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HomeMy WebLinkAboutBP & DOCS - 05-00435 - Help U Sell - RemodelZ ~ 0 = ~ ~ ~ m Ill n W~ C rn ^•~ Z ~ 3 e Z~ --I o D ~ C 0 0 ~ -o ~ ~ ~ (/~ -a m °- 3 ~ m O ~ a~~m ~ °' ~. y N ao RI v ~ _~" m ,N.., 7 ~ N (Q N Q ~. C7 N O ~, 'O C) c ~ 3 v C1 /~ m ~ ~ o' C O m ~ ~ a ~ ~ c~ ~. a ~ ~' ~ f O ? m oo~ ~ ZD °- •' `° c ° _' ~ cn -o ~- o m c `° ~ p ~- ~ ~ ~ ~ ~ ~ ~ o ~ 2 c V~ Q ~ ~ ~ ~, - °~ _ y n -~ a ~ ° m ~ ~ ~ ~ ~ a a~ Z z ~ c~ o~v3sz D ~ ~ ~ o 3 ° s ~ o ~ m °~ ~ ~ x ~ cc Z~° ~ ~ C ~ ° m ~ ~ n n~.yo~ ~ r F -_ _v o ~ ~ ag m x~ N s ~ o Z ~ ~ eSi m n o, = O _ ~ ..! .3~n 3 n /~ ?. CD 7 . ~. n V/ O ~ f' O ~ ~ ~ooo ~~m -~a a ~ W y 0 ~ ~ ~ ~* o n -~ Z O ~ :r:? z~ y m ~ ~ c~ W~ ~~ ~;~~-~ ~ ~ _ m ~. ~~`~~ ~ o o~ ~ ~ y o Z ~ ~ ~~~y 3a Z -~ y -emu ~ ~ ~ C $ ~ y ~ 'a, O~ ~D = ~ ~ a ~ O _~ ` o ~. oni 'Oy' Z ~~~ ° ~ O s-oa~D ~ m ~ ~ ~ ~ ~ r ~ H ~~ 3 ~ C O ~ C <D O „ ,,, Q. ce c. 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W N -+ 3 ~, -ri ~ Cn a m ~ O ~ ~ 3 v, ~ ~ ~ v 3 T o ~ ~ o' ~ o ° (Q r v o ~ < A D a C17,`Y OF REXB URG ~ TTT' "T " BUILDING PERMIT APPLICATION Please 19 E MAIN, REXBURG, ID. 83440 If the qui 0.5 00435 Zo8-3s9-3o2o x322 H ELP U SELL R~MC~-DEL PARCEL NUMBER: SUBDIVISION: UNIT# BLOCK# LOT# (Addressing is based on the information -must be accurate) OWNER: 2 ' G ~~ ~ ' . CONTACT PHONE # ~'J- (,~ ~(~ ., PROPERTY ADDRESS: ~~ ,~' ~• ~~ CZC~- PHONE #: Home 2c~~) ~ ~ S / ~ Work 2~) ~ ~~ ' ~~~ ( ( ~y ~~ cell ( ) OWNER MAILING ADDRESS: '~~.3J ~~~ T_CITY: L ~o~ -~STATE::~~ZIP: $~ y~ EMAIL FAX ~ SC ' y Yc° Z APPLICANT: (If other than owner) ~~4 r ~ ~ ~ ~~ I~~ ,r'! 11 (Applicant if other than owner, a statement aut ortzing plicant to act as agent for owner must accompany this application.) ~~, APPLICANT INFORMATION: ADDRESS `~ i ~ ~ ~;~ ~ `;~! U1 ~ ~-- /~~~° .CITY: J' ~G<, "'~''~~ ~ t.t- ~ STATE; ~ J~ ZIP EMAIL l~~~) of ~' ~ ~ (C~~C<`-'~ c ~ ~k' FAX PHONE #: Home ( ) Work ( ) Cell CONTRACTOR: MAILING ADDRESS: / 1'~~~ j p ) ~~ r' ~ t y ~.~' CITY~~j,j~ii ~, ~~i`'~f STATE_~ZIP ~~G l•-'' PHONE: Home# fit' ~ fit- Work#~~`~i "-,J~`k.C~ Cell# ~~~X"j - ~ `I`~~~ EMAIL ~ 1 ~';; j FAX /°~-% /'~ How many buildings are located on this property? ~ Did you recently purchase this property? No Yes f yes give owner's name) ~-~e~~~~~ ~~~~k,!'~~s Is this a lot split~,'NO,` YES (Please bring copy of new legal description of PROPOSED USE: (i.e., Single Family Residence, Family, Apartments, Remodel, Garage, Commercial, C[~~~4~~ ~ J i:.l i...., ACT ~ 5 [005 1 ~ ;' APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: un malty of perjury, I hereby certi that I have read this application and state that the information herein is correct and I swear that any information which may herea e-iu-hearinQS befor 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 regu arions an 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 applica~ ~ or gntl~ 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. / i Signature of Owner/Applicant DATE Do you prefer to be contacted by fax, email or phone? 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 3 ' **Building Permit Fees are d t time of application** **Building Permits are if you check does not clear** .Please complete the e~ire Application! ' he quest' n does not apply fill in NA for non applicable NAME ~~~~ l71 ~' UGC. PROPERTY ADDRESS " ,.~ Permit# SUBDIVISION /.~ Dwelling Units: Parcel Acres: • 4 ~ SETBACKS FRONT SIDE SIDE BACK Remodeling Your Building/Home (need Estimate) $ ~0~ 06 d ~~(~- ~ ~'n ~ .r-~..... /\~ SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building) First Floor Area l/~~ p Unfinished Basement area Second floor/loft area N~zj Finished basement area Third floor/loft area !l/!-{ Garage area ~c~~G Shed or Barn .~,~,- 2c~ca Carnort/Deck (30" above e Water Meter Count: lti/~1 Required!!! PLUMBING Plumbing Contractor's Name: Address Contact Phone: ( ) Email City Business Phone: Fax FIXTURE COUNT (including roughed fixtures) Clothes Washing Machine Dishwasher Floor Drain Garbage Disposal Hot Tub/Spa Sinks (Lavatories, kitchens, bar, mop) Plumbing Estimate $, (Commercial Only) 1 State Zip Sprinklers ~ Tub/Showers z- Toilet/Urinal ~ Water Heater Water Soften i :_;~ ~ r , ,7 ~ ~, ! ', ii OCT ~ 5 2005 j[?'?i 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 Idaho Al /~ Water Meter Size: Business Name: 4 Vtil LO un .~ i•nrn u~.i.._i i c_n _ .. _ ..__ ....OCT 25 ' 05 04 ~ 16PM DAMERON ACCT 208.g~gp2 P • 1 P 3 ' ~. {•BuiWipg Permit Fels ere ~ ti~ae o! appliesHoaa• +~~~ildie~ Pe~dite ru'e ~O~oa ebesk ioes net clear•i Please complete the entire Application! ' 6e quest n does not apply 5t1 la NA 4or non applicable NAYIE ~ LL PROPE,R7 ADI]RESS Pertnit# SUBDIVISION /.i Dwelling Units: Parcel Acres: • O SETBACKS FRONT SIDE SIDE BACK Remodeling Xoser 8idlding/~ffome {need Eetirdate) $ ~s,,,,, oa Q SCTR1~ACE SQUARE FOOTAGE: (Shall include the exterior wall meaauremertts of the building) First Floor Area l(~~L~ _ _ Unfinished $asemeat area AI /Q Second floorlloft area N~ Finished basement area ~ ~D ~'iiird floor/loin area Il//~ Garage area '°~o~ Shed or Barn .~~- __ 30+x. Cacport/Deck (30" above grade)Area ~ ~~ _. ~Nater Metec Coant: N~ Water 1Vleter~Sfisp~ Required!! r R~ UMB~NG Plumbing Contractor's Name: i c.,~ ~_ ~A T~ ~, $usirtess Name: rt..7~!~ Address ~a •yL N rte" ~S""~'a` i~.l ~f- City j , ~ . State ~~~ Zip g 3~0~- Contact Phone: (ar,4) ~ ~ ! ~ ~L G Business Pttor~e: (•u, ~ s~ ~-~- 3~a _ Hrnail f ~l~ Fax ~/.oA- Clothes Washing !Machine Dishwasher Floor Drain C3axbage Disposal Hot TublSpa _~ Sinks (Lavatories, kitchens, bar, mop) plumbing Tstimate S (Comimerciat Only) Requirrodl Signature of Licens Contractor License number The Cfp~ of Rexbw'g's permlf fee schedule is tote .YR~ Al Sprittkleze ~ Tt~b/36owens ~ Toilet/Urinal ~ Water Heater water SoRerter D ~ (c~ ~~ ~~~ ~7~~. ~ oCr d 5 1005 i Y D ' by the Srare Q/'Idaho 4 Please complete the enti•Application! If the question doe•t apply fill in NA for non applicable r NAME ~ ~da ~ /o ~e / ` S PROPERTY ADDRESS 3 S _ 2 " ~. Permit# SUBDIVISION Required!!! MECHANICAL Mechanical Contractor's Name: Business Name: Address City State Zip. Contact Phone: ( ) Business Phone: ( ) Email Fax Estimate $ (Commercial/Multi Family Only) FIXTURES & APPLL4NCES COUNT (Single Family Dwelling Only) ~_ Air Conditioner Space Heater l~ Bath Fan Vents Unit Heater ~ ~ Range Hood Vents n V ~ Boiler l Cook Stove Vents N ~ Decorative Gas Fireplaces N Q Dryer Vents /~ ~ Evaporative Cooler Exhaust or vent ducts ~ Fuel (gas) piping fixtures or appliance outlets ~1 ~ Furnace -.r._ a: ~ - ~~ w Q Furnace/Air Conditioner Combo La C ...- ~ r- ~ ~ fir, ~ ~ ~ ~ C , (~ Heat Pump ~ ' OCT ~ 5 Zi1Ci~ ! ~ ; ~ Incinerator ~~ ~~t~ Pool Heater ~y ~_.u~.~.J.,av._~y~.~e._„____~ -- 1-~, . Heat (Circle all that apply) Gas Oil Coal Fireplace Electri Mechanical Sizing Calculations must be submitted with Plans & Application Point of Delivery must be shown on plans. Signature of Licensed Contractor License number Date Required! The City ofRexburg's permit fee schedule is the same as required by the State ofldaho 5 _. _ OCT 25 '05 04~16PM DAMERON RCCT ~Pieas~ complete the emti~ Application! applicable 1 1~lPl?ViE 4.:1 r ~ PRQPERTY ADDRESS h SUSAIVISION ~equi~edl!! Mechanical Contractor's Name; I~IC.k ~: ~, .~T y~_ Business Name; ~~~ ;~~.c f~ Address ~d 7L N ~-~ ~3 S'~ LJ~ City l ~ F . State ~ ~ ~ Zip `~ 3 ~c `~,,,, Contact Phone: (z o ~ ~ ~' ~ -,~'7 ~~c Business Phone: (;,,,e~) s x.~ - 3 ~rQa Email p~ 20856-®402 P • 2 p,2 L'tAe gaestfon does noTapply fill in NA for Qon 11~EC~4~'CAL Perarit# Estimate $~ (Commerc9al/!Viulti Family Orally) FA'TURES dE ,APPL~ANCI'S CDUNT ~- Air Conditioner ~_ Batb Fen Vents ~.~i~ Range Hood Vents fY ~ Boiler r~~ Cook Stove Vents ~ A Decorative Gas Fireplaces ~_ Dryer Vents ~_ Evaporative Cooler 1~~~~ F nKg ~y~ Space Header ~~ Exhenst or vent ducts ~_ Fuel (gas) piping 5xtures or appliance outlets N A .Furnace ~p(,~, Furaace/Air Conditioner Combo Heat Pump ~A_ Incinerator ~, Pool Heater Unit Heater U ~~~~ ~i ~, ACT ~ ~ ~~~5 , Heat (Circle all that apply) (}as Oil Coal Fireplace lecu~ 1V~echanical Suing Calculation must be submitted with Plans & Applfcstiou ,~ Point of Delivery must be shown oa plans. c:,.rYr ~~ry re z~ o Signariire oP Licensed ConO•actor License number D )Ctequi~r'ed! ~e fs tits same as regsrfrad by tf~e Srote o1'ldpho S ^( tl 0Ok iAJ If f • zfb o.v lU'(L'Ni Eri- ~2C LAN~INb '~o ~>.~iS7fN6 P~lCG1-i NO ~ ~~i~ X~ `'`S=PPp r2T ~ L~k~ ~: ~" _ 2~ ~y~- _.zxb. .- .- ~{ b- 9-- ~ ---D ~~c ~~ g''~~,poSEfl ~R-J~NO EMcN*ED ~r c `Co e,v ~ eS ~i ~'I LI 7~ b SuPp04 ~'' ~~Z~ 6 B~¢ACin~~ o.~ I6"ceNTC-,< (~~HEe. 30' ST2r;ICli Wit= ~A~(? to ~o Sc~PPc~QT~~I t 1N {KE SAvkt=' 'F~SNtorv. t.~PPof if on; .q ~ ~ ri $2ACi,dC- L(X 6 ,S I wt~r_ Q ~ Z~ Iv"fo NA f / j~~'. G1ZG 4~>7, Conti C,vTC~~ ~1~1 TD (~ / -t'~`b ia~ll.C (.ls[ P6ST ~APS ,~.." ,2~jr flit Z l b ,g(CAC'c ~o~ 'TIC ~ ~ X ~ ~ lN Si,i(~rico~ ~ w:~~ PjE ~.a ~U~` ccNTeaS t,~sw~- Z~6 HAa~EQS f ~'FTE2t©'~ 'jo ~~ PAt~s're-,~ w ;rt-c ~tgANO Qr1l1VT 1, ~ ~I,l. ~A~v~}t~G-S wtLi gc taO X ~O Iv~^^ ~TWV`' V~~~ r~+~~~ a--- HLL QA~^+P Cd~r=S ~tll '~~ ~Me a~~-t ~S QOSSIdLC, ~'jv\~ (..i:SS~ ~ ~~ TI1AN z -+-p 7p hA\l.i w1 G- ~ o ~ ~ 1~.J lo" TA tL w i TK 1 ToP ¢. A.L Aw0 - I Q !1~~ a W4Lk k,Ay _ `~/~1i..~MG_ ~ t4i. ~+g ~y.v 3oTK S,vE of '~A^^~ P1ti0 b•+s $iOt:S O(= i.ANJti+.14-. gu$PCrGNf. a.n~ ~A.\LS `~b ~~ ~~ ~~"~ ~`6 ~~ ~~ ~~ BUILDING ihl~~~TJR ~= ~ - • • ~c5 3~ ~¢~ c~ (Z ~ X5l X 3/y B>~S~ '~ ~ lv X ~[o Q.u~v,v c~S Z X ~o X ~ 5~•r°vo~2r 6 Z ~ ~ ~ ! Z uv. c~N~ su~~ 3 ~ ~ ~~ t ~ LAN~7 SkY~' ~ icy ~! ~ Y x 8 PosT I6'~ Z ~ ~ ~p~n)C ~ fL5 .3~ ~ r~ 1 ~~.\` 1 Ss' i n~ Q~>L i Ss' SKeFa 2r 2~~ ~ uu p -1 D p F4\L ~nST 10 5~1, e~„~\e2 lo~jal, 7A\NT'~O.HD~• ~IOd°`° .3~f'PIZCS~NAI~i StQ.LW; 6.loCCit~ J~' r tlJ ~.(~I ni l' la 11 ` U 35 i r-+~ O O ~~~~ W m ~J ~ Q r ~~ `~~ • ~s r 7~' n :~ c -- ~, ~ c~ `~ ~, {f~. __~. n ~-, ~^ ~ ~ N . ,j ' . r q ~r , . ~ n ~ d'4„^, ;~ ~ O ~ ~ f` ~ re ~ .. ! { r~ J1 N '~- e a c. _ v~ ~ ,. r M1 ? ~ ., ~ ~ ~. f -~--~s . ~j N N~ h , ti ~ ~~ ~'= ~a~ C ~ ~~ t ~~ ~ _ \ ~_ V ~,.. i ! -., ~ ~~ 1 _~ ^aa o °~ ~, > K ~~ '~"~ ~~ .,r.,_~ ~~ ~~ a~ S r ~',~ ^- ,, ~" C ~- ~, ~~"~ q&~ w CITY OF ~.ExBUR~ AMERICAS FAMILY CC~MMUPII`fY APPLICATION: "CONSTRUCTION PERMIT" CONSTRUCTION PERM OS 00435 PERMIT APPROVED: Y HELP U SELL REMODEL -APPLICANT INFO BUSINESS NAME: APPROVEI: OFFICE ADDRESS: City ~~ ~ ~ ~. ~~- State ~ V Zip ~ 3 y y4 OFFICE PHONE NUMBER: (~~) CONTACT PERSON: CELL PHONE # ( ) -LOCATION OF WORK TO BE DONE: STREET ADDRESS WHERE WORK WILL BE DONE: ~ 8 ~ . Z `~ V BUSINESS NAME WHERE WORK WILL BE ONE: Nc f - U - Sc 1 ~ 1~~~ / ~s~c~c DATES FOR WORK TO BE DONE: as TO l z /s /os CONTACT PERSON: l~ ~ ~ f ~t b ~1 PHONE NUMBER: (Zv ~' ) ~ S 6~ 9 boa CELL # (z~~ ) 3 ~ / Os / 6 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 J~~~ ^ INDUSTRIAL OVENS I ^ LP-GAS ^ PRIVATE FIRE HYDRANTS ~;,, ^ SPRAYING OR DIPPING ^ STANDPIPE SYSTEMS ^ TEMPORARY MEMBRANE STRUCTURES, TENTS, AND CANOPIES ~~ rL !~- ~~r ~ 5 2015 ~`I;I L_ APPLICANTS SIGNATURE DATE 6 ,~ C[TY ~ i __ _ - --- R.~XBLIR~ _ _ _- ~q AMERICA'S FAMILY COMMUNITY 19 E. Main (PO Box 280) Rexburg, Idaho 83440 www. rexburg.org - _ _ - __~ _ ____.~---Phone: 208 359-3020 x326 Fax:208-359-3024 nnmiJc..rl m..hn....+... OS 0043_5 Affidavit of Legal Inter HELP U SELL REMODEL' State of Idaho County of Madison I, Senn v ~ ~e~ , Name Address clty ~~~~ 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 rant my permission to: I~ ~(.~~~ ~?'1i~Y' .~Pyc Name Address ~J 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 day of ~:~ ~ ~ , 20~~ -~~v~ _ JvL~~u~ Signature - Subscribed and sworn to before me the day and year first above written. ~~ Qf: T ,~ 5 20 05 Qy i / ~~m~,~ \\~~o ~~ e~~ t- u u u i i u r i i i r r/i ~ . •' '' . ~~'~ Notary P c of Idaho ~ ~O R.bA~ Z' Residing at: '-~ •` AOBL~G ~. ~~~eS'j~•... ...•~p\`\~ My commission expires: ~^~~ _~ ~~ rrri~ rn Innu~~~~~\\~ 2 OS 00435 suscoNTRac~ :HELP U SELL RE:MQDEL Excavation & Earthwork: Concrete: Masonry: Roofing: ~~I! Insulation: / 1I Drywall: _ Vey (y~ r w k~ ~, ~ I Painting: \/,~ S G ~ I ~N c, ~ I rl P S ~c , ~ l's . Floor Coverings: G ~ ~ h r_~„~ Plumbing: 1/es ~v vim- ~i. ; ~ c ~` !'r ~ ~ rJc ~U Heating: Electrical: /~ d Special Construction (Manufacturer or Supplier) Roof Trusses: ~~ Floor/Ceiling Joists: /y6 Siding/Exterior Trim: /~~ Other: 7