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HomeMy WebLinkAboutBP, CO & APPLICATION - 05-00467 - Tyler Fillmore-SFRZ O _ -~ m 00 m 70 c ~ rn v ~ ..~ z ~ ~ ~' o ~ s 3 D n 3 ~ C ~ T= ° ~ ~" z ~ 3 ~ ~ o d n ' ~ ~T 1 W O._3 O..f, y.y ~ d W _m ~~.~ ~ _ m, D. O y C N O ~ 7~ -p C n T N 97' ~ ~ O C O _ cmi ~ ~' a '~' p ~ ~- ~ ~ p Z ~ 3 n ~ ~ C g o ~ ~, .o ~- o ~ m v r- ca ~ _F s ~ o ~ ~ _ o ~ ~ x ~ ~ ~ o- 3 ~ ~ Q. ~ r ~ ~ ~ n o ~ ~ ~ ~ ~ a ~ o m y. v ~ ~ W 0 ~ a m ~ D p Z .., Z . c i --1 ~~,;~Z -° ~ a i i v'~ c n c. O m m ~ ~ ZncO S ~1 C. 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C 0• v ~t4: cu ~--~ ~ .0 ~~~~, n '~ ~ ~ ..~ m _3 z --1 -c '~. 0 o ~o °~ ~ ~~~ .D r C o~ R Z W C _v Z z m n Z n v ID a 04 ¢EXSURC y .'' ~ CITY O F 1 W~~~ America's Farnrty Community Certificate of Occupancy City of Rexburg Department of Community Development 19 E. Main St. / Rexburg, ID. 83440 Ph F. 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 00467 International Residential Code 2003 146 S Hidden Valley Rd Single Family Residence Type V-N, Unprotected Residential No Fillmore Tyler 4178E 550 N Rigby, ID 83442 Owner Residential, single family dwellings, lodging houses This Cen`ificate, 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 wes inspected on the date listed vies found to be in compliance vuth the requirements ofthe code for the group and division of occupancy and the use for which the proposed occupancy vies classified. Date C.O. Issued: August 10, 200 6P ) C.O Issued by: 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 Departmen • Fire Department: State of Idaho Electrical Department /208-356-48301 QTY OF REXB URG , PERMIT # BUILDING PERMIT APPLICATION Please complete the entire Applicatian! x 19 E IV'IA1N, 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: ~ Gt ' UNIT# /~BLOCK# ,vim LOT# / (Addressing is based on the information ~tfiust be accurate) PROPERTY ADD PHONE #: Home ~) ~~'S- ~~~ Work ( OWNER MAILING ADDRESS: EMAIL CONTACT PHONE # 3c1~" ~~/ ~l~`'~3/ Cell ( ) ~~`--~a~~ ~l~ ~ ~ ~~~ CITY: ~~`~- ~ STATE~ZIP: ~t~~ FAX ~~'S =~~ - APPLICANT (If other than owner) (Applicant if other than owner, a statement authorizing applicant to act as agent for owner must APPLICANT INFORMATION: ADDRESS STATE; ZIP EMAIL PHONE #: Home 'Applicant Work Cell F CONTRACTOR: ~ / _ ~~ ~, -ter-. ~K ~ MAILING ADDRESS: ~l~~ ~ S~C~ Cr/ CITY ~ STATE~ZIP~2 PHONE: Home# ~~ ~.~ Work# ~d C-~"3/ Cell# 3~ '' ~~/ EMAIL FAX ~ ~S~ '~S~ How many buildings are located on this property? Did you recently purchase this property? No ~ es If yes give owner's name) Is this a lot split?~ YES (Please bring copy PROPOSED U~ (i.e., ~~le Family new legal d scription of property) ~S~ ~. Apartmer ,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 agee 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 Interna ' de in c es of any fals atement or misrepresentation of fact in the application or on the plans on which the permit or al was d. ~,qr -j~xoi not starter%~~1~ays. Permit void if work stops for 180 days. Signature Do volt n this application.) ~/1//O~ DATE ~fer 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 **Building Permit Fees are due at time of application** **Building Permits are void if you check does not clear** l,y,~ CITY O~ ~:~. LT .F ~.~s, JI;'~ I ~i b ~ REXBL.iR~ _- __` ~' ~ ~fl _ h AMER~A'S FAMH.Y GOMMUNC(Y 19 E. Main (PO`Box 280) Phone. 208-359 3020 x326 Rexburg, Idaho 83440 Fax: 208-359-3024 www.rexburg.org comdevCilrexburg.org Affidavit of Legal Interest State of Idaho County of Madison ~ / v , Na ~t !O City Address ~~~1`~~ 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 rec~ caner o the roperty described on the attached, and I grant my %.7„~.~ permission to: ~ ~ti- i _ ~'~7$ ~ ~~ ~1~ ~;~ ~~ ~~ Na e 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 //G(~'`~`~ ~~-- , 20 O S~ Subscribed and sworn to before me ~``~ ~~< ~'~~ ~oTARY ' •~ _©- .. +oa1 day and year first above written. Residing at: -~ My commission expir s: t e Please complete the ere Application! If the qu stio~ does apply fill in NA for non applicable NAME .•,•n S~~Fa~-~ ~~ PROPERTY ADDRESS ~-~ /'% / Permit# SUBDIVISION ~~ ,.~, (/~ `ly Dwelling Units: /~ Parcel Acres: SETBACKS ~ FRONT ~C~ SIDE l~~~ Remodeling Your Building/Home (need Estimate) $ SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building) First Floor Area Second floor/loft area Third floor/loft area Shed or Barn Garage area ~j y ,~ Carport/Deck (30" above grade)Area r--- ~. n Water Meter Quantity: /f * * * * * * * * * * * * * * Water Meter Size: R--- /~--~- Required!!! PLUMBING Plumbing Contractor's Name: ~ Business Name: ~l~,M(~ Address ~~~ ~,-~ . `7_~~ 5 City ~((~•c/k-~ ~ ~ State ~ Zip ~, LZ,~ Contact Phone: (~j~) v~~~ t~~-l`Zj Business Phone: (7,;j-,~) ~'°~ ~ ~~05 Email ~, ~ ti i.a~-~" Fax -~-~, ~ ~y i5 FIXTURE COUNT (including roughed fixtures) ~_ Clothes Washing Machine ~_ Dishwasher ~ Floor Drain ~ Garbage Disposal Hot Tub/Spa i'~ Sinks (Lavatories, kitchens, bar, mop) Plumbing Estimate $ SIDE .BACK Unfinished Basement area ~~~ -- Finished basement area ~ -- Sprinklers Tub/Showers '~i Toilet/Urinal ~. Water Heater Water Softener (Commercial Only) i~ Signa ur of 'censed Contractor Li ~~ number Date he City of Rexburg's permit fee schedule is the same as required by the State of Idaho Please complete the entil"C AppllcatlOn~ If the question does not apply fill in NA for non applicable NAME ~ ~ ~~ ~C~-~ ~w ~:~c PROPERTY ADDRESS Cta / Permit# SUBDIVISION _ ~ ~.. ah~_ Required!!! MECHANICAL Mechanical Contractor's Name: 2/'S wL Business Name: ~ ` S i3v; ~2~f' ~~nL Address ~ SS"S- c,~ . S,,L,h„~., s i rte. City ~~~ ~(~ State ~ ~ • Zip ~~ <-1(- Contact Phone: (aq3) S"f3 9 - cl / S Business Phone: (da~ Sa L~ - l ~ 3 7 Email bS I.~i ~-¢~ ~ ~v ~ . vim.. Fax ~~~ - S~c.~ - ©~O ~ Mechanical Estimate $ (Commercial/Multi Family Only) FIXTURES & APPLL4NCES COUNT (Single Family Dwelling Only) _ ~_ Furnace 3 ~ ~ Exhaust or Vent Ducts ~ ~-{ s Furnace/Air Conditioner Combo Heat Pump Air Conditioner Evaporative Cooler Unit Heater Space Heater ~_ Decorative gas-fired appliance r s~ Incinerator System Boiler Pool Heater Similar fixtures or Appliances other similar vents & ducts: ~ b,~ -~ S~ ~----- ~s~ ~_ Fuel Gas Pipe Outlets including stubbed in or future outlets ~ a ~~~ 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. ~`- ~y~~ 1 1 ° a.5- Signature of Licensed Contractor License number Date Dryer Vents ~ ~ Range Hood Vents. Cook Stove Vents ~ Bath Fan Vents /o ,~ SUBCONTRACTOR LIST Excavation & Earthwork:/laU'~z- ~~,~~'~ i p ~'l Concrete: Masonry: ~ W Roofing: ,~ ~1 ~ Insulation: /'J ~ C- ~r S~ Drywall : ,~e ~-t~-+,~. S ~~+ Gsr< Painting: ~ V~ ~~i~h ! Floor ~c /.,~ - ~ _ _ ~ ~ ~ f% . Coverings: Plumbing: d Heating: c~-+. Electrical: ~~ C vvl~ ~., c~~~ G~®~ ~~~ Roof Trusses: ~ -T Floor/Ceiling Joists:_ Siding/Exterior Trim: Other: h~ ~/ Special Construction (Manu acturer or Supplier) ~;1 ~~ ~~ ~ r~ // l/ Ir