HomeMy WebLinkAboutAPPLICATIONS, CO, BP - 05-00156 - 524 Golden Willow Dr - New SFRZ
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99
L ,J
'e~~iNFO
CITY o~ Certificate of Occupancy
City of Rexburg
Department of Community Development
19 E. Main St. / Rexburg, ID. 83440
~1 W~V
America's Family Community
Phon
Building Permit No:
Applicable Edition of Code:
Site Address:
Use and Occupancy:
Type of Construction:
Design Occupant Load:
Sprinkler System Required:
Name and Address of Owner: Harris David T Etux
382E 3000 N
05 00156
International Residential Code 2003
524 Golden Willow Dr
Single Family Residence
Type V-N, Unprotected
Residence
No
Re~urg, ID 83440
Contractor: Hams, David
Special Conditions:
Occupancy: Residential, single family dwellings, lodging houses
This Certificate, issued pursuant to the requirements of Section 109 of the International Building
Code, certifies that, at the time time of issuance, this building or that portion of the building that
sties inspected on the date listed vies found to be in compliance v-ith the requirements ofthe code
for the group and division of occupancy and the use for vthich the proposed occupancy v-es
classified.
Date C.O. Issued
C.O Issued by:
Building t~cial
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 Department: Fire
State of Idaho Electrical Department
CITY OF REXB URG
BUILDING PERMIT APPLICAT~
19 E MAIN, REXBURG, ID. 83440
208-359-3020 X326
PARCEL NUMBER:
PERMIT # •
Please complete the entire Application!
If the question does not apply fill in NA for non applicable
SUBDIVISION:~1 ~,~ ~,~,, g,~r,~ FS7y4~s UNIT# ~ BLOCK#_~LOT#~
OWNER: ~~y ~ ,~ N~C~C~S CONTACT PHONE # Zv ~- 3~"] ~ Z S~3
PROPERTY ADDRESS: SZ ~{ So N-~„ G~o(dA („~ ; 11 ~ ~ 1,~.,~_
PHONE #: Home (Z~) (osZ - o ~ ~ ,-~ Work ( ) /(~;~ Cell (~~f) 3 Sl - 2 S~ 3
OWNER MAILING ADDRESS:~382 C. 30~a,it>. CITY: STATF.~7J ZIP: ~e
APPLICANT (If other than owner)-
(If applicant if other than owner, a statement
applicant to act as agent for owner must accompany this application.)
MAILING ADDRESS OF APPLICANT
CITY: Y4' STATE; ~~- ZIP~~
PHONE #: Home ( )~¢ Work ( ) ~/~(- Cell ( ) ,,1r,4
CONTRACTOR:~q ~,p ~,~,ie,~r PHONE: Home# ~Z -c9i ~~-Work# /~/l~ Cell# ,~ 3 S/-2s,~~
MAILING ADDRESS: 3 F'"L ~` 1 ~p~a ,~tJ L CITY rd STATE ~J ZIP~~
How many buildings are located on this property? ,~-
Did you recently purchase this property? No Yes f yes give owner's name) ,~j~~,,, ~ ,~ 6`,~ ~
Is this a lot split? NO YES (Please bring copy of new legal description of property)
PROPOSED
(i.e., Ingle I
Multi Family, Apartments, Remodel, (Garay 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
statement or misrepresentation of fact in the application or on the plans on which the permit or approval was based. Permit void if not
started within 180 days. Permit void if work stops for 180 days.
.~f~ - ~
Signature of Owner/Applicant
WARNING -BUILDING PERMIT MUST BE POSTED ON CONSTRi
Plan fees are non-refundable and are paid in full at the time of application begin
City of Rexburg's Acceptance of the plan review fee does not constitute
**Building Permit Fees are due at time of application**
**Building Permits are void if you check does not clear**
r /~~~/ v~
'OS
1 Q
CITY OF REXBURG
~`~,`°"~
~-
i ?~
4$t1SNE'~ ~ /
CITY O~
R~~BUR~
AMERICA'S FAMILY COMMUNffY
Affidavit of Legal Interest
State of Idaho
County of Madison
I, ~~'/ 1 rJ ~~ S ,
Name
City
Being first duly sworn upon oath, depose and say:
Address
G~ ~~-o
State
(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 ,,L~ '~ day of i~~J/ 20 O~
Subscribed and sworn to before me the day and year first above written.
```ep®1!!u 1 ~77111o~~~i
``````~~y~~TTE M~~ ~~~.
_, : N y
_s...
PU~3~~G
*:
•..
.,~~~`rT.gjE ®F ~®~~pa
/jUla l l l t!~l~~~~`
Public of Idaho ~
Residing at:
My commission expires: ~ ~ - ~j i` 6
Please complete the ere Application!
If the question does not apply fill in NA for non applicable
NAME p~ltjlb ~(,4,C.G~J
PROPERTY ADDRESS StY -fe~r<. Gd« Imo,?tm,.,ai,;,L Permit#
SUBDIVISION h/dhow`na-tc ertz~r
Dwelling Units:
SETBACKS
~ Parcel Acres:
FRONT ~ SIDE ~ SIDE
Front Footage (if applicable)
Storm Water Length
~ ~ BACK ~Q ~
Remodeling Your Building/Home (need Estimate) $
SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building)
First Floor Area „7,20
Second floor/loft area ,a-
Third floor/loft area ~---
Shed or Barn ,}-
Water Meter Count:
Required!!!
Water Meter Size: 3`Y
PLUMBING
Plumbing Contractor' Name: ~ `--v ti Busine s Name: 1 H- ~ 7~ ,/~ •- ~ / /'1 C.
Address ~ C ~~'~" ' °• State Zip~c~~ C
Contact Phone: (~~ ,_ ~ ~ - ?, } '3 ~ Business Phone:~;~) (- 3 ~ ~ -
FIXTURE COUNT (including roughed fixtures)
~ Clothes Washing Machine ~ Sprinklers
_~ Dishwasher ~ Tub/Showers
Floor Drain ~ Toilet/LJrinal
~ Garbage Disposal ~ Water Heater
1r ~~ Hot Tub/Spa ~ Water Softener
_ Sinks
(Lavatories, kitchens, bar, mop)
Plumbing Estimate $ (Commercial Only)
ignature censed Contractor Lice ber 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 .?~~
Garage area 9~ y
Carport/Deck (30" above grade)Area /I/~¢
please complete the ere Application!
If the question does not apply fill in NA for non applicable
NAME ~U ~ p ,l,/s~t{t
PROPERTY ADDRESS SZy S~k~ G6~(~ r.~,'ko~b~,l.r Permit#
SUBDIVISION l/~7(rc,, ~,,,orc ~r,4.F~r
Required!!!
MECHANICAL
Mechanical Contractor's Name: ~ 2 ,sw-~~-nr,.~ Business Name: ~ 3 k.r'~-~~-
Address Z,oor- ~~,~s,,,,,,,~ ~,~~ ~ s-„m.~.., StateT~ Zip J' Y~
Contact Phone: (~~) 3 / 3 - c9 o v ` Business Phone: (mod) ~,~,~ .- o ~, s~
Mechanical Estimate $ (CommerciaVMulti Family Only)
FIXTURES & APPLIANCES COUNT (Single Famil Dwelling Only) ~~
1_~ Furnace y '~,~ ~ ~ -e Exhaust or Vent Ducts a~
~ Furnace/Air Conditioner Combo ~ Dryer Vents \~
Heat Pump
Air Conditioner
Evaporative Cooler
Unit Heater
Space Heater
Decorative gas-fired appliance
Incinerator System
Boiler
Pool Heater
-~ Range Hood Vents
~- Cook Stove Vents
Bath Fan Vents `'~~
other similar vents & ducts:
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
Mechanical Sizing Calculations must be submitted with Plans & Application
Point of Delivery must be shown on plans.
~/ .S v
Si e o License on actor License number Date
The City of Rexburg's permit fee schedule is the same as required by the State of Idaho
SUBCONTRACTOR LIST
Excavation & Earthwork: ~,Ru~;~ r~ ~z ,,,,,f,_.T, ~ ~
Concrete:l?-~o~ ~Zt, , f,,sYc c~~ ~~-~ ~ ~~
Masonry: ~f(/,~ s ~~rv~y
Roofing: C~QlJ~~(. ~~~~~
Insulation: r'rrirl~o~Nr1-'~ In I3St~-cam ~a~
Drywall: ~U~~p~~ ~
Painting: ~.G~.2.oh.._ /'a ;~.~
Floor
Coverings:_ Sf~o~.•~~cs~ ~y3Z}c,t~,e~r
Plumbing: ~(,~-r ~o,,~ t`~zi[.~,,~ dt~
Heating:~~2 ~ ,t~ syg-Tt~
Electrical: (/ / ~~ ,,~ L (~ ~~ ~
Special Construction
(Manufacturer or Supplier)
Roof Trusses: -slag
Floor/Ceiling Joists:_ SP1~`cK S~.-~` ~
Siding/Exterior Trim:_s ~.t ~r.~~ y
Other: