Laserfiche WebLink
Please check one: /� New Addition -� � ,- �� <br /> � ,,�__ <br /> JOB SITE <br /> ��v0� ��;Y•/�� ls�Y��� <br /> Owner' s Name �J�C..(_ �(��t C 1� Telephone Number <br /> � t� � <br /> Mailing Address `,�C�c7 ( ����i � G- <br /> Sprinkler Contractor' s Name �r��T����c,r"�'�� Telephone Number `���-���/ <br /> Contact Person�}��,7�/��6�-�— <br /> Mailing Address <br /> ***********�***�*****************�**��*************�*********************** <br /> CLASSIFICATION OF OCCIIPANCIES <br /> Commercial Residential � <br /> �*****�*************************** **�*******�***�t**t�**��*�*****�*****#*t <br /> WATER SIIPPLY �' <br /> Lake Well / \ City <br /> **********��**�**�*******� **�*****�****�******�**��*�**t*�*�***********�** <br /> Year of Orifice <br /> Make Model Manufacture Size Quantity <br /> S rink�ers <br /> \ r r �- S �� �-1 S . <br /> _� � <br /> TOTAL <br /> *�******�**�:***��**�******�*******#�***�****�**:*************�*�****�t**** <br /> HYDRAIILIC CALCIILATIONS Design Data: <br /> Area of Application: Sq. Ft. <br /> Coverage per Sprinkler: Sq. Ft. <br /> No. of Sprinklers: l _ <br /> Total Water Required: GPM. <br /> **�*�**�********#�****�**�****�*��**�******:�****�******�*�*�****�*****�*** <br /> PBRMIT FEE CALCIILATION <br /> l. Permit Fee $ 30. 00 <br /> 2. State Surcharge. Based on valuation. $ .50 <br /> 3. Mail-In Fee $ 1.50 <br /> 4 . TOTAI� PERMIT FEE add lines 1-3 above $ <br /> The undersigned hereby applies to the City of issuance of a Sprinkler <br /> System Permit, agrees to do all work in strict accordance with the <br /> ordinances of the City and State regulations, and certifies that all <br /> statements made on this application are complete, true and correct. <br /> Applicant � Date ��3�� � <br /> **************** ******************* ************************************ <br /> � Denied <br /> Approved Approved with Corrections <br /> Reviewed b : <br /> _ /o--�--�� <br /> Date <br />