HomeMy WebLinkAboutAPPLICATIONS - 08-00408 - Founders Square - Lawn Sprinklers�O t q��.XBU,p�
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° REXBURG
A '•, Americas Family Community
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Please. Com ke the Entire Application!
If the question does not apply fill in Nik for non applicable
COMMERCIAL & MULTI FAMILY BUILDING T
19 E MAIN, REXBURG, ID 83440
208 - 359 -3020 X326
0800408
Founders Square Association
Sprinkler System
PARCEL NUMBER: hVV_ ' "
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SUBDIVISION: UNIT# BLOCK# LOT #,
is based on the Intormatlon - must be
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PROPERTY ADDRESS: (6 vld'wS yo r�
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PHONE #: Home ) 4 06 6 - y Nab Work
Cell (
OWNER MAILING ADDRESS: CITY: STATE: ZIP:
EMAIL FAX
APPLICANT (If other than owner) 6,4cwj'v 6Lpr ie S J � C ,
(Applicant if other than owner, a statement authorizing applicant to act as agent for owner must accompany this application.)
APPLICANT INFORMATION: ADDRESS CITY:
STATE; ZIP EMAIL FAX
PHONE #: Home (
Work (
Cell (
CONTRACTOR
MAILING ADDRESS: CITY STATE ZIP
PHONE: Cell# Work# Fax#
EMAIL IDAHO REGISTRATION # & EXP. DATE
How many buildings are located on this property?
Did you recently purchase this property? No Yes (If yes, list previous owner's name)
Is this a lot split? NO YES (Please bring copy of new legal description of property)
PROPOSED USE:
(i.e., Single Family Residence, Multi Family, Apartments, Remodel, Garage, Commercial, Addition, Etc.) — CIRCLE ONE
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalt of perjur I hereb certif 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 o ff y 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 a ' atio on the plans on which the permit or approval was based. Permit void if not started within 180 days. Permit void if work stops for 180 days.
00 / 06
atur er /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 fanuAIX L 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**
1(� n s CONTACT PHONE # 307 — b9 - Y
7
Building Safety Departme
City of Rexburg
79 E. Main jonellh@rexburg.org Phone: 208.359.3020
Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3024
O� REX B URC
CITY OF
REXBURG
Americas Family Community
Remodeling Your Building /Home (need Estimate) $
SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building)
First Floor Area Unfinished Basement area
Second floor /loft area Finished basement area
Third floor /loft area Garage area
Shed or Barn Carport /Deck (30" above grade)Area
Water Meter Quantity: * * * * * * * * * * * ** *Water Meter Size:
Requlred!►f
PLUMBING /�
Plumbing Contractor's Name: ( (.t)/y i c�"atr f C Bus.ess Name:
Address City State ID Zip S' 0
Contact Phone: (,?o ?) Business Phone: ( ,� \) Sry `
Email 1 L rrYed Q rive? b_q 4f Fax b2
FIXTURE COUNT (including roughed Fixtures
Clothes Washing Machine
Sprinklers
Dishwasher
Tub /Showers
Floor Drain
Toilet /Urinal
Garbage Disposal
Water Heater
Hot Tub /Spa
Water Softener
Sinks (Lavatories, kitchens, bar, mop)
Plumbing Estimate $
(COMMERCIAL /MULTI - FAMILY ONLY)
of Licensed Contractor License Number& Expiration Date
Date
The City of Aexburg's permit fee schedule is the same as required by the State of Idabo