HomeMy WebLinkAboutAPPLICATION - 06-00085 - Dairy Queen - Fire Suppression System.~-
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MAERICA5 FAMfi.Y CAMMUNfiY 19 E. Main St. ~ Phone: 208-359-3020 x326
Rexburg, Idaho 83440 Fax: 208-359-3024
www.rexburg.orc cdd@rexburg.org
APPLICATION: "CONSTRUCTION PERMIT"
CONSTRUCTION PERMIT #:
PERMIT APPROVED: YES/ NO $50.00 FEE PAID: ~/NO
C~f~c~ (S~ iN '~T~ c'~~t
APPROVED BY:
-APPLICANT INFORMATION:
BUSINESS NAME:
OFFICE ADDRESS:
OFFICE PHONE NUMBER:
CONTACT PERSON:
~~ s ~
~~~ ~
CELL PHONE #
c?~i~l~i,~~
-LOCATION OF WORK TO BE DONE:
STREET ADDRESS WHERE WORK WILL BE DONE: ~ ~ ~' h ~~~~r~~ ~-~'"
BUSINESS NAME WHERE WORK WILL E D NE:
DATES FOR WORK TO BE DONE: ~ TO '"
CONTACT PERSON: ~'' ~ .
PHONE NUMBER: (_) CELL # (~~` )=~ -~S'~[~
i/LEASE CHECK THE TYPE OF PERMIT(S) YOli ARE APPLYING FOR:
AUTOMATIC FIRE-EXTINGUISHING SYSTEMS
^ COMPRESSED GASES
^ FIRE ALARM AND DETECTION SYSTEMS AND RELATED EQUIPMENT
^ FIRE PUMPS AND RELATED EQUIPMENT
^ FLAMMABLE AND COMMBUSTIBLE LIQUIDS
^ HAZARDOUS MATERIALS
^ INDUSTRIAL OVENS
a LP-GAS
^ PRIVATE FIRE HYDRANTS
D SPRAYING OR DIPPING.
^ STANDPIP YST
^ T Y N RUCTURES, TENTS, AND CANOPIES
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APP ICANTSSIGNATURE ...................~ T.........................,
02/21/2006 17:13 FAX 2082320449 FIRE SERVICES OF IDAHO X001
'... '•
. G7Y OF
~~ ~I~MII,Y Gplyyy/V~Y 19 E. Main St.
Rexburg, Idaho Ob DD~oJ
www.rexDuro•oi
APPLICATION: "CONSTRUCTION PERMIT" Dairy Queen-Fire Ext. System
CONSTRUCTION PERI~u ~ R.
PERMIT APPROVED: YES/ NO $50.00 FEE PAID: ~/NO
~~~~ ~s rN ~~ ~~~ ~
APPROVED BY:
-APPLICANT INFORMATION:
BUSINESS NAME: ~. - ~~ ~ ~ ~~=~/~~~
OFFICE ADDRESS:
. C _ State Ip
'OFFICE PHONE NUMBER: (20d~ - ~'3.~ ~ ,, 3 ~
::. CONTACT PERSON: Y~9 CELL PHONE # (~~ ..~
-LOCATION OF WORK TO BE DONE: .,
STREET ADDRESS WHERE WORK WILL BE DONE; ~ ~ ~'. h_ ~! Ull'L~
BUSINESS NAME WHERE WORK WILL E D NE -
DATES FOR WORK TO BE DONE: c~ TO ~~
CONTACT PERSON:
PHONE NUMBER: (~ ) CELL # ~ 7..0~') ~?-~ I -~S~o'
PLEA~HECK THE TYPE OF PERMIT(S) YOU ARE APPLYING FOR:
AUTOMATIC FIRE-EXTINGUISHING SYSTEM3
D COMPRESSED GASES
^ FIRE ALARM AND DETECTION SYSTEMS AND RELATED EQUIPMENT
~a FIRE PUMPS AND RELATED EQUIPMENT
p FLAMMABLE AND COMMBUSTIBLE LIQUIDS
^ HAZARDOUS MATERIALS
^ INDUSTRIAL OVENS
o LP-GAS
^ PRIVATE FIRE HYDRANTS
^ SPRAYING OR DIPPING
.. Q STANDPIP YST M
^ T Y N TRUCTURES, TENTS, AND CANOPIES
~~
APP (CANTS SIGNATURE D T