4553 Slater RdPROPERTY OWNER
)� czAA4."J R._6(. P.-
Name: ' ) • ) - e. , ` C,3rpo rwsc:M• Phone:
Address / City / Zip: I /CV -S er i OC c EGA OA, MN CS
Applicant is: Owner x Contractor
TYPE OF WORK
Description of work: K,e- t) 4 4 IJiV G e- C , s
Construction Cost: 3 ✓ � ODD
CONTRACTOR
h
CA Al O /Y l V, X4 C License #: / 79h
Name: G ;ems€,y\ co` '
f`"
Address: 3 ?S /0 AA - W. . Cit Go /d V a //e
State: t i I 1 v Zip: S 4 /(,).? Phone: C7b3) .C - 13 0 C
Contact: -C .P10/1, 1 Email: VUS. e G i ' co - C�0 r�^
ARCHITECT /
ENGINEER
Name: Registration #:
Address: City:
State: Zip: Phone:
Contact Person: Email:
Licensed plumber installing
new sewer /water service: 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 Eaali
Date: L -8-10 Site Address:
Tenant Name:
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
2 )6 - 49 5 l - --f- - Rc-1
X63
Permit #:
2010 COMMERCIAL BUILDING PERMIT APPLICATION
Use BLUE or BLACK Ink
Permit Fee: v I -''h
Date Received: ( --
Staff:
(Tenant is: New / Existing) Suite #:
Former Tenant:
CALL BEFORE YOU DIG. Call Gopher State One Cali 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.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 requi es a review and approval of plans.
x St y SprJnk- x S� 2
Applicant's Printed Name Applicant's Signature
Page 1 of 3
RESIDENT / OWNER
Names l'} '( C ? OC F Phone:
Address / City / Zip: 9 e S, Ot e915 55 - 4od_-
CONTRACTOR
Name: tom+ ( 'Vie License #: / &KJ
Address: ./ LP / L t (f'E ci • E City: ye6(7116 U I lle
State: r inN Zip: <55337 Phone: 9 — ?q ®
Contact: Email:
TYPE OF WORK
New Replacement Additional Alteration Demolition
Description of work: h.'1QC e- ` (�
NOTE: Roof mounted and ground mounted mechanicalequipment is required to be screened by City
Code. Please c on tact the Mechanical Inspector for n, informatio on permitted screening methods.
PERMIT TYPE
RESIDENTIAL
Fumace
COMMERCIAL
New Constructionterior 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
bumed out appliances, ductwork, etc.) (includes
$.50 State Surcharge) �
$.50 State Surcharge) $ A 000 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 $ 7100, 00 x 1%
_ $ Permit Fee
- If Permit Fee is Tess than $1,000,
= $ i a- v Surcharge
- If Permit Fee is > $1,000, surcharge
$1,000 Permit Fee (Le. a $1,001
r-
= $ 7,0 O. mil' TOTAL FEE
CityofEaali
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
2010 MECHANICAL PERMIT APPLICATION
Use BLUE or BLACK Ink
Permit #:
Permit Fee:
_ I
Date Received: J I
Staff:
Date: /0 Site Address: 4 6 R- —Lt t (2 1e3 4 5-5 J
Tenant: i v 11-6L w' e yu ( d A i p-1 S 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.gopherstateonecall.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 plan
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J� Y in x /Aa.
Applicant's Printed Name / Applican igna ur
FOR OFFICE USE
Required Inspections
PROPERTY
OWNER
( ! J
Name: Si) e 11-C- co r po rc 4 ■o -s Phone: j 5 ) Pi / O Z7O
CONTRACTOR
Name: hieiUO•nceJ � Gcz -f , t_ l-C License #:
Address: /k7 / Z G 1: t'f I�c>✓i -c IL City: 6 c�c.N.5,, i ) e State: 7 Y\l' Zip: 5
Phone: 95 gF°5 ' ,,c/0 Email: do rei r_ ad00, pA.eckc J cc, (, cow)
TYPE OF
WORK
New ,C Replacement Repair Rebuild Modify Space Work in R.O.W.
_ _ _ _
Description of work: fep /ace_ 'Doti,' w ? +h e2)c p i &
PERMIT TYPE
COMMERCIAL
New Construction Modify Space
_ Irrigation System ( yes /4. no) ( RPZ / PVB)
_
• Rain sensors required on irrigation systems
• Avg. GPM (2" turbo required unless smaller size allowed by Public Works)
Meters Call (651) 675 -5646 to verity that tests passed prior to pickinq up meter.
Domestic: Size & Type Fire: 1
Avg. GPM High demand devices? _ Yes No • Flushometers Yes No
COMMERCIAL FEES:
$50.50 Minimum (includes State Surcharge) OR Contract Value $ 8. �`� . ., , xis
Required
- If Permit Fee is Tess than
_ $ 5s 6. 7 3 Permit Fee
on ALL new buildings and boulevard irrigation systems 4 = $ Radio Meter Read
$1,000, surcharge is $.50 = $ Meter(s)
- If Permit Fee is > $1,000,
surcharge increases by $.50 for each $1,000 jj^�
a $1,001 - $2,000 Permit Fee requires a $1.00 surcharge). = $ t 5(/ State Surcharge
$1,000 Permit Fee (i.e.
Following fees apply
Call the City's Engineering
when installing a new lawn irrigation system. $ Water Permit
Department, (651) 675 -5646, for required fee amounts.
$ Treatment Plant
$ Water Supply & Storage
$ State Surcharge
TOTAL FEES $_ — gb- - 5
City of Ea�aii
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675 -5694
/ 2010 COMMERCIALPLUMBING APPLICATION
Date: 2123110 10 Site Address: ` T ' / � Gc G� Y� fc-8
Tenant:
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 digto receive locates of underground utilities. www.gopherstateonecall.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 with permit; that the ork '11 be in accordance with the approved
plan in the case of work which requires a review and approval of plans.
x 1 for r V� n r e - h
Applicant's Printed Name ✓
x
Applicant's Signatur
FOR OFFICE US -;
Required Inspections: Under Ground
Approved
Rough -In Air Test Gas Test :;
Permit #: q 317
Permit Fee: e&.03
Use BLUE or BLACK Ink
Date Received:
Staff:
Suite #:
Date:
PRV Required: =• Yes
Page ; 1 of 3
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Use BLUE or BLACK Ink
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For Office Use
Permit 033
City of Ea
7P
e1 I Permit Fee: 0 1U'1 '
3830 Pilot Knob Road I
Eagan MN 55122 I 0
I Date Received: I
Phone: (651) 675-5675 1
Fax: (651) 675-5694 1 Staff: 1
1-----------------I
2013 COMMERCIAL BUILDING PERMIT APPLICATION
Date: 419h Site Address: 1SS3 L_._7u7 SG9 r Q
Tenant Name: 6;"lAa an im a I'd 6'P_ (Tenant is: New / Existing) Suite
/ J,~ JFormer Tenant:
Name: ,e / T~ Phone: ~j ! 5-6~ 5 ~~lO
Property Owner Address / City / Zip: A 00 l4TUPk/h s 61-o -00
Applicant is: Owner _K Contractor
Type of Work Description of work: i ~A A Q~ l 1
Construction Cost: n® 3504a
I / / I q
Name: -l`n ` License
® ) Ile
Contractor Address: A 'X / dV City: &Idt
State: Zip: Phone: 7t3 - 5 W 1300
Contact: v1'FR / "e"t Email: /ri ~~'t Lf~ • KGs
Name: Registration
x
Address: City:
Architect/Engineer
State: Zip: Phone:
Contact Person: Email:
Licensed plumber installing new sewer/water service: 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.
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 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 0611; x ( !
Applicant's Printed Narhe Applicant's Signature
Page 1 of 3