The URL can be used to link to this page

Home My WebLink AboutBP & APPLICATION - 06-00373 - Western Watts/Ashby Chiropractic - MechanicalZ O rn f 0 :~ n ~~ a F 7 I ~ D n ~~ v v m ~ 3 ~ y y ~ w N a °. ~~ ~~ ~. ~, a ~~ 3 fQ N N 7 s ~~'~~ ~ ~ ~ ~ o C ~ N ~ Z n!C ? ~o~~~, G C y p ~ ~ ~ a a o N N f~/1 W C ~;~~ . ~, s~ ~~~ c 0 m 'r o °' oy~', ~~'~.a /~ 3 C -I m ~_ Z v r v -~-I 2 m C r _v Z m a c m 0 m ~ S, ~ cr o ~ ~ ~. ~ s rn O yyZ ~ ^~ ~ roe Z ~ 3 N ~'~ ~+ m ~ m ~ m e~ W~no~ 2 C v N C• ~ ~ ~ ~ m ~~ ~ m ~ 171 '; _ C1 G ~ O~ C y O ~ N• 0 oK~~` ~ z z ~ -I a ~~~~ ~ CD ~•~ ~ a O ~ ~_ ~ y d~p~ ~ O ~ .~ O ~. Ot ^' Z n ~ ,~' _.. m ~ o ~C1~z c g ~ c~~~ ~ ~ ~ ~ °o d ~ ~ a~n ao ~ ~~z~ ~ ~ O1 ,_.r ~ ~ ~ ~ ` W y; m ~ ~ ~. __. ~ ~ ~ ~ s ~. ~ ; ~ ~~~a n y ~~~3 ~ ~ ~~ o W o ~ _. a ~~ - W :'. e~ ~ 3 p ~ ~+ ~, g ~~ ~C C ~~~ O ~~~ m .~ '~ a N ~ ~ ~ S' ~' yrt `' n n ~ C • _~ m /~ ~ ~ . ~ °•zc 9' ~ x `° ~ T ~ ~. ~ ~ x ~_~, a °: °. Z ~w~ m n ~ N ~ V1 N ~ N C ~ ~ ~ ~ ~ r N ft~ m ?~ ° ~ ~ n o ~ n ~ a ~ ~ _ a3ooo y '° ~ ~ d Z z~" ~ ~ z ~ C n ~z~ W ~~ Z z v A mg o 0 ~ ~ i ?.c znc~ ~ ~ °. ~ ~1 ~ 7 p! ~ C1 Z N p a • . CITY OF REXBURG 06 00373 MECHANICAL PERMIT APPLICATION Pleas W este rFm Watts/As h by Chiropractic ~ ~ 19 E MAIN, REXBURG, ID. 83440 If the q urnace Replacement -le 208-359-3020 X326 PARCEL NUMBER: R~ (We will provide this for you) SUBDIVISION: UNIT# BLOCK# LOT# (Addressing is based on the information -must be accurate) OWNER: (,,~ ~fcr~ ~tz~~ j ~1, ~ ~ ~,y~,,xf,Z-CONTACT PHONE # 'Tri ~3--C~,3'"~> PROPERTY ADDRESS: f 6 S ~S~ ~' PHONE #: Home Work Cell ( 3/3"`G'~~/ OWNER MAILING ADDRESS: c~~ `S l" j,;' CITY: ~ ~~ STATE: ~D ZIP: 83y~~ EMAIL FAX APPLICANT: (If other than owner) ~"~~y3 ~~-- ~/ct~; ~. ~--t-~,, (Applicant if other than owner, a statement authorizing applicant to act as agent for owner must accompany this application.) APPLICANT INFORMATION: ADDRESS_ ~D~S~ ~ /~j'/1/ CITY: R,~ b~- STATE; ~~ ZIP ~3`l~Z EMAIL PHONE #: Home Work FAX Cell (~+~ 3%3- ~~~~ CONTRACTOR: MAILING ADDRESS: /'(' ~.~~ ~ /~/~" ~'1/ CITY ~(,~~~- STATE ~/, ZIP~~~~l~-- PHONE: Home# EMAIL Work# FAX Cell# ~ 3I3-d0$/ now many nullamgs are located on this property'I 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) PROPOSED USE: (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 heazings 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 2003 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 stops for 180 days. ,~ Signature of Owner/Applicant 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 of application beginning January 1. 2005. City of Rexburg's Acceptance of the plan review fee does not constitute plan approval • • Please complete the entire Application! ift>~ gn~tlon aoea not.ppl~ fill in NA ror non applicable NAME PROPERTY ADDRESS SUBDIVISION Permit# Required!!! MECHANICAL Mechanical Contractor's Name: T~~~ ~ /~~ ~/~~'7;~ Business Name: _~fkc~~,~ X~r- L~t~as~Z Address ~'~ `~S ~ ~~ ~~N City ~, State Zip ;f3 yti.~ Contact Phone: (Zoe 3/,3 -- ~Il~~~ Business Phone: ( ) Email Fax L»~. 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 Fuel Gas Pipe Outlets including stubbed in or future outlets Inlet Pressure (Meter Supply) PSI Dryer Vents Range Hood Vents Cook Stove Vents Bath Fan Vents other similar vents & ducts: Heat (Circle all that apply) Gas Oil Coal Fireplace Electric Hydronic Mechanical Sizine Calculations must be submitted with Plans & Application Point of Delivery must be shown on plans. Signature of Licensed Contractor The City of Rexburg's License number Date schedule is the same as required by the State of Idaho r • CITY OF REXBURG MECHANICAL PERMIT APPLICATION 19 E MAIN, REXBURG, ID. 83440 208-359-3020 X326 • 06 00373 Plea Westerm Watts/Ashby Chiropractic fin! If the Furnace Replacement rl<ble PARCEL NUMBER: ~1?g~~'jl ~~~ (~ (We will provide this for you) SUBDIVISION: UNIT# BLOCK# LOT# (Addressing is based on the information -must be accurate) OWNER• (,~j~~~,,-/l %~ti CONTACT PHONE # ~ G~r~ 3 /3•-Q~6 7 PROPERTY ADDRESS: l b S 15~t ~ ~~~'s~'> ~j0 ~' 1~~~-'1 PHONE #: Home ( ) Work ( ) Cell (:1t~ ,3 ~ ,3 -` d~'d ~ OWNER MAILING ADDRESS: S 1S ~' ,~ CITY: f't c'~S~~STATE: ~~ZIP: c~.3~1Y0 EMAIL FAX APPLICANT: (If other than owner) (Applicant if other than owner, a statement APPLICANT INFORMATION: ADDRESS applicant to act as agent for owner must accompany this application.). 'D ~~6 T /~S- /~~ STATE;~,~J ZIP ,J'.3~~/Z EMAIL PHONE #: Home Work ( ) Cell ( ;Si3--D~~~_ CONTRACTOR: MAILING ADDRESS: ~d ~~ ~ ~ %~f~/1! CITY l~(~ ~3~STATE ~/J ZIP 5~3~1~'2 PHONE: Home# Work# Cell# :2-C'Jf -3/3--~d ~/ EMAIL FAX How many buildings are located on this property? CITY: ~~~~~ FAX 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) PROPOSED USE: (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 corcect 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 2003 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 for 180 days. of 7 ~ .z G ~ od 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 of application beginning January 1.2005. City of Rexburg's Acceptance of the plan review fee does not constitute plan approval ,~ Please complete the entire Application! ifthc gUes~a ao~ ~t ~pp~y ff~l in Nw fur mo® Appllcable NAME PROPER Y ADDRESS Permit# SUBDIVISION Required!!! MECHANICAL Mechanical Contractor's Name: ~~~'i3 ~~~~ ~~Cc'~~Z-- Business Name: ~~j~~(Q!x/~~t~~i~ Address ~ ~ '~ d ~ l Gi`~~^~ City S ~ State ` Zip ~3yy~ Contact Phone: (~) ,~~ ~-- Cad ~'f Business Phone: (2~ 3f 3 -- ~rtJs3'J Email Fax ,,,- ~/ Mechanical Estimate $ ~~ ~~ / (Commercial/Multi Family Only) FIXTURES 8c 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 Dryer Vents Range Hood Vents Cook Stove Vents Bath Fan Vents other similar vents & ducts: )C.,' Fuel Gas Pipe Outlets including stubbed in or future outlets ~- Inlet Pressure (Meter Supply) PSI Heat (Circle all that apply) ~a~ Oil Coal Fireplace Electric Hydronic Mechanical Sizing Calculations must be submitted with Plans & Application Point of Delivery must be shown on plans. Signature of Licensed Contractor License number Date The City of Rexburg's permit fee schedule is the same as required by the State of Idaho