HomeMy WebLinkAboutAPPLICATION - 06-00588 - 3127 S 2810 W - MechanicalNOV ,29.2006 3:54AM REXBURG MOTOR SPORTS
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CITY OF REXEURG
MECHANICAL PERMIT AIPPLICATION Please i
19 E MAIN, PFMTJRG, ID. 83440 If the ques
208 - 359 - 3020 X326
PARCEL rT[7M$ER: `� �� (V - --
SUBDIVISION: UNIT# FLOCK #_ LOT #,__
(Addressing is based on the information - must bo accurate)
0�1VER• IZo¢�g, -� ��FAr,, CONTACT PHONE 4
PROPERTY ADDRESS: Z7 y�
PHONE #: Rome .(ZsAP) 7 / d " /Cdr Work Of Cell —
OWNER MAILING ADDRESS: 31, Z M I L CITY: ?_ c: STATE
AR PL : (If other than owner)
(Applicant if other than owner, a statement authorizing applicant to act as agent for owner must accompany this application.)
APPLICANT INFORMATION: ADDRESS_
CITY:
STATE; ZIP EMAIL FAX
PHONE #: Home ( ) Work ( ) Cell ( )
COAMCTQR if-
MAILING ADDRESS: CITY STATE ZIP _
PHONE: Hom0 I Work# Coll #,
EMAIL FAX
mmy buildings are located on this property? �
Did you recently purchase this property`! No Yes (If yes give owner's name)
Is this s lot split? NO YES (Please bring copy of new legal description of property)
PROPOSED USE: e-
(i,e,, Slttglo Family Residence, Multi Family,
NO. 5180 P. 2
0600588
3127 S 2810 W -Cnty Mech
Remodel, Garage, Commercial, Addition, MO.)
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: u nder penalty of p0m l hereby eon* that I h ave
read this application and stare that the inibrinodon herein is correct and I swear that aoy infbrmalon which may hemalhrr be given by me in hearings before the Planning
and Zoning Commission or the City Council Air the City of &%hurg shat] be truthful and correct. I agtoe to comply with all City regulations and state laws relatiog to the
subject matter of this application and hormby aotboriked representadves of the City to enter upon the abovrmentioned property hr inspections purposes. NOTE. Tho
budding official may r y c It 00 approval Issued under the provisions of the 2003 bacraseon ses al Code in ca of any £else statement or misrepresentation of taut in
the application or o ®on wbtcf.�f� prove! was based. l�ennir void if not w ft within 1B0 days, Permit void if work stops 1 80 days,
It / z'7 l - OK --
o1- pplicant DATE
p r to be contacted by fax, email or phone? Circle One
WARNINO -- BUILDING PERMIT MUST BE POSTED ON CONSTRUCTION SITEI
Plan fees are non- refundable and are paid in full at the time of application beginning boon + 2. 2M
City of Ruburg's Acceptance of the plan review see does not constitute plan approval
NOV 29, 2006 3:55AM,
IIUv. 4 M 'T.,U,M
REXBURG MOTOR SPORTS
0
Building Safety Department
City of Rexburg
19 E Main janenhQmxburg.org Phono: 208.359.3020 x326
Rexburg 10 8344 WWW.texbU(g.orp Fax 208.339,3024
NO. 518p P. 3
o�esxe Red c! r Y o f
REX II3URG
'', ,, � � y , .+ A►�rerim'g J=aJ�tiiy Cammr�(ry
NAME �- , •t..
PROPERTY ADDRESS 3(? S Ze U✓ Permit#
SUBDIVISION �l I ✓; g y
Requiredlll MECHANICAL
Mechanical Contractor's Name; Oct �L46, y g' Business Name: 4,y_
Address 3/1 7.5 Z�`� l-✓ City L _State ► Zip _0YAV
Cell Phone: (4X) Eusincss Phone: (Wi') %L—ZS: /6
Fax: (74r) .3� _ Email &6i'r— �3 w�o� ya � • c: ✓^�
Mechanical Esblmate $,, (Commercial/Multi Family Only)
FDaURES & APPLXANCES COUNT (Single Family lhvcll ng Only)
Furnace -- Exhaust or Vent Duots
Furnace/Air Conditioner Combo
Heat Pump
Air Conditioner
Evaporative Cooler
Unit Heater
Space Heater
Decorative gas -fired appliance
Incincrator System
Boiler
Pool Heater
,Dryelr Vents
Range Hood Vents
Cook Stove Vents
—�— Bath Fan Vents
other similar vents & ducts:
7i Fuel Gas Pipe Outl cluding stubbed in or future outlets
Heat (Circle all that apply G Oil Coal Fireplace Electric Hydronic
Mechanical Sizing Calculations must a submitted with Plans & Annlication
P int ofDelivet;y_must be shown q Wiens
�PoLfcenmad Contractor License number Date
The City of Rezburg's p ermit fee scheduh? is the same as required by the State ofldaho
NOV, 29. 2006 3:54AM REXBURG MOTOR SPORTS N0. 518 P. 1
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Cl 1'LGASI� COMMENT
El PLI :ASE IRFpl_Y
0 PLEASE- RECYCLE-
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plioiie 200,35614000 • 1ex 208 .350.3060 . 1179 Unlvorslty ajI cj.. Rexbur0, ldal�o 03q.
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