HomeMy WebLinkAboutAPPLICATIONS - 04-00191 - 655 Harvest Dr - New SFRBUILDING PERMIT APPLICATION REXBURG, ID DATE NO.
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED ''_�_.__{
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. 608 IVB' ,
OWNER
JOB ADDRESS
dY 00/q/
STRUCTURE: NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE
19 RESIDENCE ❑ COMM. ❑ EDUCATIONAL ❑ GOVT n RELIGIOUS n FENCE n PATIO n CARPnRT n r,ARAGF n AWNINn
FOOTINGS
FOUNDATION
I BASEMENT
FLOORS
EXT WALLS
INT. WALLS
I CEILING
ROOF
HEAT
INSULATED
y��d CONCRETE
VA
CONCRETE
❑ MASONRY
❑ PARTIAL
FULL
� WOOD
13 CONCRETE
WOOD
❑ ASONRY
❑ WOOD
❑MASONRY
WOOD
DRYWALL
P.
H.
GAS
OIL
WALLS
CEILING
❑OTHER
❑OTHER
❑ NO
❑OTHER
❑ CONCRETE
CONCRETE
LASTER
H.
❑ COAL
LOOKS
s
❑VENEER
DRYWALL
❑TILE
LW
❑FIREPLACE
❑PERIMETER
untains
=Mach.
Lawn Sprinklers
Sewer
❑ METAL
❑PLASTER
❑ACOUSTIC
OOF.
❑ELECTRIC❑STUCCO
ng Mach.
Finish
Plumbing
❑TILE
❑OPEN
This permit Is issued subject to the regulations contained in the Uniform Building Code and Zoning Regulations of Rexburg, and it Is hereby agreed
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:
DEPARTMENT OF BUILDING & ZONING
VALUE
FEE PAID ❑CASH APPLICANT
n rucrx
WHITE-Ownees Copy CANARY -Building Department's Copy PINK -Assessors Copy GOLDENROD -Inspector
APPLICATION FOR REXBURG CITY SERVICE
NAME
04 00191
WATER SERVICE: Type Size
Water Connect...... $ 1100
Water Meier ....... $ 4`17
Meier Box .........
S
Ring & Lid.........5
Curb Stop .........
Showers
Setter ..............
$
Sewer Connect .....
_
TOTAL ............
In City Out of City
Storm Drains — $
APPROVED BY
CITY OF REXBURG
APPLICATION FOR PLUMBING PERMIT
OWNER
Name TSA GO(\SA(LaCA�Uf\
Address po&by°fa RI'�,iti Tel. S11 -Col
Lot 3 Bilk. 1 Add. �AWtj ttct-` N�
PLUMBER
Name PRe, 6L,,K' 'b`n1�fAn t'l(X>
Address Tel. 3�7
NATURE OF INSTALLATION
Use
Rough Plumbing Septic Tank
Fixtures Water Piping
Complete Sewer
DESCRIPTION OF WORK
FEES
Plumbing Permit ••••..•.•...•••.. ..$
Sewer Inspection • • . • • • . • . . . $
Inspection of Pipe • • • .. • • • . • • .. . • $
Inspection of Fixtures . . • • • • • • • • . • • $
$
Received: Date
By
Bath Tubs
3
Urinal
Showers
3
Sink Trap
W
Laundry Trays
Water Heater
Wash Basin
Other
Toilet
Slop Sinks
s
Rough
Plumbing
untains
=Mach.
Lawn Sprinklers
Sewer
ners
Other
ng Mach.
Finish
Plumbing
sher
04 00191
$
TOTAL $ r
INSPECTOR'S RECORD
N
S
INSP. NAME
E