4148 Arbor Lane
Use BLUE or BLACK Ink
For Office Use I
I
; Permit J1o~ 9 '
I 4- I
City of Eapn
Y
3830 Pilot Knob Road Permit Fee: 14~~1.u
I
Eagan MN 55122 I I
Phone: (651) 675-5675 I Date Received: Qh113
Fax: (651) 675-5694
I I
Staff: _
- - - - - - - - - - - - - - - J
2013 MECHANICAL PERMIT APPLICATION
❑ Please submit two (2) sets of plans with all commercial applications.
Date: 5'2$' \_j Site Address:
Tenant: A'yb b Y Lame Suite
Resident/Owner Name:D Ph~one:
Address / City / Zip: J j~E~ R"
Name: Rons Mechanical Inc License
Address: 1 201 0 Old Brick Yard Road City; Shakopee
Contractor
I State: MN Zip: 55379 Phone: 952-445-8585
t
'
I Contact: Linda Email:
New Replacement Additional Alteration Demolition
Type of Work Description of work:
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 New Construction Interior Improvement
Permit Type 7Air Conditioner _ Install Piping Processed
-
_ Air Exchanger - Gas - Exterior HVAC Unit
_ Heat Pump Under / Above ground Tank L_ Install Remove)
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) = $ UD.0 TOTAL FEE
COMMERCIAL FEES:
$70.00 Underground tank installation/removal Contract Value $ x1%
$55.00 Minimum Permit Fee
*If the project valuation is over $1 million, please call for Surcharge $ 5.00 Surcharge*
W&. 00 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.gopherstateonecall.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 which requires a review and approval of plans.
x ~ k mrdty x Ar%kl)v~
Applicant's Printed Name Applicant's Signature
FOR OFFICE USE
Required Inspections: Reviewed By: Date:
Underground Rough In Air Test Gas Service Test In-floor Heat Final HVAC Screening
PERMIT
City of Eagan Permit Type:Plumbing
Permit Number:EA111801
Date Issued:07/11/2013
Permit Category:ePermit
Site Address: 4148 Arbor Lane
Lot:016 Block: 001 Addition: Wenzel 1st
PID:10-83570-01-160
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Water Heater
Meter Size Meter Type Manufacturer Serial Number Remote Number Line Size
Comments:Please call Building Inspections at (651) 675-5675 to schedule a final inspection.
Kris Oien
3670 Dodd Rd
Eagan, MN 55123
Fee Summary:PL - Permit Fee (WS &/or WH)$55.00 0801.4087
Surcharge-Fixed $5.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Eugene W Tiffany
4148 Arbor Lane
Eagan MN 55122
Champion Plumbing
3670 Dodd Rd., #100
Eagan MN 55123
(651) 365-1340
Applicant/Permitee: Signature Issued By: Signature
0512312014 11:26 Les Jones Roofing, Inc. I:AX)9528817009 P.0071016
Use BLUE or BLACK Ink
I For Office Use
~,~-1 ^ _ - 1
Permit V
City of Eap I I 7-5
Permit Fee: G 1
3830 Pilot Knob Road I 1
Eagan MN 66122 Date Received:
Phone: (651) 676-5675 I 1
Fax; (651) 676-5694 I Staff; 1
I
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 23 Site Address; Jw4 - 4 tgL-414c -1.tt0 Q_ ~ Unlt
Name: 9o r..e AsteoQS s wc. bV'Ah*%W' hone: ~o Sl- 4 Q S- S S~~'
.n
Address /city/ Zip: li k ao Amok
Applicant Is: Owner X Contractor
Description of work K 6'at o rv6' .A,VD DGF /~pUC
Construction Cost:.* 3 Multi-Family Building: (Yes x / No 74 i r
Company: AE s .vc. Contact: Cmer s A7yJMS0A/
Address: ! T City: ,II-M,1/
A '
` Stater Zip: ,~OfVZp Phone: 545.E - 76, 7 - 0?8/7
r
License Lead Certificate 'V n 3 77
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW 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, data and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sower & Water Contractor: Phone:
CALL BEFORE YOU DIG. Call Gopher State One Cell at (661) 464-0002 for protection against underground utility damage. Call 48 hours
before you Intend to dig to receive locates of underground utilities. www gogherateleonecall.om
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 1 understand this Is not a permit, but only an application for a permit, and work Is not to start without a permit; that ft work will be In
accordance with the approved plan In the case of work which requires a review and approval of plans.
Extorlorwork authorized by a building permit Issued in accordance with the Minnesota State Building Code must be completed within 180
days of permit Issuance.
x Clfi2ld f~lUt7S0~ _ x .
Applicants Printed Name Applicant's Signature
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