HomeMy WebLinkAboutAPPLICATION - 07-00345 - City of Rexburg Annex Bldg - MechanicalBuilding Safety Department
City of Rexburg
19 E Main janellh@rexburg.org Phone: 208.359.3020 x326
Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3024
NAME CUB XY1�tiY
PROPERTY A RESS
SUBDIVISION
Required!!!
04 gexepR�
CITY OF
RE XBURG
'•, America's Family Community
0700345
City Annex Blg
Furnace Replacement
MECHAA1 t zil.
Mechanical Contractor's Name: jr c� , ICAUCr C Business Name: TYaw ka..er Cjee1r (
Address ) t s 5 �, 1= 1-- 1 City !S flat State Zip
Cell Phone: (a" ) 3 r - g i Business Phone: (z o r
Fax: ( )
Email
Mechanical Estimate $ (CommerciaVMulti Family Only)
FIXTURES & APPLIANCES COUNT (Single Family Dwelling Only)
Furnace Exhaust or Vent Ducts
Furnace /Air Conditioner Combo Dryer Vents
Heat Pump
Air Conditioner
Evaporative Cooler
Unit Heater
Space Heater
Decorative gas -fired appliance
Incinerator System
Boiler
Pool Heater
Fuel Gas Pipe Outlets including stubbed in or future outlets
Range Hood Vents
Cook Stove Vents
Bath Fan Vents
other similar vents & ducts:
Heat (Circle all that apply) Gas Oil Coal Fireplace Electric Hydronic
Mechanical Sizing Calculations must be submitted with Plans & Application
Point of Delivery must be shown on plans.
Signature of Li ed Contractor
f
License number
0/ -,
Date
The City of Rexburg's permit fee schedule is the same as required by the State of Idaho