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Home My WebLink AboutAPPLICATION - 07-00229 - 1307 S 4000 W - New SFR MechanicalCITY OF REXBURG • MECHANICAL PERMIT APPLICATION 19 E MAIN, REXBURG, ID. 83440 208 - 359 -3020 X326 PARCEL NUMBER: SUBDIVISION: Work# (Addressing is based on the information - must be accurate) rsLUC &4 LOT# OWNER: CONTACT PHONE # PROPERTY ADDRESS: / 3U� O �/Oon 0 PHONE #: Home ( ) Work ( ) Cell ( ) OWNER MAILING ADDRESS: CITY: STATE: ZIP: EMAIL FAX APPLICANT (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 PHONE #: Home ( ) Please If the que EMAIL Work ( CONTRACTOR MAILING ADDRESS: CITY STATE ZIP PHONE: Home# EMAIL _( UN� tt FAX Cell ( Cell# 0700229 1307 S 4000 W -Neff FAX 3S7- (Y2� { How many buildings are located on this property? f Did you recently purchase this property No Yes (If yes give owner's name) Is this a lot split NOS 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 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 r lication and hereby authorized representatives of the City to enter upon the above - mentioned property for inspections purposes. NOTE: The building offici oke 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 applicatio or plans on w4i f the permit or approXpl w ^ased. Permit void if not started within 180 days. Permit void if work stops for 180 days. `J / / �R PERMIT # 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 0 7 11:42a COMFORT ZONE HEATING AND 208 -5 P.1 n,u Jr. IV. (VVI IL.J /1 IYI No. 4230 P. 2 Building Safety Department ��'�"°�'ec.,o CITY OF CNy of Rexburg j .� REXBURG F9 F Main JoneN , @MX urg w9 Phone: 20&359.3= xM Rexburg, to &VQ Www omburg ot9 Fwc 208.359.3024 �..a Anwrim's Fnmi* rommrwiry NAME PROPERTY ADDRESS O p 00 W S� Pemut SUBDIVISION 4 Required H MECHANICAL Mechanical Contractor's Name: O 1��n Business Name: i Address L 5 v� � N 2AA1h?E1Z Ci J G' , ►� Cd ! top r �I1< 1p, s , Cell Phone: (;2S&) , ;.go - 2 0 7 / Business Phone:: (W c4 �p Fax: (*@ Emarl f n4�o!`C 2�r�� (J 777x. /24UL - AM Meebanieal Estimate S it), 1l�� (CommerciabMulti FsmBy Only FIXTURES 4 APPLIANCES COUNT (Srtrgk pwnMy Dwelling Only) Purnace 9- lbchaust or Vent Ducts ,J� Fu nacelAir Conditioner Combo Dryer Vents Heat Pump Range Hood Vents Air Conditioner Cook Stove Vents EvVorative Cooler a, Bath Fan Vents Unit Heater other similar vents & ducts: Space Heater Decorative gas -feed appliance Incinerator System Boiler Pool Heater _ Fuel Gas Pipe Outlets including stubbed in or future outlets Heat (Circle all that apply<ii2il Coal Fireplace Electric Hydronic Mechanical SizWs: Calculations must be submitted with Plans & AppL_ n .,._. _. Point of Delivery mast be shown on plans. kin _ Liceme n mbff Date The Gory of Rerhw9's pem,& fee s&edWe it the sane w r egwed by the State vfldaho Building Safety Department City of Rexburg 'o 19 E Main janellh @rexburg.org Phone: 208.359.3020 x326 Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3024 CITY O F MX America's Family Community NAME _ PROPERTY ADDRESS C) � Permit# SUBDIVISION Required!!! Mechanical Contractor's Name: Address Cell Phone: ( ) Fax: ( ) MECHANICAL Business Name: City State Business Phone: ( ) Email Zip Mechanical Estimate $ (Commercial/Multi Family Only) FIXTURES & APPLL4NCES COUNT (Single Family Dwelling Only) Furnace <;LExhaust or Vent Ducts Furnace /Air Conditioner Combo Dryer Vents Heat Pump Range Hood Vents Air Conditioner Cook Stove Vents Evaporative Cooler J> _ Bath Fan Vents Unit Heater other similar vents & ducts: Space Heater I Decorative gas -fired appliance Incinerator System Boiler Pool Heater 4 — Fuel Gas Pipe Outlets including stubbed in or future outlets Heat (Circle all that apply Gas it 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 The License number 's permit fee schedule is the same as Date the State of Idaho