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HomeMy WebLinkAboutAPPLICATIONS, CO, BP - 06-00142 - Henry's Fork Plaza - Bldg 1Z ~ , O _ _ ~ m m ~ ~ rn v ~ _ ~ ^~ "'' Z ~ ~ O `. ~ ~ ~ A ~ D C A. m v ~ 3 m c c'a ~ ~ ~ °- 3 m m o Z ~ . m o ~- _~ g m ~ ~ ~ ~. N N ~ m ~ N ~ ~ 3 ~ v c n- %~ v ~ ~ o C m ~ ~ n m, ~ ~ o. ' p n a ~ ~ O Z ~ O O 7 a ~ y ~ o 9 d o - C N -I a s m o r a < ~ fD ~ ~ ~ ~ -I _ v o c ~ a w m ~ ~ ~ 1~ ~ n ~ ~ ~ a ~ ~ m 3 ~ ~ v a m ~° ~ a Z Z ~ ~ vd~sz n 2 ~~`°mf ~ m R1 ~ ~ °. ~ S, o ~ ~ Z f7 f~ 3 ~ C O O O QN C1 ~ ~ f ~ag m O _ N d -Np fD O N b ~ ~ O' ~ O i C ) = 3 "'• ~ ~ • n Q ~ _ •~ m ~ ate, ~ C ~ ~ 'O o s,m o ~ ~ m oo~ n o. ~ W a 5 U! Q ~~ y ~ ~..~ ~ ~ .~ ~ p `~ C1 ~ ~ ~D O O. ~ '~ ~~°`~ ,°. V- (7 ~ ? O 0 7 Ip O. '~O ~ ~ ~' C N .y.~ c = ~300~ a~ c. o, ~ f/! S y S~ ~ n ~m~o C~ ~ W = ~ ~ • CY 3 Q ~! ~ ID ~,~~a ~ ~ ~5 o c W ce _. fD < d! ~e~~a o c.o~ ~ C1 ~ O C. lD ~ <D n 3 7 `~ a C1 ~ N o ~. 3 a 'a cc ~ T 3 O ON ~ S = ~ ~ m. O ~.(Q 7 3 C y C..O*, ~ O O.~ 7 y lD ~, O z ~ m ~_ m n n ,o ZZ -~ y ~ ~ D ~ n ^C Z c~n O CD T 7 fD N ~ ~ ~ v ~ oT ,; v N W L W g m Z m C X m v 0 m 0 rn 0 0 N }S~ cj~f x^ ~ ~~ o ~ "., ~ a~~'i~ti n H ~ ~ o O ~ /'1 A rn `c coo ~. ~ ~ ~• ~ ~ ~ Oo D ~ m $ ~ z _ ~ m N fN/1 -~1 ai O N b ~ 1'I ~ m ' !~ c ?~ ~ o i a ~ ~ ~ ° ° ~ a ~ _ 3 ' y ~ ~m ai 3 0 00 O n ~ .,: ~ ~ Z ~ ~•. ~ O W . ~ c ~ .,. C O C7 W 7 3 ~ -n r v z~ w ~~ Z Z ~ ~ Z ~ n~pz o ~•~ Q ~ ~ ~ v G7 O m ~ ~ ~ ~• ~ ~ ~ ~ Z ~ D o ~ ~ a I z ` ~ ~ N ~ n Z N n ~ O p ~ < F O Q ~ . O . 0 0 ~~,~-~ O S `C y rn N ~ ~ W c`°°,~ ~ n ~ ~ `° y' Q. V! 3 a. '+ ~ U1 ~ W N -~ ~ o ~ m v - o, c o. ~7 ~ S c ~ ? ~ v m N ? CD g m ~ fD Z (p 7 0 ~ T O ~ ~ f0 DD V O) U1 A W N -~ c~ ~ v ~ ~ - cn m ~ ~ p w g ~ ~ -n ~ ~t ~ a O.. 7 ,i ~ r o c • • gEXBUq o~ ~~,a Cr~rv or- o s REXBURG .> __. America's F'nmily Community City of Rexburg Department of Community Development 19 E. Main St. / Rexburg, ID. 83440 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: Certificate of Occupancy 06 00142 International Building Code 2003 8sq ~ t~ettov~,s~-orK, ~Io1 ~' ~loa Henry's Fork Plaza Bldg #1 Type V-N, Unprotected Business No Stevens Bart 210 Nez Perce Re~urg, ID 83440 Stevens Construction ~ ~~" ~ mu~~ u~ , .~p~v~r~ ous Business, professional or service, restaurants less than 50 This Certificate, issued pursuant to the requirements of Section 109 of the Intemational 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 sties found to be in compliance v-ith the requirements of the code for the group and division of occupancy and the use for tnhich the proposed occupancy -aes classified. Date C.O. Issued: October 1 0 6 d(~ d 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 Department• Fire State of Idaho Electrical Department (208-356-4830): f~` 3 ~ITY~OF REXB URG o6 00 ~ 42 B9 E MAIN, RE BURGPIDC834 ON IPflhe~qu Henry's Fork Plaza Bidg #1 208-359-3020 X322 PARCEL NUMBER: ~~ ~~'~ (~~ ~ ~ (~ (We will provide this for you) SUBDIVISION: J-~,~,t~ S F~ ~ K P L~4 Zri4 UNIT# BLOCK#~LOT# ~ (Addressing is based on the information -must be accurate) +~S CONTACT PHONE # ~G ~ - PROPERTY ADDRESS: ~-k,nty ~ ~G:1< PIG 2 d-1 PHONE #: Home ( ) ~'j ~(, ~~ `~ ~ 1 ~ Work Cell ( ) 7d ~ -13 I OWNER MAILING ADDRESS: ~ I O wGZ PC!Z.~C' CITY: ~ ~(y~r- STATE: ZIP: ~3~1CfG EMAIL ~i3 S~ ~u (~ C~; Blroar a~clF~ ~ S~ `° 7 31 ~~ 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 CITY: STATE; ZIP EMAIL FAX PHONE #: Home ( ) Work ( ) Cell ( ) CONTRACTOR: MAILING ADDRESS: ~l ~ ~C2 ~~~ ~e CITY ~ ~//' STATE: ZIP ~~~~1'U PHONE: Home# 3 ~(, ~- ~ 3 I ~ Work# Cell# ~~ 0 ~ 7 3 / EMAIL~aS~~lu61<a.w~~.r~'AX ~5~~-73J~ Id~h~ rec~i~-~# ~~C~T ~Ia~~ - How many buildings are located on this property?~ Did you recently purchase this property? No des f yes give owner's name) Fy ~r[) e ~ .~ ~ Is this a lot split NO YES (Please bring copy of new legal description of property) PROPOSED USE: ~p~wtk~-t.tA L (i.e., Single Family Residence, Multi Family, Apartments, 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 con•ect and I sweaz that any information which may hereafter be given by me in heazings 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 days. Signature of Owner/Applicant l ~~1~ Do you prefer to be contacted by fax, email or phone? Circle One I ~J WARNING -BUILDING PERMIT MUST BE POSTED ON CONSTRUCT ~~. ~ O O 6 Plan fees are non-refundable and are paid in full at the time of application beginni ua City of Regburg's Acceptance of the plan review fee does not constitute pla approval By - - -- ~ 3 ~ CITY ~ ~ ~ ~ : ~T-~-~: - ~~ t ~ ,.' ~ ~.f r ~` ~ a..q~-i . ., :r ~ ~ ~~- r 'Y~,~iD~ n4 L ~. ~ e... ~ -- AMERICA'S FAMN..Y COMMUNfTY 19 E. Main (PO Box 280) - ~ ~_ ~ Phone: 208-359 3020 xT ~M~n 326 Rexburg, Idaho 83440 Fax: 208-359-3024 www. rexbu ra. ora comdevCcilrexbura.org Affidavit of Legal Interest State of Idaho County of Madison r ~ I, ~ ~9 R t ;~~ j ~ /c ~w ~ ~ ,~ I ~ rUtt ~e, ~c /~ye Name Address ,~ 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 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 herin or as to the ownership of the property which is the subject of the application. Dated this ~ `J~ day of /~'~ iq~2 c!a , 20 D! r~~.,+~1 ~~" Signature Subscribed and sworn to before me the day and year first above written. Notary Public of Idaho Residing at: My commission expires: 2 **Building Permit Fees are dyye~ time of application** **Building Permits are v~f you check does not clear** ~lea~e complete the eld'Cre Application! ' If the question does not apply fill in NA for non applicable 'NAME R ~ ~f,~~ PROPERTY ADDRESS j c K ~ 4 zrt ~t ~ l,~f~-K ( Permit# SUBDIVISION < Dwelling Units: SETBACKS FRONT f ~ Parcel Acres: SIDE ,~ ~ SIDE BACK I v Remodeling Your Building/Home (need Estimate) $ ~ y` kl, vc~ ~ SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building) First Floor Area ~/ i/ ~/ ~ Unfinished Basement area G~ Second floor/loft area ® Finished basement area L~ Third floor/loft area C Garage area ~ Shed or Barn ~ Carport/Deck (30" above grade)Area ~ Water Meter Quantity: * * * * * * * * * * * * * * * * Water Meter Size: ~~y T ~~ Required!!! PLUMBING r ~~,,~ M :,,, ,~ Plumbin Contractor's Name: ~~~ ~l ~,~ol.~t ~ i~:. E, g 9 Business Name: Address City ~E~~~ tr1T_State Zip ~ 3 yyn Contact Phone: ( ) Business Phone: ( ) 3=~ L ~7 ~~ Email Fax FIXTURE COUNT (including roughed fixtures) i/~ Clothes Washing Machine ~ Sprinklers ~ Dishwasher ~ Tub/Showers ~. Floor Drain ~ Toilet/iJrinal C~ Garbage Disposal v~ Water Heater C~ Hot Tub/Spa (~ Water Softener Sinks (Lavatories, kitchens, bar, mop) Plumbing Estimate $ ~, .~~~ (Commercial Only) C? ~~/~ ~ ~ ~ O , Requir g`ignat re of Licensed Contractor License number ate The City of Rexburg's permit fee schedule is the same as required by the State of Idaho ~~ 4 Please complete the enti~.Application! If the question doe apply fill in NA for non appi'ic~ble NAME i~ !~~ ~ ~~~~5 'PROPERTY ADDRESS ~ ~ !L'~ ~~ e Permit# SUBDIVISION _ (~ ~a ~ ~,,~ K Q(.~ 2 i9 Required!!! Mechanical Contractor's Name: Address Contact Phone: ( ) Email _City Business Phone: Fax State Zip. ~5(~..~57 7~ Mechanical Estimate $ , ~fld (Commercial/Multi Family Only) FIXTURES & APPLIANCES COUNT (Single Family Dwelling Only) Air Conditioner ~ Bath Fan Vents ~ Range Hood Vents ~ Boiler ~ Cook Stove Vents G 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 1 Incinerator © Pool Heater Heat (Circle all that apply) Gas Oil Coal Fireplace Electric Space Heater C~ Unit Heater Mechanical Sizing Calculations must be submitted with Plans & Application Point of Delivery must be shown on plans. Signatur Licensed Contractor License number Date Required! The Cary of Rexburg's permit fee schedule is the same as required by the State of Idaho MECHANICAL 1~~~ TAE+K/)o~ BusinessName: ~r~~'~y ~~U~,Or.rG C l~~frr, 5 .. ~ . • #1 ~ r E K' tf ~ AMERKAS FAMILY COMMUNffY 19 E. Main St. Phone: 208-359-3020 x326 Rexburg, Idaho 83440 Fax: 208-359-3024 www.rexburg.org cdd@rexburg.org APPLICATION: "CONSTRUCTION PERMIT" CONSTRUCTION PERMIT #:_ PERMIT APPROVED: YES/ NO -APPLICANT INFORMATION: BUSINESS NAME: APPROVED BY: $50.00 FEE PAID: YES/NO OFFICE ADDRESS: City State Zip OFFICE PHONE NUMBER: ( ) CONTACT PERSON: CELL PHONE # ( ) -LOCATION OF WORK TO BE DONE: STREET ADDRESS WHERE WORK WILL BE DONE: BUSINESS NAME WHERE WORK WILL BE DONE: DATES FOR WORK TO BE DONE: CONTACT PERSON: TO PHONE NUMBER: ( ) CELL # ( ) 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 ^ INDUSTRIAL OVENS ^ LP-GAS ^ PRIVATE FIRE HYDRANTS ^ SPRAYING OR DIPPING ^ STANDPIPE SYSTEMS ^ TEMPORARY MEMBRANE STRUCTURES, TENTS, AND CANOPIES APPLICANTS SIGNATURE DATE 6 .. SUBCONTRACTOR LIST Excavation & Earthwork: ~~tJF;2 Co,~~~~c,riJ ~~ • Concrete: ~+~~= G M GN E~2 ~a ,~Sn2~cTi o ~~ Masonry: ~ ~ 'V~ -~~ ~ ,~; ,E:~ Roofing: ~~+~~+nl Insulation: ~ ~ L Lv t ~T' Drywall: R Igo ~ o E j ~ f~ w~ ~ ~ Painting: ~~2K ~6 (, ~l Floor / Coverings: ~o~ C~ /-1,,r~ E,QS~,.) Plumbing: R E ll P~~Q ~ rr6 ~ ~-~£~Q-Tr ~G~ ii Heating: Electrical: L~ f j ~ M ~~ FLE ~ ~ f C Special Construction (Manufacturer or Supplier) Roof Trusses: ~rQGK ~Lp. S tipP~y Floor/Ceiling Joists: ~QvSS To r ST ' Siding/Exterior Trim: ~ ~~ Q 0 y Q L ~q ,..Y ~, Other: 7