HomeMy WebLinkAboutAPPLICATION MECHANICAL - 17-00184 & 17-00185 - 359 W 4th S - The Landing(Illy �n � a F g �I P Building Safe De antment
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a BUlLDINC PERMIIIFCRM 310 CitMcif Rlexburg
REXBIURC7
U dare H/3611' C North 191 East
Incjucal;Family 'Comnitinity REll Idaho Eh 440
B U IIIDINC AAPL1CA TUGN
New MFR Mechanical
1, AI opert}l Ow neer
Name: _�_C)I n i `AQ �1
Adc tress: C'ty: Stater: Zip Cc del:
PH ane: Email;
'l. Mechani(lal Conll.ractar
Undo r ldal c Bu Ildir g ClodeA a neb isiti reed c on trlClcto r a lusit do the is onk for a 1M4rlth family Resident e.
Bu Sill�MQG�Gy`). CC�� u - State License #: W, Q, -C� - l �C �ENo.:.1
Adc I ess: t,� :ZC7T-) UJ tater L SZ _ Dipl Cc d e:
Pliene: Email:i.o
Cc ntacti Aepl. NzIrrle: jX;L.. �✓ F he rte-( FM - 0'24 mail:
Mtichani,czti(lantractcrAutits,rizEndSip nature; Daite: -�
f aapy c j your sic le reclistratfon/ti(E rise ig t equirec toe o fihi. If this is t he first time jlou he va Bonn work in the Cit}l o) Flainbur 1, please provide
a photo cony ofyour license. ljyd u ere unsure ify our license is on file, Flhiasd aheAl with the Pdnmit 7lechnician by colliny (1 06] 372-1.341.
J. firaject Degcripl ion
Adc 1 ess: 2j1 1 hJ _ `- l (::�, -OR- Lal #: _ Black #: _ gull c ivisliarl:
Description of mark: )A'� W_
13 N ew MFR (lc n.si l ion: # of Bu ildill *1 of Units:
• Fees for ni w constrivai l are charcli d by num l er of bunk inyls c no numilan o) units.
0 (u36 x # of bluildinc sJ + ilI a # of units) = dotal fee i.e. (13( a it baildinc s) + 165x .10 total t. nits) =
$2b( Ipuildinys] +,i( 56 (units) -$916 tonal fee
• 7M(ire will abo ble a F Ian revieta )ee tote line ;16 % c j the above jee.
AT PLiCANT'S ! iGNATURE, CERTI8ICATiON AN[ i UTHOF 17/I TiON: Undo l analty (f penjur)l, i i eseby arl ify t hat i have nead tl is application; is (I s4 to t hat the in Iormal ion t e nein
is c(mract aid 1 swear that any in bum atimr Niluch may bee; lta n be ghee n 131 me in hea rings t e Fond the l tanning and Zoning Commissia r of the (I it} Council Ibo the (I ity all Rexburg
sl all ba truthlul and aoimaal. I agnea I Aamply "iilh all City i egulations and State laws palating to the Aubjecl matteri: f Ibis application and harat yautllariaed represent alines of the
City to t nleu upon the sit ave -mentis ned Inol ly flar insil ions puspo! as. N073: Tlhi building ollfieia may nevaI e a penmil on appnoval issuer Linden t he gravisions All the 20: 3
InIarnal ional (lode in cases All any Ili a statement a r misnepnesenl ation o f haat in t he application (r( rl the plans on %, hiel the permit at appraval was based, Permit n( id ilnai
st Fled a it hin '180 days. Permit void if wa nk sl ops bu 180 days.
Ap fl ji(lan)'s Nall el (plrinl): {kna� / igr al ure: Dale: 7
Inspeatiam mug, t t e called in baPo no 8 AM an the clay tl a iml ectia r is rat ue! to d. Ir spear ion nequa as s called it afllen 8 AN will I a ! aha duled flaint I a neat business d: y.
Insgt ctlon Hotline -(148) 317.2344 www.nsxbwi€.nig I ermil Teahnicia n - (: (8) 3112.2:1 d 1