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