HomeMy WebLinkAboutAPPLICATION - 07-00407 - 327 S 3000 E - MechanicalAug, 21, 2007 9:05AM No, 4757 P, 2
CITY OF REXBURG
MEr'- . 07 ICAL PERMIT APPLICATION Please C{
19 E xhkIN, REXBURC3, ID. 83440 If the queslb
208 -359 -3020 X326
PARCEL NUMBER:
SUBDIVISION: UNIT
(Addressing is based on the information - must be accurate)
PERMIT #
0700407
327 S 3000 E -Cnty Mech
CONTACT PHONE # S ,S T - 7d—,�
PROPERTY ADDRESS; 3 7 S .. °xW SLt�c/ C r ti
PHONE #: home ( 3 X 26 Work ( o - c� S� 3 Cell(
OWNER MAILING ADDRESS: 3�z� .S'- Ica: f CITY: �_CGZ
, STATE:XO ZIP: F 3
Y � y
EMAIL s& ��r,� _ FAX 3 S �8�
APPl1lNT :
Of other than owner)
(Applicant if other than owner, a statement authorizing applicant to act as agent for owner most accompany this application.)
APPLICANT INFORMATION: ADDRESS CITY:
STATE; ZIP EMAIL FAX
PHONE #: Home (
Work ( ) cell( )
CAMMC :
MAILING ADDRESS: CITY STATE , ZIP
PHONE: Home# Work# Cell#
EMAIL FAX
How many buildings are located on this property?
Did you recently purchase this property(y) Yes (If yes give owner's name)
Is this a lot split? YES (Please bring copy of new legal description of property)
PROPOSED USE: S, , 11 1;.
(i.e., Single Family kesidence, Mild Family, Ape
Garage, Co merciel, Addition, fife.)
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: vnda peony of pcijiay, I harcby dw I have
read this applicario n and stage that the infmmalim herein is cwt and I swear that any iafotmati m which may 11 be given by an In hears before the Planning
and Zoning Commission or the Csty Conoco t?x the City of Ra &urg shall be ttutbt'itl and corroot. I ague to cwaply wlih all City rqgulatl= and State laws rclattug to the
sabjoct onion ofthis app rtlon sal taacby reprep of tip City to er r the abova aaa ioaed arty f p<upaeot. WOM MW
buitdimg official may invoke a permit on approval issued under the provisions of the 2003 Iatemationd Oode in cases of any No statement at misrepieseatatimi of ha in
the application or an ate plans on which the powd or apptavai was based, Permit void if not scatted within ISO days. Permit void if work scope for ISO days.
1 - 42
Signature of OwnerlApplicant j D.A TE
Do you prefer to be c oni acted by fax, hail or c� Circle One
WARNING — BUILDING PERMIT MUST BE POSTED ON CONSTRUCTION STTE:
Plan foss are non-refundable and are paid in fall at the time of application beginning Zqm= 1.2001
City of Rssbures Acceptance of the plan review fee does not constitute plan approval
08 -27 -2007 09 :19 PAGE2
08/27/2007 09:11
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• No.41�d N. 1/1
Building Safety Department
Cfly of Rexburg
79 E Main gmlfh@fLXbutg. Phone; 209.359.3020 x326
Kexburg, I 83"0 ww w.rexblug.org For 208.3$9,3024
NAW CR Jill h-r
YROPEWIY ADDRESS - —
SUBDIVISION
oe �zev�o
CITY o f
REX ]3URG
%••' Amv=k1"10CanmanNy
Permit#
- Required ll
MECHANICAL
M echanical Contractor's Name: wy r A JM Business Name: jydCo + &
Address 2-W 6• 1 4 66p- c ity - Rr* Sty
Zip (�3�
Cell Phone: Business Phone ( ) 10i4 - 1Q & 1
Fax. ( Email
Mechanical Rr;fl mate. __ (CommereiaMulti Family Only)
FIXTURES & APPLrANCES COUNT (Single Family Dwelling Only)
F mace — Exhaust or Vent Ducts
I Fumce/Air Conditioner Combo Dryer Vents
Heat Pump
,Aix conditioner
Evapom ive Cooler
Unit Heater
Space Heater
Decorative gas -fired appliance
In system
Boiler
Pool Heater
Range Hood Vents
Cook Stove Vents
I Bath Fran Vents
other si aar vents & ducts:
Fuel Gas Pipe Outlets including stubbed in or future outlets
Heat (Circle 811 that apply) des Oil Coal Fireplace Electric Hydronic
Neebanical SWn Calculations must submitted with Plans A AW
POW of Delive most be show tans.
signature of Licensed CoAttdCtor license number Date
The 01 Y of R=hwX',9 permit fee schedule it the same a required by the $tvfa ofldaho