HomeMy WebLinkAboutAPPLICATION - 04-00303 - Jenks Townhomes - Bldg 6CITY OF REXB
BUILDING PERMIT
19 E MAIN, REXBL
208 -359 -3020 X326
JRG u h t �
APPLICATION
ZG.ID. 83440
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SUBDIVISION:
<",, I ) PERMIT #
04 003 03
Jenks Towashomes t�nit 6 1 home
UNIT# BLOCK#
649 Tr(Jo
Z LOT# S
OWNER; )t*�y+_N Q V"4y 1f L -CC CONTACT PHONE # Aok
PROPERTY ADD SS: `tfq o S-6
PHONE #: Home ) 372- 3 aci7 Work (?s) 313 - 7 8 - 7 Cell ) - 3t; - 3 - 9 9
OWNER MAILING DRESS: S4 CITY: 1tir�STATE: f ZIP: 19301'0
APPLICANT (If othe than owner)
(If applicant if other than owner, a statement authorizing applicant to act as agent for owner must accompany this application.)
MAILING ADDRESS OF APPLICANT 5 - A-5
CITY: STATE; ZIP
PHONE #: Home ( I ) Work( )
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CONTRACTOR: N b, &, Q",,. ,,P HONE: Home# 7 Z °3 0 !!;W ork# 3r3 - 37& Cell# 3�3 ' 37 9 9
MAILING ADDRESS b�� CITY & STATE - 7-0 ZIP 83 a
How many houses are located on this property? f
Did you recently purchase this property? No bes I f yes give owner's name) ✓C , 4 f g/,, -" ✓cv
Is this a lot split? N YES (Please bring copy of new legal description of property)
PROPOSED USE: i A a h` 6 J+.., Y .
(i.e., Single Family Rsidence(lGl Fam ily partmefits, Remodel, Garage, Commercial, Addition, Etc.)
APPLICANT'S SIGIN ATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, I hereby
certify that I have read thi application and state that the information herein is correct and I swear that any information which may
hereafter be given by me i i 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 authorizer) represe tatives of the City to enter upon the above - mentioned property for inspections purposes. NOTE: The
building official may revoke a permit on approval issued under the provisions of the 2000 International Code in cases of any false
statement or misrepresentEtion of fact in e application or on the plans on which the permit or approval was based. Permit void if not
start 180 days. rmit vo' 1 w k stops for 180 days.
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Sig riature of er /Applicant DATE
AIRNI —BUILDING PERMIT MUST BE POSTED ON CONSTRUCTION SITE?
Plan fees ar on- refundable and are paid in full at the time of application beginning January], 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 you check does not clear **
1
ZOa-5 0
,. _NAME
PROPER Y Al
SUBDIVISION
Dwelling Units:
Front Footage (if
SURFACE
First Floor Area
Second floor /loft arf
Third floor /loft area_
Shed or Barn
PLUMBING
PLUMBERS NAME
CITY S -, C"('
FIXTURE COUNT
CLOTHES WASHRI
DISHWASHER
FLOOR DRAIN
GARBAGE DISPOS.
HOT TUB /SPA
SINKS
(Lavatories, kitchens,
WATER METER
HEAT (Circle all that
BUILDING ESTII►L
PLUMBING ESTIA
STORM WATER LI
FRONT FOOTAGE
STRUCTURES
USE P (, l
BEDROOMS 2
UNITS
NON CENSUS
OCCUPANCYTOAD
EXITS Z
SETBACKS
FRONT 20
k41A
f a .
G
Permit#
Parcel Acres: .
FOOTAGE: (Shall include the exterior wail measurements of the building)
62T Unfinished Basement area
L 1 -1 Finished basement area —
Gara e area
Carpo eck (30" above grade)Area �{,
ADDR -ESS `F3 / 6 - Aaf lcx , s
STATE - r-�q ZIP 63 , 1 PHONIC (;4g 2-ow _3'%
6 Z—
MACHINE /
r, mop)
T_ ----
5 pV
WATER METER SIZE v � r
Gas it Coal Fireplace Electric
inns & Apartments with
TE $ 7o, a „a
Q
I TE $
IVGTH
'k,`
.FIDE
CONSTRUCTION U-r o 9
ROOF` S / f
SANITAMNMETHODL Se�
HEAT G, h'S
FLOOD ZONE
FENCE' TYPE
OCCUP4NCY l
SIDE zo BACK �d
SPRINKLERS
TUB /SHOWERS C
TOILE".`' /URINAL Z
WATER HEATER 1
WATER SOFTENER
2