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�, 41��i15;92 12:54 THE C I TY OF OROhdO 512-473-7357 �/ r�b�3 <br /> P7.ease check one: /� New Addi�ion <br /> 7QB SITF r��S����N'Tii��. �tc'>;Y1� <br /> �i;rrter' s Name ����LS�y�f� Telephon� Numbez <br /> Mai].ing Address �IC�� i'�i���N i�,.�c.�>� �-t��� _ _ <br /> Sprinkl.er Coritrac�or' s Name ������ L�Y' Telephone Numb�x �=3 � �" ���G <br /> Contact P�xsori --l�c-�' �/�rTElZ�-LL- . . <br /> 1`�0�i ���= - �'_�.'- �ia �.• �c�:�.����-c- /I'IiJ .5.'� // ,� <br /> Ma�ling Addres� �� - � <br /> *itdt*�kdr**�t!l,t�tlef�kit*�k�k*it�t9r�k�t�lrf��*�*iM�M*��k**�tf*��Ir*ir*yrl1�*ytdt�**t*�t*+r��ttit*ff�tas�rar�e,s: <br /> CI.,ASSIP�CA'�'ZON OF OCCQPANCISS <br /> Commerc�al Regidenti�.I �� <br /> �titstytytyeitdtir:atit�+l�!*f+k+kf�rdtf�ff�lt�lh*l�k�t�k�tit!**!t*�ltft*�tir�t*�t:�tir**.rr+r�ksr�r�r�r��*ittitik�t�!* <br /> WATER ��P�LY <br /> Lake ��_ W�11 city <br /> tk�ktitlt#iktrlkdt**�F�t�k*,tie�kit9ttik�tdttt�k�r*�l�t�#�tfc#�t�Mtikdt*fdt�ltt�t#rfit*f�kiYldtitlrtiY#��tlr�*�f�tilfik��k*�Iryk <br /> Year of Orifice <br /> Make Model Manufac�uxe Size uantit <br /> prxn ers �;7a l�f � Z i L�r',�►► l <br /> `r� u� � /��3 Z z- <.:r�in 7 -- <br /> TQTA�. <br /> �f***�*f******t**f*�*:�********f**t��****t**t*�**�*:�*:*�*�*t�e*��*t***,rf**f <br /> HYDRAULxC CALCULATZONS D�sign Data� <br /> Axea of App7.ication: ��• F�. <br /> Coverage per Sprinkler: Sq. Ft. <br /> No. o£ Spr�nk�ers: <br /> Total Water Requir�d : /S GPM. <br /> ***�**t�*t�s*��*******�r,���*�*�**�t*�e***�t*���►*t*�f�r**�*��**:***�**t��**�t*� <br /> PSRM�T F'LE �ALCIII.A�'IDN <br /> 1. Permit F�e $ �Q•Q8 <br /> 2. Stat� Surcharqe. Based on valuation. $ .50� <br /> � . Ma��-�n F�� $ i.� <br /> 4. �.'OTAL PERI�iIT FE$ add I�nes 1-3 above $ '3'L• ��' <br /> The undersigned hereby appl�.es to �he Ci�y of issuanc� o� a Spzinkler <br /> System Pezmit, agrees �o do all work in strict accordanee with the <br /> ord�.n�inces of the City and Sta�e �cegul�tiions, and certif�.es that a� I <br /> statements made on this application are complete, true and c�rrect. <br /> � r -J� _-�= ' <br /> Applicant ,,, , Dat�: 1 � � <br /> x***�r,r***�t*******�r**�***�***** *�* �***********,r****�*�****,►****t�**�r***�** <br /> Appraved� Apprc�ved w�th correc�ions Denied <br /> Revi�we by <br /> .� � i � ,�� ���-"��� . <br /> - Date <br />