3925 Eagan Outlets Pkwy Suite 865 - Movado � s
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p�S �,� j Por c�ce use ---------�
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R��ErvED �,� � P��„t#: �`'�� 1 �
C1t Of �� �� � , , '"� ���
� � ��j Permit Fee: � � I, I
3830 Pilot Knob Road JUN � 1 �0 �
9 i �Q°�f�� i
Ea an MN 55122 � D a t e R e c e i v e d: �
i�hane: (651)675-5675 (�,
Fax: (651)675-5694 � Staff: ►")�� �
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2014 C4MMERCIAL BUILDING PEi�M1T APPLICATION
Date: Site Address: �Z� r.+"''`C�J'V4 L/V�l.� �� ����IA�T,�
Tenant Name: I'�CJY�� (Tenant is: d New! Existing) Suite#:_���
Forrner 1'enant:
� Name: 1� Wll.vl �Iy Phone: �'T'��'�'��
� PCO�eI'�/ OW[teC Address/City/Zip: ZI� �• ���{,� �jl, ���t''��/�I����� �2��
Applicant is: �Owner �Contractor
Type Of WOrk Description of work: �P���N� (����
� Construetion Cost: ���J��
Name: License#:
� Address; / � 5 ' City;
Contracfior �'�—
State: 1�,� Zip:���.��_ Phone: �� �" ��,/ ~ �'� 9
� 7T
� Contact: Email: - �t Yl.u� � S�u c.�e CG ���.�c
�
�� Name: /Y'�' Registration#:
Address: lX � t� ��� Ci : �/ �
AI'Glllt@Ct/E1tf�111�@I' � � tY w� � ` t
State: ��� Zip: ��� 6� Phone: ��7"2tJ�/�"l��j'
Contact Person: �� li�. � Emait:h1G�GN�Ft�1NII�,�7D��,�• �
Licensed plumber instatling new seweNw�ater service; �hone#:
NOTE:Plans artd sup�rting documents th�t yau submit are cansid�r�d to ke pukl�c informatfon. Porflo�►s af
� the ir�formation may 6e classi�ed as nan-gubllc if you prqvide specific reasons that rn+au(d Rermif th►e City!o
„� aan�lude that the are tr�de s�crefs.
CALL BEFORE YOU DIG. Call Gapher State One Call at{651)454-0002 for protection against underground utility damage.
Gal!48 hours before you intend to dig to receive loeates of underground utilities. www.qopherstateonecall.orq
I hereby acknowledge that this informatian is compiete and accurate; that the work will be in confc3rmance with the ordinances and
codes af the City o#Eagan; that I understand this is not a permit, but only an applicatio 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 i r quire a r iew nd approval of plans.
X �� � � _ �, f�l X
ApplicanYs Printed Name . Applican' ure
Page 1 of 3
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�� �� �� � � � O�f C-e�-fS �°lC`,, ,� �� . /�
DO NOT�RITE BELOW THiS LINE 7 � �'L�3 �
SUB TYPES
Foundation Public Facility E�cterior Aiteratian-Apartments
�Commerciai/Industriat � Accessory Building � Exterior Aiteration-Commerciai
_ Apartments _ GreenMouse f Terrt � Exterior Alteration-Public Facility
Misceffaneous Arttennae
woRK�r�r��s ,
_ New ✓tnterior lmprovement _ Siding _ Demolish�uilding*
_ Addition � Exterior Improvemerit _ Reroof � Demolish Interior
_ Alteration _ Repair _ Windows � Demotish Foundation
_ Reptace _ Water Damage , Fire Repair _ Retaining Wall
_ S�tlon OWner Change *Demolition of entire building-give PCA handout ta applica�rt
D�SCRIPTfON �'' �a Q
Yaluation ��7,�J Occupancy �+' MCES System �c�_
Pian Review ` �� Code Edition /�58�'�" SAC Units �„?
(25°!0_10�%0� zoning City Water �
Census Gode Storiss Booster Pump -���
#of Units Square Feet '�� PRV �
#of Buildings Length Fire Sprinklers �/��_
Type of Constructian /B Width .._,_���_.
REQUIRED INSPECTlONS
Footings(New Buiiding) Sheetrock
�
Footings(Deck) �%Finai/G.O.Required
Faotings{Additian) Final/No C.O.Required
Foundation Other:
Draln Tile Pooi:_Footings Air/Gas Tests _Final
Raof:_Deeking ilnsulabon _fce&Water �Fina! Siding:iStueco Lath _Stane Lath _Brick
v' Framing Windaws
eFirepiace:,_Rough In �Air Test _Finai Retaining Wail
✓ Insutation Erosion Gontrot
Meter Size:
Finai G/Q Inspection: Schedule Fire Marsha(to be presenf:�Yes No
Reviewed By: �(,�L�Q.- �--�`" , Buitding Inspector Reviewed By:_��'� . Ptanning
COMMERCIAL PEES
Base Fee �,�7S Water Quality
Surcharge (0'�1�-s� Water Supply&Storage(WAG)
Plan Review a�3• � Storm SewerTrunk
MCES SAC Sewer Trunk
City SAC Water Trunk
S�W Permit�&Surcharge Street Latera{
Treatment Piant Street
Treatment Plant(lrrigation) Water Laterai
Parlc Dedicatian Other.
Trai!Dedication
Water Quality 70TA ����
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