HomeMy WebLinkAboutAPPLICATION, BP - 06-00302 - Cal Ranch - MechanicalZ
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19 06 02:59p
~Vla r, 4. 2005 2: 47P~M •
CITY OF REXB URG
BUILDNG PERMIT APPLICATION
19 E MAIN, REXBURG, ID. 83440 Please
208-359-3020 X326 If the gtses•
PARCEL VUMBER:~~~~ J1 ~ r • '~
SUBDTti ISION:
p.2
• i1'o.0495 °. i
PERMIT
06 00302
Cal Ranch-Mechanical
Lei +ITT BLOCKT LOTS
OWNER ~ j~~c l~ CONTACT PHONE ~ 35(0 - 33N ~
PROPERTY ADDRESS: ~O~} ~ . 'L [-:
PHONE :: Home
OWNER iVtAII.NG ADDRESS:
CITY: STATE: ZIP:
APPLIC:At~1T (If other then owner) \'l~'1f1ct~''~ Tin ~, .
(1f applicant if other than owner, a atatcment stnhorizing applicant to act as aecrt for owTer must accomaany [t:is application.)
MAILING ADDRESS OF APPLICANT _ I
~'~"Z.Gi W . `~~n ~~ - CITY: 1C~cl~lc-5 {~~,~~5 STATE; ~ ZIP `t~34'd `L
?HONE + :Home ( ) Work ( ) CeII ( )
CONTRACTOR: ~.pY1(u~ :TY1 •;. PHONE: Home# Work# Cell
MAILING ADDRESS: CITY STATE' ZIP
Now many houses are located on this property?
Dad 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: CC~~m~X't,-~ct~?
(i.e., Single Family Residency, \~iulti Family, Aparnner_ts, Remodel, Garage, Commercial, Addition, Etc.)
APPLICANT'S SIGNATURE, CERTIFICATION Ai~TD AUTHORIZATION: Under penalty of perjury, T he: eby
Certify thEt I have tC3d Lh19 application and state that the information herein is correct and I swear that any information w~ieh may
hereaftez I;e given by the in heari:sgs before the Planning and Zoning Commission or the City Council for the Ciry o; Rexburg shail be
trutJt.ful and correct. !agree to comply wizb all Ciry regulations and State !aws relatias to the subject matter of this application and
ixeneby authorized represenratives of the Ciry to enter upon the above-mentioned property for inspections purposes. NOTE: The
building otHcial may revoke s permit on approval issued under the provisions of the 2000 Inteznationai Code in cases of nay fzlse
statement or misreprcseatation of fact in the application or on the plans on which the pera:it or anproval was based. Permit void if not
started within ~ 30~ys. ?ermjt void if work stops for 180 days.
Signature of Owner/Applicant
c'n l / 1 / (~
DATE
WA,It1VIiYG -BUILDING PERMZ'T MliST BE 1'OSTE1) ON CaNS7'RUCTION SI?E?
Plan Sees are noa-re.lltndable sod are paid ite lhtll at the Lime of appiication beginning January 1. 2003.
City of l2exburg's .9,ceepts.oce of the plan review fee does not cnnsiituie plan approval
*'Btti]diug Permit Fees are due at time of applicstloa"~
*"'Building Permits are void if you check does not clear'"
Work ( ) Cell
Jun
19 06 02:59p
~Feo. 8~ 2046 I:S8P~U1 •
• No. 1624 P, 5
Please Go;nplete the entire Application! zf the question does aat apply fill in NA for non
applicable
NAI+~ C'a4 ~LCh ---
PROPERTY ADDRESS Permit#
SllBDIVISION
p.l
required!!!
MEC~~AIVICA~
Mechanical Contractor's Name: ~l/lU,t~t 1-YiG ~ Business Name:
Address ~~ VJ . ~~~~ St City=G~G~+"tc 1-0.1 ~~ State 1.G~ Zip ~i'5~~2
Contact Phone: ( ) ____A~siness P-hone: ( ) _ -572 ".3~~ 2..._..----.._-_.._......._-_--
Email~t~u'1V1'~o+c,(~ ~~~n~ , n t Fax 5Z~ - Z. i 15
Mechanical )Estimate S 2,'~.~ ~ (CommerciaUMalti Family Onpy)
FIXTURES & APPLIANCES CDUNT (Single Family Dwelling Only)
Furnace Exhaust or Vent Ducts
Furnace/Air Coaditiorler Combo
Heat Pump
Air Conditioner
Evaporative Cooler
Unit Heater
Space Heater
Decorative gas-fired appliance
Incinerator System
Boiler
Pool Heater
Siznilaz fixtures or Appliances
Fuel Ga.s Pipe Outlets including stubbed in or future outlets
Inlet Pressure (Meter Supply) PSI
Heat (Circle all that apply) Gas Oil Coal Fireplace Electric
other similar vents & ducts:
Mechanical Sizing Caicalations must be submitted with Plans & Application
Point of Delivery must be shown on glans.
~ 11
'gnatiue of Licensed Contractor
Dryer Vents
"' Range Hood Vents
Cook Stove Vents
Bath Fan Vents
License number
The City ofRexburg's
schedule is the same as
Date
by the State of Idaho