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1520 Thomas Lake Pt - Unit 110 Use BLUE or BLACK Ink LA For Office UseP nit � ✓ * 1 / r City of Ea l �. o 3030 Pilot Knob Road " I CC-- Eagan MN minPhone:(661)675.5676 Date Received: L Stet 2017 MECHANICAL PERMIT APPLICATION ❑ Please submit two(2)sets of plans with all commercial papplications. Dab: 1 d' ("l� Bib SZ. Address; / - '"'!10 �il/4 I t Tenant: ? IC.t°N+0 L' Suite 6: /524--/ l O ResidenVOwner Name: /UOOFtL,J I hfo,G S;i4:5 Phone:(S`�.-771r—S�?6 9 Address/City/Zlp: !r O TINAY+os' e-0-4(C Tot L1+e I W. a D010V 63—Mt Name: t d is as N144 c. eoa urns y License*: >gi Contractor Address: rCIS tl�rt� V Citi: 13 c_cls cI r6 - '"( Q State: netA) Zip:s"1"3 a8 Phone: //7,63-26 t�-5-/?b Contact Ke :6'73-01%) Emelt �l W €1 k cAo o.Leo, New �Replacamant Additional Alteration Demdltlon Type of Work Description of work: (-e, -CA"'10 t— &' 4/C.- NOTE: GNOTE:Roof mounted end ground mounted mechanical equipment is required to be screened by City Code. Please contact the Mechanical Inspector for information on permitted screening methods. RESIDENTIAL COMMERCIAL V Fymaoe New Construction Interior Improvement Ail Conditioner _ Instal Piping roceeaed Penult Type _Air Exchanger Gas Exterior HVAC Unit _Heat Pump _Under/Above ground Tank ( Install I Remove) Other., RESIDENTIAL FEES $60.00 Minimum Add or alteration to an existing unit,Inductee State Surcharge $100.00 Residential New,Includes State Surcharge =$ 66.0 G TOTAL FEE COMMERCIAL.FEES Contact Value$ x.01 $60.00 permit Fee Minimum $75.00 Underground tank Installatlonlremotral,inductee State Surcharge =$ Penult Fee surcharge=Contract Value x$0.0005 =$ Surcharge If the project valuation Is over$1 million,please call for Surcharge $ TOTAL FEE You may subscribe to receive en electronic notification from the City at proposed ordinances by signing up for an email update on the City's cobalt*at www.cltvofiisan.comteubeorlbt. I hereby acknowledge that this Information Is complete and accurate;that the worik 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,end 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 end approval of plane. x /4< 4;4-ext L. Ai; is a x Applicant's Printed Nam. Applicant's Signature FOR OFFICE USE Required Inspections: Reviewed By: Date: Underground Rough in Alr Test Gas Service Test In-floor Heat Final HVAC Screening