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1278 Town Centre Dr - 180 Use BLUE or BLACK ink K ''• .�,. . giz_c ' r(i, For Office Uae I I ,1( ..EIVED Permitm /`"7,- .� /0 City 0f BB Il m Permit Fee: &e. 4..S. 1 3830 Pilot Knob Road " 0 MAY0 9 2017 Eagan MN 55122 •s /' Phone:(651)875.5675 Date Received: 5-9 -17 C_. Fax:(651)675-5694 " • '' Staff: 2017 MECHANICAL PERMIT APPLICATION ❑ Please submit two(2)sets of plans with all commercial applications. Date: `?-'7 " I / Site Address'f1 lix\` .. � Tenant: gG Suite#: I 7)/y ' I 4:'.,,,'i � i` . `�' ' " Name: �- ��/7GL Phone: T�cd '7 5 4' 2 3 3 -711R l'4,;'; x a'( 'I Address/City I Zlp: .. : • .),,,,Ir, tSH ya,, II' r! Name: �• M � 1 .. License#: IJIetB i a i r �, J, Address: _1I� _ ""�'.' City: I'il�24 01r5 i '; tip, State: / . Zip: qli Phone: j12 f" 321 -.4,.,-,.,,,,. Contact: DAvl kY 10 Iz d Email: L_ : t 1 fdA f , '�''t r 7 "xm I : 1, ' 'QIP " }l Jr {> 'New, Replacement Additional Alteration Demolition �I Description of work: Ai'fl 1 1r L�'I r ah' " ?1H Pc"Ip.1 {r ).:',44,4‘.4.4,q,„ ...4,'.:,,, pI(, I, I I II Gam/( � 4 t ,,•„,, 1 .1 '�,•f I I i rt'u 1, It f; 1 REs4pENTIAL COMMERCIAL ti`" '`' ; Furnace' New Construction Interior Improvement ,;at m; u r�, 11 Air Conditioner , ` Install Piping _Processed 1 ° "' ,i,-I`1,7 Air Exchanger: I. Gas Exterior HVAC Unit III u,,1,t' i' , ;- "' _Heat Pump' • Under/Above round Tank (_Install/_Remove) +i,I ,;�t �llNI <° Other , ?6 RI Wr 1>kr-i,ru.t RESIDENTIAL FEES $60.00 Minimum Add or alteration to an existing unit,includes State Surcharge $100.00 Residential New,includes State Siurchargk _$ TOTAL FEE tk6 COMMERCIAL FEES Contract Value$ 4 TSG 6 x.01 $60.00 Permit Fee Minimum ` $75.00 Underground tank installation/removal,includes State Surcharge =$ tnc, Permit Fee 4; _6 3� 2,11 rcarge Surcharge=Contract Value x$0.0005 "'N• .� • If the project valuation Is over$1 million,please call for Surcharge =$ (Q� •. •�17 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 niy an application for a permit,end work Is not to thout a permit;that the work will be in accordance with the approved plan in the case of work whiclrlulres a review and approval of plans. s_brAA. 14 -.e4-ee'- . Applicant's Printed Name App ant's Signature C ' ; 4', ,$to -I —1 � �' ,.... •r° ,, , Asa • , I° -----, g. � (moi ( f'7 j ,,'f c