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AUTOMATIC FIRE SPRINKLER PERMITS <br /> Please Check One: <br /> � New ❑ Addition ❑ Remodel ❑ Replace <br /> Job Site/Owner Information: <br /> Site Address: � ��� ��S�� �'���`�� <br /> Owner: S'b�t 11�0�� lJ�.l� Mailing Address: <br /> City: V f0 h 0 Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor/Applicant Information: <br /> � <br /> Contractor/A �CO`C���3 ��e. J -2r��Y �►'`�qu'��'� <br /> pp.: Contact Person: � <br /> �r /� <br /> Address: �� V � µ� 1 �v State License #: C,�U 5� <br /> City: � � Zip: �� Expiration Date: 5` �'�� � <br /> -L � <br /> Phone: 1�13 f Y''2 2-qU Alternate Phone: ��Z`�'LD" 2�� ( <br /> TYPES OF FIRE SPRINKLER PERMITS <br /> ❑ Commercial—Fire Sprinkler J�Residential—Fire S�rinkler <br /> � <br /> Fire Systems Yennit Fire Systems Permit <br /> * Base Price=Contract Price: $ ��,�� x.O125 =$ ��� (Minimum$50.00) <br /> —�— <br /> x Surcharge=Contract Price: $ �� � x.0005 =$ �• �� <br /> * Mail-In Fee(Only On Mail In Applications) _$ 2.00 <br /> *Total Cost of Permit: _$ �� �• z'� <br /> The unde igned herby applies to the City for issuance of a Sprinkler Systems Permit. Applicant agrees <br /> that all tei shall be designed, installed and maintained to N.F.P.A.-l3,N.F.P.A.-25, Minnesota State <br /> Buildi g e Minnesota State Fire Code and Standards, and certifies that all statements made on this <br /> appli ati ar completitrue and correct. <br /> t� ZS 2 a t <br /> Applic Date <br />