HomeMy WebLinkAboutAPPLICATION - 17-00212 - 525 S Center St - Austin Building - Fire Alarm4040
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BU1LL1NU AFFUCATION
Fire Alarm
Building Safety Department
City of Rexburg
35 North 1St East
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I. Applicant
Business Name: Nelson Fire Systems
Office Address: 1481 South Major Street City: Salt Lake CityUT
State.: Zip Code, 84115
Office Phone: 801-468.8300 Contact Person: Ben Nelson
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Date.
License/Registration # Expiration: IMIFUlU
2. Location of Work to be Done
StreetAddress: 525 South Center Street City: Rexburg
State: ID Zip Code:
Business Name: BYU-Idaho - Austin Building
Contact/Rep, Name: Dan Beck - Mtn. West Electric Phone: 208-684-5463
Office 0 Cell Phone
Email: _ dbeckna mtnwestelec.com
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Dates for work to be done: From to
I New Construction Contracted Amount: $ 1,920.00 Calculated Fee (See Below): $
O Up to $10,000 = (total cost of system x.02) + $60 O $10,0014100,000 = ((total
cost of system -10,000) x.01) + $260
O Over $100,001= ((total cost of system -100,000) x.005) + $1,160
4. Miscellaneous
13 -Plan Review =10% of Contracted Amount
D Re -Inspection = $65
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, I hereby certify that 1 have read this application and state that the Information herein
correct and i swear that any imrormatlon which may hereafter be given by me In hearings before the Planning and Zoning commission or the City Council for the City of Rexburg shall
be truthful and correct l agree to complywith an qty regulations and State laws relating to the subject matter of this application and hereby authorized representatives of the City
to enter upon the above-mentioned property for Inspections purposes. NOTE: The buildingofRcial may revoke a petmiton approval issued under the provisions of the 2012
International Code In uses of any false statement or misrepresentation of fact In the application or on the plans on which the permit or approval was based. Permit voidif not
started within 180 days. Permit void Ifworkstops for 180 days.
Applicant's Name (print): Signature: Date:
Inspections must be called in before 8 AM on the day the Inspection Is requested. Inspe Won requests tailed In after 8 AM will be scheduled for the next business day.
Inspection Hotline - (208) 372.2344 www.rexburg.org Permit Technician - (208) 372.2341 Revised March, 2016