HomeMy WebLinkAboutAPPLICATION FIRE SPRINKLER - 18-00314 -155 W 2nd S - Rocky Mountain Chocolate Factory - Tenant FinishC I TY OF
REXBURG
Ow -
America's Family Community
BUILDING PERMIT FORM4,02
UpdatM 10/2016
BUILDING APPLICATION
Fire Sprinkler
Building Safety Department
City of Rexburg
35 North 1St East
Rexburg, Idaho 83440
For Office Use
Permit Number: Fire Sprinkler Fees Paid ❑
1. Property Owner
Name: Sherri Fullmer
Address: 236 So. 2nd E. City: Rexburg State: ID
Zip Code: 83440
Phone: Email:
2. Contractor
Business: Phoenix Fire Protection State License #: 10812/31 2018
Address: 4130 Airport Rd. Exp.: /
City: Nampa State: I� Zip Code: 83687
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: 07.26.18
A copy ofyour state registration/license is required to be on file. If this is the first time 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: 155 W 2nd S.
Description of work: Tenant Improvement to add or relocate heads to accommodate new Walls and Ceiling
Number of Heads: 11
❑ Fire Sprinkler System Cost: $ 2,970.00
• 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. Gb-,tl/32 7
APPLICANT'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 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 n the plans 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):
Date 7 7
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
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