HomeMy WebLinkAboutAPPLICATIONS, CO, BP - 05-00021 - 624 Centennial Loop - New SFR
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~~ ~'n°F CERTIFICATE OF OCCUPANCY
• REXBLIRG City of Rexburg
~ AMERKA5 FAMILY CO(vVNUNfrY
Department of Community Development
19 E. Main St. / Rexburg, ID. 83440
Phone (208} 359-3020 /Fax (208) 359-3022
Building Permit No: 05 00021
Applicable Edition of Code:
Site Address: 624 Centennial Loop
Use and Occupancy:
Type of Construction:
Design Occupant Load:
Sprinkler System Required:
Name and Address of Owner: Fillmore Construction
624 Centennial Loop
Rexburg, ID 83440
Contractor: Owner
Special Conditions:
Occupancy:
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
wes inspected on the date listed v-es found to be in compliance with the requirements of the code
for the group and division of occupancy and the use for Which the proposed occupancy vies
classified.
Date C.O. Issued: June 23, 005 (01: PM)
~~
C.O 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
State of Idaho Electrical Department
` . CITY OF REXB URG
PERMIT #
BUILDING PERMIT APPLICATION
19 E MAIN, REXBURG, ID. 83440 Please complete the entire Application!
208-359-3020 X326 If the question does not apply fill in NA for non applicable
PARCEL NUMBER: ~~; ~ L~u~ 1 ~ ~ .~
SUBDIVISION: ff~~~ cl ~ ll -t'c UNIT#~BLOCK# ~- LOT# /~
OWNER: ! / ~l wc~~~`~. ~~`;,~y%Tiri/C'~r~y1 CONTACT PHONE # .S ~C~-~ '- ~.~3
PROPERTY ADDRESS:_ ~ ~y C,~vtif~n n 1 ~~ Loop .
PHONE #: Home () ~ i% S_ _ _~5~,~, Work (~o`'3j~~C~ - ~a"13 / Cell ~~~ ,~ ~,~ 3
OWNER MAILING ADDRESS: ~/~~ ~ ~~~/1/ CITY; ~ ,< . C STATE;~ZIP: ~' ~~~~
APPLICANT (If other than owner)_ /~~~
(If applicant if other than owner, a statement authorizmg applicant to act as agent for owner must accompany this application.)
MAILING A~~SS OF APPLICANT
CITY:_
PHONE #: Home ( ) Work
STATE; ~~ ZIP_
----~~ Cell ( ) ---
CONTRACTOR: - `~~` ~ ~f t~c.~"f PHONE: Home# Sew ~ Work# S Cm -t7 Cell# S~~ `~
MAILING ADDRESS: ~/~~~ ~ .S~ST/t~/ CITY ~c STATE,~6~ ZIP ~~-~
How many houses are located on this property?_ j
Did you recently purchase this property? No es (If yes give owner's name) f~~ K /"~f l `~-M'
Is this a lot split? ~ YES (Please bring copy of new legal escription of property)
PROPOSED USE: ~i~ t~~ t"~^ r~ ~ /'~w~,~c=~,~ ~:.~
(i.e., Single Family Residence,
r amily, 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 n the plans on which the permit or approval was based. Permit void if not
started within 180 dam. Permit~v„B~if work~ps for lays.
of Owner/Applicant
U_ 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**
~~
NAME ~I`~~~ r•~ ~~s dc' ~d
TYPE OF CONSTRUCTIONAS PER IBC_
ROOF CLASSIFICATION
PROPERTY ADDRESS _ Permit#
SUBDIVISION ~~` „~,,, ~ ~
Dwelling Units: ~ Parcel Acres: ~ ~ o
SETBACKS
FRONT '~ ~--. SIDE ~~~ SIDE BACK v
Front Footage (if applicable) /V /t
SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building).
First Floor Area / ~ ~/~. Unfinished Basement area /'~~/~
Second floor/loft area Finished basement area
Third floor/loft area Garage area ~ l~'Cs7
Shed or Barn Carport/Deck (30" above grade)Area
Remodel (Need Estimate) $
PLUMBING ~/ / y /~
PLUMBERS NAME ,Tr ~i ~'^~ / ~`r'~ °,/
CITY
STATE ~j/~ . ZIP
FIXTURE COUNT /
CLOTHES WASHING MACHINE
DISHWASHER ~_
FLOOR DRAIN ~
GARBAGE DISPOSAL /
HOT TUB/SPA _~
SINKS _~
(Lavatories, kitchens, bar, mop)
WATER METER COUNT
SPRINKLERS C}
TUB/SHOWERS
TOILET/URINAL ~
WATER HEATER ~
WATER SOFTENER d
WATER METER SIZE
HEAT (Circle all that apply Gas Oil Coal Fireplac Electric
Commercial Buildings & Apartments with 3 or more units Only
PLUMBING ESTIMATE $
STORM WATER LENGTH
FRONT FOOTAGE
STRUCTURES
DESCRIPTION
USE
BEDROOMS (If Applicable) _
APT. UNITS (If Applicable )_
OCCUPANCYLOAD
r
HEAT TYPE
ADDRESS ~~ ~ ~
L PHONE (,~~sj) ~ S'~ ^ ~~}D~
FLOOD ZONE
OCCUPANCY (As Per IBC)
2
~~ U~ G ~
MECHANICAL
Mechanical Contractor's Name: ~~„~ V~G,~NSp~.. Business Name:. ~ s ~3o i ~tJY ~,~L,
Address ~ SS S' ~} 5~~,~~a~"' State ~.d , Zip 8 340 ~
Contact Phone: (a~a) ~ - ~ 15 ~ Business Phone: (ac6) Sail - - ~ 37
FIXTURES & APPLIANCES ~ ~
Furnace ~ 3
Furnace-Air Conditioner
Combination
Heat Pump
Air Conditioner
Evaporative Cooler
Pool Heater
Unit Heate
$ecorative Gas-Fired
Appliance
Space eater
Incinerator
Broiler
EXHUAST & VENTILATION
Dryer Vents t~ l ~-~,-
Range Hood Vents
Cook Stove Vents ~ ~ ~
Bath Fan Vents 3 ~~ 1 y~
Fuel Gas Pipe (# of Outlets) a• ~ ~ ~ Mechanical Estimate $ (Commercial
Only)
Signa 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
3