HomeMy WebLinkAboutAPPLICATIONS, CO, BP - 06-00359 - 277 Jill Dr - New SFR Z
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CITY o~ >- Certificate of occupancy
1\L'~1t.13 V 1\l3
America's Family Community
City of Rexburg
Department of Community Development
19 E. Main St. / Rexburg, ID. 83440
ne
Fax
Building Permit No:
Applicable Edition of Code:
Site Address:
Use and Occupancy:
Type of Construction:
Design Occupant Load:
Sprinkler System Required:
Name and Address of Owner:
Contractor:
06 00359
International Residential Code 2003
277 Jill Dr
Single Family Residence
Type V-N, Unprotected
Residential
No
Grigg Justin D
615 Trejo St
Rexburg, ID 83440
Woodhouse & Lee Construction
Special Conditions: Sark. doors disabltd unti I l andir-~s~sfx irs arG
dance ~ a pProV ~• Ttw-P~.r~ w+r+dctc~ t~uirc~
when der ~ 6~ tared.
Occupancy: Residential, single family dwellings, lodging houses
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 vies 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: February 27, 2 7 (01:3 )
C.O Issued by:
!~~~
Building Official
There shall be no further change in the existing 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 Ofricial has reviewed and approved
said future changes.
Water Department ~'~-- Fire Department:
Electrical Department `-~~~e~~
CITY OF KEXB UAG
BUILDING hERMIT APPLICATION
19 E MAIN, REXBURG, ID. 83440
208-359-3020 X326
PARCEL NUMBER:
PERMIT #
Please cam-----'-~-
If the questii
We
~L- ---~~~- - - - ,.
06 00359
277 Jill Dr.
SUBDNISION: ~~.~ ~ s~ ~'
G ((Ib~ dt- UNITa-r n~ .v~.n+~- v i.U t ~F v
(Addressing is based on the information -must be accurate)
OWNER NAME // rr CONTACT PHONE # a
PROPERTY ADDRESS: 1`ta.~a,. S t3 ~ ~. (,~.~~t~ N
PHONE #: Home ( ) 1~ Work ( ) c~~~~-- Cell ( )
OWNER MAILIN /G ADc^DRESS: f~ % r~_CITY:~,j~_STATE:_~ZIP: S~y~i
L'TTA TT ~ ! ^ _ 1
APPLICANT (If other than owner) rxvt s ~
(Applicant if other than owner, a statement authorizing applicant to act as agent for owner must accompany this application.)
APPLICANT INFORMATION: ADDRESS /9~~ S~~ /~-/~ i~cle CITY:_ /'«~G~.vr
STATE;_ j ZIP EMAIL FAX ~~~~- 3/j
PHONE #: Home ( )~ f ~ ~- Z S g j Work ( ) 3S~ 7~~ ~ Cell
CONTRACTOR:
MAILING ADDRESS:_„~~ ,~~~..~ CITY STATE ZIP
PHONE #: Home ( ) Work ( ) Cell ( )
EMAIL FAX IDAHO REGISTRATION # & EXP. DATE~Cv Zy7 { ~
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: ~<r s ~i-- /~c~.,~~r
(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-
mentioned property for inspections purposes. NOTE: The building official may revoke a permit on approval issued under the provisions of the 2003
International Co 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 not st 'thin 180 days. Permit 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
Plan fees are non-refundable and are paid in full at the time of aI
City of Rexburg's Acceptance of the plan review fee does
**Building Permit Fees are due at time of application** **Building Per
oi~I ~IT~06
Tanuarv 1. 2005
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CITY O F
REXBURG
America's Family Community
BUILDING SAFETY DEPARTMENT
19 E. Main (PO Box 280)
Rexburg, Idaho 83440
www.rexburg.o~e
Phone: 208-359-3020 x326
Fax:208-359-3024
ianellh(a~rexb~ n ~re.ore
Affidavit of Legal Interest
State of Idaho
County of Madison
Name Address
Ciry 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: %racn~s ~~~.~_ /~ ~~
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 _ J ~.~. / \ , 20 ~i -~i
Subscribed and sworn to before me the day and year first above written.
~~~uunavp p(~~
~~~~~~, BA/i~~
Notary Public of Idaho
p~ o~AAy
~l' ~ Residing at:
~O
' ~~ pUeL O~'r~~ My commission expires: __ ~ ~ "~ ~a
~~ii..q tE O~ ~..~~,~
3
Please com lete the .tire A lication! ~
1' pp
' If the question does not apply Ell in NA foc non applicable
NAME
PROPERTY ADDRESS Permit#
SUBDNISION
Dwelling Units: Parcel Acres:
SETBACKS _
FRONT 'Z. S SIDE ~~~ SIDE ~~ BACK ~ S
Remodeling Your Building/Home (need Estimate)
SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building)
First Floor Area_ ~~~ ~ Unfinished Basement area lt~g7
Second floor/loft area ~ ~ 4 Finished basement area
Third floor/loft area Garage area ~"Z ~
Shed or Barn Carport/Deck (30" above grade)Area
Water Meter Quantity:
**************Water Meter Size:
Required.!!
PLUMBING _ _ /
Plumbing Contractor's Name: _ ZJ u- ~~ ~~~~ Business Name: /Y~~^~-~ Q!~- ~'~
Address City State Zip.
Contact Phone: ( ) Business Phone: ( )
Email Fax
FIXTURE COUNT (including roughed fixtures
Clothes Washing Machine
!~ Dishwasher
Floor Drain
f Garbage Disposal
Hot Tub/Spa
~LSinks (Lavatories, kitchens, bar, mop)
Plumbing Estimate $ (Commercial Only)
__---~ o
Sprinklers
Tub/Showers
e~- Toilet/Urinal 3
~_ Water Heater
Water Softener
:.--r`-
Contractor License Number& Expiration Date Da e
The City of Kexburg's permit fee schedule is the .came as required by the State of Idaho
4
•
Please complete the entue Application! if cite question does not ~ppiy Ell is the 6or non
a~pplicabk
NAME
PROPERTY ADDRESS
SUBDIVISION
MECHANICAL
Required.!!
Mechanical Contractor's Name: t)>~ S;.v l 1"c~~ Business Name: ~'~ii-~ ®/'~`'~G"f
Address ~ ~ 7 ~ ~~'N~ ~'~~ ~~~ City /~~ State ~ Zip ~3y~
Contact Phone: ( ) 3~y ` ~f`/~ Business Phone: ( )
Email Fax 35 ~ -- 6~~ ~°
Mechanical Estimate $ (Commercial/Multi Family Only)
FIXTURES ~ APPLIANCES COUNT (Single Family Dwelling Only)
Furnace ~ ~ / Exhaust or Vent Ducts
r 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
~~ 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
Signature of
~,ontractor
The
incense numoer
.rchedude is the came as
'-/Z aL
Date
the State of Idaho
Permit#
Range Hood Vents
Cook Stove Vents
Bath Fan Vents
Building Safety Department ~~~~xB~.RCr
City of Rexburg ~ 6.
,~ o
19 E Main janellhCa?rexburg.org Phone: 208.359.3020 x326
Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3024
CI'PY O F
I~~ V 11G
America's Family Community
~ c
OWNER'S NAME ~Gf I i r
PROPERTY ADDRESS - ~ Permit # 06 00359
SUBDIVISION e ~/ e r-1'o
PHASE LOT BLOCK~_
Required.!!
ELECTRICAL
Electrical Contractor's Name ~`~- ~ ,~~~C/ ~',~ Business Name ~~~/e GC/o ,~f /f'/-
Address ~?e~~z~ ~~~ City State Zip ~~
Cell Phone (~~ ~/ 3 '' ~~~ ~ Business Phone (~~) -?~~ " 75-9 5~
Fax ( ) Email ',
Electrical Estimate (cost of wiring & labor) $ (COMMERCIAL/MULTI-FAMILY ONLY)
TYPES OF INSTALLATION (RESIDENTIAL)
(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. rlddi 'onal inspections charged at requested inspection rate of $40 per hour.
Signature of Licensed Contractor License number Date
The
schedule is the ,came as required by the State of Idaho
7
Jan 25 2007 11:17RM Craft Electric 208-356-6797
` ~ I~
Building Safety Department a~"~"B°R~
Cffy of Rexburg v ~°~
'~ G
19 E Main janellh®rexburg.org Phone: 208.359.3020 x326
Rexburg, ID 83440 www.rexburg.org fox: 208.359.3024 ~~i'`"`° '°°~
p.l
CITY O P
..__...M.....__.- cy~ ---.___---
Americn's.Fandly Cnrnn~unity
OWNER'S NAME ~ N1 i~lr
PROPERTY ADDRESS ~ ~r'j V' Permit# Q~~ ~ 5G~
SUBDIVISION ~Y1 Z.,~r---- I
PHASE LOT BLOCK
Requi.~ed.!!~
ELECTRICAL
~ ~ ~c---
Electrical Cont~acto~~r's"Name' G G u`iess Name
Address ~~ C%~' JC. ~~~ ~~
Cell Phone () _ J ~ ~ -~ j[}~ Business Phone ( ) _
Fax (Z~~l `~ _ ---
3
Electrical Estimate (coat of wiring 81:.labor) $ (COMMERCIAL/MULTI-FAMILY ONLY)
TYPES OF INSTALLATION
(NewResidentialincltrdes everything contained within the residentialstructure and attachedgarage atthe 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 aot part of a new residential construction permit
and no additional wiring)
Modulax, 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. (oE existing wiring)
Temporary Amusement/Industry
*includ um of 3 ~ ection . dditional inspections charged at requested inspection rate of $4o per hour,
i
3~/ ~~ ~
of Licen ntt tot License number Date
The
rchedrrde rr the rams ar ~equind by the State
~l`r~ m Qh l ~ .
7
• •
SUBCONTRACTOR LIST
Excavation &
l(
Masonry: C~rrt~.~ ,~ °~,~
Roofing: ~il~-C
Insulation: ~r ~~
Drywall: ~v~~~r S~
Floor /
Plumbing:. /``~~t
Heating: ~i
Special Construction
(Manufacturer or Supplier)
Roof Trusses: ~/h~a~('K
Floor/Ceiling Joists: ~ia.L
Siding/Exterior Trim: ~Z-
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.idaiho.as~v/conthtm)
^ 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 hereb~~at the information is true and correct to the best of my knowledge.
~, j~_v~
Signature Date
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Print Name
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