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D101
For Office Use S � : � # �, � Permit#: % 76...E ,, "y "`r E AGA N Ll// 7 0 ‘4,.. ..,0 Fee: ``M Staff: 3830 PILOT KNOB ROADEAGAN, MN 55122-1810 I � Payment Recvd: Yes No (651)675-5675 TDD: (651)454-8535 I FAX: (651)675-569 I (.; I Email: buildinginspectionsacityofeaaan.com '' I Plan Submittal: eplans(cacitvofeagan.com !; L Plans: Electronic Paper t i , BY: 2019 COMMERCIAL MECHANIC RMIT 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: q7\-- 0/// Site Address: ..5.--- .3 l (._-102 s' s'}c _ C-c.rfilZ;i--- Tenant: Suite#: ;0/d / Name: Phone: i Address/City/Zip: I' y Name: t`Q Gkl ii c te%.$ h4 License#: Address: 3 'S'2 "°i7 f S S' Cit d``/©1` 4 CP Y 4-c-(2- " ` /State: /' h Zi ,5-5-3 7 a Phone: ��—5' `3 ` LL N $6�'CP Contact: j A,Q r� Email: ��i N /!ePia 7C-(HQ ® /')7a:/ E ear Y .) New Replacement Additional Alteration Demolition Type 4f ll" Description of work: ,.:. „.x �„':. _ .�. ry ,., <. ;' ;s>,,,. ,z'Y,�, 3,r,�n)"s „E" '�'s :«.�,� vY . �a.�^w-':y: ,�.. ,.^ ,�.,.. . OTE;R • __ d fi £fin hanical nt Is it 4 Wined b ,City . . -.:# s,. ate.... ,. . ailrlcal I frfo +' P ` Tt�@ts. a COMMERCIAL 0;n; 5 11 Ai 1-, x New Construction Interior Improvement — r!Jeo-yt 49; )1 f©/1 •e y-•-- Permit Typr Install Piping Processed Gas Exterior HVAC Unit — . Under/Above ground Tank ( Install/_Remove) COMMERCIAL FEES 11 $60.00 Permit Fee Minimum , d' Contract Value$Dj x.015 $75.00 Underground tank removal, includes State Surcharge =$ C(/6 . 0 0 Permit Fee =$ I U Surcharge Surcharge=Contract Value x$0.0005 If the project valuation is over$1 million, please call for Surcharge =$ 6 (. ---70 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.citvofeasaan.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 - •-rmit;that the work will be in accordance with the approved plan in the case of work which requires a review and approval of plans. ",/ Ig6.,,,,),Dx � �.�� ) Pro x ,,/ Applicant's Printed/Name Ap licant's Signatu FOR OFFI. E S �� r .«C 0 Y 4P o > r Required , - Vo-4 Y k fReview -Oat,: Underground1 h'n Z, 'Ar "Gas Ser�'T st; in-floor'Heat Fitnai HVAC Screening