4140 Durham Ct
City of Eapn 1 Permit#: d
3830 Pilot Knob Road Permit 17,41' 6b-60
Eagan MN 55122 C 4 ~i
Phone: (651) 675-5675 I Date Received:
Fax: (651) 675-5694 I Cr I
Staff:
2009 MECHANICAL PERMIT APPLICATION
Date: .3 e23-o Site Address: e 1/ .4 1 4
Tenant:
Suite
RESIDENT / OWNER Name: JC ~,q. ~JSdN Phone: 6 6"/- 6'o -7o7/
Address /City /zip:
/goC 4-/J / "1 SS~~~Z
CONTRACTOR Name: ,ynloye r-70 can ic1/ fin/ License
Address: /go
U 2iY//LLiv~ 57'
City: 7 "V
State:,/N Zip: 33
Phone: 1f 3`7- L/i 77 Contact Person:
TYPE OF WORK New _X Replacement Additional Alteration Demolition
Description of work: DE OL,q-c
NOTE:' Eoth'rt)" f mound an F ~i ni A
be screened'by pity Code eas contact,tt a IGl'e ?
at
P! q;,.ers for Information on permitted
scr it hos..
PERMIT TYPE RESIDENTIAL COMMERCIAL
Furnace New Construction Interior Improvement
Air Conditioner Install Piping Processed
-Air Exchanger Gas Exterior HVAC Unit
-Heat Pump Under / Above ground Tank Install Remove)
When installing/removing tank(s), call for inspection b Fire
Other by
Marshal and Plumbing Inspector
RESIDENTIAL FEES:
$50.50 Minimum Add-on or alteration to an existing unit (includes $.50 State Surcharge)
$90.50 Fire repair (replace burned out appliances, ductwork, etc.) (includes $.50 State Surcharge)
$ .S0 TOTAL FEE
COMMERCIAL FEES:
$70.50 Underground tank installation/removal OR Contract Value $ x 1%
$50.50 Minimum (includes State Surcharge)
- $ Permit Fee
- If P m f is less than $1,000, surcharge is $.50.
If E gang En is > $1,000, surcharge increases by $.50 for each = $ State Surcharge
$1,000 Permit Fee (i.e. a $1,001-$2,000 Permit Fee requires a $1.00 surcharge).
$ TOTAL FEE
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances and 4odes 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 plan
x~IJDf~L x
Applicant's Printed Name Applicant's Signature
FOR OFFICE 1. C•r
Reviewed By s Date
Required inspectlbhs: Under Ground Rough in Air Test
;Gs Servace Test In Etobr Heat" f tiraJ
Exterior HVAC Sor Qenln -Inspection
06/17/2014 15:07 Les Jones Roofing,Inc. �AX�528817009 P.016/020
Use BLUE or BLACK Ink
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. ' j Pertnit#: ���� j
C�ty of�a�a� � Permlt Fee: ,� �
3830 Ptlot Knob Road I �
Eagan MN 55122 � Dale Racelved: �
Phone:(651)875-5675 I 1
FBx:(661)676-6694 . � S�� �
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2014 RESIDENTIAL BUILDING P�RIWIT APPLICA710N
4i�a-��r� �ii�- yi�' /� �
Date: �7 � Slte Address:U/3b��/�S-!�/Yo-�1i�y� ���n�l (.�,a� _Unit#:
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�',' ';, ' ,, 4'',�, '� Name: �lo P2op�+2ry �-a-r�E� 6nlc.. Phone: �a$�- ssy ��yq
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',',;. ;S�i.^Q�tiyv�e� :.'� Addre96/Clty/Zlp: �D• Pp 1C 2l"Z 5 �NV�.?7-��✓�_ o}�'ls /�
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,5y�;;,�'�::.�`�'�*�.:,`;�', �'','�"r�- Applicant Is: Owner X Contractor
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; �",� ?��" ' `:�" Construction Cost: � y?7. Multi-Family Building:(Yes x /No�
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-•;;.?:,;+.:;;�.;��:�.,r�;�:,�::°=ti;,.:.�. Addrees: 9Y� �N, 8l)� .�`Ti�� City: ���N�.✓
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;:� 'f::,,,: ,,ry_:; � -- State: A ln/ Zlp: .�,�'�2D Phone: 9'S.1- 7G 7-�817
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;��- � �� Llcense#: lor��o D Lead Cerflficate#: .lJ,4T' `f p 3 7.�-/
'F:�S..c':
If the proJect Is exempt from lead certificatlon,please explaln why:(sea Page 3 for addltiona)informatian)
COMpLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 monthe,hae the Clty ot Eagen leeued a pennit for a slmllar plan based on a maste�plan?
Yes _No If yes,date and address of master plan:
Llcensed Plumber: Phone;
Mechenlcal Contractor: Phone:
Sewer 8 Water Contractor; Phone:
':"„!IY.�PI�; i�'!�/ �r11 h `� !•L�h bV » Q 4 �ui~ � L.� �*'�� �� � �''(�
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CALL.S�FOR�YOU DIG, Gell Oopher State One Call at(681)464•000�tor protectlon�galnst underground uUllty damage. Call a8 hou�s
before you Inlend lo dlg to recelve locafee of underground ulllltles. www.aoohare�ateonecell.ora
I hereby adcnowledge that thle IMonnellon le complels and eccurete;that the work wlll be In confortnance wllh the ordlnances end codea of the City of
Eegen;that 1 underetand lhls(e not a nermll,but only en eppllcatlon !o►a permlt, and work Is nat to atart wlthout a permlt;ihal the work w111 be in
eccordance with 1he approved plen In the ceee of work whlch roqulros a revlew and approval of plana_
Exterlor Work autho�lzed by e bulldtn8 pemtlt leeu9d In flcCOrdance wllh!ho Mlnnasots Steta Bullding Codo must be complaled wlthln 180
days of permlt 188uanca.
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AppltcanE's Printed Name Appllcant's Slgnature
Pape 1 of 3
02/19/2014 12:36 Les Jones Roofing,Inc. (FAK�528817009 P.0161020
Use BL.UE or BLACK Ir�k
� For Offlce U9Q^� �
I
. ' j Permlt#: ���� I
C�ty of �a�aIl , I Pertnil Fee: �l � �
3830 Pllot Knob Road
R�C�# J�D � �' �
Eagan MN 65122 j Dale Recelved: �
Phone:(6g1)676-G676 ��B � � �o�� I i
Fax:(651)675-5684 . � S�K� �
. I 1
�--------____.__�_�a
2014 RESId�NT1AL gUILDING PERMyAPPLICATION
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Date: � � Site Addreas: y/ /'1D �/ J Gat�- Unit!!:
�'F���< fn� �yJ��i�:"w;;Y_���,:;
�� ��r�n��?.���>,;�i^„`' Neme: yQ P20p�T`� GA�'Er 6NG. Phone. /va"'7� S.S�/ p��l�f
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`v�t ?���Q�%���j' ::'� `�� AddreSS/Clly/Zip: �O• 80� 212 5 /NVE)Z.C��ovd � �� 9�0
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°'' '���`�`�'�� '�,(�p '��° Appflcant 18: Owner x Contrector
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�6 ,� `,�;�;'� � �=,:- Description of work: � �/ �
����ip:���'f'VI�o:C�, ''
�.., �
��'���N�;,"` " � r"`��'' 'a ConetructlonCosr � 7�` � y Multi-Famii Bulldin Yes x !No
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;,.; �j c�' r� ��r y� Compeny: �E5 �ToNb3 RGOf��1/G- /•vG Contec�Csri¢�s ,�-,vDp2so�/
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4j '� �a ��`��,:T';�� �' Address: K/ W. �D� ��'� Clty: �a�tu.�.✓
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�.,�•� �� ��v' '`�;;; • � State:�2ip: ,�,Sr��O Phone: �5.�- 7(v ab'/9
„���t: , , i�r?�+;
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���Y"'';.� �,,;,�,.,�;�',,*. Ucense#: lp.��o� Lead Certlflcafe#: .U�T `fo 3' ?.�-/
)f the proJect Is exempt from lead ceKlfication, please explain why: (see Page 3 fo�additio�al i�formation)
COMPI,ETE THIS AREA ONLY IF CONSTRUCTING A NEW BUIL�INC
In the la9t 12 months,hea the Clty of Eagan Issued a permlt for a almllar plan based on a master plan?
� Yes _No If yes,date and eddress of inester plan:
Llcensed Plumber: Phone:
Mechanlcal Contrector: Phone:
Sewer&Water Contractor: Phone:
;��, aX� t� .,l � �o; �.�'h1- ►�{t;�+fh -"G;�. %�iL,S :+'� ��rr '" �} bs`� ibYf'"�r �I'" r� o}�y�t "s"fzt
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r � .�I i..,��"'�?;�„ a .i �d� �„A,,��`%¢� �'�. .I�fC; .s, � .a. � r„ '�'"h� ��qtii°�'�a 'Y,.�_'„' 4;�, "1�
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CALL 6� OR�YOU DIG. Cell C3ophar 9tata One Call at(651)4a4-0002 for prolectlon egetnat undarground uUllly damape. Cell 48 houre
beforo you Intend to dlg to rocelve iocates M unde�ground uUlllles. www.amohereteteoneceu.oro
I heroby ecknowledge that thls InPormallon le complete and eccurate;that lhe u+rork w111 be In conlormance wllh the orcllnences and codes of the Clty of
Eapan; lhat I unde�stand thls la not a permlt,but only an appllcadon tor e pe►mtt, and work le not to etart wllhout a permlt; thal the work wlll be In
eccordance wlth the approved plen In the caee M work whlch requlree a revtew end approval ot plane.
Exterlor work authorized by a bullding permlt Issued In accordance wlth the Mlnne6ota State Bultding Code must be completed wtthln 180
days of permlt Issuance.
x Gr�,et5 f��v0�2SO�/ x��k��� .G�s�<-�' -�.
Appllcant's Prtnted Name Appllcant's Stgnature
' Page 1 of 8