HomeMy WebLinkAboutAPPLICATIONS - 08-00499 - 1025 W 7th S - PlumbingOct, 14. 2008 3:57PM'- "'Fi rst Call Jewel
CITY OFR=
BUILDING PERMIT APPLICATION
19 E IVAIN, REXBURG, ID, 83440
208 - 359.3020 X322
No, 2315> P. 1
PERMIT
Please complete the entire Application!
If the question does not apply fill in NA for non applicable
PARCEL NUMBER: (We will provide this for you)
SUBDIVISION: UNIT# BLOCK# LOT#
(Addressing is based on the information - must be accurate)
PROPERTY
P14ONE 9" Home (
- q,,,65,9 Work
OWNER MAILING ADDRESS:
CITY, STATE: ZIP:
EMAIL FAX
�C'�J1VT (If other than owner)
(Applicant if other than owner, a statement authorizing applicant to act as agent for owner m un accompany this
APPLICANT INFORMATION: ADDRESS P"//, ZL/ eN�I
STATE; — ZIP L-3 44 5 EMAIL FAX
PRONE #.- Horne (
Work( ) 7 Call (
CONTRACTOR
MAILING ADDRESS: F/) � 02% d (7 CITY �l
PHONE: Home# Work'* , _ Call#
How many
FAX 6L,-2
are located on this property?
Did you recently purchase this property? No Yes (If yes give owner's name)
Is this a lot split? NO YES (Please bring copy of new legal desotiption of property)
PROPOSED USE:
(i.e., 3,it s Family Rosidemce, Muld Family, Apartments, Remodel, Garage, Commerclat, Addition, Etc.)
A.PPLICANI T' S SIGNATURE, CER TIFICATION ANT AUTHORIZATION: Under penalty of pedwy, I hereby cmi* that I
have had this application and state that the informadan hcrcio is eon ct and 1 swc rtbat any informilion which may h be o vea by red In hearings before the
Pleunlas ozd ZoaLng Conun1aslon ortbe Ctty Cotuoil ft tbo City of jRaabrag shell bo truNU and correct. I agree to comply with ail City reoations and 5ture laws
routing to the subjoat mafla afiWa eppliflat-ion and hereby eulhoriVil representative+ of the City to curet upon the above- mentlonod ptoycrty forinspoedons yutposcs-
N 7ho building arfffciel may rovoltc a permit ora approval issued under the p4VWjiona ofthe2000 Intcrnarional Code in cues of wyfolao ststaracot or'
misrepresentation offact.in the apph;c Zon or on dtp plans on wWa rho pcmlt or gDrovel wa beard. Permit void it not sturied wiak 180 days. Permit void if work
stops for ISO days. . t
/D / � /�
DATE
Do you prefer to be contacted by fax, email or phone? Circle One
WAlkilMG 8=1NG PERMIT 11f17ST RE POSTED ON CONSTRUCTION 3=1
Plan faits are non - refundable and are pold Lit fall at dill time of applleAon begwring jimu my 1 1 2061
City of Rasbnrg's Acceptance of the plan reran► fie doss not consttfuto plan approval
Cell (
3
,__ CONTACT PHONE #
Oct. 14, 2008 3:58PM "First Call Jewel
; Please complete OWntire Appliieationl
Yf the question does not apply sill in NA for non applicable
NAME
PROPERTY ADDRESS Permit#
SUBDIVISION
Dwelling Units: Parcel Acres:
SETBACKS
FRONT SIDE SIDE BACK
Front Footage (if applicable)
Storm Water Length
Rewdding Your Building/Home (need Estimate) $
"No, 2315 "P. 2
SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building)
First Floor Area
Second floorAoft area
Third floor/loft area
Shed or Barn
Water Meter Count:
Requiredlll
PLUMBING
ING
Plumbing Conttaaetso,,r's Name:
Contact Phone: (
Unfinished Basement area
Finished basement area .
Garage area
Carport/Deck (30" above. grade)Area
Water Meter Sin;
Phone: (
=T1RTi COUNT ( roughed fciures)
Clothes Washing Machine Sprinklers
Dishwasher Tub /Showers .
Floor Drain. Toiletfurinal
Garbage Disposal r —... Water Heater
Hot Tub /Spa Water Softener
Sinks
(Lavatories, kitchens, bar, mop)
Plumbing Estimate S _ (Commercial Only)
e0a&d LJ zea::
Siam= OfLicebsod CQntmator Licenso number Date
The City of Rexbwg's yermitfeo schedule U the scone ae raguirad by the State ofldoho