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. ��,.� _��������`a °...�n����.�:��,�CT�'�.���C-F�RE SPRINKLER.PE�tMI3'S; :::�h..,, . � <br /> ���Please Checic�One: m ,�, � �,_ � � <br /> � New ❑ Addition ❑ Remodel ❑ Replace <br /> ; Job Site/Owner Information: <br /> Site Address: �l����-u� � � J � � �.e'"'`''72SZ � ,-. <br /> `� � y '� C � � ( t <br /> Owner: � - � � Mailing Address: <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> � Contractor/Applicant Information: <br /> Contractor/App.:L��y�vF P� �!�� � Contact Person: �� � �� <br /> r� <br /> Address: �/�y� �� �� - �d � � State License#: C �G �� <br /> �vt1 ,-,_ <br /> City: � � ; ,� <br /> Zip: -� � y� 7 Expiration Date: � (_�,�[ � �� <br /> Phone: �� Z�� ��� � ���� Alternate Phone: <br /> f�.� ����,� � <br /> �.�r��.F..�,�;h� r�-�,��,���r����,��a;. �'�.,�?ES OF�T+lRE SP•ItTNKLER PERMITS ;�i:' <br /> ❑ Commercial—Fire S rp inkler ❑ Residential—Fire Sprinkler <br /> Fire Systems Permit Fire Systems Permit <br /> *Base Price=Contract Price: $�� x .0125 =$ (Minimum$35.00) <br /> *Surcharge=Contract Price: $ x .0005 =$ (Minimum $ .50) <br /> * Mail-In Fee(Only On Mail In Applications) _$ 1.50 <br /> *Total Cost of Permit: _$ �- v <br /> ����� �-f��/I.0 /� ,( / ,��J �� � ! j/t <br /> The undersigned herby applies to the City for issuance of a Sprinkler Systems Permit. Applicant agrees <br /> that all systems shall be designed, installed and maintained to N.F.P.A.-13,N.F.P.A.-25, Minnesota State <br /> Building Code,Minnesota State Fire Code and Standards,and certifies that all statements made on this <br /> application are complete,true and correct. <br /> � � �� ' - ��� -�= � <br /> Applicant Date <br /> � :� � ,��� � � : <br /> �p�'�4�� Reset Form ,� �- <br /> . / <br /> �� '�(���- �, <br /> � <br />