HomeMy WebLinkAboutAPPLICATION - 07-00430 - 905 Twin Butte Rd - New SFR Mechanical09/11/2007 08:12 FAX 2085240801
mug. 27. 2007 10 :13AM
CITY OF REXBITRG
W( ,,IMCAL Pt -kMIT APPLI C ATION
19 E MAIN, REXBURG, ID. 83z 40
208 -359 -3020 X326
B &S BOILER INC 1a002
• Nu. 4763 P. 2/31
07 0043 0
Please cc
IlP the goest 905 Twin Butte Rd- Gunderson
PARCEL NUNIRER:
a
( We will provide this for you)
SUBDIVISION:
UNIT# BLOCK#
LOT#
(Addressing is based on the informat
on - mm be accurate)
ONE1Q' �1�onti
T i ,
CONTACT PHONE #
€ ` . 1M
PROPERTY ADDRESS: 9
PHONE #: Home ( ) — -
b S Work (
) s3's - 5206 Cell ( ) s-4
1 S f
OWNER MAILING ADDRESS:
CITY: STATE:
ZIP:
EMAIL
IL
FAX
APPLICANT (If other than o
)
(�pplieattt i rodaer than owner, a statcMe. 1
ic autborWAS applicant to act as agent for a%mcr ion ust accompany this applieaiaom)
APPLICANT INFORMATION:
DRESS
CITY:
STATE; ZIP
EMAIL
FAX
PHONE #: Homc ( )
Work (
) Cell ( j
CONTRACTOR
CITY STATE
ZIP
MAILING ADDRESS:
PHONE: Home# w ork#
Cell#
EMAIL
'AX
How many buildings we located o this property'?
Did you recently purchase this
Is this a lot split? NO YES
PROPOSED USE:
(i.e., Single Family Acsidc=> ' Multi
No Yes (If yes give owner's name)
bring copy of new legal description of property)
Apa tneWs, Remodel, Garage, Caumnercial, AddidaN Etc.)
APPLICANT'S SIGNATURE, C RTTFYCATION AND AUTHORIZATION: Under pub' of pcpj -y. I Jlcycb7 ccrlify lbft J havr
wad ibb appHooden and state M flee mformst�iou h in
armn is com4 and I sweet thct 4MY filformoice which may lr be given by me m ltratings before the Planning
and Zmxi g Coission of the CWCoome>Z fnr the - ofRrAm-g sl a be tnnhfW �md cones-. I agm to comply with ell MY nVIA i0es and Steam laws relntins w the
sul j*t mans of thin application end hgare y d mptr.9madves oft]te City to inter aeon the aboVc -men Toned popaW faf inspacti0ns purposes- N(7fE: Thr
building ufi aw may revolco a pcernl: us- appmvnl i of fact in
thn application of on the plecu br wbiob the Perink epprovel was based. Permit void if not started withiv 180 days. Pt muit void if wo* A*a far 180 days.
SWaalwa of Owner /Applicant
Do you prefer to be contacted by
W.iAt1TMG—
Plan fees are
my
DATE
hail or phow? Circle One
LDLNG PERIVIIT MUST BE )POSTED ON CONSTRUCTION srM
ble and are paid In fill at the tlme of applicstlan beginning lawary 1. 300,
Acceptance ofthe plam review fee does not omatitaoe plan approval
f \
9/11/2007 08:12 FAX 2085240801 B &S BOILER INC Z001
Aug, 2l. 20 0 7 lU:I� I • ' • Nu. 4763 P. 3
Buii ing Safety Department
City of Rexburg
19 F Main j!e)1h *rekbu19.or9 Phone. 208.359.3020 --326
Rexburg, @ 83440 www.rexburg.org r=: 208.359.9024
r� R
NAME 6-te- -t- a
]PROPRX7Y .ADDRESS
SUBDIVISION
c
a
CITY OF
REX
Avmkak Afuiy Qw ty
IWA SJ1_ RA. *it v o.1A_ . P=it# M — 0 - 1 " d 3 — D S
Requiredlll
MECHANICAL
Mechanical Contractor's Name- Business Name: 13 `� U o 2�' l ►n�_
Address I S S - S - ij . SLouAWS City �Oo_I IS State a d , Zip S
Cell Phone: (aDB) 589 - y - 7 Business Phone: (3-013) S"?4 ! 1 5 - 7
Fax; (aog 3-4 - oB o t Email bs bo'i le-0 0 s-t J. ►n oA
Mechanical Estimate 5
FWVRES & APPLIANCES f
Furnace
Fumace /Air Condition
Had Pump
Air Cond iantir
Evaporative Cooler
Unit Heater
Space Heater
i Decorative gas -fired apl
Yncinamtor S y stem
Boiler
Pool Heater
Fuel Gas Pipe Outlets in
Heat (Circle all that apply) Q
5ig=td= ofLiacnscd Untr
The
(CommerciaUMulti Family Only)
WVT (Single PO & Dwelling Only)
Exhaust or Vent Ducts
Combo ° Dryer Vents
Range Hood Vcnu
Cook Stove Vents
Bath Fan Vents
other similar vents & ducts;
C
xg stubbed in or future outlets I D' ,
Coal Fireplace Electric Hydronic
9 // O 3
License n1lmbcr D aft
schedule is the same as required by Are Swo
P,
21,111