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1975 Silver Bell Rd
Receipt PLUMBING PERMIT Permit No. CITY OF EAGAN Fee Fill in numbered spaces S/C Type or Print legibly Tot. 1. Date V 2. Installation Cost 3. Job Address Lot Blk. Tract 4. Owner 5. Contractor T Phone .9 3 l? 1 6. Address 1to7 1:'*. , T 7. City Burnsville State :-Iinnesota Zip 337 B. Building Type: Residential ? Commercial lax Institutional ? 9. Work Description: New Add ? Alter ? Repair ? 10_ Describe ';as ,'i ing to install 11. No. Fixtures Water Closet No. Fixtures Cesspool/Drainfield Bath tubs Septic Tank Lavatory Softner Shower Well Kitchen Sink Urinal/Bidet Other Laundry Tray Floor Drains 1 Ciiinc se .Jok Drinking Ftn. Slop Sink Gas Piping Outlets 12. 1 hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed : for Rough Final Inspections: Date Insp. Date "7G-JT1nsp. This is your permit when numbered and approved. Approved CITY OF EAGAN 4546100 Receipt MECHANICAL PERMIT Permit No. CITY, OF EAGAN Fee Fill in numbered apacea S/C Type or Print legibly Tot. 1. Date r 2. Installation Cost 3. Job A(idfess -- Lot t Blk. Tract, ` 4. Owner 1- .,c 5. Contractor i 1 ? , C- T f'?Phone i 6. Address rr' e, J : l y. 7. City State Zip ` Building Type: Residential ? Commercial rl_ Institutional ? Work Description: New ? Add ? Alter Q Repair ? Describe Fuel Type No. Equipment BTU - M. Ea. Forced Air No. Equipment CFM A H Mfg. ir andling: Boilers Mfg. Mech. Exhaust Unit Heater Mfg. Othe Air Cond. r Mfg. Gas, Piping Outlets 12. 1 hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed : for Rough Fipal Inspections: Date Insp. Date 1 p, This is your permit when numbered and approved. Approved CITY OF EAGAN 4546100 7 Receipt PLUMBING PERMIT Permit No. CITY OF EAGAN Fee fill in numbered spaces S/C Type or Print legibly Tot. 1. Date 2. Installation Cost 3. Job Address Lot -131k. Tract 4. Owner 5. Contractor Phone 6. Address 7. City State Zip 8. Building Type: Residential ? Commercial 0 Institutional O 9. Work Description: New ? 10. Describe 11. Add 1 Alter ? Repair ? No. Fixtures Water Closet No. Fixtures ool/Drainfield Cess Bath tubs p Se tic Tank Lavatory p Softner Shower Well Kitchen Sink Urinal/Bidet Other Laundry Tray Floor Drains Drinking Ftn. Slop Sink Gas Piping Outlets 12. 1 hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed : for Rou Fi aI Inspections: Date - Insp. / a Date 11P. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 ReceiptR PLUMBING PERMIT Permit No. f CITY OF EAGAN • O O ' Fee 26) 'i Fill in numbered spaces S/C S U Type or Print legibly Tot. 1. Date 2. Installation Cost 14 ' 3. Job Address t5 t Lot ' Blk. Tract c I 4, Owner Y"' c > 5. Contractor Phone 6. Address / Lb E_ V. F 7. City a State Zip 8. Building Type: Residential ? Commercial Institutional ? 9. Work Description: New ? Add ? Alter @<" Repair ? 10. Describe 11. No. Fixtures Et1`c'-Pi C Water Closet w 0 jq I-7 1 No. Fixtures Cesspool/Drainfield Bath tubs 6F-(k E (£C , Septic Tank Lavatory cl -1 '3 $3 Softner Shower Well Kitchen Sink Urinal/Bidet Other Laundry Tray Floor Drains Drinking Ftn. Slop Sink Gas Piping Outlets 12. 1 hereby certify that the above information is true and correct, and I agree to comply with all ordinances and codes governing this type of work. Signed : f for Rough Final Inspections: Date Insp. Date /a-/- This is your permit when n ered and approved. Approved CITY OF EAGAN 454-8100 Receipt MECHANICAL PERMIT Permit No. CITY OF EAGAN Fee Fill in numbered spaces S/C Type or Print legibly Tot. 1. Date 2. Installation Cost 3. Job Address 'Lot Blk. Tract 4. Owner 5. Contractor Phone 6. Address 7. City - State Zip 8. Building Type: Residential ? Commercial Q. Institutional ? 9. Work Description: New ?-. Add ? Alter ? Repair ? 10. Describe Ili Fuel Type 11. No. Equipment BTU - M. Ea. Forced Air No. Equipment CFM Air Handlin : Mfg. g Boilers Mfg. Mech. Exhaust Unit Heater Mfg. Other Air Cond. Mfg. Gas, Piping Outlets 12. 1 hereby certify that the above information is true and correct, and I agree to comply with all ordinances and Bodes governing this type of work. Signed : for Rough Final Inspections: Date Insp. Date Insp. This is your permit when numbered and approved. Approved CITY OF EAGAN 454-8100 INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Pilot Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 s I, I I I I I N et 1:3 t" 141/?Ih SITE ADDRESS: 1 fIi .I titOC,I PERMIT SUBTYPE: APPLICANT: 6,fAi I. 1NQf ('11111 PI MI ...I , -I i 1 I TYPE OF WORK: III '.f I-1,11 N 1 1 ON 11 MANI I INVAI 1 1 'dt (i tit I I I'1} I M I I Nt INSPECTION DATE INSPTR. INSPECTION TYPE DATE INSPTR. ,+Ill,il I N 1'I f+l, 1;+.+,1+,11 ? ?• ?' ? t ti ii I f' l 11 +, + It'd !'? i I I I Iii 14AI{F '.I ('ARA i 1 I'( IrM I I'. AhF III- toil f RP Il FOR ANY I:'1 11M1+ f M6 (Ilk V I I I 11; I I At 14101"t Permit No. Permit Holder Date Telephone II ELECTRIC PLUMBING HVAC Inspection Date Insp. Comments FOOTINGS FOUND FRAMING ROOFING ROUGH PLUMBING PLBG AIR TEST ROUGH HEATING GAS SVC TEST INSUL GYP BOARD FIREPLACE FIREPLACE AIR TEST FINAL PLBG FINAL HTG ORSAT TEST BLDG FINAL S/q19 BSMT R.I. BSMT FINAL DECK FTG DECK FINAL j Wem f icate of cccupaucv W{4 91 fts" Tepwhat"t of 1580his 3MOCC&S This Certificate issued pursuant to the requirements of the Uniform Building Code certifying that at the tithe of issuance this structure was in compliance with the various ordinances of the City regulating building construction or use. For the following: Uw Clmifwuioc CRWW NISC-. ,VER ffi1. ERIbMN'L Bids permit No. 2521 I OY Type Z=ing pubic[ Type Const. OwmafBuiidug MMXA TNVM- - 7=)_ PM_Add,= 5201 W 739D ST, EDINA &.Mmg Ad . 1475 SILVER ffil, ROAD Locality T • i ` Al- (M yM m i. c ENM Sudan OQicild " POST IN A COMPMAKM PLACE 905 a ?/ / Cam./ QO Request Dale - T (? p 1 - Ire No. R I ough-in Inspection Required? O Ready Now # Will otify Inspector When Ready? I 1 JVes KNO I X licensed contractor D owner hereby request inspection of above electrical work at: Job Address (Street. Box or Route No I 9,15 Silver e11 Road city Ea. an Section No. Township Name or No. Range No. County Occupant (PRINT) y Phone No. Dom ` Izz Power Supplier Morass Electrical Contractor (Company Namel E + KI KT d i Contractor's License No. CR015"ll n c o or r o , /` Mailing Address (Contractor or Owner Making Installation) >(-&41473 ,7 509 Do w r ro t o Auth zed signature (Dona CV Making4pstallalionl ^ Phone Nu r 857 I SI - o MINNESOTA STATE BOARD OF CTRICITy ??PC M /?ntp(CMtn/ THIS INSPECTION REOUESTWILL NOT Griggs-Mldway Bldg. - Room V T3 (?.? T BE ACCEPTED BY THE STATE BOARD 1821 University Ave.. St. Paul. MN 55104 rcnf}op fr10 . vS UNLESS PROPER INSPECTION FEE IS Phone 16121 642-0800 ENCLOSED. 2 G REQUEST FOR ELECTRICAL INSPECTION pp4=K! %Y ES-0000 1-08 ?/g /? yyy q L See Instructions for comp sting this form on back of yellow opy.? 9050 {1, + 4030-30' X" gotow Work Covered by This Request wi New Add Rep. Type of Building Appliancesivired EqulpmentVVired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Other (Specify) Comm./Industrial Furnace Farm Air Conditioner Other (specify) ContractorSRamshos Wl?? +W D CE, Compute Inspection Fee Be low., voo0 - ?o 0.\rr-0_0ndl+tOYlerS # Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps % 0 to 100 Amps Transformers Above 200 -Amps Ab_ove40 Amps Signs Inspectors Use Only: f ? TOTAL Irrigation Booms J +I ?So SQ Special Inspection Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. I, the Electrical Inspector, hereby Rough-in oat. certify that the above inspection has been made. Final Z7 A& f Date 1/ OFFICE USE ONLY - "low This recuesl void 18 months mom 0v6f 5.0 X/ (,t $ T400 Request Date 7/24/90 Fire No. Rough-in Inspection Required? ? Yes No Ready Now ? Will Notity Inspector When Ready? I Ekicensed contractor D owner hereby request inspection of above electrical work at: Job Address (Street Box or Route No.) 1975 Silver Bell Rd. City Egan Section No. Township Name or No. Range No. County Dakato Occupant(PRINT) Phone No. Power Supplier n;ckata FlP Atldress Electrical Contractor (Company Name) E1flC-tri? Tn Conaector5 License No. 41 nni ._T Mailing Address !Contractor Eli Owner Making Installaton) N Ma Authorized Signature IConuactm,Owner Making Installation) Pnone Number MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. - Room S-173 BE ACCEPTED BYTHE STATE BOARD 1821 University Ave.. St. Paul, MN 55104 UNLESS PROPER INSPECTION FEE IS Phone (612) 642-01100 ENCLOSED. REGUESirFOR ELECTRICAL INSPECTION 'gee instructions for completing this form on back of yellow copy e 4 7 7 4 5 X" Below Work Covered by This Request 900/00 ew Add Rep. Type of Building Appliances Wired EquipmenlWired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Other (Specify) Comm./Industrial Furnace Farm Air Conditioner Other (specify) Contractors Remarks: Compute Inspection Fee Below: # Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps Z 0 to 100 Amps Transformers Above 200 Amps Above 100 Amps Signs inspectors use Only: TOTAL Irrigation Booms ?• ?d Special Inspection Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. I, the Electrical Inspector, hereby if Rough-in Date cert y that the above inspection has been made. Final [ ,L%•{L??,:.t+„ Date OFFICE USE ONLY This request vold 18 months from 3620 $0950 Request Oate Fire No. Rough io inspection R paired? G Ready Nowt Will Notify Inspector q ^^?? Yes G No When Ready? I licensed contractor ? owner hereby request inspection of above electrical work at: Job Address (Street, Box or Route No.) r L Ciry / C ' y/ / '4c-Aq'' & Section No. Township Name or No. Range No. County Occupant (PRINT) Phone No. -Devirt, ( Power Supplier C ^ Co ? Yp Address Electrical tractor( ICOmpany N ' me) ` Contra is License No. \ J - { N [i c/V 1 Mailing Addre tConnactor or Owner Making Installation) ?- I V , . I I , L SJ Authorized Signature tract r/O wMaking Insla Rio' Phone Num b r e o ///) / r ? (? / MINNESOTA STATE BOARD O/ELECACITY THIS INSPECTION REQUEST WILL NOT Griggs-Mldwey Bldg. - Room 5173 BE ACCEPTED BY THE STATE BOARD 1821 University Ave., St. Paul, MN 55184 UNLESS PROPER INSPECTION FEE IS Phone (612) "2-0880 ENCLOSED. S/1 V/90 REQUEST FOR ELECTRICAL INSPECTION ` tea, El3-000(1-07 structions for completing this form on back of yellow copy.+ 9 Tao? rJ 36206** X' Below Work Covered by This Request New Add Rep. - Typeof Building Appliances Wired Equipment Wired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Other (Specify) Comm./Industrial Furnace Farm Air Conditioner Other (specify) Contractors Remarks'. Compute Inspection Fee Below: # Other Fee # Service Entrance Size Fee # Circuds/Feeders Fee Swimming Pool 0 to 200 Amps 0 to 100 Amps Transformers Above 200 _ Amps 0 _ Amps Signs Inspectors Use Only', -? TOTAL Irrigation Booms Special Inspection Alarm/Communication THIS INSTALLATION MAY BE ORDERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 THS. I, the Electrical Inspector, hereby Rough-;n - uatte ?Q Certify that the above inspection has been made. Final OFFICE USE ONLY This request will is months from This request void L't 18 months from CEn 0171 ?o.od Reque st ate y r ^?^ 1 ?•1 N Fire No. Rag g h-ietl n Inspection Reu r? Ready Now ill Notify Inspec- []Ready l L ?yes ?No Whey R@ady K Ucensea Electrical Contractor I hereby request inspection of above caner electrical work installed at: Street Address, Box or l?Route No. ? { 1 l,W? Vamw City it 1.c?lt 0 ecAton No. Township Name or No. onge No. county YtV • 'r.' Occ pant IPRINTI Phone No. ?` 1 M VT Power Supplier'n Address Elec _ Contractor?(lComnptann?ly'Name) C ntra foorr's License No. Mailing Address (Contractor or Owner Making Installation) 4 E, Cum Roan Authorized Sign ure ontr cto Owner Making Installation) Phone Number 89 6 55Q7 MINNESOTA STATE BOARD OF ELECTRICITY THIS INSPECTION REQUEST WILL NOT Griggs-Midway Bldg. -Room N-191 BE ACCEPTED BY THE STATE BOARD UNLESS PROPER INSPECTION FEE IS 1821 University Ave., St. Paul, MN 66106 .i. --- rat" nay ottt ENCLOSED. REQUEST FOR ELECTRICAL INSPECTION X911 See instructions for completing this farm on back of yellow copy. C 1 "X".Below Work Covered by This Request ES-000o1.04 3$toa'7 New Add Rep. Type of Building Appliances Wired Equiplhent Wqf- Home Range Temporary Service Duplex Water Heater Lighting Fixtures Apt. Building Dryer Electric Healing Commercial Bldg. Furnace Silo Unloader Industrial Bldg. Air Conditioner Bulk Milk Tank Farm - Other peci y Ollie, (Spncifyi t nr peo y other Other Compute Inspection Fee Below # Fee Service Entrance Size # Fe Fender. /Sebteedera 4 Fee Circuits 0 to 200 AMPS 0 to 30 Amps - 0 to 30 Amos Above 200 Amps 31 to 100 Amps 31 to 100 Amps Swimming Pool ] Above 100-Amps Above 100_Amps Transtormers Irrigation Booms J Partial/Other Fee Sighs Special inspection $ ) t TO L EE © . Hough-in Final 1i ^'at ?? 1, th Inspactoq hereby certify that the above inspection has been made. This request void 18 months from `r g?i4- 428 0- ? ? ? ? O ? Re t Date ^J 1 Fire No. ough,In Inspection Required Inspection Other ThaP {lough In (You must call Inspector en ready) ? Ready Nov. WIII Notify Inspector ?- ?.Yea No Data React I T`icensed contractor ?owner hereby request inspection of above electrical work at: Jab Address (Street, Box or Route No.) -? City W ? W Z V .? ? ^ Cs O rN Section No, ownship Name or No Range No County Occupant(PRI T) Phone No. 1r) Ii04.V' Power Supplier j Address Electrical Contractor (Compan Namel Conlredofs License No. 5 l Mailing Atltlress (Contractor or Owner Making Installation) 5-131? S T 1fu 53 Authotlze gnelure I tractor/Owne Ma Install No Phone Number `f ^t7 ICITY MINNESINTA STATE a I T I Bldg. - B 1 N Y II II II I I III I II I I ( I II II II VI II VereH ve, St. P u,MN 518< U y A 1 ER INSPECTION EE S ULESOP Phnnc r6121 A42-09M I ENCLOSED. /?/ REQUEST FOR ELECTRICAL INSPECTION ra\ ee-ooooios -, 10. See instructions for completing this form on back of yellow copy. -1 9 M00", a'719C X" Below Work Covered by This Request Ne Add Re - Type of Building -Appliances Wired .Equipment Wired Home Range Temporary Service Duplex Water Heater Electric Heating Apt. Building Dryer Load Management r Comm./Industrial Furnace Other (Specify) Farm Air Conditioner Other (specify) Contractor's Remarks: Compute Inspection Fee Below. # - Other Fee # Service Entrance Size Fee # Circuits/Feeders Fee Swimming Pool 0 to 200 Amps 0 to 100 Amps Transformers Above 200-Amps Above 100 Am s Signs Inspectors Use Only: G'Q TOTAL Irrigation Booms 00 Q7D ? Special Inspection Alarm/Communication THIS INSTALLATION BE ORDERED DISCONNECTED IF NOT Other Fee COMPLETED WITHIN 18 MONTHS. I, the Electrical Inspector, hereby Rough-in Date certify that the above inspection has been made. Final e? l s OFFICE USE ONLY This request wid 18 months from Chaska Investment September 8, 2006 City of Eagan Building Inspections Department 3930 Pilot Knob Road Eagan, Minnesota 55122 Gentlemen: As owner of Silver Bell Center (1969-1989 Silver Bell Road), we recognize the building to be 111-B, mixed occupancy non-separated between occupancies (M, B and A2). Sincerely, Ted W. Tinker TWT/jmm st'p 9531 West 78th Street • Suite 350 Eden Prairie, Minnesota 55344 Telephone (952) 835-4111 Fax (952) 835-6733 E-mail: wallingfordproperties.net BUILDING PERMIT APPLICATION (COMMERCIAL) ?) v I CITY OF EAGAN y U y ?_ 651-681-4675 n • Structural Plans (2 sets) • Civil Plans (2 sets) • Certificate of Survey (1) • Code Analysis (1) " • Project Specs (1) • Spec. Insp. & Testing Schedule " • Soils Report (1) • Meter size must be established 1 1 1 1 • MC/ES SAC determination letter _S II3—] `?_ .U tc seas) • mcmiecturai rians (z sets) (2 sets) • Code Analysis (1) " (2 sets) • Project Specs (1 set) (2 sets) • Key Plan (1) (1)" • Master Exit Plan (1) (1) • Energy Calculations (1) not always- (1) • Elec. Power & Lighting Form (1) not always" • Meter size must be established - if applicable (1) (1) 1 (1) 1 (1) 1 (1) 1 • MGES SAC determinat ion letter • Architectural Plans • Structural Plans • Civil Plans • Landscaping Plans • Code Analysis • Certificate of Survey • Spec. Insp. & Testing Schedule • Meter size must be established • Project Specs • Energy Calculations • Electric Power & Lighting Form • Master Exit Plan • Fire Protection Plan • Soils Report • MC/ES SAC determination letter 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: 2 ?? y ^ ll U WORK TYPE: _ NEW REMODEL CONSTRUCTION COST: Zip d o DESCRIPTION OF WORK: v? ?i/??1CtUwS TENANT NAME: 0 vrt i n015 2'Zd SUITEM 160 CI -d 1 FORMER TENANT NAM SITE ADDRESS: 1 9Z 5-- S; A14-1- LOT Name: PROPERTY OWNER Street BLOCK- SUBD Last First Phone#: ( City // State: Zip: Company: ?+_/734 f•.CT vI eeS?X I ?S Ca?? Phone #: (/ G3^ ) a0 CONTRACTOR rr rr??q 4 1, Street Add)ress: / bd orJ ?? '•? ? Gt2? P8 Z• $'657 City ?1I/Yhah f`?l State: 171 /U Zip: ARCHITECT/ ENGINEER Company: on/ Phone #: ( ) Name: Registration #: Street Address: City State:: Licensed plumber installing sewer/water:- Phone #: DEC 1 5 ?000 J Meter Size: 1 hereby acknowledge that I have read this application, state that the information is correct, and agree to B - to of Minnesota Statutes and City of Eagan Ordinances. S- "7 Signature of Applicant::- OFFICE USE ONLY BUILDING PERMIT SUBTYPE ? 01 Foundation ? 26 Public Facility ? 30 Accessory Bldg. ? 14 Apartments 0` 27 Commercial/Industrial ? 32 Ext Alt - Apts. ? 15 Lodging ? 28 Greenhouse ? 34 Ext Alt - Comm ? 25 Miscellaneous ? 29 Antennae . ? 35 Ext Alt - PF WORK TYPE ? 31 New ? 32 Addition 0 33 Alterations ? 34 Repair ? 35 Tenant Impr ? 36 Move Bldg. GENERAL INFORMAT ON Census Code 3,2 7 SAC Code '? No. of Units No. of Bldgs. / Const. (Actual) (Allowable) UBC Occupancy In ? 37 Demolish Bldg. ? 43 Reroof ? 38 Demolish (Interior) ? 44 Siding ? 42 Demolish (Found) ? 45 Fire Repair . ? 46 Windows/Doors Zoning # of Stories Length Width Basement sq. ft . First Floor sq. ft . sq. ft. MISCELLANEOUS INSPECTIONS ? Gas Service Test ? Heating APPROVALS Planning Permit Fee Surcharge Plan Review MC/ES SAC City SAC Water Supply & Storage S/W Permit S/W Surcharge Treatment Plant Park Dedication Trails Dedication Water Quality Other Copies Total Building 1e1_a? L h? sq. ft. sq. ft. sq. ft. sq. ft. MC/ES System City Water Fire Sprinklered ? Insulation ? Plumbing ? Stucco/Stone Engineering Variance VALUATION:$ % SAC SAC Units Meter Size irCITV OF EAGAN 3830 Pilot Knob Road Eagan, Minnesota 55122-1897 (612) 681-4675 PERMIT c R M[3 z PERMIT TYPE: BUILDING Permit Number: 025211 Date Issued: 03/10/95 SITE ADDRESS: 1975 1/2 SILVER BELL RD LOT: 1 BLOCK: 1 SILVER BELL CENTER DESCRIPTION- ----- SILVER `Building..Permit Type Building Work Type BELL PRINTING COMM./IND. MISC. TENANT FINISH REMARKS SEPARATE PERMITS ARE REQUIRED FOR ANY PLUMBING OR ELECTRICAL WORK FEE SUMMARY- VALUATION $3,000 Base Fee $54.00 Surcharge $1.50 Total Fee $55.50 CONTRACTOR: - Applicant - OWNER: WALLINGFORD PROPERTIES CO 28354111 CHASKA INVESTMENT LTD PTNR 5201 W 73RD ST 5201 W 73RD ST EDINA MN 55439 EDINA MN 55439 (612) 835-4111 (612)835-4111 I hereby acknowledge that I have read this information is correct and agree to comply Statutes an City of Eagan Ordinances. PLICANT/PERMITEE SIGNATURE application and state that the with all applicable State of Mn. n g,Q?( ?I?FI CIS D (tfl SIGNATURE -%? INSPECTION RECORD CITY OF EAGAN PERMIT TYPE: 3830 Not Knob Road Permit Number: Eagan, Minnesota 55122-1897 Date Issued: (612) 681-4675 BUILDING 025211 03/10/95 SITE ADDRESS: LOT: 1 1975 112 SILVER BELL RD SILVER BELL CENTER PERMIT SUBTYPE: COMM./IND. MISC. APPLICANT: BLOCK: 1 , WALLINGFORD PROPERTIES CO (612) 835-4111 TYPE OF WORK: TENANT FINISH nFSCRIPTION STLVFR BELL PRTNTTNI INSPECTION FOOTINGS DATE INSPTR. • TYPE FRAMING DATE INSPTR. ROUGH IN PLBG ROUGH IN HTG FINAL PLBG FINAL HTG FINAL REMARKS: SEPARATE PERMITS ARE REQUIRED FOR ANY PLUMBING OR ELECTRICAL WORK CITY OF EAGAN 1995 BUILDING PERMIT APPLICATION (COMMERCIAL) 661-46 ECHVED The following are required with appropriate certification for all a= construction: MAR O 1 1995 2 each: architectural plans; mech. & elec. plans; fire sprinkler plans; stru ural plans; site plans; laandsa rig plans; grading/drainage/erosion control plan; utility plan ""- - - - - - - - - - - 1 each: set of specifications; set of energy calculations; electrical power & lighting form; Special Inspections & Testing Schedule Letter from MCMIS (phone #222-8423) indicating SAC determination Code analysis indicating: Codes used; occupancy classifications; setbacks; maximum allowable area as per Building and City Codes along with sq. ft. per floor, type of construction (synopsis of construction components) & any occupancy or area separation walls; occupancy loads; exit synopsis with a diagram indicating exiting lads from each room or area, travel paths & all rated corridors; plumbing futures; and parking. DATE: 3-1- 9 5 WORK TYPE:_ NEW ZC REMODEL DESCRIPTION OF WORK: I ?'t I .T.v?t?vl'or ReuvlocCe.I QyIN'I N?4`\ CONSTRUCTION COST: 3 WO-CLO TENANT NAME: SI Jd?Y bell SITE ADDRESS: Ig75 ??Z S?IV,er?? ICA?G( ?°° T ?S°"al`?¢ . . ,.. G7ys2 -711 j LOT ( BLOCK I SUBD. $11VAlf W1 140-1 P.I.D.# I?'dglfb-O(C-DI PROPERTY Name: e-kIA6*L. -rrlWA4i?f+& '1'W, PAP+- Phone #: 615-41d NSL W6i OWNER Street Address- 5ZO I OJ . 734 Soh' . City: Et,Q,I 04 .. State: A44 Zip: 55',qB1) CONTRACTOR Company: Il_ a? (i rr.1 Rroaga ?Oo Phone #: $35-411( Street Address' 52o I W. 73'? S-4. City: Eot, ;Urn. Zip; 5S43q ARCHITECT/ Company: NIA Phone #- ENGINEER Name: Registration #' Street Address, City: State: Zip: Sewer & water licensed plumber: I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State of Minnesota Statutes and City of Eagan Ordinances. Signature of Applicant: OFFICE USE ONLY BUILDING PERMIT TYPE ? 01 Foundation ? 18 Comm./Ind. WORK TYPE ? 31 New ? 32 Addition ,0-'.19 Comm./Ind. Misc. ? 20 Public Facility ? 33 Alterations ? 34 Repair GENERAL INFORMATION Const. (Actual) (Allowable) UBC Occupancy Zoning # of Stories Length Depth APPROVALS Basement sq. ft. First Floor sq . ft. sq. ft. sq. ft. sq. ft. sq. ft. Footprint sq. ft. Planning Building Permit Fee Surcharge Plan Review MCNVS SAC City SAC Water Conn. S/W Permit S/W Surcharge Treatment PI. Road Unit Park Ded. Trails Ded. Water Qua]. Other Copies Total: ? 21 Miscellaneous a;*?35 Tenant Finish ? 37 Demolition MC/WS System City Water Fire Sprinklered Census Code 3.7 SAC Code _ Census Bldg. -L Census Unit o Engineering Variance Valuation: $ ?? aco % SAC SAC Units Meter Size I 21 10. Ig 18 16 '1> Silver Bell Center Site Plan E H Q? H x x w 1J ?.. 1?'b 1?a 4 10 9 I0.. 1 Ib. 11> 5. I h. 1 3. 6.1 1 1 I 2. ANSUL R-101/R-102 FIRE SUPPRESSION SYSTEMS INSTALLATION DESIGN SHEET DATE 142 CUSTOMER AUTHORIZED ANSUL DISTRIBUTOR alt CYloul NAME r . _ _ - _ ?.....? STREET `rl STREET CITY, STATE,&-ZIP- ?" - CITY, STATE & ZIP FILL IN ALL APPROPRIATE DATA BELOW AND CAREFULLY SKETCH HAZARD LAYOUT ON INSIDE SYSTEM Model(s) and serial numbers Location Number of nozzles and Part No. Number of detector(s) and degree rating Energy shut-off devices - type and size Location Other accessory equipment provided (pull station, electric switches, etc.) and location COOKING/VENTILATING EQUIPMENT Number of duct(s) and size Hood size and plenum size Maximum temperature determined at detector location(s) Cooking Appliances and size of cooking surface. (NOTE: List appliances from left to right and Indicate those.being protected.) 1. 4. 2. 5. 3. 6. COMMIENTS a z N C r J? e Z 9 m S 2 0 S of 3 m n C a r FAIRMONT FIRE SYSTEMS 612 East Blue Earth Avenue Fairmont, Minnesota 56031 Doug Reed Fire Marshal City of Eagan 3830 Pilot Knob Road Eagan, MN 55122 RE: Jade Lau Chow Mein 1975 -Silver Bell--Shopping Center_) Eagan,-MN-55121 Dear Sir, PHONES: Fairmont 507.235-9860 14 June 1985 Please be advised that we extended coverage using 2 appliance nozzles to cover the installation of 2 woks. This coverage is within the limitations of NFPA 96 and the UL listing for the R-102. We are authorized Ansul distributors and work was done according to their specification also. Should you have any questions please do not hesitate in giving us a call on our toll free number - 1-800-862-8601. Sincerellyy,,I?/?? ? 7jig ?Don Anderson 2007 COMMERCIAL MECHANICAL PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan MN 55122 Telephone # 651-675-5675 Please complete for. commerciaUindustrial buildings multi-family buildin when separate permits are not required for each dwelling unit So . so Date//Q/0 ? Site Street Address 7 L ,.v 9k, unit # Tenant Name (if applicable) ? ? ?y A- Previous Tenant Name Property Owner Telephone # Contractor l??-l 2t=F ?I{-?Q .l?/V Street Address ("a n ??}. k n , ?1 S? - City Q lcgrtat-_'? State /V11C_? Zip " S"5;C(a Telephone # ( &91 a) 8 (0 ( -')3 , / 7 Bond #: L? L l Expires: ' o?) The i? Contractor Other Work SEP 1 2 20 -New Construction -Interior Improvement - Install Piping _Processed Gas Exterior HVAC Unit** **HVAC units must be screened _ Under/Above ground Tank _ Install Remove When installing/removing tank(s), call for inspection by Fire Marshal and Plumbing Inspector Nature of Work: t G ( cW C clip hoR t ttE JACK LS4fP1 ICA c. - r? re Y'.11 isr E co - 1 Q lG Permit Fees $70.50 Underground tank installationlremovat /Ahp Ca*CF?tS/Afrrr &V a- $50.50 M/Nmum (includes Smte Surcharge) ??" Contract Value $ ela , .OCR x 1% _ $ Permit Fee $ State Surcharge To calculate surcharge If Permit Fee is leas than $1,000, surcharge is 50 cents. If Permit Fee is> $1,000, surcharge increases by S.50 for each $1,000 Permit Fee (i.e. a $1,001-$2,000 Permit Fee requires a $1.00 surcharge). $ JE_J 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 and with the Mechanical Codes; 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. _ a n Applicant's Printed Name - Applicant's Signature Approved By: / -? U7 - ° - - Inspector Date: °•°~+• -• Required Inspections: _ U.G. _ RI. _ Air Test _ Gas Service Test _ Infloor Heat Final "O.-WOQ WT t?5C) 5x- 2006 FIRE SUPPRESSION SYSTEMS PERMIT APPLICATION City Of Eagan 3830 Pilot Knob Road, Eagan Mn 55122 Telephone # 651-675-5675 Fax # 651-675-5694 Requirements: 2 complete sets of drawings and specifications cut sheets on materials and components to be used / Date -9/ to Site Address: l? Jf y-(IK Tenant / Building Name: J {? (? 4-,1(? The Applicant is: Owner Contractor Other PROPERTY OWNER Address: ?i? City: State Zip: CONTRACTOR I + U( G VQIN License #: Address: l Jj ?V] f ?? • City: State: Zip: ?? Phone #: ???f? ESTIMATED COMPLETION DATE: /D l /D / U2_ FIRE PERMIT TYPE: Sprinkler System (# of heads Fire Pump _ Standpipe Other: WORK TYPE: New _ Addition Alterations Remodel Other: DESCRIPTION OF WORK: Commercial _ Residential _ Educational Other: Larg 3rr Please continue on reverse side PERMIT FEE: $50.50 Minimum Fee (includes State Surcharge) Contract Value $ ?)06' aO x .01 $ -?2 ori Permit Fee If Permit Fee is $1,000 or less, add $.50 =:> If Permit Fee is over $1,000, add $.50 per $1,000 Permit Fee 3/4" Displacement Fire Meter - $167.00 TOTAL FEE: $ 50- SO State Surcharge I hereby apply for a Fire Suppression System permit and acknowledge that the information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Minnesota Building/Fire Codes; 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 ap oved plan in the case of work which requirre]sna review and approval of plans. r"V) rV/lt°l??l LP App ant's Printed Name ppli is Signature DO NOT WRITE BELOW THIS LINE ñú þ ý þýý üû û ú ùýýúñøùë üë ô ñ ô ßä ÿ þý÷ üûúùø ÷ ô ô ÷ôùø ó ö ÷ ô ô ã ôüØ ã ôùø ã ûé ûô ü ô óû ú ò óû ú üØ ý âãÛûô ððôüó ã øýãóð ô í æêäêðä öù üûô ô íè æê ê õøôø ÷óò øø Õþôüö ûééôø ô ñ ððóôüêìèß ã ãû ç öñ ðð ÝßÜßððä×ß ô úù ö ë ô øø éô ôô ô øùö øø ú ü éã ü û ñùéþ ìô ê øø õ ô ü ûô û ùü ûô 05/30/2014 14:29 6123311161 OLSEN FIRE PAGE 01/03 Use BLUE or BLACK Ink 66 i For Otfice Use '23 I Permit City of Eajan I Permit Fee: 3830 Pilot Knob Road RECEIVED l Eagan MN 55122 Date Received: Phone: (661) 676675 MAY 3 0 2014 Fax: (661) 6766694 I Staff: 2014 FIRE SUPPRESSION SYSTEMS PERMIT APPLICATION* Date Site Address: 1Tfi Tenant: a;ae Suite: d:;. i i,, j .1: ';,•~•i::~~iii; Name: T-rtt Phone: .Le.),2- 7 3o_3J ji~lllf .I .!I LII~•- ~ ~ (f I~~ulWNl11"ll l I lr I Address / City / zip: ' 41 m< 4 ::':..•,,.tu..f; II i I II. Il'I ~lill!IIIIIj.;:Il~Illi I y III LI'! i'li 'i!`U(:'•.,`.;;'° ;li'" Applicant is: Owner Contractor I 1'; Ir•'. iC `C:a.:,l; i •I,:'.1,, I ...eI1111. !111! II' Ii:► „I 1.':,,r ` ,.I'~.. Description of work: Ir :;.I_ . I III ~,'..Il ,p:I alls~ I! illy± ,I II Estimated Completion Dater -33 Construction Cost: l . I' I I~illll•.I •I.'I:illl'iii .:iiil •';I~...~~1~. ;lull l l . .'ail:; : ; • llI.. 1 ~ c Name: a~n fly. License Address: ~1i1J1 Shy City: !''IILI;IL;~;~!;'►I; I,h;;l;:,.; .~i i:,',!li' State: Zip: x'/13 Phone; 1 331- i~il•I:G:Ill.ill;. ,I~i^'iC~d:;l,. ~ Contact: Email: r4o (d FIRE PERMIT TYPE WORK TYPE Sprinkler System of heads -L) _ New _ Addition Fire Pump _ Standpipe _ Alterations X- Remodel Other: Other: DESCRIPTION OF WORK: Commercial Residential Educational FEES Contract Value $ X.01 $55.00 Permit Fee Minimu_M ~ ► Permit Fee If contract value is LESS than $10,010, Surcharge = $5.00 '*If contract value is GREATER than $10,010, Surcharge = Contract Value x $0.0005 = $ Surcharge* "**If the project valuation is over $1 million, please call for Surcharge _ $ TOTAL FEE 3/4" Displacement Fire Meter - $260.00 Fire Meter TOTAL FEE 'Requirements: 2 complete sets of drawings and speclFlcations, cut sheets on materials and components to be used I hereby apply for a Fire Suppression System permit and acknowledge that the Information Is complete and accurate; that the work will be in Conformance with the ordinances and codes of the City of Eaqan and with the Minnesota Building/Fire Codes; that I understand this is not a permit, but only an applloatlon 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. 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I• I IJ!':.1 17;`' ? .I IIr l'.:'. • 11 •I I .1,.11. 111I,I•.!~,.' 1:1111 . n~IIII,,~ rlrl ~I I,II T . � Use.�.-.. �:;or BLACK Ink �-----------------� � For Of�ice Use / I . � � � Permit#: ���,��� 1 �lU Ol �� �� r r-� � - 3 l � Y � !�".��If�L� I Permd Fee: �� I 3 8 3 0 P i l o t K n o b R o a d R�� � i Eagan MN 55122 i � Phone: (651)675-5675 Q�B � <� �DZ� � Date Received: � Fax: (657)675-5694 j i � Staff: ----------------- �" 2014 COMMERCIAL BUILDING PERMIT APPLICATtON �'`�` �'���f Date• /ll'//7 % '���� j I� ��� � �� F'F-'l Site Address: Tenant Name: ��� 1 `?(7�'j `/ i 2�ay (Tenant is: New/ � Existing) Suite#: Former Tenant: Name: /TMIU Pv'�-�D}'� / �f`� /���� ,ru/4�P lR�� Phone: ��'Z'—g3�—/,�3� Property Owner Address/City/Zip:�m,�0,;- Pc�r�uedD� RD� �f UI �t. �� 35"y3� Applicant is: Owner � Contractor Type of Work Description of work: L.� P��o o��-e Construction Cost: d?� I�= l0,0 0� tvame: z- a�cs n C'n H 5�vvc.�F i�� t h �.. �icense#: �G`�`�fo S/7 7 v Contractor Address:j� (,�, 13 vx �'� city: �-e�r�� State: ��'1 z�p: 5(� (a 7 2 Phone: 7�3 - �g'� -�03 � Contact: ��'�� Email: 6 ��j��7/✓!C Ur ��/�o��a�� ��0�"''1 V Name: �'�U� � s��^E� 1'�rc�5 1���, Registration#: ArchitectlEngineer Address: �7�7� �v��q ���a_�5�_Ciry: lV� I�P ��'�� � �a State: ��Zip: �� �/L� Phone: �5� ` �2��Ts�� Contact Person: �t'�S/C� Emait: Licensed plumber installing new sewer/water service: M1'V b UI'f' Phone#: NOTE:P/ans and supporting documents that you submit ar+e considered to be public information. Portions of the information may be cfassifred as non-public if you provide spec�c 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. I hereby acknowledge that #his information is complete and accurate; that the work will be in conformance with the ordinances and codes of the City of Eagan; that 1 understand this is not a permit, but only an appfication 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 ease of work which requires a review and approval of plans. x ��'i-�I/ � a ni e� x � Applicant's Printed Na e Applicant's Signature Page 1 of 3 « : ' j��-� ���� 13��j �� +�a-� ��� DO NOT WRITE BELOW THIS LINE L SUB TYPES Foundation Public Facility Exterior Alteration-Apartments —, — — ✓Commercial/Industrial Accessory Building Exterior Alteration-Commercial _ Apartments _ Greenhouse/Tent _ Exterior Alteration-Public Facility Miscellaneous Antennae WORK TYPES / _ New ✓ Interior Improvement _ Siding _ Demolish Building* _ Addition _ Exterior Improvement _ Reroof _ Demolish Interior _ Alteration _ Repair _ Windows _ Demolish Foundation _ Replace _ Water Damage _ Fire Repair _ Retaining Wall _ Salon Owner Change *Demolition of entire building-give PCA handout to applicant DESCRIPTION ,,� Valuation �D��Q� • � Occupancy -P MCES System � Plan Review �✓ Code Edition t�7/r'�SP,,� SAC Units 0/.� �� /N GSt oG �•Ldf� (25%_100%� Zoning �� City Water �/ Census Code Stories Booster Pump #of Units a Square Feet PRV � #of Buildings / Length Fire Sprinklers Type of Construction „�%,P� Width REQUIRED INSPECTIONS Footings(New Building) Sheetrock Footings(Deck) � Final/C.O. Required Footings(Addition) Final/No C.O. Required Foundation Other: Drain Tile Pool:_Footings _Air/Gas Tests _Final Roof:_Decking _Insulation _Ice&Water _Final Siding:_Stucco Lath _Stone Lath _Brick �= Framing Windows Fireplace:_Rough In _Air Test _Final Retaining Wall Insulation Erosion Control Meter Size: f �Final C/O Inspection: Schedule Fire Marshal to be present: � Yes No . __.__ Reviewed By: �� , Building Inspector Reviewed By: , Planning COMMERCIAL FEES Base Fee /f/.75� Water Quality Surcharge S'�d Water Supply 8�Storage(WAC) Plan Review /2�"` Storm Sewer Trunk MCES SAC Sewer Trunk City SAC Water Trunk S8�W Permit 8�Surcharge Street Lateral Treatment Plant Street Treatment Plant(Irrigation) Water Lateral Park Dedication Other: Trail Dedication Water Quality TOTAL .32�• 3 � Page 2 of 3 ' � �a-� J ��r City of Eagan Per the reznodeling plans for the Domino's in Eagan the seating in Che c�.istomer lobby area is designed for the customer waiting experience.The lobby area will rennain the sa�ne size as it is naw.We are merely adding in more seats so customers wili have a place to wait. The remodeling project will`o�en' up our kitchen to our customers.They will he able to watch the pizza maliing experience. Domino's is a delivery and takeout aperation. Our staff consists of delivery drivers and pizza makers.We have no waiters or waitresses on our staffs. I laope this clarifies the intent behind aur remodeling pi•oject. �,�'�.:,�.�,_:`, Wayne Peterson President Tri Pete's i'izza (DBA Domino's Pizza) 1975 Silver Bell Road Eagan MN 55122 4ctober 29, 2014 For Office Use C� _�j 4 I , Permit#: 73'--/ ! S / 4 . „ E N AGA Permit Fee: Staff: 3830 PILOT KNOB ROAD EAGAN,MN 55122-1810 C �a�smm�sa we air. No I a,,s9 us um 1 Payment Recvd: Yes _No (651)675-5675 I TDD:(651)454-8535 I FAX:(651)675-56 Email: buildinginspections(c�cityofeagan.com SEP P 1. 9 2018 Plans:_Electronic _Paper Plan Submittal:eplans cityofeagan.com JGt L hnP lam 2018 COMMERCIAL MECHANICAL PERMIT APPLICATION ❑ Please submit two(2)sets of paper plans with all commercial applications as well as an electronic set of the submittal,submitted via email,CD or flash drive Date: 9/11/2018 Site Address: Silverbell Road Eagan MN 55122�/ Tenant: Domino's /?7/ / Suite#: Name: Phone: ijynter Address/City/Zip: Name: Summit Facility & Kitchen Services License#: TLIC22437 ContractorAddress: 2445 Nevada Ave North city: Golden Valley State: MN Zip: 55427 Phone: 763-404-8297 Contact: John Anderson Email:john@summitcanfixit.com New ✓ Replacement Additional Alteration Demolition Type of Work Description of work: Replace RTU NOTE:Roof mounted and ground mo mechanical equipmeildtsequipment . d kite ed ,i! y Code. Pleasecontact theMechanical speota Information re odd ,,A;;...: COMMERCIAL ,3f i,, , New Construction _Interior Improvement "Permit Type Install Piping _Processed • _Gas ✓ Exterior HVAC Unit Under/Above ground Tank ( Install/_Remove) COMMERCIAL FEES 7 640.00 $60.00 Permit Fee Minimum Contract Value$ x.01 $75.00 Underground tank installation/removal,includes State Surcharge =$ 76.40 Permit Fee =$ 3.82 Surcharge Surcharge=Contract Value x$0.0005 If the project valuation is over$1 million,please call for Surcharge =$ 80.22 TOTAL FEE You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at www.citvofeaqan.com/subscribe. 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 a royal of plans x John Anderson X Applicant's Printed Name Appl' ant's Signat re FOR OFFICE USE Required Inspections: Reviewed By: Dioe , i Underground Rough In ! Air Test ' Gas Service Test in-floor Heat Final HVAC Screening C For Office Use � y" : �f Permit#: / ' •% � e �• :::tFee ECEIVEDEAGAN j� ` , MAR 0 5 2019 Payment Recvd: Yes No 3830 PILOT KNOB ROAD I EAGAN, MN 55122-1810 (651)675-5675 I TDD: (651)454-8535 I FAX: (651)675-5694 Plans: Electronic Paper buildinginspections[a�cityofeanan.corn L 2019 FIRE SUPPRESSION SYSTEMS PERMIT APPLICATION Date: 2/26/19 Site Address: 1975 Silver Bell Road Tenant: TrueCare Chiropractic, LLC Suite#: S C 0 0 Requirements: 2 complete sets of drawings and specifications,cut sheets on materials and components Name: Phone: Property Owner Address/City/Zip: A2plicant is: Owner Contractor Type of Work Description of work: Relocate pendent heads as needed for new walls. Construction Cost: Estimated Completion Date: Name: International Fire Protection License#: C084 Contractor Address: 833 3rd Street SW #3 city: New Brighton State: MN Zip: 55112 Phone: 612-567-4653 I Contact: Brad Zurn Email: Bradz@intl-fire.net FIRE PERMIT TYPE WORK TYPE 1 Sprinkler System (#of headsa,y) _New _Addition Fire Pump _Standpipe Alterations ✓ Remodel —Other: _Other: DESCRIPTION OF WORK: / Commercial Residential Educational FEES $60.00 Permit Fee Minimum Contract Value$ � --?`- --'(2 x.01 =$ 60.00 Permit Fee Surcharge=Contract Value x$0.0005 If the project valuation is over$1 million, please call for Surcharge =$ 1.66 Surcharge $100.00 Residential New(includes State Surcharge) _$ 61.66 TOTAL FEE 3/4"Fire Meter-$290.00 =$ Fire Meter Radio Read(required with Fire Meters)-$190 =$ TOTAL FEE You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's website at vww.citvofeadan.com/subscribe. I hereby apply for a Fire Suppression System permit and acknowledge that the information is complete and accurate;that the work will be in conformance with the ordinances and codes of the City of Eagan and with the Minnesota Building/Fire Codes;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 i....,r--,PI r ) -7.--‘2Af--i x 7_,7. 'Z 'eTeed/cie/Z 4,71-1--——-- Applicant's Printed Name Applicant's Signatur /Sq:=DS- 7 FOR OFFICE USE REQUIRED INSPECTIONS Hydrostatic Flow Alarm Drain Test ough In Trip Pump Test Central Station 1,-."-Final Conditions of Issuance: G Permit Reviewed by: Date: / ii / ) /