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Home My WebLink AboutALL DOCS - 07-00356 - 460 S 4th E - FireplaceJ g 03 07 03:50p Myron Creager 208 - 356 -3988 p.1 I?'Y OF RFXBURG f PERMIT # BUILDING PERMIT APPLICATION Please 19 E MAIN, REXBURG, ID. 83440 If the que: 07 0 56 208 -359 -3020 X322 PARCEL NUMBER - hEfle1'AAC � LUVCO22 C 460 S 4th E -Hayes SUBDIVISION: UN (Addressing is based on the information - must be accurate) 0"ATR. CONTACT PHONE # �h PROPERTY ADDRESS: PHONE #: Home (�) 35/0 — Work ( ) Cell ( ) OWNER MAILING ADDRESS: s—�f CITY: taC Ia �s STATE: ZIP 8' 3Y / !J dor 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, STATE; ZIP EMAIL PHONE #: Home ( ) Work ( ) ) CONTRACTOR MAILING ADDRESS: S % S� xP��yJS ate- 'p/ CITY STATE ZIP PHONE: Home# Work## Cell#, EMAIL FAX 3�; G 3 9 S --2r How many buildings are located on this property? Did you recently purchase this property? No Yes (If yes give owner's name) Is this a lot split? NO YES (Please bring copy of new legal description of property) vu nnnaFTl I TRR- (i.e., Single Fancily Residence, Multi Family, Apartments, Remodel, Garage, Commercial, Addition, Etc.) APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION Under penalty of perjury. I hereby certify that I have read this application and state that the information herein is correct and 1 swear that any information which may hereafter he given by me in hearings before the Planning and Zoning Commission or the City Council for the City of Rexburg sball be truthful and confect_ 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. MOTE: The building official may revoke a permit on approval issued under the provisions of the 2000 Intemational Code in cases of any false statement or misrepresentation of factjolie application or an a plans on which the permit or approval was based. Permit void if not started within 180 days. Permit void if work swps for I8� / o3 16T7 Signature of Owner /Appli DATE Do you prefer to be contacted by fax, email or phone? Circle One WARNING — jaUIZDING PERMIT MUST BE POSTED ON CONSTRUCTION STTE: Plan fees are non- refundable and are paid in full at the time of application begioning lmtuary 1.2005. City of Re :burg's Acceptance of the plan review fee does got constitute plan approval . CITY: FAX 3 Aug 03 07 03:50p Myron Creager 208- 356 -3988 p.2 lease complete the eICIt1I'�91'pp)1cation! If the question sloes apply fill in N. for non applicable NAME � � .�� r PROPERTY ADDRES � G Permit# SUBDIVISION Required!!! MECHANICAL Mechanical Contractor's Name: J mo usiness Name: Address �� y /I� �' ,q( City /c ✓`1 _ State Zip P3TAKe Contact Phone: ( ) Business Phone: Email -Fax 98' Mechanical Estimate $ (Commercial/Multi Family Only) F"TURES & APPLIANCES COUNT (Single Family Dwelling Only) Air Conditioner Bath Fan Vents Range Hood Vents Boiler Cook Stove Vents Decorative Gas Fireplaces Dryer Vents Evaporative Cooler Exhaust or vent ducts Fuel (gas) piping fixtures or appliance outlets Furnace Furnace /Air Conditioner Combo Heat Pump Incinerator Pool Heater Heat (Circle all that apply)( Crate Oil Coal Fireplace Electric Space Heater Unit Heater Mechanical Sizing Calculations must be submitted with Plans & Application Point of Delivery must be shown on plans. 07 Sianaturc of eased C011tl'h1Ct07 License number Date Required! The City of R"burg's permit fee schedule is the same as required by the State of Idaho "A REX!IVRG City of Rexburg 0 O ,m Department of Community Development 0 Receipt Number: 19 E Main St. / Rexburg, ID. 83440 Phone (208) 359 -3020 / Fax (208) 359 -3024 0700356 CHECK RPRRHE1006 Mechanical Residential Fixtures 005715 $ 85.00 Total $85.00 $85.00 $85.00 $0.00 Total: $85.00 5 2008 r r 0 avt� Wed Lcp f I "p 1A C.e uy 4 - genpmtrreceipts Page 1 of 1 Ah INSPECTION TICKET ❑ Bldg. ❑ Plumb. ❑ Elect. 4 Mech. ❑ Free Inspectigt,Requfst` Rec'd By Date ? C — 1 Req. By� '� "e �� Phone No. Pr0jecI 1A&k Permit No. r Address lkL, f � Inspection Type C` n Day /Time Req.. Inspector's Report ❑ Res. ❑ Comm. INSPECTED ITEMS CONFORM TO APPROVED DWGS ❑Y ❑ N ❑ N/A INSPECTOR'S ACTION ,2 1 A CO PPROVED ❑ DISAPPROVED Q FINAL ❑ C.O. (FINAL) ❑ NOT APPLICABLE ❑ DID NOT INSPECT ACTION REQUIRED: Signe Rec't Acknowledged While - Office Copy F- FIR -0003 YeNow - Job Copy Pb* - bMgecia's Coon