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HomeMy WebLinkAboutAPPLICATION - 06-00496 - BYUI - Spirit Week FireworksE O� gEXRURC �� t a � 0� �SMED 10 CITY OF REX America's Family Community BUILDING SAFETY DEPARTMENT 19 E. Main St. Rexburg, Idaho 83440 www.rexbura.ora Phone: 208- 359 -3020 x322 Fax: 208-359-3024 edd @rexburg.org "OPERATIONAL PERMIT" APPLICATION PERMIT #: o(_c ( $50.00 FEE PA Y /NO PERMIT APPROVED: YES /NO BY: DATE: /0 4 1 - 4(a Owner Information Parcel Number: Owner: NA XI C {/ W, WT_ Phone Number: 35y L/�i 7 Owner Mailing Address : -3 (�aT_ .Yp1��� 1 7��-� Property Address: Cell /Office Number: Business Name Where Work Will Be Done: Office Address: ) 7 A 1 3y I) Lti, Office Phone Number: 3"Sq _ GlYb Contact Person: f lit Contact Phone #: Applicant Information- Name: Name of Business: rC 1 j "� f y 2I!:5TFCA)\ J l C5 Address: Q (_J /4 i �3_Lzo (_A')�� . - 7 8�3't /1 Contact Person: , 7- � l _LF PHONE NUMBER: 351 "S� CELL # 1 �1-3 '� /SO Parade Route /Assembly Location: 1 5/4dQ7 7 'Ai6 k(3(i07 (I/J 5 e - >c A477 ttC65!r e (Map required for Parades) l !) TO .5� APpL TISMIGNA TURE DATE Permit # PLEASE CHECKTHE TYPE OF PERMITS YOU ARE APPLYING FOR: ❑ Aerosol product manufacturing List of contents: ❑ Combustible dust - producing operations Location: Type of dust: ❑ Covered mall buildings Location: ❑ Cryogenic fluids Types: ❑ Cutting and welding operations Location: ❑ Dry Cleaning plants Location: Types of Chemicals: ❑ Exhibits and trade shows Location: Type of Fire Extinguishers & Location: ❑ Explosives Location: Types: ❑ Fire hydrants and valves Locations: Types: ❑ Flammable and combustible liquids Types: ❑ Floor finishing Types: ❑ Fruit and crop ripening Locations: Types: ❑ Fumigation and thermal insecticidal fogging Locations: Types: E ❑ Hazardous materials Locations: Types: , ❑ High -piled storage Location: Contents: o Hot work operations Location: Dates & Times of Operation: ❑ HPM facilities Location: ❑ Industrial ovens Location: Types: ❑ Large capacity battery systems Location: Type: ❑ Liquid /gas vehicles /equip. in assembly buildings Location: Type: ❑ LP gas transportation Location: Type: ❑ Lumber yards /plants Location: ❑ Magnesium work Location: ❑ Misc. combustible storage Location: Type: ❑ Open burning Location: Time & Date: ❑ Open flames /torches Location: Time & Date: ❑ Operating amusement buildings Location: ❑ Operating aviation facilities Location: ❑ Operating carnivals or fairs Location: Dates & Times: ❑ Organic coatings Types: ❑ Places of assembly Location: Dates & Times: ❑ Private fire hydrants Location: ii/ rotechnic special effects material (Fire works) Location: Types: 11 — 5" ❑ Pyroxylin plastics Types: ❑ Refrigeration equipment Types: ❑ Repair garages /motor fuel dispensing Location: ❑ Rooftop heliports Location: ❑ Spraying or dipping Location: ❑ Storage of combustible fibers Location: Types: ❑ Storage of scrap tires /etc. Location: ❑ Temp. membrane structures, tents, and canopies Location: Date & Times: ❑ Tire - rebuilding plants Locatio ❑ Use /Storage of compressed gases Location: Types: ❑ Waste handling Types: ❑ Wood products Types: Additional Information: `� frr�Ti r c Tj� Cf1A tJ & t L) F-1 _,m �Fvz raps you) s _ cFr__7 w--t7 eN