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Home My WebLink AboutAPPLICATIONS - 08-00502 - 6695 Mud Springs Rd - Cnty Mech08/28/2008 12:51 2085234638 JaN. 18. 2001 1�0 :14AND CITY OF REXBURG MECHAN PERMIT APPIJCATION Plel 19 E MAiN, pMMURG, ID. 83440 If able LEISURE TIME INC PAGE 02/02 08 0050 * "" 6695 Mud Springs -JAB Construction 208.359- 3020 X326 PARCEL NUMBER: )� `"E this, for you) SUBDNISIONi UNl1 BLOCK #, O7# (Addressing is bused on the information - must be avccmate) CONTACTPHONE OWNER MAILING ADDRES&A, V EMA17, FAX A8E4W& - (i other than owner) (Applicant if other then MO r, a stattstnent y appli= to act as tt)r;ant Far owner muR a000mpany this aAP licatioo. ) APPLICANT INFORMATION: ADDRESS CITY: ' STATE; r ZI1?�IS� O P.MAII. FAX W PHONE #: Home ( ) *jg) ) CONTRACTQ� • MAILING ADDRESS: CrrY STATE ZSP PHONE: Homc# Work# Cell# EMAIL FAx How many buildings arc located on this property? Did you recently purchase this property? No Yes (If ycs give owner's name) Is this a lot split? No YES (Please bring ropy of new legal description of .property) PROPOSED USE: (i.c., Single Family Residence, Mull Family, Aparhaeats, Remodal, Oataga, Comttaercial, Addition, Etc.) APPLICANT'S SIGNATURE, CERTIFICATION AND ALTTHORIZATION: Trader tfy of pctjm. i bareby wlt6 tw 1 have toad this epplloaNa> seal essee Qud tbti ietbemmlaa beleia Is o met end I sww tbst tety btfbm xft wWah =y bem� be &e° by me in bewbgs bcfum the Plsoning end Zonft Lbatntlsslao or the C1W Commll for tb0 Cliy ot'Raxbtrrg shall be cut U MA eorrxt I to ootrlp�y wish ail City tcgtslatioa� and State la+w relating to the suMea manor of tbb a pplltsatlon end hmby mtibmixed r01 Of The GYry m enter uDm the ebov0• ad ptopatty ibr bzpectionr p►s po=, NOTE! The bulldlsg ofclal may revoke a porNltoo app low under t o provisions of the Y003 mDametlamal Cob in am Q(XW 1W6e eta =01 Of mLrePreseatadan of fact m the " . *d ip or oil the plena tm which t or approval was besod, PGtml! void U not fretted Wdthia 180 days. hermit void !f vm* sops for , 180 days. r,.._��. _..,:..,... DATE Do you prefer to be contacted by fax, email or phone? Circle One WARNING —BUU. jNG PERMIT MUST BE POSTED ON CON57RUMON Srul Plan fen are non- refaudable and art p In fall at the time of oppllcatlon beginning Jm owl_ BOOS City of Rezbon's Accaptanee of the plan review Ito does pot eorstitute pion approval 08/28/2008 12:51 2085234638 Jail 18. 2007 10 14AM 40 LEISURE TIME INC 0 Building Safety Department CRY of Rexbum 19 E MGfn jW*1 h®texbwq Q Phone: 208.359.9020 x926 , ID _ www.roxo F= 200.9P. 4 PAGE 01/02 No. 3539 P. 3 CITY OF s $ REXB t? NAME. PROPERTY aWU�6'f.4� Permit# SUBDIVISION Required!!! Meebauical Contractor's CcU Phone: ( ) Fax: asl C � i Ni d _ Business Nedric � _ Q ` �� Cit a Stat Zip8 Business Phono:zil -:? r-»' I /1 t _ , _ . I - -- - j. _ n itwf�l MechaWeal Ratim S--_ (Com 1n0rCbjVMn1d FAMW 0 FIXTURES & APPUANCES COUNT (Sksgde Family DeUb8 may) Furnace Exhaust or Vent Ducts Furnace/Air Conditioner Combo Heat Pump Air Conditioner Evaporative Cooler Unit Heater Space Heater Decorative gas -fired appliance x hLcinarator System Boiler Pool Heater Dryer Vents Range Hood Vents Cook Stove Vents Bath Fan Vents other similar vents & ducts: Fowl Gas Pipe Outlets including stubbed in or f ih o outlets Heat (Circle all that appl�� Coal Fireplace Electric Hydronic Mechanical Sig iue CalculatiQlls must b S mitten th plans & Appli cations �.._ Poin of Delive _ sh '�'�, 011 a>a� Az- &2 iP11=e dI.icdtsed Contractor Liceme numbw Date The Cny cgabrogIs permit ee jdw&de & the smite a required by the SYme ofldaho R11 MECHANICAL CITY OF'PEXBURG 0 PERMIT # 0 MECHANICAL PERMIT APPLICATION Please complete the entire Application! 19 E MAIN, REXBURG, ID. 83440 If the question does not apply fill in NA for non applicable 208- 359 -3020 X326 PC�5►��1 a'� �c;T77Z PARCEL NUMBER: �76C(S `muJ (We will provide this for you) SUBDIVISION: UNIT# BLOCK# LOT# (Addressing is based on the information - must be accurate) OWNER: eta Y2 1 CONTACT PHONE # PROPERTY ADDRESS: � C 1 �Ml l� �2pr " - ci 5 N PHONE #: Home ( ) OWNER MAILING ADDRESS: EMAIL Work ( ) CITY: IW.'" STATE: ZIP: APPLICANT (If other than owner) (Applicant if other than owner, a statement authorizing applicant to act as agent for owner must accompany this application.) APPLICANT INFORMATION: ADDRESS CITY: STATE; ZIP EMAIL FAX PHONE #: Home ( ) Work( ) Cell ( ) CONTRACTOR 1'c yylcJ.r F 4 LL 0 MAILING ADDRESS: t o — 1�1 tk ,) 1-0 PHONE: Home# EMAIL CITY d ,,ho t tk V) STATE S ZIP mi 3 `/6 �? Work Q1*6 Cell# i0'�l 1 FAX 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 of new legal description of property) PROPOSED USE: (i.e., Single Family Residence, Multi Family, Apartments, Remodel, Garage, Commercial, Addition, Etc.) APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: under penalt of perjury, I hereb certify that I have read this application and state that the information herein is correct and I swear that any information which may hereafter be given by me in hearings before the Planning and Zoning Commission or the City Council for the City of Rexburg shall be truthful and correct. I agree to comply with all City regulations and State laws relating to the subject matter of this application and hereby authorized representatives of the City to enter upon the above - mentioned property for inspections purposes. NOTE: The building official may revoke a permit on approval issued under the provisions of the 2003 International Code in cases of any false statement or misrepresentation of fact in the application or on the plans on which trmit or approval was based. Permit void if not started within 180 days. Permit void if work stops for 180 days. Signature o Owner /Applicant DATE Cell ( ) Do you prefer to be contacted by fax, email or phone? Circle One WARNING — BUILDING PERMIT MUST BE POSTED ON CONSTRUCTION SITE! Plan fees are non - refundable and are paid in full at the time of application beginning January 1, 2005. City of Rexburg's Acceptance of the plan review fee does not constitute plan approval • Buildi g Safety Department City of Rexburg 19 E Main janellh @rexburg.org Phone: 208.359.3020 x326 Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3024 O X B 7 w 4 __:_. Americas Family t"°ornm€anify NAME PROPERTY ADDRESS SUBDIVISION Required!!! MECHANICAL Mechanical Contractor's Name: 1\ 1C../ Business Name: Oc�N��, T Address Tr Z �5 , - M k� City _IV4(,� 9J5 State - zip �g3yQ2 Cell Phone: (2' :D) (to Business Phone: F) S_ a a -'as ? Fax: (a)F,,) Email Mechanical Estimate S (Commercial/Multi Family Only) FIXTURES & APPLIANCES COUNT (Single Family Dwelling Only) Furnace Exhaust or Vent Ducts I Furnace /Air Conditioner Combo Heat Pump Air Conditioner Evaporative Cooler Unit Heater Space Heater Decorative gas -fired appliance Incinerator System Boiler Pool Heater other similar vents & ducts: /`; Fuel Gas Pipe Outlets including stubbed in or future outlets Heat (Circle all that apply) Z�l Oil Coal Fireplace Electric Hydronic Mechanical Sizing Calculations must be submitted with Plans & Application Point of Delivery must be shown on plans. Signature of Licensed Contractor License number Date The City of Rexburg's permit fee schedule is the same as required by the State of Idaho _2 Dryer Vents Permit# Range Hood Vents Cook Stove Vents Bath Fan Vents T