGE - $.50 FOR II
TENANT NAME: EACH $1,000 OF PERMIT FEE.
SUITE $25.00 MINIMUM FEE. ,
INSTALLER: CONTRACT PRICE x 1% $ li
ADDRESS: STATE SURCHARGE $ Ii
CITY: ZIP:
TOTAL: $ il
PHONE
FOR: (SIGNATURE)
CITY OF EAGAN I~
i
II
CITY OF EAGAN
L ~ B / MECHANICAL PIItMIT REcEnyr#
SUBD. ~ (612) 681-4675 DATE 1~~ 'L q
- RESIDENI7AL - -
PLEASE COMPLEI'E UPPER PORTION ONLY FOR SINGLE FAhfII.Y DWELLINGS. ALSO, COMPLEI'E FOR
TOR'NHOMFS/CONDOS WHEN SEPARATE PERMTI'S ARE REQUIRID FOR FACH DR'ELLING UNIT.
OR'NER: FEFS
STfE ADDRFSS: ADD ON/REMODEL (EXISTIIVG $ 15.00
CONSTRUC!'ION ONLI)
INSTALLF.R: AVAG 0.100 M BTU 24.00
PHONE ak: ADDITTONAL 50 M BTU 6.00
nnnREss: cns ovTIEfs - hmvn?iuM i Cd $3 Fa. 3.4ZD i~)
CI1'Y: ZIP: SURCHARGE $ ' m
SIGNNTUR~ Q t ,~yA ~ TOTAL: S.S
COMMERCIAL
PLEASE COMPLE!'E THIS PORTION FOR ALL COMMERCIAI/INDUSTRW, BUILDINGS. ALSO COMPLEI'E FOR
APARTMENT BUII.DINGS OR OTHER MULTI-FAMILY BUILDINGS WHEN SEPARATE PERMTTS ARE NOT REQUIRED FOR
EACH DWELLING UNI7'.
WORK DFSCRIPTION: CONTRACT PRICE FEFS
196 OF CONTRACf FEE.
STATE SURCIL?RCE IS $.SO FOR FACH
$1,000 OF PERMIT FEE $
PROCFSSED PIPING - $25•00
a
MINIMUM FEE - $25.00
OWNER: TOTAL: $
STfE ADDRFSS:
1'ENANT:
SUITE (
INSTALLER:
~ t
ADDRESS:
CI1'P: ZIP:
PHONE CI1'Y SIGNATURE:
SIGNATURE:
!
2004 RESIDENTIAL BUILDI'iVG PERNIIT APPLICATION
City OfEagan ~
o~ 3830 Pilot Knob Road, Eagan MN 55122 ~
Telephoue # 651-675-5675 FAX # 651-675-5694
New ConstNdion Reouirements RemodellReoair Renuirements 'Oifice Use On
3 registered site surveys showing sq. (L of lot sq. ft of house; and all roofed areas 2 copies of plan Ge[t of Survey Recd ' _=Y =a
(20%mauimum lot wverage allaued) 1 set of Energy Calculations for heated additions Tree Pres P~n Recd~~ Y _ ty
2 copies of plan shaving beam 8 window sizes; poured found design, etc. 1 site survey for addPoons & deGrs ITree Pres Requ'ued' Y_ N
7setofEnergyCalcula6ons AddRion - indicafei(on-sdesepficsysfem 0-slteSepficSvstem,__Y
3 copies of Tree Preservation Plan'rf lot platled after 7/1193
Rim Joist Dehail OpGOns seleciion shcel (bldgs wrfh 3 or less units
Date o1 0? 4 ConstructionCast 3 l, 3S'
Site Address - UniUSte #
Description of Work AR4 QX A1 f D
Multi-FamilyBldg _ Y _ nT Fireplace(s) _ 0 _ 1 _ 2
Property Owner ~`l ~0\ Telephone # ((pS (OS I
Q3
PELLA WINDOWS & DOORS
Contractor 15300-25TH AVE. N. STE. #100
Address PLYMOUTH, MN 5447 _ City
State 763-745-1400
LICENSE #20165884 phone # ( )
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
Energy Code Category - Minnesota Rules 7670 Categorv 1 _ Minnesota Rules 7672
(Jsubmission type) • Residential Ventilation Category 1 Worksheet . New Energy Code Worksheet
Submitted Submitted
• Energy Envelope Calculations Submitted
Have you previously construc 'I g in Eagan with a similar plan? Y N If so, 25% plan review
fee applies. - -
'n - 04
Licensed Plumber
~ LU Telephone )
k
Mechanical Contra' t, r / Telephone # ( )
Sewer/WaterContra ~ Telephone#( )
I hereby apply, for a Residential Building Permit and acknowledge that the information is complete and accurate;
that the work will be in conformance with the ordinances and codes of the City of Eagan and the State of MN
Statutes; I understand this is not a pemut, but only an application for a pemut, 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.
dh0.~!',.~~SO ~ A JIG~' o.~,/~ ~
ApplicanYs Printed Name ApplicanYs Signature
OFFICE USE ONLY
Sub Types
? 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 Ext. Alt - Multi
? 03 01 of _ plex ? 09 07-plex ? 17 Garage ? 22 PorchlAddn. (4-sea.) ? 33 Ext. Alt - SF
? 04 02-plex ? 10 OS-plex ? 18 Deck ? 23 Porch (screenfgazebo) ? 36 Multi Misc.
? 05 03-plex ? 11 10-plex ? 19 Lower Level ? 24 Storm Damage
? 06 04-plex ? 12 12-plex Plbg_v or _ N ? 25 Miscellaneous
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish Interior ? 44 Siding
? 32 Addilion ? 36 Move Building ? 42 Demolish Foundation ? 45 Fire Repair
? 33 Alteration ? 37 Demolish Building' ? 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolition (Entire Bldg) - Give PCA handout to applicant
Valuation Occupancy MCES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
# of Units Sq. Ft. PRV
# af Bldgs Length Fire Sprinklered
Type of Const Width
- REQUIRED INSPECTIONS
Footings (new bldg) _ Final/C.O.
Footings (deck) _ Final/No C.O.
Foo[ings (addition) _ Plumbing
Foundation _ HVAC
Drain Tile Other
Roof Ice & Water Final _ Pool _ Ftgs _ AidGas Tesu Final
Framing _ Siding _ Stucco _ Stone _ Brick
Fireplace R.I. AirTest Final Windows
Insulation _ Retaining Wall
Approved By: , Building Inspector
Base Fee
Surcharge
Plan Review
MC/ES SAC
City SAC
Utility Connection Charge
S&W Permit & Surcharge
Treatment Plant
License Search
Copies
Other
Total
• ' .Wd9E:l •8 uo~ awil paniVay
Pella Windows & Doors - Twin Cides, Inc 15300 25TH AVE. N. STE. #100
PLYMOLTTH, htN 55447
763/745-1400
~ WATS 1-800-462-5359
FAX 763/7451401
3une 8, 2001
Ciry of Eagan
3836 Pilot Knob Road
Eagan, MN 55122
Dear Jan:
Elder Jones Corporation is authorized to pull building permits for Pella Windows &
Doors - Twin Ciries, Inc. Ylease ailow their representative to provide that service for us
in Eagan. This authorizafion shall be valid until such time as the division manager
expressly revokes it, in writing to the City.
I request that this authorizaHon be accepted expeditiously, so as to not delay the
processing of'our building permits any further. Please call me if there are any questions,
I can be conYacted at 763-74>-1432.
Your icmnediate attention to this matter is appreciated.
' cerely,
''V ERE W. SpN80
Bryan. May ~
Replacement Sales Manager Yy~,ucm,o~en,p,~pe
cc: Kaza - Eldcr Jones
Denna Krafly - Replacement Sales Process Coordinator
Windows, Doors,
& Skylights
7nna cvrrrn hrrur_rju 61'bT eF) 7ro vcra IT:CT rva rnionion