HomeMy WebLinkAboutAPPLICATIONS, CO, BP - 05-00169 -1129 Golden Willow Cir - New SFRZ
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`p~gEXBUg~,9 -- CITY o~ Certificate of Occupancy
°Y~ ~~~~ City of Rexburg
'- `U' Department of Community Development
Ameritai F'nrnily Community
19 E. Main St. / Rexburg, ID. 83440
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:
Special Conditions:
Occupancy:
05 00"169
International Residential Code 2003
1129 Golden Willow Cir
Single Family Residence
Type V-N, Unprotected
Residential
No
Highmark Inv.
1114 Golden Willow Circle
Re~urg, ID 83440
Highmark Investments
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
wes inspected on the date listed vies 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 wes
classified.
Date C.O. Issued: July 24, 2006 (02:51 P
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: p
State of Idaho Electrical Department
CITY OF REXB URG •
BUILDING PERMIT APPLICATION
19 E MAIN, REXBURG, ID. 83440
208-359-3020 X322
PARCEL NUMBER:
We will provide this for you)
SUBDIVISION: .,t.,9 I ~ ~ D(r~ ~j~pp ~ UNIT#~BLOCK# ~ LOT#
(Addressing is based on the information -must be accurate)
OWNER:
PROPERTY ADDRESS:
CONTACT PHONE # ~ l (~ ~- 6-? 5 `~-
PHONE #: Home (~) 35~-5-7 a a- Work (act ~ (o o~~ 5 ~- ell ( )
OWNER MAILING ADDRESS: f 11 ~ Go 1,JP;, v~~ Uo ~ c c rCITY: ~~ ~u STATE:~~ ZIP:C~ ~~~
EMAIL FAX
APPLICANT (If other than owner)
(Applicant if other than owner, a statement authorizing applicant to act as agent for owner must accompany this application.)
APPLICANT INFORMATION: ADDRESS
STATE;
ZIP EMAIL
PHONE #: Home
FAX ~~. 6 - ~ S aiti
CONTRACTOR:
CITY:
FAX_
Cell ( )_
1~,~- ~ 5 , ~' ~
MAILING ADDRESS: ~ ~~j {~I (/~5~"yyt,Zl~t~~ CITY C LJ STATE o~o~ ZIP~~3~~
PHONE: Home# Work# ~5~c 5so0 Cell#
EMAIL
How many buildings are located on this property? ('~
Did you recently purchase this property? No es (If yes give owner's name) `,'~„ [,-, ~~,~- k ~ 1~) ~,
Is this a lot split? ~ YES (Please
PROPOSED USE: ~i ~ ~ `
(i.e., Single Family Residence, Multi
Work
g copy of new legal description of property)
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 herea8er 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
permjf o~ppr~al was base~Permit void if not started within 180 days. Permit void if work stops for 180 days.
Signature of Owner/
a~ l 0 3 / a5
DATE
Do you prefer to ~ contacted by fax, email or phone? Circle One
PERMIT #
Please com lete th • tire A lication!
P PP
If the question does not apply fill in NA for non applicable
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.200S.
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**
~----~ • •
Please complete the entire Application!
~L If the question does not apply fill in NA for non applicable
NAME ~ I~ ~ wt,~i.~~~- ~V
PROPERTY DRESS )6~-- ~ `~ll~- 3 YJ~~ Permit#
SUBDIVISION (,~,> ~ (,~ d ~ ~ Yin ~.
Dwelling Units:
SETBACKS
FRONT SIDE
Parcel Acres:
SIDE
BACK
Remodeling Your Building/Home (need Estimate) $
SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building)
First Floor Area ~ S ~~ Unfinished Basement area ~~~~
Second floor/loft area ~ Finished basement area -C~
Third floor/loft area Garage area 511a
Shed or Barn Carport/Deck (30" above grade)Area
Water Meter Count:
Water Meter Size:
Required!!!
PLUMBING
Plumbing Contractor's Name:
Address
Contact Phone:
Email
FIXTURE COUNT (including roughed fixtures)
Clothes Washing Machine
?~ Dishwasher
~ ~ Floor Drain
=~~ Garbage Disposal
Hot Tub/Spa
~~ Sinks
(Lavatories, kitchens, bar, mop)
Plumbing Estimate $
Business Name:
City State
Business Phone: ( )
Fax
Sprinklers
~X/ Tub/Showers
~7` Toilet/L7rinal
~,~ Water Heater
Water Softener
(Commercial Only)
Signature of Licensed Contractor License number Date
The City of Rexburg's permit fee schedule is the same as required by the State of Idaho
Zip
ie~complete the entire Application! it tb~stion does not apply fill in NA for non
applicable
NAME
PROPERTY ADDRESS
SUBDIVISION
Requited!!!
Mechanical Contractor's Name:
Business Name:
Address City
Contact Phone: ( ) Business Phone:
Email Fax
Permit#
Mechanical Estimate $ (Commercial/Multi Family Only)
F RES & APPLIANCES COUNT (Single Family Dwelling Only)~~
_~ Furnace s
-~- Furnace/Air Conditioner Combo ~_ Dryer Vents ~~
Heat Pump ~K~Range Hood Vents
Air Conditioner Cook Stove Vents
Evaporative Cooler ~7 ~ Bath Fan Vents 7.~
Unit Heater other sirnilaz vents & ducts:
Space Heater
=~ Decorative gas-fired appliance ~'ilre w, (~ ~ ~
Incinerator System
Boiler
Pool Heater
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 it Coal ireplac Electric
Mechanical Sizing Calculations must be submitted with Plans & Application
Point of Delivery must be shown on plans.
Signature of Licensed Contractor
The City ofRexburg's
MECHANICAL
License number
schedule is the same as
State Zip
Date
the State ofldaho