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HomeMy WebLinkAboutAPPLICATIONS, CO - 05-00327 - 351 Talon Dr - New SFR04 g,EXBURG lQ F 9~ L O ., ~~` :~ CITY o ~ Certificate of Occupancy REXBURG - ~ Amerita's Fnmily Community City of Rexburg Department of Community Development 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: 05 00327 International Building Code /IRC 2003 351 Talon Dr Residential Type V-N, Unprotected Single Family Residence No Name and Address of Owner: Jackson Dick L Etux 1101 Ingleside Ave Mclain, VA 22101 Contractor: ~ K K Construction Special Conditions: ~rbn~- w~.lk b~i~~ dare by ~~~'~~*- ~., na cif coa(G ~-~-~~c.".-~.n~c.~ ~ ~f~~. Occupancy: Residential, single family dwellings, lodging houses 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 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: May 10, 2006 (09:41AM) C.O Issued b G~`~~ Y 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 De artment: ` ire D t: ~~ p State of Idaho Electrical Department (208-356-48301: _.- CITY OF REXB URG BUILDING PERMIT APPLICATION 19 E MAIN, REXBURG, ID. 83440 208-359-3020 X322 PARCEL NUMBER: PERMIT # • Please complete the entire Application! If the question does not apply fill in NA for non applicable ~~~ ~ G LiI~J"~ (dC/ ~~ (We will provide this for you} SUBDIVISION: ~AC7L~t~iix~z~ ,~ ; ,n©,~ f UNIT# BLOCK#~_LOT#~ (Addressing is based on the information -must be accurate) ~itr - CONTACT PHONE # ~ (7,3 ' .3 $~ - 3 Li' 7~ PROPERTY ADDRESS,• .~ 5 ~ T~k [.~: ~ ~ PHONE #: Home (~~,~ ~~t ~ y~~ Work ( ) .Cell (~~~~ ~ ~ ~ 3 y °I ~* OWNER tMA~ILING ADDRESS: I~,I ~~~~~i~~ ~l~'~ CITY:_ ~t(~,~~ STATE:~ZIP: 2~1~ EMAIL~~ ~ ra • ~~ ~ ~~,rn~L u~~4X ~~'l..ea v~ APPLICANT (If other than owner) ~[R_K i~~k~I[~ ~ ~K CE`~1St~C-~Tic~A J 'K~~! 'bA~tl ~~ (Applicant if other than owner, a statement authorizing applicant o act as agent for owner must accompany this application.) APPLICANT INFORMATION: ADDRESS i35 E i.btFtci~.l S7- CITY: R[Ci~Y STATE; - D~ l-Ec, ZIP ' 4 Z EMAIL i<. t [Zk.~',KK Ccr~I ~T:ccx~~X ~~5:~ Imo{ c; PHONE #: Home ( } Work (~c~~'~) ~~~5.5"f5~ Cell f~C Z~ ~ ~ CONTRACTOR: MAILING ADDRESS: i ~3~ E yVll~ i~a I -'~n ~C, ><z~CITY ~..((-~ e~~STATE (~ZIP~ PHONE: Home# Work# ~~}5`-Si5SCe11# ~/. ~G%`~S r~$1-,~o~tb EMAIL ~,~ , kIt cc~r~tSi~ Ccx~(FAX 'fi~#5. ar ~o How many buildings are located on this property? Did you recently purchase this property? No Yes (If yes give owner's nam Is this a lot split`~~ YES (Please bring copy of new legal description o~y) 1 2005 PROPOSED USE: ~l<~ (i.e., Single Family Residence, Multi Family, Apartments, Remodel, Garage, Commercial, iition, 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 here88er 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 of Owner/Applicant DATE Do you prefer to be contacted by fax, emai phone? Ciilcle One WARNING - BUILDING P IT MU~~E POSTED ON CONSTRUCTION SITE! Plan fees are non-refundable and are pay ~n 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** • Please complete the entire Application! If the question does not apply fill in NA for non applicable NAME ~lck ~~ck~~l ~ KEG. Lal(S'tR.UC't'l D~l.~ PROPERTY ADDRESS ~t / ~-/}~,~ ~_ Permit# SUBDIVISION E~kG.t.EWOOD ~4-bDr77dK./ Dwelling Units: ~ Parcel Acres: ~ 5~ }}Pni¢cyc' SETBACKS ~ FRONT ~ SIDE /O ~ SIDE /a ~ BACK /S Remodeling Your Building/Home (need Estimate) $ /~-oa, r,~, SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building) First Floor Area ~~~ Unfinished Basement area /~ Second floor/loft area ,/ Finished basement area $"O( Third floor/loft area .~ Garage area ~ZG Shed or Barn f Carport/Deck (30" above grade)Area / Water Meter Count: Water Meter Size: Required!!! PLUMBING Plumbin Contractor's Name; ``,., r~~~ ~ ~ /` ~ ft, ~' g i~~~'' ~,~; / Business Name: ~ ~ a /~'~ '`~ Address ~~ ~~~ ~/Z9~' City,~j,~~~ {~~~ State ~~ Zip ~.~ a Contact Phone: ( ) .3l ~ (n~t~Q Business Phone: ( ) J` ~ ~' t~7~3 Email ~l*,,-~ _~~ 'T~r.. , ,~/~ ~' Fax FIXTURE COUNT (including roughed fixtures) Clothes Washing Machine Dishwasher Floor Drain Garbage Disposal Hot Tub/Spa Sinks (Lavatories, kitchens, bar, mop) ~ 2~7 ° ~ vS/S'` Sprinklers Tub/Showers Toilet/L7rinal .~~ Water Heater Water Softener Plumbing Estimate $ (Commercial Only) ~~~ ~~ Signa re of Lic sed Con or License number Date The Ciry of Rexburg s permit fee schedule is the same as required by the State of Idaho Sep O1 05 12:42p Dick Jeckaon FRDM KpZ'Y KAB 1 N CONSTRUCT l O~C. f'1i0F3E NO. 75407 703 356 347© p.l ~ep. 01 2005 [~2:21A;w1 P2 _ 4: !'1'Y t3F _ M1t;RK,s15 iM6lLY C~ZMMUk17Y 19 E. AAetirt {YQ 8oa 280} i'hsma: 2Q$-353020 x326 Rrxbeug, laphv 83aa0 fax 206.9bt#-3024 ww~d_r~hura.orn cemdav~rexbura.or9 A-ffildavit of ~ega1 lnt~lrest Stata of Naha County of Madison ~ 5 ~ Its , i~Iil~li r ! / ~ F---- ~. ~ ~ a City Add/rea/~ ~/~""""~ State Beix-g first duly swam upon oath, depose ana say: (If Applicant is also Uwaer a! Rerord, skip to Bd A. 17saC I am the record avner of the prx~perty described on rls~c axtached, and I grant my pertmissiartto: kK `L~.~iK~~?Y~~,~.. ~.~,~.. C ~~ ~;", F~lC3 ~ I1~'~~`!~' Narso Address to submit tha aaccrospanyins application pextairsing to that property. 8. Y agree to ir-dcsnlnsfy, dafend arsd hold Rexburg Ciry and its employees Isarm[ess from any elaim or liability resulting frasar aay dispute as to the statements contained herein ar as to Ilse ownership of the pxopetty which is Ilse subjecc of the ~plicaRaan. / ,/~ I~ted chic ,1 ~ t~~+af. l f C~~'Z-~~%:'~'" ~, 20G°_r~ f~ ~....~ Sigtrasure - -- ~ubscrebed And sworn to before me the day and year i;4rsi above wrirtett. No4ury Public nt ldahn Rcsidir~ at: My comtrsissinn expires: Please comp 0 applicable 5 00327 PROPERTY AD: 3 51 1 L~,1 Q .n D r SUBDIVISION Required!!! MECHANICAL Mechanical Contractor's Name: ~ ~d~( Business Name: td Address ~ 5~~'r ~. y~ d /t/, City ~ Sta Zip~S Contact Phone: (~) ~ I ~-6 2 ~' ~ Business Phone: (~) ~~ ~/°~`~6'J~ Email Fax ~~ ~"~ ~~~ Mechanical Estimate $ (CommercialfMulti Family Only) FIXTURES & APPLIANCES COUNT (Single Family Dwelling Only) ~-1S-Y~ ~ Furnace ~ ~S ~ ~ 5 ~_ Exhaus or Vent Ducts l~ Furnace/Air Conditioner Combo ~ Dryer Vents 65 Heat Pump ~_ Air Conditioner -S 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 X51 3 Inlet Pressure (Meter Supply) PSI Heat (Circle all that apply) Gas Oil Coal Fireplace Electric Range Hood Vents Cook Stove Vents Bath Fan Vents ZD toes not apply fill in NA for non SEP G 2005 other similar vents & ducts: Mechanical Sizing Calculations must be submitted with Plans & Application Point of Delivery must be shown on plans. ~~~ Signature of License Contractor _ /~~ License number - 6 - o~ Date The City of Rexburg's permit_fee schedule is the same as required by the State ofldaho Affidavit ~rf Lega! fnterest Mate o[ ~annty of lk[tard#sen y~`~~'~ .~ ~- ~ ~~ , City ---- Addresa ~ yL~ ~"'`' ~ ~' t State Being first duly sworn upon oath, depose a~ say: (Y[Applit:ant fls also (Jvra~er t-f Rerord, skip to )g) A. That I am the record owner of the properly dcscribeci on the attached. and I grant my permission to:.~..~ C~w1~rt~~GTtEti~ _.._. ~' ~ ~,~(~i'. i~1L~h3 Y I d '~3 ~{'f Namc Addrrtss ifl saxbtnit the aaxompanying application pertaining to that property. B. l agree to indattanify, defend arui hold Rcabwrg pity and itv employees haxxntess from any ctait» or liability resetting from any dispute as to the: statements contained herein or as w the owncx°ship of the property which is the xubject of the plioation. i Datt:d this _ ,.,.,,./ _ clay of ~ rr"',p , 2t}l7~__~ /,-~ -~ f/.~. ~~ ~..~-,.;tea-~-- Si~nature SuRtacribs'd s-nd sr+rcrn to before me the day and year first above ~rrritteti. ~~lr ~ Notary tlo of~trFro ,1.~~.r.-~-~~-~ _.._.. Residing at:1~l ~~~,.~-~.*-.-> ~~!~ -~°~ ~r'~-1-~~-~-• C~~ 1VIy cepmmisaion expires: ~J~d~~~r~S - ;,- SUBCONTRACTOR LIST Excavation & Earthwork: ~C F.xc~y~r~e~/ Concrete:~C, ~~~~~' Masonry: J~ w~ ~ASSE~ Roofing:~~_ Insulation: .p~~(,t~a((~'D - !S ( . Drywall: ~(~D~r~FS DR~/IAJ~~C Painting: i,J E~ _ si"v~ C'C~7a ~ p~ rM'/N' ~ Floor Coverings: ~711.~~5~ f S ~`D o R--/~u Plumbing:_,(~~,~"~(~7-- j~LUwtj3~~t!'G Heating: ~•'t ~ 35~~ h u~~r- .J • ; i>b '~, ~ ~ ~ - sL ~ ~ ~ Electrical: ~n~y(Z. fr?~GT72./G. Special Construction (Manufacturer or Supplier) Roof Trusses: ~jyyl~ Floor/Ceiling Joists: ~~! Siding/Exterior Trim:~,~~lE" Other: ~