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, :� <br /> , <br /> �b/�- o�� <br /> � <br /> � New ❑ Addition ❑ Remodel ❑ Replace <br /> Job Site/Owne;Information: ^ � <br /> Site Address: ���I� ,�`���r� (,�j�,�. �� � <br /> Owner: �� U�..Y.�' ��J� Mailing Address: <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor/App.:�;��t�, ��' �l,l.G-j-`-�'/L-T Contact Person: �3C�L U"V ) <br /> —T—�— <br /> Address: �� ,��`�� ����/��State License#: ��Cj�G�(�L��' �� <br /> City: ,� 'Y Zip: ��� Expiration Date: <br /> Phone: /r1.���`1�7 �s'�i�.�� Alternate Phone: <br /> ❑ Commercial—Fire Alarm � <br /> ;�Commercial—Fire Extin uisher <br /> Fire S stems Permit Fire S stems P i' '" �\ <br /> * *� 'r'� —J - �. <br /> *Contract)Price: $ *Contract Price: $ '� (�� • L' V <br /> ❑ Residential—Fire Alar ;�_ . <br /> Fire S stems Permit <br /> * � <br /> *Contract Price: $ <br /> '"NOtO:.� <br /> permit, <br /> I herby apply for 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)or 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 accordance with the approved plan. <br /> r; , , <br /> ' ' �� J <br /> Ap 1 cant � Date <br /> �, <br />