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Home My WebLink AboutAPPLICATIONS - 08-00050 - 1424 W 7200 S - MechanicalCITY OF REXBURG • • MECHANICAL PERMIT APPLICATION Please 0800050 19 E MAIN, REXBURG, ID. 83440 If the quv 1424 W 7200 S -Munns 208 - 359 -3020 X326 rr PARCEL NUMBER: 1' l f;t�n� '�(O(10 ( We will provide this for you) SUBDIVISION: UNIT# BLOCK# LOT# (Addressing is based on the information - must be accurate) OWNER: TJF ,k(A eF EU il�{' IJe �nnns CONTACT PHONE # �5(Q — �00 PROPERTY ADDRESS: N2y N - _� 200 PHONE #: Home QD 3 P U? - Q Work ( ) Cell ( ) OWNER MAILING ADDRESS: JH2} N - - I2W3 - CITY STATE: 10 ZIP: d EMAIL FAX APPLICANT (If other than owner) (Applicant if other than owner, a statement to act as agent for owner must accompany this application.) APPLICANT INFORMATION: ADDRES S Y-� CITY: 1 4 STATE; C ZIP EMAIL FAX PHONE #: Home ( (, 3 �- 5�1 Work ( ) Cell ( CONTRACTOR MAILING ADDRESS: CITY PHONE: Home# Work# EMAIL FAX Cell# F E6 - 5 2008 How many buildings are located on this property LX Did you recently purchase this property? S Yes (If yes give owner's name Is this a lot split? @) YES (Please bring copy of new legal description o property) PROPOSED USE: S� A (i.e., Single Family Residence, Mu amily, Apartments, • Garage, Commercial, Addition, Etc.) APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: under penalt of perjur I hereb certif that I have read this application and state that the information herein is correct and I swear that any information which may hereafter be given by me in hearings before the Planning and Zoning Commission or the City Council for the City of Rexburg shall be truthful and correct. I agree to comply with all City regulations and State laws relating to the subject matter of this application and hereby authorized representatives of the City to enter upon the above - mentioned property for inspections purposes. NOTE: The building official may revoke a permit on approval issued under the provisions of the 2003 International Code in cases of any false statement or misrepresentation of fact in the app4c4tio}q_on the plans on which the permit or approval was based. Permit void if not started within 180 days. Permit void if work stops for 180 days. . Do you p r fry er to be qontacted by fax, email or phone? Circle One WARNING — BUILDING PERMIT MUST BE POSTED ON CONSTRUCTION SITE! an fees are non - refundable and are paid in full at the time of application beginning January 1. 2005. City of Rexburg's Acceptance of the plan review fee does not constitute plan approval • • Please complete the entire Application! NAME 7).eAr1z Lars PROPERTY ADDRESS J H )LA �� 7 Sa Permit# SUBDIVISION IWO e tdredM MECHANICAL Mechanical Contractor's Name ] �1'� t V� Business Name • � � Address City State Zip Cell Phone ( ) Business Phone ( Fax ( Email Mechanical Estimate $ (Commercial /Multi Family Only) FIXTURES & APPLIANCES COUNT (Single Family Dwelling Only) I "-- Furnace Furnace /Air Conditioner Combo Heat Pump Air Conditioner Evaporative Cooler Unit Heater Exhaust or Vent Ducts Dryer Vents Range Hood Vents Cook Stove Vents i Bath Fan Vents Space Heater ' Decorative gas -fired appliance other similar vents & ducts: Incinerator System Boiler Pool Heater Fuel Gas Pipe Outlets including stubbed in or future outlets Inlet Pressure (Meter Supply) PSI Heat (Circle all that apply)' Gas Oil Coal Fireplace Electric Hydronic Mechanical Sizing Calculations must be submitted with Plans & Applicatio Point of Delivery must be shown on Plans. Signature of Licensed Contractor License number Date The City of Rexburg s permit fee schedule is the same as required by the State of Idaho 5 °v, 1 : 1 li 4, 2 : y, L ,_ complete the entire Application' NAME _ -- PROFERTY ADDRESS 6J. 2A- 4. P�ru►it$ Required AY MECH "ICAL Mechaaic�t! Coattasior's Nazue �P-��,��'e'�'bY1 Bt�neas �� C� TTC� 1 1nq Fitz /7�_ y� -ems Mee6setticwl Estimrtte s (Co�amecaia! /Multi. Ftiuily �tY) FZrMJ &APPZ"MCSS COUNT (Sir,&* Fimt7yD g 0* Furnace Exl:aeut or Vent Duets Futacc /Air Conditio= Combo ` Dxyer Vents Beat Pump Air Conditicner EvapomdVt: cools Unit Heater Range Hood V ents Cook Stave Vents Bath Fan Vents other similar vents dr dwtb: Space Heater Decorative gas -fired appliance luchmuxor Systems Boiler Pool Heater Fuel Gera Pipc Outlets including stubbed in or fnm= oudets Inlet Pressure (Meter Supply) PSI meat (Circle all tlit Opp 106 Oil Coal Fireplace Electric Hydrtmic Mechanical Sizing Calculation m Ast c sub '. d with Plans & ApPlIcati-Q P oint of D 'verymu be s _Nq .Q plans• z co y��n.�l�prpp�..�r.�r.+.rr`•, w . �+ wi�r�r.,« ww« �w..«. ww. �r .�.rlAld.n_._..yaa- ��e.a_Z.. [J Td WdVE:ET 800E TT sad 17E906S280E: 'ON Xdd 6uTIPaH 9Tf: