HomeMy WebLinkAboutAPPLICATIONS - 08-00045 - 20 E 2nd N - MechanicalJAN -25 -2008 FRI 07:44 AM FIR CALL JEWEL
0
BUILjxNG PERMIT A� ,, LIGATION Plea
19 E IMAIN, REXBURQ, M. 83440
208 -359- 3020 X322 If the I
FAX N0. 12085292793
0
Og 00 045
P. 01
20 E 2 N -Kunz
PARCEL NUMBER: ,
SUB- DIVISION: - -- wuJ tut YOU)
(Addressing is based on the information - must be accurate UN � — "- -BLOCK# _ LOT#
CONTACT PHONE #
PROPERTY ADDRLc3S: _2_n „
PRONE #: Home ( ) Work
G
OWNER MAILING ADDRESS: e
EMAIL CITY: STATE: Z1P:
FAX
: (If othcr than owner)
(Applicant if other than O%vn", a statetnerrt
t0 act as agent fbr 0U jcr, —n= aCGO�gpy t�I9 a
APPLICANT WOR14ATION: ADDRESS rru�auvn.)
STATE;
EMATL FAX _
PHONE #: Home ( ) Work —,- ( Cell ( )
MAILING ADDRESS:
---CITY STATE z p,�
PHONE. Houle# Wor - : 7 Calm
YA11
Howm=y buildings are located on this propercy7
Did you recently purchase this propczty? No Yes f
(I yes give owner's name)
Is this a lot split? NO YES (please bring copy of new legal description of property)
PROPOSED USE:
(1e., akWe Family R cd.,wnoc W= Farm A
l3'' lam. Remodel, Garage, Commercial, Addition, Ett:.)
APPLICANT'S SIGNATURE, end CERTIFICATION AND AUTHORIZATION: Under aer
Jim lead Ws aDplica6oa state go iniorrmtiou a oorroct p=ahy °t'Fadwy, I hereby certify that 1
?1=08 sa he subjed Zapirg Commlaion or the City Coeaail for tbo City d k ! an be a iafbrmblian which may hGvx& r be given by tae ip hearings before the
rdsftg to tet mocr of this Vplieation 90 heteby mahcrind B autbllrl and con�eet. I agree m comply with sU City ngulat iom and Stan laws
NOTE: ntc building WOW may revolre a t mivm otUW Clty :o M W 0 20 ebovw d pt for m >�W.
mfsrepmeambm of f= in the pee am opProVd iss h wader the ppovisiora ofthe 2000 7olctnemotWl Code in ce= of jW fataa atatemwt or
1!f ttpplleatlo>t or on Etc Plet+s on wtttob rho yearplt or s Pw"l ws Pcrrnit void zttmot started witbm f 80 days Permit void iPworL-
/ \ 4
or phone? Circle One
WARMNG — 8U'LDTNG PER119T MMT SE POSTRD ON CONSTRUCTION M=1
Plao Ace d as pW in ftA at the qW at sppticagal, as 1, 30
°lttf°GQ ottlss P� tn.?aw 1. does at coaslltutrplsa apprairal
s` wna/App 1��
D O you prcfcr to ix conblatt d by fax '1 DATE
3
JAN -25 -2008 FRI 07:45 AM FIR CALL JEWEL
applica w e "A "r`vcc entire Application!
NAME
PROPERTY ADDRESS
SUBDIVISION
Required1/1
FAX N0. 12085292793
110, VYL7
P. 5
It the gaestWe9 not apply B>U in NA for non
Permit#
MEOUNIC21 L
Mechanical Contractor's Name:
Address Business Name:
City !/, — Stal e
Contact Phone: ( )
Email
Business Phone: ( )
Fay. .3
Mechanical Estimate $�� (CammerclaUMulti Family Only)
FIXTURES & APPLL41V'CEY COQ'
— Furnace
. ,~ FwnaceAir Conditioner Combo
Heat Pump
� . Air Conditioner
Ivapoxative Cools
Unit Hester
- Space IRaater
z� Decorative gas -fired appliance
Incinerator system
Boiler
___ Pool Beazer
. Similar fixtures or Appliances
Dryer Vents
Range Hood vents
Cook Stove Vents
Bath Fan Vents
other similar vents & ducts:
Fuel Gas Pipe Outlets including stabbed in or fat= outlets
Inlet pressure (Meter Supply) PSI
Heat (Circle all that apply) Gas Oil Coal Fireplace = ccuic
Mechanical Sizing Ca,leuletions must be submitted with Plans & Applicaon
Point ofDeNvery must be shown on puns.
3ga& of.L {Dossed contract Licoa9e aurabar U
Required:
049 Pmuffy Dw 4lxg Only)
`. Exhaust or Vent Ducts
21 0 Ctry of'Rerbwg s pamitfee 3ch*4/e is the same as r . ed by the size ofldaho