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HomeMy WebLinkAboutBP, CO & APPLICATION - 05-00248 - Fireplace Shop - Tenant FinishZ .~ O ~ ~ ~ m ITI n W ~ c ~ rn v _ ,~ ^~ Z ~ z~ ~o D ' ° ' ~ C ~ ~ n ~ D c ° ~ s 3 ~ `D ~ "` 7 fD (D 'O ~ Z ' n 3 m m a ° 0 -1 ^ ' ~ ~ N- _~ _ . ~ v - - ~ O O' N m ITI O ~ m n O •~ c 3 ~ ~ (7 /~ v ~`Q'o n C 0 m ~ n ~ ~ v ~ Q m , °' o _ °~ o Z °' o o S A ~ Q~~ C -o s o m -~ `° ~ v r Q ~ ~ ~ ~ o ~ o o ~ ~ ~ C ~ ~ ~ ~ ~ r °~ ~ ~ D ~ ~ ° ~ -G o ~ o m W v a ~ - Z D ~ z ~ -~ mm~gZ D = ~~~~~ ~ m ~ ~ S C 4 m .°-' N °- 'c -i ~ C 7 N z n (O 7 ~ C O O O O' ~_ (~ ~~ N m ~ D r a N- ° ~ ~ 0 m a o ~ m v N ~ ~ o Z N -_ -o o ~ T r1 Y~ m v n a. 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Ut I A I W~ N ~ .~ i Z m m rn~ 3 ~ N A , 'Ti ~I~icni IT I ~_n~cn p I 3i~t!~~-niri ~ ~ Fo ~ T ~ ~ Q ~F+ ! m ~ ~ ! ~ i ~ c m i m I ~ ~ ~ - ~ I m I ° ~ °o o ; 3 ~ n m ~°~ T ~ `° ~ ~ ~ _~~ p~ im i ~ ;~ ~°' ~ , g v i~ ~ ~ _ 3 '~ m N ~ 3 O ! 2~ ~ i i ~ I Z m ~ r m i I W z~~ v ~ Z ~ i o I ~ (7 n ~ ' ' ~ O ETC ~ ~ ~ w~ j o o I ; !~ ~ W -rl = i I ! ' j I j r o v~ m o ~ ~ Z m - - _= Z ~ --~ m .'0 ~ ___ - - ' I Z ~ DD _ _ -__ ~ r { O 3 ~ rf - '~ ~N ~!lD ~ ~ !N g N - ~ lD ~ ~ Z O N ,° ~o o i , ' IQ ~ ~Q I ~ ~ , .Q I:~~6 • q CITY OF RExBUR~ AMERIC:A5 FAlv11LY COMMUNITY 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 00248 2 rev ~ 1 a~G..- ~~5 S ~,~bc~~~rz~r~-~G.. ~~t~ ~~~ i:l - 5ti ~...~ ~=~ I~ b Name and Address of Owner: t=~ ~~~1.a~~ ~~~ Contractor: Special Conditions: Occupancy: Futures Of Idaho 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 was inspected on the date listed wes found to be in compliance with the requirements ofthe code for the group and division of occupancy and the use for which the proposed occupancy wes classified. Date C.O. Issued: August 01, 2005 (03:23PM) 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 Department:, ~' ire De i State of Idaho Electrical Department i 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: ~P ~ ~} NR,~ ©O (~$D (We will provide this for you) SUBDIVISION: UNIT# BLOCK# LOT# (Addressing is based on the information -must be accurate) OWNER: CONTACT PHONE # -7 r, ~- X337 PROPERTY ADDRESS: ~~.~ ,~ ~ ~ ga/ f--} ev.~-~,s ~a~ k Plaza PHONE #: Home ( )_ _~~-~1 ..bi. Work ( ) Cell ( ) OWNER MAILINGADDRESS:43o f,J ~,~t~r~y ~,b CITY: ~ k ~T STATE:I~ ZIP: g3 ~~-( EMAIL FAX 7~ S - L ~~ 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 PHONE #: Home ( ) Work ( ) Cell ( ) CONTRACTOR: ~ ~,t. -T' U, Ie ~ a ~ l b !~ w~ MAILING ADDRESS: 4 ~o Lis µ tw fk y oZ ~p CITY T3 ~ PHONE: Home# EMAIL EMAIL CITY: FAX STATE ~ ~ ZIP $ 3 ZZ, Work# Cell# ~ ~ 9. -- b ~ ~ 7 FAX 7~ S- 124"3 How many buildings are located on this property? S ~ E S 4 T E h'~ Did you recently purchase this property? ~ Yes (If yes give owner's name) ,~ 1.1 Is this a lot split? ~ YES (Please bring copy of new legal description of property) PROPOSED USE: ~ o /~ M C IQ G ~ I~- ~-- --' ~ l ~ Ic ~' L Re ~ (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 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. ~ ~ 7 / Z.2/~ Signature of O er/Applicant DATE Do you pre e to be contacted by fax, emai ph ?Circle One WARNING -BUILDING PERMIT MUST BE POSTED ON CONSTRUCTION SITE! Plan fees are noa-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 3 Affidavit of Legal Interest State of Idaho County of Madison I, Address Name City State 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 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 are at time of application** **Building Permits are~d if you check does not clear** Please complete the ire Application! If the question does not apply fill in NA for non applicable NAME PROPERTY ADDRESS Permit# SUBDIVISION f -{ ~ ~} ~,y~s F'o ~2 k Liz ~4 Dwelling Units: Parcel Acres: SETBACKS S ~z/ S ~-c'~ >~'L~IJ FRONT SIDE SIDE BACK Remodeling Your Building/Home (need Estimate) $~ 080 ' SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building) First Floor Area ~ O ~ ~ ~ ~ Second floor/loft area Third floor/loft area Shed or Barn Unfinished Basement area Finished basement area_ Garage area 0" above grade)Area Water Meter Count: Water Meter Size: _- Requi~ed!!! PLUMBING Plumbing Contractor's Name: ~ ~ L~- S ~' L (,l M g t Nc~jBusiness Name: Address City 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 $ ~, ~ b15 (Commercial Only) Sprinklers Tub/Showers Toilet/Urinal Water Heater Water Softener Required! 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 Fax Zip, State 4 Please complete the ent~ Application! If the question dot apply fill in NA for non applicable NAME PROPERTY ADDRESS Permit# SUBDIVISION Required!!! MECHANICAL Mechanical Contractor's Name: ~ < <--(... S ~~-U.M~ R Gt~Business Name: Address City State Contact Phone: ( ) Email Business Phone: Fax Mechanical Estimate $_s~~~ (CommerciaUMulti 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 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 Dryer Vents Range Hood Vents Cook Stove Vents Bath Fan Vents other similar vents & ducts: Zip Mechanical Sizing Calculations must be submitted with Plans & Application Point of Delivery must be shown on plans. Signature of Licensed Contractor Required! License number The City of Rexburg's permit fee schedule is the same as Date the State of Idaho 5 • SUBCONTRACTOR LIST Excavation & Earthwork: ~ ~ ~ Fk T G ~ Concrete: ~0 I--I, L C~ Masonry: ~ Roofing: Insulation: ~- ~- ?~ Drywall: ~~ ~ ~ ~ Painting: ~ ~ ~ Tom" Floor Coverings: ~ 12- ~CZ O 12-7 Plumbing: H, (L L Heating: ~ ~ L L S Electrical: ~ ~- ~` ~ ~ ~ ~ ~ ~ 1 N Special Construction (Manufacturer or Supplier) Roof Trusses: Floor/Ceiling Joists:_ Siding/Exterior Trim: Other: o ~-I~1~ Q~ STb C~ ~~~~ 7