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i `Pass Sr'e`�.�^y }• <br /> �'-�y���' l' C a ass A <br /> ❑ New ❑ Addition II Remodel ❑ Replace <br /> b <br /> Site Address: 450 Old Crystal Bay Road <br /> Owner: JEM TECHNICAL Mailing Address:450 Old Crystal Bay Road <br /> City: Orono Zip: 55323 <br /> Home Phone: 952-473-5012 Alternate Phone: <br /> .t6 7 443A0116-': 1 164MY®�sma ado i s <br /> u#'�g,..�..,� <uti. 4.�,�:�� f .. < .ttca:.�l- rF� ��_: vi.a <br /> Contractor/App.: General Security Services Corp. Contact Person: Ash Siyani <br /> Address: 9110 Meadowview Road State License#: TS000276 <br /> City: Bloomington Zip: 55425 Expiration Date: 07/31/2016 <br /> Phone: 952-858-5000 Alternate Phone: 952-858-5063 <br /> [t, R,KIMETP-Ettal: <br /> ❑X Commercial—Fire Alarm ❑ Commercial—Fire Extinguisher <br /> Fire S stems Permit Fire S stems Permit <br /> * PWy: ) * W () <br /> *Contract Price: $ 1900.00 *Contract Price: $ <br /> ❑ Residential—Fire Alarm <br /> Fire S stems Permit <br /> *Contract Price: $ <br /> eea k,� l°•,L da �x`i '.�. .�� .�0_- s <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 <br /> State 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; <br /> and that the work will be in accordance with the approved plan. <br /> 09/22/2015 <br /> Applicant Date <br />