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For I Office Use
l Permit Z~ U J
City of Ea
I t
3830 Pilot Knob Road i Permit Fee: d 1
Eagan MN 55122 1 l
Phone: (651) 675-5675 Date Received'
Fax: (651) 675-5694 l
l Staff: I
L-- ----1
2014 COMMERCIAL BUILDING PERMIT APPLICATION
1~'-r l
Dater 4-1-6-H Site Address: 0A, Ti~~✓~ltJ
Tenant Name: U/114l1 Jr rg"I 1 P fl (Tenant is: New / Existing] Suite
Former Tenant:
Name: 0- 719A r! 0 7 Phone: tom _770 Oec?
Property Owner Address / City l Zip: , L'#0 el? I 04
Applicant is: Owner Contractor
Description of work: -fet4A-
Type of Work
Construction Cost:
Name: NCR W e ! 04 Il"9~4 / License
Contractor Address: 6( 117 0,413 City: c'7r1(- flyL'~-
State: Zip; Phone: b I - L 1 / 1
Contact:i la t~'l' Email:
Name: _ A) /I Registration
Arch itectlEngineer Address: City:
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 Call at, (651) 45"002for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.aopherstateonecall.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 ich requires a review and approval of plans.
,fit r U
X
Applicant's Printed Name r is nt's Signat
Page l of 3
For Office Use _
Permit#: ( ) )-,—)192
i' i
e ° j
` ° � EAGA
ED Permit Fee:
Staff:
20Va i
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 v Payment Recvd: _Yes No
(651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694
Email: buildinginspections(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 s.
Date:.` ---3,-)—i V Site Address: / 0 / ",i/L OA lli 0./L ov
Tenant: Suite#:
Property
a
/ if(
j y�
OWner ,..Name: I ,� !� u� df �/ i/ ' , Phone: t f — �� � 7c1 iI
/'Name: J I f,t,L,,7/N�rvse#: l
t Contractor ''j"� ��,�/� � hf Zip: C�'
t
Address: q I / ! A/2 City: d,0 State S�Q t 7
/CO 6
I 1
Phone:(oJ '' / 7 0.; 5 7 Email: 0 e � Cnin IL ice'
New ' t�(, Re lacement Repair Rebuild ModifySpace Work in R.O.W.
— p
Type of Work E rc._
p
- . 1(2--
L______ i
j Description •of work / \ �� 1
1 [COMMERCIAL New Construction Modify Space
Irrigation System( yes/_no)( RPZ/_PVB)
t • 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. 4
I
Domestic:Size&Type Fire: 1 s
i Avg.GPM High demand devices? Yes No Flushometers Yes No '_
COMMERCIAL FEES
Contract Value$ 6 t® d x.01
$60.00 Permit Fee Minimum
$60.00 PVB/RPZ Permit(includes State Surcharge) =$ G � Permit Fee
t =$ 7 fi Surcharge
Surcharge=Contract Value x$0.0005
If the project valuation is over$1 million, please call for Surcharge =$ 47- C 6 TOTAL FEED
I 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 recaW an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at
www.citvofeanan.com/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 or• ances and co--s o;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 wiut a permit;that the work will be in - ••arae wi the= 'rove•plan in the case of work which requires a review
: anVhJ
nd td/-:e/' 7�,fr1V� x ai_/ �
Applicant's Printed Name Applicant's Signature
FOR OFFICE USE Approved By: Date:1121_5_2 d Sr
O
Required Inspections: _Under Ground Rough-In Air Test Gas Test ' Final PRV Required:_Yes_No
Meter Related Items: Meter Size Radio Read Manometer Staff:
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