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A <br /> SY TE TYLE <br /> Wet Dry Deluge PreAction <br /> Year of Orifice Temperature <br /> Make Model —Mangfacture size. Ougntity R— <br /> aline-- <br /> �-� 165 <br /> ri lers � 69 � 3z. <br /> t 6 5 <br /> ero d _ <br /> TOTAL <br /> AlarinDevice Maximum Time to Operate Thru Test Pi e <br /> Type Make Model Mmim Sec. <br /> Alarm Valv <br /> Flowlindicator <br /> Hylplj&ULICLCULA Design Data: V!X T e,� ��a� GPM/Sq. Fc. <br /> Density <br /> Area of Application: <br /> Coverage per Sprinkler: 100 \3o Sq. Ft. <br /> � � <br /> No. of Sprinklers Calculated: 1 <br /> Total Water Required: GPM Including Hose Streams <br /> PERMIT FEE CALCULATION <br /> 1. 1,25% of Contract Price* or Minimum Fee I35. _ c' <br /> S' - x .0125 $ <br /> (contract price) <br /> 2. State S rehar e, ** Add the State Building Code Division c <br /> Surcharge to each permit, x 0005 $ <br /> JAX <br /> or $.50, whichever is greater (contract price) <br /> 3. I'ost,3ge au Handling (Only mail-in applications) $ 1.50 0-1� <br /> 4. TOTAL PERMIT FEE (Add lines 1-1 above) $ _ 35- <br /> * CONTRACT PRICE or JOB COST tneans the actual or estimated dollar amount charged for the permitted <br /> work including materials, labor, profit, and other flxcd costs. It is the amount to be charged to the <br /> customer t'or the work done. If any material, equipment, labor, or installation are furnished by the owner, <br /> tenant or any other party the reasonable market value of such items must be added to the estimated cost <br /> or contract price for permit fee purposes. In the event that there is a dispute oil the amount of the job cost, <br /> the City may request the submission of a signed copy of the actual contract. <br /> ** The STATP SURCHARGE is .0005 of the contract price under $1,000,000 or $•50 - whichever is <br /> greater. For valuations over $1,000,000 call the Department of Iuspeetlonal Services for the price. <br /> The undersigned hereby applies to the City for issuance of a Sprinkler System Permit, agrees <br /> to do all work in strict accordance with the ordinances of the City and regulations of NFPA 13, <br /> and certifies that all statements made on this application are complete, true and correct. <br /> Applicant Date <br /> Approved l�'`� � Date <br />