1014 Kensington Tr #101 m For Office Use C
Permit#:
Permit Fee: 60-do `-
3830 PLOT KNOB ROAD I EAGAN,MN 55122-1810 -- Date Received:?'/T - U
(651)675-5675(TDD:(651)454-8535 I FAX:(651)675-5694
Email. ; ilriin Ins echor-45),sayofeagan cora
AUG 14 Z018 �Staff:
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Commercial Plan Submittal:ensC�z)c.% ��tea .uiar
2018 RESIDENTIAL MECHANICAL PERMIT APPLICATION
Date: . .> Site Address: I D) t "t ir,
Tenant: Suite#:
Name: ..fid' Phone:
Resident/Owner #
Address I City I Zipt
( y1 t a n vi'-'tot
: Name: '"` �''4 Air License#. ME PI
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Contractor Address: saE l aye . City: t
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State: Zip: 55439 Phone: `7 6-»m ro 7777 1
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Contact: t �} t� � Email: e.cam,,
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RESIDENTIAL,
Furnace
X Air Conditioner
Permit Type
_Air Exchanger t
Heat Pump
g
Other
New i Replacement Additional Alteration Demolition
Type of Work
Description of work: ' . «
RESIDENTIAL FEES
$60.00 Minimum Add or alteration to an existing unit,includes State Surcharge t
$100.00 Residential New,includes State Surcharge =$ 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.citvofeauan.cornisubscribe.
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 Wade
Applicant's Printed Name 3 Applicant's Signature ..
FOR OFFICE USE
Required Inspections: Reviewed By:- Date:
Underground _Rough In _Air Test Gas Service Test In-floor Heat Final