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Home My WebLink AboutAPPLICATION - 06-00502 - 1154 McJon Ln - New SFR Mechanical• • CITY OF REXBURG 0600502 MECHANICAL PERMIT APPLICATION Plea 1154 McJon Lane -Cnty Mech nI 19 E MAIN, REXBURG, ID. 83440 If the ble 208 - 359 -3020 X326 PARCEL NUMBER: (�S ()DCMa (� ( We will provide this for you) SUBDIVISION: UNIT# BLOCK# LOT# (Addressing is based on the information - must be accurate) CONTACT PHONE # PROPERTY ADDRESS: I I S IMC J LAAJE PHONE #: Home ( ) 5 ( -- 7 y go Work /n ( ) OWNER MAILIN� DRESS: J 10 AkZ Pe_/Zx CITY EMAIL FAX Cell ( J( STATE:'j;0ZIP: It 6 APPLICANT (If other than owner) Q .+P- r -) 11: Vi =A-'_) (Applicant if other than owner, a statement authorizing applicant to act as agent for owner must accompany this application.) APPLICANT INFORMATION: ADDRESS I �e 2 P e /Ce CITY: ir STATE; 4-D ZIP a3gL10 EMAIL FAX PHONE #: Home ( ) 5 (.`7 3 Work ( ) Cell( CONTRACTOR Aj MAILING ADDRESS: 10 0 J E CITY PHONE: Home# EMAIL Work# FAX Cell# How many buildil�l are located on this property? Did you recently purchase this property T��o a Yes (If yes give owner's name) Is this a lot split` YES (Please bring copy of new legal description of property) PROPOSED USE: : F (i.e., Single Family Residence, Multi Family, Apartments, Remodel, Garage, Commercial, Addition, Etc.) APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: under penalt 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 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 in cases of any false statement or misrepresentation of fact in the application or on the plarls 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 STATE ZIP Building Safety Department City of Rexburg 19 E Main Rexburg, ID 83440 NAME gKj&jb n T PROPERTY ADDRESS SUBDIVISION Permit# D(V Required!!! Mechanical Contractor's Name: Address Cell Phone: ( ) Fax: ( ) Mechanical Estimate S janellh@rexburg.org Phone: 208.359.3020 x326 www.rexburg.org Fax: 208.359.3024 OF ,0X8UJ� C ' a r 0 a CITY O F REXBURG _ . _ OW _, Americas Family Community MECHANICAL �J�L �[.i,►�c(f�iK,1b �i same: AJep4; 1ze� City _ State State Zip Business Phone: ( ) c 3,5_6 j7 70 Email (Commercial/Multi Family Only) FIXTURES & APPLIANCES COUNT (Single Family Dwelling Only) Furnace P Exhaust or Vent Ducts o� Furnace /Air Conditioner Combo c� 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 Fuel Gas Pipe Outlets including stubbed in or future outlets 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 License number Date 10/10/2006 15:52 FAX Oct. 10. 1006 3:3 e e Building Safety Department City of Rexburg 19 E Main jonellhOreycburg.org Phone: 206.359.3020 x326 Rexburg. 0 83440 www,rVxburg.orq Fax: 208.359.3024 NAME PROP,ERTX Al SUBDIVISION 001 No. A/U r. 4o �a1%ay.P Q � a CITY O P REX �' ,.• Amcriwk Pami)l Community Required!!! MECHANICAL Fertnit# E)(_0 Gua) Mechanical Contractor's Name: PLy,,,,Kj Aad> -ASS P, o. s 7 q c ity x G d, 5 J stave Zipj934 f 0 Cell Phone: ( ) Busincss Phone: ( ) _ 9 _ ? 76 Fax: ( ) Email Mechanical Estimate $ (CommerciaUMaltf Fa m0y Only) FIXTURES & APPLL NCES COUNT (Single Family Dwelling Only) Furnace Exhaust or Vent Ducts o� Furnace/Air Conditioner Combo G Dryer Vents Heat Pump Range flood Vents Air Conditioner Evaporative Cooler Unit Heater Space Neater Decorative gas -fired appliance Incinerator System Boiler other similar vents & ducts: Pool Heater r Fuel Gas Pipe Outlets including stubbed in or future outlets Heat (Circle all that apply) Gas Oil Coal Fireplace Electric Hydronic Mechanical Sizing Caicu tion must be submitted with Plan i ,Application Point 2f ww Delivery must be shaven on mans. www ww � � � yd-r - e - qIC/ -cr 9' Sigoatm of Weased Contractor Mcaaae number Date Cook Stove Vents Bath Fart. Vents The City of Rzebz g's permit fee schedule is tyre sate as required by the State of ldaha