HomeMy WebLinkAboutAPPLICATIONS, CO, BP - 06-00546 - 553 S 4th E - New SFRZ
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O �RexsUR� `Q C I T Y O k Certificate of Occupancy
RE X 3URG City of Rexburg
`
America's Fam y Community
Department of Community Development
Fam
19 E. Main St. / Rexburg, ID. 83440
Phone (208) 359 -3020 / Fax (2081359 -3024
Building Permit No: 0600546
Applicable Edition of Code: International Residential Code 2003
Site Address: 553 S 4th E
Use and Occupancy: Single Family Residential
Type of Construction: Type V, non -rated
Design Occupant Load: Residential
Sprinkler System Required: No
Name and Address of Owner: Springmont Llc
P O Box 604
Rexburg, ID 83440
Contractor: Springmont Llc
Special Conditions:
Occupancy: Residential - less than 2 units, permanent in nature
This Certificate, issued pursuant to the requirements of Section 109 of the Intemational Building
Code, certifies that, at the time time of issuance, this building or that portion of the building that
Kos inspected on the date listed vies found to be in compliance Wth 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: July
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 Inspector: re Inspector: —
Electrical Inspector- P&Z Administrator: N-��
C17'Y OF KEXB URG •
Work ( )
PF.R MT-r f+
BUILDING PERMIT APPLICATION Please cc 0600546
19 E MAIN, RE xB URG, ID. 83440 If the questio 553 S 4th E -Whyte
208 - 359 -3020 X326 GG�
PARCEL NUMBER: C�� ► —�� (we v
SUBDIVISION: UNIT# BLOCK# ( LOT# Y
(Addressing is based on tlfe information - must be accurate)
OWNER NAME. 5�g L L G'' CONTACT PHONE # ?S - l � S" `�✓"
PROPERTY ADDRESS: 3 �> �/ t Rc
PHONE #: Home ( ) Work ( ) 5 ,�Y 4 , 0 5 Cell
OWNER MAILING ADDRESS: Ole, s x_ ` CITY: -A / STATE: ( ZIP> b
EMAIL �%� �; ° .� ��' (C..ti' FAX 3 54 0 4,
APPLICANT (If other than owner) �7e /,�— �, �
(Applicant if other than owner, a statement authorizing applicant to iGas agent for owner must accompany this application.)
APPLICANT INFORMATION: ADDRESS CITY:
STATE; ZIP EMAIL F
PHONE #: Home (
L
CONTRACTOR
L
Cell (
.d 1, /,_ -l
MAILING ADDRESS: 26 /Y CITYY , STATE ZIP � f
PHONE #: Home ( ) _4Y6 Q.J OT' Work ( ) r( d S T Cell( ) 3J '2 3 2 3—
EMAIIA FAX � �r G IDAHO REGISTRATION # & EXP. DATE f i — /b' 0 7
How many buildings are located on this property? "y D w e -
Did you recently purchase this property? No a5 y (If yes give owner's name)
Is this a ? lots ht NO lease bring co of new le gal descr of ro er
p C � YES �' g pY g p
tY)
PROPOSED USE: l its
(i.e., Single Family Residence, Multi Family, Apar
Remodel, Garage, Commercial, Addition, Etc.)
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, I hereby certif
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 Code in cases of any false statement or misrepresentation of fact in the applic or on the plans on which the permit or approval was
based. Permit if not started within 180 days. Permit void if work or 0 days. ,�(] j�
�f L+C
Signature of Owner DATE
Do you prefer to be contacted by fax, email or phondgle One 9 005 IJ
WARNING — BUILDING PERMIT UST #E POSTED ON CONST CTI F
E!
Plan fees are non - refundable and are paid in full at�he rime of application be i ning 1 2005.
City of Rexburg's Acceptance of the la eview fee'es fat Q n
* *Building Permit Fees are due at time of applicatio **Building Perlri - 621 11 ill r es not clear**
s,d
N
Build
19 E. Main
Rexburg, ID 83440
Safety Department
City of Rexburg
janellh@rexburg.org Phone: 208.359.3020
www.rexburg.org Fax: 208.359.3024
REXB UR lO
o
� �
C I T Y OF
REXB
_ 0
Americas Family Community
Affidavit of Legal Interest
State of Idaho
County of Madison
I,
Name
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 Ae- , C -) day of , 20 —v�—
Signature
Subscribed and sworn to before me the day and year first above written.
Notary Public of Idaho
Residing at:
My commission expires:
Please complete the Are Ap
•
p �p
If the question does not apply fill in NA for non applicable
NAME 0 y L G G . >>
PROPER . ADDRE S S`S 3 .f o `� 4e Xf ( Permit# �' 4 3 L
SUBDIVISION J��O&,t
Dwelling Units: Parcel Acres:
SETBACKS
FRONT SIDE / SIDE BACK
Remodeling Your Building /Home (need Estimate $ 00V
SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building)
First Floor Area S Unfinished Basement area
Second floor /loft area 2-221
- 2 21 Finished basement area
Third floor /loft area Garage area tZ g to
Shed or Barn Carport /Deck (30" above grade)Area
Water Meter Quantity:
* * * * * * * * * * * ** *Water Meter Size:
Required.hff
PLUMBING ) f�
Plumbing Contractor's Name: ��C/ �(� �2 Business Name:
Address /; Lf, &X �j'� City State Clc Zip
Contact Phone: ( ) `,C� Business Phone: ( )
Email Fax
FIXTURE COUNT ('including toughed fixtures)
Clothes Washing Machine
Dishwasher
Floor Drain
I Garbage Disposal
Hot Tub /Spa
Sinks (Lavatories, kitchens, bar, mop)
Plumbing Estimate $
' Sprinklers
Tub /Showers
T Toilet /Urinal
Water Heater
Water Softener
(Commercial Only)
Signature of Licensed Contractor License Number& Expiration Date
The City of Rexburg s permit fee schedule is the same as required by the State
D
Idaho
4
,A jk
:o"'' ' Buildin g Safet / De p artment C , .r ,: City of Rexburg T�� mG
1 VR
Ow
19 E Main ionellh @rexburg.org Phone: 208.359.3020 x326 Americas Family Community
Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3024
OWNER'S NAME � �� c.� �
PROPERTY ADD Permit #06 00546
Y >—
SUBDIVISION 553 S 4th E
PHASE � ( LO BLOCK
Required!!! 6 i., LE_CTRICAL
Electrical Contractor's Name Business Name , A r7fzl
Address 3 7��n City State � Zit
Cell Phone (��. J S� -��%� Business Phone,)'G�) 513 6L 3
Fax ('L ) ��� (. Email r ( (sA � ` nh' 4-
Electrical Estimate ( cost of wiring & labor $ j jj� (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 m um 3 ins lions. Additional inspections charged at requested inspection rate of $40 per hour.
I �? z ��, I — / 0 -- 3 1) — 0 ('�
Sign e of Licensed Contractor License number Date
The City of Rexburg's permit fee schedule is the same as required by the State
7
Please complete the entire Ap
P pP
applicable
NAME - oz-% �� /A, /vT' G L c?
PROPER ADD SS
SUBDIVISION
Permit# � G e l S 3 ? Z
RequlredLY MECHANICAL
Mechanical Contractor's Name: Business Name: / F(d hN b
Address �� , ��` City State z Zip
Contact Phone: 1 Business Phone: ( )
Email Fax k 77 .4'
Mechanical Estimate $ (Commercial /Multi Family Only)
FI URES & APPLIANCES COUNT (Single Family Dwelling Only)
Furnace , r Exhaust or Vent Ducts S
Furnace /Air Conditioner Combo 35' ( Dryer Vents 1
Heat Pump
Air Conditioner
Evaporative Cooler
Unit Heater
Space Heater
1 Decorative gas -fired appliance jS
Incinerator System
Boiler
Pool Heater
Fuel Gas Pipe Outlets including stubbed in or future outlets 3v
Inlet Pressure (Meter Supply) PSI
Heat (Circle all that apply) a Oil Coal Fireplace Electric Hydronic
17
Mechanical Sizing Calculations must be submitted with Plans & Application
Point of Delivery must be shown on plans.
d Ll r- c -
Signature od4ee.sed Contractor License number
The
schedule is the same as
Date
the State of Idaho
i
If the question does not apply fill in NA for non
Range Hood Vents
Cook Stove Vents
4 — Bath Fan Vents ZD
other similar vents & ducts:
5
Building Safety Department ji t: i Y o City of Rexburg T I �X lJ T RG
cy,
19 E Main ionelih @rexburg.org Phone: 208.359.3020 x326 Americas Family Community
Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3024
OWNER'S NAME S"� r.,�Y�� oe2La
PROPERTY ADDRESS Permit#
SUBDIVISION F
PHASE � ( L T t f BLOCK �t
HOME OWNER -S ELECTRICAL PERMIT
Home Owner's Name
Address City State Zip
Cell Phone ( ) Home Phone ( )
Fax ( ) Email
i
i
TYPES OFINSTALLATION(RESIDENTIAL)
(New Residential includes everything contained within the residential structure and attached garage at the same time)
Up to 200 amp Service*
i
201 to 400 amp Service*
I Over 400 amp Service*
Temporary Construction Service, 200 amp or less, one location (for a period not to exceed 1 year) j
I
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.
Signature of Home Owner Date
The City o Rexburg s p fee scbedule is the cam as requir by the State of Idab
G
SUBCONTRACTOR LIST
Excavation & Earthwork: ,y j iv? G- C.-
Concrete: J v
Masonry: D !i w
Roofing: ` ,/ a z,meW
v
Drywall: 14 &' 1yie. -S c A-) b A q j,
Painting:
Floor / 1
Coverings: L +. b l /- S Aj
Plumbing: LLkllyi5 /� �•.� i�vt� i �/�g
Heating: Y i iiii �P to ^,6
Electrical:
Special Construction
(Manufacturer or Supplier)
Roof Trusses:
b
Floor /Ceiling Joists: L
Siding /Exterior Trim:
a
E
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
❑ 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.
� �-W&Al– "/ ,� - --z Y — o
Ir
Signature Date
:7?, L u Z
Print Name
11
nrira - ' 't �.
April 18, 2006
SPRINGMONT LLC
TED & NANCY WHYTE
PO BOX 604
REXBURG ID 83440
RE: Registration Notification
Congratulations!
Owyhee Plaza
1109 Main St., Suite 220
Boise, Idaho 83702 -5642
(208) 334 -3233
FAX (208) 334 -3945
E- Mail, ibo n:ibol.idaho:gov
Website www.ibol.i'daho.9-ov
The IDAHO CONTRACTORS BOARD has reviewed your application for registration as a
CONSTRUCTION CONTRACTING business in Idaho. Based on documentation that you
have met the requirements for said registration, the Board has approved your application and
authorized me to issue registration number RCE -15392 for your entity. This Re
egistration
authorizes the named entity to practice=as a CONTRACTING BUSINESS in Idaho.
Your registration cards are attached belp�y and kvlli expire 0440 007. This.registration
;.
subject to rerieyval each year before the anm�ersary, date of issue. A renewal noticefiIl be ='
mailed approximately 6 weeks before the expiration'date.
Please notify this office immediately of any necessary corrections -or changes to. your name or-
address.
Sincerely,
Rayola Jacobsen
Bureau Chief
Bureau of Occupational Licenses Your re lstratwn
Department of Self Governing Agencies must be S�IOWR Otl
The person named'has met' the:requirements for tie and is _ r n
entitled under the laws and rules of the state of Idaho to operate as a(ny ' ' dEiltand'
Rayola Jacobsen
Chief, B.O.L
RCE -15392
Number
carry this copy
display this copy
04/18/2007
Expires
IfltlIIn6lIlAlluflVIURIIIIIV
BUREAU OF OCCUPATIONAL LICENSES