Laserfiche WebLink
(�..i� o� O�'O� <br /> AUTOMATIC FIRE-SPRINKLE�i2 i ERl�ZITS >.- .,� <br /> �' �d��7 <br /> r�V4W«'r.t.�a�.u.�T���',� �A��.. `$i-`g;i � .m * <br /> a'1F� <br /> 131� 1 <br /> ❑ New ❑ Addition � Remodel ❑ Replace <br /> i <br /> Job Site/ , '��Infoarmation �:�,, <br /> h :.��� � <br /> Site Address: �� - r r �- ��- , ' � � <br /> �'r����1 u..r�s � � Z �_��.�<<-a-r�� <br /> Owner: �,(�:�''�� , �� Mailing Address: <br /> City: ,����_ v"'a'L� Zip: _� � lj .� � <br /> Hon�e Phone: Alternate Phone: <br /> Contractor/Applicant Information:° � ,, ,, <br /> Contractor/App.:,lU, Mlrii�r'ite.�fO��Crw._. ContactPerson: ��"Z� �' J�1,_� � <br /> Address: ��l /�pp Cpc,�r� State License #: ` —�75 <br /> City: 1.,� �(o Zip: ��l� Expiration Date: (9 — 3� "'� <br /> Phone: ��J�' ��— ��� Alternate Phone: 11:�j /- �5����_ /`h�y <br /> � �� ��'YPES OF�FIRE��SPRINKI;ER PERMITS � �� ��� � . :�_���`��� <br /> � Commercial—Fire Sprinkler ❑ Residential—Fire Sprinkler <br /> Fire Systems Permit Fire Systems Permit <br /> *Base Price=Contract Price: $ ,_.,/ ( ���� x.0125 =$_ ���p�� (Minimum $35.00) <br /> *curcl:arge=Cor.tra�t Price: � .�`71���'. x:�4�5 =e /f• `�S (Mini�azs: $ .S�J) <br /> *Mail-In Fee(Only On Mail In Applications) _$ 1.50 <br /> *Total Cost of Permit: _$��2 U <br /> The undersigned herby applies to the City for issuance of a Sprinkler Systems Permit. Applicant agrees <br /> that all systems shall be designed, installed and maintained to N.F.P.A.-13,N.F.P.A.-25, Minnesota State <br /> Building Code, Minnesota State Fire Code and Standards, and certifies that all statements made on this <br /> applicatiou� complete,tru�nd correct. <br /> , <br /> ; „ <br /> ; ,�. � � _ � �_ � / <br /> �.— _ __.< ��; �.� <br /> Applic,�hnt --: -� • ' Date <br /> � Reset Form /q�p rov�e.� �/� Z/6 7 <br /> '7Q..�-� �'�.0�� <br />