HomeMy WebLinkAboutAPPLICATION - 99-00005 - Super 8 - RemodelCITY OF REXBURG, IDAHO
APPLICATION FOR BUILDING PERMIT
Date ofApolic-ation7
`� zj"� q Gj Permit No.
Site address
Mailing Address
City/S#ateIZip
T�Jephone/Fax/Mobile �._ . �. .�,_._. ,.,... ..__.�.... .�_,._..�.
CONTRACTOR
dame -/-,% Mailing Address
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City/3tate/Z'"p_
Tei epho ne/F ax/Mo bile .�
PROJEC-TiNFORMLTION
Architect or Engineering Firm
Plan Dame
REdivisionLot�i- $hack
asy att � scary
(circle ane) Res iceritial/CommerciallEducati onal/Gove=entiReligic us
D�sc�xptic�n
{Examples: � ew nouse I AGGICIOU toDose onr�zx�erciaRemoi�ev!--
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Square feet- No. of Stones Height of Building
Basement finished/unfin'sheid Garage sq. feet Patio/CarporTJAwni'ng
What will &-ructure be used for (including name of business if appfilcakaIe)e
If used for a multiple karzzily unit please indicate number of units -
Total Estimated Cost6T&I
00 � Will dweiling be in a flood plain?
Signature of
LBC
Tax, Code Zone.
Building Type
Signature of Inspector
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11
FIOR PEKE USE ONLY
Building Petmit Fee /zcv `'
�um�ing Permft,Fe....._��
-Plumbing
Dieing Perrriit fees
Linear Foot Charge
Water & Sewer Fec.,s
Plan Checkcees � Sa 3_`'`-
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Drywall:
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Floor Coverings
Plumbing:
Heating ;
Electrpcal:
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SUBCONTRACTOR LIST
SPECIAL CO.N'S-FRUCTION
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