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Home My WebLink AboutAPPLICATIONS, CO, BP - 06-00174 - 655 Meadowbrook St - New SFRZ O _ ~ ~ m m oo ~ rn ~ ~ .~ z ~ ~ ~.o~s,a 3 C O p ~ ~ ~ O. '~. 'A.. ~ ..« a -• ~ ~ -~ ~' ~ F.~, ~ _~ m 177 _ U1 7 a' N O c y n ~- ~ ~ c 3 ~ v n d ~~'o C 'O m '__ ; a m M n. p n a ~~ ~ Z ~ O O 3 ~ _ 7. d N `. O j d -o s o ~ m -1 v ~ Q ~ F ~ -~ o o W ~ ~ ~ C ~ ~ __ ~ 3 -~ < ~ r Q. 3 _ ~ ~ --~ -t v t/! m W ~ o a ~ ~ n a Z - .~ , ~sZ a = ~ ~ o m 111 ~ ~~~a~ ~ to Z~~ i -n C 0 0 ~ v v n d .+ N O N ~ v = n N ~- O R1 . .. _ ' ~ ~ ~ v~ ° . m o Q ~ ~ .~ n ~~o°'o ~' m m ~ S, n ~"' a ~ ~ ~.~'n3 Z ~ c e~ °~ ~ ~ _ .~ ~ ~ O cco~N O n ~ ~~~ Z Q ~ ~ . y Z ~ W ~. ~~~~ C'f A ~ C/ ~ =ti D~ ~ o~.c~i~ Z ~~~ ~ O O y n= ~ ~ d O Q. ~ (D ~ '8 ~D ~ ~ ~ ~ y y ~ ~ ~ eD ~ O ~ Q QN C.~ ~ ~N ~.~ S 'yp' ~ n ~ ~ ~. 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Main St. / Rexburg, ID. 83440 Phone (208) 359-3020 /Fax (208) 359-3022 Building Permit No: 06 00174 Applicable Edition of Code: International Residential Code 2003 Site Address: 655 Meadowbrook St Use and Occupancy: Single Family Residence Type of Construction: Type V-N, Unprotected Design Occupant Load: Residential Sprinkler System Required: No Name and Address of Owner: Jemmett Benjamin 438 W Main St 119 Rexburg, ID 83440 Contractor: Owner Special Conditions: 1461 sq ft Unfinished Basement Occupancy: 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 was inspected on the date listed vies found to be in compliance with the requirements of the code for the group and division of occupancy and the use for which the proposed occupancy wes classified. Date C.O. Issued 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 D /. State of Idaho Electrical Department CITY OF REXB URG BUILDING PERMIT APPLICA~ 19 E MAIN, REXBURG, ID 208-359-3020 X326 PARCEL NUMBER: SUBDIVISION: ~~~t"~e L% OWNER: ~~~ Ic APR 0 4 ~~~~ PROPERTY ADDRESS: ~ j 5 yL1 ~~a~~w bfr~c ~c S ~'. PHONE #: Home ( ) Work ( ) Cell (~p~j; ~~yG ~°~L~~ OWNER MAILING ADDRESS: ` ~1~~ ~~ CITY: STATE:~ZIP:S~ ~(~ APPLICANT (If other than owner) (If applicant if other than owner, a statement authorizing applicant to act as agent for owner must accompany this application.) MAILING ADDRESS OF APPLICANT ~~j~ : ~tr ~ L~c~~,n ~`~ ~~I f y CITY: '~ , ,: vc STATE, ~ ~sz~ ' ZIP _~ ~ . ~ . PHONE #: Home (~~~ 7~'~f -/~y~',~ Work ( ) '. Cell (~ '~,~~~~ ~r,Y~,3 CONTRACTOR: PHONE: Home# Work# Cell# PERMIT # ~ ~~ ~~ ~ s~ cor 06 00174 :ion ~ 65 5 Meadowbrook St UNIT#~, ~s BLOCK#~LOT#~(,~ _CONTACT PHONE # ~ ~~~ MAILING ADDRESS: CITY STATE ZIP How many buildings are located on this property?~iq~ Did you recently purchase this property? No es If yes give owner's name) ~N'1d.N~~ h l~~:~N Is this a lot split? NO YES (Please bring copy of new legal description of property) PROPOSED USE: (i.e., Single Family Multi Famil~ 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 f ct in the application or on the plans on which the permit or approval was based. Permit void if not started within 180 days. Perm' oid if work stq~s' for 180 days. ignature of Owner/Applicant /~/ ~ DATE ® 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 Rezburg'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** . c~` ~a CITY O~ R~x~u~~ AMERICA'S FAMILY COMMUNITY i L _ __---- 19 E. Main (PO Box 280) Rexburg, Idaho 83440 www. rexbu rg. oro --- _ Phone: 208-359-3020 x326 Fax:208-359-3024 comdev@rexburq org Affidavit of Legal Interest State of Idaho County of Madison I, ~~~yti+tt9V1, ~i ~ ~ ~ -~ I Q, Name Address ~ Y~~ City Sta e Being first duly sworn upon oath, depose and say: (If Applicant is also Owner of Record, skip to B) A. That I am the reco d owner~£the prope described on the attached, and I g t permission to: ~~~~` u'3~ ~ , ~li(.p ~~ ~~~ 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 herein or as to the ownership of the property which is the subject of the application. Dated this day of , 20 Subscribed and sworn to before me the day and year first above written. Notary Public of Idaho Residing at: My commission expires: Please complete the ire Application! If, he questio does not apply fill in NA for non applicable NAME ~~ PROPERTY A DRESS `.~ - ~~ ~ Permit# sUBDIV1sION _, ~~~~ z~~'~' a Dwelling Units: [ Parcel Acres: SETBACKS ~ FRONT SIDE SIDE BACK Front Footage (if applicable) Storm Water Length Remodeling Your Building/Home (need Estimate) $ SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building) First Floor Area (~~ ~ Unfinished Basement area ~ ~"~ f Second floor/loft area Finished basement area Third floor/loft area Garage area Shed or Barn Carport/Deck (30" above grade)Area Water Meter Count: ! Water Meter Size: 3 Required!!! _._____~___.__ PLUMBING ._. _ Plumbing Contractor's Name: ~~"~ G~ <,~r Busines Name: ~ , ~ wc~ ri i Address C ~~~ ,~ f ~ , Mate ' Zip Contact Phone: ( ) ~J -- ;,~-~~. Business Phone: ( ) ~ C~ - 3~s' G ~-.- FIXTURE COUNT (including roughed fixtures) ~ Clothes Washing Machine ~_ Dishwasher Floor Drain ~ Garbage Disposal Hot Tub/Spa ~, Sinks S (Lavatories, kitchens, bar, mop) ~~ Sprinklers ~_- Tub/Showers ~ y 2.. Toilet/LTrinal 3 ~ Water Heater ~~ Water Softener Plumbing Estimate $ (Commercial Only) e of Licensed Contractor License number ate ~,/'~, The City of Rexburg's permit fee schedule is the same as required by the State of Idaho Please complete the e~ire Application! If the question does not apply fill 'n NA for non applicable NAME ~ ~ PROPERTY AD RFCC (~ Permit# SUBDIVISION _ ~~~~'~5~~, Required!!! MECHANICAL Mechanical Contractor's Name: 6 ~~` Business Name: ~~~/~ ~r~~v,~L C Address ~~ ~ State ~~ ho Zip-~'~~1~ Contact Phone: (dug) 3 t 3 - Doo ja sines Phone: (~,g) 3 ~ 3 ova ~ Mechanical Estimate $ (CommerciaUMulti Family Only) FIXTURES & APPLL4NCES COUNT (Single Family Dwelling Only) ~ Furnace 3 s~ ~ Exhaust or Vent Ducts ~S Furnace/Air Conditioner Combo Heat Pump Air Conditioner Evaporative Cooler Unit Heater Space Heater Decorative gas-fired appliance Incinerator System Boiler Pool Heater Similar fixtures or Appliances Dryer Vents S Range Hood Vents Cook Stove Vents z Bath Fan Vents ~~ other similar vents & ducts: /yo ,~ Fuel Gas Pipe Outlets including stubbed in or future outlets zs 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. ~~~ ~ ~ ~ Signature of icensed Contractor License number ate The City of Rexburg's permit fee schedule is the same as required by the State of Idaho « • 7 SUBCONTRACTOR LIST Excavation & Earthwork: Concrete: 4 Masonry: ~.'~ Roofing: ~ L Insulation: Drywall: ~ 1~1 L Painting: ~~~QZ ~~~~ ~ ~ ~. ~ ~ ~ a ~ ~L Floor Coverings: C9S 5 ~G f t ~ I Plumbing: ~ ~u,1PG~ i Heating:~~~~' Electrical: 1 _~ :~~ in~a ~ ,y^ ~ 61rs i `Y1, f r' 1 ~ ~ _ Special Construction (Manufacturer or Supplier) Roof Trusses: ` ~ ~ V~L (, l AIF, "~, _ _ w Floor/Ceiling Joists: ~~~ `~ d Siding/Exterior Trim: ~ ,~~~ ~d,~~(~jZ Other: ~- ~' 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.~ov/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 herebycertify that t above information is true and correct to the b st of ~ y knowledge. ,/~ ~ c ~ S gnature D -, --, ,, Print N 7 ~~~, CI fY OF R~XBL_ IR__G ~~'~crs~, R~~II KI~~~\'> I ~~1~.1" ~ ~~RL~4UI~I I Y 12 North Center (PO Box 280) Phone: 208-359-3020 x313 Rexburg, Idaho 83440 Fax: 208-359-3022 www.rexburo.or~n blairtcLci.rexburg.id.us CONTRACTOR BUSINESS LICENSE APPLICATION Name of Business: Locatio>< Type of Person applying: ~ ~n ~n~,~~_ Rezburg Address• 4" ~ `fi ~,1~. ~,~~.~vi ~~. ~~ Other address, city, state & Trp) Home Phone: Business Phone: Mobile Phone: Faz: Location of previous Drivers License Number: State: ~/X4~-YOU Date of Birth: `„~/.Phi.' /l`~~ State Taz I.D. Number: Nearest friend or (Name) (address, city, state, ap) References if new business: Amount of license: Signature• Date: Approved Date.