HomeMy WebLinkAboutFS APPLICATION - 18-00260 - Five Guys Burgers and Fries - Tenant FinishCITY OF
REXBURG
America's Family Community
BUILDING PERMIT FORM 4OZ
updated 10/2016
Building Safety Department
City of Rexburg
35 North 1St East
Rexburg, Idaho 83440
BUILDING APPLICATION
Fire Sprinkler
For Office Use
Permit Number: 13— (X ZcQ6 Fire Sprinkler Fees Paid M
1. Property Owner
Name: Meister Guys DBA Five Guys
Address: 125 W. Burton Ave. Ste B Cin,: Salt Lake City State: UT Zip Code: 84115
Phone: Email:
2. Contractor
Business: Phoenix Fire Protection State License #: 108 EXp.: 12/31/2018
Address: 4130 Airport Rd. Ci : Nampa ID 83687
ty State: Zip Code:
Phone: 208-468-9115 Email: teri@phoenixfp.com
Contact/Rep. Name: Teri Cruickshank Phone: 208-468-9115 Email: teri@phoenixfp.com
Contractor Authorized Signature: Date:
A copy ofyour state registration/license is required to be on file. If this is the first tune you have done work in the City of Rexburg, please provide
a photo copy ofyour license. Ifyou are unsure ifyour license is on file, please check with the Permit Technician by calling (208) 372-2341.
3. Project Description
Address: 226 South 1st West - Rexburg
Description of work: Tenant Improvement -Add or relocate Heads to accommodate for new ceiling and walls.
Number of Heads: 25
❑ Fire Sprinkler System Cost: $ 7,940.00
• Fees for fire alarm systems are charge by cost:
o First $10,000 = 2% + $60. From $10,000 to $100,000 = 1% + $260. Above $100,000 =.5% +$1,160. i.e. Work costing
$15,000 will be charged $260 for the first $10,000 and 1 % of the remaining $5,000 = $260 + $50 = $310 total fee
• There will also be a plan review fee totaling 10% of the above fee. 0 2_4
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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 1 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 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 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 Cruickshank
Digitally signed by Ten Cruickshank
DN: -=Ted C,ukk,hank o -Phoenix Fire
Prot-ion,—Design Administrator,
mail=teri@phoenWp.m ,c U5
Signature: Da :Zo,8.o'.Zo,z3657-x00' Date: 07.20.18
Inspections must be called in before 8 AM 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