HomeMy WebLinkAboutPERMIT APPLICATIONS - 04-00114 - 637 Palmer Circle - New SFRCITY OF REXBURG
APPLICATION FOR
OWNER
a.
Name
Tel.
Address.
Add
Lot B I k,■
PLUMBER
N a m
Address
ION
NATURE OF INSTALLAT
wpmm
Rough Plumbing
Fixtures
Complete
DESCRIPTION OF WORK
U rri n a I
Bath Tubs
Sink Trap
Showers
Water Heater
Laundry Trays
Wash Basin Other
Toilet
SlaI3 Sinks
Kitchen Sinks
Floor Drain
Drinking Fountains Lawn Sprinklers
Water Softeners
Dish Washing Mach,
Clothes Washer
;��- OI?I ISI
PLUMBING PERMIT
FEES
X.
PlumbingPermit - --------
Sewer Inspection ......... 1h*E EWAN$
inspection of Pipe
inspection c)f Fixtures E 0 0 r $
oe
4�
TOTAL
Received: Date
M
OF R
R 4
Rough Plurnbirig
$
aHECK 8 -Sewer
tithe
Finish Plumbing
INSPECTOR'S RECORD
INSR NAME
wi
.-J
0'.
Rt11LD1j4G PERMIT APPLICATIuN EXBURG, ID DATE N
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS.
"All
➢ PHONE
JOB ADDRESS
OWNER
BUILDER ARCHITF-CT DESIGNER
STRUCTURE: LINEW U REMODEL C3 ADDITION Ll REPAIR RENEWAL FIRE DAMAGE
C)COM W M. U EDUCATIONAL C1 GOVT Ll RELIGIOUS Q FENCE J PATIO U CARPORT (3 GARAGE Q AWNING
Ll RESIDENCE T
ME -9 -M -1-M --WMMMMMT'W 11 ... I -- i I % IF -W- P, h I & I I I I K 4T' IAF I HFA INSULATED
LIMASONRY
LJ OTHER
Q CEILING
J FLOORS
0 PERIMETER
hey ag
Th'is permit isissued subject to the regulations contained In the Uniform Building Code and Zoning Regulations of Rexburg, and it' is rebreed
that the work to be done as shown in the plans and specifications will be completed in accordance with the regulations
pertaining and applicable thereto: The issuance of the permit does not waive restrictive covenants.
REMARKS.
Orv' I I Nme M. 1 k 1b.A %ft=v'W=Pr K'qwrlm
I)EPARTMENT OF BUILDING & ZONING
VALUE III
FEE PAID
BUILDING
INSPECTOR
I
CASH
L
tiECK $
CHEC�
DATE
APPLICANT
ADDRESS
WHITE—Owner's Copy CANARY—Budding Departmeff$ Copy PINK—Assessor's Copy GOLDENROD -Inspector
NAME
NL A-
-el
26
APPLICATION FOR REXBURG CITY SERVICE J�J` �'�`� � � k
7-roA Jos
, G4`r'
&- VN
PLUMBER
PROPERTY OWNER— D O�L
Size
WATER SERVICE Type
out Of City
I. CRY
Water Connect.
Water Meier .......
U
"Offix Sicir
Mef er Box
Ring & Lid
7 3Low
Curb: Stop &.60 Isom DWS--- MAR 0 9004
Se tt e r . d a 0 a a 4P M lb & 4 9 Or
Sewer Connect S7f PAJD GDAISH $
F
'h*0&%#HECK APE"Yke
TOTAL.