HomeMy WebLinkAboutAPPLICATIONS - 07-00344 - 3231 Paradise Ave - New SFR MechanicalP .
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CNTY OF REXBURG PFR MIT #
MECHANICAL PERMIT APPLICATION Please co
19 E MAIN, REXBURG, ID. 83440 If the questi 0700344
208 - 359 -3020 X326 3231 Paradise Ave -Park
PARCEL NUMBER: e-�- L ( W1
SUBDIVISION: UNIT#
(Addressing is based on the information - must be accurate)
OWNER: CONTACT PHONE #
PROPERTY ADDRESS: T oc t' A A
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 as agent for owner must 1&pany this application.)
APPLICANT INFORMATION: ADDRESS CITY:
STATE; ZIP EMAIL FAX
PHONE #: Home ( ) Work ( ) Cell ( )
CONTRACTOR
MAILING ADDRESS:
PHONE: Home#
EMAIL
Work#
FAX
CITY
Cell#
How many buildings are located on this property?
2 2007
Did you recently purchase this property? No Yes (If yes give owner's name)
Is this a lot split? NO 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 perjur 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 this application and hereby authorized representatives of the City to enter upon the above - mentioned property for inspections purposes. NOTE: The
building official may revoke 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 application or on the plans on the permit or approval was based. Permit void if not started within 180 days. Permit void if work stops for 180 days. .
/ " '/
Signature of Owner/ plicant 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
Please complete the entire Application!
NAME
PROPERTY ADDRESS
SUBDIVISION
Permit#
RequlredN MECHANICAL
A- �-
Mechanical Contractor's Name Business Name _
Address( City State
Cell Phone ( ) Business Phone (
Fax (
Mechanical Estimate $ (Commercial /Multi Family Only)
FIXTURES & APPLIANCES COUNT (Single Family Dwelling Only)
Furnace
Furnace /Air Conditioner Combo
�_ Heat Pump
Air Conditioner
Evaporative Cooler
Unit Heater
Space Heater
Decorative gas -fired appliance
Incinerator System
Boiler
Pool Heater
other similar vents & ducts:
L
Fuel Gas Pipe Outlets including stubbed in or future outlets
Inlet Pressure (Meter Supply) PSI
Heat (Circle all that apply) G' Oil Coal Fireplace Electric ydronic
0
D) E
� ll auc - 2 200 LO
��n- �REXSURG
Mechanical Sizing Calculations must be submitted with Plans & Application
Point of Delivery must be shown on plans.
ILi (C
Signature of Licensed Contractor License number
The
Exhaust or Vent Ducts
Dryer Vents
Range Hood Vents
Cook Stove Vents
�` Bath Fan Vents
schedule is the same as
t
the State of Idaho