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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 ) , <,i, r4:: ,;.. - `•: ' -:' >.•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