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3600 St Francis Way ACity of Iaau 3830 Pilot Knob Road Eagan MN 55122 Tenant: Use BLUE or BLACK Ink For Office Use i Permit #: ! �� Permit Fee: Date Received: U L Phone: (651) 675 -5675 Fax: (651) 675 -5694 Staff: / 2012 MECHANICAL PERMIT APPLICATION Date: 7/3/1 Site Address: 3 i(70 S f4 �l C es lr✓ C a Vi i/ T / 551)3 Name: Seo 7 Y 17c% 1-14 viev,y. Phone: Address / City / Zip: S % / Fumace Air Conditioner Air Exchanger Heat Pump 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 COMMERCIAL FEES: $75.00 Underground tank installation /removal (includes $5.00 State Surcharge) $60.00 Minimum (includes State Surcharge) - If the Permit Fee is Tess than $10,010, surcharge is $ 5.00 - If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee (Le. a $10,010 -$11,010 Permit Fee requires a $ 5.50 surcharge) OR x Applicants Signature Suite #: 07 3 / RESIDENT / OWNER CONTRACTOR TYPE OF WORK PERMIT TYPE Contact: Name: T` ,m f■s�r i � r' ( - License #: fl i P f L Address: ;Tt(0 CONCORDIA City: ST. PAUL, MN 55104 I State: Zip: r d {� o gPPhone: '�.� ! -�i' �'V t a�So s New Replacement Additional Alteration Demolition Description of work: / e/ 4 e e � NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City Code. Please contact the Mechanical Inspector for information on permitted screening methods. RESIDENTIAL Email: COMMERCIAL New Construction Interior improvement Install Piping Processed Gas Exterior HVAC Unit Under / Above ground Tank ( Install / — Remove) TOTAL FEE Contract Value $ _ $ Permit Fee _ $ Surcharge _ $ TOTAL FEE CALL BEFORE YOU DIG. Call GopherState 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 uti hies. www. • o s herstateonecall.a I hereby acknowledge that this information is complete and accurate; that the work will Eagan; that understand this is not a permit, but only an application for a permit, and wo with the,approved plan in the case of work which requires a review and approval of plans x kLE ` i' A Applicants Printed Name ce with the ordinances - nd=codes of the City of ithbq a permit; t e'work will be in accordance FOR OFFICE USE Required inspections Reviewed By: Date: Underground Rough In Air Test Gas Service Test In -floor Heat Final HVAC Screening For Office Use 1 _ F....di: /.5-V 7.f-- 71 EAGAN , POMA Foe; 6 -C,*, - —7 Date Reservist 1 3830 PILOT KNOB ROAD I EAGAN,MN 55122-1810 I (651)875-5675 1 TDD;(651)454-8535 1 FAX(BSI)675-5604 Staff il 13.;.1411:121NR9tratiCtri$etAjearrAtilitlft cry11 .... ... ...4 2019 RESIDENTIAL BUILDING PERMIT APPLICATION Data. Site Address: 36,t)0 St• I:(4 - ORI Unit It i i , I NaMe: '--- - i '`i.-: 1 ( 4... . ,I. . - i`k 4.)a, Phone: ‘‘1 -0) ‘s ; ; Resident/ Owner j Address i City/Bp: J(c,(--)4.:7) A — r1^", 3 N • F. 4-.1..-, (...." ),.-• Applicant is. Owner .,\-C. ontractot . Description ype of 11M7rkF--- ---7 -- T __j...„... j lcAmstr0000ncost. ....,_i , __.. 0 C.-;' -2-- Multi-Family&Ming,(Yes I No t Company: -71-1-Z. tc-0 0 .-4, v--5, '" Ai 1:...- k Contact 0 t•1/4,--- C rsr-ei tel.6Cr.4.,t--• 1 Address ¶1 10 c .., 4,:i kk,,, ;..IY`--v-- 6 iv A ikd -'" - - CitY. /...,4,k -C..- Co actor , 1 , i-3- v 1 SU"' /-‘ 4" ZIP S -.1:.LY. z . Pohe. i-S /- / ? / • Email. ,-5 I A.- t''- -j -; f' .1,, s Al %., ;2 .c 1 License ii. . - L i s'.. t* i q Lead Certificate*, 4 1 11 i _ 4. ;)-.) 4 - i _ ..„...-- If the project is exempt from feed certification, please explain why: COMPLETE THIS AREA ONLY IF CONSTRUCTING A pIEW BUILDING In the last 12 months,has the City of Eagan issued a porn*for a&Snider plan based on a master plan? _ — Yes No If yes,date and address of master pain: Licensed Plumber: Phone: Mechanical Contractor Phone: Sewer&Water Contradkor Phone: Fire Suppression Contractor Phone: MOTE:Plaid and suppolIng documents*Wyou subeditors coneldensi to be pubic behtmellon. Parbene ofI to e taletatelitsh my be dowelled es non-oublo ff re Feet*'mite meow mat weekt pelmet the aly Ilis ononaltidt MP"WV are bees ooteete. You may subscribe to receive an elects:Mc notification from his City of proposed andminces by Mph*up for as amain matt on the Ctrs webs's'at itwri cit comistdiscgat Exterior work authorised by*btaldhig pima issued bt w000rdwitati with the tithwateota PA*Building Code must be competed linden lid days of permit issue. raL.BEFOOM YOU QR. Call Gopher Stale One CM at(551)4844002* prolix:bon against underground utility&maw Call 48 hours before you intend to(%)to receive locates of widow:mind utilities 166167001erS1ateOreciaLQU I hereby acicroitedge tat the irdocniation ie complete end eccurees:tisk the work will be in conktonance wth the ordinerwas and codes of the Cky or Eagan,that I understand tie W not$pent*, but only set appicadion for a permit, and work is not to start withoit a pent*,that the work.wit be in ecowderve rah its approved pan in the cruse id wort which requires a review end approved o.±01204,_ __ A1.4)1.:„..,-, Sv-.....-T.4 .. 1.— Applicantle Printerd Name Applicants Signature —-- -— • Oet 2. 2014 12:05PM Crest Exteriors 651-463-8095 P• 2 Use BLUE or BLACK Ink -----------�------ � For oftice Use � ' j Pemi111F: ��� / /� j City of Ea�a� I peRnit Fee: ���� � 3830 Pilot Knob itoad � / � Eagan MN 56122 � Date Recelved: / � Phone:(6b1)676-6676 I i Fax:(6b1)676•5694 I Slafi: 1 I ► ����.�._�.-..-..._.___�___J 2014 RESIDENTIAL BUILDING PERMIT APPLICATION Date:�� Site Address: � Unit�: Name:CI��Zn����a t l�K.� PhonA:lYJI 1 J��� (11,�� Resldent/ I � Owner Address l Cily I Zip: C Applicant is: Owner Conlraclor Type of Work Descriplion of work: ConslrucGon Cost:��� b� MuIG-Family Building:(Yes�/No�) Company: J �l��J, L��_� Conlact: f--lit 1 1�/ Contracfor Address� ��] � l�I� ���- Cicy: State:�Zip���� Phone: ��mail:�Q,S��►]�S r�i�,rc�-r�.t License#:������ Lead CeRiflCate#: If lhe project is exempf from lead ce�tiFication, please explain why: (see Page 3 for additional informalion) � , � COMPLETE THIS A A ONLY IF CONSTRUCTING A N�W BUILDING In the last 12 months,has the Clty of Eagan issued a permit for a similar plan hased on a master plan7 `Yes _No IF yes,date and address of master plan: Llcensed Plumber: Phone: Mechanlcal Contractor: Phone: Sewer 8 Water Contractor, Phone: NOTE:Plans and supportln,g,docum�nts thRt you subm/t ere constdgred!o be pub►lc.lnformetion. PorfJons of the jnformation,may be classifled as�iion public if,you provide�peclilc reasbns fhaf would pe►m/t ihe C/ty to � ��'con�lir�e that�[he are trade secreb, � CALL B�FORE YOU DIG, Ca�l Gopher Slate One Cell al(661)464-0002 for proteclion agaiml underground uliliry damage. Call 48 hours be(are you inlentl lo dlg lo retelve Iocsles ot underground uGlilies, www,vooherslaleonecall.oro I hereby acknowledge lhal Ihls In(ormatlon Is complela and accura�e;(hat Ihe work will be In conformanGe wilh Ihe oldinances end codes of the City of Eagan; Inal I undelsland lhls IS nol H pemlil, bul onty an applicalion for a permil, and worK is nol lo slarl withoul a permil: Ihal Ihe work will be in accordance wilh Ihe approved plan in Ihe case oF work which requires a revlew and approval of plans. Extarlorwork authorized by a bullding permlt IssuAd In accordance wllh the Mlnnesota Slate eullding Code must be compleled wilhin 180 daye of permil IseuanCe, x ���\�� � � x , AppllcanPs Prin ed ame9 Appli nt's Signature Page 1 of 3