Suite 930 - Fossil �. � �f.,
Use BLUE or BLACK Ink
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• R�C'�IV� �^�(
I Permit#: � ""' I
C�t of �a �Il AY 12 201� i . � �} Z � �
� � � � Permit Fee: ` ✓ �I
3830 Pilot Knob Road � �
Eagan MN 55122 i i
Phone: (651)675-5675 � Date Received: �
Fax: (651) 675-5694 j i
� Staff: �
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2014 COMMERCIAL BUILDING PERMIT APPLICATION �,��``�
Date: S IZ I��I" site Address:3�'tZ5 E/SG/•�t�l O�tS�I��'S �2kWp i
Tenant Name: �OSS(L (Tenant is: Y New/ Existing) Suite#: q�+ Q
Former Tenant: 1���
tvame: Pl�CLAG�rJ O�li'��3' t�A�f1.C�EQS L� Phone: ZZ-g !�� ,3A66 .
Pt'Qp��Q�iFt'l�1". - Address/City/Zip: ��, � . ,c�:u�� $r'R•V-�:� ,Z���E-"�OD((,'QA�..t"ICr1�.E,
rno Z�zo2
Applicant is: Owner Contractor
.�,������ Descriptionofwork: Qt1►l,O UJ� O�� 1�E�A�L.T't�r�/y1�1�' S�G�
Construction Cost:Z�d��� � �
�"Jy � �i1`slrvr.�--'�f d/'�,
Name: License#:
�� �+�#l�G�O�` �� Address: �Jr� �C�O�'l ne-�� S� City: L-Q-��5 ✓i f j�
,r� Co7 9,��- �3�-i� x
State:�_Zip: 7S�-S ! Phone:(C� `�7,'l. -`�'S5- S3 y$
; Contact:W�yh� L�(I��¢" Email: 1�7I d�-o�'�0.G'ff�sv�s`F"►"'o�-�-�-��s. . C dyy�
Name: �'OLS�11 �1b1A60.S M�IWp t�A(�'��Registration#: Z�1�
A�'C�#�#8��1"1��118�1` Address: �JUO� A�S�Q✓GY�'� (�V�O, c�ry: OUfSC,trJ
State: Q� Zip: ���1 Phone: (��`� •6� •7{3q
Contact Person: '�ACLC�E �A1�� EmaiL• � cK��•�QY�S�.� r'�'1^�.(�S.t
Licensed plumber installing new sewer/water service: Phone#:
�1�3�'�.P1ar�s a�tl s�p�vrting��r�t���i�#°���r��r���e����c�r�cf��e����� `rt� ��w a�#��';
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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.qopherstateonecall.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 require a review and approval of plans.
X -r��nsc,��v as23yS.�o4o X �
Applicant's Printed Name Applic ' Signature
Page 1 of 3
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DO NOT WRI�BELOW THIS LINE I � J��
SUB TYPES
Foundation _ Public Facility _ Exterior Alteration-Apartments
�Commercial./Industrial Accessory Building Exterior Alteration-Commercial
_ Apartments _ Greenhouse/Tent _ Exterior Alteration-Public Facility
Miscellaneous Antennae
WORK TYPES /
_ New ✓ 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 2����� ""� Occupancy 1H MCES System Y
Plan Review � ✓ Code Edition �O�p BG SAC Units �
(25%_100% '!�) Zoning � City Water ✓
Census Code Stories � Booster Pump
#of Units v Square Feet 2-�4f�2.. PRV
#of Buildings � Length Fire Sprinklers �
Type of Construction �g Width
REQUIRED INSPECTIONS
Footings(New Building) �heetrock
Footings(Deck) Final/C.O.Required
Footings(Addition) Final/No C.O.Required
Foundation Other:
Drain Tile Pool:_Footings _Air/Gas Tests _Final
,Roof:_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 ����L•�� Water Quality
Surcharge /bs, ot� Water Supply&Storage(WAC)
Plan Review �r / I'�•$�f Storm SewerTrunk
MCES SAC Sewer Trunk
City SAC Water Trunk
S8�W Permit&Surcharge Street Lateral
Treatment Plant Street .
Treatment Plant(Irrigation) Water Lateral
Park Dedication Other:
Trail Dedication
Water Quality TOTAL � Z-��37. L�
Page 2 of 3
� � �� CALL FOR CREDIT CARD PAYMENT Use BLUE or BLACK Ink
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105070 612.843.3210 � For Office Use i
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�� �� ll� N�/�lJ�f N� G✓"l/� i Permit#: �� i
� � � Permit Fee: l(Z� I
3830 Pilot Knob Road �,����� � �
Eagan MN 55122 � Date Received:
Phone:(651)675-5675 �'1N � '� �0�� I
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Fax:(651)675-5694 V � Staff: �
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SY: ------ ---------�
2014 FIRE SUPPREtSSION SYSTEMS PERMIT APPLICATION*
✓
�ate: 6/18/14 s�te address: 3925 Eagan Outlets Parkway
Tenant: FOSSII su�te#: 930
Name: Phone:
Property Owner Address/City/Zip:
' Applicant is: Owner Contractor
Type of Work oescr�pt�on ofwork: Install sprinkler heads in new tenant space
_ Construction Cost: �5000.00 Estimated Completion Date: 7/1 O/14
Name: Ahern Fire Protection �icense#: C039
Con#ractor
Address: 13705 26th Ave #110 c;ty: Plymouth
State: MN zip: 55441 Phone: 763.268.0515
cor,tact: Ray Polos Ema;i: rpolos@ahernfire.com
FIRE PERMIT TYPE WORK TYPE
X Sprinkler System(#of heads�9j New _Addition
Fire Pump _Standpipe XAlterations _Remodel
Other: Other:
DESCRIPTION OF WORK: X Commercial Residential Educational
��ES Contract Value$ 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$1 million, please call for Surcharge
_$ CO.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 612.843.3210 X
ApplicanYs Printed Name Applicanfs Signature
.�
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FOR OFfICE USE
REQUIRED INSPECTIONS
Hydrostatie � � Flov�r Alarm �� Drain Test � ,ROugh In ��
Trip Pump Test ' Gen#ral Station ' �
� �� ; ������� .� `.
Conditions of Issuance:
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Permit Reviewedby: � ��'�� ' Date..•; =�� �
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Use BLUE or BLACK Ink
-----------------,
� For O�ce Use I
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��U,� U�11� �11 ��l.�l ,�/ ��� i Permit#: •1 �.,.7(Q 6 J i
3830 Pilot Knob�ad ��p ` y� t.�� � Permit Fee: � j
Eagan MN 55122 .��� ) � I I �
Phone:(651)675-5675 � n1� � Date Received: /3 I
Fax: (651)675-5694 � j
� Staff:
________ ________J�
2014 MECHANICAL PERMIT APPLICATION C� ����
❑ Please submit two(2)sets of plans with all commercial applications. � \
'/ �;c�
Date: I l l 7 Site Address: 3ef.���i�{$� LJu,;7''Z-�T� ��Cs!�
Tenant: ��.5"S.y-� � Suite#: •7 3�
R���������� Name: Phone:
;-�' Address/City/Zip:
Name: ,�".S,S�.Ti�y.�l'� -�`���r�=��!%��l=Cr�S:ense#:
: ' ,
Address: 1�:� 7 ���-SC'�'r�'��-�+�� City: �,� ;t d�'�9c�
:,Gor��Eracfcr= . �
State:�Zip: � �� I G Phone: ���4� —5�4��5 � S�f�
Contact: /12L�L�'fL'Email (,� / �''��^�-� �'e��
�New Replacement Additional Alteration Demolition
'�'yp����"�p� Description of work: �1.Z,� I�..�3":,�.Z.���,��.�r' i��,� `'� ...i�
�t�'1�.Raaf ntcsurt�id��ttl�r�aun,d m�e�nted�ii����i�t�u�p!�en��s�u�e�tn�e=�cre�n��€by�it�;
Gc�ci���*lea��isn#����t���r���l insp��Ecu~fsir;rn�'�a�tr��c�n,-�r�t►����re+�ning m±et�+�s: :.:
RES/DENTIAL COMMERC/AL
_Fumace �New Construction �Interior Improvement
�.������,������ _Air Conditioner _Install Piping _Processed
_Air Exchanger Gas Exterior HVAC Unit
�� ' _Heat Pump Under/Above ground Tank (_Install/_Remove)
Other
RES/DENTIAL 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$ �1��'t'���(� 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$1 million, please call for Surcharge =$ f(`�� U'� 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 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�� �i2;2 LrL��! x a��l
ApplicanYs Printed Name Applicant's nature
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R�uin�d tnspe�ttort�s �e�ti�e�rreci�� �`� i�a#� `
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