unit C Oct 2 2014 12. 05PM Crest Exteriors 651-463-8095 P. 5
Use BLUE or BLACK Ink
�---------,-------�
� For Office Use
i J�7�10�- i
Clty of Ea�a� , Permil#: I
' �7fi��� '
� Permll fes: �
3830 Pilot Knob Road j GZ � f j
Eagan MN 66122 � Da1e Recelved: V �
Phone;(661)676•5675 I Staff: �
Fax;(661)676-5694 � �
`__-_____ �._-____J
2014 RESIDENTIAL BUILDING PERMIT APPLICATION
Date:I� Site Address: ' Unit�I:
Name:l� Phon��,�J���7�1� (1\���
ResiilenU P - . � �
��''�' Address/Ci p
Owner h+/zt �
����,;,:_ ;,t•;.::,�,. : Applicant is: Owner Contractor
,:,�, R;-�•*�.�.;.�E,� ��
��R �a'�''�P`' Descrlption of work: - '
s e'of, o��
�'�.r..�� �l. /�
"�-'' ' Canstruction Cosl:� v`� y Buildin :(Yes�1 No_�
� Multi-Famil g
:- ,. .. • Company:l J► �(�jl x�,( �1)1 J� LLJ� i _ContacL��,,�
,';�� �:: Address:�7 � I 1 � (\����Clty: .
�;f3ontractor
��;,<--::�. (� �.,,`'
• State:�Zip� lJ��'�' Phone: � `�mall:��,s1�T�.���r�� �Q,��2�r►�t
License#:���\Y�7-�'�VJ���� Leed Ce�tificate#:
If the project is exempt from lead certfflcatlon, please explain why: (see Page 3 for additional information)
U �, �� 1 ;�� r� �� ' r, � � - ,i' 1� -� C� ,
COMPLETE THIS A A ONLY IF CONSTRUCTING A N�W BUILDING
In the last 12 months,has the Clty of Eagan issued a permlt for a similar plan based on a master ptan9
,�Yes _No If yes,date and address of master plan:
Llcensed Plumber. Phone:
Mechanfcal Contractor: Phone:
Sewer&WaEer Contractor: Phone:
NOTE:Plansandsu;���tl"� 'cu"`'e�� -Y�a�+q!/; ��i `�`r'e'cq P ')'E�'_o�lii.e' ubllcinfo►7ndtion. Port7onsof
tfie informe'`�%n htay�°classif -i�y ��c' �. , ��would permi��Iie�City to
.. _ . . ,- : . `_`Eo � e_ a��t r,a ts . .. � . '
CALL BEFORE YOU DIG. Call Gapher Stete Ona Call al(ebi)464•0002(o�protecllon againsl undefground ulility damage, Call 48 hours
before you i�lend lo dlg to recelve locales of underground uIIllUes. www. o hersl e Il.or
1 hereby acknowledge thal lhis inforrnalion IS complete and accurale:lhal the work wlll be in con(ormance wlth lhe ordinanc�snd codes of lhe City of
�agan;lhal I understand►hls Is not a permil, but only en appllcallon for a permil, end wollc fs not lo sleri wilhout a permll; Ihal lhe work v✓�II be in
accordence wllh the approved plen(n lhe ease of work which requifes e fevlew and approval of plBnS.
Ezterlor work authorizad hy a bullding permit issued In aeeordance wlth the Minne6ota Slale 8ullding Cada must 6a compleEed witnln 180
days of parmll Issuance.
X ; �,W���.C�'�� � x .
Applicant's P�Inted Name Applic nt's Slgnature
Page 1 oF 3
PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA135565
Date Issued:03/23/2016
Permit Category:ePermit
Site Address: 3612 St Francis Way C
Lot:012 Block: 05 Addition: St Francis Wood 4th
PID:10-65903-05-012
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.
Carbon monoxide detectors are required within 10 feet of all sleeping room openings in residential homes (Minnesota State
Fee Summary:ME - Permit Fee (Replacements)$59.00 0801.4088
Surcharge-Fixed $1.00 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 -
Kevin J Mccarthy
3612 St Francis Way Unit C
Eagan MN 55123--116
Heating & Cooling Two
18550 Cty Rd 81
Maple Grove MN 55369
(763) 428-3677
Applicant/Permitee: Signature Issued By: Signature