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HomeMy WebLinkAboutAPPLICATION - 05-00083 - Rexburg Motor Sports - Site PlanCITY OF REXB URG PERMIT # ~~ ©p~ g ~ BUILDING PERMIT APPLICATION 19 E MAIN, REXBURG, ID. s344o Please complete the entire Application! 208-359-3020 X326 If the question does not apply fill in NA for non applicable PARCEL NUMBER:_ ~U SUBDIVISION: /~ ~ ~ UNIT#-~,,~-BLOCK# /U~LOT#~ OWNER: ~,.~ IJc~ rZ,-~- CONTACT PHONE # j,:,S9 Z30~ ~T ._ PROPERTY ADDRESS:_ C/ 7.S ~ 2-~-~ PHONE #: Home ( ) /U_ ~~ Work (20~ ,~5~ - yG?~IjCell ( )_ ~U,,~, OWNER MAILING ADDRESS: I`iNl. ~ ~ CITY: ( "' t ~ STATE: I~ ZIP: 3YYt~ APPLICANT (If other than owner) (If applicant if other than owner, a statemen uthorizing applicant to act as agent for owner must accompany this application.) MAILING ADDRESS OF APPLICANT ~-~-~w ~. ~SSa. c~.~ 5 CITY~c }c,~.e ~ .STATE; I•~.~~ ZIP_ 3 y~o PHONE #: Home ( ) N~,1~ Work (208).3.59 ?3b 9 Cell ~o~a)~`~ p 2l~ 10-7 CONTRACTOR: ~.1,~ ~~~T. PHONE: Hoine# n~ ~ Work# 53 5,1~ Cell# S - 5 7 8 S ~_ MAILING ADDRESS: ~-]DD M l ~t_! ~ ~.~ IZ ~ CITY ~t~k{o ~A~~,~,~STATE_~_~ ZIP ~334~C>Z 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?~NC YES (Please bring copy of new legal description of property) PROPOSED USE: ~ p,,.,i ~„~ -~ 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 mattex 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 in cases of any false statement or misrepresentation of fact in the application or on the plans on yvhich the permit or approval was based. Permit void if not started within 180 d~;~;s-Void if work stops ~i{ 180 days. IL A of Owner/. 3 / / `~ / D~ DATE WARNING - BUII,DINGY'ERMIT 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 Rexburg'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** NAME ~~=?c+"3ye.co ~"~~TV~ S/ov2~ PROPERTY ADDRES S _ q -] 5 5 ~ 2y ~. ~ SUBDIVISION _ ,~ , ~b Dwelling Units: ~ ~ Parcel Acres: 3 ~ ~ <o }~L't~~ SETBACKS FRONT ~ S Permit# SIDE ~ ~ SIDE ~ ~ BACK ~o ~ C~ ~ ,.e..ctit ~~rY-- Front Footage (if applicable) /U/A Storm Water Length SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building) First Floor Area 37 ~ `7 -] ~.~ Second floor/loft are-- a ~~ . Q ~~.~ Third floor/loft area_,U~ , Shed or Bam ti ~„ Remodel (Need Estimate) $ Water Meter Count: Water Meter Size: PLUMBING Plumbing Contractor's Name: Address Contact Phone: FIXTURE COUNT Business Name: State Business Phone: 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 $ (Commercial Only) Signature of Contractor License number The City of Rexburg's permit fee schedule is the same as required by Zip ~ N~2~ ~C-'~c~ j ~1scl-L l~ E ~G~~ l~~ }~~ UNl3.`/ v Unfinished Basement area__ N/,q Finished basement area ~,,~~ Garage area_ ~ ,~~ Carport/Deck (30" above grade)Area .,~/,~ 2 t' NAME IZ~X ~u~ C~ ~~L ~ 02'~ 5 PROPERTY ADDRESS q 5 S I Z-~~ t,J Permit# SUBDIVISION _ ,V ~ MECHANICAL Mechanical Contractor's Name: Address Contact Phone: ( ) Business Name: _ State Zip, Business Phone: ( ) FIXTURES & A.PPLL9NCES COUNT ^ Furnace ^ Incinerator 0 Furnace/Air Conditioner Combo ^ Boiler ^ Heat Pump 0 Pool Heater ^ Air Conditioner ^ Similar fixtures or ^ Evaporative Cooler Appliances:- ^ Unit Heater ^ Space Heater ^ Decorative gas-fired appliance ^ Exhaust or Vent Ducts ^ Dryer Vents ^ Range Hood Vents ^ Cook Stove Vents ^ Bath Fan Vents ^ Other similar vents & ducts: ^ Fixtures or Appliance outlets of the gas piping system Mechanical Estimate $ (Commercial Only) Heat (Circle all that apply) Gas Oil Coal Fireplace Electric Point of Delivery must be shown on plans. Please check all that Apply: Signature of Contractor License number Date The City of Rexburg's permit fee schedule is the same as required by the State ofldaho ~j 13 C ~~~~ ~ ~ J ~~ ~. ~L. CU~tJ~/~G"Z~ 3