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HomeMy WebLinkAboutAPPLICATIONS, CO, BP - 06-00394 - 555 Golden Willow Dr - New SFR Z .~ O ~' " O ~ m m W ~ c ~ rn Z -~ ..~ o ~ ~z~-ioD ~ C / /~ ~ -~ -~ ~ z ~ ~ m m v ~' o- W _~ °' ~~ ~N o _ ~ ~ a C p) 7 m o ~ f ~ 01 T C ~ ~ "6 n N m ~ ~ o C O ~ ~ ~ a m ~ dNa o a~ ~ Z o m o o' ~ ~ ~ o, ~ ~ C o ~ o m v ~ o r ~ ~ ~ (D •~'^ s s v o o m _ V1 ~ c ~ • fD 7 N ~ o ~ o m ~~ ~ W0 i a ~ ~ Z »="a n _ ~< a ~ - m n7 o f ~ ° ~. 5. o m v ~ ~~ y ~ Z n to ~ ~ C 'fl 0 0 ~ ~ °_' n ~. C N O (D g o~ a o m o ~~~ m ~ G ~ Z 1 N N ~ N N (~7 ~. y //~ ~ m 0 o f ~ ~--~ , <~s~~ ~ m m o o ~ o ~a a ~ ~ v °:. 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Q Ut ~ W N ?~ G) ~ ~ cn m - ° c a o ~ ~ _~_ ~' m ~ ~ ~. ~ ~ ~ m ~ m ' n ~ m o 7 ~ 'O CO W V ~ Ut A W N _n fn ~. ~ ~ N - 5 ~ ~ ~t ~ ~ -n ~ o• ~ -n ~ r ~ m ~ ~ ~' ~ m N ~ d m N ~ v ~ -o ~ d ~ ~ N co ~ ~ ~ OF 48XBURC, Certificate of ccupancy `; ~9 ___ CITY O F ~YF ~ ~~jjjZ~ City of Rexburg ``-- `~ ~, Department of Community Development 'm,, H AnsericdsFamil Comrnuni 19 E. Main St. / Rexburg, ID. 83440 Phone (208) 359-3020 /Fax (208) 359-3024 Building Permit No: 06 00394 Applicable Edition of Code: International Building Code 2003 Site Address: 555 Golden Willow Dr Use and Occupancy: Single Family Residence Type of Construction: Type V-N, Unprotected Design Occupant Load: Residential Sprinkler System Required: No Name and Address of Owner: Muhlestein Dan M Etux 644 Sunflower Rd Rexburg, ID 83440 Contractor: Owner Special Conditions: Unfinshed Basement Occupancy: Residential, single familydwellings, lodging houses 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 tees found to be in compliance vuth the requirements of the code for the group and division of occupancy and the use for v~hich the proposed occupancy vies classified. Date C.O. Issued: September 21, 200 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 Inspect Fire Inspector: - `~ ~~ Electrical Inspector ~` P~ZAdministrator: ~ ~~ 1w7TY OF REXBURG PERMIT # BUILDING PERMIT APPLICATION P~~dSty ~Ciil7plE'it~ t~i~ ~iltl~ e I~pU~ICa~lOil: 19 E MAIN, REXBURG, ID. 83440 If the question rlnes not apply fill in NA for non applicable 208-359-3020 X322 PARCEL NUMBER: ~ PR w L I~L%a~431X~~~ (V 06 00394 suBDlvrsloN: (~,11~~ ~i~~~ uN 555 Golden Willow Dr. (Addressing is based on the information -must be accurate) OWNER NAME: ~ _, ` CO/N~TACT PHONE # ~~~ - 3D~6 PROPERTY ADDRESS: ~SJ Cr2tll~B~z Gi',s~ G~~~/.Oi^ PHONE #: Home (~) °~,~~- 3v'~ 6 Work ( ) Cell (~ 3S°t -? 3~ 3 OWNER MAILING ADDRESS: ~D~~~/,,?+~loer.0`j~ITY: STATE:,~ZIP: $,~~lcl0 EMAIL: " ~,`es~lLy~c~:1 ` F i V `~ APPLICANT (If other than owner) ~~~ ~5 Tor>~ (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 Work CITY: FAX Cell ( ) PROPOSED USE: (i.e., Single Family Re ~f~ ~~~ dent ulti 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 a licati fives of the City to enter upon the above-mentioned property for inspections purposes. NOTE: o al y vo a ni royal issued under the provisions of the 2000 International Code in cases of any false statemen ' ~re~esio~f t the r on the plans on which the permit ~roval was based. Permit void if not started within 180 day voi i work stops for 180 da /~_/~ Do you prefer to be contacted by fax, email or ho '. WARNING -BUILDING PERMI MUS Plan fees are non-refundable and are paid in full' City of Reabnrg's Acceptance of the plea **Building Permit Fees are dae at time of application** One oes nod eonstitate plan approval **Ba~7ding Permits are void if you check does not clear** How many buildings are located on this property? Did you recently purchase this property? N~ Yes (If yes give owner's name) Is this a lot split? YES (Please bring copy of new legal description of property) • ~ e~ _ C.IiY ~~l `~~et~514E0.4~ ~~tEEtk 1'~ I :\~iR l ~ ~~~1\tUi~f I1 19 E. Main (PO Box 280) Phone: 208-359-3020 x326 Rexburg, Idaho 83440 Fax: 208-359-3024 www.rexburg.org comdevCrD_rexburp.org Affidavit of Legal Interest State of Idaho County of Madison / /~ /J/ /~ ^/ I, ~G, h ~ Gr,~i fG' S ~ei~~ ~ (O y _I ~~'i.rt fi/ll~.+t/ / l~l Name Address R~,~bl~ ~r ~ ~~ City 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 ~ day of__~G~s~ ' 20~- Subscribed and sworn to before me the day and year first above written. ~~ ~~~~ ~~.ra Notary Public of Idaho Residing at: ~~kEJ r-, _~ My commission expires: ~ - `~~ ~ ~~~~ • • Please complete the entire Application! if the nnection ~l~es not anpb fill in NA fnr non annlicahle NAME j~i~ F2 ~, ~~ (~5 ~e_ r9 PROPERTY ADDRESS 5S~ ~--~dfcfez Er,,~;t`/.=;~~ ~~~- Permit# SUBDIVISION GLI, r'~~? fyra~<5, Dwelling Units:, Parcel Acres: ~;:~ S~C SETBACKS r i .% ' 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 / ~ ~ ( Unfinished Basement area l Second floor/loft area Finished basement area ~f Third floor/lo$ area~~ ` Garage area .~~ Shed or Barn __ / Carport/Deck (30" above ~rade)Area /1/ Water Meter Quantity: ~ * * * * * * * * * * * * * * Water Meter Size: 3 ~ " Recjui~e~.' ~ r PLUMBING Plumbing Contractor's Name: ~ e f .-F Sys ~~" ~ Business Name: Address Z} ~ ~,~ 1 F. 1 ~~~ '~J City State~yj Zip i. Contact Phone: (2~ )~3 4' ' `71'7 "~ Business Phone: S~c~) 3q p - ~~ S' 1 Email FIXTURE COUNT (including roughed fixtures) ~_ Clothes Washing Machine Dishwasher ~_ Floor Drain Garbage Disposal Hot Tub/Spa _~ Sinks (Lavatories, kitchens, bar, mop) Plumbing Estimate $ (Commercial Only) Sprinklers Tub/Showers ~_ Toilet/[Irinal ~_ Water Heater T Water Softener ~ 3(n~ S' tore o Licensed Contractor License number The City of Rexburg s permit fee schedule is the same as )-~ - ~ (,~ Date by the State of Idaho Fax • ,. Ple~Se COrilplete t~le eritlt'e AppllCatlOri ~ If the question does not apply fill in NA for non applicable NAME ~~GzJt ~~~u ~~=~~ ~~~ ~. ~. PROPERTY ADDRESS, ,~~~-7~/;,C~~ t~~d~~rzr~ d,~,r'~ Permit# ~ OG 3~ SUBDIVISION ~~..~',~ ~~~;-~~ ~,~~~~~ Required!!! MECHANICAL Mechanical Contractor's Name: ~+ Business Name: T~ i ~.~~,r ~ i~-ic_~~r;,.`;c~ Address ~'~~ t~~.lLx ~ ~ u ~ ~, l~k'.t_ ir.. City ~~-i-b '~ ~-~~ State ~ ~ r-I,e~ Zip F' ~ C c. Contact Phone: (~~~,) ~`1~ °-c~Z y° Business Phone: ( ) Email .,f+:.~.-~;.~ ~~4:~rc-n ~ ~= .,vSr~ ~ c'~y-~ Fax ~,;~~ ~~ c~ ~>"2.5 Mechanical Estimate $ (Commercial/Multi Family Only) FIXTURES & APPLIANCES COUNT (Single Family Dwelling~nly) _~ Furnace `-W Exhaust or Vent Ducts ~ ~ Furnace/Air Conditioner Combo ~~ ! Dryer Vents S 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 y Bath Fan Vents 2a - other similar vents & ducts: -- Similar fixtures or Appliances ..~ Fuel Gas Pipe Outlets including stubbed in or future outlets Z~ // Lh. Inlet Pressure (Meter Supply) PSI - i,,re-M~~rw,.~ ~.~; 5~,~;,,,7 ~~ D ~\ 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 icensed Contractor License number ~- >y-~~ Date The City of Rexburg's permit fee schedule is the same as the State of Idaho } • • ^•rarrarrsarrauawsrresrrausarrs:rrrssrrrsrrsr•arr^u^ru^rrraraarsa^^^^rursaaarrrsrru~ SUBCONTRACTOR LIST Excavation & Earthwork: ~~~(~ l'"1~ /~ Concrete: Masonry:, Roofing: ~ G~ Insulation: ~~~~,~~,~~ ~,.i?5~~~,~,~-~~ Drywall: 5~ l Painting: Floor Coverings: Plumbing: ~~~ sf~; ~~'l Heating: Electrical: Special Construction (Majnufacturer or Supplier) Roof Trusses: ~ ~~~~, ~;„ ; ~(1/, ~ ~ Floor/Ceiling Joists: "~;~~Z vt.~~Ura SidingBxterior Trim: S~~l~ 63 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 ~f 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 Lion is true and correct to the best of my knowledge. 8 ~~ ~ ~~~~ ~~~ Print Name Please cnnplete the en>~ Application! applicable NAME r PROPERTY ADDRESS '' G,J SUBDNISION ~ ~ ,''~© If the question dot apply fill in NA for non ~~ a ~-~~ 3 City of Rexburg Home Owner's Electrical Permit Permit #06 003 94 Required.~~~ ELECTRICAL - ~br~ ~1--n'K Electrical C,*o~ntractor's Name ~6 Gn ~Lch~~5~f1~_Business Name Address (D~~ ~G.n ~l~w~t/ / 1(1 City ~~.~Jv~r'~y State ~ Zip~~~x Cell Phone ) ~~~ 7 ~~ ~ Business Phone ( ) Fax ( ) Email Electrical Estimate (cost of wiring & labor) $ (~ ~ ~C~ (Commercial/Multi Family Only) TYPES OFINSTALLATION-RESIDENTIAL (New Residential includes everything contained within the residential structure and attached garage at the same tame) Up to 200 amp Service* 201 to 400 amp Service* Over 400 amp Service* Existing Residential (# of Branch Circuits) _.~_ Temporary Construction Service, 200 amp or less, one location (for a period not to exceed 1 year) Spa, Hot Tub, Swimming Pool Electric Central Systems Heating and/oY 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. Signature of Licensed Contractor The License number schedule is the ,came as Date the State 6