HomeMy WebLinkAboutAPPLICATION FIRE SPRINKLER - 16-00577 - 117 S 2nd E - Mattson Apts - Bldg B NO 23 UnitsC I TY OF
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Americas Family Community
BUILDING APPLICATION
Fire Sprinkler
Building Safety Department
City of Rexburg
35 North 1St East
Rexburg, Idaho 83440
For Office Use
Permit Numbe� l(,-oo577 Permit approved: ❑Yes [7) No
Fees Paid: Yes ❑ No
1. Applicant
Business Name: Phoenix Fire Protection
Office Address: 4130 AirportRd. City: Nampa State: IU Zip Code: 83687
Office Phone: 208-468-9115 Contact Person: Teri Cruickshank Cell Phone:
Contractor's Authorized Signature: Date: 03.24.17
License/Registration # FPSC -108 Expiration: 12/2017
2. Location of Work to be Done
Street Address: E 1st S ands 2nd East City: Rexburg State: ID Zip Code: 83440
Business Name: Mattson Apartments -North
Contact/Rep. Name: Teri Cruickshank Phone: 208-468-9115 R1 Office ❑Cell Phone
Email: teri@phoenixfp.com
Dates for work to be done: From to
3. New Construction Contracted Amount -$ 72,250 Calculated Fee (See Below): $ 882.50
❑ Up to $10,000 = (total cost of system x.02) + $60 ❑ $10,0014100,000 = ((total cost of system -10,000) X.01) + $260
❑ Over $100,001= ((total cost of system -100,000) x.005) + $1,160
4. Miscellaneous
❑ New Construction = $1 per sprinkler head ($2,000 max) # of heads: 315
❑Existing Inspection Base = $65
❑ Plan Review =10% of Contracted Amount
❑Re -Inspection = $65 $ 971.30
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, [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 Zoning Commission or the City Council for the City of Rexburg shall
be truthful and correct. I agree to comply with all City regulations and State laws relatingto the subject matter of this application and herebyauthorired representatives of the City
to enter upon the above-mentioned property for inspections purposes. NOTE: The building official may revoke a permit on 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 if not
started within 180 days. Permit void If work stops for 180 days.
Applicant's Name (print):
Teri
Signature: Cruickshank Date: 03.24.17
Inspections must be called in before SAM on the day the inspection is requested. Inspection requests called 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