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-� � . `. � <br /> ���n�i� ZO l S��`7 �S ��'�p2� .�c� �� <br /> AUTOMATiC FiRE SPRiNKLER PERMiTS <br /> Please Check One: <br /> ❑X New ❑ Addition ❑ Remodel ❑ Replace <br /> Job Site/ Owner Information: <br /> Site Address: 100 Kintyre Lane <br /> Owner: Gonyea Homes Mailing Address: 6102 Olson Memorial Hwy <br /> City: Golden Valley Z,p: 55422 <br /> Home Phone: �63.432.4500 Alternate Phone: <br /> Contractor/Applicant Information: <br /> Contractor/App.:�kyline Fire Protection, InC. ContactPerson: Jason MaCk <br /> Address: 10900 73rd Ave N, Suite #108 State License#: C-008 <br /> C;ty: Maple Grove Zip: 55369 Expiration Date: 6.30.2016 <br /> Phone: 763.425.4441 Ext: 4 Alternate Phone: 612-408-4858 <br /> TYPES OF FIRE SPRINKLER PERMITS <br /> ❑ Commercial—Fire Sprinkler XD Residential—Fire Sprinkler <br /> Fire Systems Permit Fire Systems Permit <br /> * Base Price=Contract Price: $ 1$,550 x.0125 =$ 231•$$ (Minimum$50.00) <br /> *Surcharge=Contract Price: $ 18,550 x.0005 =$ 9.27 <br /> * Mail-in Fee(Only On Mail In Applications) _$ 2.00 <br /> *Total Cost of Permit: _$ 243.15 <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, Minnes a ate Fire Code and Standards, and certifies that all statements made on this <br /> applicatio e comp t , e and correct. <br /> � <br /> �f l�/Z�� S <br /> Appl nt n n A� )� Date <br /> J 1`��r,� � �� � ��., <br />