511 Classic Ct Unit B102
___Use_B_L_UE or BLACK Ink
For Office Use j
40~ -
City of Eapn Permit I
3830 Pilot Knob Road Permit Fee:
Eagan MN 55122 l (t~
Phone: (651) 675-5675 1 Date Received:
Fax: (651) 676-5694 I I
~ Staff: ~
2013 MECHANICAL PERMIT APPLICATION
❑ Pleasesu it two-(2) sets of plans with all commercial applications. F1 S-) , /Eh 6&7e r` mid/
Date: ~ G '1 /Site Address:
Tenant:
Suite Z
Resident/Owner Name: Phone:
Address / City / Zip:
Name:,4t/ES-J Z7C~ C License
I~ Cam! f~d<7~'_ j_/zv
Contractor Address:
State: .~i Zilp: Phone: CP l
Contact: IY1~,?mai1:
ew Replacement Additional Alteration Demolition
Type'ofWork Description of work: la r~CGo~i1~~~~r✓~ j
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 COMMERCIAL
Furnace Construction _ Interior Improvement
Perm it Type -Air Conditioner _ Install Piping _ Processed
- Air Exchanger _ Gas _ Exterior HVAC Unit
- Heat Pump _ Under / Above ground Tank Install Remove)
Other
RESIDENTIAL FEES:
$60.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge) I'
$100.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) = $ TOTAL FEE
COMMERCIAL FEES: V~K e
$70.00 Underground tank installation/removal Contract Value $
$55.00 Minimum Permit Fee
*If the project valuation is over $1 million, please call for Surcharge 5.00 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.oooherstateonecall.ora
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 of to start without a permit; that the work a in accordance
with the approved plan in the cas work which requires a review and approval of plans.
x x
Appl cant's Printed Name App icant's Sig re
FOR OFFICE USE
Required in" spections Reviewed By:Dater t
Underground -Rough In',: _ Air Test Gas Service Test -floor Heat _ Final HVAC Screening`