HomeMy WebLinkAboutAPPLICATIONS, CO, BP - 05-00346 - Valley River Retail - ExpansionZ ~ ~ ~ ~ Z -
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~o~gExecg~,,' CITY o 1: Certificate of Occupancy
`~ ~~~~ City of Rexburg
`~ ,, Department of Community Development
America's Famil Communit
[p ~
19 E. Main St. / Rexburg, ID. 83440
Phone (208) 359-3020 /Fax (208) 359-3022
Building Permit No: 05 00346
Applicable Edition of Code: International Building Code 2003
Site Address: 160 Valley River Dr
Use and Occupancy: Retail
Type of Construction: Type V-N, Unprotected
Design Occupant Load: Valley River Retail
Sprinkler System Required: No
Name and Address of Owner: Keystone Properties Llc
160 E Valley River Dr
Rexburg, ID 83440
Contractor: Blue Creek Const
Special Conditions:
Occupancy: Mercantile, display and sale of merchandise
This Certificate, issued pursuant to the requirements of Section 109 of the International Building
Code, certifies that, at the time time ofissuance, -this building or that portion of the building that
sties inspected on the date listed sties found to be in compliance tn/th the requirements ofthe code
for the group and division of occupancy and the use for v~hich the proposed occupancy vies
classified.
Date C.O. Issued: June
C.O Issued by:
01, 2006 (02:14PM)
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.
WaterDepartment:~ Q Fire De rt ent:
,-
State of Idaho Electrical Department (208-356-48301:
Clfi~' OF REXB URG
BUILDING PERMIT APPLICATION
19 E MAIN, REXBURG, ID. 83440
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)
O
CONTACT PHONE # '~(fl K ~~~y
PROPERTY ADDRESS: ~(op ~, ~I~ ELI ~ll/~Q D~
PHONE #: Home (fig') "J~.- ~g73 Work (~) 3Slo- $~~'`~ Cell (~j X1'7- JSIz
OWNER MAILING ADDRESS: /(0@7 ~1~?!l~gl~l~ CITY: Ct R STATE: ZIP: ~/~
EMAIL
AX
APPLICANT: (If other than owner) ~ ~s-. lQ.~yE
(Applicant if other than owner, a statement authorizing applicant to act as agent for owner must accompany this application.)
APPLICANT INFORMATION: ADDRESS
CITY:
STATE; ZIP EMAIL
PHONE #: Home ( )
Work
FAX
Cell
CONTRACTOR:
MAILING ADDRESS: ~Y ~ 'zZcap >` CITY ~, ~-~, STATE~ZIP ~3 y
PHONE: Home# 205 335 <z5o Work# SA~+e Cell# SAavl~
EMAIL
How many buildings are located on this property?
Did you recently pu~r~chase this property? No Yes (If yes give owner's name)
Is this a lot split? ~>/ YES (Please bring copy of new legal description of prope
PROPOSED USE: Go~trn6,eci~4
(i.e., Single Family Residence, Multi Family, Apartments, Remodel, Garage, Commercial, Addition,
i`~
r
-'~~l
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, 'her b ~t 1
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 ation 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 I~Qtla3cs~
r~~d ~3 / lv / ~"
Signatute of Owner/Applicant DATE
Do you prefer to be contacted by fax, aI or ho 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
FAX
SEP 1 4 2005
PERMIT #
Please com lete the~entire A lication!
P PP
If the question does not apply fill in NA for non applicable
3
Affidavit of Legal Interest
State of Idaho
County of Madison
Name Address
~~~~~~
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 l ~ day of ffu~ ~s'~ , 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 d time of application** **Building Permits are v ~f you check does not clear**
Please complete the a ire Application!
If the question does not apply fill in NA for non applicable
NAME
PROPERTY ADDRESS D 1% ~•- Permit#
SUBDIVISION
Dwelling Units:
Parcel Acres:
SETBACKS ~ ~ ~
FRONTS SIDE 5 SIDE ,~ BACK
Remodeling Your Building/Home (need Estimate) $
SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building)
First Floor Area ~. '7'7 Z
Second floor/loft area
Third floor/loft area
Shed or Barn
Unfinished Basement area
Finished basement area
Garage area
30" above grade)Area
Water Meter Count: ~.
Water Meter Size: 'y
Required!!!
PLUMBING 1
Plumbing Contractor's Name: Business Name: ~~
Address
Contact Phone:
City
A
State ~ Zip
Business Phone:
Email Fax
FIXTURE COUNT (including roughed fixtures)
Clothes Washing Machine
Dishwasher
"Z Floor Drain
Garbage Disposal
Hot Tub/Spa
Sinks
(Lavatories, kitchens, bar, mop)
Sprinklers
Tub/Showers
z Toilet/LJrinal
~_ Water Heater
Water Softener
Plumbing Estim to $ ~, 7 3~ (Commercial Only)
t~~a~ ~ ~~
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 Ida o
4
Please complete the enti~Application! If the question doe apply fill in NA for non
applicable
NAME ~
PROPERTY ADDRESS ~ >~ ~1~- Permit#
SUBDIVISION
Required!!!
Mechanical Contractor's Name:
Address
Contact Phone: ( )
Email
MECHANICA
" u i ss e:
City State
Business Phone: ( )
Fax
Mechanical Estimate $~ro, ~s~ (CommerciaVMulti Family Only)
FIXTURES & APPLIANCES COUNT (Single Family Dwelling Only)
Air Conditioner
~. 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) Gas Oil Coal Fireplace Electric
Zip
Space Heater
Unit Heater
Mechanical Sizing Calculations must be submitted with Plans & Application
Point of Delivery must be shown on plans.
f`flb ~ ~
Signature of Licensed Contractor License number Da
Required!
The City of Rexburg's permit fee schedule is the same as required by the State ofidaho
5
i •
~ can a~
q~rs~, AMERICAS FAMILY CQMNtUAIITY
L._I
APPLICATION: "CONSTRUCTION PERMIT"
CONSTRUCTION PERMIT #:_
PERMIT APPROVED: YES/ NO
-APPLICANT INFORMATION:
BUSINESS NAME: ~Z,uC'
OFFICE ADDRESS: 1l~v
APPROVED BY:
y~
City State Zip
OFFICE PHONE NUMBER: (2~ g ) ~S~-S~fi~~}
CONTACT PERSON: Peat CELL PHONE # (~ 8 ) 3i'7-/.~Z
-LOCATION OF WORK TO BE DONE:
STREET ADDRESS WHERE WORK WILL BE DONE: ~U C_ hp l?,urlt- OR .
BUSINESS NAME WHERE WORK WILL BE DONE: ~Va~~ s nl
DATES FOR WORK TO BE DONE: TO
CONTACT PERSON: ~c~ ~e~
PHONE NUMBER: ( ) 5.~•.-r~ CELL # ( ) S.a~..c
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
~-~u J vS
APPLI A SIGNATURE DATE
$50.00 FEE PAID: YES/NO
,`r
6
SUBCONTRACTOR LIST
Excavation & Earthwork:- ~ ~~, >` C~ce k C~,r r ;
Concrete: ,~Gt~ COY
Masonry: ~c~~d ~ a uu~ ~ S~ e,~ E
Roofing:- iN•omAS Qegi S6h QooF~~h
Insulation: gG~c C~~~' ~e~r, l Arn ~ ~,l F ~;
Drywall:
Painting: R~;, ~ C~F_k Coas~ -
Floor
Coverings: Sc.Fo~ rA•Sr ~~rTF,,/Zr~Z.S
Plumbing:- ~XButLt; (~8~~~ ~ /~a:~~/6
Heating: ~ K R t,,~ (, r~.~~ ~ I~T~.t(,
Electrical: ~IZ.~o ~ 1EC7itr t
Special Construction
(Manufacturer or Supplier)
Roof Trusses: 6 M C ~r S% j ~,~,ss P~r
Floor/Ceiling Joists: ~~ ~c r,
Siding/Exterior Trim: ~ci~ Ru~r~~s` 5~.~.,
Other: