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HomeMy WebLinkAboutAPPLICATION - 08-00542 - 485 N 2nd E - Deseret BookstoreNov. 5. 20087 4;18PM1;[1 F rst Call Jewel No. 25415 P. 1' CITY OF'REnUR* PERIMIT# 0 3 -,/ BUILDINGPERMITAPPLICATION Please complete the entire A pplication! 19 E MAIN, REXBURG, ID, 53440 If the question does not apply kill in NA for non applicable 208-359-3020 X322 PARCEL NUMBER: ( We will provide this for you) SUBDIVISION; UNIT# BLOCK# LOT# (Addressing is based on the information - must be accurate) PROPERTY ADDRE PHONE #: Homc ( OWNER MAILING ADDRESS: CITY: STATE: ZIP; EMAIL FAX APP ; (If other than owner) � 4W e.� e (Applicant if other than owner, a staremant authorizing appboam to act as agent for owner must accompany APPLICANT INFORMfLTION: ADDRESS I 67ygd CITY: Z44 - 4t&5 STATE; ZIP EMAIL FAX PHONE #: Home ( ) Work ( ) .� - 2 77 ? Call ( ) CON?'.RACTOR MAILING ADDRESS: PHONE: Rome# CITY-9/ r 0 5 STATF, 3 Work# Call# EMAIL ,How many buildings are located on this property? Did you recently purchase this property? No Yes (If yes give owner's name) Is this a lot split? NO YES (Please bring copy of new legal description of property) PROPOSED USE: ox,, S,ilrgle Family Residence, Multi Fa illy, Apartments, Remodel, Garage, Commercial, Addition, Etc.) APPLICANNT' S SIGAlATURE, CERTIFICATI0AN AND AUTHORIZATION Under penalty of papery, I h—V =:* that I have irad this applicadoa and strati"du iaforroadtin horoia is ovnwt and 1 aWcV that pay iuformelion whiob may ficmA r ba; van by me in heerinps before the PlannJng and Zaalgg Commlasion ortho City Coim6J.for the City ofRexbwg shell be trulbU and coffee t ag ea to comply with a ll City regulations and Stale laws 01*36 to 1119 subject manor of thle appliMton and hMby 0111110"d repreeeeraUM U1110 City to enter upon the above- mantioncd proputy for Ingpecdons purposes. NOTE: The building official may ravoke a permit on approval imed under the ptovislow of tart: 2000 Intamadonal Codo in aria+ of wY false rwiUmt or misnptemraaon of Wc.la the SpplicWon or on dm plans on which tho perroit or approval was based, Permit voJd Knot s"d within 180 days_ Permit void if Work stops for 180 days. , r / / / �_ DATE Do you profer to be eoatactcd by fax, email or phone? Circle One WAAMC – W=ING PERMIT MUST SE POSTED ON CONSTRUCTION SrITI Plan ibex are con- rafuatiable and are pale hLMO at tho limo of epP1148don boonniog 1, 3 06 Oty ofResbarg's Acreptemes of the p" review in dons not constitute plan approval ,(�_oJ 4<r9-a�l/� _C v , CONTACT PHONE # Nov. 5. 20081 4:18PM)r First Call Jewel "'No, 2541 r ' P. 2 • 0 Buliding Safety Department • city of Rexburg 19 E M& 1ane11h6rexburg.orp Phvno :909,950,3020 x526 Rexbvrg, ID 99440 www,rexbUto.org Fox. 200.359.SD24 CITY or REXBURG AmerlcA hinily CoMmwdy OWNER'S NAM PROPERTY ADDRESS Pemlit# SUBDIVISION PHASL LOT BLOC Requ redffl Electdcai c ontiracctoes Nome Addreas t 96-"0 —q- q a Name Cell Phone ( ) B ualnees Phone( ) e LaZa -- Z 7 7 7 pax( ) Electrlc111 Eatimatc (cos[ of wlriag & labor) (COMMERCIAL /lAULTI- FAMILY ONLY) ryas oplMAL" (Now,Resldanrialladudes vmgddgr oowm&e Wld dh the teddeptdd e0udum and Art ah&d bzgp at the s ome dma) Up to 200 amp Service"` 201 to 400 amp Sorvica'O Over 400 amp Service* Temporary Construction Service, 200 amp or lees, one locadou (for a pedod 1109 to exceed 1 year) Existing Resideatial (# of Branch Circuits) Spa, Hot Tub, SVritnming Pool Flectric Central Systems Heating and /or Cooling (when not part of it now reddendal construction pewit sad no additional wWat Modular, Manufactured or Mobile Home OtheF Installations: Wlring not specifically covered by any of the above Coot of Wiring & Labor: 3 Pumps (Domestic Watet, Irrigation, Sewage) Requested Inspections (of existing wldno Temporary Amusement /Industry *Includes a mmlm= of 3 io.pecdons. Additional inspcctiom charged 4t tequested inspection rate of $40 per hour, Zdmt 4 ..2 az= SiSnatute of Licensed Contesuol Uocme number Dso Tht ELECTRICAL lehedwb it the ran► 4r ngahr /' As Si dte