HomeMy WebLinkAboutAPPLICATION - 08-00531 - 387 Airport Rd #22 - Mobile HomeBuilding 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
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Americas Family Community
NAME
PROPERTY ADDRESS
SUBDIVISION
Permit#
Required!!!
MECHANICAL
Mechanical Contractor's Name: -5� de. L.r�z dG Business Name: 1C9h S c✓ // C014 9
Address �e��� , City n" X 4 ,, I State fO -A " Zip 3 Y�l.0
Cell Phone: (aop 3 S 3 S`,S ,J' Business Phone: (a °1) 3 5-1 Y2 q�
Fax: Email
Mechanical Estimate $ (Commercial/Multi Family Only)
FIXTURES & APPLIANCES COUNT (Single Family Dwellin Only)
Furnace /� Exhaust or Vent Ducts
Furnace /Air Conditioner Combo
Heat Pump
Air Conditioner
Evaporative Cooler
Unit Heater
p ace Heater
Decorative gas -fired appliance
Incinerator System
Boiler
Dryer Vents
Range Hood Vents
Cook Stove Vents
Bath Fan Vents
other similar vents & ducts:
Pool Heater
Fuel Gas Pipe Outlets including stubbed in or future outlets
Heat (Circle all that apply) Gas Oil Coal Fireplace EDtricl Hydronic
Mechanical Sizine Calculations must be submitted with Plans & Application
Point of Delivery must be shown on plans.
Signature of Licensed Contractor
The City of Rexburg's
# 1-5'6 q
License number
schedule is the same as
e) — 91 -bJ
Date
the State of Idaho