HomeMy WebLinkAboutAPPLICATION - 02-00002 - Sleep Institute - RemodelBUILDING 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 .4.4, s „A . n. <,+ 6 ' ' .• , t ks ?, "� JOB ADDRESS
BUILDER
STRUCTURE:
0 RESIDENCE
FOOTINGS
0 CONCRETE
Q MASONRY
O OTHER
REMARKS:
0 NEW
0 COMM.
ArREMODEL
Q EDUCATIONAL 0 GOVT
DEPARTMENT OF BUILDING & ZONING
VALUE, !
FEE PAID 0�CK
BUILDING
INSPECTOR
ARCHITECT
0 ADDITION
Q RELIGIOUS
DESIGNER
0 RENEWAL 0 FIRE DAMAGE
Q FENCE o PATIO : Q CARPORT 0 GARAGE D AWNING
INSULATED
0 REPAIR
FOUNDATION
0 CONCRETE
o MASONRY
0 OTHER
BASEMENT
O PARTIAL
❑ FULL
0 NO
FLOORS
0 WOOD
0 CONCRETE
0 OTHER
EXT. WALLS
o WOOD
o MASONRY
O CONCRETE
O VENEER
0 METAL
0 STUCCO
INT. WALLS
O WOOD
❑ MASONRY
O CONCRETE
O DRYWALL
O PLASTER
0 TILE
CEILING
0 wooD
0 DRYWALL
Q PLASTER
O TILE
O ACOUSTIC
O OPEN
0 BUILT UP.
0 WOOD SH.
O COMP. SH.
O TILE
0 ROLL ROOF.
Q METAL
HEAT
Q GAS
O OIL
o COAL
0 FIREPLACE
0 ELECTRIC
APPLICANT
ADDRESS
WHITE - Owner's Copy CANARY- Building Departmenrs Copy Mk- Assessor's Copy GOLDENROD- Inspector
0 WALLS
0 CEILING
0 FLOORS
0 PERIMETER
This permit is issued subject to the regulations contained in the Uniform 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
pertaining and applicable thereto: The issuance of the permit does not waive restrictive covenants.
Date of Application f! '7 "6 ,
OWNER (( l �
Name .SG T / Cr MJ ! -La _ � DCZ t/lSti�
Site Address r3 Pro-re5 5 i U P64 2-C{. 5
sc-'fl
Mailing Address
City /State /Zip
Telephone/Fax/Mobile
CONTRACTOR) ,/� /� ' ' ^, /
Name '2.4.1 G L f - i n (tot, ! Ji-� -/ , YL YL.
0
Mailing Address
City /State/Zip
Telephone/Fax/Mobile
PROJECT INFORMATION
Lot Square Footage
Property Zone: Is existing use compatible with zoning, (screening parking, etc)
( A07 OR/
U / (rIL ,o n b4[-
When was this building last occupied J-4_,.6 ( L & ll tit /OA
Architect/ Engineer Firm Uf UU Plan Name
Subdivision Lot Block
Circle One Residential Commercial Educational Government Remodel Other
Circle One New House Addition/Remodel to House New Commercial
Circle One Basement: None/ Finished / Unfinished
Square Feet Garage Square Feet Number of Stories Height of Building
What will structure be used for: Home
Will there be an apartment?
Total Estimated Cost 4 g&Li •
Signature of Applicant
Code
Zone
Building Type
APPLICATION FOR BUILDING PERMIT
CITY OF REXBURG, IDAHO
q 6 • ouLt
745- flo
DEPARTMENT APPROVAL
Lot Width
Home Business Apartment Commercial Other
If so, how many units
Are you in a flood plain
Permit No. �G ®� - _ 5
Commercial Remode
Other: None/ Patio/ Carport/ Awning
N/A
Building Permit Fees
Plan Check Fees
Plumbing Permit Fees
Digging Permit Fees
Water & Sewer Fees
TOTAL $
Signature of Inspector
Issued by
Rough Plumbing
Septic Tank
Fixtures
/
Water Piping
Complete
Sewer
Bath Tubs
Urinal
Showers
/
Sink Trap
Laundry Trays
Water Heater
Wash Basin
J
Other
Toilet
f
Slop Sinks
Kitchen Sinks
Floor Drain
Drinking Fountains
Lawn Sprinklers
Water Softeners
Dish Washing Mach.
Clothes Washer
Name
Address
Lot
Blk.
Add.
Name
Address Tel.
NATURE OF INSTALLATION
Use
DESCRIPTION OF WORK
CITY OF REXBURG
APPLICATION FOR PLUMBING PERMIT
Plumbing Permit
Sewer Inspection $
Inspection of Pipe $
Inspe tion of Fixtures $
r.M.&L 3 $
Received: Date
By
Rough Plumbing
Sewer
Other
Finish Plumbing
JAN
FEES
7 2002
L.C.. N OF REXBURG
TOTAL $
kidic
i INSPECTOR'S RECORD
INSP. NAME