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HomeMy WebLinkAboutAPPLICATION - 05-00394 - 3855 Mountain View Dr - Mechanical,t 19 05 12:42p -~ITT~O.FREXBURG • BUILDING PERMIT APPLICATION PERMIT # Please cot `~~~,~, .~ 19 E AMAIN, REXBURG, ID. 83440 If the question 208-359 p.1 0 5 ©o~~ ~ X~~ 05 00394 ~~-y 7` Firepl e W. ount View Dr. PARCEL NUMBER: ~~~M ~ VE 2 r~ L ~~~1 ~' (We SUBDIVISION: UNIT# BLOCK LOT# (Addressing is based on the information -must be accurate) OWNER: ~d~ >13Lo~.~~.m<~ CONTACT PHONE # ~~$~- 3~s5 PROPERTY ADDRESS: 3g"SS ~• ~oyw~;.. (:~`.~cv D~_ ~,~~~ PHONE #: Home ) ~S(v- 3 y3`f Work OWNER MAILING ADDRESS: EMAIL Cell CITY: ~~ ~ ~~ STATE: Z~GIP: ~~y~o FAX APPLICANT (If other than owner) C ~- `~~-- ~~ ~S ~ F. ~-~~.L ~~.--s {Applicant if other than owner, a statement authorizing applicant to act as agent for ov~~ner must accompany this application.) APPLICANT INFORMATION: ADDRESS ~~ ~ S' ~`O/~~~~s~s~r~'~~I'I'y. ,~'x~ ~~5 STATE; ~~ ZIP ~3y~~ EMAIL PHONE #: Home ( ) Work (zca).~Sg-- gOaB' Cell FAX 3 Ste- 3 S ~` CONTRACTOR: C ~9-T~~. ~~• ~~,., F ~..~l,L~- -ter MAILING ADDRESS: ~~~ S, ,~//aw~~ ~ ~~~ CITY mac ~~~~ STATE L~ ZIP~y~ PHONE: Home# EMAIL Work# 3S~-~~ Cell# FAX 35G-3g~ Hove many buildings are located on this property? ~ ~ ~ l~ QED Did you recently purchase this property? No Yes (If yes give owner's name) Illy Is this a lot split? I~~O YES (Please bring copy of ne~~ legal description ofproperty) ~ 00~ PROPOSED USE: (i.e., Single Family Residence, Multi Family, Apartments. Remodel, Garage, Commercial, Addition, Etc.} CITY OF REXBURG APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury,l hereby certify that I have read this application and state that the information herein is correct and I swear that any information which ma}~ 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 pro~•isions of the 2000 tntemational 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 Permiword,jf~~ed within ] 80 days, Permit void if ~sork stops for 180 days. rim- ~ i ~~~ '~ / ~ Signature oFOwner./App cant DATE Do you prefer to be contacted by fax, email or phone? Circle One WARNING -BUILDING PERMIT MUST BE POSTED ON CONSTRUCTION SITE! Plan tees are non-refundable and are paid in full at the time of application beginning January T. 2(IDS. City otRexburg'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*x Oct 19 05 12:42p p.2 -1'Icase complete the ent1~ AppllCatlOll ~ If the question doe~ot apply fill in NA for non applicable I~IAME ~ L ~.~ ~-.~ ~ ~~ %~Id PROPERTY ADDRESS ~~'S5 Cy.hTpv,~ taw. v,`.u,~S,.,,._ pe~~ SUBDIVISION ~~ Required!!! 1VIECI~ANICAL Mechanical Contractor's Name: Business Dame: C~~~~.~,rk F..~-~~1.~, , Address__ ~S r S • y~/sow ,-~ ~4.U.~ ego i City ~..~-~~ ~ State ~~ Zip ~~`r~~% Contact Phone: ( ) Email Business Phone: ('~j 3s~--~oa8' Fax 3 SCo - 3S 8'b"" Mechanical Estimate S (CommerciaUMulti Family Only) FIXTURES & APPLIANCES COUNT (Single Family Dwelling Only) Furnace / Exhaust or Vent Ducts FurnacelAir Conditioner Co 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} ~~Oil Coal Fireplace Electric CITY OF REXBURG Mechanical Sizing Calculations must be submitted with Plans & Application Point of Delivery must be shown on plans. ~~ Signature of License ontractor License nwnber Date Repaired? The Crty ofRezburg's per-rzit fee schedule is the same as required by the State of Idaho Dryer Vents Range Hood Vents Cook Stove Vents Bath Fan Vents other similar vents & ducts: RECEIVED OCT 1 ~ 2005