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Home My WebLink AboutAPPLICATION, BP - 06-00287 & 288 - Henry's Fork Plaza - Bldg #12 - Site PlanZ O ~"~ -~ ~ ~ m m W ~ rn v ~ .... v v ~ z ~ ~ f, o c~i S ~ D 3 a , C. ~~ ~~ ~~ Z N ~ ~ - (D 'O '~. ~ . ~ D. ° ~ n ~ m a : .. ~ v 7 N., F N N _ o ~_~~ . m~~ a N - m m o ~ m a ' ~ ~ O -~,, ~ o ~ C7 v m~ o ' C O m __ ~ a ~ m m a ~ C a ~ _F d o o ~ o ~ DD _ D. ~ ~ C Z O 7 N v s o (/~ m v r- ~ ~ '~ ~ o ° ° o `D is ,~ ~ C ~ ~ ~~ C v n 3 d a ~' 3 ~ D ~ ~ ~ ~ ~ ~ ` 7 o ~ ~ m v a m ~ ~ D O z ~ .~ Z ~v,~Z n = _~ ~o m ~o =o ~ (ap ~ 7.. im ~ W V ! C fQ Z n !p S ~ C 0 0 ~ a ~? l'1 O. .~. N O N ~ f ~ ~ ao m ~v y'~ ~ c Z ~ ;.~ ~ 3 ~ ~ O ^/.~~ Y/ d ~ ~ -3' ~~ a o c .~ n n ~ J Q N O ~ ' O ~~o°~~ ~ ~ m 0 a T °- n v ~~ ~~ ~, ~ ~~:~ ~rt c~ ~ K y ~ ~ ~ .~ .~ ~;~ ~ ~ ~ ~ `~ x ~. ~ ~o a~ , ~N' ~ Q ~~ ~ k y , a' _ C !: <D ~ y Q. ~ao~_ 1 n ~ ~~ ~ ~ ~ lD C 7. pn1 ""' __ ,~ ~',cc~ N (7 C ~' ~ ~D ~ <D ~ ~D O y .y~- ~ c = ~ ~ O rt a~ _a-• o- ~G y S y S ~ ~ C7 tD <D ~ W ~ y ~ c •~~ ad~~ y ~,~3a ~/! 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W N -• ~ O C N v - ° ~ a o c ~ _ ~ ? ~ C °' m ~ ? ~~ ~ ~. m ~ ~. m o T 0 7 CO 00 ~1 ~ CT A W N -• v c ' ~ ~ a ~ °~ m v, °: ~ ~ `° o a °: o ~ o ~ ~° v c Building Safety Department ~a~~~XB~A~I~ ___~ i T Y o City of Rexburg ~ 90 " ~ I~~ 1,.11t~ 19 E Main janellh@rexburg.org Phone: 208.359.3020 x326 America's Family Community Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3024 r OWNER'S NAME ~"= r•' _ ' ~~~~ PROPERTY ADDRESS 8 ~~ ' r. a ' ts-r~? `~ e SUBDIVISION ~ ~,~ ~~ ~- u PHASE LOT BLOCK 06 00200 Henry's Fork Plaza Bldg # 1.2 Required.!! ELECTRICAL Electrical Contractor's Name ~ le ~ ~1~~~ Business Name ! t'o ~~G~l' j =''G- Address_ ~`~'~ ~yZ~°~ City ,~'G~~:~7~ State ~~ Zip ~s'22.1 Cell Phone ( )~4%~' ~~ Business Phone ( ) _ ~~~" ~~ g~ Fax ( ) 7`,~ S - 7/~~~ Email p.~^~~~~~r- ~~~ ~fS~ . c'd~.~2 Electrical Estimate (cost of wiring & labor) $~~~ (COMMERCIAL/MULTI-FAMILY ONLY) TYPES OFINSTALLATION (New Residential includes everything contained wrtbin the residential structure and attached garage at the same time) Up to 200 amp Service* 201 to 400 amp Service* Over 400 amp Service* Temporary Construction Service, 200 amp or less, one location (for a period not to exceed 1 year) Existing Residential (# of Branch Circuits) Spa, Hot Tub, Swimming Pool Electric Central Systems Heating and/or Cooling (when not part of a new residential construction permit and no additional wiring) Modular, Manufactured or Mobile Home ~1 Other Installations: Wiring not specifically covered by any of the above Cost of Wiring & Labor: $ ~~~ Pumps (Domestic Water, Irrigation, Sewage) Requested Inspections (of existing wiring) Temporary Amusement/Industry *Includes a maximum of 3 inspections. additional inspections charged at requested inspection rate of $40 per hour. Signature of Licensed Contractor The ~~21~ License number schedule is the .came as ~ ~B~ Date the State of Idaho CIi'Y Or KERB U1~G BL.IILDITIG PERMIT APPLICATION Please cc 19 E MAIN, REXBURG, ID. 83440 If the questia 208-359-3020 X326 ff PARCEL NUMBER: ~~~ C~ 4 ` (We SUBDNISION: ~.tr ~ "~~.•~ ~/ z~~ UNITS • PERMIT # 06 oo2s7 & 06 oo2ss Henry's Fork Plaza Bidgs #12 _ ~Addressing is based on the`tntormatron -must be accurate) %7c'/ * /„~i>,,,2 OWNER NAME.• /J~*r 5 ~ ~`~~tS ~ CONTACT PHONE # ~ ~7C`~ ~' 73 PROPERTY ADDRESS: ~ ~ ~ 5 I C~~~~*%5-~6 ~ G PHONE #: Home ( ) .3 ~~ - 73rd Work ( ) Cell ( ) •7r'~ ' 7 ~ ~~ OWNER MAILING ADDRESS: ~~~' .-G'~y ~''~t CITY: ~ ax5`ur STATE:ZO ZIP: lb 3`~~~ EMAIL F. 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 CITY: STATE; ZIP EMAIL FAX PHONE #: Home Work ( ) Cell ( ) CONTRACTOR: ~~~~~_~ s MAILING ADDRESS: „~io .2~r ~ "~i« ~v~ PHONE: Home# ~~3c~ - 73<,,7 Work# EMAIL IDAHO REGISTRATION # & EXPIRATION DATE y~ 8y /~/~ ~ 7 How many buildings are located on this property? G Did you recently purchase this property? No es~ If yes give owner's name) ~~~~~` ~ ~ i` ~ ~%~ Is this a lot spli NO YES (Please bring copy of new legal description of property) PROPOSED USE: G'~m..+~ r~~ a (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 hearings before the Planning and Zoning Conunission 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 approval was based. Permit void if not started within 180 days. Pemut void if/work stops for 180 days. Signature of Owner/Applicant Do you prefer to be contacted by fax, email or phone? Circle One WARNING -BUILDING PERMIT MUST BE POSTED ON CONSTR Plan fees are non-refundable and are paid in full at the time of application begi nu 1 2005. City of Rexburg's Acceptance of the plan review fee does not constitute n prov~'~ **Building Permit Fees are due at time of application** **Building Permits are void i u ec not e -CITY ~<~~~~'~STATE ~~ ZIP ~ `3 yyU Cell# 7~ ~ - ~~'' ~ Fax# ClTYOF REXBURG OF gEXB URG • ~,y r9 C ~ O F ~- BUILDING SAFETY DEPARTMENT `~~ ~ REXI3URG ~' 19 E. Main (PO Box 280) Phone: 208-359-3020 x326 a America's Family Community Rexburg, Idaho 83440 Fax: 208-359-3024 B~~SNED \• ~~ty.rexburg.o~e ianellh o.rexbu~re.ore Affidavit of Legal Interest State of Idaho County of Madison Name Address ~rn ~~~dJ city Being first duly sworn upon oath, depose and say: 1`~~ State (If Applicant is also Owner of Record, skip to B) A. That I 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. 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 herin or as to the ownership of the property which is the subject of the application. --~' Dated this ~4 day of ~.,~r , 20 eW Signature Subscribed and sworn to before me the day and year first above written. Notary Public of Idaho Residing at: My commission expires: 3 • Please complete the entire Application! If the question does not apply fill in NA for non applicable NAME e~/2i *~'~'~'tJ'F..'~,S PROPERTY ADDRESS Ht'~~ys ~y,(~[' ~L.~2.-1 ~~;~-"~ yKl~.~3~3~.i't Permit# SUBDIVISION ~^~'~'`~~p,~F V1~Z~- Dwelling Units: Parcel Acres: SETBACKS FRONT SIDE SIDE BACK Remodeling Your Building/Home (need Estimate) $ SURFACE SQUARE FOOTAGE.• (Shall include the exterior wall measurements of the building) First Floor Area ~f~'a~y Unfinished Basement area 2 Second floor/loft area ~ Finished basement area t;' Third floor/loft area ~•' Garage area (`?- Shed or Barn Carport/Deck (30" above grade)Area /i Water Meter Quantity: ~, ' ~ " ~`~ ' ~ '~~ ~" Water Meter Size: Required.!! PLUMBING Plumbing Contractor's Name: ~~~~rg ~~~'~/~cwio ~Tr ~tl~j"is' ~ Business Name: 6ZC~'1~'''' 'l~~~Q ~~ Address ~~~ r„ ~ `~r.~C~~.~'t j?3,~.f City ~~~~~ State ~' Zip f`j ~1 Contact Phone: ( ) Business Phone: ( ) ~~(A-- C~7 Z~ Email F FIXTURE COUNT (including roughed fixtures Clothes Washing Machine Dishwasher Floor Drain Garbage Disposal Hot Tub/Spa Sinks (Lavatories, kitchens, bar, mop) Plumbing Estimate $ c q~ • ~ (Commercial Only) Sprinklers Tub/Showers ~- Toilet/Urinal ~ Water Heater Water Softener Required! Signature of Licensed Contractor License number to The City of I~exburg's permit fee schedule is the .came as required by the State of Idaho 4 06/08/2006 14:17 FAX ~~~~• u. LUVU ~:u~rm ~1~ease complete the e>«tire Appbic~ti,oni NAl1QE k ~~~~~a^-`~ PRQPERTY AD S ~~~~~l~~S.; a.•~ SUBDIVISIpN .~~P~.~+~ ~. P ~! Requ.~ed.~l.~ 11-1EC~41vICAL Mechanical COIItX9CLpY'S Naxr~c: ~ ff~$e ~ usines9 dame: ~ean'S _/L~Ar.~rb ~~ ~,~, Address /'~ '~ GLO 7~n+E Citq Sta~ee Zip ~k~ Conmet Phoac: ( ) _ Business Phosie: ( ) a' ~ ~ g ~ ~ e'9 Email F n ~ MecTtit~uical Esdma~e $`~ poi (Copam~emsal/Mufti Family Only) FIX7ZTX~S & AP,I',LIANGES CDU1V3' (5ing,~e Farailp.DwcX&ng Ori1PI Furnace Exhaust of Vent Duos ~_ Furnace/Ail Cozlditioner Combo I?ryer Vents Heat Pump Aix Condit(oaer ~_ Evapozalive Cooler Unit ,Heater Spa~~ Heater Decorative gas-feed appliance Inciae[ator System Boiler Pool Heatez f~ 002 No, 2252 P, 2 If cite question does not apply ~fl is 1VA hoe t-oti Permit# Rsuxge Hood Vests Cook Steve Vents ~~ Bath Fan Vcants other simiistt vests & ducts: Fuel Gas Pipe duffels iacladfflg stubbed in ox £utuxe outlets Inlet P~ressuxe (Meter Supply) PSI Heat (Circle all that apply) Gas Oil Coal Fireplace Electtle Hydmnic . .. t bmi d lication Point of_1~e,]iverv~e ehown osz ~ gri . ~~/c- c- f~~~_ Re9w~d! co,a~~ Iac«~ n r~. d~~~~~ `~ ~sa~ofr~~ 5 Pl€ase complete the en>~ Application! if the que:lion doe~ot apply fill is NA for non applic~b~e ,~ NAME f~k~" ~ ~ /`~~~~--~t'~ PROPERTY ADD SS ~~ S `{.~'%~~~u S; D;-~'~` Permit# SUBDIVISION js~ S ~o ~-~ h~.«2~Z Required!~~ Mechanical Contractor's Name: MECHANICAL .v~a,~` cT tN~w`Se ti{ Address 7(a ~, d~' ~-~C. ~i~~-~~~~`T~:~ ~ City Name: /u~EY~~~s+5 ~L,.~g~u1r,~.'~ t!r e~i~z~r~c CtatP :~~ `7in ~'~Ylt`C~ Contact Phone: ( ) Business Phone: ( ) 3 ~ "- ~ 7 1 LY Email Fax Mechanical Estimate $ (Commercial/Multi Family Only) FIXTURES & APPLIANCES COUNT (Single Family Dwelling Only) Furnace Exhaust or Vent Ducts Furnace/Air Conditioner Combo Heat Pump Air Conditioner Evaporative Cooler Unit Heater 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 other similar vents & ducts: Heat (Circle all that apply) Gas Oil Coal Fireplace Electric Hydronic Mechanical Sizing Calculations must be submitted with Plans & ~nylication Point of Delivery must be shown on lens. Required! Sigma o ~censed Contractor License mnnber The Dryer Vents Range Hood Vents Cook Stove Vents v~- Bath Fan Vents schedule is the tame ar ate the State of Idaho 5 J ' }~EXBUR C o~ ~ CITY O F ~ v o ~ ~`VT?Tm(~ 1\1~ V lw BUILDING SAFETY DEPARTMENT s ~ 19 E. Main St. Phone: 208-359-3020 x326 'B ~ ~ America's Family Community Rexburg, Idaho 83440 Fax: 208-359-3024 s N F D ~ x~vw.rexburg.org janellh e,rexburg.o~rp APPLICATION: "CONSTRUCTION PERMIT" CONSTRUCTION PERMIT #: PERMIT APPROVED: YES/ NO $50.00 FEE PAID: YES/NO APPROVED BY: -APPLICANT INFORMATION: BUSINESS NAME: 5~~v«s ~,,sJ ~~. OFFICE ADDRESS: ~cx7a~'~3 ZL> g'3~yyG C4i~ State Zip OFFICE PHONE NUMBER: (.?~ s ) ~5~= - ~ 3~z CONTACT PERSON: ~dr,/ S-~~ ~~~s CELL PHONE # ( ~ sr') 7d9 - 7312 -LOCATION OF WORK TO BE DONE: STREET ADDRESS WHERE WORK WILL BE DONE: ~ ~9 S' ~//®;~ s~.1~ ~ /~e/ ~ %20;1 BUSINESS NAME WHERE WORK WILL BE DONE: ~~~~~ DATES FOR WORK TO BE DONE: _~'/I %~i~ TO /~///~~ CONTACT PERSON: _ ~~~%-~ S~ v~~ s PHONE NUMBER: (,~) 3 5"(E -- 73i~Z CELL # (?a ~) 7~~ ~ 7 3 i,2 PLEASE CHECK THE TYPE OF PERMIT(S) YOU ARE APPLYING FOR: ^ AUTOMATIC FIRE-EXTINGUISHING SYSTEMS ^ COMPRESSED GASES ^ FIRE ALARM AND DETECTION SYSTEMS AND RELATED EQUIPMENT ^ FIRE PUMPS AND RELATED EQUIPMENT ^ FLAMMABLE AND COMMBUSTIBLE LIQUIDS ^ HAZARDOUS MATERIALS ^ INDUSTRIAL OVENS ^ LP-GAS ^ PRIVATE FIRE HYDRANTS ^ SPRAYING OR DIPPING ^ STANDPIPE SYSTEMS ^ TEMPORARY MEMBRANE STRUCTURES, TENTS, AND CANOPIES APPL CANTS SIGNATURE DATE 6 SUBCONTRACTOR LIST Excavation & Earthwork: ~li/y ~~+~ e r c! ~~.a~~ Masonry: .~~ ~~1~ 5 c~ t Roofing: ~jl~~ ~~t~-~ Insulation: ~~L~ ~~ s Painting: l~i f ~ ~n ~:~ ~~~ Floor Coverings: ~ ~ . -~ Hea i' Electrical: ~ ~~ ~~~ ~ 0'i 5,~5 Special Construction (Manufacturer or Supplier) Roof Trusses: ~I~1C' ~}~ 5'~ Floor/Ceiling Joists: Siding/Exterior Trim:~~~r~i ~~=7 k~ 7 ._ ~ • • ~ 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 fox 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 Print Name Date 8 04 RE1CB URC ;~ 19 O ~, 9 a,, 6 (~ S M E D ~ CITY-O F REXBURG America's Family Community BUILDING SAFETY DEPARTMENT 19 E. Main (PO Box 280) Rexburg, Idaho 83440 www.rexburg.org Phone:208-359-3020 x326 Fax:208-359-3024 ianellhCa)rexburg.org Site Plan Checklist Application Information Permit Number: Applicant: fj~zr~ ~tCYC,+S Phone: Jc=~- 7`3iL FAX: 35~ ~~ ? biz Applicant's Address: _~/~ ,~GZ ~~<<~ City: K,!,.F ST: 1"~ Zip: ~'3~ ~ Project Address: $~~`I S Y//a~,~s-~a~a~ Recorded Owner: ~", Recorded Owner Address: Phone: Development Information City: FAX: ST: Zip: ^ 1. Site plan must be drawn to scale, be legible and also be submitted electronically if possible. ^ 2. Adjoining streets labeled. ^ 3. Right-of--way location and width, curb to curb widths and sidewalk location. ^ 4. Building location, sq footage and dimensions, with distance to property lines and distances between buildings. ^ 5. Show existing and proposed easements. ^ 6. Existing utilities (waterlines, sanitary sewer lines, manholes, storm drains). ^ 7. Proposed utilities including tie in location to existing services and new easements. ^ 8. Proposed storm drain and sanitary sewer elevations (for pipe inverts at manholes and catch basins). ^ 9. Storm drainage plan for parking lot and roof areas, with calculations. ^ 10. Fire hydrants and fire suppression lines (including tie to City lines). ^ Sprinkled ^ Not Sprinkled ^ 11. Indicate Fire apparatus access. ^ 12. Parking (including parking lot, drainage arrows, dimension of lot, distance between rows, and total numbers). ^ 13. Landscaping (type and total area, including dimensions). ^ 14. Trash facilities. ^ 15. North Arrow ^ 16. Drawing to Scale, including a graphic scale (11 % x 17" paper if possible). ^ 17. Proposed street improvements (curb, gutter, sidewalk, pavement, etc.) ^ 18. Legal description of proposed building site included. ^ 19. Percent of lot covered by building or paving calculated. ^ 20. Show 10% snow storage area. ^ 21. Distance of entrances from street corner indicated. ^ 22. Current Vicinity Map. (81/2 x 11 ") at 1" = 300' scale, showing location of the property. ^ 23. Lighting Plan NOTE: SITE PLANS MUST BE COMPLETE AND SUBMITTED FOR REVIEW BEFORE THE PROJECT WILL BE PLACED ON THE PLANNING & ZONING AGENDA. °~7