HomeMy WebLinkAboutAPPLICATION, BP - 06-00069 - 796 Barney Dairy Rd - New SFR Mechanicalr
~ ~~
C o
~
~ N
o Z ~
~
a ~
`~"~ .• UZZ W F-
~ O O m p N a~ W
Q ?
G ~ ~ M Z m D. M
~ ~? H
'~
~y
a L y 5
L ~~
o
~ U
2_
~ O
V ~
m o
~ ~
d c
ii ~ °
Z~ U O
a te?
Z
Q
U
U
V
O +~ a
i
C
C OOm
W
d~
f06 fC6 _
N T ,
G U F
-
V 0 O
V
U
yU~
ytL ~
~+
t6 i
~ . Y
C ~
a .
~ ~ ~
d ~ 2 2 J LL ~ C ~
N
N p
~-' _
w
N
Z
~
~
~i
ri
~
~ci ~ vm
a
.~
N
~ ~
m
• ~ Q~
H
N
W
C
U
DC
.~
N
m
m
C7
o ~ c~ W 3 O
,, ~ a ... z
~~~ w ~
,N N
U ~ V
..
~ O O N
H' c z
`Q~gO ~ N V
~~' =. W ' W
~ _
~ W
w YJ F-
~ ~ ~
apd't/J ^ `'t ~ v ~ z LOL
U
J
C
0
C
t
O
0
Z
V
W
z
W
s ~ c
c
.. o
ohm
~,~_
O i C.
.
R m ~
3
L
r
+
~
~
~ +
+ !
0
~ ~ ~V
C C G
QQ
N ~ V
'
~
.
~ A .
!0 (a ~"~
°'3m
O ~ « L
v
V
w ~ ~
}
~
= C 4f V m C
~moa 'a
V
~ c
O
~
~
C ,
~ ~ C1 N
.~ ~ ~ C m
m m
= o. ~ '3
`.3~~m
~smm
r+ ~ w
10
0~.. ~~
:.+ 'O m 'd
>
7 « ~
m ~ m a
s~~~
w 3
R
`~
R O
v Q~Q
N
v_
v
3 m O Q.
~ ~ ~~
d ~ 3
~ m
• ~ GC pm
>
,
~
.~' ~ o ~
'
,
Em«~
c
~
a
a ~ v '~
omm m
w
;= w ~ of e
0
~v o~+ O
y
_J
M~
W
H
J
_~
0
J
H
Z
W
m
G
W
~ m
c o 0
a~3oo
~`o~.~
~~~~~
00 m N ~ N
C ~ O
~ ~ ~ V ;
a~ a~e
m Q
W O ~,
N C O
Y ~ L > C
°; ~' ° Q
O d ~ a
z ~ S ~ a
m m
n ~
Y E ~
C
C V
7 '~
E ~
~ .O L
~ tll
~ p 3
~ m ~_
3 a
~ ~ E
oL~. a
m 5 `o
c Q
v~~m ~
c -
o ~ m
a ~ ~
G ~C O U
~ ~ qU ~
O y .Q C N
m
umi ~ "; W 4 0
w ~ r v` ~ °a
~~
cL ~ao ~
V C L U O :C
o ~ m z ;
~ N cq
~~^
`Clr~' OF REXBURG ~ PERMIT #
~UILDING PERMIT APPLICATION Please complete the entire Application!
19 E MAIN, REXBURG, ID. 83440 If the question does not apply fill in NA for non applicable
208-359-3020 X322
PARCEL NUMBER: ~~~ ~~~' ~'~ ~,~( We will provide this for you)
SUBDIVISION:
UNIT#
(Addressing is based on the information -must be accurate)
BLOCK# LOT#
CONTACT PHONE # ~~,5- l3/02
PROPERTY ADDRESS:
PHONE #: Home ( ) ~- 02~ o ~ Work ( ) Cell ( ) ~OS- ! 3/a
OWNER MAILING ADDRESS: J`J /~1 Lc. ~ot-~a~CITY: ~:2x,8-~t,,~2G STATE: >~ ZIP: ~3~~0
EMAIL
FAX
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
STA
PHONE #: Home
ZIP EMAIL
Work ( ) Cell
CITY:
FAX
CONTRACTOR:
MAILING ADDRESS: CITY STATE ZIP
PHONE: Home# Work# Cell#
EMAIL FAX
How many buildings are located on this property?
Did you recently purchase this property` Yes (If yes give owner's name)
Is this a lot split? NO YES (Please bring copy of new legal description of property)
Single Family
Multi Family, Apartments, Remodel, Garage, Commercial, Addition, Etc.)
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, I hereby certify
that I have read this application and state that the information herein is correct and I swear that any information which may hereafter 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 correct. I agree to comply
with all City regulations and State laws relating to the subject matter of this application and hereby authorized representatives of the City to enter
upon the above-mentioned property for inspections purposes. NOTE: The building official may revoke a permit on approval issued under the
provisions of the 2000 International Code in cases of any false statement or misrepresentation of fact in the application or on the plans on which the
permit or ap royal w based. Permit void if not started within 180 days. Permit void if work stops for 180 days.
Sig ure of Owner/Applicant DATE
Do you prefer to be contacted by fax, 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 Rezburg'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**
c r„
Please complete the entir Application!
applicable
NAME ~if2l3 clS~iJSO~IJ
PROPERTY ADDRESS _'~'~!o ,3~-,2,~ey /~-ii2Y
SUBDIVISION
If the question does not apply fill in NA for non
7~)(~ Barnev Dain~ Rd-Cnty. Mech.
Required!!!
MECHANICAL
Mechanical Contractor's Name: ~ (alp ~- F,.,~> ..~ b h ~15~~3usiness Name: ~~ 5t~n/ ~ ~ ~4~-i,~~
Address ~y~ (,y,I(ow~~~L ci2t,1-~ City ~e;F...[,~,,,~ State ~~--» Zip o3~/ c:
Contact Phone: (Z~~~) .~ 9f1- 6 ~Z S' Business Phone:
Email So L, n Sy.v ~}e~g-,r-~ ,, ~., l~ hn 5n~ . Co .~ Fax 7~ r3 - ~ 5~ - o S" Z ~'
Mechanical Estimate $ (Commercial/Multi Family Only)
FIXTURES & APPLIANCES COUNT (Single Family Dwelling Only)
Furnace Exhaust or Vent Ducts
~ Furnace/Air Conditioner Combo
Heat Pump
Air Conditioner
Evaporative Cooler
~_ Unit Heater ~„q-~fi~
Space Heater
a Decorative gas-fired appliance
Incinerator System
Boiler
Pool Heater
Similar fixtures or Appliances
Dryer Vents
Range Hood Vents
Cook Stove Vents
Bath Fan Vents
other similar vents & ducts:
--
~ ~~; _
a
~I
~_:
Fuel Gas Pipe Outlets including stubbed in or future outlets ~ ~~
Inlet Pressure (Meter Supply) PSI z W ~.~~~~
i h,~m~
Heat (Circle all that apply) Ga Oil Coal Fireplace Electric ~ GJ~"
Mechanical Sizing Calculations must be submitted with Plans & Application
Point of Delivery must be shown on plans.
a ~~
~~Z~,
Signature
,L~.
Licensed Contractor
The City of Rexburg's
13 z7 z-~- a~
License number Date
schedule is the same as required by the State of Idaho