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'e <br /> ❑ New ❑ Addition ❑ Remodel ❑ Replace <br /> Mx <br /> Site Address: <br /> Owner: Mailing Address: <br /> City: Zip: <br /> Home Phone: Alternate Phone: <br /> Contractor/App.: Contact Person: <br /> Address: State License#: <br /> City: Zip: Expiration Date: <br /> Phone: Alternate Phone: ti <br /> r�t. IE <br /> 1J"'`' �JJ1UN J7 <br /> ❑ Commercial—Fire Alarm ❑ Commercial—Fire Extin iug sher <br /> FireSstems Permit Fire Systems Permit <br /> * * e3i X13 <br /> *Contract Price:$ * Contract Price:$ <br /> ❑ Residential—Fire Alarm <br /> Fire S tams Permit <br /> * ^�.' �_ <br /> *Contract Price: $ <br /> e areal actµ '' C_ -c <br /> „ .. o , 'ili= t few <br /> I herby apply for a Fire Alarm/Extinguisher Permit and I acknowledge that the information above is complete <br /> and accurate;that the work will be in conformance with the Ordinances and Codes required by Minnesota State <br /> Building Code (MUBC) or Minnesota State Fire Code (MUFC) shall be installed and maintained as per <br /> National Fire Protection Association (NFPA) 72 and 72E, 1996 edition, National Electrical Code and <br /> manufacturers requirements;that I understand this is not a permit and work is not to start without a permit;and <br /> that the work will be in accordance with the approved plan. <br /> Applicant Date <br />