HomeMy WebLinkAboutALL DOCS - 16-00095 - 240 S Holmes, Idaho Falls - Peak Alarm Company, IncRexburg-Madison County
35 N 1st E Emergency Services
Rexburg,ID 83440
www.rexburg.org
Phone:208.359.3020 Fax:208.359.3022 Hotline:208.372.2344 or Text:inspections@rexburg.org
CITY OF
REXBURG---"'---AmeTica~Family Community
SAFETY SYSTEM CERTIFICATION PERMIT APPLICATION
PERMIT#:_
$100 Fee Paid:0Yes 0 No Permit Approved:0Yes 0 No
BY:Date:_
"A srife!JI.rystem certification permit is reqttired to instal4 modify,maintain,or seroice all new and existingfire
extinguishers,fire suppression .rystems,fire alarm .rystems,and other life safety .rystems withitl the City qfRexbut:g"
BUSINESS NAME:Peak Alarm Company,Inc Parcel:_
OFFICE ADDRESS:240 S Holmes Idaho Falls,ID 83401
OFFICE PHONE NUMBER:_(2_0_8_>_5_24_-4_28_2 _
CONTACT PERSON:_K_im_S_t_J_o_h_n CELL PHONE #:_
PLEASE IDENTIFY SYSTEMS TO BE COVERED BY THIS PERMIT-CHECK ALL
THAT APPLY.
o FIRE ALARM SYSTEMS -Alarm Contractors shallhave a minimum of NICET Level 1
Certifications or equivalent.
•:.PLEASE PROVIDE CERTIFICATIONS:
.:.NICET Certification
.:.Panel Certification
.:.Proof of LiabilityInsurance
o AUTOMATIC SPRINKLER SYSTEMS -Fire Sprinkler Contractors shall have a
minimum ofNICET Level III Certifications or equivalent.
•:.PLEASE PROVIDE CERTIFICATIONS:
.:.NI CET Certification
.:•.AnyAdditional Certifications
.:.Proof of LiabilityInsurance
o FIRE EXTINGUISHERS
.:.Proof of Certification &Training
o AUTOMATIC FIRE EXTINGUISHING SYSTEMS FOR COMMERCIAL
COOKING
.:.Proof of training for commercial cooking heads
o STANDPIPE SYSTEMSoSMOKECONTROLSYSTEMS
o SPECIAL HAZARD SYSTEMSoFIREPUMPS
_1 _
***PLEASEPROVIDE DOCUMENTATION OF TRAINING LEVELS,
INSTALLATION CERTIFICATIONS,LIABILITY INSURANCE,ETC.FOR ALL
DISIPLINES***
BUSINESS NAME:_
PLEASE LIST ALL COMPANIES YOUR BUSINESS IS AUTHORIZED TO
REPRESENT:
COMPANY NAME:PHONE#:
COMPANY NAME:PHONE#:
COMPANY NAME:PHONE#:
COMPANY NAME:PHONE#:
COMPANY NAME:PHONE#:
COMPANY NAME:PHONE#:
COMPANY NAME:PHONE#:
COMPANY NAME:PHONE#:
COMPANY NAME:PHONE#:
I certify that I have read this application and declare under 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
relating to the installation,modification,service,and maintenance of new 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 work,or I represent the owner as signified abov d am acting with the owner's
/contractor's full knowledge or consent.
Kim 8t John -Branch Manager
PRINT NAME OF APPLICANT
February 25,2016
DATE
PERMIT VALID UNTIL DECEMBER 31 OF THE CALENDAR YEAR APPLIED FOR.
*******************************************************************************
-')-
Permit
Review
Summary
Permit Status of (REVIEW) as of Report Date: 05/03/2017 9:10 am
Application Details Permit Application Number: 16-00095
Peak Alarm Company, Inc
240 S Holmes, Idaho Falls
Annual Fire Safety Certification
Review History *Refer to Individual Review Reports for more Details
Fire Dept. Review
08/24/2016Fire Department Review Dale Pickering APPROVED
Transaction detail for payment to City of Rexburg. Date: 02/26/2016 - 10:49:04 AM
Billing Information
Peak Alarm Company, Inc Peak
Alarm Company, Inc
, 84127
kim@peakalarm.com
City of Rexburg
35 N 1st East | PO Box 280
Rexburg, ID 83440
208-359-3020
ub@rexburg.org
XBP Confirmation Number: 15385676
Transaction Number: 48258087PT
Visa — XXXX-XXXX-XXXX-2009
Status: Successful
Account # Item Quantity Item Amount
Fire Permit 1 $100.00
Notes: 2016 Fire Certification Fee Peak Alarm Company
TOTAL:$100.00
Transaction taken by: porterw
Xpress Bill Pay - Payment Processing https://www.xpressbillpay.com/common/payment_process.php
1 of 1 2/26/2016 10:49 AM