4541 Villa Pkwy
ft8'JGWICK HEATING & AIR CONDITIONING CO. HEArINC Joe ,o
8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS. MN 20 •(952) )GITY 9000 TEST RECORD
ADDRESS y~ q7Q~
OCCUPANT OWNER
SOLD BY INSTALLED BY
MAKE MODEL 3/UIY" v3COG /O
SERIALNO. (/SO rAd(O y7 / INPUT
THERMOSTAT < VENTSIZE ~
VALVE tt" TYPE OF LINER
LIMIT T ~ -A' LINER SRE
C
LIMITSETTING 2~ ~ FILTERS: SIZE &4X2SlS ~ NUMBER ~
FANSETTING ~'nY WIRING -
PILOTTYPE TEST7AG ~
IGNITION MODEL --LIGHTING INST.
PILOTTIMING DATE TESTED -3 , .2 Lp,OG/ .
PRESSURE ~ PERCENTCOi
COMPANYTESTING
INPUT CFH ~ PERCENT Oz ~
STACK TEMP. 77 pERCENT CO NAME OF TESTER
FORM235(REV.H/e9) FORMDISTRIBUTION: WHITECDPY - JOBFILE VELLOWCOPY - CITV
-SEDGWICK HEATING & AIR CONDITIONING CO. HEAriNC iof~o.
8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS, M/N 55420 •(952 81-9000 TEST RECORD
ADDFiESS ~~~L~' V' ~V GTY L'Q~`~1p'J
X~^S I T
OCCUPANT 1r hq 4-5,/11 T OWNEF
SOLDBV
T INSTALLED BY
yyy~~~ / A /
~ ~y,/~ MODEL > 70
MAKE -r
SERIAL NO. o~o -j~~ `2g` ~ INPUT 6 ~ie,%4 G 9/ 21 ~
L„
THERMOSTAT ~ VENT SIZE
VALVE 7YPE OF LINER
LIMIT X' 'r LINER SIZE SI
LIMITSETTWG FILTERS: SIZE NUMBEfi /
FAN SETTING WIRING
PILOTTYPE `u 0•1 TESTTAG ~
IGNITION MODEL LIGHTING INST. -
PILOTTIMING ' s _Z
^ ~ DATETESTED
PRESSURE ~Cf PERCENT COz ~
° COMPANV TESTfNG
INPUT CFH PERCENT Oz `
STACK TEMP. PERCENT CO NAME OF TESTER ~_~"FORM235(REV,1V99) FORMDISTFIBUTION: WHITECOPY -JOBFILE YELLOWCOPY-qTY
-SEDGWICK HEATING & AIR CONDITIONING CO. HEaTiNG JOBNO.
8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS, MN 55420 •(95 881-9000 TEST RECORD
ADDFiESS LI ~-L/l ~r qTV `~Qq9~l
OCCl1PANT F/~~ lG`1JT OWNEF ~
SOLDBV Se. INSTAIL€DeV 2-~/Z6J-` ~ .
MAKE /J r yA/~ T mooeL 3 I UO~/~3,~( 70
SERIALNO. QSD~J/~alo INPUT `r/~/ ~S
THERMDSTAT VENT SRE ~
VALVE NPE OF LINER
i'
IIMIT ~ LINER SIZE _7
O
LIMITSETTWG G FILTERS: SIZE ~SX I NUMBER /
FAN SETTING WIRING
PILOTTYPE TESTTA6
IGNITION MODEL LIGHTING INST.
PILOTTIMING p C/
r /y DATE TESTED PRESSURE L. Ci pERCENT COz ~ ~B
INPU7 CF PERCENT Oz S 9~ COMPANY TESTING
STACK TEMP. PERCENT CO NAME OF TESTER
FORM235(FEV.HI89) FORMOISTRIBUTION: WHITECOPY - JOBFILE VELLOWCOPY -CITV
. . _ . . , .
. _
'$EDCaWICK HEATING & AIR CONDITIONING CO.- HEATING JoeNO.
8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS, MN/,55420 •(952)TEST RECORD
ADORESS / S LlI U/ ~ GC/ I f\ ~ Y \ U/~l )81-9000
CITY ~C/CI9/`I
OCCUPANT ~ ~-y~ OWNER
SOLD BY C7 V" C INSTALLEn aY 5 r~
MAKE ~/-lA~r ~ MODEL 3104400 3~ ~ 70
SERIALNO. 105011,4 ac~ `lo(o INPUT
i
THERMOSTA7 VENTSIZE
VALVE 4,'~ /S, ~ TYPE OF LWER
LIMIT LINERSIZE y
LIMITSETTING FILTERS: SIZE NUMBER /
FANSETTING ~ ~-el WIRING
~ ~
PILOT NPE TEST TAG
IGNITION MODEL LIGHTING INST.
PILOT TIMING ~
~ Uy
/ DATE TESTED / /
PRESSURE 22 ~ ~ PERCENT COz
INPUT CFH PERCENT Oz COMPANYTESTING
-
s
STACK TEMP. ~
~cC1fL~ PERCENT CO NAME OF TESTER - Z
FOPM 235 (PEV. 11/89) FORM DISTRIBUTION: WHITE COPV -JOB FILE VELLOW COPY - CITY,
PLUMBING (RESIDENTIAL)
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122 0
Telephone 9 651-675-5675 FAX # 651-675-5694
Please complete for. Single Family Dwellings
Townhomes and Condos when permits are required for each unit
Date / 03
Site Address ys y I V• I l& f°e"k I~i.i ~~rh4 19Unit #
Property Owoer F/'G ?Iti Son S Telephone )
Cootractor V a I I~~
o rdar-~
Address ~er f~ ~ t• City
staee 1111 ,AV z,P ~S3Sa- Telephone # (95-4
The Applicant is _ Owner ~ Contractor _ Other
Septic System New Refurbished Submit 2 sets of plans and MPC license $ 100.00
Includes County fee. Addltional consultant 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 tumaround 5!8" meter if needed -$121.00)
Other:
_ RPZ _ new installation _ repair _ rebuild $ 30.00
_ Lawn irrigation system
_ Water softener _ Water heater $ 15.00
_ replacement _ addifional
StateSurcharge SL~' $ .50
I
U Ll
Total ~
BY.
I hereby apply for a Residential Plumbing 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 with the Plumbing 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 the
approved plan in the case of work which requires a review and approval of plans.
Applicant's Printed ame Appli anYs Signature
RESIDENTIAL MECHANICAL
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122 ~
~ Telephone # 651-675-5675
Please complete for. Single Fanvly Dwellings & Townhomes and Condos when permits are required for each unit
Date cf
Site Address IInit #
,
Property Owner ~iiENllC! J ~jy~p Telephone #
Contractor
~..~+ve.w Rti4Ji'Ib 7'U 7::771, .
C~ 10 Weniv,ror;`~ f.e~:,. ^j Stree[ Address City
nuui a l, tlY j&;20
State 881'900 Zip Telephone # ( )
Bond Expires:
The Applicant is _ Ownet ? Contractor _ Other
Add-on, modification or alteraflon to eaisting dwelling unit $ 30.00
furnace replacement
air exchanger
air conditioner _ New _ Replacement
other
? -
State Surcharge $ .50
Total St't~ ~U~ i $ ~
i
I hereby apply For a Residential Mechanical Pertnit and acloiowledge 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 with the Mechanical Codes; that I understand this is not a
pernnt, but only an applicaaon for a pemut, and work is not to start without a pernvt; that the work will be in accordance with the
approved plan in the case of work which requires a review and approval oF plans.
smswicK HrG. & AIR coao. co g
Applicant's Printed Name ApplicanYs Signature
I
COMMERCIAL MECHANICAL
Permit Apptication
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675
Please complete for: commerciaVindustnal buildings
multi-family Uuildings when sepazate pemvts are not required for each dwelling unit
Date
Site Stree[ Address Unil #
Tenant Name (if applicable) Previous Tenant Name
Property Owner Telephone # ( )
Contractar
Street Address City
State Zip Telephone # ( )
Bond Expires:
The Applicant is Owner Contractor Other
Work Type
_ fVew construction _fnsfall _Remove Underground Tank
_ Interior Improvement Schedule inspection during installation or removal of tank
Processed Piping
Nature of Work:
Perrcti[ Fee $50.50 Minimum Fee (inciudes State Surcharge)
Contract Value x 1% Pemut Fee
• If permit fee is $1,000 or less, add $.50 $ State Surcharge
If permit fee is over $1,000, add $.50 per
$1,000 Permit Fee
$ Total Fee
I hereby apply for a Commercial Mechanical Permit and aclmowledge that fhe informafion is complete and accwate; that the work
will be in conformance with the ordinances and codes of the City of Eagan and with the Mechanical Codes; that I understand this is
not a permit, but only an applicarion 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 wluch requires a review and approval of plans.
Applicant's Printed Name ApplicanPs Signahue
Approved By: , Inspector Date:
o cl- 1 S5~ l-J Co l~ Sa
6'-s coDanaERCIAL
2002 BUILDING PERMIT APPLICATION ~
CITY OF EAQAN
651-681-4675
~
Foundation Oni New Construction Interior Im rovement
. Strudural Plans (2) sets . AahifecWral Plans (2) aefs • Architecturdl Plans (2) sets
• Civfl Poaris (2) . Shuclural Plans (2) • Code Anatysis (1)
. CeNficateo4Survey (1) . CivilPlans (2) • ProJectSpecs (1)
• CodeAnalyWs (1)" • larMscapingPlans (2) • KeyPlan (1)
. Projed Specs (1) . Cade Anatyak (1) " . Master E)dt Plan (1) • Spec. lnsp. & Testlng Sdiedule " • Certifiwte ot Survey (1) • Energy Calwlations (1) not always"
• Solls RepoA (1) • Spec. Insp. & Testlng Schedule (1) " • Elec. Power & Llghting Form (1) not ahvays"
• Meter s@e must 6e esfablished • Mefer s'¢e musl be esfablished • Meter size must be established - ff applicable
. PtoJect Specs (1) ,
j . EnergyCalalatia7s (1) " 1
4 . EleWiePower&UghtirgFOmi (1)1
? • Master E)dt Plan (1) 1
4 • Emergenry Response Site Plan (1) 1 .
? . SOi1SRepoA (1) ?
• MC/ES SAC determinallon leqer . MGES SAC detemdnatlon ktter . MGES SAC detertninatlon IeUer
cx11651ti02-1000 cail 651-602•1000 call 651-602-1000
Food & beverage or bdging facilifies - submN plan to MN Departrnent of Health. Call 651-215-0700 for details.
Contact BuGdmg Inspedbns for sample.
"•Permitfornow buldingsoradd onswillnotbeprocessedwithoutEmergencyResponseSitePlan. AskBuii ' glnspectionsforrequiremeMs.
~ -
DATE: 02 VVORKTYP~: X NE REMODEL CONSTRUCTIONCOST: 3~G,
y~s~1/
SITE ADDRESS:
TENANTNAME: Cedar Villas Housing SUITE#:
FORMER TENANT NAME, IF APPLICABLE:
DESCRIPTION OF WORK 6C"cf'2.L e4~47e4C l%0~
Nme; Cedar Villas, LLP. Phune#: 6( 12 ) 341-7800
PROPERTY Last First,
OWNER _
SftetAddress: 900 Second Avenue South, Suite 880
~ (~462U L`,
~h,. Minneapolis 5~~; MN 15
NJU 2 1 2~02 U
cxmpauy; Frana and Sons, Inc. Phone#: 95 935-8600
-
CONI'RACT'OR
Steetpddress; 633 Second Avenue South
City; Hopkins State: MN Zip: 55343
AR(HIITECT/
ENGINEER Company: Elness Swenson Graham ArchitectsPhone#: ( 612 ) 339-5508
Name: David Graham Registration#: 14808
SueetAddress: 700 Third Street South
Cin,. Minneapolis 5tate: MN zip: 55415
UcensedplumberlostallingnewseweNwacerservice: Imperial Developers phone#: 6( 51 ) 454-3330
1 hereby edcnowledge thet I have read Ns applk:atlon, sfate thffi the Irdortnation %1.8 oorrect, a g a~m~W-eN ePPlicable State of
Minnesofa Statutes and Cily of Eagan Ordinanoes.
I SignatureofApplicantr~ f~
Upda(ed 7/02
OFFICE USE ONLY
SUBTYPE
? Ol Foundation ? 26 Public Facility ? 30 Accessory Bldg.
? 14 Apartments O 27 CommerciaVlndustrial ? 32 Ext Alt - Apts.
? 15 L.odging ? 28 Crreenhause ? 34 Ext Alt - Cormn.
0 25 Miscellaneous ? 29 Antennae ? 35 Ext Alt - PF
WORK IYPE ? 37 Nail Salon
O 31 New ? 35 Tenant Impr ? 42 Demolish (Foundation) ? 46 Windows/Doocs
? 32 Addirion ? 36 Move Bldg ? 43 Reroof ? 47 Repair ,
? 33 Alterations ? 37 Demolish (Bldg) ? 44 Siding ? 48 Authorization
? 34 Replacement ? 38 Demolish (Int) ? 45 Fire Repair
GENERAL INFORMATION
Census Code 7Aning sq. ft.
SAC Code # of Stories Sq g. -
No. of Units Length sq, ft.
~
Na of Bldgs. Widdi
ConsL (Actual) Basement sq. ft. MC/ES System
(Allowable) First Floor sq. & City Water
UBC Occupancy s9• ft- Fire Sprinklered
MISCELLANEOUS INSPECTIONS
? Gas Service Test ? Heating ? Insulation Q Plumbing ? Stucco/Stone
APPROVALS
Planning Buildin8 Engineering Variance
Pertnit Fee C~ S 3~- ~ S VA-UATION $ Surcharge / • 6 o '
Nan Review So , 5-g -
NClES SAC 51 a u, % SAC L/
li(y SAC SAC Units
Nater Supply & Storage ao . ~ v Meter Size
i/W Pertnit o o.
i/W Surcharge
; reatrnent Piant
'Jar1c Dedication
'rails Dedication
Vater Quality
)ther
:opies
'otal 1~ ~ ~ S y..4 3.
Use BLUE or BLACK Ink
r
For Office Use
lip, Permit 5 171
City of Ea a~ I
d E I Permit Fee: ✓ 4 oCJ
3830 Pilot Knob Road I
Eagan MN 55122 I 3 I
Phone: (651) 675-5675 i Date Received:
new
Fax: (651) 675-5694
j Staff: ` I i
L-----------------I
2013 COMMERCIAL BUILDING PERMIT APPLICATION
Date: qhq) 1- Site Address: Ah*
Tenant Name: 6cd o r'' V1Ila S (Tenant is: New / Existing) Suite
Former Tenant: p Q ~y
Name: 60. ec'nd10/l`~ on Phone:
j
Property Owner Address / City / Zip: ® o 6 S f roV,
Applicant is: Owner Contractor
Description of work: Ah # T :5 i JI ,I
Type of Work
Construction Cost: 3,, h , /I
Name: License 13q6
~J
COntraCtOr Address: 3 S, S' A95 11 yt A) City: 6-v Id e i vo lle`"9
State: n Zip: Y5q) Phone: 7 6 3 ~7 ® A00
Contact: V 4 v11h Email: da m i when ® C
Name: Registration
Architect/Engineer Address: City:
State: Zip: Phone:
Contact Person: Email:
Licensed plumber installing new sewer/water service:
_ _ Phone _ _
NOTE: Plans and supporting documents thaf you submit are considered to be public information. Portions of ✓ I
i the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that the 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.aopherstateonecall.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.
Al
jpl x
Applicant's Printed Name Applica is Signature
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