HomeMy WebLinkAboutAPPLICATIONS, CO, BP - 06-00318 - 377 Oaktrail Dr - Basement Finish Z ~
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o~AEXgUR~ Certificate of Occupancy
~a CITY O F
F
a~ ~ ~~~G City of Rexburg
~' Department of Community Development
America's Family Cc~mmunily
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 00318
International Residential Code 2003
377 Oaktrail Dr
Single Family Residence
Type V, non-rated
Residential
No
Name and Address of Owner: Johnson Ryan
377 Oaktrail Dr
Rexburg, ID 83440
Contractor: Ryan W Johnson
Special Conditions: Not approved as a duplex.
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 wes found to be in compliance vtith the requirements of the code
for the group and division of occupancy and the use for ttihich the proposed occupancy vies
classified.
Date C.O. Issued: February 05, 20 (02:5 M)
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.
ector o-"-Fire Inspector: YI ~(~
Plumbing Insp
Electrical Inspector: PB~ZAdministrator: h ~~
CITE' OF REXB URG
PF,R MTT # ~ I~~ I
BUILDING PERMIT APPLICATION Please c
19 E MAIN, REXBURG, ID. 83440 If the ques O6 OO3 1 g
208-359-3020 X326 ; 77 Oaktrail-.Basement Finish
PARCEL NUMBER: ~~~ f~A~~`- (~j j~ ~~~;~y ( ~
SUBDIVISION: UNIT# BLOCK# LOT#
(Addressing is based on the information -must be accurate)
CONTACT PHONE #
PROPERTY ADDRESS: , ~^] ~ ~~.~r•za ; ~ ~,r ~~,
PHONE #: Home (~~;) wl~_y~~+-~ Work ( )
Cell ( )
OWNER MAILING ADDRESS: ~~-],j ~~,.Lc~~i,;' ~n ~ CITY: ( ~~~ STATE:~~ ZIP: ~~yu
i i , _
EMAIL
~.
FAX
APPLICANT (If other than owner)
(Applicant if other than owner, a statement authorizing
APPLICANT INFORMATION: ADDRESS
STATE:
ZIP EMAIL
PHONE #: Home ( )
to act as agent for owner must accompany this application.)
Work ( )
CITY:
FAX
Cell ( )
CONTRACTOR:
MAILING ADDRESS: 277 0~1.~.~}y~r~-: I ~r~, CITY ~~ STATE ~~ZIP ~~~t-~,p
PHONE #: Home (2c~) 3(3 -H 34~~~ Work ( ) ~.:,,,~ Cell ( ) ~,,,,,~,~,
EMAIL o~` CNtr' ~;, FA~~~l~ IDAHO REGISTRATION # & EXP. DATE QCT- I ~ l5 l Z/3/i
now many nullamgs are located on this property'1
Did you recently purchase this property? No Yes (If yes give owner's name)
Is this a lot split? ~TO~ YES (Please bring copy of new legal description of property)
PROPOSED USE: ~if1 vim;
(i.e., Single Family Residence, lti Family,
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 ternationa de in cases of any false statement or misrepresentation of fact in the application or on the plans on which the
permit or approval based. P void if not started within 180 days. Permit void if work stops for 180 days.
Signature of
Do you p
lO /~/
DATE
~fe to be co~tacted by fax, email or((~~ one. Ircle One
WARNING -BUILDING PERI~~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
' o~REXB~rRC
~4 r0
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N~
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9B[iSNED~
CITY O 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.org janellh@rexburg.orq
Affidavit of Legal Interest
State of Idaho
County of Madison
I, +~ ~~ ~ ,
Name
city
X77 c~~~ ~-1-r~~~ 1 `fir.
Address
`~ ~~iJ
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 ,i ~ ~ day of ~;/~ ~ , 20 U (~
Subscribed and sworn to before me the~ay and year first above written.
~' ~F~ Notary Public of I ho
NOTi~gr ; ~ ~
~~~ ~ ~ Residing at: `, ~ rj~j
p ,,,,
`~'0.~+ .,.~' a~ My commission expires: ~ 3~ ~
~4.
~OF ~o--`?~°~
2
`Please complete the e~ire A lication!
pp
If the question does not apply fill in NA for non applicable
NAME
PROPERTY ADDRESS
SUBDIVISION
Dwelling Units:
SETBACKS
FRONT
SIDE
BACK
Remodeling Your Building/Home (need Estimate) $ f a o ~~
Permit#
SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building)
First Floor Area `',. `,~ Unfinished Basement area ~ ~~
Second floor/loft area ~~%~'~ Finished basement area ' ~~~ s
Third floor/loft area_~~ Garage area `~
Shed or Barn ` ~ Carport/Deck (30" above grade)Area ~
Water Meter Quantity: ~ %{}-
Required!!!
PLUMBING
Plumbing Contractor's 1\
Address
Contact Phone: ( )
Email
***~********** w~ts.r Meter Size: ~~~
~ ~~- ~
~~i ~~ ~
Bus ~ f ~~~~~'-~~-
City _ ~''lt `~~ rf ~~r -Zip
-Business Phone: ( )
Fax
YTURE CDUNT includin rou hed txtu s
Clothes Washing Machine Sprinklers
Dishwasher Tub/Showers
Floor Drain Toilet/Urinal
Garbage Disposal Water Heater
Hot Tub/Spa Water Softener
Sinks
(Lavatories, kitchens, bar, mop)
Plumbing Estimate $
(Commercial Only)
Signature of Licensed Contractor
The City ofRexburQ's
SIDE
License number
e schedule is the same as
Date
the State ofidaho
Parcel Acres:
4