896 Wescott Square - ME93034RESIDENT / OWNER
Name: E (i G Ibre r4 kilkii 1 Phone: ( CV - 4;43 – 7‘37
Address / City / Zip: a g `( F,Fkr/-k F 9an Al 4/ 531X
CONTRACTOR
Name: (h – tf U Etc License #:
Address: 16 & 36 A a f f (4(0
/ ,,
LJr l y5r. City: f �91
State: 1 1 / " 1/ Zip: �3 72 ( ( 6 ( (- 93
„ Phone:
Contact: ($ l''�9.' ` 4-f /i nt (JJ Email:
TYPE OF WORK
New Replacement Additional Alteration Demolition
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. , J
Description of work: 0116 18}- £' (9f red '+4. ed 4. 01 CitCe
NOTE: Roof mounted and ground mounted Mechanical equipment is required to be screened by Ci
Code. Please contact the Mechanical Inspector for information on permitted screening methods
PERMIT TYPE
RESIDENTIAL
Furnace
COMMERCIAL
_ New Construction Interior Improvement
Air Conditioner
Install Piping _ Processed
Air Exchanger
Gas _ Exterior HVAC Unit
Heat Pump
_ Under / Above ground Tank ( Install / _ Remove)
_
Other
** 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)
$.50 State Surcharge) $ TOTAL FEE
$90.50 Fire repair (replace
COMMERCIAL FEES:
$70.50 Underground tank
$50.50 Minimum (includes
installation /removal OR
State Surcharge)
surcharge is $.50.
increases by $.50 for each
$2,000 Permit Fee requires a $1.00 surcharge).
Contract Value $ x 1%
_ $ Permit Fee
- If Permit Fee is less than $1,000,
= $ Surcharge
- If Permit Fee is > $1,000, surcharge
$1,000 Permit Fee (i.e. a $1,001-
_ $ TOTAL FEE
City of 8apll
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
2010 MECHANICAL PERMIT APPLICATION
Date: r O/O Site Address:
Tenant: L 5 k �
x rep fff, i n 1 -5
Applicant Printed Name
Applican ( Si • nature
Use BLUE or BLACK Ink
1
° ce Use
Permit #: 93°34
Permit Fee: 5D- 5t
Date Received: — A)
Staff: 0
Suite #: 0
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.gopherstateonecall.org
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 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.
, IA rL.,._..'AA
UnderGr
Reviewer) y.
— Rough In >_ Air Tact Gas Se mce T
Exterior HVAC Screening Inspection ..
FOR OFFICE USE
Required Inspection