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SYSTEM TYPE <br /> Wet X Dry Deluge PreAction . <br /> Year of Orifice Temperature <br /> Make Model Manufacture S'7e Quantity _iiating -_ <br /> S inkle o <br /> M Vikin& 1/? __ __ 155° <br /> TOTAL <br /> Alarm Device Maximum Time to Operate Thru Test Pi <br /> _ I vi2e Make Model min. Sec. <br /> Alarm Valve/ <br /> Fl w Indicator Notifier WFD 4 <br /> HyDRALMIC CALCULATIQN Design Data: GPM/Sq. Ft. <br /> Density .1 <br /> Area of Application: 1500 Sq. Ft. <br /> Coverage per Sprinkler: 168 Sq. Ft. <br /> No. of Sprinklers Calculated: 11 <br /> Total Water Required: 168 <br /> Sprinklers only <br /> PE�Mrr E cA .cvLATION <br /> 1. 1.25% of Contract Price* or Minimum Fee ($35.-0)l <br /> 15*000 x .0125 S 187.50 <br /> (contract price) <br /> 2. State Surcharge. ** Add the State Building Codc Division <br /> Surcharge to each permit. 151000-00 x .0005 $ 7-50 <br /> or $.50, whichever is greater (contract price) $ 1.50 <br /> 3. Postage and Handling. (Only mail-in applications) $ 196.50 <br /> 4. TOTAL PERWT FEE (Add lines 1-3 above) <br /> " CONTRACT PRICE or JOB COST means the actual or estimated dollar atuvunt charged for the permitted <br /> work including materials, labor, profit, and other fixed costs. It is the amount to be charged to the <br /> customer for the work done. If any material, equipment, labor, or installation are furnished by the owner, <br /> tenant or any other parry 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 on the amount of the fob cost, <br /> the City may request the submission of a signed copy of the actual contract. <br /> *" The STATE SURCHARGE is .0005 of the contract price tinder $1,000,000 or 5.50 - whichever is <br /> greater. For valuations over $1,000,000 call the Department of Inspectional Services for rhe 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 /> Date <br /> Applicant <br /> Dace <br /> Approved <br />