4534 Villa Pkwy
SEDGYi11CK HEATING & AIR CONDITIONING CO. ?+eariNC JOe~ SU~`~3
6910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS, MN 55420 •(9/52) 881~-9000 TEST RECORD
ADDRESS ~53y I// ? ~ ~ ~ hI / ///GITV~
l^
OCWPANT nOWNER
SOLO BY INSTALLED BY C
MAKE MODEL3/e 1141 C) -3 62 70
SERIAL NO. 37D3l~ Y-3 7 / INPUT(o 6/ GOG ~j Ti// ~
~~/L
7HERMOST T!, T~~~~I VENT S2E ~
VALVE " ` TYPEOFLINER 'J ury~
LIMIT LINER SIZE
LIMITSETTING~/v~ ~ FILTERS: SIZE,F NUMBER '
FAN SEffING WIRING `
PILOTNPE TES7TAG
~
IGNITION MODEL LIGHTING INST. .
PILOT7IMING DA7ETESTED ~/U-
PRESSURE ~•S ~"•rr pERCENTCOg
SID ~MPANYTESTWG
INPUTCFH~q-- PERGENT Oz ~
STACN TEMP. ~ pERCENT CO NAME OF TESTER
FOFM235(REV.11189) FOFMDISTRI6UTION: WHITECOPVJOBGILE YELLOWCOPV-CITY
. . . . . /3 //'OOG9.3
SEDGWICK HEATING & AIR CONDITIONING CO. HEATING
TESTRECOR~ ~OBNO.
8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS, MN 55420 •(952) 681-9000
ADDRESS ~J V!!i{~q / K~y. L III / _ r' qTV ~Q C?
OCCUPAN7 4GIlA~ S S OWNER
SOLD BY INSTALLEDF1Y ST ~ tu ~
MAKE '8~ lyA~ ~ MODEL 31101" Vd 3l7070
SERIAL NO. INPUT
y„
THERMOSTAT VENTSIZE ~l
VAWE ~"L' TYPE OF UNER _1.L~y
LIMIT LINER SIZE S
LIMIT SETTING FILTERS: SIZE /GYZ T~ I NUMeER
FAN SETTING ~ WIRING
PILOT7YPE d1 r TESTTAG
IGNITION MODEL LIGHTING INST.
PILOT7IMING `j- /O-G Y~
_7 DATE TESTED
D
PRESSURE PERCENT COz
INPUT CFH PERCENT Oi COMPANY TESTING
STACK TEMP. ~ a~~F PERCENT CO NAME OF TESTER
FORM235(REV.1fl89) FORMDISTRIBUTION: WHRECOPY - JOBFIIE YELLOWCOPV - CITY
~ HEATING ~ 0 Glp
SEDGWICK HEATING & AIR CONDITIONING CO. resTReeoa~ JOBNO.
8870 WENNJORTH AVENUE SOUTH • MINNEAPOLIS, MN 55420 •(952) 881-9000
ADDRESS q CIN
OCCUPANT +ran¢" ^I OWNER
SOLD BY ~ wi'~ INSTALLEO eV a w~C c
MAKE ~ 6" ~ / MOOEL 31 oA AI/ 3 t~ o7o
SERIAL NO. ~ ~O~A 213 ~.P CO . INPUT66
q
THERMOSTAT VENTSIZE
VALVE ~ NPE OF I.INER
LIMITLINER SI2E ~
LIMITSETTING FILTERS: SIZE T~ ~ NUMBER ~
.r
FAN SETTING WIRING ~
PILOTNPE TESTTAG
IGNITION MODEL IIGHTING INST.
PILOT TIMING DATE TESTED
PRESSURE PEFiCENT COz
~ COMPANVTESTING
INPUT CPH ~ PERCENT Oi ~ G B \
STACK TEMP. 62 It PERCENT CO NAME OF TESTER ,
FORM 235 (REV. 11I89) FORM OISTRIBIITION: WHITE COPY -JOB FILE VELLOW COPY - CfiV
SEDGWtCK HEATING & AIR CONDITIONING CO. HE^nNC JOBNO.
8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS, MN 5542q •(952) 881-9000 TEST RECORD
I
7 /
ADDRESS I SJ y V r f~d ~/l n~cin TGc7'wh
occuPnNr ra d f- feh r l
/ OWNER
SOLD BY ~G f C\ INSTALLEo BV
MAKE MODEL VQ36POZO
SERIAL NO. INPUT QQ `
THERMOSTAT VEM SIZE L
VALVE TYPE OF LINER
LIMIT LINER SIZE S
LIMIT SETTING FILTERS: SIZE NUMBER
FAN SETTING ~ ~h f WIRING
PILOTNPE TES7TAG
IGNITION MODEL LIGHTING INST. -
PILOTTIMING
~ DATETESTED
PRESSURE PERCENTCOi
INPUTCFH LPERCENTOz COMPANYTESTING
STACK TEMP. -im / PERCENT CO NAME OF TESTER
FORM 235 (REV. 11I89) FORM OISTRIBUTION: WHITE COPV - JOB FILE VELLOW COFY -CITV
CLAIM VOUCHER - REFUND REQUEST ~ " 3 / • ~
CITY OF EAGAN
MAKE CHECK PAYABLE TO: VALLEY PLUMBING
ADDRESS: 860 QUAKER AVE
JORDAN MN 55352
RECEIPT il/DATE: 50926 7/10/03 ,
51203 7115/03
52185 7/31103
52788 8/13/03
REASON FOR REFUND: INCORRECTLY CHARGED PERMIT 60180, 60183, 60271, 60272
60273,60561,60562,60563
60564;60769-~
TYPE OF REFUND:
Plumbing Pemut 9001.4087 $
Mechanical Permit 9001.4088 $
Building Permit Fee 9001.4085 $
Plan Review Fee 9001.4222 $
SAC (MC1WS) 92202275 $
SAC (City) 9379.4681 $
SAC (Admin) 9001.4246 $
Water Connection 9220.3865 $
Sewer Permit 9220.4532 $
WatarPeimit 9220.4507 $
Account Deposit 9220.2252 $
Water Meter 9220.4509 $
WaterTreatment 9220.4685 $
Water Supply & Storage 9220.4680 $
Surc6arge 9001.2195 $ 26.50
Overpayment 9001.2250 $
Club Box Deposit Refund 92201253 $
ConstrucHon Meter Dep Refund 9220.2254 $
Other - Fire Pernut 9001.4096 $
TOTAL $ 26.50
I de;cT under the penalties of law that this account, claim, or demand is just and that no part of it has been paid.
8/19/03
9IGNATI7RE DATE
PLiIMBING (RESIDENTIAL)
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122 ~ 3(~ -~i.
Telephone # 651-675-5675 FAX # 651-675-5694
Please complete for: Single Family Dwellings
Townhomes and Condos when pernuts are required for each unit
Date $ / la- /oi
Site Address q5-3 9 V i lfc ('u. k oa../ ?7v: ~~tn~ ~~3 Unit # I' y
PropertyOwner r?aw,ti ct" S a n s Telephone )
Contractor (IvinlJMj
Address Q./.= kc~ i¢?G . CiTy Jo/~<ol
State ,r~.? zsP sS35-d Telephone # QSa > y9> >/W
The Applicant is _ Owner f Contractor _ Other
Septic System ZC New _ Refurbished Submit 2 sets of plans and MPC license $ 100.00
Includes Counly fee. Additional consuitant fees may apply.
Alterations To Existing Dwelling Unit, Including $ 50.00
_ Adding fixtures to lower levels or room additions, excluding water softener and water heater
_ Abandonment of septic system
_ Water turnaround 5/8" meter if needed -$121.00)
Other:
_ RPZ _ new installation _ repair _ rebuild $ 30.00
_ Lawn irrigation system
_ Water softener _ Water heater $ 15.00
_ replacxment _ additional
State Surcharge $ .50
~I
2 2003 3 ~o. 0
Total $ a.o
~a-o
I hereby apply for a Residential Plumbing Pemut and aclaiowledge that the inF oniz~4lnplct.e and accy~rate; that the work will
be in conformance with the ardinances and codes of the City of Eagan and with t e~lumlimg des; ffiat7'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.
7osl.J~. 1LL II,, ~1~~
ApplicanYs Printed e Apphc St isan ature
RESIDENTIAL MECHA1vICAL
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675
lO
Please complete for: Single Family Dwellings & Townhomes and Condos when pemvts are required for each unit
Date if / / Q 3
Site Address Unit #
Property Owner ~ ? /f~p Telep6one # ( ~sd ) ~7'1.~~~~~
Contractor
dl
street aaaress E~ ;D NJenlvloR7 Ciiy
A4inneapoUs, MN Sc~;20
State (952j$8j.0,07dp Telephone # ( )
Bond Eapires:
The Applicant is _ Owner ? Contractor _ Other
Add-on, modificatlon or alteration to esisflng dwelling unit $ 30.00
furnace replacement
air exchanger
air conditioner _ New _ Replacement
other
. , .
State Surcharge t1t /z,) $ .SD
~
i~ ~1:~~ia r~ i 2 k ,
Tota? ~ X74 " SEP 0 8 Z003 I I~ g~p~id
's
ii
I hereby apply For a Residenrial Mechanical Permit and aclrnowledge that the informarion is wmp e-1 te 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 khis is not a
pernut, but only an applicarion 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.
SEDCIh'OK F!'rG R AIR CQyn 1`r1 j
ApplicanYs Printed Name Applicant's Signahue
COMMERCIAL MECHAAIICAL
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675
Please complete for. commerciaVindustrial buildings
multi-family 6uildings when separate permits are not required for each dwelling unit
Date
Site Street Address Unit #
Tenant Name (if applicable) Previous Tenant Name
Property Owner Telephone # ( )
Contractor
Street Address City
State Zip Telephone # ( )
Bond Eapires:
TLe Applicant is _ Owner _ Contractor _ Other
Work Type
New construction _Install _Remove Underground Tank
Interior Improvement Schedule inspection during InsWllatian or removal of tank
Processed Piping
Nature ofWork:
Permit Fee $50.50 Minimum Fee (includes State Suroharge)
ConhactValue $ x 1% _ $ PernutFee
• If permit fee is $1,000 or less, add $.50 $ State Surcharge
If permit fee is over $1,000, add $.50 per
$1,000 Pemut Fee
$ Total Fee
I hereby apply for a Commercial Mechanical Permit and aclmowledge that the information is complete and accurate; tUat the woxk
will be in conFormance with the ordinances and codes of the City of Eagan and with the Mechanical Codes, that I understand tlus is
not a permit, but only an application for a pernilt, 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 tequires a review and approval of plans.
ApplicanPs Printed Name Applicant's Signature
Appmved By: , Inspector Date:
1-0 ~ a a; o c~-1
~xcrni. i S o 3~. g5-
2002 BUILDING PERMIT APPLICATION +
CITY OF EAGAN
651-681-4675
0 4~
Foundation Onl New Constniction Interior Im rovement
• SWcWral Plans (2) sets . Archltecturel Plans (2) sets . Architactural Plans (2) sets
. C1v11Plans (2) • SWCWreIPIans (2) • CodeAnalysis i~)
• CertiflcaTeofSurvey (1) . CivilPlans (2) . ProjectSpecs
. coeeaialysls (1)" . LandscapingRans (z) . KeyPoan (~l
• ProledSPees (1) . CodeMalysis (1) MaslesExitPlan (1)
, Spec. Irrep. & Testlng Schedule . Certificaie of Survey (1) ~ EnergyCalcula6ons (7) not always«
. Safs Report (1) . Spec. Insp.,& Testlng Sdhedule (1) . Elec. Power & Lightlng Form (1) not always••
• Meter size must be estabBShed • Meter size must be esta6lished • Meter s¢e must 6e esfablished - if applipWe
• Project5pecs (1) l .
1 • FsergyCafalations (1)
1 . EledAc Power & Lighting Form (1)" j .
j . MasterE)dtPlen (7)
1 . Emergeney Response Sfte Plan ('I)
j . SoilaRepoR (1) 1
• MGES SAC deDermina8on letter • MGES SAC determination let6er • MClES SAC detenninaBon IeUer -
call 651-602-1000 call 651-802-9000 ca11.651-602-1000
Food 8 beverage or lodging fadli6es - submit plan to MN Deparhnent of Health. Call 651-215-0700 for detalis.
" Conffict 8uildirg Inspections for sampte.
Permrt for new buildings or addlUons will not be processed witfwut Emergency Response Site Plan. Ask Building Inspections for requiremenfs.
DATE: 02 WORKTYPE: X NEV~/~ REMODEL ~ CONST CTI ~COS .J~,61~Da
S3'~ ~ a. 1~
SITE ADDRESS:
TENANTtdMAE: Cedar Villas Housing SUITE#: ~
FORMER TENANT NAME, IF APPLICABLE:
OESCRIPTION OF WORK CX'/V~r~PlY~ L''~il) CIPW AtiV
Nam; Cedar Villas, LLP. Phone#: 6( 12 ) 341-7800
PROPERTY Lest Fust.
OVJIVER
StreetAddress: 900 Second Avenue South, Suite 880
CiTy,. Minneapolis gtate, MN 7ip; 55402
;~..1
CAmpany; Frana and Sons, Inc. - Phone#: 952 `93
CONTRAGTOR I
StreetAddress: 633 Second Avenue South u
City; Hopkins Smte: MN Zip:~g'553A=
ARCHIT'ECTY
ENGINEER Company: Elness Swenson Graham Architect~hone#: ( 612 ) 339-5508
N~: David Graham Registration#: 14808
SteetAddress: 700 Third Street South
City: Minneapolis Spte: MN Zlp; 55415
Ucensedplumberlnsta111ngnewsewerlwatarsarvice: Imperial Developers phone#: 651 454-3330
I hereby adcnoMAedge tliat 1 have read 1hFs epplicadon, state that the IrNormatlon I correct, an gree 6,e ~N-epP1YCable State of
Minnesofa StaWtes and Cily of Eagan Ordinances. r~
Signature of ApplicaM:
- Updated 7I02
OFFICE USE ONLY
SUBTYPE
? Ol Foundarion 0 26 Public Facility ? 30 Accessory Bldg.
? 14 Apaztments ? 27 Commeroialllndushial ? 32 Ext Alt - Apts.
? 15 I,adging ? Zg Greenyouse ? 34 Ext Alt - Comm.
? 25 Misce1laneous ? 29 Antennae ? 35 Ext Alt - PF
WORK TYPE ? 37 Nail Salon
O 31 New ? 35 Tenant Impr ? 42 Demolish (Foundarion) ? 46 Windows/Doors
? 32 Addition ? 36 Move Bldg ? 43 Reroof 0 47 Repair ,
? 33 Alterations ? 37 Demolish (Bldg) ? 44 Siding ? 48 Authorizarion
? 34 Replacement p 38 Demolish (Int) ? 45 Fire Repair
GENERAL INFORMATION
Census Code Zoning sq. ft.
SAC Code # of Stories sq, ft.
No. of Units Iength sq, ft:
No.ofBldgs. Width
Const. (Actual) Basement sq. R MC(ES System -
(Allowable) First Floor sq. ft City Water
UBC Occupancy sq. & Fire Sprinklered
MISCELLANEOUS INSPECTIONS
El Gas Service Test Heating ? Insulation q Plumbing ? Stucco/Stone
APPROVALS
Plamun8 Building Engineering Variance
VALUATION $
Pertnit Fee
5urchatge '
'Ian Review
VIC/ES SAC % SAC
-ity 3AC SAC Units
Nater 3uppiy & Storage Meter Size
ilVH Permit
iNU Surcharge
,~reatment Plant
'ark DediqUon
-rails DedicaUon
Vater Quality
)ther
:opies
'otal 1 ~ ~ O 3 g ~
Use BLUE or BLACK Ink
For Office Use I
^ I
Permit oL
City of Ed b I Permit Fee:
3830 Pilot Knob Road I I
Eagan MN 55122 I I
Phone: (651) 675-5675 Date Received: 00 lot ~3 I
I
Fax: (651) 675-5694 I I
I Staff: I
L-----------------I
2013 COMMERCIAL BUILDING PERMIT APPLICATION
a "
Date: Site Address:
Tenant Name: 6CAl- 411a $ (Tenant is: New / Existing) Suite M
F_ 54,11, 6 Former Tenant: C Q
Name: 6) /,,PC rA 0-n Phone: 1 ) -a~!
Property Owner.
Address /City /Zip: (1a 11 k LLo S f roy d~
I
Applicant is: Owner Contractor
Type of Work € Description of work: T lh
Construction Cost: ~Ll ~J~, a~
Name: 6 ''t/ en V t~ • License 1,7q 6
Contractor Address: !S'' /0 /71/G 112, City: Id j1a //e.:j
State: n Zip: ~b~ Phone:7 ! 3 0 0
Contact: ' V~io\ +y1/ ~ Email: do U1 a a M f ~a~~,) 0 ° CLl
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 that you submit are considered to be public information. P o r t ions of
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..qopherstateonecall.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.
x 1 Al ~lx
Applicants Printed Name Applica is Signature
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