HomeMy WebLinkAboutAPPLICATIONS, CO, BP - 06-00198 - 1074 Arctic Willow Dr - New SFR~ Z
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RiO~ ttEX6 UgC •'
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~, T Y o r Certificate of Occupancy
REXBURG
Americn's Farnily CarnmuniYy
City of Rexburg
Department of Community Development
19 E. Main St. / Rexburg, ID. 83440
Phone (2081359-3020 /Fax (20813
Building Permit No:
Applicable Edition of Code:
Site Address:
Use and Occupancy:
Type of Construction:
Design Occupant Load:
SprinklerSystem Required:
Name and Address of Owner:
06 00198
International Residential Code 2003
1074 Arctic Willow Dr
Single Family Residence
Type V-N, Unprotected
Residential
No
B & L Homes Corp
P.O. Box 612
Sugar City, ID 83448
Contractor: Yankee Fork Construction Inc.
Special Conditions: S I ~~'-~~-~ ~' £ ~~:.~ ~ ~~ ~~~
~~eh ~~~~ ~~rn~~ ~ ~~ IQt~~ -~1
~~~ ~~~
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
wes inspected on the date listed wes 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: January 12, 2 02:
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:
State of Idaho Electrical Department
CITY OF REXB URG
BUILDING PERMIT APPLICATION Please c~
19 E MAIN, REXBURG, ID. 83440 If the questi
208-359-3020 X326
PARCEL NUMBER: ~P~ I~L~~~J 3®1~a (WE
PERMIT # ~ ~~ ~ ~
06 00198
1074 Arctic Willow-B&L
SUBDIVISION:_~~+ ~- UNIT# BLOCK#~_LOT#~
(Addressing is based on the information -must be accurate)
CONTACT PHONE # ~'1 -I(3.(_(~
PROPERTY ADDRESS: )() ~ ~- ~r~ti j,~,lt`f1o~ .~~-
PHONE #: Home (~~~~, ° ~i~'~ Work Q4~j ~~ y-~ (e Cell ( ) (~y,i1>=.
OWNER MAILING ADDRESS~~ ~( 2..- CITY: STATE:~ZIP~S~
EMAIL ~vLi71 /IG-d~S /(~Tj~,~yi . (`~~ FAX is !~ - ~2'
APPLICANT (If other than owner)_
(Applicant if other than owner, a statement
to act as agent for owner must accompany this application.)
APPLICANT INFORMATION: ADDRESS
STATE; ZIP EMAIL
PHONE #: Home
CITY:
FAX
Work
Cell
CONTRACTOR: ~L '
MAILING ADDRES : ~~(~ ~ ~l~f_f~' CITY v"' STATE~ZIP ~32Z~
PHONE #: Home ( ) Work Q~~j} ~l ' ~~S Cell ( ) ,f '- ~ 6
EMAIL FAX ° 3 IDAHO REGISTRATION # & EXP. DATE CC~ /~
How many buildings are located on this property?~--~ /
Did you recently purchase this property? No~f yes give owner's name)
Is this a lot split? ~% YES (Please bring copy of new legal description of property)
PROPOSED USE:
(i.e., Single Family Residence,
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 y false statement or misrepresentation of fact in '~ari~„ nr nn +hgn,~ns on which the
permit or approval was based. Permit void if not s ed within 180 days. Permit void if work stops for (}.c~ s~ ~ ~ (~// ([~'
U /V L~
Signature of Owner/Applicant D~~~ 2 ~ 206
Do you prefer to be contacted by fax, mail or phone? Circle One
WARNING -BUILDING PERMIT MUST BE POSTED ON CONSTR CTI N SITE!
Plan fees are non-refundable and are paid in full at the time of application beg mn (~++
City of Rexburg's Acceptance of the plan review fee does not constitut pl~n p v 1 R ~ ~ R ~l
**Building Permit Fees are due at time of application** **Building Permits are void i
r OFµP.XBiJlr~, •
~y r~ CITY OF
_.~~.._._.._...TT-----VV_ __~~..--T--m~_____.__.
~ c
V x 1~1`l~ V 1\~
s.
~s' America's Farrt~ily~ Cvr77munity
~f G
BUILDING SAFETY DEPARTMENT
19 E. Main (PO Box 280) pn~„o• 9nn_Z~o_~non ..~~~
Rexburg, Idaho 83
www. rexbu ra. ora
06 00198
Affidavit of Legal : 1.074 Arctic Willow Dr
State of Idaho
County of Madison p
I, ~ ~ k 6 ~ ~--'
Name Address
City
4~~'~ D
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 re ord o of the property described on the attached, and I grant my
permission to: ame Ad~s~~/ ` ~G~C~~
~-~f~r 1 ~~u 1
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 ~tT ~ (~ , 20 Db
o•
Signature
Subscribed and sworn to before me the day and year first above written.
Notary Public of Idaho
Residing at:
My commission
2
' r
Please complete the entire Application!
If the question does not apply fill in NA for non applicable
NAME ~-~ ~ ~~s~
PROPERTY ADDRESS Permit#
SUBDIVISION ~,,~ ~ ~ ~,,y,~~~ ~,( ~ 2
i
Dwelling Units: ~ Parcel Acres: , ~J ZGY,,(L~,
SETBACKS
FRONT SIDE,
SIDE ~U BACK ~®
Remodeling Your Building/Home (need Estimate) $ ll
SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building)
~. ~~wG qJ5 (f t'~~°~ \ It ~~
First Floor Area ~ ~ ~ Unfinished Basement area
Second floor/loft area (pSO ~ti~P Finished basemen area ,b~3
Third floor/loft area /~ 1 Pf Garage area DU S
Shed or Barn Carport/Deck (30" above grade)Area
Water Meter Quantity:
' /~
************** Water Meter Size:
Required!!!
PLUMBING
Plumbing Contractor's Name: ~ ~ L~IIZ~Nk~/''~ Business Name: ~~ U~K- ,E ~
Address_ ~)(°` r~ City~~D~ State /' Zip
Contact Phone: ~) ~~ ' ~~~ ~ Business Phone: ( ) ,ff~i~
Email
FIXTURE COUNT (including roughed fixtures)
Clothes Washing Machine
Dishwasher
~ Floor Drain
Garbage Disposal
Hot Tub/Spa
Sinks
(Lavatories, kitchens, bar, mop)
Fax
~1 A Sprinklers ~
Tub/Showers
Toilet/Urinal
~_ Water Heater
~,_ Water Softener
Plumbing Estimate $,1~_ (Commercial Only)
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
4
Please complete the entire Application!
applicable
If the question does not apply fill in NA for non
NAME L ~ 3 ~. ~-Z ~;~~ 3
PROPERTY A DRESS ~ (p~,,~~„--(o. Permit#
SUBDIVISION lt~r ~~
Required!!!
MECHANICAL
Mechanical Contractor's Name: /'ZNtZFv/ ~~,gNC1+~~'~Business Name: ~~~~;~ ~ /~~~,~~
Address p (1. ~- ~;,~,5 City C. ~ ~- State ~~ Zip~~
Contact Phone: ~ ,_.._..__.
(~ Y) ' "~ . _ L7 ~ ? ~ Business Phone:- f---)--~"~""`_..__ ~`~~_ _.~
Emai ~ o~r.~ :~ ~:~t ~ ~ ti ~~~C' ,~-' Fax,
Mechanical Estimate (Commercial/Multi Family Only)
FIXTURES & APPLL9NCES COUNT (Single Family D elling Only)
Furnace (S C~~ Exhaust or Vent Ducts ~ ~ o
~_ Furnace/Air Conditioner Combo 3 ~ ~ Dryer Vents f
Heat Pump
_ Air Conditioner
Evaporative Cooler
Unit Heater
Space Heater
Decorative gas-fired appliance ~ ~
other similar vents & ducts:
~~
Incinerator System
Boiler
Pool Heater
~(
Similar fixtures or Appliances ~ , _,f
i ~ aS ~-'~~~~- l C!~ _= ~-~.~.r r: (sir`
Fuel Gas Pipe Outlets including stubbed in or future outlets ~, ~~~ ~1Cr', `i ,.~:~ -~ 2 w ~,
~D ~`
Inlet Pressure (Meter Supply) PSI
Heat (Circle all that apply) G Oil Coal Fireplace Electric
Mechanical Sizing Calculations must be submitted with Plans & Application
Point of Delivery must be shown on plans.
~ ~,,- ~~~
Signature of Licensed Contractor
The City of Rexburg's
~c~~t
~~~
License r'iumber
schedule is the same as
~~ f aG
Date
the State of Idaho
Range Hood Vents
Cook Stove Vents
Bath Fan Vents ! ~
5
• •
SUBCONTRACTOR LIST
Excavation & Earthwork: ~~ U ~ ~f,~ ~ (;,r~l
Concrete: ~,~5 ~~`~
Masonry:_~ ~,(j~(,~~y
Roofing:
Insulation: P.~r
Drywall: ~~~,,,~ ®il~/ ~,~ __
Floor
e
Coverings: F
Plumbing: ~t,.,~ ~ „gyp ~Vv
Heating: ~ i~9 ~~ ~
Electrical: 1 ~ t 1f ai,.,,. ~~
Roof Trusses:
Floor/Ceiling Joists:_
Siding/Exterior Trim:
Other:
Special Construction
(Manufacturer or Supplier)
6