3920 Beau D Rue Dr
This request void 18 months from ~~-ICJ L a'1 G
'Date of to Request 6 3 5 7 0
I•, as LEI Licensed Electrical Contractor ❑ Owner, do hereby request inspection of the above electri-
cal 'wiring installed at:
Stieet Address or Route No. C/ Zo k City
Section Township / Range County pif ke_
Which is occupied by y~/-a 12cAX L1-r:;t
(Name of Occupant)
Is a roughin inspection required /on this job? No ❑ Yes [a---~ Ready Now ❑ Will Call lid
Power Supplier 4614-K Address t!/k'ti 4N
Electrical Contractor X - 11 t t `E Li ' 110
N ~f
Contractor's cense o.
(C mpany Name)
Mailing Address fv f
(Ele trio Contra< r r Owner Making This Installation)
Authorized Signature . Phone No. /~SZ'~~(p f
( ec ical Contractor or Owner Making This Installation)
SI gl BO C This inspection request
proper inspection pnot be e accepted the
U~ State Board unless ss o er inss acti tion fee is enclosed.
R mmnesota state tsoaro or tiectnclty _
1954 University Ave., St. Paul, Minn. 55104-Phone 645-7703 M1 ,Y f
-REQUEST Fr ELECTRICAL INSPECTION 570 ✓
CtiFGKBELOW WO&RED BY THIS REQUEST
Type of Building New Add--Rep. Check Appliances Wired For Check Equipment Wired Fm
Home ❑ ❑ ❑ Range ❑ Temporary Wiring ❑
Duplex ❑ ❑ ❑ Water Heater ❑ Lighting Fixtures ❑
Apt. lyldg. ❑ ❑ ❑ Dryer ❑ Electric Heating ❑
CoMmercial Bldg. ❑ 13~❑ Furnace ❑ Silo Unloader ❑
Industrial Bldg. ❑ ❑ ❑ Air Conditioner ❑ Bulk Milk Tank ❑
Farm El 11 El p List Ire
~ rs
Other -O ❑ ❑ Rereers List
COMPUTE INSPECTION FEE BELOW
Service Entrance Size: # Fee Feeders&Subfeeders: # Fee Circuits: # Fee
J t( 0.O
0 to 100 Ato s. 0 to 30 Amperes 0 to 30 Amperes
101 to 200 Amps. 31 to 100 Amperes 31 to 100 Amperes
Above 200 Amps. _AbQye 100 Amps. Above 100 Amps.
Ttansformers a eControl Circ. Partialorotherfee O
Signs ".1 i c Inspection Minimum fee 15.00
Remarks TOTAL FEE
1, the Electrical Inspector, hereby certify ti~ t e ab i on has been mad . -J
(Rough-in) ( to
(Final) ✓s>~a~.~-8- m`r
This request void 18 months from
For Office Use , --7C
a ® # r Perm7 it#: �/ 1 E AGA N
C"
Permit Fee:
Staff:
L J
`
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 Payment Recvd: X1 Yes No
(651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694
Email: buildinginspections(ni,cityofeagan.comr Plans: Electronic Paper
Plan Submittal: eplanscu�citVofeagan.com ( 42Qc— � CC�r OKt L
2018 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
Date: 8/16/18 Site Address: 3902-3938 Cedar Grove Pky
Tenant: Cedarvale Shopoping Center Suite#:
Property
ner
', Name: JBL Phone:
Name: Gilbert Mechanical License#:
r Y���i � Address: 5251 West 74th St Edina mnZip: 55439
City: State:
Phone: 952-835-3810 Email: rhammond@gilbertmech.com
1tltliIIIPgIa
New _Replacement Repair _Rebuild Modify Space _Work in R.O.W.
Typ. :fictql
Description of work: Backflow prevention per Hydrocorp
'0G'r 'II�Iuq���P� COMMERCIAL New Construction ✓ Modify Space
Irrigation System( yes/ I no)( RPZ/ PVB)
9�s@,:,1,0111111100 Rain sensors required on irrigation systems
Permittype • Avg.GPM (2"turbo required unless smaller size allowed by Public Works)
0���I tllo�m pr '' "„u��mm��l Meters Call(651)675-5646 to verity that tests passed prior to picking up meter.
Domestic:Size&Type Fire: 1
tl Avg.GPM High demand devices? Yes_No Flushometers_Yes_No
COMMERCIAL FEES Contract Value$7500 x.01
$60.00 Permit Fee Minimum
$60.00 PVB/RPZ Permit(includes State Surcharge) -$ 75 Permit Fee
=$ 3.75 Surcharge
Surcharge=Contract Value x$0.0005
If the project valuation is over$1 million,please call for Surcharge =$ 78.75 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
=$ 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.cltyofeaoan.comisu bscribe.
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 Rick Hammond
Applicant's Printed Name Applicant's Signature
FI Ii =' ii'!"19YD@l'hi i ` a ''''1000040000
.(IgolM . A P _
red Inspect _- (1 f K(yrr ll�I�E III '__ a x�, es".;.TM' #1
r.no3 -' "f__�, itlgllPiiliria, lldlk�
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