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. - ' , ' . <br /> ., � :. ,.... _ <br /> .. <br /> _ , ���, p � � .. ._ . . -- _. _.�.G�3EN EX'I'� i7IS�ERF�EI�1�L[ �S'�;����ti,�� � <br /> d��,�: �.,,.,�. ,IRE,A OR <br /> �Pleasa.Chec1�'One��i�-�:'�` <br /> � New - ❑ t�ddition ❑ :�iuodel ❑ Replace - <br /> Job Sitep/O�vner Info,"rmation _,Xz <br /> Site Address: 2500 Shadywood Road, Orono, Mn 55331 <br /> Owner: , Mailing Address: <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor/Applicant Informarion: <br /> Lontractor/App.:^Total Life Security Contact Person: Melinda Plzak <br /> Address: 321 Wilson Street NE State License#: TS646980 <br /> City: Minneapolis Zip: 55413 Expiration Date: 7/31/18 <br /> Phone: 612-676-2020 Alternate Phone: <br /> � � m . ._ . , . . <br /> �. - �. � -..� � . ,: .-a�, <br /> � . _ _ __ .. <br /> �����..��.:,_ � . �� � � ���� � . S�=�OF�FIR��PE ����5 .�f,. �:;a ,� <br /> � Commercial—Fire Alarm ❑ Commercial—Fire Extin uig sher <br /> Fire Systems Permit Fire Systems Permit <br /> *(Per UBC) *(Per UBC) <br /> *Contract Price:$ 5000.00 *Contract Price:$ <br /> ❑ Residential—Fire Alarm <br /> Fire Systems Permit <br /> *(Per UBC) <br /> *Contract Price:$ <br /> *Note: Permits a;e calculated with UBC Fee S�hedule;submit application and we will call vou with a total fee for the <br /> permit• <br /> I herby apply for a Fire Alarm/Extinguisher ermit and I acknowledge that the information above is complete <br /> and accurate; that the work will be in conf�rmance with the Ordinances and Codes required by Minnesota <br /> State Building Code(MUBC)or Minnesota�State Fire Code(MUFC)shall be installed and maintained as per <br /> National Fire Protection Association (NF�A) 72 and 72E, 1996 edition, National Electrical Code and <br /> manufacturers requirements;that I underst�nd this is not a permit and work is not to start without a permit; <br /> and that the work will be in accordance wi�h the approved plan. <br /> . a,.�-4�. �_ - y 10/18!?0!� _-�-_�--___ ..e___ __.a_. . ___-s �— <br /> t`�pplicant�������1� Date <br />