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HomeMy WebLinkAboutAPPLICATIONS, CO, BP - 05-00402 - 28 Mill Race Rd - New SFRZ 0 rn so~~~ p p ~ N .6 S C. C '~ N N 01 p. N 'D -gyp .p.. d ~~ ~ ~ ~ ~. N ~, -~~ a~+ ~ ~ n ~ N ~ C C ~ ~ N N - ~ ~ ~ ~ o - ~ m y y 4 ~ r. a= A p ~ ~ ~ a o v ~ ~ ~ 3 ~ a ~ ~ ~ o o w x ~ N ~ S a w ~ Q °: m p ~ 0 o v a m ~v~sZ ~~ ~ ~~ p < S =_. 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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 00402 International Residential Code 2003 28 Mill Race Rd Single Family Residence Type V-N, Unprotected Residential No Ra~ss Stan 1318E2375N Lehi, UT 84043 Duffin, Marty 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 vies inspected on the date listed vies 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: C.O Issued by: November 14 -006 (09:38 ) ~~ 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 State of Idaho Electrical Cl~"Y OF REXB URG • PERMIT # _ _ - .. BUILDIl~G PERMIT APPLICATION Please CU ~ ~ ~ --' ~ - ~ `' ~" ~ 19 E MAIN, REXBURG, ID. 83440 If the questic 208-359-3020 X322 0_5 00402 PARCEL NUMBER: ~ ~~ ~ (We 28 Mil 1 Race Rd - SFR SUBDIVISION:~,~ ~ Vl~ ~~ UNIT#~BLOC;K# vc Lv i ~~ (Addressing is based on the information - ust be accurate) OWNER NAME: ;~ ~~y ~~ CONTACT PHONE # ~/ ~~~.~ PROPERTY ADDRESS: ~ `~ ~ ~ ~~~~ ("Q ~--P'~ PHONE #: Home (` ) Work (~ '~~jv - ~ <'`~ Cell (~.~) ~(~, ~ '" `'~ `~ y OWNER MAILING ADDRESS: ~~~J~ ~: ~.,~~-]~/t~.. CITY: ~ STATE: t.~ i ZIP: ;' p EMAIL FAX APPLICANT (If other than owner)_ (Applicant if other than owner, a statement to act as agent for owner must accompany this application.) APPLICANT INFORMATION: ADDRESS ~~~`~ ~~,~~,~ ~,,,,,~. CITY: P'~ STATE; ~ ZIP ~ ::~0 EMAIL -`~-~ FAX PHONE #: Home G~i~s) l;s'~"-- ~,~~`~v f Work (~) :~'~tc' -~I~E~ Cell (:tom a~~"1'D - ~~~ CONTRACTOR: MAILING ADDRESS: ;~; ~1;'Q.r L'ctr~~. CITY ~~ ;~ STATE~_ZIP ~' PHONE: Home# ~~'(~ ~T7~ (~ 1 Work# ~~ --~t~~-r Cell# ~j© - q~~ EMAIL FAX How many buildings are located on this property? ,~~~;,,,~. Did you recently purchase this property? No 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: r~, (i.e., Single Family Residence, Mi ~nru.~,~ ~i~es;~ ~f, OCT 2 1 2005 ~' r Garage, Commercial, Addition, 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 approval was based. Permit void if t started ithin 180 ays. Permit void if work stops for 180 days. Signature o Owner/Applicant DATE Do you prefer to be contacted by fax, email o hone? 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 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** • . To whom it mat concern, I give permission to Marty Duffin to act as my agent in the application and construction process for the house located in the Hidden Valley subdivision in Rexburg. Signed Stan Raass ,.~~,.., .. ~.~,..a„~... ,.. _ ~.<...~ .w. ~.. ~ C1TY OF ~-- _ - . _~~ REXBLIR~ _ W. --_ - _ _. q ~ AMERKA'S FAMFLY C~?MMUNI'fY 19 E. Main (PO Box 280) Phone: 208-359-3020 x326 Rexburg, Idaho 83440 Fax: 208-359-3024 vrww. rexburg. org comdev(a) rexburg.orq Affidavit of Legal Interest State of Idaho County of Madison -~'~ Name Address Lam; ; (,t. ~ ~ ~c~-t ~ 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 Qf the property described on the attached, and I grant my permission to: . ~ l i,,, .~ ;,~ ~~ ~~-~~„ r~ 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 ~ ~~~ ~ 20 0 ~~ Subscribed and sworn to before me the day and year first above written. oO~~NNA D. ~ i~i~~~ otary Public of Idaho 4~P • ~~i~'y's Iz •'~QTA~ }~ ~' ~ Residing at: 7 4~ `I ~'I ~~ i.I,itt Sd~ ..,•"' My commission expires: C D ~- ~ Ll' ~~ pUBL ~G *:• :: •. • o ~. Please complete the e~ire Application! If a question does not apply fill in NA for non applicable NAME PROPERTY A SS Permit# SUBDIVISION , ~,,v ~ 11~ ~ ~,~ Dwelling Units: L SETBACKS FRONT ~~ SIDE Front Footage (if applicable) Storm Water Length Parcel Acres: '7 S SIDE ^r ~ ~~ Remodeling Your Building/Home (need Estimate) $ BACK ~ j SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building) First Floor Area ,I~~_~ Second floor/loft area Third floor/loft area Shed or Barn Water Meter Count: Required!!! PLUMBING Water Meter Size: 3 y ~~) Plumbing Contractor's Name: ~ -~~ ( S ~ ~~. i Business Name: f ~ ~~:>> ~ ~- ~~ I w t-~~ i ~ ~'~ Address '~, y~ ~~~~ 1 ° ~~ ~ ~ ~~ ° State ;~~~ 1+~~ Zip ~ ; ~Cr Contact Phone: (~~~-) J~}~~- t<,~"~~,, Business Phone: ( ) FIXTURE COUNT (including roughed fixtures) 1 Clothes Washing Machine Dishwasher ~_ Floor Drain Garbage Disposal Hot Tub/Spa "~ _~ Sinks (Lavatories, kitchens, bar, mop) Plumbing Estimate $ Unfinished Basement area '° J ~ ~~ Finished basement area Garage area ~GI Z Carport/Deck (30" above grade)Area ~ Sprinklers y ~_ Tub/Showers Toilet/LJrinal ~`~~ Water Heater Water Softener (Commercial Only) ~~ 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 ...r,~.k... ~4.,. ,.. __.~NM..~~..A.,.~~.r... ,~ ,,~.,...~,......... ,_.~.~.,~._,~.,~,...._.~~:., .,.. .,.~.~~.:. ease eomp~ete the enti~Ap Cat10Il ~ If the question does not apply fill in NA for non applicable NAME ~~ S?~~ r ; : •~ PROPERTY ADD SS Permit# SUBDIVISION 1~ ; ~c~~z~ j,j I~,y Required!!! MECHANICAL Mechanical Contractor's Name: .~ ~ Business Name: ~~ ~ Address d2 /.SJ' ~ y~ Q /~. Cit . ~t, Stat ~~ Zip. Contact Phone: (~ ~) 3 j 3 - fa ~-`f ~ Business Phone: (~ ) ~ ~ `r - /~{~~ Email Fax Mechanical Estimate $ (Commercial/Multi Family Only) FIXTURES & APPLL4NCES COUNT (Single Family Dwelling Only) u> ~ Furnace ~-(~~~ 35 ) 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 ~i~ Similar fixtures or Appliances other similar vents & ducts: //b -~- s a lGo Fuel Gas Pipe Outlets including stubbed in or future outlets ~S ~o Inlet Pressure (Meter Supply) PSI Heat (Circle all that apply) Gas Oil Coal Fireplace Electric Mechanical Sizing Calculations must be submitted with Plans & Application Point of Delivery must be shown on plans. ~~'~ ~ Signature of Lice ed Contractor The City of Rexburg's License number Date fee schedule is the same as required by the State of Idaho ~ Dryer Vents t s Range Hood Vents Cook Stove Vents ,,,5 Bath Fan Vents ~s ~. • SUBCONTRACTOR LIST Excavation & Earthwork: ~u,~, T<~~~,`NS~,~J ~~ OQ1~,02 ~~$~ A~~ 28 :Mall Race Rd - SFR Concrete: Masonry: ~awt ~-- ~ ~~,p~,&o Roofing: ~ /~,v~irJ __-- Insulation: ~ ~~~ ,I Drywall: p~ Painting: Floor Coverings: ~~N;a~ ~l'.~ S Plumbing: `R ` Heating: :~~ ElectricaL_ ~p, ~, Special Construction (Manufacturer or Supplier) Roof Trusses: ~ i'~~ ~e~~.. Floor/Ceiling Joists: ,~'I'~1(,, ~I~eS ~ SidingBxterior Trim: Other: ~~~~o~~CfI OCT 2 1 2005 U