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/�C�� <br /> \ y� <br /> �LCG�._ �IS /n �[iV�Y' -�l7�5�' - <br /> AUTOMATIC FIRE SPRINKLER PERMITS <br /> c�pi�-o�5� <br /> Please Check One: <br /> �1 ,�?��,, n e_��;r;,,. � 12�r1��l�t I—I �2_���lana <br /> c <br /> ��CIiflO\�' ?�:'V'1Ct': � -g�'I� P��B <br /> I ,Iob Site /O���ner Information: ! <br /> SitcAddress: 3333 S �aR�-�►�� �R _ <br /> Owner: ��► �t_,12�—�� �,s Mailing Address: <br /> City: N q-V !\ R.�..F Zip: <br /> Home Phone: Alteniate Phone: <br /> Contractor/Applicant Information: <br /> Contractor/App.: SNI�LD G�R� �;taT. ContactPerson: �i�� �-��.v��l <br /> Address: Z$S � �OS�Lr4.,�� 11'+i'� State License #: C�1� <br /> City: �1K ) �,, t�p Zip: �� Expiration Date: �D � <br /> Phone: (i'S I �►3(i "]1 � Alternate Phone: <br /> TYPES OF FI�tE SPRINKLER PERMITS <br /> �Commercial–Fire Sprinkler ❑ Residential–Fire Sprinkler <br /> Fire Systems Permit Fire Systems Permit <br /> ����� *Base Price=Contract Price: $ �1�� x.0125 =$ � (Minimum$50.00) <br /> * Surcharge=Contract Price: $ x.0005 =$ � <br /> *Mail-In Fee(Only On Mail In Applications) _$ 2.00 <br /> * Total Cost of Permit: _$ 5 3 � <br /> The und.��'s� ned herby applies to the Cit}-for issuance of a Sprinkler Systems Pennit. Applicant ab ees <br /> that �ll syste s shall e designed, installed and inaintained to N.F.P.A.-13,N.F.P.A.-25,Minnesota State <br /> Buil�ing Cod , Min ota State Fire Code and Standards, and certifies that all statements made on this <br /> application ar corr�pl,te, true and correct. <br /> � � � 12 • S� - ll� <br /> Applicant� Date <br />