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' - i. — . e+ t 'Y Naga e / Use BLUE or BLACK ink I For Office Use t` Permit r 3 City Of Eapn -7 I 9 Permit Fee: t 3830 Pilot Knob Road I l Eagan MN 55127 t Date Received: I Phone: (651) 675-5675` l Fax: (651) 675-5694 l' I P Staff: L--.-----'---- -I 2014 COMMERCIAL BUILDING PERMIT APPLICATION Date: Site Address: 10)- 191-7 . / 910 / ~ Lv &A - Tenant Name: L414-1,1 yr fR,'J~ Oaf, (Tenant is: New I Existing) Suite # Former Tenant: Name: f_ -7j9/Vr7 F? '7 Phone: t~', 770 Property Owner Address i City / Zip: ~1U, ~,/1, ► Applicant is: Owner _X Contractor T e of Work Description of work: -'e44et- e A" " 4-A44 Yp Construction Cost: Name: /v oP,1y e 5-r C o 4 Tl e k try' a Ltcense Contractor Address: t- 13 City: 17 State: Zip: 55 311 Phone: Contact: J( 44 0,kA"OO Email: Name: Registration Architect/Engineer Address: City: Stater 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 Call 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.got)herstateonecall.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 work ch requires a review and approval of plans. x ,r sM 3~'1 Applicant's Printed Name is _nt's Signat Page 1 of 3 For Office Use ) y ri ffi ! 0'4:44, .4''''',..0 E A G A A NPermit#: ` S� "S .„.., ,1 (0(. t,0 Permit Fee: Staff: ..,auaw.. L J 1 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 Payment Recvd: _Yes No (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Email: buildinqinspections a(�.cityofeagan.com I Plans: Electronic Paper Plan Submittal: eplans(&cityofeagan.com 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 drive Cf 7----,Date: 2-07 i, ! c( Site Address: /g if / 1 r/4// L k) A LJr f v e___ Tenant: Suite#: Property -;;;" Owner Name: �' �/ 4 - ! i ILLS ,L, 'hone: . "--1— V5 v Name: Ij l':. 1_I �(9...L i... ...........Lt'c�rfse#: P,..1 7L/ 1 S / 0 IContractor Address: L-11.5- 1 J''f A/2 1City: .4 //, ...-11F i Statel)U Zip:S'5Q d (-)' PhoneJ / �a S Email: � d t h �1 rC : (© Type of Work —New -F�Replacement Repair Rebuildld Modify Space Work in R.O.W. Description of work: r / a �C t\ A- .Q V2- . ,___ .. . , � COMMERCIAL ..�.. .,�... New C .._.,.� ,...W . � .. .., ... _....... . .._ . ._, onstruction Modify Space Irrigation System( yes/_no)( RPZ/_PVB) • Rain sensors required on irrigation systems Permit Type • Avg.GPM (2"turbo required unless smaller size allowed by Public Works) _Meters Call(651)675-5646 to verity that tests passed prior to picking up meter. j Domestic:Size&Type Fire: 1 a Avg.GPM High demand devices?_Yes_No Flushometers_Yes_No j COMMERCIAL FEES Contract Value$ R 0 a x.01 i $60.00 Permit Fee Minimum $60.00 PVB/RPZ Permit(includes State Surcharge) =$ Permit Fee Surcharge=Contract Value x$0.0005 =$ Surcharge If the project valuation is over$1 million, please call for Surcharge =$ 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 for an email update on the City's website at www.c itvofeana n.co m/subscribe. CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground uti'_..mage. I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with e o. ances and co--s• the City of Eagan;that I understand this is not a permit,but only an application fo a permit,and work is not to start witkWut a permit;that the work will be in - o.an wi the- .rove. plan in the case of work which requires a review and a val of plans. �,�t/yp x / X /,I ) 611/--e-,-50 i__' _ �f •.0 Applicants Printed Name Applicant's Signature v FOR OFFICE USE Approved By: � Y l Date: 73/ i_ L� � � Required Inspections: Under Ground Rough-in _Air Test Gas Test U Final PRV Required:_Yes No Meter Related Items: Meter Size Radio Read Manometer Staff: Page 1 of 3