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:
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Applicant is: Owner Contractor
Description of work: IQ 0 01.04 4 Leinci rA,,, tj(-4(tivrt) Q
Construction Cost: tLeNoJ
tjosfor Name: License#:
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Address: City:
State: Zip: Phone:
Contact: Email:
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Name: Registration#:
Address: City:
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= State: Zip: Phone:
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Y� rte` Contact Person: Email:
Licensed plumber installing new sewer/water service: Phone#:
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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.
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Applicant's Printed Name Applicant's Signature
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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'�
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