HomeMy WebLinkAboutAPPLICATION - 07-00328 - 64 N 4th E - MechanicalJUL -24 -2007 TUE 10:55 AM FIRST CALL JEWEL
Jul.l�, 100� 1:lli'M •
CITY OF REn URG
BUILDING PRZMIT APPLICATION Please
19 E MAIN, REXBUR0, ID. 83440 If the qu
208 -359 -3020 X322
FAX N0. 12085292793 P. 03
• IYO, UyL� �
PERMIT #
0700328
PARCEL NUMBER .�` ( 64 N 4th E -Air Conditioner
SUBDIVISION• U;
(Addressing is based on the information - must be accurate)
CONTACT PHONE #
PROPERTY AT)DRiSS: Y !j = ' -
PHONE #: Homc I Work( ) CCU( )
OWNER MAILING ADDRESS: CITY: STAn- aZIP:Z3_�4V0
EMAIL FAX
(If other than owner) I it c �°/l
(Applicant if outer than owner, a statelnattt mEhori2ing applicant to act as agent for owner must accompmy this application,) l
APPLICANT INFORMATION: ADDRESS CITY:
STATE; ZIP EMAILL FAX
PHONE #: Home ( ) Work - 77L Cell ( )
CONTlUCTOR
MAILING ADDRESS. CI STATE ZIP
PHONE: Home#
EMAIL FAX
How many buildings are located on tltis prop
Did you recently purchase this property? No Yes (If yes givo owner's name)
Is this a lot split? NO YES (Please bring copy of new legal description of property)
PROPOSED USE:
0.e., Slagle Faxt4 Residowe, Multi Family, Ap®t=ts, Remodel, Cierage, Qxrmercdal, Addidon, Btc.)
APPLICANT'S SIMVATURE, CERTIFICATION AND AL 7 HORIZATION: under p<n by olpepary, l ba&br ced* tbu I
have read this apphatioa and sdms tbu t w infiotm uca botoin is groat nd I swwr that any itufot WQA which mw/ hwaonr ba; v a by me in heatinip blare the
Plemft ad ,Zczbw Coizaab ion or the City Cotmcil ,fixr the City of Retch q shill be tnAN and comet. 14gtaa to comply wttb aU City ragnlatitun add Blau Isms
tt;W ft to dw s*#%manor of Qua applioation end hsatby aathorit" rspt Wen ivea of the City to enmr upon me Above -maw mad plopm for bmatlome Dai'DoM.
NOTF- The buiidhol adticiai may revolt; a permit of approval Wood under the p avisimm of ft 2000 Immadanal Coda in cases of avy Use smammt or
miumpransmion affect In rA axwostiott w oa plms oa wbloh do permit or appmvd was based. Permit void if not stwted within 190 days. Pa nit void if -m*
stop; far 180 days.
L k - %- el 1
Sigpatare of /Applicant DATE
Do you prefer to be contacted by fax, email or phone? Circle One
WA,IRMG ULTUbING P&Rll W MUST BR POSTED ON CONSTRUCTION 91TRI
Plan Ass are nowra lkadtable and as Paid in !IW at thttllna Of 60*808 MOSSAI 1 + - 2M-
Chy pd RsbosS's Azeeptanca of do plan awiew in dnaa not um phut approval
3
JUL -24 -2007 TUE 10:55 AM FIRST CALL JEWEL FAX N0. 12085292793
.l les•3e - Complete the Jtnire Application! uma 9 vcstion dow not apply fill iu NA for non
applicable
P. 02
NAME
PROPERTY ADDRESS Pmt#
SUBDIVISION
RequiredUl MECHAMC44L
Mechanical Contractor's Name: mess Name•
Address City State Zip
Contact Ph= ( ) Business Phone: ( )
Email Fax
Mechanical F4thnate S (Commercial Malb Family Only)
FI GVMS & APPLIANCES CDUNT (Slagle Finn& DuWfing Only)
Furnace Exhaust or Vent Ducts
Furnace /Air Conditioner Combo
Heat Pump
Air Conditioner
Evaporative Cooler
Unit Heater
Space Heater
Dcccrativc gas -fund appliance
Incinerator System
Boiler
Pool Heater
Similar fvstures or Appliances
Dryer Vents
Rangc Hood Vents
Cook Stove Venn
Bath Fan Vents
other similar vents & ducts:
Fuel Gag Pipe Outlets including stubbed in or future outlets
Inlet Preset a (Mater Supply) PSI
Heat (Circle all that apply) Gas Oil Coal Fireplace ctrl
Mechanical Slaing Calculations mumt be submitted with Plans & Application
Point of Delivery must be shown on plam
AA
o
pate
The Cby gfAftkaog's p~ fen sehowe is the setae ca rgw"d by she, of zha