Unit 307 • • • : , , For Office use
%..� .,„ , EAGAN Pe #:
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~`` Permit Fee: led ' V
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810Date Received: (P- o?‘'"7
(651)675-5675 TDD: (651)454-8535 FAX:(651)675-5694 _
Email:buildinginspections[acityofeagan.comCEr��
Commercial Plan Submittal:p!Lans( cityofeagan.com LStaff: _
--
JUN 2 6 [u19 J
2019 RESIDENTIAL MECHANICAL PERMIT APPLICATION -�� (
Date: ' -'
�6-I c! Site Address: )10 --/r�ra.w G.a Ac;,,,,e f %•1'f 3
Tenant: /1'1411-`o;,v,d'e )i ',,'s,'-, Lam,,,
ySuite#: �
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Name: N tlfr�.�G-. / ter r' rte �a:_-
ReSidentiOWnet 1 r Phone: ? _ / 7 b
Address City l zip: /. toc) S ,--.7 'ie &ee/ 1)klii Y 12,--cct ,. c6-71-"---, /71.'4/V .;,5�
,�/ r -7/5.' License#: / /�c�f
Contractor, Address: PPI' r30k: e2-L( City: /f,,'/cci.to
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State: ,�? / Zip: ->”7r 2C .1- Phone: ') /- /'' C
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Contact: ° f Email: ,/tet o.F 4.
,.....;:-.44A—. 1 .., c' ",»r, t r. ,
RESIDENTIAL
_Furnace
Air Conditioner
Permit Type 4
_Air Exchanger
Heat Pump
Other
New (C Replacement Additional Alteration Demolition
Type.of W®rk
Description of work: RP 77104-' i/i ( Lf,1 /
RESIDENTIAL FEES
$60.00 Minimum Add or alteration to an existing unit,includes State Surcharge
_
$100.00 Residential New,includes State Surcharge =$ TOTAL FEE
You may subscribe to receive an electronic notification from the Ci3 -/5ty of proposed ordinances by signing up for an email update
on the City's website at www.cityofeagan.comtsubscribe.
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 nota 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.
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Applicant's Printed Name Applicant's Signature
FOR OFFICE USE
Required Inspections: ReviewedyiBy:
Date:
Underground _ { Rough ttt Air;Test .- . Gas service Test In-floor Heat • Final