HomeMy WebLinkAbout2011-00077 - fire extinguisher CITY OF ORONO PERMIT NO.: 2011-000��
�" � 2750 KELLEY PARKWAY
� ORONO, MN 55356- DATE IssuEn: 02/18/2011
952 249-4600 FAX: 952 249-4616
ADDRESS : 2060 SIXTH AVE N
PIN : 27-118-23-31-0002
LEGAL DESC : UNPLATTED 27 118 23
: LOT 000 BLOCK 000
PERMIT TYPE : FIRE SYSTEMS
PROPERTY TYPE : COMMERCIAL-BUSINESS
CONSTRUCTION TYPE : EXTINGUISHER
NOTE: INSPECTIONS ARE DONE BY FIRE MARSHALL,JAMES VAN EYLL.
PLEASE CALL JAMES VAN EYLL DIRECTLY AT:(952)473-9701 TO SET UP AN INSPECTION.
ENTER CONTRACT PRICE 1850 ENTER THE VALUTATION 1850
APPLICANT FIRE ALARM 70.50
NORTHLAND FIRE AND SECURITY STATE SURCHARGE VAL OTHER 5.00
4445 77TH ST. W.
EDINA,MN 55435- MISC FEE 0.00
(952)893-0905 TOTAL 75.50
OWNER
CHURCH,TRINTY LUTHERAN
2060 SIXTH AVE N
LONG LAKE,MN 55356
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances goveming this type of work
shall be compied with whether or not specified herein.This permit wi11
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections aze
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause. `
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Applicant Permitee Signature Date Issued By ' ature ate
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB .
. � i FIRE ALARM OR KITCHEN EXTINQUISHER PERMITS
aoi�-�a�d7�
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Please Check One: � ��
`� New ❑ Addition ❑ Remodel ❑ Replace �
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Job Site/Owner Information:
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Site Address: ���00 — �� �c9t., �
Owner: / KiN�I� L�T/t�2�N C�u� Mailing Address: O��'O � �� �`��- N
c�ty: Lo,�C� C.�-kE zip: ��� ��
Home Phone: Alternate Phone: �,SZ-' �73�S5 7?
EF• ��
Contractor/Applicant Information:
Contractor/App.:/�2Tft[,Ptic.A F��E�'.�tU�c:tir Contact Person: � �� "'"�S
Address: �1����.�� ST State License#:
City: � (itJ�' Zip: SS�3S Expiration Date:
Phone: ��Z.' gq3' Oq�S Alternate Phone:
TYPES OF FIRE PERMITS
❑ Commercial—Fire Alarm �inmercial—Fire Extin�uisher
Fire Svstems Pennit Firc S��stems Permit
* (Per UBC) '�(Per UBC)
x Contract Price: $ x Contract Price: $ �BJ��•��
❑ Residential—Fire Alarm
Fire Sy��tcm�Pcrmit
* (Per LIB�} �
* Contract Price: $
*Note: Permits are calculated with UBC Fee Schedule;submit application and we will call vou with a total fee for the
permit.
I herby apply for a Fire Alann/Extinguisher Permit and I acknowledge that the information above is complete
and accurate;that the work will be in conformance with the Ordinances and Codes required by Minnesota
State Building Code(MUBC)or Minnesota State Fire Code(MUFC)shall be installed and maintained as per
National Fire Protection Association (NFPA) 72 and 72E, 1996 edition, National Electrical Code and
ma ufacturers requirements;that I understand this is not a permit and work i not to start without a permit;
and at the work will be i accordance with the approved plan.
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Applic Date
Reset Form
PR❑JECT NAME; Trinity Lutheran Church y N
PR��ECT ADDRESS; 2060 - 6th Ave N, Long Lake MN 55356 � Y � � ��
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