1446 Yankee Doodle Rd . . '�
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Use BLUE or BLACK Ink
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� For Office Use �
• � i��y 5�1`� ►
n��� n� n��4�� I Permit#: I
41 U IJ
3830 Pilot Knob Road �ECEIVED � Permit Fee: • �5 �� i
Eagan MN 55122 �y I �
r7i'J� � � ��� � Date Received: �
Phone: (651)675-5675 � �
Fax: (651)675-5694 � Staff: �
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2014 COMMERCIAL BUILDING PERMIT APPLICATION ,.���
Date:___�i ° l 1 � 1�' Site Address: �'Q'�'� � ��'I�V ��C►-N�,2.Q. �OC�dL1lY_ 14h1
Tenant Name: Y�+'eC S�.uarK �J�+�aocra �'�►"�" (Tenant is: New/ Existing) Suite#:
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��'ormer Tenant: �`�
''� �. ���'�' Name: �l F C. �ro,c��`�� '�'.� . �L� Phone: foJ�"4-52 -�v�3 C'�3
��� Address/City/Zip: 3�-"ln vJ�s��ha�o h �r �1�2, Gn�no�.� . 1�� � S�22
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� � Applicant is: Owner �Contractor
� �� � � ; Description ofwork: �'�� -}ae'��►�qS TE��r �1�✓-�i�'t Ep�c�0��7
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'"'' Construction Cost: � ��,DO d
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� ' � � Name:�M S C�n��'r'�c��c•r, Servtc�s, zo
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� U��icense#: 443��$
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�°���`� b`'� � � Address: ���10 tr,��i�'ltY.��r�.,
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'� � State:�_Zip: 5�12-Z- Phone: fo �Z- �[R 9 Sfl b 8
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�•� ����� Contact: �G� CJ�+C�.E.� o:eldf�� � � '�.� S� COf'h
,,, . Email: C S � +r'� ��+' �aT
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��� Address: City:
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�,�_� Contact Person: Emaii:
Licensed plumber installing new sewedwater service: ��� Phone#:
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CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for proteetion against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www,qopherst8teor+� Il.orta
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.
CN�S �nS'�ratie�iw, Gjtv-vltvA j (�L.G �,. ,
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Applicant's Printed Name Applicant's Signature
Page 1 of 3
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DO NOT WRITE BELOW TI91S 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 (��DOD � Occupancy � �S MCES System �
P l a n R e v i e w �/ C o d e E d i t i o n 2 0 0�M S�, S A C U n i t s
(25%_100°/a� Zoning �� City Water
Census Code Stories Booster Pump
#of Units d Square Feet PRV
#of Buildings � Length Fire Sprinklers
Type of Construction �'�j Width
REQUIRED INSPECTIONS
Footings(New Building) Sheetrock
� Footings(Deck) inal/C.O.Required
Footings(Addition) �inal/No C.O. Required
Foundation Other:
Drain Tile Pool:_Footings _Air/Gas Tests _Final
Roof:_Decking _Insulation _Ice&Water _Final Siding:_Stucco Lath _Stone Lath _Brick
Framing Windows
Fireplace:_Rough In _Air Test _Final Retaining Wall
Insulation Erosion Control
Meter Size:
Final C/O Inspection: Schedule Fire Marshal to be present: Yes V No
Reviewed By: ���4 , Building Inspector Reviewed By: sr. , Planning
COMMERCIAL FEES
Base Fee Z�S, r� Water Quality
Surcharge 7'�d Water Sampling Fee
Plan Review 172•S� Water Supply 8�Storage(WAC) '�
MCES SAC Storm Sewer Trunk I',
City SAC Sewer Trunk �I
S&W Permit&Surcharge Water Trunk
Treatment Plant Street Lateral
Treatment Plant(Irrigation) Street
Park Dedication Water Lateral
Trail Dedication Other:
Water Quality TOTAL �.��
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