HomeMy WebLinkAboutAPPLICATION FIRE ALARM - 17-00435 - 525 S Center St - BYUI - Kimball Ste 130 Remodel04�04�
CITY OF
REXBURG
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BUILDING APPLICATION
Fire Alarm
Building Safety Department
City of Rexburg
35 North 1st East
Rexburg, Idaho 83440
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I. Applicant
Business Name: Nelson Fire systems
Office Address: 1481 South Major Street City: Sa Make city State: UT Zip Code: 84115
Office Phone: 801468.8300 Contact Person: Ben Nelson
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Date: CA Ize
LiceIlss/$ggistration �1 alair LSIX EXRlration: 17-WIIUI s
2. Location of Work to be Done
StreetAddress: 525 S. Center St BYU-1 Kimball Bldg City: bAbu$
State: ID Zip Code: 83460
Business Name: Nelson Electric
Contact/Rep. Name: Leff Nelson Phone: _ 208-754-9389
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Email: Teff@nelson-electricllc.com
Dates for work to be done: From to
3. New Construction Contracted Amount; $ 4978.00
Calculated Fee (See Below):
O Up to $10,000 = (total cost of system x.02) + $60 0 $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
Q j Plan Review =10% of Contracted Amount
D Re -Inspection = $65
APPUCANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, I hereby certify that I have read this application and state that the Information herein
correct and 1 swear that any inrormatlon which may hereafter be given by me In hearings before the Planning and ZoningCommisslon or the City Council for the City of Rexburg shall
be truthful and correm l agree to comply with all Cfty regulations and State laws relating to the subject matter of this application and hereby authorized representatives of the City
to enter upon the abov&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. Permlt void if not
started within 180 days. Permitvofd lfworkstops for 180 days.
Applicant's Name (Print): --Signature: Date:
Inspections must be called in before SAM on the day the Inspection Is requested. Inspection requests called In after SAN will be scheduled for the next business day.
Inspection Hotline —(208) 3722344 www.rexburg.org Permit Teduddan — (ZOO) 3722341 Revised March, 2016