3953 Valley View Dr SCity of Eagan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
,JUN
Use BLUE or BLACK Ink
E. 96%
Permit #:
Permit Fee:
Date Received:
Staff:
2011 COMMERCIAL BUILDING PERMIT APPLICATION
Date: r'r' i`/- /1 Site Address: 3 553 - 3 9 5-7 ` /4y D,
S.
(Tenant is: New / ....--Existing) Suite #:
Former Tenant:
Tenant Name:
PROPERTY OWNER
Name: i, //4( fF�.�/ .1. / 14G Phone: (a.Sr`" '95`f p2/`'
,..,z,
Address / City / Zip: 3 7 1' V.--1/,,,,', U:,,,, % D. I�a�C c y► IP() S"S/a 2.
/
Applicant is: Owner Contractor
TYPE OF WORK
�- ''l
Description of work: r;•�a`rr t'�lis . V. ry t Siit_s Si- Irj✓)4e� �'4k,_� S01
llj
rtc.--
Construction Cost: ao` 0009
CONTRACTOR
Name: 4,46,1De/ A e). K:e-,s{-,,, /,o<+`, Lc. License #: 42636 3 96S '
Address: o247?5 Co,ndy Jiwy f City: ie. ie.
State: kA.'J-- Zip: .5-97Y5.-- Phone: G' /02 - 74// /79/
,+ I -g
Contact: DeY 1$9 1 Email: e,i` o►+e 1 p a: J4..r/. + rn i Gr? •^-t.•
ARCHITECT /
ENGINEER
Name: Registration #:
Address: City:
State: Zip: Phone:
Contact Person: Email:
Licensed plumber installing
new sewer/water service: Phone #:
NOTE: Plans and supporting documents that yousubmit 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
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.00pherstateonecall.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 an royal of plans.
x YG°11;e ( JG zSlS%tGs-,.
Applicant's Printed Name
x
Ap. icant's Signature
Page 1 of 3
Aug 25 11 03:01p Bruce Nelson Plumbing & H
411' CityofEaaii
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 575-5675
Fax: (651) 675-5694
6517312804 p.22
Use BLUE or BLACK Ink
For Office Use
Permit #: /00757
Permit Fee: ,f51 0 V
)
Date Received:
Staff:
2011 COMMERCIAL PERMIT APPLICATION
Date:ng jSite Address C 1772" WI`` 'Ji.LV- r I,
h
Tenant Name t .t.-\.PrikfmcU hpis
4 anent is: New/ V Existing) Suite #:
1
Former Tenant
PROPERTY OWNER
Name: ` }C \1 '�S phone: 05 raj --S- r
Address ! City I Zip:1 Q \J^' L l r`\( i I'1 ‘(.)sV t y St 4tt.d Mn 31 C)Z--
;
Applicant is: Owner ti% Contractor
_
TYPE OF WORK
Description of work Q ? T , rst.5 i \ a
Construction Cost
CONTRACTOR
t ��j I
Name: cl.l.0 Q V ,Q \ Pw--) t{ t\k License #: ��.1:3
Address,\'lD. Jr) Rb Nf>- (A,&4 12c City. '_`‘- PPh .
State: \C\ Zip: L- 3 7,`-1 hone: l.l°' i 1' ''l�j e -j j.1-1
Conte C (1(1%'1 Email:
ARCHITECT /
ENGIN EER
Name: Registration #:
Address: City:
Slate: Zp: Phone:
Contact Person: Email:
Licensed plumber installing
new sewer/water service: Phone #:
NOTE: Plans and supporting documents that you submit are considered to be,oublic information. Portions of
the information may be classed as non-public if you provide specific reasons that would permit the City to
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.eoohershtteoneaall.org
I hereby acknowledge that this information is complete and accuate; 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 —se of wortwhich requires
uires a review and approval of plans.
c,. .0\4ACt
Applicants Printed Name `�Applican s Signature
Page 1 of 3
~0,4 9-_~-- Yoy 69
2005 COMMERCIAL BUILDING PERMIT APPLICATION '5~4
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5694
. . • ' . . Interior . . -
• Structural Plans (2) sets • Archkedural Plans (2) sets • Archftectural Plans (2) sets
. Civil Plans (2) • Siructural Plans (2) • Code Analysis (1) "
• Certficate ot Survey (1) • Civil Plans (2) • Projed Specs (1)
• Code Analysis (1) • Landscaping Plans (2) • Key Plan (1)
. ProjectSpecs (1) • CodeAnalysis (1) " • MasferExitPlan (1)
• Spec. Insp. 8 Testing Schedule ° • Certifcate of Survey (t) . Energy Calculations (1) not always"
. Soils Report (1) • Spec. Insp & Testing Schedule (1) " • Elec, Power 8 Lighting Fortn (1) not always"
. Meter size must be established • Meter size must be established • Meter size musl be established-if applica6le
1 • Project Specs (1)
y • Energy Calculations (1) " 1
1 • EleCric Power & Lighting Form (1)
1 • Master Exit Plan (1) 1
1 • Emergency Response Srte Ptan (1)
1 • Soils Report (1) 1
• SACdetermination-ca11651-602•1000 • SACdetertnination-ca11651-602-1000 • SACdetertnination-ca11651-602-1000
. • Fire Sto in Submittals
Call MN Dept of Health at 651-215-0700 for details regarding tood & beverage or lodging facilities.
Contact Building Inspections for sample and if required
Pecmi[ for new building or addition will no[ be processed without Emergency Response Site Plan.
Date ~ l~~T l 07 Construction Cost 60
Site Address 3/ S~J yct ~~CY v+'2w ~f 7 UniUSte #
Tenant Name Former Tenant Name
Description of Work r/u 4 /ovl -ln ui~
PropertyOwner yl-eV`~ d i n7C !Y/~'~r7~P n~S Telephone )
Contractor ~ / -m em a/dC/In-q ~vlC _
ZI 6/0Qv~P~j City /~iv+dlC~,~o~5
Address GD
State Zip Telephone #(6JZ
Arch/Engr Registration #
Address City
State Zip Telephone # ( )
Licensed plumber installing new sewer/water service: Phone U
I hereby apply for a Commercial 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 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 aireview and
approval of plans. 1111 1
> ~ _J
14 f~'~ ~?h leQ U ~ I
Applicant's Printed Name Applicant's Signature
OFFICE USE ONLY
Sub 7ypes
? Ol Foundation O 26 Public Facility ? 30 Accessory Building
0 14 Apartments ? 27 CommerciaU[ndushial Er- 32 Ext Alt-Apartments
? ] 5 Lodging 0 28 Greenhouse ? 34 Ext Alt-Commercial
? 25 Miscellaneous ? 29 Antennae ? 35 Ext Alt-Public Facility
? 37 Nail Salon
Work Types
? 31 New ? 35 Ini Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. O 42 Demolish (Foundation) ? 45 Fire Repair
C3' 33 Alteretion ? 37 Demolish (Bldg)` 0 43 Reraof O 46 Windows/DOOrs
O 34 Replacement 'Demolition (Entire Bldg only) • Give PCA handout to applicant
Valuation Izo Type of Const L/~ Width
Plan Rev 100% 25% ~ Occupancy 22 MCES System
Census Code Zoning 24 _ City Water ~
SAC Units Stories ~ Booster Pump ~
Nbr. of Units - Sq. Ft. PRV ~
Nbr. of Bldgs Length Fire Sprinklered ~
Required Inspections
_ Footings (new bldg) _ Insulation
_ Footings(deck) FinaUC.O.
_ Footings (addition) ? Final/No C.O.
Founda[ion O[her
Drain Tile~
oof ? Ice Pr Decking _ Insul _ Final _ Pool Ftgs Air/Gas Tests Final
? Framing _ Siding _ Stucco _ Stone
_ Fireplace _ R.I. _ Air Test _ Final _ Windows
Approved By: Planning rn` 6' Building Inspector
Base Fee 1 F 0??175
Surcharge 57,50
Plan Review 25 °7o a69. 43
SAC-MCES
SAGCity
S/W Permit
S/W Surcharge
Treatment Plant Financial Guarantee
7reatment Plant (Irrigation) Storm Sewer Trunk
Park Dedication Sewer Lateral Sewer Trunk
Trail Dedication SUeet
Water Quality Water Lateral Water Trunk
Water Supply & Storage (WAC) Other
Total ~ / 6 g
2005 COMMERCIAL PLUMBING PERNIIT APPLICATION ~
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Date Site Add~s Unit k
Tenant Name Former Tenant Yame
Property Owner Telephone # ( )
Contractor 10
~
Address l'O t"S~~,Ly) ( 1 City
State m~ Zip S 1~S Telephone
License # Expires:
The Applican[ is _ Owner Contractor _ Other
Work Type New Bldg _ Modify Tenant Space RPZ PVB New Repair/Rebuild _ Replace
_ Irrigation sys[em Work within public righ[ of-way/easement _ Yes _ No
Rain sensors are re uired cn irri ation svstems.
Description of Work u 2 H-'r- 4 Ru asu
To inquire if Pressure Reducing Vaive is reqwred on new sen•ice, ca I 651-675-5646 Nli
Me[ers - Call 651-675-5300 to verify that hydrosta[ic, conductivity, and bacteria tests passed orior to oickine uo meter.
Irrigation Size & Type Avg GPM 2" hubo req'd unless smaller size allowed by Public Works
Fire Size & Price 3/4" disolacement 5161.00
Domestic Size & Type Avg GPM Includes high demand devices? _ Yes _ No
Flushometers _ Yes _ No PRV Required _ Yes _ No
Permit Fee $50.50 mininruni (includes State Surcharge)
Con[rac[ Value $ 'D . 00 x 1% Pemu[ Fee
$ Me[er(s)
Required on all new buildings & boulevard irricanon svstems $ Radio Me[er Read
If permi[ fee is $1,000 or less, sureharge is 5.50 $ $t2t2 Sll7C}18rgC
If permit fee is over SI,000, sureharge is $SO per $1,000 of [he Permi[ Fee
Following fees apply only when installing new irtiga[ion system Water Pemut
Call7erty Wobschall at 651-675-5024 for reqwred fee amounts
S Treatment Plant
$ Water Supply & Storage
$ State Surcharge
$ ~O, ~,v To[al Fee
I hereby apply for a Commercial Plumbing Permit and acknowledge that the information is complete and accurate; that the work will be in
confortnance 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 pertnit, and work is not ro start without a permit that the work w,i1TBin aecordance with the approved plan i case of work
!imm~ p roval of plans. ~l'1 a~-~~2W5
ApplicanPs Prin[ed Name ~ App icanPs Signature
CITY USE ONLY
REQUIRED IYSPECTIONS: _ U.G. _ AirTest _ GasTest _ Rough In _ Final
PLANS SUBMITTED APPROVED BY: gU1LDING INSPECTOR
Geoeral Information
• Radio Meter Read (required on all new buildings R boulevard irriga[ion systems- 5141.00
• RPZ's must be tested every year and rebuilt every five years. Test results should be mailed to Paul Heuer at the Ciry of Eagan.
• A rttinimum fee permit per address is required for the (ollowing RPZ's: new, rebuild, re air, remove.
• Water meters include copper horn/strainer, remote wire, and touch-pad meter.
METERS REOUIRING 4-HOUR ADVANCE NOTICE PRIOR TO PICK UP
GPM METERS USE PRICE GPYt METERS USE PRICE
1-20 5/8" residential 5125.00 4-120 1-1/2" jnj.-a[ion Syst S 735.00
displacement smcommercial turbine** public Works
maximum
continuous mus[ approve
1 O meter size
2-30 3/4" lawm irrigation 5161.00 4-160 2" turbine Ig irrigation syst S 931.00
tnaximum displacement residential gz
continuous sm commercial production lines
IS
3-50 1" displacement very Ig res 5296.00 1/4 to 160 compound bldgs over S 1,849.00
bldg to 24 units 65 units
maximum sm commercial
continuous & Ig comm bldgs
25 irriation s stems
5-100 1-1/2" bldgs 25-64 units 5429.00
maximum displacement &
continuous most comm bldgs
50
METERS REOUIRING 30-DAY ADVANCE NOTICE PRIOR TO PICR UP
GPA7 METERS USE PRICE GPM METERS USE PRICE
5-350 3" turbine very Ig irrigation $1,182.00 6-500 4" compound +300 unit bldgs & $3,563.00
syst 8• produc[ion very Ig comm bldgs
lines
1/2-320 3" compound +200 uni[ bldgs $2,282.00 10-1000 6" compound +400 unit bldgs $6,076.00
very Ig comm bldgs very Ig comm bldgs
15-1000 4^ turbine very Ig irrigation $2,226.00
s}•st
& production lines
Comments
• To schedule inspec[ion of [he inside water line and backflow preaen[er, call 651-675-567J.
• To arrange for a•a[er tum-on, call 65 L675-5300.
cc: Maintenance DiNision Clerical Technician January 2005
2005 COMMERCIAL MECHANICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telephone # 651-675-5675
Please complete for, commercial/industrial buildings
multi-family buildings when separale permits are no[ required for each dwelling unit
Date c
~
Site Street Address 3qSS V " 0 akDL)`ri Unit #
Tenant Name (if applicable) Previous Tenant Name
Property Owner Telephone k ( )
Contracror ~i L) d
Street Address ~ 14 C) &dkR-d flwk City 31- paj~&
State rn 1 v Zip -S!S~ )Telephone #(~I ) O(~~ 9d 0v
Bond Expires:
The Applicant is _ Owner ~ Contractor _ Other
Work Type
New Construction _ Underground Tank _ Install _Remove "see below
Interior Improvement I ,~,I Install Piping Processed Gas
Nature of Work: ~ J~-1-~,~~1 v~ K~AS MffiD
"When insialling/removing underground tank, caN for inspection by Frre Marshal and Plumbing Inspector
P¢I'm1I F¢eS: 570.50 Underground tank installahon/removal
$50.50 3.'inimcm (includes Sta;c Surchargc)
or.
Con[ract Value $ ~ oO x 1% _ $ 4 O ~ V Permit Fee
1
• If ep rmit fee is $1,000 or less, add $.50 ~ $ 4,,50 State Surcharge
(f ep rmit fee is over $1,000, add $.50 for ~D
every $I,000 ep rmit fee $ o Tatal Fee
I hereby apply for a Commercial Mechanical 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 Mechanical Codes; that I understand this is
not a permit, but only an application for a permit, and work is not to start witho ermit; that the work will be in acc r nce with
the !aTppjr9Yd plan in the case of work which req s a review and approval of ans. +
~r~_t-~~~LWS
Applicant's Printed Name ApplicanYs Signature
Approved By: ::5> \I Inspector Date:
2005 RESIDENTIAL MECHANICAL PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan MN 55122
Telep6one # 651-675-5675
Please completc (or. singlc family dwellings & townhomes/condos when pcrmits are rcquired for each unit
Date
Site Address Unit #
Property Owner Telephone # ( )
Contracror
Street Address City
State Zip Telephone # ( )
Bond Expires:
The Applicant is _ Owner _ Contractor _ Other
Add-on or alteration to existing dwelling unit $ 30.00
furnace _Additional _Replacement
air exchanger
airconditioner _New _Replacement
other
State Surcharge $ 50
To[al $
I hereby apply for a Residential Mechanical Permit and acknowledge that the information is complete and accurate; Ihat the work will
be in conformance with the ordinances and codes of [he City of Eagan and wi[h [he Mechanical Codes; that 1 understand [his 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 Name Applicant's Signature
-41 1J 9 2005 COMMERCIAL BUILDING PERMIT APPLICATION V(q ~ ' 1O ~
City Of Eagan Ck,,,,,z 99 3
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5694
e e., x i, e s , o e a
. Strudural Plans (2) sets . Architectural Plans E (2) sets . Archflectural Plans (2) sels
. Civil Plans (2) • Structural Plans (2) • Code Analysis (1) "
. Certificate of Survey (i) • Ciwl Plans (2) • Project Specs (1)
. Code Analysis (1) " • Landscaping Plans (2) • Key Plan (1)
. Project Specs (1) • Code Analysis (1) " • Master Exil Plan (1)
. Spec. Insp. & Testing Schedule " • Certificate ot Survey (1) • Energy Calculations (7) not always"
. Soils Report (1) • Spec. Insp. & Testing Schedule (1) " • Elec. Power & Lighting Form (1) not always"
. Meter size must be established • Meter size must be established • Meter size must be established-if applicable
1 • ProjectSpecs (i)
1 • EnergyCalculations (1)" l
1 • Eleclric Power 8 Lighting Form (1)
y . Master Exit Plan (1) L
1 • Emergency Response Sile Plan (7)
1 . SoIlsReport (1) 1
. SACdetermination-ca11 651-602-1 000 . SACdetermination-ca11 651-602-7 000 • SACdetermination-ca11 651-602-7 000
. Fire Sto in Submittals
Call MN Dept of Health at 651-215-0700 for details regazding food & beverage or lodging facilitles.
" Contact Building Inspec[ions for sample and if required
Pemii[ for new building or addition will not be processed wrthout Emergency Response Site Plan.
Date /0/ / b t Constructiou Cost -3f' 0°°• ~
Site Address 5-3 (J a(/-~., -,dr . 5, UniUSte #
Teoant Name Former Tenant Name
.
Description of Work c -f u' I
Property Owner /T r rr/o /r & Telephane #r/) '72 f- 7
Contractor ~//`'ts tzl`^A'`"3
Address 6 90o w• ~ S/ S4- City /6~Zlf t/Q
State Zip SSi 1 y Telephone G/L) 9-6 c-&G
Arch/Engr Registration #
Address City
State Zip Telephone # ( )
Licensed plumber installing new sewerlwater service: Phone
I hereby apply for a Commercial 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 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.
k-6-10"n ga
Applicant's Printed ame Applicant's Signature
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 26 PubGc Facility ? 30 Accessory Building
? 14 Apartments D 27 CommerciaUlndustrial ? 32 Ext Alt-Apartrnenu
? 15 Lodging ? 28 Greenhouse ? 34 Ext Alt-Commercial
? 25 Miscellaneous ? 29 Antennae Ll 35 Ext Alt-Public Facility
? 37 Nail Salon
Work Types
? 31 New ? 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
0 32 Adddion ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Alteration ? 37 Demolish (Bldg)• O 43 Reroof ? 46 Windows/Doors
? 34 Replacement 'Demolition (Entire Bldg only) -Give PCA handout to applicant
Valuation Type of Const Width
Plan Rev 100% _ 25°h _ Occupancy MCES System
Census Code Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr of Bldgs Length Fire Sprinklered
Required Inspections
_ Foolings (new bldg) _ Fireplace _ RI. _ Air Test _ Final
_ Footings(deck) _ Insulation
_ Footings (addition) _ FinaVC.O.
Foundafion _ FinaUNo C.O.
Drain Tile Other
_ DriveRay Apron _ Pool _ Ftgs _ AidCras Tesu _ Final
_ Roof lce Pr _ Decking _ Insul _ Final _ Siding _ Stucco _ Stone
_ Framing _ Windows
Approved By: Planning Building Inspector
- - - -
Base Fee
Surcharge
Plan Review
SAC-MCES
SAGCity
SIW Pemtit
SIW Surcharge
Treatment Plant Financial Guarantee
Treatment Plant (Irtigafion) Storm Sewer Trunk
Park Dedcation Sewer Lateral Sewer Trunk
Trail Dedcafion SUeet '
Water Quality Water Lateral Water Trunk
Water Supply & Storage (WAC) Other
Total
COMMERCIAL
, 2002 BUILDING PERMIT APPLICATION
° CITY OF EAGAN
o ~ 651-681-4675 0
_t.
Foundation Onl New Construction Interior Im rovement
• Structural Plans (2) sets Archdectural Plans (2) sets • NchitecNral Plans (2) sets
• Civil Plans (2) • SVuctural Plans (2) • Code Analysis (i) "
• CenificateofSurvey (1) • CivilPlans (2) • ProjectSpecs (7)
• Code Analysis (1) . Landscapinq Plans (2) • Key Plan (1)
. Project Specs (1) Code Analysis (1 ) " . Master Exil Plan (1)
• Specrlnsp. & Testing Schedule " Certificate of Survey (1) • Energy Calculahons (1) not always"
• Soils Report (1) • Spec. Insp. 8 Testmg Schedule (t) " • Elec. Power 8 Ligh6ng Form (i) notalways"
. Meter size must be establis~qd . Meter size musl be established • Meter size must be established - if applirable
• ProjectSpecs (1)
1 • EnergyCalculations (1)
1 • Electnc Power & Lighfing Form (1)
1 . Mas[erExrtPlan (1) 1
1 • Emergeney Response Site Plan (t)
1 • SoilsReport (1) 1
• MC/ES SAC determination letter . MC1ES SAC delerminatlon letter • MC1ES SAC determination letter
call 651-602-7000 call 6511'i02-1000 call 657-602-1000
Food 8 beverage or lodging facilities - submit plan to MN Department of Health. Call 651-215-0700 for details.
" Contact Building Inspections for sample.
Permit for new buildings or additions will not be processed without Emergency Response Site Plan. Ask Building Inspections for requirements.
RUCTION COST:
DATE: WpRK TYPE: NEW ~;~Z/17 L z
SITEADDRESS: ~ / ~.1 J ~ ~ ~ C> EJ Li
TENANT NAME: SUITE
FORMER TENANT NAME, IF APPLICABLE:
DESCRIPTION OF WORK -ff~JN +p OE 11 T~/~e~
r~~..,.
Name: 6~004 C'r
jeAfi;;~YJ(•1~j'fC. btCJ''i/~!S_ Phone 1f: (!43- 5SS~I ^ / 7lI
PROPER"CY La First
OWNER
StreetAddress:2ns !"rM0,vy1,( ~ • tLp~
City: State: W. Zip: __545~'"/6
Company: / Y / ' l A( J / (leC Phone ( 763 ) 5~7-7 ' ~ ~ 23
CONTRACTOR
StreetAddress: - 12 O-L Z (
City: A Stare: m41. Zip:
~ 'n ~ 1 iao2
ARCHITGCT/ ~ AVG
EVGINEER Company: Phone ( )
Name: \Ckli _ Registration
, -
Street Address:
City: State: Zip:
Licensed plumber installing new sewer/water service: Phone
I hereby acknowledge that 1 have read this application, state that the information is correc d ree to omply i II applicable State of
Minnesota Statutes and City of Eagan Ordinances.
Signature of Applicant
~ Updated 7I02
OFFICE USE ONLY
SUBTYPE
' Ol Foundation 3 26 Public Facility ? 30 Accessory Bldg.
~ 14 Apartments ? 27 CommerciaUIndustrial ? 32 Ext Alt - Apts.
; 15 Lodging . ? 28 Greenhouse G 34 Ext Alt - Comm.
: 25 Miscellaneous ~ 29 Antennae ? 35 Ext Alt - PF
WORK TYPE Tx:r_-~ ? 37 Nail Salon
~ 31 New ? 35 Tenant Impr ? 42 Demolish (Foundation) ? 46 Windows/Doors
' 32 Addition ? 36 Move Bldg C 43 Reroof 47 Repair
~ 33 Alterations ? 37 Demolish (Bldg) C 44 Siding C 48 Authorization
7 34 Replacement ? 38 Demolish (In[) G 45 Fire Repair
GENERAL INFORM Ti~ ION
Census Code Zoning sq. ft.
SAC Code # of Stories sq. ft.
No. of Units Length sq. ft.
Vo. of Bldgs. Width sq. ft.
Const. (Actual) v- Basement sq. ft. MC/ES System
(Allowable) First Floor sq. ft. City Water
UBC Occupancy sq. ft. Fire Sprinklered
MISCELLANEOUS INSPECTIONS
- Gas Service Test ? Heating u Insulation 0 Plumbing ? Stucco/Stone
APPROVALS
Planning Building Engineering Variance
~
32f Zy VALUATION $ tO, 000
Permit Fee
3urcharge
Plan Review i1AC/ES SAC % SAC
City SAC SAC Units
Water Supply & Storage Meter Size ,
S/W Permit
S/W Surcharge
Treatment Plant
°ark Dedication
Trails Dedication
'Nater Quality
Jther
Copies
S ~U . 0 ~
Total
VALLEY VIEW DRIVE NO
VTF.W Pn1NTR APTS
3900/ 10 01900 031 10 ,(24-urrIT nrT.)
3904
3910/ 10 01900 031 10 (24-[JNIT APT.)
3914
3911/ ] 0 01900 031 10 (24-UNIT APT.)
3915
3921/ 10 01900 031 10 (29-UNITAPT.)
3925
3931/ 10 01900 031 10 (24-urnT arr.)
3935
VALLEY VIEW DRIVE SO
VTFW PniNTF. APTfi_
3901/ 10 01900 031 10 (24-UNIT APT.)
3905
3902/ 10 01900 031 10 (24-UNIT APT.)
3906
3908/ 10 01900 031 10 (24-UNIT APT.)
3912
3916/ 10 01900 031 10 (24-UNIT APT.)
3920
3923/ 10 01900 031 10 (29-UNIT APT.)
3927
3933/ 10 01900 031 10 (24-UNIT APT.)
3937
3943/ 10 01900 031 10 (24-UN1T APT.)
3947
3953/ 10 01900 031 10 (29-UNIT AP I)
3957
6
~ ~2000 BUILDING PERMIT APPLICATION (RESIDENTIAL)
cinr oF encM 2 g~, a-rj
3830 PILOT NNOB RD - 55122 J
851-881-4875
,v comm,cna, aeawremenh `3l{Gl~ I
, s refllateroa wa wrvey& u,owmp ,y. IL a at, s% n. a nouae Z coaws a plan
and yp rooled arew f20% mmdmum lof coverace albwedl -7"-,V7, OU 1 set of enerpy calcWaMOns tor heated addlMOns
> 2 coples ol plmu (show bearn ! wlndow sIzes; poured tnd desiqn; etc.) 1 sIte wrvey tor extedor addlHOns d decks
> 1 sel ol eneryy calculaqons
* 3 coples of hae Preservatlon plan H lof plalfed aRer 7/1/93
i. .
DATE: 7. f ig 10o CONSTRUCTION COST: n0o
DESCRIPTION OF WORK: RimooF 3 Gaea~e.s- 3 T,•-~P~' 3f~5
STREET ADDRESS: ~39 4E Y V 11EN7 # 0 r 5 C-A(,An1
LOT: ~ BLOCK: t 0 SUBD./P.I.D. A: Sef fl U y) 10)
Name: 00071n1 Usn DEVIELo P,*FnlT CLc Phone#: 6/2-35'-I- 55oa'
PROPERTY Lost flral
OWNER • n / . • '
Sfreet Addresa: a~J SS' /OLg2 i3 4A-~/~ NO~tT~ 5 v'TE Ido `
ci~, ?yl• .7 h e a p o I r,S state: ' Iti1.J np; SS~'S~ 7
. Company: ScN 41 icKExT CoNpa+JY Phone 0: '~"87 38 7- 3/01 £rTZ3t
(areacode)vrx 38'7- 537-7
COMRACTOR
SheetAddress:-3-;0 PoPLA2ST Pb Wx 1119 Ucense# 9194 Exp.3j~_im/
.
ciy WI ~u k ATo stare: M~ nP: S6~a -/i~9 -
~ ~
~GoPc~ L~ctNSE ~ S.rw PC,4.,J 4 Ac9coQc 'OC~. L.c/a.ck A-7T4C4 E40
ARCHITECT/
ENGINEER Company: A/D AtE Name:
Telephone 0: ( )
Shee1 Address: RegishaHon M:
~
CHy Sfafe: Zlp:
3ewerhvater iicensed plumber (if inatallina sawarlwater): aQ Al~L Phone
hereby aeknowledye Maf I have read this aPPlkatlon, afate that fhe fnformaNon la corteef, and ayree to eompy wNh aG appYoable Stale
)f Minnesota Stafutes and CHy of Eayan Ordinances. /J
Slpnalure W Appllcant ~ ~ Of
~"w 14Er-T O - OFFICE USE ONLY
G~o4F~N~D ~I~~7 ~9R
:artincaceg or suNey Receivea _ ves _ Na ' JUL Z 4
1'ree Preservatlon Plan Received _ Yes _ No _ Not Required i• ,
fi't,~,•
p
s 4. .
1999 BUILDING PERMIT APPLICATION (COMMERCIAL)
G651 681 467~
Re uirements to buildin ermit
Foundation Onl New Construction Interior Im rovement
• Structural Plans (2 sets) . Architectural Plans (2 sets) • Architectural Plans (2 sets)
• Ciwl Plans (2 sets) . Structural Plans (2 sets) • Code Analysis (1) ^
• Cotle Analysis (1) . Civil Plans (2 sets) • Projecf Specs (1 set)
• Prqect Specs (1) . Landscaping Plans (2 sets) • Key Plan
• Spec. Insp. & Testing Schedule " . Code Analysis (1) " • Master Exit Plan
. SAC determinatipn letter from MClES SAC determina[ion letter 6om MGES - call • SAC determinahon letter from MGES - call
call 657-602-1000 657-602-1000 651-602-1000
. Spec.Insp.8TestingSchedule (1) " • EnergyCalculations (1)notalways"
• Project Specs (1) • Elec. Power 8 Lighting Form (1) not alv,ays ^
• EnergyCalculations (7) "
• Eleclric Power & Lighting Form (7) "
. Master Exit Plan
• Soils Re ort 1
" Contact Building Inspections for sample
Food & beverage or lodging facilities: Plan must be submitted to Minnesota Department of Health. Call 651-215-0700 for details.
DATE: V13.) 9q WORK TYPE: _ NEW ~ REMODEL
DESCRIPTION OF WORK: R.Lrecf t aZ cu•~-~~, ~
CONSTRUCTION COST: ~ftoOU - TENANT NAME:
SiTE ADDRESS: _ 3ciS' 3-S-7 U SUITE
LOT BLOCK ~ SUBD. 'S 6-i C9 v-~- IP D.~
Name: U'; kw" Po ~ vJ'L A50~5 Phone
PROPERTY Last Firsi
OWNER
S[reetAddress:0c{ so. iJaN-Ly OhLu -
City T- s.y y„` State ?M w_ Zip: rS1 ~ Z
a
Company: A1l, S N 5t.n.w.s ~o0 f7;`-~~ Phone if: (D~llo-3S 3~
CONTRAC COR
Street Address:;Z ~3 4 0 C~AJ' S A-U.1`
City State: IA.{" . Zip: 'SS I I Lk
ARCHITECT/
ENTGINEER Company: ~ Phone
Name: Registration
Sneet Address:
~ Ciry State: Zip:
Sewer & water licensed plumber (onlv if instatlinq sewer & water): C~p IQ7
I hereby acknowledge that I have read this application, state that the informahon is correct, and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances
Signature of Applicant:
OFFICE USE ONLY
BUILDING PERMIT TYPE
? 01 Foundation ? 26 Public Facility ? 28 Greenhouse
? 25 Miscellaneous 0~27 Commercial/lndustrial ? 29 Antennae
WORK TYPE
? 31 New ? 34 Repairs ? 37 Demolish Bldg. ? 43 SidinglSoffitslFacia
? 32 Addition ? 35 Tenant Impr ? 38 Demolish (Interior) ? 44 Windows/Doors
? 33 Alterations ? 36 Move Bldg. 13- 42 Reroof ? 45 Fire Repair
GENERAL INFORMATION
Const. (Actual) Basement sq. ft. Census Code
(Allowable) First Floor sq. ft. SAC Code
UBC Occupancy sq. ft. No. of Units
Zoning sq. ft. No. of Bldgs.
# of Stories sq. ft. MC/ES System
Length sq. ft. City Water
Width Footprint sq. ft. Fire Sprinklered
APPROVALS
Planning Building Engineering Variance
~
Permit Fee VALUATION: $
Ll ~ ~5 • SS
Surcharge ~ ~ . L
Plan Review
MC/ES SAC % SAC
City SAC SAC Units
Water Supply & Storage Meter Size
S/W Permit
S/W Surcharge
Treatment Plant
Park Dedication
Trails Dedication ,
Water Quality ~
Other
Copies
Total y (O 3 - ~
VALLEY VIEW DRIVE SO
V[EW POINTE APTS.
3901/ 10 01900 031 10 (z4-UrriT nPT.)
3905 •
3902/ 10 01900 031 10 (24-urrtT Awr.)
3906
3908/ 10 01900 031 10 (z4-uivtT nwr.)
3912
3916/ 10 01900 031 10 (z4-uivir nrT.)
3920
3923/ 10 01900 031 10 (z9-uiviT.arr.)
3927
3933/ 10 01900 031 10 (z4-urrtr nrr.)
3937
3943/ 10 01900 031 10 (z4-UNrr.avT.)
3947
3953/ 10 01900 031 10 (z9-utatT nrr.
3957
4
EAGFN TOWNSHIP
3795 Pilot Knob Road
St. Yaul, Minnesota 55111
Telephone 454-5242
PERtaT FOR WATER SERVICE CONNECTION
Date:December 2, 1969 Number: 390
Billing Name: Car-Bor-Nel - Valley View Atitte Address; 3953 ~eadVal~e~l~ew(~~'
Owner: _Car-Bor-Nel Billing Address
Pltmber:Mitsch Plumbing
Location of Connection Meter Size.l X~ " Connectlon Chg.
Meter Nowlc', -7 Permit Fee 7.50 pd 12/2/69
~ Meter Readingoo~...; Meter Dep.
Meter Sealed: Yes Add'1 Chg.
NO Total Chg.
Inspected by
Da te
Building ie a: Remarka:
Residence
Multiple xx t;o. UnitS?4
Commercial
Industrial By:
Other Chief Inapector
In consideration of the iasue and delivery to me of the above permit, I
hereby agree to do the proposed work in accordance with the rules and
regulations of Eagan Township, Dakota C:Z2) tMinesota.
By: 4/~~
Mitsch Plumbing
Osseo, Minn.
Please notify the above office when ready for inepection and connection.
in
EAGEli TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242 -
PERMIT FOR SEWER SSRVICE CONNECTION
DATE: December 2, 1969 P3UKBER536
OWNER:Car-Bor-Nel - Valley View AptAddress 3953 Rahn Road
PLUMBERMitech Plumbing TYPE OF PIPE cast iron
DESCRIPTZON OF BUIIAING
Industrial Commercial Residential Multiple Dwelling No. of unfts
xx
Location of Connections: Connection Charge
Permit Fee 7.50 pd. 12/2/69
Street Repairs
Total
Inspected by:
Date
Remarka•
By.
Chief Inspector
In consideration of the issue and delivery to me of the above permit, I
hereby agree Co do the proposed work in accordance with the rules and
regulations of Eagan Toc•mship, DalcotB =Coun ~ ~ sotlGi~
YJ
Mitsch Plumbing
Osseo, Minn.
Please notify when ready for inspection and connection and before any portion
of the work is covered.
2005 COMMERCIAL BUILDING PERMIT APPLICATION
City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-675-5694 q$ ~7-1 S
. s • d Improvement
. SUuctural Plans (2) sets • ArchRecturel Plans (2) sets . Architecturel Plans (2) sets
. Civil Plans (2) • Structural Plans (2) • Code Analysis (1) "
. Certificate of Survey (1) • Ciwl Plans (2) • Project Specs (1)
. CodeAnalysis (1) " • LandscapingPlans (2) • KeyPlan (1)
. ProjectSpecs (1) • CodeAnalysis (1) " . Master Exit Plan (1)
• Spec Insp. & TesUng Schedule ° • Certificate of Survey (1) • Energy Calculations (1) nol always°
. Sods Report (t) • Spec. Insp. & Testing Schedule (1) " • EVec. Power & Llghting Form (1) not always"
. Meter size must be established • Meter size must be established . Meter size must be established-H applicable
• ProjectSpecs (1)
L . EnergyCalculations (1)
1 . Electric Power & Lighting Fortn (1)
1 • Master Exit Plan (1) 1
1 • Emergency Response Site Plan (1)
1 • SoilsReport (1) 1
. SACdetertnination-ca11651-602-1000 • SACdetertnination-ca11 651-602-1 000 • SACdetermination-ca11651-602-1000
• Fire Sto in Submittals
Call MN Dept uf Health at 651-2I5-0700 for details rcgarding food & beverage or lodging facilities.
Contact Building Inspections for sample and if mquired
Permrt for new buildmg or addition will not be processed withou[ Bmergency Response Site Plan.
Date (J 2 Constructioo Cost ti1 (P ~ ~ Lo
Si[eAddress JiFr.J loqu G'Y UniUSte #
Tenant Name Former Tenant Name
Description of Work pa DavrS d, o te4
Property Owner LL e- Telephone # (~/5l ) / ~-21q6
~ y
Contractor L)i Frti'~ r?T ~Q'~TY7~'i'"'TS ~ L L
Address City
State W Zip 'SS 12 2 Telephone #((y'i/ ) 4` Szf -2
Arch/Engr Registration #
Address City
State Zip Telephone # ( ) r-
l~rl~s(~i~~1LIL~f
Licensed plumber installing new sewer/water service: Phone FEB p2005 I
IJLI
I
I hereby apply for a Commercial Building Permit and acknowledge that the information is complete_and-.acc.urate;
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 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 Name pplicant's Signature
OFFICE USE ONLY
Sub Types
? 01 Foundation ? 26 Public Facility ? 30 Accessory Building
? 14 Apartments ~ 27 Commercial/Industrial ? 32 Ex[ AIt-Apartments
? 15 Lodging ? 28 Greenhouse ? 34 Ext Alt-Commercial
? 25 Miscellaneous ? 29 Antennae ? 35 Ext Alt-Public Facility
? 37 Nail Salon
Work Types
? 31 New )311~ 35 Int Improvement ? 38 Demolish (Interior) ? 44 Siding
? 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
? 33 Aiteration ? 37 Demolish (Bldg)' ? 43 Reroof ? 46 Windows/Doors
? 34 ReplaCement 'Demolition (Entire Bldg only) - Give PCA handout to applicant
OJ~
Valuation )7~ tDO Occupancy ~Z MCES System ~
Census Code ~ Zoning City Water
SAC Units Stories Booster Pump
Nbr. of Units Sq. Ft. PRV
Nbr. of Bldgs ~ Length Fire Sprinklered
TypeofConst 317 'd Width
Required Inspections
_ Footings (new bidg) Insula[ion
_ Footings (deck) V/ Final/C.O.
_ Footings (addi[ion) _ FinaUNo C.O.
Foundation Other
Drain Tile
_ Roof Ice Pr _ Decking _[nsul _ Final _ Pool _ F[gs _ AidGas Tes[s _ Final
_ Framing _ Sidine _ Smcco _ Stone
_ Fireplace _ R.I. _ AirTest _ Final _ Windows
Approved By: Planning Building Inspector
sase Fee 9. Z r
Surcharge
Plan Review
MCES SAC
City SAC
Water 5upply & Storage (WAC)
S/W Permit
S/W Surcharge
Treatment Plant
Park Dedication
Trails Dedication
Water Quality
Copies
Water Trunk
Sewer Trunk
Other
Total 287• 7
~
2004 COMIMERCIAL PLUMBLNG PERMTT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Date~/
Site Address ilnit #
Tenant Name Former Tenaat Name
Property Owner Tefephone
i
Contractor
Address CiTy 3-
State , ~ -
Z' 19 Telephone
The Applicant is _ Owcer ` Contractar Other
Work Type _ New Bldg _ Add-on Repair RPZ pVB Irrtgation system *
° Jem wuhxhall ro calndate fcec. Re uired meter size is'_" turbu unless smaller size ermitted 6v Publit H'orl:s
Descriptlon of Work-TMVA~` ~.Z ~t
Ta inquirc if Pressure Reducing Valve is rcquired on new service, ca11651-675•5646
Meters - Ca11 65 1=675-5 300 W verify that hydrostatic, conductivity, and bacteria tests passed urfor to otckine uo meter
Irrigarion Size & Type ' Avg GPM
Fire Siu & Price - 3/4" di.tilaecrnm! sIt c nn •
Doaustic Size & Type Avg GPM Includes hfgh Jemand devices'.' _ Yes _ No
Fiushometers _ Yes _ No PRV Requfred _ Yes _ No "
Permit Fee $50.50 'n mu (loeludes State Surcharge)
Coatact Value $ x 1% Base Fee
S Meter(s)
Required on ail mg buildings & boulevard irriaation svstems RadiO Meter Read
(f bax fee is S1,000 or Iw, wreharqe Is f.50 $ St9te SUICh3[ge
[Cbase Cee is over $1,000, mrc6aree is S30 per $1,000 of rhe Base Fee
Followtng fees apply ouly when installing new Irrigatton rysteni $ Water Permit
Conhac Jerty Wobsehatl it bSl -675-5024 for requircd tee amounn
$ TreaCnent Plant
3 Watet Supply & Stornge
S State Surcharge
- .
Total Fee
( hereby apply for a Commercial Plumbing Pemut and aclm'owledge that the infoRnation is complete and accurate; that the work will be in
conformance with the ordinances and codes of the Ciry of Eagan and with the Plumbing Codes; thaz I understand this is not a pemrit, but only an
application for a pemut, and work is not to start without a pemiir, that the wo lc will be in acc mce with the approved plan in the case of work
which requues a review and approv of pl
Applicant's Printed Name pplicanc's Signature
CITY USE ONLY
REQUIREDINSPEC7)ONS: _ U.G. i AirTest_ GesTest _ Roughln Finaf
PLANS SUHMITTED APPROVED BY; BUILDING INSPECTOR
General Iaformation
• Radio Meter Read (required on all ~ew, buildings & boulevard irrigation systems- S 141.00
• RPZ's must be rebuilt every fve years. A minlmum fee yermit per address is roquired for RPZ rebullding or repairing.
• Water meters include copper horNstrainer, remote wire, and touch•pad meter
GPM METERS USF. PRICE GPM ME7'$RS USE PRICE
1-20 5181, re.;idential Si2i.oo a-120 i-ln^ irrigation syst S 788.00
displacement sm commercial . turbine•!
maxinttun must receive
continuous approval
10 from Public
Works .
2-30 3/4" ' lawn irrigation $I55.00 4-160 2" turbine Ig irrigation syst S 992.00
maximum displacement rosidential & .
conlinunus sm commertial production lines
.
15
3-50 1" displacemept very Ig res $200.00 1/4 to 160 2" compound bldgs over S 1,880.00
bldg to 24 units 65 uniu
niaaimum sm commercial '
&
continuous & Ig comm bldgs
25 irri ation s stems
5-100 I-1/2" bidgs 25-64 units $488.00
misimum displacement &
continuous most comm bidgs
SO
METERS REOUIRINC 30-DAY ADVANCE NOTICE PRIOR-TO PICK UP
CPM METF.RS USC PRICE CPM METERS USF. PRICF,
$-350 3^ turbine very Ig irrigation $1,338.00 6-500 4" campound +300 unit bidgs & $3,749.00
syst & production very Ig comm blJgs
lines
U2-320 3" compound +200 unit bldgs S2,407.00 10-1000 G" campound +400 unfl bidgs 56,123.00
very Ig comm bldgs ven• le comm blAgs
I5.I000 4" turbine very Ig irrigatlon 52.384.00
syat •
3c productlon Iinea
Comments
• To schedule inspection of tho inside water Iino and backflow preventer, cali 651-675-5675.
• To arrange for water turn-on, call 651-675-5300.
ec: Mninlenance Division Clericel Ttthnician UDdated 8103
A
Use BLUE or BLACK Ink
For Office Use
City ofEaan
RECEIVED F
or
#: /110 0 3'37
: .7g's"./
3830 Pilot Knob Road DEC 272016
Eagan MN 55122
Phone: (651)675-5675 Date Received: '�7-4,
Fax: (651)675-5694 Staff:
i -) No)
2016 COMMERCIAL BUILDING PERMIT APPLICATION
Date: 12/20/16 Site Address: 3953 Valley View Drive S, Eagan, MN 55122 i}e
Tenant Name: (Tenant is: New/X Existing) Suite#:
Former Tenant:
"e��4i, Name: View Point Apartments Phone:
A. ' Ownell• 3898 Valley View Dr S, Eagan, MN 55122
E \\ / Address/City/Zip: )/
�"s Applicant is: Owner Contractor
: 444
' 40 KW of Solar, Part of a 160 KW at apartment complex.
Description of work:
Construction Cost: $30,000
` Name: Premise Inc. License#: BC706364 & EA709349
p p
4k �� � i 2010 E Hennepin Ave Box #2 Minneapolis
f, y7e ° 4 Address: City:
a
Con�,, o ;.
'% ' State: M N Zip: 55413 Phone: 612-216-1850
ffr �F ! contact: Matt Cina Email: admin@premiseco.com
- ' — ''"ir)41t.,,,,,%:
PZSE, Inc. Structural Engineers . 52544
�' Name: Regi #:
%` 8150 Sierra College Blvd, Suite 150 Roseville
i to .,,,,„„i,1 Address: City:
O yCA 95661 916-961-3960
r ',/ ' y State: Zip: Phone:
N''‘, Al";� t = Paul Zacher
i '`c t 5,,. l t; _ ..�, Contact Person: Email:
Licensed plumber installing new sewer/water service: Phone#:
!..,,4 67r;tifj;Z:k--'17 -',;iiiiii.lg;':0 lieritftr7;qi;IqViirtr4ri!.;dagligir:777altVrgi,TTairfaatM7:Vli.7704,,Q1ii
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.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 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 rk wh. , requires a review and approval of plans.
xMatt Cina xAr
T
Applicant's Printed Name A lic nt's Signature
I Page 1 of 3
.
3963 Ve// / r/�e tJ .6r- 4 iyo 337
DO NOT WRITE/BELOW THIS LINE
SUB TYPES
Foundation _ Public Facility _ Exterior Alteration-Apartments
,/ Commercial/Industrial Accessory Building _ Exterior Alteration-Commercial
Apartments Greenhouse/Tent _ Exterior Alteration-Public Facility
Miscellaneous Antennae
WORK TYPES
New Interior Improvement Siding _
_/ Demolish Building*
Addition ✓ Exterior Improvement Reroof _ Demolish Interior
Alteration Repair Windows Demolish Foundation
Replace Water Damage Fire Repair _ Retaining Wall
Salon Owner Change *Demolition of entire building-give PCA handout to applicant
DESCRIPTION
Valuation if) ODD °—'" Occupancy U MCES System iv/4
Plan Review ✓ Code Edition 2b Is- 114 SAC Units
(25%_100% •4 Zoning r2 e1 City Water
Census Code Stories I Booster Pump
#of Units 0 Square Feet PRV
#of Buildings / Length Fire Sprinklers
Type of Construction V • & Width
REQUIRED INSPECTIONS
Footings(New Building) Final/C.O. Required
Footings(Deck) Final/No C.O. Required
Footings(Addition) Other:
Foundation Foundation Before Backfill Pool:_Footings Air/Gas Tests _Final
Drain Tile Siding:_Stucco Lath _Stone Lath _Brick_EFIS
Roof:_Decking _Insulation _Ice&Water _Final Retaining Wall
Framing 30 Minutes 1 Hour Erosion Control
Fireplace: Rough In _Air Test _Final Concrete Entrance Apron
Insulation Meter Size:
Sheetrock Electronic Plans Required
Windows
Final C/O Inspection: Schedule Fire Marshal to be present: Yes No
Reviewed By: 6 , Building Inspector Reviewed By: , , Planning
COMMERCIAL FEES ,/ Water Quality
Base Fee T 4 4. 7 r- Storm Sewer Trunk
Surcharge /I- °-o Sewer Trunk
Plan Review 30 3 • 3 ' Water Trunk
MCES SAC Street Lateral
City SAC Street
S&W Permit&Surcharge Water Lateral
Treatment Plant Other:
Treatment Plant(Irrigation)
Park Dedication
Trail Dedication TOTAL: 7B /'
Page 2 of 3