HomeMy WebLinkAboutAPPLICATIONS - 08-00157 - 2076 W Hwy 33 - MechanicalApr 01 2008 6:04PM
R -1 WINDSHIELD,
I
(208)356 -7846
Apr. 1, 2008 MHAM No.60 P. 1
CITY OF REXBURG
MECHANICAL PERMIT APPLICATION
19 E MAIN, REXBURG, ID. 83440
208 - 359 -3020 X326 Lei
PARCEL NUMBER: Z0 7 W
SUBDIVISION:
PE 0800157
Please cur
,.
ryIf the question 2076 W Hwy 33_Orme
"�w 3�
� ( We will provide this for yot*
UNIT# BLOCK# LOT#
(Addressing is based on the information - must be accurate)
'-" Z�_ CONTACT PHONE # t O
PROPERTY ADDRESS: 210 J L J • , y 3 5
PHONE k Home ( ) Work ( ) Cell ( ) 5 / ` G �J 0 d
OWNER MAILING ADDRESS: 2-5 ,/V � / � (,✓ CITY : STATEr ZIP: y O
EMAIL �� ... FAX 3576
T � g
APPLICANT (If other than owner)
(Applicant if other than owner, a statement authorizing applicant to get N agent for owner most accompany this application.)
APPLICANT INFORMATION: ADDRESS
CITY:
STATE; ZIP EMAIL FAX
PHONE A Home ( ) Work ( )
)
CONTRACTOR
MAILING ADDRESS: 2 S A/ f / 2 1 ' t--- CITY . STATE ;X22 ZIP 9 3y` 1 0
PHONE: Home# Work## Cell# S O 0
EMAIL FAX
How many buildings are located on this property? f
Did you recently purchase this property ?(�p Yes (If yes give owner's name)
Is this a lot split? ® YE S (Please bring copy of new legal description of property)
PROPOSED USE: C_. (::�) 4-7^ AV) e 4'c /'' C- /
(i.e., Single Family Residence, Multi Family, Apartmenis, Remodel, Garage, Commercial, Addition, Etc.)
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION Under penalty of perjury I hereby ce rtify star 1 have
read Ads appliatioo sod State that the inFonaariaa bmin is comet end 7 swear that any information which may hereaffm be given by me in hearings before the Planning
and Zoning Commission or the City Council for the City of Itexbtug shall be t uWW and coma. 1 agree to comply with all City r cgulatione and Swe laves relating to she
subject mwrcr of this application and Jx:70y sathorlud repreaetm dws of the City to mice upon the above•mendoned property for inspections purposes. NOTE: The
bW Idinaofficial may rovokc a permit on approvAjUved under the pmvisions of the 2003 lauernedonal Code In cases of any false sutenett or mi srepmscatsW on of tact in
the application Oran the„pl rc It approval was based Peemh void if not stared within 180 days. Penrnit void if work stops for LSO days.
Sienatwe o caner /AnD icant DATE
Do you prefer to be contacted by fax, email or phone? Circle One
wA1tXjNG —BUILDING PERMIT ML'S? BE POSTED ON CONSTRUCTION SITE!
Platt fees are eon- refuedaWeand are paid In full at the time of opp6eation beginning 1. 2005
City of Rexburg!* Acceptance of the plan review fee does not eonstitata plan approval
npr 01 2008 6:04PM
n -1 WINDSHIELD, INC.
(208)356 -7846
p.1
e Apr 1. 2008 10:28AN No. 6096 K 2
■
■
Building Safety Department ,� C I T Y Of
City of Rexburg REXBT RG
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19EMdn jane11ha3rrexbcsg.org Phone: 208.359.3020x326 a �.• AMtrkA AM* OnMIMilY
Rexbwg, ID 634.10 www.rexbtrg.org Fox 208.359.3024
NAME a E
PROPERTY ADDRESS d 0+6 W • ui 33 Permit#
SUBDIVISION ,_ ,C � =W ` 3 'L/y-O
Required! l! MECHANICAL
Mechanical Contractor's Name: �y a .v- ofl�E'CCnST � � usiness Nan*:
Address ZS -A/ C2 Ci State d ZIP S y yQ
Cell Phone: (A 6S .3S (- V SO0 Business Phone: ( ) aCJ $ r 3-5 V -S 0 0
Fax: ( ) 20 E .35fn.^ ?,?Z Email
Mechanical Estate $ oZ Q (Commercial/Muld Family Only)
FIX V"S A APPLIANCES COUNT (Single Family Dwelling Only)
Furnace Exhaust or Vent Ducts
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) Gas Oil Coal Fireplace Electric Hydronic
Mechanical Sizinf: Calculations must be submitted with Plans & Annlication
Point of Delivery most be shown on plans.
%et ure o x L' cen sed Contractor License number
The
schedule is the some as
0 8
Date
the State ofldaho