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2020 Park Avenue Building Department Burley, ID 83318 (208) 647-7086 Building Inspector Plumbing Inspector Electrical Inspector HVAC Inspector Gary (208) 431-5425 Mark (208) 650-1258 Floyd (208) 650-1098 Gary (208) 431-5425 Please fill out this application completely and submit with payment. If you have questions or need assistance completing the application please call the Building Department. Please note: permit fees are non-refundable and non-transferable. Applicant Information Property Address of Construction Owner: Address: City State: Zip Code: Email: Contractor Information Name: License # : Address: City: State: Zip Code: Email: Phone Type of Work : New Addition Alteration Repair Roof Move Remove Describe Work: Valuation of Work: $ Building Permit Fee: $ Permit to Connect to City of Burley Water System New Connection Residential Commercial Disconnect Re-Connect Other Location, Size, Length, Meter The Contractor or Installer shall notify the Superintendent of the wastewater department (878-8525 or 878-2103) at the time of Inspection and before any underground portions of the sewer line is covered. Water Connection Fee: $ Sewer Connection Permit Type of Material: Slope or Grade: New Connection Residential Commercial Location, Size, Length and type of connection at trunk line: In City Limits Out of City Limits A backflow device is required. Where will it be installed? The Contractor or Installer shall notify the Superintendent of the wastewater department (878-8525 or 878-2103) at the time of Inspection and before any underground portions of the sewer line is covered. A grease trap is required for commercial connections. Where will it be located? Will there be any flammable liquids, toxic or poisonous solids, mud, rocks, or other vicious substances being discharged into the sewer lines? If Yes Explain: Sewer Connection Fee: $ Total All Fees: $ Date: Signature: Please bill my Credit Card: Visa Discover MasterCard Card # Exp. Date: 3 Digit Sec. SIGN