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HomeMy WebLinkAboutAPPLICATION ELECTRICAL- 19-00056 - 642 Trejo St - Basement Remodelo4oxavpc ` _ IT r o F Building Safety Department _ ._.. - BUILDING PERMIT FOR121 V ��WloM City of Rexburg .` America's FzzmiiyCanurrrnzig' 35 North 1St East Rexburg, Idaho 83440 BUILDING APPLICATION Remodel SFR Electrical Permit Number: ❑ Electrical Fee Paid Name: i3 G fr�� Address• City:'it'ltY1 tAJ 1 Phone:7. tc� A - { �jG t ' State: �i�1 Zip Code:-- ` 11 Under Idaho Building Code, a homeowner is allowed to do work on theEmail: "ir nwn by e � { i �, ���i A`3 Oro . ("& r" Are you a homeowner doing work on your own home? 0 Yes (Skip to and complete the Homeowner's Exemption) Q No, I am working with the homeowner Business:.. State License #: � / � Exp.. D i 3? Address: � �- f��;¢a,�•.v /fes/r; City: _ / � �a ;.� }�},.� State: Phone: Z ©'$ - J y a- y s a 1 _Zip Cade: Email: pR`�'"kC L_ci 2 r /4•vi c i< /d . r� i� . c Contact/Rep. Name: Phone: 20fg}0-'9s of C Email. Electrical Contractor Authorized Signature: \ A rub siitil Date: 0 d / f thf..'t> Ir ec rtst: uthu,� licrrz: r: r:'. rsr f to l7F ttn file. 11 this is Else f+rst tern vol, hint, drone ururk ur tiac• Cizv, Rr:rirurq, tzJe• rsz nr:zz•r '; n 7llo,o zrrrc of tour l rertc:. t{ 1 „u gxrz :insure ; ,your krensr: is ran jtlt;