HomeMy WebLinkAboutAPPLICATION - 02-00020 - Dr Max Crouch Office - Remodel. .
BUILDING PERMIT APPLICATION REXBURG, ID DATE : NO. k �
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS.
OWNER t %4 ( - Ir 444 JOB ADDRESS I C„
BUILDER
STRUCTURE:
0 RESIDENCE
'WINGS
CONCRETE
❑ MASONRY
p OTHER
REMARKS
' r
0 NEW
LYCOMM.
❑ REMODEL
❑ EDUCATIONAL
DEPARTMENT OF BUILDING & ZONING
VALUE
FEE PAID
BUILDING
INSPECTOR
❑ GOVT
ARCHITECT
CitoADDMON
❑ RELIGIOUS
❑ REPAIR
O FENCE
❑ PATIO
t 1 , L PNONE
DESIGNER
0 RENEWAL
❑ CARPORT
0 GARAGE
O FIRE DAMAGE
❑ AWNING
INSULATED
` F�OUN��DATION
&CONCRETE
❑ MASONRY
❑ OTHER
BASEMENT
p FU l
� LL
0 NO
FLOORS
OOD
0 CONCRETE
❑ OTHER
❑ ECH CK
EXT. WALLS
0 MASONRY
()CONCRETE
❑ M VENEER
E TAL
p STUCCO
INT. WALLS
atirVOOD
❑ MASONRY
❑ .n RETE
ALL
LASTER
❑ TILE
L
c
.
DATE
CEILING
p � DI W R
O TILE
❑ ACOUSTIC
0 OPEN
ROOF HEAT
❑ DJ1ILT UP. ar&S
d WOOD SH. ❑ OIL
❑ COMP. SH. ❑ COAL
0 TILE 0 FIREPLACE
❑ ROLL ROOF. ❑ ELECTRIC
❑ METAL
This permit is issued subject to the regulations contained in the Uniform Building Code and Z• g Regulations of
that the work to be done as shown in the plans and specifications will be completed in acc • $ _ re
pertaining and applicable thereto: The issuance of the permit does not waive restrictive covenan
WHITE - Owner's Copy CANARY - Building Department's Copy PINK - Assessor's Copy GOLDENROD- Inspector
LING
trPLOORS
&PIERIMETER
ag
Date of Application 1 — R CR-
OWNER
Name a 4- Cf L
Site Address 1c I1A' 4S�a
Mailing Address g. -fie''
City /State /Zip 46442
Telephone/Fax/Mobile 3 ' Co ( P'S
CONTRACTOR
Name
Mailing Address
City /State /Zip
APPLICATION FOR BUILDING PERMIT
CITY OF REXBURG, IDAHO
31• Co-it
ptitv . 03410
Telephone/Fax/Mobile "3 'SS 4 `°7i 31
PROJECT INFORMATION DEPARTMENT APPROVAL
Property Zone: Is existing use compatible with zoning, (screening parking, etc
When was this building last occupied
Architect/ Engineer Firm f I..J__� L (l i kkL• Plan Name
Subdivision Lot
Circle One Residents. Commercial Educational Government Remodel Other
Circle One New House Addition/Remodel to House New Commercial
Circle One Basement: None/ Finished / (Unfrnishecl�
Lot Square Footage Lot Width
Do
Square Feet 12 01) Garage Square Feet Number of Stories Height of Building (l f ^kulpS
What will structure be used for: Home Home Business Apartment C.Canunerci Other
Will there be an apartment F-T)
Total Estimated Cost //YD. ()be Are you in a flood plain K,p
Signature of Applicant
Code
Zone
Building Type
Signature of Inspector
MAY a 7 2002
TYy
If so, how many units
TOTAL $
Permit No.
Block
as. -as -o
Other: None/ Patio/ Carport/ Awning
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * ** ************************************** * * * * * * * * * * * * * * * * * ** * * * * * * * * * * **
Building Permit Fees 41 3.7
Plan Check Fees 9 /. 3Q
N/A
Plumbing Permit Fees , if OD
Digging Permit Fees
Water & Sewer Fees
Front Footage Fee
Issued by /
Rough Plumbing
r'
Septic Tank
Fixtures
Water Piping
Complete
Sewer
Bath Tubs
Urinal
Showers
Sink Trap
Laundry Trays
Water Heater
Wash Basin
Other
Toilet
Slop Sinks
Kitchen -Sinks
Floor Drain
Drinking Fountains
!
Lawn Sprinklers
Water Softeners
Dish Washing Mach.
Clothes Washer
Name
Address
Lot
Name
Address
CITY OF REXBURG
APPLICATION FOR PLUMBING PERMIT
OWNER FEES
t,L Plumbing Permit $
t4 Tel. C f Sewer Inspection $
Inspection of Pipe
Inspection of Fixtures $
Tt /� $
Blk. Add.
PLUMBER
d u.
lit! rU }L, 3
Tel.
NATURE OF INSTALLATION
Use
DESCRIPTION OF WORK
TOTAL $ D.
Received: Date
By
INSPECTOR'S RECORD "
N
Rough Plumbing
Sewer
Other
Finish Plumbing
INSP. NAME
E
_Excavation &
k e ku tti -
Concreta : ( 360i 1-6411 vkh
P i 41.
Masonry: 144-8-
Roofing: " {v kP. 61.4.te.to,‘.
Insulation: [l14L . Drywall : J' ot b iivi d
Painting: - -svd,S
Floor Coverings: (1
Plumbing: VIAL% IN
Heating :k y;
Electrical: 4 EI
Roof Trusses:
Floor / Ceiling Joists
Cabinet‘ : (,.c"
SiQi a Ea = =d= "T'r ?. 12 :
SUBCONTRACTOR L I ST
SPECIAL CONSTRUCTION
(MANUFACTURER OR SUPPLIER)
• kvtit_c_
r r- bAitt_ 7
S.(4- Rte=
MEMO:
TO:
FROM:
DATE:
RE:
TO WHOM IT MAY CONCERN
CHRIS HUSKINSON, FIRE MARSHAL
MAY 03, 2002
DR CROUCH ADDITION
TO WHOM IT MAY CONCERN:
Upon review of the site plan drawings submitted the following items need to be
addressed:
1. Fire extinguisher needs to be placed near the exit door of the new addition. Minimum
size shall be 2A1OBC.
If there are any questions please feel free to contact me.
I)
Chris Huskinson
Fire Marshal