HomeMy WebLinkAboutAPPLICATIONS, CO, BP - 07-00041 - 654 Harvest Dr - New SFRa
Z
m n
m
.�
m
O
cn cn - �i
y
S
3 :05)
Dh
RD m -
° a
m
0
7
CD. m
_
cM
m
m M
�' 3
0
co 0 0
-n
n
CD
A
C
zx
rn_
0
v
O
z
OHO
O 0
�
p .
3
■
z
C,O
o 00) 3 D
C
m z
0 n 0
o
CD
O
CD
0
°
3
3 0
- -0 °- 3 m m
o z
O
o
o
v
0 3 <D
7 � �. y CD
= m
M
m
\1/
:u
—Ch N
m
7
ca m a o
o -�
N n 3 r
Cu
m o _
3 - 0
n
0
c
N <D O
o
C O
cn
CD �_ � m
v CL 't3 CD CD m
CD
0 N N
m
m
0 N Vl (Q
C C
�
0 ���
v
o Z
m o o o
O
:3 ° w,
c
n
o 0 v
0 5 0
N
m
' G N =r N
c CD =3
v r'
CD
cn
❑
k
v
0
m
0
o
(0)
3
7
� sl
d
:
m
v m 3
N D
CD ° �
0 :3
U)
O .�
o m
CD
a
CD 3 D
W v
Q. CD
z
z
Q
C7 CD 3
3
v �
va) ��
.f
0 rttQ
a =
00
CD 0
<�0)
m m
*
W
CD
' � 0
E ca �
0 0
CD
n N 0
" r
0
CD
f 9
0
m y
0
N CD'ro
o Z
Cn _
T ^
YI
v d 0 2. v
O
—(D
- 3 • 3
a-, 0 l<
n
n
CD
0 �•�- N
_�
0
< �0 o
m
cD 0
0
` 0
xfD
CL
n
a
o
m n
m
I
m
O
cn cn - �i
y
S
3 :05)
Dh
RD m -
° a
m
0
7
CD. m
_
cM
m
W
�' 3
0
co 0 0
-n
n
CD
A
v
zx
D)
z
O
z
OHO
O 0
=
p .
3
- D
(4) T C
C,O
D
m z
o
N
o
CD
O
n
o
0
°
3
3 0
l" O
�v
m
m
z g
o
o
m
a
N '�
.
\1/
0 Z
N
7
O
O
--1
N n 3 r
CD
3
N
13
°
0
O
A W
0 0
CL 3
0
ED
3
NI -,
G
v
CD
cn
CD
;2 .
CD
0
3
T
CD
CD
Cn
CD
z-
° r
CD c
0 K
3 W
z
v G)
(D m
v
sv
m
o
v
So C»
m
O
rt
CD �� y
z
m
A,
°' °
X
_
OM
° c
m
o
3 ,
- n
o
c°
P!
m
C
3 x
x
v
f� °
M -% C u;
O
O
z
1 cD
(D O N
X N
z
- D
CL
8- rt
D
I�j
� (QNQ.
n
C
'a O (DD C
0
O
co
3
O'
N '�
.
z
co
O ".
cc °
7
O
N n 3 r
CD
0
a) O Q CD
cn
X
v CL 't3 CD CD m
CD
A
0 N Vl (Q
C C
U
O
_
O
O
CD 3 O O
O
CL (D ao
n
m
' G N =r N
N
cn
❑
N C Z O
c-
(0)
=
7
O
c C
:
m
N
EL
,G C
U)
O .�
CD
CL
y W
M
0
N< N
Q
C7 CD 3
3
C-
O
1
.f
0 rttQ
00
g
3 3
m
0
C 3
2 a ca
Ul
—(D
3 O CO
1
CL
CD 3' C
xfD
0 O
❑
3 = N
Q su
O O 3
3 y CD
3
N
13
°
0
O
A W
0 0
CL 3
0
ED
3
NI -,
G
v
CD
cn
CD
;2 .
CD
0
3
T
CD
CD
Cn
CD
z-
° r
CD c
0 K
3 W
z
v G)
(D m
v
sv
m
•
i
(
o > ' crrf
v tv
�C
P ��
l
0
A (�
� � H
n 0
� `r1
n
lz;� 1
H,
0"G
o
'A
m
VI
fn
m
p
m
�°
OM
° c
m
o
3 ,
- n
o
c°
r
z�
Sr
>
0'
R
0
v
0
v
v
C_
CD
- n
- D
;u
N
CD
..
0
co
3
co
7
0
m
O
X
•
i
(
o > ' crrf
v tv
�C
P ��
l
0
A (�
� � H
n 0
� `r1
n
lz;� 1
H,
0"G
m
r
m
0
Ov
C
r
v
z
7 Q
v
D
D
3
3
D
i
E
y
a
m
0
-1
z
r�
o
fn
m
p
co
c
o'
'n
3
to
OM
° c
m
o
3 ,
- n
o
c°
r
z�
Sr
>
0'
R
0
v
0
v
- n
- D
;u
w
C
N
co
3
co
7
m
r
m
0
Ov
C
r
v
z
7 Q
v
D
D
3
3
D
i
E
y
a
m
0
-1
z
r�
';oe RaxeuR� �v
U O
~'• � S SMFO
CITY OF
REX
CW
Americas Family Community
Certificate of accupancy
City of Rexburg
Department of Community Development
y 19 E. Main St. / Rexburg, ID.'83440
Building Permit No: 0700041
Applicable Edition of Code: International Residential Code 2003 ",
Site Address: 654 Harvest Dr
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: Thueson William R Etux
52 W Sunset
Rexburg, ID 83440
Contractor: Brett Jensen Construction
Special Conditions: Unfinished basement
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 viith 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:
C.O Issued by.
February , 2009
Building Official
PM)
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: Yl I I 4lr
Electrical Inspector: P&Z Administrator: l VA
0 9
CITY OF AEXB UAG PERMIT #
BUILDING PERMIT APPLICATION Please complete the entire Application!
19 E MAIN, REXBURG, ID. 83440 If the question does not apply fill in NA for non applicable
208 - 359 -3020 X326
PARCEL NUMBER: hjhJZVfl M3)W -_�7 (We will provide this for you)
SUBDIVISION: e- UNIT# BLOCK# LOT # -3
(Addressing is based on the information - mu be accurate)
ACT PHONE # 3 1 7 - C, , 73 S
PROPERTY ADDRESS:
PHONE #: Home V.S �J_3 Work ( ) Cell (Op 7 - Co ?
OWNER MAILING ADDRESS: ? CITY: P-c 6L STATE:"' E,_ � ;
EMAIL G �- .- /�tl'Vl/� C � _ C'�t �� � f��C . l � FAX ! - 07
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
STATE; ZIP,
PHONE #: Home (
EMAIL F
Work (
Cell (
CONTRACTOR E�,SpAk SGASCt\_ Cons!
MAILING ADDRESS: P 0. &X b 7 CITY u STATE � ZIP 0 y
PHONE #: Home ( ) 5S2 Work( ) Cell ( ) 31 - 4e 73
EMAIL FAX IDAHO REGISTRATION # & EXP. DATE K—_ & y - 4& 7 V
How many buildings are located on this property?
Did you recently purchase this property? No es yes give owner's name) A
Is this a lot split YES (Please bring copy of new legal description of prope
F
PROPOSED USE: f� i n t. L IA4VX \. , r AN g 17 2007 On
(i.e., Single Family Reside
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: 4 o L.
that I have read this application and state that the information herein is correct and I swear that any informatiorrt�hi -izereaft��rkie -g�vg
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. Permi void if not started within 180 days. Permit void if work stops for 180 days.
/3
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 fanugtX 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
CITY:
Build
Safety Department
City of Rexburg
19 E. Main
Rexburg, ID 83440
janellh@rexburg.org Phone: 208.359.3020
www.rexburg.org Fax: 208.359.3024
OF REXBURC
o
CITY O F
REXBURG
Americas Family Community
Affidavit of Legal Interest
State of Idaho
County of Madison
I, LAC 6 .ky
Name Address
g � �� W 10
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 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 Z day of Ck'C e 1 04 4 - - , 20 a
Signature
Subscribed and sworn to before me the day and year first above written.
' �. ..........�9Gy ►►
m :� ��TAR y •:
r
J, ►s
4 6iz� �'
Notary Public of Idaho
Residing at: ' C��D
My commission expires: Og
3
Please comp lete the entire Ap
p pP
NAME & -
PROPERTY ADDRESS APE,
SUBDIVISION 'J
Dwelling Units:
Parcel Acres:
* * * * * * * * * * * ** *Water Meter Size: 9 2 14 -
SETBACKS r I l
FRONT 5� SIDE �` SIDE BACK l�
Remodeling Your Building /Home (need Estimate) $
SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building)
First Floor Area Z Unfinished Basement area 2`t
Second floor /loft area Finished basement area
Third floor /loft area Garage area f 06 O
Shed or Barn Carport /Deck (30" above arade)Area
Water Meter Quantity:
RequiredLY
PLUMBING
Plumbing Contractor's Name: CY`V —f'& rn � - Business Name:
Address City State Zip
Contact Phone: Business Phone: ( )
Fax
FIXTURE COUNT (mcludingroughed fixtures
Clothes Washing Machine
Dishwasher
Floor Drain 3
Garbage Disposal
Hot Tub /Spa
Sinks (Lavatories, kitchens, bar, mop) 8
Plumbing Estimate $
Sprinklers
Tub /Showers y
Toilet /Urinal
f— Water Heater
_ I Water Softener
(COMMERCIAL /MULTI - FAMILY ONLY)
Signature of Licensed Contractor
The
License Number& Expiration Date
0
X01
/,I / /� D
7 ate
schedule is the same as required by the State of Idaho
4
Please complete the entir A p p lication!
NAME 6U4 CCf1 -
PROPERTY ADDRESS /OL & Z.
SUBDIVISION ACS e
0
Permit#
Required!!!
MECHANICAL
Mechanical Contractor's Name �ll � t� lJ 6 inc� Business Name
Address City /Z-ej& State 17.7 Zip
Cell Phone ( ) Business Phone ( ) 2g T L — bl 70
Fax (
Mechanical Estimate $ (Commercial /Multi Family Only)
FIXTURES & APPLIANCES COUNT (Single FamilyDwel ng Only)
Furnace 3 f 1 Exhaust or Vent Ducts 16"
Furnace /Air Conditioner Combo
Heat Pump
Air Conditioner
Evaporative Cooler
Unit Heater
Space Heater
Z- Decorative gas -fired appliance �!p
Incinerator System
Boiler
Pool Heater
Dryer Vents 5
Range Hood Vents b'_
Cook Stove Vents
7 Bath Fan Vents Z,v
other similar vents & ducts:
Fuel Gas Pipe Outlets including stubbed in or future outlets q(
Inlet Pressure (Meter Supply) PSI
Heat (Circle all that apply) Gas Oil Coal Fireplace Electric Hydronic
Mechanical Sizing Calculations must be submitted with Plans & AUplication
Point of Delivery must be shown on lane.
Signature of Licensed Contractor License number Date
The
schedule it the same as required by the State of Idaho
5
a 0 0 m ; 0 - .............................. 0 ............................
SUBCONTRACTOR LIST
Excavation & Earthwork: 1ti II "Y
-t
Masonry: 1 S b (�
Roofing: AM /
Insulation: Ad V. 0
Drywall: �-
Painting: , zC (��- �-w l L
1
Floor T
Coverings: �)i`� .� il
Al»ml� 1 % � 9 I Aft,`l1..,
I C.. G (
Special Construction
(Manufacturer or Supplier)
Roof Trusses: SLz ra m � 4
Floor /Ceiling Joists: f C-
Siding/Exterior Trim:
8
• • EXEMPTIWS FROM STATE RE*STRATION
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.
m
Signature Date
cAe �
Print Name
0
Building Safety Department
City of Rexburg
79 E Main jonellh@rexburg.org Phone: 208.359.3020 x326
Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3024
of RExa up
�s �O
's
o
CITY O F
REXBURG
America's Family Community
OWNER'S NAME l �r. � � � Coa, J
PROPERTY ADDRESS
SUBDIVISION ���
PHASE LOT BLOCK
Permit 107 00041
654 Harvest Dr- Jensen
Requiredffl
ELECTRICAL
Electrical Contractor's Name �� Business Name
Address 1 13 1 6 — 4 5L. L. City �CC�3cc t r, State — = zip _pw
Cell Phone ( ) �A 7 — ; S_Zc �� — Busin ss hone ( )
Fax ( ) Email
Electrical Estimate ( cost of wiring & labor $ (COMMERCIAL /MULTI - FAMILY ONLY)
TYPES OFINSTALLATION(RESIDENTIAL)
(New Residential includes everything contained within the residential structure and attached garage at the same time)
K Up to 200 amp Service*
201 to 400 amp Service*
Over 400 amp Service*
_ 2 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)
Tempora musement /Industry
*Includes a.. aximum of 3 ins tions. Addi ections charged at requested inspection rate of $40 per hour.
ignature o Licensed Contractor License number Date
The
schedule is the same as required by the State of Idaho
7