HomeMy WebLinkAboutAPPLICATIONS - 08-00293 - 999 E 7800 S - MechanicalJun. 17
� 3D�
2008' 4:50PM 1 : First Call Jewel
CITY0F.Amuff
BUILDING PERMIT APPLICATION
19 E MAIN, REXHURG, ID, 83440
205- 359.3020 X322
P (0 00293 »i
rj 999 E 7800 S- Squires .)Ie
PARCEL NUMBER: �CPCVI (We will provide this for you)
SUBDIVJSION: UNIT# BLOCK# LOT#
(Addressing is based on tho informatlau - must be aoaumte)
o CONTACT PHONE # ZU, �,,� (� 6
PROPERTY ADDRESS: D 6 S ft / e � V 0
PHONE #.-Home ( ) work ( ) Cell ( )
OWNER MAILING ADDRESS; CITY: STATE: ZIP:
EMAIL FAX
!L (If other than owner)
(Applicant if other than, ovrmor, a statement authorizing applicant to act as agent for owner mast accompany this application.)
APPLICANT INFORMATION: ADDRESS
STATE;
— ZIP,?326 5 EMAIL
PHONE #: Home ( ) Work ( ) ,.1 - 7777 Call (
FAQ 2 -:)� Z
CDNVTRACTOI�
MAILING ADDRESS:
1 �
PHONE: Home# Work?,Q #_
EMAIL FAx ,�2
How many buildings are located on this proparty'1
Did you recently purchase this property? No Yes (If yes give ownar's namo)
Is ibis a lot split? NO YES (Please bring copy of new legal description of propeM)
PROPOSED USE; - - - - - -- - -- - -
(i.e., ftoe Funny Roaldottae, Multi Family, Aparnnonts, Remodel, Garage, Commercial, Addition, Etc.)
APPLICANT'S SIGNATURE; CERTMCATIONANZAUTHORIZATION. Underpomatydp'Ww % lhamby.=nifyThatT
have iced this applieatim and stag that the Inforraadon halals is wriest sad 1 setae jW w lnfoaaedcn which may hmeaflet 6e �vee by ma in hesrines before the
Pleanlao sad Zoning CotIIgileeiOA ordte C Coma tlae City om h g Aall ba nihlw and roam I was to comply whh all City regatadoes and Stale laws
ra awl to the o0jem Manor o ftws wpp1lastion grid hMby auLhmi2ad rapreseatartYm ofibe Cityto eater upon the abov"awtionod pmpcm formspootbae purpoeae,
NOTE Thu: building uffir l may mvoko a permit on Wpawal k urd undatho ptorbloas of tht2000 .Tn=odoW Codo in cases ofaayfalse ststcmmt of
mistwprasentmim offwr.ln ma pppllcstlon or on & Pleas on whlob the permit or approvwl wag bred, Permit void if nat m"ad wellfia 110 days_ Pe-rWt void ifwork
stops for 180 days. . I
Simnam m Owner /A %m DATE
Do you profar to be contacted by fax, exuail or phone? Circle Ono
WAW4NG- 13=1WG PE &WT KU5T73$ POSTED ON CONSTRUCIZON SMI
Plan few an non-refundable and ara paid IRM at tUtlpte atAPPRO M013 beglpalag �srvZ a00S
City of R=hnrS's Aeeeptaoee of the plan rwriew to does not oonsd' F - plan approval
3
Jun. 17. :50PM Call Jewel ivo, 0831 P .0831 P.
Please complete t ntire Application if the questl.onek not apply fill in NA for non
applicable
NAME
PROPERTY ADDRESS Permit#
SUBDIVISION
Requrredl!! MECHANICAL
Mechanical Contractor's Name: Business Name: ',
Address ej) Ci State Zip, 3
Contact Phone: ( ) �� o? a � 2 7 7 Business Phone:
Email Fax
Mechanical Estimate S , (Commerefal/Multi Family Only)
FMTUIjES & APPLL4NCES COUNT (Sitagk Family Dwelling Only)
✓ Furnace Exhaust or vent Ducts
Furnacc /Air Conditioner Combo
i/ Heat Pump
Air Conditioner
Evaparadve Cooler
Unit H eater
Space Heater
Decorative gas -fired appliance
Incinerator System
Boiler
Pool Heater
Dryer Vents
Range Hood Vents
Cook Stowe Vents
Bath Fan vents
other similar vents & ducts:
Sirnilar fixtures or Appliances
Fuel Gas Pipe Outlets including stubbed in or future outlets
Inlet Pressure (Meter Supply) PSI
Heat (Circle all that apply) Gas Oil Coal Firepla lcctric
Mechanical Sizing Calculations must be submitted with Plans & Application
Point of Delivery must be shown on plans.
nz., , i�o� _61tel
si lure of Lie ed Contractor License number Date
Required!
The Ci{y of RzxbuM's permit fee schodule Is the same as regutred by the State qf7daho
5