4157 Ruby Lane
Use BLUE or BLACK Ink
Y I For Office Use
Permit
City of Ea~a~
I Permit Fee: 04Y1 i
3830 Pilot Knob Road I
Eagan MIN 55122 I ?
Phone: (651) 675-5675 i Date Received:
Fax: (651) 675-5694 j Staff: j
1-----------------I 6
2013 COMMERCIAL BUILDING PERMIT APPLICATION 4 whl ~
Date: O~ 1771 (1 Site Address: 1 ^ i I y~~~~y~ssf y~ s~ 124 L VZ
Tenant Name: Q~ ~~th (,otfts ~.i►~~aS ~ ~ar~cn kom%(Tenant is: New / > Existing) Suite
Former Tenant:
Name: r.N Got~hohs V M0.6 ok,%A a1aC~s w ~cS Phone: S5a- 4 3 a' 817 9
i Property Owner Address/ City /Zip: _P.d D&X S f103e.ho\)V% ~ M u 55n (oe
Applicant is: Owner Contractor
Description of work 1 Graf" d ~F GK nor 5, Ct'Oh%(-
Type of Work
Construction Cost: 3 1;t s 3 7
Name: O ~ LOVX 5 ~ ("JA i o License l ) 1 { oZ
Address: lle `p~ fe V `ojv\a{ 1C- a%/L City: 1C)S<- MOJVX
Contractor
State: Mk Zip: '75_0(69 Phone:" GJr I - 2 ` 9 605"
Contact: L&J Email: LL`Jt
Name: Registration
Address: City:
Arch itect/Engmeer
State: Zip: Phone:
Contact Person: Email:
Licensed plumber installing new sewer/water service: Phone
n.NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may be classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
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 L,,~ . , g-o v x_-
Applicant's Printed N e Applicant's Signature
Page 1 of 3
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA125385
Date Issued:07/22/2014
Permit Category:ePermit
Site Address: 4157 Ruby Lane
Lot:068 Block: 04 Addition: Diffley Commons 2nd
PID:10-20451-04-068
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Scott Lofgren
5708 Upper 147th St W #102
Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088
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 -
Huong T Ly
2504 58th St S
Gulfport FL 33707
Lofgren Heating & Air
5708 Upper 147th St W
Suite 102
Apple Valley MN 55124
(952) 431-5811
Applicant/Permitee: Signature Issued By: Signature