HomeMy WebLinkAboutAPPLICATIONS, CO, BP - 06-00444 - 278 Seagull Dr - New SFRZ
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Certificate ®f occupancy
~~ CITY OF
~" c ---- -
~~~,~..7 City of Rexburg
~_ ~,___......__ De artment of Community Development
Amerfcai Family Consmu~sif}~ p
19 E. Main St. / Rexburg, ID. 83440
Phone (208) 359-3020 /Fax (2081359-3022
Building Permit No: 06 00444
Applicable Edition of Code: International Residential Code 2003
Site Address: 278 Seagull Dr
Use and Occupancy: Single Family Residential
Type of Construction: Type V-N, Unprotected
Design Occupant Load: Residential
Sprinkler System Required: No
Name and Address of Owner: Genta Broc
Po Box 582
Rexburg, ID 83440
Contractor: Kay, Jared
Special Conditions: Unfinished basement.
Occupancy: Residential, single family dwellings, lodging houses
This Certificate, issued pursuant to the requirements of Section 909 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 ofthe code
for the group and division of occupancy and the use for which the proposed occupancy vies
classified.
Date C.O. Issued: March 26, 2007 9:5
'~
C.O Issued b ~~~ --
Y
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 Official has reviewed and approved
said future changes.
Water Department: ` Fire Department:
Electrical Departmentg)•~ -~~.~~~~. I I
CITY OF KEXB UKG
BUILDING PERMIT APPLICATION Please
19 E MAIN, REXBURG, ID. 83440 If the que
208-359-3020 X326
PARCEL NUMBER: ~~.~ N >~ ~~~~ ~~
PF.R MT'T ft
06 00444
278 Seagull Dr-Gents
SUBDIVISION: ~-t ENO ~'~jr~/ UNIT# BLOCK# CO LOT# l~
(Addressing is based on the information -must be accurate)
CONTACT PHONE # °7
PROPERTY ADDRESS:
(t
PHONE #: Home (~~~) b~G " fit' ~ ~ "Work (~) X5(3 - O~y 3 Cell (~) ~S 7-- ~GU~
OWNER MAILING ADDRESS: ~ U. /~~ S~t3- CITY: ~$~~<~. STATE:~-~ ZIP: ~ ~`~''~~'
EMAIL ~1~'JC-~(~P~cTrS.c1~U C'dl.Mu~ ~rCv ^n FAX ~-J~ ,-~S~_ ~L cj ~;
-~- ,
APPLICANT (If other than owner) ~~q~~ ~ . ~y
(Applicant if other than owner, a statement authorizing applicant to act as agent fox owner must accompany this application.)
APPLICANT INFORMATION: ADDRESS q~~ l~/.S l~F .4/~ CITY:__ 9~ 1~(Q(~~
STATE; ~ ~ ZIP_~ EMAIL JAEEfl IGIY~ C~tBtff~(i , rlk T FAX ~~~ S3S4
PHONE #: Home
( )~35 9'~9~oZ Work ( ) ~ Cell ( ) ~~ Ig `CL
CONTRACTOR: ~-/YJ,~..
MAILING ADDRESS:
CITY STATE ZIP
PHONE #: Home ( ) Work ( ) Cell ( )
EMAIL FAX IDAHO REGISTRATION # & EXP. DATE (fl J U~U
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 des ~ r~r f ~o
PROPOSED USE: -~ ~ IZ
(i.e., Single Family Residence, Multi Family, Apartments, Remodel, Garage, Com ci Add~~, EMc.y
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHO IZ ~TnN' T Tn~Trr nPn..1~ ~~~~~~, hereby certify
that I have read this application and state that the information herein is correct and I swear ha be ~ven by me in
hearings before the Planning and Zoning Commission or the City Council for the City of R xb~~e hf comply with all
City regulations and State laws relating to the subject matter of this application and hereby a or~ze 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 Code in 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 void if not started within 180 days. Permit void if work stops for 180 days.
of Owner/
9 /~/~(
DATE
Do ~'ou 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 lanuarxl. 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**
b~-~
2
Buil
g Safety Departure
City of Rexburg
19 E. Main
Rexburg, ID 83440
janellh@rexburg.org Phone: 208.359.3020
www.rexburg.org Fax: 208.359.3024
~~ fRERB URC l7
U O
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MEO
CITY O F
REXIiURG
America's Family Community
Affidavit of Legal Interest
State of Idaho
County of Madison
Name Address
,~
J ~ -~ X~:; r ~, ,
City '
Being first duly sworn upon oath, depose and say:
~~4~~
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
r~ddress
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 .~ ~~ /'C ~'- ~c.~' , 20 'D
Signature
Subscribed and sworn to before me the day and year first above written.
BRYNNE HANSEN
STATE OF IDAHO
NOTARY PUBLIC
Residing at: ~' ~~
My commission expires: ~ r-- U'
3
l Please com lete the Mire A lication!
P pp
If the question does not apply fill in NA for non applicable
NAME J ~ r ~' ~- C.7 ~ ~ fiA
PROPERTY ADDRESS Permit#
SUBDIVISION ~-1-t'ariL~I~~ .~
Dwelling Units:
SETBACKS
FRONT
Parcel Acres:
SIDE SIDE BACK
Remodeling Your Building/Home (need Estimate)
SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building)
First Floor Area ,~,/~71 Unfinished Basement area ~Jr7~
Second floor/loft area d Finished basement area 4
Third floor/loft area Garage area S~ ~
Shed or Barn Carport/Deck (30" above grade)Area
Water Meter Quantity:
**************Water Meter Size: 3!~ i~
Required!!!
PLUMBING n
Plumbing Contractor's Name: ~ ~~~t~ ~ '~' ~ Business Name: ~~~ ~(~'
Address City State Zip
Contact Phone: ( ) Business Phone:
Email Fax
FIXTURE COUNT including roughed fixtures
_~ Clothes Washing Machine
Dishwasher
Floor Drain
~_ Garbage Disposal
~ Hot Tub/Spa
`i Sinks (Lavatories, kitchens, bar, mop)
Plumbing Estimate $ Lv J~-~'p~ (Commercial Only)
1~ Sprinklers
Tub/Showers
_~ Toilet/Urinal
~ Water Heater
Water Softener
~ Od 9 5 ~~,~ ~~
Signature of Licensed Contractor License Number& Expiration Date Date
The City of Kexburg's jiermit fee schedule is the .came as required by the State of Idaho
4
r Please complete the entlte AppllcatlOn~ If the question dcea not apply fill in NA for non
applicable
NAME ~1~-'i~~~ ~ -~ ~ `~
PROPERTY ADDRESS Permit#
SUBDIVISION i~JC n P {S ~ .i1
Required.!!
MECHANICAL
Mechanical Contractor's Name: KE><~ ~g I" l//•s~- ~~~~ ~
Address ~~ ~ ~ ~ x ~ Sy City
4usiness Name:
f~uKG- s
~34~Q
Contact Phone: ( ) Business Phone: ( ) ~.~ ^ c~ 7 ~d
Email Fax ~~ ^ ~ 7 7
Mechanical Estimate $ (Commercial/Multi Family Only)
FIXTURES & APPLIANCES COUNT (Single Family Dwelling Only)
~_ Furnace 3 ~ i~_ Exhaust or Vent Ducts ,S
Furnace/Air Conditioner Combo
Heat Pump
Air Conditioner
Evaporative Cooler
Unit Heater
Space Heater
Decorative gas-fired appliance
Incinerator System
Boiler
~_ Dryer Vents 15~
~_ Range Hood Vents
~_ Cook Stove Vents
Bath Fan Vents /S
other similar vents & ducts:
~/ ys-
Pool Heater
P ~ Fuel Gas Pipe Outlets including stubbed in or future outlets is
Inlet Pressure (Meter Supply) PSI
Heat (Circle all that apply) Ga Oil Coal Fireplace Electric Hydronic
Mechanical Sizing Calculations must be submitted with Plans & Application
Point of Delivery must be shown on plans.
~f~C ~ ~' ~ I¢ /v~
Signa re f Licensed Contractor ~ License number
The City of Kexburg's permit fee schedule is the .came as
~i- ~- ~~
Date
the State of Idaho
5
Please complete the ent~ Application! If the question ao~t apply fill in NA for non
applicable
NAME ~ rec. G-e. ~ }-c„ Permit # 06 00444
PROPERTY ADDRESSa2"1`~, ~~.~ ~ ~~ Henderson Subdivision
SUBDIVISION ~Z-~,~ r~u ~ '
Block #6 Lot #12
Required.!! ~~~ ~S~EI~ECTRICAL
ElectricallC/ ontractor's Name ~~C AG y ~ ~~rP/~' Business Name
Address 7~'J~ ~~U'~ ~ `~' City ~~X~J~~-~ State ~ ~ . Zip ~s~~~~
Cell Phone (ZC~ ~ 9U ~- ~('} 2 Business Phone (Z~) ~J ~ _ 97 `t
Fax (~(~') ~ ~ ~ ` ~ ~ ~~ Email
Electrical Estimate (cost of wiring & labor) $ "7C~' ~1 ~ (Commercial/Multi Family Only)
TYPES OFINSTALLATION-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*
_ 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/or Cooling (when not part of a new residential construction permit
and no additional wiling)
_ 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.
35 a i ~~,~ ~ ~ ~ o~
Signature of Licensed Contractor License number Date
The City of Kexburg'.r permit fee rchedule is the .came as required by the State
6
SUBCONTRACTOR LIST
Excavation & Earthwork: fxK/;~~', ~W ~~~jr')p~/
Concrete: ~ ~UY~I~'~rc~ ~' ~~ 5
Masonry: ~ j (,(~ y1~d~ ~Y
Roofing: ~r~i ~~ j~,2~f'%~~~
Insulation: ~{~~'~((~ %/~( Sf~U~T7Q~/
Drywall: ~ (~C~.~1~- ~~G~~
Painting: ~ /~{~.~'~~
Floor
Coverings: ~~ ~JL 5c~ic/
Plumbing: ~ ~~~ t ~ °~{'
Electrical: 1e1C ~~ ~f. fi~Zl~I
Special Construction
(Manufacturer or Supplier)
Roof Trusses:_ ~~~~~}( CD/n6'Q~V~MrS
Floor/Ceiling Joists: ~i `Tt~Gi~C GC~rl7 ®(1+t1 f'c~cl T
Siding/Exterior Trim: ~ R~l ~ (~
~~
i
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 iboLidaho 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.
Date
~~~ ~ - ~ y
Print Name
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