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�_��� �- �-�-���--. <br /> AUTOMATIC FIRr SPRINKLER PERMITS � <br /> � Please Check One: � � � <br /> ❑ New ❑ Addition ,[], Remodel ❑ Replace <br /> I2:i;��i10.,,., Tln.J1C�: ,� F�'�.�'}� � PV� <br /> Job Site/ Owner Information: <br /> Site Address: v�n�� ��-1� �.1 C��'�� � � <br /> Owner: �� �f:� �C��.�.i ti Mailing Address: <br /> �-'� ,�a►-.a>.�.�� �`�n-�s <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor/Applicant Information: <br /> �ontractoriApp.:�L�`• ��2����� ContactYers:�n: ���:i� �f�.S�,r�1 <br /> Address: ��l ��L��v l�i 1��r State License #: ����� <br /> City: �1 ,��� Zip: ��� � Expiration Date: � � � � <br /> Phone: ��1_���1 -''�� 1 1 Alter�one: (f>\Z �-`�� �-7�`X� <br /> TYPES OF FIRE SPRINKLER PERMITS ` '' <br /> � Commercial—Fire Sprinkler ❑ Residential—Fire Sprinkler <br /> Fire Systems Permit Fire Systems Permit <br /> � C�Q <br /> * Base Price=Contract Price: $ �.��('��� x.0125 =$ ��� . (Minimum$50.00) <br /> �n <br /> * Surcharge=Contract Price: $ �`����� x.0005 =$ � <br /> * Mail-In Fee(Only On Mail In Applications) _$ 2.00 <br /> c� <br /> * Total Cost of Permit: _� �`�� <br /> 'rhe 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,-Zs,Minnesota State <br /> Building Code,Minnesota State Fire Code and StandardS, a11d CeI�]f�eg that a��Stat <br /> application are complete,true and c eme�tS mad�p�th�S <br /> � �� <br /> �� t, <br /> � � � <br />