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Home My WebLink AboutAPPLICATION - 06-00251 - 265 E 2nd N - RemodelMay, 22. 2006 lO:OIAM • No, 2158 P. 4 CITY OF REXBURG PRRIUTT ~ • B~JILDING PERMIT APPLICA?ION Please ct l9 E MAIN, REXBURG, ID. 83440 If the questit nfi nU251 208-359-3020 X326 26~ E 2nd N-Windo« Replacement PARCEL NUMBER: (~P~'~)CP~ ~ b~~~-~ (We SUBDIVISION: _UNIT# BLOCIC#~LOT# (Addressiutg is based on the information - must be accurate) CONTACT PHONE # ?~t~ - ,? ~°~ PROPERTY ADDRESS: Z.~.k~~ G Z-r~'(! 1~ PHONE #: Home ( ) Work ( ) Cell ( ) OWNER MAILING ADDRESS: Z-l,r~~j C , 2 '~ 1~" . CITY: ' ~ v STATE:~ZIP;~ EMAIL FAX APPLICANT (If other than owner) (Applicant if other than ownea, a statement authorising applicant to act as agent for owner roust accompany this application.) APPLICANT INFORMATION: ADDRESS STATE; ZIP EMAIL, PHONE #: Home ( ) Work CITY: AX Cell ( ) CONTRACTOR: ~~,v, ~ - V-Zti~~~- ~Cl~ _ Y>~~ ~ I~~~ _ MAILING ADDRESS: ~1 ~1=~~Q~, CITY ~ ~~I; ~'G11I~ STATE ~ . ZTP ~5 ~Z PHONE #: Home ( ) _ Work (~ ~Z-k' ~ ~~ r C> _ Cell ( )!.P`~/- ADD EMAIL />f- FAXS~"03oq IDAHO REGISTRATION # & EXP. DATE ~1C.E - Z~ ~'--~ How many buildings are located on this property? 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 Re Family, Apartments, Remodel, Garage, Commercial, Addition, >=LC.) APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, I hereby certify that 1 have read this application and state that the information herein is correct attd i swear that any information which may hereafter be given by me in hearings before the Planning and Zoning Comtotission or the City Council for the City of Rexburg shall be truthful and Correct, 1 agree to comply with all Ciry regulations and State laws rclatitlg to the subject matter of this application and hereby authorized representatives ofthe Ciry to enter upon the abovo-mcntioned property for inspections purposes. NOTE: The building official may revoke a pertttit on approval issued under the provisions of the 2003 international Code in cases of any false statement or misrepresentatioe of fact in the application Or on the plans oo which the permit pr approva)~c based. Permit void if not started within 180 days. Permit void if work stops for 180 days. _ _ Signature Ownot/Applicant Do you prefer to be contacted by fax, email or phone? Circle One WABN,ING - BUII.DIlVG PERMIT MU3? BE POSTED ON CONSTRUCTit Plan fees are non-refbodahle and are paid in full at the time otapplicatioo beginning City of Rexburg'a Accepla:nce of the pl^n review fee done not constitute plan , **Buildiag Permll Fees are due at time of applicatfon"" *+18uildiag Permits are void if your . ,~~ ~ ~ ~ ldAY 2 3 2006 EXBI~RG May. 22. 2006 10:02AM Please complete the entYre Application! No, 2158 P. 5 ~f the question does not apply fll an NA for non applicable NAME ~0~~)0~l ~~~~~ PROPERTY ADDRESS ~ - . 2~'-`~- Permit# SUBDIVISION Dwelling Units: Parcel Acres: SETBACKS FRONT SIDE SIDE BACK Remodeling Your Building/Flome (need Estimate) S~ ~ SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building) Lz:~ First Floor Area Unfinished Basement area~~ ~ . SS 1J~~~ Second floor/loft azea Finished basement area Third floor/loft area Garage area Shed or Barn Carport/Deck (30" above grade)Area Water Meter Quantity: ************** Water Meter Size: Required!!! PLUMBING ~ I ~ Plumbing Contractor's Name: Business Name: Address City State Zip Contact Phone: ( ) .-Business Phone: ( ) Email Fax FIXTURE COUNT (including roughed aztures) Clothes Washing Machine Dishwasher Floor Drain Garbage Disposal Hot Tub/Spa Sinks (Lavatories, kitchens, bar, mop) Plumbing Estimate S (Commercial Only) Signature o€Licensed Contractor The Ciry oJRexburg's p Sprinklers Tub/Showers ToiletlUrinal Water Heater Water Softener License number Date e schedule is the same as required by the State of Idaho 4 ,AT S ^,v~4'~4~ov O'I~A. 4 ,~ December 6, 2005 GARY KENTS INC DBA GK S GARY CHRISTENSEN, ET AL P O BOX 51601 IDAHO FALLS ID 83402 RE: Registration Notification Congratulations! Owyhee Plaza 1109 Main St., Suile 220 Boise, Idaho 8 3 70 25 64 2 (208)334-3233 FAX (208) 334-3945 E-Mail ibol ii)ibol. Idaho a~~ Websiteh sa/www.ibol_idnhu,gp~ The IDAHO CONTRACTORS BOARD has reviewed your application for registration as a CONSTRUCTION CONTRACTING business in Idaho. ,Based on documentation that you have met the requirements for said registration, the Board has approved your application and authorized me to issue registration number RCE-2774 for your entity. This Registration authorizes the named entity to practice as a CONTRACTING BUSINESS in Idaho. Your registration cards are attached below and will expire 12/06/2006. This registration is subject to renewal each year before the anniversary date of issue. A renewal notice will be mailed approximately 6 weeks before the expiration date. Please notify this office immediately of any necessary corrections or changes to your name or address. Sincerely, Rayola Jacobsen Bureau Chief Bureau of Occupational Licenses Your registration Department of Self Governing Agencies must be shown on The person named has met the requirements for reglstretbn and is entitled under the laws and rules of the State of Idaho to opsreta ae a(n) demand. CONTRACTING BUSINESS GARY KENTS INC DBA GK S carry this copy GARY CHRISTENSEN. ET AL 2990 3 YELLOWSTONE HWY IDAHO FALLS ID 83402 display this copy l~ ~J Rayola Jacobsen RCE-2774 12/08/2008 Chief, B.O.L Number Expires ~I~I~NW~~IM Bureau of Occupational Licenses Department of Self Governing Agencies The person named hat met the requirements for registration and is entitled under the lawn and rules of tM State of Idaho to operate as a(n CONTRACTING BUSINESS GARY KENTS INC DBA GK S GARY CHRISTENSEN. ET AL 2890 S YffLLOWSTONE HWY IDAHO FALLS ID 83402 Rayo~obsen RCE-2774 12/06/200E Chief, B.O.L. Number Expires BUREAU OF OCCUPATIONAL LICENSES May. 22. 2006 10:O1AM ~> ''•~~~H[o ~~, No. 2158 P, 3 CITY O F nrvnTm~ BUILDING SAFETY DEPARTMENT c~+V It 19 E. Meln (PO Box 280) Phone: 2 8-359-3020 x328 Rexburg. Idaho 83440 Fax: 20t3.359~024 America's Family Community www.rexbum.ors~ ~n~Uh rsxburg;org A#~idavit of Legal Interest State of Idaho County of Madison I, Name City Being first duly sworn upon oath, depose and say: Address State (If Applicant is also Owner of Record, slop to B) A. That 1 am the record owner of the property described on the attached, and I grant my permission to• • Name Address to submit the accompanying application pertaining to that property. B. 1 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 Signature Subscribed and sworn to before me the day and year first above written. Notary Public of Idaho Residing at; My commission expires: 2 ,:, e , A s ~ot~e arr P~,e.o.T RFQaroe E - .vsm t y(,cEg~. 'lr: yve. s E Gk's Cv.~er_.Fr~vr,~c.) n /NSTK ~ ~ aAsLME,~TE6~F1J' ~fi°tAtf ~T 2 '~^"~~~~ 1i:E 3ASE~i'NT W.Nr~~ ur , ,~.~~ ~-- .z~sF,zN~ N. ~ax73weG, fir, ~yya fAr To Gka A3~i~/.'GA~y F~ ~ S2S-o3o 9