HomeMy WebLinkAboutAPPLICATIONS, CO, BP - 06-00168 - 601 Autumn Ct - New SFRZ ~
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"T Y p ~ Certificate of Occupancy
T~tE~BURG
- ~ -
America's Family 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:
06 00168
International Residential Code 2003
(poi 14k+kmh C~-
Single Family Residence
Type V-N, Unprotected
Residential
No
Jensen Brett Etal
P O Box 847
Rexburg, ID 83440
Brett Jensen Construction
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
v-es inspected on the date listed vies found to be in compliance vuth the requirements of the code
for the group and division of occupancy and the use for v~hich the proposed occupancy vas
classified.
Date C.O. Issued: February 26, 2007 (10:23AM}
C.O Issued by:
j~~~
Building OfFcial
f
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: ire Dep m
State of Idaho Electrical Department
CITY OF REXB URG ~ PERMIT #
'BUILDING PERMIT APPLICATION Please coy
19 E MAIN, REXBURG, ID. 83440 If the question O ~ O Q 1
208-359-3020 X326
PARCEL NUMBER: ~Q~~~~~ ~a-Q~~~(Wev~ 601 Autumn Ct-Jensen
SUBDIVISION: ,~~ ~.. ~ ~ ~~?~` ~.S UNIT# +/ BLOCK#~_LOT#~
(Addressing is based on the information ust be accurate)
CONTACT PHONE # ..~~'/.a"' ~-~~
PROPERTY ADDRESS: 1..Q ~ ~ ~~ f~.,~r ~~
PHONE #: Home ltZr:.g) 3sj - ~~~~ Work ( ) Cell ( ) .~/.~ ~ ~' ~ `3,G
OWNER MAILING ADDRESS: h~ ~'y,~ CITY: ~~~ STATE:~ZIP:~y
~...
EMAIL J t, ; ss,-~ ~c-~S~~- ~~ Cc• ~~r G~ ~..rl/e'~` FAX 35 ~ -- C~'i~~S
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; ZIP EMAIL
PHONE #: Home
CITY:
FAX
Work
Cell
CONTRACTOR: ,`~~~?~ ..~~i.'.S`r-~ l'~ ~~'=~~-'7`~ ~--v.....
MAILING ADDRESS: ~~-~~~' ,flu,.-~.~`~ Q~ CITY ~~ ~. STATE~ZIP
PHONE #: Home ( ) .:~ ~ ~ --S3 Work ( ) Cell ( ) ~/.3~- G~ i :~~
EMAIL
FAX 339- c';~S IDAHO REGISTRATION # & EXP. DATE ~G~-?78`/ cY-~ ~ c
How many buildings are located on this property? (',.~~
..
Did you recently purchase this property? Yes I yes give owner's name)
~_ ~~._.
Is this a lot split NO....-''~ES (Please bring copy of new legal description of property)
_ .
PROPOSED USE: S,Y-~ ~~' ~.,.~~ /`~
~~a
MAR 3 0 L006
(i.e., Single Family Residence, My~fi 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 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
permit or approval w based. Permit"void if not started within 180 days. Permit void if work stops for 180 days
~. ~_._/'
°a'~ure of Owner/
DATE
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
**Building Permit Fees are due at time of application** **Building Permits are void if your check does not clear**
Pl ~' - ~
ease complete the entire Application.
_ If the question does not apply fill in NA for non applicable
NAME ~ 5 ~~ J-~~~-._
PROPERTY ADDRESS Permit#
SUBDIVISION _~i- ~J~>,~ 7~.C.~`~ L .S
Dwelling Units:
Parcel Acres:
SETBACKS ``/ ~
FRONT SIDE ~~, ~ ~~ SIDE ~ ~
Remodeling Your Building/Home (need Estimate) $ ,~L-~ .G~c~) •"'~'
SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building)
~,..
First Floor Area ,- ,~~ Unfinished Basement area
Second floor/loft area Finished basement area ,~3~5
Third floor/loft area Garage area //;,~?..5
Shed or Barn Carport/Deck (30" above grade)Area
3
Water Meter Quantity: ~ * * * * * * * * * * * * * * Water Meter Size:
Required!!! ~`~
~~~ ~
PLUMBING ~ /~~j'
Plumbing Contractor's Name: ~'~~ ~~~/C~/'7 Business Name ~µ
Address City State Zip
Contact Phone: ( ) 3~~ u- ~~7G Business Phone: ( ) . ~'~~-- ~,_~7v
Email Fax .~~G ~~ ~ rJ~"
FIX/TURF COUNT (including roughed fixtures)
/ Clothes Washing Machine
Dishwasher
~_ Floor Drain
Garbage Disposal
Hot Tub/Spa
Sinks
(Lavatories, kitchens, bar, mop)
Sprinklers
~ Tub/Showers
GJ_~ Toilet/LJrinal
Water Heater
Water Softener
Plumbi g Estimate $ /C~~ (Commercial Only)
l" f7
Signature o icensed Contractor Licens number
The City of Rexburg's permit fee schedule is the same as
3 - Z 9 -- o -G
Date
the State of Idaho
BACK
4
' ~~ i ~
. Please complete the entire Application! If the question does not apply cn in Na for non
applicable
NAME 1~1~~~/ ,~„~t2~,~f,~.z
PROPERTY ADDRESS Permit#
SUBDIVISION /~7lca,.r/~ ~~4
Required!!! MECHANICAL
Mechanical Contractor's Name: ,~~~ /f, ~ f~~~E~-~. Business Name: ~~ c ~~~~ 4 ~i!
Address City P"X~ State .. ~ ~ Zip . .3 ~ l~
Contact Phone: ( ) ~~j~~).- ~/~~ Business Phone: ` ) SSA- ~ ~ ~O
Email Fax ..~~~~- ~ ~~ ~
Mechanical Estimate $ %._~ (CommerciaVMulti Family Only)
FI URES & APPLL4NCES COUNT (Single Family Dwelli g Only)
~- ~ Furnace 3S ~ Exhaust or Vent Ducts l~ ~ ` '~
'~ / Furnace/Air Conditioner Combo ~ ~ ~ Dryer Vents ~ ~
Heat Pump
Air Conditioner
Evaporative Cooler
Unit Heater
~_ Range Hood Vents S
Cook Stove Vents
~_~ Bath Fan Vents Z
other similar vents & ducts:
Space Heater
.c Decorative gas-fired appliance 3 d
Incinerator System
Boiler
Pool Heater
Similar fixtures or Appliances
~' Fuel Gas Pipe Outlets including stubbed in or future outlets yo
Inlet Pressure (Meter Supply) PSI
Heat (Circle all that apply) Gas Oil Coal Fireplace Electric
2~'
Mechanical Sizing Calculations must be submitted with Plans & Application
Point of Delivery must be shown on plans.
Signature censed Contractor License number Date
The City of RexburQ's permit fee schedule is the same as required by the State of Idaho
5
EXEMPTIONS FROM STATE REGISTRATION
As of January 1, 2006, the City of Rexburg can no longer sell permits without having a copy of your State
registration number or your exemption from the State registration. Please send a copy of your state registration
or fill out this form showing your exemption and send it with your license renewal or your next permit
application.
(This list is a summarization of Idaho Code Title 54 Chapter 5205, for full definitions of these exemptions
please see the State's website at www.ibol.idaho.gov/cont.htm)
^ Currently State licensed pursuant to Title 54 Idaho Code, Chapters:
3 Architects,
10 Electrical Contractors/Journeyman,
12 Engineers/Surveyors,
19 Public Works Contractors (exempt from fee only registration required),
26 Plumbing/Plumbers,
45 Public Works Construction Management Licensing Act (exempt from fee only registration required),
or
50 Installation of heating, ventilation and air conditioning systems
^ Employee or volunteer of a licensed contractor or part of an educational curriculum or nonprofit
charitable activity with no wages or salary
^ Employee of a US Government agency (State, City, County, or other municipality)
^ Public Utility doing construction, maintenance, or development to its own business
^ Involved with gas, oil or mineral operations
^ Supplier doing no installation or fabricating
^ Contracting a project or projects with a total cost less than $2000
^ Operation of a farm or ranch or construction of agriculture buildings exempt from Idaho Building Code
^ Any type of water district operations
^ Work in rural districts for fire prevention purposes
^ Owner who performs work on own property or contracts with a registered contractor to do work as long
as the property is not for resale within 12 months
^ Owner or lessee of commercial property performing maintenance, repair, alteration or construction on
that property
^ Real estate licensee/property manager acting within Idaho Code
^ Engaging in the logging industry
^ Renter working on the property where they live with the property owners approval
^ Construction of a building used for industrial chemical processing per Idaho Code
^ Construction of a modular building (defined by Idaho Code) to be moved out of state
I hereby certify that the above information is true and correct to the best of my knowledge.
..
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Date
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Print Name
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