HomeMy WebLinkAboutAPPLICATION - 07-00351 - 3968 Taylor Ln - New SFR MechanicalCITY OF REXBURG 0700351
MECHANICAL PERMIT APPLICATION Please 3968 Taylor
19 E MAIN, REXBURG, ID. 83440 If the ql y Ln -Cnty Meeh
208 - 359 -3020 X326
PARCEL NUMBER: Q� (� ( We will provide this for you)
SUBDIVISION: UNIT# BLOCK# LOT#
(Addressing is based on the information - must be accurate)
t
.e
OWNER: CONTACT PHONE #
PROPERTY ADDRESS: taylor In.
PHONE #: Home ( )_313 -4755
OWNER MAILING ADDRESS:
EMAIL
FAX
Cell ( )
STATE: ZIP:
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 P.O. Box 627
CITY:Rigby
STATE; Idaho ZIP 83442 EMAILhighcountr�htgga netscape.com FAX 2087450817
PHONE #: Home (208 )709 -4650
Work ( )
Work( )_same_ Cell( )_same
CONTRACTOR: _
MAILING ADDRESS:
PHONE: Home#
INUTEMA
Work#
FAX
CITY:
STATE ZIP
How many buildings are located on this property ?1
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:
CITY
(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 ft provisions of the 2003 International Code in cases of any false statement or misrepresentation of fact in
the application or on the plans on which t rt or pproval based. Permit void if not started within 180 days. Permit void if work stops for 180 days.
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
Cell#
EXB�
Building Safety Department
City of Rexburg = s
19 E Main janellh@rexburg.org
Rexburg, ID 83440 www.rexburg.org
NAME Jaeger Construction
PROPERTY ADDRESS _3968taylor In.
SUBDIVISION
�� Required!!!
Phone: 208.359.3020 x326
Fax: 208.359.3024
CITY OF
REXBURG
OW
America's Family Community
Permit#
MECHANICAL
Mechanical Contractor's Name: Steve Dick
Address P.O. Box 627
Cell Phone: (208 ) 709 -4650
Fax: ( 208 ) 745 -0817
Mechanical Estimate $ (Commercial/Multi Family Only)
FIXTURES & APPLIANCES COUNT (Single Family Dwelling Only)
Furnace i Exhaust or Vent Ducts
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:
,. Fuel Gas Pipe Outlets including stubbed in or future outlets
Heat (Circle all that apply) Gas Oil Coal Fireplace Electric Hydronic
Mechanical Sizing Calculations must be su bmitted with Plans & Application
Point of Delivery must be shown on plans.
Steve Dick > 6068 _7 -31 -07
Signature of Licensed Contractor License number Date
City Rigby
Business Name: High Country Heating
State Idaho Zip 83440_
Business Phone: ( 208 ) 745 -8056
_Email highcountryhtg@netscape.com
t Dryer Vents
Range Hood Vents
Cook Stove Vents
Bath Fan Vents
The City of Rexburg's permit fee schedule is the same as required by the St of Ida ho