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From: Parsons Exteriors Inc Fax: (888) 426.9712 To Fax: +1 (651) 675-5694 Page 18 of 26912612013 8:24
Use BLUE or BLACK Ink
IF r office 11seGG [ I
1
l i">~~1 i
P C Pt:M. ity of a 3830.PiTot I£nobRoad (
Eagan N9i1! Daie Rcceived I 1 l
I. l
Phone: (651') 675-5675
1.
Fax; (651) 675-6694 `t 8W, t
L-_
Datey Site ,address tlnH4..
- - ~ f4amty =Pfiarte
Residen
Owner i Addretks City l dip: °
i
Applicant is- r
Owner Contractor
of Work " DescOptlon of Work e+'
Y
R __.64 Construcion Cosh fAulti-Familly Dzildinrg,- Yes ~ i No
orripany: sp " ' , KContact: ~_JL
,
Address: L ,74 lr 44 city-
Contractor
State INA ~j ~ Fhorie y ~ar - ~ " 70( 141 -7 1
A ' N pia S , o, sa k
License ft. Lead Certifi"to 9:
If the project is ex -not from lead certification, please explain why-*: (see Page 3 for adt itional information)
COMPLETE THIS AR A ~ ]ldl,"' IF CO F tl 'ii G.A NEW BUILDING
In the last 12 months, has the City of,Eaqan issued a permitfor a similar plan based on a :master plan?'
Y'es
_No If yes, date and address of master plan'.
Licensed lsiumber: _ phone: -
Mechanical Contractor: Phone:
Sewer & Water Contractor.. Phone..
NOTE flans and supporting dr~ctrrrtenfs that you sr~l~mit are considered to be publro information. Portions of
the Information maybe classified as non-public if you provide specific reasons that would permh the City to
conclude that they are trade secrets.
CALL BEFORE YOU DIG. Call Gopher State One, tali at (651) 464-0002 for prolecticn against underground OtiliV darnaga. Call 48 hours
before you intend to diem receive locates ofuodergroundutilities-»va e~~h r , ( re 71 rfy
I hereby aevrrowledge that this ictfomaborz is cc,,rnplete and accurate; that tnewtork v?ilt bein =nformance with the ordinances arrd codes of the City of
.Eagan; that i oridemond.iryis 1s not a. permit, but only an application for a permit, and wsut4 is rv to start wiihcwz a perinit:.tnat the work MI be In
accordance with the approved plsl in 1hp case of work ivhlch requires a renew and approval Of places,
erior work authorized by a building pe rn-rt issued in accordance with the Unnesote State Saildit~g C*de must 6e cbtaiplnt&d withiP 1Bie .
dais o5 permit issuance.
Appli•craot"s Printed Name 4pplicanift signaftive
Page of 3
Use BLUE or BLACK Ink
I
I For Office Use I
Permit o L I c I
I
City of Eanan
3830 Pilot Knob Road I Permit Fee: UM~.
Eagan MN 55122 I I
Phone: (651) 675-5675 I Date Received:
Fax: (651) 675-5694 I Staff:
L-----------------I
2014 MECHANICAL PERMIT APPLICATION
❑ Please submit two (2) sets of plans with all commercial applications.
Date: Site Address:
Tenant: Suite
1
Resident/Owner Name: E/~zt C 57HftA) '4,:! Phone: 651- V=S 2 - "'IQ
Address / City / Zip: / ► 1~~//~ b~ ~(S</~ ~i64C7A GAS ~7~
Name: 1!>C) L_41 T License
Contractor Address: 7 ~310 /2 - City: -
State: Zip: Phone: Co J t 7- 7 7/ 6 Q
Contact: Z70_ 1_A51 V cit,
New Replacement Additional Alteration Demolition
Type of Work Description of work: /T ply ~ 2q//2
NOTE: Roof mounted and ground mounted mechanical equipment is required to be screened by City
Code. Please contact the Mechanical inspector for information on permitted screening methods.
RESIDENTIAL COMMERCIAL
_ Furnace New Construction Interior Improvement
Permit Type XAir Conditioner Install Piping Processed
Air Exchanger Gas Exterior HVAC Unit
Heat Pump Under/Above ground Tank L_ Install Remove)
Other
RESIDENTIAL FEES
$60.00 Minimum Add or alteration to an existing unit (includes $5.00 State Surcharge)
$100.00 Residential New (includes $5.00 State Surcharge) _ $ TOTAL FEE
COMMERCIAL FEES Contract Value $ x .01
$55.00 Permit Fee Minimum
$70.00 Underground tank installation/removal Permit Fee
*If contract value is LESS than $10,010, Surcharge = $5.00 Surcharge*
**If contract value is GREATER than $10,010, Surcharge = Contract Value x $0.0005
***If the project valuation is over $1 million, please call for Surcharge = $ TOTAL FEE
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 Ooe~2 6® z_ -r x
Applicant's Printed Name Applicant's Signature
FOR OFFICE USE
Required Inspections: Reviewed By: Date:
Underground Rough In Air Test Gas Service Test In-floor Heat Final HVAC Screening
`\ Use BLUE or BLACK Ink
For Office Use f
f Eaaau
41,11
City Ol Permit Fee: /(6. 4A
3830 Pilot Knob Road
Eagan MN 55122 APR 1 3 2017 Date Received: -13 '1
Phone:(651)675-5675
Fax:(651)675-5694 Staff:
1. J
2017 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 1� 17 Site Address: ► 1 k' I 1 • V ( , LA) Unit#:
Name: Phone:
Resident/
Owner Address/City/Zip:
Applicant is: Owner Contractor
Type of Work
Description of work: Z00 F
Construction Cost: 1 Multi-Family Building:(Yes pc I No )
Company: V Cray--, COBS '1't-• c Contact: OS1-iv• S1/100.-‘
Contractor Address:\\QO"I p i�v�J 2p City: (Qi- +Cr% Cil
State:T•� Zip:-'cb12 Phone:(�I2- /99-`1146 Email: 3Ush\--N e vv-4,
License#: f p Lead Certificate#: / )
If the project is exempt from lead certification, please explain why:
COMPLETE THIS AREA ONLY IF CONSTRUCTING A NEW BUILDING
In the last 12 months,has the City of Eagan issued a permit for a similar plan based on a master plan?
_Yes No If yes,date and address of master plan:
Licensed Plumber: Phone:
Mechanical Contractor: Phone:
Sewer&Water Contractor: Phone:
Fire Suppression Contractor: 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.gooherstateonecall.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.
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 U%-N%IN c0',1-viS.—
Applicant's Printed Na
PP me nature
Page 1 of 3