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Suite FC4 - Villa __Use_BLUE-or-BLACK Ink ~~/~aS,~~ CN'EG~ For Office Use /p7J(G / City of Ewell C EI VE I Permit I (/,f~ c SLR I Permit Fee: 'jv I 3830 Pilot Knob Road I r~ Eagan MN 55122 JUN 2014 I Date Received: Phone: (651) 675-5675 n I I Fax: (651) 675-5694 BY: Staff" J 2014 COMMERCIAL PLUMBING PERMIT APPLICATION Please submit two (2) sets of plans with all commercial applications. Date: Site Address: K PIJ Suite X 04 4-E2 3 Tenant: 4 Property ii Owner Name: ~l "vylv,~ Phone: I M Name: License Contractor Address: AP T-0~--r State: -AAkk ip: ~2-5 Phone: U1J( Email: Type of Work -New _Replacement -Repair _Rebuild Z Modify Space - Work in R.O.W. Description of work: Li ~ ) 60A11- .1 - . COMMERCIAL New Construction Modify Space _ Irrigation System yes / _ no) RPZ / _ PVB) • 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 $ X.01 $55.00 Permit Fee Minimum _ $ Permit Fee *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 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 TOTAL FEE CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. \ 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, Awork ot to st without a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and a. x x Applicant's Printed NameAgnature FOR OFFICE USE Approved By: Date: Required Inspections: )g!~Llnder Ground Rough-In ~ir Test _Gas Test Final PRV Required: _ Yes - No Meter Related Items: Meter Size Radio Read Staff: Page 1 of 3 a• Use BLUE or BLACK Ink - - - - - - - - - - - - - - - - - For Office Use 7 a~ I Permit ~f !d(O'1`~ ! Ron City of Ea ~cr F I I Permit Fee: 3; I 3830 Pilot Knob Road APR 1 s ~~1G , , Eagan MN 55122 Date Received: Phone: (651) 675-5675 Fax: (651) 675-5694 i Staff: , J 7 2014 COMMERCIAL BUILDING PERMIT APPLICATION Date: 04/10/14 Site Address: PARAGON OUTLETS, TWIN CITIES AT EAGAN, MN Tenant Name: VILLA ITALIAN KITCHEN, (Tenant is: X New/ Existing) Suite FC04 & FC05 GREEN LEAF'S & BANANA'S Former Tenant: N/A Name: VILLA ENTERPRISES MGMT Phone: 973-206-7286 _ Property Owner Address/ City /Zip: 25 WASHINGTON ST., MORRISTOWN, NJ, 07960 Applicant is: X Owner Contractor Type of Work Description of work: NEW RESTAURANT TENANT BUILDOUT AT NEW TWIN CITIES OUTLETS§, Construction Cost:-4y Wc?,5, Name: T . B . D . KO v, c- 1 1k-WA IiD )At CWU, ~ License Address: ct OkJ, City: /~LNI`tcy!/ Contractor T 7 State: A). Zip: 0 ~7W3 0 Phone: i90/ ' 3 7 Contact' 7 m Email: d U ee-- Q ✓ t @ O 1J, Name: DAVID WATT Registration 42125 Address: 4410 W. MELROSE AVENUE City: TAMPA Architect/Engineer State: FL Zip: 33629 Phone: 813-333-2717 Contact Person: MOSAD ELEWA Email: IN`T`O@MCDART. NET Licensed plumber installing new sewer/water service: T. B. D. Phone M e~ - 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 eview and approval of plans. X M A~ aiW X 40- Applicant's Printed Name TTTT'"' Appli nt' Si ure Page 1 of 3 y-- cS - qto-5- c a A ~ 0 u ~ - f°kw ~ DO NOT RITE BELOW THIS LINV zygo(p SUB TYPES F undation _ Public Facility _ Exterior Alteration-Apartments :Co' mmercial / Industrial _ Accessory Building _ Exterior Alteration-Commercial _ Apartments _ Greenhouse / Tent _ Exterior Alteration-Public Facility Miscellaneous Antennae WORK TYPES _ New i/ Interior Improvement Siding _ Demolish Building* _ Addition _ Exterior Improvement Reroof _ Demolish Interior Alteration Repair Windows Demolish Foundation Replace Water Damage Fire Repair Retaining Wall Salon Owner Change *Demolition of entire building - give PCA handout to applicant DESCRIPTION Valuation Occupancy (j MCES System Plan Review Code Edition )itSdC-, SAC Units 0 C►~ID (25%_ 100%__) Zoning + City Water Census Code Stories Booster Pump # of Units p Square Feet Z 5-Z-, PRV # of Buildings Length Fire Sprinklers Type of Construction Width REQUIRED INSPECTIONS Footings (New Building) Sheetrock Footings (Deck) Final / C.O. Required Footings (Addition) Final / No C.O. Required Foundation Other: Drain Tile Pool: -Footings Air/Gas Tests -Final oof: -Decking -Insulation -Ice & Water -Final Siding: -Stucco Lath -Stone Lath -Brick Framing Windows Fireplace: -Rough In -Air Test -Final Retaining Wall Insulation Erosion Control Meter Size: / Final C/O Inspection: Schedule Fire Marshal to be present: ✓ Yes No Reviewed By: , Building Inspector Reviewed By: , Planning COMMERCIAL FEES Base Fee Water Quality Surcharge Water Supply & Storage (WAC) Plan Review Storm Sewer Trunk MCES SAC Sewer Trunk City SAC Water Trunk S&W Permit & Surcharge Street Lateral Treatment Plant Street Treatment Plant (Irrigation) Water Lateral Park Dedication Other: Trail Dedication Water Quality TOTAL Page 2 of 3 AllkTIE CAD 39ZS E"A-Al avrzC-rS P,-wt y, Su/ 4 . 7 f C tl5rO.t4Fil~- _ _EA77AI & CD uti7E/2,. 15 8-5 FIE&r IY/ L &JCrF . 17M C-/6S5 Ft-odt- Mt,PA-- QP I#c 7?LwAAr - SPht,r-- /S 770 sQ. rr-. g'S (,t N FT- b F GV vivre. S lav . FT~ c s 'CAI = 3. G x SS i S lrrS 140 Stets l ;A c *gr"& . So ??D 54Fr. i 2114 1 Craig Novaczyk 2 o('0 From: Nye, Jessica <jessica.nye@metc.state.mn.us> Sent: Friday, May 09, 2014 10:15 AM To: Sarah Brandel Cc: Craig Novaczyk; Mike Lence; Cappaert, Karon Subject: RE: SAC determinations It is a change of use and a determination would be required. Whether the City or MCES completes the determination it is up to the City. We are currently 15 business days out on determination reviews. For counters we charge the greater of number of seats shown on the plan or the number of potential seats. Counters are 1.5' per seat. We'd measure the length of the counter divide that by 1.5' and divide that number by 10 seats/SAC to get the SAC charge. Then the credit would be their tenant square feet @ 3000 sq. ft./SAC. Take the charge - the credit to get the net. From: Sarah Brandel [mailto:sbrandel@cityofeagan.com] Sent: Friday, May 09, 2014 10:12 AM To: Nye, Jessica Cc: Craig Novaczyk; Mike Lence Subject: RE: SAC determinations Jessie, Actually Craig just brought it to my attention that there are 3 stools at a counter at Auntie Annie's and 4 stools at the Great American Cookie space would this qualify for additional SAC? Thank you and sorry for the confusion. Sarah Sarah Brandel I Office Supervisor / Administrative Assistant I City of Eagan City Hall 13830 Pilot Knob Road I Eagan, MN 55122 1 (651) 675-56711 (651) 675- 1 5694 (Fax) I sbrandel(@citvofeagan.com 04 of THIS COMMUNICATION MAY CONTAIN CONFIDENTIAL AND/OR OTHERWISE PROPRIETARY MATERIAL and is thus for use only by the intended recipient. If you received this in error, please contact the sender and delete the e-mail and its attachments from all computers. From: Nye, Jessica [maiIto: jessica.nye(~b metc.state.mn.us] Sent: Friday, May 09, 2014 9:59 AM To: Sarah Brandel Cc: Craig Novaczyk; Mike Lence Subject: RE: SAC determinations Well we had Kelly, Kristi & Karon. So you're bound to mix them up! Kristi replaced Kelly last year as SAC assistant. Now Cindy replaced Kristi as SAC assistant. Karon is still here as SAC Technician doing determinations. On the Paragon Outlets bldg 300 at 3965 Eagan Outlets Parkway, and bldg 400 at 3925 Eagan Outlets Parkway most everything was charged as retail with the addition of the food court i seats. Auntie Annie's and Great American Cookie spaces were charged as retail so as long as they aren't adding seating (take out only), no SAC determination would be necessary. From: Sarah Brandel [mailto:sbrandel(a)cityofeagan.com] Sent: Friday, May 09, 2014 9:49 AM To: Nye, Jessica Cc: Craig Novaczyk; Mike Lence Subject: RE: SAC determinations Oh, good! Thank you for the email. I was maybe getting Karon mixed up with Kelly The addresses are in the Paragon Outlet Mall 3925 Eagan Outlets Pkwy (Suite 945) and 3905 Eagan Outlets Pkwy (Suite 345). The buildings were originally charged for retail space only. Sarah Brandel I Office Supervisor / Administrative Assistant I City of Eagan City Hall 13830 Pilot Knob Road I Eagan, MN 55122 1(651) 675-56711(651) 675-~ 5694 (Fax) I sbrandel(a)citvofeagan.com * Qq Ealan THIS COMMUNICATION MAY CONTAIN CONFIDENTIAL AND/OR OTHERWISE PROPRIETARY MATERIAL and is thus for use only by the intended recipient. If you received this in error, please contact the sender and delete the e-mail and its attachments from all computers. From: Nye, Jessica [mailto:jessica.nye@metc.state.mn.us] Sent: Friday, May 09, 2014 9:44 AM To: Sarah Brandel Cc: Craig Novaczyk; Mike Lence Subject: RE: SAC determinations What is the original letter reference and/or address? Not sure what to look up. From: Sarah Brandel [mailto:sbrandelOcityofeagan.com] Sent: Friday, May 09, 2014 8:36 AM To: Nye, Jessica Cc: Craig Novaczyk; Mike Lence Subject: FW: SAC determinations Jessie, Good morning. I couldn't remember if Karon is still in the same position or if she was promoted to a different one at the Met Council. If it's still Karon, that is fine, but I was thinking that maybe someone else should have been copied as well. Below is an email from Craig regarding SAC determination for a Paragon food vendor that is located outside of the set food court area. Thank you, Sarah Sarah Brandel I Office Supervisor / Administrative Assistant I City of Eagan City Hall 13830 Pilot Knob Road I Eagan, MN 55122 1 (651) 675-56711 (651) 675- 5694 (Fax) I sbrandel(Dcitvofeagan.com C4 of THIS COMMUNICATION MAY CONTAIN CONFIDENTIAL AND/OR OTHERWISE PROPRIETARY MATERIAL and is thus for use only by the intended recipient. If you received this in error, please contact the sender and delete the e-mail and its attachments from all computers. 2 From: Craig Novaczyk Sent: Thursday, May 08, 2014 3:02 PM To: Cappaert, Karon (Ka ro n. Ca ppaert@metc. state. m n. us) Subject: SAC determinations Good afternoon Karon, We have two proposed food vendors at the Eagan Outlet Stores that are not within the food court. One is Auntie Annie's pretzels (3925 Eagan Outlets Pkwy., suite 945) and the other is Great American Cookie (3965 Eagan Outlets Pkwy., suite 345). It is our understanding that the food court vendors were included in the SAC determination for the project as a whole. Should we be asking for a SAC determination for these two spaces outside the food court? Please advise. Thank you, Craig Craig Novaczyk I Senior Building Inspector I City of Eagan City Hall 13830 Pilot Knob Road I Eagan, MN 55122 1 (651) 675-56831 (651) 675-5694 (Fax) I cnovaczyk(cDcityofeagan.com 94 of Ea THIS COMMUNICATION MAY CONTAIN CONFIDENTIAL AND/OR OTHERWISE PROPRIETARY MATERIAL and is thus for use only by the intended recipient. j If you received this in error, please contact the sender and delete the e-mail and its attachments from all computers. 3 - Use BLUE or BLACK Ink p~ CALL FOR CREDIT CARD PAYMENT \ i For Office Use / Permit ~~~i(Q I City of EaEdii ECEIVE d I Permit Fee: I 3830 Pilot Knob Road I I Eagan MN 55122 JUN 1 1 20% Date Received: j Phone: (651) 675-5675 I I Fax: (651) 675-5694 Staff: 4 BY. A& - 2014 FIRE SUPP E S QN SYSTEMS PERMIT APPLICATION* Date: 6/6/14 Site Address: .:3-pagan Outlets Parkway Tenant: Auntie Annie's Suite 945 Name: Phone: Property Owner Address / City / Zip: Applicant is: Owner Contractor Type of Work Description of work: Install sprinkler heads to protect all new ceilings Cost: $2500.00 Estimated Completion Date: 7/1/14 - Construction Name: Ahern Fire Protection License C039 Contractor Address: 13705 26th Ave #110 city: Plymouth a State: MN Zip: 55441 Phone: 763.268.0515 Contact: Ray Polos Email: rpolos@ahernfire.com FIRE PERMIT TYPE WORK TYPE X Sprinkler System of heads 19/ _ New _ Addition Fire Pump _ Standpipe XAlterations _ Remodel Other: Other: DESCRIPTION OF WORK: X Commercial Residential Educational FEES Contract Value $ X.01 $55.00 Permit Fee Minimum = $ Permit Fee *If contract value is LESS than $10,010, Surcharge = $5.00 **If contract value is GREATER than $10,010, Surcharge = Contract Value x $0.0005 = $ Surcharge* ***If the project valuation is over $1 million, please call for Surcharge 60.00 _ $ TOTAL FEE 3/4" Displacement Fire Meter - $260.00 Fire Meter TOTAL FEE *Requirements: 2 complete sets of drawings and specifications, cut sheets on materials and components to be used I hereby apply for a Fire Suppression System permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Minnesota Building/Fire Codes; 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 Barb Barnes x Applicant's Printed Name Applicant's Signature FOR OFFICE USE 1 REQUIRED INSPECTIONS Hydrostatic Flow Alarm Drain Test ough In Trip Pump Test Central Station :jO4~inal Conditions of Issuance: ,t Date: Permit Reviewed c� �ti-� � Use BLUE or BLACK Ink �L�4��Np A ', ,-----------------, G.�f�f� � For Office Use I ��} (� �� Q � U{' p � Permit#: 1� � � I 6� 1 �Q�1�� 3830 Pilot Knob Road �UN � p 20�4 � Permit Fee: � Eagan MN 55122 � I � Phone:(651)675-5675 � Date Received: �� Fax:(651)675-5694 BY� � j � Staff: � �� J 2014 MECHANICAL PERMIT APPLICATION � Please submit two(2)sets of plans with all commercial applications. Date: � Site Address: �A;� �: 1 `v Tenant• � C Suite#• �L'� �'FGs Resident/Owner Name: � �� Phone: ' Address/City/Zip: ( �� pnn Sa�t�, Name: ` ' '�' icense#: L lo �`�� Address: � City: ��5� L�� Contractor �` q� State:��Zip:� Phone: lV �-��• O Contact: u�.l( Email: G��S� r �� X; New Replac men Additio al Alteration De olition t � ✓ Type of Work Description of work: ��. r n /� �� NOTE:Roof mounted and ground moun d mechanical equi ent is equired to be screened by City ; Code. PCease contact the Meehanical Inspector for information on permitted screemng methods. RESIDENTIAL COMMERCIAL _Fumace ,� New Construction _Interior Improvement P@I'1'Ylit T�/p@, —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 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$ �7 �� x.01 $55.00 Permit Fee Minimum $70.00 Underground tank installation/removal =$ Permit Fee "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 I understand this is not a permit,but only an application for a permit,and work is not to start wit ut a permit;that the work will be in accordance with the approved plan in the case of ork which requires a review and approval of plans. � �x I�J�� x Applicant's Printed Name Applicant' Signature FOR O��ICE USE ,' ` Requirecf lnspections: � �,f�j,�''� Reviewetl By:___� �� Date. �.� .� '�� , .. Underground '�Rough In '�Ir'Test ': Gas Service Tesfi In-floor Heat rv -�inal HVAC Screening * _, � 105345 CALL FOR CREDIT CARD PAYMENT Use BLUE or BLACK Ink i----------- 612.843.3210 � For office use � . i ^� � � Permit#: J � I C�t af �� n � . �; � � � � Permit Fee: � I 3830 Pilot Knob Road � l Eagan MN 55122 � Date Received: � Phone:(651)675-5675 � I � Fax:(651)675-5694 � Staff: � � I ��__��_��J 2014 FIRE SUPPRESSION SYSTEMS PERMIT APPLICATION* �ate: 6/17/14 s�te address:✓3965 Eagan Outlets Parkways rer,ar,t: Villa Kitchen su�te#: FC 004 & 005 Name: Phone: PPOpeI'ty OWtI@C Address/City/Zip: Applicant is: Owner Contractor Type of Work �escript�on ofwork: Install sprinkler heads in new tenant space Construction Cost: $3500.00 Estimated Completion Date: 7/10/14 rvame: Ahern Fire Protection �icense#: C039 Contractor Address: 13705 26th Ave #110 city: Plymouth state: MN zip: 55441 Phone: 763.268.0515 cor,ta�t: Ray Polos Ema;i: rpolos@ahernfire.com FIRE PERMIT TYPE WORK TYPE X Sprinkler System(#of heads 17) New _Addition Fire Pump _Standpipe XAlterations _Remodel Other: Other: DESCRIPTION OF WORK: X Commercial Residential Educational FEES Contract Value$ x.01 $55.00 Permit Fee Minimum =$ Permit Fee *If contract value is LESS than$10,010, Surcharge=$5.00 **If contract value is GREATER than$10,010, Surcharge=Contract Value x$0.0005 =$ Surcharge* **"`If the project valuation is over$1 million, please call for Surcharge 60.00 _$ TOTAL FEE 3/4"Displacement Fire Meter-$260.00 =$ Fire Meter _$ TOTAL FEE "Requirements:2 complete sets of drawings and speci�cations,cut sheets on materials and components to be used I hereby apply for a Fire Suppression System permit and acknowledge that the information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Minnesota Building(Fire Codes;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 Barb Barnes 612.843.3210 X+�� ApplicanYs Printed Name Applicant's Signature � 4 , C� 3 l `FOR OFFICE USE REQUIRED INSPECTIONS Hydrostatic Flow Alarm Drain Tes# �ugh In Trip Pump Test Central Station �-'Final Conditions of Issuance: � ! Permit Reviewed byc� Date: !�/� � II Use BLUE or BLACK Ink �-----------------� � For Office Use - � � I Permit#: ��y� I Clt of �a a� ; . �; � � � Permd Fee: � � 3830 Pilot Knob Road � Eagan MN 55122 ��,.��(�� j I Phone:(651)675-5675 � Date Received: � Fax:(651)675-5694 �� Y� s��A � � ��t� � Staff: � `��J 2014 COMMERCIAL FIRE ALARM PERMIT APPLICATION* Date: � � � ( � Site Address: J� �S �`^ �`^ ��t�J �K'W `� 0.✓1 c.n F ��t e ., Lt t FJ ` � ��a C� �c�.� t-�� Fc- 5 Tenant: V � '^Suite#: , _�� Name: Phone: �� ":' Address/City/Zip: ` Applicant is: Owner Contractor �� Description of work: l^� S�a�� c (��a�� SY S�r� �"�ij�@ i3��`� � , , ,, �'� Construction Cost: 4�� Estimated Completion Date: � "3 (—�� , ;, .-.-. i {° Name:/� �RS�c� ( <<�ns�o S y Cjc �u.r(! �icense#: TS o 1 S `1-'i ��`��tc� � �� Aad�ess: 43 S S S 12 3 "� .S't— VJ �;ty: S A v FF G G ,�� State: V�L �'' Zip: S S 3� � Phone: �S� - ��f3' ��f � . Contact:/� �; K� �.5•,'�'�e h Email: Kn i k� . �o�--�c.. CSl 1 �E . Co Xlew Remodel �'�� ` % Addition Other: ` " �� Alterations DESCRIPTION OF WORK: �ommercial Residential Educational FEES Contract Value$ x.01 $55.00 Permit Fee Minimum *If contract value is LESS than$10,010, Surcharge=$5.00 °$ Permit Fee **If contract value is GREATER than$10,010, Surcharge=Contract Value x$0.0005 =$ Surcharge* �"*If the project valuation is over$1 million, please call for Surcharge _$ �� TOTAL FEE *Requirements:2 complete sets of drawings and specifications,cut sheets on materials and components to be used I hereby apply for a Fire Alarm permit and acknowledge that the information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Minnesota Building/Fire Codes;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 ��e.J� /" \R c (L '�, ��/�ar1'� x Applicant's Printed Name ApplicanYs Signature fQR C?�'F'ICE US� ', R6Yi+erW@�!`8�%: ..,� �, .r .,; , 13�quirec!lnspec�ictns. F�i�g#�-in '; �i��l �"��rm�"�s# , � ' ` �te+�t�tlr�(n�c��rrst T,;,...�.,Rt>ugh�� I.` ` �`F'�r�a�r��"��, ,�_.. �, ..�.��. �-t-e ve i - �n ��— '� " X pp licant s S�gnature ppplicanYs Printed Name � , �� , � 4 � �� ' � �� s �� , �. ��TiW�� ' 3_ , �, � h j t 1 '"".��,�r .`r '�'s" �. , .; ,? . . �� ' Y� � � � � � '� ��1 ; :�� . . ,. �� _�� " r v ��+=� C3��. �� ' � E : ..,� '�'. ��tl��, ��' �'`.,: Use BLUE or BLACK Ink �-----------------� � For Office U - � � �2'�I�•��%T�/'�.. �d�� I Permit#: �-�� I Clt af �a a� � [�' ; . � � � � �"""' �� Permd Fee: � 3830 Pilot Knob Road , Eagan MN 55122 I��G � � �� Date Received: U O ( ' 1 � Phone:(651)675-5675 � I Fax:(651j675-5694 QY: �, � staff: � �----------------� 2014 FIRE SUPPRESSION SYSTEMS PERMIT APPLICATION* Date: ��[�� Site Addres : � `�� --� �C� Tenant: ��/e�/J Suite#• �� — �� , ��' _; bf ��,<- � . � =: Name: Phone: ' � � :. � � ��e '� ��Q��;�- Address/City/Zip: �� : :� � r �� :; ��,� ,�� Applicant is: Owner Contractor � �� (�/�JT�(A i �LC�, °��""°�1 � .�.��`��,��, Description of work: � " \p �f / �`� �_;_:� ��,;,':� Construction Cost: / �� \ Es6mated Completion Date: lJ /� �� ^ � A �� -- � ��, n �` � `�� Name: �(�-l I�Y�B�� /�� ^�� icense#: 4�� - :. �� ,�j�, c �� '��J'�,"�' Address: � //�� City: `T'G°�'l�� ;�?��'� ' � State:�Zip: _ (��'3/ Phone: �� - ��L� � � �, �� » � � Y �'� ��f Contact: Emaii:_[��i��rl�/�f�i re� � ,� FIRE PERMIT TYPE WORK TYPE _Sprinkler System(#of heads_) �New _Addition Fire Pump _Standpipe Alterations Remodel ,�Other. I— Other. DESCRIPTION OF WORK: �Commercial _Residential _Educational FEES Contract Value$ ��` x.01 $55.00 Permit Fee Minimum =$ �j j ,�, Permit Fee 'If contract value is LESS than$10,010,Surcharge=$5.00 *'If contract value is GREATER than$10,010,Surcharge=Contract Value x$0.0005 =$ � --- Surcharge* **`If the project valuation is over$1 million,please call for Surcharge _$ �� TOTAL FEE 3/4"Displacement Fire Meter-$260.00 =$ Fire Meter _$ TOTAL FEE `Requirements:2 complete sets of drawings and specifications,cut sheets on materials and components to be used I hereby apply for a Fire Suppression System permit and acknowledge that the information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Minnesota Building/Fire Codes;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 Q '�� - �� VlJ 1 ��d� X �^�� lmY�� ApplicanYs Printed Name ApplicanYs Signat e ��-��3 FOR`OF.,,FICE USE ; , ' RERUIRED ITJSPEG714MS3 _._ .: kiydrostat�c= _ =_°° _; . �[ow:Alarm ` Dra��Test Rocrgh!r�` , ' .. : Trip �umP Tesf ::, GenXral Station ' ;�F ni a( � �" :Conditions of IsSua�ce: - ; � � � ,. � ',,:, . :.. _' � ,'�- 43 �; .; ,,,-v+v " ,' .�'''. ,.� 'a "_ ,. 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