HomeMy WebLinkAboutAPPLICATIONS - 04-00196 - 644 Stonebridge St - New SFRC) C) �!
BUILDING PERMIT APPLICATION REXBURG, ID DATE s Z5 NO.
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS.
OWNER �Ovxfve;)' C-0,Vi/ • JOB ADDRESS PHONE
STRUCTURE: ❑ NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR ❑ RENEWAL ❑ FIRE DAMAGE
r.EMC. n enssu n PnunATlnNAI n GOVT n RELIGIOUS ❑ FENCE ❑ PATIO ❑ CARPORT ❑ GARAGE ❑ AWNING
FOOTINGS
FOUNDATION
BASEMENT
I FLOORS
EXT. WALLS
I INT. ALLS I
EILING J
ROOF
AT
I INSULATED
ONCRETE
ONCRETE
❑SIAL
COD
❑ WOOD
ODD❑
Y9ilOD
=ALL
❑ BUILT UP.
D SH.
GAS
❑OIL
ALLS
J3'C€ICING
❑ MASONRY
(3 MASONRY
ULL
13'LrONCRETE
❑ MASONRY
❑ MASONRY
❑
COMP. SH.
❑ COAL
❑ FLOORS
❑ OTHER
❑ OTHER
L) NO
❑ OTHER
L3CQNeRETE
❑ C91iCRETE
❑ PLASTER
L3 TILE
[I FIREPLACE
LI PERIMETER
Wr'rENEER
❑ METAL
®•DRYWALL
❑ PLASTER
❑TILE
❑ACOUSTIC
❑ROLL ROOF.
❑ ELECTRIC
❑ STUCCO
❑ TILE
❑ OPEN
❑METAL
This permit is issued subject to the regulations contained in the Uniform Building Code and Zoning Regulations of Hexburg, ana It Is nereoy 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:
WHITE -Owners Copy CANARY -Building Department's Copy PINK -Assessors Copy UULMNrnl inspecmr
WORK ORDER
ACC# R T# / rhv/N C EFFECTIVE DATE DATE
NAME py�l±c i /f C�/SLS SERVICE P
MAILING ADDRESS /3 d e figs f /7=�Si�•
OWNERS ' PHONE
EMPLOYER OR RELATIVE
SS#
SIGNATURE
❑ IN
❑ READ
❑ RENTING
❑ ON
❑ RE -READ
❑ BUYING
❑ OUT
❑ CHECK LEAK
❑ SELLING
❑ OFF
❑ WTR.SWR ONLY
❑ OWNER
❑ VACANT
❑ GR CONT. #
❑ BL CONT. #
METER SIZE _
LOCATION
COMPLETED BY
NO. OF PEOPLE
WORKPHONE Of--&
DEPOSIT AMOUNT
DATE PAID IN —
REFUND DATE _
AMT. REFUNDED _
AMT. APP. BILL
GR RT# BIN SIZE NO. OF BINS
ISSUED BY
UTD WD 000
❑ COMPUTER FILE
CITY OF REXBURG
APPLICATION FOR PLUMBING PERMIT
�OWWWIy�R� FEES
Name e s u CC01 Plumbing Permit • • • • ....... ...... $
AddressJ)J04dr�( Tel. `_J'9P-07&V -0"/475 Sewer Inspection .................... $
Lot __y__ Blk. Z Add. S{unr���� Inspection of Pipe ................... $
Inspection of Fixtures ................$
PLUMBER
Name a�ltf { Lf %tr/�+i•: $
$
Address Tel. $
NATURE OF INSTALLATION TOTAL $
Use
Rough Plumbing
Septic Tank
'
Fixtures /•�L Water Piping
Complete
Sewer
$
DESCRIPTION OF WORK
Bath Tubs
Urinal
Showers
Sink Trap
Laundry Trays
Water Heater
Wash Basin
Other
Toilet
_
Slop Sinks
f
Kitchen Sinks
$
Floor Drain
f
Drinking Fountains
Lawn Sprinklers
Water Softeners
/
Dish Washing Mach..,._.
_
Clothes Washer
//
12WILM4
Received: Date
By—
INSPECTOR'S RECORD
N
W
Rough Plumbing
Sewer
Other
Finish Plumbing
APPLICATION FOR REXBURG CITY SERVICE
/ l t:l/ �J
9
NAME
PROPERTY OWNER /�r. sa E/ (c>�
WATER SERVICE:
Water Connect......
_
Water Meter .......
f
Meter Box .........
$
Ring & Lid.........
f
Curb Stop ........._
Setter ..............$
Sewer Connect .....
_
TOTAL ............
_
Size
In City Out of City
Storm Drains — $
APPROVED BY
E
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