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-fee: LIT 0t <br /> FIRE ALARM OR KITCHEN EXTINQUISHERPERMITS <br /> Please Check One: <br /> n New Addition n Remodel I I Replace <br /> Job Site/Owner Information: <br /> 2350 W.Wayzata Blvd <br /> Site Address: <br /> Otten Brothers 2350 W.Wayzata Blvd <br /> Owner: Mailing Address: -_ <br /> Long Lake 55356 <br /> City: Zip: <br /> (952)745-2257 <br /> Home Phone: Alternate Phone: <br /> Contractor/Applicant Information: <br /> ADT Security Services Matt Snyder <br /> Contractor/App.: Contact Person: <br /> 5910 Rice Creek Parkway,#700 TS00021 <br /> Address: State License #: <br /> Shoreview 55126 05/09/11 <br /> City: Zip: Expiration Date: <br /> Phone: (763)792-6966 <br /> Alternate Phone: <br /> TYPES OF FIRE PERMITS " <br /> 0 Commercial—Fire Alarm Commercial—Fire Extinguisher <br /> Fire Systems Permit Fire Systems Permit <br /> *(Per UBC) * (Per UBC) <br /> *Contract Price: $ 1°85. <br /> 41) * Contract Price: $ <br /> ❑ Residential—Fire Alarm <br /> Fire Systems Permit <br /> * (Per UBC) <br /> *Contract Price: $ <br /> *Note: Permits are calculated with UBC Fee Schedule;submit application and we will call you with a total fee for the <br /> permit. <br /> 1 herby apply for a Fire Alarm/Extinguisher Permit and 1 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 w•' will be in accordance with the approved plan. <br /> Ltp <br /> 5/127( . <br /> Applicant Date <br /> Reset Form <br />