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HomeMy WebLinkAboutAPPLICATIONS, CO, BP - 05-00241 - Walmart Subway - Tenant FinishZ ~ o = -i ~ m m n W ~ c ~ rn ^.~ Z ~ Z ~ -I ~ D s o ~ n ~ D C ~ 0 o m .D ~- o - -C ~ ° m m ~ a m v ~ c Z ~ a ~ (p (D II N ' ° v ~ ~ ° -^_ ~N m m o ~ ~ n 0 = 3 ~ -o f7 /~ m m t° o C m ~ ° ~ N ~ m O ~ ~ a o = ° ` O _ - ~ O Z ~? o o ~ - ,'D n ~ ~ ~ _ ~ C ~ ~ m -o s o fA m ~ ° I- ~ ~ ~ co ~ ~ o s ~ v 3 ~ .~ ^ r °'~ ~ ~ D ,~ n ~ ~ -I ° o ~ o m 3 W o ~ ~ ~ a ~ Z D ~ z o -~ ~ ~ ~ g z D = ~~~~~ ~ m 3 ~ S ~ O m °-' w a ~ 1 ~ Z n ~ T 7'1 0 0 ~ ~ ~ N m - o- n r o ~ a ~ N o m D -'~ v ~ ~ ~ Qo m mss= ~~ ~ o _ Z ~ ~ _~ o ~ ~, ~ m d n 0 O ~ m ~ ~ n ~ o~o F g m o o _ a n 7 m .A. 0 v _ v r. N ~ N 0 o~ ~~ ~ m z ~s ~ ~ ~ z ~ ~ W ~; ~ ~ -~ m , ~ Q M ~ -. ~ 2 m cn ~~x~. 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D 'b J - ~ - -- _ m ~ ~ ~ i D ~ m !m i< ~~ CITY OF RExBUR~ AMERICA5 FAMILY CO1vLMUNITY 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 00241 International Building Code 2003 530 N 2nd E Business Type II, 1 Hour, non-combustible Walmart Subway No Silvertree Builders Inc Business, professional or service, restaurants less than 50 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 v-es found to be in compliance v-ith the requirements ofthe code for the group and division of occupancy and the use for ttihich the proposed occupancy vies classified. Date C.O. Issued: October 28, 5 11:40 M) C.O Issued by: _____ _ - __Building_O_ff_icial _____ 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 Departmen • Fire State of Idaho Electrical Department (208-356-4830): ~' 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 CITY OF REXB URG , PERMIT # BUILDING PERMIT APPLICATION Please complete the entire Application! 19 E MAIN, REXBURG, ID. 83440 If the question does not apply fill in NA for non applicable 208-359-3020 X322 PARCEL NUMBER: (We will provide this for you) SUBDIVISION: UNIT# BLOCK# LOT# (Addressing is based on the information -must be accurate) see ~a ~ Ca-^tiPge OWNER: ( WaI wear-F- ~ 5 ~.,gway CONTACT PHONE # 3~~-- ya 17 PROPERTY ADDRESS: c~D N ~~ PHONE #: Home Work OWNER MAILING ADDRESS: EMAIL FAX Cell CITY: u,r STATE:Sd ZIP: g3`~`lU APPLICANT: (If other than owner) S' 1 V eJ ~T ~ e I~u`~ lde /S ~l v~~ 'I 'r'~ 7 5~' (Applicant if other than owner, a statement authorizing applicant to act as agent for owner must accompany this application.) APPLICANT INFORMATION: ADDRESS /(75'.~ c.~ ! yam- IV CITY: j2e~C,~i yc~o~ STATE; ~~- ZIP ~3YYa EMAIL ~S~C~ ~~c!a . 1•t•~~FAX \1 PHONE #: Home (zg~ ~`'6 - 53 3q Work ( ) X35 ~ -a yaa Cell ( ) ~ 9D -5 3 3 ~ CONTRACTOR: 5.) ~''`~ree g ~1vI evs ~~ ~ . MAILING ADDRESS: 005 W iy?~'- ~ CITY ~ 511 rt,v~ STATE ~ ZIP PHONE: Home# ~~~ 533 Work# ~,;6 ~~Y~oCell# 39'0-5',37 EMAIL S4~ee ~ Tc~~ . ,~. FAX (o5b - D ypa How many buildings are located on this property? Did you recently purchase this property`?~O 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: (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 sweaz that any information which may hereafter be given by me in heazings before the Planning and Zoning Commission or the City Council for the City of Rexburg shall be tmthful 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. i of L~ ~s i~ 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 1.2005. City of Regburg's Acceptance of the plan review fee does not constitute plan approval 3 d~~"~`"~d CI~ R~BLIR~ ~~.~~ AMERICA'S FAMILY CQMMUM`(Y Affidavit of Legal Interest State of Idaho County of Madison I, Name Address City State Being first duly sworn upon oath, depose and say: A. (If Applicant is also Owner of Record, skip to B) 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 herin or as to the ownership of the property which is the subject of the application. Dated this day of , 20 Signature Subscribed and sworn to before me the day and year first above written. Notary Public of Idaho Residing at: My commission expires: 2 **Building Permit Fees a ue at time of application** **Building Permits o~d if you check does not clear** Please complete the~tire Application! If the question does not apply fill in NA for non applicable NAME PROPERTY ADDRESS SUBDIVISION Dwelling Units: SETBACKS FRONT Parcel Acres: SIDE SIDE BACK Permit# Remodeling Your Building/Home (need Estimate) $ `'a5, 6l~ 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 Unfinished Basement area Finished basement area Garage area Carport/Deck (30" above grade)Area Water Meter Count: Water Meter Size: Required!!! PLUMBING ~,;.~ ~ y,,~ Plumbing Contractor s Name: ~ Ko~,/Q-l !~ ~ yQ-~ f~ ~~ Business Name: Address City State Contact Phone: ( ) Business 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 $ ~, 6~ (Commercial Only) Required! Signature of Licensed Contractor License number The City of Rexburg's permit fee schedule is the same as Zip, Date the State of Idaho Fax Sprinklers Tub/Showers Toilet/Urinal Water Heater Water Softener 4 Please complete the ere Application! If the question d~not apply fill in NA for non applicable NAME PROPERTY ADDRESS Permit# SUBDIVISION Required!!! MECHANICAL Mechanical Contractor's Name: 1 V ~ Business Name: Address City State Contact Phone: ( ) Business Phone: ( ) Email Fax Mechanical Estimate $ FIXTURES & APPLL4NCES COUNT (Single Furnace 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 Fuel Gas Pipe Outlets including stubbed in or Inlet Pressure (Meter Supply) PSI Heat (Circle all that apply) Gas Oil Coal Zip Family Only) Dwelling Only) Exhaust or Vent Ducts Dryer Vents Range Hood Vents Cook Stove Vents Bath Fan Vents other similar vents & ducts: outlets Electric Mechanical Sizing Calculations m st be submitted with Plans & Application Point of Delive must be shown on plans. Signature of Licensed Contractor Lic~ise number Date Required! The City of Rexburg's permit fee schedule is the same as required by the State of Idaho 5 • ~~'°`~ CITY OF REXBLIR~ R'~iq~~~ AMERICA'S FAMILY C(3MNlUt~tl'(Y APPROVED BY: APPLICATION: "CONSTRUCTION PERMIT" CONSTRUCTION PERMIT #:_ PERMIT APPROVED: YES/ NO -APPLICANT INFORMATION: BUSINESS NAME: OFFICE ADDRESS: $50.00 FEE PAID: YES/NO city OFFICE PHONE NUMBER: CONTACT PERSON: State CELL PHONE # -LOCATION OF WORK TO BE DONE: STREET ADDRESS WHERE WORK WILL BE DONE: BUSINESS NAME WHERE WORK WILL BE DONE: _ DATES FOR WORK TO BE DONE: CONTACT PERSON: PHONE NUMBER: ( ) CELL # PLEASE CHECK THE TYPE OF PERMIT(S) YOU ARE APPLYING FOR: ^ AUTOMATIC FIRE-EXTINGUISHING SYSTEMS ^ COMPRESSED GASES ^ FIRE ALARM AND DETECTION SYSTEMS AND RELATED EQUIPMENT ^ FIRE PUMPS AND RELATED EQUIPMENT ^ FLAMMABLE AND COMMBUSTIBLE LIQUIDS ^ HAZARDOUS MATERIALS ^ INDUSTRIAL OVENS ^ LP-GAS ^ PRIVATE FIRE HYDRANTS ^ SPRAYING OR DIPPING ^ STANDPIPE SYSTEMS ^ TEMPORARY MEMBRANE STRUCTURES, TENTS, AND CANOPIES APPLICANTS SIGNATURE DATE Zip TO 6 ~ ~ SUBCONTRACTOR LIST Excavation & Earthwork: Concrete: Masonry: Roofing: Insulation: Drywall: Painting: Floor Coverings: Plumbing: Heating: Electrical: Special Construction (Manufacturer or Supplier) Roof Trusses: Floor/Ceiling Joists: Siding/Exterior Trim: Other: 7