HomeMy WebLinkAboutAPPLICATIONS - 08-00294 - 449 Partridge Ln - MechanicalJun, 18. 2008 12:13PM 4;'F' t Call Jewel
CITY OF AE n
BUILDING PERMIT APPLICATION
19 E MAIN, REMURG, ID. 83440
208-359- 3020 X322
No. 08*25 P. 2 2
D . PFRMI*
Pie` A �+ .alyn� +tints
If tht
0800294
PARCELNUMBER: �P 449 Partridge-Cushin
SUBDIVISION:
(Addressing Is based on the ipformation - must be aocurato)
CONTACT PHONE #_ l� /- 11,4 .M
PROPERTYAr)rmsS: V
PHONE #: Home ( ) -- v Work ( ) Cel ( )
OWNER MAILING ADDRESS: CITY: STATE; ZIP:
EMAIL, FAX
P11C : (If other than owner)
(AppReattt if other than owner, a stateMernt aurhOrizing applicant to act as agent fbr owner must accompany 'this application,)
APPLICANT INFORMATION: ADDRESS CITY: s
' /, ,
STATE; ZIPS -�'- BMAIL FAX
I PRONF,74: Home ( ) — Work( ) 5,�a Z 72 C all( )
CO NMUCTOR: ,
MAILING ADDRESS:
an-M M " M
PHONE: Home# W orb all#
EMAIL SAX c �Z2 9 - .2 7�'g
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 (PIoaso bring copy of new legal description of property)
PROPOSED USE;
O.e., SkWo Fat:Mily Rastdenee, Muir! FamAy, Apardaei ts, Remodel, Garage, Commercial, Addition, Etc.)
APPLICANT'S SIGNATURE; CERTMCATION AND AUTHORIZATION: Underpme tyafpCdjny 1hnrbr.eertify1ha11
have read this VpUcadoa cad stoic that the infoltaadoa hcrvin le oarrvvi and t awvu that any iufvimtsblva wltl wsy kttaaatder be 7irea by tae is hearUtga before'the
Planmgg sad Zoa W Commlealon or tho City CouuW for the City of JZe xhM shell be au hU and eon=L I agree to comply with all City rogolations and Stare lava
Maft to tho wbjovl manor ofthis a"Hastion and hmvby awmr ¢ed tepta6eamcivn untie Cavio eptatpom im abovc-mantionodpropm forhapocdaas PUMP=
NOTE, Tito building afiioia) may revoke a permit oa approval issued vader the provisions oft ba 2000 Lc=alonai Cado Inca= of aay Woo ritivmatt or -
misrepresentadon ofractin the aypllcadon or on the pleas on which the pormit or approval was bated. Faamit void if wtstwed withk 180 ,days. Farah void iPWotk
stabs for 180 &YO. r
DATE
Do you prcfcrto be contacted by fax, email orphone? Circle One
WAXMG -- KMMING )PERMIT MUST RE P09710 ON CONSTRUMON SPP,St
Plan teen an non rotllindable and Are paid lnftA at tha ttme of appllcsef on be&lial Jmumv l
City atRmhurg's A=eptanes uttha plan redaw fee does not constilm 13119 apptaw21
r
Jun 18.uu2008 1213P�:22Phi St Call Jewel �N�o, 0843 P P. � 3
Please complete the entire Application! If th gn ention 0 not apply flU Iu NA for non
applicable
NAME
PROPERTY ADDRESS Permit#
SUBDIVISION
Requiredl !1
MECHANICAL
Mechanical) Contractor's Name;, - Business Name.
Address T�> r 9 City State Zip
Contact. Phone; ( ) &'-Q „ 7 2- 7 Business Phone: ( )
Email ,. Fax Q !Z — -2- 2!Z1
Mechanical Estimate S (Commercial/Multi Family Only)
FIST UM A A PPLMNCES COUNT (Single Family Dwelling Only)
Furnace Exhaust or Vent )Ducts
Furnace/Air Conditioner Combo
Heat Pump
_ - ZZ A.ir Conditioner
Evapo Cooler
Unit Heater
Space Hester
Decorative gas-Med. appliance
Incinerator Systcm
Boiler
Pool Hcatcr
Dryer Vents
Range Hood Vents
Cook Stove Vents
Bath Fan VentS
other similar vents & ducts:
Similar fixtures or Appliances
Fml Gras Pipe Outlets including stubbed in or future outlets
Inlet Pressure (Meter Supply) PSI
Heat (Circle all that apply) Gas Oil Coal Fireplace Electric
Mechanical Sizing Calculations must be submitted with Plans & Application
Point of Delivery must be shown on plans.
fti 4 e of tfcofi4id Contractor License nmuber
Required!
The City of Rezburg's permit fee schedule is the same as
6�_ /���
Date
sire State
5