No preview available
 /
     
1731 Bluebill DrCityofEaall 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 rHoe t7 - 206) Use BLUE or BLACK Ink Permit #: / Permit Fee: 0 ; ` �yU Date Received: F 1/ Staff: 2011 MECHANICAL PERMIT APPLICATION Date: 7/7_V,Ji 1 Site Address: /7 3 / 6�GL `e. 1( 12' Tenant: ri i_/`%'e 77 1-1 Suite #: 1 RESIDENT / OWNER hv /"5� 7 - S -s77- I% Name: D73 ' / )- ,p (et -Phone: Address / City / Zip: 17 2 A) (AJ ��`���7. 1(e A'�1_. L49 tfe�' TZQ..('', .M/ CONTRACTOR sz OS' Name: �u Q� Z -Z� f/ .! i�` �1i� License #: Address: 1 1 Li C a L-0 S•7 �� ii,�: City: E -b.._ � � Phone: ' Ci -- 9 -Ct 4� 0/ State: Zip: SZ -/ Contact. t �i ��1J.Agmail: {Lv\ Q L C @_vie,.„ -:e. Iry&c. ca r TYPE OF WORK New `v Replacement Additional Alteration Demolition Description of work: ' ti�rorand mounted mechanicalequip ene °fir City NOTE Roof mounte °r Code.: Please co } tete Mechanical ins pe c. • nfo mGtaiio ° :$ " a c t • ds. PERMIT TYPE RESIDENTIAL F ce COMMERCIAL New Construction _Interior Improvement Air Conditioner Install Piping Processed _ Air Exchanger Gas Exterior HVAC Unit Heat Pump Under / Above ground Tank ( Install / _ Remove) Other **When installing/removing tank(s), call for inspection by Fire Marshal and Plumbing Inspector RESIDENTIAL FEES: $55.00 Minimum Add-on or alteration to an existing unit (includes burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) $5.00 State Surcharge) $ STh TOTAL FEE $95.00 Fire repair (replace COMMERCIAL FEES: $75.00 Underground tank $55.00 Minimum (includes installation/removal OR State Surcharge) $10,010, surcharge is $ 5.00 surcharge increases by $.50 for each $1,000 Permit Fee requires a $ 5.50 surcharge) Contract Value $ x 1% _ $ Permit Fee - If the Permit Fee is less than Fee = $ Surcharge - If the Permit Fee is > $10,010, (i.e. a $10,010-$11,010 Permit = $ TOTAL FEE CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection a • ainst undergrou:d utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www. • o • herstateonecall • r I hereby acknedge that this information is complete and accurate; that the work will be Eagan; that I . nderstand this is not a permit, but only an application for a permit, and work is with the p oved plan in the ca wprk which requires a reviiw and approval of plans. x r, Printed Name rdinances and cod-- •f the City of t; that the worbe in accordance 7 - FOR OFFICE US Required Inspections: Reviewed' it Test or HVAC Screening lnspecto' Use BLUE or BLACK Ink' "IIP -, ,....., C!ty of Eaujll G Permit Fee: . ., ` w 3830 Pilot Knob Road RECEIVED Eagan MN 55122 Date Received: Phone: (651) 675-5675 JUL1 8 2011 Staff: Fax: (651) 675-5694 I ,2010 RESIDENTIAL PLUMBING PERMIT APPLICATION Date: 11 q 1 I 1 Site Address: 13 s I t) KthilI 13r Caja., �J o. S� o Tenant: 6r t tr1� Jrni l `/ Suite #: RESIDENT / OWNER Name: P 64-i-nQ,t,i Sill tin-, Phone: (a5 I 5D -5 5'foci Address / City / Zip: (361i1k�I I ! 1 r, ►" CONTRACTOR Name 5f, Cit) iy Va.-1 r t4 License #: (i. 'MCI 7 Address: 3 d0 r• City: State: wI Zip: "fU l Phone: IIS 38L0 ebW Contaet: Email: I ber I TYPE OF WORK _ New Replacement Repair _ Rebuild Modify Space _ Work in R.O.W. Description of work: (Y,. t tt bf Wafer heater PERMIT TYPE RESIDENTIAL Water Soften er IWater Heater i i Add Plumbing Fixtures ( Main / _Lower Level) Lawn Irrigation (_ RPZ / _ PVB) Water Turnaround Septic System New _ Abandonment 1 RESIDENTIAL FEES: i $55.00 Minimum Water Heater, Water Softener, or Water Heater and Softener (includes $5.00 State Surcharge) I $35.00 Lawn Irrigation (includes $5.00 State Surcharge) $55.00 Add Plumbing Fixtures, Septic System Abandonment, Water Turnarund" *Water Turnaround (add $166.00 if a 5/8" meter is required) $105.00 Septic System New ($10.00 per as built) (includes County fee and $5.00 (includes $5.00 State Surcharge) State Surcharge) $95.00 Fire Repeir (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) 65 TOTAL FEES $ 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.gopherstateonecall.org I hereby acknowledge that this information is complete Eagan; that I understand this is not a permit, accordance with the ap roved plan in the case of x and accurate; that the work will be in but only an application for permit, and wor work which requires a review and approval o Z - X onformance with the ordinances and codes of the City of is not to start without a permit; that the work will be in plans" .o/ id Alf, 1i. ,. Applic nt's Printed Name Applica t' I.�Rte, I ' FOR OFFICE USE Reviewed Required Inspections:nden GroundT-Rough-In , ,-�,, .gin Telt _ _Gds Test Ftnal I i 1 \IR -1 raot Clyof Eapri 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 1,13t fl ii:kus) LI D -r -- Use BLUE or BLACK tnk For Office Use Permit #: I 31 a Permit Fee: 1 • -I Date Received; Received: O I 1.9.) Staff: 56 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Site Address: --1-2 t'ZS 33 Date: Unit #: Name: Phone: Address / City / Zip Applicant is: Owner Contractor Description of work: C-Crra c 4 Construction Cost: 51 00 Multi -Family Budding: (Yes >0 / No ) C -Nn Company: CO. ?*44°- CCA Address: 6P0 State: M A) Zip: License #:3C- (-Si& ,4 5 Cont *- city: Phone: 3'4 9.900 Lead Certificate #: A)1:1 -r - ( If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) Leapt 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: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: Phone: GALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility dam e. Gall 48 hours before you intend to dig to receive locates of underground utilities. w,vw,qopherstaieortecali.oro 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 1 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. fixterior work authorized by a building permit issued In accordance wlth the Minnesota State Building Code must be completed within 180 days of permit issuance. L1 —eel-ie.-tr. Applicant's Printed Name k'Fh! Applicant's Signature Page 1 of 3