HomeMy WebLinkAboutAPPLICATION - 08-00514 - 267 Apache Furnace & Water Heater Replacement_►���05y P I
��
71. (r
BUILDING PERMIT
19 E MAIN, RMOURGr, ID, 53440
208- 359 - 3020 X322
Pl ease W 0800514
If tIze que; 267 Apache- Furnace & Wtr Htr Replacement
PARCEL NUMBER:
SUBDIVISION: UNIT# BLOCK## LOT#
(Addressing is based on the information - must he soourate)
CONTACT PHONE #.
PROPERTY
PHONE #: Homc ( ) Work ( ) Cell ( )
OWNER MAILING ADDRESS: CITY: t-f- STATE: 1, ZIP:Y34_)
EMAIL, FAX
.PLICANT (If other than owner)
(Applicant if other that owner, a srstemetrl a uthorizing applicant to act as agent for owner mnet accompany this application,)
APPLICANT INFORMATION: ADDRES D , r�29� _ C ITY: s
S TAIL; ZIP _ EMAIL F AX
PRONE A -Home ( ) Work ) 5,22 " 2 77 Call )
CONTRACTOR:
14AIUNG ADDRESS:
PHONE: Home# Wort Cell#
EMAIL FAX
How many buildings are located on this property?
Did you recently purchase this property? No Yos (If ycs give owner's name)
Is this a lot split? NO YES (Please bring copy ofnew legal desctxption ofproperty)
PROPOSED USE:
(i.e., 3,itagle Family Residence, Multi Fancily, Apartments, Remodel, Garage, Commercial, Addition, Etc.)
APPLICANT'S SIGNATURE, CERTIFICATIONA.ND AUTHOPJ7ATION: Undrrpeaalryofpennry ,I hereby car* thdiI
havo mead this applicadou and no do the infbMndon hatoia ie eonv6t e>bd 1 ewoar that any information which may barcaEar be 1;i by m e in hearings before the
Fiannmg and Zoniq Commission orti c City Cotmr;il .for the City ofRexbmo sba(1 be and W and correct t agree to comply with an city rsgWadons and 5t= laws
y1la Bto the subloat teener of WA appliamion and hereby aulhoriad rep>pmretimt of The Ctty to eater upon the above•mendoncd plopctty for lwpcdons ptrtpores.
NOTE; The building QfficimJ may revoke a permit on approval Wuedimderthe provisions of thr2000 In=cdonal Codc in cp m ofmyMod statement or -
mImprosotation cf fwr Jt! Ole appllcoon or on dro plans on whicb the pcnolt orapproval was based. Pamit void iftol z4Wed within 180 days. permil void ifivori
Slops for 1 ti0 dqa. . ,
dos - - -- ��
Sigllaxure OwnerA t - - DATE
Do you prefox to be contacted by fax, email or phone? Circle One
wA,RMG — 71t=ING PERMIT MV9T IM POSTED oN COMTRilCrION SrrX1
Plan fens are non -refoa tole and are pold lA MU at We time of application beglnning ,lmnrery 1,20t
Cjty of Resbrn'r Amnptance of the plan ravlaw fee does not coPSItata plan approval -
Jul, 15, 2005 2;22P No. 0925 P. 3
Please complete thT entire Applicationt if the gnestion does not apply feu 1 NA for non
applicable
NAME
PROPERTY ADDRESS
SUBDIVISION
Permit#
R eq uiredl l l MECHANICAL
Mechaaical Contractor's Name: Business Name; �I , t i i LL
Address p"l — � City State .�[ Zip - &W
f
Contact Phone; ( ) Business Phone: ( )
Email Fax
Mechanical Estimate S (Commerei"ulti Family Only)
FIXTURES & AP,PLIANCES COUNT (Single Family Dwelling Only)
1-'Furaace Exhaust or Vent Ducts
Furnacc /Air Conditioner Combo
Heat Pump
Air Conditioner
Evaporative Cooler
Unit Heater
Space Neater
Decorative gas-'fired appliance
Incinerator System
Boiler
i
Pool Heatcr
Similar 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 Firoplacc Electric
other similar vents & ducts:
Mechanical Sizing Calculations must be submitted with Plans & Application
Point of Delivery must be shown on plans.
f -
A ),
Signature of Licensed Contrac! r Lic_ens�e number Date
Required:
The City of Rezburg's permit fee scf vdule !s the same x required by the Stage gf1daho
Dryer Vents
Range Hood Vents
Cools Stove Vents
Bath Fan VerrtS
5
A'.
If
entire Application!
question does not apply fill in NA for non applicable
NAME
PROPERTY ADDRESS
SUBDIVISION
Permit#
Dwelling Units: Parcel Acres:
SETBACKS
FRONT SIDE SIDE BACK
Front Footage (if applicable)
Storm Water Length
Remodeling Your BuWinglHeme (need Estimete) S
SURFACE SQUARE FOOTAGE: (Shall include the W=ior wall measurements of the bWlding)
First Floor Area Unfushed Basement area
Second floor/loft area Finished basement area
Third floor/loft area Garage area
Shed or Bam Cazport/Deck (30" above gmde)Arca
Water Meter Count: Water Meter Size;
Require
PLUMBING
Plumbing Contr*tor's Name:
Contact Phone: ( ' ) _ .
, �4 a --
COUNT (including ioughad, f Mass)
Clothes Washing Machine
Dishwasher
Floor Drain
Garbage Disposal
Hot Tub /Spa
Sinks
(Lavatories, kitchens, bar, mop)
Phone: (
SprinklcrS
Tub /Showers
Toilet/Urinal
_Water Heater
Water Softener
7A
plumbing. Estimate S (Commercial Only)
.9jgosturs of Licensed Cann ctor Liceme number pat
The City gfRexbwg's permitfae sehmhik is the same as required by the State ofidaho