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FIRE ALARM OR KITCHEN EXTIN UISHER PERMITS <br /> /� <br /> Please Check One: �j1,� <br /> � New ❑ Addition ❑ Remodel ❑ Replace <br /> Job Site/Owner Information: <br /> •� C� . <br /> Site Address: ��U��' ����2,�.��, ��U`�'�� <br /> Owner: �cono�tav�`r' Mailing Address: 33$v �tcNe I,nQ.l�c- <br /> City: ��.v�, Zip: ���� <br /> Home Phone� l�lZ� �g (��;�, Alternate Phone: <br /> Contractor/Applicant Information: <br /> Contractor/App.: �,�����e�v.«�v� Contact Person: �r�lrL,,�}�����„ �(��Z,l��'Z.�1� <br /> t <br /> Address: ���C�tric,�� State License#: �Gb�-2.1� <br /> c <br /> City: �oc-�C-�a-� Zip: �� Expiration Date: ��� -Z01� <br /> Phone: �1�'��., �1�2� 3i��-` Alternate Phone: �IC 3�`�77 -�3t3� -cKF �I+e'� <br /> TYPES OF FIRE PERMITS <br /> ��Conunercial—Fire Alarm ❑ Commercial—Fire Extin i_ •u� <br /> Firc SySicros Pcrmit Fire S stems Permit <br /> * (Per UBC) *�) <br /> * Contract Price: $��(� *Contract Price: $ <br /> ❑ Residential—Fire Alarm <br /> Fire S ste��it <br /> * <br /> *Contract Price: � <br /> *Note: P <br /> pennit. <br /> I herby apply far a Fire Alarm/Extinguisher Permit and I acknowledge that the information above is complete <br /> and accurate; that the work will be in conformance with the Ordinances and Codes required by Minnesota <br /> State Building Code(MUBC)ar Minnesota State Fire Code(MUFC)shall be installed and maintained as per <br /> National Fire Protection Association (NFPA) 72 and 72E, 1996 edition, National Electrical Code and <br /> manufacturers requirements;that I understand this is not a permit and work is not to start without a permit; <br /> and that the work will be in accardance with the approved plan. <br /> � <br /> ,,� , � ��u3i ao�'1 <br /> plic t Da1�— <br />