3830 Pilot Knob Rd - Cascade Bay
Use BLUE or BLACK Ink
For Office Use I
I I
Permit
City of Evan I b
I Permit Fee:
3830 Pilot Knob Road I
Eagan MN 55122 ~ Date Received: I
Phone: (651)676-5675
Fax: (651) 675-5694 Staff: f / "
2013 COMMERCIAL PLUMBING PERMIT APPLICATION
❑ Please submit two (2) sets of plans wit all commerc' 1 pplications.
Date: ' ite Address: i o 1 to l
Tenant: h~ Suite
Property b bb
Owner Name: Phone: t5 _l' lu j
Name: l1~ tmen e
Contractor Address: City: State Zip: ~
i Phone: viGiS
Type of Work - New _ Replacement Repair _ Rebuild _ Modify Space _ Work in R.O.W.
Description of work:
COMMERCIAL ~X_ New Construction _ Modify Space
Irrigation System t/ ` yes no) (XRPZ 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.
Domestic: Size & Type Fire: 1
Avg. GPM High demand devices? _Yes No Flushometers Yes No
COMMERCIAL FEES Contract Value $ 55 (r_x.01
$55.00 Permit Fee Minimum = $ 1~ V5+ t~ Permit Fee
*If contract value is LESS than $10,010, Surcharge = $5.00 = $ 4) 00 Surcharge*
**If contract value is GREATER than $10,010, Surcharge = Contract Value x $0.0005 j
***If the project valuation is over $1 million, please call for Surcharge = $ bo a L) ~ TOTAL FEE
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
w (0o. OD 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 p mit, and k 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 r
-IRCLA I o plans.
x Lb _4 ~V~L ~ x F'VlO oipz~~
Applicant's Printed Name } Ap I'
FOR OFFICE USE Approved R, Date:
Required Inspections: Under Ground Rough-In Air Test Gas Test Final PRV Required: _ Yes No
Page 1 of 3
05/28/2014 15:36 FAX 6516026699 MAIN FAX Lsfl0002/0002
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Use BLUE or BLACK Ink
---j
~ For Office Use
MIX-
01 Eapn Per
mit 3 t 1 3830 Pilot Knob Road Permit Fee:
Eagan MN 55122 I I
Phone: (551) 675-5675 1 Date Received I
Fax: (651) 675-5694 I I
Staff:
~LJ
2014 PERMIT APPLICATION
❑ Please submit two (2) sets of plans with all commercial applications.
Date: Site Address:(} 1.4 Kn010
f,p
Tenant: L?A.:4 CA, - c,4Je Suite
Name: 'y Phone_ - Co7S- SQ
~~I Residefit/tDvuneF, ~ E°4^
Address / City / Zip: 38'SG Q, to i K..o b RJ E&4 of A/
s t , ai Name: License
Address: 509 M,-n City: ~R *c Q
cost', 6r ICE,
C,! State: tA/V Zip: SS707 Phone: (4S'1-La?'l -(oGt7
Contact: -V,~n o fet6a Email: ((~ijC ~c ~to~¢~~a ~1 rnCC .Cow
New __A~ Replacement Additional Alteration Demolition
r
` Type` of Work Description of work:
NOTE; Roof:mounted ancEground zr►ounted mechanical e~tbprnegtr15 regtzred tore s ed bye r
Code Please contact ffie"Mechanicalglnspectorfor mormation on pefmttted~screen( [netho s
s^ RESIDENTIAL COMMERCIAL
Furnace _ New Construction _ Interior Improvement
E ; Permtt Type - Air Conditioner _ Install Piping _ Processed
_ Air Exchanger
Gas _ Exterior HVAC Unit
Heat Pump _ Under/Above ground Tank L Install Remove)
u,R a+ Other
RESIDENTIAL FEES
$60.00 Minimum Add or alteration to an existing unit (includes $5.00 State Surcharge)
$100.00 Residential New (includes $5.00 State Surcharge) TOTAL FEE
COMMERCIAL FEES Contract Value $ &P 2 x .01
$55.00 Permit Fee Minimum 4
$70.00 Underground tank installation/removal Permit Fee
IM _
'If contract value is LESS than $10,010, Surcharge = $5.00 Surcharge*
**If contract value is GREATER than $10,010, Surcharge = Contract Value x $0.0005
***If the project valuation is over $1 million, please call for Surcharge - TOTAL FEE
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 the work will be in accordance
with the approved plan in the case of work which requires a review and approval of plans.
x~g:,,..
X
Applicant's Printed Name Applicant's Sig6fitureF
~FOrW FQGE USF w Ple - yu fia~ronr
Regurred tnspecUdns Revtewe'dr ~DaE °
"r, 11h
Underground' Rough In Air Test , Gas Service Test "fn`=floor Heat' . rnalJ„ Vl Screevl
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