1540 Thomas Lake Pt - Unit 114 Use BLUE or BLACK ink
Forr
411.011 Permit (47(
City of Eagall Permit Fee: 60- OD
CC-
MN Pilot Knob Road
Eagan MN 55122
Phone:(651)675.5675 Date Received:
L staff:
2017 MECHANICAL PERMIT APPLICATION
0 Please submit two(2)sets of plans with all commercial applications.
Date:0 -8 -17 Site Address: 15'0 o T),a r„d, ?d:x.16 c Rc Ca 9c,.,,.► )ivW s.r 1 ZZ
Tenant: /1.4I if `'r-.]`7,``-��� / J`�<: Suite 0:
RAlIt IM1�OtM1I • Name:/UCUWwh�1 t•dl G Kat,,Sh3Q Phone:4j5'I-6 8- 797
Address/City/zip:I OO i l.o, s tJ0e. ?d:14.14_, Rcg • PAL50-..1 jr1r4) 5-57Li
Name: 6;/sot.) kV/ C.. Cerl License# A)I,'`1
• ' Address: /'.5+2.g / t A V. City: '67.e‘_heir
Contractor, , >
State:_ rJ Zip: S`-5'3 0 5 Phone: g 3- Z l6 I-�/ 9r
' .• Contact: Kw WI LSO t' Email: Gl)l XS WAG 63oJvn 0 +C10 w+
•
New ✓Replacement Additional Alteration Demolition
Type'Of Work Description of work:&Q Com. L...v e.c.e.... 4 /1 /C
NOTI:Roof moimmts�,and.groind,mou , d mechanical equipment is required to be screened by City
Code►,Pispq..t ontltet lite MI" ',', a�*specter to Information on permitted screening methods.
• RESIDENTIAL COMMERCIAL
JZFumace New Construction interior Improvement
pil>yllt. .,i,,ZAlr Conditioner _Instal Piping _Processed
Air Exchanger _pas J Exterior HVAC Unit
----Heat Pump Under/Above ground Tank Install/_Remove)
Other
RESIDENTIAL FEES
$60.00 minimum Add or alteration to an existing unit,includes State Surcharge //
$100.00 Residential New,includes State Surcharge =$ fO 040 0 TOTAL FEE
COMMERCIAL FEES
$60.00 pylntit Fee MinimumContract Value$ x.01
$75.00 Underground tank Inatellatlon/removal,includes State Surcharge _$ Permit 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 an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.oltwfeaosn.comrsubserib.,
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 Ie 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 frcase of work which requires a review and approval of plane.J!� ,(/
x f' d.t> � LU /
)[60,.) x /.4,L,../. 5 , ,j
Applicant's Printed Name Applicant's Signature
FOR°ma use
Required.tssp ons: Reviewed By Date:_„__„_,,,
,Unclog/pond Rough In Alr Teat Das Stlrvica Test in-floor Heat Final HVAC Screening