HomeMy WebLinkAboutALL DOCS - 12 00346 - Gem State Fire Protection Annual Certification35N I.tE
Rexburg, lD 83140 www.rer(burg.org
Rexb0rg-Madison County
Emergency Services
Phone: 208.372.2326
Fol<:208.359.3022
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REXBURG
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*A tortry rysten wtificatiottperrvit is rvqahvd to install, modifi, maintain, or all neat and existingfirv
ertinguisbm,firv supprssion gtstems,ifire alanz gtstens, and athn life safeE
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aitbin tbe CiA of&exbury"
Parcd:BUSINESS NAME:TAT
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OFFICE ADDRESS:
OFFICE PHONE NUMBER:
coNTACr pERSON: ,, r Mo g crn N CErr pHoNE
PLEASE IDENTIF"T SYSTEMS TO BE COVERED BY THIS PERMIT. CHECKALLTHATAPPLY' {Iro<. ht^ffi 2q 3 q?'d *
-FIBE AU'RM SY-STEMS - Alarm Contractors shall have a minirnum of NICET kvel 1
Certifications or equivalent.
{.PLE.ASE PROVIDE CERTIFICATIONS:
€.NICET Certification
€.Panel Certification
{. Prcof of Liability Insurance
€.NICET l-evel II required for design work
/-AUTOMATIC SPRINKI.ER SYSTEMS * Fire Sprinkler Contractors shall have a
minimum of NICET Ievel I Certifications or equivalent.
€. PLEASE, PROYIDE CERTI FICATIONS :
€.NICET Certification
€. Ary Additional Certifi cations
€.Proof of Liability fnsurance
{. NICET Level II required for design work
FIRE EAINGUISHERS
€.Proof of Certification & Training
-AUTOMATIC FIRE EXTINGUISHING SYSTEMS FOR COMMERCIAL
COOKING
_].sreNDprp'Jil";rtortrainingt"*'"*Yr.JiHil'ffi ,^*osysrEMS
SMOKE CONTROL SYSTEMS Y TIRE PT.JMP_JCrrnB PT.JMP
#PIEASE PROWDE DOCAMENTATTON OF TRAINING LEWI.S,
INSTALIA,TION CERTIFIUTIONS, LIABILIW INSURANCE' ETC. FOR ALL
DISIPLINESW
I ce*iff that I have read this ap,plication and &clare under pendty of periury that the information contained
hereinis cotr€ct and complete. i agr.e to comp$ with all city ordinances' adopted codes, and state laws
i"tt, -"Cn"fuon, seroice, and maintenT-ro "f ".*..and eristing 1t .t*Y,:f:"-T' I
hereby authorize representatiras of this city to inspect any purposes. I anr eitlrer the
contractor responsible for the wor\, orl reprcsent tlrc
APPLI SIGNATURE
PERMIT vALID UNTIL DECEMBER 3I OF tHE CALENDAR YEAR APPLIED FOR.
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