HomeMy WebLinkAboutAPPLICATOIN - 07-00249 - 3951 S 3300 W - MechanicalJUN -06 -2007 WED 11:29 AM F CALL JEWEL
Jun, 6. 2007 10:56AM
CITY OF REXBURG
hfflC1L4 NICAL PERMIT APPLICATION P14
19 E MAIN, IzMmuRG, a 83440 N tI
209- 359 - 3020 X326
FAX N0. 12( 85292793 P. 01
16 No. 4323 P. 1
0700249
3951 S 3300 W -Air Conditioner
I:
PARCEL NUMBER - bP� S,2, �C) ( we will provide this for yon)
SUBDIVISION: UNIT# BLOCK# LOW
(Addreasing is based on the information - must be a=nte)
CONTACT PHONE #
PROPERTY ADDRESS: ,
PHONE #: Ho= ( ) Work ( ) Ceti ( )
OWNER MAII,IAi4 ADDRESS: CITY: STATErA ZIP-11c 0
EMAIL j FAX
ipzl : (If other than owner)
(Applicant if other thdn owner. a smut applicant to act as agent for owner MjW accompany this applicadon.)
APPLICANT INFORMATION: ADDRESS G o2 eO CITY: S
STATE, � 1� ZIP ,C3� – EMAIL. FAX
PHONE #: Home ( ) Work ( ) Cell( )
COI =CZ0R
NAILING ADDRESS: �`� CITY STATE
PHONE: Home# wOfk# _7777 Cell#
EMA L
How manv buildinss are located on this mnnwto
Did you recently purebase this proparty? No Yes (If yes give owner's n=o)
Is this a lot split? NO YES (Please bring copy of new legal deact'iption of property)
PROPOSED USE:
(Le., shwa Family Residence, Muhl Fancily, Apart erA Remold, Chnge. Cu®merdal, Addidan, Etc.)
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under pmolty of perjury, I beeby no* dwj bave
ned tma vpIcaft od arm thaw me fo4ar AHM bads is MUM and 1 dwear tlet aey atf enatien w hich mq huesaer be pivaa by = in binfiv befine dw Piow tg
aaf zamdas CaatmisrlOn au du Cidv Cb®cll far 1be dry oPRoxbtug elmu b. ttwhiw sad t agm. m coaaply wish aU t�►tro®uaticoe and stele ►aWn teleriag m the
OuWtmw of dds 4WpHndon and busby s aWmd mp acstodm oft a 011YW office IMM tat obwe-namtlowd jpngmW 1br lam p uposw NOTE: Tat
buil4int abaW maw revolve a pe M oe eppro.et isaaat tttrdor Ibe pttTris = of*o 2003 Iotatnatiaael Code in trots of xW fades sttttaamatlt ter tawop tualatiea of lion! in
00 appUeadm Of m dw plmu oar Mich the pennk or approval ass buses. Pmait void if mr sumd wirbin 180 day& Patin it void if work scope Q 180 40%
/ 1� / 0 :2
Signs of Own=/A DATE
Do you prefer to be cued by fact, elm W or phone? Ci> etc One
WARNING — BUILDING PERbW MUST BIt POSTED ON CONSTRUCTION Sd'I`EI
Phu fora are am fumble and are paid is fEN at the ON* otappii adve beginning =
City of Raburles Aaxep as of fte plea review fee dm net conul to phin approval
JUN -06 -2007 WED 11:30 AM.FIJ& CALL JEWEL FAX N0, 12085292793 P. 02
Jun, 6. 2007 10:56AM W 0 No. 4323 P. 2
Buliding Safety Department
Cly of Rexburg
19 E Main junoAhOmburg org Phone. 208.359.3020 x326
Rewbwg.ID83"o www.mxburg.org F= 208.339.3024
CITY OF
RMURG
c�v
AmM*6 Romig CMmwdly
NAM
PROPERTY ADDRESS
SUBDIVISION
Permit#
Requiredlll
MECHANICAL
Mechan[W Commaatoes Name: Business Name: J_Z� 1:�"& La,
Address .r 2 mo City State f, 7 ip `
Cell Phone: ( ) Business Phone: (�O q . 7 1
Fax: Q, p�) _.. � 9 Email
Mechsinieai Eetlmate $ (Commereial/Multi FaaWy Ouly)
FIXTURES & APPLIANCES COUNT (Nngk FawAy DweHing Only)
Furaeee Exhaust or Vent Ducts
F umnace/Air CozAtioncr Combo
Heat Pump
Air Conditioner
Evaporative Cooler
Unit Heater
Dryer vents
Range Hood vents
Cook stove vats
Bath Fan Vents
Space Heater
Decorative gas -fired appliance
Ineint� System
Boiler
Pool Heater
other similar vents & dents:
Fuel Gas Pipe Outlets Muding stubbed in or 1bture outlets
Heat (Circle all that. apply) Oas Oil Coal F'ireplace/*e_0'W0'�ffydrm*
MechanieW Sizing Caleulations mint be submitted with Plnns & Application
Point of Dd h fy m1181bg_shown on Glans,
is the some aye
the Sydte of 1darho