HomeMy WebLinkAboutAPPLICATIONS - 08-00095 - 1952 W 6000 S - Lyman LDS Church - MechanicalCITY OF REXBURG
MECHANICAL PERMIT APPLICATION New 08 00095 � r
19 E MAIN, REXBURG, ID. 83440 If the( 1952 S 6000 W -LDS Church >le
208 - 359 -3020 X326
PARCEL NUMBER: flF A_1 3 ( We will provide this for you)
SUBDIVISION: UNIT# BLOCK# LOT#
(Addressing is based on the information - must be accurate)
CONTACT PHONE #
PROPERTY ADDRESS: 1-goll 0 (0 DO o s . V�flxswue , I PA40
PHONE #: Home ( ) Work (
OWNER MAILING ADDRESS:
EMAIL
1W
CITY:
STATE: ZIP:
APPLICANT (If other than owner) V_W 1� Af�OC. NN"r .
(Applicant if other than owner, a statement authorizing applicant to act as agent for owner must accompany this application.)
APPLICANT INFORMATION: ADDRESS II951 B aJD -f/ CITY: r&E4(6M1ZtP
STATE; �VA ZIP '6 '0 EMAIL wak5cp � ,r w a. i��j�• Z27 `
PHONE #: Home ( ) Work ( ) 3 "' 23oq Cell ( ) ?,q p - ZbG 7
CONTRACTOR V. L,. eez te-► ItIc.
MAILING ADDRESS: (e S0 S, 1 100 0 CITY get o STATE t O • ZIP 53 44o
PHONE: Home# Work# &46.1344 Cell# V Z - li! 3¢
EMAIL FAX
Hnw manv buildings are Incited nn this nronerty?
Did you recently purchase 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: Go#4tr't c4a Adr .
(i.e., Single Family Residence, Multi Family, Apartments, Remodel, Garage, Commercial, Addition, Etc.)
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: under penalt of perjur 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 Co 'ssion or the City Counci r he City of Re urg shall be truthful and correct. I agree to comply with all City regulations and State laws relating to the
subject er of the yrepvpZaon and he y a of ed repre ntatives of the City to enter upon the above - mentioned property for inspections purposes. NOTE: The
buil ' g official ma permi n app sy�d u er the provisions of the 2003 International Code in cases of any false statement or misrepresentation of fact in
th application or o on ich th t o) /ap v*was based. Permit void if not started within 180 days. Permit void if work stops for 180 days.
2 / 2
Cell ( )
Signature After /Ap tc�C DATE
Do yo refer to b contacted by fax, email phone? ircle One
WARNING — BUILDING ST 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
FEB-27-2008 10:35 From:20e5247374 To:3592271
Feb 27 08 10:26a David Beck 0
Pa9e: 1
209345 P-3
Building Safety Department
Cify of Rexburg
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L\�IausL or Vent 1)ucis
Fumnee/Air Condit its -er Curr.n..,
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Air Coveitioner
I_vaporativc (7otilk:r
Unit I leater
NpaCe I jeater
Incim:r.-itor S%Nteill
Boiler
Pool Hunter
1) � Cr Vents
R .1!;L: I load Venus
(ur)kStave Vents
B, Fan VcnLs
o sinillar vents &, ducts:
FLIel GLO; Pipe (),itlels t: et,
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Siz-4 n11144 be submittc(j N%,jrjj plans ,& APPlication
Nint of Ddrverk must he
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