HomeMy WebLinkAboutAPPLICATION - 07-00607 - 237 E 3750 N - Mechanical1
CITY OF REXBURG
MECHANICAL PERMIT APPLICATION
19 E MAIN, REXBURG, 1D8`440
208-359-3020 X326
PARCEL NUMBER:
S+iLVV1
PER
Please com
If the question d
-0700607
237E 3750 Nll- McGowan
�ut��1VISI�N: �'
I Coe ( WP will provide this dor your
(Addressing is based on the information -must be accurate) �IT� BLOCK# L+aT#
rol
PROPERTY ADDRESS: Z's
PHONE #.- Home ( ) Work ( ) Cell ( )
OWNER MAILING ADDRESS: O,--F�,. ,..... __
EMAIL
J7 Al r;: ZIP:
FAX
AEP.L,AC,ANT (If other than owner
(AppIicant if other than vwner, a statement authorizing applil
APPLICANT INFORMATION: ADDRESS
STATE; ZIP EMAII,
PHONE#: Home ( ) Work
CONTR. CTOR:
to apt as agent
a
wner Must
Cell
CITY:
FAX
Y this application.)
MAILING ADDRESS: --- ----_cITY STATE ZIP
PHONE: Home# Work# Cell#
EMAIL FAX
L
How many buildings are located on this property?
Did you recently purchase thi'sroDerty? No y�s (�f vesgive owner's name
Zs this a lot spilt? NO YES(PI ease h,-,,,� rn___--
Y.._.b ,,,,rT „� 11,, ►� l�gal uCscripnon of prope
va v.�t,L UJB;
r
Multi Family� Apartments, Remodel., Garage� Commercial Addition. t
"'fes I `S S •— - S r... '.e. �L.o �tip,
RT ACATION - AUTHORIZATION" 9•.
stateread this application and n1 n t1 n n 1 r t n t z ;p r til Jim
and t any inform tin which may hereafter b given bam in hearings nx� "n�r-���i�n or �h� Council for the, i
ty of Rexburg shal I be tnithful and subject matter f t��i �pl1��t� n gra �r�r�� authorized agreecomply with all City r uI tions r1 t
r r ent .t.i gyres � the City to enter upon the above-mentioned � � � relating :e the
�.�ilrn. official rn revokepermit on approval issued��� for inspections Purposes- the provisions of the 2003 International Code i � � _ 'I,�: ��1�
the application r on theplans.9- �v�ih rntt. or d. n �a�� � i fl statement � Y -
app rov al w based. P nmit void r not stied within 180 d ire res nt t"ori. f fact in
i Permit if Mops for 180 days.
Signature f Own iDo you prefer tobe
contacted fax
, email or phone? Circle One DATE
WARNING — BUILDING PERMIT MUST BE POSTED ON CONSTRUCTION SITE!
Plan fees are non-refundable and are i *U full at the time of application beginning
City of Rexburg's Acceptance of the plan review fee does not cOnstitute plan approval
NAME
Building Safety Department
19 E Main
Rexburg,, 18 3440
jone11h@rexburg.o[-g
www,rexbt)rg.org
PROPERTY ADDRESS 2", :; 9-r=-2�--0: � A
L
SUBDIVISION
City of Rexburg
Phone.- 208.359.3020 x326
Fax., 208,3,59.3024
Fermit#
Mechanical Contractor's Name:
Address
Cell Phone: (
Fax: (
usiness Name:
AA
J
C1 TY 0 F
R,EXBURG
QW
Amen'ca� Fa 1
'I
in Y Community
_City
Zip
Business Phone: ( ) �Q -fij � j U _.�:
Email
Mechanical Estimate $(CflmmQrciaUMulti Fonly,
FIXTURES &APPLIANCES COUNT
Furnace
Furnace/Air Condtianer Combo
Heat Pump
Air Conditioner
Evaporative Cooler
>_ — Unit Heater
Space Heater
Decorative gas-fired appliance
Inci
I nerator System
Boiler
Pool Heater
(Single Family Dwelling Only)
Exhaust or Vent Ducts
Dryer Vents
Range Hood Vents
Cook Stove Vents
Bath FanVents
other similar vents &dus:
c
Fuel Gas Pipe Outlets including stubbed in or future outlets
Heat (Circle all that apply) Gas 01-1 Coal Fireplace Electric Hydronzc
Mechanical SizinCalcLLLA!KR!At10ns must be submitted with Plans & A
,Point of Delivery must be shown on p
Signature of Licensed Contractor
License number
Date
The City of Rexburg -s permitfee schedule i's
re
the same as required by the State o'Idaho
lication