HomeMy WebLinkAboutAPPLICATION - 10-00087 - Madison Jr High School - Remodel Construction • •
Building Safety Department
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City of Rexburg 0 ___ CI TYoF G�
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Rexburg,ID 83440 Phone:208.372.2326 MfO � • -Family------._-
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Www.rexburg.org Fax:208.359.3022 America's Family Community
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APPLICATION: "CONSTRUCTION PERMIT"
CONSTRUCTION PERMIT#: 10
PERMIT APPROVED: YES/NO $50.00 FEE PAID: YES/NO
Madison High School Remodel Construction Permit
-APPLICANT INFORMATION: `'PROVED BY:
Business Name: u •Office Address: 2. • • X32
Office Phone Number: ( ) 5 Ci a City
6 � -
" Zip
Contractor Performing the Work:
Contact Person..
-LOCATION OF WORK TO BE DONE Cell Phone # ( )
Street Address Where Work Will Be Done: I M:1 .,b. IV a
Business Name Where Work Will Be Done: Ex i r„�c i le
Dates For Work To Be Done: Jui--r 'WO „� .o o
To
Contact Person:
Phone Number: ( )
Cell # (
PLEASE CHECK THE TYPE OF PERMIT(S) YOU ARE APPLYING FOR:
0 AUTOMATIC FIRE-EXTINGUISHING SYSTEMS
❑ COMPRESSED GASES
)(FIRE ALARM AND DETECTION SYSTEMS AND RELATED
❑ FIRE PUMPS AND RELATED EQUIPMENT EQUIPMENT
❑ FLAMMABLE AND COMMBUSTIBLE LIQUIDS
❑ HAZARDOUS RDOUS MATERIALS
❑ INDUSTRIAL OVENS
❑ LP-GAS
❑ PRIVATE FIRE HYDRANTS
❑ SPRAYING OR DIPPING
❑ STANDPIPE SYSTEMS
❑ TEMPORARY MEMBRANE STRUCTURES, TENTS,AND CANOPIES
A •licant's Signature —
Date
8