Laserfiche WebLink
��� �Q 2��C �°��� � <br /> Please check one: 1/ New Adclition - � 3g�� <br /> D <br /> Jos si� �?�?�._3-" ���_ �� <br /> Owner' s Name ��� 11`- _�� ���- Telepho�u�� �- C� <br /> , 1 <br /> Mailing Address ,_, ���s - <br /> ' ��-�s�s' <br /> Sprinkler Contractor' s Name �-�.,..,,� � / � �v��c-Telephone Number <br /> .�-� <br /> Contact Person J�/'ry �i�-.� <br /> Mailing Address <br /> ******�********t�****t#**********�*�**�******�**�********#**#:************* <br /> CLASSIFICATION OF OCCIIPANCI$S ' / <br /> Commercial Residential // <br /> *t*********:***:#****t**#*t�*******�******t**t*****�***�**************tt**t <br /> WATER SIIPPLY <br /> Lake Well !./� City <br /> *****************�***#*********�**********�****:*****�t***��r*****t*�******� <br /> Year of Orifice <br /> Make Model Manufacture Size uantit <br /> prin lers pGP A���_1�� �o-9i �� --f <br /> t�»J�i r Y <br /> p �� ' <br /> ��/ y '�nlS.�� ��L-! / �t <br /> TOTAL � � <br /> ***�**t**********�r�************�**�********�***t****t****#***��*****�****** <br /> HYDRAIILIC CALCIILATIONS Design Data: <br /> Area of Application: Sq. Ft. <br /> Coverage per Sprinkler: �� � Sq. Ft. �c,- /a'o 0 <br /> No. of Sprinklers: �S""3 <br /> Total Water Required: L t^ GPM. �' �� . ,.a`- � �" ` <br /> *�tiFdt*,tit�t*it*iririt#***itit�tt#�t*�rit#it�k�Fi!!t*at'it irit�t�rtit*�kit**it#*�r*it�F�iFitiFyk�ritik�r*�ktir*ik***** <br /> P$RMIT FSE CALCIII,ATION <br /> l. Permit Fee $ 30.00 <br /> 2. State Surcharge. Based on valuation. $ .50 <br /> 3. Mail-In Fee $ 1.50 <br /> 4. TOTAL PERMIT FEE add lines 1-3 above $ <br /> The undersigned hereby applies to the City of issuance of a Sprinkler <br /> System Permit, agrees to do all work in strict accordance with the <br /> ordinances of the City and State regulations, and certifies that all <br /> statements made on this application are complete, true and correct. <br /> Applicant , � Date �' �- - <br /> *************************** * ****** ************************* ****** <br /> A roved A roved with Corrections_� Denied ; <br /> PP PP <br /> Reviewed y• , <br /> �����J � <br /> Date ' <br /> �3���`� ; <br /> � <br /> i <br /> � � <br />