HomeMy WebLinkAboutAPPLICATION - 06-00176 - 319 Rodney Dr - FireplaceC��-ITY_OFREXBU,RG
BUILDING PERMIT APPLICATION
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PERMIT
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SUBDIVISION: UNI
(Addressing is based on th1c'bnf0 ation - must be accurate)
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PROPERTY ADDRESS:
71� 1�ojme
06 00'176
31
9 Rodney Dr -Mechanical
CONTACT PHONE
PHONE #: Home Work (" ) Cell(
0-%VNER MAILING ADDRESS.. CITY:
K ✓i-= S
EMAIL FAX
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TATE, ZIP -
other APPLICA1V'3": (�f e� that owner - % -
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(Applicant if other than owner, a statement authorizing applicant to act as agent for owner mast accompany this application.
APPLICAN"I' INFORMATION: ADS ,..t
STATE; �Dd� ZIP 7�3/Z
PHONE #: Home( ) 0( YDI"`
161
d.
-?` Cell
FAX -3 SG 39 8K`
CONTRACTOR: iro ��
MAILINGADDRESS-`6'59 5.`Lv/law-i�..�o/ CITY �xLiv�S STATE
PHONE: No im-4 W rk# JSP'—b'Ua'Ce1l# � "-
EMAIL FAX
How many buildings are located on this property?
,.�►�A�-�4����y
�,ULUn�nt� Espropex�ty'�
No
Yes (If yes
give vwner's name)
Is this a
Ian split?
NO `YES
fPje'a_qe_'hn"
On�,<�
PROPOSED USIE,
.�a��...t7 F.Y 1.10i'V ugiu uoSGripLIon Qt
0 X. Sirig le Farn 2 ly Residence,
Multi Family, Apartments, Remodel,
Gara Commercial,Adiqj"'tjnn
T11 -r -T OF REXw'"6[JR'0-
APPLICANT�'S
have Mad Lh y&MU
RI cat CEN .U' T
on ani' the X 011 in Is c0�1 and I sweat t a 0f p'eju I hercby certify I
I , rx n O i i on r the City p unci I for 0 i � i ch m a here- after be .i vee Tnc in b uarN n s be far r
b l and correct I araecomply ii, l i y h
rte � � r�hj�° �� �� ,���I���rr� � 1t1lT�+ �.� � �I����� �
of o rT zed mp r en Latif es of e i Co r 1e. laws
NO -11: e building tial may � oe eit o� �rovisions n the, a ve,menti ed pro ��r 0rt
rn i � l] on f fact in the appI i hon oron t of qie 2000 � r��l � �� � ��1�
Slatement or
stops for 1 d s, I t v id i f not staned ivi Lhin 190 days, Pe rmit vo i
d f work,
Signage of 0WnC_r1APvPv1i
Do YOU Prcfer to be c0ntacted by faxeniails le ()ne DATE
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Plan fee� � �'� �_+� ������ � � � � � � �� � ��- p� i� ire u j� a-(te �.�
egi nUl ng.Janua" 1- -2005.
plan review fee does n Ot cOnstitute plan a
pproval
�-d 886£-95£-80z
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,•� �q � ,� �� �r � �� : �- '' ��� 'moi t� t, � '� ,�y - � �
- � � •��� ply ,� r-�i �4 ��� � �� ;�"� � �
ues o 'IF
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NAME �.
PROPERTY
SUBDIVISIO,N
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MECHANICAL
permit#
Mechan�cal ��n�.ractor's Name: �� y r r�� rr..,p q , �� S Business NT
ame,,-
Address-
--City ,�.��� � State � e�
Contact Phone:
Fm a;1
BUSjne45S3Phone: (�� � S'—
FaL,:�- e:E�) 35 6 - 3P 8'8'
Mechanical Estimate $ (CommerciaLqqtflti Family only)
FIXTURES & APPLIANCES COUNT (Single Fanaly Dwelling Ont�V)
Air Conditioner
Bath Fan Vents Space Heater
Range Flood Vcnts
Boiler
Cook Stove Vents
�P<im,--,Decorafive Gay F"replaces
DiYer Vents
Evaporative Cooler
exhaust or vent ducts
gel (gas) Piping fixtures car appliance outlet
Fumace
Furnace/Air Conditioner Combo
�.� Heat Pump
Incinerator
Pool Heater
Heat (Circle all that apply)
Gas 061 coal ireplace
IR Jectric
Unit Heater
V
10
Zip
echa�xYcax Smng C`a%cuIai%OBS must be submitted with Pians & APPPont of i?eliverymust b�e so�nplans*
�icat�on
a�
�z
L,cense nUffibu
The Citi-* of Re.Jr
Schedide is the wine as re,2jj p .4ze�:kej �-,-or r _ F
886£-95£-80Z
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