HomeMy WebLinkAbout2012-00559 - fire systems , CITY OF ORONO * 2 0 1 2 - 0 0 5 5�9�
�t 2750 KELLEY PARKWAY DATE ISSUED: 06/20/2012
ORONO, MN 55356-
(952 249-4600 FAX: (952)249-4616
ADDRESS : 2765 KELLEY PKWY
PIN : 33-118-23-12-0002
LEGAL DESC : WILLOW PROPERTIES ADDN
: LOT 001 BLOCK 001
PERMIT TYPE : FIRE SYSTEMS
PROPERTY TYPE : COMMERCIAL-BUSINESS
CONSTRUCTION TYPE : SPRINKLER SYSTEM-IN BUILDING
NOTE: REPAIR OF SPRINKLER SYSTEM
ENTER THE VALUTATION 8690
APPLICANT FIRE SPRINKLER-COMMERCIAL 108.63
NATIONAL AUTOMATIC SPRINKLER CO. STATE SURCHARGE VAL OTHER 4.35
3061 103RD LN
#200 MAIL-IN FEE 2.00
BLAINE,MN 55449 MISC FEE 0.00
(763)784-8902 TOTAL 114.98
Minnesota State License#:C042
OWNER
Professional Prop Orono,LLP
LLP,PROFESSIONAL PROP ORONO,
835 PARTENWOOD RD
LONG LAKE,MN 55356-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be perfortned according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and dces
not grant permission for additional or related work which requires separate
permiu. All provisions of laws and ordinances goveming this type of work
shall be compied with whether or not specified herein.This permit will
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 app►icant is responsible for assuring all required inspections are
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 Si ture ate
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED AB VE.
,
AUTOMATIC FTRE SPRINKLER PERMITS
Please Chec�Gne:
❑ New ❑ Addition ❑ Remodel � Replace��'��c���'
Job Site/Owner Information:
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Site Address: -� �C:�t-� �- C:\, � ��`%`•
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Owner: ` Mailing Address:
City: Zip:
Home Phone: Alternate Phone:
Contractor/Applicant Information:
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Contractor/App.; '1.�:� �•.,nc� � ��1,�v Contact Person: j-11/�- ' �� = C ✓1 '
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Address: ��v � V�_�Y�� U'1 ��-�-� State License#: �� �-"
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City: �,O.,l�'�k...� Zip: ����1 Expiration Date: � �: � �
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Phone: ��L� ��4.--�` 1��. AlternatePhone: ��" � - � �
TYPES(?F FIRE SPRINI�LER PERMITS
�Commercial-Fire Sprinkler ❑ Residential-Fire Sprinkler
Fire S�stems Pennit Fire Systems Permit
* Base Price=Contract Price: $ � ' ��� x A125 =$-��`�—� )
*Surcharge=Contract Price: $ C� x.0005 =$ b� �G�
* Mail-In Fee(Only On Mail In Applications) _$ 2.00
*Total Cost of Permit: _$�� ,��
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
ication e cam ete,true an orrect.
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Applicant Date
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