HomeMy WebLinkAboutAPPLICATION - 04-00236 - 525 Maple Dr - Remodel0 • •
BUILDING PERMIT APPLICATION REXBURG, ID DATE -� "��
N0.
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS.
OWNER C � L,r �e -yj � �(� n� JOB ADDRESS PHONE �r' J �% }
- 0 2
BUILDER ARCHITECT
STRUCTURE: ❑ NEW RE MODEL ❑ADDITION ❑ REPAIR
DESIGNER
❑ RENEWAL
❑ RESIDENCE ❑ COMM ❑ EDUCATIONAL ❑ GOVT ❑ RELIGIOUS ❑ FENCE ❑ PATIO
❑ FIRE
❑ CARPORT
DA
FOOTINGS
FOUNDATION
BASEMENT
FLOORS
EXT. WALLS
INT. WALLS
CEILING
❑GARAGE
(3 AWNING
El CONCRETE
❑ CONCRETE
❑ PARTIAL
❑ WOOD
❑ WOOD
❑ WOOD
❑WOOD
ROOF
HEAT
INSULATED
❑ MASONRY
❑ OTHER
❑ MASONRY
❑ OTHER
❑ FULL
O
❑ CONCRETE
❑ MASONRY
❑ MASONRY
❑ DRYWALL
L) BUILT UP.
❑ WOOD SH.
❑GAS
L) OIL
L) WALLS
❑ OTHER
❑ CONCRETE
❑ VENEER
❑ CONCRETE
❑PLASTER
❑COMP. SH.
❑COAL
L) CEILING
❑ FLOORS
❑ METAL
❑ DRYWALL
❑ PLASTER
❑ TILE
❑ ACOUSTIC
C3 TILE
❑ ROLL ROOF.
❑ FIREPLACE
❑ELECTRIC
L) PERIMETER
L) STUCCO
❑ TILE
❑ OPEN
❑METAL
This permit is issued subject to the regulations contained in the Uniform Building Code and Zoning Regulations of Rexburg,
and it is
that the work to be done as shown in the plans and specifications will be completed in accordance
hereby agreed
with
the regulations
pertaining and applicable thereto: The issuance of the permit does not waive restrictive covenants.
REMARKS: i ► _ .'_ (L
DEPARTMENT OF BUILDING & ZONING
VALUE
FEE PAID ❑CASH pppl 1CehIT
BUILDING II DATE ADDRESS
WHITE -Owner's Copy CANARY - Building Department's Copy PINK - Assessor's Copy GOLDENROD- Inspector
APPLICATION FOR BUILDING PERMIT
CITY OF RE"URG, IDAHO
Date of Application _6 - 2)-- 6>1 Permit No.
OWNER
Name
Site Address
Mailing Address K1V—e-
City /State/Zip q-0
Telephone/Fax/Mobile '� �6 - 6 -7 Z5L Qu�p�a✓ e , qi j
CONTRACTOR
Name
Mauling Address
City /State/Zip
Telephone/Fax/Mobile
PROJECT INFORMATION DEPARTMENT APPROVAL � �e1/l, f
Property Zone: Is existing use compatible with zoning, (screening parking, etc)
When was this building last occupied ��l ?
Architect/ Engineer Firm Plan Name
Subdivision Lot Block
Circle One Residential Commercial Educational Government (emode Other
Circle One New House Addition/Remodel to House New Commercial Commercial Remodel
Circle One Basement: None/ Finished / Unfinished Other: None/ Patio/ Carport/ Awning NIA
Lot Square Footage 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 Horne Business artme Commercial Other
Will there be an apartment? If so, how many units
Total Estimated Building Value q O Q 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 Front Footage Fee
(Parks, Fire, and Police) Impact Fees
Signature of Inspector
Issued by
Building Permit Fees
Plan Check Fees
Plumbing Permit Fees
Digging Permit Fees
Water & Sewer Fees
TOTAL S
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