1613 Oak Ridge CirSITE ADDRESS /6/5 ?41<? i CJQE l'.t f. Unit #
Permit # a-96 5 93
L ? s ? sect.isub.oalc 'dae Pan1IV HOusinu
°O?? ?-
INSPECTION INSPECTOR DATE COMMENTS
,
• ?y _ ??
g-Yy
v?w
? 4=aa--4
INSPECTION INSPECTOH DATE COMMENTS
SITE ADDRESS IIPI3 Val< iQaQ e4r. unit # Permit # a&SJp3
B -
I INSPECTION I INSPECfibR I DATE I COMMENTS I
Wet*jicate of cccu.oanc?
? 4 of Cpagan
?e,p?rtatatt of VnIbblg aaiopection
Tlus Cenifecate issued pursuant to tlre requirements of 1he Uaiform Bui[ding Code
certifying that cu t!u tinee of issuance tltis stnecture was in compliarice with the various
orrli?rances of the City regulating building constructioa or use. For the fotlowrng:
ux cI=sjfjcuo&- nrm.rFSr eag. renTdi No. 26563
OC-P-r TYrC R3/01 7AW.a nonia H4 Typc const- 3M-
o.,mocsWkingnatt[rrpLrnrnM uae Aam- 2496 11E5M ST W; ?Llb?l[NI
s.ddin Aamm1613 cY?tt RmcE i'TM p LAxwity
/.ewww oirx;r
POST IN A CONSPICl10US PIACE
6---.i-.• INSPECTION RECORD
CITY OF EAGAN PERMIT TYPE:
3830 Pilot Knob Road " • Permit Number: ?'' 1' 19 ^3
Ea an, Minnesota 55122-1897
9 Oate Issued:
(612) 681-4675
SITE ADDRESS: APPLICANT:
1 . ! 'eq { H.'tt.
PERMIT SUBTYPE: '
TYPE OF WORK:
?, 1 1 1
INSPECTION .. .
; .., .•
t'I I;1r ff ! i•
??td1A V } . ?II11
1 t? 1!, (? F1 k: R IV OF 1'. I k
t;, 4J N I 1.1 Fl
I
•
L
?
?
Parmit No. Psrmit Holder Date Talephone S
ELECTRIC °, t ?.
PLUM8ING (- gQ57
HVAC WA*A?j
-?OQ
Inspection Date Insp. Commente
FOOTINGS
FOUND
'FRAMING
ROOFING
ROUGH
PLUMBINO
PLBG
AIR TEST
ROUGH
HEATING
GAS SVC
TEST
INSUL
GYP BOARD
FIHEPLACE
FlREPLACE
AIR TEST
FINAL PLBG
FlNAL HTCa
ORSAT
TEST
BLDG FINAL ?
BSMT R.I.
BSMT FINAL
DECK FTG
DECK FINAL
S#c
T.46-
?D q_ !'O r I REQUEST FOR ELECTRICAL INSPECTION ??. %, ens-oooaryi-?ays
d- Tl Z? jl? See instmctions for completing this form on back of yellow copy.
? A r r•, ?
,5 "X" Below Work Covered by This Request
Ne Adtl Rep. Type of Builtling pppli i Wired Equipment Wired
Home Range emporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Load Management
Comm./Industrial Furnace Other (Specify)
Parm Air Conditioner
Other (specify) CoMradofs Remark5.
s 7V ?.?
7 e,,,,'-
Cqmpufe Inspection Fee Below.
#: Other Pee # Service En[rance Size Fee # Circuits/Feeders Fee
Swimmin Pool 0 to 200 Amps 0 to 100 Amps y
? Transformers A6ove 200_Amps Above 700 -Amps
SI nS Inspectar's use Only, TOTAL
Irrigation Booms ? lri3_
Special Inspection
Alarm/Communication THIS INSTALLATION MAY BE ORDERED OtSCONNECTED IF NOT
Other Fee COMPLETED WITHIN 18 M S.
I, the Electrical Inspector, hereby
tif
h
i
ti
h
b
h Rough-in oate
cer
y i
ove
nspec
at t
e a
on
as
been made. F??ai o 7?-
OFFICE USE ONLV
This request void 18 months irom
Om ?r ??CyS (? : p• o-y
? 5
Req esl Dace Fire o. Rough-In Inspecti n uired n pe bn Oth r han Rough-In
//
1
(VOU must call insoector when eady) qea0y Now ? Will Notity Inspector
0 Ves r o Date Reetl
Iicensed contractor ?owner hereby request inspection of above electrical work aC
Job Adtlress (StreaL Box or Poure No ) Clry
168 1K.74!r' ? ->r.J ^
Section No. Townshlp Name or N. Range No. Counry
Ocfpant (PRINT) Phone No.
?'z2?,? -t-?'??s r1Y/-
Power Supplier Atldress
?-
Electncal Contractor ICompany Name) Comractor s License No.
1?7 'Ni.,;- /-A-d 7
Malling Atltlress (COntmctor or Owner Making Installation)
?/
/ L?. S:' )c? .S ?: ?G\.'lC TIG' /Y/.YV,? SJ ?) S /
Authorizetl SignaWre onlrnclodOwner Making stallalion) ' Phone Number
? y7P, C-.Ax;)-£°
c _
'C'TY T
n,
?
?
U S
8 II ? I I III I I I I I I I I II I I I IIII p
BO
vee
MN
5510C
y Ave., St
821 U
PS II 1 ROPER NSPEGTION
E
N
Phone (612) 642-0800 11 ? GLOSE
E
, 9q1,J,?? REQUEST FOR ELECTRICAL INSPECTION
See instmclions for completinq Ihis form on back of yellow copy. ?°
??? ee-oao(a?i-os
55'3 T??
'X: Below.Work Covered by Thrs Request Ne Atld Rep. Type of Building Appliances Wired Equipment Wired
Home Range ' Temporary Service
Duplez Water Heater Electric Heatin
ApL Building Dryer Load Management
Comm.llndushial Fumace Other (Specify)
Farm Air Cond'Rioner
Olher (specify) CoNractors Remarks: '
Corupute lnspection Fee Below:
# : Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee
Swimming Pool 0 to 200 Amps 3? 0 to 100 Amps
Sransformers Above 200 Amps Above 100 -Amps
SIgf15 Inspectors Usa Only: TOTAL
Irrigation Booms //??//
//,/,/O
Special Ins edion ? _?
AIarMCommunication THIS INSTALLATIO Y BE R NNECTED IF NOT
Other Fee COMPLETED WIT MO
I, the Electncal Inspector, here6y Rough-in F oate
cedity that ihe above inspection has
been made. F??? oa ? /_
OFFlCE USE ONLY
This requesl vaid 18 manths trom
-223 01
'9
1t
Req est Date Fire o. - Slovgh-In Ins ?ion Required 1 s ectlon Other Than Rough-In
tG 1 (VOU musi cal inspMO1when reetly) Reatly Now Lj Will Notify Inspecror
%
a ? Yes ? N. pale Reatl
I icen d co t tor ? owner hereby request inspection ot a6ove electrical work at:
Job AtlCre ( , r Roule No.) Ciry
-11"6; -07'41- d/fIr--.el- c Ciyt?/r - -frJ ^
Section No. Township Name or Na Range No. County
?7?•.
Occupanl(PPINT) Plipne No.
8o 9 erllo 99
Power Supplier Address .
' O41eerv- ill-54iiii,Z
Electrical Conl2ctor (COmpany Name) ConVadors License No.
Malling Atltlress (COntraclor or Owner Making Installation)
?v b? x J G ?..,4 m.unl s's"3 s
Authorized -9naNre (COnt2c[or/Owner Making Instailation) Phone Number
1/7$ 68.1
MINNESOTA STA Aqp OF ELE RICITY I THIS INSPECTION REQUEST WILL NOT
Griggs-Mitlway B .- Poom 5-128 ? I I I I ?
? I (I
eE ACCEPTED BV THE STATE BOARO
1821 University Ave., SL Paul, NN 55104 I UNLE55 PROPER INSPECTION FEE IS
Plwlle I6121 6A2411M00 . FNf.I (1SFf1
REOUEST FOR ELECTRICAL INSPECTION '? Ee-oOaoi-os
? See instniraons lor complelinq Ihis form on back oi yellow copy. ?? ?5S ?Z 7
"X" Be/ow Work Covered by This Request
New Add Rep. Type of Building -_ Appliances Wired Equipment Wired
Home Range Temporary Service
Duplex Water Heater Electric Heating
Apt. Building Dryer Load Management
Comm./Industrial Furnace Other (Specify)
Farm Air Conditioner
Other (sper.ity) Contraclofs Pemarks:
Coropute lnspection Fee Below:
# ' Other Fee # Service Entrance Size Fee # Circui4s/Feeders Fee
Swimming Pool 0 to 200 Amps ;LV 0 to 1D0 Amps
Transformers Above 200_Amps JaIIL? 100 _Amps
SignS lnspector's Use Only: TOTAL
Irrigation Booms
Special Inspection ?
Alarm/Communication THIS INSTALLATIO BE R DIS NNECTED IF NOT
O[her Fee COMPLETED WIT MO
L lhe Electrical Inspector, hereby Rouyn-m
certify that the above inspection has
been made.
Final
? /
D e
r [
OFFICE USE ONLV
This request void 18 mon[hs fmm
?§53s1-7
0?
9 7222
?
Req es1 oat Fire N. ough-In Inspectio eQUlred Ins n Other rnan Rough-In
(VOU mus? cal inspeclor when reatly)
? eatly Now ?-9GIII Nofily Inspeclor
es
No Date Reatl
I f?'(censed co actor ? owner hereby request inspection of above electrical work at:
Job Atltlre , r floute No.) Ciry
7`1? 0 4 K4+06t e,'Yz.c%
Seclion No. Township Name or No. Range No. Counly
D?-i'-"+i+v
Occupani (PflINT) Phme??
Power Supplier Atltlress
Electncal Comraclor (Company Name) Comradofs License No.
4IE ' execv-7uz- C eAO l.)8 7
Mailing Atltlress iCOnfrador or Owner Making Installetion)
'ek 6n
Aulho?ized Si alure (COnVactor/Owner aking Installalion) Phona Number
/
bOyGj?-
MINNESOT ATE ppp OF EL TFICITY
I THIS INSPECTION PEQUEST WILL NOT
Grigga-Midwey Bltlg. - Room 5428 I II I I ? I? I I I I I I I I BE ACCEPTEO BV THE STATE BOARD
1821 Universiry Ava., S[. Paul, MN 55104 ? UNLESS PROPER INSPECTION FEE IS
PAeiw IF121 944-fIMO i FNr.i nseo.
F. j
CITY OF EAGAN
3830 Pilot Knob Road
Eagan, Minnesota 55122-1897
(612)681-4675
PERMIT
/o /a ;/g6?
PERMITTYPE: BuzLozNe
Permit Number: 0 2 6 5 2 3
Date Issued: 10 / 2 0/ 9 5
SITE ADDRESS:
1613 OAK RIDGE CIR
LOT: 1 BLOCK: 1
OAI< RIDGE FAMILY HOUSING
DESCRIPTION:
8uildinqi?_Permit Type DUPLEX
;E3uilding Wo,rg Type NEW
"'iJBC Qecupancy'? F2-3 U-1
Cons CrucZion Typ,e V-N
Zona:ng I2-4
Building Lenqth 39
Buzlding Width 55
B}a3].tling . stories
-
r
,
4. , ; f; , • '
REMARKS:
zNCLuoes
PRv
iels oan RroGe r.iri
s & w PLsR -
FEE SUMMARY:
VALUATION $151,000
Base Fee $1,292.25 CITY SAC $200.00
Plan 12evierw $452.29 WA7ER CONNECTIDN $1,500.00
Surcharge $90.50 S & W PERMIT $100.00
SAC $1,700.00 S & W SURCHARGE $.50
SAC % 100 TREAI" MEN7 PLAN1' $744.00
SAC Units 2 ROflD UNIT $850.00
Subtotal $3,535.04 Total Fee $6,929.54
CONTRACTOR: - Applicant - sT. LIC. OWNER:
FRANA & SONS INC 19910282 0007620 DAK07A COUNTY HRA
7500 FLYIN6 CLOUD D}2 755 2496 145T11 ST W
EDEN PRAZRSE MN 55344 ROSEMOUN7 MN 55058
(612) 941-0282 (612)423-8111
I hereby acknowledge that T have read tha:s
,infcrrmatiors is ocr,rrect etnd agreeta Compiy
5tatutes and City of Eagan Qrdinances.
APPLICANT/PERMITEE SIGNATURE
application and stats thet the
wieLh al1 applic-able 5'tate o( Mn.
?
-E SI A U
C1TY OF EAGAN ? L 11.v ?
le" t3 3830 PILOT KNOB RD - 55122
1995 BUILDING PERMIT APPLICATION (RE5IDENTIAL)
' 681-4675
New ConstrucNon Reauirements RemodeVReoair Requfrements
? 3 isgisterod site surveys ? 2 apies of plan
? 2 eppiea ot plena (indude beam 5 window s'¢es; poured Ind. design; etc.) ? 2 sfte surveys (exterior addttions & deeka)
? 7 enerpy ealalations ? 1 energy celwlaGona tor heated addibans
? 3 copies of tree pisservatlon plan 'rf lol pWKed after 7!1193
required: _ Yes _ No
DATE: 9-19-95 CONSTRUCTION COST:
DESCRIPTION OF WORK: wooD FttnME SLAB ON GRADE TOWNHOMES
. n I .. A r_
STREET ADDRESS: ,I1oC? G #
LOT --_ BLOCK
$tf22t AfJfIreSS' 2496 145th ST. WEST
u
°
PROPERTY N8I71@: DAKOTA COUNTY HRA Phone #:612 9==70?26
OwNER ua* rnsT
City. ROSEMOUNT
CONTRACTOR Company:
ARCHITECT/
ENGINEER
SUBD./P.I.D. #:
State:MN Zip: 55068
FRANA AND SONS, INC.
PhOne #:612-941-0282
Str88t AdCIfESS:7500 FLYING CLOUD DR. #755 License #• 0007620
Cj{y;EDEN PRAIRIE
COmpany: PAQL MADSON & ASSOC.
Namg: PAUL MA?SON
PhOne #'612-332-7026
Registration #'013243
Street Address. 420 N STH sT.
Cjty; MINNEAPOLIS, Statg: MN ZjP; 5407
Sewer & water licensed plumber.
change are requested once permit is issued.
I hereby acknowledge that I have read this application and state th<
applicable State of Minnesofa Statutes and City of Eagan Ordinances.
Signature af Applicant:
OFFiCE USE ONLY
Certificates oi Survey Received _ Yes _ No ; S Ep 2 p w5
Tree Preservation Plan Received _ Yes _ No
5tate: MN Zl(]' 55344
OFFICE USE ONLY
BUILDING PERMIT TYPE
M
?a??, ` , ?? „
0 01 Foundation aR?-06 Duplex o 11 Apt./Lodging ? 16 Basement Finish
? 02 SF Dweiling ? 07 4-plex ? 12 Multi Repair/Rem. 0 17 Swim Pool
0 03 SF Addition ? 08 8-plex ? 13 Garage/Accessory ? 20 Public Faciliry
0 04 SF Porch ? 09 12-plex ? 94 Pireplace n 21 MisceUaneous
0 05 SF Misc. ? 10 = piex ? 15 Deck
WORK TYPE
jo?- 31 New ? 33 Alterations o 36 Move
0 32 Addition ? 34 Repair o 37 Demolition
GENERAL INFORMATION
Const. (Actuai) Basement sq. ft. ? MC/WS 5ystem °?-
(Allowable) Main level sq. ft. i, z7 S City Water
UBC Occupancy ?"'? sq. ft. s O Fire Sprinklered
-
Zoning ?t?5Y sq. ft. PRV 5
# of Stories sq. ft. Booster Pump
Length sq. ft. Census Code.'
Depth 53- Footprint sq. ft. SAC Code oi
Census Bldg ?
Census Unit Z
APPROVALS
Planning Buiiding Engineering Variance
Permit Fee
Valuation: ?
$ Z& %do ?
Surcharge
Plan Review
License
MCNVS SAC
City SAC
Water Conn.
Water Meter
Acct. Deposit
S/W Permit
S/W Surcharge
7?
p
Treatment PI.
Road Unit
Park Ded.
Trails Ded.
Other
Copies
Total:
Ta? "LI
% SAC
SAC Units z
L_L BL ? OFFICE USE ONLY RECEIPT #: L5-;?rwF/
SUBD: (04 I?L?LI Am.. ?u DATE:
1996 PLUMBING PERMIT (COMMERCIAL)
CI7Y OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Piease compiete for: . afi commercial/industrial buildings.
+ multi-famity buifdings when separate permits are pgt required for each dwelling
unit.
DATE:
CONTRACT PRICE: 7 3 g0 . otp
WORK TYPE: NEW GONSTRUCTION _ ADD ON _ REPAIR
DESCRIPTION OF WORK: 42<&2 A'-;' M2 Ll A--,?'2
IS WATER METER REaUIRED9 L/ YES _, NO. IF SO, PLEASE PROVIDE THE FOLLOWING:
.
WATER FLOW: 6PM. ARE FLU5HOMETER:i TO BE INSTALLED? _ YES? NO.
FAILURE TO PROVIDE THIS INFORMATION WILL RESUL7' IN A DELAY OF METER 13SUANCE.
WILL YOU BE INSTALLING A METER FOR A FUTURE U.G. SPRINKLER SYSTEM? _ YESX NO.
IF SO, YOU MUST APPLY FOR A SEPARATE U.G. SPRINF(LER PERMIT.
FEE: $25.00 minimum fee or 7% of contract price, whichever is greater. State surcharge of $.50 per
$1,000 of permit fee due on all permits.
CONTRACT PRICE x 1%
STATE 5URCHARGE
TOTAL ; &(3 ?
SITE ADDRESS: ?6
TENANT NAME:
STE. #
OWNER NAME: A& ICr, 4-.c L.T Y?,s.. ? e.!? ? c 1 nm vtA r.??2??GY
INSTALLER: oXL( r T lJG B 6
ADDRESS: 6 y? i? F? Y4L l ?-- /19 e-2YL
CITY: ??CA9 Pu.r'?`'t°' STATE: ki/J ZIP: grtZ:E YY
PHONE !xa ;-;' SIGNATURE: I t;
APPLICANT
. 'S EJ
? 93 ,R?
OFFICE USE ONLY
METER SIZE: DATE: INSPECTOR:
L 8L
SUBD.
1996 PLUMBING PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 6814675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
FIXTURES EACH rLQ„ IS?TAL
5hower • 3.00 x
Watsr Closet 3.00 x =
Bath Tub 3.00 x =
Lavatory 3.00 x =
Kitchen 5ink 3.00 :c =
Laundry Tray 3.00 :< _
Hot Tub/Spa 3.00 x =
Water Heater 3.00 ;c =
Flaor Drain 3.00 :c =
Gas Piping Outlet ' minimum - 1 3.00 x =
Rough OPenings 1.50 :< _
Watet Softener 5.00 x =
Private Disposal " Dakota Cry. license 65.00 =
(new and refurbished systems)
U.G. SpflnkleY ' home under eonst. 3.00 =
Alterations * to ewsHng 20.00 =
Water Tum Around 20.00
STATE SURCHARGE .50
TOTAL
SITE ADDRESS:
OWNER NAM
INSTALLER NAME:
CITY USE ONLY
RECEIPT #:
DATE:
STREET ADDRESS:
CITY:
STA
ZIP:
PHONE #: (
CITY USE ONLY
L ? BL RECEIPT #:
DATE: 041
SUBD.
1996 MECHANICAL PERMIT (COMMERCIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: ? ail commercial/industrial buildings.
? multi-family buildings when separate permits are IIQt required
for each dwelling unit.
DATE: % ? CONTRACT PRICE: ? C?
WORK TYPE: _z_lr NEW CONSTRUCTION INTERIOR IMPROVEMENT
DESCRIPTION OF WORK:
FEES: ?$25.00 minimum fee QC 1% of wntract price, whichever is greater.
? Processed piping - $25.00
? State surcharge of $.50 per $1,000 of permit fee due on all permits.
CONTRACT PRICE x 1% /09• O9
PROCESSED PIPING
STATE SURCHARGE
TOTAL
60
(Dg. S?
?p SITE ADDRESS: I ?1Z" 161S Q41` ??-
OWNER NAME: //aGlJJ?1/? TELEPHONE #:
TENANT NAME: (IMPROVEMENTS ONLY)
INSTALLER:
ADDRESS: .? ,! 2':2 / c? ,2iu? av? ? iv .?, u? "
CITY: STATE:
PHONE #: o o
SIGNATURE: vk?" ?1-
PERMITTEE CITY INSPECTOR
SIGNATURVqy
L BL
SUBD.
1996 MECHANICAL PERMIT (RESIDENTIAL)
CITY OF EAGAN
3830 PILOT KNOB RD
EAGAN, MN 55122
(612) 681-4675
Please complete for: ? single family dwellings
? townhomes and condos when permits are required for each unit
New construction Add-on furnace
_ Add-on air conditioning Add-on air exchanger, i.e. Vanee system, etc.
Date:
FEES
? Minimum Fee: Add-on/Remodel (existing residence only) $20.00
? HVAC: 0-100 M BTU 24.00
Additional 50 M BTU 6.100
? Gas Outlets (minimum of 1 required @$3.00 each)
? State Surcharge .50
TOTAL
SITE ADDRESS:
OWNER NAME: PHONE #:
INSTALLER NAME:
CITY USE ONLY
RECEIPT #:
DATE:
STREET ADDRESS:
CIl'Y:
STATE:
ZIP:
PHONE #: ( )
I
For Office Use I
# Permit
City of Ea an
Permit Fee: I ~I 0
3830 Pilot Knob Road I I
Eagan MN 55122 I
I Date Received:
Phone: (651) 675-5675 I I
Fax: (651) 675-5694 Staff:
L-----------------
2009 COMMERCIAL BUILDING PERMIT APPLICATION
Date: Site Address: Vi3•-is 04$- ~-A14& CuLcL(-
Tenant Name: (Tenant is: New / Existing) Suite
Former Tenant:
latfL.A- ~_i1ar
PROPERTY OWNER Name: e* err) it-Y rtVJ r.JG r;-rb P rN0124 hl1hone: (6571) ; c - L140C
Address / City / Zip: ( 2 23 'TJ C am - b A I L , 4 &iAi'1 55-12-3
Applicant is: Owner Contractor
TYPE OF WORK Description of work: Kec t= fZtr. t'4 q,r~.+.tnr-,u'T (t a >c.L, te-c- r A:1t . rCLT MMP"--wf
a t c~"_ S i diEn?'TSr I cc S, i i.
Construction Cost:
CONTRACTOR Name: Ct3S Co'3T~~t7c`.i T-r=vAct'y5- t,lSC_ License#: ZC3 _t,
Address: 1 \ 2- AL.-A r) _
City: t_ 1 State: t Zip: i5`53 i L
Phone: (Jt 3) 5br1 Contact Person: -9A A ! ' ' + r
ARCHITECT / Name: fitA Registration
ENGINEER
Address:
City: State: Zip:
Phone: Contact Person:
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 be classified as non-public if you provide specific reasons that would permit the City to
conclude that they are trade secrets.
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 requir s a review and approval of plans.
x J6,5 t) iJ A P_Kl - -'Y- x
Applicants Printed Name g -1 ii Appl' it's Sign
r J
Page l of 3
JUN182009
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09/13/2013 02:36 6122251801 CNC CONSTRUCTION PAGE 03/10
1t~131 MS
Un mm or
cirbe
• O~ ~ PwnNtllk 5
3810 1~nOl, LEW
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2013 COMMERCIAL BUILDING PERMrr APPLICATION
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' 41. Use BLUE or BLACK Ink
For Office Use c„...-as .,)
Cityof Permit#: /i
3/ i
����Il 190°`'
3830 Pilot Knob Road Permit Fee:Eagan MN 55122
Phone: (651)675-5675 Date Received:
Fax:(651)675-5694
• Staff:
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2017 MECHANICAL PERMIT APPLICATION
I- Please submit two (2) sets of plans with all commercial applications.
Date: 2-,j/'1/��/"" j/10( 7 Site Address: � /6"/ Q, kil,'
• e'
Tenant:
Suite#:
A £ t 40
fir- �^ { lk 4)4 ,,.�- ,,/ rte,
Name: DAI 0i+ C—f t`jr5, 7,4-----4/ 1
, ...b...,. Address/City/Zip: • A.2 41? -u ;1 ' ,5"6-412,.3.` 0.4
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4,,,,,Iiiiwgio.gootzst4. Name: Ray N Welter Heating Company License#:
IgiNQW.RetZ' ;', 4 '' Address: 4637 Chicago Ave city. Minneapolis
' ' State: MN Zip: 55407 Phone: 612-825-6867
t , Contact: 4ierr' w. Email: rickw@welterheating.com
A.
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New Replacement Additional Alteration Demolition
®e ,, .o, Description of work:
41gti NOTE Roof"tnou ted and gr aund mounted nechanic equipmen# rir
c e,d to�.be scree ed syCity`-
.� Code Plea on acute l leo(latacal nspector for information o per fitted screening met rodss i
RESIDENTIAL COMMERCIAL
—Furnace New Construction Interior Improvement
o . a•; _s___Air Conditioner Install Piping •_Processed
Air Exchanger g Gas Exterior HVAC Unit
��;� f� Heat.Pump
� �;� —Under/Above ground Tank ( Install 1 Remove)
, M - Other
RESIDENTIAL FEES
$60.00 Minimum Add or alteration to an existing unit, includes State Surcharge
$100.00 Residential New, includes State Surcharge =$ TOTAL FEE
COMMERCIAL FEES Contract Value$ x.01
$60.00 Permit Fee Minimum
$75.00 Underground tank installation/removal, includes State Surcharge =$ Permit Fee
=$ Surcharge
Surcharge=Contract Value x$0.0005
If the project valuation is over$1 million, please call for Surcharge =$ TOTAL FEE
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 wor nooto 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.ii
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Applic is Printed NameApplicant's S': ature' ''
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