HomeMy WebLinkAboutAPPLICATIONS - 08-00600 - 3469 E 6000 S - WillardDec, 18. 2008) 5:23PM1:111Fi rst Call Jewel
3 0�' CITY OF=UR*
13VILDING PERMIT APPLICATION
19 E MAIN, REXBURG, ID. 83440
208 X322
Please
If the qu
No. 3037► P. 1/2
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PARCEL NLT11r1BER �; ( 3469 E 6000 S- Willard
SUBDIVISION: (Jr
(Addressing is based on the idotmation - must bo aootlrate)
CONTACT PRONE #
PROPERTY
PHONE #: Flomc ( ) Work ( )
OWNER MAILING ADDRESS:
PERMIT
CITY
EMAIL FAX
( ) ;LZ& PoSL 7
STATE: ZIP:
ASP : (If other than owner) G� �.�2t Ja
(Applicant if otbar than ow er, a statemow authorizing applicant to act as agent for owner mast accompany this application,)
APPLICANT INFORMATION: ADDRESS ? CITY: S
STATE, ZIP EMAIL
PHONE #: Home (
Work ( ) ..- 777 % Call ( )
_11'1c�it1i1/� '
PHONE: Home# Work# Call#
ENTAIL FAX
many =1=gs are
on this property?
Did you recently purchase this property? No Yos (If yes give owner's name)
Is this a lot split? NO YES (Please bring copy ofnew legal description ofproperty)
PROPOSED USE:
(i,e,, ShWje Family Residence, Multi Family, Apartments, Remodel, Garaga, Commercial, Addition, Etc.)
APPLICANT'S SIGN
ATURE, CERTIFICATION AND AUTHORIZATION: Gn dcr peaalry of pedury, I hereby =a that I
have lead [his applicatioa and state then the informndon hmvio n oanr4 and I swop dad noy informetion which w ay htmeftr be ; von by me In hiarinp before the
Planning = zoning Comudolon orthc City Council .far tha City of Re:bwg sbali be trmhMW and corracL I agree to comply with alt City regulations and 5tau law9
rclv&g to the nb)cot matter of iltie appliomion end hereby euthorit'td ierreseerettm of the Cltyto enter upon the above-alurloned ptoperry forinspccdom purposcu.
NOTE: Tito bAd* afPtcial may revoke a permit on ayproval issued undo mho pravisjum oftho 1000 intemadonal Coda in caul of sa felon ;tumcnt or
miampresenutionofra" JatheAppilosdonorondecplawonwhichthepeimitorapprovolwasWed. Fetmit void ifaotstartad within 190days, PetmilvoidifIvork
stops for 180 days-
.s 1�l! 7
SWoanirie DATE
Do you prefer to be coutactcd by fax, email or phone? Circle One
WAMMG — R=ING P ERMIT IMUST BE PASTED ON CONSTRUL=Qb1 S=l
Plan flues eta non- raduadablo and are pald In MU at the time of applicadoa bezonlag 02- - ary L 20a
City of Rexburg' Acceptance of the phut review fey dou not eonstFoka pbou approval
3
Dec.18, 2008 5:24PM First Call Jewel
Jul-15. 2005 2:22P
Please complete th entire Application!
applicable
NAME
PROPERTY ADDRESS
SUBDIVISION
Permit#
Requiredlll
MECHANICAL
Mechanical Contractor's Name: usiness Nam e: `;(�1,d'(.�.�� J ¢ �
Address City $taw zi p - S T
Contact Phone; �Z _ 7 7 Z7 Business Phone: ( )
F.mail FaX
Meciranical Estimate S .S ~ �/ (CommereialfMulti Family Only)
FMTU & A PVANCES COUNT (Single Family Dwenwg Only)
Furnace E3cbaust or Vent Ducts
Furnace /Air Conditioner Combo Dryer Vents
Heat Pump
Air Conditioner
Evaporative Cooler
Unit Heater
Space Heater
Decorative gas =fired appliance
Incinerator System
i;
Boiler
Pool Hcatcr
Similar fixtures or Appliances
del Gas Pipe Outlets including stubbed in or future outlets
Inlet Pressure (Meter Supply) PSI
Heat (Carle all that apply) Gras Oil Coal FircpIac !ectri
other similar vents & ducts:
Mechanical Sizing Calculations must be submitted with Plans & Application
Point of Delivery roust be shown on plans.
_r (<
Signarure of Licensed Contractoxt License muuber
Required!
The
schedule is the some as
the State
No.3037 P. 2/2
No. 0925 P. 3
If the question does not apply flu in NA for non
Range Hood Vents
Cook Stove Vents
Bath Fan Vents
/,'P - 1'7 OF
Data