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( ] New ❑ Addition ❑ Remodel ❑ Replace <br /> Site Address: 3(OS5 <br /> Owner: i�/N Erj->om Mailing Address: <br /> br- -5-L-'q"/p5 <br /> City: /)Ramo Zip: <br /> Home Phone: 9S2- q7/-g/q5 Alternate Phone: 170 <br /> Contractor/App.: 5t--N7I2�( �YS7t/Y!!S lNL Contact Person: <br /> Address: State License#: TSOj 00 3 <br /> City: W Ni7-F-gw- Z'e Zip: SS/1a Expiration Date: 3/ e) �-' <br /> Phone: (�S�- 29�-33 2 �J Alternate Phone: (�5/-7 SS-(o3 9 Q <br /> Commercial—Fire Alarm ❑ Commercial—Fire Extin igu cher <br /> ! Fire S stems Permit Fire S stems Permit <br /> * * <br /> *Contract Price:$ 4000-9 *Contract Price:$ <br /> ❑ Residential—Fire Alarm <br /> Fire Systems Permit <br /> *AM <br /> *Contract Price:$ <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 and stand this is not a permit and work is not to start without a permit; <br /> and th c w' be ordan wi the approved plan. <br /> Applicant Date <br /> NINE= ,4pv �•�U' 9/i 7/0S <br />