HomeMy WebLinkAboutAPPLICATIONS - 08-00282 - 6282 S 3100 W - Mechanical�GJun• 12. 2008 11,26*1irhFirst Call
CITY 0FAMUR0
BUILDING PERMIT APPLICATION
19 E MAIN, REXBURG, ID, 83440
208 -359- 3020 X322
PARCEL 1N'UMB.ER: w J JN `3'1 E 30_ 7c-� l
SUBDIVISION; U
(Addressing is based on the •infoamatiou - must be amurate)
CONTACT PHONE #
PROPERTY ADDI2SS ; .ld,�2c�� Qp
PI30NE #: Horuc �o� (2L2/l! Work ( ) o Cell
OWNER MAILING ADDRESS: CITY: STATE: ZIP:
EMAIL FAX
(If other than own &, _
(Applicant if other than owner, a statemetrt aurhorWng applicant to agent for owner most accompany
APPLICANT INFORMATION: ADDRESS - CITX:
STATE, ZIp e32k_3 I FAX
PHONE #: Rome ( ) Work Qa -7727 Cell ( )
CONTRACTOR: - _ tea % ,71 . a „ 17
1 1 11' � ► F / , i
PHONE: Home# Work# ell#
EMAIL FAX 0����79_3
How many buildings are located on this property?
Did you recently purchase this property? No Yes (If yes give owner's name)
Is this a lot split? NO YES (Please bring copy ofnew legal dosciiption ofproperty)
PROPOSED USE;
(i,e,, S.ilagle Fa Mily Re9ldenoe, Muld Family, Apartments, Remodel, Garage, Commercial, Addition, Ptc.)
APPLICANT'S SIGNATURE, CERTIFICATIONANvDAUT14O 17ATION Gnderpaaelryafpajwy lhetebyeer*thotl
have read this awlicadon and on drat tiro intottaadon boroin is cored and I swca< IW any informstiom wh(oh may horaA w be oven by mein hearings before the
Plannlug and ZonLw Commission or tltc City Couaail for ft City of )texburg shell be lmffi l and cotrest. I agree to comply whL all City regal atiom end 5= laws
elating to dw eubJoot matter of thin appliodion and hamby 9whodnil tepresentatim of the Clty io eam upon the above- mantlonod pwyorty for ltrsp ow gwp0oas.
NOTH: Tito building official may revoke a permit on approval issead under duo provislom of the 2000IntrmadoW Coda in cow of mayfalss Ym mart or
mimprwentatlonoftamin the opplicoonorondw plow on which tbcparnitorapprovalvmbeed. Parmitvoidifaot #Wed within Igo days. Permit voidifwork
stops for 1811 days. , (Y Z
Signature of Owner/ 'cast DATE
Jewel
PERMIT 0
Please complete the
If the qr
No. 0773 1P• 1
entire Application!
0800282
6282 S 3100 W- Carlson
Do you prefer to be contacted by fax, email or phone? Circle One
WARN C.— RUII.DING PEMW MUST RE POSTED ON CONSTRUCTION SXTE1
Mani fens are non rdundable and are pnld in fdU at th e time of Anumv 1.2005
City of Rnhw®'s Acceptance of the plan r.vi.w 1w don not coardUL a plan approval
Jun. 12. 2008 11:26AM, Call Jewel
"u ,, I!• LV V! L•
Please complete th0ittire Application!
applicable
NAME
PROPERTY ADDRESS
SUBDIVISION
1 N"o. Y 0773 p P.
If the gaestion46 not apply tlU In NA for non
Permit##
Requiredl !!
MECHANICAL
Mechanical Contractor's Name: oueiness Name. � c�"�.a�
Address :` 9) City s Slate
Contact Phone: ( ) � � — 7 7 7 Business Phone: ( )
Email Fax
Mechanical Estimate S (Commercia Family Only)
FIXT 2ZES & APPLIANCES C0UNT (Shy gle 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
luciuerator systcw
Boiler
Pool Heater
Similar fixtures or Appliances
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
Inlet Pressure (Meter Supply) PSI
Heat (Circle all that apply) Gas Oil Coal Firepla Blcctnc
Mechanical Sizing Calculations must be submitted with Plans & Application
Point of Delivery must be shown on plans.
/f 24X,
S tore o a Centre r r License number
Required!
The 00 of aburg's permit fee schedule is the same as
Date
the State