HomeMy WebLinkAboutAPPLICATION ELECTRICAL - 18-00557 - 1382 Stone Dr - New SFRof ae xtupc
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RExBuRGBUILDING PERMIT FORMA ntrdca» FantlryCornmunily
Building Safety Department
SFR ELECTRICAL BUILDING APPLICATION
0 New Construction r..4
City of Rexburg
35 North 2st East
Rexburg, Idaho 83440
dthon r 13trsement Finish C
FoV Dr is• 1 > Accessory Structure>200
Permit Number:
1'► rrl C Electrical Fee Paid
Name: 4;Lirr-'
Address: gj _A1Q114-1-==�"----.
- = �G
Phone:g)- State: Q„y=t_
Under Idaho Building Code, a homeowner is allowed tp do work on their - �� zip Code: _
Are you a h01i}aowner doing work on your own home? roWn home'
❑ Yes (Skip to II; and complete the llorneowner's Exemption)
10,1 am working with the hOulcowner
... i•:,I•, rril�:
Business:
Address:
Phone: 2h
Contact/Rt
Herh-iral C
A copy olyoa
a photo cop
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`3. Projet:? r3ee Boit
Address: . -1W-'7
2
Description of work: v
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NPW SFT: t wtsrruchun:
• Fees for additions ore charged bysquare footage: Up to 1,500 sq. ft, gr;dtl +
thereof. $6S/or(wrhadditional 1,000sq. ft or•portion
Sounl e Frtnrrt�le= - -
Q to 1,50Qsq, fi S130
$1
Crrct
1.500 to 2,500sq.fl. `- x'130
2,500 to 3,500sq. ft. 51.95
3,500 to 4500sq �� _ - - 5260
------------
5325
Add 565 per
additlonal thausuntl sq� ff -
❑ 5it:ts,'1'rtuls/generators: ❑ Yes ❑ No
-
- , V-11- t ort n wftn the Permit Techniciay tailing (20R) 3."2.2341, 'VVttte
n b
-OR- Lot # ` Block h:
Subdivision:----------------
• ,Vote 11 that spasJpaols/ycyte"Utors are not included in
squANpLICt1YT'S Slu7�ATl RE, tERTtFICATtoh ANS Al1THORIZ.IT[ON: ilndrr prnatry a1 e 00 aq CaSIS and will be charfged $6.9 per lnSpertl()n.
Is torrectand l swear that any bifart to on which may hereafter be by mem hrarongs befa e:he Pymm�gand'Latutg Commiss.un or the City C3tcth t t the C,ty a ion her
P t1; tY. i itcrMry cel2tty that Char • read ytls ap�hrahon and stateth, t the Information herein
Shull be truthful and correct t agr it to cn rply wt•.ji all City rPmttra•r n<an { laws arngs b
fitsiiiinterupn:ithe hove-mcrtioltedpropertyforins tttothw subktzma:trrottM1ssa S
latarnatianal Code to rase<of any file statement or ntisrept lolls purposes.
es. N in ire ri pNiiAm of is tie plans un :a h the APWication and hereby a"Usot+rad n ep,esentati es of the
h poops tIn t' The licati nit it on tj may ns j a Per nit'. ort apps oval issued tttutet tite provisit'"s of the 2012
slatted wit ;n l9tl days. Penna void if work sops 1, 1110 days.
Perns.. tr nppnrvnl was based. Pttrrr iC void if not
iI
Applicant's Mame (print): N �
/gnature
1011;n (2 •r,ust 2 r turd to bw fore 0 AN en the day the ins — Date: f
Inaprrmm llntl:ars- (2110) 372 ?,39q pinion is reques n
spall on re ,costs caped iter N 11t wia Ie xEeduled for the next :ntstness clay.
Permit Technteiay - (209) 372,2311