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j - ' �L�TO1�I_�TIC FIRE SPRLNKLER PER�YIITS . <br /> � <br /> t�1 l.�'� '''- ;:��i ✓ � <br /> �;;Please Cbecic.One: - - <br /> ❑ New ❑ Addition � Remodel ❑ Replace <br /> Job Site./,Own,er Information: ' <br /> _ ,< , <br /> ���� ���z <br /> Site Address: _- �' � �i �Z�� r�r` \ CZ <br /> Owner: 1� ti`�1 Mailing Address: <br /> City: ���� r�1�.j Zip: <br /> Home Phone: Altemate Phone: � 1� - P�`� ���' � <br /> Contractor/Applicaut Information <br /> Contractor/App.:�c_5�;__, ��.�,�_ ��.�,� ContactPerson: Y1����� ��,; <br /> Address: �-�Z...1 V��1,Sc-,r� 'S i 1�, State License#: ����4�� <br /> City: �`'�'�. �, Zip: �!}�� Expiration Date: C-, - "3C:;- 1 (r� <br /> Phone: �\Z. �Z'�D - 11`1�?C � Alternate Phone: <br /> ;. TYPES OF'FIRE SPRINKLER PERMITS �' � ' <br /> � Commercial—Fire S rp inkler ❑ Residential—Fire Sprinkler <br /> Fire Systems Permit Fire Systems Permit <br /> � _. <br /> *Base Price=Contract Price: � �I ,G C``; x.0125 =$ 1�`> ?, (Minimum$35.00) <br /> s c <br /> � <br /> *Surcharge=Contract Price: $ 1 1 ,c('�C_> x.0005 =� �' (Minimum $ .50) <br /> *Mail-In Fee(Only On Mail In Applications) _$ 1.50 <br /> �� c-- <br /> *Total Cost of Permit: _$ � �k�} , <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 certifes that all statements made on this <br /> application are complete, true and coiYect. <br /> �h����; �t-���v �-� - -7 � I ci.c� <br /> Applicant Date <br /> Reset Form <br />