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Unit 104
For Office Use E � N Permit#: �.` Permit Fee: 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 Date Received: /l-01'4 r (651)675-5675 I TDD:(651)454-8535 I FAX:(651)675-5694 Email: buildinginsoections( citvofeagan.com Staff: Commercial Plan Submittal:eplansc citvofeaoan.com L — 2019 RESIDENTIAL MECHANICAL PERMIT APPLICATION Date: ! /4 a-( of Site Address: 2/03 S'I re)r ig tl a. Tenant: SP\�L Suite#: I 0 Zi Resident/Owner Name: L�il.Uro 1.r� kt t YU\ Phone: b 5 (- 21 y - c 4 t CD Address/City/Zip: 2.103 S''\\ f 041 ca-.• (o`f" i. Ea360 MN 551 Z2, Name: ct ko pee_ Pt&a+ijJt tiC License#: Mf Address: ! f'Ct- Contractor �Q 9O�i�7 City: 5/4,l © e -' State: MN Zip: 3-'537? Phone: cA�I's� o�2�' 45 Contact: /_4110. .i l 4 QsD✓I Email: G0974 RESIDENTIAL /Furnace /Air Conditioner Permit Tvpe Air Exchanger Heat Pump tv 1 /� / ther�'D lJ tigmNeUriI`�' -1 ta6e ± 0!C eiri l one. W1 New /Replacement Additional Alteration Demolition Type of Work Ij 1'?11 gem, IAn/f' Description of work: 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 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. X 4/4Ce. inkecco'1 X I. Applicant's Printed Name Applicant's Sig 'ure FOR OFFICE USE Required Inspections: Reviewed By: Date: Underground Rough In Air Test Gas Service Test In-floor Heat Final