HomeMy WebLinkAboutAPPLICATION - 05-00106 - Rexburg Rehab - Tenant Finishv
Please complete the entire Application!
NAME
PROPERTY ADDRESS
SUBDIVISION
Dwelling Units:
SETBACKS
FRONT
If the question does not apply fill in NA for non applicable
SIDE
Front Footage (if applicable)
Storm Water Length
Parcel Acres:
SIDE
BACK
Permit#
SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building)
First Floor Area
Second floor/loft area
Third floor/loft area_
Shed or Barn
Remodel (Need Estimate) $
Water Meter Count:
Unfinished Basement area
Finished basement area
Garage area
Carport/Deck (30" above grade)Area
Water Meter Size:
PLUMBING � 1vt4-A�
Plumbing Contractor's Name:}. ,� Business Name:�tS%l�y�, 6
Address qST Stater Zip 322
Contact Phone: Business Phone:
FIXTURE COUNT (including roughed fixtures)
Clothes Washing Machine Sprinklers
Dishwasher Tub/Showers
I Floor Drain j Toilet/Urinal
Garbage Disposal Water Heater
Hot Tub/Spa Water Softener
3 Sinks
(Lavatories, kitchens, bar, mop)
Plumbing Estimate $ (Commercial Only)
l:! yY 7 5V 2 a
Signature of Licensed Contractor License number ate
The City of Rexburg's permit fee schedule is the same as required by the State of Idaho
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