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' �����vv � t?IL�G4Y4b�lo Ui5/'l�slyy u�:S/ � :USf(i3 �iJ:�i�y <br /> � � �� � s� <br /> Pl�tts�check on�: New� Addition <br /> • , <br /> JU8 S�'E���1 Sfi�d��l,/�t'il�_�J e�l�__�......,....�- - <br /> . <br /> ()wmer's 1'��me � � Teleph��x Number <br /> Nieiting Address . <br /> Sprir�lder Ccantractus's hame f � TclephoneNumbCr �- <br /> CcxtUct Per3on�.�h�l �cS _ <br /> M�iling,Addrass G , �- � � <br /> ��:r���r $�n�.c> >�Ir�� J�N`v•,�'.S3 yc� <br /> Lake_,� Weil. �ity� <br /> �A�'Y.O'44�D�VICE <br /> AVE PV'8 <br /> � � Xcar of <br /> �rk.Q �t�1 11��wtl4�tsu� S�!�i� <br /> �prsnkle�s Y` � <br /> .�_.�.. TUTAI. — <br /> ,�$1�,�7.��I,�C��„3TL.A'I"IONS Design Data: <br /> Acai ofApptication: �, .........,` Sq �t. <br /> L`overa$c per 3pris��ier: � Sq. Fc. <br /> No. af Sprialcl�rs: <br /> Totsl�V�t�c Required� ____��pn� <br /> 1. Ptr�it Fee �._ 3S.Q4 <br /> 2. SL�i�_53�LC�€St'�8f $ .50 <br /> 3. Mul�lnFee �- �.SQ <br /> 4. T'UTAL PERM�'1'FEE {Add lines l�3 abav�) � g . � <br /> The undersigned hereby appties to the�it�r ft�r issuancc�f s Sprink!er System permit, agre�s ta�n <br /> t�I waric in sfrict aceprdance with thc ordin�rr,ccs of the City and State regulati��ns, and GPrtifiss that <br /> �1i �ta�tements made on this appiication are complrte, true and correct. <br /> Apptictrnt _ . . ..•__ Daic � <br /> ��s�**r�►�tt i4�ktyrM�i*M�Y'ir�YM#N#Mi��t�1�M�YRi��M#�hi�9�+k9�Yi�F#*l�A�***F+tw+l�+r+►*+M4i�i�+BiMMM�+Mri�M�**�!• <br /> Approved� _ App�oved with Corrcctions� Denied <br /> Rtviewed by: r � <br /> ���-' _ Date_Q`�- �`�� � <br /> /l � d --- ,5 � <br /> � �t- �Y1�i4L(.: ��1�4 h �C�,c'1(X� �'a v / �4 y (��- r ��d c�G�t� yp� � �� ��� <br /> � � � ��'9-� Gi�b9�-�/L�1� <br /> GC�� � 'v��•rr ��f� r.� re ��;v�d `�'�u.�' (� � ��VR � � <br /> � � � � <br />