HomeMy WebLinkAboutBP & APPLICATION - 06-00390 - Appletree Daycare - MechanicalZ
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C.
Aug. 2. 2006 3:33PM
CITY OF RE~URG
MECHANICAL PERMIT APPLICATION
19 E MAIN, REXBURG, ID. 83440
208-359-3020 X326
No. 2514 P. 1
06 0390
Plea Appletree Daycare-
udet Boiler Replacement
PARCEL NUMBER:-1`~~~g ~~ ~~ (We will provide this for you)
SUBDIVISION: UNIT# BLOCK# LOT#
{Addressing is based txt the information -must be accurate)
CONTACT PHONE # ?,pk'-3SG~•~S~ZO 3i i
PROPERTY ADDRESS: ~ / 2 y$ St~~. s ~-~- LE1QK~ . ~ ~ ~f~t9
PHONE #: Home ( ) Work ( ) 511t/~t.C. Cell ( ) 3 5v -'aF~l~
OWNER MAILING ADDRESS: 7~~' J'~ ~ /~ CITX: Y STATE:~ZIP:_~~~LO
EMAIL FAX SSG -t~~G
APPLICANT: (If other than owner) ~,~ ,' ~ ~y Y ~ ~ ~ ~~, ~ ~ ~yyr~. ~~
(Applicetlt of odlel• thant ot+hoter, a state~oaegt autUtottzittg applicaltt to act as agent #o(r7o®tmer steal accoct-pattythis applicadon.)
APPLICANT INFORMATION: ADDRESS ~ ~ ~ ~ ; / `'~"-~-' < CITY: ~ B
STATE; ,~~. ZIP;1 ~''4 ~~ EMAIL FAX ~ ~7 l • `- ~' ~ ° 1~
PHONE #: Home ( ) Work ( ) Cell ( ) ~ ~`"(' ~ l~ ~
CONTRACTOR: i ~ 1^~'ii;' ~?t.~ ~;S' L~~?v~ ~ .
MAILING ADDRESS: ~ ~ ~ ~ ~ `~t^ ~ CITY ~~ e ~ STATEZIP ~4y
PHONE: Home# Work# ~ ~~-t~~ 1 ~ CeII#
EMAIL FAX
How marsv bttildintzs are located on this rnotxrly?
Did you recently p~ursc~hase this property? l`o Yes (If yes give owner's name)
Is this a lot split? ~9' XES (Please bring copy o~>aew legal description of propefiy)
PROPOSED USE: ~~ 6~1 ~i ~- J (~ /
(i.e., Single Famity Residence, Multi Family, Apartments, Remodel, Garage, Commercial, Addition, Etc.)
APPLICANT'S SIGNATURE, CERTYFICATTON AND AUTHORIZATION: under pendty orperjruy, I hereby certify that I have
read tl-is appliu8iaat sad slate that the iafwmaticrtt hereiar is correct arrd l swear that aay infomoatiar wbiCh may iusvalter bo gives by the in hearing before the Phnmittg
and Zoning Contmissien or the City Cotmcil far the City of Rexburg shall be 1rnOtful cad correct I agta to cortlply wits all City regulations and Stela laws m the
subject matter al'this application and hereby authorized tepramntives of the City to suet upon the above~meetioaed property lion inspectims putpoaes. NOTE: lac
building official may revoke a permit oo approval issued under the provision of the 2003 h~tanstieanl Codc is cmea of any false stmt ar ~r~tt~ian of fact in
the application ~ an ttu p~any6n~rhicb the pFrt<tit or aPPro^'~ was based ~orit void if not ataroed w.irbar l8p dsyl. l'grmit void if.vork crops idr 180 days. •
Do you prefer to be convected try fax, email or phone? Circle One
WARNII~iG - BUILDIIVG PERMIT MUST BE POSTED ON CONSTRUCT]
Plea tea are aoa-relttodable surd are paid is taB at the tilae o! applkatlon begltdnlal
City of Rertbur~'s Acaptaace of the play review fee dos not conatitttte plan
~d~~~.
CITY OF REXBURG
Aug. 2. 2006 3:33PM
No. 2514 P. 2
Please complete the entire Application! u dK q ace. act apply i~ill;a NA ~,~ ap~ete
NAME
PROPERTY ADDRESS Pemut#
SUBDIVISION
Required!!! MECHANICAL
Mechanical Contractor's Name: w ~ '' Business Name: ~d ~/~-- ~~,~/ku ;~-~,~,~
Address ~ 3 ~- `~~ ~~ ~
1 city state ~d, Ztp~
Contact Phone: ( )_ `~ ~~~- ~1l% Business Phone: ( )
Email Fax
Mechanical Estimate S 6d~ ~ (Commercial/Malti Family Only)
FIXTURES' Bc AP1~LL4NCES COUNT (Singly Family Dwelling Only)
Furt~~ ~ 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 Gras Pipe Outlets including stubbed in or future outlets
Inlet Pressure (Meter Supply) PSI
other similar vents 8t ducts:
Heat (Circle all that apply) ~~' Oil Coat Fireplace Electric ydronic
Meclmnical Siting Calcutat~ns lp,~st be s®bmitted with Plans & A 'cation
rrwww~~wwwiw ~w~^ ^w~
~ Point of Delivery must be :boron on clans.
6~~C.- C-4~5~ ~o 0
8igneture of L' Cotrttactor License number ~ to
The Ciry ojRacblrrg's permit fee Jdiedule is the same as regained by the State of Idaho
Dryer Vents
Range Hood Vents
Cook Stove Vents
Bath Faa Vents