HomeMy WebLinkAboutAPPLICATION - 93-00010 - City of Rexburg - Porter Park - Shelter Additioni
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RPPLICAFTION FOR BUILDIUG PERMIrr
` CITE' OF REX UR , I AE'
Date of Application &
Penis.
CONTRACTOR
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Namoe
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Street Address
-.2.4 r er.,4 JA"I St-reet Add r e s.s J-4 5� Y":;L
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Mailing Address Mailing Addreas
Cityr State city states xr
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zip
Telephone
A-rchitect or Engineering Firm &..r,,e
.d Lic* Noe
LEGA DESCRIPT10N (ATTAMi Copy IF NECESS
AR
Lot Block
subdivis,
Job Address.
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ProLect Information o be completed by applicaat)
Residence
0 MM Educational Comlt �Religious
Fence
Carport Garage i Awning _�"A
Structure, -New Remodel Addition Repair
.renewal
Total Floor Axesliumber of Stories Hai ht of Build
Sq. footage:
unfl..nished Bas f
Basement
---�� Finished
Whatwill'Structure be uE;ed for (includ
name of businens
applicable
If use is Multiple family (apartments) how m----
EstLmated
t
Use classification
Group Type construction
Building Permit Fees lV"IC- Plan Check
Fees
Plumbing Pen it Fees Digging Permit FeesWater Sewer Hookup fe'es Other Feei3
1
Signature Of Applicant
signat-ure of Building Inspecto r
eF�
Issued by �/