HomeMy WebLinkAboutPLUMBING PERMIT APPLICATION - 08-00151 & 08-00152 - Upper Valley Options - AdditionCITY OF REXBURG
APPLICATION FOR PLUMBING PERMIT
FEES
OWNER
Plumbing Permit ........... * , , * * .. " $
Name
Tel.
Address
Lot -�
Blk. Add.
PLUMBER
Name
Tel.
Address
NATURE OF INSTALLATION
Use
Septic Tank
Rough lumbing
Water Piping
7Fi,xtures
Sewer
te
DESCRIPTION
OF WORK
Urinal
Bath Tubs
—�—
Sink Trap
Showers
Water Heater
Laundry Trays
Other
Wash Basin
Toilet'
Slop Sinks
Kitchen Sinks
Floor Drain
l
Lawn Sprin ILA
Drinking Fountains
Water Softeners
I Dish Washing Mach.
i
Clothes Washer
4
Sewer Inspection ...... • • • • .... , , , • • * $
Inspection of Pipe ............ • • • • • .. $
Inspection of Fixtures ................$
$
TOTAL $
Received: Date
By
INSPECTOR'S RECORD
N
Rough Plumbing
Sewer
Other
Finish Plumbing
S
INSP. NAME
E