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Home My WebLink AboutAPPLICATION - 05-00449 - 262 E 2nd N - Fireplacelov 14 05 05:35p Myron Creager Cl~ OF REXB URG • BUILDING PERViIT APPLICATION 19 E MAIN, REXBURG, ID. 83440 208-359-3020 X322 Please co If the questia PARCEL NUMBER~~-~~''~~~~ C~~ (We Si; BDIV ISION: UNIT# (Addressing is based on the information -must be accurate) 208-356-3988 0.5 00449 p.1 2fi2 E 2nd N-Fireplace BLOCK# LOT# OW.'YER: ok~ ~, 4 n s CONTACT PHONE # ~~'~3 ~sG--vy~ ~ PROPERTY ADDRESS: o~lc 2 ~=- ~..~ 1~~• PHONE #: Home (~} 356 `5`</77 Work OWNER MAILING ADDRES 5:,2 ~~,~ ~-' ~ a .>`~ ~ CITY:, EMAIL AX Cell ~~~/..rf STATE: ~~- ZIP: ~ 3yya APPLICANT (If other than owner) ~'~. ~ e -~~~~ ~- ~~~ ^'~ ~' (App]icant if other than owner, a statement authorizing applicant to act as agent for owner must accompany this application.) __ APPLICANT INFORMATION: ADDRESS ~"~9 S• ~ ~~~~CITY: `,;~ STATE; ~ ~ ZIP ~ 3 %~lCj ENTAIL FAX 33~ - J~~. PHONE #: Home Work ~) 3 55'-$G ~-~ Cell ( ) CONTRACTOR- C ~- - ~ ~~.r~;,s n "`' -"`~`r MAILING ADDRESS: ~ 59 S' y~~~~~ ~`~~'/ CITY ~~~~STATE ~~ ZIP~'%~~~~~ PHONE: Home# Work# 359-~~-~ Cell# EMAIL FAX ~S ~ " 39~ How many buildings are located on this property's ~ 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 ne~v legal description of property) aunpncFn l:I~>=.~ (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. 1 ages 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 ~n cases of any false statement or misrepresentation of fact in the applicatyon or on the plans on which the permit or approval was ba Perm' of started within 180 days. Permit void if work stops for 180 days. ~.. Signattue of Ovvner%Applica 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 otapplication beginoiogJanuary 1.2005. City of Rexburg's Acceptance of the plan revieh~ fee does not constitute plan approval **Building Permit Fees are due at time of application** "*Building Permits are void if you check does rat clear** Nov 14 05 05:35p Myron Creager 208-356-3988 p.2 Please complete the enti~Application! If the question does~t apply Ell in NA for non ._ applicable pp ~ NAME of~ k ~ I • ~ L ~ ~` PROPERT ADDRESS ~- ~ ~-- F - ~ ~-~ /~!, Pernut# SUBDIVISION Required!!! MECHANICAL Mechanical Contractor's Nam~e-: ~~!•~~~'~°'~'~'~ Business Narne: (~~^' Lam- •-~~r ~- ~~~•~ Address ~ ~ ~ S~~'`~a~vr'ia-~'' ~9~'/ City ~~~. b~~~ State _.L s~ Zip `~%~ /G Contact Phone: (at`~) 35 g - ~'~~--~ Business Phone; ( ) Email Fax 3SG-~~~~ Mechanical Estimate $ (CommerciaUMulti Family Only) FIXTURES 8c APPLIANCES COUNT (Single Family Dwellin Only) Furnace ~ Exhaust or Vent Ducts FurnaceiAir Conditioner Combo Heat Pump Air Conditioner Evaporative Cooler Unit Heater Space Heater Decorative gas-fired appliance Incinerator System Boiler Pool Heater Dryer Vents Range Hood Vents. Cook Stove Vents Bath Fan Vents other similar vents & ducts: 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. Signature of icensed Contractor License number Date Regaired! The City of Rexburg's permit fee schedule is the same as required by the State of Idaho 5