HomeMy WebLinkAboutAPPLICATION - 05-00056 - The Village Apartments - Bldg 11 18 UnitsCITY QF
AMERACAS F.'1MLY COMML��� 19 E. Main Sf. Phone= 208-359-302 x326
Rexburg, Idaho 83440 Fax: 208-359-324
rexb^ uccfd@rexburg.org
APPLICATION: "CONSTRUCTION PERMIT"
CONSTRUCTION PERMIT #:
PERMIT APPROVED : YES/ NO
-APPLICANT INFORMATION:
BUSINESS NAME:0
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APPROVED BY
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OFFICE ADDRESS: .2 1 t
$50.00 FEE PAID.: YES/NO
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City State Zip
OFFICE PHONE NUN BER: (mos I e-. /- 4�? ro 0
CONTACT PERSON: Car-cvo., me,e4eN%
CELL PHONE #
-LOCATION OF WORK TO BE DONE;
STREET ADDRESS WHERE WORK WILL BE DONE: q20
BUSINESS NAME WHERE WORK WILL BE DONE:
DATES FOR WORK TO BE DONE: TO
CONTACT PERSON: CA'^4ao�
rHLnt numrstrc: �a�� J sa-t- 4(e?
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CELL # )
PLEASE CHECK THE TYPE OF PERMIT(S) YOU,ARE APPLYING FOR:
6 AUTOMATIC FIRE -EXTINGUISHING SYSTEMS
0 COMPRESSED GASES
K FIRE ALARM AND DETECTION SYSTEMS AND RELATED EQUIPMENT
C' FIRE PUMPS AND RELATED EQUIPMENT
0 FLAMMABLE AND COMMBUSTIBLE LIQUIDS
1-1 HAZARDOUS MATERIALS
Ll INDUSTRIAL OVENS
❑ LP -GAS
❑ PRIVATE FIRE HYDRANTS
❑ SPRAYING OR DIPPING
❑ STANDPIPE SYSTEMS
Ll TEMPORARY MEMBRANE STRUCTURES, TENTS, AND CANOPIES
3 /0
APPLICANTS SIGNATURE
DATE
N MEN ONE MORN ■ E A M# WANKM MANOR Emma Mann mom 0■■■ 1■ r WORMS M IOno Emm a NNOMMMMMMM■ M O M M U M M E N 0 ... N.