HomeMy WebLinkAboutAPPLICATIONS, CO, BP - 05-00403 - 132 S Hidden Valley Rd - New SFR~Z
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CITY or Certificate of Occupancy
~xBU.~~
- ~ -
America's Fnmily Community
City of Rexburg
Department of Community Development
19 E. Main St. / Rexburg, ID. 83440
Building Permit No: 05 00403
Applicable Edition of Code: International Residential Code 2003
Site Address: 132 S Hidden Valley Rd
Use and Occupancy: Single Family Residence
Type of Construction: Type V-N, Unprotected
Design Occupant Load: Residential
Sprinkler System Required: No
Name and Address of Owner: Jeppesen K Merle Etux
434 Morgan Dr
Rexburg, ID 83440
Contractor: Gil J Shirley Const Llc
Special Conditions:
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 wes 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: July 24, 2006 (02:42PM)
G=~~-~'"
C.O sued 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: Fire
State of Idaho Electrical Department
' Cl~ Y OF REXB URG PERMIT #
_,_~~.~... v ,..,._ _ _ ~ ..~....,
BUILDING PERMIT APPLICATION Please
208-3519- 020 X3 BURG, ID. 83440 If the quf Oti 00403
l32 S Hidden Valley Rd - SFR
PARCEL NUMBER: ~ ~ ' 1(
SUBDIVISION: `~d W~ e UNIT# BLOCK# LOT#
(Addressing is based on the informatio -must be accurate)
O
--
CONTACT PHONE # ~~ - 3~3~
PROPERTY ADDRESS: f ~~~ ~ • ~%G~Gi~ ~~1 vU~ ~~e u ~6~ . ~~Xbu r ~i , .~ ~ Gt n ~'~ 5/y~ ~
PHONE #: Home (~o~ 3 s~~ - ~~3 rY Work ( ) -~~' Cell (2~ ~3y _ .~~~~
OWNER MAILING ADDRESS: Lt''i otr~ ~~-CITY. STATE~_~ZIP: ~'3~~~
~ e ~-I ~ ~a u~ `, ce ~~ "~
EMAIL ~~ahQO ~ ~ ~ ,-,1 FAX dY~
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;
PHONE #: Home ( )
Work
Cell
CONTRACTOR:
MAILING ADDRESS: ~~~errt~s L~nQ CITY 1~e~6y~STATE~~ ZIP 3 b
PHONE: Home#~5~--2/G~ Work# 3s1~7192 Cell# ~5-~-~I4~...
EMAIL Q~~~~ / F~t~,~S-~ --2/~ ~
.(AWI
How many buildings are located on this property?
Did you recently purchase this property? No es yes give owner's name)
Is this a lot split? NO YES (Please bring copy of new legal description of
PROPOSEJ~ USE: S
(i.e., Single Family Residence, M lti Family,
FAX
~ ~'~al ~ Wirt ~ ~
Remodel, Garage, Commercial,
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Und " ify
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
permyt<sr~approval was based. unit void if not started~within 180 days. Permit void if work stops for 180 days.
Owner/
.. v :. U
Do you prefer to be contacted by fax, email o phone Circle One
-BUILDING PE T MUST BE POSTE
CITY:
ZIP EMAIL
~i~~ i~
DATE
WARNING DON 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**
dt C1TY O ~`
RE:~BLiR~
------
.~~• AMERICA'S FAMILY COMMUNITY 19 E. Main (PO Box 280)
Rexburg, Idaho 83440
vrww.rexburg.or9
~- _ , _.
i
.. _ -
Phone: 208-359-3020 x326
Fax: 208-359-3024
comdev@rexburq.org
Affidavit of Legal Interest
Address
~~
~ ~ ~~~
State
Being first duly sworn upon oath, depose and say:
A.
(If Applicant is also Owner of Record, skip to B)
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 ~~-~-~ , 20
Subscribed and sworn to before me the day and year first above written.
Notary Public of Idaho
Residing at:
My commission expires:
State of Idaho
County of Madison
Please eo~nplete the ~~ire Appiication!
If the question does not apply fill in NA for non applicable
NAME
PROPERTY ADDRESS d q, ~~ , Permit#
SUBDIVISION /~ id~oh l~r. PEA
Dwelling Units: / Parcel Acres:
SETBACKS
FRONT ~ S ~ SIDE / S ~ SIDE ~ S ~ BACK 7 ~ /
Remodeling Your Building/Home (need Estimate) $
SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building)
First Floor Area ,~q~3 Unfinished Basement area -
Second floor/loft area -- Finished basement area
Third floor/loft area - Garage area / ~ 9 G,
Shed or Barn -- _ Carport/Deck (30" above grade)Area ---
Water Meter Quantity:
Required!!!
~~
************** Water Meter Size: ~.~y
PLUMBING , , ~ ~ ~~
Plumbing Contractor s Name: ~ ~ Vy l t I IQM/jS Business Name. ~ Q,W1, !a{~, ~ ~~
Address `j (~ ~ ~. ~~ ~ ~ City State Zip 8394oc
Contact Phone: (2081)/^313 - 33 r3S Business Phone: (Zc~ 35~ - ~t4g 7
Email w t ~i GtnMS ~ Du u r . ~~ Fax 20~ '~'~~ - (o~~/
FIXTURE COUNT (includine rouehed fixtures)
Clothes Washing Machine
~_ Dishwasher
~_ Floor Drain
~_ Garbage Disposal
Hot Tub/Spa
5 Sinks
(Lavatories, kitchens, bar, mop)
~_ Sprinklers
~_ Tub/Showers
3 Toilet/Llrinal
Water Heater
Water Softener
Plumbing Estimate $ (Commercial Only)
~~ti~~~~~ C ~ /6 2Z io ~9 o s
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
Please complete the enti~ Application! If the question does of apply fill in NA for non
applicable
NAME
PROPERTY ADDRESS
SUBDIVISION
Permit#
Required!!! MECHANICAL
Mechanical Contractor's Name: ~ruYhD ~~~ ~' Business Name: ~ ~ II~G.+MS
Address ~((~ (,~. ~Lbb 1~ . City l2~u6~,e~,, State Zip~3~
Contact Phone: (~ 313 - 33 8 8 Business Phone: (~) ~/' SR - 9 4 a 7
Email ~ ~ ~ ~ i U.r/t S k~ ~u N ~ . ~ ~ Fax ~ ~~ ~~ ' ~ 4~
Mechanical Estimate $ (Commercial/Multi Family Only)
F~/ Furna ePPLL9NCES~OUNT (Single FamilyDwellini OExhaustorVentDucts IY~LI~'t"C~~~wN~
Furnace/Air Conditioner Combo `S ~ Dryer Vents
Heat Pump
Air Conditioner
Evaporative Cooler
Unit Heater
Space Heater
S~ Range Hood Vents
Cook Stove Vents
~~'j Bath Fan Vents
~ Decorative gas-fired appliance 3b
Incinerator System
Boiler
Pool Heater
Similar fixtures or Appliances
other similar vents & ducts:
t~D
f b"'~
1.---
~ 9~ .
Fuel Gas Pipe Outlets including stubbed in or future outlets 20
Inlet Pressure (Meter Supply) PSI
Heat (Circle all that apply) Ga Oil Coal Fireplace Electric
Mechanical Sizing Calculations must be submitted with Plans & Application
Point of Delivery must be shown on plans.
~~
Signature of Licensed Contractor
/~~
License number
The City of Rexburg's permit fee schedule is the same as
~e l vs
Date
the State of Idaho
•~ ~ i
...._..... .__,,_..~... _._~~~. .._._...~_..~~I
SUBCONTRACTOR LIST
Excavation & Earthwork: h-4ru ~KauP.r'
r ,~~ // 1
Concrete: _~ Od ~ ~c+~ ~~ e'P' ~ahs~"~
Masonry: ~ Q n darn e~ CGS s~,
Roofing: ,Q~,y~ ~~`!P~ /C~ed~r5
Insulation: Ad y ~i/l c °~ - C~ CGS L 2Gc,TLS
Drywall: %P2n c~~ S f ~V~2 S
Painting: ~'1~ Gt?'K (il~t ~2~
Floor /
Coverings: Sh6~~.~e .~/Z ~t-/''/6)"~
Plumbing: p~ Qw~6!'l~ 4C ` ~u~~e (,t) ~~l ~Q~W~,~
Heating: ULl~,lno~ Old ~/r K(~.~/ A J..r, (~ I, C~V~,S
Electrical: SG6 ~ `Q/ShyL(,~`~_ ~l ~~
Special Construction
(Mal nufacturer or Supplier)
Roof Trusses: S~-nCK w~ ~ O6In c~
Floor/Ceiling Joists: ~f ~'~-L W ~2I ~
Siding/Exterior Trim: 1~ ~ ~ Std G
Other: