HomeMy WebLinkAboutAPPLICATIONS - 08-00601 - 2889 S 5500 W - RileyBuilding Safety Department
City of Rexburg
19 E Main janellh @rexburg.org
Rexburg, ID 83440 www. buoyorg
NAME
PROPERTY ADDRESS
SUBDIVISION
Required!!!
Phone: 208.359.3020 x326
Fax: 208.359.3024
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MECHANICAL
Mechanical Contractor's Name: Business N
Address z6l/
Cell Phone: (�� 2° z/0� Business Phone: )�L
Fax: ( ) Email
Mechanical Estimate $ (Commercial/Multi Family Only)
FIXTURES & APPLIANCES COUNT (Single Family Dwelling Only)
Furnace
Exhaust or Vent Ducts
Furnace /Air Conditioner Combo
Dryer Vents
Heat Pump
Range Hood Vents
Air Conditioner
Cook Stove Vents
Evaporative Cooler
Bath Fan Vents
Unit Heater
other similar vents & ducts:
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 Electric Hydronic
of Licensed C tractor License number Date
The City of Rexburg's permit fee schedule is the same as required by the State of Idaho
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CITY OF
REXI3URG
Americas Family Community
State
12/19/2008 12:59 2085233864 WIEMER HEATING PAGE 01
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Building Safety Department
City of Rexburg
9 F M(Yir jCInP(1h@rexburg.o(g Phone: 20, 1 cO 'If"In -100
It, " P.1440 www.rexburg.org Fa
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NAMf.,
PROPER Al)l,)Rl,
S1 I'13DIVISION
REXBURG
0800601
2889 S 5500 W-Riley
.Req u ired! . P MECHANICAL
t 4 Mechanical ('on tractor's Nam( "usiness Name:
Address City
. . ... ..... . Lo_.5 State IL
_Zip
('.'ell Phone:
Business Phone: a Izz
Email
/i Lza C-
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Mechanical Estimate S (Commercial/Multi Family Only)
FIXTURE & APPLIANCES COUNT (Single Family Dwelling Only)
Exhaust or Vent Ducts
. ....... . .... ...... . .. - Furnace/Air (.'..,onditioner Combo Dryer Vents
I le,41 PUMP, Range Hood Vents
" X
Air Conditioner Cook Stove Vents
l"vaporative Cooler Bath Fan Vents
.. . ...... ...
.............. . ............. .. t.'Tilt Heater other similar vents & ducts:
Spy (.-v h eater
. ... .. . .. 1)ecorative gas-fired appliance,,
.......... .. .......... ... . Incinerator System
Boiler
Pool Healer
. . . ...... .. .............. ... . Fuel Oas Pipe Outlets including stubbed in or future outlets
I leas, (Circle al) t hat apply) (Jas Oil Coal Fireplace Electric Hydronic
Meebanical Sizing Cuculations must be submitted with & AD
. ..... _Dfication
Poi 1
of Delivery must be shown on plans.
C"I"
... ... ... ... ...
i License iin ()K 1 (�ontracto r number
The 01�- r?I'R(, I urg'spermilfteSchedule is the same as required by the State qf1daho
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