HomeMy WebLinkAboutAPPLICATION - 07-00338 - 4035 Molly Dr - New SFR MechanicalC -z of RexburgliV-adison Coun.
t"y
BUILDING
PERMIT APPLICATION
19 E MAIN, REXBUR-G, ID., 83440
P322
208-359-3020 _
0700338
4035 Molly D.r-R Hill Constr
PARCEL NUNIBERV�,����l�I �W.i�� (we wia� p�ov�e ttus�or you
SUBDIVISI.-ON: UNiT� BLflCK40c LOT#
(Addressing is based on the information - must be accurate)
CONTACT PHONE
PHONE #-. Home C ) Work ( ) Cell t )
OV/NER MAILING ADDRESS: CITY: STATE: zips
EN4t1IL
FAX
FE. ago (If otber than owiaer)
(App I cant if other th an owner, a statement authorizing applgc�nt #v act as agent AA A
far vWner must, accompany this application.)
APPLICANT INFORMATION: ADDRESS !;7
STATE-- zip 8 .3 Ef a EMAIL
■r
L01ff]�A
0
6
CITY
STATE
ZIP
PHONE.,& •
Home#,,--,-,--,Work4
ENIAIL FAX
l13�
i F
k4MA�fFAX '�� zz 4-F. -2,q 7 t
Cell
4
1
h
t
riOw many bul dings are located on th*s pro.perty?Did you recently purchase this property: ��s (If y% -Ws give ��nel'S name)
Is this a lit split? NO YDS (Please bring �f �legal description rn •� yPROPOSED USE:
Rer&diO.,kl.26, wng3e ramfly N-1 on, Etc.
APPLICANT'S SIGNATURE
T_y� +
� f� � � ����� � ����9i � tit
h2V � t * application and �t the information b r is orT t rnfon-nati()n which � �
Planning and Zwlng Commission ortheC'1yCouncil f0Jr the Cidan co may hereafter hearings before the
relating t the subject �e l i h P' with . I � mogul ani. � amiss
NOTE: The building o0ocial M, zed representatives o the City er . the a-mlo inspections
under the provisions ofd 2000 I� a onCO'de in cam Of anY
false statement r
al
stops 478 70a:Val based. Pett void i � within 1 a .
•misrep n of fact in thr, application or on the plans on wbicb the ennit or if work
DNA
{2 r -o
Owner/AtFV1ca,,L
f)o
Y011 pro-fer to be contacted. by :fax i� r - I T .- � ��
WkR',NWG :0 1 i � �
PERMIT WST BE POSTED CCNS°
Plan � are n - dab SITE;
full tie � a 1 1 - - i
inmnig 'rianyja-
CRY of ReAurg's is l review fes doe,3
gJ a
ot . itu. planappy
N
.ice
NAME
mrzww�
PROPERTY ADDRE_q'SS_.,_
- UD91y §10N ek-ica..-
A
Yb3N'telC
0,11 rnnt-rqetnr s Nama.
�.1
#_ 46
MECHANICAL
.� dV<<I�,�c_ _Business Nine:
C13
I
yj.CVO !4.e --- 7 .6
m
state
city
SS
Contact Phone: Business Phone:
+� i
Fax
Email
Ift
Furnace
Furnace/Air Conditioner Cornbo
Fiz�at Pump
��x Conditioner
F
vapo-rative Cooler
Unit Heater
Space Heater
Decorative gas-fired appliance
Llicinerator System
Boi.ier
Dryer Vents
Range Hood Vents
Cook Stove Vents
Bath Fan Vents
other similax vents & ducts..
Pool Heater
Simil.ar �ixtures or Appliances
Fusel Gas Pipe Outlets cluding stubbed in or future outlets
ffilet Pressure (Meter Supply) PSI
Fireplac
[MMT!
A, r, U
i" A U KI IL
-eb— Z 5— 4rdn'
Date
by the State of1daho
The City ofRexbvrg-�spermUfee schedule is thO samc c's reclu 'e4l'