HomeMy WebLinkAboutAPPLICATION - 08-00370 - 1133 S Railroad Ave - Commercial Mechanical2008-07-29 14;45 HIGH COUNTRY HEATING 2087450817 »
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CITY OF UXBURG PERMIT
MECHANICAL PERMIT APPLICATION Please complete the entire Application!
19 E MAIN, REXBURG, ID. 83440 If the questiondoes not app
208-359-3020 X326 br fi,p in for applicable
PARCEL DUMBER: ( We will provide this for you)
SUBDIVISION: UNIT# BLOCK# LOT#
(Addressing is based on the Information - must be accurate)
PROPERTY ADDRESS:! 1 1 3 3
PHONE #: Home ( ) z work
CONTACT PHONE #
Cell ( )
OWNER MAILING ADDRESS:_L/_3� 3 ►/ CTfY: STAT ZIP: 3`—
EMAIL FAX .�
(If other than owner)
(Applicant if other than owner, a statmnmt audxAzing epplioam to 9A as agent for owner must accompany this appl
APPLICANT INFORMATION: ADDRESS CITY:
STATE; ZIP F yi- EMAIL ~r
FAX Of.3l�
PHONE #: Home ( ) Work ao��S Cell (2" .sr/ yS`
•11 ��tt•
CITY STATE ZIP
PHONE: Home# Work# Cell# -�
EMAIL FAX
How many buildings aro located ou this property?
Did you r=cntly purchase this proper No Yes (If yes give owner's name)
Is this a lot Splice- YES (Please bring copy of new legal descfiption of property)
PROPOSED USE:
(1.0•. Shale Family Rasidmw, Multi Family, Apw mme, Remoaol,
Commercial,
APPLICANT' S SI ATURE, CERTIFICATION AND AUTHORIZATION: uw, pmaltv of wjruy, I b=by wr* um l ba"
read Ihla epplloa M Wd�xw mat #a thnnama WOW In earrera and 1 swim Mx Any 11116M IM vrhtoh may+ ber�eal be given by MG m AsarhW bdbre tns pimnloa
md � spDl� Cod COwHO fbr fD Ch9 ofRaxbtua abell be mrrhM and wrtoet 1 aWoo to Comply with so City te�ulstfoot cod 8tda IAaa � b tbo
to 'eat mktor of bmby wtiiarLmd teprwanwim of Uro City to c do wm the abovea�putluncd
bLdl ' o81c;n1 reunite a parotic oa under the pro+�i�oeA of the 2D031nbanstioD� Code b, otytt o of 10n°'�' N01E The
the apprear (m the pum on 16� IitY t w mi
approvai a+At bated yL
if Dot stared Wkdit t 84 deyL Permit void if wmt stops for 1 utio° °f i�o11t1
Stag= of Owner/Applicant DATE
Do you prefer to be conte d by fax, email 0 Circle One f 3 - 31
Y Sr
o — Bi7II.DING MUST BE POSTED ON CONMucTTON srTE!
FUn feesare volt-rKrt;d ble cad rrD paid In full at the time or Applleadon beginning jaga P 1. 2Qft�
City of Rexbarg'a Acc"xce of the plan review fee does not eonsthrrte plan approval
2008-07-29 14;35 REXBURG CITY OF
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08-07-29
14;44 HIGH COUNTRY HEATING 2087450817 >>
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Building Safety Department
CCITY or
City of Rexburg R. '' XBLMG
9 E main Jane4A&exburg.or9 Phone: 208.959.3020 x326 h'
Rexbur�,IDA3tI0 www.nexbvr9,org Fa;c208.359.302s �''��e. '� �nyariirryconmus1�
NAME
PROPERTY ADDRESS .Permit#
SUBDIVISION
Requi'redlll MECIUNICAL
Mechanical Contractor's Name: �-„4
Business Name:
Address �. e . (o Ciry State Zipc{�,
Call Phone: ( ) �q — L(6 s`b Business Phone: ( ) $� .-�' o S -T.
i
Fax: (
Email
4 1g1 S-12,
Mechanical Estimate S� (C me z[ Muld Fa ralty Only)
FIXTURES do APPLIANCES COUNT (Single Farr Dwelling Only)
-VLFurnace Exhaust or vent Ducts
��— Furnace/Air Conditioner Combo
Heal Pump
Air Conditioner
Evaporative Cooler
Unit Heater
Space Heater
Decorative gas-fired appliance
Incinerator System
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
Meat (Circle all that apply) 4, pil Coal Fireplace Electric Hydronie
sl-bL••.ttGd nil h PlaW
Point of Delivery mush be shown on plans.
� `-f 7 ---2, r- e->�
Sigoatiut+e of Licensed Cotmactor License number Date
=.C.2 Rrx :r Permirfeeschedide Is the saline as rep&ed by the &Xe ofldaho
2008-07-29 14:35 REXBURG MY OF
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