HomeMy WebLinkAboutAPPLICATIONS - 08-00574 - 1900 Robison Ln - Perkins11/24/2008 10:47 20874550
Ser.17, 2C�i 17.3�P�N1
CITY OF RE)MURCT
MECIiANICAL PERMIT APPLICATION
19 .MAIN, REnjJRC, ID. 834 0
208_3593020 X326
ADVANCED PLUMBING PAGE 03
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0800574
Please cc
if the questh 1900 Robison Dr- Perkins
pAR CEI. NUM � I3ER: - S N � G� 1'.� i We w►Ax pz�tviaa ua WA yvu� LOT#
SUBDIVISION:
_IjNI`C#
(Addressing is based on the information - must be accurate)
CONTACT PHONE #
PROPERTY ADDRESS!
T
`',. � �r1,Q1 Work
PHONE #: Home ( / 4,Q -.-
O
�uNER, MAILING ADDRESS: 1 9gD obi A — CIT
PPL T. (If other than s licacior,.
(Applicant if other than owner, a stotemc3jt. zutboriaing applicant: tc. act as meet far. owner mutt accompany tit% )
APPLICANT INFORMATION. ADDRESS
STATE. _ ZIF_. — .._ EMAIL
PUIONE #: H OMO ( ) ^ Work (
CIT
FAX
�_ Cell ( )
CON TO :
MAILING ADDRESS:
CITY
A
!0 y
�' •Cell# `� v
PHONE: Home
EMAIL P
How many buildings are located on this proPerty ?._
Did you recently puxchase thin pmpEt�.j? No 'acs (I'f yes give ownEr's name)
1s this a lot split? NO YES (P'leagc bring copy 4f new legal description of property)
PROPOSED USE:
(i.e., Stele Family Residence, Multi Family, ApAttt3lept4, Remodel, Garage, Commemial, Addition, Etc)
APPLICANT'S SIGNATURE, CERTIFICATION .ANA AUTHORIZATION U nder penalty of perjuryy. I hereby cattily that t ha
lead. this application eod state that the informnion herein, is cornet and i sweat that any infbtmWon which may hurcafw be *= by.nno in hemogs belbte the Plmwirig
Rod Zoning Commission Of the City council for the Cily of RcebuTg shall be trntbfid and correct_ l agree to comply With all City regWrdom and gtam laws relatingto the
subject mater of this application and hereby authorized mpresentntives ofthe City to enter upon be ve•tnattioned property for inspections putpeaes. NO bcn of fkdt i'l
building official may nyokc s<pCtmR on approval issued under the provisions of the 2003 inumsdowd Coda in t• 88 of any frdsc st=Mci t Or � -
the oa sox on cb the pet>alt ar approval hand. Permit void if trot sGtrtcrl within ISO days. pttrttt$ void if w ork 9 � 80
DATE
Signpplicant 7 Circle OW
fax
o you pmfa to be crnMm*!d by : l or pbWe
wARNIN(; — 'BUILDING PERMIT MUST BF, pdSTTM ON CONSTRUCTION SITE!
plan fees nre non- refundable *odor* paid its full of the time of tjpplleatltln be�eolII$ Jmrateru 1. 20AS.
City of Rexburg!x Acceptance of. th a plan review fee dogs not aoastito" plan approved
11/24/2008 10:47 20874550
ADVANCED PLUMBING
N
Building Scaf ety Depajimen
C,ry of Rexburg
Phone: 20B.25q.3o2o x326
19 E Moir) Janellh ®IexburA•o Fri 208.359.3
Rexbur_q, ID 83440
tvww.rexburg.o
NAM1r
pROpERTY ADDRESS �� -- - --
SUMMSION
Require+dd 11
MECHANICAL.
city
address � `'
cell phone ( )
Fax: am)
Ao.096 �
PAGE 02
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Name.
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State
zipl r
Mechanical Estimate
(C,omm�crciaUUkVliilti Family Only)
M7 & APPLJANCES C0v7vT
Fumacc
- - -- Furnace/Air Co><tditionex Combo
�� Beat pump
Aix Coaditiorxe'r
Evapwarive Cooler
Unit Heater
Space Heater
pecorative gas -fired appliance
. incinerator System
Boiler
Dryer Vents j _ 6 0 .
g,nge Hood Vents
Coolz Stove Vents Y NCO
Bath Fan Vents
�^ o*= similar vents & ducts:
Pool Beater
Gas pipe Outlets including stubbecl, ill or future outlets,
Heat (Circle all that apply) Gas Oil C001 Fireplace FlectTic Hydrollic
Point o Delivery u t be aura o>a gkm
L OU g 2 9
Si a ceased Contractor Tuet Date
(Single Fu>ntidy Dwe"tng Exhaust or Vent Ducts
The City of ReXburg's,permit fee srhedule is the same as required by the Slate