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HomeMy WebLinkAboutAPPLICATIONS, CO, BP - 06-00429 - 1150 S 2nd E - New SFRZ O m 0 X W N W N z = M t t Q ;a Ul m F) m w m ;u E N B .q m 3 to 0 0 ?i X G 2� - n Ln M p m <D O N v N ■� z lu m O Q a w -i �.o D w O O - eta n n m �0 N w = N K C7 3 m v v z n go C: a Z L4 V, CD v w Q 3. m - a 3 m 0 n .O p o w uj N 5, �. W m m 3 K to � ° (n m -n c o _ o � v . 2 �, N n S < (D 0 o o 3 v n n X O O Q O v CL <D -i CD U7 c 'O O rt CO N n 7 m c 0 a CD I) a 0 O C lu ->, X 3 u, C O 3 O CD Cn N o. , v 0 ,fi Q N Q- C Q Q m 0• y N n m =3 N C z xo v m z = e-F 1"' — 1 m m co Q < f, p r W 2. y _ C7 N = S -q c x '00 • 7 Q 1 M j (D 7 = 0 co 'c n m Q. 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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: Name and Address of Owner: Contractor: Special Conditions: Occupancy: 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 was inspected on the date listed was found to be in compliance with the requirements of the code for the group and division of occupancy and the use for which the proposed occupancy was classified. 0600429 International Building Code 2006 1150S 2nd E Single Family Residence Type V, non -rated Residential No Stevens Bart Etux 210 Nez Perce Rexburg, ID 83440 Stevens Construction 1217 Sq Ft Unfinished Basement Residential - 2 units or less, permanent in nature Date C.O. Issued: October 23, 2009 (01:06PM) C.O Issued by: 4 , 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. Plumbing Electrical Inspector: Fire Inspector: ri a- P &Z Administrator CITY OF AEXB UKG BUILDING PERMIT APPLICATION Please c 19 E MAIN, REXBURG, ID. 83440 If the queal 208 - 359 -3020 X326 ���.,(( ��n //�� //�� PARCEL NUMBER Q\ �101Y�� rI V�Wl V W i 0600429 1150 S 2nd E- Stevens I SUBDIVISION: %`aLLr_' H (,''i �, UNIT# BLOCK #LOT #� (Addressing is based on the information - must be accurate) PROPERTY ADDRESS: r PHONE #: Home; �'(� " 13 I Work OWNER MAILING ADDRESS: ,)) o aL V; z f' iZ CONTACT PHONE # 1 16D cS a ny Cell (k� 7o `1 - J � I,a CITY: h tX&0i2L STATE - 50 ZIR S3 1 --A,6 EMAIL FAX APPLICANT (If other than owner) 64 `> i 1�,r ►i (Applicant if other than owner, a statement authorizing applicant to act as agent for owner must accompany this application.) APPLICANT INFORMATION: ADDRESS j 1 ►L' Z f i� c.i= CITY: K� t X JJ g L- STATE; 1) ZIP y3 q q & EMAIL FAX PHONE #: Home (kb) 3SG- 1 31 Work ( ) Cell PLYo) 70 " 73 7y CONTRACTOR MAILING ADDRESS: v 1 0 fU L (Z� r E CITY PHONE #: Home pf;6) 3 5 - 7 - 1 Work ( EMAIL F ATE F4-) ZIPS LJtJ Cell OLb) 704 - 3.1.1 IDAHO REGISTRATION # & EXP. DATE 1 K a How many buildings are located on this property? I Did you recently purchase this property No I Yes (If yes give owner's name) Is this a lit? lots N(T - YES lease brin of new le gal description of p roper ty) p� r �' g c t g p� p p tY) PROPOSED USE: S, .,i i ;O M i L -1 �i: k (i.e., Single Family Residence, Multi Family, Apartments, Remodel, Garage, Commercial, Addition, Etc.) APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalt of perjur 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 b t on a prf issued under the provisions of the 2003 International Code in cases of any false statement or misrepres ac t p 'canhn on which the permit or approval was based. Permit void if not started within 180 days. Permit void I [ n i� III III 111111 7 / .s ! / Signature df pplicant DATE Do you` refer to be contacted by fax, email or pho ? Circle C►ne WARNING — BUILDING PE C NST UCTION SITE! Plan fees are non - refundable and a p f i [I!► be inning lanuary 1 2005. City of Rexburg's Acceptance o �Gtu a plan approval **Building Permit Fees are due at time of application ** **Building Permits are v if your check does not clear** 2 O� REXB URC UN � S 'e < 00, S HED � 0 C I T Y OF REX Americas Family Community BUILDING SAFETY DEPARTMENT 19 E. Main (PO Box 280) Rexburg, Idaho 83440 www.rexburg.ore Phone: 208- 359 -3020 x326 Fax: 208-359-3024 janellh@rexburg.o�rg Affidavit of Legal Interest State of Idaho County of Madison Q I, zct L, S t� relGF Name Address'' f� k �� �J City State Being first duly sworn upon oath, depose and say: A. (If Applicant is also Owner of Record, skip to B) 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 S day of "T"A ti , 20 00 Signature Subscribed and sworn to before me the day and year first above written. Notary Public of Idaho Residing at: My commission expires: W Please complete the e�tire A lication! p Pp If the question does not apply fill in NA for non applicable NAME PROPERTY ADDRESS E,}, Z u r; i�j Permit# SUBDIVISION LJAt it : -1 Uj fay d- 5 Dwelling Units: I Parcel Acres: SETBACKS FRONT SIDE I �' SIDE I C` BACK - RemodeK ng Your Building /Home (need Estimate $ - ,4 � 15 40 0.0 SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building) © ` First Floor Area •�'� - Unfinished Basement area I•��' i � � 1 Second floor /loft area Finished basement area +-6 " Third floor /loft area Garage area - 1 60 Shed or Barn Carport /Deck (30" above grade)Area Water Meter Quantity: * * * * * * * * * * * ** *Water Meter Size: j 1 Y, � Required.!! PLUMBING Plumbing Contractor's Name: ►1= L� Business Name: Address .7� A,! `��/Idv�3Tetir City h6Xde State 10 Zii) Contact Phone: ( ) (� �S - 7 7 C Business Phone: Email Fax FIXTURE COUNT ('including roughed fixtures Clothes Washing Machine Dishwasher I Floor Drain Garbage Disposal Hot Tub /Spa Sinks (Lavatories, kitchens, bar, mop) Plumbing Estimate $. (Commercial Only) Water Softener ignature ;fTAcensed Contractor License Number& Expiration Date The City of Rexburg's permit fee schedule is the same as required by the State /,3/ Date Idaho Sprinklers 3 Tub /Showers Toilet /Urinal I Water Heater AIL. 4 Please complete the entire AppliCationl If the question does not apply fill in NA for non applicable NAME tC V PROPERTY ADDRESS n F.1 Permit# SUBDIVISION " Required!!! MECHANICAL Mechanical Contractor's Name: ��ry/� c )D1fH%S�� -% Business Name: ✓l i =�' /jam' ��'`'''�yt"'G �Nz Address 76 4 tU � f 0,. C City ,��itd&i( State Z) Contact Phone: ( ) 3 G Business Phone: Email Fax Mechanical Estimate $ (Commercial /Multi Family Only) FIXTURES & APPLIANCES COUNT ,J :::� Furnace t6 - _� Furnace /Air Conditioner Combo Heat Pump Air Conditioner Evaporative Cooler Unit Heater (Single Family Dwelling Only) 1,5 % Exhaust or Vent Ducts 5 g - _1 Dryer Vents S Range Hood Vents Cook Stove Vents (O oZ Bath Fan Vents 3 other similar vents & ducts: Space Heater Decorative gas -fired appliance' Incinerator System Boiler Pool Heater Fuel Gas Pipe Outlets including stubbed in or future outlets 3� Inlet Pressure (Meter Supply) PSI Heat (Circle all that apply) Gas Oil Coal Fireplace Electric Hydronic ZP Signature tensed Contractor License number Date The City of Kexburg's permit fee schedule is the same as requir by the State 5 0 • SUBCONTRACTOR LIST Excavation & Earthwork: K (. L t , C;D -1 t' Masonry: J tv Insulation: 6 vtl C Drywall: boAQE S (JJNrti rAj L. Painting: Floor Coverings: f oy Plumbing: j, i , •�+ �I Electrical: t 16 mwt q � Et G ► gi L Special Construction (Manufacturer or Supplier) Roof Trusses: d'Tc Floor /Ceiling Joists: TKuS5 To I Siding /Exterior Trim: A LL M A Other: 2 , . . . 0 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.ggv /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. Signature Print Name Date 7 y Building Safety Department City of Rexburg 19 E Main janelih@rexburg.org Phone: 208.359.3020 x326 Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3024 o� a exs uq� 9� v c CITY O F REXBURG Americas Family Community OWNER'S NAMEG� L PROPERTY ADD SS - SUBDIVISION A PHASE LOT I BLOCK (= Permit 406 00429 1150 S 2nd E Requiredffl ELECTRICAL Electrical Contractor's Name �/ }� r.i /�(S i1M At\.( Business Name LPL Pt C G GT('�I L Address z j f 5 - r - > 7 City -4 E- — G; C� State �' �. Zip Cell Phone (Z�) �v Business Phone (�) 7 4�� Fax 3 5 9 2 4 Email Electrical Estimate ( cost of wiring & labor) $ (COMMERCIAL /MULTI - FAMILY ONLY) TYPES OF INSTALLATION (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. /Voy J0. G �q Signature of Licensed Contractor License number Date The schedule is the same as required by the State of Idaho