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1..,t� d� �('0Y1� 7—/]—!�� <br /> r .. � <br /> . � � �h�� , � . <br /> ;���_?�>�����,��; .�� � <br /> l9//2Z Y <br /> , ... <br /> Please� ,,^ , ,� ,p� �, �:: <br /> ❑ New ❑ Addition �] Remodel ❑ Replace <br /> . e.� <br /> �u, �.� ;�.. <br /> Site Address: o�`��C/ 5�1C�C��.1 la.):C�C'Y� �� <br /> Owner: �i'���c.,.���� ��� Mailing Address: <br /> City: ��iUv�U Zip: <br /> Home Phone: Alternate Phone: <br /> Contract�� <br /> Summit Fire Protecrion �„ �.} �/ �.�� <br /> Contractor/App.: Contact Person: <i.c.� u <br /> 575 Minnehaha Ave.W. C-075 <br /> Address: State License#: <br /> St.Paul 55103 6-30-0 <br /> City: Zip: Expiration Date: <br /> (651)251-1880 <br /> Phone: Alternate Phone: <br /> �.--__. <br /> :�L�i- �w _ .. : TYPES t)F,FIRE:SPR�l1'I�LER-PERIYII <br /> (�] Commercial—Fire Sprinkler ❑ Residential—Fire Sprinkler <br /> Fire Systems Permit Fue Systems Permit <br /> *Base Price=Contract Price: $�_ x.0125 =$ �(�� � (Minimum$35.00) <br /> *Surcharge=Contract Price:$ 4(�(;) x.0005 =$ � �'�� (Minimum $ .50) <br /> * Mail-In Fee(Only On Mail In Applications) _$ 1.50 <br /> *Total Cost of Permit: _$ � <br /> The undersigned herby applies to the City for issuance of a Sprinkler Systems Pernut. 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 /> Buildin de, Minnesota State Fire Code and Standards, and certifies that all statements made on this <br /> applic io are com lete, true and correct. <br /> 7��� <br /> Applicant Date <br /> �.p .0 y s e+,?�s "��- :�,�,� k"'u;�' -�. <br /> � ,��� � �? <br /> '��n .�. � �,�� �'���' �� ��,P ,���e� -7�� y <br /> �, �� ��, <br /> � <br />