HomeMy WebLinkAboutAPPLICATION - 07-00413 - 672 Centennial Loop - Lawn Sprinklersy - "Building Permit Fees are t time of application" "Building Permits are #d if you check does not clear"
Please complete the sire Application!
If the question does not apply fill in NA for non applicable
NAME Je p �vsa�v
PROPERTY ADDRESS boo
SUBDIVISION
07 00413
Dwelling Units:
SETBACKS
FRONT SIDE
SIDE BACK
Remodeling Your Building/Home (need Estimate) $
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 grade)Area
Water Meter Count:
Water Meter Size:
Required!!!
PLUMBING /
Plumbing Contractor's Name: e.� l e,-7yl?11 Business Name:
Address �®,5��,.�N� �,� �O,G'�,y l7 City T Z�u State Zip
Contact Phone: (dad ) lTf - q-?X
Business Phone: (,?,oj
Email ZI V & &e2-, edi Fax
FIXTURE COUNT (including roumhed fixtures)
Clothes Washing Machine
Dishwasher
Floor Drain
Garbage Disposal
Hot Tub /Spa
Sinks
(Lavatories, kitchens, bar, mop)
Plumbing Estimate $
(Commercial Only)
Tub /Showers
Toilet/Urinal
Water Heater
Water Softener
A6� � zQCr -/7cl,9a <f-2
Required! Signature of Licensed Contractor License number Date
The City of Rexburg's permit fee schedule is the same as required by the State of Idaho
Parcel Acres: 672 Centennial Loop
/- sier
i/ Sprinklers
19