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Home My WebLink AboutAPPLICATION - 06-00182 - 461 Maple - PlumbingPlease complete the e~ire Application! If the question does not app'-' *~" ~~ N A fnr ..ten annli~ahlp NAME PROPERTY ADDRESS SUBDIVISION Dwelling Units: SETBACKS FRONT SIDE 06 00182 461 Maple-Plumbing BACK 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 Unfinished Basement area Finished basement area Garage area Carport/Deck (30" above grade)Area SIDE Water Meter Quantity: **************** Water Meter Size• Required!!! PLUMBING Email FIXTURE COUNT (including roughed fixtures) Clothes Washing Machine Dishwasher Floor Drain Garbage Disposal Hot Tub/Spa ~ Sinks (Lavatories, kitchens, bar, mop) Sprinklers Tub/Showers Toilet/Urinal Water Heater Water Softener Plumbing Estimate $ ~~ ~ -- (Commercial Only) `~ Required! Signature of Licensed Contractor License number Date The City of Rexburg's permit fee schedule is the same as required by the State of Idaho Plumbing Contractor's Name: ~~ u ~ f S.z,., t` J~ Business Name: f ~• ~ ~~ ~ ~~r ~ jy~ r ~; Address ,~ ~ `~ ~ / ~=~ ~.J City ~ -State /~ Zipr~'_)y~,. Contact Phone: (~.~.~`}- -?rte.. ~ ~ l ,~-~ Business Phone: ( ) Parcel Acres: Fax 4 • • 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. Signature Date I ~ Print Name 8 . CITY OF REXB URG BUILDING PERMIT APPLICATION 19 E MAIN, REXBURG, ID. 83440 208-359-3020 X326 Addressing is based on the information -must be accurate) _( We will provide this for you) UNIT# BLOCK# LOT# PARCEL NUMBER: SUBDIVISION: OWNER NAME: CONTACT PHONE # PROPERTY ADDRESS: PHONE #: Home ( ) Work ( ) Cell ( ) OWNER MAILING ADDRESS: CITY: STATE: ZIP: EMAIL FAX 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 ( ) Work CONTRACTOR: MAILING ADDRESS: PHONE: Home# EMAIL Work# FAX How many buildings are located on this property? CITY: FAX Cell ( ) CITY STATE ZIP Cell# IDAHO REGISTRATION # Did you recently purchase this property? No Yes (If yes give owner's name) Is this a lot split? NO YES (Please bring copy of new legal description of property) PROPOSED USE: (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 correct and I swear 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 DATE Do 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** PERMIT # . Please complete the entire Application! If the question does not apply fill in NA for non applicable 3 ~ Of ~iEXBLtR~ ~y ra CITY F v~~ 0 1?~~~-m~ BUILDING SAFETY DEPARTMENT ' J.W ~ ~.J 1~ 19 E. Main (PO Box 280) Phone: 208-359-3020 x326 " Amer-ia;'s Family Community Rexburg, Idaho 83440 Fax: 208-359-3024 Q °, `~~~f~ ~° www.rexbura.ora ianellhC~rexbura.ora Office Hours: Monday-Friday 8:OOam-4:OOpm Commercial/Multi Family Pre-Construction Checklist Seismic Design Category - D Roof Snow Load - 3516s. per sq. ft. (unless soil evaluation confirms category C) Ground Snow - 501bs. per sq. ft. Wind Load - 90 MPH Frost Depth - 36" The following items should be completed before you submit your building permit application. Completion of a Building Permit Application: You may print this application from our website www.rexburg.org or pick up a copy at the Community Development Office (address above). Commercial Permits: (the following must be submitted with the Application) ^ 4 sets of site plans and 2 sets of building plans stamped by a licensed professional ^ Site plans and building plans on CD ^ Structural Calculations stamped by a licensed Engineer ^ Energy Compliance Report: As per the 2003 IECC, a Compliance check must be completed and submitted (the comcheck is available online at www.energycodes.gov) ^ Page 3 of the Application must include the Idaho Contractor's Registration Number or the exemption form must be completed and s~ned, see Page 8. ^ Page 4 of the Application must be completed and signed by your Plumber. A copy of the~P~l}~ber's License is required for our files. "T1~ ~5 ~ `j ~,.~_~.2c~..t ~~ '(I (J~~S~c.7' - ^ Page 5 of the Application must be completed by si ng ed b~your~echanical Contractor, a copy of the Mechanical License is required for our files. ^ Mechanical system sizing and design ^ Emergency Services Construction Permit Electrical Permit: If your construction involves electrical, you will be required to purchase an electrical permit from the State of Idaho according to the State of Idaho Electrical Department. • The Electrical Inspector can be contacted at (208)-356-4830 or toll free 1-800-839-9239. • The Electrical application is available at the Community Development Office. Remodels: If you are considering a remodel, a cou of the bid or estimate for the remodel must be submitted with the Permit Application. • 2 set of plans (may need IECC Review) • Additions - Same as new construction gEXB(~A ~o~ ~'ro CITY 1 ~`~ v~ REXI3URG ____ FAX TRANSMITTAL FORM America's Family Community 'NED DATE: ~' City of Rexburg TO: NAME: P.O. BOX 280 19 East Main COMPANY: Rexburg, Idaho 83440 Phone: (208) 359-3020 ~~~ I ' ~~~~ FAX NUMBER: FAX: (208) 359-3024 PHONE NUMBER: FROM: NAME: JANELL HANSEN PHONE NUMBER: x 326 PAGE _~ OF 'r° Please forward this fax transmittal to the above named individual. ~.T,R,r~ Liu lPn~ -i ~w n ~'lir~"