HomeMy WebLinkAboutAPPLICATION - 07-00424 - 2387 Little Town Dr - New SFR Mechanical0
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.CIT OF REXBURG 0700424
MECHANICAL PERMIT APPLICATION Plea
19 E MAIN, REXBURG, ID. 83440 If the 23 Little Town Dr -Jenks
208 - 359 -3020 X326
PARCEL NUMBER: (We will provide this for you)
SUBDIVISION:_Saddle Creek UNIT# BLOCK# LOT#
(Addressing is based on the information - must be accurate)
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OWNER: Tony Jenks
CONTACT PHONE #_208- 313 -3799
PROPERTY ADDRESS: 2387 Littletown Dr.
PHONE #: Home ( ) Work ( ) Cell ( )
OWNER MAILING ADDRESS:
EMAIL
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CITY:
STATE: Z.IP:
APPLICANT (If other than owner)_High Country Htg.
(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 EMAILhi hc�yhtgka,netscape.com FAX 2087450817
PHONE #: Home (208 )709 -4650
Work ( )_same_ Cell ( )_same
CONTRACTOR High Country Htg.
MAILING ADDRESS: Box 627 CITY Rigby STATE_Id. ZIP_83442_
PHONE: Home# Work# Cell #709 -4650
EMAIL FAX
How many buildings are located on this property?
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-mention E: The
building official may revoke a permit on approval issued under the provisions of the 2003 International Code s y se ter nit mi pr n of fact in
the application or on the plans on which the permit or approval was based. Permit void if not started within 1 d oi k st s a
Inil
Signature of Owner /Applicant SE ArT ZIP
Do you prefer to be contacted by fax, email or phone? Circle One
WARNING — BUILDING PERMIT MUST BE POSTED ON C
Plan fees are non - refundable and are paid in full at the time of applica iotCj n
City of Rexburg's Acceptance of the plan review fee does not c ns t 1Aa
- _ Building Safety Department
City of Rexburg
19 E Main ionellh@rexburg.org Phone: 208.359.3020 x326
Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3024
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Ameriraa Family Community
NAME _Tony Jenks
PROPERTY ADDRESS 2387 little town dr.
SUBDIVISION
Permit#
Required!!!
MECHANICAL
Mechanical Contractor's Name: Steve Dick
Address P.O. Box 627
Cell Phone: (208 ) 709 -4650
Fax: ( 208 ) 745 -0817
Mechanical Estimate $
Business Phone: ( 208 ) 745 -8056
_Email highcountryhtg @netscape.com
(Commercial/Multi Family Only)
FIXTURES & APPLL4NCES COUNT (Single Family Dwelling Only)
Furnace k 2 Exhaust or Vent Ducts
2 Furnace /Air Conditioner Combo _2 Dryer Vents
Heat Pump 1 Range Hood Vents
Air Conditioner Cook Stove Vents
Evaporative Cooler
Unit Heater
Space Heater
2 Decorative gas -fired appliance
Incinerator System
Boiler
Pool Heater
5 Bath Fan Vents
other similar vents & ducts:
7 Fuel Gas Pipe Outlets including stubbed in or future outlets
Heat (Circle all that apply) Gas Oil Coal Fireplace Electric Hydronic
Mechanical Sizini! Calculations must be submitted with Plans & Application
Point of Delivery must be shown on plans.
Steve Dick
Signature of Licensed Contractor
The City of Rexburg's
schedule is the same as
7 -31 -07
Date
the State of Idaho
City Rigby
Business Name: High Country Heating
State Idaho zip 83440_
6068
License number