HomeMy WebLinkAboutAPPLICATION - 07-00617 - 3854 Orrin Ln - New SFR Mechanical12/13/2007 17:56 FAX 2085240801
Sep, 10, 200 "1 11:2 V
CIT OF REX BURG
MECHANICAL PERMIT APPLICATION
19 E MAIN, REXBURG, ID. 83440
208- 359 -3020 X326
B &S BOILER INC 002
is No. 4S3v P. 2
Masi 0700617
If thega 3854 Orrin Ln- Fillmore
PARCEL N[IMSER -(4�gl ' ?.6 CO ,J)0 (We will provide this for you)
SUBDMSION: v,:eA I UNIT# BLOCK# LOT# —7
(Addremdng is based on the information - must be accurate)
CONTACT PHONE i
PROPERTY ADDRESS: 5( Dv� ice- L, 35
PHONE #: Home ( ) Work ( ) CCU( )
OVINER NIAMING ADDRESS: CITY: STATE: ZIP:
EMAIL FAX
APPLICANT (If other tbm owner) - -- - --
(Applicant if other than owr,cr a statt=mt auflm imig appliessrt to act $s agent for Owner ttlmst accot3vatty this application.)
APPLICANT INFORMATION: ADDRESS CITY;
STATE; ZIP
PHONE #: Home (
EMAIL FAX
Ccll (. )
Work (
CONT'RAC ?OR
MAILING ADDRESS: Lai.; �0 _ 3 vo �1, CITY 1Zc STATE 24 - ZIP 0 3444
a'
PHONE: Home# 35b G 7 S r Work# c ll#
EMAIL F
How many buildings arc loc on this properrty'?
Did you recently pemchase this property? No Yes (If yes give owner's name)
Is this a lot split? NO YES (Please bring copy of new legal description of property)
PROPOSED USE:
(ha., Singh Fm m* Residence, Mnl>s Family, Apatmem s, Remodel, Garage, Commoenial, Additioq Etc.)
APPLICANT SIGNATURE CERTIFICATION AND A= ORIZ.ATION_ use¢ oaf, l�raebrcadrylbmclbaoe
rend this aypliceivu and stoic ma the itdortmtim boein is aoaect mad i mmar iuit aq irt6tt0tb m which m ty ha=fw be givm by= im hcw4W bvf= the Plmliog
and 2aamg Cbumssim ar the City Caftc l for the City of Rodkn shall be mahfol and corr=L L agm io c as* With all City tagalss m Ind Sine laws Hoisting a the
mbjca taattrs of this ap$icadoa and bomby mmha�d mprosim tivas oftba Cay to aeon upon the ahove4n atiomed prvpetey the iaspmdms p-vposm..% Nmm- The
>stdJdLtd o ®3131 ma rcvakc a pernit an appieval W20d =Oath* pvewieions of iho 2003 hMOCi=W t odo;n msas e£anyfale. vna�t er o�fiac in
tJto spp00600 of an the plies an *blob the pormh er sp vvW .w bated P«mit void #f no! witltltl lA0 dtryt, permit vafd i1?aoxk > far 180 dttyS
Signatm of 0wnedApp4Gmt DATE
DO you p mfw to be toAftcOd by fax, avAd or phone? Cuck Qw
WARN NG — I&MDING I'ER1td3T MUST' BE POSTED ON t'JONSMUt;,` ON WTI!
Pima few rare nost rohnd9ble and sra paid In loll at the time of anplleatloa >seplpnlbe
Cby of Rezbt rp's Acceptsme er the plan resko ice deem not constitute plan approval
12/13/2007 17:56 F
C 2H7
X 2085240801 B &S BOILER INC
I ;29AM Aik
2001
No.IE, P.
Building Safety Department
I CRY of Rexburg
CITY OF
R&
' -�., � ,..� Anurlyd,�Famf�pCmNnerrrtq
• v
1 � E Main Phone: 208.359 3020 x326
P,exbwg. !� 89440 WWW.Mxbwg.org Fax 208.339.3024
NANM Fi 11
PROPERTY AI
SUBDIVISION
Required!!!
Mechanical Contrg
Address i 55 , _c7 e
Cell Phonc: ( )
Fax: ( )
Name:
Permit;#
MECH."ICAL
Name: � "• S 13,, ti lo,r ,8.,.. _
City ,Q�u,r- ?wAL, State .';U. Zip 831 oa
Buainess Phone: ( ) Sac{ —
� I
Mechanical Estimate S (CommerciaUMniti Family Only)
Y
FIXTURES 49 APPLIANCES COrINT ' (Single Family Dwelling Only)
FMace Exhaust or Vent Ducts
FumacrJAir Conditioner Combo I Dryer Vents
Heat Pump] Range Hood Vents
Air Conditioner Cook Stove Vera
Evaporative Cooler Bath Pan Vcuts
Unit Heater other similar vcnfis & ducts:
Space Heat
Decorative gas -fired appliance
Inch=at0r1Systcm
Boiler
Pool Heater
T � Fuel Gas Pipe Outlets including stubbed in or frntiue outl
Hcat (Circle all that a r r pply) Gas Oil Coal Fireplace Electric Hydronic
Point i of l livery must be shown on nlan&
J
Signature of Lic�oaed Catttrachor : Liceusc cumber Date
i
12he City ofR,-bw' m Is Permit fee schedAde it the same as reasdsed hY the Stare Qfldaho
i/ 7 V -I