4138 Beaver Dam Rd411°
City otBaQan
Date:
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
JUL;
COS5e
Use BLUE or BLACK Ink
0.01—t*Aisa
Permit #. i Q ®d7tO
Permit Fee: GS_ ® U
Date Received: ?ICl/
Staff:
2011 MECHANICAL PERMIT APPLICATION
Site Address: 1/43g LJ- &L
Tenant:
Suite #:
V v
RESIDENT / OWNER
Name: f,, „, k N. L L1)
Phone: 6 --- / ' Z D -7/Address
,,pp
/ City / Zip: 7/,0 g - DLA- /tA tt al -./o L S 7 2
CONTRACTOR
11
Name: 5 OWilk .i -le,„.. lie 1t e/e,„ AK,- License #:
Address: bel - N aril -City: 1,..)
State: Zip: Phone: 9 �__
00— o3
P�$7
Contact: Rt t4/4t4/ t4 Email:
TYPE OF WORK
New Replacement Additional Alteration Demolition
Description of work:
NOTE: Roof mounted and grout! mounted mechanical equ pment' s tequired to be screened by City
Code. Please contact the Mectiianical Inspector for information on permitted screening methods.
PERMIT TYPE
RESIDENTIAL
Furnace
COMMERCIAL
New Construction Interior Improvement
_
1/Air Conditioner
T
_ Install Piping Processed
Air Exchanger
Gas — Exterior HVAC Unit
Heat Pump
Under / Above ground Tank ( Install I Remove)
_
Other
**When installing/removing tank(s), call for inspection by Fire
Marshal and Plumbing Inspector
RESIDENTIAL FEES:
$55.00 Minimum Add-on
or alteration to an existing unit (includes
burned out appliances, ductwork, etc.) (includes
$5.00 State Surcharge)6-0
Srs ,
$5.00 State Surcharge) $ TOTAL FEE
$95.00 Fire repair (replace
COMMERCIAL FEES:
$75.00 Underground tank
$55.00 Minimum (includes
installation/removal OR
State Surcharge)
$10,010, surcharge is $ 5.00
surcharge increases by $.50 for each $1,000 Permit
Fee requires a $ 5.50 surcharge)
Contract Value $ x 1%
= $ Permit Fee
- If the Permit Fee is less than
Fee = $ Surcharge
- If the Permit Fee is > $10,010,
(i.e. a $10,010-$11,010 Permit
= $ 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.youpherstateonecall.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 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. 1
x s;e le— r
Applicant's Printed Name
Applicant's Signature
FOR OF
Require
ICE USE
Reviewed; By;
Under Ground — Rough In Air Test Gas Service E
VAC S
City of Eaaii
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (651) 675-5694
MART fr 2011'
For Office Use pp��
Permit: ! V a 7
Permit Fee: 0-7) - '5
Date Received:
Staff:
L
L3 2009 MECHANICAL�PERMIT APPLICATION
Date: 3 " l l 0 Site Address: Z sll 8 - r�1 i2-04.41-, I9 awn.. "f
Tenant: (ii-rU)
Suite #:
RESIDENT /OWNER
Name: J ,i Phone: [A.2 S -1;//r...2, 0 7 I
N"� 1 /
`� yy�
Address / City / Zip: I/ /3 g ' 61-� '49! ! j�J- c, l /ln. 3 D -A 2_
CONTRACTOR
Name: So c.:(111 S—el�'�. 110 #4K , -License #:
Address: I t g O 0 - #, -4, 61-v--01-,,
City: State: ! y�/13,,- Zip:5;1(3 7
71--�
Phone: 9 -sv-°-‘22.j/ SS Contact Person: Se X . Zairet*
TYPE OF WORK
New Additional Alteration Demolition
,/Replacement
p p
Dtesc t oftwit: if . x ,�p1/o52g1Gt/t
NOTE: Both roof mounted and d mounted mechanical equipment is required to
be screened by City Code. Please contact the Mechanical inspector or one of the
Planners for information onpermitted screening methods.
PERMIT TYPE
RESIDENTIAL
XFurnace
COMMERCIAL
New Construction — Interior Improvement
—
Install Piping — Processed
Air Conditioner
—
Gas _____Exterior HVAC Unit
Air Exchanger
—
Under / Above ground Tank ( Install / Remove)
F Pump
�" When installing/removing tank(s), call for inspection by Fire
Marshal and Plumbing Inspector
Other
RESIDENTIAL FEES:
$50.50 Minimum Add-on
or alteration to an existing unit (includes $.50 State Surcharge)
out appliances, ductwork, etc.) (includes $.50 State Surcharge)
$ b 0 - D TOTAL FEE
$90.50 Fire repair (replace burned
COMMERCIAL FEES:
$70.50 Underground tank
$50.50 Minimum (includes
installation/removal OR
State Surcharge)
surcharge is $.50.
increases by $.50 for each
Permit Fee requires a $1.00 surcharge).
Contract Value $ x 1%
$ Permit Fee
- If Permit Fee is less than $1,000,
= $ State Surcharge
- If Permit Fig is > $1,000, surcharge
$1,000 Permit Fee (i.e. a $1,00142,000
$ TOTAL FEE
I hereby advnowedge 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. „ 1
x Ro r
Applicant's Printed Name
FOR OFFICE USE
Reviewed By: Date:
Required inspections: Under Ground — Rough In Air Test Gas Service Test In -floor Heat Final
Exterior HVAC Screening Inspection
06/17/2014 15:08 Les Jones Roofing, Inc. (FAX)9528817009 P.020/020
41,11IPPCity of Eaau
Date:
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675-5675
Fax: (661) 675-5694
Use BLUE or BLACK Ink
For Office Use
Permit #: l �3
Permit Fee: q3(4:1'
a
Date Received:
Staff:
% 20`14 RESIDENTIAL BUILDING PERMIT APPLICATION
I I f7 Slte Address: en 379' C//�7SE7- �/ty.. GA49 44/30- y.�.241P 3y ` unit
`^";. '1; ;'
.
/ f, / i � 1.
Y
, . 1
;E. r`.ner; ,• +
r: a i?a ;' � : %.. J;,
Name: 10 PeOPe4Ty coeleE t Nc., Phone: 457- 3-3-21-3-3-21-99.4/.1
i
Address / City / Zip: RD, BOX 2t 2 5 /Nvi12-6a2-Dv-i hrs Ad olip 2
Applicant Is: Owner X Contractor
,^, A .r°''` "
; 'y e; prk'.
. :',: " '
Description of work: Q /?Pc,14 SAO/A14-,.
Construction Cost S' . 35-5. d 7 Multi -Family Building: (Yes A / No
)
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' -:'
>.•1:f . "': a=.
•'.,.'J'.�p.% � ,!'�� ;:� � `$'`'� � �'�''''
so
Company: AE3 X24/63" RGIOfsit/b /Ale -Contact: Cw•sets �O�AJ
Address: 9'i i W. 80 rA4 j°r ! City: AzePtseA rDA/
State: Mn/ zip: .ff 4!2c Phone: 9S2 — 76 7 - 4128/9
License #: 4.5-64) Lead Certificate #: ./f.,4 - YO 3 9R - /
If the project Is exempt
from lead certification, please explain why: (see Page 3 for additional Information)
In the last 12 months,
If
COMPLETE THIS AREA ONLY IF CONSTRUCTING A JVEW BUILDING
has the City of Eagan Issued a permit for a similar plan based on a master plan?
yes, date and address of master plan:
_Yes _No
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
Phone:
';'004%.1.1 '., '.F• ,:!f-`U{>'.:.;"h .n#::':�d:S * _oi' �t.i.l: es'a`:bufsu !c%ae d'u°'sn s d+'be$i: Ubll,7I)ff#1,0 - 'f
lo• fii 141 �!r..fIs �d��!pc.ruPovie.pcruCea .. ulle a lY'R
firfs'i.viJ
6 " ::.:;44."-.''' '• . �P-Rq MN1.hrTi.i 1n :'sj`. an �,
... . r.
CALL, BEFORE YOU PIG. Call Gopher State One Call at (661) 464.0002 for protection against underground utility damage. Call 48 hours
before you Intend to dig to receive locates of underground utilities. www.gopherstateonecag,g[
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 plane.
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,
x Gtt?,s AVD6725'c '
Applicant's Printed Name
Applicant's Signature
Page 1 of 3
02119/2014 12:38 Les Jones Roofing, Inc. ffAK09528817OO9 P.0201020
Date:
City of Eaafl RECEi ED
3830 Pilot Knob Road FEB 1 9 1014
Eagan MN 66122
Phone: (651) 675-6676
Fax: (661) 676-6694
Use BLUE or BLACK Ink
For Office Use
% p'�V
Permit ii: c. ✓ A jl
Permit Fee: C)
Date Received:
Staff:
J
2014 RESIDENTIAL BUILDING PERMIT APP KATION
�a�
//q/i Site Address: /.99,`y/1,39,, Unit #:
t `
s'>>: '',? -'^'
w YLp dehy / ,
r`'' ,a Y'.' ;F°
-, „, : '^'>'' .m, .
.4,'-�':`.
Name: 7o peopEQTY c.elea I. NG., Phone: 4057- S.�"S% 99yq
I
Address / City / Zip: V d). Bak it z 5 /NIEp._ 472444 - s 21, /Lift/ 6 76
Applicant is: Owner X Contractor
..; � .. "6:;'41.-s
"'1t' � I.;
, .?,,,,,, '';-:
Description of work RF/1440k0 4 i/rJ C.RC.,i - flvax-
Construction Cost: ?../ g 2a Multi-FamilyBuilding: (Yes X / No ____)
s, ,;;a>ry; ;! .
;;,,;�w:.�j � �!•. a� J t" '.
); F ,f' e y '61.
' '
r -r !gip ,.P; ; ' ,,:
Company SES .72)&63* Ro p.#471.1 lb- /NG Contact 4'ss/el s �W 2.SOAJ
Address: gY! 1N. �D 7}! �/-eV%r City AgGvu,rt161-72e/
7e, 7 -
State: kid Zip: Phone: 9.5A a8/9
.5
License #: 6373,) Lead Certificate #: ,(447- 410 3 2? - /
If the project Is exempt
from lead certification, please explain why: (see Page 3 for additional Information)
In the last 12 months,
Yes No If
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
has the City of Eagan issued a permit for a similar plan based on a master plan?
yes, date and address of meeter plan:
Licensed Plumber:
Mechanical Contractor:
Sewer & Water Contractor:
Phone:
Phone:
Phone:
1 cr ` +��...•.�-•' ry, .a:a�..p.rn•. Y 1.... p otir N + •' 1" v .��\ 1„
k;;( goir s i ':di b iii �4 7r `H t 3, • `aG ?"6' ,48,6 1d: ,• ,.e ,001 "74 . 1, : , 0464. fj.,,,,
• e . a �7�. ,� �. �1�k � , ��� �t, � _ r. �r ., pry ; M� c.4T � �!' ��t(T�: � � . �,a S � � ' �; F � � .i,ha.
; ig.oe 6 , 1,.; `�� r . ,. �.A 6. ... . 0. t1 11940 , I ,v ! ' ' IJI\ f1' 1s'' o ;3100000 `: ..1 .$0,0 i6 N,
,...t ,-,e-=%iw„Yt✓Y:iA 1 �:',A ,l \, '�'CkO 1!}1,PT,i������/�41S1:' . �+�"fi���” S Q�p��'�:� n�...44,4',,c, w•b�. 9rn:�..: a4�',y„a...,:,.,e..�ii'� . i
,...d.�ry,¢.: ..r :t�; ,... x..FJk.0 E' ,..�N;:?” � \ /,i> � "'T'.} �1... ,ai:'��1 '� ..4 .?ri.�-.,,
CALL BORE YOU DIG. Call Gopher State One Call at (661) 464.0002 for protection against underground utility damage. Call 48 hours
before you Intend to dig to receive locates of underground utilities. www.aooherstateonecall.ora
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 le not a permit, but only en 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.
x G 215 441'0(4C OA/
Applicant's Printed Name
d'G
Applicant's Signature
Page 1 of 3