HomeMy WebLinkAboutAPPLICATIONS - 07-00488 - 460 Maple Dr - MechanicalSEP -28 -2007 FRI 03:55 PM FIR 6CALL JEWEL
2uuj 1:11rm
CITY OF RM URG
BUILDING PERMIT APPLICATION Please
19 E MAIN, REXBURG, Ile, 83440 If the qu
208- 359 -3020 X322
PARCEL NUMBER:
SUBDMSION: U
(Addressing Is based on the information - must be accurate)
FAX N0. 124292793 _- - P.
PERMIT #
0700488
460 Maple Dr -Royer
CONTACT PHONE #
PROPERTY ADDRESS:
PHONE #: Home ( ) Work (
Cclly
OWNER MAILING ADDRESS: CITY: STATE: ZIP:
EMAIL FAX
01
APPLICANT INFORMATION: ADDRESS Z1.� CTTX: 14-5
STATE; I -- ZIP EMAIL PAX .�- x
PHONE #: Home ( ) Work ( ?a -:Z-2. ell ( )
AP„ ZIP (If othcr than owmr) " .
(Applicant if other than, owner, a stattmeac author i g appllcant to act as agent for owner
MAILING ADDRESS: 10,0 _ CI STA
PHONE: Homo
many m ates are
Do you preferto be coutaecd by fax, email or phone? C401e One
W"N M — $(=1NG PSRMI'i' Mt78T U pOSTIm oN CONSTAUCTMN SITE!
Plan fk a are aoa relitndahte sad as paid in W at tft pate of 4jP&2ftlk bA&nlog AdEM 1. 2"
Clly ofAabsarles Amgrb nca of d ph m. view in does not "enfilade pmt apprat►al
stops for 180 des_
Sipamm o waer/Appli DATE
on this property?
Did you recently purchase this property? No Yes (If yea give owner's natnc)
Is this a lot split? NO YES (Ple me bring copy of new legal description of property)
PROPOSED USE:
a.e., $bgle Fatuity Ftaidence, Muld Family, Apw=eats, Remodel, Gatago, Com xt roK Additions, Eta.)
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION. t;04a peasoty oft cow, I heretty cw* that I
hove read this appl iwo and store due the inkmwtian hcMm is 0=44 wd I sweet that MY iaBoTmslian whroh may hae�r+r b"i� by t+te in heasipp before 1110 P1smdug sad Zooittd Commiselat orths City camw afar tba city of R=&" shill b& t u&M aed eonact. l wo m toot * with sli City renalatioraand sax laws
tt�iatm8 to dw sub foot matter of this Ipplicadw sand hmby aathosialtd repro atia m a City to sates upon me aboveaneattonad pwpcnY for bopoxim rimoo'
NOTE The bWlditra of MAJ mY rovoke a portals as appraYSi issued aodw the PwWsiuns 20M T ld nYAaf CA D in G within y f days vrnd if wock
mists pssleraildos► alfuct.ln du applksslott of onttx phme a1S wbioh tiro pomdt or�gtovli
3
35 - ?ate 4
SEP -28 -2007 FRI 03:56 PM FIRS CALL JEWEL FAX N0. 120 5292793 P. 02
.1 complete the entire A If th question does not apply fill in NA for non
applicable
NAME
PROPERTY ADDRESS Permit#
SUBDIVISION
RequiredI R
Mechanical Contractor's Name:
Name:
Contact Phone: 7 7 7 :2 Business Phone: ( ) � -- 77 - 7 - 7
Email Fax fS -�9 -2
Mechanical Estimate $ 270, Z a (CommerciaVMniti Fam* Oath')
FnTURES AAPPLIANCES COUNT (Single Farnify Dwellthg Only')
Furnace Exhaust or Vent Ducts
Furuam/Air Conditioner Combo
Heat Pump
Air Conditioner
Evaporative Cooler
Unit Heater
Space Heater
i_ Decorative gas -fired appliance
Dryer Vents
Range Hood Vents
Cook Stove Vents
Bath Fan, Vents
other similar vents & ducts:
Incinerator System
Boiler
Pool Hearer
Similar f alum or Appliances
Fuel Gag Pipe Outlets including stubbed is or future audleta
Inlet Pressure (Meter Supply) PSI
Heat (Circle all that apply) (�jg Oil Coal fireplace Electric
Mechanical Sbdng Calculations must be submitted with Plans die Application
Point of Delivery must be shown on plum
lair'
Sip== o Liowsed Co Lionse m=bar
The City 0 1 1 =bW8's P ~.fft J&W R/e tr Ae same ar
JWCHAMCAL
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