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. • �,��'� d� ��o n o ��C l nG��- u'� � c���'✓ <br /> . _ .:.. .� <br /> �����` _. „�: �._._.,' d� a <br /> - _. _.. .: <br /> �olC� —O � <br /> Please � ��,�� � ���,� �'�x, "�� .� �f_2q- 1 D <br /> ,�� �., x-�,;� <br /> ❑ New � Addition ❑ Remodel ❑ Replace <br /> �� _ _ ..�: " � <br /> Site Address: L� � U� .�'l4'�-� ����/ ��� <br /> ' � �. <br /> Owner: ��.�.n=, � �� �v�5�'``� �e� Mailing Address: � <br /> ciry: ��c c e � s��v _ zip: �� 7' �� <br /> Home Phone: Alternate Phone: � <br /> Contractor' �� <br /> A Summit Fire Protecrion ���� S <br /> Contractor/Arr.: contact Person: <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 ����_Z��—���� <br /> Phone: Alternate Phone: � <br /> .�,.. �: . -- -- �._ <br /> -�;�- � :: TYPES OF FIRE SPRINKLE�P�RM�- <br /> � Commercial—Fire Sprinkler ❑ Residential—Fire Sprinkler <br /> Fire Systems Pernut Fire Systems Pernut <br /> *Base Price=Contract Price:$ �� �� x.0125 =$J��� Z� (Minimum$35.00) <br /> *Surcharge=Contract Price:$� x.0005 =$ L/ G' S (Minimum $ .50) <br /> *Mail-In Fee(Only On Mail In Applications) _$ 1.50 <br /> � � v <br /> *Total Cost of Permit: _$ l�C� <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 /> applicat' are compl�f�, true and rrect. <br /> ; � <br /> , <br /> /�,,. ....__ �/�� `��7 � <br /> � <br /> App i Date <br /> 4`�R�,�fi i�� �� �-���`: <br /> � ' <br /> .��.�.��.,_ ,��,� ,���� ��a�,: _ � .�. <br />