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C103 Use BLUE or BLACK Ink For Office Use j Permit#: 17 City of Eaall Permit Fee: 14 0• 3830 Pilot Knob Road C Eagan MN 55122 Date Received: 7 / 17 Phone: (651) 675-5675 �; [i 2017 buildinginspections ancitvofeagan.com Staff: 2017 COMMERCIAL BUILDING PERMIT APPLICATION Date: Ill i r 7 Site Address: le� l► Sii CIA.55 ;e (sur{. 103 Hi...) Tenant Name: (Tenant is: New/ Existing) Suite#: I d35,z3 Former Tenant: �E Z yr Name: �1 IAl11 �1 1, T Lj g !1 (�l,y �' Phone: �� S �� g '41) iftie y C Address/City/Zip: y.Z kJ-eif-ce,Q D ail r 0 M N 55 Y12_ Applicant is: Owner Contractor Description of work: IQ 0 01.04 4 Leinci rA,,, tj(-4(tivrt) Q Construction Cost: tLeNoJ tjosfor Name: License#: Aor Address: City: State: Zip: Phone: Contact: Email: amt y Name: Registration#: Address: City: y1A �� = State: Zip: Phone: t y Y� rte` Contact Person: Email: Licensed plumber installing new sewer/water service: Phone#: 3 ..4, � � / �F�Y� -,.: ..... %ii%" o- x a x *€A"F?ntl, :fi,w',, i?°le u S.._.,.. 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 website at www.citvofeagan.com/subscribe. CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. Call 48 hours before you intend to dig to receive locates of underground utilities. www.qopherstateonecall.orq 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 which requires a review and approval of plans. x x [ a.% Applicant's Printed Name Applicant's Signature Page 1 of 3 1 i L. Cl- `1`' C - 163 E1� �i� DO NOT WRITE BELOW THIS LINE SUB TYPES �r-oundation _ 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 DESCRIPTIONj Valuation . -t)0 ` Occupancy 1 MCES System Plan Review Code Edition AOI S SAC Units (25% 100%_) Zoning PD City Water Census Code Stories 1 Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Sprinklers Type of Construction \JI7 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 EI ctronic Set of Final Revised Plans Windows Fireplace: Rough In _Air Test _Final final/C.O.Required Pool:_Footings Air/Gas Tests Final / Final/No C.O. Required Final C/O Inspection: Schedule Fire Marshal to be present: c/ Yes No Reviewed By: , Planning New Business to Eagan: Reviewed By: , Building Inspector FEES Water Quality Base Fee 4'0 : L Storm Sewer Trunk Surcharge '--' Sewer Trunk Plan Review t--- 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: / _ Trail Dedication TOTAL: ld'� Page 2 of 3