4610 1/2 Penkwe WayRESIDENT / OWNER
Name: A-L 2i'+Z
Phone: 01 2-I O — 16 - 16U - 1 I
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Address / City / Zip: 1 4010 1 12 Per) we WI
CONTRACTOR
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State: ,,,
In Zip: Phone: S ^. (
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Contact: Email:' i(, • t /
TYPE OF WORK
New _ Replacement Additional Alteration Demolition
Description of work: 1,11 a
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RESIDENTIAL
"Furnace
— 7
Air Conditioner
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COMMERCIAL
New Construction Interior improvement
PERMIT TYPE
Install Piping Processed
_ Air Exchanger
Gas Exterior FIVAC Unit
Heat Pump
_
Under / Above ground Tank (.. Install / Remove)
Other
_
"When installing/removing tank(s), call for inspection by Fire
Marshal Plumbing Inspector
RESIDENTIAL FEES:
$50.50 Minimum Add -on
or alteration to an existing unit (includes
burned out appliances, ductwork, etc.) (includes
and
$.50 State Surcharge)
$.50 State Surcharge) $ TOTAL. FEE
$90.50 Fire repair (replace
COMMERCIAL FEES:
$70.50 Underground tank
$50.50 Minimum (includes
- If Permit Fee is less than $1,000,
installation /removal OR
State Surcharge)
surcharge is $.50.
increases by $.50 for each
- 02,000 Permit Fee requires a $1.00 surcharge).
Contract Value $ x 1%
$ Permit Fee
= $ Surcharge
- If Permit Fee is > $1,000, surcharge
01,000 Permit Fee (i.e. a $1,001
$ TOTAL FEE
10/11/2010 MON 10:27 FAX 6514378831
City of Eapti
3830 Pilot Knob Road
Eagan MN 55122
Phone: (651) 675 -5675
Fax: (651) 675-5694
AL
Use BLUE or BLACK ink
Permit #:
Permit Fee:
n 2010 MECHANICAL PERMIT APPLICATION
Date: $1 Site Address: `r(Df) t12 ItriKwe tear Wm
Tenant ;�..
•
01 002/002
-0 0
Date Received:
Staff:
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.00pherstateonecai.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 1 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 iin �
the
,, caasse of work which requires a review and approval of plans.
Applicant's Printed Name
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PERMIT
City of Eagan Permit Type:Mechanical
Permit Number:EA109557
Date Issued:03/19/2013
Permit Category:ePermit
Site Address: 4610 Penkwe Way 1/2
Lot:2 Block: 05 Addition: Johnny Cake Ridge 4th
PID:10-39803-05-020
Use:
Description:
Sub Type:Residential
Work Type:Replace
Description:Furnace & Air Conditioner
Comments:Questions regarding electrical permit requirements should be directed to State Electrical Inspector, Mark Anderson at (952)
445-2840.
Ashley Orman
130 Plymouth Ave N
Fee Summary:ME - Permit Fee (Replacements)$55.00 0801.4088
Surcharge-Fixed $5.00 9001.2195
$60.00 Total:
I hereby acknowledge that I have read this application and state that the information is correct and agree to comply with all applicable State
of Minnesota Statutes and City of Eagan Ordinances.
Contractor:Owner:- Applicant -
Allen P Zeitz
4610 1/2 Penkwe Way
Eagan MN 55122
(651) 688-8095
Standard Heating & Air Conditioning
130 Plymouth Ave. N
Minneapolis MN 55411
(612) 824-2656
Applicant/Permitee: Signature Issued By: Signature
,�"
II,
11
For Office Use
�� 4� a #' Remit#:
II",ktere
E AGA N
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Permit Fee: /,:::2 6,9
Date Received: —71-9
3830 PILOT KNOB ROAD(EAGAN,MN 55122-1810 J;J[ p Q ?Q 18
(651)675-5675 I TDD:(651)454-8535 FAX:(651)675-5694 Staff:
buildinainspectionsacitvofeagan.com L
2018 RESIDENTIAL BUILDING PERMIT APPLICATION
Date: 7-1 s3-I g Site Address: Li-6 /o '/a Peen k we kl A. Unit#:
Name: Phone:
Resident/ l
Owner i Address/City/Zip: N (v 1 V / . Pic h k We Way
I
(
Q Applicant is: Owner X. Contractor (
E 1 Description of work: Re/ i aye a4-7d replace,. y-p n 5 e--7' .., i
i Type of Work
i Construction Cost: $ a.40 - Multi-Family Building:(Yes /No ) t
Z-4-All Conn-refe t WA:te -prop i n
Company: C ct.mcarKcac_J-,rbcdc r
Contractor Address:1-fay 97e Do d t 13'v d City: Roe !lop D i1 -
State:m'v Zip: D(04Phone: 9 --]7 L f/Email: j Amd-1'Y1 Gwiici N.),0G a J.CD
License# ✓ a e C 1 p . Lead Certificate#: R-X-43/e 39-/3- o o S t'./
If the project is exempt from lead certification,please explain why �,z... ...r_..b. ...1.
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:
1 Licensed Plumber: Phone:
Mechanical Contractor: Phone:
1
Sewer&Water Contractor: Phone:
Fire Suppression Contractor: Phone:
NOTE:Plans and supporting documents that you submit are considered to be public i iformaffan Portions of the information maybe
classified as blit if , reasons that would the , to conclude that are trade secrets.
You may subscribe to receive an electronic notification from the City of proposed ordinances by signing up for an email update on the City's
website at www.citvofeaaan.com/subscribe.
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.
CALL BEFORE YOU DIG. Call Gopher State One Cali at(851)454-0002 for protection against underground utility damage. Cali 48 hours before you
intend to dig to receive locates of underground utilities. www.conherstateonecall.ora
I hereby acknowledge that this information is complete and accurate;that the work we 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 "TO an YY1 ,�xhro.e_4y- x on.-t. in' c z
Applicant's Printed Name Appii 's Signature
4
DO NOT WRITE BELOW THIS LINE /—/& /0 Vt_ 6'e-n/4 6 tU /' Q 7 3
SUB TYPE
Foundation _ Fireplace Porch(3-Season) _ Exterior Alteration (Single Family)
Single Family _ Garage Porch (4-Season) _ Exterior Alteration (Multi)
Multi _ Deck _ Porch(Screen/Gazebo/Pergola) _ Miscellaneous
01 of_Plex _ Lower Level _ Pool _ Accessory Building
WORK TYPES
New _ Interior Improvement _ Siding _ Demolish Building*
Addition _ Move Building _ Reroof _ Demolish Interior
Alteration _ Fire Repair _ Windows _ Demolish Foundation
Replace _ Repair _ Egress Window Water Damage
Retaining Wall *Demolition of entire building-give PCA handout to applicant
DESCRIPTION
Valuation 112(000Occupancy 4MCES System
riot Plan Review Code Edition + to, SAC Units
(25%_ 100%)( Zoning City Water
Census Code Stories Booster Pump
#of Units Square Feet PRV
#of Buildings Length Fire Suppression Required
Type of Construction Width
REQUIRED INSPECTIONS
Footings (New Building) Meter Size:
Footings (Deck) Final/C.O. Required
Footings (Addition) X Final/ No C.O. Required
Foundation Foundation Before Backfill HVAC_Gas Service Test Gas Line Air Test Hood
Roof: Ice &Water Final Pool:_Footings _Air/Gas Tests Final
Framing 30 Minutes 1 Hour Drain Tile
Fireplace:_Rough In Air Test Final Siding:_Stucco Lath _Stone Lath _Brick^ EFIS
Insulation Windows
Sheathing Retaining Wall:_Footings_ Backfill_Final
Sheetrock Radon Control
Fire Walls Fire Suppression:_Rough In_Final
Braced Walls Erosion Control
Shower Pan Other:
Reviewed By: , Building Inspector
RESIDENTIAL FEES
Base Fee
Surcharge ,
Plan Review
MCES SAC
��
City SAC 40
UtilityConnection n Charge 94 L9 °
S&W Permit&Surcharge /
Treatment Plant
Copies
TOTAL
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