Loading...
HomeMy WebLinkAboutAPPLICATIONS, BP - 05-00154 - 539 Maple Dr - AdditionZ ~ N ~ ~ W ~~ ~ _ ~ N ~ C. n ~ ~ ~ m 111 ° Q' " ~ 3 ~ ~ O ~ 'O" C C ~ ui ~ v ~ N N ~ O N O v ~ ~ ~ ~ Q $ (G ~ C N ~ O' O v '° m 3 n~'•OV Z ~ ~ ._. tY' m ~= ~ m a o a ~ m O ~ W O d rt o ~ ~ ~_~ ~ W m =~,~ o ~~~~NO `~ o ~ N~=~ o~~ ~ ~ ~ dOQ~ ~ ~~ ~_ ~ o m o ~ ~ ~ ~ y~ C m O v a~ a.r ~~ °~~~ d o 0 3 O ~ Z ay ..~ y =' N ~ ~ a~~ C . .N ~ ° ~ d o fn m -1 S ~ '* p OO?_ r W ~; ~' m Q ~ ~. ~ ~ ~• C7 ~ _ ~~ ~ ~ o o ~°'~~° ~~~~. N a ~ ~ ~ C ~D N~ O W ~ ~ ~ -1 '~ = W O C. ~ tC o ~, c ~ o ~ O W 111 y ~ ~ ~ ~ m n .. o ~ ' ~ = 3 Z O ~ ~ ~ ~ a - s° ~ n = ~ N ~~ O 'c~ m ~ `~ m ~~_ ~ ~? N a ~c ~{ ~ ~ t1 CY ~ ~n Z chi ~ ~ Tt C ~ ~ c ° ~ m ~ n ~ = O ~ Q Q "' N ~O N ~ m Q ~ m ~ . S C x fD a ~ o _ ' °_~~= ~ O T Z '°~o m ~v o ' mvo°° O ~ d.~ y 7c . m _~ o ~° ~ ~ a°: ° m ~ ~ a~ C ~ , O ~ ,..' m o o d o, m = y ~D ~ n fl n . rn Z m C7 0 Z ~~ ~Y~ m ~~ -~ c~ L W v m N to W CD DZ 3 v n m m rn v O .. u cry aye ~~.~~ ~~ ~ M ~ ~, ~~~~ ~ oo'Hj'6~~ ~ ( 1 r :f. '*s ~ n > ~ '^ a I'~ "./ C} ' `"l ~` b ~ cp ~. ~ ~ ~: 0o D ~ N m ~ ° _ O f ' ~ A . C N ~ ~ ~+ -~ 3 n ~ J~o C T ~ N d r o y cu to .~. O • 3~m N N 3 O ' z -o ao 0 o n m ~* o r W n z ~ " ~, ... Z no ~ C c _ r o G, o ~ on = 3 3 v ~, y~c ~ ~ ~ Z °° Z z v v z ~ w ~ ~ m ~ o o ~ v ~ ~ G1 1 m g ° = c ~ ~ ~ pmt ~ ~ - ~. ~ Z N O ~ O ~ O ~ m ~ O, C U1 ~ W N ~ ~ ~ ~ ~ m N c ~ ~ _ ~ ~ Q ~ o ~ 2 ~ ~. ~ m m o 0 T I C° 00 V ~ U7 A W N ~ Z6 ~ ~ v a ~ N ~ C ~ ~ ti N O ~ d ~ f0 o ' 41 ~ o O f0 v C CITY OF REXB URG ~ PERMIT # • i ~ ~/ BUILDING PERMIT APPLICA N 19 E MAIN, REXBURG, ID. 83440 208-359-3020 X326 Please complete the entire Application! If the question does not apply fill in NA for non applicable PARCEL NUMBER: ~ C" R ~ ~ ~r ~ QC'~ l ~ SUBDIVISII~ON: r 1 UNIT# BLOCK# LOT# OWNER:.lir• ~~ j s ~',IVI~~,~r! l.~Jffi R~2 CONTACT PHONE # Z ©$' ~ 3 S~ - 2 2 7 8~ PROPERTY ADDRESS: ,S~-3 tx-13~~e~ ~' ~ ~3yYo PHONE #: Home (gas) 356 - ~~'~ Work (~~--~'~` Cell (wg) 3S/ - z 2 7 $~ OWNER MAILING ADDRESS: ~~~ ,l''/~} ~L r ~~' CITY: ~ FxeuRy' STATE: / p ZIP: g`3 ~y ~ 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 :J fl- CITY: ~tl A STATE; ,u r9 ZIP ,~1 t}- PHONE #: Home ( ) ,~,~ f~ Work ( ) ti'~'9 Cell ( ) ,t1 A CONTRACTOR: ~~cyL~~si,IrlgN PHONE: Home# jsb°3ib'l Work# Cell# 390-3i~'/ MAILING ADDRESS: ~~ ~ ~ ~r,(~s~ ~ ~l R. CITY ~~X Qu~G STATE J I, ZIP ~'~ ~y ~ How many houses are located on this property? ~p~ ~ 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: ~~ ~L~ ~A/ ]lc (i.e., Single Family Residence, Multi Famil fFP~ E U2 r v ~: y, 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 in cases of any false sta ment or misrepresentation of fact in the application or on the plans on which the permit or approval was based. Permit void if not sta e withi 0 s rm~' v id if work stops for 180 days. ~,,~ / ~ Signature of Owner/Applicant S // 3 /©S DATE WARNING -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 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** • ~,~~ C1TY Q~ __ . RE:~B~R~ _ _ =- +- AMERKAS FAMfLY COMt~tUNIT(Y 19 E. Main (PO Box 280) Phone: 208-359-3020 x326 Rexburg, Idaho 83440 Fax: 208-359-3024 www.rexburg.orq comdev(ilrexburg.org Affidavit of Legal Interest State of Idaho County of Madison I, Name Address City State Being first duly sworn upon oath, depose and say: (If Applicant is also Owner of Record, skip to B) A. That I am the record owner of the property described on the attached, and I grant my permission to: Name Address to submit the accompanying application pertaining to that property. B. I agree to indemnify, defend and hold Rexburg City and its employees harmless from any claim or liability resulting from any dispute as to the statements contained herein or as to the ownership of the property which is the subject of the application. Dated this day of , 20 Signature Subscribed and sworn to before me the day and year first above written. Notary Public of Idaho Residing at: My commission expires: Please complete the ere Application! ~ If the question does not apply fill in NA for non applicable NAME PROPERTY ADDRESS ~~3~~vJ,gptE /l, ~'FXB~Ity Permit# SUBDIVISION Dwelling Units: Parcel Acres: SETBACKS FRONT SIDE SIDE BACK Front Footage (if applicable) A Storm Water Length ~ A SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building) First Floor Area ~~ ~ j 7S Second floor/loft area /J R Third floor/loft area n! F} Shed or Barn ~! ,~ Remodel (Need Estimate) $ Water Meter Count: f Water Meter Size: ~~ PLUMBING n _ Plumbing Contractor's Name: /3,--,~ ~ _ /~-~~~/ Business Name: ~~~L~.~l ~t~~ Address ~ ~~ 1L~ ~~ f~j:~ State ~~ Zip ~ ~~~v Contact Phone: ( ) Business Phone: ( ) 3 ~U •- ~fCf~~z FIXTURE COUNT (including roughed fixtures) ft Clothes Washing Machine h~ ~ Sprinklers !J~ Dishwasher ~ Tub/Showers ~ A Floor Drain ~ Toilet/LTrinal .~ Garbage Disposal N ~ Water Heater Hot Tub/Spa N R Water Softener Sinks (Lavatories, kitchens, bar, mop) Plumbing Estimate $ (Commercial Only) Signature of Licensed Contractor License number Date The City of Rexburg's permit fee schedule is the same as required by the State of Idaho Unfinished Basement area ~ ~ ~ Finished basement area Q Garage area 3 Z " Carport/Deck (30" above grade)Area fl • Please complete the e~iire Application! ~ If the question does not apply fill in NA for non applicable NAME PROPERTY ADDRESS 3 /Vl ~F ~ . Permit# SUBDIVISION MECHANICAL Mechanical Contractor's Name: Business Name: _ Address State Zip Contact Phone: ( ) Business Phone: ( ) Mechanical Estimate $ (Commercial/Multi Family Only) FIXTURES & APPLIANCES COUNT (Single Family Dwelling Only) Furnace Exhaust or Vent Ducts Furnace/Air Conditioner Combo Heat Pump Air Conditioner Evaporative Cooler Unit Heater Space Heater Decorative gas-fired appliance Incinerator System Boiler Pool Heater Similar fixtures or Appliances Fuel Gas Pipe Outlets including stubbed in or future outlets Inlet Pressure (Meter Supply) PSI Heat (Circle all that apply) Gas Oil Coal Fireplace Electric Dryer Vents Range Hood Vents Cook Stove Vents Bath Fan Vents other similar vents & ducts: Mechanical Sizing Calculations must be submitted with Plans & Application Point of Delivery must be shown on plans. Signature of Licensed Contractor License number Date The City of Rexburg's permit fee schedule is the same as required by the State ofldaho SUBCONTRACTOR LIST Excavation & Earthwork: Concrete: Masonry: Roofing: Insulation: Drywall: Painting: Floor Coverings: Plumbing: Heating: Electrical: Special Construction (Manufacturer or Supplier) Roof Trusses: Floor/Ceiling Joists: Siding/Exterior Trim: Other: