HomeMy WebLinkAboutAPPLICATION - 94-00004 - Madison County Courthouse - Remodelf
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APPLICATION FOR BUILDING PERMIT
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Date of 2ppjjcaticn
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CONTRACTOR
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street Address
Street .s X� {
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Mailing Addrein13
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City, State{J/j L_.'� Lz'L:6
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Telephone'
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gineering im
A-rchitect 01: En
i IF S Ll��RY
t LEGAL DES
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Lot Now
Block-
s o
job s
Pro�ect informati-in (To be campleted.by aPPlicant)
Religious
Educational
Residence
F
Fence patio
far P Or t Garage .Awning
Addition Repairnew
New 4Xo
structure
lqumber
Tot loop �
a e o Building
ea
Unf inished Basement FllniBhed Basement
W h w i acture be used fOr (include name of businens if
applicable)?
if uoe in mult P I e f &MIly (apartments) how many u
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ClassifryUse
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struction use Zone
Type Con
Building r.
plumbing PermLt Fees Digging permit Fees ftmp
fees other Fees
signature
signature
issued by
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THE UNDERSIGNED HE " APPLIES FOR A PERMIT FOR THE WORK HrREIN INDICAT�
OR S SHOWN AND APPROVED IN THE ACCOMPANYING
PLANS
j SPECIFICATIONS. fir+
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OWNER
ADDRESS
BUILDER
TMJ CT LIRE:
PHONE
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w�. T s ! T r ��T—rte �.irarr - .. � f � � PARCHITECT a•�s... DESIGNER
E] NEW LJ REMODEL RENEWAL—
FIFE EAE
L -J RESIDENCE 0 Comm,
EDUCATIONAL ] "'T D RELIGiOUS FENCE
PATIO
CARPORT
GARAGE
AWNING
FOOTINGS FOUNDATION
---� - --
B A SEEMS N T FLOORS
EXT, WALLS
INT. WALLS
CEILINGROOF
HEAT
I U L A T E D
J CONCRETE I CONCRETE
0 PARTIAL � WOOD
;�_
D WOOED
� WOOS
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�L��LT �'�.
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�`�WALLS
MASONRYEl C MASONRY.ESL
L 0 CONCRETE
El -
EJ MASONRY
DRYWALL
WOO[ SFS.
L] ILEILI�J�
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Cl NO L-; OTHER
Ll CONCRETE
D CONCRETE
PLASTER
COMP, SH.
COAL
FLOORS
J VENEER
0 DRYWALL
TILE
TILE
L1, FIREPLACE
[_1 PERIMETER
F1 �AETAL
0 BLASTER
El
ACOUSTIC
ROLL ROOF.
ELECTRIC
TLS
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OPEN
f-1
AkETAL
FRON'r PROPERTY L -INE
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This permit i issued
subject to the
j
regulations c rotai di in
the
f d I -
Code a nZoning
lad'
I
lations fRexburg,
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and It is hereby agreed that
the work
fo be done as
shown In
i h Ian and
lcain l
completed in
accordance
t regulations
I
Rk pi l
thereto: The issuance
of the permit
does not waive
restricliVe covenants.
L1�
0-
REAR PROPERTY LINE
OCCUPANCY
Aa 6 C D. E. F. G. HF N, J.
NE + —OPEN
I his application -
co a valid permit
whferi signed by build-
Ing
REMARKS;
DEPARTMENT OF BUILDING ZONING
L U
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FEE PAID El CASH
BUIL[
INSPECTORS _
APPLICANT
ADDRESS
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1
BUILDING PERMIT CHECKLIST
is Application For Building Permiet
2. Building Permit Application
3. Valid Rexburg Trade License
4. Subcontractor List
5. New Add1°€'SS Given
6. Copy of Building Memorandum Issued
7. Two Complete Sits of Plans Including:
Pio 'Plat Plan
Be Foundation Plan
Ca Floor Plan
De All 4 Elevations
Ea Building Section
F. Door & Windows
Ga Special Sections
H,c Materials List
or Specif ications
Ie State Healthy Sewer
and Wader Permit
8e Plan Check & Approval
Permits & Fees Amount
A. Building Permit
B. Plumbing Permit
Co Sewer & Water Ser.
D * Diggi ng Permit
IEe IRES Energy Permit
F. Plan Review Charge
�.�. Electrical Temp .
Power -
10. X11 Permits & Fees Issued & Paid For,:
11. Inspection Record hard Issued:
12a Building Permit Issued:
13. Stamped Sed of Plans Returned:
DATE
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