HomeMy WebLinkAboutAPPLICATIONS - 06-00591 - 2511 W 4700 S - MechanicalDEC -01 -2006 FRI 03;_31 PM FIRST CALL JEWEL
Jul , 15 ...200
2: Z i. -N.
CITY OF RM UR G
FAX N0. 120 5292793 P. 02
ivv. v7f4 1. L
BUILDING PERMIT APPLICATION Please c 0600591
19 E MALN, REXBURG, ID. 83440 If the quest
208- 359 -3020 X322 2511 W 4700 S —C CIt y M eeh
PARCEL NUNMER:
SUBDIVISION: llNIT# BLOCK# LOT#
(Addressing is based on the information - mist b accurate)
CONTACT PHONE #.
PROPERTY ADDRESS:,
PHONE #: I-Iomc ( ) Work ( ) _ . _ Cell ( )
OWNM MAILING ADDRESS: S, CITY: STATE: ,ZIP:_& �
E:NfAIL FAX
AP.P : (If other than owner) p licatim)
(.4pplir.= if other than ovner, a sratetttottr authorizing applicant to act as adeat for owner mast accom any this app
APPLICANT INFORMATION: ADDRESS CITY:
STATE; ZIP EMAIL FAX
PHONE #: Home ( ) Work ( ) Cell ( )
CQNT1tACT0j &r- STATE -
MAILING ADDRESS;
�ZIP
PHONE: Home# Work#� �'77? Ce11�"
many buildings are located on this property?
Did you recently purchase this property? No Yes (If yea give owner's name)
Is this a lot split? NO yES (Please bring copy of new legal description of property)
PROPOSED USE:
0.e., shmoe Fatally Rmidotsse, Multi Family, Apan meats, Remodel, Grange, Commercial, Additloa, Etc.)
Co
APPLICAII TT'S SIC= NATURE, CERTIFICAT10 - 44 AND AL H04 TION_ u iWv, i ' �'t t
have grad this emu== and state that the Wformadoo bunio is 00=9 and I swvu Shat our iuforsuArtion whialt WAAy 11A�cV..w bit v6A by me is be ilia
Plaauiag raid Zom&W Commir�iou or ttte City nseil for the City of )t=baro shall be o4Bhfid and cw =L I a= m C=Ply with aA City rs man Smote laws
rWaft w ft subjoot nedtes• of this oppiicatioa and hereby awborisad sepresmrative9 of Ire Chy to enwr upon tale above�mtoacloncd DtoD y for beepecdo� WtP°aC
NOT& The building afPimW may Mvolte a permit an approval issued uuda the pluryW OM C2000 sed b=zii void in= = with = i as s udc0=1 or it old iiwoxl:
micrepresanrarioa of tact iA the appUOtUdoa era' 00 the ylaas on whleh the ptutti t or sQpf
stops for 180 days.
Siguamre of Owner /App19CM DATE
Do you prefer to be contacted by fax. email or phone? Circle One
WA MG — nmDING PEItMi T 11iMTER POSTM ON CONSnWC=N 5=1
Plan bw era B012- rWhu"blo and WO Psid 10 ftffl St ths 6=4 Ot APPfiCadon DO&WOQ A MUM I • -'
City o[R.rr hwj Accapl m of ttsr plea rariow Aw 4l ant coasttlssta plea approrsrl
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DEC -01 -2006 FRI 09:37 AM FI T CALL JEWEL
.Please complete tentire Ap
$PPhcable ��
r NAME
PROPERTY ADDRESS
SUBDIVISION
.Required!!!
FAX N0. 1 085292793 P. 05
If the ���
9a� es not apply fill In NA for non
Permit#
MECHANICAL
Mechanical Contractor's Name: � Business Name: . -
Address Ci S
Contact phone: ( ) Business Phone:
Email --~-
Fax
Mechanical Estimate S . (CommertdaUMWd Family Only)
FIXTURES & APFU4NCES COUNT (Singk Family Dwelling only)
Furnace — Exhaust or Vent Ducts
—� Furnacc/Air Conditioner Combo
Heat Pwnp
Air Conditioner
Bvaparadve Cooler
Unit Heater
Space Heater
Decorative gss -fired appliance
JnCinemtor System
Boiler
Pool Hcatcr
Dryer Vents
Range Hood Vents
Cook Stove Vents
_ Bath Fan Vents
other similar vents $ ducts:
. Similar fixtures or Appliances
Fuel Gas Pipe Outlets including stubbed in or future outlets
Inlet Pressure (Meter supply) PSr
Heat (Cinele all that apply) <� Oil Coal Fireplace Electric
Mechanical Sizing Calculations must be submitted with Plans dt Application
Point of Delivery must be shown on plane.
sispo ofLicamed Comractor f
I
Required! .icans0 Wombat
The Cry
saki We is the same ar
Date ✓ Q
the State o Idaho
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