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Home My WebLink AboutAPPLICATION - 04-00404 - 616 Chad Dr - AdditionCITY OF REXB URG PERMIT # BUILDING PERMIT APPLICATION 19 E MAIN, REXBURG, ID. 83440 Please complete the entire Application! 208 - 359 -3020 X326 If the question does not apply fill in NA for non applicable PARCEL NUMBER: 90 S h Uo , I o,� SUBDIVISION: ,�s (,J �� UNIT# BLOCK # # OWNER: G se /C CONTACT PHONE # PROPERTY ADDRESS: G//_ Cz� PHONE #: Home , j�G- � p Work ( ) Cell � / —G e2 e-� - I y OWNER MAILING ADDRESS: alj!� CITY: STATE:-2;J-ZIP +-e APPLICANT (If other 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 CITY: r STATE; 7 ZIP PHONE #: Home ( ) Work ( ) ell ( ) CONTRACTOR: PHONE: Home# ork# Cell # v MAILING ADDRESS W - 224o CITY STATE How many houses are located on this property? / Did you recently purchase this propert 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: (i.e., Single Family Multi Family, Apartments, Remodel, Garage, Commercial, Addition, Etc.) APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, I hereby certify 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 official may revoke a permit on approval issued under the provisions of the 2000 International Code in cases of any false statement or misrepresentation of fact in the application or on the plans on which the permit or approval was based. Permit void if not started wi 'n 180 days. Permit v id i work stops for 180 days. ,� q of Owner /Applicant DATE 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 January 1. 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" NAME G'- PROPERTY Aj5DRESS l_�'��/J� SUBDIVISION Q — k s Dwelling Units: Parcel Acres: . .20 e) Front Footage (if applicable) Permit# SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building) First Floor Area , Z /� Second floor /loft area Third floor /loft area Shed or Barn Unfinished Basement area Finished basement area Garage area 0 Carport/Deck (30" above grade)Area Remodel (Need Estimate) $ ,3 _ PLUMBING PLUMBERS NAME S e o ADDRESS CITY STATE ZIP PHONE ( FIXTURE COUNT CLOTHES WASHING MACHINE DISHWASHER FLOOR DRAIN GARBAGE DISPOSAL HOT TUB /SPA SINKS (Lavatories, kitchens, bar, mop) WATER METER COUNT SPRINKLERS TUB /SHOWERS / TOILET/URINAL WATER HEATER WATER SOFTENER WATER METER SIZE HEAT (Circle all that appl Ga) Oil Coal Fireplace Electric Commercial Buildings & Apartments with 3 or more units Only BUILDING ESTIMATE $ PLUMBING ESTIMATE $ STORM WATER LENGTH FRONT FOOTAGE STRUCTURES DESCRIPTION USE BEDROOMS UNITS NON CENSUS OCCUPANCY LOAD, EXITS SETBACKS FRONT SIDE SIDE CONSTRUCTION ROOF SANITATION METHOD HEAT FLOOD ZONE FENCE TYPE OCCUPANCY BACK 2 SUBCONTRACTOR LIST Excavation & Earthwork: Concrete: Masonry: y e t Roofing: Insulation: Drywall -- -- - Painting: t p Floor Coverings:_? Plumbing: . t". ^/ r Heating: Do C - S Electrical: ,mk. a sa>ej e Y- SPECIAL CONSTRUCTION (Manufacturer or Supplier) Roof Trusses: G Floor I Ceiling Joists 7'(!�— Cabinets: - -„ O o l e Siding /Exierior Trim: