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Pleas check one: _�New Addition <br /> Jos s � 3 I I.5 S��,sex (��, <br /> Owner s Name CRy��t. PA6t�� NpmSS Telephone Number <br /> Maili g Address _ <br /> Sprin ler Contractor' s Name6R� A�:� Sp�'^'r�u���elephone Number 9�� "1�32 <br /> Conta t Person joNN Ge�'►s� <br /> Maili g Address ���6 �Ltv+o� �Lo a��re 1�� S1' �'s 'P��. �'f►J 5�'�� <br /> ***** **�******:t***:****���***�**��***************�**�****************:**� <br /> CLASS FICATION OF OCCIIPANCIES <br /> ommercial Residential X <br /> ***�* ***�**�*:*****�***�t��*�****��***�***�#tt*�*t****:���*********��***t: <br /> WATER' SUPPLY <br /> ake Well � City <br /> *****�***:��*******::*****�r****:***************�****�*�*************�****** <br /> Year of Orifice <br /> ' Make Model Manufacture Size uantit <br /> S rin lers -T�Ro S^O �`�`l2- I,S GPrM O' <br /> �r��0 60o ti 1 z .� cfm <br /> --Tc�L� 3c7 o I 9 9 2- l.7 GPr� <br /> TOTAL <br /> �**� **t���:**********#**�**��******�******�*****��****�*****�*�*********#* <br /> HYD IILIC CALCIILATIONS Design Data: <br /> Area of Application: Sq. Ft. <br /> Coverage per Sprinkler: � "� Sq. Ft. �70= !Z' �ov�.�y,�orr-3; <br /> No. of Sprinklers: � <br /> Total Water Required: GPM. <br /> **** ********t***#*t*******�****** *************�*�*#*****�#**�**�***�f <br /> PERMIT FEE CALCIILATION <br /> 1. ermit Fee $ 30. 00 <br /> 2 . tate Surchar e. Based on valuation. $ .50 <br /> 3. ail-In Fee �- 1.50 <br /> 4. OTAL Pffi21KIT FEE add lines 1-3 above $ 3o,5U <br /> The ndersigned hereby applies to the City of issuance of a Sprinkler <br /> Syst m Permit, agrees to do all work in strict accordance with the <br /> ordi ances of the City and State regulations, and certifies that all <br /> stat ments made on this application are complete, true and correct. <br /> � <br /> Applicant C✓�� Date 31y�. <br /> / <br /> � � � <br /> � - � � �/ �_��� u <br /> �����e- l ,���'� ���e � � ��,�� <br /> � <br /> e ��` �... <br />