HomeMy WebLinkAboutAPPLICATIONS, CO, BP - 06-00566 - 100 Crest View Dr - New SFRZ .�
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CITY OF
REX
Americas Family Community
Certificate of Occupancy
City of Rexburg
Department of Community Development
19 E. Main St. / Rexburg, ID. 83440
Fax
Building Permit No: 0600566
Applicable Edition of Code: Intemational Residential Code 2003
Site Address: 100 Crest View Dr
Use and Occupancy: Single Family Residence
Type of Construction: Type V, non -rated
Design Occupant Load: Residential
Sprinkler System Required: No
Name and Address of Owner: Kidd Myrth J
145N 3E
Rexburg, ID 83440
Contractor: Rivers Edge Construction
Special Conditions:
Occupancy: Residential - less than 2 units, permanent in nature
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
vies inspected on the date listed vies 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 wes
classified.
Date C.O. Issued: February 06, 8 (11 8AM)
C.O Issued by:
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
Electrical Inspector:
Fire Inspector: t 1A,
P &Z Administrator: I A-
I r r 0
' CITY OF KEXB UAG PER >\al -r tt
BUILDING PERMIT APPLICATION Please con 06 00566
19 E MAIN, REXBURG, ID. 83440 If the question
208 - 359 -3020 X326 906 Hillview Dr -Kidd
PARCEL NUMBER: & (We will
SUBDIVISION: C ) L� t./ � � UNIT# BLOCK# LOT #�`�
(Addressing is based on the information - must be accurate)
OWNER NAME: CONTACT PHONE #
PROPERTY ADDRESS:
PHONE #: Home ( k ) 3 � Work ( ) / Cell ( )
OWNER MAILING ADDRESS: /,.5` JV O 'mod CITY: STATE,::JZZIP:�
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 F.
Work (
Cell (
PHONE #: Home (
CONTRACTOR inn t J t - ,,, " 4
MAILING ADDRESS: (o ®d -S CITY 'R-e ,f of STATE ZIP 9 YYo
PHONE #: Home ( ) �� `�S Work 4) 60 / •- � � Cell (#) 6 d Y f 7 � 7
EMAIL FAX IDAHO REGISTRATION # & EX DATE C ,6 — D I 7
7 'O
How many buildings are located on this property ? /
Did you recently purchase this property? No O(If yes give owner's name) M ✓ a- L,- o "
Is this a lot split ?(93 YES (Please bring copy of new legal description of property)
PROPOSED USE: _�),' in f.-A L .
(i.e., Single Family Residence, Multi F mily, Ap artments,
Garage, Commercial, Addition, Etc.)
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalt of perjury 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 building official may revoke a permit on approval issued u the provisions of the 2003
International Code in cases of any false statement or misrepresentation of fact in the application or on the 1 h t r ro w
based. Permit void i tarted wit 180 da s.. t void if work stops for 180 dayys. p P T n
Signature Owner /Applicant D t •• 3 J
Do you prefer to be contacted by fax, email o hone? Circle One tYI�Y
WARNING — BUILDING PE UST BE POSTED ON CONST UCT N SITE!
Plan fees are non - refundable and are paid in full at the time of application be nn ( X$ U R G
City of Rexburg's Acceptance of the plan review fee does not constitut 11Wi h p v
* *Building Permit Fees are due at time of application ** * *Building Permits are void i your c ec r
o c ea
2
Build
g Safety Department
City of Rexburg
19 E. Main
Rexburg, ID 83440
ionellh @rexburg.org Phone: 208.359.3020
www.rexburg.org Fax: 208.359.3024
04 4EXB URC
U 70
CITY O F
REXBURG
OW
Americo Family Community
Affidavit of Legal Interest
State of Idaho
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 th property described on the attached, and I grant my
permission to: v t,/ 5 60,q 5 LEO a T b
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 —cC_ day ofd �� , 20
Signature
Subscribed and sworn to before me the day and year first above written.
LYNDA MERRILL
NOTARY PUBLIC
STATE OF IDAHO
3
County of Madison
My commission expires: 0,8
Please complete the entire Application!
NAME
PROPERTY ADD SS Permit#
SUBDIVISION
Dwelling Units: Parcel Acres:
SETBACKS
FRONT SIDE SIDE BACK t l
Remodeling Your Building /Home (need Estimate
SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building)
First Floor Area 1 Unfinished Basement area
Second floor /loft area Finished basement area (p L
Third floor /loft area / Garage area _+ b
Shed or Barn / Carport /Deck (30" above grade)Area
Water Meter Quantity:
* * * * * * * * * * * ** *Water Meter Size:
Requiredffl
PLUMBING
Plumbing Contractor's Name: k i t 45 1 I Name: d L $
Addr cf ` ^^ J �` City State Zip V
Contact Phone: ( ) Business Phone:
Email Fnx
FIXTURE COUNT /includin rouehed fixtures
Clothes Washing Machine _ Sprinklers
L Dishwasher Tub /Showers
Floor Drain Toilet /Urinal
Garbage Disposal Water Heater
Hot Tub /Spa —° Water Softener
Sinks (Lavatories, kitchens, bar, mop)
Plumbing Estimate $ (COMMERCIAL /MULTI - FAMILY ONLY)
X1.56' _
Signature of Licensed Contractor License Number& Expiration Date
The City of Rexburg s permit fee scheduk is the same as required by the State
Date
4
Please complete the entire Application!
NAME
PROPERTY ADD SS Permit#
SUBDIVISION CrP;S' t1_VCn
Requlredffl MECHANICAL
Mechanical Contractor's Name MI �'1 I,��� Business Name
1 "&,4 1
Address City 7 - y State I Zip
Cell Phone 3 p - ( /� y Business Phone ( )
Fax ( ) Email
Mechanical Estimate $ (Commercial /Multi Family Only)
FIXTURES & APPLIANCES COUNT (Single Family Dwelling Only)
Furnace
i
Furnace /Air Conditioner Combo
Heat Pump
Air Conditioner
Evaporative Cooler
Unit Heater
Space Heater
1 Decorative gas -fired appliance v�
D�p�
Incinerator System
Boiler
Pool Heater
µ
1 Exhaust or Vent Ducts
Dryer Vents G'
Range Hood Vents
Cook Stove Vents
Bath Fan Vents { '6
other similar vents & ducts:
1 -10
_ Fuel Gas Pipe Outlets including stubbed in or future outlets '5 5,
Inlet Pressure (Meter Supply) PSI
Heat (Circle all that apply) Gas Oil Coal Fireplace Electric Hydronic
Mechanical Sizing Calculations must be submitted with Plans & Application
Point of Delivery must be shown on plans,
Signature of Licensed Contractor License number Date
The 00 of B exburg's permit fee schedule is the same as required by the State
u
Building Safety Department a4 0.EXB�R C
City of Rexburg o y
o
19 E Main janellh@rexburg.org Phone: 208.359.3020 x326
Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3024
CITY O F
REXB
Americo Family Community
OWNER'S NAME
PROPERTY ADDRESS
SUBDIVISION
PHASE LOT BLOCK
Permit#
HOME OWNER'S ELECTRICAL PERMIT
Home Owner's Name
Address City State Zip
Cell Phone ( ) Home Phone ( )
Fax ( ) Email
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 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.
Signature of Home Owner Date
The City of Bexburg's perm t fee schedule is the same as required by the State of Idaho
0 -
Building Safety Department a ' ,1 Y OF
City of Rexburg n rvnT mG
l�.r.1117 �J 1\
19 E Main ionellh@rexburg.org Phone: 208.359.3020 x 326 America's Family Community
Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3024
OWNER'S NAME _ - Cnu A
PROPERTY ADD SS c,L k, M I I Permit #06 00566
SUBDIVISION AUS K41� 906 Hillview Dr -Kidd
PHASE LOT � l -- BLOC
Requiredffl ELECTRICAL
Electrical Contractor's Name C A fL- , Business Name �-
Address ,-S / `l L.,-1 k no 0 /3J City Z L/, Lm State Zip
Cell Phone ( ) Business Phone C� _ 5'-� Q `/
Fax ( ) Email
Electrical Estimate ( cost of wiring & labor $ S v (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 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 ma Zof 3 inspections. Additional inspections charged at requested inspection rate of $40 per hour.
Signature of Li tensed Contractor License number Date
The City
schedule is the same as required 4 the State
7
SUBCONTRACTOR LIST
Excavation & Earthwork: 1 wu 0,4 Q ►" u t;X)
Concrete: Ak,,"k W q"vJ
Masonry:
Roofing: 6 Cx�,,
�vt ✓S rC"le, z S a-
Floor
Plumbing. 1-1 C C.d `
Heating
Electrical: 5k4l f — 1_�-' k Cs
Special Construction
(Manufacturer or Supplier)
Roof Trusses: - I - rkll-o
Floor /Ceiling Joists: S�Z
Siding /Exterior
Other:
EXEMPTIAS FROM STATE RECOTRATION
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.gQv/cont.'U
❑ 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 certit that the info nation is true and correct to the best of my knowledge.
Date
u
Print Name
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