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505 Hope Dr For Office Use 1p + + fo ° :::: ' 6111 y� / elf . Date Received: 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651)675-5675 I TDD:(651)454-8535 I FAX:(651)675-5694 Staff: buildinginspections(cr�citvofeagan.com L 2018 SEWER AND WATER CONNECTION AND AVAILABILITY CHARGES EXISTING COMMERCIAL PROPERTY Date: l ' , Property Owner: 601/4/l' l '� gef (�� city ` ' ' I �ti"Q Phone Number: cf--'—`1 zY 93ciu Address: Plumber: \Ir fit,oula,trt, `' -U"\) 'PIN. Int0100P c GW� {,' ::'4t44, ,fes x '. � f,"4";. . 4. ;'14:14:2:4:•.=,.. r ...r ..f„..M., .. ... Sewer Service Water Service Sewer lateral charge Water lateral charge Sewer trunk Water trunk City SAC @$114/unit Water supply storage MCES SAC @$2,485/unit Receipt#: , Date: Receipt#: , Date: Treatment Plant @$924.50/unit Permit Fee, including State Surcharge $65.00 Permit Fee, Including State Surcharge $65.00 TOTAL: *Plumbing Permit Required—water meter to be acquired with building permit TOTAL: Sewer Service I Water Service Sewer lateral charge Water lateral charge Sewer trunk Water trunk City SAC MCES SAC Receipt# , Date Water supply&storage Receipt# , Date Treatment plant Permit Fee, including State Surcharge $129.00 *Plumbing Permit Required—water meter to be acquired with building permit TOTAL: Number of SAC units is determined by the Metropolitan Council Environmental Services (651) 602-1000. 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.citvofeacian.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.gopherstateonecall.orcl Cc: City of Eagan Finance Department F.—iii - za E g � ti 4 a INK LL mN z 44 , ,t Wii y . � ;v I 4— Q ZZ Q s - g 1., ° LiT4 iGYagB2 V a d mL Lwo G K n1 m11 u 3N v @ AlL < ° a jf\I CtD m t1 ,aes0 a c ' m W m 3c f, f0m m 4 z.., m . aCOOt n° m I Agn • 4131< Uy a 22 BTy 5 j � W` Yt ,--1gc zo ° a z Z" 2 v oZg ° ythu Eyc y 1 Z3 mr ,, _Ill 3ac €l2> cm € 0 jm o• W am wya " y O' m_ - „ �oE W— ! Noff' WE aK _Im'gm to .1 ', =d 2s70-cc moe685-7.27-F, Ce E aw arNm -2(=21mSN c'd.gi;gg - 03 (.4 4' � 4 Q _ a n alw (13w 4 mi airga°a ° ctf `J Ce W '3 of ay ' Darc0La im .0o m8aya a �l Ct Ce aY G fl� v' , ` 32a aZ v adm2 a^m`m a-L,tt � = g 1 Qw 1— r^ N vn um °~ °i 1 -. 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Lt Cfv For Office Use p ,lj�Pt{I IC Permit#: / /19.b (U �f ' 1ji: EAGAN % % Permit Fee: s Staff: 'rw �1 r Payment Recvd: Yes 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 REC;r"'�''"''- 651 675-5675 TDD: (651)454-8535FAX:(651)675-5694 • ( ) � I Plans Electronic Paper I Plan Submittal:e•lans• cit ofea•an. •m /-vJUN (- /-5/ a6z018 2018 OMMERCIAL BUILDING PERMIT APPLICATION Date: 6-1-18 Site Address: 505 Hope 61i-DD Tenant Name: Gateway 3 (Tenant is: New/ Existing) Suite#: Former Tenant: Name: Buhl Eagan Gateway LLC Phone: 612-590-1643 Property Owner Address/city/Zip: 5100 Eden Avenue, Suite 317 Applicant is: Owner ✓ Contractor Type of Work Description of work: 135,000 sf new construction precast building Construction Cost: 6,698,000 Name: RJ Ryan Construction License#: 1100 Mendota Heights Road Mendota Heights Contractor Address: City: State: MN Zip: 55120 Phone: 651-365-7024 Contact: Jason Folger Email: jfolger@rjryan.com Name: Mohagen Hansen Registration#: Architect/Engineer Address: 1000 Twelve Oaks Center Dr. St. 200 City: Wayzata State: MN Zip: 55391 Phone: 952-426-7413 Contact Person: Steve Oliver Email: soliver@mohagenhansen.com Licensed plumber installing new sewer/water service: Voson Phone#: 952-938-9300 NOTE:Plans and supporting documents that you submit are considered to be public information. Portions of the information maybe classified as nonpublic 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 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.qooherstateonecall.orq I hereby acknowledge that this information is complete and accurate;that the work will be in conformance with th- ordinances and codes of the City of Eagan; that I understand this is not a permit, but only an application for a permit, and wor not to start wit,out a permit; that the work will be in accordance with the approved plan in the case of work which requires a review and approval f lans. x Jason Folger .X pliAl...... Applicant's Printed Name A. .li,,ant's Sign. e / DO NOT WRITE BELOW THIS LINE / /Lig‘ 6 SUB TYPES ,:_S-0 /7' �c ,90/2.d _ Foundation _ Public Facility _ Exterior Alteratiorf-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 67G gq/dao ' Occupancy 5- I / B MCES System '� Plan Review v/ Code Edition ?�/S MBL SAC Units 3//1.e7TEL,_ (25% 100% V) Zoning City Water ✓ Census Code Stories Booster Pump #of Units V Square Feet /35-,Oo c PRV #of Buildings / Length Fire Sprinklers ✓ Type of Construction Jr*6 Width REQUIRED INSPECTIONS ✓ Footings V New Building_Deck Addition _,Drain Tile iv Foundation V Foundation Before Backfill V Retaining Wall Vapor Barrier "' Erosion Control ✓Framing 30 Minutes `-/ 1 Hour v' Steel Reinforcement ✓Insulation +/ Street/Curb Cut Inspection VSheetrock Other: V Roof:v'Decking ✓Insulation Ice&Water v'Final Meter Size: Siding: Stucco Lath _Stone Lath Brick EFIS Electronic 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 i Final C/O Inspection: Schedule Fire Marshal to be present: "Yes No Reviewed By: A/' e-' , Planning New Business to Eagan: v/E-5 Reviewed By: C-' -/ , Building Inspector FEES Water Quality Base Fee Z81 75Z. . 75 Storm Sewer Trunk/ Surcharge I S8 4 • i C Sewer Trunk Plan Review i $/ 6$q.?1f Water Trunk MCES SAC 77/ 03S. t-c-) Street Lateral City SAC 33 S3'71,0-0 Street S&W Permit&Surcharge /Z9• "'O Water Lateral Treatment Plant 2 , 45 1 •57 Stormwater Performance Security Treatment Plant(Irrigation) !13-0 Landscape Security /o) coo . Park Dedication /7-4/ 5-0Other: Trail Dedication I P j r1(1$.ad TOTAL:413/6/'7// '9' Page 2 of 3 MCES USE:Letter Reference: 18050763 Address ID:719068 Payment ID:411462 /W6‘6 L 6/ Date of Determination: 05/07/18 Determination Expiration:05/07/20 Greetings! Please see the determination below. Project Name: Eagan Industries III Project Address: 505 Hope Drive Suite#/Campus: Gateway 3 City Name: Eagan Applicant: Jason Folger, RJ Ryan Special Notes: The Council understands this building has speculative office/warehouse. At the time the finishing permits are issued,the SAC assignment needs to be reviewed for a new determination based on that change. Charge Calculation: Office Speculative: 139,842 sq.ft.x 30%@ 2400 sq.ft./SAC= 17.48 Warehouse Speculative: 139,842 sq.ft.x 70%@ 7000 sq.ft./SAC= 13.98 Total Charge: 31.46 or 31.00 Credit Calculation: na Total Credit: na Net SAC: 31.00 —or— 31 SAC Due The business information was provided to MCES by the applicant at this time. It is the City's responsibility to substantiate the business use and size at the time of the final inspection. If there is a change in use or size,a redetermination will need to be made. If you have any questions email me at:core.mccullough@metc.state.mn.us. Thank you, Cory McCullough SAC Technician Please visit our SAC website by going to: http://www.metrocouncil.org/SACprogram 390 Robert Street North I St. Paul,MN 55101-1805 -- Phone 651.602.1000 I Fax 651.602.1550 I TTY 651.291.0904 I metrocauncil.org METROPOLITAN COUNA Equal Opportunity Employer Iml —Jw yap a a _ 2.h \ .3 3 _ W u Q Ie 2 N & i g'z a �g'e 9EE Q z 5 W z _ M dos = ago € x € m = z 'e�€= ' '`� 6g CC CCd <200 u o w d W € 4 11011.1,01911.11131110. .30,33,: u --\ PP- `go Bg g iU = e€ c c gG° 5 - m °t5 G E c a GES -e=y & - d g o.. EG O5 $ s H s Eq6 OJ Cwkoz3's` c tl Z g 5a o_Smg GG`o - g q2 G 8 H3 0,, j `gum BCg28u2 -2- i3o W R S ;No $E$ a _- L.,M. mG u 529222B565E 0 o a -5 22 N °LL5'W i g °8 QB Q▪ s zVg .-L . O l'� ii_gk'f�d og Y O O Q Q Q Q FAz in I I I = m O `r� g� 3511 HJ1tlW • ' ]Nn HJ1tlW �� 0 t: i 1 t_` 6 �'f ilm 0 1 �� =o ,,_ W N Et o ) 2 0 0 0. 1 - -- —_— __ — 1 S 8740 I2I N 7 a', e N _ i O00 0 O N oN �1 ws 0 . ... ' O = 0 Lr& a I .o szz I I I 0 csi \ - _ Z_ Z_ €€fig €Es € 5 G \\V`\ M. m = W N= Z= Z 8: 9 PM $ R n eaee = o 5 d N W :fig i 1111 e_~ i I 1 a A V� ae..n,me nu.m. Mum3:ism a1115.1M .0..461..:10A..a I 110114.3a33>,. B. 3G6 E f$Rci E A E o ga<80 3dk „o $e k. s$W Z �� a ? sm 0 O 5E-L_ -, 0 3 0 oo�f ' tiA1 - 8 - 4 o =_ D neo 2RglEg Rig n os aEa1,4!o 2 x °Z°ops "e3 :ESE .. o "g - 8 v. o`o°W22 gl ,,880 Z 5 ii US mos o3o`sV ' g,s%g N o° a.t0 °z:e Y ~mo S., MES-- • O 0 O Q Q O ♦ ♦ ♦ i��II .o se e vc l'�0,l .o se \ o JI 2 I I oN O -F-fA.-- T E..C m\J 7 1 ^ o o , e 1 0 ( m 11 \ —e F.p 0 m Tv gill = . • O 81-, -, w$ a E. 0 z 1 —,-,- t 0 1 J .” I \o Cr \ O — —,,-,- 0 1 I' • • 1 a) LO ' ; 3NI1 H]1HWI I 3N11 H]1HW —,-,- 0 kII- I 1 so Z 1 I Q 11= s 1 111 O O (iD 0 U 4D w.m.,au-II WO m«3p.wdiw,k.3 chila r For Office Use 4- 414 I ' / /IC 2g 3 EAGANe. �1 Permit#: (17 � I GniII6� •, • � oe �.5 Permit Fee: ! I Staff: Payment Recvd: Yes o I 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 RECIeviE0 (651)675-5675 I TDD:(651)454-8535 I FAX:(651)675-5694 Plans: Electronic Paper Plan Submittal:splansCa?cityofeagan.com JUL ? 0 201 8 2018 COMMERCIAL BUILDING PERMIT APPLICATION Date: 7-1° C.) Site Address: SO'S Tenant Name: C,(446(1))4-g . (Tenant is: New/ Existing) Suite#: Former Tenant: Name: il(.s\\ e -5 G ,y 1"\4-' Phone: 6\2-- HIE- 60'13 Property Owner Address!City/Zip: S\00 3i7 Applicant is: Owner / Contractor Type of Work Description of work: c211-4`cr•\.1N ••i\ •C�+�^•\� Construction Cost: 2-QC), C3(9C) Name: t1c,-3' 5‹- `' CC:4\:*r''`C "''-PN License#: Contractor Address: '1(::0S--7-- Com.s>c \. City: cc rV�Sv�`\+� State: Zip:S-S Ys 7 Phone: 611--s—`i'? Contact char, ‘6,\e.\\IN Email: �ci+v,c_c..\1`.c.e.r Name: `L C-4`S‘st"- '''n Registration#: n1431. t"( ja 1 t t>y�c ` Architect/Engineer Address: jc��.sv-1s City: State: \ti''1' Zip : ' c"'* -'\'i,.2. Phone: 6\2--6.-7 ")-70(.' Contact Person: \ ` O'--c'"``-' 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 maybe classified as nonpublic 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 website at www.citvofeagan.comisubscribe. 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.gopherstateonecall.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`dawith the approved plan in the case of work which requires a review and approval of plans. X Applicant's Printed Name Applicant's Signature DO NOT WRITE BELOW THIS LINE /--. 6) --7 - SUB - 6 � T SUB TYPES 0 ". ,49e6 L1i 'Foundation _ Public Facility _ Exterior Altion-Apartments v/Commercial I Industrial _ Accessory Building _ Exterior Alteration-Commercial _ Apartments — Greenhouse/Tent _ Exterior Alteration-Public Facility Miscellaneous Antennae — WORK TYPES _ New Interior Improvement — Siding ` Demolish Building* _ Addition v/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 1-6C)btcs•6--c.) Occupancy IA MCES System Plan Review v Code Edition 2G L*. M p, SAC Units EXT. Wt.EV- (25% 100%") Zoning City Water 1I�� Census Code Stories Booster Pump 1 #of Units Square Feet PRV #of Buildings Length Fire Sprinklers Type of Construction V 'Fa Width REQUIRED INSPECTIONS Footings New Building_Deck_Addition Drain Tile Foundation Foundation Before Backfill a/ Retaining Wall Vapor Barrier Erosion Control Framing 30 Minutes 1 Hour Steel Reinforcement Insulation Street/Curb Cut Inspection — Sheetrock Other: Roof:_Decking _Insulation _Ice&Water _Final Meter Size: Siding:_Stucco Lath Stone Lath __Brick_EFIS Electronic Set of Final Revised Plans Windows Fireplace: Rough In Air Test Final Final/C.O.Required Pool:_Footings _Air/Gas Tests Final V Final/No C.O.Required Final C/O Inspection: Schedule Fire Marshal to be present: Yes ✓ No +�/ Reviewed By: �,h4 - \\Vt-ei1 i' tCL ..Planning New Business to Eagan: yrs Reviewed By: 'K.'', , Building Inspector FEES Water Quality Base Fee ifo54- •Ise- Storm Sewer Trunk Surcharge /b O • 0'0 Sewer Trunk Plan Review !v7 L •8' 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: r Trail Dedication TOTAL:"" Z B 33 •G t Page 2 of 3 Lt; Pry'I i ';s lemic W i i 1 t✓/� For Office Use I��i`/ Z : 1-f;C�s4 t.) - Permit#: /150-g/6 1 `4 �� ., E AGAN 6 6l 73.' Permit Fee: � 1 Staff: � ` 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 RECD"\,rr Payment Recvd: _Yes 7*lo I (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 s I Email: buildinginspections citvofeacian.com I c(D. Plan Submittal: eplans@cityofeagan.com JUN 19 2018Plans:_Electronic )Paper I 2018 COMMERCIAL PLUMBING PERMIT APPLICATION Z Please submit two(2)sets of paper plans with all commercial applications as well as an electronic set of the submittal, submitted via email,CD or flash drive Date: 6"'3..c,- (g3 Site Address: Ape.. DC-Ne_.., Tenant: ' W 1iiie Suite#: Aigil,plipviiit �'li -''' Name: ()uh\ FA Ct,A 6A-re...IA,+7 1—LC Phone: Name: Vc' oN `tl,yyskjc A.. License#: pm 060607 ot ContractorpAddress: 1(10 COe6 ASCity: ewrnini � State: 411 Zip: Phone: ' Sc3- `I w 3v0 Email: i-""r6 @ U C'Svit Pk)frb,`4 . Goy' Type cif . c `f New _Replacement _Repair _Rebuild _Modify Space _Work in R.O.W. O hi , ` 4*�q"i� AMA ViDescription of work: S he xl, t.c�t L f,)in) COMMERCIAL )c New Construction _Modify Space 7.7 / j'Z.- „ ,�tl�ti _,, _Irrigation System( yes/_no)( RPZ/ PVB) a"7 .0.,tO • Rain sensors required on irrigation systems Permit Type • Avg.GPM (2"turbo required unless smaller size allowed by Public Works) fig t 0 arid I," a��:q,,, ,,,,,:v , _Meters Call(651)675-5646 to verity that tests passed prior to picking up meter. //� o s Domestic:Size&Type Fire: 1 -46110-(5) 4 d©-© Avg.GPM High demand devices?_Yes_No Flushometers_Yes_No COMMERCIAL FEES Contract Value$ -1 d, 000 x.01 $60.00 Permit Fee Minimum $60.00 PVB/RPZ Permit(includes State Surcharge) =$ � �� Permit Fee Surcharge=Contract Value x$0.0005 =$ � ob Surcharge If the project valuation is over$1 million, please call for Surcharge =$ TOTAL FEE Following fees apply when installing a new lawn irrigation system $ Water Permit Contact the City's Engineering Department,(651)675-5646,for required fee amounts. $ Treatment Plant $ Water Supply&Storage $ / State Surcharge =$ ( _/ /S`bO 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.citvofeacian.com/subscribe. CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. 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 F-J 1121-- Uot S x _.<2.—„— Applicant's Printed Name Applicant's Signature ~ Pl td Approved By .. Date:' d . FQR"vFFICEUSE i �� - � �,�� l,� Requf-red�Ins„pections , . ndef1 Ground a igh-ln,,f a . t ” a s T.. t �I� Ftndl" �`u`'' PRV Require :„ � i N `„„� _;.� ��t ca � "� ,�;'ta7 oaszi W, Meter Related Items � PMeter-Size i��G',� Radio Read 'Manometer -S a � ffi<.r . -,"._ -: Page 1 of 3 �'r-/ j�'iY�c r For Office Use i ; � � p�� S�CE /16() )// /v//„� Permit#: ?/7 Q 0 • � r „ pit , � `� S Permit Fee: / �•s-t) (..;-___\: C Date Received: 5-/7 "l ti?'” 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675- 694 SEP 1 7 2010 Staff: q , buildinginspections ancityofeagan.com 2018 MECHANICAL PERMIT APPLICATION ❑ Please submit two (2)sets of plans with all commercial applicati ns. J29091 Date: Site Address: 0 6ti ' Tenant: /% Tot - ,S Suite#: IReside,r ti wner,. .. Name: Phone: - �`. 344:1';,1"� 4 Address/City/Zip: MODERN HEATING & AIR CONDITIO N/A ::',4a,—.. �'' ,0 t, 4,V ,, Name: kaicense#: l� k,ICAID� ', Address: 2318 FIRST ST NE City: MINNEAPOLIS t �ontrator MN 55418 612-781-3358 �'� Phone: � <�',�i�"� � = State: Zip: hl . �r-',4=4,,'; ,) s' JIM TURPIN JTURPIN@MODERNHTG.COM -_ < Contact: Email: z r ,.., a 10,1` Al'og _ ... . ._.. ... .., �.._ ..._._. 6 ' �IPO PH New Replacement Additional Alteration Demolition 1y"p0° f iNork Description of work: INSTALL(7) UNIT HEATERS PER PLAN ,. '�L a.",d rR �. i i`9hi " i u�,�. r i i -�- a w .. d „:,,,,,,,i - > r i R t•''£ ii• a{ d ground o. 4',1ited mechen�(c i eggi�o �,,, t:is req 'Iitied to:I.?,'.- 4-::.:-.:=-_--'r ity6=. ..` ..,,s1,/',',7,',.::-- r �1 ` 1�17-744.4°'','' e� i. lease=contact the M--,--_-,,,',,,o;cir�Cris ect I info �orr c p'rr fitted renethods. , , h,..4,1v�Ami, ..> �.k v ... . a r p- ,i d r �, _ " how ,,,,,,,A,,,,,,,,,,..—: 4,4 �_ 41;40,44,4,, RESIDENTIAL COMMERCIAL .„ Furnace New Construction Interior Improvement ''''''4414140-0,,,,(0,-;,y4--,-, Air Conditioner Install Piping Processed P€rwi h � :h�ij ,�;_ � ,�� Air Exchanger Gas Exterior HVAC Unit m „ m l fibra, a i ; Heat Pump Under/Above ground Tank ( Install/_Remove) A ,a 11404",P ', qta k,-, —Other .. RESIDENTIAL FEES $60.00 Minimum Add or alteration to an existing unit, includes State Surcharge $100.00 Residential New, includes State Surcharge =$ TOTAL FEE COMMERCIAL FEES15,000.00 Contract Value$ x.01 $60.00 Permit Fee Minimum $75.00 Underground tank installation/removal, includes State Surcharge =$ 150.00 Permit Fee _$ 7.50 Surcharge s Surcharge=Contract Value x$0.0005 If the project valuation is over$1 million, please call for Surcharge =$ 157.50 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.cityofeagan.com/subscribe. 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. '"` rte__ Applicant's Printe Name Appl'• re �Fp eSeFtC q , '--. � r i�� ---� "i4ik 9� ... ..;5 ,.YS1PIu; Jt x; , 1iti , a L " -,)„,,t-ft,-,-,,,I,.-.4,,..p m - ,, N �1ry » i . ,� , " ; ,� os", ' aItia ri ? ,aii'r '4 � �� ct _ �1a� Reut ,II4y i�44 Nib, E , rteRequAt.rd1rl�p"tectici : 4 ' . i1,x * e . � t , , .+. _ d , l i i'' Pt U1'e rot.rid� � ),ii * --'''''''''J'''' a ' * .s: 1 # :PP,-,4 1.-- ,p 4QCHea i [ "'" *.'Yrf , b J c, - - , For Office Use %� i i �� 1 .� J ::::e: „ , E AG A N I CO 1.t .........ft% RECEIVED Date Received: l -/;-1 0 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651)675-5675 I TDD:(651)454-8535 I FAX:(651)675-5694 SEP 12 2018 Staff: buildinginspections(&cityofeagan.com L7 , 2018 FIRE SUPPRESSION SYSTE PERMIT APPLICATION Date: 09-10-18 Site Address: 5 ROAD j 0j� 1pe �/ K, Tenant: GATEWAY 3 Suite#: 0 Requirements: 2 complete sets of drawings and specifications, cut sheets on materials and components Name: Phone: Property Owner Address/City/Zip: Applicant is: Owner Contractor Type of Work Description of work: NEW SHELL BUILDING WET PIPE ESFR SYSTEMS Construction Cost: 135,000 Estimated Completion Date: DEC. 2018 Name: ESCAPE FIRE License#: C086 Contractor Address: 3000 CENTERVILLE ROAD City: LITTLE CANADA State: MN Zip: 55117 Phone: 651-771-8874 Contact: GREGORY M. PFEIFER Email: GREGP@ESCAPEFIRE.COM FIRE PERMIT TYPE WORK TYPE 1 Sprinkler System(#of heads=).,,. 1New _Addition Fire Pump Standpipe _Alterations _Remodel Other: 1573 TOTAL HEADS, Other: DESCRIPTION OF WORK: 1 Commercial Residential Educational FEES 135 000.00 Contract Value$ ' x.01 $60.00 Permit Fee Minimum 1350.00 Surcharge=Contract Value x$0.0005 =$ Permit Fee If the project valuation is over$1 million, please call for Surcharge =$ 67.5 Surcharge $100.00 Residential New(includes State Surcharge) =$ 1417'5 TOTAL FEE 3/4”:Fire Meter-$290.00 =$ 480.00 Fire Meter Radio Read(required with Fire Meters)-$190 =$ 1897.5 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.citvofeagan.com/subscribe. I hereby apply for a Fire Suppression System permit and acknowledge that the information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Minnesota Buildin• ire Codes;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 ., cordance with the approv piSr`i" cas;o ork which requires a review and approval of plans. x GREGORY M. PFEIFER x JJ ' in, Applicant's Printed Name Applicant's gat 41) FOR OFFICE USE REQUIRED INSPECTIONS �/ Hydrostatic Flow Alarm Drain Test t---Fro-Cigh In Trip // Pump Test Central Station Final Conditions of Issuance: Permit Reviewed by — G Date: ! / / / For Office Use 22 ( p C �" Permit#: 5 J SO j `T AC, EAGANPermit Fee: �'�► Staff: ( 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 Payment Recvd: _Yes _No (651)675-5675 1 TDD: (651)454-8535 I FAX: (651)675-5694 Email: buildinginsoectionsAcitvofeaaan.com Plans: Electronic Paper Plan Submittal:eplansecitvofeaoan.com L 2019 COMMERCIAL PLUMBING PERMIT APPLICATION ❑ Please submit two(2)sets of paper plans with all commercial applications as well as an electronic set of the submittal, submitted via email,CD or flash drive ,arc • Date: 1-3C� ` 1 cv Site Address: c 1,'-c( p I d.UA, Tenant: Suite#: Rropertjf 0,41:;6011 ,,,:. Name: Phone: Name: \Jr1 Pikirv,k l t-pL License#: All (OGS Contractor " = Address: 9//C) 6,(IO Ai-. City: 'l(5 �'11.,k)cit State: kl4i4 Zip: S1"120 1; ' Phone: C/S�"-c/2A—L1{,,`i Email: 1,L- ( �' L) '1 04-'44.1 (..c✓"f ,, — New —Replacement —Repair —Rebuild Modify Space Work in R.O.W. TXe Qf Werk Description of work: COMMERCIAL )� New Construction Modify Space ) // p 6 Nee.. Irrigation System(_yes I_no) _PVB) / • Rain sensors required on irrigation sy ems a"l1I • Avg.GPM (2"turbo required unless smaller size allowed by Public Works)] Lfr ;� l' 'l,j', Meters Call(651)675-5646 to verity that tests passed prior to picking up meter. Domestic:Size&Type Fire: 1 Avg.GPM High demand devices?_Yes_No Flushometers_Yes_No COMMERCIAL FEES Contract Value$ x.015 $60.00 Permit Fee Minimum = $ � O Permit Fee $60.00 PVB/RPZ Permit(includes State Surcharge) Surcharge=Contract Value x$0.0005 =$ Surcharge If the project valuation is over$1 million,please call for Surcharge =$ TOTAL FEE Following fees apply when installing a new lawn irrigation system $ S -OO Water Permit Contact the City's Engineering Department,(651)675-5646,for required fee amounts. $ Treatment Plant $ -7e-0 u Meter Fee $ State Surcharge =$ 7� "OC) 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.citvofeaaan.com/su bscrlbe. CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. 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 kA—AL. Uvs x Applicant's Printed Name Applicant's Signature FOR OFFICEUSE Approved By: Cate. -a-17 Req fired Inspections: Under Ground Rough jn ,_ Air Celt G'as Test _� Final PRY Required to , Meter Rented It tns: Meter"Stxe Radio Read` Martcrrleter w Staf� � Page 1 of 3 Peggy eIeck / gg/ From: Abby Decker Sent: Wednesday,January 30, 2019 7:08 AM To: Karl Voss Cc: Peggy Fleck Subject: FW:Gateway 3 Irrigation plan Peggy, I'm sorry I don't know the address of this site. Karl Voson from Voson plumbing will be in touch with you this week to purchase a 1" Irrigation meter for Gateway 3. It will be housed indoors. Karl, Call Peggy at 651-675-5674 to provide necessary information to complete a permit and discuss payment. Then head on over to 3419 Coachman Pt anytime between 7-3:30 to grab your meter. STAY WARM! abby Original Message From: Brent Massmann Sent:Tuesday,January 29,2019 6:46 PM To:Abby Decker<adecker@cityofeagan.com> Subject: RE: Gateway 3 Irrigation plan This is approved for a 1" meter housed indoors. .urrhase.a sadio, Kind Regards, Brent Massmann Utilities Operations Supervisor 3419 Coachman Pt I Eagan, MN 55122 Office: 651-675-5217 https://www.cityofeagan.com Original Message From:Abby Decker Sent: Wednesday,January 23, 2019 1:56 PM To: Brent Massmann<bmassmann@cityofeagan.com> Subject: FW: Gateway 3 Irrigation plan Here is a copy of an irrigation request. I can't remember if I sent it to you today. Original Message From: Karl Voss<karl@vosonplumbing.com> Sent: Wednesday,January 23, 2019 1:35 PM 1 A ij11\*a caul' di For Office Use Il dqr/ Permit#: SSC t — rk I��G! L� � PeritFee: / / J� °% I C a�G�S Staff: Payment Recvd: Yes No I 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 I (651) 675-5675 TDD: (651)454-8535 (651)FAX: 675-5694 I PlanSubmittal: eplans ancityofeacian.com L Plans:_Electronic _Paper J 2018 COMMERCIAL BUILDING PERMIT APPLICATION Date: 12/18/2018 site Address: 505 Hope Drive, Eagan, MN 55121 Tenant Name: Hy-Vee, Inc. (Tenant is: ✓ New/ Existing) Suite#: Former Tenant: N/A Name: Buhl Investors Phone: 612-968-3728 Property Owner Address/city/zip: 5100 Eden Avenue, Suite 317, Edina, MN 55436 `, Applicant is: Owner ✓ Contractor Y Ambient& refrigerated warehouse, lockers/breakroom/offices, food prep "dor'a Description of work: ' A`� W million C5) ) Construction Cost: X F Hy-Vee Construction IR657070 y't1 d, Name: License#: v Address: 5605 NE 22nd Street city. Des Moines capiractorf w State: IA Zip: 50313 Phone: 515-360-6784 Matt Frandsen matt.frandsen@hy-veeconstruction.Com Contact: Email: Name: Cuningham Group Registration#: 22899 - Mike Strand 612-379-3400 Minneapolis . Archife /Etginr Address: City: State: MN N Zip: 55414 Phone: 612-379- 5317 Contact Person: Craig St. Clair Email: cstclair@cuningham.com Licensed plumber installing new sewer/water service: Cool Air Mechanical Phone#: 651-489-8821 NOTE:Plans and suppo �# is .w mit a consi to be p is in ormation Portions,of Op Info n may be classified as non-p c you !vv i � o l asoi s that wor permit the�Cl?ty to clads that they arse secrets;inform, 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.citvofeauan.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.uooherstateonecall.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 Matt Frandsen f--,,,,„,,,,,,„y,X Applicant's Printed Name Appl c nt's Signature DO NOT WRITE BELOW THIS LINE i._C. �~ -SUB 1`YPES e.,--0 hie, O,e 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 V.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 S 0001/OG.w Occupancy 4.3 t 8, 5.2. MCES System V Plan Review V Code Edition Z'/SMBG SAC Units 04.4SI7'E-i.-- (25% 100% ✓) Zoning "j� I City Water ✓ Census Code Stories I Booster Pump #of Units '0 Square Feet Pri Doo PRV #of Buildings / Length 3 48 Fire Sprinklers Type of Construction ji•fS Width l41►i4 222 REQUIRED INSPECTIONS 1,/Footings_New Building_Deck_Addition Drain Tile Foundation Foundation Before Backfill Retaining Wall Vapor Barrier Erosion Control V Framing 30 Minutes ✓ 1 Hour Steel Reinforcement Insulation Street/Curb Cut Inspection Sheetrock Other: Roof: Decking _Insulation _Ice&Water _Final Meter Size: Siding:_Stucco Lath _Stone Lath _Brick EFIS Electronic 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 CIO Inspection: chtdale ire Marshal to be present: ✓Yes No Reviewed By: , e''' )', Planning New Business to Eagan: 7 --- (i-A-U•• � Reviewed By: , Building Inspector FEES Water Quality Base Fee 2 6 fcc.7r" Storm Sewer Trunk Surcharge /i rot" ..1-4-- Sewer Trunk Plan Review /'/, 27/ • B f 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: 2, 37, 7Lg.G fL Page 2 of 3 •MCES USE:Letter Reference: 181224A7 Address ID:719068 Payment ID:417432 Date of Determination: December 24, 2018 Determination Expiration: December 24, 2020 Greetings! Please see the determination below. Project Name: Hy-Vee Project Address: 505 Hope Dr Suite#/Campus: n/a City Name: Eagan Applicant: Craig St Clair,Cuningham Group Architecture, Inc. Special Notes: *The rules allow for these 6 net credits where SAC was actually paid to either be taken city-wide or left site- specific. Any net credits taken city-wide can only be taken if the project is reported to MCES at the time the permit is issued. Otherwise,the net credits remain site-specific. Charge Calculation: Warehouse: 89,763 gross square feet @ 6950 square feet/SAC= 12.92 Fixture Units: 27 fixture units @ 17 fixture units/SAC= 1.59 Total Charge: 14.51 Credit Calculation: Eagan Industries III (SAC 8/18) Office: 89,763 gross square feet x 30% @ 2400 square feet/SAC= 11.22 Warehouse: 89,763 gross square feet x 70% @ 7000 square feet/SAC=8.98 Total Credit: 20.20 Net SAC: -5.69* —or— 0 SAC Due The business information was provided to MCES by the applicant at this time. It is the City's responsibility to substantiate the business use and size at the time of the final inspection. If there is a change in use or size,a redetermination will need to be made. If you have any questions email me at:core.mccullough@metc.state.mn.us. Thank you, Cory McCullough SAC Program Technical Specialist Please visit our SAC website by going to:www.metrocouncil.org/SACprogram 390 Robert Street North ; St. Paul. MN 55101 1805 Phone 651.60?.1000 I Fax 651.602.1550 I TTY 651.291.0904 I metrocouncil.orcl METROPOLITAN COUNCIL r For Office Use ‘:i:.: \\ i ° Permit#: / / d ':°:# E AGA N Permit Fee: E C E I V E Date Received: c2 /6- 3830 `3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 f''' FEB 1 2 2019 Staff: buildinciinspectionsi7a.cityofeacian.com I_ BY: 2019 COMMERCIAL FIRE ALA 1tIT APPLICATION Date: 2-34-19 Site Address: =`�7' d � �1f I{{'' Tenant: Gateway III Bulk Distribution .0.S suite#: -1 Requirements: 2 complete sets of drawings and specifications, cut sheets on materials and components Name: Buhl Investors Phone: 612-968-3728 Property Owner5100 Eden Avenue, Suite 317, Edina, Mn 55436 Address/City/Zip: Applicant is: Owner Contractor Type of Work Description of work: Install FA System to monitor water flow, tampers and fire pump Construction Cost: $5,490.00 Estimated Completion Date: 2-13-19 Name: ESP,Inc. License#: TS642681 Contractor Address: 1940 Park Ridge Court City: Chaska State: MN Zip: 55318 Phone: 612-965-5368 Contact: Tom Cashman Email: tcashman@getesp.net New _Remodel Work Type Addition Other: — Alterations DESCRIPTION OF WORK: Commercial _Residential f Educational FEESContract Value$5,490.00 x.01 $60.00 Permit Fee Minimum = 60.00 $ Permit Fee Surcharge=Contract Value x$0.0005 =$ 2.75 Surcharge* If the project valuation is over$1 million,please call for Surcharge _$ 62.75 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.citvofeaoan.com/subscribe. I hereby apply for a Fire Alarm permit and acknowledge that the information is complete an.accurate;that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Minnesota Building/Fire Codes;t :t understand ' 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 W the approv:• •a in e case of work which requires a review and approval of plans. xTom Cashman III Applicant's Printed Name ,ppli- nt's •ignature FOR OFFICE USE' Reviewed By: ® Date: 2'i' -/9 Required Inspections: Rough-InFinal Fire Alarm Test r For Office Use Permit#: 7 7� / �{/J \ --i t''` %.,..,,,, „,,„,,, E AGA N Permit Fee: I ..„........... Staff: I 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 � Payment Recvd: \ Yes o (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 I / I Email: buildinginspections(a,cityofeagan.com I Plans: Electronic `aper I Plan Submittal: eplanscityofeaqan.com t- -' 2019 COMMERCIAL PLUMBING PERMIT APPLICATION ,p Please submit two(2)sets of paper plans with all commercial applications as well as an electronic set of the submittal, submitted via email, CD or flash drive (6-Matt. -Ft, &p C Ct.TV ef 01C-AkJ,l_,,,v) Date: I Iit/c � Site Address: CC:. H-t1S b�VV / -&M A '• I N /t' Tenant: ` 4,1--VE-e-, SIC:.• Suite#: i Property Owner Name: l4y-V/ , -YUVC. • Phone: sIC--J3/- 3(E U Name: (&U( At /' ftimoCA-1 I N[:• License#: RU0 3(,40 Contractor Address: t /9 (3e/ t1vf, N City: ick Iaue- State: MAJ Zip: cc Phone: 763-.,4a -0b4-I d°i Email: (//del II ()(oo/4i444-1,G /0Cft'Lw/41 v-----New Replacement Repair Rebuild Modify Space Work in R.O.W. Type of Work — — u -, /�Description of work: ��'4146/NCI 4. n.IG p,,,... ��, �" COMMERCIAL 1,----New Construction Modify Space Irrigation System( yes/ no)( RPZ/ PVB) I • Rain sensors required on irrigation systems Permit Type . Avg.GPM (2"turbo required unless smaller size allowed by Public Works) Meters Call(651)675-5646 to verity that tests passed prior to picking up meter. Domestic:Size&Type Fire: 1 Avg.GPM High demand devices? Yes No Flushometers_Yes_No COMMERCIAL FEES Contract Value$ ,.. 1 S,©oo•co x.015 • $60.00 Permit Fee Minimum =$ Si Jas AO Permit Fee $60.00 PVB/RPZ Permit(includes State Surcharge) $ 101.E Surcharge Surcharge=Contract Value x$0.0005 If the project valuation is over$1 million, please call for Surcharge =$ / 350,5.0 TOTAL FEE Following fees apply when installing a new lawn irrigation system $ Water Permit Contact the City's Engineering Department,(651)675-5646,for required fee amounts. $ Treatment Plant $ Meter Fee $ State Surcharge .$ 3/3S a .So 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.citvofeaga n.com/subscribe. CALL BEFORE YOU DIG. Call Gopher State One Call at(651)454-0002 for protection against underground utility damage. I hereby acknowledge that this information is complete and accurate,that the work wit 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 off plans. ! X Ali IalAF— &Afê2if41 t- x iv. /2 ,i Applicant's Printed Name Appl' ' ature FOR OFFICE USE Approved By: _ _Date: ' Required Inspections: ' ,•Under Ground \Rough-In Air Test Gas Test 'AFinal PRV Required: Yes No Meter Related Items: Meter Size Radio Read Manometer Staff: Page 1 of 3 For Office Use I Permit#: /'�ii t o i , % , , , EAGAN �"' —...• Permit Fee: a DCla n Staff: 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Payment Recvd: Yes No Email: buildinginspections(c�citvofeaoan.com Plan Submittal: eolans(&.cityofeagan.com I Plans: Electronic Paper 1 Vit(. 2019 COMMERCIAL MECHANICAL PERMIT APPLICATION �`3� 17 Please submit two (2) sets of paper plans with all commercial applications as well as an electronic set PP submittal, submitted via email, CD or flash drive C of the Date: 1/!8/11 Site Address: Sb1 Dat..., , .4F /14,V 1 Tenant: k _Ui3 C,' Suite#: Owner Name: Oltti:r -1N-C---• Phone: Address/City/Zip: S 1Al �L...„.1 0,...<„,„ w&i i m,,,,v,. , qft v),1-44. Name: Cpx)1 Ali k J1CA Lt lug License#: /44.60(1341490 Contractor Address: I cliti [w-6-Avs NeCity: j-bgr1't Stater Zip: 3t%7 Phone: ' -6,S' c5--Ua)-1 Contact: Wei 114.41,16.7944-u Email: i4i iii(7,4,fra4,---uA/vu r c,,,,, IV-New Replacement Additional Alteration Demolition Type of Work Description of work: Nl€641W e b telo 4 tigtvki6 fes„ p6.1trs NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City Code. Please contact the Mechanical Inspector for information on permitted screening methods. COMMERCIAL V New Construction Interior Improvement Permit Type Install Piping Processed / Gas _Exterior HVAC Unit Under/Above ground Tank (_Install/ Remove) COMMERCIAL FEES $60.00 Permit Fee Minimum Contract Value$ 1 SCI 4tC.cO x.015 $75.00 Underground tank removal, includes State Surcharge =$ 0.2! OOH,0-0 Permit Fee Surcharge=Contract Value x$0.0005 =$ (a Co Surcharge If the project valuation is over$1 million, please call for Surcharge =$ c,O9c 'SD 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.citvofeagan.com/subscribe. 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. 40, Ati,,,4,4„) Applicant's Printed Name f„,-,. 4441, can s ' g ature FOR OFFICE USE Required Inspections: / Reviewed By: Date: Underground Y Rough In Air Testi Gas Service Test In-floor Heat y Final HVAC Screening For Office UseCC" r Permit#: / y-?/S %%.:k E AG N •�•• •tea Permit Fee: Staff: 3830 PILOT KNOB ROAD I EAGAN, MN 55122-18 Payment Recvd: _Yes No (651)675-56751 TDD:(651)454-8535 I FAX:(651 E6CEIVE Email: buildinpinspections©cit ofeaoan.com y L 1 3 20 Plans: Electronic aper Plan Submittal:eolansCa�citvofeaa an.conn MAR 19 BY: 2019 COMMERCIAL MEC PERMIT APPLICATION 0 Please submit two(2)sets of paper plans with all commercial applications as well as an electronic set of the submittal, submitted via email,CD or flash drive Date: 3/11/2019 Site Address: 505 HOPE DR Tenant: Suite#: Owner Name: HY-VEE Phone: Address/City/zip: 505 HOPE DR EAGAN MN Name: DIVERSIFIED PLUMBING & HEATING License#: PC667869 contractor . Address: 125 E. RAILROAD STREET City: NORWOOD State: MN Zip: 55368 Phone: 952-448-0756 Contact: COLLIN KING Email: COLLIN@DIVERSIFIEDPH.COM New Replacement 1/ Additional Alteration Demolition Type of work Description of work: ADD FROST LOOP TUBING IN FREEZER FLOOR NOTE:Roof mounted and ground meteor ed mechanical equip rtrent is required to be Screened by City Code. Please contact the Mechanical inspector for information on permitted sing- cis.. COMMERCIAL New Construction / Interior Improvement Permit Type _Install Piping Processed Gas Exterior HVAC Unit Under/Above ground Tank ( Install/ Remove) COMMERCIAL FEES 12 000 Contract Value$ ' x.015 $60.00 Permit Fee Minimum 180.00 $75.00 Underground tank removal, includes State Surcharge =$ Permit Fee $ 6.00 Surcharge Surcharge=Contract Value x$0.0005 = If the project valuation is over$1 million, please call for Surcharge =$ 186.00 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.citvofeacan.com/subscribe. 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. )(COLLIN KING X Applicant's Printed Name Applicant's Signature FOR OFFICE USE • Required inspections• Reviewed By: ® I Underground Rough in '"" Air Test Gas Service Test in floor Heat inal 'HVAC"tattOing'" l z1 a sq For Office Use Check q- Permit#: 7�� /� t,%%., ,,,, , E AG A N ... .... pli.ins 6Lcd Permit Fee: C) .'� or AC Staff: 'Ir0 ........ �i�ce.... L----=-- = J —� rlo h? 11 V w,"'�" Payment Recvd:7\Yes No , 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 I (651)675-5675 I TDD:(651)454-8535 I FAX:(651)675-56 FEB 1 9 2019 I Plans: Electronic Paper buildinciinspectionst&citvofeacian.com L 2019 FIRE SUPPRESSION gif-STENS-11ERMIT APPLICATION Date: 02-13-2019 Site Address: 505 HOPE DRIVE Tenant: HY VEE FULLFILLMENT CENTER Suite#: fer Requirements: 2 complete sets of drawings and specifications, cut sheets on materials and components Name: Phone: Property Owner Address/City/Zip: Applicant is: Owner Contractor • Type of Work Description of work: ADD RELOCTE FOR NEW TENANT BUILDOUT (254 HDS) Construction Cost: $85,000.00 Estimated Completion Date: APRIL 2019 Name: ESCAPE FIRE License it C086 Contractor Address: 3000 CENTERVILLE ROAD City: LITTLE CANADA State: MN Zip: 55117 Phone: 651-771-8874 Contact: GREGORY M. PFEIFF Email: GREGP@ESCAPEFIRE.COM FIRE PERMIT TYPE WORK TYPE ✓ Sprinkler System(#of heads ✓)2sit _New _Addition Fire Pump _Standpipe _Alterations I Remodel Other: —Other: — DESCRIPTION OF WORK: Y Commercial _Residential _Educational FEES 85 000 Contract Value$ x.01 $60.00 Permit Fee Minimum =$ 850.00 Permit Fee Surcharge=Contract Value x$0.0005 If the project valuation is over$1 million, please call for Surcharge =$ 42.50 Surcharge $100.00 Residential New(includes State Surcharge) _$ 892.50 TOTAL FEE 3/4"Fire Meter-$290.00 =$ EXISTING Fire Meter Radio Read(required with Fire Meters)-$190 =$ EXISTING 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.citvofeaaan.comisubscribe. I hereby apply for a Fire Suppression System permit and acknowledge that the information is complete and acc ate;that the work will be in conformance % : •ina and codes of the City of Eagan and with the Minnesota Building/Fire Codes;that I understand this is not a pe, it,but only an application for a•-• it, •• •� • jf without a permit;that the work will be in accordance with the approved plan in the case of work which requ' --a review and approval of• =,i-i �, X GREGORY M. PFEIFERx i Applicant's Printed Name Applicant's gn-tur= FOR OFFICE USE REQUIRED INSPECTIONS Hydrostatic Flow Alarm Drain Test (NCRough In Trip Pump Test Central Station X Final #1 Conditions of Issuance: , t i kik Permit Reviewed by: -- ��'^u�''�" Date: 3 / _. For Office Use • • ,..:„... ,,,,,, E AG A N Y� O Ek6 c Y e 1 A.6 )6_..---C I d Permit#: ...., Permit Fee: .� E l I /C c Date Received: 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 E'JE 1 (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-56944 Staff: buildinginspections(a�cityofeagan.com il MAR 19 2019 L 2019 COMMERCIAL FIRERAL i = 0. ' :4 IT APPLICATION Date: 3/18/2019 Site Address: 505 Hope Drive Tenant: Hy-Vee Suite#: 1Ff Requirements: 2 complete sets of drawings and specifications, cut sheets on materials and components Name: Hy-Vee Phone: 515-267-2880 Property Owner Address/city/zip: 5820 Westown Parkway, West Des Moines, IA 50266 Applicant is: Owner ✓ Contractor Type of Work Description of work: fire alarm notification installation in fulfillment center Construction Cost: 50056.65 Estimated Completion Date: 9/1/2019 Name: A+ Communications & Security License#: TS001728 Contractor Address: 5609 NE 22nd St City: Des Moines State: IA Zip: 50313 Phone: 515-645-2345 Contact: AL Ward Email: al.ward@onlineaplus.com ✓ New Remodel Work Type Addition Other: Alterations DESCRIPTION OF WORK: ✓ Commercial Residential Educational FEES Contract Value$50056.65 x.01 $60.00 Permit Fee Minimum = $ 500,5x, Permit Fee Surcharge=Contract Value x$0.0005 =$ 25.03 Surcharge* If the project valuation is over$1 million, please call for Surcharge 525,��( _$ 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.cityofeagan.com/subscribe. I hereby apply for a Fire Alarm permit and acknowledge that the information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Minnesota Building/Fire Codes;that I understand this is not a permit,but only-n 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 requires a review and M/e oval of plans. _ / r xo'N - Q/ L x (‘,/,-e „APPlicant s Printed Name ApPlSignature FOR OFFICE USE Reviewed By: Z ,......t?---, L__^ A _ Date: /b2-r q Required Inspections: Rough-In XFinal Fire Alarm Test 1 � For Office Use llir` � E AGA N //tt Permit#: / 5. ��Q 7 `� i i �� : � ��✓(/�l I J� %� jØ Permit Fee: 1 �.. 4. Staff: I 1 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 Payment Recvd: _Ye No I (651)675-5675 I TDD: (651)454-8535 I FAX: (651)67 pg �'�� Email: buildinginspectionsCa)cityofeagan.com L Plans:_Electronic . Paper I Plan Submittal: eplans(a cityofeagan.com -' APR 2 3 2019 2019 COMMERCIAL ` . _ ► CAL ERMIT APPLICATION ❑ Please submit two(2)sets of paper plans with all commercial applications as well as an electronic set of the submittal,submitted via email, CD or flash drive Date: Ov C � Site Address: 6°S /4/ 120- 1)-r li/e- Tenant: Ai 1)es_ c I .Pt 1 M tom-f (NW4-02— Suite#: E5/5 -3� - o'Vo Ire a ""� � Name: � � Phone: ,� Address/City/Zip: 34::,C)--6.- if\i, .:E.... 9_ /lei S4" S P9Qi its 5o3/-3 Name: —As 2 Cr 0; CA �� License#: 9-0D)0(2008 SSV Address: // 93 ,4%^ 4 ((fy,\) 1JaCl City: ' / M i►�j /UZ'v Cahtr Gt©r ' 1 1-/. 0-/,9- ;.,,,,,,,:,,,,,,' f 0 State: J1 i1V Zip: �5�30 Phone: (fa - - . /,9" ,-,...„--..,,„:,:,, -.:•,:,„:.,,,,,„,,,_,,,,i,,,-,,,,,,,,,:,-,-„l,,,,,, Contact: U94 .)Email: e-V'ebYh 0( New Replacement Additional Alteratio Demolition W ' �ryp�of Word ; Description of work: W P' � ��l�A C � �� l,�� ' - r NO E R t�of mounted and ground mounted mechanical equipment is required fob screened py ty Code.:.'`Please contact the Mechanical Inspector for information on,permitted screening methods 1 �, ,r` 1,14 M,, COMMERCIAL _ New Construction Interior Improvement — p P rmit Typ Install Piping Processed �F' Gas Exterior HVAC Unit Under/Above ground Tank ( Install/_Remove) COMMERCIAL FEESn.��l x.01 Contract Value$ 4aj(TOO $60.00 Permit Fee Minimum $75.00 Underground tank removal, includes State Surcharge =$ ,37.5v Permit Fee _$ /d.< Surcharge Surcharge=Contract Value x$0.0005 If the project valuation is over$1 million, please call for Surcharge =$ 34Z75 75 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.citvofeaaan.com/subscribe. 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. I ��.a-N x I x c )cs1 0 R Applicant's Printed Name Applicant's !nature FOR OFFICE'USE .. :,..-„,,,,,,-:::*:-.::,,,s,,,,!,,,,,...,,z,...-r,--]:„.sr,::::',:-..,,,-.,:;?,:,-..,,,,!,...„--,:::-,,,,,,,,!7., ,,,,,,,,,i!, ,,,,,,,e7,_,,,,,N''',ef'-':4,1,,,a,r1-,,,,,,A,,,,,..?,,,....,.;:,',,r,:c....-_-.--,,,,,,, Required Inspections , Reviewed By ?vie Underground Rough In , Air Test was Service Test; In floor Heat pPFinal HVAC:Screening r' For Office Use Permit#: /5764;R4,0'11 %%.1 Permit Fee: E AGA N Staff: Payment R vd: Yes o 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651)675-5675 I TDD:(651)454-8535 I FAX:(651)675-5694 Pla Electronic Paper Plan Submittal: eplans(a�cityofeagan.com L 2019 COMMERCIAL BUILDING PERMIT APPLICATION Date: 7/31/2019 Site Address: 505 HOPE DRIVE, EAGAN MN 55121 Tenant Name: HY-VEE, INC. A (Tenant is: New/ I Existing) Suite#: Former Tenant: Name: BUHL INVESTORS Phone: 612-968-3728 Property Owner Address/City/Zip: 5100 EDEN AVE., SUITE 317, EDINA, MN 55436 Applicant is: Owner ✓ Contractor Type of Work Description of work: ADDITIONAL OFFICE SPACE BEING ADDED TO EXISTINi Construction Cost: $25,000 Name: HY-VEE CONSTRUCTION License#: IR657070 Contractor Address: 5605 NE 22ND ST city: DES MOINES State: IA Zip: 50313 Phone: 515-401-6118 Contact: JACK MEYEREmail: JACK.MEYER@HY-VEECONSTRUCTION.COM Name: CUNNINGHAM GROUP Registration#: 22899-MIKE STRAND Architect/Engineer Address: city: MINNEAPOLIS State: MN Zip: 55414 Phone: 612-379-3400 Contact Person: CRAIG ST. CLAIR Email: CSTCLAIR@CUNNINGHAM.COM Licensed plumber installing new sewer/water service: COOL AIR MECHANIC Phone#: 651-489-8821 NOTE:Plans and supporting documents that you submit are considered to be public information. Portions of the information maybe 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 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.aopherstateonecall.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. JACK MEYER x x _. 1604 Applicant's Printed Name App nt's Signature 1 DO NOT WRITE BELOW THIS LINE / 7O '�- SUBTYPES 5°5 hiap6 LJr- 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 `�C 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 'r __ o D Occupancy S-Zr$ MCES System Plan Review ,' Code Edition 241c AIL_. SAC Units (25% 100% ) Zoning City Water Census Code Stories Booster Pump #of Units Square Feet PRV #of Buildings Length Fire Sprinklers Type of Construction 'J 3 Width REQUIRED INSPECTIONS Footings New Building Deck Addition Drain Tile Foundation Foundation Before Backfill Retaining Wall Vapor Barrier Erosion Control ?c Framing 30 Minutes 1 Hour Steel Reinforcement Insulation Street/Curb Cut Inspection Sheetrock Other: Roof: Decking Insulation Ice&Water Final Meter Size: Siding: Stucco Lath Stone Lath Brick EFTS Electronic Set of Final Revised Plans Windows Fireplace: Rough In Air Test Final Final/C.O.Required Pool: Footings Air/Gas Tests Final V Final/No C.O.Required Final CIO Inspection: Sch dule Fire Marshal to be present: Yes 7{ No Reviewed By: a , Planning New Business to Eagan: Reviewed By: /4L__--- - , Building Inspector FEES 1 Water Quality Base Fee 111 �``O Storm Sewer Trunk ...... Surcharge /. .S i'2 Sewer Trunk .-0 if Plan Review �(s `f.>- 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 r— Other:Trail Dedication g3.TOTAL: (v 15- Page 2 of 3 BACKFLOW PREVENTOR � � Q a Agog (RPZ) TEST REPORT wM44mmM 15441341" Ave. NE, Ham Lake, MN 65304 PH: 65°1-489-8821 FAX: 661-489-6763 JOB ADDRESS: 1 D 5 h e_. l�-E M s S� OWNER / OCCUPANT / C NTACT PERSON: J CONTACT PHONE: � y DEVICE LOCATION: L 4 �-e— FLOOR #: ROOM #: SERVES WHAT SYSTEM: MAKE: �.. MODEL: v li O SIZE: SERIAL #: [3 INSTALL DATE (MM/DD/YYYY): OVERHAUL DATE(MM/DD/YYYY): TESTDATE(MM/DD/YYYYY): / � �-C)" TEST BEFORE REPAIRS FINAL TEST DESCRIBE REPAIR IF ANY: #1 CHECK VALVE RELIEF PSI / DIFF PSI / DIFF trc CHU-n vHLvt c)C15' c, TEST COMPLETED BY: (PLEASE PRINT FIRST &LAST NAME) CERTIFICATION NUMBER: COOL AIR MECHANICAL, INC. CONTRACTOR LICENSE #: 59249 PM 1544 134h AVENUE NE COMPANY PHONE #: 763-205-0821 HAM LAKE, MN 55304 CONTACT PERSON / PHONE #: 1 t 1 BACKFLOW PREI/ENTOR(00o LMao - (RPZ) TEST REPORT NECHANICAc, INC. 1544 134th Ave. NE, Ham Lake, MN 55304 PH: 651-489-8821 FAX: 651-489-6763 JOB ADDRESS: J � -` o t L�K OWNER /, OCCU ANT"/ CONTACT PERSON: CONTACUVNE DEVICE LOCATION: FLOOR #: ROOM #: SERVES WHAT SYSTEM: MAKE: MODEL: SIZE: 3 SERIAL #: k iol 'c INSTALL DATE (MM/DD/YYYY): OVE HAUL DATE(MM/DD/YYYY): TEST DATE (MM/DD/YYYY): #1 CHECK VALVE RELIEF #2 CHECK VALVE PSI / DIFF PSI / DIFF TEST BEFORE REPAIRS FINAL TEST DESCRIBE REPAIR IF ANY: TEST COMPLETED BY: (PLEASE PRINT FIRST & LAST NAME) CERTIFICATION NUMBER: COOL AIR MECHANICAL, INC. CONTRACTOR LICENSE #: 59249 PM 1544134th AVENUE NE COMPANY PHONE #: 763-205-0821 HAM LAKE, MN 55304 CONTACT PERSON / PHONE #: BACKFLOW PREVENTOR (RPZ) TEST REPORT goo/ Z A g NECHANICAL, INC. 1544134`h Ave. NE, Ham Lake, MN 55304 PH: 651-489-8821 FAX: 651-489-6763 JOB ADDRESS: p 5d Nv r U-t.... OWNER / OCCUPANT / CONTACT PERSON: CONTACT PHONE: 8v v _ _ 8yz� DEVICE LOCATION: FLOOR #: ROOM #: SERVES WHAT SYSTEM: I MAKE: MODEL:: SIZE: SERIAL #: 7 ' 6- � llq 1- ,6 IN TALL DATE (MM/DD/YYYY): OVERHAUL DATE(MM/DD/YYYY): TEST DATE (MM/DD%YYYY): #1 CHECK VALVE RELIEF it? CUFCK VA VF PSI / DIFF PSI / DIFF TEST BEFORE REPAIRS r� DESCRIBE REPAIR IF ANY: TEST COMPLETED BY: (PLEASE PRINT FIRST & LAST NAME) CERTIFICATION NUMBER: L eJ L e ?)F-po l 30 COOL AIR MECHANICAL, INC. CONTRACTOR LICENSE #: 59249 PM 1544134`h AVENUE NE COMPANY PHONE #: 763-205-0821 HAM LAKE, MN 55304 CONTACT PERSON / PHONE #: BACKFLOW PREVENTOR (RPZ) TEST REPORT 1544 134" Ave. NE, Ham Lake, MN 55304 PH: 651-489-8821 FAX: 651-489-6763 JOB ADDRESS: OWNER / OCCUPANT/ CONTACT PERSON- CONTACT PHONE: 1 i DEVICE LOCATION: FLOOR #: ROOM #: L), 4,1,y /I A) e-/ SERVES WHAT SYSTEM: c `,,,,.cq j wCS;A MAKE: MODEL: SIZE: SERIAL #: a c F�1q- 3 � 6� - /-10 .> INSTALL DATE (MM/DD/YYYY): OVERHAUL DATE(MM/DD/YYYY): TEST DATE (MM/DD/YYYY): TEST BEFORE REPAIRS Ia1klI_101X.1f1 DESCRIBE REPAIR IF ANY: #1 CHECK VALVE RELIEF #2 CHECK VALVE PSI / DIFF PSI / DIFF &0-5- lo.5ecl TEST COMPLETED BY: (PLEASE PRINT FIRST&LAST NAME) CERTIFICATION NUMBER: ai-q- Lq rto "mt. 6F& 136 COOL AIR MECHANICAL, INC. CONTRACTOR LICENSE #: 59249 PM 1544134 th AVENUE NE COMPANY PHONE #: 763-205-0821 HAM LAKE, MN 55304 CONTACT PERSON / PHONE #: BACKFLOW PREVENTOR (RP4 fj ZEST REPORT Pv 1544 134th Ave. NE, Ham Lake, MN 55304 PH: 651-489-8821 FAX: 651-489-6763 JOB ADDRESS: o o ac OWNER / OCCUPANT / CONTACT PERSON: CONTACT PHONE: DEVICE LOCATION: FLOOR #: ROOM #: SERVES WHAT SYSTEM: MAKE: MODEL: SIZE: SERIAL #: ili- L�K-A& "7 INSTALL DATE (MM/DD/YYYY): OVERHAOL DATE (MM/DD/YYYY): TEST DATE (MM/DD/YYYY): #1 CHECK VALVE RELIEF PSI / DIFF PSI / DIFF #2 CHEICJk SALVE TEST BEFORE REPAIRS FINAL TEST DESCRIBE REPAIR IF ANY: TEST COMPLETED BY: (PLEASE PRINT FIRST & LAST NAME) CERTIFICATION NUMBER: CL�-P "'eVlCtlt 4,4 r— .6 Facao -; COOL AIR MECHANICAL, INC. CONTRACTOR LICENSE #: 59249 PM 1544134th AVENUE NE COMPANY PHONE #: 763-205-0821 HAM LAKE, MN 55304 CONTACT PERSON / PHONE #: BACKFLOW PREVENTOR (RPZ) TEST REPORT JOB ADDRESS: OWNER / OCCUP CONTACT PERSON: 1544134t" Ave. NE, Ham Lake, MN 55304 PH: 651-489-8821 FAX: 651-489-6763 CONTACT PHONE: DEVICE LOCATION: FLOOR #: ROOM #: kt '- SERVES WHAT SYSTEM: MAKE: MODEL: SIZE: SERIAL #: WIG INSTALL DATE (MM/DD/YYYY): OVERHAUL DATE(MM/DD/YYYY): TEST DATE (MM/DD/YYYY): #1 CHECK VALVE RELIEF #2 CHECK VALVE PSI / DIFF PSI / DIFF TEST BEFORE REPAIRS FINAL TEST DESCRIBE REPAIR IF ANY: TESTC6MPLETED BY: (PLEASE PRINT FIRST&LAST NAME) CERTIFICATION NUMBER: COOL AIR MECHANICAL, INC. CONTRACTOR LICENSE #: 59249 PM 1544134th AVENUE NE COMPANY PHONE #: 763-205-0821 HAM LAKE, MN 55304 CONTACT PERSON / PHONE #: BACKFLOW PREVENTOR (RPZ) TEST REPORT JOB ADDRESS: 41 MECIMNICAL„ /NC: 1544134th Ave. NE, Ham Lake, MN 55304 PH: 651-489-8821 FAX: 651-489-6763 OWNER / OCCUPANT / CONTACT PERSO& CONTACT PHONE: DEVICE LOCATION: FLOOR #: ROOM #: SEW -ES \WHAf SYSTEM: c 5 fit, MAKE: MODEL: SIZE: / SERIAL #: %% INSTALL'DATE (MM/DD/YYYY): OVERHAUL DATE(MM/DD/YYYY): TEST DATE (MM/DD/YYYY): TEST BEFORE REPAIRS FINAL TEST DESCRIBE REPAIR IF ANY: #1 CHECK VALVE RELIEF #2 CHECK VALVE PSI / DIFF PSI / DIFF /t' 5t9�7J'{r TEST COMPLETED BY: (PLEASE PRINT FIRST & LAST NAME) CERTIFICATION NUMBER: L.�� --` COOL AIR MECHANICAL, INC. CONTRACTOR LICENSE#: 59249 PM 1544134 th AVENUE NE COMPANY PHONE #: 763-205-0821 HAM LAKE, MN 55304 CONTACT PERSON / PHONE #: BACKFLOW PREVENTOR (RPZ) TEST REPORT JOB ADDRESS: OWNER / OCCUPANT / CONTACT PER ON: 1544 134" Ave. NE, Ham Lake, MN 55304 PH: 651-489-8821 FAX: 651-489-6763 CONTACT PHONE: DEVICE LOCATION: FLOOR #: ROOM #: SERVES WHAT SYSTEM: MAKE: MODEL: SIZE: p SERIAL #: INSTALL DATE (MM/DD/YYYY): OVERHAUL DATE(MM/DD/YYYY): TEST DATE (MM/DD/YYYY): #1 CHECK VALVE RELIEF PSI / DIFF PSI / DIFF #2 CHECK VALVE TESL BEFORE REPAIRS FINAL TEST DESCRIBE REPAIR IF ANY: TEST COMPLETED BY: (PLEASE PRINT FIRST & LAST NAME) CERTIFICATION NUMBER: COOL AIR MECHANICAL, INC. CONTRACTOR LICENSE #: 59249 PM 1544134`h AVENUE NE COMPANY PHONE #: 763-205-0821 HAM LAKE, MN 55304 CONTACT PERSON / PHONE #: e Vkm"FLOWPRE �N� -K =vim KFLOWREVENMR P)TEST !R REPORT d,. i a 0 f� s aEPo ; oa •�•,• �••�FC6(3w lRazl resTRErtroai �'�`—y�� WtEwx o... n../.lwm•'m ' m � (RPZ)riS eero`V�`iiOR�--i-+@0mzul t MMROWMWENT (NYZ)MTRFV T xavuw�wtcwa� �xivtcwi/o�xE �.