HomeMy WebLinkAboutAPPLICATION - 07-00517 - Vector Security - Fire Safety Certification7- Oct -12
08:56 AM
The Security Group
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2088958401
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Rexburg- Madison County _y� ° " ° R °a
o CITY U I
Emergency Services RE
19 East Main 51 ionellh@rexburg.org Phone: 208.359,3020x326 ' — n "
.9�rcricds Fallaily Cnllnauniq�
Rexburg, 10 83440 www.rexburg,org Fax: 208.359.3024
SAFETY SYSTEM CERTIFICATION PERMIT APPLICA
PERMIT #:
$100 Fee Paid: Yes /No Permit Approve es No
BY ate, / - 7
"A safety .Duteni certificalionpe7mit is required to install, nsodi, maintain, or service all naw and existing fire
extinguishers, fire srppressien gstews, f re alarm systems, and other life safcbi systems within the City of Ilexbmg"
BUSINESSNAME:
VEc.tor
6-ecur - ; �4
Parcel:
OFFICE ADDRESS:
106'/
ttlgkoMow 0
8aria s.5eys, • _VA a0116_
OFFICE PHONE NUMBER: (70:3 So
CONTACT PERSON: M ike. K 'A -ko ne. f CELL PHONE #: (tlo 7 q'2 - 4 yba
PLEASE IDENTIFY SYSTEMS TO BE COVERED_ BY THIS PERMIT- CHECK ALL
THAT APPLY.
.FIRE ALARM SYSTEMS - Alarm Contractors shall have a minimum of NICET Level 1
Certifications or cquivalcnt.
❖PLEASE PROVIDE CERTIFICATIONS:
❖NICET Certification
•:•Panel Certification
4 of Liability Insurance
AUTOMATIC SPRINKLER SYSTEMS * Fire Sprinkler Contractors shall have a
minimum of NICET Level III Certifications or equivalent.
4-PLEASE PROVIDE CERTIFICATIONS:
•.•NICET Certification
4-Any Additional Certifications
•:•Proof of Liability Insurance
FIRE EXTINGUISHERS STANDPIPE SYSTEMS
SMOKE CONTROL SYSTEMS FIRE PUMPS
SPECIAL HAZARD SYSTEMS
__AUTOMATIC FIRE EXTINGUISHING SYSTEMS FOR COMMERCIAL
COOKING
1/2
2007
57 AM The Security Group
•
2088958401
•
*-"PLEASE PROVIDE DOCUMENTATION OF TRAINING LEVELS,
INSTALLATION CERTIFICATIONS. LIABILITY INSURANCE, ETC. FOR ALL
DISIPLINES * *M
BUSINESS NAME: jleG to
PLEASE LIST ALL COMPANIES YOUR BUSINESS IS AUTHORIZED TO
REPRESENT:
COMPANY NAME:
COMPANY NAME:
PHONE #:
PHONE #:
COMPANY NAME: PHONE #:
'F�`t'LN:AJG LINT ADDE11UNAL GUMVAIVY AUTHORIZATIONS ON THE BACK Or
THIS FORM**
I certify that I have read this application and declare tinder penalty of perjury that the information contained
herein is correct and complete. I agree to comply with all city ordinances, adopted codes, and state laws
rely L 1% w the iusuplatiu", n1vaiiicauun, acavicc, a auaiu(cuaucc vC ucw .%u1 cauating 1;& va&ty oyotomo. I
hereby authorize representatives of this city to inspect any work for compliance purposes. I am either the
contractor responsible for the work, or I represent the owner as signified above and am acting with the owner's
/contractor's full knowledge or consent.
PRINT NAME OF APPLICANT APPLICANT'S SIGNATURE
DATE
PERMIT VALID UNTIL DECEMBER 31 OF THE CALENDAR YEAR APPLIED FOR.
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