HomeMy WebLinkAboutAPPLICATIONS, CO, BP - 06-00578 - 709 Johnson St - New SFREr
O
z
O
M
� v
0 :1 = 0
o
a a 3
C
0 - m
@
n
N O d
3 � �
N 0 O
C 3 d
d c a
CL c �
0 0
_ N
= y
EP
M �.
o
m "
= m
CL 3
6
O (D
3 �
E
CD
vm�5Z
= m O
a d
o o c o
�'d y a is
Z r- m �
w
N N
c
ID m a
=p- = N p (D
f m _a o
N � N
a
v 0 ° v
- 3
0
Q m = .�
n 0 F a
o
a
=a
_2
M Ill
W X
c E
v
z
G) jC
Z
O
� W
M M
O
c
Fri
v
O
C
CO) -1
v
2 _D
c
M r
D
o m
W o
Z
-�
n M
M
;D co
r
M
O Z
0 A
O 47
n y
n
M
0
-G
W
c
M
CD
C
0
1
0, 0 - •1
W O 0 (�D
(C O tr
x r
C
a O m c
0 rr
p C . C
wm
y n 3
Df O L
'O C. 0
CD M
O U) rt C
c
( a 0
CD CL
K y = N
rt M ,Cr
N S 0
. 3
Ty
n (D 3
3 K C.
(C O X F
CL
61 (1)
(� < 0)
(1 (D C
o a °
.. (c
pt
.r O 0
(D M
0 _�
a
n�
0 _. C
c p�
n C1 (C
(D
O (D
C 3 C
CD x (D 'Cr
(D 0
-.m 3
c�+
Oar0
�N(D
c) -n
Z O
X
'M
p 2
m
0 n
O O
Z Z
--I CO
X -4
D c
n C
q n
o
•••1
z
0
O O
CO
C-
0
cn
N
g
M
O
CO
C-
0
S
7
O
D
(D
y Z
3
cn
0
3
l<
M
C
X T
M
X
C
M
O
4a
C_l]
•
ys 3 cl
a v �
�C
l
�• i /yyJ n
y"
A ~
� � y
�C
o O
c0 �.
o
O
v
O
V7
A
'?Y
(a
p
5
'71
T
'n
r
��
Z
w
N
N
- n
'v
;a
T n
m
m ;a 5
7
�
S
N
�
7
CO) 3 05 �
cc
v
0
v
c
n
go T N v Q
C
co
CD
(D
-
(C
m
CL
c �- D i : :'�
=
m
m
O
m N C
w_ N 3
o
c
-?
m
Z
Z O N n z =
N
N
r
m
W 0
O
r
O 0 =3
CA
0
0
n
m g o o 0
p G
p
n
O m < 'D CD �' �.
Z 0 0 D =. 3 a
Z O y
7
N
c
CL
n
et•
(D
o
N
1 C
CL
1,
�
O
v
O
V7
A
'?Y
(a
p
5
'71
T
'n
r
��
- n
'v
;a
7
�
S
N
�
7
gF.Xe U,r
CITY O F Certificate of QXcupancy
REX BT JR G City of Rexburg
;'►� Department of Community Development
Ameilca' Family Community
19 E. Main St. / Rexburg, ID. 83440
Phone (208) 359 -3020 / Fax (208) 359 -3022
Building Permit No: 0600578
Applicable Edition of Code: International Residential Code 2003
Site Address: 709 Johnson Ave
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: Vrska Timothy Etux
659 Trejo St
Rexburg, ID 83440
Contractor: Owner
Special Conditions: Unfinished basement 60 10 sF)
Occupancy: Residential, single family dwellings, lodging houses
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
sties inspected on the date listed vies found to be in compliance idth the requirements of the code
for the group and division of occupancy and the use for Mich the proposed occupancy VLes
classified.
Date C.O. Issued:
C.O Issued by.
April 25, 2007 10:44A
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: �Q
aTY 6F KEXB UKG •
BUILDING PERMIT APPLICATION
19 E MAIN, REXBURG, ID. 83440
208 - 359 -3020 X326
PARCEL NUMBER: �'� a V�1� L ( ( (We
SUBDIVISION: H e h Ae l5bl , . G u 6 Ai4'05!a BLOCK# 2 LOT# 2_'6
(Addressing is based on the information - must be accurate)
OWNER NAME rv, Y rs CONTACT PHONE # ?--o`s - 75 - 7-1k , 77-
PROPERTY ADDRESS:
PHONE #: Home (2cr3) - 7 5 - - 2 Work ( ) Cell ( )
OWNER MAILING ADDRESS: 5 r P 1 0 CITY: R Y STATE D ZIP: 83 4 1 6
EMAIL `� o l o o 1. t D y FAX
APPLICANT (If other than owner) 1J A
(Applicant if other than owner, a statement authorizing applicant to act as agent for owner must accompany this application.)
APPLICANT INFORMATION: ADDRESS
STATE; ZIP
PHONE #: Home (
LJ
Cell ( )
r r_- - -- -
Please c( 0600578
If the questit
709 Johnson -Vrska
CITY:
EMAIL FAX
Work (
T ` MAILING ADDRESS: CITY STATE ZIP
PHONE #: Home (
Work ( ) Cell (
EMAIL FAX IDAHO REGISTRATION # & EXP. DA
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 description of
PROPOSED USE: 1 paw^,1 n R{51 ke
(i.e., Single Family Residence, Multi Family, Apartments, emodel, Garage, Commercial, Add
F
i
OF REXBURG
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, I hereby certi
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 application or on the plans on which the permit or approval was
based. Permit void if not started witlq 180 days. Permit void if work stops for 180 days.
Signature of Owner /Applicant DATE
Do you 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 knu - E 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
Build% Safety Department oF�EXBU��, CITY O F
City of Rexburg �� o � rvT�T mG
'> 1tG 1�1� V I
19 E. Main janellh@rexburg.org Phone: 208.359.3020 Americas Family Community
Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3024
Affidavit of Legal Interest
State of Idaho
County of Madison
I.
Name
City
Address
State
Being first duly sworn upon oath, depose and s y:
(If Applicant is also Owner of Record skip to B)
A. That I am the record owner of the proper 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 it and its employees harmless from any
claim or liability resulting from any dispute as to a statements contained herein or as to the
ownership of the property which is the subject o the application.
Dated this day of , 20
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 Atire Application!
NAME – �1 U r s k .,,.
PROPERTY ADDRESS
SUBDIVISION �{rHC�asor s�.Sd /o�
Dwelling Units: Parcel Acres: . i
SETBACKS e
FRONT
0
Permit#
SIDE 16 t SIDE 1 (0' BACK 3 1
Remodeling Your Building /Home (need Estimate $
SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building)
First Floor Area i S- 3 �- Unfinished Basement area ;,5
3 S�
Second floor /loft area i Finished basement area N /A
Third floor /loft area N!R Garage area y 6 b
Shed or Barn N/A Carport /Deck (30" above grade)Area. N
Water Meter Quantity:
* * * * * * * * * * * ** *Water Meter Size: : ZZ
Required!fl
PL UMBING
Plumbing Contractor's Name: �� -f "'� I'� l t� Business Name'
Address - / '� S t
city
J� a -�_ State J , zi p 3yy.
�� _
Contact Phone: ( ) Business Phone:
Email Fax
FIXTURE COUNT /including roughed fixtures
Clothes Washing Machine Sprinklers
7— Dishwasher Tub /Showers
Floor Drain 4 Toilet /Urinal
/ Garbage Disposal Water Heater
Hot Tub /Spa / Water Softener
Sinks (Lavatories, kitchens, bar, mop)
Plumbing Estimate $ (COMMERCIAL /MULTI - FAMILY ONLY)
ignatureeef Licensed Contract 6r License Number& Expiration Date Date
The City of Rexburg's permit fee schedule is the same as required by the State of Idaho
4
Please 'com 'complete the entire Ap
p PP
NAME ' Vr_sk -,
PROPERTY ADDRESS
SUBDIVISION cLt >` 1 10 4 d cs / s
Permit#
Required!!!
MECHANICAL
Mechanical Contractor's Name Stet/ e D i c. k Business Name A (,.; A � ik. //,.r f A , r
Address y ' jfux 6Z7 City R I I W State TIb Zip 93yq
Cell Phone (Z,;e) ? N 6 56 Business Phone ( )
Fax (zo R) 15 5 7 -1 - 12,38 Email
Mechanical Estimate $ (Commercial /Multi Family Only)
FIXTURES & APPLIANCES COUNT (Single Family Dwelling Only)
rL Furnace 0
Furnace /Air Conditioner Combo 3 5 -
Heat Pump
Air Conditioner
Evaporative Cooler
Unit Heater
Space Heater Ptooe�6
Decorative gas -fired appliance 1
Incinerator System
LAO 6
Pool Heater
3 z � Fuel Gas Pipe Outlets including stubbed in or future outlets
24 — Inlet Pressure (Meter Supply) PSI
Heat (Circle all that apply) Gas Oil Coal Fireplace Electric Hydronic
Contractor License number
The City of Rexburg's permit fee schedule is the same as
other similar vents & ducts:
0
r
9 19
Date
the State
01 Exhaust or Vent Ducts 1 S
Dryer Vents
Range Hood Vents
Cook Stove Vents
q if" Bath Fan Vents -
k ,
Building Safety Department
City of Rexburg
19 E Main janellh@rexburg.org Phone: 208.359.3020 x326
Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3024
OF 4EXB (JR
U �
CITY O F
REXBURG
.________ ._.. O
Americas Family Community
OWNER'S NAME
PROPERTY ADDRESS - 1 �'CD1 -►�n sph
SUBDIVISION tRv t a
PHASE LOT 2 a BLOCK Z
0600578
709 Johnson -Vrska
Requiredffl
ELECTRICAL
Electrical Contractor's Name �� t Q 1
b S "' Business Name _
Of 42 b ')
Address
City 1,xb,
State T b
Zip P3'IVO
Cell Phone (id8) 31'3 Business Phone
Fax (zj b) 3 S I ` $- j o & Email
o%
Electrical Estimate (cost of wiring & labor) $ J� 0 (COMMERCIAL /MULTI - FAMILY ONLY)
TYPES OFINSTALLATION
(New Residential iocludes 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 f 3 X spections. Additional inspections charged at requested inspection rate // of $40 per hour.
�__. C — &V gy / ZO, o
Si afore of Licensed Contractor License number Date
The
schedule is the same as required by the State of Idaho
VA
SUBCONTRACTOR LIST
Excavation & Earthwork:
R -7 1"6r 'SI - ,:lece-
Masonry: r �]
Floor
Coverings:
Plumbing:
Heating: H 'G h Faun 6 � Reel �, f
Electrical: /UPS
Special Construction
(Manufacturer or Supplier)
Roof Trusses: ' u m l" i Tru5
Floor /Ceiling Joists: -�o �� ge I "� � ,� P e W
Siding /Exterior Trim: d T q -1) A e x I R�e 3
EXEMPTI(*S FROM STATE REASTRATION
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 bogie information is true and correct to the best of my knowledge. L ��-- 11/2 / 1 6 r`,
Signature
-T,
Print Name
Date
V]