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ATT'FOM .' L , s r ER.PER it i.46 <br /> ❑ New ❑ Addition ❑✓ Remodel ❑ Replace <br /> Site Address: 2380 Wayzata Blvd. <br /> Owner: Harvest Moon Co-op Mailing Address: 2380 Wayzata Blvd. <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor/A Midwest Fire Protection, Inc. Contact Person: James A. Kuempel <br /> pp.. <br /> Address: 324 Harding Street NE State License#: CO21 <br /> City: Minneapolis Zip: 55413 Expiration Date: 6/30/10 <br /> Phone: (612)331-1411 Alternate Phone: <br /> `3.t • 4> 3...! ,, 4,,a f'Fi ? .N LE 'TIP, i�`�1�� <br /> 0 Commercial—Fire Sprinkler 8 Residential—Fire Sprinkler <br /> Fire Systems Permit Fire Systems Permit <br /> * Base Price=Contract Price: $ 7,984.00 x.0125 =$ 9980 (Minimum$35.00) <br /> *Surcharge=Contract Price:$ 7,984.00 x.0005 =$ 3.99 (Minimum $ .50) <br /> * Mail-In Fee(Only On Mail In Applications) =$ 2.00 <br /> *Total Cost of Permit: =$ 105.79 <br /> The . sersig.ed herby applies to the City for issuance of a Sprinkler Systems Permit. Applicant agrees <br /> -at all system, shall be designed, installed and maintained to N.F.P.A.-13,N.F.P.A.-25,Minnesota State <br /> Building Code innesota State Fire Code and Standards,and certifies that all statements made on this <br /> applicationar mplete,true and correct. <br /> 04/12/10 <br /> ApplicantDate <br />