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3323 River Bluff DrCityofEaau 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5675 Fax: (651) 675 -5694 / S3/6; �.� /� ` / / 23 Date: 4 • n • a0 // Site Address: x ��oe/I te.601 Applicant's Printed Name 2011 RESIDENTIAL BUILDING PERMIT APPLICATION A .pl nt's Signature Use BLUE or BLACK Ink Permit #: ClO 9)*(9 Permit Fee: Date Received: Staff: RESIDENT / OWNER TYPE OF WORK CONTRACTOR .3/3 At i RJa Pr Name: Om Address / City / Zip: Applicant is: Owner x Contractor Phone: 76.E - Hy9 - WO() IL Ad Description of work: RP ,�f7)p Construction Cost: 49y G //. $ 5 Multi - Family Building: (Yes X / No ) Company: . t ,t o ke ,h 61 o f ) 7 - Contact: Address: 59 760 14 State: M f\J Zip: 55//O Phone: 6 - 76 - 9029'5 License #: c15 /5 /g City: it Pit c1, Lead Certificate #: NAT-- 3 -0 �I Pe l lithe project is exempt from lead certification, please explain why: (see Page 3 for additional information) COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? Yes No If yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: i TE: Plans a nfor Unit #: 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. wvvvv.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 app , val Page 1 of 3 V�l7�i L71.YV V� Y�/'��.ra��• r-----------.�_._—_— 1 For Offfce Usa � I // � ��`7� I C�t af �� ; PeRnit#:_ ' S I � � ' o� � , I PeRnit Fee: , 3830 Pilot Knob Road � I EagBn IIAN 55122 � Dake Received: � Phane:(657)675-5675 I � Fax:(651�576-5694 ' � Staff: j '�Yr,CZ.t, E �� . �I�'•l��y C..�� G' �,4��;CY1 ' _.—__..� C�vr ��_...—_--�.__-- 2015 RESIDENTIAL BUILDING PERMIT APPLICAT1t]N C-e�.�;:,r' �3(,u�'-� Tc��+ h�� s-c� . , Qar�:?�-/�'� r? Site Address: 33 i 3 ��v��t�,�r I,c,��'j�-:v'�e., 55�a��n��: ��..'�,� _ �. s ,��i 5�, 33 � 1, '3� I �' �33�� 3 3�-3 � ' ; ;�v+c.l-N ; Name: �hone: � � Residentl ; ; pW�� ; Address/City/Zip: r ; �S 3 Applicant is: Owner ,,,�,�Cvntractor � .._..�_e...�_......_. .�....�.�.. ._o_,__._.. ..,.,,.._,_..�� Y 1 � T e of Wor1c � Descri tian of work: �� C� n 4� � r yp • p � °'' � � : 4 ; Construdion Cost: � ��: �v�� Multi-Family Building:(Yes 1 No !' t.......�.,,�.,,p.,.-.��,.�,...,__ .�._...�.... . _.,..�-�.�.-_�.�.v. _.�.�.._. �-�..�.__. � � ,� ..__. . . - � �s Cornpany:Cj�.'�Y1 r��{-' 1'S-�w1 �c�-z.�t'S Contact: ,J c�(?.� �-�'_� .��iY 1 � At�dress:�-l'� lG' �R:�� l 1/1-� Cily: �'�'� �t�t 1 , Co�rtractor (' � � State: �1/t� ZEp: � C� !v Phone: Ernail: �Yi`'t'v P S-t tn r� ��'2�^�-�'��.�5� t ! i - (��T-�a :��. � License#: � �V � i S ,� �_Lead Certif+cate#: '� �3� � ° �....,,........,..�F-,....,...F�.,.�......._...e..�.....�..�.,e....�.... _,._. r.,.y..._.,,.,a�.,.,�.,..,.�,�..�..,u,....,,....s.,. i ? �f the pro�ect is exemp#fcom lead certi#icati�n,ptease expiain why: ; i : �---�-- ,,,�__� GOMPLETE TNIS AREA ONLY IF CONSTRUCTING A NEW BUILDING € !n the tast 12 months,has the City of Eagan issued a permit for a similar plan based o�a master�ian? ; 5 ' Yes No If yes,date and address of master plan: ' t � Licsnsed Plumber Phone• � � s ' i : lNechanical Corrtractor. Phone: ' � � ; Sewer 8 Wate�Contractor: Phone: ` i � � Fire 5uppression Cor�tractor. Phone: a � NOTE:Plans and s�pportfng docurnents thatyou submitare considered to be public ir�format+on. Potfions of ; r the intorr�ation may be cla�ed as non public if yvv provide specff'rc reasons that wo�ld permit th�e City to � �y�� --- ----.._.�...,�..�..�. conclude that they are tr�de secrets. �.�._._. ..�...- CALL BEF�RE YOU DIG. Caa Gopher S1ate One Cali al�651)d5�E-OD02 for prolection against underground uliliy da�nage. Ca1148 haurs before you iMend to dig lo receive locabes of�dergraund utillties. wwir�.ga�herstateor�ecall.om I here6y s�[cnowledge that ihis infamation is compiete and accurate;that the work wiil be in coaformance with lhe orclinances and codes of the City of Eagan; that 1 understand this is not a permit, hvl anly an application iw a permit, and work is not to sfart without a pennit;that ihe woiis v,riEl be in accordanfle with the approved plan in the case of work whic�h requir�a review and�proval of plans. Exieriorwork authorized by a 6uilding permit issued In accordancewifh fhe Minnesota State BuUding Code must be complated within 180 ilQ�f 9f pV►lnit isal��nwo _... x �,� Q,�-�.�,,�' c,,.� -�_.--� x AppiicanYs Prinded�lame A s ignature ,` Qage i ot 3 Use BLUE or BLACK Ink � r----------------� I For Office Use � C' � Permit#: /��//�� j �� O� `�� I Permit Fee: / �J� � j I 3830 Pilot Knob Road � � Eagan MN 55122 � Date Received: � Phone:(651)675-5675 I � Fax: (651)675-5694 � Staff: I � I 2015 RESIDENTIAL BUILDING PERMIT APPLICATION —� �'`-��.� Date: Site Address:� ��.�� G� �� Unit#: , Name: Phone: ReS�+C1+�� / -� (}yy�g� ;�; �: Address/City/Zip: ��! � �iVLR13�u,FF� .�R • �6•�ii �1'1�✓� SS/�3 Applicant is: Owner �Contractor � �` � ` Description ofwork: �C'P��4c� �'�r+-R.ia.t,-rf �oOlt,� T�p+R 4��►�rk ' w Construction Cost: � .3 Multi-Family Building: (Yes�/No� Company:(_�}-i1,YVo�J Vil-U��w, ��Crri° d�Dizs�,L[,C, Contact: �7Fi1�'��0�✓�'"� ��, Address: 357RD 91�� AI.E�. City: (_.�9'NNd�✓�i??�LS : State:�Zip: SSUO Phone: �oS/-�y5- 03�/ Email: SJohtAtSav�CA+✓�N✓ki��/��qd�"� ns,c�„ License#: /J�� Lead Certificate#: N�f} If the project is exempt from lead certification, please explain why: ,No Le� Pafs�.vr' COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING In the last 12 months, has the City of Eagan issued a permit for a similar plan based on a master plan? Yes No If yes,date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Phone: Sewer&Water Contractor: Phone: Fire Suppression Contractor: Phone: �OT�';Pta�is.�r�d;sr��por�g t��ur��e�,s f��,�uu��br�i�are;c��d��ed to bE�trf�c�nai��.:Ptrrfio�s.�rf : �e i�fvrr»�f1c�n�a,�y��cla�st�'ietl�rs��n pubt��if y�u}�ra��l�s�ecifrc r�p�s tt�a#t�c��l�l per��f�e C��°�. ' �or��ud�.t�a#fh are tw��(e�e�r�: 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.orq 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. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. x S�'�VE" �uN�NSc�N x Applicant's Printed Name Appli ant's Signatu e Page 1 of 3 Use BLUE or BLACK Ink r For Office Use/` `y OF,Fq 4 _ Permit#: i7Gi 4 7 u • ••• z RECEIVED s %.,-* ..w s 'v V Permit Fee: �f ,� �� +`� NOV 1 6 2017 Date Received: .1✓ i6. -1 ittsMI9 3830 Pilot Knob Road I Eagan MN 55122 Staff: Phone:(651)675-5675 I buildinginspections@cityofeagan.com -TJ 2017 MECHANICAL PERMIT APPLICATION n Please submit two(2)Sets of plans with all commercial applications. c� Date: ) 1 - i 3- ( 7 Site Address: 332.RJ .++t c-r .l T 4-",,v e Tenant: ( n t' \r Suite#: esid@Int/Owner . Name: n (-\4.-‘6‘-'-N Phone: ': Address/City/Zip: ' ;, ''.,,,,•'.." Name: f' S i C-' ' t cz' .\ "•(:-.\ e\' License#: a r, 4 1 65 E. Li\ 5l 5T- Sc_),)-(_. k City: t\• '� co l.0 tri f A Address: n State: t� Zip: <i s r 1 Phone: �j )` �j 3 Z-�j 3 4Contact: rm �A �L Email: an n t e C- ��a �� a,tC C [? r7 ' = New "K Replacement Additional Alteration Demolition 6-'63.0c06,16.� (3 t'd- of Work Description of work �e csz- T �c . C osfr c-c j cv S r-c 7 Z- ' NOTE oof 11111 unted;3i a ®��' • #11ount(�•.<. = tical equ,:.4;.• w. is �' to be screened Shy Cit�l ';` Codde Please contact P'4,',,,,;,, ical lnspe •. .err inforfrte ,$ p.#7" =d$,,c,..5,1", = ins =rte is' tyke-.- 4 , RESIDENTIAL COMMERCIAL - urnace New Construction Interior Improvement . -r'' _Air Conditioner Install Piping Processed ullIcv • Air Exchanger Gas Exterior HVAC Unit k ' _Heat Pump Under/Above ground Tank (—Install/_Remove) erns ' v.: —Other RESIDENTIAL FEES $60.00 Minimum Add or alteration to an existing unit, includes State Surcharge ll 4p $100.00 Residential New, includes State Surcharge =$ b 6 TOTAL FEE COMMERCIAL FEES Contract Value$ x.01 $60.00 Permit Fee Minimum $75.00 Underground tank installation/removal, includes State Surcharge =$ Permit Fee Surcharge=Contract Value x$0.0005 =$ Surcharge If the project valuation is over$1 million, please call for Surcharge =$ TOTAL FEE You may subscribe to receive an electronic notification from the City of proposed or, ances by signing up for an email update on the City's website at www.citvofeagan.com/subscribe. I hereby acknowledge that this information is complete and accurate; that the work will be in c• formance with the or'inan -s and codes of the City of Eagan;that I u erstand this is not a per it,but only an application for a permit,and work is n to .tart without a per i /'h work will be in accordance with the approve Ian in the ca e work hich requires a review and approval of plans. x � � D_ / f x r Applicant's Printed Name `'�/ Applican':. 'ignature / ....../,,,„ . .„i......,,,,,...::::,/,::„.„, :1. : ' e = Ik� FICE�US reviewed By 'R _ oservi et n 1 d RoughIn < .Ai• ,