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Use BLUE or BLACK Ink
/ I For Office Ilse I
Perrrtit# I
71770"' City of Eaba
n 10
1 Permit Fee ( I
3830 Pilot Knob Road I
Eagan MN 55122, I ; 1
Phone: (651) 675-5675 I Date Received:
Fax: (651) 675-5694
I Staff:
I
-l
2014 COMMERCIAL BUILDING PERMIT APPLICATION
t
Date: Site Address:L~
Tenant Name: ulfi-lli l r ra,./ f s
(Tenant is: New ! Existing) Suite #
s~ Former Tenant:
Name: !-"C?t r f ~ l Phone: fit' '776 G
Property Owner City l~'1U
Address f / Zip: Az,
Applicant is: Owner _X Contractor
Type of Work Description of work: fie l?- Q f', 0
Construction Cost: q q~ 5-2
Name: 1 a Lv e G' ,1 %,e J,4 ! Y License
Contractor Address: L4 City: MOO&- 61t'
State: 1/- Zip: 5 f I Phone: 1 17 i
Contact 1, Email: c1 -Al L5 ~ We--S, rc- -1
Name: Registration r~
Architect/Engineer Address: City:
I State: Zip: Phone:
Contact Person: Email:
Licensed plumber installing new sewer/water service: Phone
NOTE: Plans and supporting documents that you submit 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 Gall at (651) 454-0002 for protection against underground utility damage.
Cali 48 hours before you intend to dig to receive locates of underground utilities. www.goRherstateonecall.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 ragan; 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 ich requires a review and approval of plans.
Applicant's Printed Name - cant's Signat
Page 1 of 3
For Office Use r,
ti.
Permit#: ` i `e
E A Pertik Fee: 607-ifW)
AN �-
RECEIN :.) Staff.
3830 PILOT KNOB ROAD
IEAGAN,MN 55122-1810) JUN 0 4 2018 Payment Recvd: Yess_No
(651)675-5675 TDD:(651)454-6535 FAX:(651 675-5694
Email:buildinginspections[fr�cityofeagan.com Plans: Electronic _Paper,
Plan Submittal:eplail,s 5 cityofeayiz.c,gn� L
2018 COMMERCIAL PLUMBING PERMIT APPLICATION
❑ Please submit two(2)sets of paper plans with all commercial applications as well as an electronic set of the submittal,
submitted via email,CD or flash drivej �
Date: ---S130/1 g Site Address: / g Tr G t. L(.J Q y `.J r
Tenant: Coo,1..Y10T "Yrc L S APa.es-r'/ tC.nrS suite is:
Name-
.6)4 Lma- t LS A Pek rTivenr--._1 Phone: 6/2-9 3 9-o l`7 -7
of Name: 1/►'t't S Q Oa L Ct/ P L(J rY )JI r3icense#: V C9 L) P✓Y)
* Address: �C ou n4 y ld el City DSS e.O State/�i'�ZIp.. 3 4 9
•
�� t
; ,m Phone:763-142K-5 5 g Email:„ rn - 'iPL0171Qr, (1 c_ornca$l: �✓e-T'
" New Replacement Repair. �y � � pi pair Rebuild _Modify Space Work in R.O.W.
*it( Description of work: re P2.0..0
ri - ' COMMERCIAL New Construction _Modify Space
T _Irrigation System L_yes/_no)(_RPZ/ PVB)
• Rain sensors required on irrigation systems
4: 4i,44.1,40:,.." • Avg.GPM (2"turbo required unless smaller size allowed by Public Works)
_Meters Call(651)675-5646 to verity that tests
rtlY passed Prior to t>ic kinfl up meter.
• f` 2 Domestic.Size&Type Fire: 1
ttl.�"rye , � ,, Avg.GPM High demand devices? Yes No Flushometers Yes_No
COMMERCIAL FEES Contract value$ 54 eV.OQ x.01
$60.00 Permit Fee Minimum $ ��,OQ Permit Fee
$60.00 PVB/RPZ Permit(includes State Surcharge) (� C56Surcharge
Surcharge=Contract Value x$0.0005 =$ ^'V
If the project valuation is over$1 million,please call for Surcharge =$ f: 2 ` C30 TOTAL FEE
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
=$ TOTAL FEE
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up far art ami update on the City's webslta at
veww.cityafe4uan.com/subscribe.
CALL BEFORE YOU DIG.Call Gopher State One Call at(651)4540002 for protection against underground utility damage.
I hereby ackrawAedge that this information is complete and accurate:that the work will be in conformance with the ordi of of Eagan;that I understand this is not a
penult,but only an application for a permit,and work is not to start without a pen*that the work will be In accords .
and approval of pians. pitch the case of work which ragtime a review
X Dar)1 1— N&INCA.c, se, i
X
Applicant's Printed Name Applica s Signatu
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�us T� ,� ��+E ���,��� � ,�"�,ie. � �+ r� yla ��arM 4
is • G Pm i., 3=a. € s Y at,EI
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� � � i s �• k�� :�5 f A'�j;,.s�."W.4'r $�'�Sz x .'.1 7 � 9
s � YAP F
h: FpA r'.r}i{ s�a7A"0`9�rfie MG .'.;$, 1:z�a�`'
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Page 1 of 3