HomeMy WebLinkAboutAPPLICATION - 19-00016 - Phoenix Fire Protection CITY OF Building Safety Department
City of Rexburg
REX.BURGsub ie y err
35 North 1st East
Americas&mily Community Rexburg, Idaho 83440
Safety System Certification Permit Application
For Office Use
Permit Number: Permitapprove d: []Yes El No
$100 Fee Paid: 13 Yes 13 No
1. Property Owne,,,
Business Name: Phoenix Fire Protection
Office Address: 4130AI!port Rd City: Nampa State:JR............................._ Zip Code: 83687
Office Phone- 208-468-9115 — Contact Person. Jacci Hunt Cell Phone:............................................................................
2.Project Description
Please identify systems to be covered by this permit
Check all that apply:
0 F1 re Alarm Systems-Alarm Con acto rs shall have ini NICT Level 1 Certification ore uivalent
OThe Following Certifications are Reanirr&ONICET Certification 0Panel Certification oProof of Liability Insurance.
(DAuto matic Sprinkler Systems®Fire Sprinkler Contractors shall have minimum NICET Level III Certification ore uivalent
OThe Following Certifications are Regniad.ONICET Certification oAny Additional Certifications 01proof of Liability Insurance
DAuto matic Extinguishing Systems for Commercial Cooking 0 Proof of training for commercial cooking heads Required
0 Fire Extinguishers 0 Proof of Certification and Training&qviod
E]Standp!2e Systems E)Fire Pum2s 0 Special Hazard Systems QSmoke Control SXstems
K Ile prie
seinled Companies
Please list all companies thatyour business is authorized to represent
Company Name: Phone Number:
Company Name: Phone Number:
Company Name: one Number-
Company Name: Phone Number.
Company Name: Phone Number.
Company Name: Phone Number-
'PLEASE PROVIDE DOCUMENTATION OF TRAINING LEVELS, INSTALLATION CERTIFICATIONS, LIABILITY
INSURANCE, ETC. FOR ALL DISCIPLINES'
APPLICANTS SIGNATURE,CERTIFICATION AND AUTHORIZATION!Under penalty o(perJuM I hereby certify that I have read this application and state that the Inrortnatlan herein
Is correct and I swearthat any Information which may hereafter be given by me in hearings before the Planning and Zoning Commissl,an 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-mentionLd property for Inspections purposes.NOTE!The building official may revoke a permit on approval Issued under the provisions ofthe 2012
International Code in cases orany false statement or misrepresentation of fact In the application or on the plans on Web the permit or approval was based. Permit vuldifnat
started within 180 days.Permit void ifwark stops for 180 days
Applicanes Name(print)- Trentllice
Inspections must be called in before SAM an the day the inspection is requested.Inspection requests called In ifteril AM will be scheduled for the next business day
Inspection Hotline-(208)372,2344 www,rexburg.org PermitTechnician (208}372,2341 Revised March,2416