HomeMy WebLinkAboutAPPLICATION - 08-00529 - 3573 W 2000 N - Gas linel
Building Safety Department
City of Rexburg
19 E Main ionellh @rexburg.org Phone: 208.359.3020 x326
Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3024
CITY OF
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America's Family Community
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Permit#
Required!!! MECHANICAL
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Mechanical Contractor's Name: b P Business ae:
Address J Cit State
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Business Phone: ( )
Email
Zip
Mechanical Estimate $ (Commercial/Multi Family Only)
FIXTURES & APPLIANCES COUNT (Single 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
Incinerator System
Boiler
Pool Heater
Dryer Vents
Range Hood Vents
Cook Stove Vents
Bath Fan Vents
other similar vents & ducts:
F uel Gas Pipe Outlets including stubbed in or future outlets
Heat (Circle all that apply) Gas Oil Coal Fireplace Electric Hydronic
Mechanical Sizing Calculations must be submitted with Plans & ADDlication
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