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HomeMy WebLinkAboutAPPLICATION - 07-00065 - 883 S 12th W - New Commercial MechanicalCITY OF REXBURG MECHANICAL PERMIT APPLICATION Please v 07 19 E MAIN, REXBURG, ID. 83440 If the questi Q Q � c � 2th «T _Cn�, Mech 208 - 359 -3020 X326 00 S7 VV PARCEL NUMBER. ( (We SUBDIVISION: UNIT# BLOCK# LOT# (Addressing is based on the information - must be accurate) OWNER: tv z T e7 N CONTACT PHONE # PROPERTY ADDRESS: PHONE #: Home ( ) Work ( ) Cell ( ) OWNER MAILING ADDRESS: CITY: STATE: ZIP: EMAIL FAX 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 CITY: STATE; ZIP EMAIL FAX PHONE #: Home ( ) Work ( ) Cell ( ) CONTRACTOR MAILING ADDRESS: , CITY STATE IP F„ 3 Vy Z. PHONE: Home# '7�„ O Work# Cell# EMAIL FAX How many buildings are located on this property? Did you recently purchase this property�� 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: (i.e., Single Family Residence, Multi Family, Apartments, Remodel, Garage, Commercial, Addition, Etc.) APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: under penalty 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 approval issued under the provisions of the 2003 International Code in cases of any false statement or misrepresentation of fact in the application or on the plans on which the permit or approval was based. Permit void if not started within 180 days. Permit void if work stops for 180 days. .1 _ " S. a Z Signature of Owner /Applicant DATE Do you prefer to be contacted by fax, email or phone? Circle One WARNING — BUILDING PERMIT MUST 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 r t. r 1 inch equals 30 feet Building Safety Department City of Rexburg 19 E Main janellh@rexburg.org Phone: 208.359.3020 x326 Re ID 83440 www.rexburg.org Fax: 208.359.3024 �� RtiX a URC r d Us� O CITY O F REXBURG 0 America's Family Community NAME zc PROPERTY ADDRESS SUBDIVISION Required!!! ,.Cj - - / Permit# 3Y�' MECHANICAL Mechanical Contractor's Name: ! r` Business Name: - Address f / L( s N City State Zip R3 tft/ z Cell Phone: ( 1 / �.�^ ` Business Phone: ( ) ��. - 25'3e6 Fax: ( ) Email Mechanical Estimate $ 1 A&- (Commercial/Multi Family Only) FIXTURES & APPLL4NCES COUNT (Single Family Dwelling Only) Furnace 5 " 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 Dryer Vents Range Hood Vents Cook Stove Vents Bath Fan Vents other similar vents & ducts: _ Fuel Gas Pipe Outlets including stubbed in or future outlets Heat (Circle all that apply) Ga Oil Coal Fireplace Electric Hydronic Mechanical Sizing Calculations must be submitted with Plans & Application Point of Delivery must be shown on plans. n Signature of Licensed Contractor The City of Rexburg's L number schedule is the same as the State of Idaho - /- ©:7 Date w ,. , 1' ,< .; .�� , 2» � � � � : \ <. � � . � . �� . . � � . . ti � � � ? \� « . /�� � � . \�� � »w� »<� �� � \ /�/ �/� »: � .. � \° ��� / / �� � � \ \ >� � � .. \ % � �� a) � \$�� t � ��� 2 \ \� ��� \ \ `.� \ \�\ � «\ � f- }aa} p s ens be youi 3�M >10,T,°,9,'") 3 S c) (D C O (D a Z N . - 0 . f0 -0 Q fD cu m .. O .F e� S r+ cn O 0 ,- O S 0) - 0. t n' n 0o rn , fD - =� Cl) N Vi a O. r < D) .94 C 0 1_, �QS� O rt Q , 3 CD O ( m N rt fD Q o N r. LA 0) M. CD < ° g ort n Z m o _ � 2Z — I -- I V) X ' ' 0 N N M o a o 2°—QC, m C S - -, 0 Z 7 c X < = _Q '• (n fl) , ca * fD C .••r D N rt D- Cu i ,g Co C� -a(D rt rt e -1. - i 0) . = c, O5 o ; • 0 c, co P- co N Q O � N Q 3 N rt N fD O r+ (D Q 0 0 S < Q N pJ r 0 + tD c) y (D D) (D -1 -, ( - D MA fD Q N 3 C 0 S N fCD 1-- fD -a Q r•+ r O fD 0, • Ln lD S 3 00 cu to A Q J o N S v X 0 N fD 0 , 01 Q _ = (0 _ Q 0) A. ---P `< S (% H C .< _S fD z S o• S S cu Q fD ' (D Q- C of -. c • 0 el. OQ r Q = 3 Q A fD LJ fD d Q c) (D .< Q = 0 O < C S e-P N c) (D • < .Q S fD C fD < �• Q (D Q fD c, - a (D .< 0 Q 0 (D O (D 3 cu Q (D Q O Q Vf • • S 'F y fD O S (D