HomeMy WebLinkAboutAPPLICATION - 08-00233 - 612 Island St - MechanicalMAY -6 -2008 02:32P FROM;LINCWLEMEN7ARY 6247691
4 6247223 P.1
City of Rexburg/ Madison County 0800233
BUILDING rMUvflT AP PLICATION 11?16 !4a0 i.bj 612 Island St -Henry
19 E MA]N, REXBURG, ID. 83440 I
209 359 - 3020 X322
PARCEL NUMBERS ( We will provide this for you)
SUS DIVISION: L cik t� 1�_ vj kn UNIT #. BLOCK# _S LOT# 4
(Addressing is based on the information - must be wcumto) Sa.ct,o 31
_.�,..__. ONTACT PHONE # Zc>A
PROPERTY ADDRESS: L
I 3qp -Iw'1
PHONE #; Home (2* S - - L47,� Work ( 10 a- i,I z Cell (2�
U WNER MAILING ADDRESS: %3 C T I 6 CITY: � STA'! M 2TP: 0
EMAIL I-r; lrh ni In 5A j6 In f AX I , 4 - 1 4-- , 9 1 C- VJCw, }L *u-k. — p 14 I 1 St
�4PPl,,lCA1Vl (If dther than owner) "Az -
(Applicant If other than owner. a tlWO M014 ltutlwrIZIV9 applicant to let a9 agont for ovmar must accompany this application.)
APPLICANT INFORMATION: ADDRESS 9 I< AAA — ems CTn: `A -
STATE � ZIP , {P AX 7.a'8 -�ll.
PHONE #; Home (zoe) n a - & I Work Cell (24U o - t'-i`1�
MAILING ADDRESS: 2�tS 3 D N • C1TY' St - f ST ATE :,D ZIP 14
PHONE: Home# work# e j 4 (0) Cell# 31 6 Z LD
EMAIL FAX
many buildings are located on this properly?.
Did you racently purchase this prvperty'?(o yes (7f yes give owner's nanm)
Is this a lot split? NO YES (Please bring COPY of new legal description of property)
PROPOSED USE: S r le.
(i.e., Single Family Residence, Multi
Garage, Commercial, Addition. Etc.)
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under pontlty of penury. I hereby certify that I
tpw raid "a application end sm asst dw infonaetion herein it wrect snit I nw m that say iafom odw which mmy hereaf ., be given by stn in Marie beibrr the
rimudag m a z on i ng Commin" or dw Chy Comma &r toe city orRo6mg Omit be buthibl. and eotamt 1 rppae to comply with dt City rusuletiou pad State left
closing to tie mbjoxt mama of this sppti=Ww sad bemby eudhoriaed apmseantim of dw City to enter too am diuvatnenlialed property for smprrtiom purpo M
Nam. The building official any rwoke a permit on epprovd cawed wtdcr dro provitiorm of Ilse 20M latenod0d Code in coa orany min tttttermt ar
rrliseV of ow in the appitcoiea or an ft pima on v&jch the permit at apprwd was hosed permit void if not started widlict 180 days. Pamil void if watt
smpa for 180 d ays.
or
�r � � � ' -
DAT2
Do you prefer to be - contacted by fax, email or phone? Circle One
WARNING - Buuj r. Pm1mT must ox gos m ON comMuc 81131
Plan tees arc; son- tWundable said are paid In fWl at the lime or appltcatloa bm$lnuing damrary .1,, �p2�
City of FlaborVii Aceeptiltsco ofddm OUR ravlory too 0100 not constitute phis approval.
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MAY -6 -2008 02:32P FROM;LINC*ELEMENTARY 6247691 6247223 P.2
U co III ple-te the e ll dre Aj3j.5 iCatld n-I If t hej 1414rb: i0ii dares naI apply fail in NA fox' iltut
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NAME G . Qjnd K✓15-h v%d- b
PROPERTY ADDRESS W7- St. _ Permit#
SUBDIVISION L�� Lbmne.
Requireftdd r!
MECHANICAL
lv wJmnical Contractor's Name: d JLOA Business Name: JUd GD
Adds 2�1 S City S� - F�c state - ice
Contact Phone: ( ) " 13 f Le2:4 - 1 Business Phone: ( ) 2� -
Email Fax t02 _ 7 712�j
Meclia nical Estimate $ _ (C o mmerelaYMultt Family Only)
FLICT I" &APPLUNCES COU'N'T (Slagle Family.Awelling Only)
_ Furnace _ Exhaust or Vent Ducts
Furnace/Air Conditioner Combo �_ Dryer Vents
Heat Pump
Air Conditioner
Evaporative Cooler
Unit Heater
Space Heater
Decorative gas - frcd appliance
Incinerator System
Boiler
Range Hood Vents
Cook Stove Vents
3 Bath Fan Yeats
other similar vents,& ducts:
Pool Heater
Similar fixtures or Appliances
_ Fuel Gas Pipe Outlets including stubbed In or fan re outlets
Inlet Pressure (Meter Supply) PSI
Heat (Circle all that apply) (& Oil Coal Fireplace Electric
Mechanical Sizing Calculations must be submitted with Plan & Application
Point of Delivery most be shown on plans.
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Sipaniv vrl.keii<,ed Lt)iilr for Liceim nuoibtr
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The CIO CfA=burg's penny fee schedule Is the same
Idaho
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