HomeMy WebLinkAboutAPPLICATION FIRE SPRINKLER - 19-00604 - America First Credit Union - Remodel 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
Building Safety Department City of Rexburg 35 North 1st East Rexburg, Idaho 83440
BUILDING APPLICATION
Fire Sprinkler For Office Use Permit Number: ____________________ Fire Sprinkler Fees Paid ⧠ 1. Property Owner Name: ___________________________________________________________ Address: ___________________________________________________ City: __________________________ State: ____________ Zip Code: _________________ Phone: _____________________________________________ Email: _____________________________________________________________ 2. Contractor Business: _________________________________________________________ State License #: _________________________ Exp.: _______________________ Address: ___________________________________________________ City: __________________________ State: ____________ Zip Code: _________________ Phone: _____________________________________________ Email: _____________________________________________________________ Contact/Rep. Name: ______________________________________ Phone: _____________________ Email: __________________________________________ Contractor Authorized Signature: ____________________________________________________________________ Date:________________
A copy of your 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 of your license. If you are unsure if your license is on file, please check with the Permit Technician by calling (208) 372-2341. 3. Project Description Address: _______________________________________ Description of work: _____________________________________________________________________________________________________________________ Number of Heads: _________ ⧠ Fire Sprinkler System Cost: $ ___________________
• 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. 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 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 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): ___________________________________ Signature: _____________________________________________ Date: _______________
BUILDING PERMIT FORM Updated 10/2016 402
AFCU - TI
510 North 2nd East Ste 3 Rexburg ID 83440
Phoenix Fire Protection 108 12/31/2019
4130 Airport Rd. Nampa ID 83687
208-468-9115 teri@phoenixfp.com
Teri Cruickhsank 208-468-9115 teri@phoenixfp.com
11.04.19
510 North 2nd Ste 3
13
Tenent Improvement to 1353 sq ft 1 level bldg - reloate heads to accommodate new walls and ceilings.
3,625.00