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3010 Denmark Ave2012 FIRE SUPPRESSION SYSTEMS PERMIT APPLICATION* Date: Site Address: 30\0 Qqnrncar�,, lk'Je-, e an r rnA 5SJ21 Tenant: Suite #: Name: Phone: PROPERTY OWNER , Address / City / Zip: Applicant is: Owner Contractor TYPE OF WORK Description of work:.1 h S4c 11 0 A e t J2-� �i P� "�k�cG� "" Sy S 4-e— '� a5-/ 606 , O 0 j jI Aa 12 Construction Cost: Estimated Completion Date: /! t Name:�P "Q-V i UI P;'(Le 1 r-0-�--e.0 I License #: �{ CONTRACTOR Address: a o ��^ + ' � (�S City: State: /" Zip: Phone: — Contact: Email: FIRE PERMIT TYPE WORK TYPE 1 Sprinkler System (# of heads _) or �° New _ Addition Fire Pump _ Standpipe Alterations _ Remodel Other: 1 Other: DESCRIPTION OF WORK: X Commercial Residential Educational FEES $60.00 Minimum (includes State Surcharge) OR Contract Value $ �S tb 6 a x1% - If the Permit Fee is less than $10,010, surcharge is $ 5.00 = $ 6-U Permit Fee - If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee (i.e. a $10,010 - $11,010 Permit Fee requires a $ 5.50 surcharge) = $ 5-,6-D Surcharge =$ a'4575-' 6 TOTAL FEE 3/4" Displacement Fire Meter - $231.00 = Fire Meter i = $ TOTAL FEE 'Requirements: 2 complete sets of drawings and specifications, cut sheets on materials and components to be used I hereby apply for a Fire Suppression System permit and acknowledge that the information is comp) and accurate; that thew rk will be in conformance with the ordinances and codes of the City of Eagan and with the Minnesota Building /Fir Codes; that I u rstand 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 acc which equfres a review . nd approval of plans. S ance with the a p oved plan in the case of work x i AKplicanrs Printed Name pplicanrs Signature Sat D I-)2A&X &r�- Avc- /0 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 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 s rt without a permit; that the work will be in accordance with the appp d pla in the �case /of work which requires a review and approval of plans. PV Applicant's Printed Name Applicant's Signature City of Eapn 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5675 Fax: (651) 675 -5694 .� Lj I t)q RECEIVED MAY U 4 1011 Use BLUE or BLACK Ink 1------------ - - - - -� For Office Use I Permit #: Permit Fee: t� j Date Received: I I Staff: 2 2012 COMMERCIAL BUILDING PERMIT APPLICATION f" Date: May 4, 2012 Site Address: 3010 Denmark Avenue, Eagan Mn 55124 Tenant Name: �� C Ro'%;/A (Tenant is: New / Existing) Suite #: Former Tenant: Name: EP Development LLC Phone: 952 - 857 -1529 Address / City / Zip: 5435 Feltl Road, Minnetonka MN 55343 is: Owner X Contractor Description of work: New urgent care facility Construction Cost: _$2,324,182.00 Name: RJM Construction, LLC Address: 7003 West Lake Street #400 State: Minnesota Zip: 55426 Contact: Ross Bertelsen Name: Collaborative Design Group Address: 100 Portlane Avenue South License #: City: St. Louis Park Phone: 952 - 837 -8600 Email: ross State: Minnesota Zip: 55401 Phone: 612 - 332 -5654 Contact Person: Bess McCollouah Email: Licensed plumber installing new sewer/water service: _United Water and Sewer Registration #: 20111 City: Minneapolis Phone #: 763 -537 com 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 w k which re uires a review and approval of plans. x_Ross Bertelsen x Applicant's Printed Name Applicant's Signature Page 1 of 3 + SUB TYPES _ Foundation Commercial / Industrial Apartments Miscellaneous WORK TYPES New Addition Alteration Replace Salon Owner Change DO NOT WRITE BELOW THIS LINE Public Facility Accessory Building Greenhouse / Tent Antennae — Exterior Alteration- Apartments Exterior Alteration - Commercial Exterior Alteration - Public Facility IoVG� Interior Improvement Siding _ Demolish Building* Exterior Improvement Reroof _ Demolish Interior Repair Windows Demolish Foundation Water Damage Fire Repair _ Retaining Wall *Demolition of entire building - give PCA handout to applicant I./GJVRIr I IVIN #,P7 4* - Valuation �'_ Z; 00 Occupancy Plan Review yt3r' -7 Code Edition (25 %_ 100% Booster Pump Zoning Census Code _-» Stories # of Units .... Square Feet # of Buildings Length Type of Construction VA Width REQUIRED INSPECTIONS Footings (New Building) Footings (Deck) Footings (Addition) Foundation Drain Tile Roof: _Decking _Insulation _Ice & Water !Final ✓ Framing Fireplace: _Rough In Air Test _Final ✓ Insulation Meter Size: 6 MCES System 4* - ;Vol MSPC- SAC Units �_!`tttis✓ {� D City Water qC0 1 Booster Pump --� a. $"� PRV Treatment Plant (Irrigation) 78�1�. Water Lateral Fire Sprinklers — Sheetrock :%Final / C.O. Required Final / No C.O. Required Other: Pool: _Footings —Air/Gas Tests _Final Siding: _Stucco Lath Stone Lath _Brick Windows Retaining Wall Erosion Control Final C/O Inspection: Schedule Fire Marshal to be present: Yes Reviewed By: A?e- 1,. , Building Inspector _No Reviewed By: . 544AH , Planning COMMERCIAL FEES Base Fee / /AS(,, ?S- -/ Water Quality Surcharge 99 7..,�> Water Supply & Storage (WAC) Plan Review 07,31&19 Sewer Trunk MCESSAC ,3 _7695, dy'' Sewer Trunk City SAC 300. 00 Water Trunk S&W Permit & Surcharge Street Lateral Treatment Plant / Q7! Street Treatment Plant (Irrigation) 78�1�. Water Lateral Park Dedication — Other: 4 ^dS Trail Dedication Water Quality Seca TOTAL 37, -716,967 "age 2 of 3 • ''� Metropolitan Council G d Environmental Services April 20, 2012 Dale Schoeppner Building Official City of Eagan 3830 Pilot Knob Road Eagan, MN 55122 Dear Mr. Schoeppner: The Metropolitan Council Environmental Services (MCES) Division has determined the SAC to be charged for the wastewater capacity demand for The Urgency Room #2 to be located at 3010 Denmark Avenue within the City of Eagan. The City will be charged 3 SAC Units for this project, as determined below. SAC Units Charges: Clinic 51 f.u. @ 17 f.u. /SAC Unit 3.00 The business information was provided to MCES by the applicant at this time. It is the City's responsibility to substantiate the business use and size at the time of the final inspection. If there is a change in use or size, a redetermination will need to be made. If you have any questions, call me at 651 -602 -1118 or email karon.cappaert@metc.state.mn.us. Sincerely, aron Cappaert SAC Technician Environmental Services Division KC:kb: 120420A6 Determination expiration: April 20, 2014 cc: J. Nye, MCES Peggy Fleck, Eagan (email) Ross Bertelsen, RJM Construction (email) www.metrocouncil.org 390 Robert Street North o St. Paul, MN 55101 -1805 0 (651) 602 -1005 o Fax (651) 602 -1477 o TTY (651) 291 -0904 An Equal Opportunity Employer 40� City of Eapn 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5675 Fax: (651)676 -5694 Use BLUE or BLACK For Office Use Permit #: ---r del (4, AV140uy f . I Permit Fee: // 1 _ v 1 ( cl /� } : _ '_ �l41? tGd CL 4.G?t L {� r I Date Received: 1 Staff - - - -- - - - - - -- MAY 3��2012 2012 COMMERCIAL PLUMBING PERMIT APPLICATION ❑ Please submit two (2) sets of plans wwitt�h all commercial applications. Q 151 Date' - b 2 Site Address• 1-�' 1 o D%S 1f�& ::L Tenant: -T D u- rV) y ( `o ®m Suite #: PROPERTY = UdjQqhWj tic Rate: OWNER Name: Phone: PRV Required: _ -Yea s Pmo Name: icense #: lQ 1. 131 CONTRACTOR Address: AOI .1M CC ity _ Zy State: Nzip: ✓5�1� e c r Phone: Email: TYPE OF X- New _Replacement —Repair _Rebuild _ Modify Space _ Work in R.O.W. WORK t Description of work: COMMERCIAL x New Construction _ Modify Space Irrigation System (,L yes / _ no) C)� RPZ / T PVB) Rain sensors required on irrigation systems PERMIT TYPE . Avg. GPM (2" turbo required unless smaller size allowed by Public Works) _ Meters Call (651) 6756 to that tests passed prior to picking up meter. ,vrity Domestic: Size & Type L 1 7-4 Fire: 1 Avg. GPM High demand devices? _Yes No Flushometers _Yes No COMMERCIAL FEES: $60.00 Minimum (includes $5.00 State Surcharge) OR Contract Value $ ` i o 00r x1% 0U ( =$ 1,050 _.-. Permit Fee Required on ALL new buildings and boulevard irrigation systems 4 $ 1-7-7-00 Radio Meter Read - If the Permit Fee is less than $10,010, the surcharge is $5.00 $_ �p f d Meters) - If the Pe Fee is > $10,010, the surcharge increases by $.50 for each $1,000 Permit Fee rmit $_ �� ® _ State Surcharge i.e. a $10,010 - $11,000 Permit Fee r uires a $5.50 surcha e) Following fees apply when installing a new lawn irrigation system $ Water Permit Contact the City's Engineering Department, (651) 675 -5646, for required fee amounts. $ Treatment Plant $ Water Supply & Storage $ State Surcharge 00 TOTAL FEE 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.or:7 I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and cedes 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. X Nil [An kwTI x - Applicant's Printed Name Applica s Signature FOR OFFICE USE Approved By: Rate: Required Inspections: tinder Ground Rough -In Air Test _Gas Test j�Final PRV Required: _ -Yea No Page 1 of 3 401" City OC Eapn 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675 -5675 Fax: (651) 675-5694 IF / EL i MAY 302012 Use BLUE or BLACK Ink I For Office Use I I j Permit #: 1Q ( L/ / -7 �n 1 I Permit Fee: jDate Received: I I I Staff: - - - - - - - - - - - - - - - - J 2012 MECHANICAL PERMIT APPLICATION ❑ Please submit two (2) sets of plans with all commercial applications. ns. Date: 5 2 Site Address: 30`0 D @ irk h yt Tenant: yQ. 1! r a rr) Rum Suite #: 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.gol2herstateonecall.ora 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 aooroved plan in the case of work which reauires a review and approval of plans. X N6(011V Kwrl Applicant's Printed Nam Applicant's Ulm, 10 EMU, FOR OFFICE USE Required Inspections: Reviewed By: ';` DaW: Underground Rough In Air Test Gas Service Test In -floor Heat rnai i-iVAC Screening Name. EP VUi;l N � �C.f 1 L L G Phone RESIDENT / OWNER Address / City / Zip: 543 bp ma (; i r License* 1' M o B31 Name: Ni '(,��! CONTRACTOR Address: ��C(i! �� 11 UV U Ud SjLs O V City: �e tiff, State: 11/1 �� Zip: 55' 1A Phone: �' Contact: MbKina Email New eplacement Additional Alteration Demolition TYPE OF WORK Description of work: ik 14 NOTE: hoof mounted and glound 1nounted mechanical equipment is required to be s6eaned by City Code. Please contact the Mechanical Inspector for information on permitted lro mew. RESIDENTIAL COMMERCIAL _ Furnace New Construction _ Interior Improvement PERMIT TYPE — Air Conditioner Install Piping _ Processed —Air Exchanger Gas K Exterior HVAC Unit Heat Pump Under/ Above ground Tank (_ Install / _ Remove) Other RESIDENTIAL FEES: $60.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge) $100.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) = $ TOTAL FEE COMMERCIAL FEES: D $75.00 Underground tank installation /removal (includes $5.00 State Surcharge) OR Contract Value $ x,11 -- X 1 % $60.00 Minimum (includes State Surcharge) =$ Permit Fee - If the Permit Fee is less than $10,010, surcharge is $ 5.00 =$ _ Surcharge - If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee (i.e. a $10,010 - $11,010 Permit Fee requires a$ 5.50 surcharge) _ $_ �y� TOTAL FEE 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.gol2herstateonecall.ora 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 aooroved plan in the case of work which reauires a review and approval of plans. X N6(011V Kwrl Applicant's Printed Nam Applicant's Ulm, 10 EMU, FOR OFFICE USE Required Inspections: Reviewed By: ';` DaW: Underground Rough In Air Test Gas Service Test In -floor Heat rnai i-iVAC Screening 08/24/2012 09:22 7634287656 AUG/24/20I2/FR1 09:05 A}A (:iLy of .;,agar >� City of Eap 3830 Pilot Knob Road B7gon MN 55122 Phone: (651) 6755675 Fax. (651) 675 -5694 5 20.12 COMMERCIAL GRMECHANICAL PAGE 01/01 11, UJ2 Usb 13LUE or BLACK Ink I For Office Use I 1 � Permit 1R: Permit Fee:Q I I I DItA Received: I I I Staff: PLUMBING PERMIT APPLICATION Please submit two (2) sets of plans with all commercial applications. Date; Site Address, Tenant: L�� Suite #: PROPERTY OWNER.' Name: Phone: Name: (�, IG G'� 1 C �_ License #: CONTRACTOR � r7 �_, �� -6 State Address. �D r l7 ��/ ty; (7 / !� Email: TYPE pF WORK.. ^ Now � Replacement Repair _. Rebuild � Modify Space _ Work In R.Q.W. Description of work. MMERCIAL _ New Conatructlon Irrigation System (_ yes / _ no) ( RPZ 1 _ P\Bl) Modify Space �I S Rain sensors required on Irrigation cyntomo PERMIT TYPE Avg. OPM (2" turbo required unless smaller size allowed by Public W rltn) _ Met . m Call (651)1375 -5846 to vArlty that tests passed prlor to ricking up meter. Domestic; Sire & Type Fire: 1 Avg. GPM High demand devlcon,? Yes _„No Fluahometers Yes „-,_,No COMMF_R[:IAL FEES: $60.00 Minimum (includ;a $5.00 State Surcharge) OR Contract Val tie $ _ x1% = $ Z) Permit Fee Required on ALL new buildings and boulevard Irrigation systems > $ Radio Meter Read - if the EaCM2 Fee Is Iese than $10,010, the surcharge is $5.00 $ - If the P=P.It F�M iz > $10,010, the surcharge Incresges by $.50 for each $'1,000 Permit Fee SUrCharQp (i.e. a $10,010 -$11 000 Permit Fee ro ulres a $5.50 surcharge) _State Following fees apply when In .tolling a new lawn irrigation system r� Water Permit Contact the City',,; Engineering Onrartment, (651) 675 -6646, for required fee emountz. $ Treatment Plant $ Water Supply & Storage State Surcharge FEE CALL. Call Gopher St:ito One Call at (651) 464.0002 for protection against underground utillty damage. Call 48 hour before you Intend to dill to receive locates of underground utilitit -11. www.0oohor_ tataoneoall.orq I hereby acknowlatlge that Oii.� Informatlon Is complete and accurate; that the work will be in conformance with the ordinances and C*des of the City of Eagan; that I understnnd 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 wlth the approved plan In the case ofrnwork which requires a review and approv I of plans. 7 - 11 . jdoi'4c"� X / .1 /I'S r/ r / X Applic tt'0 PtAtid Name A . plic is Si ature FOR OFFICE USE Approved BY: Date: Required IrispIctibns: �_.Under•Ground _Rough -In _ —Air Test Ca9 Test TFinil PRV Required: — Yes No lt_._ Page 1 of 3 f Fleck �2)& LI From: Linda Dralle Sent: Thursday, August 23, 2012 1:23 PM To: Peggy Fleck; Scott Peterson Cc: Leon Weiland Subject: 3010 Denmark Avenue We will issue an 1.5" Displacement for the irrigation for the Urgency Room located at 3010 Denmark Avenue for GR Mechanical, but they have not had their Bacteria test completed according to PIMS, so until that has been entered into the computer we will not be issuing any meters. Also, I don't show where they have pulled a irrigation permit yet either. So Peggy call me when they pay for their permit and I'll watch for the Bacterial test results to be entered. Thanks, Linda l_%v�,da DrGill,e city of Eac�av�- Ltt%lities 3419 C 0OQ C h vvu2 v� rzoa d E R R CI VI. M N 55122 (651) 6 ,-5 -5200 1 Jr wpt 1, C�?ctJofeac�ay.covu City of Eaku 3830 Pilot Knob Road Eagan MN 66122 Phone: (661) 676 -6676 Fax: (661) 676 -6694 ,�r G� 1a n S tea (",-v Use BLUE or BLACK Ink For Office Use I I Permit #: I 1 Permit Fee: I I Date Received: ®� I I Staff: I I 2012 COMMERCIAL FIRE ALARM PERMIT APPLICATION* Date: _!�/ / Site Address: _i�ai Tenant: 92�C Construction Cost: Owner Contractor Suite #: Phone: Estimated Completion Date: Name: A _ .i S /6 ,,,� � License #: % Z3 Zsn Address: Sf % Q 0 .L -;Z,/ r x� r. Q 6 City:. State: j4h— Zip: !E L/y Phone: 2C, S 3 7C, Contact: _LzNew Addition Alterations DESCRIPTION OF WORK: FEES $60.00 Minimum (includes State Surcharge) OR - If the Permit Fee is less than $10,010, surcharge is $ 5.00 - If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee (i.e. a $10,010 - $11,010 Permit Fee requires a $ 5.50 surcharge) Educational Contract Value $ 00 (7C�is o X1% =$ / . OAS Permit Fee = $ �S 00 Surcharge TOTAL FEE *Requirements: 2 complete sets of drawings and specifications, cut sheets on materials and components to be used I hereby apply for a Fire Alarm 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 Minnesota Building /Fire Codes; 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. X V �4 Applicant's Printed Name Appli nYs Si hat Special Inspection Final Report The Urgency Room 3010 Denmark Avenue Eagan, Minnesota Prepared for Emergency Physicians, P.A. Project BL -12-01739 September 26, 2012 Braun Intertec Corporation BRAUN INTERTEC Special Inspection Final Report Braun Intertec Corporation 11001 Hampshire Ave S Minneapolis, MN 55438 Phone: 952.995.2000 Fax: 952.995.2020 Web: braunintertec.com City of: EAGAN, MINNESOTA Date: September 26, 2012 Project: The Urgency Room Page 1 of 2 Attention: Mr. Thomas H. Klassen 3010 Denmark Avenue Eagan, Minnesota Braun Intertec Project: BL -12-01739 In accordance with the Minnesota State Building Code, Section 1704 of the International Building Code and the agreed upon scope of services, the required special inspections and testing have been provided for the following items: Concrete The required testing in the field and in the laboratory has been completed. The results have been forwarded under separate cover. The compressive strength testing indicates the concrete placed has met the project requirements. The placement procedures used were judged to have met the project requirements. There are no outstanding or unresolved concrete -related issues. Reinforcing Steel The reinforcement placement detailed in the attached Special Inspection Daily Reports was observed according to the requirements of the project plans and specifications. There are no outstanding or unresolved reinforcing steel -related issues. Structural Masonry Construction The required structural masonry observations detailed in the attached Special Inspection Daily Reports have been completed in general accordance with the requirements of the project plans and specifications. There are no outstanding or unresolved structural masonry -related issues. Anchor Bolts The required observations of the anchor bolts have been completed. The installation was found to be acceptable. There are no outstanding or unresolved issues. Bolting The bolted connections detailed in the attached Special Inspection Daily Reports were observed in general accordance with the requirements of the plans and specifications. There are currently no outstanding or unresolved bolted connection -related issues. Topside Metal Deck Welding and Fasteners The metal deck welding, deck fasteners and side -lap fasteners detailed in the attached Special Inspection Daily Reports were observed in general accordance with the requirements of the project plans and specifications. There are currently no outstanding or unresolved decking -related issues. Mechanical Fasteners The mechanical fasteners detailed in the attached Special Inspection Daily Reports were observed in general accordance with the requirements of the plans and specifications. There are currently no outstanding or unresolved mechanical fastener -related issues. AA/EOE Providing engineering and environmental solutions since 1957 Emergency Physicians, P.A. Project BL -12-01739 September 26, 2012 Page 2 Wood Framing Periodic observations were made during the roof and wall framing and sheathing. The purpose of our services was to observe the materials and installation for general conformance with the project drawings, changes, and specifications. Discrepancies were noted and documented. The installation was found acceptable following the review by the project structural engineer. There are no outstanding wood framing issues. Conclusion Based upon the inspections performed, the testing completed and the attached Special Inspection Daily Reports, it is our professional judgment that, to the best of our knowledge, the inspected work was performed and completed in accordance with the approved plans, specifications, structural engineer provided modifications and applicable workmanship provisions of the International Building Code. Inspecting Firm: Braun Intertec Corporation I hereby certify that this plan, specification or report was prepared by me or under my direct supervision and that I am a duly Licensed Professional Engineer under the laws of the State of Minnesota. i`'',1", 4 R. Ja ro, PE, PG Vice President— Principal Engineer License Number: 18221 September 26, 2012 LICENSED PROFESSIONAL ENGINEER �. ip•\ . A. 18221 A.. "'l111111 I U' Attachments: Soil Inspection Reports 1 and 2 Non -Structural Steel Special Inspection Daily Reports 1 through 9 Structural Steel Special Inspection Daily Report 1 BRAUN INTERTEC For Office Use ,/i % ; E AGA roeWCETVF Permit /6,0q0 :2 ( (� ,� e� I� oI MAR 1 0 2020 Permit Fee: �0 �� ti Date Received: 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810t' (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 �G` Staff: KA buildinginspections(c�citvofeacian.com D L 2020 COMMERCIAL FIRE ALARM PERMIT APPLICATION 03/10/20 3010 Denmark Avenue, Eagan, MN 55121 Date: Site Address: Tenant: Urgency Room Suite#: 0 Requirements: 2 complete sets of drawings and specifications, cut sheets on materials and components Name: Eppa health Phone: Property Owner 3010 Denmark Avenue, Eagan, MN 55121 Address/City/Zip: Applicant is: Owner ✓ Contractor We are taking over the existing Silent Knight 5208 panel and adding a cellular modem.We will perform a fire test and Inspection. Type of Work Description of work: Construction Cost: Estimated Completion Date: Name: Wellington Security System License#: TS00657 Contractor Address: 5555 W. 78th Street, Suite H City: Edina State: MN Zip: 55439 Phone: (612)8224094 Contact: Amanda Nelson Email: ADM@wellingtonsecurity.com _New _Remodel Work Type Addition ✓ Other: Take over system and add a Cellcom 1 Alterations DESCRIPTION OF WORK: ✓ Commercial _Residential _Educational FEES Contract Value$517.00 x.01 $60.00 Permit Fee Minimum =$ 60.00 Permit Fee Surcharge=Contract Value x$0.0005 =$ .26 Surcharge* If the project valuation is over$1 million, please call for Surcharge _$ 60.26 TOTAL FEE You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeagan.com/subscribe. I hereby apply for a Fire Alarm permit and acknowledge that the information isi complete and accurate;that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Minnesota Building/Fire Codes;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. x Amanda Nelson x /lit Applicant's Printed Name Applicant's Signature FOR OFFICE USE Reviewed By: P'IN�.. tie Date:___,_110/2_, / R= Required Inspections: Rough-In Final Fire Alarm Test