Fillable Fire-Protection-Permit-Application-PDF JOB ADDRESS

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Fire-Protection-Permit-Application-PDF JOB ADDRESS

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U.S.A. forms for City of Andover

BROWSE CITY OF ANDOVER (MN) FORMS

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1685 CROSSTOWN BOULEVARD NW, ANDOVER, MINNESOTA 55304 (763) 755-8700 • FAX (763) 755-8923 • WWW.ANDOVERMN.GOV
Project Address:
Legal
Lot
Block
Development
Owner
Telephone
E-Mail Address
Contractor
License Number
E-Mail Address
Mail Address
Contact Person
Telephone
Property
Type
(CHECK ONE)
S
ingle Family
Residential
Two-Family
Residential
Multifamily
Residential
T
ownhome
A
gricultural
Commercial Industrial Institutional Public / Gov’t OTHER
Fire Protection Permit Type
Project Valuation
Fire
Suppression
System
Wet Sprinklers
$
Dry Sprinklers – Pressurized
Chemical, Ansul / Comm Kitchen - OTHER
Fire Alarm
System
Fire Suppression Monitoring System
$
Building Fire Alarm System
$
Tanks
Above Ground
Installation
Specify Fuels, Number and Tank Volumes: ____________________
________________________________________________________
________________________________________________________
________________________________________________________
$
Removal
Below Ground
Installation
Specify Fuels, Number and Tank Volumes: ____________________
________________________________________________________
________________________________________________________
________________________________________________________
$
Removal
OTHER FIRE PROTECTION SYSTEM (Specify Type & Number)
$
Signature of Fire Protection Contractor Date
Signature of Owner (If Owner is Builder) Date
I hereby apply for a Fire Protection permit and acknowledge: the information above is complete and accurate; the work will be in conformance with the ordinances and codes of the
City of Andover and Minnesota State Building and Fire Codes; I understand this is not a permit but only an application for permit; work is not to start without permit; work will be in
accordance with the Approved Plan when City plan approval required. This application and any issued permit may become null and void if permit is not issued or work is not
commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. I hereby certify that I have read and examined this application. The granting of a permit
does not presume to give authority to violate or cancel the provisions of any other state or local law regulating construction or the performance of construction.
BELOW - FOR CITY USE ONLY
PLAN CHECK REQUIRED
65% of Permit Fee
Plans Checked By
Approved for Issuance Date
FIRE PROTECTION PERMIT APPLICATION
Fire Protection Permit Fees
Project Valuation to be used in computing permit fee is the fair market value of work, including
the total costs of materials, labor, profit and overhead for which the permit is issued.
Minimum Permit Fee (All Permit Types) $90.00
Fire Suppression System 1.25% of Project Valuation
Fire Alarm System 1.25% of Project Valuation
Commercial Fuel Storage Tank 1.25% of Project Valuation
Other Fire Protection System 1.25% of Project Valuation
Plan Review Fee
(Charged For All Permit Types When Plans Must Be Submitted) 65% of Permit Fee
Minnesota State Surcharge must be charged
in addition to permit fees for all permit types: .0005 x Project Valuation
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Completed 10 July 2020

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