HomeMy WebLinkAboutAPPLICATION - 97-00009 - Madison Library - Heating & Air ConditioningAPPLICATION FOR BUILDING PERNfIT
CITY OF REXBURG, 1DAE40
Dace ofAppli��[io� Permit No.
OWNER CONTRACTOR
Name_J�� Name ��
Site Address I �9freet Address
1
Mailhig Address Mailing Address
City/State/Zip City/State/Zip
Telephone Telephone
12
Me
.,
Mob*le Ph
PROJECT INFORMATION
Architect or Engineer Firm
Legal Description (attach copy if necessary)
lda.Lic. No. Lot No.
Blick
Plan Name— Subdivision
Residence Conizri. Educational Gov"t Religious Street Address
Fence Patio Carpoit Garage Awning
Description Structure
New/Remodel/Addition/Repair/Renewal
Sign Sigrz Size Kind
Total Floor Area No. of Stories Height of Buzlding--
5q. Feed Unfinished Basement Finished Basement
What wiil structure be used for (including name of Business if applicable)
If ase is multiple Family (apartnients) flow many units
Total Estimated Cost Are you in a flood plain?
Signature Of Appl -
t W �F �Y � � a � !; � �1! i ! i •WII 7�!1 ! 7 !! ! iV ice! !! W ! i ii+r � �. � 111 i�F it
UBC use Classification Building PermitFees
Tax Code done Pluilling Pen -nit Fees
Building Type Digging Pernift Fees
Signature of Building Inspector
Issued by_
Water & Sewer Fees
Plan Check Fees
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