4570 Villa Dr . . . HEATING
SEDGWICK HEATING & AIR CONDITIONING CO. JosNO._~
8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS, MN 554720•(9 881-9000 TEST RECORD
ADDRESS / Sf~~0 II1 1~ ~4 ~ J~ i ~!l n~( -'49 CITV
OCCUPANT I I"' ~`T 5~ S OWNER
SOLD BYINSTALLEO gY d~?~~ ^
MAKE MODEL D/oA AU~3q/,~ci70
SERIAL NO ngdy INPUT
THERMOS7AT VENTSIZE /
VALVE k, TVPEOFLINER ~-~~l 7L
i/
LIMIT~ , Q c LINER 52E ~
LIMIT SETiING FILTERS: SIZE a:;t I/` I NUMBER /
FANSETfING WIRING
PILOT NPE ~ l`'fw Col• TEST TAG ~
IGNI710N MODEL LIGHTING INST.
PILOTTIMMG 1(~-O ~
^ ~ DATETESTED~ ~
PRESSURE PERCENT COz 7• /
INPUT CFH pERCENT Op COMPANV TESTWG , K
STACKTEMP. PERCENTCO NAME OFTESTER g
FOFM235(REV.11/B9) FORMDISTRIBUTION: WHITECOPV - JOBFILE YELLOWCAW-QTY
, . . . . . a . . . . .
SEDGWICK HEATING & AIR CONDITIONING CO. HEaTINC JOBNO.k)-g' 6CA~
8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS, MN 55420 •(952) 881-9000 TEST RECORD
ADDRESS q5-7O V- l4f~r , I V n I~- CITY1~1)
OCCUPANT 14'¢ ~ OWNER
SOLD INSTALLED eV ~ C
MAKE 13 rvQ~~~ MODEL ~1 Uo 3GG ~b SERIAL No. 70 Ko y14 a4~ 5- 3/ INPUT~p ~ a~~ 97 tl y
„
THERMOSTAT VENTSIZE
VALVE k' TYPE OF LINER ~-t~ey
LIMIT f LINER SRE ~
LIMIT SETTING FILTERS: SIZE Z(C' ~2 rX / NUMBEfi
FAN SETTING T~) ~/WIRING ~
TESTTAG ^
PILOTTYPE 61
IGNITION MOOEL ~ LIGHTING IN57
PILOT TIMING L~ •~L/ • G G~
DATE7ESTED ~
PRESSURE 2 / s tarr, pERCENTCOi
INPUT CFH L(!~' PERCENT Oz COMPANYTESTING
STACK TEMP. 33,277 PERCENT CO NAME OF TESTER
FORM295(REV.11/89) FORMOISTRIBUTION: WHITECAPV - JOBFILE YEILOWCOPY - CItY
.
SEDGWICK HEATING & AIR CONDITIONING CO. HeaTiNC JaBNd~)-S~
6910 WENTWOR7H AVENUE SOUTH • MINNEAPOLIS, MN 554Jp0•(9 ) 887-9000 TEST RECORD
ADDRESS lI~~D IV/ " Dl J_~ CITY
OCCUPANT ~ ~Q¢ SS OWNER ,
SOLD BV INSTALLEDaY ~ ~y Lv~ C
MAKE MODEL ~n A1103Gn '20
SERIALNO. 080 ~~~2,LSI/ INPUT -I~(d DGU 1'
[ J
THERMOSTAT S~ 4 VEM SIZE
VALVE ~ NPE OF LINER
i~
LIMIT- LINER SIZE
Lt---
~
LIMITSETTING FILTERS: SIZE NUMBER
FAN SETTING ^ f/I"I P /WIRING ~
PILOT TYPE ` l lb'(~ TEST TAG
IGNITION MODEL LIGHTING INST.
PILOT TIMING DATE TESTED
PRESSURE PERCENTCOz
INPU7 CFH PERCENT Oz COMPANV TESTING
c ~
STACK TEMP. ~ PERCENT CO 1- NAME OF TESTER
i
FOf1M 95 (REV. 11/B9) FOFM DISTRIBIITION: WHITE COPY - JOB FILE YELLAW COW - CITY
. HEATING
SEDGWICK HEATING & AIR CONDITIOIJIl~~CO. resr RecoRO ~OBNO.
8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS, MN 55420 •(952) 881-9000 \
nooaESS V , LOJ' O) ciTV r4'9ai7
i ~
OCCUPANT OWNER
~
SOLD BY INSTALLEn av ~-r ~Q w C
MAKE MODEL 3/a,~,lll/0 3/ a-70
SERIAL NO. O~l ~AOC~ l~~ INPUT 9-77/ J
THERMOSTAT VENT SIZE
VALVE ~ TYPEOFLWER (,-e h
~i
LIMIT ~ LINER SIZE h
LIMIT SETTING FILTERS: SIZE NUMBEF /
FAN SETfING 71) Y WIRING
PILOTTYPE TESTTAG ~-IGNITION MODEL LIGHTING INST.
PILOTTIMING Q y
~~/^JJ DATE
PRESSURE PERCENTCOz TESTED ~
INPUT CFH ~ PERCENT Oz COMPANYTESTWG ~ ,
~ d
STACK TEMP. ~ PEFCENT CO NAME OF TESTER
FORM235(REV.H/98) FORMDISTRIBUTION: WHITECAPV - JOBFILE VELLOWCOPV - CIN
. . . ~
SEDGWICK HEATING & AIR CONDITIONING CO. HeariNC JOBNE
8970 WENTWORTH AVENUE SOUTH • MINNEAPOLIS, MN 55420 •(952) 887-9000 TEST RECORD
ADORESS GI~7 70 V/ho L` \U/I/ L C~ CI7y 1-4G1G/I)
/
OCCUPANT OWNER
~ I
SOLD eV INSTALLED BY ~ wI C
MAKE ~,y~CI~ ~ MODEL ~Iv~ Vd/COc/ e
SERIALNO. QaDl/~`19~~ N INPl1T 6 6/ GOO 07U-
THERMOSTAT VENT SIZE
VALVE LL T1'PE OF LINER
LIMIT LINER SIZE ~S )
LIMIT SETTING 2GV c FILTERS: SIZE Y-2 57X / NUMBER /
FAN SETTING mT WIRING
PILOTTVPE TESTTAG ~
~
IGNITION MODEL LICaHTING INST.
PILOT TIMING L/ 0 y
DATE TESTED ~
PRESSURE PERCENT COz
INPUT CFH PERCENT Oz COMPANY TESTING
STACK TEMP. ! PERCENT CO NAME OF TESTER
FOflM235(REV.11/89) FORMDISTRIBUTION: WXITECAPY - JOBFILE YELLOWCOPV - CITY
HEATING
SEDGWICK HEATING & AIR CONDITIONING CO. resr aecoao JOB NO.
8910 WENTWORTH AVENUE SfOUTH • MINNEAP/OLIS, MN 55420 •(952) 881-9000
ADDRESS V l LI4 l I 7 CITY C: q Qf9
OCCUPANT ~K-f/p4 ~~r/ S OWNER
SOLDBY INSTALLED gY Sr nwIL
i
MAKE MODEL
l 1 OL/ INPUT ~ ( n R761 'f
SERIAI No ~ K0~ ~ 6 /
THERMOSTA VENT SIZE q
VALVE ~ TYPE OF LINER ? ~
LIMIT~~ x P LINER SRE
LIMIT SEffING ~G ~ FILTERS: SIZE I/n X~~,Y I NUMBER
FAN SETTING V 1 , f"N WIRING ~
PILOTNPE TESTTAG
i~
IGNITION MODEL LIGHTING INST.
PILOTTIMING " DATETESTED
PRESSURE IAZ-C, PERCENTCOz
INPUTCFH PERCENTOz COMPANYTESTING 14
~ ~ s
STACKTEMP._2~~? _ PERCENTCO NAMEOFTESTER
FORM235(FE¢H/B9) FOFMDISTPI9lfIlON: WHRECOPY-J06FILE YELLOWCOPY - CITV
SEDGWICK HEATING & AIR CONDITIONING CO. HEaTI"G JoaN~o
8910 WENTWORTH AVENUE SOUl H• MINNEAPOLIS, MN 55420 •(952) 881-9000 TEST RECORD
ADDRESS ys7o Vi ~Ga Aoi" CIr
,
OCCUPANT 2- ` d S OWNER
SOLD BV ` INSTALLED BY r 9t,?~
MAKE rf PVA/I~ MOOEL 9~1J`f1~V~J3C~ O/ D
SERIAL N ~ OI~a K5 L/"' INPUT
THERMOSTAT VENT SIZE
VALVE it/ NPE OF LINER j~,` ~f 74
i
LIMIT P LINER SIZE 7
' o
LIMITSETTING ~ FILTERS: SIZE / NUMBER /
FANSETTING WIRING
PILOTTYPE veW ~ I TESTTAG ~
IGNITION MODEL LIGHTING IN57.
PILOTTIMING DATETESTED L, L/
PRESSURE C' PERCENTCOz h
COMPANVTES7ING '~e j4?, C ,
INPUT CFH PERCENT Oz
°
STACKTEMP.t-PERCENTCO NAMEOFTESTER
FORM235FtEV.11/89) FORMDISTRIBIITION: WHITECOPV - JOBFILE YELLOWCOPY- CITY
~SEDGWICK HEATING & AIR CONDITIONING CO. HEATING resTRecoRO JoB"". SO(~
8910 WENTWORTH AVENUE SOUTH • MINNEAPOLIS/, MN 55420 •(952 861-9000
ADORESS `157 / O V'" a )or CITY
OCCUPAM ?~i~Q ¢ S~7 f OWNER
SOLD BV St" 9~"-'C INSTALLED BY
~-7D
MAKE /J! ddl,4 ~I MODEL 31a/JA4 7 36 0
SERIALNO. OI~~rI ~U SL/ INPUT 6,10
THERMOSTAT C VENT SIZE y~
VALVE k' TYPE OF LINER /7 - Lw
LIMIT LINER SIZE l,
LIMIT SETTING FILTERS: SIZE )Le~~ "21~~ / NUMBER ~
FAN SETTING WIRING
r^-
PILOTTYPE Q6• CUI TES7TAG
IGNITION MODEL LIGHTING INST.
PILOT TIMING DATE TESTED
PRESSURE pERCENTCOz -2 9
COMPANY TESTING
INPUT CFH ~ PERGENT Oz
STACK TEMP. PERCENT CO NAME OF TESTER
FORM235(REV.H/99) FORMDISTRIBUTION: WHITECDPY - JOBFlLE VELLOWCOPY-C1iV
k~
RESIDENTIAL MECHANICAL
Permit Apptication
City Of Eagau
3830 Pilot Knob Road, Eagan Mn 55122
6~1 Telephone # 651-675-5675
l I
Please complete for: Single Fanvly Dwelliags & Townhomes and Condos when permits are required for each unit
Date I / 'd
Site Addeess YJ ~~.~C7/%~/•-(~ - /Q Unit #
Property Owner ? Z,,, Telephone #
Contractor
..i.tit9YY1G .
Street Address 8510 4VentwCr;'i .;J. Cpty
unneapo u, d .,,Z
State (952081-9O(Lip Telephone # ( )
Bond Expires:
The Applicant is _ Oumer ? Contractor _ Other
Add-on, moditication or alteration to existing dwelling unit $ 30.00
furnace replacement
air exchanger
air conditioner _ New _ Replacement
other
State Surcharge $ .50
y/ 11 T ~~,1~~ /~so
Total U ,Y 7d- $
iillil
I hereby apply for a Residenrial Mechanical Permit and acknowledge that the In3formation-is complete-and accurate; that the work will
be in conformance with the ordivauces and codes of the City of Eagan and with the Mechanical Codes; that I understand this is not a
permit, but only an application for a pernut, and work is not ro start without a permit; that the work wil be in accoidance with the
approved plan in the case of work wluch requires a review and approval of plans.
SEDGWIC~( M'G & A!R COND. CO
_Ixmak
Applicant's Printed Name Applicant's Signature
COMMERCIAL MECHANICAL
Permit Application
City Of Eagan
3830 Pilot Knob Raad, Eagan Mn 55122
Telephone # 651-675-5675
please complete for: commerciaUindustrial buildings
mul6-family buildings when separate pemtits aze not required for each dwelling unit
Date
Site Street Address Unit #
Tenant Name (if applicable) Previous Tenant Name
Proper[y Owner Telephooe # ( )
Contractor
Street Address City
State Zip Telephone # ( )
Bond Expires:
The Applicant is _ Owner _ Contractor _ Other
Work Type
New construction _Install _Remove Underground Tank
Interior Improvement Schedule inspection during installation or removal of tank
Processed Piping
Nature of Work:
Permit Fee $50.50 Minimum Fee (includes Sfate Surcharge)
ContractValue $ x 1% _ $ PermitFee
• If pemut fee is $1,000 or less, add $.50 $ State Surcharge
If permit fee is over $1,000, add $.50 pec
$1,000 Permit Fee
$ Total Fee
I hereby apply for a Commercial Mechanical Permit and aclmowledge that the information is complete and accura[e; that the work
will be in wnformance with the ordinances and codes of the Ciry of Eagan and with the Mectianical Codes; that I understand ttris is
not a permit, but only an application for a pernut, 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.
ApplicanPs Printed Name Applicant's Signature
Approved By: , lnspector Date:
PLUMBING (RESIDENTIAL)
Permit Application
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5694
Please complete for: Single Family Dwellings
Townhomes and Condos when permits are required For each unit
nace °l i 3 i O 3
Site Address y.S 7o U 1 1)a U~~ ? L ~~i~ 7 f~ 1:~r Unit #
Property Owner FsGrr~. ~ SOrI S Telephone H( )
Contractor PkYyb,,,q
i
naa,ess 8"G O 4v e. city T~~ ~
State A1~ Zip Telephane# (9SJ~ yga
The Applicant is _ Owner J4 Contractor _ Other
Septic System New _ Refurbished Submit 2 sets of plans and MPC license $ 100.00
Includes County fee. Additlonal consultant fees may apply.
Alterations To Existing Dwelling Unit, Induding $ 50.00
_ Adding fxtures 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 _ additional
~ f l
50
State Surcharge Fn 13 ~393 I
Tofal
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; Yhat I understand this is not a
permit, but only an application for a permit, and work is not ro 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.
J G,.,4 ~ei/y
Applicant's Printed Name Appli ant's Signature
a- EAocU i ~'s L (
J:11Q'-S conUMxcrni.
2002 BUILDING PERMIT APPLICATION
CITY OF EAGAN
651-681-4675 ~ ~ -
"J
Foundation Onl New Construction Interior Im rovement
. SWdural Plans (2) sets . ArchitecWral Plans (2) sefs . ArddtecWral Plans (2) sets
• CivilPians (2) . . StruduralPlans (2) • CodeAnalysis (1)
. CertificateofSurvey (1) . CivilPlars (2) • ProJedSpecs (1)
• CadeAnalysis (1)" . LarWscapingPlans (t) • KeyPlan (1)
• Pro)easpecs (1) . codennalysis (1) " • MasaerEidtPlan (1)
• Spec.Inap.BTestingSchedule" . CeAiflpteof5urvey (1) • EnergyCalalaUons (1)notalways«
• SoflsReport (1) . Spealnap.& TestingSchedule (1)" • EleaPower&LightingFortn (t)notalways"
• Meter efze must be established • Meter size must be eslsblished • Meter size must be established - if applipble
. ProjectSpecs (7)
1 . EnergyCalculations (1) " 1
1 . ElectricPOwer8ll9MingFortn (1) 1
i • MasterExttPlan (1) 1
1 • Emergency Response Site Plan (i)'TM 1
S • SoilsReporl (1) l
• MC'ES SA:, deteemhiation tetter • MC/ES SAC detertNnation letter • MCIES SAC determination letter
call 651-6o2-1ooo ca11851-602-7000 qtl &51-802-1000
Food & beverage or lodging facilities - submit plan to MN Department of Heallh. Call 651-215-0700 for details.
Contact Buflding Inspections for sampie.
Permtt for new buldings or addklons will not be processed witlrout Emergency Response Site Plan. Ask Building Inspectians for requiremerrts.
DATE: /0s!2 0 2 ORK TYPE: X NENv REMODEL CONSTRUCTION COST:--"`,Sy
SITE ADDRESS: A-
~ a ¦ ~ -
TENANTNAME: Cedar Villas Housing SUITE#:
FORMER TENANT MAME, IF APPLICABLE: 1~v ~ I C~
~ - Cl
pESCRIPTION OF WORK<~
Name; Cedar Villas, LLP. Phone#: 6( 1 2 ) 341-7800
PROPERTY Iast Fust,
OWNER
StreetAddress: 900 Second Avenue South, Suite 880
L.m,. Minneapolis gffiu; MN - - Zlp: 55402
~mP~, Frana and Sons, Inc. phone#: 9( 52 8fip
CONTRACl'OR
SucetAddress: 633 Second Avenue South
City: Hopkins State: MN Zip:
ARCHITECf/
ENGINEER Company: Elness Swenson Graham ArchitectsPhone#: ( 612 ) 339-5508
Hame: David Graham Registratian#: 14808
StreetAddress: 700 Third Street South
City: Minneapolis 5tate: MN Zip: 55415
tJc:ensedplumberlnstallinenow sewerlwaterservlee: Imperial Developers phone#: 6( 51 ) 454-3336
1 hereby ednwwledge that 1 have read tlhis applfcation, state that tlhe IMormation is correct, an g o pq[.adtd-all appiipble State of
Minnesofa 5tatutes and CKy of Eapan Ordinances.
Sipnature of Appiicant:
Updated 7/02
OFFICE USE ONLY
SUBTYPE
? Ol Foundarion ? 26 Pablic Facility ? 30 Accessory Bldg.
? 14 Apamnents ? 27 CommerciaUIndustrial ? 32 Ext Alt - Apts.
? 15 I.odging ? 28 Greenhause ? 34 Ext Alt - Comm.
? 25 Miscellaneous . ? 29 Antennae ? 35 Ext Alt - PF
woRK nrPe ? 37 Nail Salon
O 31 New ? 35 Tenant Impr ? 42 Demolish (Foundarion) ? 46 Windows/Doors
? 32 Addilion ? 36 Move Bldg ? 43 Reroof ? 47 Repair
? 33 Alterations ? 37 Deznolish (Bldg) ? 44 Siding ? 48 Authorization
O 34 Replacement ? 38 Demolish (Int) ? 45 Fue Repair
GENERAL INFORMATION
Census Code 7.oning sq. ft.
SAC Code # of Stories sq, g,
No. of Units Length sq. ft".
No. of Bldgs• Width sq, R, ,
Const. (Actual) Basement sq. ft. MC/ES System
(Allowable) First Floor sq. ft. City Water
UBC Occupancy sq. ft. Fire Sprinklered
MiSCELLANEOUS lNSPECTIONS
? Gas Service Test Heating ? Insulation Q Plumbing 0 Stucco/Stone
APPROVALS
~lanmg Building Engineering Vatiance
Pertnit Fee VALUATION $
Surcharge '
'lan Review 1 1 10 O b
WC/E3 SAC % 5AC
:,ity SAC SAC Units
Nater Supply & Storage Meter Size
i/W Pertnit
3M/ Suroharge
-reatrnent Plant
'ark Dedication
'rails Dedication =
Vater Quality
Hfier
:opies
qp " `Yhc~-J a20o . ~ O
'otal . 3a r 7 5 s. `I (
Use BLUE or BLACK Ink
r
For Office Use
' D
City of E n on Permit
Q I I Permit Fee: 504-25-
3830 Pilot Knob Road I
Eagan MN 55122 I O I
Phone: (651) 675-5675 i Date Received: 1
I I
Fax: (651) 675-5694
Staff:
--P
2013 COMMERCIAL BUILDING PERMIT APPLICATION
Date: j 3 Site Address: (9 f O r
I-V
Tenant Name: 6e d a 1- 11111a s (Tenant is: New / Existing) Suite
/ Former Tenant: c
Name: 6 y 1-'PL" rs11~, d-n Phone: .J
Property Owner
Address /City /Zip: fo Lt
j Applicant is: Owner Contractor
r h
T e of Work Description of work: ?'lh 4- !h
Yp 22} Q
Construction Cost !
Name: (,fit ~~~°1 l~ • License
Contractor Address. ~ q5 1LZ ~ ! l (i City: ()"D M ~
State: l n Zip: S5't/ ) Phone: 363- N` 3 0 0
Contact: ' V'i 0\ v1 / 4'1 Email:
Name: Registration
Arch itectlEngineer Address: City:
State: Zip: Phone:
I
Contact Person: Email:
r I
Licensed plumber installing new sewer/water service: Phone
$ NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
I' 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.gopherstateonecall.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.
/10
x 214 ov , x
Applicant's Printed Name Applica is Signature
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