Suite 100 1a�� �C_ /„ _ ^ [� Use BLUE or BLACK Ink
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Cl 0� '��G.e� I UC' � Pe�„t#: �
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3830 Pilot Knob Road
Eagan MN 55122 I /�, J�
Phone:(651)675-5675 ��,�,.,�����..� i Date ReceivedtL����—/.7 '
Fax:(651)675-5694 � �--�� ~ [+ �
� Staff:�� 1
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2015 COMMERCIAL FIRE ALARM PERMIT APPLICATION*
Date: 06/23/15 Site Address: 3420 GOLF VIEW DRIVE EAGAN 55123
Tenant: CARRIAGE HILLS Suite#:
{ .. Name: Phcne:
Address/City/Zip:
Applicant is: Owner Contractor
, , Description of work: FIRE ALARM SYSTEM UPGRADES
Construction Cost: $4046.50 Estimated Completion Date: 6/30/15
Name: NARDINI FIRE EQUIPMENT CO.. INC. License#: TS-000686
��; Address: 405 COUNTY RD E WEST City: SAINT PAUL
State: MN Zip: 55126 Phone: 651-483-6631
� Contact: MARK VANGUILDER Email: mvan uilder nardinifire.com
New Remodel
, � .
Addition Other:
�Alterations
DESCRIPTION OF WORK: �Commercial Residential Educational ',
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FEES
Contract vaiu�$ x.09
$55.00 Permit Fee Minimum
"If contract value is LESS than$10,010,Surcharge=$5.00 =$ 55.00 Permit Fee
•*If contract value is GREATER than$10,010, Surcharge=Contract Value x$0.0005 =$ 5.00 Surcharge*
"*"If the project valuation is over$1 million, please call for Surcharge 60.00
_$ 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. `
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App icanYs Printed Name Ap icant's Signature
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