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2904 Lone Oak Pkwy??r' I?. 2005 COMMERCIAL PLUMBING PERMIT APPLICATION J'7 CITY OF EAGAN 3830 PILOT KNOB ROAD, EAGAN MN 55122 651-675-5675 Dateta_ / SiteAddress ?N!?N Unit# Tenant Name Former Tenant Name Property Owner Telephone # ( ) Contractor Tfn?C.x\ tTcch Address `leabi C(eLys'( Ncvxc- L' c City (6,?fN?? State Zip,SW,`j'? Telephone # F.?, aP ( - _15AC License # ,?',1"? r'?y'r? Expires: 11- ak4? The Applicant is _ Owner _ Contractor _ Other Work Type New Bldg _ Modify Tenant Space RPZ PVB New Repair/Rebuild _ Replace _ Irrigation system Work within public right of-way/easement _ Yes _ No Rain sensors are re uired on irriation s stems. Description of Work ?? *AJ CA To inquve if Ressure educing alve is required on new serncq ca11 6 5 1-6 7 5-5 646 Meters - f:all 651-675-5300 to venfy that hydrostatic, conductiviry, and bacteria tests passed prior to oiclune un meter. Imgation Size & Type Avg GPM 2" turbo req'd unless smaller size allowed by Public Works Fire Size & Price 3/4" disolacement $161.00 DomestiC Size & Type Avg GPM Includes high demand devices? _ Yes _ No Flushometers _ Yes _ No PRV Required _ Yes _ No Permit Fee $50.50 minimum (includes State Surcharge) Contract Value $ x 1% _$ PermitFee $ Meter(s) Requ'ved on all new buildings & boulevazd irrisation svstems $ RBdio Meter Read ff pemtit fee is $1,000 or less, sorcharge is $.50 $ Sta[e Surcharge I£perm([ fee te over $1,000, aurcharge fe $.50 per $1,000 of the Permit Fee -------------- Following fees apply only when installing new irrigaNon sys[em ? $ W3ter Pemut CaR Jerry Wobschall at 651-675-5024 for required fee amounts $ Treatment Plant $ Water Supply & Sroragc $ State Surctiarge ------------------ ----------------------- ------- ------- ------- --------------- ------ $ ---- \L----?------ ------------- ---------------- ------° Total Fee I hereby apply for a Commercial Plumbing Pemu[ and acknowledge that the mtb[mation is complete and accurate;Jtnat me wor??wip' oe?: confoanance with the ordinances and codes of the City of Eagan and with the Plumbing Codes; that I understand th?s ,is not a pemrit, burbnly= application for a pemiit, and work is no[ to start without a peanit; that the work will be in ac ce with the apprbved pl"lvt gie3asoof?.v+c which requires a review and approval of plans. ,?ou A ??? K Applic ted Nazne Appli t's i ure PLUMBING (COMMERCIAL) Permit Application City OfEagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX # 651-675-5694 _5 K?D .Cfb .._. . w ? __j Date /o ! J I (az SiteAddress 2)oy L,:M4t' P?-`?L L?Ct- Unit# Tenant Name /sc WGcL +'u3 k Former Tenant Name Property Owner Telephone # ( /44 Contractor Address ? cv?Y`?` City \J?a° State Zip-s ?? 3 9 Telephone #(?? The Applicant is _ Owner Conlxactor _ Other Work Type _ New Bldg _ Add-on Repair _ RPZ PVB _ Irrigation system ' Jer Wobschall [o calculate fees. Re uired meter size is 2^ [urbo unlus smaller size ermitted bv Public Works Description of Work 9,2bvAA kP Z To mquire iFRessure Reducing Valve is required on new service, call 651-675-5646 Meters - Call 651-675-5300 to verify that hydrostatiq conductivity, and bacteria tests passed prior to pickine uo me[er Irrigation Size & Type Avg GPM Fire Size & Price 3/4" disolacement $156.00 Domestic Size & Type Avg GPM Includes high demand devices? _ Yes _ No Flushometers _ Yes _ No PRV Required _ Yes _ No Permit Fee $50.50 minimum (includes State Surcharge) Connact Value $ x 1% _ $ Base Fee $ Meter(s) Required on all new buildings & boulevard irri¢ation svstems $ Radio Meter Read If base fee is $1,000 or less, surcharge is $.50 $ $t8[0 SuiChaigO If base fee is over $1,000, surcharge is $SO per $1,000 of the Base Fee Following fees apply oNy when installing new irrigation system Water Permit Conpct Jerry Wobschall at 651675-5024 for required fee artrounts $ --- - -Tyatrnent Plant ?r g r,-i c', I ? •• ? I ?Vater Supply & Storage " $ ?Sfate Surcharge -------------------------------------------=------------------------------- ? ------------------------------- """"___"'___""__"""""""""'___""" $ a._ •S?__i9ltal Fee '-'? - I here6y apply for a Commercial Plumbing Permrt and acknowledge that the information is complete and accurate; [hat the work will 6e in conformance with the ordinances and codes of the City of Eagan and with [he Plumbing Codes; that I understand ihis is not a permit, but only an applica[ion for a permit, and work is not ro start without a pemut; that the wor ill be in accor ance the approved plan in the case of work which requires a review and approval of plans. ppphcanPs Printed Name ApplicanPs Signature PLLiMBING (COMIIJERCIAL) Permit Application City Of Eagan 2:E?o .5 ? 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 FAX #t 651-675-5674 Date o? / _i-a / _? Site Address OnN LuDe WL Unit # Tenant Name j n A PQYI Former Tenant Name Property Owner Telephone # ( ) Contractor }?wli fZ 1Y1C' ? Address Ci[y ?r ? ?j +S Telephone # (-ff?Z ) 4 0 State ?N Zip L* The Applicant is _ Owner ? Contractor _ Other Work Type _ New Bldg _ Add-on _ Repau ? RPZ PVB Irrigation system * •.Snrrv Wobschall to cnimilate fees. R uired meter size is 2" torbo un]ess xmaller sizr ennit[ed bv PuhGeR'orks Description of Vi'ork fpz ie5? 0vC"`Y%0 To inquire if Pressure ReAucmg Valve is required on new service, cail 651675-5646 Meters - Call 65I-675-5300 to verify that hydrostatiq conducfiviry, and bac[eria tests passed prior to oickine uo meter Irrigation Size & Type Avg GPM Fire Size & Price 3/4" disolacemen[ $156.00 Domeatic Size & Type Avg GPM Includes liigh demand devices7 _ Yes _ No Flushometers _ Yes _ No PRV Req uired _ Yes _ No Permit Fee $50.50 minimum (includes State Surcharge) Contract Value $ x.Ol°/a =$ Base Fee ??• ? $ m Lat? ? CI '? '? 1 r ? Required on all new buildings & boulevard inigation svstems $ um Meter Read ' , 4 7003 ? ? [? If base fee is $1,000 or less, surcharge is $.50 ?_? $ S t??'S?" If base fee is over $1,000, surcharge is $.SO per $1,000 of the Base Fee ?? Following fees apply ouly when instatling new irrigation system Wa Pennit _? ? $ Y Contact Jerty Wo6schall at 651-675-5024 for requued fee amounts $ Treatrnent Plant $ Water Supply & Storage $ State Surcharge ------------------ ------------------- ---------------------------------------------------- ------- ------------- - ---------------------------------------------- - $ C-513150 Total Fee I hereby apply for a Commercial Plumbing Permit and aclmowledge that the mformanon is complete and accurate; that the work will be m confoimance with the ordinances and codes of the Ciry of Eagan and with [he Plumbing Codes; that I understand this is not a permit, but only an application for a pemilt, and work is not to start without a pemvt, that the work will be in accordance with the approved pian m the case of work which requires a review and approval of plans. ApplicanPs Prnted Name ApplicanYs SigpliNre y s PERMIT #: RECEIPT DATE: HOOE COMM£RCIAL PL1JbI$INH PEiiMIT RPPLICi4TION CTfYOF Ek6kF S$SO PILOT KFOH RD EA&AH, MA 851 EE 631-881-4875 1NCOMPLETE APPLlCATlONS WlLL NOT BE PROCESSED Date: % ? ! " d -2- WORK TYPE New Bldg Add-0n Repair RPZ _ PVB Irrigation system • Jerry Wobschall to calculace fees. Required meter size is 2" turbo unl s Iler size permitted by Public Works DESCRIPTION OF WORK ??S'f h L () ??? To inquire if Pressure Reducing Vslve is required on new service, ca11 65 1-681-4646 METERS - Call 651-681-4300 to verify that hydrostatic, conductiviry, and bacteria tesu passed prior to oickin¢ un meter Irrigation 5ize & Type Fire Size & Price 3/4" disolacement $152.00 Domestic Size & Type Does this inciude high demand devices i FLUSHOMETERS Site Address: Tenant Name: _ Yes _ No _ Yes _ No (Area code) Was there a previous tenant in this space? _ Y_ N. If Yes, Name: Instalier Natne: T4 e i /?' Telephone #: /-S°Z " ? V Lq - S 3 v'-I _ (nrea Code) Installer Address: 17- v 6 l.? o`?> J a City: Cko., I?Yb. I rj'L State: FEES Contrect price $ 32?,? x 1% ($50.00 min) Requ'ved on all new buildings & boulevard irrigation systems Surcharge: $.50 Minimum. If base fee exceeds $ 1,000, calculate at 50 cents per $1,000 base. Supplementary fees for new irrigation system: Contact Jerry Wobschall at (651) 6814624 regarding fees Plbg Permit Meter(s) Radio Meter Read Stste Surc6arge Sub ToteUTotal Zip Code SS ? V ? $ $ $ S ?Q ?- ' $ Water Permit $ Su.Ov" Treahnent Plant $ 640.00 Water Supply & Storage $ State Surcharge $ a Total $ I hereby acknowledge tha[ I have read this applicarion, sta[e that the informarion is coaect, and agree to comply with all applicable Ciry of Eagan ordinances.Itistheapplicant'sresponsibilitytonotifythepropertyowner CiryofEagan assumesnoh i foranydamagescausedbytheCiry during its nortnal operational and maintenance activiees to the faciliries co eted er this it ' hin r), right-of-way/easement. SI ATURE F PE EE Yes No CITY USE ONLY Avg GPM Avg GPM PRV REQUIRED