C112 Use BLUE or BLACK Ink
For Office Use `71,
Permit*.
/ `/
City ofty f Permit Fee: ge)-
3830 Pilot Knob Road _ ,
Eagan MN 55122 Date Received: ((
(2
Phone:(651)675-5675
buildinginsoections@citvofeagan.com Staff:
AtuJ
2017 COMMERCIAL BUILDING PERMIT APPLICATION:. C 1,:1
Pit'Date: Site Address: / (�&sS�C l ®cec //2 U
i3/1 / ,/ �
Tenant Name: � Cl�t t/C Y' (Tenant is: /� New! Eidsting) Suite#:
Former Tenant: /
Name: /3r�/ k� C' V r Phone: 6/. —%'767-2‘/O 26/o
Property Owner Address/City/Zip: /3 /IS /-L,., c=Serd,
Applicant is: / Owner Contractor ✓
Type of Work Description of work: 4 vvo,,,,,t vn-T° �`� �'/ �a�i s r, e.<4:-4/
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Construction Cost: v
Name: /7 J` ''t License it:
Contractor Address: City;
State: Zip: Phone:
Contact: Email:
Name: /V40 el <• Registration it:
Architect/EngineerAddress: City:
State: Zip: Phone:
Contact Person: Email
Licensed plumber installing new sewer/water service: Phone#:
NOTE:Plans and supporting documents that you submit are considered to be public information. Portions of the
information may be classified AS non-public if you provide specific reasons that would permit the City to conclude that they
are trade secrets.
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email
update on the City's y's website at www.citvofeaaan.comi subscribe.
CALL BEFORE YOU DIG. Call Gopher State One Call at(651)45440002 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.aooherstateonecall.orci
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 whic equires a review and approval of plans.
x / </ '!� 1�f/'
Applicant's Printed Name App cant's Signature
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Sz_i C q 3s_ cl-- - c i 14117g1
DO NOT WRITE BELOW THIS LINE
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 5o O. a..pi Occupancy S. / MCES System AV*
Plan Review Code Edition ZO 1 T P1IC.- SAC Units /
(25%_100% ) — Zoning Pb City Water ✓
Census Code Stories / Booster Pump
#of Units I Square Feet PRV
#of Buildings ( Length Fire Sprinklers
Type of Construction V'8. Width
REQUIRED INSPECTIONS
Footings—New Building_Deck_Addition Drain Tile
Foundation Foundation Before Backfill Retaining Wall
—
Vapor Barrier Erosion Control
Framing 30 Minutes_1 Hour Steel Reinforcement
Insulation Concrete Entrance Apron
Sheetrock Other:
Roof:_Decking _Insulation _Ice&Water _Final Meter Size:
Siding:_Stucco Lath Stone Lath _Brick EFIS Electronic As-Built Plans Required
Windows /
Fireplace:_Rough In _Air Test _Final ✓ Final/C.O.Required
Pool:_Footings _Air/Gas Tests _Final ��Final/No C.O.Required
Final CIO Inspection: Schedule Fire Marshal to be present:----7Yes No
Reviewed By: ,Planning New Business to Eagan:
Reviewed By: Chi e, , Building Inspector
FEES / Water Quality
Base Fee Y"O.5-0 Storm Sewer Trunk
Surcharge /ill GLO Sewer Trunk
Plan Review itlo VE Water Trunk
MCES SAC Street Lateral
City SAC Street
S&W Permit&Surcharge Water Lateral
Treatment Plant Stormwater Performance Security
Treatment Plant(Irrigation) Landscape Security
Park Dedication Other:
4Trail Dedication TOTAL: Sid
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