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HomeMy WebLinkAboutCO & APPLICATION - 05-00335 - 790 Poplar Cir - New SFR~ ¢EX B Uk~, O IQ :~ 7y > ° ~`` sF ~rTY of Certificate of Occupancy 1 W~ V 1 \V Americus Fnmily Comnn4nity City of Rexburg Department of Community Development 19 E. Main St. / Rexburg, ID. 83440 Phone (208) 359-3020 /Fax (208) 359-3022 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 00335 International Residential Code 2003 790 Poplar Cir Single Family Residence Type V-N, Unprotected Residential No Wacker, Mary & Leslie 836 Engleman St Rexburg, ID 83440 Owner 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 vies 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 vies classified. Date C.O. Issued: July 05, 2006 (02' PM) 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 buildir~g~:or any portion thereof until the Building Official has reviewed and approved said future changes. Water Department• ~ ire De State of Idaho Electrical Department-(208-356-4830):-~ • CIT ~' 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: (~ ~ b~^cc~K ~ ~ , UNIT# BLOCK#~_LOT#~_ (Addressing is based on the information -must be accurate) CONTACT PHONE # PROPERTY ADDRESS: PHONE #: Home ( ~ ~'(~, - ~~ ~ ~~ Work ( ) OWNER MAILING ADDRESS: ~,~~, ,~~ J,~ ry~q k~ ~~CITY: EMAIL ~®.. FAX .~ ~~ ~ ~ ~'' Celli ~~9-~~~~ ,Cj v~ STATE: ~~ ZIP:~~(~ 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 CITY: PHONE #: Home ( ) Work ( ) EMAIL Cell .emu. FAX CONTRACTOR: MAILING ADDRESS: ~~~ ~~~ ~.~ ry~ q ~ S'f, CITY ,~~~c~jr;~STATE-~/J ZIP ~yyr~ PHONE: Home# - ~iVork# Cell#~~~9-y~~ 7 EMAIL FAX ~ 5 6' y~ ~j ..7 How many buildings are located on this property? Did you recently purchase this property? No ~If yes give owner's name;(~~~d ~ /a ~ /tea ~ ~5 ~ccf`r Is this a lot split?~l~ YES (Please bring copy of new legal description of property) PROPOSED USE: ~- ~~~~ lr (i.e., Single Family Residence, lti Family, 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 started within 180 days. Permit void if work stops for 180 days. S gnature weer/App icant DATE Do you prefer to be contacted by fax, email phon 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 Rezburg'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** rv c»~~ v 3-v~~ cQ to °~ x x w ~ ~..c =' Z ~c~vv~o~ - Q' o ~ m m ~ ~ .. .. .. .. ,~ ~ OO b9 O N ffl -~ N W W r C) v Z1 N D 0 N N O W 0 0 0 0 0 CO ~~ 'n ~ 0 W 0 W O A D 000 +n C O Z1 .~ ZOO on No JornZ J~ =7C ~O~o Cow Zoo m~ ~OnmN Z~ ~~~~o C w fA = w moo ~c O~ p< m ~o -_ ^' D O W ~ v o = ~ o_ r Z O n w N N N ~ ~ w c~ O A r"r ~ ~ N -__...._.__ _ .~___ N .~._`- -----_, Cii c0 m O 41 't,..,... ~...,..~.,s~,~.~m-....m..., ', Q 7[ 7T [~ V ~ ~ ~ ~ a m m C3 tlB~~f B'O Affidavit of Legal Interest State of Idaho County of Madison JJ,, ~^ I, ~~/tl~~l~ ~ C~ly~~rYlanl ~~, Name Address ~~' YJU i^a ~- ~. 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 herein or as to the ownership of the property which is the subject of the application. Dated this „~ ~ day of vG v ~~ f ` , 20 ~_ Subscribed and sworn to before me the day and year first above written. ~f~ Q® ~~: ~ /r//~' Notary blic of Idaho '~® ~ `~ ~ Residing at: %,risS~~ ~.~ ~ ~~ My commission expires: 1 , 'Please complete the e~ire Application! t question does not apply fill in NA for non applicable NAME PROPERTY ADD SS ' ' ~ ,, ~~ Permit# SUBDIVISION _(',~~ ~~ br~~°~ ~~,k~a=t ,~j ~ Dwelling Units: ~ Parcel Acres: SETBACKS FRONT ,~ S ~ SIDE 1.3~ SIDE / ABACK / ~ Remodeling Your Building/Home (need Estimate) $ ~~~p~ f~C:~ 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 /q- Third floor/loft area ~ Garage area '~ Shed or Barn /~/~ Carport/Deck (30" above grade)Area Water Meter Count: Water Meter Size: ~~ ~ Required!!! PLUMBING Plumbing Contractor's Name: ~ y/~ (Tq ~~ ~ ~ h Business Name: ~l Ue ~ ~1 ~ 9~ ~'/G h') ~1 a Address ~,~ ~ D C~ City ~ ~~ State ,~ Zip ~.3~51 Contact Phone: f~p$~ !~~' ~'" ^ G~/~ ~ Business Phone: (a p~ 1~~' ~ -- .Gf/o? ~ Email FIXTURE COUNT (including roughed fixtures) Clothes Washing Machine _~ Dishwasher Floor Drain _~ Garbage Disposal Hot Tub/Spa Sinks (L vatories, kitchens, bar, mop) Plumbing Estimate $, (Commercial Only) ~_ Sprinklers ? Tub/Showers ~_ Toilet/CJrinal Water Heater _~ Water Softener ~'D ~y~h ~ ~ 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 Fax ~D g_ ~5 ~S" ~©3 9 'P1e~'se complete the entiaApplication! If the question doe apply fill in NA for non 1 apphcab e NAME ~ "`f r^ PROPERTY ADD S S ' % C ' r ~ o~,~ Permit# SUBDIVISIONS b ~ ~/oc ~ ~" 9 Required!!! MECHANICAL Mechanical Contractor's Name: ,~l ~~ /tiJ,~ ~ y~~i Business Name: ~~~ ~ ~~~ ~~ ~~~` Address ~~ ~ ~ ~l~;C/ ~~ City ~~~ ~t~ State ~ s~ Zip ~YyD Contact Phone: (~ ~~ / ~ ~ ~ Business Phone: (~ ~S~ os7m/ Email~~.,~~ ~~ t ~'~ • ~~ Fax Z~ ~ ~ ~~ ~~~s- Mechanical Estimate $ (Commercial/Multi Family Only) FIXTURES & APPLL4NCES COUNT (Single Family Dwelling Only) Air Conditioner Space Heater .~ Bath Fan Vents Range Hood Vents Boiler Cook Stove Vents Decorative Gas Fireplaces Dryer Vents Evaporative Cooler Exhaust or vent ducts Fuel (gas) piping fixtures or appliance outlets ~ Furnace Furnace/Air Conditioner Combo Heat Pump Incinerator Pool Heater Heat (Circle all that apply) ~ Oil Coal Fireplace Electric Unit Heater Mechanical Sizing Calculations must be submitted with Plans & Application Point of Delivery must be shown on plans. '"' Signature of Licensed Contractor License number Required! Date The City of Rexburg's permit fee schedule is the same as required by the State of Idaho 4 V • • ^ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ 1 SUBCONTRACTOR LIST Excavation & Earthwork: /~'/a t' 7~, Ci/a 11'C ~'I' Concrete: -~rl Gt ,rrk. !' e ~-c Masonry: L~l`nJ~~',~~an! ~' ~sa~/`V Roofing:~~Q rf ~` Insulation: /~~i,t~ Q Drywall: Painting: Floor Coverings: Plumbing: Heating: ~~r ~ ~f~j ,~. ~r~ '~i^~ ~ Electrical: ~` ~i ~ eu J ~I r~~ '~i^ i t_ Special Construction (Manufacturer or Supplier) Roof Trusses: Floor/Ceiling Joists: Siding/Exterior Trim: Other: