HomeMy WebLinkAboutAPPLICATIONS - 07-00556 - Intermountain Gas - Storage Facility - MechanicalNov. 5. 2007 4:43PM
CITY OF REXBURG
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PERM
MECHANICAL PERMIT APPLICATION Please CO impl
19 E MAIN, REXBURG, ID. 83440 Uthe question doe
208- 359-3020 X326
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No. 5306 P. 1
0700556
Intermountain Gas Storage Facility
PARCEL NUMBE& 5L` L qLa We will provide this for you)
SUBDIVISION: UNIT# BLOCK# LOT#
(Addressing is based on the information - must bo accureme)
D_1�1YER,�. k�tchowrek� �n _e_ CONTACT PHONE #
PROPERTY ADDRESS: . 3'00 S
PHONE #: Home (• ) Work (loo Ir l�� Cell ( )
OWNER MAILING ADDRESS: 15. Noll, CIIY: STATE:, TSY D
EMAIL TU A FAX N3 44
APPLICANTS (If other than owner)
(Applicwt if other than owner, s statement
APPLICANT INFORMATION: ADDRESS
CITY:
STATE; ZIP EMAIL FAX
PHONE #: Htmle ( ) Work ( ) Cell ( )
CONTRACTOR
MAILING ADDRESS: PO, $ t(v jam_ CPry Td A, G=as a STATB ,Zi2_ a3
PHONE: Home# Work#I �+lS`IS #
EMAIL
How many buildings are located on this property?
Did you recently purchase this property ?.® Yes (!f yes give owner's name) -i,L 46
Is this a lot split? NO YES (Please bring cov new legal description of property)
PROPOSED USE: ,Q e t x_ I1 /tiD Tn�
(i.e., Single Family Retidencq
Apartments, Remodel, Garage, Cots mental, Addition, Etc.)
APPLICANT'S SIGNATURE, CERTWICATTON AND AUTHORIZATION: underpenaityofpvajwy r be+abyeattifyemi hm
=4 this application and slate that the informsum heroin is carcd and I strait that a0' iotbrrnsaion tvhicb may herea8rr be given by ma is haaiags boJbre the 111m niag
and Zmft Coanmission of the C* Council for th e City of Raburg shall be tndhfol and correct. I agr to amply with all Cily regulations and S tara lava relating to>be
Bubjea roamer of tWs sppU=da n imd haatby eaa himi rapmtntadves of the LYW to !BEGS qm the abovco-u=ti0aed property f0f h spectiena pmpoms. NurE; The
building official may rcvolrc n p=4 on approve issued tinder the provisions of the 2W hrtematiora9J Code in cam of any mse ststement or mtancprcmilallce of fat in
Um application or on The plans on which the 't or approval wjm based. Torah void if not salted within 180 days. Fen dit void if worlr stop for 180 days.
Signature of Owner/Applicant DATE
Do you prderr to be mdeccted by fax, email or phone? Circle One
WARNING — BUILDING .PPJLMIT MUST BE POSTED ON CONS'IRUC170N 9>"A'!Cl
Plan has are non- refundable and are paid In fiN at the time of application beginning Jeaf—s'e_nn L 2001
City of Reaburg's Acceptance of the plan MIrw he do" not constitute plan approval
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to act as agent for owner must accompany this application.)
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Nov, h. 2001 4:43NM
Building Safety Department
City of Rexburg
19 EMain jpneAh *raxburq wq Phono. 20R3593020x326
Rexbufg,10 83"0 www.mexburg.org Few 20B.3S4.3024
NAME Tn+c-wrn= GPI.$
PROPERTY ADDRESS -J5
SUBDIVISION
Requiredlll
MECHANIGmA.
No, )JUO r. j
tea$ c + CITY OF
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0700556
Intermountain Gas Storage Facility
Mechanical Contractor's Name ;. [CC? Sc-- 0 n Business Name: n ice 1 Ett�
Address P. O. �3r�,g� 1 �e 9 a Ci tY9� e �o. l I S State t ►� Zip
Cell Phone: 000 a 1 — Business Phone: Qog) _5 �fa- �,St(S"
Fax: poo Email
Mechanical Estimate $ _..�0 (Commereial/Mtrlti Family Only)
FIXTURES & APPLIANCES COUNT (Single Family Dhnwff zg Orr, ►)
Furnace Exhaust or Vent Ducts
Furnace/Air Conditioner Combo
Heat Pump
Air Conditioner
Evaporative Cooler
Unit Hester
_ Space Heater
Decorative gas -fired appliance
Incinerator System
Boiler
Pool Heater
Dryer Vents
Range Hood Vents
Cools Stove Vents
Bath Fan Vents
other similar vents & ducts:
Fuel Gas Pipe Outlets including stubbed in or future outlets
Heat (Circle all that apply)l Oil Coal Fireplace Electric Hydronic
Nechaniad Sizing Calculations must be subM ftW with Plans & An2jeation
Pout of 1WL= must be shown_ ,D
C, I S10
Signature of LIceased tMiitof License =umber
Ir
sr1edrd& is the same ass
the State af1daho
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Date
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