Loading...
HomeMy WebLinkAboutAPPLICATIONS, CO, BP - 05-00291 - Parkside Townhomes - Bldg #15Z O C7 rn ~~p c~i ~~ O O N (D =' C~. C 'O ~ N D N D_ ~_ fD D Q ~~ p ~ v ~. y ~_~ -~_~~~ ~ ~ a n ~' o c 3 ~. ~ ~ ~ ~ ~ ~ ~ ~ (p O N .n+ 7 ~ D_ C n' O 9? O O d ~ O j "O S O N i 6 (fl ~ O p~ ~ O N ~ S O' ~. o ~. o Q ~-°o' ~Z ~ o ~ -o m ~ ~ c. ~ ° ~ ~ o °- n is (D ~ N (O Z n f~ S n N O O' N N C ~°~ao 7C p~ N ~ N N -'O N O d N n O. ~ O• .0.. 7 ~ ~ ~ 5'~ o ° ~~ n ~ < x' s v ~o~Qo Q _ ~ ~o,n-~ ~~ e-~ v ~ S ~ N W ~ ~ ~ , .~ Q ~~; m , ~~ ~ ~ lD Q ~ l D ~ M ~ y a ^~ . ~ C D~ y Q C 'C O ~ C 1 C _j fD n O ~• ~ y, m ' ~ ~ '~ V! (7 = 3 lD ~ O Q C H N = ~ Z 3 O :; Q. ~ Q O N S N ~ a "' ~ ~ ~ ~ ? ~ r '' W ~ ~ ~ ~ Q ~ ~ ~ ~~~~ W N ~ ~ G1 :rt 3 3 ~ ~ D Q ~ 0 ~ ~ ~ W ~;, o ~ ~ '~~~ a o ~~~ ...I ~ ~ n 3 pl ,~ ~ a ~ ~ N rn ~` ° ; ° ~ ~ W r, . d n n cC C ~ ~ 1 ~ o v Q S ~ x~ _ Z rt Imo d. ~ 7 ~ ~ N _~ Q rt ~ rn 3 ~ ~ N rn z m z /~ n -i /~ 7 .~-t 'n Z -~ m m ~ n o o Z ~ C ~ n ~ Z ~ ~ ~ ~ Q W v ~: o~ g~ m ~_/~ _y~a* ~, '~ C rn ' ~aa v ~ ~ o ~ ~ ~ ~ ~ O m ~ ~ ~ *k W D ~ Z m n o m o N ~ m N ~ 3 ~ ~ i t n - 117 S~ C T ~ N d C) ~°n ~ °~ _ ~ - Q ' Z 6 ~: 9 ~~0~ w =~~ ~ 3 r ~~+~ ~ ~ ~' W ° v v z W ~~ Z z Z ~ ~ ~ N o, ~ v ~ v G) c !~F t eD ~p ~ ~ ~. pm zn . ~ ~ a g o N ~ > n Z N O O ~ emu N a a Ui A W N ~ ~ ~ ~ ~ ~ m ~ ~ ~ C ~ ~ d ~ ~ ~ m ~ ~ 3 m ~ ~ ~ . . ~ m m ' 0 0 T CO ~ V ~ ~ ~A W N ~ ?t ~ z psi ~. v cn m ~ v 'c p v 5 ~ 3 ~ ~ ~ 'n a v o' ~ ~t ~' ~ r c .~O~gEXBCipG t9 -- - Certificate of Occupancy ciTY or ~~~ ~~~~ City of Rexburg `U' Department of Community Development '.~, ~ AmericaiFamilyCnmmunity 19 E. Main St. / Rexburg, ID. 83440 Phone 208 359-3020 /Fax 208 359-3022 Building Permit No: 05 00291 Applicable Edition of Code: Site Address: Use and Occupancy: Type of Construction: Design Occupant Load: Sprinkler System Required: Name and Address of Owner: Contractor: Special Conditions: Occupancy: International Building Code 2003 869 Capital Ln Townhome Type V-N, Unprotected Residential No Georgetown Development Inc 2230 N University Parkway Provo, UT 84604 Georgetown Development Residential, single family dwellings, lodging houses This Certificate, issued pursuant to the requirements of Section 909 of the International Building Code, certifies that, at the time time of issuance, this building or that portion of the building that wes inspected on the date listed vies found to be in compliance vuth the requirements of the code for the group and division of occupancy and the use for which the proposed occupancy vies classified. Date C.O. Issued: August 11, 2006 08:5 ~~ C.O Issued by: - Building Official There shall be no further change in the existing occupancy classification of the building nor shall any structural changes, modifications or additions be made to the building or any portion thereof until the Building Official has reviewed and approved said future changes. Water Departmen • Fire State of Idaho Electrical Department o4REXB~x~. Certificate of Occupancy `~ ~' _ CITY OF "„ _~~j,jjZG City of Rexburg Amrrica'sFam yCommunity Department of Community Development 19 E. Main St. / Rexburg, ID. 83440 Phone 208 359-3020 /Fax 208 359-3022 Building Permit No: 05 00291 Applicable Edition of Code: Site Address: Use and Occupancy: Type of Construction: Design Occupant Load: Sprinkler System Required: Name and Address of Owner: Contractor: Special Conditions: Occupancy: International Building Code 2003 871 Capital Ln Townhome Type V-N, Unprotected Residential No Georgetown Development Inc 2230 N University Parkway Provo, UT 84604 Georgetown Development Residential, single family dwellings, lodging houses This Certificate, issued pursuant to the requirements of Section 109 of the International Building Code; certifies that, at the time time of issuance, this building or that portion of the building that tees inspected on the date listed toes found to be in compliance tMth the requirements of the code for the group and division of occupancy and the use for ttihich the proposed occupancy saes classified. Date C.O. Issued: August 11, 200 (09:OOAM) C.O Issued by: -- -- Building Official There- shall be no further change in the e~asting occupancy classification of the building nor shall any structural changes, modifications or additions be made to the building or any portion thereof until the Building Official has reviewed and approved said future changes. ~ / Water Department: 6 0~',•,".`'~ Fire D State of Idaho Electrical Deaartment n o~REXB~k~.,a _ ~, T Y Q r Certificate of Occupancy ° R.EX13CTi{~ City of Rexburg ~~ ~ -- `~' De artment of Communi Develo ment "•~, ~ America: Family Community p ty p [6 ~ 19 E. Main St. / Rexburg, ID. 83440 Phone 208 359-3020 /Fax 208 359-3022 Building Permit No: 05 00291 Applicable Edition of Code: Site Address: Use and Occupancy: Type of Construction: Design Occupant Load: Sprinkler System Required: Name and Address of Owner: Contractor: Special Conditions: Occupancy: International Building Code 2003 873 Capital Ln Townhome Type V-N, Unprotected Residential No Georgetown Development Inc 2230 N University Parkway Provo, UT 84604 Georgetown Development Residential, single family dwellings, lodging houses This Certificate, issued pursuant to the requirements of Section 109 of the International Building Code, certifies that, at the time time of issuance, this building or that portion of the building that vies inspected on the date listed vies found to be in compliance v-ith the requirements ofthe code for the group and division of occupancy and the use for vihich the proposed occupancy vies classified. Date C.O. Issued: August 11,2006 09:01AM) C.O Issued by: Building Official There shall be no further change in the e~asting occupancy classification of the building nor shall any structural changes, modifications or additions be made to the building or any portion thereof until the Building Official has reviewed and approved said future changes. Water Department: Fire D State of Idaho Electrical Department (208-356-48301: OE IiEXBUgC r 2 °.~ O CITY of Certificate of Occupancy RE~BURG America's Family Community City of Rexburg Department of Community Development 19 E. Main St. / Rexburg, ID. 83440 Building Permit No: 05 00291 Applicable Edition of Code: International Building Code 2003 Site Address: 875 Capital Ln Use and Occupancy: Townhome Type of Construction: Type V-N, Unprotected Design Occupant Load: Residential Sprinkler System Required: No Name and Address of Owner: Georgetown Development Inc 2230 N University Parkway Provo, UT 84604 Contractor: Georgetown Development Special Conditions: Occupancy: Residential, single family dwellings, lodging houses This Certificate, issued pursuant to the requirements of Section 109 of the International Building Code, certifies that, at the time time of issuance, this building or that portion of the building that vies inspected on the date listed wes found to be in compliance with the requirements of the code for the group and division of occupancy and the use for which the proposed occupancy wes classified. Date C.O. Issued: August 11 C.O Issued by: Building Official 9:01 There shall be no further change in the e~asting occupancy classification of the building nor shall any structural changes, modifications or additions be made to the building or any portion thereof until the Building Official has reviewed and approved said future changes. Water Departmen • 're State of Idaho Electrical O~ gEX6 Ugh r s "»~ O ~1TY of Certificate of Occupancy REXBURG Am~~rica~ Family Community Building Permit No: Applicable Edition of Code: Site Address: Use and Occupancy: Type of Construction: Design Occupant Load: Sprinkler System Required: Name and Address of Owner: Contractor: Special Conditions: Occupancy: City of Rexburg Department of Community Development 19 E. Main St. / Rexburg, ID. 83440 Phone (208) 359-3020 /Fax (2081359-3022 05 00291 International Building Code 2003 877 Capital Ln Townhome Type V-N, Unprotected Residential No Georgetown Development Inc 2230 N University Parkway Provo, UT 84604 Georgetown Development Residential, single family dwellings, lodging houses This Certificate, issued pursuant to the requirements of Section 109 of the International Building Code, certifies that, at the time time of issuance, this building or that portion of the building that vies inspected on the date listed v-es found to be in compliance vuth the requirements ofthe code for the group and division of occupancy and the use for vihich the proposed occupancy v-es classified. Date C.O. Issued: August 11, 20 9:02AM) C.O Issued by: ~~ Building Official There shall be no further change in the e~asting occupancy classification of the building nor shall any structural changes, modifications or additions be made to the building or any portion thereof until the Building Official has reviewed and approved said future changes. Water Department Fire State of Idaho Electrical Department (208-356-48301: oQ REXB UgG, t r.~ 'y M.~ o City of Rexburg ~ ~~ 1 ~~~ Department of Community Deve v~ ' ~ C~Q~ 19 E. Main St. / Rexburg, ID. 83 Phone (20.8) 359-3020 /Fax 208 3 -•s Certificate of Occu~~~~~• G CITY O F RE?~BURG America's Family Community Building Permit No: 05 00291 Applicable Edition of Code: International Building Code 2003 Site Address: 873 Capital Ln Use and Occupancy: Townhome Type of Construction: Type V-N, Unprotected Design Occupant Load: Residential Sprinkler System Required: No Name and Address of Owner: Georgetown Development Inc 2230 N University Parkway Provo, UT 84604 Contractor: Georgetown Development Special Conditions: Occupancy: Residential, single family dwellings, lodging houses This Certificate, issued pursuant to the requirements of Section 109 of the International Building Code, certifies that, at the time time of issuance, this building or that portion of the building That v-es inspected on the date listed vies found to be in compliance tMth the requirements ofthe code for the group and division of occupancy and the use for ttihich the proposed occupancy vies classified. Date C.O. Issued C.O Issued by: Building Official There shall be no further change in the e~asting occupancy classification of the building nor shall any structural changes, modifications or additions be made to the building or any portion thereof until the Building Official has reviewed and approved said future changes. Water Department: Fire State of Idaho Electrical Department (208-356-4830): ' ,CITE= OF REXB URG BUILDING PERMIT APPLICATION OS n~29.1 • ~ ~~~~"~4 19 E MAIN, REXBURG, ID. $3440 Foundation Only Garage ~~ ~ ~c4~bl~ 208-359-3020 X322 I'arkside 869,71.73,75,77 Capital PARCEL NUMBER: t W G Will 1.71 V Y t~.~, u~.., a.._ , _ __, SUBDIVISION: l~yl him ~3 UNIT#~BLOCK#_~LOT#_~ (Addressing is based on the information -must be accurate) ~ ~p/- ~,$' OWNER: CONTACT PHONE # PROPERTY ADDRESS: ~(Q - 8 7l -8~3 - ~ 75-8' 7 T ~~~ ~ a ~ I~ . PHONE #: Home ( ) Work ( ) Cell ~) ~/, o -o/ ~S OWNER MAILING ADDRESS: o~Z,~p W i VGsi~ PII+~ITY: v~ STATE:~~ZIP: &~f~ EMAIL FAX &o! -3'1 S-cs~2 APPLICANT: (If other than owner) (Applicant if other than owner, a statement authorizing applicant to act as agent for owner must accompany this application. ..,.~. - . APPLICANT INFORMATION: ADDRESS CIT ~°~2 ?' 't'~ STATE; ZIP EMAIL FAX PHONE #: Home { ) Work ( ) Cell ( ) Pv CONTRACTOR: MAILING ADDRESS PHONE: Home# EMAIL CITY~~vy STATEj,(~ ZIp~~~ Work#~~~,~~~ 1Z Ce11# ?O~r 7~ o -~o,8.s FA~,~y--_y 7aS How many buildings are located on this property? ~ Did you recently purchase this property`.~e~ Yes (If yes give owner's name) Is this a lot split?~~„ YES (Please bring copy of new Legal description of property) PROPOSED USE: C>'bt (i.e., Single Family Residence, r 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 sweaz 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 incases of any false statement or misrepresentation of fact in the application or on the plans on which the permit or approval was based. Permit void if not started within 180 days. Permit void if work stops~'nt~0 days. _ Q Signature of Owl Do you prefer ~i~_~ D~ DATE o~contacted by fax, email or phone? Circle One WARNING -BUILDING PERMIT MUST BE POSTED ON CONSTRUCTION STTE! 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 APPRO ED ~~ ~~~©~ BUILDING IN~P~GIQR ~~~~ CITY ; - --_ 8 o ~ ~~ ~~ ~ RE:~Bt,IR~ ~. ------ - - ~~ f ~, ANiERtCA'S FAMtt Y C~7MtVlUhtfY 19 E. Main (PO Box 280) Phone: 208-369-3020 x326 Rexburg, Idaho 83440 Fax: 208-359-3024 www.rexburg.grg comdev a(~.rexburq.orq Affidavit of Legal Interest State of Idaho County of Madison I, , Name Address City State Being first duly sworn upon oath, depose and say: A. (If Applicant is also Owner of Record, skip to B) That I am the record owner of the property described on the attached, and I grant my permission to: Name Address to submit the accompanying application pertaining to that property. B. I agree to indemnify, defend and hold Rexburg City and its employees harmless from any claim or liability resulting from any dispute as to the statements contained herin or as to the ownership of the property which is the subject of the application. Dated this day of , 20 Signature Subscribed and sworn to before me the day and year first above written. Notary Public of Idaho Residing at: My commission expires: 2 NAME PROPERTY ADDRESS SUBDIVISION Permit# ~ ~~ .~ ~~~ Mechanical Contractor's Name: Address Contact Phone: { ) Zip Mechanical Estimate $ ~~'ttl~ t'tt~~ c~~esti~z~ ~~a~g~t a~t~ly ~I ~n N~ f+a~• ~~~pa MECHANICAL Business Name: State Phone: Family Only) FIXTURES & APPLL9NCES COUNT ( le Family Dwelling Only) Furnace Exhaust or Vent Ducts Furnace/Air Conditioner Comb Dryer Vents Heat Pump Range Hood Vents Air Conditioner Cook Stove Vents Evaporative Cooler Bath Fan Vents Unit Heater other similar vents & ducts: 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 Mechanical Sizing Calculations must be submitted with Plans & Application Point of Delivery must be shown on plans. t L ~~.i=Tttit ; i.:l[~'tl'c1C'st?t' ~~Y The i,'::~d74', .:i Date 's permit fee schedule is the same as required by the State of Idaho 5 • • f ---- - --------- ~~-RO ~ C17Y OF RE:XBLIR~ ~-- --- -- ~ AMERICAS FAINTLY Cc'~41MUN(FY ~ 9 E. Main St. Phone: 20&359-3020 x326 4e~~y.~EO Rexburg, Idaho 83440 Fax: 208-359-3024 www.rexburo.oro cddQrexburg.org APPLICATION: "CONSTRUCTION PERMIT" CONSTRUCTION PERMIT #: PERMIT APPROVED: YES/ NO $50.00 FEE PAID: YES/NO APPROVED BY: -APPLICANT INFORMATION: BUSINESS NAME: cDrA~ OFFICE ADDRESS:2c.~.. W, ta.Hf yers;-I-~+.t ~c.~ wa.H ~7 r- Provo L! _ S-~l~o~ cry ~ star zlp OFFICE PHONE NUMBER: (~~ 1 1 3-7 ~ - z~?~ 2 CONTACT PERSON: 7r~,,; ~~'T~/t ks CELL PHONE # (~~) ~~0~-01 -LOCATION OF WORK TO BE DONE: STREET ADDRESS WHERE WORK WILL BE DONE: ~ ~ ' ~ s- BUSINESS NAME WHERE WORK WILL BE DONE: ~;[,,~. ~~ ~ cyr~ hom ~s DATES FOR WORK TO BE DONE: q -~s-ds TO „~-~s-o s CONTACT PERSON: ~ rcw ^s ~y~ks __ PHONE NUMBER: O CELL # (.z~~) 7 ~ o -ol ~S PLEASE CHECK THE TYPE OF PERMIT(S) YOU 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 ^ LP-GAS ^ PRIVATE FIRE HYDRANTS ^ SPRAYING OR DIPPING ^ STANDPIPE SYSTEMS ^ TEMPORARY MEMBRANE STRUCTURES, TENTS, AND CANOPIES ~~.vL t ~r ~~/~ 7~ wn hvm ~ ~-9-ate APPLICANT NATURE DATE v x ` SUBCONTRACTOR LIST Excavation & Earthwork: Concrete:~C 1C Yl/ /3~: J~~ rS Masonry: Roofing: ~j~ ~ /,J~ Insulation:~~ -~- Drywall:_~I~ ~~~~p yf Painting:_~- Floor Coverings: Plumbing-~"- Heating: ~~ Electrical:s~c,.~YG Y!'I e ~!{..~?y~ "G Special Construction (Manufacturer or Supplier) Roof Trusses: Floor/Ceiling Joists: ~yJ7G Siding/Exterior Trim:, Other: **Building Permit Fees are da~time of application** **Building Permits are voi if you check does not clear** ... ~~ _ ~ ?~~ NAME PROPERTY ADDRESS Permit# SUBDIVISION Dwelling Units: SETBACKS FRONT Parcel Acres: SIDE BACK Remodeling Your .Suilding/Home (need Estimate) $ SURFACE SQUARE FOOTAGE: (Shall ~clude the exterior wall measurements of the building) First Floor Area Second floor/loft area Third floor/loft area Shed or Barn Water Meter Count: Unfinished Basement e Finished basement ea_ Garage area Carport/Deck ( "above ater Meter Size: PL I~MBIIVG Plumbing Contractor's Name: Address Contact Phone: ( ) Busine~ Email Fax_ FIXTURE COUNT tincludin~ roughed frxtures) Clothes Washing Machine Dishwasher Floor Drain Garbage Disposal Hot Tub/Spa Sinks (Lavatories, kitchens, bar, mop) Plumbing Estimate S (Commercial Only) ~i,~_ ~ i_ _ .. <~.. __ . The City of Rexburg's SIDE Business Name: State Zip Phone: ( ) ~.~.~ , schedule is the same as Sprinklers Tub/Showers Toilet/LTrinal Water Heater Water Softener Date the State ofldaho 4 CITY OF REXB UR G ~ j~ ` - BUILDING PERMIT APPLICATION V J ~ O y~ ration! 19 E MAIN, REXBURG, ID. 83440 Parkside 243,4>,47,4g,~ 1 Colonial Wa~,~ applicable 208-359-3020 X322 PARCEL NUMBER: _ v_ (We will rovide this for you) SUBDIVISION:~,~ ' -~w~ `je~~ UNIT#~~~~-BLOCK#_ ~ LOT# ~ ~ ' ~' fc~Sz ~ (Addressing is based on the information -must be accurate) O PROPERTY ADDRESS: PHONE #: Home Work Cell v OWNER MAILING ADDRESS;~23o N z/r~-y s. ~P~ITY:-~~~~a STATE:~ZIP:-~~ S'~• 7G EMAI a.,./1Sr'1t ¢ac.~~!`in~»GS FAX ,359-`~~' .,, ... APPLICANT: (If other than owner) (Applicant if other,than owner, a statement authorizing applicant to act as agent for owner must accompany this application.) APPLICANT INFORMATION STATE; ZIP PHONE #: Home CONTRACTOR: MAILING ADDRESS: ADDRESS C: EMAIL F Work ( CT ' ~ 2005 Cell (~ ~(~'~Yt L CITY PHONE: Home# EMAIL FAX 'ACT PHONE # 7jo0 -O/~S Cell# How many buildings are located on this STA Did you recently purchase this property?~ Yes (If yes give owner's name) Is this a lot split. NO YES (Please bring copy of new legal description of property) ~ _ r. PROPOSED USE: ' ~ '/ G,~,,,,Q c ~ `~~ (i.e., Single Family Residence, Multi Family, rtme ts, Remodel, rage, 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 approval was based. Permit void if not started within 180 days. Permit void if work Signature of Owner/ DATE Do you prefer t ontacted by fax, email o phone? Circle One Work# WARNING -BUILDING PE ST 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 ime of application** **Building Permits are ~a c fyou check does not clear** ~'Yease complete the ~:>tre Application! If the question does not apply fill in NA for non applicable NAME e ~ ~ t./l7 ~ /r,vrr~~s, -~ PROPERTY AD RESS ,3 L'o~r~,G; c,~a y Permit# SUBDIVISION ~ r~5,~~c Dwelling Units: SETBACKS FRONT ~- BACK ~- Remodeling Your Building/Home (need Estimate) $ .®-- SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building) r~.tQ ~ First Floor Area i4 liy„~ @,~ ~~lfs Unfinished Basement area ~-' Second floor/loft area ~f'~/~ ~ti„ ~~ Finished basement area -~-- Third floor/loft area -~= Garage area ,~ ~..(~ , ~ G Shed or Barn --~---- Carport/Deck (30" above grade)Area Water Meter Count: / rr Water Meter Size: Required!!! PLUMBING ; Plumbing Contractor's Name: ~ J ~ ~-~~--5 Business Name: l` Address Cpl ~~~r-~~~,,, w City % --~trv~ State %!~ Zip ~~~~~ Contact P'yhone: ("~ ~~=•-~;.~ Z Z Business Phone: (2~~) ,~;~ _~3 Z Email ~J~~ Pd,~t-' hC f~ ~J 1 ~~ ~~T' Fax ~. ~~~ ~~ J - ~' `~'~ FIXTURE COUNT (including roughed fixtures) J~ Clothes Washing Machine ~_ Dishwasher --~- ~ -Floor Drain Garbage Disposal _~ Hot Tub/Spa ~,L Sinks (Lavatories, kitchens, bar, mop) ~ Sprinklers ~.c.,scq~c .~ Tub/Showers /~ Toilet/LJrinal .~ Water Heater ~- Water Softener Plu ing Estimate $ ~ Sa ~ (Commercial Only) R quired! Si afore of Li ensed Contractor License number Date The City of Rexburg's permit fee schedule is the same as required by the State of Idaho Parcel Acres: SIDE ~- SIDE 4 Please complete the ent~r ,pplication! If the question doe lppIy fill in NA for non applicable NAME ~ ~ ~-~ „[1~..~Lr..~~ ,L PROPERTY DRESS __ Permit# SUBDIVISION ~ ~ ~ , h~~ r ~ Required!!! MECHANICAL Mechanical Contractor's Name: [_p ~rl ~a r ~ 2 o nc Business Name: Address ~ Q (j ~ 3 `~'O ~ City Z'~~ ~IOFl~~State ~~ Zip 83~01~' Contact Phone: (Leg) ,S`2 4 - 6~'S' g Business Phone: ( ) Zoe .- s2 ~.- Lg~~ Email (~ L ~~,~ ~,~-t' ~ So rV« ry~ Cow Fax s 2? - c~4 ~ Mechanical Estimate $ (Commercial/Multi Family Only) FIXTURES & APPLIANCES 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) Ga Oil Coal Fireplace Electric other similar vents & ducts: Mechanical Sizing Calculations must be submitted with Plans & Application ~~Point of Delivery must be shown on plans. Required! The Contractor Rexburg's _~ ~ Dryer Vents Range Hood Vents ~~ Cook Stove Vents /1~ Bath Fan Vents number schedule is the same as Date by the State ofldaho 5