EA180801 - Mechanical - Furnace - Issued Date 12/28/2022 PERMIT
City of Eagan a , o , Permit Type: Mechanical
3830 Pilot Knob Rd ,��;; m Permit Number: EA180801
Eagan,MN 55122 EAGAN
(651)675-5675
111111111111
www.cityofeagan.com * E R 1 8 5 8 m 1
Date Issued: 12/28/2022
Site Address: 1421 Kings Wood Rd
Lot: 5 Block: 2 Addition: Kings Wood 2nd
PID: 10-42001-02-050
Use: * 10 - 4200 1 - 0z - 0S0
Description:
Sub Type: Furnace
Work Type: Replace
Description:
Comments:
Fee Summary: ME-Permit Fee(Replacements) $59.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
Total: $60.00
Contractor: - Applicant - Owner:
Boehms Inc Jessica Kessler
1598 Selby Ave 1421 Kings Wood Rd
St Paul MN 55104 Eagan MN 55122
(651)644-1410
This permit shall be null and void if work does not start within 180 days of issuance,or if work is suspended for 180 days or more after
started.
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Applicant/Permitee: Signatures� . Sig nat
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w r I For Office Use I
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Permit#: [\ v I I
EAGAN I I
I Permit Fee:
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� Date Received: j
3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 I I
(651)675-5675 1 FAX: (651)675-5694 Staff:
Email: build ineinsoectionsancityofeaoan.com -----------------
RESIDENTIAL MECHANICAL PERMIT APPLICATION
Dater Site Address: 11 N�� ° �U Unit#: 1
Applicant is: ❑ Owner Contractor
Name: J�-'_S'� l��i ;Az i� `
Homeowner Address: �;�e V�cc� `� City: c,
V $s I : XA,- ,��� Email:
State: �i Zip: Phone:
Type Of Work —New XReplacement _Repair _Alteration _Remove
Description of work: �w�- Urnc�t� w,T� �w ��« �� S�(S�ri.� Q
Furnace _Heat Pump
Description Air Conditioner Other
Air Exchanger c
Company:�;;e�.ti 2 a�2A.,, cc Contact:
Mechanical Address:_1 SCf% 7 eA\� $ z City: .�>} , LJ
Contractor
State:4�_Zip: C) Phone: F i-���'«I o Email:
License#: Expiration Date:
RESIDENTIAL FEES
$100.00 New Residential(includes State Surcharge)
$60.00 Furnace,Air Conditioner,or Furnace and Air Conditioner(includes State Surcharge)
$60.00 Add or alteration to an existing unit(includes State Surcharge)
TOTAL FEES $ )
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.cityofeagan.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.
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Applicants Printel Name Appli a ' .S ture
FOR OFFICE USE
Required Inspections: . Reviewed By: Date:
Underground Rough in Air Test Gas Service Test In-floor Heat Final