4433 Cinnamon Ridge Cir06/01/2010 TUE 12:05 FAX 6514378831
City of aall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax; (651) 675.5694
Date: (P-1-1010
Tenant:
a002/002
Use BLUE or BLACK Ink
tet : r.ftrk'
Permit #:
Permit Fee:
Date Received:
Staff: C. -
2010 MECHANICAL( ERM IT tP�jLICC?ATION
Site A dress: `'I 33 �..�1 h
Suite #:
a
RESIDENT / OWNER
Name: Gt„ A C't.. rl,,,.Q,_
Phone:
(/off --0276 - 7/ All
Address / City / Zip:
6 /a " 7 lad&
CONTRACTOR
Name: 01(011 f'1U� P1.i}i.[' i 7(}`3Cj 1'"Cd fi'�1 cerise
ui
Ho
'ni[i.RS --I Li 1
Address: 19 04 +J evrn 0
1 i en • - .qty_
•St t1 S
Stater Zip: 33 Phone: (DS) - (-1.3-7- 41 1 -r
Contact: tcycn)'1ct Email:' r f.. 0 , .. .. t , t 1 1 / F
TYPE OF WORK
New 1, Replace
ent
CV
Ad, itional Alteration
�i
Demolition
Description of work: i c L '
i4—" e.
,,y� y- Y XY t "%e
V' �@me 3 F of �,}.
B ffx a Q�+{. ' �'�g� �
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RESIDENTIAL
Fumace
��)�E�,-
Mfg
y-4gq �y. q, fC31C'�
LE).'a�P�r i.�.l�� P S
{1'� S'.`.b� �!1 yY.��a �4 �,�
?.? lfQ h�,A� � � 4
New Construction
Install Piping
�
� B. g
COMMERCIAL
Tank
tank(s),
Inspector
�
P .
i. f"�yC' 3 r �l 1
i.�
n f F'.
Interior Improvement
PERMIT TYPE
_
AAir Conditioner
Processed
Air Exchanger
`
Gas
Exterior HVAC Unit
Heat Pump
—
tinder / Above ground
—
( Install /_ Remove)
call for inspection by Fire
Other
**When installing/removing
Marshal and Plumbing
RESIDENTIAL FEES:
$50.50 Minimum Add-on
or alteration to an existing unit (includes
burned out appliances, ductwork, etc.) (includes
5.50 State Surcharge) �j
5.50 State Surcharge) $ • ✓D TOTAL FEE
$90.50 Fire repair (replace
COMMERCIAL FEES;
$70.50 Underground tank
$50.50 Minimum (includes
installation/removal OR Contract Value $
State Surcharge)
=$
surcharge is $.50.
increases by $,50 for each = $
Permit Fee requires a'$1.00 surcharge).
$
x 1%
Permit Fee
- If Permit E is less than $1,000,
Surcharge
- If Permit Fee is > $1,000, surcharge
$1,000 Permit Fee (Ie. a $1,001-$2,000
TOTAL FEE
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 454-0002 for protection against underground utility damage. Catt 48 hours
before you intend to dig to receive locates of underground utilities. www.aooherstateonecall.oru
I hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances
Eagan; that 1 understand this is not a permit, but only an application for a permit, and work is not to stajwithout a permit; that t)ie
approved plan in tbe.sase,oi trvork which r quires a review and approval of plans.
App cant's Printed Name
x
Gt, KA -N. �.
Applicant's Signature
d codes of the City of
rk will be in accordance
City of Eaall
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
031010
Use BLUE or BLACK In
or Office Use �J
Permit #: • L[
Permit Fee: v7) '
Date Received: _
Staff:
2010 MECHANICAL PERMIT APPLICATI
- t lO 4433 O/iJIJ1 Y. i mode LZ e
Date: Site Address:
Tenant:
Suite #:
RESIDENT / OWNER
Name: �2IL4kF/L (D
Address /City /Zip: ti33%Adylm.A2
_ 6;
/U Phone: 6S I- 646- 027
WAS �
CONTRACTOR
Name: J VVgL4/�- `6„6",_ License #:
Address:lit51 efri / atea Eo City: fir/ 1/Y J i
Zip: 59-1 D Phone: (1 _F11 S v 6
State: ga
_� _
c.Contact: _ 4\ Email: P 1 Ck Jfa (,rhe L`fzr/JXg47/1 • eam
TYPE OF WORK
_ New 1/Replacement
Description of work: /e o.L 1
____ Additional ____ Alteration _ Demoliti n
C1 lt t ea IL LTJ ✓ fi keVA
NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City
Code. Please contact the Mechanical Inspector for information on permitted.screening methods.
PERMIT TYPE
RESIDENTIAL
Furnace
Air Conditioner
____ Air Exchanger
Heat Pump
____ Other
COMMERCIAL
____ New Construction __ Interior Improvement
____ Install Piping ____ Processed
____ Gas ____ Exterior HVAC Unit
____ Under / Above ground Tank (__ Install / ___ Remove)
** When installing/removing tank(s), call for inspection by Fire
Marshal and Plumbing Inspector
RESIDENTIAL FEES:
$50.50 Minimum Add-on
or alteration to an existing unit (includes
burned out appliances, ductwork, etc.) (includes
$.50 State Surcharge) 5�
$.50 State Surcharge) $ /t T TOTAL FEE
$90.50 Fire repair (replace
COMMERCIAL FEES:
$70.50 Underground tank
$50.50 Minimum (includes
installation/removal OR Contract Value $ x 1%
State Surcharge)
= $ Permit Fee
surcharge is $.50.
increases by $.50 for each = $ Surcharge
Permit Fee requires a $1.00 surcharge).
_ $ , TOTAL FEE
- If Permit Fee is Tess than $1,000,
- If Permit Fee is > $1,000, surcharge
$1,000 Permit Fee (i.e. a $1,001-$2,000
CALL BEFORE YOU DIG. CaII 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
Eagan; that I understand this is not a permit, but only an application for a permit, and work is not to sta .out a permit; that)rk will be in accordan,
with t approved plan in the case of work which requires a review and approval of plans. rte
x
x_
1 \41244-1-001,.
1y
Applicant's Printed Name Applicant's Signature
i
FOR OFFICE USE
Reviewed By: Date:
Required Inspections: ___Under Ground Rough In ___Air Test ___Gas Service Test In -floor Heat __Final
RESIDENT OWNER
Name: /77A,.i :e le oc Phone: (;51 ,i 4/ 3 's 93
Address City Zip: /'C/ C :n4,, e,, a';Ipe C ;r e j ih s'
i 1
Applicant is: X Owner Contractor
TYPE OF WORK
Description of work: ,e, `T.15J if Le i Ail/ ,A.,
Construction Cost: Multi- Family Building: (Yes No
CONTRACTOR
Name: ‘7c Id License
Address:
City: State: Zip:
Phone: Contact Person:
COMPLETE
In the last 12 months, has
No If yes,
THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
the City of Eagan issued a permit for a similar plan based on a master plan?
date and address of master plan:
_Yes
Licensed Plumber: Phone:
Mechanical Contractor:
Sewer Water Contractor:
Phone:
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.
City of Etan
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
Date: IG ?f t/O r/ Site Address:
Tenant:
Applicant's Printed Name
x
JJ
df`-
2009 RESIDENTIAL BUILDING PERMIT APPLICATION
Applicant's Signature
For Office Use
Use BLUE or BLACK Ink
Permit
Permit Fee:
Date Received:
Staff:
Suite
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.000herstateonecall.orq
-J
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.
Page 1 of 3
CITY OF EAGAN !MATER SERVICE PERMIT
3830 Pilot Knob Road
P. O. Box 21199 PERMIT NO.:
Eagan, MN 55121 DATE:
Zoning: _ _ No. of Units:
Owner: _
Address:
Site Address:
Plumber:
Meter No.: Connection Charge:
Size: Account Deposit:
Reader No.: Permit Fee:
I agree to comply with the City of Eagan Surcharge:
Ordinances. Misc. Charges:
Total:
By``" Date Paid:
Date of Insp.: V77173, Insp.:
CITY OF EAGAN SEWER SERVICE PERMIT
3830 Pilot Knob Road
P. 0. Box 21199 PERMIT NO
Eagan, MN 55121 DATE:
Zoning: No. of Units:
Owner:`
Address:
Site Address:
Plumber:
1 agree to comply with the City of Eagan Connection Charge:
Ordinances.
Account Deposit:
Permit Fee:
By Surcharge:
Y Misc. Charges:
Date of Insp.: Total:
Insp.:____ _ Date Paid:
0c t, 18. 2013 9:OOAM Crest Exteriors 651-463-8095 P. 19
Use 13LUE or BLACK Ink
For Office U50 JL4
1
Permit M 1
City of Eatan I 17
1
I Permit Fee: (
3830 Pilot Knob Road t
Eagan MN 55122 I Date Recelved:
Phone: (651) 676-5675 1 I
Fax: (651) 676-6694 1 Slaft: 1
2013 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 0-1- 1'6 Site Address: ` Unlt p:
0
Name: Qi Phone:
Resi nt1
• O eP Address /City /Zip:
Applicant is: -Owner ✓ Contractor
y e o Description of work: r
Construction Cost; Multi-Family Building: (Yes No____)
Contact
Company'
~;~Address:
2 ZM ZZ
9
State: ~ 1\ zip, ' LI I Phone:
` License -kO 2 U Lead Certificate
If the project is exempt from lead certification, please explain why: (see Page 3 for additional Information)
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months, has the City of Eagan Issued a permit for a eimllar plan based on a master plan?
Yes ZNo If yes, date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer a Water Contractor: Phone:
NOTE# la d o g`do '"ts yo°°~°"fib°" t - =co s - ed~f"° e" b t:.lnfori# Uon.•=P'' ons:of
S :G O'a•
3t e:. n ab e,.e at1:R!'t
:;:~~;co c -.that.. a .~ep•
CALL BEFORE YOU DIG. Call Gopher State One Call at (651) 464.0002 for protection against underground utility damage- Call 48 hours
before you Intend to dig to receive locales of underground utilities, www.ooph rataleonecall org
1 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 Minnesota State Building Code must be completed within 180
days of permit Issuance.
W x
Applicant's Printed Name Appllcant's Signature
Page 1 of 3