HomeMy WebLinkAboutAPPLICATIONS, CO, BP - 07-00058 - 794 Yost St - New SFRG)
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Certificate of Occupancy
Cl9 CITY OF
us� REX City of Rexburg
"
America's Fam Community
Department of Community Development
t
19 E. Main St. / Rexburg, ID. 83440
Phone 208 359 -3020 / Fax 208 359 -3024
Building Permit No: 0700058
Applicable Edition of Code: International Residential Code 2003
Site Address: 794 Yost St
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: Shaw Homes
4546 E 370 N
Rigby, ID 83442
Contractor: Shaw Homes & Construction
Special Conditions: 1) Unfinished basement
2) Electrical rough in was not inspected.
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
vies inspected on the date listed vies found to be in compliance vuth the requirements of the code
for the group and division of occupancy and the use for Mich the proposed occupancy mes
classified.
Date C.O. Issued: August 14, 2007
e
C.O Issued by: c
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: Fire Inspector: ► u�
Electrical Inspector: PAZ Administrator: IQ
CITY OF REXBURG 0
YES (Please bring copy of new legal description of property)
BUILDING PERMIT APPLICATION Pleas
19 E MAIN, REXBURG, ID. 83440 If the q Permit # 07 00058
208-359-3020 X326
PARCEL NUMBER "� �1�cr 794 Yost St -Shaw Homes
iiII l/��
SUBDIVISION: Lk1_V d e✓`.5e 1V UNIT # BLOCK# LO T# `
(Addressing is based on the information - must be accurate)
CT PHONE # %e5 —
PROPERTY ADDRESS: 6 1 A_
PHONE #: Home ( ) Work ( ) 2a .0 Y/ Cell ( ) 705 ' 7 0 5- x'
OWNER MAILING ADDRESS: yG :� 7D A/ CITY: 9 1'6-13 STATE_1_VZIP: <3
EMAIL - V-- ka 2 x0 M 3 /V FAX E3 9 1 ' - 777 1- 1
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 FAX
PHONE #: Home ( ) Work ( ) Cell ( )
CONTRACTOR
MAILING ADDRESS: lt�g6 ,eE�7 3,;;;D CITY � - STATE�ZV ZIP S3 �
PHONE #: Home ( ) Work ( ) O� Cell ( ) �GS
EMAIL FAX S39' -777 IDAHO REGISTRATION # & EXP. DATE —&L — /2.
How many buildings are located on this property?
Did you recently purchase this property? No Xs (If yes give owner's name) J - k-( e1 , .s0
Is this a lot split?
5 i/I/ G-- 6e
PERMIT #
AeSi` //.v_ .C/e
Multi Family, Apartments, Remodelyd�arage, Commercial, Addition, Etc.)
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalt of perjur I hereb 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 on the plans on which the permit or approval was
based. Permit void if not started within 180 days�Permit void if work stops for 180 days.
Signs of Owner /Applicant DATE
Do u prefer to be contacted by fax, email o hon Circle One
WARNING — BUILDING PE UST BE POSTED ON CONSTRUCTION SITE!
Plan fees are non - refundable and are paid in full at the time of application beginning Janes 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
Bu
19 E. Main
Rexburg, ID 83440
g Safety Department
City of Rexburg
ionellh@rexburg.org Phone: 208.359.3020
www.rexburg.org Fax . 208.359.3024
�F RkXH URC
7�
U O
CITY OF
REXBURG
America's Family Community
'2 J44 da
City State
Being first duly sworn upon oath, depose and say:
(If Applicant is also Owner of Record, sldp 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.
) 1
Dated this '� day of fi 46 , # , 20 Z
Signature
Subscribed and sworn to before me the
f
_ NOTARY,
* PUBLIC
Notary
and year first above written.
114A i
u c of Idaho
Residing at:
My commission expires: _
Notary Public for the State of Idaho
F- , din ' q in Fremont County
..— Expires 06 -21 -2011
3
_
�° l` it
Affidavit of Legal Interest
ffi
r 'r
State of Idaho
r r
County of Madison`'
Name
Address
'2 J44 da
City State
Being first duly sworn upon oath, depose and say:
(If Applicant is also Owner of Record, sldp 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.
) 1
Dated this '� day of fi 46 , # , 20 Z
Signature
Subscribed and sworn to before me the
f
_ NOTARY,
* PUBLIC
Notary
and year first above written.
114A i
u c of Idaho
Residing at:
My commission expires: _
Notary Public for the State of Idaho
F- , din ' q in Fremont County
..— Expires 06 -21 -2011
3
Please complete the entire A p p lication!
NAME
PROPERTY ADDRESS Ger,,
SUBDIVISION &Lk
Dwelling U
Parcel Acres: V' 2.Z
Permit#
SETBACKS le
FRONT 5, 40 SIDE SID BACK _
Remodeling Your Building /Home (need Estimate) $
SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building)
First Floor Area /a ?5 Unfinished Basement area / 0 6 5_
Second floor /lo area q Finished basement area -e9–
Third floor /loft area - Garage area 5
Shed or Barn $"' Carport/Deck (30" above grade)Area t k
Water Meter Quantity:
* * * * * * * * * * * ** *Water Meter Size:
Required N
PL UMBING
Plumbing Contractor's Name: �T r "'�C Business Name: ,V/e–
y
���1 Vii/ T dLG
Address City State Zip
Contact Phone: ( ) �D. S ^ -5 Business Phone: ( )
Email Fax
FIXTURE COUIVT 1wc1u&n_- roughed fixtur
Clothes Washing Machine
Sprinklers
Dishwasher
Tub /Showers
_ Floor Drain
Toilet /Urinal
Garbage Disposal
Water Heater
Hot Tub /Spa
Water Softener
_Z Sinks (Lavatories, kitchens, bar, mop)
Plumbing Estimate $
(COMMERCIAL /MULTI - FAMILY ONLY)
afore.(IAVwed Contractor License Number& Mpintion Date Date
The City of Rexburg s permit fee schedule is the s ame as required by the State
4
i 0
Please complete the entire Application!
NAME _59641 96-?1?e5
PROPERTY ADDRESS 7' 2,3 f34r 11' Permit#
SUBDIVISION Y!�WZ -;1 5� , W
RequrredLY MEC11"ICAL
tj Mechanical Contractor's Name /V e.i ry
i! Address Z E. LWN
Cell Phone ( ) 3 - Io2_4 - 1
Fax (p2� -`I 1.23
Mechanical Estimate $ (Con
FIXTURES & APPLIANCES COUNT
Furnace
Furnace /Air Conditioner Combo
Heat Pump
Air Conditioner
Evaporative Cooler
Unit Heater
Space Heater
Decorative gas -fired appliance
Incinerator System
Boiler
Pool Heater
, 'ACTS F; Business Name Z.+ 4 e,GO
Cit si- Ar)YIynk/ State =A zip g3Y &6
Business Phone l4''") 3 3— !v2 q
Email rv�hj n/11 SS i'l (F y koD • 610"
imercial /Multi Family Only)
(Single Family Dwelling Only)
Exhaust or Vent Ducts
Dryer Vents
Range Hood Vents
Cook Stove Vents
Bath Fan Vents
other similar vents & ducts:
Fuel Gas Pipe Outlets including stubbed in or future outlets
Inlet Pressure (Meter Supply) PSI
Heat (Circle all that apply) 7 as Oil Coal Fireplace Electric Hydronic
Mechanical Sizing Calculations must be submitted with Plans & Application
Point of Delivery must be shown on plans.
D_ m 07W 11 1 14el 2- -1-o - 7
Signature of Pcensed Contractor License number Dare
The City of Rexbuq s perma fee schedule is the same as required by 16e State of Idaho
5
I'd Itr90- 6S6_(802) meys uor d90 =E0 LO 6I 9aj
Please complete the entire A p p lication!
P pP
NAME 511, 4 96 - ? 1 7 eS
PROPERTY ADDRESS Lo Y 23 L54s e-R S
SUBDIVISION JeA1,11,M 5� W
0
Requlre&ff MECHANICAL
Mechanical Contractor's Name � Business Name J-uQGO
Address City State zip
Cell Phone ( ) Business Phone ( )
Fax ( )
Email
Mechanical Estimate $ (Commercial /Multi Family Only)
FIXTURES & APPLIANCES COUNT (Single Family Dwelling Only)
' Furnace
Furnace /Air Conditioner Combo
Heat Pump
Air Conditioner
Evaporative Cooler
Unit Heater
Space Heater
Decorative gas -fired appliance
Incinerator System
Boiler
Pool Heater
Exhaust or Vent Ducts
Dryer Vents
Range Hood Vents
Cook Stove Vents
3 Bath Fan Vents
other similar vents & ducts:
Fuel Gas Pipe Outlets including stubbed in or future outlets
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
The
License number
scheduk is the same as
Permit#
Date
the State of I
5
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
04 4Exe URC
U 0
C I T Y OF
REXBURG 1-1 - _. Ow ____ _ _
Americas Family Community
OWNER'S NAME
PROPERTY ADDRESS
SUBDIVISION
PHASE LOT
BLOCK
Permit#
HOME O WINER 'S ELECTRICAL PERMIT
,r
Home Owner's Name r
Address City ' J State Zip_
i
Cell Phone ( ) Ho Phone ( )
Fax ( ) Email
TYPES OFINSTALLATION
(New Residential includes everything contained wit
residential structure and attached garage at the same time)
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 (whet, not part of a new residential construction permit
and no additional wiring)
Modular, Manufactured or Mobile Home
Up to 200 amp Service*
Other Installations: Wiring not specifically covered by any df 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 pee hour.
Signature of Home Owner
The
schedule is the same as
Date
the State of Idaho
SUBCONTRACTOR LIST
�{ i t we
Excavation &Earthwork: � � � 1 � '
Concrete: -I�A W Na 7n-- 5'
Masonry: >� /A '/3�_ .
Roofing: �5 /y G
Insulation: (} G
Drywall:
Floor If
Coverings: S(T1> W //,/
Plumbing:
Heating:
Electrical:
Special Construction
(Manufacturer or Supplier)
Roof Trusses: n M
Floor /Ceiling Joists: PEW C% r
Siding /Exterior Trim: r lJ i�A Kf!5;f1V �✓
EXEMPTIWS FROM STATE RECSTRATION
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.lbol.idaho.gov /cont.him
❑ 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
G1
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
OWNER'S NAME �. fz/ fCf�,Ze'
PROPERTY ADD SS -2 > >3!> r ,S�
SUBDIVISION Ha f �/F?l' S.v Jt /
PHASE ' LOT g 3 BLOC
4EXBURC,
U � 0
C I T Y OF
REXBURG
_ ._. Ow __ -- --
America's Family Community
Permit # 07 00058
794 Yost St
Required �!f
ELECTRICAL
Electrical Contractor's Name 0V4 y �� ae &41 Business Name
T�
Address 7 W 0-35 City 1 1 State � Zip
Cell Phone /._ Business Phone
Fax ( ) Email
Electrical Estimate (cost of wiring & labor) $ (COMMERCIAL /MULTI - FAMILY ONLY)
TYPES OF INSTALLATION
(NewResideatial includes everything contained within the residential structure and attached garage at the same tune)
_I- 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 Licensed Coniractor License number Date
Th City of Rexbwg's permt fee tcheduk it the same as required by the Sta of Idaho
7