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2005, 11-10 Permit App: 05004254 Mechanical Fixtures Unit AProject Number: 05004254 Inv: 1 - Application., THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 11/10/2005 Page 1 of 2 Project Information: Permit Use: MECHANICAL FIXTURES -UNIT A Setbacks: Front Site Information: Plat Key: Left: Right: Rear: Name: SHP-15-04 Contact: RAIN DANCE PROPERTY MAINTENAN Address: 9443 N GOVERNMENT WAY C - S - Z: HAYDEN, ID 83835 Phone: (208) 762-9857 Group Name: Project Name: District: Nort Parcel Number: 45164.0501 SiteAddress: 114 N BOWDISH RD Location:: CSV Block: Zoning: UR -22 Urban Residential -22 Water District: 011 MODERN Lot: 2 Owner: Name: HIGH WING CONSTRUCTION INC Address: 601 E SELTICE WAY STE 7-B POST FALLS, ID 83854 Hold: ❑ Area: 0 Sq Ft Width: 80 Depth: 118 Right Of Way (ft): 50 Nbr of Bldgs: 1 Nbr of Dwellings: 3 Review Information: Review Plan Review Permits: Released By: Contractor: RAIN DANCE PROPERTY Address: 9443 N GOVERNMENT WAY HAYDEN LAKE, ID 83835 Item Description GAS WATER HEATER GAS APPLIANCE<=100,000BTU GAS PIPING CLOTHES DRYER HOOD -TYPE II GAS APPLIANCE - MISC. PROCESSING FEE Mechanical Permit Firm: RAIN DANCE PROPERTY MAIN Phone: (208) 762-9857 Units Unit Desc 1 NUMBER OF 1 NUMBER OF 3 # OF UNITS 1 NUMBER OF 1 NUMBER OF 1 NUMBER OF 1 SELECT Fee Amount $10.00 $12.00 $3.00 $10.00 $10.00 $10.00 $35.00 Permit Total Fees: $90.00 Operator: CJJ Printed By: KJK Print Date: 11/10/2005 Project Number: 05004254 Inv: 1 Notes: Applictttion- THIS IS NOT A PERMIT Penalties will be assessed for commencing work without a permit Date: 11/10/2005 Page 2 of 2 Payment Summary: Permit Type Mechanical Permit Fee Amount Invoice Amount Amount Paid Amount Owing $90.00 $90.00 $90.00 $0.00 $90.00 $90.00 $90.00 $0.00 Disclaimer: Submittal of this application certifies the owner (or person(s) authorized by the owner) has both examined and finds the information contained within to be true and correct, and agrees that all provisions of laws and/or regulations governing this type of work will be complied with. Subsequent issuance of a permit shall not be construed to be a permit for, or an approval of, any violation of any of the provisions of the code or of any other state or local laws or ordinances. Signature: Operator: CJJ Printed By: KJK Print Date: 11/10/2005