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Certificate of Occupancy C['Cti' O F ~ y _._..... __ _.... --- - _ " y ~~~ZG City of Rexburg y~ - ~ J ,3n~eri~a'sran,irvCamn~umty Department of Community Development 19 E. Main St. / Rexburg, ID. 83440 Phone (208) 359-3020 /Fax (208) 359,3024 Building Permit No: Applicable Edition of Code: Site Address: Use and Occupancy: Type of Construction: Design Occupant Load: Sprinkler System Required: 06 00315 International Residential Code 2003 337 W 1st N Duplex Type V, non-rated Residential No Name and Address of Owner: Diamond L Investors Llc 4455 Judd St Rexburg, !D 8340 Contractor: Legacy Electric, Inc Special Conditions: Occupancy: Residential -less than 2 units, permanent in nature This Certificate, issued pursuant to the requirements of Section 109 of the lntemational 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 vtas found to be in compliance vuth the requirements of the code for the group and division of occupancy and the use for vihich the proposed occupancy vies classified. Date C.O. Issued: C.O Issued by: November 04, 08 (10:35AM) ,~ 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 ~' ~~~~"1 Fire Inspector: 4~`s ~(~ Electrical Inspector' PBZ Administrator: ~...C=.3 o~4~,xnvR~,y ~, E.j }. o ~ Certificate of Occupancy ~ y _..--_--__._ _..__.._..._.____.. Us~ ~~~~ City of Rexburg - "°'--- Department of Community Development America's Family Conen:unily 19 E. Main St. / Rexburg, ID. 83440 Phone (208) 359-3020 /Fax (2081359-3024 Building Permit No: Applicable Edition of Code: Site Address: Use and Occupancy: Type of Construction: Design Occupant Load: Sprinkler System Required: 06 00315 International Residential Code 2003 33q W 1st N Duplex Type V, non-rated Residential No Name and Address of Owner: Diamond L Investors Llc 4455 Judd St Rexburg, ID 83440 Contractor: Legacy Electric Inc Special Conditions: Occupancy: Residential -less than 2 units, permanent in nature This Certificate, issued pursuant to the requirements of Section 109 of the lntemational 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 vies found to be in compliance -tiith the requirements of the code for the group and division of occupancy and the use for v~hich the proposed occupancy teas classified. Date C.O. Issued: C.O Issued by: November 0 (10:3 ''"~ 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- ' Fire Inspector:~~ Electrical Inspector: P8Z Administrator: Building Safety Department City of Rexburg ., 19 E Main janellhQrexburg.org Phone: 208.359.3020 x326 Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3024 O~ pEXB U'QC ~y ~O U 70 's ~ CITY O F REXBURG America's Family Community OWNER'S NAME ~ 1 ~ l') U ~ Q L .-SIN ~ E S Tvf` S+ PROPERTY ADDRESS 3~~ ~ ~ S"~~U~'T!~ SUBDIVISION PHASE LOT BLOCK Permit #06 00315 339 W 1st N-Duplex Requlred.!~! ELECTRICAL Electrical Contractor's Name ~~,~ ~E~~L`1$ ~ Business Name L-1 / Gn ~ ~.'~ ~L~L ~J Address ~~ 55 Tl~ ~ ~ f .. Ciry~ -'~x8~1R~j State .~~ Zip Cell Phone (~) ~~~ ~ v~t~~p Business Phone (j,;;~) 35~ ° `~79 ~ Fax (~,-~) ~ J `~ ' ~"~ ~ ~ Email Electrical Estimate (cost of wiring $~ labor) $ / 5 r~t~ _ (COMMERCIAL/MULTI-FAMILY ONLY) TYPES OFINSTALI.ATION (New Residential includes everything contained within 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 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. . ~ ~5~~~ Ny~j S. (~~ ,. c.a Signature of Licensed Contractor License number Date The schedule is the ,came as required by the State of Idaho ~C'~ TY OF REXB URG ~0 00315 BUILDING PERMIT APPLICATION Please ~ 19 E MAIN, REXBURG, ID. 83440 If the ques ~~ W 1st N- L e i s h m a n 208-359-3020 X326 PARCEL NUMBER: ~.Q~~,~I ~ (~) (~ ~ (We will provide this for you) SUBDIVISION: UNIT# BLOCK#~LOT#~ (Addressing is based on the information -must be accurate) uwlVL'K LVAM~: ~_~ L ~~~ GEC. CONTACT PHONE # 2C~ ~ ~~ -- q'~ ~ PROPERTY ADDRESS: ~y ,,;~~; ~ ~~~'~'' J -° ~ ~'~ PHONE #: Home (~ -~'~^~74 ~ Work f~ 7 (~ ^C~tl2t~ Cell ( ) OWNER MAILING ADDRESS: `>!`IS~ ~ ~ ~ . CITY: ~o STATE: ZIP: ~`f'Y EMAIL /'1 r~rk ~el r~~. V~r1l r`~_~ Wla. ~( , C~.11~t/1 FAX 2~ :_ 3s~ ~ 7~, 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 Cell ( ) CONTRACTOR: ~ `- ~ ,, j=~,~, MAILING ADDRESS: ~~~ ~~ CITY_ - STATE „~~ZIP ~3'~`~ PHONE #: Home ( r~~i -~~ Work Cell ( ) '~t(~,C:`~! AX IDAHO REGISTRATION # & EXP. DATE ~~ How many buildings are located on this property? ~ Did you recently purchase this property? No es If yes give owner's name) ~~tL ~Q,~kr`vt~~ Is this a lot split? NO YES (Please bring copy of new legal description of property) PROPOSED USE: ~ (i.e., Single Family Residence, Multi ~ sly, Apartments, APPLICANT'S SIGNATURE, CERTIFICATION ~ that I have read this application and state that the information herein i; in hearings before the Planning and Zoning Commission or the City C with all City regulations and State laws relating to the subject matter c upon the above-mentioned property for inspections purposes. NOTE: provisions of the 2003 International Co~ m~ cases of any false statemi permiy~ortappro j~al was bled. Permit alp if not started within 180 d. may revox~ n of fact in salty of perjury, I hereby certify h may hereafter be given by me L and correct. I agree to comply entatives of the City to enter approval issued under the ~n or on the plans on which the - / ~~~s~ ` ~-~_.'~ ~,~;'°C--/~~ t v ~ I ~ v r t~ CJl CS U tS U ~ ~/~~.L'~ ~_.' ~ ~ / Signature of Owner/Applicant DATE Do you prefer to be contacted by fax, email o hone? Circle One WARNING -BUILDING PER UST 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** Commercial, Addition, and I swear that any i-'n o it the City of Rexburg shall ~o. `'moo U 7 ~~ B~~ S N E D ~ e 0", • CITY O F REXBURG America's Family Community BUILDING SAFETY DEPARTMENT 19 E. Main (PO Box 280) Phone: 208-359-3020 x326 Rexburg,ldaho 83440 Fax:208-359-3024 www.rexbura.org janellh rexburg.org Affidavit of Legal Interest State of Idaho County of Madison Name Address ~X~ City Being first duly sworn upon oath, depose and say: ,1C%~ 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 herein or as to the ownership of the property which is the subject of the application. Dated this ~~ day of ~-~~~ , 2p~_ ~i~iia~ure Subscribed and sworn to before me the day and year first above written. ~0~.~ ''. r' Y': 'Not~y P blic of Idaho ~ --? s s-os '~ Residing at: _ z .,* p~'gL1C - • ` ~d'l~ •. ••N„~~```~~~~` '' ~ p `~ My commission expires: ~ ~ - ,,1- ~~ ~ ~=, ~o '~ ~ `P~~~ 2 Please complete the e~ire A lication! Pp If the ques 'on does not apply fill in NA for non applicable NAME ~~ C., .Tyl ~ L-G~. PROPERTY ADDRESS Permit# SUBDIVISION Dwelling Units: SETBACKS FRONT ~SSIDE SIDE ~ a ~ BACK ~ Z • S Remodeling Your Building/Home (need Estimate) $ "~~ ~~ -~~ rye ; ..~ -~ C~ , SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building) First Floor Area ~ ~ . ~ Unfinished Basement area ~~ - ~ Second floor/loft area j~.l ~ Finished basement area t\( /~ Third floor/loft area /`t /~ Garage area °( Shed or Barn ~ Carport/Deck (30" above grade)Area f~ ~! Water Meter Quantity: ~ Water Meter Size: Required!!! PLUMBING Plumbing Contractor's Name: ~ ~ ~ Business Name: Address ity u, State (( Zip~~ Contact Phone: Email FIXTURE COUNT (including roughed fixtures) ~_ Clothes Washing Machine ~ Dishwasher ~_ Floor Drain W-~' _ Garbage Disposal Hot Tub/Spa Sinks (Lavatories, kitchens, bar, mop) Sprinklers Tub/Showers Toilet/LJrinal ~_ Water Heater ~_ Water Softener Plumbing Esti $ mmercial Only) Lj ~ ~ ~ vim, ©~ 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 )~ - ~7 (~ Business Phone: ( ) Parcel Acres: ~© Fax 4 • • • P1eaSe Complete the entire AppllCatlOn~ If the question does not apply fill in NA for non applicat~le NAME PROPERTY ADDRESS SUBDIVISION Required!!! MECHANICAL { ,,~~~ Mechanical Contractor's Name: ~ <_ try" ~ , ~`'t. ~ ~ ~ Y~#°`r 1Bt~iness Name: -~ Address Contact Phone: ( ) Email _City Business Phone: ( ) Fax Permit# State Zip Mechanical Estimate $ (CommerciaUMulti Family Only) FIXTURES & APPLIANCES COUNT (Single Family Dwelling Only) ~~_ Furnace ~_ Exhaust or Vent Ducts Furnace/Air Conditioner Combo ~'~ Dryer Vents Heat Pump Air Conditioner Evaporative Cooler Unit Heater Space Heater Decorative gas-fired appliance Incinerator System Boiler Pool Heater Range Hood Vents Cook Stove Vents ~_ Bath Fan Vents other similar vents & ducts: ~ Fuel Gas Pipe Outlets including stubbed in or future outlets W N f Fvr~ 0 Inlet Pressure (Meter Supply) PSI Heat (Circle all that apply) ~ Oil Coal Fireplace Electric Hydronic Mechanical Sizing Calculations must be submitted with Plans & ADUlication Point of Delivery must be shown on plans. Signature of Licensed Contractor License umber Date The City of Rexburg's permit fee schedule is the same as required by the State of Idaho 5 • • SUBCONTRACTOR LIST Excavation & Earthwork: ( ~ Concrete: ~J~~ 'L~.~ Masonry: ~~„~~ ~l~~0~'l` i ~ Roofing: Insulation: ~ v~/1C ~~ ~~(~yl ~~/ ~,,/\ Drywall: ~~ Painting:_ ~I ~, Floor Coverings: Plumbing: Heating: Electrical: Special Construction (Manufacturer or Supplier) Roof Trusses: / V Floor/Ceiling Joists: Siding/Exterior Trim: ~~ Other: ~ f ~r 6 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~ that tl~ye above ~ormation is true and correct to the best of my knowledge. ~~ Signature - Date t I~ /~ Print Name 7 ~~ q O r U 7 ' N~ r ,e ee, S M E D ~ C I T ~ F REXBURG America's Family Community BUILDING SAFETY DEPARTMENT 19 E. Main (PO Box 280) Phone: 208-359-3020 x326 Rexburg, Idaho 83440 Fax:208-359-3024 www.rexburg.oor~n janellh@rexburg.org Office Hours: Monday-Friday 8:OOam-4:OOpm Single Family Residential Pre-Construction Checklist Seismic Design Category - D Ground Snow - 501bs. per sq. ft. Frost Depth - 36" Roof Snow Load - 351bs. per sq. ft. Wind Load - 90 MPH The following items should be completed before you .rubmityour building permit application. Completion ofa Building Permit Application: You may print this application from our website www.rexburg:org or pick up a copy at the City Hall Annex Building (address above). For Residential Permits: (the following is required to be submitted before the Application can be approved) 2 sets of site plans and~ets of building plans Energy Compliance Report: The State of Idaho has adopted the International Energy Conservation Code (IECC). A Compliance Review must be completed and submitted (the rescheck software is available online at www.ener codes.gov). - ^ Page 3 of the Application must include the Idaho Contractor's Registration Number or the exemption form must be completed and si ed, see Page 7. Page 4 of the Application must be completed and signed by your Plumber. A copy of the Plumber's License is required for our files. ~- `~ Page 5 of the Application must be completed and signed by your Mechanical Contractor, a copy of the Mechanical License is required for our files. ~~ Mechanical system sizing and design is required. ~1~.. Truss details including engineered floor joists are required. Electrical Permit If your construction involves electrical, you will be required to purchase an electrical permit from the State of Idaho according to the State of Idaho Electrical Department. • The Electrical Inspector can be contacted at (208)-356-4830 or toll free 1-800-839-9239. • The Electrical application is available at the City Hall Annex Building. Subdivisions: If you plan to build in a subdivision please check the Rexburg Development Code for any requirements such as, property setbacks, architecture board approval, etc. This information is available at Rexburg City Hall located at 12 N. Centex. New Residential Homes If your building permit is for a new home, you will need the parcel number (a parcel number is the county s property identifzcation which recogni~er a plot of lan~ and a new physical address will be issued. If you do not know the parcel number and cannot find a record of it, please bring the name of the subdivision, phase, and the lot and block numbers. The correct location is vital to assure correct addressing. Remodels: If you are considering a remodel, a co of the bid or estimate for the remodel must be submitted with the Permit Application. • 2 sets of Plans are required (may need IECC Review). • Additions are the same requirements as new construction.