EA185127 - Mechanical - Furnace & Air Conditioner - Issued Date 07/07/2023 PERMIT
City of Eagan ® ® m a Permit"':
Mechanical
3830 Pilot Knob Rd ®®®®® ®®®®® Permit Number: EA185127
Eagan, MN 55122 ®®®® ®®®® EAGAN
(651)675-5675 111111111111 IN 1111111111111111111111111
www.cityofeagan.com * E R 1 8 5 1 2 7
Date Issued: 7/7/2023
Site Address: 3637 Blue Jay Ct
Lot: 9 Block: 1 Addition: Lexington Place South 3rd
PID:10-45062-01-090 11111 im
Use: * 1 0 — 4 5 0 6 2 — 0 1 — 0 9 0
Description:
Sub Type: Furnace&Air Conditioner
Work Type: Replace
Description:
Comments:
Fee Summary: ME-Mechanical Residential Alteration $64.00 0801.4088
Surcharge-Fixed $1.00 9001.2195
Total: $65.00
Contractor: - Applicant - Owner:
Groff's Heating&Air Conditioning Josefa Gaona-Pacheco
18636 Delaney Dr 3637 Blue Jay Ct
Farmington MN 55024 Eagan MN 55123-225
(651)423-3802
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: Signature ssued B . Signature
rFor office use---------
I Permit# 1
EAGAN
Permit Fee: n
^+ Date Received: L� 1
3830 PILOT KNOB ROAD 1 EAGAN, MN 55122-1810 I
(651)675-5675 1 FAX:(651)675-5694 �— --------------Staffj
Email:buildinginsaectionst&citvofeagan.com
RESIDENTIAL MECHANICAL PERMIT APPLICATION
Date: 7/1113 Site Address: '31037 R)Le- L4 Unit#:
Applicant is: ❑ Owner b Contractor
Name: ,7- S A Aa 011A
Homeowner Address: 3 7 61 LA t4_ Ci to �-
ty:
State: Zip: S 2_ Phone: (AS 1 *3 314 3 SI
Email:
Type of Work _New !l.Replacement _Repair _Alteration _Remove
Description of work:
__/ Furnace _Heat Pump
Description >0 Air Conditioner Other
Air Exchanger(fes /►
Company:�t�g-: (rL
' ��� Contact: 41,16►
Mechanical Address: /%&�t a b tti/±2n!!5 ril'- City: �"^ -
Contractor State:OIL Zip: ESOZ,� Phone:U S1 L(13,3< ail:
�
License#: Expiration Date:
RESIDENTIAL FEES
$150.00 New Residential(includes State Surcharge)
$65.00 Residential alteration,furnace,air conditioner,ductwork,or any combination(includes State Surcharge)
$100.00 Residential fireplace(s)(includes State Surcharge)
TOTAL FEES$
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 websfte at
www.citvofeaaan.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 th7/71 oved plan in the case of work which requires a review and approval of plans.
A
x x
Applicant's Printed Name Applicant's Signature
FOR OFFICE USE
Required Inspections: Reviewed By: Date:
Underground Rough In Air Test Gas Service Test In-floor Heat Finat