Laserfiche WebLink
Please check one: New Addition X <br /> JOB SITE \ A, 1 C) c,; <br /> Owner's Name \I1 r,Rr ciTelephone Number <br /> Mailing Address 'Icicic C,Jesb- Bocci4k, <br /> Sprinkler Contractor's Name � Gree,, Telephone NumbeK6,I,)) ).c, <br /> Contact Person C) L)-f e L,,ea( <br /> Mailing Address S C (�w \ tea-k c e l l c nri„ . S S 3 G <br /> WATER SUPPLY <br /> Lake Well X City <br /> BACKFLOW DEVICE <br /> AVB PVB <br /> Year of <br /> Make Model Manufacture Quantity <br /> Sprinklers <, 15,6k dttt ') <br /> 41 <br /> TOTAL L-) CCC <br /> HYDRAULIC CALCULATIONS Design Data: <br /> Area of Application: �> C_ Sq. Ft. <br /> Coverage per Sprinkler: 1. f J'c; Sq. Ft. <br /> No. of Sprinklers: 4/6 <br /> Total Water Required: GPM <br /> PERMIT FEE CALCULATION <br /> 1. Permit Fee $ 35.00 <br /> 2. State Surcharge. $ .50 <br /> 3. Mail-In Fee $ 1.50 <br /> 4. TOTAL PERMIT FEE (Add lines 1-3 above) $ <br /> The undersigned hereby applies to the City for issuance of a Sprinkler System Permit, agrees to <br /> do all work in strict accordance with the ordinances of the City and State regulations, and certifies <br /> that all statements made on this application are complete, true and correct. <br /> Applicant Date -5- <br /> ****************************************************************************** <br /> -S-****************************************************************************** <br /> Approved 2(,_ Approved with Corrections Denied <br /> Reviewed by: ; <br /> /, '/ <br /> 7--� ; ii Date <br />