HomeMy WebLinkAboutAPPLICATION - 18-00419 - BYUI - MC Ballroom Fire Permit 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 Revised March, 2016
Building Safety Department City of Rexburg 35 North 1st East Rexburg, Idaho 83440
Operational Permit Application
For Office Use Permit Number: ____________________ Permit approved: ⧠ Yes ⧠ No $50 Fee Paid ⧠ Yes ⧠ No Approved By: ___________________________________ Date: ________________ 1. Property Owner Name: ___________________________________________________________ Address: ___________________________________________________ City: __________________________ State: ____________ Zip Code: _________________ Phone & Type: ______________________________ ⧠ Office ⧠ Mobile Email: _________________________________________________________________ 2. Applicant Name: _____________________________________________________________ Name of Business: ______________________________________________________ Business Address: ______________________________________________________ City: ________________________ State: _________ Zip Code: ___________ Phone & Type: _______________________ ⧠ Office ⧠ Mobile Email: _____________________________________________________________________ Contact/Rep. Name: ______________________________________ Phone: _________________ Email: ______________________________________________ Applicant Signature: _________________________________________________________________________ Date: _____________________________________ 3. Project Description Name of Business where work will take place: ____________________________________________________________________________________________ Address: ___________________________________________________________ City: __________________________ State: ____________ Zip Code: ____________ Contact Person: ___________________________________________________ Contact Phone: _________________________________________________________ Description of work: _____________________________________________________________________________________________________________________ Type of Permit(s) applied for (alphabetical):
List anything specified in parenthesis in the area provided at the end of this application.
A: ⧠ Aerosol Product Manufacturing (contents)
C: ⧠ Combustible Dust-Producing Operations (type of dust) ⧠ Covered Mall Buildings ⧠ Cryogenic Fluids (types) ⧠ Cutting and Welding Operations ⧠ Compressed Gas Use/Storage (types)
D: ⧠ Dry Cleaning Plants (chemicals)
E: ⧠ Exhibits and Trade Shows (type of fire extinguisher and location) ⧠ Explosives (types)
F: ⧠ Fire Hydrants and Valves (types) ⧠ Flammable and Combustible Liquids (types) ⧠ Floor Finishing (types) ⧠ Fruit and Crop Ripening (types) ⧠ Fumigation and Thermal Insecticidal Fogging (types)
H: ⧠ Hazardous Materials (types) ⧠ High-piled Storage (contents) ⧠ Hot Work Operations (dates & times of operation) ⧠ HPM Facilities
I: ⧠ Industrial Ovens (types)
L: ⧠ Large Capacity Battery Systems (type) ⧠ Liquid/Gas Vehicles/Equipment in Assembly Buildings (type) ⧠ LP Gas Transportation (type) ⧠ Lumber Yards/Plants
M: ⧠ Magnesium Work ⧠ Misc. Combustible Storage (type)
O: ⧠ Open Burning (time & date) ⧠ Operating Amusement Buildings ⧠ Operating Aviation Facilities ⧠ Operating Carnivals or Fairs (dates & times) ⧠ Organic Coatings (types)
P: ⧠ Parade (schedule, map of route, times & dates) ⧠ Places of Assembly (dates & times) ⧠ Private Fire Hydrants ⧠ Pyroxylin Plastics (types)
R: ⧠ Refrigeration Equipment (types) ⧠ Repair Garages/Motor Fuel Dispensing ⧠ Rooftop Heliports
S: ⧠ Spraying or Dipping ⧠ Storage of Combustible Fibers (types) ⧠ Storage of Scrap Tires, Etc.
T: ⧠ Temporary Membrane Structures, Tents, or Canopies (date & time) ⧠ Tire-Rebuilding Plants
W: ⧠ Waste Handling (types) ⧠ Wood Products (types)
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 Revised March, 2016
Additional Information:
Applicant’s Name (print): ___________________________________ Signature: _____________________________________________ Date: _______________