HomeMy WebLinkAboutAPPLICATIONS, CO, BP - 06-00289 - 632 Meadowbrook St - New SFRZ
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CITY O F
REXBURG
Ameritas Family Community
Certificate of Occupancy
City of Rexburg
n Department of Community Development
19 E. Main St. / Rexburg, ID. 83440
Building Permit No:
Applicable Edition of Code:
Site Address:
Use and Occupancy:
Type of Construction:
Design Occupant Load:
Sprinkler System Required:
06 00289
International Residential Code 2006
632 Meadowbrook St
Single Family Residence
Type V, non-rated .
Residential
No
Name and Address of Owner: Price Vaughn B Etux
315 Millhollow Rd
Re~urg, ID 83440
Contractor: Vaughn Price
Special Conditions: Unfinished Basment
Occupancy: Residential -less than 2 units, permanent in nature
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
vies inspected on the date listed v-es found to be in compliance vtith the requirements ofthe code
for the group and division of occupancy and the use for vihich the proposed occupancy vies
classified.
Date C.O.` Issued: October 15, 2008 (12:56
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.
Plumbing Inspector:
Electrical Inspector:
Fire Inspector:
PBZAdministrator: N~
Jan. 9. 2007 3:11PM
• No.34b2 P. 2
Building Safety Department
City of Rexburg
19 E Main janeJlh~rexburg_org Phone: 208.359.3020 x326
Rexburg, ID 83ddo www,rexburg.o-g Fax: 208.359.3024
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CITY OF
R~XBURG
_____ ~,
America; FamJJy Commu~lty
OWNER'S NAME ~-
PROPERTY ADDRESS ~ ~?'~ ~
SUBDNLSION ,UJ
PHASE I LOT ~ ~'1 .BLOC
06 00289
632 Meadowbrook-Price
,,~OM_E O UT!VER'S EL~ECTRICA.L PERN,IIT
Home owzter's .lYazae ~~~ G~'#-.'"t. P~,t-e
Address 3 t ~ µ ~ ~l ~ l~~ '~-~ Citp (~•-~.~-( State .L~ zip ~~ `~ `~~
Cell Phone (,say) 3S C' / ~ `f ~ Home Phone (~a~ 35~ "`~ ~ ~ ~(
Fax (~,~,~ ~~ ~.- ~ ~'~CSr Email ~ P..-~ ~ rt-~b;w.s .e~~
TYPES OFINST~IZ~TION(RESIDENTIAL)
(NewReaidenrial includes everything contained a~rlrin the rrsidautial structure and attacJaed ga,-age at the same trine)
/ 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/oz Cooling (when rwt part of a aeov residential construction permit
and no additional wiring)
Modular, Manufactured or Mobile Home
Other Iastallatiorxs: Wirixtg 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 matimum of 3 inspections. ddditiomal iaepectiane charged at requested inspection rate of X40 per hour,
V
Sigaaiucc of Homc Owner
/~ 9- a~
Date
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i ~~ P, 1
• ~ ~ ~ Merry TX Result Report (Jan. 11, 2007 12:1QPM) ~ ~ ~
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2)
Date/Time: Jan, 11. 2007 12:lOPM
File Page
No. Mode Destination Pg(s) Result Not Sent
----------------------------------------------------------------------------------------------------
34$3 Memory TX Rocky Mtn Power P, 1 OK
----------------------------------------------------------------------------------------------------
Reason for error
E. 1) Hang up or line fail E. 2) Busy
E. 3) No answer E. 4) No facsimile connection
E. 5) Exceeded max. E -m a i 1 s i z e
Jan, 9. 2007 3:11PM Na.3462 P. 2
Building SaFety Department y [1'[Y~97F~/~
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OWNERS NADdB
PxoPF.>~xx~nnaass ~~,~ R 06 00289
s">in"''st°I'T 632 Meadowbrook-Price
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HomeDaae~sJVame da~4.~e-As Pie
Addmes 31 S M •1l ~. tia-' eC+~ qty 12.s:L~.-S score 1~ zm~'s 4~l c7
C,ellFhmte (,~dy} ~'!~ f?'f 4 Hmm:Phave (aa~ SS6 '41?Q
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(1V+v~esfiodd8ebde~esnya6fywar~oderJhSle tiemtWmRefetremlme®dattse8edgynr®gesed see
17p m 200 amp Services
201 m 400 amp Setvicei'
Dyer 4~'~ Srrver~'
llpmjfoaaep Conauaelion 5ervioy 200~s~ ar ]aq ~e ]ate (Sae: apniod not to cxcad 1 yatj
H~sring Reeidaoty! (# a5$YSar~ Gavin)
Spy Hot Toh, S~vimmapg Pal
Flertae Cenral Systems Heatingaod/ac Coaling (a3mnw pat ofss¢mm®dmdal ®aaumonpe~it
~amaaai,;~®~
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BUILDING
SAFETY
DEPARTMENT
117 V 1\v
V1\
19 E. Main (PO Box 280)
Phone: 208-359-3020 x326
~ c1v
e~, 00, America's Family Community
SHED Rexburg, Idaho 83440
uwvw.rexburg.org Fax: 208-359-3024
janellhCiilrexburg.org
Affidavit of Legal Interest
State of Idaho
County of Ma 'son
I, +~. ,
Name
~~~--~
city
3~ S n~:~~~u..~ ~1.
Address
~~
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 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 herein or as to
the ownership of the property which is the subject of the application.
Dated this l ~_ day of `,~ ~,~ , 20~
Subscribed and sworn to before me the day and year first above written.
2
CITY OF REXB URG
BUILDING PERMIT APPLICATION
19 E MAIN, REXBURG, ID. 83440
208-359-3020 X326
PARCEL NUMBER:. RP~25TNB (O
6 3 Z >~~ btao ~,
SUBDIVISION: ~j~,~(Avtag~
PERMIT # ~ ~ ~~
Please complete the entire Application!
If the question does not apply fill in NA for non applicable
~~(~~ (We will provide this for you)
UNIT# BLOCK#~_LOT# 1~
(Addressing is based on the information - must be accurate)
CONTACT PHONE # (Lv5r~ 3~~ -
PROPERTY ADDRESS: (p 3 Z ~~~.~J ~v"tse~
PHONE #: Home (2o~3S~-`31~r-i Work ~,~}-~S~ -YY34 cell~~ ~-S/-I7~f 9
OWNER MAILING ADDRESS: ~-t 5 J`~itll~.a((~p~ ~. CITY: ~~~..~ STATE:~ZIP:~~~ti
EMAIL ~ ~vz c~ ®'~-~(p~t ~ ~,~,~ FAX C2 e~ ~~ 3~6 - `l YY~
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
PHONE #: Home
Work
FAX
Cell
CONTRACTOR: ~~C
MAILING ADDRESS: 3 ~ S JJl ; l (l,~,E,(( ~„J CITY ~ (e,.....r STATE ~- ZIP ~3Y ~-(a
PHONE #: Home (zoo' 3 S.~ ''9~7~1 Work (~ ~-$ ~L~Y~i!~ 1 Cell (z~ 3~j - /7 ~-I'/~'
EMAIL I/P~o~~vs~a~X 3SL-y'-(Y~IDAHO REGISTRATION # & EXP. DATE~C~ -~~~~ Ij' ~~
How many buildings are located on this property? /~! vre a, (- (~,,•,s„o,~.f
Did you recently purchase this property? No es f yes give owner's name) ae 5~..~pv~.d~~o LC.C,
Is this a lot split?~ YES (Please bring copnny of new legal description of property)
PROPOSED USE: s ~ r5 ~t ~w~: (~p 1css, `d.~~t
(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 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- entioned property f r inspections purposes. NOTE: The building official may revoke a permit on approval issued under the
provisions of the 003 International ode in cases of any false statement or misrepresentation of fact in the application or on the plans on which the
permit or approvl was based. Pe i void if not started within 180 days. Permit void if work stops for 180 days.
U~ ~~,.; y l~l o b
Signature of Owner/ pplicant 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**
3
Please com lete the .tire A lication! •
p pp
nn If the question does not apply fill in NA for non applicable
NAME ~~~ ~~ -l~n`~e
PROPERTY ADDRESS G 3 Z-- l~l..-~ ~10..~ ~.r.+~K, , Permit#
SUBDIVISION S ~ I~,,,~d
Dwelling Units: "1 Parcel Acres: ~ o ~"
SETBACKS
FRONT SIDE SIDE
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 g
Water Meter Quantity:
7 a
************** Water Meter Size: ~ y
Required!!!
PLUMBING
Plumbing Contractor's Name: G= ~ ~ w ~~~ Business Name: ~~ ~ w,. d ., p~~.,.,,,(~o ~•tiS
Address_ ~ ~ d ~ ~ Y.3 City a ~ /C~.- State ~ . Zip j ~3 ~
Contact Phone: (?.aY) GZ `{ ' 7G6 ~ Business Phone: (~~ 3 17 - (~6s'
Email
FIXTURE COUNT (including roughed fixtures
Fax
~ Clothes Washing Machine Sprinklers
f Dishwasher Z Tub/Showers
~ Floor Drain Z Toilet/[Jrinal
t Garbage Disposal ~ Water Heater
Hot Tub/Spa Water Softener
Sinks
(Lavatories, kitchens, bar, mop)
Plumbing Estimate $ (Commercial Only)
c bQ 9 ~! (o
Signature of Li ensed Contractor License number
The City of Rexburg's permit fee schedule is the same as
Date
by the State of Idaho
BACK
4
• •
Please COlllplete the eritlPe AppllCatlOri~ If the question does not apply fill in NA for non
applicable
NAME ~au.~ Fty-J
PROPERTY ADDRESS . „~ Permit#
SUBDIVISION s~ lo,.ti~d~2
Required!!!
MECHANICAL
Mechanical Contractor's Name: ~~ ~-.e (4 ~,,.,.,.o-~j Business Name:
Address ~ ~0, $ S~ 17' 3 City l a. ~ fir' State L~ , zip ~ 3 SF3~
Contact Phone: (1~j ~- Z `~ "7 ~ ~ ~ Business Phone: (~~ 3 ~ 7 - l9` S
Email
Fax
a~
Mechanical Estimate $ ~~~ (CommerciaVMulti Family Only)
FIXTURES & APPLIANCES COUNT (Single Family Dwelling Only)
~,/ Furnace f ~- Exhaust or Vent Ducts
Furnace/Air Conditioner Combo
Heat Pump
Air Conditioner
Evaporative Cooler
Unit Heater
Space Heater
t Decorative gas-fired appliance
Incinerator System
Boiler
Pool Heater
Similar fixtures or Appliances
~ Dryer Vents
Range Hood Vents
Cook Stove Vents
Bath Fan Vents r~~ ' ~`
other similar vents & ducts:
j~~,
~ x Fuel Gas Pipe Outlets including stubbed in or future outlets
Inlet Pressure (Meter Supply) PSI
Heat (Circle all that apply) Gas it Coal Fireplace Electric
Mechanical Sizing Calculations must be submitted with Plans & Application
Point of Delivery must be shown on plans.
~.
Signature of Licensed C actor
The City of Rexburg's
Z ~ ~o
License number
it fee schedule is the same as
~i~-/~
Date
the State of Idaho
5
•
SUBCONTRACTOR LIST
Excavation & Earthwork: ~a~~y Vps S Cowl' tt~iy.•c
Concrete:
Masonry: .J ~( Mas.u.v~l
Roofing: VA~LL6 etx1 ~J`~
Insulation: ygy.G ~ ~,~ cP
Drywall: ~qi,i~ rru-~ ~/-tp
Painting: Va~.~Gr ~ ~U,,.tp
Floor
Coverings: ~J ~a~ caS e r 1ti~e . ~wg /Au ` tt~J .P1`.+'c.'P
Plumbing:~.,r ~ ~„ a~ ~ ~
Heating: ~z ~
Electrical: C.t.s ~.,.~.a,,,) ~1~~' ~
Special Construction
(Manufacturer or Supplier)
Roof Trusses: ~ 1.~1.~ ~.J-•S'r'
Floor/Ceiling Joists: (~ ~C c~ g'~'
Siding/Exterior Trim: ~(l Q w t ~~~s
Other:
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
Print Name
7