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HomeMy WebLinkAboutCO, BP, AFFIDAVIT, & APPLICATIONS - 05-00101 - 649 Johnson St - New SFRO .~~. Z O rn ._ ~ v ~ ~ ~ ~ O ~ ~ N ~ ~ ~~ a 3 ~ m ~3 N ~ y N ~_~~ (Q (U y ~. a M 0 C N 3 ~ v ~ o ~ a v ~' a n. c v ~~ a ~ ~ y g 0 m ~ m ~ o v .a ~ ~ m v ~ v o ~ ~~ s~ _~' ~o ;a~~o ~~Na~ ~ C ~ N Z A ~ S A fl7 j N y ~ Q p_ C N p W ~ ~ a_o o c ~ 7C v N S N N S _" (D 7 G1 G1 .n~. ~• N ~ ~' .~. 7 ~ ~ ~ 3 V ~ o F ? m ~ x s m ~ m o o ~ o m ~ a a ~ ~ ~ y ~ ~ S W ° ~ ° ~ 111 o - ~~ ~. ' ~ ~' ~ c c ° c= , ~ ~Q y. _~ ~ ~ ~a== y~ y O. C 'O O ~ C ~ C'! C1 ~~ ~ ~~~ C ~• ~ .. r- m . ~~~° N ~ 3 ~ ~ Q. ~ 1 Q ~ V! ~ (~ ~ C ~ O ~ „~,r C ID Q. 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CO 00 V ~ CTl A W N -~ ?1 ~ Z 26 O7 (n Q ~ ~ ~ 3 ur T p~ 'n ~ 3 -n ~ r ~ o ~ -CITY OF R~BUR~ + AMERICA5 FAMILY COMMUNffY Building Permit No: CERTIFICATE OF OCCUPANCY City of Rexburg Department of Community Development 19 E.Main St. / Rexburg, ID. 83440 Phone (208} 359-3020 /Fax (208) 359-3022 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 00101 ~ ~ L' c 649 Johnson Ave singlL f~rnl~ty r~ic,~e~~~ ~yP~ v-N, c~,s~`c~cX-~-i~ Y`~s t`~~-h`ct P NO Ruud Enterprises Llc 649 Johnson Ave Re~urg, ID 83440 Ruud Enterprise Special Conditions: ~/n~i;~~.~~~~ ~aSc,~nr~,' Occupancy: R„~SiG~~~T~l~, ~1nc~~e. -Fam-ly ~i~v~lllr~~ 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 vies inspected on the date listed vies found to be in compliance vuth the requirements of the code for the group and division of occupancy and the use for v~hich the proposed occupancy vies classified. Date C.O. Issued: October 11, 2005 (04:10PM) 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 Department• ire Dep e s a State of Idaho Electrical Department (208-356-4830): CITY OF REXBURG BUILDING PERMIT APPLICATION 19 E MAIN, REXBURG, ID. 83440 208-359-3020 X322 PARCEL NUMBER: SUBDIVISION:~e~y c('~o'S'c ~/ (Addressing is based on the information - mu; PERMIT # • Please complete the entire Application! If the question does not apply fill in NA for non applicable ( We will provide this for you) UNIT# BLOCK# LOT# ~t be accurate) OWNER: .f~a,c~ ~~ ~D,O CONTACT PHONE # PROPERTY ADDRESS: ~y ~ ~~i time ~ Ads PHONE #: Home ( ) Work ( ) Cell OWNER MAILING ADDRESS: CITY: EMAIL FAX STATE: ZIP: APPLICANT (If other than owner) /J~ i,~,L ~ ~a ~ (Applicant if other than owner, a statement authorizing applicant to act as agent for owner must accompany this application.) APPLICANT INFO//RMATION: ADDRESS ~~ ,~,~ / ~' ~" CITY: STATE; / ~• ZIP_~3yy~ EMAIL FAX PHONE #:~e~e (~~) Work Cell CONTRACTOR: MAILING ADDRESS: ~O ~~~ / ~~_JCITY ~ -J- STATE PHONE: Home# EMAIL Work# Cell# 3 90- ~G G ~ FAX T7.___. W_~__ 1____1 1' ZIPC/~ aiv rv uiwi•y ~uiauiii~~ aio tv~a«u ull uus property, Did you recently purchase this property? o~'es (If yes give owner's n~;ne) Is this a lot split`~~ YES (Please bring copy of new legal description of property) PROd'~1~ I~SF• Single Family ramtly, 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 days. Permit void if work stops for 180 days. / / Signature of Owner/Applicant DATE Do you prefer to be contacted by fax, email or phone? Circle One 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 I, 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** `Please complete the entire ~ hcatlon! if the question does not'.i"pply fill in NA for non Pp applicable d NAME ,~ ~,s, ~/ PROPE TY ADDRESS ,r, {~~ J Permit# SUBDIVISION Required!!! MECHANICAL Mechanical Contractor's Name: ~/,~rp ~~~~~ Business Name: ~Jik'~ ~„~ Address~x-11~ ~ City State / Zip_~~~~~~ Contact Phone: ( ,~ y~~ (,"`~ ~ Business Phone: ( ) Email Fax Mechanical Estimate $ (Commercial/Multi Family Only) FIXTURES & APPLL9NCES 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 ~_ Dryer Vents Range Hood Vents Cook Stove Vents ~~ Bath Fan Vents other similar vents & ducts: `', Fuel Gas Pipe Outlets including stubbed in or future outlets Inlet Pressure (Meter Supply) PSI Heat (Circle all that apply) Ga Oil Coal Fireplace Electric Mechanical Sizing Calculations must be submitted with Plans & Application Point of Delivery must be shown on plans. ~~ Signature of Licen ed Contractor The City ofRexbur ~dZ~ License number 's permit fee schedule is the same as G /~ Da e the State of Idaho CI°TY OF REXB URG BUILDING PERMIT APPLICATION 19 E MAIN, REXBURG, ID. 83440 Please 208-359-3020 X326 If the quest PARCEL NUMBER: OSOO l01 SFR Henderson ~PQ11-n1DS nOZp150 SUBDIVISION: 1UP_ {~~~~ 1^S~ ~ UNIT# BLOCK#_ ~ LOT#~ OWNER:~~1,(.~~ ~1~ tE ~ ~ i~ ~` se ~, ~ . ~, , CONTACT PHONE # ,~ ~ ~ - ~ ~ ~ PROPERTY ADDRESS: ~ f n ~ y~ 5C ~ J f ~J'VC• PHONE #: Home (~v~~~ ~; c-~ 5 ,~ Work (2~~} ~l ~- n~ ~ .h Cell (~o~ ~ f .~ - ~ ~ ~~ OWNER MAILING ADDRESS:~~ ,'// R~~'P ~v~,~ CITY: ~ STATE~ZIP: d~(,1 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 AD RESS ~ APPLICANT ' ~ 4 --CITY: ~ i~ ~ STATE; _ ZIP ,3 ~/ PHONE #: ome ( } ~35~j-,~ ~; .~ ~ Work ( ) -G~SS~S- Cell ( ) ~ J _ ~ ~ f) .S~SS' CONTRACTOR:~i,~ Uc.~ ~n UDr, sc PHONE: Home# ,3~ 252 ~Work# 3 j,~--p sS S Cell# -cis S S- MAILING ADDRESS: ~( /l~; // ~ e ~ CITY bur STATE~ZIP ~/~~ How many houses are located on this property? `~ Did you recently purchase this property? No ~(If yes give owner's name) t~~'nrf P~` Sr srl Is this a lot split? ~ YES (Please bring copy of new legal description of property) PROPOSED USE: ~' J`-~~'1 (i.e., Single Family Resident ,Multi Family, 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 epresentation~f~ fact in the application or on the plans on which the permit or approval. was based. Permit void if not started w' in 180; days. Pe^,r"'J~~oid if work stops for 180 days. ~/ `J' /~ DATE W - D PERMIT MUST BE POSTED ON CONSTRUCTION SITE! lan fees are non-refund bie dare paid in full at the time of application beginning January 1, 2005. ~j~(~i~ of l~iurg ptance of the plan review fee does not constitute plan approval * u ing Permit Fees are due at time of application** n * g Permits are void if you check does not clear** °° ,~,~ CITY OF ~~~ - ° RE:XBLIR~ ~~:~i Tq$trSNE4~~T ,•V~rILRICA'S FAMILY COIW~+tUNi~fY 19 E. Main (PO Box 280) Phone: 208-359-3020 x326 Rexburg, Idaho 83440 Fax: 208-359-3024 www.rexbur9.org ~~ ~_ Affidavit of Legal Interest State of Idaho Cou f ' on I, , Na .. C City C~ Q' , Address ~~~ State 1;. 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 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 entire Appl~tication! ~ ~~ ' J ~ It Ilse question doer not iPPiy flU ~a NA for non eppltcable PROPERTY A,DIG~SS _a,~ ~ h n ~? n S ~r P t PCrmit# SU13D>!Vt5ION _.1 f`~c~~ r s~ v, Dwcllang Units: 5,_;~f amel Acres:~~/ /~ SETBAC~CS FROM? 3 3~ ~ "C~ BIDE ~ `~ SiDE~BACK Front Footage (i~ appticabte) q ~. ~~', Swan Water Leasgth __ M/ ~ SURFACE SQUARE FOOTAGE. (Shall include the exterior wall measur+ctnents of the buildir-g) First Floor Aria ,1, C 3 ,d,Q , ,~~ UnaBn~ished BesenrRCrrt arcs ~ 7UU .o ~~ Second floor/!oft area_ " ~~/~ Finished basement area r ~~ Tktird floor/loft arca_ ~G'/~ Qaragt area ~' ~ Shed oar Barn ~t/ l~ Carport/Dcck (30" v grade}Area ~N/ !~- ,+lRentodel (Need Estimate} ~~ Water Meter Count: ~~ ~"L UMB.~,~G Plumbing Contractor's N Contact Water llxeter Siu; Name: _~..~.?il~~Y4 (n (goy) ~17~ G;POa FIXTURE CDUNT r~nclrtdireg roa~1i<ed, ffaurrns) r croth~ washing Machine ~ Dsshwe4sher ~- Floor Drain Garbage Disposal 0 got Tubls~a ~y _ sinks (Lavatories, kitchens, bear, mop) C? Spnanklers~ `~ Tub/Shawets __,~ ToiletNarin~al ~ Water Heater ~~ water softener ~'lu g F.at ate S (Commercial inky) L: ~~/~s'r,~ ~ 3.3i- 05 Sign Licensed Cantractvr License number Deto Ths Ctry ajRsxbarg'a pernir fats schedule is e!-n santo as ~rqutrsd by tht State of Idaho a•d easa~s€~ol LtiZ9~ZS8aa ~~z~a~w:wo~~ i=T:titi s©ea-iz-~~.~ SUBCONTRACTOR LIST Excavation & Earthwork: Wavne Parkinson Excavation Concrete: K&C Concrete Masonry: Dan Barney Masonry Roofing: Top Home Builders, Inc. Insulation: BMC West Drywall: Expert Drywall Painting: Banta Painting Floor Covering: Gunderson Carpet Plumbing: Hotshot Plumbing Heating: Mike Wood Heating & Cooling Electrical: L & F Electric, Inc. SPECIAL CONSTRUCTION (MANUFACTURER OR SUPPLIER) Roof Trusses: Floor/Ceiling Joists: Siding/Exterior Trim: Other: BMC West BMC West Boot Hill Sidins ease complete the entire Application! If t1~e question does not apply fill in NA for non appli osooloi NAME Ruud Enterprise, LLC SFR Henderson PROPERTY ADDRESS .Johnson Street SUBDIVISION Henderson Subdivision/Rexburg, Idaho MECHANICAL Mechanical Contractor's Name: M, ~ k/~k Busines~ Name: I~(j,(% ~/,ti N '~;,,~ r~(j,~,~ Address State /G , Zip-&~~$' Contact Phone: ~~ - C Business Phone: ( ) Mechanical Estimate $ (Commercial/Multi Family Only) FIXTURES & APPLL9NCES 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 1 Dryer Vents Range Hood Vents ~_ Cook Stove Vents ,~. Bath Fan Vents other similar vents & ducts: 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 APR 6 2005 ~~~' OF REXBURG , Mechanical Sizing Calculations must be submitted with Plans & Application Point of Delivery must be shown on plans. ~a3.S ~ ignature o icensed Contractor License number ate The City of Rexburg's permit fee schedule is the same as required by the State of Idaho