HomeMy WebLinkAboutAPPLICATION, CO, BP - 05-00010 - Royal Market - Tenant FinishZ
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Cl7Y OF
RExBURG
nnn~x~5 Fn~na..r conan~un,m
Building Permit No:
Applicable Edition of Code:
Site Address:
Use and Occupancy:
Type of Construction:
Design Occupant Load:
Sprinkler System Required:
CERTIFICATE OF OCCUPANCY
Name and Address of Owner:
Contractor:
Special Conditions:
Occupancy:
City of Rexburg
Department of Community Development
19 E. Main St. l Rexburg, ID. 83440
Phone (208) 359.30201 Fax (208) 359-3022
05 00010
England Joe 6 Etux
583 Maple Dr
Rexburg, ID 83440
Owner
This Certificate, issued pursuant to the requirements of Section 109 of the lnternati"onal Building
Code, certifies that, at the time time of issuance, this building or thatportion of the building that
uu~s inspected on the date listed vas found to be in compliance v~ith the requirements of the code
for the group and division of occupancy and the use for v~iich the proposed occupancy vas
classified.
Date C.O. Issued: April 27, 2005 (03:20PM)
C.0 Issued by:
Building Official
There shall be no further change in the e~asting occupancy classification of the building nor shall any structural changes,
modifications or additions be made to the building or any portion thereof until the Building Official has reviewed and approved
said future changes.
Water Departure Fire De
State of Idaho Electrical Department (208-356-4830):
CITY OF REXB URG
~~ BUILDING PERMIT APPLICATION
19 E MAIN, REXBURG, ID. 83440
208-359-3020 X326
PARCEL I~f UMBER:
SUBDIVISION:
OWNER: o ~t ~ ~,•.c ,~L~v~ CONTACT PHONE # Z,~ ZS ZS l ' 11 S s
PROPERTY ADDRESS: ,3 ~ 3 S o.J(~ Z~ W PT S y. ~ ~ ~ Q.~e,~cl~.rc ST D k'3~1~{d
PHONE #: Home (t~ C, SCo - 43`~ a
Work (zas) ZS 1
PERMIT #
Please complete the entire Application!
If the question does not apply fill in NA for non applicable
1 SS-Cell
OWNER MAILING ADDRESS: ~~3 mz ~. CITY:~~~.r STATE:~D ZIP:~'3 rya
APPLICANT (If other than owner)
(If applicant if other than owner, a statement authorizing applicant to act as agent for owner must accompany this application.)
MAILING ADDRESS OF APPLICANT
~~3 ~Mtnl~e, CITY: ~XI~M~ STATE, ~ ZIP~~~~~
PHONE #: Home (zo5d ~,S 6- i5 3ya Work (z6Y) SI - tl S5/ Cell ( )
CONTRACTOR:. `~ ~~ a ~` ; ~~' PHONE: Home# Work#
MAILING ADDRESS:
UNIT# BLOCK# LOT#
CITY
How many houses are located on this property?
Did you recently purchase this property? No Yes (If yes give owner's name)
Is this a lot split? NO YES (Please bring copy of new legal description of property)
PROPOSED USE: tmwl~e r t~~ ~
(i.e., Single Family Residence, Multi Family, Apartments, Remodel, Garage, Commercial, Addition, Etc.)
APPLICANT' S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, I hereby
certify that I have read this application and state that the information herein is correct and I swear that any information which may
hereafter be given by me in hearings before the Planning and Zoning Commission or the City Council for the City of Rexburg shall be
truthful and correct. I agree to comply with all City regulations and State laws relating to the subject matter of this application and
hereby authorized representatives of the City to enter upon the above-mentioned property for inspections purposes. NOTE: The
building official may revoke a permit on approval issued under the provisions of the 2000 International Code incases of any false
statement or misrepresentation of fact in the application or on the plans on which tb.e permit or approval was based. Permit void if not
started within 180 days. Permit void if work stops for 180 days.
ignature of Owner/Applicant
~, ~, ~ s
DATE
R~ARNING -BUILDING PERMIT MUST BE POSTED ON CONSTRUCTION SITE!
Plan fees are non-refundable and are paid in full at the time of application beginning January 1, 2005.
City of Regburg's Acceptance of the plan review fee does not constitute plan approval
**Building Permit Fees are due at time of application**
**Building Permits are void if you check does not clear**
Ce11# 3~3- 4 52,0
STATE ZIP
1
~, NAMESo~e ~~c~.?,,tea ~~~e ~~iZ~ ~tr~~
PROPERTY ADD S S 3 ~ 3 sc~-'C~,~ Z'"`
SUBDIVISION
Dwelling Units:
SETBACKS
FRONT
SIDE
Front Footage (if applicable)
Storm Water Length
Permit#
SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building}
First Floor Area ~ 5 O Z
Second floor/loft area
Third floor/loft area
Shed or Barn
Garage area
Carport/Deck (30" above grade)Area
Remodel (Need Estimate) $ a 5TH
PLUMBING
,~
Plumbing Contractor's Nam . ~~~~ ~ Business Name: ,
Address ~ ~ ~ ~ D ~ State ~ ~ Zi
p
Contact Phone: (~~ ,~) ('~(~ ~~~ ,~~ ~~ ~ Business Phone: (~o~ w S~
FIXTURE COUNT
Clothes Washing Machine Sprinklers
Dishwasher Tub/Showers
Floor Drain Toilet/Urinal
Garbage Disposal Water Heater
Hot Tub/Spa Water Softener
Sinks
(Lavatories, kitchens, bar, mop)
Plumbing Estimate $ Z a o ~= (Commercial Only)
r ~ ~ ,~a6s
Signature o trac or License number Date
The City of Rexburg's permit fee schedule is the same as required by the State of Idaho
Parcel Acres:
SIDE BACK
Unfinished Basement area
Finished basement area
2
11IECI~'ANICAL
Mechanical Contractor's Name: Business Name:
Address tate Zip
Contact Phone: ( ) Business Phone: ( )
FIXTURES ~ APPLIANCES
Furnace _
Furnace-Air Conditioner
Combination
Heat Pump _
Air Conditioner
Evaporative Cooler _
Pool Heater
EXhIUAST ~ VENTILATION
Dryer Vents _
Range Hood Vents
Fuel Gas Pipe (# of Outlets)
Signa of Contractor
Unit Heater
Decorative Gas-Fired
Appliance
Space Heater
Incinerator
Broiler
~t`~ 0
Cook Stove Vents ~a(~.SD
Bath Fan Vents ~l~p
~„'1o.8'a
Mechanical Estimate $• rl~ b D (Commercial
Only)
License number Date
The City of Rexburg's permit fee schedule is the same as required by the State of Idaho
WATER METER COUNT
WATER METER SIZE
HEAT (Circle all that apply) Gas Oil Coal Fireplace Electric
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