HomeMy WebLinkAboutBP & APPLICATION - 06-00060 - 1221 Red Cedar Rd - New SFR Mechanicalv
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~'f~~Y OF REXB URG PER ~,
PERMIT APPLICAT~N Please comb 06 00060
BUILDING
1~ E MAIN, REXBURG, ID. 83440 If the question d~ 1221 Red Cedar Rd-Cnty. Mech.l
208-359-3020 X322 ~1 --~~~~~,~~gg
PARCEL NUMBER: ~~~ <~ ~ ~~ ~11~~ We will proviue tnis iur yvu~
SUBDIVISION:._,) c~r2,~P ~~ ~ IT# BLOCK# LOT#
(Addressing is based on tie information - must be accurate)
O
PROPERTY ADDRESS:
PHONE #: Home
OWNER MAILING ADDRESS:
EMAIL
FAX
Cell ( )
STATE:- ZIP:
APPLICANT (If other than owner)
(Applicant if other than owner, a statement authorizing applicant to act as agent for owner must accompany this application.)
APPLICANT INFORMATION: ADDRESS ~ l~ ~ ~.-1~~~~ ~ CITY: ~~
STATE; ~ ZIP ~3 EMAIL ~/ ~,~ 1G1 ~L' tub 1~ FAX ~~ Z - ~ (o `] 1-
PHONE #: Home () ~ ~ -~r(~[~ Work (~~ ~~' t~! Cell ( ) ~~~
CONTRACTOR:
MAILING ADDRESS: 1 ~
Work
CITY
PHONE: Home# ~~ _CG ' r ~}Work# Sts % " K"~ l ell#
EMAIL
How many buildings are located on this prop
Did you recently purchase this property? No
Is this a lot split? ~ YES (Please brim
PROPOSED USE: ~/
(i.e., Single Famil side~c@, Multi Family,
CITY STATE~ZIP
yes give owner's name)
copy of new legal description of
FEB 0 3
Remodel, Garage, Commercial, Addition, Etc.)
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of per;ury, i ~iereby certify
that I have read this application and state that the information herein is correct and I swear that any information which may herea cer be given by me
in hearings before the Planning and Zoning Commission or the City Council for the City of Rexburg shall be truthful and corree~ T agree to comply
with all City regulations and State laws relating to the subject matter of this application and hereby authorized representatives of he City to enter
upon the above-mentioned property for inspections purposes. NOTE: The building official may revoke a permit on approva~ ~~s ied under the
provisions of the 2000 International Code in cases of any false statement or misrepresentation of fact in the application or n .ie plans on which the
permit~pr approval wajalbased. Permit void if not started within 180 days. Permit void if work stops for 180 days.
of
_? i=3 i~
DATE
Do you prefer to be contacted by I~x, email or phone? Circle One
WARNING -BUILDING PERMIT MUST BE POSTED ON CONSTRUCTION SITE!
Plan fees are non-refundable and are paid in full at the time of application beginning January 1.2005.
City of Rexburg's Acceptance of the plan review fee does not constitute plan approval
**Building Permit Fees are due at time of application** **Building Permits are void if you check does not clear**
FAX
CONTACT PHONE # 3 1 '~ ' (v ~ S ~
Pease com~~lete ii~e en~ ~.~~P1ic~tionf
`~~~)~iC~l~)~C .~
1~1AME ~ ~,~ `~,J
PROPERTY ADDRE S t ~ ( ~ ~ ~,~,
SUBDIVISION ~ ' •~ ~ t j;
I#'the c~uc~stio)) clot api)I,y till i)) N<<~ tt)A' nC)n
~~ Permit#
~egr~irecl!1 !
MEC~ANICA~L
Mechanical Contractor's Name: ~~:ir'6~t~1~~ rl~,./ Business Name: _~-; Y - ~T~c~ ~
Address ~~~ ~ , ~ ~' ~ ~~~, f %
City State. Zip 1
Contact Phone: ~~ ~~~ ~ ~~ ~ ~ Business Phone: ~`~ )~~',,~~ - ~ ~~ ~
Email F~ ~ ~ ?.
Mechanical Estimate S ~~oyu ~- ~ (CommerciaUMniti )Family Only) ~ X11 e ~ 2v~-~ I
ES & APPLIANCES COUNT
Furnace
~_ FurnacelAir Conditioner Combo
_ Similar fixtures or Appliances
Fuel Gas Pipe Outlets including stubbed in or future outlets
~~~ Inlet Pressure (Meter Supply) PSI
Heat (Circle all that apply) G ~ Oil Coal Fireplace Electric
Heat Pump
Air Conditioner
/~ Evaporative Cooler
~_ Unit Heater
~~~ Space Heater
A____~ Decorative gas-fired appliance
/1/ Incinerator System
Boiler
Pool Heater
' Mechanical Sizing Calculations mast be submitted with Plans & Application
Point of Delivery must be shown on plans.
-~ v--
~ ~ ~~ ~
~;i~~n~ tui • ~,t ,icensed C~)nlractor License number Date
R c ~~ ,,; -
The
(Single F Dwelling Only)
~ Exhaust or Vent Ducts
~1 ~ Dryer Vents
[ ~_~ Range Hood Vents
'~-= Cook Stove Vents
~Z~ Bath Fan Vents
.~~ other similar vents & ducts:
schedule is the same as required by the State of Idaho
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