HomeMy WebLinkAboutAPPLICATION - 06-00304 - Stonebridge Subdivision - Lawn SprinklersCITY OF REXB URG
`BUILDING PERMIT APPLICATION Please c
19 E MAIN, REXBURG, ID. 83440 If the quest
208-359-3020 X326
PARCEL NUMBER:~,X ;J~ ~' r (VV
PERMIT #
06 00304
Stonebridge LLC-Sprinkler Permit
SUBDIVISION: UNIT# BLOCK# LOT#
(Addressing is based on the information -must be accurate)
- CONTACT PHONE # r~2o3~ SZl-
PROPERTY ADDRESS:- ~N~grt.~~~5y6~-y~Stoa1 - ~'~ 1lJ t~Xi3u2ht ll)
PHONE #: Home ( ) ~1.~ Work ( ) ~//~- Cell ( ) w~~
OWNER MAILING ADD~R~ESS: .Sc~o N Ma~r~, CITY: C~-v-uE- STATE: UT ZIP:
EMAIL Gt ~ ~"n e-~P~I • (_',o~. FAX [7-~8~ b?-~(-1 ~g3
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
STATE; ZIP
PHONE #: Home
EMAIL
Work ( )
CITY:
FAX
Cell ( )
CONTRACTOR I'bA~1o (~i(L.D~1 S - J~tA'r~ 1~1,p
MAILING ADDRESS: ~3(p ~(/(S~-~,J~ ~ CITY ~~~-kFb6(~ STATE l~ ZIP $3ZZ
PHONE #: Home ( ) Work (j,~g) ~~ (~$c~ Cell (~ ~~~ -Z4
EMAIL FAX. IDAHO REGISTRATION # & EXP. DATE
How many buildings are located on this property?
Did you recently purchase this property? No Yes (If yes give owner's nal
Is this a lot split? NO YES (Please bring copy of new legal description
PROPOSED USE: ~W1Gl~ ~,~tl-[- F~2 olrr~t~c nt= ~~
(i.e., Single Family Residence, Multi Family, Apartments, Remodel, Garage, Commercial,
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATI ~~~~ ~ by ce ify
~6 ~~~06
tgn ur e pp a DATE
Do yo prefer to be contacted by fax, email r phone . Circle One
WARNING -BUILDING PER ST 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 your check does not clear**
that I have read this application and state that the information herein is correct and I swear that any i or h a b me
in hearings before the Planning and Zoning Commission or the City Council for the City of Rexburg ply
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 2003 International Code in cases of any false statement or misrepresentation of fact in the application or on the plans on which the
permit o • pproval was based. Permit void if not started within 180 days. Permit void if work stops for 180 days.
3
Plearse com lete the a*ire A lication!
P pP
If the question does not apply fill in NA for non applicable
NAME
PROPERTY ADDRESS
SUBDIVISION
Dwelling Units:
Parcel Acres:
SETBACKS
FRONT SIDE SIDE
Remodeling Your Building/Home (need Estimate) $
BACK
Permit#
SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building)
First Floor Area
Second floor/loft area
Third floor/loft area_
Shed or Barn
Unfinished Basement area
Finished basement area
Garage area
Carport/Deck (30" above g
Water Meter Quantity:
************** Water Meter Size: ~~
Required!!!
PLUMBING
Plumbing Contractor's Name: P'~Tl~ ~D Business Name: ~~~ ~j.4dL~E.N,S
Address ~~3 b Ill/F,ST 1 ~ City $lgt.IcFooT' State 1 Dq~-~ Zip 3u~
Contact Phone: ('f~o$) ~~~ -~~~ Business Phone: (fig) ~gS-(.~g~
Email
FIXTURE COUNT (includins roughed fixtures)
Clothes Washing Machine
Dishwasher
Floor Drain
Garbage Disposal
Hot Tub/Spa
Sinks
(Lavatories, kitchens, bar, mop)
Plumbing Estimate $
(Commercial Only)
Signature of Licensed Contractor
The City of Rexburg's
License number
fee schedule is the same as
Date
the State of Idaho
Fax
C Sprinklers
Tub/Showers
Toilet/Urinal
Water Heater
Water Softener
4