HomeMy WebLinkAbout2006-P10400 - sprinkler system PERMIT
CITY OF ORONO permit Number:
2750 Kelley Parkway- PO Box 66 P10400
Crystal Bay, Minnesota 55323 Permit Type:
(952) 249-46QD Fire Systems Permit
. Date Issued: l0/3/2006
SITE ADDRESS: 2765 Kelley Pkwy Unit#
Long Lake,MN 55356
P��� 33-118-23-12-0002
DESCRIPTION:
Proposed Use: Commercial-Business
Permit Class: General
Permit Type: Fire Systems Pernut Permit Sub-type(s): Sprinkler System
DETAILS:
Approved per resolution#:
Separate permits required:
NOTICES/REMARKS:
To Be Inspected By Fire Marshall-Bill Meyer 612-490-2307
FEE SUMMARY: Pernut Fee: $ 35.00 valuation: $ 1,200.00
State Surcharge Fee: $ 0.60
Mise.Fee: $ 1.40
TOTAL FEE: $ 37.00
APPLICANT: Shield Fire Protection,Inc. OWNER: Skin Care Doctors
4392 W. Round Lake Road 2765 Kelley Pkwy
Arden Hills,MN 55112 Long Lake,MN 55356
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
AND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND STATE OF
MINNESOTA BUILDING CODE REQUIREMENTS.
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APPLICANT PERMITEE SIGNATURE ISSUED BY S[GNATURE
Copies: 1-File(SignaturesRequired), 1-Applicant, l-MonthlyReports, I-Assessing,(IfSeptic, 1-Septic) Page 1
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Job Site/Owner Infc�rmatian:
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Owner: Mailing Address:
City: Zip:
uome Phone: Alternate Phone:
Contractor/Applicant Information:
Contractor/App.:��� ��v�- ����-��rt Contact Person: ��. w. �--�, r,c-�
Address: �1,�'�I� �, �ovr,cl L,I� �� State License#: (`�O l �-{
City: � � � Zip: �� Expiration Date:
Phone: Alternate Phone: (,��%- (G 3(�� )/�/
���� �� TYPES OF FIRE SPRINKLER PERMITS � � �� � �� ���
[� Commercial—Fire Sprinkler ❑ Residential—Fire Sprinkler
Fire Systems Permit Fire Systems Permit
* Base Price=Contract Price:$ c�-� . x.0125 =$ �� • (Minimum$35.00)
* Surcharge=Contract Price:$ x.0005 =$ N S� (Minimum $ .50)
* Mail-[n Fee(Only On Mail In Applications) _$ 1.50
* Total Cost of Permit: _$ J ��
The undersigned herby applies to the City for issuance of a Sprinkler Systems Permit. Applicant agrees
that all systems shall be designed, installed and maintained to N.F.P.A.-13,N.F.P.A.-25,Minnesota State
Building Code, Minnesota State Fire Code and Standards, and certifies that all statements made on this
application are complete,true and correct.
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Applicant Date
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Reset Form �
5 EP 2 8 2006
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