HomeMy WebLinkAboutAPPLICATION, BP - 06-00467 - Tanner Airplane Hanger - MechanicalZ
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CITY OF REXBURG
MECHANICAL PERMIT APPLICATION Please 06 00467
19 E MAIN, REXBURG, ID. 83440 If the que Tanner Airplane Hanger-Mechanical
208-359-3020 X326
PARCEL NUMBER: ~~~(~~~~~D ~ ( __ r__ . ___ ____., _,,. ,.,~,
SUBDIVISION: UNIT# BLOCK# LOT#_~
(Addressing is based on the information -must be accurate)
CONTACT PHONE #
PROPERTY
PHONE #: Home ( ) Work ( ) Cell ( ) ,~~ - bw~ ~
OWNER MAILING ADDRESS: ~ CITY: STATE:~ZIP:~ 5/fr'r~
EMAIL FAX
APPLICANT: (If other than owner) ~ ~" ~ 1~f71~~"~ ~"/$~ ~ ~Z ~
(Applicant if other than owner, a statement authorizing applicant to act as agent r owner must accompany this application.)
APPLICANT INFORMATION: ADDRESS~~~~~ ~ ~f Z~' ~ CITY:
STATE; ZIP__s~(,EMAIL FAX
PHONE #: Home ( ) ~' ' ~'' Work ( ) Cell ( ) J~/^~-~ ~%~~
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 cottect 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 cottect. 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 ay re e a permit on app, al ~ sued under the provisions of the 2003 International Code in cases of any false statement or misrepresentation of fact in
the application o on a plans on which or approval was based. Permit void if not started within 180 days. Permit void if work stops for 180 days.
Si ature f O r/A licant >sA l
P~ Pp
Do you prefer to be contacted 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
Building Safety Department
City of Rexburg
19 E Main janellhC~?rexburg.org Phone: 208.359.3020 x326
Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3024
OF RtiX B UDC
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NAME
PROPERTY ADDRESS
SUBDIVISION
Permit#
Required!!!
MECHANICAL
Mechanical Contractor's Name: ~/~J~Z?~i~' Business Name:
Address City State,
Cell Phone: ( )
Fax: ( )
Business Phone: ( )
Email
T rC'~IjTTY O'~"F
1 Wl 1L V 1\V
... ......,.. ~b+........_.__ _._.__.
America's Family Community
Zip
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 ~,~~ ~~f
Decorative gas-fired appliance
Incinerator System
Boiler
Pool Heater
Dryer Vents
Range Hood Vents
Cook Stove Vents
Bath Fan Vents
other similar vents & ducts:
Fuel Gas Pipe Outlets including stubbed in or future outlets
Heat (Circle all that apply) Gas Oil Coal Fireplace Electric Hydronic
Mechanical Sizing Calculations must be submitted with Plans & Application
Point of Delivery must be shown on plans.
j//` -/
Si ature of License Contractor License number Date
The Ciry of Rexburg's permit fee schedule is the same as required by the State ofldaho