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HomeMy WebLinkAboutAPPLICATIONS, CO, BP - 06-00521 - 118 S Hidden Valley Rd - Basement FinishZ .� 0 CO) w N m T m T w N C T __ m r o ■� z 0 Z c so D D C -� o m CD s - C v m 0 �� a Z -� � m o a 3 m O m a _ E3 m 3 0 7 D) �. y m C 7 O N O CD tQ m O a O O E , c n o 3 v N CD O C O CL m 0) Na v CL :3 Z Q= O 7 co 7 dl C W �m o o O j SU a o CO) m �. EF CD v 1— � cc a v o � c V 3 g p 3 C V s 77 "n cr 3 ga y O 7 N - 00 w 0 m a (D o m d 3 W v a. � D z N n c co o c Z E m W a m = m m n> > s Z �I �� 3 0 s C O N v C f0 r Z n 0 z O O O O CD (� v n N d 0 m is p� y S N o m �. T ^ ZZ Y! m' 0 m CD O O �' n m a �■ m X00 0 g m 0 n 0 -a 0 0 (A y c (D CL IW -n z n -i X O CO) s ryo.a z X W s y m m _ x EL C u rt X .9 177 r H O Z Q v o�0ti CD z CD y CO) n �+ C O X O r: y0 D � �ya n C Z. . U) C7 p n c 'S •° C O .. d - 6� X O o o m�.I. m n o C -n 0 n X �n y 0 3 m CL V m - CD CD OD `z < C O C O = m 0 ! N Q CL 0 CL a co = 0 C CD CD Sa rt 0 - CD 0 CD 3 m j 0<) c � y N (D _. 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Main St. / Rexburg, ID. 83440 359 -3 59 -3 Building Permit No: 0600521 Applicable Edition of Code: International Residential Code 2003 Site Address: 118 S Hidden Valley Rd 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: Fillmore Construction Inc 4178 E 550 N Rigby, ID 83442 Contractor: Fillmore Construction Special Conditions: Finished Basement Occupancy: Residential, single family dwellings, lodging houses A 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 of the code for the group and division of occupancy and the use for Mich the proposed occupancy vies classified. Date C.O. Issued: Novem r 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. Water Department Fire Department: State of Idaho Electrical Department • CITY OF KEXB UKG BUILDING PERMIT APPLICATION Please i 19 E MAIN, REXBURG, ID. 83440 If the ques 208 - 359 -3020 X326 PR.R MIT tt 0 0600521 118 S Hidden Valley PARCEL NUMBER: (W Basement Finish SUBDIVISION: b l tC // Gt d UNIT# BLOCK# LOT# l (Addressing is based on the information - m st be accurate) CONTACT PHONE # - 3q6 PROPERTY ADDRESS: ,�/.,S? PHONE #: Home �W) 2 Vg_' e59-5,�1W oor OWNER MAILING ADDRESS: CITY: STATE: ZIP: EMAIL FAX APPLICANT (If other than owner) (Applicant if other than owner, a statement authorizing applicant to act as agent for owner must accompany this application.) APPLICANT INFORMATION: ADDRESS CITY: STATE; ZIP EMAIL FAX PHONE #: Home ( Work ( Cell ( CONTRACTOR MAILING ADDRESS: CITY STATE ZIP PHONE #: Home ( ) Work ( ) Cell ( ) EMAIL FAX IDAHO REGISTRATION # & EXP. DATE �Q How many buildings are located on this property? Did you recently purchase this property? To Yes (If yes give owner's name) ((����► Is this a lot split? 0 YES (Ple e bring copy of new le 1 de W t of p l� PROPOSED USE: - �t`1�t t`3/ (i.e., Single Family Residence, Multi Family, Apartm nts, Remodel, Garage, Commercial, Additi •) OCT 2 C APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATIO un c f that I have read this application and state that the information herein is correct and I swear that any info tioF c in hearings before the Planning and Zoning Commission or the City Council for the City of Rexburg shall be rut n 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 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. Permilwco not st wi s. Permit void if work stops for 180 days. 1;2 /L Signature of er /Applicant DATE Do youyi&et 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 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** 2 Buil g Safety Department o4gtxBtlpC City of Rexburg �` �y „ o 19 E. Main ionellh@rexburg.org Phone: 208.359.3020 Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3024 CITY O F REXBURG __._..1.1.1._1.__... (y ,._.__._....._ ---- ------ America's Family Community Affidavit of Legal Interest State of Idaho County of Madison Na e City Address 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 Signature 20 Subscribed and sworn to before me the daly and year first above written. Notary Public of Idaho Residing at: My commission expires: 3 Please complete the ettire Ap 40 NAME �` ``" / PROPERTY DD S /g t" voe I Permit# SUBDIVISION At'. c a. Dwelling Units: Parcel Acres: SETBACKS FRONT SIDE SIDE BACK Remodeling Your Building /Home (need Estimate $ / c �, c� 0 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 l 0 Third floor /loft area Garage area Shed or Barn Carport /Deck (30" above grade)Area Water Meter Quantity: * * * * * * * * * * * ** *Water Meter Size: Required Y PLUMBING Plumbing Contractor's Name: L`'r Business Name: Address City �State ZYe Zip Contact Phone: Business P �ghon ) Email Fax / V — �,90 FIXTURE COUNT (including roughed fixtures, Clothes Washing Machine Dishwasher Floor Drain Garbage Disposal Hot Tub /Spa Sinks (Lavatories, kitchens, bar, mop) Plumbing Estimate $ Signature of Licensed Contractor The City of Bexi Vq '5- Sprinklers f Tub /Showers Toilet /Urinal Water Heater Water Softener (COMMERCIAL /MULTI - FAMILY ONLY) License Number& Expiration Date Date fee schedule is the .came as require by the State of Idabo 2 P. 1 Mer11'3ry TX Result Report ( Oct, 20. 20P 1:41PM ) 2) Date /Time: Oct.20. 2006 1:40PM File Page No. Mode Destination Pg(s) Result Not Sent ------------------------------------------------------------------------------------------------ 2940 Memory TX 7854905 P. 1 OK --------------------------------------------------------------------------------------------------- Reason for error E. 1) Hang up or 1 ine fail E. 2) Busy E. 3) N o a n s w e r E. 4) N o f a c s i m i 1 e c o n n e c t i o n E.5) Exceeded max. E —ma i 1 size Please com the entire Application! PROPERTY DRESS / °Am,., SUBDIVISION i ar ti / Dwelling Units Pucel Acres: SETBACKS FRONT SIDE SIDE BA CK R- -defiag y Bugdmg/Fl (need Estimate) 162 LvQ0 SURFACE SQUARE FOOTAG& (Shall include the exterior wall tueasureratats of the buiklioo First Floor Area Unfinmhed Basement area Second f6ot/loft stea Finished basement sees Tbitd Boor /loft arm Garage anew_ t Shed or B ata C oat /Deck (W above gr*&) Water Meter Qr tity: ­ -------Waft, `" -Water Meter Saar. Requiredffif PLUMBING Plumbing Contractor's Name: Business Nance: Address �'P(� CitpS . Contact Phone: ( , r �i 1 �aY3 Baainras Pcybo��ncr'(• Hmatl F ax / 5 C IF/ i — PLUVRE GQ NVT md -fi5AV °'rSired err ueaj . Clothes Washing macbioo Spunkl Dishwasher Tub /Showers Floor Drain f Toikt✓Uffita] Garbage Disposal Water Heater Hot Tub /Spa Water Softeaet Sinks (Iavatode%).tchens, bar, mop) Plumbing Estimate $ (COMMERCML/MUL- n FAMH.Y ONLY) Numbrt &Baplratim Date Date sg- b=otL_.a Cora as 1 715 v t /9o'5 4 Please complete the entire Application! • NAME PROPERTY ADDRESS SUBDIVISION /Multi Family Only) Family Dwellingl Require 6 MECHANICAL Mechanical Contractor's ame Business Name Address City ' Cell Phone ( ) Business Phone ( ) Fax ( ) Email Mechanical Estimate $ FIXTURES & APPLIANCES Furnace Furnace /Air Conditioner Combo Heat Pump Air Conditioner Evaporative Cooler Unit Heater Space Heater Decorative gas -fired appliance Incinerator System Boiler Pool Heater Exhaust or Vent Ducts Dryer Vents Range Hood Vents Cook Stove Vents Bath Fan Vents other similar vents & ducts: Fuel Gas Pipe Oude including stubbed in or future outlets Inlet Pressure (M er Supply) PSI Heat (Circle all that ap ) Gas Oil Coal Fireplace Electric Hydronic Signature of Licensed Contractor The License number Permit# Date fee schedule is the same as required by the State of Idaho 5 Building Safety Department City of Rexburg 19 E Main ionellh@rexburg.org Phone: 208.359.3020 x326 Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3024 OF RBXB(JRC U � C I T Y O F REXBURG ­_._­1 . CW _._.____._._ -. America's Family Community OWNER'S NAME PROPERTY ADDRESS SUBDIVISION PHASE LOT BLOCK Permit# RequiredN ELECTRICAL Al _Y_Cll " C wt Electrical Contractor's Name C Business Name Address o o`Z /U (� p © �_ City y State 7 - Z> Zip Cell Phone Business Phone Fax ( ) Email Electrical Estimate (cost of wiring & labor) $ / `b• ' m (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* Temporary Construction Service, 200 amp or less, one location (for a period not t 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 *Include um of 3 inspections. Additional inspections charged at requested inspection rate of $40 per hour. C - a - (096 1 /6- a3 -0� W gnature of Licensed Contractor License number Date The schedule is the same as required by the State 7 SUBCONTRACTOR LIST Excavation & Earthwork: Masonry: Painting: ;r� C,, & t., wv( �/ Floor f /� Coverings: ►'-1 e`Uj Plum Special Construction (Manufacturer or Supplier) Roof T Floor /Ceiling Joists: Siding /Exterior Trim: 8 EXEMPTIWS FROM STATE REMSTRATION 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 ❑ 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 W