HomeMy WebLinkAboutAPPLICATION - 08-00418 - Viking Automatic Sprinkler Company - Fire Safety CertificationAug 25 08 09:41a Steve Johnson
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Rexburg - Madison County
Emergency Services
19 East Main St jane!!h -9rsxbwg.org Phone: 208.359.3020x326
Rexbwg, ID 83440 v .vw_rexburg.arg Fax 208.3S9.3024
801 - 766 -2085 p.1
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PERMIT#: 10 t7 02!11 t
$100 Fee Paid: Pro Permit Approved: Yes /No
BY: Date:
"A srrfetl system cer[#ication permit is required to install, modify, maintain, or service all new and ex&ir�g re
exiinguishers,fte sx0pression 3ysdemc, fire aAvm teems, acrd other life safely systems wthin The City of xtg"
BUSINESS NAME: Viking Automatic Sprinkler Co. P arceL-
OFFICEADDRESS: 32 East Bower Street Meridian, ID 83642
OFFICE PHONE NUMBER: 208 - 888 -2762
CONTACT PERSON: Ron A Larson CELL PHONES 20 890 -9901
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 equivalent.
d +PLEASE PROVIDE CERTIFICATIONS:
•: +NICET Cerdficarion
: +Panel Certification
ti +P_oof of I labiliry Insurance
X AUT OMATIC SPRINKLER SYSTEMS * Fire Sprinkler Contractors shall have a
m;n;tn of NICET Level III Certifications or equh alert.
❖PLEASE PROVIDE CERTIFICATIONS:
4 +tiiICET Certification
4-Any Additional Certifications
4-proof or Liability Insurance 06 C 0 M► r r U 7(vn
FIRE EXTINGUISHERS X STANDPIPE SYSTEMS
SMOKE CONTROL SYSTEMS X FIRE PUMPS
SPECIAL HAZARD SYSTEMS
AUTOMATIC FIRE EXTINGUISHING SYSTEMS FOR COMMERCIAL
COOKING
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-1 -
Aug 25 08 09:41a Steve Johnson 801 - 766 -2085 p.2
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***PLEASE FROYIDEDOC )3MNTAT[0NOFTRAININGLEYEES,
INSTALLAT?ONCERTTFICATTONS, LIABILITYRVSURANCE, ETC. FOR ALL
DfSIPLYNES'** *
BUSINESS NAME: Viking Automatic Sprinkler Co.
PLEASE LIST ALL COMPANIES YOUR BUSINESS IS AUTHORIZED TO
REPRESENT:
COMPANY NAME:
COMPANY NAME:
PHONE #:
PHONE ##:
COMPANY NAME: \_ PHONE #:
**PLEASE LIST ADDITIONAL COMPANY AUTHORIZATIONS ON THE BACK OF
THIS FORM**
I certify that I have read this application and declare under penalty of perjury that the information contained
herein its correct and complete. I agree to comply with all city ordinances, adopted codes, and state laws
relating to the installation, modification, service, and maintenance of aew and existing life safety systems. I
hereby authorize representatives of this city to inspect any work for compliance purposes. I am either the
contractor responsible for the vxmk or I represent the owner as signified above and am acting the owner's
/contracmes fall knowledge or consent.
Ron A Larson, VP
PRINT NAME OF APPLICANT
8/25/08
.'PURE
DATE
PERMIT VALID UNTIL DECEMBER 31 OF THE CALENDAR YEAR APPLIED FOR.
-2-
Viking Automatic Sprinkler
C o
32 E Bower St
Meridian, ID 83642
PERMIT# 08 00418
2008
mf ' A
CITY OF
RE"URG
cw ---
9
ATURE DATE
VALID THROUGH DECEMBER 31, 2008
0