HomeMy WebLinkAboutAPPLICATION - 07-00355 - 3979 Spring Creek Dr - Gas LineAug, 7. 2007 9 :40AM ALPHA MECHANICAL No•3957 P. 1
Aug. 6. 2007 1; 59PM • • No. 4634 P. I
CITY OF UXBURG 0700355
1 ME CHANIC AL In I8 Plea 3979 spring Creek Dr- Merrill
208 -359 -3020 X326
PARCEL NUMBER: � (We will provide this for you)
SUBDIVISION; UNIT# $LOCK# LOT#
(Addressing is based on thle information - must be accurate)
" .zn CONTACT PHONE #
PROPERTY ADDRESS:
PHONE #: Dome ( ) Work ( ) Cell ( ) 1 2
OWNER MAILING ADDRESS: Ste. ew.S abovd CITY: STATE; ZIP:
EMS FAX
JEEL - 10 yz : (IF other than owner)
(Applicant if other tWm owmter, a statement authorizing applieaot to act as agent for owner must accompany tbls application.)
APPLICANT INFORMATION: ADDRESS
STATE; ZIP EMAIL FAX
PHONE #: Howe ( ) Work ( ) Coll ( )
CONW OU
MAILING ADDRESS: 3 E> �t /l1 4 aST CITY 4 (� STATE TD ZW ¢T d o /
PHONE: Home# Work# .2.2 7— 0676 Cell#
EMAIL FAX
many buildings an looted on this property?
Did you recently purchase this property? No Yes (If yes give owner's name)
Is this a lot split? YES (Please bring copy of new legal description of property)
PROPOSED USE : -� C�
(i.e., Single Family Residettco, Multi FaInily, Apartments,
(3arnge, CoMmercial, Addition, Eta)
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION Undo peaalty of petgu m l hereby oereidy that l have
read this applicstion and state that rho infrnmatiot► herein is correct and 1 swear say tnfwmation which may hereattcr be gives by me in hearingo before the Plaaai ng
wA Z=ft Commission or the City Council for the Ciw of Rexburg shall be tnAhful and correct I agree w eomply wM all City reguistions and St* Igm relating to the
subject marter of this applioatioa ad hereby authorized xcpmcatatives of the City to enter upon the above mcatiooed property for impcotioes purpostu. N0rE Yea
building OJMQ al may rovoke s permit on approval Issued under the paovisions of th 3000 Intcrnatiortal Code in cases of any false Bt*MQnt ur Tnigrepreseetation of fact in
do application or an the plaza on which the perrrr t or approval was Dried. Permit void if not starved within 180 days. Permit void if work stops for 180 days.
Signature of OwnedApplieaut DATE
Do you prefer to be contacted by £ax, email or phone? Circle One
WARNING — BLU DING PERMrr MUST BE POSTED ON CONSTRUCTION SITEI
Plan fees ore non - refundable and are paid in full at tae time of application beginning zarjoy 1 26
City of Rexburg's Aocegtauee of the plan review fee does not constitute plan approval
CITY:
Aug. 7. 2007 9:40AM ALPHA MECHANICAL
Aug. 6. 2007 1:59PM •
0
No. 3957 P - 2
No, 4634 P. 4
Building Safety Department
City of Rexburg
19 E Main JonvUh &mxburg.otg Phone; 208.359.3020 x326
R ID 83440 www•►exbvig.org Fax =359.3024
t una
CITY OF
° REX
w '•�,,� � �•` RmericaSFwnlJyCpmnu�nity
5.W WS;
041J.
Ra ee
Required l
MECIZgN�CAL
(]
Mechanical Contractor's Name; usiness Name:
Addres 0 k A m C _ty S tate :::� Cell Phone: (�) 0 Business Phone•
Fax: ID Email
�Q Mechanical Estimate $ (CommerciaUMulti Family Only)
FIXTURES & APPLIANCES CDUNT (Single Family Dwelling Only)
Furnace Exhaust or Vent Ducts
Furnace/Air Conditioner Combo Dryer Vents
Heat Pump Range Hood Vents
Air Conditioner Cook Stove Vents
Evaporative Cooler Bath Fan Vents
Unit Heater other similar vents & ducts:
Space Heater
Decorative ps -fired appliance
Inc'nerator System
oiler
Pool Heater
1 Ptiiel Gas Pipe Outlets incluclling stubbed in or future outlets
,Heat (Circle all that apply) GaS Oil Coal Fireplace Electric Hydronic
mw Cw , �N
The City ofResburg's perm fee schedule is the smme as required by the State