HomeMy WebLinkAboutAPPLICATION - 07-00441 - 4391 N 5631 W - New SFR Mechanicalep 14 07 09:00a
r --
COMFORT ZONE HEATING AND
208 - 529 -6846 p.1
0 No. 4812 P. 3
Building Safety DeP artment
City of Refturg
19 E Moin jana#h ®oexbugy.ory Phone_ 208. -- -- --
Rexbuig, 10 83440 www.rexbuSorB Fox
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PROPERTY ADDRESS 3�t i�
SUBDIVISION
Required!!!
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REXB
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0700441
4391. N 5631 W -Cnty Mech
MECH"ICAL
Mechanical Contractor's Name: - � Business Name: ti��� � �,
Address 1,� �, C Y'C� Vl Wl.� � State � zjP_ `�
Cell Phone: ( ) �� <5� Business Phone:
Fax:
Mechanical Estimate s (COmmerWaUMulti Family Only)
FIXTURES & APPLIANCES COUNT (Single Famdy Dwelling Only)
Furnace a -- Exhaust or Vent Ducts
Fwmce/Air Conditioner Combo ( Dryer Vents
Heat Pump
Air Conditioner
Evaporative Cooler
Unit Heater
Space Heater
Decorative gas -&red appliance.
Incinerator Systm
Boiler
Pool Heater
Fuel Gas Pipe Outlets including stubbed in or future outlets
Peat (Circle all that apply) Gas Oil Coal Fireplace Electric Hydronic
License mmtber
The City 2f2c — c arg's permit jcc sched a 1he same as
I Range Hood Vents
Cook Stove Vents
Bath Fan Vents
other similar vents & ducts:
n��t��uv�x�
n5� SEP 1 4 2007
CITY OF REXBURG
Date
the State of fdaiia
ep 14 07 09:11a COMFORT ZONE HEATING AND 208 - 529 -6846 p.1
No. 4812 P. 2
CI TY OF REXBURG PERMIT #
MECHANICAL PERMIT APPLICATION Please complete the entire Applica
19 E MAIN, REXBURG, ID. 83440 If the gne does not do not s
208 - 359 -3020 X326 PPly IM in NA for 9ppl bk
PARCEL NUMBER;
SUBDIVISION: We will provide this for you) (Addressing is bases! cm the Wbrmasion - muss be accurate) UNIT# BLOCK# LOT#
PROPERTY
CONTACT PHONE #
PHONE #: Home ( ) - 3S1� �37iS'W ( ) N Cell OWNER MAILING ADDRESS: Al CITY; STATE:
�� - _-9/& FAX MZIP:
r
dEMIC4Nn (If other than owner)
(Applicant if other than owner, a sttdem a w1hotiziag ap to act as ageQt itr oarner mu9t accompany
APPLICANT INFORMATION: ADDRESS C1TX:�L�� I I S
STATE ,
ZIP ��� EMAIL FAX 5ar, 1 4 ,( -
PHONE #: Rome ( ) A�� -+7Oc Work ( ),Zd ,, q !P Cell
() -'
CONTRACTOR --
MAILING ADDRES
CITY
STATE ZIP
PHONE: Home# ' 7 Work# Cell#
EMAIL FAX
How many buildings are located on this property?
Did you recently purchase this properly? 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 ResadeACe, Multi Faoft Apat , Remodel, Garage, Cotntaoreial, Additica, Etc.)
APPLICANT'S SIGNATURE, CERTIFICATION AND and A v,�p I
read Ibis app)ie' anise Owthe infwatadw hemm is eoffm and I swear that Waby mt ry that I ba t
C� inn a tbo CLLy Cwa�cil for the CRy orRar6seg sLdl 6e trutbdul and ewtect ] WM bu � aD MY reg kb= and � leas � p idatm S 0
m+9'te+ralca a permit oa ,. r a aR the GStyto eNa upon *0 above- Aepuioa�eQp epperty ha Purposes. No7E: the
� r provisions of the 2003 Iatanetfinei Coda is cases or aay faire atattaDeae orm of fist is
tF,1e appJicatim at as approval � based', p� void if not started within IBO
VCR"
an
days, Permit void i£,rark sDo� 6or 180 dqs.
Dta14MA DATE
0.7 "Fft emsll or phone? Cnvle One
WARMM — BuILMmG PLRMrr MusT BE POSTED ON CONSTRUC aON Srlr>i::
"an Eery are eo- rdsmd&W and are paid in fnn at the time or appfica en beonaing Anna" L 2M
City of Rmftre's Ameptuoce adthe plan review fee doer ant constitute plan approval