HomeMy WebLinkAboutAPPLICATIONS - 07-00497 - Reals on Deals Home Decor - Mechanical•
CITY OF RF,XBURG
MEGAA NNIC "AL PT RMIT APPLICA 140N
19 F, MAIN, REX13URG, TD. 43440
208 -359 -3020 X326
•
Plea, 0700497
If the q Reals on Deals Home Decor - Mechanical
PARCEL NUMBER: �r ) _ l ( W'e will provide this fur yowl
SUBDIVISION: LTNITt# BLOCK#
(;Addressing is based on the information - must he accurate)
LOT'#
PROP.IRTY ADDRESS:. {~
CONTACT PHONE
PfIONE #: Houle ( ) ���! - - Work ( )_ .� - - -- -- C;ell'
OWNER MAILING ADDRESS: � �kct C'I Y �' TATE: ZIP: (z:
EMAIL 4 FAX__ -- - - -._
APPLICANT (If other than awtter)____ t �l 1(l ---- � 1``1 _I_�Y _ _ - --
_-_-_--
(Applicant if other than owner, a statement authorizing applicant to act as agent for owner must accompany this application.)
APPLICANT INFORMATION: ADDRESS - - 'w ZV 'l c� _ _____CI`T'Y: - -_� �p r
STATE; _ - -- --- _Z.IP_�3`-��� EMAIL - - -p AX -
P11ONF -, #: Home ( ) �11�} Work (
' 5 S.- - Cell
iC'ONTRACT ON
M AIL TING A DDRESS _� � _l� . ��Y�ill1� � t S • CITY ��_!�_� -_�
{ K q hf AT �
PHONE: Home Work# ,N Cell#� _` ` t 13 i
EMAIL. ,
How many buildings are located on this property? ____,_ - _
Did you recently purchase this prop erty? 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: 1
(i.e., Single Family Residence, Matti Family, Apartments, Remodel, Garage, Commercial, Addition, Etc.)
APPLICAN - T' S SIGrNATLIRF, CERTIFICATION AND AIJTHORIZA`I'ION: Under penalt of perjury, I hereby certify that I have
read this application and state that the information herein is correct and I swear that any inlbrtnation which may hereafter be given by me in hangs before the Planning
and Zoning Commission or the City Council for the City of Rexburg shall be truthful and correct I aptc to comply with all City regulations and state laws relating to the
subject maner of this application and hereby authorized representatives of the City to enter upon the abovo-mentioncd property fbr inspections purposes. NOTE♦ The
building official may revoke a permit on approval issued under the provisions of the 2M3 Itttcmational Code in cases of any false statement or misrepresentation of fad in
die application or n tim plans on which the permit or approval was based. Permit void if not started within 180 days. Pcnttit void if work stops for 180 days.
,
Signature Owner /Applicant DATE
Do you prefer to be contacted by fax, email or plf>lone? Circle One
WARNING — BUILDING PERMIT MUST BE POSTED ON CONSTRUCTION SITE!
Plan fees are non - refundable and Are paid in full at the time of application beginning .Taman+ 1. 2005.
City of Rexburg's Acceptance of the plan review fee does not constitute plan approval
OCT 03,2007 15:33 REXBURG CITY OF Page 2
OCT-04-2007 04:37 AM P.01
OCT 03,2007 16:23 • 12083568833 page I
Budding Safety Department 011(v 0r
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REXBURG
Xt A Wwi4A Fam'ly
r
NAME
PROPERTY ADDRESS
SUBDIVISION
d
RequiredIl! MECHANICAL
Mechanical Cotitmctor'.s Name: Natn(;.' CO'
Address - c r city
IV/ ' tat "'j
Cell Phone ( 716) Huxiness Phone: (Iql& 70 r-,5/3
!fax.( )---
E n1ad - --
WummemiaY.Muki Fit akily Only)
FLYMMS A APPwXCES couN7 (nigie t-em oy Dwwung only)
Exhaust or Vcnt Ducts
Vumaoe/Air Conditioner Cornho Dryer Vents
t leat I-lump
Air Conditionur
Evaporative Cooler
Unit I leater
Spa". lienter
Incincratnr System
- Soilcr
Rage Hood Vents
Cook Stave Vcnli
Rath Fall Vents
crater similar vents & ducts.
Pool Heater
Fuel Qas lipc Outict',t including -dubbcd M Of I'UtUre 0111le?s
Rent (0rul4 all that apply) Giu Oil Coal 1 EIcctrit:)Iiyciri)ni4;
HEMW01 MAWS QMbWU Wed We acbmifteA 3d1h Plans A Aukagge
PWRI 2t Mysty most bc Ahms On pbus
cr'T 01 --", I ') :U:XBUFC C 1 ce 0: -'
13
Liccruse number
F-1 �j o (
OCT 03,2007 16:30 COMMINS JENNIFE Page 1