HomeMy WebLinkAboutCO & APPLICATION - 05-00476 - Melaleuca Office - RemodelU~4REX8°RCr~ ~jT'~)rC'~I]TY of ~1 CERTIFICATE OF OCCUPANCY
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'e,, e,~ America'sFamityCommunity Department of Community Development
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19 E. 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:
05 00476
International Building Code 2003
36 S 1st W
Melaleuca Office Space
Type V, 1 Hour
33
No
Name and Address of Owner: Melaleuca Inc
3910 S Yellowstone Hwy
Idaho Falls, ID 83402
Contractor: Vance Nelson Construction
Special Conditions:
Occupancy: Business, professional or service, restaurants less than 50
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 vtith the requirements ofthe code
for the group and division of occupancy and the use for which the proposed occupancy vies
classified.
Date C.O. Issuec
C.O Issued by:
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 Depart t: `
State of Idaho Electrical Department
C.~~'Y OF REXB URG .
BUILDING PERMIT APPLICATION
19 E MAIN, REXBURG, ID. 83440
208-359-3020 X322
PERMIT #
Please -~-~--~'~~~ '-~~~-~*;~.n A r~r-lins~•init ~
If the qua
PARCEL NUMBER: ~X~ ~ (~~ ~~ ~ ~JU
SUBDIVISION: T Ul
(Addressing is based on the information -must be accurate)
0_5 00476
Melaleuca :Remodel
eta_~.L~~ ~~ T
CONTACT PHONE # 3 t3 - ,z ~ y ~
PROPERTY ADDRESS: 3G' S~„~..~-lti 1 ~ fit~~c-5f ~e-,E-~r-ct
PHONE #: Home ( ) Work ( ) Cell ( )
OWNER MAILING ADDRESS:~q~o ~, 'T<.~Ivi.:S_ CITY: T~ ~G,(~g STATE: ~~ ZIP:_~~vz,
EMAIL
FAX
APPLICANT: (If other than owner) ~/I/ ~
(Applicant if other than owner, a statement authorizing applicant to act as agent for owner must accompany this application.)
APPLICANT INFORMATION: ADDRESS
STATE; ZIP EMAIL
PHONE #: Home ( )
Work ( ) Cell
Y: -.._ ~-~ f~ jy~
CONTRACTOR:
MAILING ADDRESS: X87 ti~ 33aa %= CITY Z` STATEI~1 ZIP~~Z--
PHONE: Home# ~~S y- g 8 y ~ Work# 3 /3-73 7,3 Cell# 3 l 3 - ~7 ~, ?
EMAIL K a ~ ~ ~,.. k ~? ~~y. H e f FAX 7S y~- y ~ 3 .~,
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? ~ YES (Please bring copy of new legal description of property)
PROPOSED USE: ~~ ~~.~1 -~c- v ~~~~
(i.e., Single Family Residence, Multi Family, Apartments, Remodel,
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 sweaz 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 or approval was based. Permit void if not started within 180 days. Permit void if work
stops for 180 d~ys~ _
!l / Z~ /p.S
Signature 6f Owner/Applicant DATE
Do you prefer to be contacted by fax, email phon ~ ircle One
WARNING - BUILDING P T 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 dy ~at time of application** **Building Permits are v if you check does not clear**
Please complete the e~ire Application!
If the question does not apply fill in NA for non applicable
NAME
PROPERTY ADDRESS
SUBDIVISION
Dwelling Units:
SETBACKS
FRONT
SIDE
Remodeling Your Building/Home (need Estimate) $
Permit#
SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building)
First Floor Area ,~~ 3cx~ S cp ~-~--. Unfinished Basement area --`"
Second floor/loft area -- Finished basement area /`
Third floor/loft area - Garage area
Shed or Barn / Carport/Deck (30" above grade)Area ~
Water Meter Quantity:
SIDE
**************** Water Meter Size•
Required!!!
PLUMBING 11 rr n l ,
numbing Contractor's Name: ~C w 7 ~ l h c- Eusiness Name: /-~!. ~ ~ ~ ~ V I k ~ S+`~ ~ i~' 4
Address 3~ 3 ~ ~,' ~ ~/ ~ N City~7 State S ~ Zip g.~~1Y
Contact Phone: (~ a 8) 7 y s- 7 p •~.. ~ Business Phone: ( ) 7 ~~ S- 7 d a- ~
Email
BACK
Fax
FIXTURE COUNT (includins roughed fixtures)
Clothes Washing Machine Sprinklers
Dishwasher Tub/Showers
Floor Drain Toilet/Urinal
Garbage Disposal Water Heater
Hot Tub/Spa Water Softener
Sinks
(Lavatories, kitchens, bar, mop)
Plumbin Estimate $ ~ 0~ IJ ~~ (Commercial Only)
Re wired! Signat e of Li used Contractor License mm~ber Date
The City of Rexburg's permit fee schedule is the same as required by the State of Idaho
Parcel Acres:
4
P~.ease complete the ent~ ApplicatlOn ~ If the question doe~t apply fill in NA for non
applicable
NAME
PROPERTY ADDRESS Permit#
SUBDIVISION
Required!!!
MECHANICAL
Mechanical Contractor's Name: So urL~. ~e-~rca ~E'~ ~ h Business Name:
Address~d~jC7 ,:i.,~,~,,,x.~-,~'~~,,( 131v~1 City `~-~;.~, ,, ~Cl.s State L~ Zip ~3~/
Contact Phone: (app 3K1- Damon x243-7ko5`Business Phone: (~jg-) ~3~~ - ~~Oy
Email j ,~rv Fig ~ ~~ urce rr_~,«~a~Se~.Fax ~~ ~s'~- `-~c~~a - 7r 1!S`
~ c=ow
Mechanical Estimate $ L,JW[/ (CommerciaVMulti Family Only)
FIXTURES & APPLL4NCES COUNT (Single Family Dwelling Only)
Air Conditioner Space Heater
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
Unit Heater
Mechanical Sizing Calculations must be submitted with Plans & Application
Point of Delivery must be shown on plans.
~ - ~° F~-~ac--~ 1 ~~-I, / ~~- ~ -t~ ~
Sig, ature o ensed Contractor License number Date
Required!
The City of Rexburg's permit fee schedule is the same as required by the State of Idaho
5
12/20/2005 14:38 FAX 5282083 PLANT ADMINISTRATION ~ 002/004
OS 00476
Melaleuca Remodel
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