HomeMy WebLinkAboutAPPLICATIONS, CO, BP - 05-00017 - 77 S Hidden Valley Rd - New SFRZ
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D~~~XB°RG.d CITY o~ Certificate of Occupancy
~~~~ City of Rexburg
-~ ~'' Department of Community Development
Ameritas Family L'ommuuify
'=H.4
19 E. Main St. / Rexburg, ID. 83440
Phone (208) 359-3020 /Fax (2081359-3022
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:
Contractor:
05 00017
International Residential Code 2003
77 S Hidden Valley Rd
Single Family Residence
Type V-N, Unprotected
Residential
No
Hill Randall J
6579E 113 N
Idaho Falls, ID 83401
R Hill Const
Special Conditions: 700 sq ft unfinished basement
Occupancy:
Residential, single family dwellings, lodging houses
This Certificate, issued pursuant to the requirements of Section 909 of the International Building
Code, certifies that, at the time time of issuance, this building or that portion of the building that
vies inspected on the date listed vies found to be in compliance vtith the requirements ofthe code
for the group and division of occupancy and the use for v~hich the proposed occupancy vies
classified.
Date C.O. Issued: January 19, 2007 (01:42P
~. c~~
C.O Issued by: ~~~---___
Building Official
There shall be no further change in the existing 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 Depa nt:
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 NUMBER:
PERMIT #
Please complete the entire Application!
If the question does not apply fill in NA for non applicable
SUBDIVISION: ~ DD Fz ~c,~ (~~}-c.i..~y UNIT# ~f' 7 BLOCK#~LOT#
OWNER: R ~ f L.L.- e~°y~ ~-hru.G~,~rn, LLC. CONTACT PHONE # i'Z® `f,6~ /
PROPERTY ADDRESS: ~ ~~~ ~~Q:a.~,
PHONE #: Home dog} r, Z3 -c~t1~ic~ Work ( ) SL3~o ~l5`3 Cell
OWNER MAILING ADDRESS: (, 5~ t ~z' i 13 ~ CITY: i ~
~~0 1.LS/
STATE: ~~ ZIP: el~t f
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
CITY:
PHONE #: Home ( )
CONTRACTOR:
MAILING ADDRESS:
STATE; ZIP
Cell ( )
Work# Cell#
CITY
How many houses are located on this property?
Did you recently purchase this property? No~~If yes give owner's name)
STATE ZIP
Is this a lot split?~ YES (Please bring copy of new legal description of property)
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 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 Pelr'mi~t void if ork stops for 180 days.
Signature f Owner Applicant DATE
WARNING - BUII.DING 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 Rezburg'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**
~ g ~...~w~.Q.~.-~
~~~~- g
~ ~a~
Work
PHONE: Home#
Jan 21 2QQS 1tl:4SRM
:`~~~vSE
PRt?PERTY ADDRESS
SUBDI~ISIOI~
MR~E~lS#°LtlMB i ~4G
3573439 ~o. i
Permit#
Dwelling Units
SETBACKS
FRt~I+TT SIDE
From Fcotage (if applicable)
Storm Wafer Lerlgth
Sll3E BACK
SURFACE S(~UARE FOOTAGE: (Shall include the exteTitr wall measurements of the huiidng}
First r1oQrArea Z! l 1, Unfinisf~ed Basement area 7_0o I
Second floarJloft area Finisltexi basement area
Third fluor/loft area Garage area 8~~
Shed or Barn CarporklL~k (30" above grade}Area
Remt~t~ed CN~d Estimate} $_
PZUM~NG r
Fl~nbing Ccxustractor's Names Business IJ e: u, J
Address '~~ 5 State `~ Zip~~_~~
Contact Fhone: ( }__ ~~ gr ~~ ~i/ Business Phone: '}_,;3~`~--3 ~I3 ~
Fl~?7IRE CQUIVT'
Clothes Washing Machine Sp~~ - I
Dishwasher 1 T`ublShaw~ers _
Flcxar Drain ~ Ttrilet/Urinal _ t~
Garbage I?isposai ~ Water Heater ~
Hot Tab05pa Water Softener _..-,~-
Sinks
(Lavatories, kitchens, bar, mop)
P! ing Estivate ~ (Goffimcrc~l Qaly) ~'~-g.. C.~~'l`~
Signet~er~ csf Cvn~cter License gttmber ~aie ,
T7re Cfty of Re~rtrg's ~+errnrt fee aches~le is the same ~ regu~i ed by the State of Idafro
Parcel Acres:
MECEANICAL G
Mechanical'Contractor's Name: ~ orp,0 ~ ~ ~'~ ~ tat Busin s Name:. ~,? /J~
Address `~ S ~ /iuan C~~a,a S~ta~te Zip 3
Contact Phone: (~08) S~/o~~7/ Business Phone: (,~~) ~v~l L?~7
FIXTURES & APPLIANCES
Furnace _
Furnace-Air Conditioner
Combination
Heat Pump
Air Conditioner
Evaporative Cooler
Pool Heater
SO
~ 3~
Unit Heater
Decorative Gas-Fired
Appliance
Space Heater
Incinerator
Broiler
I;XHUAST & VENTILATION ~ 5
Dryer Vents / ~ s Cook Stove Vents
Range Hood Vents _~5 Bath Fan Vents ~~o
~5
Fuel Gas Pipe (# of Outlets) 5 a~ Mechanical Estimate $ (Commercial
/ Only)
/~ ~ ~ ~ 1 ~ ~ dJ~
S' afore of Contractor 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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