HomeMy WebLinkAboutAPPLICATIONS, CO, MULT DOCS - 07-00032 - B'Dazzled Hair & Nails - RemodelZ
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CITY OF
Certificate of occupancy
R City of Rexburg
`;
America's Family .. Corr�snuni l� Department of Community Development
19 E. Main St. / Rexburg, ID. 83440
Phone (208) 359 -3020 / Fax (208) 359 -3022
Building Permit No: 0700032
Applicable Edition of Code: International Building Code 2003
Site Address: 16 W 1st S
Use and Occupancy: B'Dazzled Hair & Nail Salon
Type of Construction: Type V -N, Unprotected
Design Occupant Load: 11
Sprinkler System Required: No
Name and Address of Owner: Morris James G And Lela G
60 Millhollow Road
Rexburg, ID 83440
=Contractor: Virgin, Kevin
Special Conditions:
Occupancy: Business, professional or service, restaurants less than 50
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 wes 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: March 20.2 (09:37AM)
C.O Issued by:
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.
Water Department: Fire Department
lectrical Department
tt
Applicable Edition of Code:
Site Address:
CITY OF Certificate of Occupancy
REx -.
America's Family Community
Building Permit No:
Use and Occupancy:
Type of Construction:
Design Occupant Load:
Sprinkler System Required:
Name and Address of Owner:
=Contractor:
Special Conditions:
Occupancy:
City of Rexburg
Department of Community Development
19 E. Main St. / Rexburg, ID. 83440
Phone (208) 359 -3020 / Fax (208) 359 -3022
0700032
International Building Code 2003
16 W 1 st S
B'Daaled Hair & Nail Salon
Type V -N, Unprotected
11
No
Morris James G And Lela G
- 60_Millhollow Road
Rexburg, ID 83440
Virgin, Kevin
Business, professional or service, restaurants less than 50
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 wes 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: March 20 200
C.O Issued by:
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.
Water Department: Fire Departmen -
CITY OF AEXB URG PERMIT #
BUILDING PERMIT APPLICATION Please cot
19 E MAIN, REXBURG, ID. 83440 07 0003 2
208 - 359 -3020 X326
PARCEL NUMBER: P RI e3 a (We wi B'Dazzled Hair Salon - Remodel
SUBDIVISION: UNIT#
Is based on the, information - must be
CONTACT PHONE #
PROPERTY ADD
PHONE #: Home (2Ob) 35 L - ) - _ 91 4 1 Work (266) 3�_ • 0) Cell (2e� 351 - SSi fl
OWNER MAILING ADDRESS: 3q13 E . XT 9, CITY: 'SO46A, STATE::Id- ZIP: $W
EMAI A FAX h
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
PHONE #: Home (
EMAIL F
Work (
Cell (
CONTRACTOR
.
MAILING ADDRESS: 333 . +J 34� [- . CITY �fUi' STATE ZIP ��
PHONE: Cell# Work# 5� 1 Fax# A;I q
EMAIL IDAHO REGISTRATION # & EXP. DATE
How many buildings are located on this property? rr
Did you recently purchase this property ?C�o Yes (If yes give owner's name)
Is this a lot split? NO YES (Please bring copy of new legal description of ty)K6 +
PROPOSED USE: S alrj�) —
(i.e., Single Family Residence, Multi Family, Apartments, Remodel, Garage, Commercial, AdditionAiEvv n
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION'TT penalty 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 under the provisions of the 2003 International Code in cases of any false statement or misrepresentation of fact
in the application or the plans o w the permit or approval was based. Permit void if not started within 180 days. Permit void if work stops for 180 days.
Signature& Owner /Ap
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 &ayaov 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
Buildifg Safety Department
City of Rexburg
19 E. Main janellh@rexburg.org Phone: 208.359.3020 ext 326
Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3024
OF RBX
�� f 0
'm
U G
CITY O F
REXBURG
_-___ -__ _ CW
Americas Family Community
Affidavit of Legal Interest
State of Idaho
County of Madison
I, rTr ��1 lr } r►`i 5 �C(r N , 1 �����1�a1'L`
Name Address
LIAO lctah-r,
City 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 rec rd owner of the property described on the attached, and I grant my _
permission to: 1 ,3`(13 Xty ti . `r i t ZX , �Jqq g
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 herin or as to the
ownership of the property which is the subject of the application.
Dated this day of 2 20 e 7
Signature
Subscribed and sworn to before me the day and year first above written.
Notary Public of Idaho
Residing at: �
My commission exe
September 20, 2012
BONDED THRU NOTARY PUBLIC UNDERWRITERS
3
Please complete the Are Application! 0
If the question does not apply fill in NA for non applicable
NAMIJ R
PROPERTY ADDRESS 16 (T 166 Permit#
SUBDIVISION
Dwelling Units: Parcel
SETBACKS
FRONT SIDE SIDE BACK
Remodeling YourBuildiniug /Home ( need Estimate $ 30
'
SURFACE SQUARE FOOTAGE. • (Shall include the exterior wall measurements of the building)
First Floor Area 1 :34 c G Unfinished Basement area
Second floor /loft area Finished basement area
Third floor /loft area Garage area
She or Barn Carport /Deck (30" above grade)Area
Water Meter Quantity:
Water Meter Size:
Regzuredffl
PLUMBING
Plumbing Contractor's Name: (,vtYY Business Name:
Address Y-�Z 6 r I7 � I i�dd�� . City - State � l� Zip
Contact Phone: ( ) 2P -3 L_.. Business Phone:
Email ............._..._ F
FIXTURE COUNT CmcludWZroWhed fixtures
Clothes Washing Machine
Dishwasher
Floor Drain
Garbage Disposal
Hot Tub /Spa
Sinks
(Lavatories, kitchens, bar, mop)
umbinLr Estimate $ =; 00
J Contractor
The City of &
Sprinklers
Tub /Showers
l Toilet /Urinal
^' Water Heater
Water Softener
(Commercial Only)
a-
License number Date
Burg's permit fee schedule is the same as required by the State of Idabo
4
Please complete the entif Application! If the question doeS apply fill in NA for non
applicable Dud -.
NAM 15 ��uLded �.ti� � ' � � �
PROITRTY ADDRESS _11V IAA Ibb 3 i ( Permit#
SUBDIVISION
Required MI MECHANICAL
Mechanical Contractor's Name: SVIA.� ,, Business Name: Nbuitf K PLC
Address yq Iq 6 . H /1 • City W lit i State Zit y2
Contact Phone: -3 13- 6 Business Phone: ( ) t
Emai A) /, 4 Fax /V'
Mechanical Estimate $ (Commercial /Multi Family Only t
r1 ►�oru
FIXTURES & APPLIANCES COUNT (Single Family Dwell#ig Only) v ats
Furnace O Exhaust or Vent Ducts
Furnace /Air Conditioner Combo Dryer Vents
�.XtS� lklGf�ik►1tE"
Heat Pump Range Hood Vents 4- A - 1. -0'0 .
Air Conditioner Cook Stove Vents Q
Evaporative Cooler Bath Fan Vents / �(•`
Unit Heater other similar v is & ducts:
Space Heater
Decorative gas -fired appliance ,
Incinerator System
Boiler
Pool Heater
Fuel Gas Pipe 04ts including stub d in or future outlets
Inlet Pressure (Meter Supply)
Heat (Circle all that app X tea' 1.Oil Coal Fireplace Electric Hydronic
r
Point of Delivery must be shown on plans.
Required! Signature of Licensed Contractor
The
License number
schedule is the same as
Date
the State of Idaho
5
Building Safety Department �
City of Rexburg o
19 E Main ionellh@rexburg.org Phone: 208.359.3020 x326
Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3024 °
CITY OF
REXBURG
Americas Family Community
OWNER'S NAME 1(&y a lk4l4t 4ki4 - 3
PROPERTY ADDRESS 16 \;� . [01) j �J< Z�4 — � Permit#
SUBDIVISION
PHASE LOT BLOCK
Required!!! ELECTRICAL
Electrical Contractor's Name 47 14 7A) - i l Busines:
Address t �S �� City
Cell Phone (.?v$) _i n 3 �S' Business Phone ( )
Fax ( )
Electrical Estimate (cost of wiring & labor) $ (CO
LTI- FAMILY ONLY)
TYPES OFINSTALLATION
(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*
Existing Residential (# of Branch Circuits)
Temporary Construction Service, 200 amp or less, one location (for a period not to exceed 1 year)
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)
Tempork Amusement /Industry
*IncludesAmaximum of 3 jflspections. Adspections charged at requested inspection rate of $40 per hour.
Signature Licensed Contractor License number Date
The 00 of Aexburg's permit fee schedule is the same as required by the State of Idaho
Name
�/, d,
3y�
EXeU��
Build'iXg Safety Department A
City of Rexburg
19 E. Main janellh@rexburg.org Phone: 208.359.3020
Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3024
CITY O F
REXBURG
_._._._.... — ow
America's Family Community
APPLICATION: "CONSTRUCTION PERMIT"
CONSTRUCTION PERMIT #:
PERMIT APPROVED: YES/ NO $50.00 FEE PAID: YES /NO
- APPLICANT INFORMATION:
Business Name:
Office Address:
APPROVED BY:
Office Phone Number: ( )_
Contractor Performing the Work:
Cit
State Zip
Contact Person: Cell Phone # ( )
- LOCATION OF WORK TO BE DONE:
Street Address Where Work Will Be Done:
Business Name Where Work Will Be Done:
Dates For Work To Be Done: To
Contact Person:
Phone Number: ( ) Cell # ( )
PLEASE CHECK THE TYPE OF PERMITS) YOU ARE APPLYING FOR:
❑ AUTOMATIC FIRE- EXTINGUISHING SYSTEMS
❑ COMPRESSED GASES
❑ FIRE ALARM AND DETECTION SYSTEMS AND RELATED EQUIPMENT
❑ FIRE PUMPS AND RELATED EQUIPMENT
❑ FLAMMABLE AND COMMBUSTIBLE LIQUIDS
❑ HAZARDOUS MATERIALS
❑ INDUSTRIAL OVENS
❑ LP -GAS
❑ PRIVATE FIRE HYDRANTS
❑ SPRAYING OR DIPPING
❑ STANDPIPE SYSTEMS
❑ TEMPORARY MEMBRANE STRUCTURES, TENTS, AND CANOPIES
Applicant's Signature Date
FA
SUBCONTRACTOR LIST
!
Excavation & Earthwork:
Concrete:
Masonry:
Floor
Coverings:
Plumbing:
Hea
Special Construction
(Manufacturer or Supplier)
Roof
Floor /Ceiling Joists:
Siding /Exterior Tri
Other:
8
EXEMPTIAS FROM STATE REATRATION
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
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