HomeMy WebLinkAboutAPPLICATION FIRE ALARM - 16-00599 - 285 S 1st W - Kimball Remodel Rooms 170, 244, 250CITY OF
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tsUtLVIIYU AYYLICATION
Fire Alarm
Building Safety Department
City of Rexburg
35 North 1St East
Rexhurp- Idahn AR440
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, l hereby certify that I have read this application and state that the information herein
correct and I swear that any information which may hereafter be given by me In hearings before the Planning and ZoningCommission Or the City Council forthe City of Rexburg shall
be truthful and correct. I agree to comply with all City regulations and State laws relating to the subject matter of this application and hereby authorind representatives of the City
to enter upon the above-mentioned property for inspections purposes. NOTE: The building official may revoke a permiton approval Issued under the provisions of the 2012
International Code in cases of any false statement or misrepresentation of Fact in the application or on the plans on which the permit or approval was based. Permit void Knot
started within 180 days. Permit void ifworkstops for 180 days.
Applicant's Name (print): tA011 irn Signature:ftff,�M Date:
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Inspections must be called In before 8 AM on the day the inspection Is requested. Inspection requests called In after 8 A will be scheduled for the next business day.
Inspection Hotline - (208) 372.2344 www rexburg arg Permit Technician - (208) 3722341 Revised Mardi, 2016
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1. Applicant
Business Name: Nelson Fire Systems
Office Address: 1481 South Major Street City: Salt Lake City
State• UT
• Zip Code: 8411
Office Phone: 801.468-8300 Contact Person: Ben Nelson
one:
Cell Phone.
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Ggnii tor�_s, 4� ftr pd Signature: /-�
Date: Z
License/Registration # Expiration: IMSITUDIU
2. Location of Work to be Done
Street Address: 525 South Center Street City: Rexburg
State: Io , Zip Code: 83460
Business Name: BYU-1 Kimball Building Remodel
Contact/Rep, Name: Lee Boren - Rocky Mountain Elec. phone: 208-589-6826
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D Office D Cell Phone
Small: rme@ida.net
Dates for work to be done: From to
3. New Construction Contracted Amount: $ 6,647.60 Calculated Fee (See Below): $ 192.95
P(Up to $10,000 = (total cost of system x .02) + $60 13$10,001-$100,000 = ((total cost of system -10,000) x .01) + $260
0 Over $100,001= ((total cost of system -100,000) x.005) + $1,160
4. Miscellaneous
13.Plan Review =10% of Contracted Amount
O Re -Inspection = $65
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, l hereby certify that I have read this application and state that the information herein
correct and I swear that any information which may hereafter be given by me In hearings before the Planning and ZoningCommission Or the City Council forthe City of Rexburg shall
be truthful and correct. I agree to comply with all City regulations and State laws relating to the subject matter of this application and hereby authorind representatives of the City
to enter upon the above-mentioned property for inspections purposes. NOTE: The building official may revoke a permiton approval Issued under the provisions of the 2012
International Code in cases of any false statement or misrepresentation of Fact in the application or on the plans on which the permit or approval was based. Permit void Knot
started within 180 days. Permit void ifworkstops for 180 days.
Applicant's Name (print): tA011 irn Signature:ftff,�M Date:
1-ol lu
Inspections must be called In before 8 AM on the day the inspection Is requested. Inspection requests called In after 8 A will be scheduled for the next business day.
Inspection Hotline - (208) 372.2344 www rexburg arg Permit Technician - (208) 3722341 Revised Mardi, 2016