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City of Jerome Manufactured Home Building Permit Application NEW BUILDING GARAGE SITE PLAN FLOOR PLAN USED BUILDING CARPORT FOUNDATION PLAN BLOCKING SINGLE WIDE PATIO TIE-DOWN LAYOUT VISQUEEN DOUBLE WIDE DECK MFGR SPECS. TRIPLE WIDE TILT-OUT STEPS-LANDINGS OWNER: DESCRIPTION OF WORK ADDRESS: SELLER/DEALER: PHONE: LICENSES NO. PRIOR USE: INSTALLER: PROPOSED USE: PHONE: LICENSE NO. PROJECT MANAGER: PROJECT ADDRESS: PHONE: LEGAL: LOT: BLK SUB MANUFACTURE: MODEL: MFGR. DATE: ROOF SNOW WIND ZONE MPH: SOIL BEARING: SIZE:_____X X MAIN S/F CARPORT S/F GARAGE S/F PATIO S/F DECK STORAGE BLDG The applicant represents that all statements are a true description of the proposed uses and/or buildings and that all laws governing this project will be complied with and provisions made to allow inspections by city and state representatives. SUBMITTED RECEIVED BY: DATE: DATE: TIME: DISTANCE TO FIRE HYDRANT: OFF STREET PARKING:______ No.: CURB & GUTTER: CURB CUT NEEDED: WATER EXISTING: NEW: SIZE: SEWER: EXISTING: NEW: SPECIAL PROVISIONS: s/f x = Valuation s/f x $ = Valuation s/f x $ = Valuation Total UBC Valuation $ Building Permit Approved By: Date PUBLIC WORK FEES FIRE DEPT FEES BUILDING DEPT FEES TOTALS Water Gas Permit Building Permit Public Works Sewer Hydrant Plan Review Fire Dept Curb Cut Other Invest Fee Building Dept Balance Due: NOTIFIED BY: Please submit this form to City Hall, 152 East Ave. A, Jerome, ID 83338 fax: [PHONE REDACTED]