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1886 Southpointe Ter.City of Ekon 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 JUL_262012 6)609F 19 52( Uset°°'°6 E or BLACK Ink For Office Use �// /e 1 L� Permit #: Permit Fee: Date Received: Staff: 2012 MECHANICAL PERMIT APPLICATION ❑ Please-�submit two (2) sets of plans with all �commercial applications.�ti tV Date: I I 12— Site Address: t (� i�LQ OW y ►"- 1 Pc 1 V1+ :t% 1 D C Tenant: Ncknc, L L' (k leV1 e. (TerSuite #: Phone: 1X5 "Z `OS� Address / City / Zip: 1$ LQ 1,t -W10 {� T-�1/- CO . Name: Oat t-1-0-10 l-- 1y License #: ' 2 2-02-65) Address V (r� j (f Or? s) --City: ( S �J yZ State: VL& Y Zip: 55 0-3 7D Phone: 1CS) , "TJ")S1 K 2-t o RESIDENT I ;OWNEF CONTRACTOR Name: KlAvi C ! Lutc / fv L LA Contact: _{Q__V/hJ TYPE OF WORK PERMIT T"YPE'. Email: O a. New • Replacement Additional Alteration Demolition Description of work: f NOTE: Roof mounted and ground mounted mechanical equipment,): Code. Please contact the Mechanical Inspector for information on RESIDENTIAL Furnace Air Conditioner Air Exchanger Heat Pump Other quired to be screened by City mnitted;screening methods. COMMERCIAL New Construction Interior Improvement Install Piping Processed Gas Exterior HVAC Unit Under / Above ground Tank ( Install / _ Remove) 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) _ $ Leo °TOTAL FEE COMMERCIAL FEES: $75.00 Underground tank installation/removal (includes $5.00 State Surcharge) OR Contract Value $ 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) = $ 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.uopherstateonecall.orq 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. x Applicant's Printe• Name FOR OFFICE USE Required Inspections Underground R x Applicant's Sign Cn-• 41' City of Eta]] 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 6754594 Use BLUE or BLACK Ink For OMce Use � Penn t * 12:31% Permit Fee: S( o Date Received: Staff. 2013 RESIDENTIAL BUILDING PERMIT APPLICATION Date: ir S- -J�i% Site Address: it o"9A,Cv"vb� B if o Spony pe, " 7-d .r,Z2 Unit Rte, Owner Name;'/ f1 G 7' /4 ,4, )4 r,1/1.1 8U % .X":4) Address / City I Zip: VS -0 hr. e- 4 ru R AV L .7g14 r2 A Goi.h z,,1 mvu s v 7 Phone: 7& -.. f 3 - 9 7 )O Applicant is: Owner x Contractor Type,o wlin{c• Description of work: -7-C•41-2 F Construction Cos13 x 7 85. GQ Multi -Family Building: (Yes %C / No Cir Company: E,r r CR l o de /%i..l :. p Contact k44,-1/ CI" RR t 5 Address: Or W D S? . City: /h PL—S . State:1"1 Zip: .5 -s -V1 9 Phone: - ra Z'/3 - License it: C .i' 1I 3 / Lead Certificate #: If the project is exempt from lead certification, please explain why: (see Page 3 for additional information) tIa-h/os l.)f_aL R.>, -i r. Posr J COMPLtTE THIS AREA ONLY IF CONSTRUCTING A ?IEW BUILDING In the last 12 months, has the City of Eagan Issued a permit for a similar plan based on a master plan? Yes No If yes, date and address of master plan: Licensed Plumber. Phone: Mechanical Contractor: Phone: Sewer & Water Contractor: Phone: tfte Nor ; R; : (.•, .. ,�� ,� • veep",- ':z �yc u<R",h`,hfa►JD�k'G!iVK�. r F . !r..r,'. Zu ., k ,�' y ,BALL BEFORE YOU DIG Cali Gopher State One Call at (651) 4644002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utillues. »ww,apoherstateonecad.oro 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 worn win be in accordance with the approved pan in mho case of work which raqulaes a review and approval Of plans. Exterior work authorized by a building _. _ ssued in accordance with the Minnesota State Solidi Code mint be completed within 180 days of permit ieauance. I a 2lZ l3 Applicants Printed Name ZO/T0 39vd x Appllcante Signature Page 1 of 3 INIvW 1X3 I3S L9Z9T98ZT9 VS:80 bTOZ/TT/90 *City 0Ibin 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 PA -r V Use BLUE or BLACK Ink For Office Use Permit* I 2 - Permit Permit Fee: FLP LCt1 Date Received: Staff: 2013 RESIDENTIAL BUILDING PERMIT APPLICATION -1 l/% >atie,,sz,IN, re,a� Date: Site Address: /1'7ov 9X , Fy, 1/e, 7t, r gam Sor:srf/P6 •••)7." 7.7-Z Unit #: J Res'e/. , OOAfner : Name: % ACT /y104 n.3 �4 6 E /11 8 AA.l T .T•} C Phone: 74 - .S-9 3 - 9 7 7° ` �f/ Address / City / Zip: 'S> lis e, r4 "—Li A, /91/ N 'ter ,2 4 boil E -3 m•As-53-17,1, Applicant is: Owner X Contractor 7 Type O.WOrk Description of work: A 1- o d E 4 2 CPL /t r. E .5;4/0.)4:0 CPO Construction Cost 2 9 to cI° - Multi -Family Building: (Yes %C / No ._...j Coa - Company: il£ I £, rf2 0 0147.s -r. P Contact 2kAv Q tZR r S Address: 'i/ t3 6 ty ‘7. . City Ai PG $ , State: M" ci Zip: .5-S-1// 9 Phone: lo',t - S96 / - 6 A i/3 License #: a C Pi ! / 3 / Lead Certificate #: If the project is exempt Qin-Dios i.)E.2i; from lead certification, please explain why: (see Page 3 for additional information) riv1L Po.s J 9'7 i? In the last 12 months, _Yes No If COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING has the City of Eagan issued a permit for a similar plan based on a master plan? yes, date and address of master plan: Licensed Plumber: Phone: Mechanical Contractor: Sewer & Water Contractor: Phone: Phone: NOTE: i s iR ''• the . i.i ' r y r ! 7J 5 ^ 'd c iii .^it - _•-. .-, i. .... t ' AiA,„,:' ,mDh:#a1¢:s!.ta]..... f... _ :•jW^. Y �0 ,f AML& K•'J inT 4 wr SS t i SQA s ti 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.000herstateonecall.orq 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 or work which requires a review and approval of plans. Exterior work authorized by a building permit issued in accordance with the Minnesota State Building Code must be completed within 180 days of permit issuance. x b,AV/N qv(Zt ,S Applicant's Printed Name x Applicant's Signature Page 1 of 3