2202 Liberty Lane2007 COMMERCIAL PLUMBING rExMrr nrrLicnTiox ??? E? KS
CITY OF EAGAN
3830 PLLOT KNOB ROAD, EAGAN MN 55122
651-675-5675
Date
Site Address /.(,,4,? Unit #
?
TenantName ? .?Ti1) `?u^!ll'tfl*j?r_ FormerTenaotName
Properly Owoer Telephone # ( )
Contrector
Address W.t4(1G-'C< ? c,?
State Zip Telephone #
License # 23? Oh Expires: ? Z CJ7
The Appticaut is _ Owner _; Contractor _ Other
Work Type New Bldg _ Modify Space _ Irrigafion System•• Yes No Work in public r-o-w / easement?
X'APZ _ PVB: _ New _ Repair/Rebuild T?Replace _ Remove
Raiu seusors are r uired ou irriation systems
Description of Work 'z -
To in uir ?CPressure Reducing Valve is reqmred on new service, ca11 6 5 1-67 5-5 646
Meters - Ca11 6 5 1-67 5-5 646 to verify that hydrostatic, conductivity, and bacteria tesfs passed grior to oickine uo meter.
Imgation Size & Type Avg GPM 2" twbo req'd unless smaller size allowed by Pu6lic Works
Fire Size & Price 3/4" meter 174.00
Domestic Size & Type Avg GPM Includes high demsod devices? _ Yes _ No
Flushometers Yes No PRV Required _ Yes _ No
Permit Fee $50.50 minimum (includes State Surcharge)
Conhact Value $ x 1% _$ Permit Fee
$ Meter(s)
Required on all new buildings R. boulevazd irrieation systems $ Radio Meter Read
$ State Surcharge
If oemit fee is lesa thm S1,000, surcharge is $.50
If cennit fee ia morc thao $1,000, surcharge is A50 for nch SI,000 owed.
Following fea apply wheu inatalting orn lawo irrigafion rystem $ We[ei Pe°mt Y
Cal I the Ciry's Engineenng Departrnent, 651-675-5646, for reqwreA fee amounLs
$ Treatment Plant
$ W ater Supply & Storage
$ State Surcharge
$ Total Fee
1 hereby apply for a Commercial Plumbing Pelmi[ and acknowledge tl?at tlie infonnazion is mmPiac md accurale; llm[ de `"°? ?l bc in conformance with the
ordinances and codes of the City of raga" and with the Plumbing Codes; ihat 1 understeW thfs is not a pe*mit, bu[ only an application for a pertnR, and wrork fs rrot to
hich requires a review and aEpmval of plans.
stert wi out a er ?4 ?? e work will be in eccordar?ce with the approved plan in the case oFIZW?V-S-Signaturc
? -P?-? ti GJ?
ApplicanPs Printed mme
0 1 ??,?ty.ao
2005 COMMERCIAL PLUMBING PERMIT APPLICATION
CITY OF EAGAN
3830 PILOT KNOB ROAD, EAGAN MN 55122
651-675-5675 k0 3
nate Cr / ) i? R
SiteAddress aAog Unit#
Tenant Name Former Tenant Name
Property Owner 191"Jn `C'4 Telephone # ( / r ) 41?L 2 ti fL
Contractor W r5- /
Address City (TC?I ?
State Zip Telephone # e(L )
License # Expires:
The Applicant is _ Owner Contractor _ Other
Work Type New Bldg _ Modify Tenant Space _YRPZ PVB New Repair/Rebuild _ Replace
-Arrigation system Work within public right uf-wayleasement Yes _ No
Rain sensors are reaired on irri ation s stems
Description of Work
To inquve if Pressure Reducing Vatve is requaed on new servmq ca11 6 3 1-673-5646 • '1 .
Meters - Call 651-675-5300 to verify that hydrostahc, conductivity, and bacteria tests passed prior to pickine up meter.
er size.allowed by Public Works
Irrigation Size & Type Avg GPM 2" tyr?o req'd ess s, mall
`?/
Fire Size & Price 3/4" disnlacement $161 00 `\ Pa ?
Domeslic Size & Type Avg GPM Includes high demand devices? _ Yes _ No
Flushometers _ Yes _ No PRV Requimd _ Yes _ No
Permit Fee $50.50 mimmum (includes State Surcharge) p
u
Contract Value $ x 1% _$ -SU PernutFee
Meter(s)
Requued on all new 6uildings & boulevard irrieahan systems $ ?`7"'• ?? Radio Metei Read
If pemtit fee is $1,000 or tesa, snrchazge is $.SO $ ?J State Surcharge
If pemdt fee is over $1,000, surchsrge is 5.50 per $1,000 of the Permit Fee
Following fees apply only when installing new imgation system Water Pernut
Call Jerty W obschail az 651-675-3024 for required fee amowrts Q p ? ot•? ?
$ ?p(o; TreatmentPlant \
$ / '? 0 ? Wa[er Supply & Storage
$ . 5d State Surcharge
---------------------------- ------------- ------- --------------------- ---------- -- ------------------- - -------------------------------
------- n q pb
$ d ? `Ti Total Fee
I hereby apply for a Commercial Plumbing Pemut and acknowledge that the information is complete and accurate; tliat the work will be m
confoimance with the ordinances and codes of the CiTy of Eagan and with the Plumbing Codes; that I unders[and this is not a pczmit, bu[ only an
application for a pemvt, and work is not to staR without a perntit; that the work will be in accordance with the approved plan in the case oF work
which requires a review and approval of plaris.
? ` ?!-
?h7`! ,?{ c/ /-?
ApplicanYs Piinted Name Applicant's Signature
Use BLUE or BLACK Ink
I For Office Use ~ -2, I
I
I I
City of EaRan I Permit F
1HJ
i Permit Fee:
Pilot Knob Road
3830 \I
Eagan MN 55122 I Date Received: Z -
75
Phone:
Staff:
Fax: (651) 675-6694
2012 COMMERCIAL PLUMBING PERMIT APPLICATION
❑ Please ub it two (2) sets of plans with all commercial applications.
Ur
Date: Site Address: oG
ILA 10M
r
Tenant: Suite
PROPERTY
OWNER Name: Phone:
Name: License
CONTRACTOR
Address: City: State: Zip:
Phone: Email:
a W TYPE OF -New _Replacement -Repair Rebuild - Modify Space - Work in R.O.W.
WORK
Description of work:
CO ERCIAL _ New Construction _ Modify Space
Irrigation System (y yes / - no) Lk_ RPZ / - PVB)
Rain sensors required on irrigation' systems
PERMIT TYPE . 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 up meter.
Domestic: Size & Type Fire: 1
Avg. GPM High demand devices? Yes No Flushometers -Yes -No
COMMERCIAL FEES;
$60.00 Minimum (includes $5.00 State Surcharge) OR Contract Value $ x1%
= $ Permit Fee
Required on ALL new buildings and boulevard irrigation systems 4 $ Radio Meter Read
- If the Permit Fee is less than $10,010, the surcharge is $5.00 $ Meter(s)
- If the Permit Fee is > $10,010, the surcharge increases by $.50 for each $1,000 Permit Fee $ State Surcharge
i.e. a $10,010-$11,000 Permit Fee requires a $5.50 surchar e
Following fees apply when installing a new lawn irrigation system $ Water Permit
Contact the City's Engineering Department, (651) 675-5646, for required fee amounts. $ Treatment Plant
$ Water Supply & Storage
$ - State Surcharge
= , W TOTAL FEE
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.goopherstateonecall.org
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. Ik PIMA
x x -JWMA ~Ahmw Applicant's Prin d Name Ap I ant's ure
FOR OFFICE USE Approved By: Date: i
Required Inspections: Under Ground Rough-In -Air Test Gas Tesi% Final PRV Required: Yes No
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