HomeMy WebLinkAboutAPPLICATION - 04-00229 - 370 S 5th E - Deck0 • 0
BUILDING PERMIT APPLICATION REXBURG,ID DATE NO.
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS.
OWNER J)lAVj 4 /A I 1 ,e in JOB ADDRESS 370 S QW PHONE 3 Sb 313-
1
BUIL DER ARCHITECT NA
DESIGNER
STRUCTURE: I Q NEW REMODEL ❑ ADDITION ❑ REPAIR Q RENEWAL
L1 FIRE DAMAGE
LrA ESIDENCE
❑ COMM. ❑ ED CATIONAL ❑GOVT n aFt tr_ini is n cr.lr`r — .,.r.,. _
— — -- — -- �+ • u �. w u CARPOR
FOOTINGS
FOUNDATION
BASEMENT
FLOORS
EXT. WAL L-5 /
CEILING
ROOF
Q GARAGE
❑ AWNING
CONCRETE
(3 MASONRY
CONCRETE
Q MASONRY
Q PARTIAL
❑ FULL
a_WOOD
(3 CONCRETE
❑ WOOD
❑ MAS RY
Q WOOD
❑BUILT P.
HEAT
❑ GAS
INSULATED
❑WALLS
❑ OTHER
❑OTHER
❑ NO
Q OTHER
❑ CO RETE
/WIALJL
Q D LL
Q P ER
Q W D SH.
❑ MP.
❑ pl
❑ CEILI
❑ V EER
QTI
SH.
ILE
❑ AL
(REPLACE
❑ FL RS
❑ RIMETER
❑ ETAL
Q USTIC
ROLL ROOF
ELECTRIC
STUCCO
OPEN
❑METAL
F�1111 w-�Ueu �Uulet;t tv u to regulations contamea In the unitorm Building Code and Zoning Regulations of Rexburg, and it is hereby agreed
that the work to be done as shown in the plans and specifications will be completed in accordance with the regulations
pe and applicable thereto: The issuance of the permit does not waive restrictive covenants.
REMARKS: 8 f x 1 NPGL
UtVAHTMENT OF BUILDING & ZONING
VALUE (,od
FEE PAID
BUILDING
INSPECTOR
WHITE —Owner's Copy CANARY — Building Departments Copy PINK — Assessor's Copy GOLDENROD - Inspector
APPLICATION FOR BITW* 'F%IMT/V nwnl► riT
CITY OF REXBUI
Date of Application 0 0 4 0 0 2 2 9 Al l en/ r at10
. OWNER . _
Name haiad Mtt-,
Site Address 37 0 S. GTH
Mailing Address SA tm•C
city /State/zip aexG tc.- 0 3
Telephone/Fax/Mobile - 01 '
S — 3.1 - 3 3
CONTRACTOR
Name
City /State/Zip.
Teleohone/Fw
PROJECT INFORMATION DEPARTMENT APPROVAL
Property Zone: Is existing use compatible with zoning, (screening parking, etc)
When was this building last occupied ?
Architect/ Engineer Firm Plan Name
Subdivision Lot Block
Circle One Residen ' Commercial Educational Government Remodel Other
Circle One New House tion/Remodel to Ho e
Circle One Basement: None/ Finished / Unfinished
Lot Square Footage
New Commercial Commercial Remodel
Other: None/ atio Carport/ Awning N/A
Lot Width
Main Level Square Feet Upstairs Square Feet Basement Square Feet
Garage Square Feet Number of Stories Height of Building
What will structure be used for: Home Home Business Apartment Commercial Other
Will there be an apartment? 1U,- If so, how many units
Total Estimated Building Value LOO .Al2 Are you in a flood plain
Signature of Applicant
Code
Zone
Building Type
Commercial Building Plumbing bid
Commercial Building HVAC bid_
Commercial Building Square footage
(Parks, Fire, and Police)
Signature of Inspector
Building Permit Fees
Plan Check Fees
Plumbing Permit Fees
Digging Permit Fees
Water & Sewer Fees
Front Footage Fee
Impact Fees
TOTAL $
Issued by