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r � e <br /> � <br /> ,�=, s �y, ° " � �,AUTQMAT�^��S�RII�KL�R:PER��TS.. . �'�" <br /> � <br /> �'1ea�e�lze,�kflme .� �,�` 3 ` <br /> ,., <br /> ,,� New ❑ Addition ❑ Remodel ❑ Replace <br /> J�b srt�/Owner Tufarinat�o�: <br /> _:�. <br /> Site Address: � � � .�TT�� �0 O d �� <br /> Owner: Mailing Address: <br /> City: Zip: <br /> Home Phone: Altemate Phone: <br /> �ontractor t�A�ipl�c�rit��orinat�on�f'� .�' <br /> Contractor/App.: ��-F�S�EW� r �rQ `� TO`� ' Contact Person: 1 '�-r� w d �� <br /> Address: �.�yD�'����p � D State License#: � � � � <br /> City: �' Zip: S.�y�� Expiration Date: CS' ^ �G � O �P <br /> Phone: � �o�' - a�' 3�� S�� � Altemate Phone: � �a-a ��-� `�`�� <br /> r '" t� '�.�'���5%Q��������i�i��47 H, <br /> Commercial—Fire Sprinkler ❑ Residential—Fire Spnnkler <br /> Fire Systems Permit Firo Systems Permit <br /> *Base Price=Contract Price: $ �� x.0125 =$ � /S.U�(Minimum'$35.00) <br /> 09 <br /> *Surcharge=Contract Price:$ U D U, x.0005 =$ (Minimum $ .50) <br /> *Mail-In Fee(Only On Mail In Applications) _$� <br /> *Totat Cost of Permit: _$ �.�� <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 /> application are complete,true and correct. <br /> /,c� � `a ���S— <br /> Applicant Date <br /> ����� r' + ' rr' u�r <br /> � ,� � �BSBt���a i <br /> ��en>V..`.'� �a:� _.'�,�d.�. .J.�_��'��; .,.�.' i t , . . <br /> �9PP�o�.� d 7/ �� / o s �.�-y ��� <br />