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HomeMy WebLinkAboutBP & APPLICATION - 06-00239 - 530 E 2nd S - RemodelZ ~ O _ ~ ~ ~ m m ~ 70 ~ 3 rn ~ ° - - -~ ..~ ~ _ ~o ~ ~~ D 3 C oo~~D?~ ~ (/~ c ~ ~ ~ ~° Z ~ aa~ ~ O °:a~~ ~ ~ m ~N~~yo -pro m o.-~ N c ~ C ~ ~ ~ n T m' ~ `~ o C N O - ~ m `_ °, a m a ~ ~ O o F o Z d o S' 3 ~ _ ~ °~ ~ y C $ ~ w ~ ~ o d1 m ~ ~ ~ v I- v ~ ~ S 5 v 'g C _ ~ d ~ ~ ~ r ` (7 7y+ o m W v a m Z Z c~ ~ z a 2 ' ~~ ~ Qf m i 17 ~ ~ a 5 0 ~ O ~C1 CN ~ C F ~ ~ °a c m ~ ~ o Z y '~ o ~d~~' o ~ = 3 c ~ ~ n ~ ~o ° ~ C _ F : ~oo ~ m ~, (~ M ~ ~. A ` , a ~ W m n m $ N 1 ~ S ~ ~ l~mr m ~ n TT 3~m ai y ~ O a 0 0 ~~ n ~ '~ v, c ~ Z y ;~ W .~ ~, -p ~ Z ~ N ° ~ W O o~~ o ~ _ ~ ~ !~ ~. Z n n ~ ~ j C A ~I ~ D ~ Z 7 y ~ Z N ~O W C. 7 ~Q H a v ~. c~ 11~ 0 .~ ~ o- y y C <D S ~ e~..r:z W ~ ~ y ~a ~;~~~ =~X~. Boa= ~~~~. 3 ~~c ~~~'~ ~ o ~ c . -~ ~ p y ~ ~; ~D p ~. ~ "" __ .. ~~~ W ~ 3 ~ c-oo, ~ ~ ~ ~ O ~ .y-~ c ~ 3 0 °: a~n ao ,~u~,z~ ~ W .~- n = O W ~ ~ ~ ~ ;,~~a !G Ct .: ~ G. ~ O ~ W ep < to p, 0 ~ M ~ C1 S ~ G. ~~eD not of 7 ~ .~ `~ a ~~ ~ _ ~ 3. n n ~ 3 O Q' ~ C x~°* d. ~ 3 3 C ~- fl. ~ ~ O ^" 3 ~ ~ m Z m z O L g m cn W 0 m N 7 a C= LL m co m C X A W N ~ TI 7 O 01 ~' ~ ~ m ~ ~ cn m ~ ~. ? m ~ C1 ('~ 0 c 7 ~ a v C v O .. '~ m 3 ~t 0 0 0 N W r C 3 ~_ Z >S' • ~'rr ° ~A ~% o ~ :; `~; o~~o $_ A a ~ ~ -~ ~e ~ O 3 ~ ~ ~Il b ~ t0 ~. ~ ~ ~' N. ~~ CO 00 ~I ~ CT A W N -+ ?i ~ cn ~ v - 5 ~ T ~ -n o -n o W C Z v C) 9 7 7 C 9 s Z m n ~_ 2 yn v CITY OF REXB URG , BUILDING PERMIT APPLICATION 19 E MAIN, REXBURG, ID. 83440 208-359-3020 X326 PERMIT # Please cor If the question PARCEL NUMBER: ~P~-N~L'~J`~~ 1~( We v~ 530E 2nd S-Barney Remodel SUBDIVISION: UNIT# BLOCK# LOT# 06 00239 (Addressing is based on the information -must be accurate) OWNER NAME: ~e.~,.. CONTACT PHONE # 2~f -v/y~ PROPERTY ADDRESS: j~© ~, ? ~` ~~ PHONE #: Home (~~) Work ( ) Cell (za~j ~o [ -~f"y 4 OWNER MAILING ADDRESS: ,j ~~ ~~ Z'~`~ 4Jv~ 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 CITY: FAX Work CONTRACTOR: MAILING ADDRESS: PHONE #: Home ( ) Work Cell EMAIL FAX IDAHO REGISTRATION # & EXP. DATE How many buildings are located on this property? ,~- Did you recently purchase this property N Yes (If yes give owner's name) Is this a lot split NO ~~ YES (Please bri/ng,c/opy o/'f new legal description of property) PROPOSED USE: ~ ~.a.. GL ~~; ly Ir.QS, ~,~C,«ci (i.e., Single Family Residence, CITY Cell ( ) STATE ZIP 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 2003 International Code in cases of any false statement or misrepresentation of fact in the application or on the plans on which the permit or appro~~ bas Permit void if not started within 180 days. Permit void if work stops for 180 days. of ~/ [ ~ / ~~ DATE Do you prefer to be cafitacted 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** 3 ~ • Please complete the e~tire Application! ` If the question does not apply fill in NA for non applicable ' NAME ~ 5 ~ / j~~~~~ PROPERTY ADDRESS Permit# SUBDIVISION Dwelling Units: Parcel Acres: SETBACKS FRONT SIDE SIDE BACK Remodeling Your Building/Home (need Estimate) $ /Q~?. ~ 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 0" above grade)Area Water Meter Quantity: Unfinished Basement area Finished basement area Garage area * * * * * * * * * * * * * * Water Meter Size: Required!!! PLUMBING Plumbing Contractor's Name: Address Contact Phone: ( ) Email City Business Phone: Fax FIXTURE COUNT (including roushed fixtures) Clothes Washing Machine Dishwasher Floor Drain Garbage Disposal Hot Tub/Spa Sinks (Lavatories, kitchens, bar, mop) Plumbing Estimate $ Sprinklers Tub/Showers Toilet/Urinal Water Heater Water Softener (Commercial Only) Signature of Licensed Contractor The City of Rexburg's License number Date e schedule is the same as required by the State of Idaho Business Name: State Zip 4 • • P1CaSe COIIlplCte the entire AppllCatlOn~ If the question does not apply fill in NA for non applicable NAME PROPERTY ADDRESS SUBDIVISION Permit# Required!!! MECHANICAL Mechanical Contractor's Name: ~~~ Business Name: -~_ - Address City State Contact Phone: ( ) Business Phone: ( ) Email Fax Mechanical Estimate $ (Commercial/Multi Family Only) FIXTURES & APPLIANCES COUNT (Single Family Dwelling Only) Furnace Exhaust or Vent Ducts Furnace/Air Conditioner Combo Dryer Vents Heat Pump Range Hood Vents Air Conditioner Cook Stove Vents Evaporative Cooler Bath Fan Vents Unit Heater other similar vents & ducts: Space Heater Decorative gas-fired appliance Incinerator System Boiler Pool Heater Fuel Gas Pipe Outlets including stubbed in or future outlets Inlet Pressure (Meter Supply) PSI Heat (Circle all that apply) Gas Oil Coal Fireplace Electric Hydronic Mechanical Sizing Calculations must be submitted with Plans & Apalication Point of Delivery must be shown on clans. 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 Zip 5 • SUBCONTRACTOR LIST Excavation & Earthwork: Concrete: Masonry: Roofing: Insulation: Drywall: Painting: Floor Coverings: Plumbing: Heating: Electrical: Special Construction (Manufacturer or Supplier) Roof Trusses: Floor/Ceiling Joists: Siding/Exterior Trim: Other: 6 M 1 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 certif~t~~the~ve information is true and correct to the best of my l~nowledge. dl~'11CLLUIG / C (~,r~ Print Name 7