HomeMy WebLinkAboutALL DOCS - 08-00135 - 159 S 4000 W - Electrical - Cancelled••,
Building Safety Department
City of Rexburg
79 E Main lonellh@rexburg.org Phone: 208.359.3020 x326
Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3024
CITY OF
IWXBURV
Americo Family Community
OWNER'S NAMl
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PROPERTYAD& S 0800135
SUBDIVISION
PHASE LOT BLOCK 159 S 4000 ' r _ N e
HOME O W NER -S ELECTRICAL PERMIT
Home Owner's Namq -\ Aau L-+ L4A
Address City
State Zip `5:3y4/6
Cell Phone 42Cr6j 6L)q - ,, x o Home Phone ( )
Fax ( )
TYPES OFINSTALLATION(RESIDENTIAL)
(New Residential includes everything contained within the residential structure and attached garage at the same time)
Up to 200 amp Service*
201 to 400 amp Service*
Over 400 amp Service*
Temporary Construction Service, 200 amp or less, one location (for a period not to exceed 1 year)
Existing Residential (# of Branch Circuits)
Spa, Hot Tub, Swimming Pool
Electric Central Systems Heating and/or Cooling (when not part of a new residential construction permit
and no additional wiring)
Modular, Manufactured or Mobile Home
Other Installations: Wiring not specifically covered by any of the above
Cost of Wiring & Labor: $
Pumps (Domestic Water, Irrigation, Sewage)
Requested Inspections (of existing wiring)
Temporary Amusement/Industry
*Includes a maximum of 3 inspections. Addition)1 inspections charged at requested inspection rate of $40 per hour.
Home Owner
The City of Rexburg'r permit fee schedule is the same as
Date
the State of Idaho
0
e
REXIIURG City of Rexburg
Department of Community Development Receipt Number: 08-0174
19 E. Main St. / Rexburg, ID. 83440
Phone (208) 359-3020 / Fax (208) 359-3024
i
Receipt Date: 03/21/2008 Cashier: JANE -LH Payer/Payee Name: DANIEL NEF
Original Fee Amount Fee
Permit# Parcel Fee Description Amount Paid Balance
0800135 RP06N39E28L Permit- Electrical
$80.00 $80.00 $0.00
Total: $80.00
Previous Payment History
Receipt # Receipt Date Fee Description Amount Paid Permit #
PaY went Check Pa y
men#
Method Number Amount
CHECK 4524 $ 80.00
Total $80.00
genpmtrreceipts
Page 1of1
CLAIM FORM
VENDOR #
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TELEPHONE
DESCRIPTION
CODEAMOUNT
APPROVED
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