HomeMy WebLinkAboutAPPLICATION - 07-00295 - Lincoln Elementary - Fire Alarm System•
Rexburg- Madison County
Emergency Services
19 East Main St
Rexburg, ID 83440
janelih @rexburg.org
Phone: 208.359.3020 x326
Fax. 208.359.3024
L
REXBURG
APPLICATION: "CONSTRUCTION PERMIT"
CONSTRUCTIO RMIT #:
PERMIT APPROVEZ • I� NO $50.00 FEE PAID (YE NO
APPROVED B
- APPLICANT INFORMATION:
Business Name:
Office Address:
Cm
C State zip
Office Phone Number: ( a � ) ! � - �-�-ZS �-
Contractor Performitm the Work:
Contact Person: Y " Cell Phone # ( )
- LOCATION OF WORK TO BE DONE:
Street Address Where Work Will Be Done: 351E5 Ef��-y 2y
Business Name Where Work Will Be Done: L-� r,c.c�l cj _owI .a� I
Dates For Work To Be Done: To -4uk,,
Contact Person:
Phone Number: (1) 359 - 330 0 3014 Cell # ( )
PLEASE CHECK THE TYPE OF PERMITS) YOU ARE APPLYING FOR:
❑ AUTOMATIC FIRE - EXTINGUISHING SYSTEMS
❑ COMPRESSED GASES
li( FIRE ALARM AND DETECTION SYSTEMS AND RELATED EQUIPMENT
❑ FIRE PUMPS AND RELATED EQUIPMENT
❑ FLAMMABLE AND COMMBUSTIBLE LIQUIDS
❑ HAZARDOUS MATERIALS
❑ INDUSTRIAL OVENS
❑ LP -GAS
❑ PRIVATE FIRE HYDRANTS
❑ SPRAYING OR DIPPING
❑ STANDPIPE SYSTEMS
❑ TEMPORARY MEMBRANE STRUCTURES, TENTS, AND CANOPIES
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Contractor's S• ature 4� 4&4444 Date
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