HomeMy WebLinkAboutBP & APPLICATIONS - 06-00325 - 1080 Desert Rock Dr - FireplaceZ
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"- 4l 28 06 09:54a Myron Creager
CITY OF REXBURG
BUILDING PERMIT APPLICATION
19 E MAIN, REXBURG, ID. 83440 _
208-359-3020 X322
208-356-3988 p.1
~~~~ c~ 06 00325
the ~~aesfit 1080 S Desert Rock-Cnty Mech
PARCEL NUMBER:{~~.(,~ (We will provide this for you)
SUBDIVISION: UNIT# BLOCK# i:OT#
(Addressing is based on the information - must be accurate)
OYT'NER: ~,• ~ ~ a /.mss CONTACT PHONE # 3S~o-Gg~a
PROPERTY ADDRESS: ~~~-U .$'~ I~vr`~lQ;~~l~ L~, 2~.~ar^
PHONE #: Home (~,q~ 3S~--G~'~G Work (- } Cell (~~ ~S/-3y/7
OWNER MAILING ADDRESS: S~ -ti..-r =s 1,~,....f CITY: ~~~~5 STATE:,~~ZIP: 3 y V
EMAIL FAX
.4PP~ICANT: (If other than owner)_ G~ s`~"~ ij~r c ~ ~„~~~ `,.,r
(Applicant if other than owner, a statement authoreztng appltcant to. ct as agen for owner mast accompany this application)
APPLICANT INFORMATION: ADDRESS ~ ~ 9 S~ ~oll~,r7~ ~9~/ crrY:_ ~~,~.~~~~f
STATE; ~ ZIP ~~ `fyv EMAIL FAX ~5~~ 31
PHONE #: Home ( ) Work (~.~~ 3 Ss - b'G ~ g' Cell ( )
CO~YT'RACTOR: ~'~, s~-,r.,, ~ s,~ %-~°~t~~•-.r
MAILING ADDRESS:_ ~~ S_~~~~.~„~~~~~ CITY ~ oClo.•ls STATE-ZD ZIP~`~~~
PHONE: Hotne#
work#3j~ ~~,.z~' Cell#
EMAIL FAX 3S~- 3~~'''
How many buildings are located on this properly?
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 ofperjury, l hereby certify That I
have read this application and state chat the information herein is correct and ]swear that any infomtation which may hcreatter be given by me in hearings before the
Planning and Zoning Commission or the City Council for the City otliexburg shall be truthful and correct [agree to comply with all Ciry regrelations and State laws
relating to the smbject matter of Ihis application and hereby authorized representatives of the City to toter upon the above-mentioned property for inspectiarc; purposes.
NOTE: The building ofFcial may revoke a permit an approval issued under the provisions of the 2000 Entematianal Code in cases of any Faise statement or
misrepresentation offact is the application or on the plans on which the permit or approval was bated. Permit void ifnmt storied within 18D days. Permit void if work
stops for I80 dam/~ ~ /~j~
Signattve of Owner/A cant ~ / ~~ /06
Do you prefer to be contacted y f email or phone? Circle One DATE
WARNII~IG - ING PERMIT MUST BE POSTED O]V CONSTRUCTION SITE!
Plan fees are nog-refundable and are paid in full at the time otapplicaHan beginning JanuaN 1.2005
City ofReaburg's Acceptance of the plan review fee does not constitute plan approval
Jun 28 06 09:5 Myron Creager 208-356-3988 p.2
• =- - v - ~::~_.. _^ N:~ a ~:y ~`•` ~ -acs n.-•i~~ - P
NAME ~ ~ a ~ j
PROPERTY ADDRESS ~p - ~-~s% ~o~d4
L ~
SLTBDNISION ~
„
Permit#
o
,~~~
MECHANICAL
Mechanical Contractor's Name: ~/d7y~yw ~t~~~.,v/
Business Name: ~~ s io.~ ~r~~: ,~ ,C,~.,
Address ~S~ S ~ ,~~/dr,~r~,~„"~ D ~ r~ `~1. ".s
~ ~ .-City_ rTl/ ~~f~.,!~ State ~ ~ Zip~v
Contact Phone: (Zv8`) 3~j - $'G a--g' Business Phone: ( ) ~.-~--y
Email Fax ~ 5~_ ~%'8'~
Mechanical Estimate $ (CommerciallMulti Family Only)
FIXTURES & APPLIANCES COUNT (Single Family Dwelling Only)
Air Conditioner Space Heater
Bath Fan Vents Unit Heater
Range Hood Vents
Boiler
Cook Stove Vents
f Decorative Gas Fireplaces
Dryer Vents
Evaporative Cooler
Exhaust or vent ducts
_~ Fuel (gas) piping fixtures or appliance outlets
Furnace
Furnace/Air Conditioner Combo
Heat Pump •
Incinerator
Pool Heater
Heat (Circle all that apply) ~ Oil Coal Fireplace Electric
Mechanical Sizing Calculations must be submitted with Plans & Application
Point of Delivery must be shown on plans.
Si~iiat~Fre of .icens~d Conttnctrn• License number
. ~,.R ;, •-, Y'~ ~ Date
The City of Rexburg s permit fee schedule is the same as required by the Stare o}'Idaho
5