HomeMy WebLinkAboutAPPLICATION - 08-00595 - 262 E 2nd S - CarlileDec. 16. 2008 5;39PMZ : rst Call Jewel
CITY OF = Ulq
BUILDING PERMIT APPLICATION
19 E MAIN, REXBURG, ID, 83440
208- 359. 3020 X322
PERMIT 40
Please
If the que:
PARCEL NUMBER: ( y
SUBDIVISION: UNl
(addressing le based on the informatlon - must be aeourate)
No-30035 P, 1!
0800595
262 E 2nd S- Carlile
UMNE CONTACT PHONE #
PROPERTY ADDRESS - 2�,�2 E 4'4 �5 T � V —
PHONE #: home Work ( ) Cell ( )
OWNER MAILING ADDRESS: CITY: STATE: ZIP:
EMAIL FAX
AP CANT (If other than owner) .e
(Applicant if other than owner, a statemear authorizing applicant to act as agent for owner moat accompany
APPLICANT INFORMATION: ADDRESS P al" , C�Vge CITY: �pS
STATE; ZIP EMAIL FAX
PHONE #: Home ( ) ) 5,? -277 Call ( )
CONTRACTOR
MAILING ADDRESS:
CITY 0 5 STA.TE_LILzIP
PHONE; Home# Worku Cell#
EMAIL FAX - t &29 - .? 79U
�-Iow many buildings are located on this property?
Did you recently purohese this property? No Yes (If yes give owner's name)
Is this a lot split? NO YES (Please bring copy of now legal description of property)
PROPOSED US&
(i.e., 3.it1 a Family Re9idence, Mint( Family, A,par menU, Remodel, Grange, Commercial, Addition, ;Etc.)
APPLICANT'S SIGNATURE, CERTIFICATIO;- i AND AUTHORMAT10N: undop=aliyofpeguMthembyr=fyshatl
have read this mplicadou and =te that the infPMm66n homio is owrmn raid l svrcar tbat dny idarmatian vrluah mayhgmofiw be given by me to hearings before the
Flautdng mid Zoning Commission orthe City Council .for the City of Rexbwg shell be oruthlld and correct. I swee to comply witd aU Chy zagulatlow and Stew laws
relating to rho subject matter of this opplioEdion and hereby audlorivd rep2eeeaEa0m of the CJty to enter upon the anovnmandoncd property for hwpccdons purposes.
NOTA: Tba balldiag o0cial may revoke a petmir on approval ism under the provisions of thv=0lawsmadowd Codo in cases of anY false sWMMI ar
misnpreseumdon of fact.lo the application or on the plans on which tho permit or approval was based Permit void if not Mwied within 180 days. Permit void if work
stops for J 80 dvo. r
DATE
Do you prefer to be contacted by fax, email or phone? Circle One
WAfirliNG -- K=ING Mt&TMDBTSE POSTED ON CONSTRUCITON S1TTl
Plan few are non.rafnndable and are paid In A W at the time ai sppiicsdon be&alag J Mary 1, 30 t7S_
City of R=bnrg's decaptsnce of the plan rmawfee don not coustitate plan approvsl -
Dec,16. 2008 5:40PM First Call Jewel No-3003 P. 2-
Jul. 15, 2005 2:22P* No, 0925 P, 3
Please comPlel e the entire Appl ication! If the qu estion does not apply fm in NA for non
applicable
NAME
PROPERTY ADDRESS permit#
SUBDIVISION
Required111 MECHANICAL
Mechanical Contractor's Name: usinesg Name: J�
Address �, . " 1 City, a, State ZA - - Zip _
v
Contact Phone, ( ) �612 2. 7 '7 *7 `7 Business Phone: ( )
Email
Mechanical EAtlmate 5, (Cosa merelaUMulti Family Only)
FIXTURES & APPLUNCES COUNT (Single Family Dwelling Only)
Furnace Exhaust or Vent Ducts
Furnace/Air Conditioner Combo
Heat Pump
Air Conditioner
Evaporative Cooler
Unit Heater
Space Heater
Decorative gas =fired appliance
Inciuerator System
Boiler
Pool Heater
Similar .fixtures or Appliances
Fuel Gas Pipe Outlets including stubbed in or future outlets
Inlet Pressure (Meter Supply) PSI
Heat (Circle all that apply) Gas Oil Coal Fireplace Electric
other similar vents & ducts:
Mechanical Sizing Calculations must be submitted with Plans fit: Application
Point of Delivery must be shown on plans.
1 .- ,/
SignacureofI.l sed contractor/ Licensenumber
Required!
The
Dryer Vents
Runp Hood Vents
Cook Stove Vents
Bath Fan Vends
seWal a Is the scone as
Date
the Slate
5