3343 Coachman RdCONIMERCIAL
''4? „ .
BDING PERMIT APPLICATION
CITY OF EAGAN
651-681-4675
Foundation Onl New Construction Interior Im rovement
• Swctural Plans (2) sets • Architectural Plans (2) sets • Architectural Plans (2) seb
• Civil Plans (2) . StrucWrel Plans (2) • Code Analysis (1) •'
• Certificate ot Survey (1) . Civil Plans (2) • Project Specs (1)
• Code Anaiysis (1) •' . Landswping Plans (2) • Key Plan (1)
. Project Specs (1) • Code Analysis (1) " • Master Exit Plan (1)
• Spec. Insp. & Tesfing Schedule " • Certificate of Survey (t) • Energy Calculations (1) not always"
• Soils Report (t) . Spec. Insp. & Testlng Schedule (1) • Elec. Power 8 Lighfing Porm (1) not ahvays••
• Meter size must be esWblished • Meter size must be established • Meter size musl be established - if applicable
• ProjectSpecs (1)
1 • Energy Calculations (1) " d
! • Electric Power & Lightlng Form (1)
1 • Master Exit Plan (1) 1
1 . Fire Protection Plan (1)" 1
1 • Soils Report (1) 1
• MGES SAC determination letter . MGES SAC determination letter • MGE5 SAC detarmination letter
call 651-602-1000 call 651-602-1000 cail 651-602-1000
Contact Building Inspections for sample
Food & beverage or lodging facilities: Plan must be submitted to Minnesota Department of Health - call 651-215-0700 for details.
DATE 4G ??O iy WORK TYPE _ NEW JC REMODEL CONSTRUCTION COST // 70 0 i GG
SITE ADDRESS
TENANT NAME
FORMER TENANT NAME
SUITE #
DESCRIPTION OF WORK -t/Cv
,//
Name: ? Jr?l 1%5 ??! Phone#:
PROPERTY Last First
OWNER ?
SueetAddress es-J
City (? ? State Zip 7??N'/
comPany
CONTRACTOR
SheetAddress: cnn:-
City State A---? Zip ? 3 Q .?'
ARCHITECT/
ENGINEER Company Phone #
Name
Sheet Address
City
State
Licensed plumber Instaliina new sewer/water service: Phone #:
I hereby acknowledge that I have read this application, state that the information
Minnesota Statutes and City of Eagan Ordinances.
Zip
correct, and agree to comply with all applicable State of
?
Signature of Applicant
?^ rUpdated 1/01
Registration #
May 02 06 01:18p PORT R WELDInG InC. 763-428-7654
? 31 ?14 2oo6 COMMERCIAL BUILDING rERmrr nrrLicnTIox
City Of Eagan
3830 Pilot ICnob Road, Eagan Mn 55122
Telephone # 651-675-5675 FAX # 651-6755694
. SGUCtural Plaf7s (2) aete
. Civll Plans (2)
. CertificateofSurvey (7)
. CodeAnalysis (1)
. Projed Specs (1)
. Spec. Insp. & Tesdng Schedule "
. SoflsReport (1)
• Meter Slze must be eetebOShed
. SACdetermination-pllR7-602-1000
. Architectural Plarre (2) sets
. Stnrotural Pians (2)
. Civil Plans (2)
. Landscaping Plana (2)
. Code Analysls (1) °
. CeAlficate of Survey (1)
. Spec. ImQ. & Testing SchedWe (1) "
• Mete! Slze must be estebllahed
. Projed5pecs (t)
. Energy Calalations (1) "
. Electric Power & Lightlnp Form (1) "
. Master ExN Plan (1)
• EmerAency Reaponse Site Plan (1)
. SoilsReport (1)
. SAC determinatlon - ca0 651-602-7000
• Fire Stopping Suhmilfals
p.4
or-0
. Arcnneuurai ndm
. CodeAnalysls (1) ••
. Projed Specs (1)
. Key Plan
(?)
. Master Ecit Plan (7)
. Energy Cakulalkons (1) iwt eAvays"
. Elec. Power 8 Light'mg Fortn (1) rwt aM2ys"
• Meter siae must be eateblisM1ed-If applicable
)
?
1
1
1
. SAC delerinination = ea116511'i02-7000
Call MN Dept of Health at 651-21 SD700 for details regarding foad & beverage or ioa6mg tacmncs. ,
?• Contact Huilding inspcctions for sample and if requircd MAY z
?•• Pemut for new 6uil(ling or addition witl not be prceessrd without Emagency Response Sito Plan.
Date / 00 G?L p,id 2 ConstnictionCost? Z?ooU nr,
SiteAddress 3 5 'f Co L?rrn.ri ?r,_2-nr hn ? CCJ.? 1 UnitlSie #
-"
Tenant Name f
Former Tenwt Name
i 4LLAvrl rix?k
tion of Work ?
Descri i13o e)nr ?4o me-of cmd.
On W2ek v±n
p
P Vy
R.
LI hf Telephone #({IS 1 ) 777- 4 c' < i(
t
r{'F p
t
d kt
Property Owner f
e
e
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11
Applicautis: Owner X Coatractor comacm cb3 ) 4as3
Tn
Coetractor 71 O r} 1? W &A'+c. C
?
neauees 4-7 00 D-ezrLtronil ta- crtY -YYlinnZ4i. _
State IY1 0.l Z+p 6 534-3 Telephone#(743) Ca$-"1 S3
m
ArchlEngr Regjatratiou #
Address City
State Zip Telep6one#( )
Licerued dumber installing 9=sewerlwater service: Phone#:
I herebv aoulv for a Commexcial Building Pernrit and acknowledge tha[ the infortnation is oomplete and accurate; tlmt the woiic will be in
cortformance wtith the ordinances and cades of the City of Eagan aad the 5tate or 1vuN Z!itam[es; i unaeisrana uus m wc a W,.Rus Vu. V y o..
application for a pemeit, and wock is not to sfatt without a pemut, that the wodc will be m acco:danre with the appmved plan in the case of
work which requires a teview and approval of plans.
tYe?tti,?-
G I Y?D CJaL?? Yl . 1l _ PYLS. / ?'rd? \' Ce
Appli ant's Printed Name,p _we?d Zn?, lican Signa _1t} _Wp,??if, ?}?,
Q
DO NOT WRITE BEI.OW THIS LINE ?J '? I c? ?
Sub Types
p 01 Foundation
? 26 Public Facility
? 30 Accessory Building
? 14 Apazhnents 0 27 CommerciaUlndustrial ;,0' 32 Ext Alt Apartments
El 15 Lodging 0 28 Greenhouse ? 34 Ext Alt-Commercial
G` 25 Miscellaneous n 29 Antennae 0 35 Ext Alt-Public Facility
? 37 Nail Salon
Work Types
O 31 New ?
35 Int Improvement O 38
Demolish (Interior) ? 44 Siding
O 32 Addition ? 36 Move Bldg. ? 42 Demolish (Foundation) ? 45 Fire Repair
O 33 Alteration ? 37 Demolish (Bldg)• ? 43 Reroof ? 48 Windows/Doors
V 34 Replacement "Demolition (Entire Bldg only) - Give PCA handout to applieaM
Valuatlon 000 Type of Const ViAdth
Plan Rev 100%- 25% ? Occupancy
07 MCES System
t
Cit
W
SAC UnRS Zoning a
er
y
N6r. of Unils Stories - Booster Pump ?
Nbr. of Bldgs Sq. Ft. ? - PRV
Length ? Fire Sprinklered ?
Required Inspections
_ Fooflngs (new bldg)
_ FooGngs(deck)
_ Footings (addition)
Foundation
Drain Tile
_ Driveway Apron
? Roof _ Ice Pr _ Decking _ Insul _ Final
.% Framing
Siding _ Stucco Lath _ Stone Lath _ Final
Windows
Final C/O Inspection: Schedule Fire Marshal to be present. _ Yes _'---No
Approved By: Planning rhl- Building Inspector
Base Fee
Surcharge
Plan Review
SAGMCES
SAGGty
SAN Pertnit
SNY Surcharge
Treatment Plant
Treatment Plant (irrigation)
Park DedicaGon
Trail Dedication
Water Quality
Water Supply 8 Stwage (WAC)
^ Fireplace _ R.I. _ Air Test _ Fina]
Insulation
Sheeunck
FinaUC.O.
? FinaUNo C.O.
Other
Pool Ftgs _ Air/Gas Tests Final
Financfal Guarantee
Sfortn Sewer Trunk
Sewer Lateral
Street
Water Lateral
Othar
Total
8awer Trunk
Water Trunk
?&-007
2U06 COMMERCIAL PLUMBING PERMIT APPLICATLON
CTfY OF EAGAN
3830 PILOT K1YOB ROAD, EAGAN MN 55122
651-675-5675
'5D,S-b
Datc-fl._1ac) / b(O
Site Addnss ' Q G Unit #
Tenant Name ? Former Tenant Name
Properh Owoer 'I/)x 1 ?
< 1Q CJb(fS Telephone#(?JI
Contractor lc/L
Address p City
State Zip °JSH 13 TelephooeN((o5? (fi
License # Eapires: -n Q(J
The Applicant is _ Owner Coniractor _ C)thet
Work'Iype NewBldg _ ModifySpace _IrrigatianSystem"• Yes No Wotkinpu6licr-o-w/easement?
I RPZ _ PVB : ?_ New _ RepairlRebuild _ Replace _ Remave
T Rain scnsors are reuired on ir ' ation s stems
Description of Work n{iw U2-1-ke'f'
To'ntquiw d' Pcessure Redacmg Vah-e is roquireJ on ncw service, call 651b75-5646
Me[crs - Cat1651-6755300 to verify tiwt hydrostatiq wndmtivity, and bacteria usts pnssed ?rior to nicitina uo meter.
Imgntion Size; & Type Avg GPM 2" hvbo req'd unless smallec size allowed by Public VNoiks
Fire Size Br.Rice 3/4" metcr I67.00
Domestic Size 8c Type Avg GPM includes high demaud devices? _ Yes _ No
Flushometers _ Yes _ Nu PRV Required _ Yes _ No
Permit Fee $50.50 murinnmi [mdudes Sate Surcharge)
ContracfValue $ 1% _ $ PermitFee
$ Meter(s)
RequiicJ un all new buildings & buulevan l imp.ation nvslems $ Radio Mete7 Aeatl
$ 3tafe Sueciiage
ltpennit fee is kss lhau SI.000, wrcharge is $.50
If prnoit fee is mure fhan $1,000, surcharge it $50 Tor each SI,990 owal.
Fdlowing fees aPPlY whm inshifing nrew lawn irrigadon syshm ? r--, J- a[er Permit
Call We CitJs Nnginea'vng Departmen4 651 fi75-5646, fur required fx amounta
n i n?,?2 4PON_ reatment Plant
$ Wa[er Supply & Stornge
$ State Surcharge
$ TotalFee
7 haeby apply FM a Commescial Plumbing I'amit and admuwledge tlut IMe infpmatmm is complete and accurate; [ha[ the wwk will be m contwman?w ?W tbe
md' a•s aod cadcs of the City of Esgan ard with d?e Plumbmg Cadea; tl?at I wdentand tl? is a p?aniiS but only m 1' Sor a pami[, w L not b
s ithout a pxmi[; fhat ?he wq(Ic will6e in nlanee with tlw approved plan ?n the caae nEm hich requires a rev al of plnns.
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Appicant PrintedNa[ne jphc 's ignmure
? I O` t O 1 2007 COMMERCIAL BUILDING PERNIlT APPLICATION 42
? City Of Eagan
3830 Pilot Knob Road, Eagan Mn 55122
Telephone#651-675-5675
Plans are considered public information unless you state they are trade secret and why.
• acrucmrai rians in secs i-
. Civil Plans (2)
• Certifcate of Survey (1)
• CodeAnalysis (i)
. ProjectSpecs (1)
. Spec Insp & Testing Schedule (1) ""
• Soils Report (1)
. Meter size must be established
1
1
1
1
1
1
• SAC determination - call 651-602-7000
at
• Certificate of Survey (1)
• Structural Plans (2)
• ArchRectural Plans (2) sets
r HVAC units req'd. on bldg elev. / sde plan
? Civil Plans (2)
Landscaping Plans (2)
• CodeAnalysis (i) °
• EnergyCalculaGons (7) "
• Emergency Response Sde Plan (9)
• Spec.lnsp.&Testing5chedule (1)"
• EI ctric Power & Liqhting Form
?
"
(1)
• Pr
jectSpecs (1)
• Master Exit Plan (1)
. SAC determination - call 651-602-1 000
• Fire Stopping Submittals
. Fve Suppression/Alarm Form
or
• Architectural Plans (2) sets
. CodeAnalysis (1) "
• ProjectSpecs (t)
. Key Plan (1)
• Master Exit Pian (1)
• EnergyCalculations (1)notalways"
• Elec. Power & Lighting Fortn (1) not always"'
• Meter size must be established-if applicable
. SAC determination • call 651-602•1000
Con[act Buifding Inspections to see if it is required and for a sample
*** Permit for new building or addition will not be processed wi[hout Emergency Response Site Plan.
Date __1_! _?3 L / V7 Construction Cost e)ov ' D o
Site Address UniUSte #
Tenan[ Name Former Ten ant Name
Description of Work &v>Uz°,
-Sll`a l/L4-°I? 4Z) ?Aa S PzD±
.
U
Property Owner r/" l12p- Telephone ti
Applicaut is: _ Qwner _ C tractor Contact
J ? /
Contractor iZ c'T'
Address City ZAJp Y? l/nl7
State r KA1 Zip Telephone #(??b
ArchBngr Registration #
Address City
State Zip Telephone # ( )
Licensed plumber installing new sewer/water service: Phone #:
I hereby apply for a Commercial Building Permit and acknowledge that the information is complete and accurate; that the work will be in
conformance with the ordinances and codes of the Ciry of Eagan and the State of MN Statutes; I understand this is not a permit, but only an
application for a permit, and work is not [o 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. r_?
??U qge?? _ "?
Applicant's Print?d e Applic Ys gna
DO NOT WRITE BELOW THIS L1NE
Sub Types
? 01 Foundation
? 14 Apartments
? 15 Lodging
,0' 25 Miscellaneous
jpl?r?
Work Types
? 31 New
0 32 Addition
? 33 Alteration
? 34 Replacement
? 26 Public Facility
? 27 Commercialllndustrial
? 28 Greenhouse
? 29 Antennae
? 35 Int Improvement ? 38
? 36 Move Bldg. ? 42
? 37 Demolish (Bldg)* ? 43
•Demolition Building - Give PCA handValuation 4)U6.0V
Plan Rev 100°/a 25%
SAC Units
Nbr. of Units
Nbr. of Bldgs
Fire Sprinklered
Required Inspections
Footings (new bldg)
? Footings (deck)
_ Footings (addition)
_ Foundation
_ Drain Tile
_ Driveway Apron
_ Roof _ Ice Pr _ Decking
_ Framing
? 30
? 32
D 34
? 35
? 37
Demolish (Interior)
Demolish (FOUnda1
Reroof
)ut to applicaM
Accessory Building
Ext Alt-Aparpnents
Ext Alt-Commercial
Ext Alt-Public Facility
Nail Salon
? 44 Siding
ion) ? 45 Fire Repair
? 46 Windows/Doors
Type of Const Width
Occupancy 1 MCES System
Zoning p ?I City Water
Stories Booster Pump
Sq Ft. PRV
Length Code Edition
^ Fireplace _ R.I. _ Air Test _ Final
Insulation
'
? Sheetrock
FinallC.O.
Y FinaUNo C.O.
Other
Insul _ Final _ Pool Ftgs Air/Gas Tesu Final
_ Siding _ Stucco Lath _ Stone Lath _ Final
Windows
Final C/O Inspection: Schedule Fire Marshal to be present. _ Yes _ No
Approved By: Planning ?OL Building Inspector
Base Fee
Surcharge
Plan Review
SAGMCES
SAGCity
SIW Permit
SIW Surcharge
Treatrnent Plant
Treatrnent Plant (Irrigation)
Park Dedication
Trail Dedica6on
Water Quaiity
Water Supply $ Storage (WAC)
Financial Guarantee
Starm Sewer Trunk
Sewer Lateral
Street
Water Lateral
Other
Total
Sewer Trunk
Water Trunk
a3 ia
* City of ?apfl
Date:
Tenant:
Suite #:
PROPERTY Name: Q 1r1 d 4. (..?) Q..?Q-s Phone: 65I- 4`54"' 5-765
OWNER
CONTRACTOR Name: (L 1 I lai-L Y06 License #: 0I708ItI^ PM-
JaU
698 5"J10't"
mlv Zi
S
Address
City: iJl
-- p:
tate
Phone: WJI- oGQ? " 0 lo24Contact Person: I?im CY Ie l la-?.
TYPE OF New Repl cement Re air aRebuild Modify Space _ Work in R.O.W.
-
?
WORK 1
-pZ
Q hLl
?
'
?
Description of work:
l
T
Y
1
PERMITTYPE COMMERC/AL
_ New Constructlon _ Modify Space
_ Irrigation System (_ yes 1_ no) (_ RPZ PVB)
0 Rain sensors required on irrigation systems
. Avg. GPM _(2" tur6o required unless smaller size allowed 6y Public Works)
Meters Call (651) 675-5646 to verity that tests passed prior to oickina up meter
Domestic: Size & Type Fire: Size & Price 3/4" meter 183.00
Avg. GPM High demand devices? _Yes No Flushometers _Ves No
COMMERC/AL FEES:
$50.50 Minimum (includes State Surcharge) OR Contracf VaWe $ x 1%
Permit Fee
Required on ALL new buildings and boulevard irrigation systems 4 _$ Radio Me[er Read
- If Permit Fee is less than $1,000, surcharge is $.50 =$ Meter(s)
- If Permit Fee i5 >$1,OOQ Sumharge increases Gy $.50 fOr each $1,000
$1,000 Permit Pee (i.e. a$1,001-$2,000 Permit Fee reqmres a$1.00 surcharge) _$ State Surcharge
Following fees apply when installing a new lawn irrigation system. $ Water Permit
Call the Ciry's Engineering Department, (651) 675-5646, tor required fee amounis.
$ Treatment Plant
$ Water Supply & Storage
$ State Sumharge
TOTAL FEES $
,----. ------------,
I Permit#.
I ?
j Permit Fee:
I ?
? Date Received:r, ? ra n rn rP i- l I
. , i Staff: _
2008 COMMERCIAL PLU?MBWG PERMIT APPLICA
Site Address: S3 ?I'? l.tJ(.lL? tMQ11/Yld•
I hereby acknowledge ihat [his information is comple[e and accurate; that ihe work will be in coniormance wltn ine ominances ano coaes oi me cny a cagan; mac
I understand this is not a perrnit, but onry an applica[ion tor a permit, and work is not to start wrthout a '; hat [he wurk will be in accomance with the approved
plan m t e case of work whi requires a review and approval of plans ?K--
X? M? L?i ? ?k aa X l?.
ApplicanYs Printed Name Applicant's Signature
EAGAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR WATER SERVICE CONNECTION
Date: June 14, 1971 Number: 641
n 55121
Billing Name:Fcn-ride>e Apartnr nt8 #1 Site Address: ,1.1
Owner: nare. Billing Address
Plumber: iergborat Plumbing Heating
Location of Connection
Meter Size
Connection Chg.
20704;17
Meter No. 'oY '} Permit Fee inn n_i
Meter Reading_ Meter Dep.
Meter Sealed: Yes_ Add'l Chg.
NO Total Chg.
Inspected by +1idea/r
Building is a:
Date
Remarks:
Residence
Multiple xx No. Units74
Commercial
Industrial
Other
$25.00 RE -INSPECTION FEE FOR
IMPROPERLY INSTALLED METERS.
By:
Chief Inspector
In consideration of the issue and delivery to me of the above permit, I
hereby agree to do the proposed work in accordance with the rules and
regulations of Eagan Township, Dakota County, Minnesota.
BY:
1 lu.al:
Please notify the above office when ready for inspection and connection.
EAGAN TOWNSHIP
3795 Pilot Knob Road
St. Paul, Minnesota 55111
Telephone 454-5242
PERMIT FOR SEWER SERVICE CONNECTION
DATE• Lm14 l.9
NUMBER 74,3
OWNER: e Ant 11 t
Address "+qtr,,:
PLUMBER berrlurat P1uuLIng Heatic'tTYPB
OF PIPE Cac
DESCRIPTION OF BUILDING
Industrial
No. of units
Location of Connections.
Connection Charge
Permit Fee tq
Street Repairs
Total
Inspected by:
Remarks;
Chief Inspector
In consideration of the issue and delivery
hereby agree to do the proposed work in acco
rdance ce wiof th above the rules and
regulations of Eagan permit, I
g n Township, Dakota County, Minnesota
}i.t1L'i
Coon Lupido, Ninn
se
en
flt work coowaredddy for inspection and connection and before any portion
City of Etall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #: i l 61 (070
/9� OJ
Permit Fee: �N
Date Received: 1,)/10/- /1 3
Staff: UGI,
2013 COMMERCIAL PLUMBING PERMIT APPLICATION
❑ Please submit two (2) sets of plans with all commercial applications.
Date: /Z- /3 Site Address: (13 5/2 Ca Aa,xi.a N AV) •
Tenant: / x ',OGi/9f%9g/4tC.4Z
Suite #:
:`P,roperty <, ;
wner
Fox Ridge Estates Limited Partnership 1
Name: phone: 651-454-5765
Contractor ' :
,,
Name: JCA% /�Lgdd6 License #: "At (:)41,5-5
Address: /9,59 Sh .11vCe XD City: £e6,49,-' State:/'ai Zip: .56 %ZZ
Phone: 651-:..3/ 9 ` 5'i.37 Email: CA -t i C 4 e/S44-)14)61.M( • ecA-%-
Type of;.Work
New _ Replacement Repair X , Rebuild Modify Space _ Work in R.O.W.
Description of work:
=
Permit Type
COMMERCIAL New Construction Modify Space
_
Irrigation System (_ yes / no) ( , RPZ / PVB)
• Rain sensors required on Irrigation systems
• Avg. GPM (2" turbo required unless smaller size allowed by Public Works)
Meters Call (651) 675-5646 to verity that tests passed prior to picking uo meter.
Domestic: Size & Type Fire: 1
Avg. GPM High demand devices? _Yes _ No Flushometers Yes _No
COMMERCIAL FEES
$55.00 Permit Fee
Contract Value $ x .01
Minimum'"``'
r.-.$ Jr✓� • Permit Fee
*If contract value is
**If contract value is
***If the project valuation
LESS than $10,010, Surcharge = $5.00 = $ 6 �o
• Surcharge*
GREATER than $10,010, Surcharge = Contract Value x $0.0005
= $ TOTAL FEE
is over $1 million, please call for Surcharge
Following fees apply
Contact the City's Engineering
when installing a new lawn Irrigation system $ Water Permit
Department, (651) 675-5646, for required fee amounts. $ Treatment Plant
$ Water Supply & Storage
$ 649 • 44?State Surcharge
$ TOTAL FEE
CALL BEFORE YQU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours before you
intend to dig to receive locates of underground utilities. www.aooherstateonecall.orq
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 �VV# A"irah P.�1
Applicant's Printed Name
R OFFJCE USE'
k is Y�;l M
Required lnspec(ioiu
x
Applicant's Signature
Page 1 of 3
ay
City of Eagan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
r
Use BLUE or BLACK Ink
For Office Use
Permit #: 1Y7 2 c
Permit Fee: LI1 V•517
Date Received:
Staff:
2014 COMMERCIAL BUILDING PERMIT AP
PLICATION
Date: 07'07(i Site Address: 1":) 4 1, - m&. -r
Tenant Name:
(Tenant is: New /
Former Tenant:
Existing) Suite #:
Property Owner
Type of Work
Name: C R t( ( g5-1-6446ti-rh 64. `1- Phone: LO
Address / City / Zip: Ct6-civntLie3 apiktX !Y) (
Applicant is:
Owner Contractor
Description of work: —1)14 r O rf,„,,,2 pEpL44C&'MI'.07-
Construction Cost:r�$. X00 0°
Contractor
Name: &yi p; PE ODOR 4,3 G,4sS
License #:
Address: 39/ SE , 747% 5 T r City: i o 1Jei4pd .- S
Architect/Engineer
State: ION Zip: SS V0 (o
Contact: .33d$Lai E i2ILG
Phone: 6/a ' 3;47- 4/043
Email: bbho ( 6+41P; /2 DODQ 4•+/5 ‘444.55 #6o+4.1
Name: Registration #:
Address: City:
State: Zip: Phone:
Contact Person: Email:
Licensed plumber installing new sewer/water service: Phone #:
NOTE: Plans and supporting documents that you submit are considered to be public information. Portions of
the information may classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage.
Call 48 hours before you intend to dig to receive locates of underground utilities. www.qopherstateonecall.orq
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 c e o rk which requires a review and approval of plans.
x 1.6.1z//c.
Applicant's Printed Nme
Applicant's Signa re
Page 1 of 3
City of Eapii
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
CO lel. vg -k -e Cl Gi
r
Use BLUE or BLACK Ink
For Office Use I
Permit #: l al Ca
Permit Fee: 10`D�
Date Received:
Staff:
2015 R IBENTIAL BUILDING PERMIT APPLICATION
Date: Da • /3- - 15 Site Address: 3 33' 3 co.;cw,AAA",/ k .ol • Unit #: /D'+
.
=Resident!
Name: Phone:
Address / City / Zip:
Owner r
j� ? V
Applicant is: Owner
pp 7C Contractor
Description of work: W; N bo-,...)E.-pt_ANca,4,,,7T"
Type ofWork
ter ;
Construction Cost. %e q, c1Do - _ Multi -Family Building: (Yes x / No )
Company: Et.m); 2� \DooR s C,L.,--., Contact: bs- R -i"
Address: 3 `/JS 1 . ,-.3-1=4s4 . City: M: "I►•Ik=.N-- S
It
Contractor.
State: 1.4 NI Zip: 55`-'oL Phone: 49/.2 • -301.9-1/403 Email:
License #: 44106 Lead Certificate #: 8.--fi �y 9(D a 5 a
If the project is exempt from lead certification, please explain why: (see Page 3 for additional information)
In the last 12 months,
Yes No If
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has the City of Eagan issued a permit for a similar plan based on a master plan?
yes, date and address of master plan:
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
Phone:
NOTE:_ Plans antl pp i g do nth heat, you submit cons de ed=to be public nformatio Portions ofd
hie info mattonn maybe classifedas anon puublic rf you provr elspecifr reasonsthat would perfnrt=the'City `to
3
concludelhatktheyare tradessecrets, mss -.. 4
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Call 48 hours
before you intend to dig to receive locates of underground utilities. www.gopherstateonecall.orq
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.
Exterior work authorized by a building permit issued in accordance with the Mirpaesota State Building Code must be completed within 180
days of permit issuance.
61. P-7 a etLKt.
Applicant's Printed 11ame
x
Applicant's Signature
Page 1 of 3
11/10/16 THU 14:50 FAX 6517741007 FOREMOST MECH
41 City of Evan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
r
ij 003
Use BLUE or BLACK Ink
For Office Ush°11
Permit #:
Permit Fee: (U) + ��
Date Received:
Staff:
2016 MECHANICAL PERMIT APPLICATION
Please submit two (2) sets of plans with all commercial applications.
�0 I
Date: � �' Site Address: .� t� ed')G. r:liN Mt'W1 ?•C
Tenant:
Resident/Owner`
Contractor
Type of Work
Name: (°\ &ek CUM' l eSlccAei
Address / City / Zip
Phone:
Suite #:
1
C57 -- qs-q —S 7 63 --
Name: ni
s
Name:n)Cv\ lG�1 C License#:
AddresssI 1 1 141,04 , t L City: ler s -e-A-000
C0
r Y 9
State: M ! (. Zip: 109 Phone: 6S -1—g—
Contacts &Y' te'-. (C1Emai1: SkeOlnl`:' i!YICQ Ui \\Q,A_V`t )S a CGi1'�
New replacement Additional Alteration Demolition
Description of work: e( c 2 C' I a_
NOTE Roof mounted and ground mounted mechanical;equipment is required to be screened by City
..Code.`: