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027/3 – 000?6— <br /> FIRE <br /> 5FIREI ALARM OR KITCHEN EXTINQIJISHER PERMITS <br /> Please Check One: <br /> H New ❑ Addition ❑ Remodel g. Replace <br /> Job Site/Owner Information: <br /> Site Address: a) � �c I Z� (u d <br /> Owner: Ser vtCL �,00 Mailing Address: 1 qb y z 1"`2) <br /> City: C-e1yk5 1<e Zip: 55 3 s <br /> Home Phone: Alternate Phone: 5 75--T74/ 7 <br /> Contractor/Applicant Information: n <br /> Contractor/App.: T4 Cc) 5 Contact Person: 3�'t' <br /> Address: •-)).0 A Y`tk u `3 T State License#: ` S G S/©(p 3 <br /> City: Ve5ovil (e- Zip: S-5-1/ 3 Expiration Date: <br /> Phone: (o t 1 C} - C",' Alternate Phone: 6 I ) -7(0 -/-(70 <br /> TYPES OF FIRE PERMITS <br /> ‘1 -11:) <br /> Commercial–Fire Alarm ElCommercial–Fire Extinguisher <br /> Fire Systems Permit Fire Systems Permit <br /> *dier UBC) * (Per UBC) <br /> * Contract Price: $539'3,c63 * Contract Price: $ <br /> ❑ Residential-Fire Alarm <br /> Fire S stems Permit <br /> * <br /> *Contract Price: $ <br /> ,, t ��;;,�� ,� � ,ed with UBC Fee Schedule;submit ap#� ;we will call you with a to fee for the <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 i accordanc with the approved plan. <br /> Applicant Date <br />