The URL can be used to link to this page

Home My WebLink AboutAPPLICATIONS - 08-00575 - 1089 East Butte Rd - Cnty MechCITY 0 0 C OF REXBURG PERMIT # MECHANICAL PERMIT APPLICATION 19 E MAIN, REXBURG, ID. 83440 208 - 359 -3020 X326 PARCEL NUMBER: SUBDIVISION: _( We will provide this for you) UNIT# BLOCK# (Addressing is based on the information - must be accurate) LOT# CONTACT PHONE # 7S PROPERTY ADDRESS: PHONE #: Home 7S� 'fa /p Work �.b 5.;2 6 -5p7 / Cell j s) 5 ; _3SsS OWNER MAILING ADDRESS: /per &s gurrF P o CITY: j11 STATEa 3_ 3 5— EMAIL s. -.�o APPLICANT (If other than owner) (Applicant if other than owner, a statement authorizing applicant to act as agent for owner must accompany this application.) APPLICANT INFORMATION: ADDRESS STATE PHONE #: Home ( Please complete the entire Application! If the question does not apply fill in NA for non applicable Work ( Cell ( ) CONTRACTOR ,,,& s MAILING ADDRESS: CITY STATE ZIP PHONE: Home# Work# Cell# EMAIL FAX How many buildings are located on this property? p Did you recently purchase this property(s) Yes (If yes give owner's name) Is this a lot split NO YES (Please bring copy of new legal description of property) PROPOSED USE: 5,416 AC 5/ Oar (i.e., Single Family Residence, Multi Family, Apartments, Remodel, Garage, Commercial, Addition, Etc.) APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: under penalt 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 application and hereby authorized representatives of the City to enter upon the above - mentioned property for inspections purposes. NOTE: The building official may revoke a permit on ap roval issued under the provisions of the 2003 International Code in cases of any false statement or misrepresentation of fact in the applicatio�r on the plans on w ' e permit or approval was based. Permit void if not started within 180 days. Permit void if work stops for 180 days. W , / Signature of Owner /Apl}Yicant DATE /� /�� ZIP EMAIL CITY: AI4 Do you prefer to be contacted by fax, email phone Circle One WARNING — BUILDING P UST 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 PROPERTY ADDRESS SUBDIVISION ionellh@rexburg.org Phone: 208.359.3020 x326 www.rexburg.org Fax: 208.359.3024 OF gEX URC U � CITY O F REXBURG __.____ _._ C)W __ America's Family Community ,8 Permit# Required!!! MECHANICAL Mechanical Contractor's Name: _A�6,4y "gT& P/ Business Name: p&-w r?p Address C g-sr r /_ City 14�� State Zip �t� 9- Cell Phone: ",70 _ 5z q - 3 S S Business Phone: ( ) Fax: ( ) Email Mechanical Estimate $ (Commercial/Multi Family Only) FIXTURES & APPLIANCES COUNT (Single Family Dwelling Only) l 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 Bath Fan Vents other similar vents & ducts: Fuel 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 & Application Signature of LVensed Contractor The City of License number 's permit fee schedule is the same as the State of Idaho Dryer Vents Range Hood Vents Cook Stove Vents i ate 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 other similar vents & ducts: C I T Y OF REXBURG America's family £;ommunity NAME PROPERTY ADDRESS SUBDIVISION —Erryer Vents Required!!! MECHANICAL Mechanical C ontractor's Name: �` #- )16'71 Business Name: � " V Z° Address V City �c� �� Zi nAkW Cell Phone: ( ) c YZ Zn Business Phone: ( L5_ :� j � Fax: ( c9 `A� a Z_ Email ll s /12 V<Zr- a� Kat ll T2 r C 07w Mechanical Estimate $ 05f0l (Commercial/Multi Family Only) FIXTURES' & APPLIANCES COUNT (Single Family Dwelling Only) (�/ Furnace _E xhaust 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 Fuel Gas Pipe Outlets including stubbed in or future outlets Heat (Circle all that apply) Gas Oil Coal Fireplace 6q;) Hydronic 11 Signature of g Calculati Point of DE The City of Rexburg's Permit# Range Hood Vents Cook Stove Vents 3 Math Fan Vents ust be submi ery mu License number schedule is the same as the State of Idaho U � e} y� 4, ,a Plans & on ratans.