HomeMy WebLinkAboutAPPLICATION, BP - 06-00410 - 1050 S 2nd E - PlumbingZ
0
rn
^~
r
f_oZ~ S~ D
n
0 0 ~ ~ ~ o
~ ~ m m ~
~ m 'a 'a
v w °' 3 ~ m
0 o n ~ m
3 ~ ~• N N
~_~~
- N 3 LT N O
^" cn m a
C (/~ C1 C 01
n o ~..a
c ~ ~ -a
m
~ ~ ~ n
n °' ~' a
~ c v
°' ~ ~
°? o o
j Q ~ cN
~ ~ v
v g o
~ ~ co
a ~ ~
3 ~
~ o
o m
w .o
x ~ m
~ ~ 3
v
Q ~ 3
n 3 ~
o ~, Q
~ o ~
~~~
a~
v v ~ sZ
~ -~°o m ~ o
=~~~o
~ v y a is
~ Zc~ico s
c o ~ ~ v
.N.n N
a ~ N o m
f ~ m n o
~ N N N ~
N - -o 0
~~~~_
= 3 " ~ ~
0
CD F' ~v
~ p F_ ? v
~G ~ ? N ~
~oo~o
m ~a
a
2
m
C
m
~_
Z
r
v_
r
m
a
m
c_
r
Z
_~
m
W
C
Q.
3
H
.a
0
0
N
N
0
O
v
0
c~
N
N
C
~D
Q
\/
M
Q
30~~~
~ '. r: 3'
W ~ p1 y
.a
~:~~~
.~ W
(C O a' '_'
~ ~~ N
x ~.y
~ a ~
~~ya
'd O ~ C
n ~ ~a
C1 ~ ~ ~
O ~. ~ '~
__ ,.
~~~ ~.
V! n = S
~ ~
c~oa
'~O ~ ~ ~
O W ~ ~
~ ~ O ~
am ao
~ H S N
S ~ ~' C'1
~ ~ ? 3
W ~ N ~
~• n ~ 3
a d ~ ~
~~3a
~ O1 ;~
a
'C O ~ W
N
A <D 3 a
0 a ~
~ n
0
~~~
~ 3 ~
;~ ~ 3
~ a
C1 y ON
o =. ,
~~
- ~ ~
7 O ~
asp
K ~ ~:
~. ~ ~
3 ~ N
Q. ~ ~
O '~
3 N ~
m
z
m
Z
n
N
C
Q
N
O
v
N
L
W
g
m
y
0
Cn
O
N
Q
m
z
tD
~~
tQ
~_
C
v
m
O
d7
O
O
O
~'rr
`~i~ ~~,
_~
~~
. ~t~~O
~~ n
H
A '' r
K
,~
o o
~ ~ ~,
3
t'00 ~.
~ ~
~ ~.
ti• ~
~~
n
~ z
m
m o
o
N N
~
C 'i ~ 3 ~ ~ ~
~ n
!t~ T
~o~ m
~ v a
~ ~ i
o
-
~_
3? m v, ~ 3 Q Z
~
~ c ~ w ~ 3 ~ ~
yT~
Z ~ v ~
~ Z oo v
~
n
~ N ~. (
'p
Q ~
~
~
~
~.
~ °'
~
ZAA j
~g ~ y ~ n
n Z N ~
O A
O.
•
CITY OF REXBURG PEl
MECHANICAL PERMIT APPLICATION Please com 06 00410
19 E MAIN, REXBURG, ID. 83440 If the question c 1050 S 2nd E-Hoidaway
208-359-3020 X326
PARCEL NUMBER: i ~tZ ~ (~L,q- D 3 la 3 ~ ~ (We will provide this for you)
SUBDIVISION: UNIT# BLOCK# LOT#
(Addressing is based on the information -must be accurate)
CONTACT PHONE # ?~~6 --mot Z3~
PROPERTY ADDRESS:
PHONE #: Home ( )
OWNER MAILING ADDRESS:
EMAIL
FAX
CITY:
STATE: ZIP:
APPLICANT: (If other than owner) 0. (, (,~-~f-
(Applicant if other than owner, a statement authorizing applicant to act as agent r owner must accompany this application.)
APPLICANT INFORMATION: ADDRESS ~~ (~, N . ~ ~ ~ t _ CITY: ~ ~ s
STATE; ZIP 7 p EMAIL ( FAX ~~ $~ '7'~~ Z---
PHONE #: Home ( ) Work ( ~ h °'f r"`a ~ ~ . ~--) 7
CONTRACTOR:
MAILING ADDRESS: CITY STATE ZIP
PHONE: Home# Work# Cell#
EMAIL FAX
How many buildings are located on this property?
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 of perjury, I hereby certify that I have
read this application and state that the information herein is correct and I sweaz 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 applicati~ 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
Work ( ) Cell ( )
! •
..
Please complete the entire Application! ift>~ question apes not apply tw in 1vA for non Applicable
NAME
PROPERTY ADDRESS
SUBDIVISION
Permit#
Required!!!
Mechanical Contractor's Name:
Address
Contact Phone: ( )
Email
Business Name:
_City State
Business Phone: ( )
Fax
Zip
Mechanical Estimate $ (CommerciaUMulti Family Only)
FIXTURES & APPLIANCES COUNT (Single Family Dwelling Only)
Furnace Exhaust or Vent Ducts
Furnace/Air Conditioner Combo Dryer Vents
Heat Pump Range Hood Vents
Air Conditioner Cook Stove Vents
Evaporative Cooler Bath Fan Vents
~~ Unit Heater other similar vents & ducts:
~', Space Heater
Decorative gas-fired appliance
Incinerator System
Boiler
Pool Heater
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.
MECHANICAL
Signature of Licensed Contractor License number
Date
Please com lete the Mire A lication!
p pp
NAME
PROPERTY ADDRESS
SUBDIVISION
If the question does not apply fill in NA for non applicabk
Dwelling Units: Parcel
Permit#
SETBACKS
FRONT SIDE SIDE BACK
Remodeling Your Building/Home (need Estimate) $
SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building)
First Floor Area Unfinished Basement area
Second floor/loft area Finished basement area_
Third floor/loft area Garage area
Shed or Barn Carport/Deck (30" above
Water Meter Quantity:
**************Water Meter Size:
Required.!!
PLUMBING use ~ ~0.~~f~~-~-
Plumbing Contractor's Name: ~ Business Name:
Address ~ ~E 39 (Q ~~ ~ l ~~ ~ Ciry ~ • {~. State ~ Zip g 3 `~ ° f
Contact Phone: ( ) ~$ ~- ~ 3 g ~ Business Phone: ( )
Email ~/YtC~,'{~Px p~ww-.~un,o (~ h6lt~wtow~.Cbw~~ Fax
FIXTURE COUNT (includingrou~hed fixtures
Clothes Washing Machine
Dishwasher
Floor Drain
Garbage Disposal
Hot Tub/Spa
Sinks (Lavatories, kitchens, bar, mop)
Plumbing Estimate $
(Commercial Only)
Sprinklers
Tub/Showers
Toilet/Urinal
_~ Water Heater
Water Softener
Signature of Licensed Contractor License Number& Expira ~on Date Date
The City of Bexburg's permit fee schedule 1s the came as required by the State of Idaho
4