HomeMy WebLinkAboutAPPLICATION - 18-00718 - 525 S Center - BYUI - MC Ballroom Fire Permitv� a� CITY OF Building Safety Department
REXB V RG Submit By Email City of Rexburg
``ll"' 35 North 1St East
'°<, F Americas Family Community
Rexburg, Idaho 83440
For Office Use
Permit Number:
$50 Fee Paid ❑ Yes ❑ No
Operational Permit Application
Approved By:
1. Property Ow er
Name:
Address: pj�
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�1I�wr�ln--City:ba
Phone &Type: _1,��--�Office[]Mobile Email:
Permit approved: ❑ Yes ❑ No
Date:
_Mr — Zip Code:
ca — no %1 In I . _ .
2. Applica �nnA R ;
Name: r�1�L1------- Name of Bu mess:
Business Address: _ ]� State
-City: -�----
Phone & Type: O�i1� �2L�[�.9ffice[]Mobile Email:
Contact/Rep. Name: Phone: _-- __
Applicant Signature: Email:
n i e , Qj� - ----- ----
Date I
-- Zip Code:
3. Project Description I --
Name of Business wh e work will take place: —
Address: _ Ai- t- — --
-------
Cit —+Contact per ---- y' tate: Zip Code:,son. �1 _ Contact Phcne: —4Description of work: n k+,� Un.b _ .F� � ont -— -----.
i ype or rermlt(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)
HPM Facilities
H: Hazardous Materials (types) ❑High -piled Storage (contents) Hot Work Operations (dates & times of operation)
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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) 00perating Amusement Buildings []Operating Aviation Facilities
❑Operating Carnivals or Fairs (dates & times) []Organic Coatings (types)
P: []Parade (schedule, map of route, times & dates) Places of Assembl (dates ×) []Private Fire Hydrants
[]Pyroxylin Plastics (types) l�y'
R: Refrigeration Equipment (types) E]Repair Garages/Motor Fuel Dispensing []Rooftop Heliports
S: EJ 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
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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 g g Permit Technician - (208) 372.2341 Revised March, 2016