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HomeMy WebLinkAboutBP & APPLICATION - 05-00244 - 266 W 3rd S - MechanicalZ ~ O ~ m m W ~ c ~ rn v_ ,~ ^~ z ~ ~ ~. o " 3' D D C c ~ O S ~ ~ ~ ~ m ~ ~ Z m n n 3 p ~ m ~ °-' ~- -~ ~ 7 ~ ~. in ~ _~ W co m Q ' p -0 ~ n ~ o ~. ~ c 3 ~ C1 (~ ~ v n~ ~ 1° o C / 0 n m ~ ~ o ,~ . m 3 ~ 67 n~ ~ D Z , ~ O O 7 .77 3 ~" 7 [N C O = ~ ~ g o ~ m '~ v t- ~ ~ -< s ~ ~ ~ = F m O o ;~ ~ ~ C V) ~ 3 .O T r 6 °~ 3 ~ D ~~ ~ ~ '~ o ~ o m v a ~ - Z D ~ Z o -~ v m ,~sZ D = ~a ~o r" 3~s~o ~ ~v Q~ ~ N ~~~~ -~ -~ c ao~~~ ~ ~~N~~ N ~ r a~ O~ o F p m ' m o a O O _ ~ N N (p O - T N ~ O a O ^ YJ i O ~ N N ( " 7 6 N ~ ~G ( ) n r/~ v' ~ O. ~ O ~ ~FO~~ ~ g rn O ~p 'm ~ a a n ~ N N C a "p'n-i m ,. ': ? 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FORMATION: ADDRESS 5 ~~ N /~D ,~~ CITY: .~` ~ ,'~~~ STATE; ~ ZIP ~.~~i`~MAIL FAX PHONE #: Home Work Cell CONTRACTOR: a m ~s ~ ~-~ ., e~,--~ _ __ MAILING ADDRESS: vim' ~`~ /,~ /~at~ ~= CITY ,z d r STATE .~ ZIP ~-~`T'D PHONE: Home# ~'2~i' y~work# ,.~%3 `7'~~~Cell# ~' s~~- EMAIL ,,~'u ~ e s ~' ~~ ~y-Q'f~ f .. FAX How many buildings are located on this property? Did you recently purchase this property? No Yes (If yes give owner's name) Is this a lot split? NO YES (Please bring copy of new legal description of property) PROPOSED USE: (i.e., Single Family Residence, Multi Family, Apartments, Remodel, Garage, Commercial, Addition, Etc.) APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, I hereby certify that I have read this application and state that the information herein is correct and I swear that any information which may hereafter be given by me in hearings before the Planning and Zoning Commission or the City Council for the City of Rexburg shall be truthful and correct. I agree to comply with all City regulations and State laws relating to the subject matter of this application and hereby authorized representatives of the City to enter upon the above-mentioned property for inspections purposes. NOTE: The building official may revoke a permit on approval issued under the provisions of the 2000 International Code in cases of any false statement or misrepresentation of fact in the application or on the plans on which the permit or appr 1 was based. 't void if not started within 180 days. Permit void if work stops for 180 days. ~ ~ l /9 l GZ~ Signa of Owner/Applicant DATE Do you prefer to be contacted by fax, email or phone? Circle One WARNING -BUILDING PERMIT MUST BE POSTED ON CONSTRUCTION SITE! Plan fees are non-refundable and are paid in full at the time of application beginning January 1, 2005. City of Rexburg's Acceptance of the plan review fee does not constitute plan approval **Building Permit Fees are due at time of application** **Building Permits are void if you check does not clear** ~~CaaC winplete the entire Application! If the question does not apply fill in NA for non ;applicable • ' NAME ~~~Q.~~ .oO,. PROPERTY ADDRESS Permit# SUBDIVISION Required!!! Mechanical Contractor's Name: Address Contact Phone: ( ) Email Mechanical Estimate $ MECHANICAL City Business Name: Business Phone: Fax (Commercial/Multi Family Only) State Zip FIXTURES & APPLL9NCES COUNT (Single Family Dwelling Only) Furnace Exhaust or Vent Ducts Furnace/Air Conditioner Combo Heat Pump ~_ Air Conditioner Evaporative Cooler Unit Heater Space Heater Decorative gas-fired appliance Incinerator System Boiler Pool Heater Similar fixtures or Appliances Fuel Gas Pipe Outlets including stubbed in or future outlets Inlet Pressure (Meter Supply) PSI Heat (Circle all that apply) Gas Oil Coal Fireplace Electric APPRQVED ~°~"~~ ~~~~, ~~~ BUILDING INSPECTOR Mechanical Sizing Calculations must be submitted with Plans & Application Point of Delivery must be shown on plans. Signature o Licensed ontractor License number Dryer Vents Range Hood Vents Cook Stove Vents Bath Fan Vents other similar vents & ducts: 'yi g /o ~ Date The City ofRexburg s permitfee schedule is the same as required by the State ofldaho