HomeMy WebLinkAboutAPPLICATIONS, CO, BP - 05-00097 - 665 Centennial Loop - New SFRZ ~ G) ~ Z y~~~ctry
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UO4RExBUkCr~ CITY o~ CERTIFICATE OF OCCUPANCY
Y~ REXBUIZG
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America'sFamityCommuniry Department of Community Development
~~~s Nao .e
19 E. Main St. / Rexburg, ID. 83440
Phone (208) 359-3020 /Fax (208) 359-3022
Building Permit No: 05 00097
Applicable Edition of Code: International Building Code 2003
Site Address: 665 Centennial Loop
Use and Occupancy: Residential
Type of Construction: Type V-N, Unprotected
Design Occupant Load: Single Family Residence
Sprinkler System Required: No
Name and Address of Owner: Jeppesen Dalian
434 Morgan Drive
Rexburg, ID 83440
Contractor: Owner
Special Conditions: Landings at exterior door to be finished as weather permits.
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 with the requirements ofthe code
for the group and division of occupancy and the use for lahich the proposed occupancy sties
classified.
Date C.O. Issued: March 17, 2006 (01:43 )
f;~ 4
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 Departure ^~"' Fire De
State of Idaho Electrical Department
CITY OF REXB URG
BUILDING PERMIT APPLICATION
19 E MAIN, REXBURG, ID. 83440
208-359-3020 X326
PARCEL NUMBER:
OS 00097
Plea S F R Jeppesen ,n,
If the question does not apply sill in NA for non applicable
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SUBDIVISION: ~ ~1~~, _____ UNIT#_~BLOCK#~_LOT#~)
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OWNER ~ "'` f Q~' ~,~ CONTACT PHONE # ~Ib`-I c~pLo
7l ~
PROPERTY ADDRESS: (~'~ ~rr2rt.f ~ ; ~.~ (!~
PHONE #: Home (~~ ~j5~-'2~ ~9 Work (2L~) ~~, %~ - ld L (,~ Cell ( ) 3l 7 ~ 7Ga `~~
OWNER MAILING ADDRESS:-'~'-:~-L ,DY' i? I~-', CITY: (}BUY STATE: ~U ZIP: S3`}~/(}
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: STATE; ZIP
PHON #: Home ( ) Work ( ) Cell ( )
CONTRACTOR:~~ ' PHONE: Home#'.~~~'ork# 3~'D-IQQ(eCell#
MAILING ADDRESS:_~3~ Iv1D1'A Yl DY, CITY ~l STATE ~ ZIP ~~~
How many houses are located on this property? ®Y1~
Did you recently purchase this property? No Yes If yes give owner's name) (~,~',~, ~~J m~
Is this a lot split? TO~ YES (Please bring copy of new legal description of property)
PROPOSED USE:
(i.e., Single Family
Multi Farrkly, 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
~~~/,~~
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 (,~ ~ _ ___
PROPERTY ADDRE S
SUBDIVISION
Dwelling Units:_
SETBACKS
FRONT ~ 5
Permit#
Parcel Acres: s ~'b
,. , ,
SIDE W) 32, (o SIDE BACK ~~ ~'
Front Footage (if applicable) - $~,'~2
Storm Water Length
SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building)
First Floor Area~2.~ Unfinished Basement area 20~-~}'
Second floor/loft area Nf~] Finished basement area IV
Third floor/loft area nJ~,q- Garage area~~* x 2 $, ~ ~ ~ 23 q ~
Shed or Barn ~~,~ Carport/Deck (30" above grade)Area ~/~
Remodel (Need Estimate) $
Water Meter Count:
Water Meter Size:
PLUMBING _
Plumbing Contractor's Name: ~~j 1 j Business Name: ~ b -~~~ cJ
Address State ~ Zip
Contact Phone: (~) ~9- 9~k 7 Business Phone: (Z~g) 3t3- X388
FIXTURE COUNT
Clothes Washing Machine ~_ Sprinklers
Dishwasher _~ Tub/Showers ~~~1Q '4
Floor Drain ~_~ Toilet/LTrinal ~'' /-~
Garbage Disposal _I Water Heater
Hot Tub/Spa r A Water Softener ~
Sinks ~~
(Lavatories, kitchens, bar, mop)
Plumbing Estimate $ _ (Commercial Only)
KM~ti1l~ C t! IoZZ. 3~ZZ-~ os
Signature of Contractor License number Date
The City of Rexburg's permit fee schedule is the same as required by the State of Idaho
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NAME ~~~ rQ c
PROPERTY ADDRESS
~-
SUBDIVISION ~ f'~ _
MECHANICAL
Permit#
Mechanical Contractor's Name: ' ~ 7 ~ Business Name: _ ~~
Address I' /~ State Zi
1 ~ W 5(L~i __ r
Contact Phone: (2pg) '3 5 9- 9'tJrQ ~ Business Phone: ( )
FIXTURES & APPLIANCES COUNT
Furnace
^ Furnace/Air Conditioner Combo .
^ Heat Pump
^ Air Conditioner
^ Evaporative Cooler
^ Unit Heater
^ Incinerator
^ Boiler
^ Pool Heater
^ Similar fixtures or
Appliances:
Exhaust or Vent Ducts
Dryer Vents
yIGy~Range Hood Vents
Cook Stove Vents
^ Space Heater
Decorative gas-fired appliance
Mechanical Estimate $ ~s~11~ (Commercial Only)
Heat (Circle all that apply) Gas Oil Coal 1~ irc•~?=~s:e Electric
Point of Delivery must be shown on plans.
~ ~ s5.~
Fixtures or Appliance outlets of the gas piping system
Bath Fan Vents
^ Other similar vents & ducts:
Please check all that Apply:
Signature of Contractor
1357
~ ~ZZ !~`
Date
License number
The City of Rexburg's permit fee schedule is the same as required by the State of Idaho
3