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HomeMy WebLinkAboutAPPLICATION - 06-00501 - BYUI - Spirit Week TorchesU 0 C IT Y OF R.EXBURG • BUILDING SAFETY DEPARTMENT Americas Family Community 19 E. Main St. Phone: 208 - 359 -3020 x326 Rexburg, Idaho 83440 Fax: 208 - 359 -3024 www.rexburq.orq janellh @rexburg.org OPERATIONAL PERMIT" APPLICATION PERMIT # O�,Q CSC $50.00 FEE PA :YES 0 PERMIT APPROVED: YES /NO BY: -- DATE: lD `/O O Owner Information: Parcel Number. Owner: 6f'1 t t J 1 ArvL I Phone Number: q q � - 3 _fib Owner Mailing Address: J'YlA r ✓lam Property Address: Cell /Office Number: Business Name Where Work Will Be Office Address: Office Phone Number: Contact Person: Contact Phone #: Applicant Information: Name: - 1 q Name of Business: Address: 16 M F r Contact Person: e-t k-Y PHONE NUMBER: CELL # 31.3 y3l Parade Route /Assembly Location: (Map required for Parades) OCT 0 6 2006 il Ai� 0 4.el Ae� 4 1 /��o� APPLICANTS SIGNATURE DATE 1 Permit # PLEASE CHECKTHE TYPE OF PERMIT(S) 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: ❑ Hazardous materials Locations: Types: ❑ High -piled storage Location: Contents: ❑ 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 /torcJb Location: �u . d ke Time & Date: IWI laG ❑ 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: ❑ Pyrotechnic special effects material (Fire works) Location: Types: ❑ Pyroxylin plastics Types: ❑ Refrigeration equipment Types: ❑ Repair garages /motor fuel dispensing Location: ❑ Rooftop heliports Location: Additional Information: J ❑ 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 Location: ❑ Use /Storage of compressed gases Location: Types: ❑ Waste handling Types: ❑ Wood products Types: F l�C IFL, fl\V�[F_D OCT 0 6 2006 pp � pp ACCOt;�J��N�GE(�VICES