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AUTOMATIC FIRE SPRINKLER PERMITS <br /> Please Check One: /fS77t.GLcj2C�i /Mai �" �i seams Q.PSTt2c4 c/ <br /> ri9-eLfeC<CsZesys/rt�1j -¢ rOSe gu - neW <br /> ✓ New El Addition ✓ Remodel Replac C 7//e 6 <br /> 1:11° <br /> eXrS7`7' reev <br /> letk <br /> Job Site/Owner Information: Q6� <br /> Site Address: 850 West Wayzata Blvd <br /> Owner: Orono Montessori Mailing Address: <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor/Applicant Information: <br /> Contractor/A Ahern Fire Protection Contact Person: Barb Barnes <br /> PP•� <br /> Address: 13705 26th Avenue Suite 110 State License #: C039 <br /> City: Plymouth Zip: 55441 Expiration Date: 06/30/2010 <br /> Phone: (763) 268 0515 Alternate Phone: (612) 843-3210 <br /> TYPES OF FIRE SPRINKLER PERMITS <br /> Commercial—Fire Sprinkler 8 Residential—Fire Sprinkler <br /> Fire Systems Permit Fire Systems Permit <br /> * Base Price=Contract Price: $ 850.00 x 0125 =$ 35.00 (Minimum$35.00) <br /> * Surcharge=Contract Price:$ 850.00 x.0005 =$ 0.50 (Minimum $ .50) <br /> * Mail-In Fee(Only On Mail In Applications) =$ 2.00 <br /> *Total Cost of Permit: =$ 38.00 <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 certifies that all statements made on this <br /> application are complete,true and correct. <br /> Ge _ 3/3 /0 <br /> Applicant Date <br /> Reset Form <br />