HomeMy WebLinkAboutAPPLICATION - 08-00585 - 3834 Taylor Ln - ClarkROM :PERFORMANCE AIR LLC FAX NO. :2085425130 . Dec. 03 2008 03:47PM P1
Dec. 1 2008 4:08PM No-7493 P. 3
CITY OF REXBURG PERMIT
MECHANICAL PERMIT APPLICATION Please complete the entire Application!
19 E MAIN, REXBURG, ID. 53440 N the question does not apply fill in NA for non applicable
209- 359 -3020 X326
PARCEL NUMBER: We will provide this for you)
SUBDIVISION: UNIT# BLOCK# LOT#
(Addresaing is based on the information - muse be mcuratc)
CONTACT PHONE #
PROPERTY ADDRESS: �'� TA o t LW,
PHONE #: Home ( ) Work( ) Cell ( )
OWNER MAILING ADDRESS: UA I - *>' w ed' CITY: A � bb,r �S STATE:-,13) ZIP:
APPLICAIY.T (If other than owner) .t) k trope i`�- nU F>L C Q fVt cL C— b L
(Applicant if Other than owntu, s statement authorizing applicant to act as ;Bent for owner must accompany this application.)
APPLICANT INFORMATION: ADDRESS CITY: N mMo "
STATE; duo ZIP ? 0 EMAIL er �o rnnwrc 2 �� FAX
PHONE #: Home ( ) Work ( ) cell( ) 5 '7 - 0,5 33
CQ TOR: — Pe_C 0 - r^� a ,-,c:e
MAILING ADDRESS: A L� CITY ►� STATE T ZIP �3� �I
PHONE: Home # ►3\a Work# - M-053 Cell#
EMAIL t(k of��� Ica .te +; �.ro j�A X 5 qa - 5 3 U
How many buildings are located on this property?
Did you recently Purchase this properly ?I No Yaa (If yes give owner's name)
Is this a lot split?
,.or--\ (Please bring copy of new legal dcscription of property)
PROPOSED USE: G' e\ (e Q 0
(i.e., Single Family Residence, Multi amily, Apartments, oriel, Gemge, Comnwoial, Addition, Etc - )
APPLICANT'S SIONATURE, CERTIFICATION AND AUTHORIZATION: undue penata of r oQn.1 bercby ocrtify that I havc
teed this applltmlon and stele then the information burin is oofteat and I swear that anY information which may beteafta be given by me in hcarinp bofom the Planning
and zonins Commission or the city Counted for ft CtW of Rmtbors shall be trudibi end canct l ON to comely with 811 GSty teQut8t9ous and laws rolado^ to the
tulljeat rttalter ofthis applleatlon and baroby authori=d wpMontAtives of the City to enter upon the shove-Ineatitmed property for Inspections pttepom- NOTE: The
building off W tnay mvtdw a pm nit nit an epptoval issued under the provisions of the 3003 Internatlonal Code In cum of any false statement of nilerapme ntatlon of fact in
tltc 6 on or on the plants 'wit permit or oproval vise based. Pcrmit void If not swud within 180 days. 1'ramit void if work stops lbr 180 days.
eq
DATE
sipature of Owaer /Ap an .
Do you prefer to be contacted by bxx, ermail phon 9 Circle One
WARG _ BUIIAING PE MUS
IM T BE PQMD ON CONSTRUCTION SITE!
Plan fees are non- rdbndtlble and are paid In full at the dyne of application beginning L4MM I. 2003
Chy of Rexburg's Acceptance of the plan review fee does not constitute plan approval
FROM :PERFORMANCE AIR LLC • FAX NO. :2085425130
Dec. 3. 2008 4 :08PM
Dec. 03 2008 03:47PM P2
No. 7493 P. 4
Building Safety Department
Clay of Rexburg
19 E M01n fonelAterexburP.ttirg Phone. 208.359.3020 426
Rexburg, 1b 83440 www.rexbUrg.org Fox: 208.354.3024
CI or
RE
"•�,,�. Arwieas Family Gammuntty
NAME
PROPERTY ADDRESS
SUBDIVISION
Permit#
Required!!!
MECHANICAL
Mechanioal Contractor's Name: " Bfe fvk J �5 Business Name: ' ?e-r }o r M ame, k r L�
Address 1 k o8 5 . Lc ,._ city A ,nn rh q r State i�A Zip 13 Le �
Cell Phone: (a O@ _2 S 2 - b 5 3'/ Business Phone: (
Fax: ( ) S y - / ? j _ EmaiI (1r%A n '(_ e., u : r a w&a . L C •-►-�
Mechanical Estimate $ (Commercial/Multi Family Only)
FIX TURES A APPIJANCES COUNT O brglte FwW& .Dwe(tlang Only)
Furnace 4# _ Exhaust or Vent Ducts
II Furnac Conditioner Combo
Feat Pump
Air Conditioner
Evaporative Cooler
Unit Heater
. Space Heater
Decorative gas -fired appliance
Incinerator System
Boiler
Pool Heater
Dryer vents
Range Hood Vents
r Cook Stove Vents
Bath Fan Vents
other similar vents & ducts:
Fuel Gas Pipe Outlets including stubbed in or future outlets
Heat (Circle all theft apply) Gas Oil Coal Fireplace Electri Hydronie
Me5h8niesl Sizing Calculations_m� submitted wilk Plans & A vo lisadomt
Point of D li
yer
must be Am on pla
e -- )(, 34 i 2 D
oi%wtor Lioense number D e
The Clty o Rexburg's permit fe s8 hetfllle is the some w M ired by the Swr Idaho