Laserfiche WebLink
` —: ��==-�/1��.�' �2�f ���a���r <br /> � ��`�=,AUTQMATIC'FIRE SPRINKLER PERM�� �'� J '}� �� <br /> �'�i�v�� �a��-��� �/ <br /> yf ; �BPq „ , s`.wr-,,,.�� '�'�� h,���. ������L" �;r' <br /> ..:� ,� _<����d�� .f"� n-4�,..:,t '� ,l <br /> �,�j /b�/Zr�� <br /> New ❑ Addition ❑ Remodel ❑ Replace <br /> � �� � � �: � �� � � �� a <br /> . e ,,..�' �' �6:., �`���s..�r ,�,f'�. <br /> ..�4,.n5.. '.:� . <br /> Site Address: ��7� COIJ b�<iS�yr� �v2� <br /> Owner: ��?����f}C�i�tn� Mailing Address: <br /> City: 0/�/!(� Zip: <br /> Home Phone: �-/.SZ ��y�—�'���g Alternate Phone: <br /> Contractc�r 1 Applicat�t Information: <br /> Contractor/App.:,�i�GS�vt�!-i/.0 �2j�. Contact Person: /1�N c> <br /> Address: ,SO�C�i¢yz,�(�}- Lv(� State License #: �'p�� <br /> City: � �l� Zip: A1N Expiration Date: � -� ZD/ Z/ <br /> Phone: ��� 5�73'��/� Alternate Phone: �/7 ���7�1i8� <br /> a� .����,,�� �� . k�,,,,�„:' . TYPES.QF FIRE SPRINKLER'PERMITS �M .,�,_tt; ,���.. �����h�:�. � x":: <br /> ❑ Commercial— Fire Sprinkler �Residential—Fire Sprinkler <br /> Fire Systems Permit Fire Systems PeRnit <br /> x Base Price=Contract Price: $`��� x.0125 =$ '�7.v�lJ (Minimum $35.00) <br /> * Surcharge=Contract Price: $ � x.0005 =$ <br /> * Mail-In Fee(Only On Mail In Applications) _$ 2.00 <br /> *Total Cost of Permit: _� • <br /> The undersigned herby applies to the City for issuance of a Sprinkler Systems Permit. Applicant agrees <br /> that a11 systems shalf 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 /> appli tion are complete, true and correct. <br /> /� - �3 -�o// <br /> Applicant Date <br /> ��� � ���Reset �orm � <br /> � ��. <br />