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3652 Denmark AveJul 12 10 08:14a Gates General Contractors 41,11 City of Eapll 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 (763) 498-7710 p.5 Use BLUE or BLACK Ink For Office u7qe Permit Fee: 50 Si Date Received: Staff: r 2010 RESIDENTIAL BUILDING PERMIT APPLICATION Date: i(i i. 0 Site Address: .a► Z80 7T-ifi G✓ 1 'G" Suite #: Tenant: J RESIDENT / OWNER Name:714 4. 4-n r..-- ` •c1biilG.+1..-S. Phone: Address !City !Zip: FfrAl 50C--' 0� `/� Applicant is: Owner Ge Contractor TYPE OF WORK Description of work: c /7 Construction Cost /4) SI 7' M '- amity Building: (Yes a' ! No ) CONTRACTOR Name: 4-5 4 #(4 4,7- 7 License*: G 7 q.?% C -t Address: 7 bD 176 00r 1 -it City: /%r iffentr `" 51-C---54,10---557 1 (Z-- 713 �.7 f�!r State: .4-1�; J Zip: � (1/7Ph ne: Contact: 7 .1Z... [.-t-- Email: % AC,r/L vs r/r4 COMPLETE In the last 12 months, has 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 _No 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 My 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. Iwww.copherstateonecali.org hereby acknowledge that this information is complete and accurate; that the work will be in conformance with the ordinances • • codes of the City of Eagan nderstand this is not a permit, but only an application for a permit, and wo . r to start without a perm i hat the work will be in acco = an.y' h the approved plan in th a e of work which requires a review and ap Appii s Printed Name Applicant's Signature Page 1 of 2 City of Eapft 3830 Pilot Knob Road Eagan MN 55122 Phone: (651) 675-5675 Fax: (651) 675-5694 S) Ye) Use BLUE or BLACK Ink For Office Use /� "�; Permit #: /19(!// 60 r Permit Fee: ` Date Received: Staff: 2012 MECHANICAL PERMIT APPLICATION ❑ Please submit two (2) sets of plans with all commercial applications. Date: -Lf - Y Site Address: 366-,,R Tenant: Suite #: J RESIDENT / OWNER CONTRACTOR 167.3.5" Address / City / Zip: /000 E • 144-.5-73± W 4J6Vt I /F, SS33-7 Name: Yv N 14- ,.14-7-71\./ 4.. 4- 4 /c License #: Address: /2-f ! yN-K_F ALJ Nit, City: 132 , /�te_tL State: Y1/ k l Zip: 4-9-¢3 Contact: Phone: '71a R 5;342 O&7<p 7 Email: C 11/1 rtie_s 14- c /YI - r bre Demolition New X. Replacement Additional Alteration TYPE OF WORK Description of work: NOTE: Roof mounted and ground mounted mechaniical equipment is required to be screened by City Code. Please contact the Mechanical Inspector for information on permitted screening methods. 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) RESIDENTIAL FEES: $60.00 Minimum Add-on or alteration to an existing unit (includes $5.00 State Surcharge) ``^^ $100.00 Fire repair (replace burned out appliances, ductwork, etc.) (includes $5.00 State Surcharge) = TOTAL FEE COMMERCIAL FEES: $75.00 Underground tank installation/removal (includes $5.00 State Surcharge) I$60.00 Minimum (includes State Surcharge) - If the Permit Fee is Tess than $10,010, surcharge is $ 5.00 - If the Permit Fee is > $10,010, surcharge increases by $.50 for each $1,000 Permit Fee (i.e. a $10,010-$11,010 Permit Fee requires a $ 5.50 surcharge) OR Contract Value $ = $ Permit Fee = $ Surcharge = $ TOTAL FEE x 1% 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 plans. Applicant's Printed Name Applicant': Signature FOR OFFICE USE Required Inspections: Underground Rough In ning