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CITY OF
REX BURG
- - - --
Americ4 Family Community
Certificate of Occupancy
City of Rexburg
Department of Community Development
19 E. Main St. / Rexburg, ID. 83440
Phone (208) 359 -3020
Building Permit No: 0700082
Applicable Edition of Code: International Residential Code 2003
Site Address: 472 Woodbridge 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: Orvin Randy
68 W 1435 S
Orem, UT 84058
Contractor: Randy Orvin Construction
Special Conditions: Unfinished basement
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 v►es 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 ms
classified.
Date C.O. Issued: August 09,_Z9O7 (08:41AM)
C.O Issued by:
ing 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 Inspecto
Fire Inspector: 0 1 U
P&ZAdministrator: ��
.rte OF KEXB URG 01 TAT+ 1? ARTT' 4 •
BUILDING PERMIT APPLICATION Pleas 0700082
19 E MAIN, REXBURG, ID. 83440 If the qi
208 - 359 -3020 X326 c 472 Woodbridge -Orvin
�� p �
PARCEL NUMBER: 1� G'`J� 0
SUBDIVISION: S'A orrCr5C cV_-.e UNIT# BLOCK #
(Addressing is based on the information - must be accurate)
CONTACT PHONE # SZ)/ Y Zv j 7/ c
PROPERTY ADDRESS: `Y7 Z U ��'��5�'f�
PHONE #: Home Work Y`1) ` - `Zo / ;Yly' Cell( >) yZV /7/
OWNER MAILING ADDRESS: Y3 5 S CITY: STATE: 1�l7 ZIP:
EMAIL FAX is -- ? z ki �
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: C2 9 tiJ /-/25 CITY U �
STATE &f;` ZIP �O� y
PHONE #: Home ( ` o Work (� /) -IZe /' ?/`1 Cell �V) 'V-70 1 - 71 "
EMAIL E> dut•R, / FAX /V3 /�2 -d4" IDAHO REGISTRATION # & EXP. DATE Zc iy 9
How many buildings are located on this property?
Did you recently purchase this property? No (CJe (If yes give owner's name).
Is this a lot split? YES (Please bring copy of new legal description of
PROPOSED USE:
(i.e., Single Family Residence, Multi Family, Apartments, Remodel, Garage, Commercial,
I
t
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under 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 ses of any false statement or misrepresentation of fact in the application or on the plans on which the permit or approval was
based. Permi id ' not started within 180 days. Permit void if work stops for 180 days.
Si ture 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 Tanuary Z 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**
)MAR -'2 2007
2
Building Safety Department oFaEXB °Rq, CITY o F
City of Rexburg �y o 7� XB m G
11G1�1) V 1�
19 E Main jonellh@rexburg.org Phone: 208.359.3020 x326 Americo Family Community
Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3024
OWNER'S NAME S °r 000A) Permit #07 00082
PROPERTY ADDRESS -Y :gz
SUBDIVISION 472 Woodbridge - Orvin
PHASE LOT Z BLOCK 3
Required!!! ' 4LW �TRICAL
Electrical Contractor's Name $> sines Name �llc �' rL 1-4
Address 7Gt be x 7�� r City < _State n Zip
Cell Phone I Z- 7 Business Phone
Fax ( ) Email
Electrical Estimate (cost of wiring & labor) $ L� (COMMERCIAL /MULTI - 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*
� 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 Contractor
License number
Date
The
schedule is the same as
the State of Idaho
7
0310112007 12:51 20852997 B;Y CE
i wK. l. c r i iFPM N0. Z99
Please complete the entire AppHcatd on!
SAME
( v ' J
PROPERTY ADDRESS `72 c..�� •3,c:t,C Pemait#
SLTB MSION Ii Q
Dwelling Unim: Parcel Acres: j
SETBACKS
FRONT SID SIDE C
i
Remo, de1g YOUr Ba WID& OMe (need Estimate) ;
SURFACE
PAGE 02
P. 2/S
FOOTAGE: (Shill include dw Wdriot wall meastiurdr JAI ena of dw buildiag)
First Floor Area (LSD Unfinish Baeetaaat I �Li�D
Second 10000 atea_ Finished b e mean
w
Third Race /loft area _ Garage st
Shed or B4tn_ , Carport/Deck 0" abo" jg�cde)A
��- --•mom // (�
Woter -Helot Q�ua�lty; µ �•w .... wMwWaruer Melee Since: l `7
N
RequiredIll
d PLIr11BI11TG
/ L
Pluwmbdng Contmetor's l` -t one , C ^/ u ! 3
aimess Nam
U .� -mot. �c���� c
Cct9 Scs xip .I
Contact Pho a , , 3 / gn Phones
m =mv cr it
Clothes Washing MAChiae g
i
_ b3eliwashet Tub /Showers
..._Floor Dmit _ ? Tw4t/Urins]
Garbage Deposal �, Wat�r Plantar
Hot Tub /Spa CPatk Softener
IG SinIm Clavatozies, ddcclsena, bat, trop)
J�
Flutabwg Batimate 1. (COMUMCIAL/MULTI•FAM�Y ONLM
Of
fi 4
t ale of Uctnad - --- Do*
Goaa�srcm iksnse Nnrbsedc E�pssaoe Do* Date
.m%rlr ir & ra e w i ivai i ►y 0 Smo
4
. 0 •
Please complete the entire Application!
NAME `C`-f QiQW
PROPERTY ADDRESS S Lveey :5 — Permit#
SUBDIVISION
Required!►)
MECHANICAL
Mechanical Contractor's Name 5T�-t/,5 Business Name / / G A/rX &�1
Address � X City State, Zipo?
Cell Phone ( �J 7_09 Business Phone (' ®) 7 yob
Email
Fax (�l�C * ) / �.� � ,r
Mechanical Estimate $ (Commercial /Multi Family Only)
FIXTURES & APPLIANCES COUNT (Single Family Dwelling Only)
Furnace
'"' Furnace /Air Conditioner Combo 3�
Heat Pump
Air Conditioner
Evaporative Cooler
Unit Heater
i Space Heater
6 Decorative gas -fired appliance
Incinerator System
Boiler
Pool Heater /
Fuel Gas Pipe Outlets including stubbed in or future outlets
Inlet Pressure (Meter Supply) PSI
Heat (Circle all that apply) �Uas�" Oil Coal Fireplace Electric Hydronic
of Licensed Contractor
The
f Exhaust or Vent Ducts 1S
I_ Dryer Vents (f
Range Hood Vents
Cook Stove Vents
Bath Fan Vents I b
schedule is the same as
other similar vents & ducts:
4 1V
3 -c7,z
Date
by the State of Idaho
License number
5
0
SUBCONTRACTOR LIST
Excavation & Earthwork:
Concrete: tJ
Masonry:
Roofing:
Insulation: �?14
Drywall: T�E Q "W
Painting: " -► <f�Vinl
Floor
Coverings: -- r ktu S
Plumbing: Vk iL.r PL, us -4 toe /!k-7,ti) c =)
Heating:
Electrical: A+& P `6 C— (,--L1 �QC.
Special Construction
(Manufacturer or Supplier)
Roof Trusses: > IA�Is 11 "C
Floor /Ceiling Joists:
Siding /Exterior Trim:
0 0
JaNell Hansen
From:
Sent:
To:
Subject:
OKAY
Joyyn Briggs
City of Rexburg
(208) 359 -3020 Ext. 336
Have a great day!
Jolyn Briggs
Monday, October 22, 2007 11:52 AM
JaNell Hansen
RE: 472 Woodbridge
From: JaNell Hansen
Sent: Monday, October 22, 2007 11:52 AM
To: Jolyn Briggs
Subject: 472 Woodbridge
Jolynn,
I gave you an invoice for 472 Woodbridge (permit #07 00082) for finishing the basement. They ended up leaving the
basement completely unfinished so they do not owe any fees. Please remove them from your billing.
Thanks,
JaNell Hansen
Building Safety Coordinator
Phone: (208) 359 -3020 ext. 326
Fax: (208) 359 -3024
Email: janellh ,rexburg.org
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