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Home My WebLink AboutAPPLICATIONS - 08 00051 2682 Little Town Dr-Price• • CITY -OF REXBURG MECHANICAL PERMIT APPLICATION Please v 0800051 19 E MAIN, REXBURG, ID. 83440 If the questil 2 6 8 2 Little Town Dr-Price 208 - 359 -3020 X326 PARCEL NUMBER: ?Q`' ; Sj�?L ( We will provide this for you) SUBDIVISION: UNIT# BLOCK# LOT# (Addressing is based on the information - must be accurate) OWNER: CONTACT PHONE # PROPERTY ADDRESS aG 8'a ; - �tc�'ow p-y i y c PHONE #: Home ( OWNER MAILING ADDRESS: EMAIL Work ( CITY: STATE: ZIP: APPLICANT (If other than owner) (Applicant if other than owner, a statement authorizing applicant to act as agent for owner must accompany this application.) APPLICANT INFORMATION: ADDRESS CITY: STATE; ZIP EMAIL FAX PHONE #: Home ( ) Work ( ) Cell ( ) CONTRACTOR w { MAILING ADDRESS: L o qO N CITY R c 5 4 STATE JA ZIP TY Z PHONE: Home# 7 Ll5 - G 3V S Work# '7 YS- 7 dal Cell# 3 11 1 1 EMAIL How many buildings are located on this property? Did you recently purchase this property? No Yes (If yes give owner's Is this a lot split? NO YES (Please bring copy of new legal descripi 2 5 200 i PR0P0SFD i1SF,: rl--�.I-) r -., (i.e., Single Family Residence, Multi Family, Apartments, Remodel, Garage, Commercial, Addition, Etc.) APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury I hereby certify 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 applicaUawopon the plans on w1ri�9 the permit or approval was based. Permit void if not started within 180 days. Permit void if work stops for 180 days. of FAX FAX 7 7 3a5 Cell ( ,:V / 0!� /_ DATE Do you prefer to be contacted by fax, email or phone? 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 January 1, 2005. City of Rexburg's Acceptance of the plan review fee does not constitute plan approval Building Safety Department City of Rexburg 19 E Main ionellh@rexburg.org Phone: 208.359.3020 x326 Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3024 OF REXBUQC 's U O C I T Y O F REXBURG 11 (-,w _..... _ .. ,..... America's Family Community NAME PROPERTY ADDRESS SUBDIVISION Permit# Required!!! MECHANICAL Mechanical Contractor's Name: gc vKl v Business Name: Mol e.r, Pl k�b i � G Address 9) L 0 1 LI0 u City ; Sy State I Zip 5; Cell Phone: (JD$) 317 Business Phone: (d Dg) 7 - 70 d• ( Fax: (a1 p$) -2V 5– 73 2i Email Mechanical Estimate $ (Commercial/Multi Family Only) FIXTURES & APPLIANCES COUNT (Single Family Dwellin Only) Furnace Exhaust or Vent Ducts a . Furnace /Air Conditioner Combo Heat Pump Air Conditioner Evaporative Cooler Unit Heater Space Heater Decorative gas -fired appliance Incinerator System Boiler Pool Heater Dryer Vents Range Hood Vents Cook Stove Vents _ Bath Fan Vents other similar vents & ducts: Fuel Gas Pipe Outlets including stubbed in or future outlets Heat (Circle all that apply) 0 Oil Coal Fireplace Electric Hydronic Mechanical Sizine Calculations must be submitted with Plans & Application Point of Delivery must be shown on plans. SignatAre of Licen ed Contractor The City of Rexburg's /q59 License number schedule is the same as Date by the State of Idaho 02/04/2008 16:10 2085234638 LEISURE TIME INC PAGE 02/02 ' • IVO, )))y i, c Jai 16, 2001 10 :14RM OF REXBLJRG 0800051 CITY UECHANICAL PERMIT APPLICATION Please 2682 Little Town Dr -Price 19 B MAIM, REXBURG, ID- 83440 If the 9 n 208- 359- 302 X326 � provide tbis. for YO„ PARCEL NUMQER: #� BLOCK #— LOT #,_� SUBDIVISION: (Addressing is based on the illfarmatioa must be acctat9) _ , - P51 CONTACT PHONE # $ 3u . PROPERTY ADDRESS: _ +�� p1joNE #: I7o Q J work CC CITY: STATE: ZIP' —, OWNER MAILING ADDRESS; EMAIL FAX (1f other than owner) (Applictwt if other than owaedr, a atammant . ADDRass Cam APPLICANT INFO FAX Coil STATE; zrn_� PHONE #: Home ( ) WoxlC ( ) ( ) RMATION to uet tea' owaat must 90aornpUP7 om CITY STATE, — MAILING ADDRESS: Pj (N Cell#) PRONE: Home# Work# I EMA� PAX How many g property? Did you reoartly PUTObBS a this FOP")? , No 'Yes (If yea give owners dame) Is this a lot split? NO YES (Please bring copy of new legal description of pmpc'ty) brand—.. are locawd on PROPOSED USE: S e Fetatily Re Red — FGuy, Apsslmonts, Remodeb F-ta.) that i hnve TION: Under pnahy ofpmdwy, i baeby APPLICANT'S SIONAT= CERTIFICATION AND AUMO bdro er be &a by me in hcarlogs wo the Planing rcad fit owlavi o and awe tw dte lnfaesrarlan herein h wcol and I screw that EW M=0 with all City re pwomt Ed sto 1 avr1 milting to the , � �ealtairm or t h e City C mail fbr the City edp wbtrrg sbsll be WOW and � I �>o °°° * of f N07E: 7Le "gam, of tt& qVfloatlon sad hereby xttbQ imd npmentedvas of ibe City io eamar epos the abOYeaz�iont:d property for � p>e�' wtetneot ar tesentBtson act m buadbq offiaid may rwaka a por h el leaned naderthe pmvislow ofthe 2000 ktMW=d Colo in ors of IM '�� Ic�t an or on 1bo pleas tm aht the p c or apyraval was m + Ftirtait void if not tmied within t 80 days. Pettoit void ff awlc scope fur 180 days. _ D.A,TE Do you prefer to be con tied by fax, email or phone? Circle One WAVJ;Mo - svan>NQ a'r,.I AW Musa U POSTED o N CONSTR SIM Plan fad bra non - refundable $Ad are paid to rail at the time of appliradadon beginning Jeerua - nL1 J s Ct� of Re:borg's Accaptaace of the plan review fa don rot eoratitate pten approval 02/04/2008 16: 10 2085 0 No. 3hD PAGE 01/02 Y. J LEISURE TIME INC Jan.18, 2007 10:14AM Building Safety Depci �ment Cmy rg 79 E main jarmhelexbum ong Phone: 208.359.3020 X926 v 89440 nxburg -org Fax: ?09.959.902 - NANiI?. PROPERTY ADD SUBDIVISION Requiredlll Mecbanical Contraator'.s N Address Cell Phone;) - Fax: bw C I T Y 0 P `a REXB :. �+ Amerluk "4 Gommxniry frr� � on PRIM 4WIMA gal Mechanical Estlmste S (CommordaUMuld Family Only) FIXTURES &,APPLUNCES COUNT (Single Family Dw Ubw Orly) Furnace Exhaust or Vent Ducts Furnace /Air Conditioner Combo Dryer Vents Heat Pump Air Conditioner Evaporative Cooler Unit Heater Space Heater cbmative gas -fired appliance Incinerator System Boiler Pool Heater Range Hood Vents Cook Stove Vents Bath Fan Vents other similar vents & ducts: Fuel Gas Pipe Outlets including stubbed in or Um outlets Heat (Circle all that apply) Gas Oil Coal F'irePlace Electric Hydmnic Point of Dgvely must k hM on WAR& mhctor Ljconso numb Deco The City afRexbi s permit fee schedule Is dw sane at required by the State ol7daho