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~#~ CITY OF
REXBLIRG
+ AMERICAS FAMILY COMMUIvfTY
Building Permit No:
Applicable Edition of Code:
Site Address:
Use and Occupancy:
Type of Construction:
Design Occupant Load:
Sprinkler System Required:
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
05 00203
66 E Main St
Name and Address of Owner:
Contractor:
Special Conditions:
Occupancy:
Advanced Plumbing
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 u~ith the requirements of the code
for the group and division of occupancy and the use for ttihich the proposed occupancy vies
classified.
Date C.O. Issued: November 17 05 1: M)
C.O Issued by:
Building Official
There shall be no further change in the ebsting 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 Departmen • Fire Departure
State of Idaho Electrical Department (208-356-4830):
Apex Alarm Llc
124 E Main St
Rexburg, ID 83440
CIT~'~' OF REXB URG PERMIT #
BTJILDING PERMIT APPLICA
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: ~ ~ ~ ~ X ~ ~ D 3FSOQ~f~
SUBDIVISION: ~V IJNIT# BLOCK# LOT#
OWNER: ~tp~*/yl ~,~, CONTACT PHONE # I-So~- ,~~ ~g]
PROPERTY ADDRESS: ~~~ ~ //'R~f- ~~ . ~{~C D ~/~- ,~ 1~ ~~GGG
PHONE #: Home (~) 33q-J98'3~ Work ( ) /~~ Cell ~) 334 ~5(.2~
OWNER MAILING ADDRESS: 73 ~,~ 1s~J- ~/~J.CITY: ~ ~ STATE:T~ ZIP:~G
.~----- n
APPLICANT (If other than owner) rq~,ti! ~ ~ 1 ~5~3,~~
(If applicant if other than owner, a statement authorizing applicant to act as agent for owner must accompany this application.)
MAILING ADDRESS OF APPLICANT
,$,~,.,~ ~y). ~/~~ CITY: STATE; ~~ ZIP $3 `/~D
PHONE #: Home ( ) .Sc.~.. ~S ,lw(c.,. )
CONTRACTOR:~~ygp,~ PHONE: Home#~39-1~83`Work# Cell# BSc.-•.,.._
MAILING ADDRESS: ~SG~.~.. ss s ~-~ CITY STATE ZIP
How many houses are located on this property?
Did you recently purchase this property? No Yes (If yes give owner's name)
Is this a lot split? NO YES (Please bring copy of new legal description of property)
PROPOSED USE: Rg.~,a(~ C~~C l~o~a- CIO~,S~
(i.e., Single Family Residence, 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
stud within 180 days. Permit void if work stops for 180 days.
Applicant
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 Regburg'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**
2
' ' **Building Permit Fees are due at time of application** **Building Permits are void if you check does not clear**
Please complete tl~entire Application!
If the question does not apply fill in NA for non applicable
NAME
PROPERTY ADDRESS Permit#
SUBDIVISION
Dwelling Units:
SETBACKS
FRONT SIDE
SIDE
Remodeling Your Building/Home (need Estimate) $
SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building)
First Floor Area
Second floor/loft area_
Third floor/loft area_
Shed or Barn
BACK
(30" above grade)Area
Water Meter Count:
Water Meter Size:
Required!!!
PLUMBING
Plumbing Contractor's Name: ~~ j~ JD ~d. ~Gc ~_Business Name: ~-r~. (ira +-~.Cc~ /~iti~i ~- J
Address /~ ~~ J~ ~p ~;/ ~~~ City e v State Zip ~-gY`i~
Contact Phone: ( ) Business Phone: ( ) ~~ S6 - 0,3~~
Email
FIXTURE COUNT (including roughed fixtures)
Clothes Washing Machine
Dishwasher
Floor Drain
Garbage Disposal
Hot Tub/Spa
Sinks
(Lavatories, kitchens, bar, mop)
Sprinklers
Tub/Showers
Toilet/LJrinal
Water Heater
Water Softener
Plumbing Estimate $ ~ (Commercial Only)
Re it d. ignature of Licensed Contractor License number Date
The City of Rexburg's permit fee schedule is the same as required by the State of Idaho
Parcel Acres:
Unfinished Basement area
Finished basement area_
Garage area
Fax
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CITY OF
e r '___ ~ .... '.~ .. -~... .._ ~. - - Y~~~..n ....
AMER.{CA'S FAMILY COMMUNt'tY 19 E. Main (PO Box 280)
Rexburg, Idaho 83440
www.rexburp.org
Phone: 208-359-3020 x2
Fax:208-359-3024
comdev .rexburg.org
Application for Demolition
Permit #:
Applicant Information I $10.00 Fee Paid: Yes/No Permit Approved: Yes/No
Name: ~Glt,~ ~ ~~ ~S~vo,~~-h
Applicant's Address: 75 Sov~h ~.s+ Wes- City1ST/Zip: ~eXb~ ~i) S3Y~~
Telephone: ~~g) 3~'1-/9Fss Mobile: ~~ 3~5 -O~/~.2
Contact Information
Person or Company doing the demolition: LG~,, ,, doss Co~~,s~2G-~-,~+
Address: ~, d ~,~ ~~ City/ST/Zip: ~~ C,'~- y ~D ~~O
Telephone: ~~~~ ~3'`- 57,3"g Mobile: (~~ 7Q 4 - 03,3'
Demolition Information
Property Owners: ~Dex ~ ~~~+~ LLC. ~ ~(: ~~ /f/,e1eS~
Property Address: ~~' I1~la,'~- S~- ~vr~. ~D ~~yc!Q'
Summary of what is being demolished: `ice ~n cl G'd ~,'~$n C~ o~ O~
~%L~ IAA ~f~2 ~u: ~ ~,nw . ~- / Gas f is ~ ~joo~.
Signature of Applicant:
~~ ~
a
~~~~~
cmr Q~
RE:~BLIR~
AMERICA'S FAMILY CQMMUtVtTY
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19 E. Main (PO Box 280) Phone: 208-359-3020 x2
Rexburg, Idaho 83440 Fax: 208-359-3024
www.rexburg.orq comdevna.rexburo.orq
Application for Demolition
Permit #:
Applicant Information $10.00 Fee Paid: Yes/No Permit Approved: Yes/No
Name: PAGt ~ ~1~~~
Applicant's Address: rf,'S .S ~' ~ City/ST/Zip: ~~~, -~ D ~3~kl~
Telephone ~ $,~ ~.3" Mobile:C~ 3;39-0'Y.?~-
Contact Information
Person or Company doing the demolition: ~/~j/ ~aSS CO/s~/~c~'Fr'o~'1
Address: _~,0 ~ .''~~ City/ST/Zip: ~~ ~,~'~. ~/ $~/~~
Telephone: ~ 3.~('~j$Ki Mobile: , ~ -
Demolition Information , /
Property Owners: A,~C,~~~, ~~~rGf7j G~l~n ,~
Property Address: ~33q y~ Sew ~ `a. 1 ~
Summary of what is being demolished: ~P,/rpli~il4 ~Ot~~ ane~ dY~ tl~%kit.
Signature of Applicant: `Gr~ /l
Rug 04 05 02:26p
Please complete the e~e Applicationl If tt~e question Goes apply fit! in NA for nan
applicable
NANIE __ __ _
PROPERT r DRESS t<,~, ~ nlu,., -TV_ Perntit#
SUBDIVISIOIv~
p.l
required!!!
M.~CHA~VI~~l~
itleck-anical Contractor's dame: Bry-~`~ ~~ ~~ti~ Business Name:~yl~~.,1- ns __
Address ~~~ i~. ~ ~~ ~ w ____Clty ~ ,„State .l ~ Zip R3 Y.Z
Contact Phone: (,~~,_ 5;~_. ~. _~~L__ $usiness Phone: ~x ),~~_,~5 72~
Emai1_~f~ni1}~{~~ '!~!._L'U l,~.F..N~Fax O~ ~_,~_~_a`~1l ----~~
ivlechanical Estimate ~ w ~ F ~ : '-'° (Commercial/I47ul~ti Family Oaly}
FIXTURES & APPLIAI'VCES COU~WT (Single Family Dwelling Only)
Air Conditioner _ Space Heater
Bash Fan Vents Unit Heater
Range Hood Vents
Boiler
Cook Stove Vents
_v____ Decarative Gas Fireplaces
_ _ _ ~ Dryer Vents
__ Evaporative Cooler
Exhaust or vent ducts
~___ Fuel (gas} piping fixtures or appliance outlets
Furnace
FumacelAir Conditioner CoI*~bo
Heat Pump
Incinerator
Pool Heater
Heat {Circle all chat apply) Ga Oil Gaal Fireplace Electric
Mechanical Suing Calculations anust be submitted with Plans & Application
Point of Delivery must be shown on plans.
~ignzture of Licensed Contractor Licettse ttumber ~t llate
RCCluireCl ~
Tha City of •Rexbzrr~'s permit fea.. schedule is the same as req+.~ired by the State of Idaho
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