HomeMy WebLinkAboutAPPLICATION - 08-00535 - Shaun Boice Office - MechanicalCITY OF REXB
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MECHANICAL PERMIT APPLICATION Please co
19 E MAIN, REXBURG, ID. 83440 If the questio
Q
0800535
Shaun Boice Office -2684 S 2000
208 - 359 -3020 X326 VV
V
PARCEL NUMBER: N-3>1' F, (We ....
SUBDIVISION: UNIT# BLOCK# LOT#
(Addressing is based on the information - must be accurate)
OWNER: Q , CONTACT PHONE #
PROPERTY ADDRESS: 6 si
PHONE #: Home ( ) Work ( ) Cell ( )
OWNER MAILING ADDRESS: CITY: STATE: ZIP.
EMAIL FAX
APPLICANT (If other than owner) f C ] , jA , R
(Applicant if other than owner, a statement authorizing applicant to act as agent for owner must accompany this application.)
APPLICANT INFORMATION: ADDRESS 9 C1q t qc as CITY:
STATE; c7w -99 ZIP g / 6 EMAIL FAX ��-
PHONE #: Home ( ) Work ( ) SZ5- c63Z _ Cell( )
CONTRACTOR
MAILING ADDRESS:
CITY STATE cQJ ZIP
PHONE: Home# SZZ - 5 , � /5 Work# SZ5 - 9,3 32 Cell# ?70
EMAIL
FAX S L E 13 7
now many ouuamgs are Iocatea on tnis property'!
Did you recently purchase this property? 9 Yes (If yes give owner's name)
Is this a lot split? eo YES (Please bring copy of new legal description of property)
PROPOSED USE: C mww— r
(i.e., Single Family Residence, Multi Family, Apartments, Remodel, Garage, Commercial, Addition, Etc.)
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: under penalty of perjur I hereby 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 ap ca nand hereby authorized representatives of the City to enter upon the above - mentioned property for inspections purposes. NOTE: The
building official may r o a rmit 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� e 1 o which the permit or approval was based. Permit void if not started within 180 days. Permit void if work stops for 180 days.
r
/ W / C>
Signature of Oder /Applicant
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
Building Safety Department
City of Rexburg
19 E Main
Rexburg, ID 83440
NAME ` 5 � , ,,,.�
PROPERTY ADDRESS
SUBDIVISION
janellh@rexburg.org Phone: 208.359.3020 x326
www.rexburg.org Fax: 208.359.3024
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C I T Y OF
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America's Family Community
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Permit#
Required!!!
MECHANICAL
Mechanical Contractor's Name: ft ,� CG � Business Name: 1JCS ` /�"
Address - 321 - Z City State Zip ?,3/C>
Cell Phone: (2 ?) SA - 3 ���/ Business Phone: ( ze -5 -q,3--?
Fax: ( )
Email
Mechanical Estimate $ (CommerciaUMulti Family Only)
FIXT & APPLL4NCES COUNT (Single Family Dwelling Only)
zD 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:
Fuel Gas Pipe Out le ncluding stubbed in or future outlets
Heat (Circle all that apply) Gas Oil Coal Fireplace Electric Hydronic
cal Sizing Calculations must be su bmitted with Plans & A
Point of Delivery must be shown on plans.
z1 h, _- — - 1'60 !l -3 - 09
of Licensed Contractor License number Date
0 4
JaNell Hansen
From:
Shauna Ringel [sringel @co.madison.id.us] ,
Sent:
Monday, November 03, 2008 3:44 PM
To:
JaNell Hansen
Subject:
RE: Shaun Boice Commercial Bldg
Our permit has 2684 S. 2000 W.
From: JaNell Hansen [mailto:janellh @rexburg.org]
Sent: Monday, November 03, 2008 2:31 PM
To: Shauna Ringel
Subject: Shaun Boice Commercial Bldg
Hi Shauna,
Could you verify the address for Shaun Boice's office building on S 2000 W over by Triple A Landscaping? He gave his
mechanical contractor 2684 S 2000 W. Is this correct?
Thanks,
JaNell Hansen
Building Safety Coordinator
Phone: 208.359.3020 ext 346
Fax: 208.359.3024