HomeMy WebLinkAboutPERMIT APPLICATIONS - 04-00092 - 1114 Golden Willow Circle - New SFRCITY OF R X URG
APPLICATION FOR PLUMBING PERMIT
OWNER FEES.
Name
Address Tel.
Lot Blk. Add.
PLUMBER
Mame
Address Teti
NATURE OF INSTALLATION
Use
Rough Plumbing Septic Teak
Fixtures 'Tater Piping
complete Sewe r
DESCRIPTION QF WORK
Beth Tubs
For
Laundry Trays
Wash Basin
Toijet
Slop Sinks
Kitchen Sinks
Floor Drain.
Drinking Fountains
Water Softeners
Dirsh Washing Mach.
Clothes Washer
Urinal
Sink Trap
Water Fleeter
Other
Lawn Sprinklers
Plumbing Permit .. r•.... r i F Y 1 4 r r i i F S
Sewer Inspection
r • i ■ . � . �+ i ■ i r � r r ■ . r
Inspectionof Pipe
Inspection o f Fixtures i I 1 ■ . l F I ■ ■ ■ i ■ + F
TOTAL
Received: Date
By
INSPECTOR'S RECORD
BUILDING PERMIT APPL.. ICATIUN REXBURG, ID DATE
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HE -REIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS.
OWNER
13UIL ER
STRUCTURE:
FOOTINGS
,UCONGRETE
MASONRY
OTHER
4NNEW
IJ REMODEL.
0 ADDITION
Il REPAIR
IJ
RENEWAL
COMM.
CJ EDUCATIONAL 0 GOV-PT
Q RELIGIOUS
J FENCE J PATIO
LI
CAR DORY
LJ FIRE [DAMAGE
LIGARAGE Q .IIS
HET INSULATED
I GAS WALLS
11L CEILING
I COAL � LOOKS
This permit i*s issued subject to the regulations cont in in the Uniform Building Code and Zoning Regulations
t F� � Rexburg, �� it i hereby agreed
work t done shown in the pleas and specifications will feted min accordance .
R !� with the r� �t� t�r�
pertaining and applicable thereto. The issuance of the rmi't does not waive restrictive nar
REMARKS: J .-
�= Opp
DEPARTMENT OF BUiLDfNG &ZONING r��;� E
VALUE ."�. ..
SEE PAID 1J casN APPLICANT
GHECK
BUILDING DATE ,aDflREss
INSPECTOR
WHfTE-0wner's Copy CANARY—Budd-Ing Department's Copy PINK—Assessor's Copy GOLDENROD -Inspector
APPLICATION FOR REXBURG CITY SERVICE
NAME
ADDRESS � If� Y,
PLUMBERC'
r
PROPERTY OWNE
WATER SERVICE:Typ Size
1D
Water C'onnett....
.. $ ��+� 120�'"' In CRY �"�. Out 0f City
Water Meter .... _ _ . �
/010.��,»...3'�`,J. �.+
Meter Box � .... e � � Storms Drains $ PAID
Ring & Lfd .. . IF ... �►
Curb StopOEM FE 9,2004
Setler. 0 IP 1 0 1b qh ip. 0 P 0 $
game
Sewer Conned ....'G-
. $ �►
TC3TAL ............ j .�' c?J' — MPROV
J