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HomeMy WebLinkAboutAPPLICATIONS, CO, MULT DOCS - 07-00130 - BYUI Romney Building - RemodelZ o m .� O m m co v VI Fn -4 y o a) m M v a ic m m T . cArn = o . ...� z n C n ic 0 0 s= a 3 C s-^m ?o cn c c m 3 CD 'D g Z `'° WO oT a n 3 o -i n «n�3 m m — ca 7 S cn 0 o c mr CO 0 CD Q -^ C (A n Z n n � T C N c 3 n V 3' v CD 0 o c X O `_ O ° N CD j I Q m v 0 �� o Z �? o O_ o .� ° n C $ m o (A a `D � m v r CD o v � o � C V Ch CD r 3 X D 0 j -i 0 -^ CD o m � 3 W v D) CD CL CD Z D z C) D = w m g Z l< a m CD O 0 m c o N m 0 * CD o N O O S = Z n fL] _1 11 C O O n Q d r CL CT yO (D 'o —>I v : E C m N �CD o Z CD m n G1 v m o,� O - 3 O' m 0 n 0 V CD o O �• d •� Zq (R 0K0 m 0 n g CD C n 0 o� CL tC 3 V (D n O 1 0 N N 0 0 4 rt cD 12 9 0 CD om N C CD a d!j *t: 0-4 (D r.► x S_ S� N o �qx. m (� N. x rt a o c n n `� 6 Q N 0 � S 01 O Q (D a m .9 m O 0 0 c = (D 0 R+ r L M CL S "► 0 <D (D ? 3 c � � C. � (D (=mr:� CL •�'v m < U Q. 0 CL (7 (D 7 o co .« O m * m 0 3 a 0 5 N O c 7 3 �• n (> to m A 7 o (D CL S = x m o Q rt_ -h 3 y CD C) z m � D n z X n q A (D z m W L g m M m 3 *k F, LIA C v O S n n o D o m 0 m m co v Fn -4 y o a) Si m v a o D m T . cArn = o . O O 0 0 ,n n C n - p n 0 (n c m Z ° `'° WO ° ° Z n C CD O - � m n o c MIL Z n n � c = CD CD �I A y oz N I m m v (D v 3 CD O m v °.: fD v m m r m X c r z v � co D O m Q . Z cn m n 4 z Cam. 6t 0 o co v m r m X c r z v � co D O m Q . Z cn m n 4 z Cam. 6t CITY OF REXB URG BUILDING PERMIT APPLICATION Ple 07 00 13 0 in i 19 E MAIN, REXBURG, ID. 83440 Romney Bldg Remodel -BYUI 208 - 359 - 3020 X326 PARCEL NUMBER: I Iii X �, f V (We will provide this for you) SUBDIVISION: UNIT# BLOCK# LOT# (Addressing is ba sed on the information - must be accurate) WNER NAME• ,B U - /pswa CONTACT PHONE # - Z.08 • cf`1G • Zy+V9 PROPERTY ADDRESS: GEcle&e S Aowv&•y 8 - Roo�.,s- Zs zs� 241 Z PHONE #: Home Work Cell ( OWNER MAILING ADDRESS: AW3 OV - 7 - CITY: RMW&AG STATE: lD ZIP: AjJo&0 - & EMAI u FAX Lob Y9G • G Yy 9 APPLICANT (If other than owner) N /A• (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 FAX Work ( Cell ( CONTRACTOR aYU- 110*H115 MAILING ADDRESS: cE 4-- W3 ppt,T CITY 1e&_X&VRC- STATE /A ZIP 8.31100 - PHONE: Cell# Work# Zo8 • y%• LYY9 Fax # _ 2-0a • Y96 • b yy9 EMAIL W 9�C Yui. M ADAHO REGISTRATION # Sc EXP. DATE How many buildings are located on this property? M.1Ny Did you recently purchase this property ?(�D Yes (If yes give owner's name) Is this a lot split? YES (Please bring copy of new legal description of property) PROPOSED USE: GoM�rE,tcrgL oEL. �ol�E ��Gt 4SS,am�J .�rtoo� (i.e., Single Family Residence, Multi Family, Apartments, Remodel, Garage, Commercial, Addition, Etc) APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalt of perjur 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 pear it on approval issued under the provisions of the 2003 Intemational 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. Sign4(ure of Owner /Applicant Do you prefer to be contacted by fax, email or phone? Circle One WARNING — BUILDING PERMIT MUST BE POSTED Plan fees are non - refundable and are paid in full at the time of al City of Rexburg's Acceptance of the plan review fee does **Building Permit Fees are due at time of application ** **Building Pei O 3 / LO / p 7 7- beginning Tanuary 1, 2005. itut aIRP v 7 oid =r dhAckl not CITY OF REXBURG 1 2 BuilTing Safety Department City of Rexburg 19 E. Main ionellh@rexburg.org Phone: 208.359.3020 ext 326 Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3024 Y, � RF.X9 URr O U , C [ T Y OF REXBURG - - - -- I-- I- OW -- - Americas Family Community State of Idaho County of Madison I, Name Affidavit of Legal Interest 1114 City 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 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 herin or as to the ownership of the property which is the subject of the application. Dated this day of , 20 Signature Subscribed and sworn to before me the day and year first above written. Notary Public of Idaho Residing at: My commission expires: Please complete thetntire Ap 1' Pp NAME ,l3YC/ - /taaH If the question does not apply fill in NA for non applicable PROPERTY ADDRESS ,QavaN6- - Bui Wt r ZSS, m1t, zw z77Permit# SUBDIVISION Dwelling Units: SETBACKS FRONT Parcel Acres: SIDE SIDE BACK Remodeling Your Building /Home (need Estimate $ //9, /5/ CS a - ,fi7 - ~erP) SURFACE SQUARE FOOTAGE.- (Shall include the exterior wall measurements of the building) First Floor Area 32 Unfinished Basement area Second floor /loft area 3'/, ;L9y Finished basement area /Z 7n Third floor /loft area Garage area Shed or Barn Carport /Deck (30" above grade)Area Water Meter Quantity: Water Meter Size: Requlredffl PLUMBING aD r,*z R^= Plumbing Contractor's Name: B Y!/- /D Alo Business Name: Address City State Zip Contact Phone: ( ) Business Phone: ( ) Email Fax FIXTURE COUNT (including toughed fixtures Clothes Washing Machine Dishwasher Floor Drain Garbage Disposal Hot Tub /Spa 7 - - Sprinklers 63O F /,ateocrront, Tub /Showers Toilet /Urinal Water Heater Water Softener Sinks �p_ L Yi}Y 60xar r (Lavatories, kitchens, bar, mop) INSMU- y k~ ✓,+Y Boss Z , 5Y! C3 D 1 �,e oT�tTla � C,e YU &,*&q) Plumbing Estimate $ 3 `19 3 6 t �Commercial Only) • ��i�vr�x � '1 8 Y 11 - A WN C) ('rr7Ze Sy - 2-4 o z rh* e) E — VR V c Signature of Licensed Contractor License number Date o.A41.Y The C ity of Rexburg s permit fee schedule is the ,came as required by the State of Idaho 4 03/21 /2007 19:56 208521 MAR -20 --2007 TUE 0818 AM 3 D FIRE PROTECW PAGE 02/02 P. 02 Please complete the entire Applicationl If the question does not apply On in NA for non Applicable NAME AYO - lay-ra PROPERTY ADDRESS C S &wAMD ; AW, W, 20 X7;Perm.(t# SUBDIVISION owelling Units: Parcel Acres SETBACKS FRONT SINE SIDE BACK Remodekng YourBuif&tiglHome (need Estimate) Id /5/ _ #fr"ei) SURFACE SQU ARE FOOTAGE.- (Shall include the exterior wall measurements of the building) First Floor .Area 3 Unfinished Basement area Second floor /loft area a,`� Finished basement area �� � Third floor /loft ateA Gatage � Shed or Bata . ott /Deck 0" zbove de Area Water Meet Quantity: ' ` Water Metet Size• RequrredlY PL UMBVVG -w piote rte, v Cs-~ Owe) Plumbing Contmctot's Namc. 8 YV' IDOW0_ Busiue4s Name: Address 2Z &% 50)4 S City W awn Contact Phone: !22!. r l�l Business Phone (lob)_ - 1 ~ l Emai 1 brnox -R l� j' �. Crs�w� Fax ,�C'�� C .O,�.�1�G :t� mnghcd l�ixtunesl Clothes Washing Machine Dishwashct Floor. Nain Garbage Disposal ?- Sprinklers C30 1%.r Tub /Showers Toilet/Urinal Water Heate=r _ riot Tub /Spa Water Softenct � Sinks Z- VA s /' Bc►�T � (Lavatories, kitchens, bar, o) rovstw -e- N 2 f3v riec �,�rarerr�arr� CA3 YV-� /,rw� a Plumbing Rat' to $ 93 &j)Co�nmmeM Qn1y) k%6Lr5 D`1- OQO.19 Regmcndl sig i mLC' o Licensed Contnetor License OMMb" DAte The ON of Rc hMM pe"m0l f e,rn"k u the J w rquisdd by l lx Sk# Af t daba Please complete the At Application! If the question does not apply fill in NA for non applicable NAME 9 1A4,Y0 PROPERTY ADDRESS &+FATE 255, 25'x, u/, 2.77 Permit# SUBDIVISION RequiredW MECHANICAL Mechanical Contractor's Name: BY!/ - 4!), o Business Name: Address City State zip Contact Phone: ( ) Business Phone: ( Mechanical Estimate $ 1 ?Z (Commercial /Multi Family Only) FIXTURES & APPLIANCES COUNT (Single Family Dwelling Only) Furnace Furnace /Air Conditioner Combo Heat Pump Air Conditioner Evaporative Unit Hr Deco�l- `, Incinerat- v� Boiler Pool Heater 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) Gas Oil Coal Fireplace Electric Hydronic Mechanical Sizing Calculations must be submitted with Plans & Application Point of Delivery must be shown on plans MIA - Al B Y B y1/- / A*w0 Required! Signature of Licensed Contractor License number Date The Gi i of Rexburg s permit fee schedul is the same as required by the State of Idaho Building Safety Department oFR tiXa� a � City of Rexburg J i 19 E Main ionellh@rexburg.org Phone: 208.359.3020 x326 Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3024 C[ T Y OF REXBURG ____— cw — - - - - - - -- Americas Family Community OWNER'S NAME dyy- lz*Kc PROPERTY ADDRESS ,S, ►,v�yQ�ic oavC�, 215 2-S-7- 2,77 Permit# SUBDIVISION PHASE LOT BLOCK RequiredLY ELECTRICAL Electrical Contractor's Name 8Y11 1-0*H0 Business Name Address City State Zip Cell Phone ( ) Business Phone Fax ( ) Email Electrical Estimate (cost of wiring & labor) $ ? 335 (COMMERCIAL /MULTI - FAMILY ONLY) TYPES OF INSTALLATION (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 y/ Other Installations: Wiring not specifically covered by any of the above Cost of Wiring & Labor: $ 7 ' 335 - Pumps (Domestic Water, Irrigation, Sewage) Requested Inspections (of existing wiring) Temporary Amusement /Industry *Includes a ma um of 3 rspns. Additional inspections charged att requested inspection rate of $40 per hour. D �/ 7 ) Signature of Licensed Contractor License number Date"' The schedule is the same as required by the State of Idaho 0 Buil ng Safety Department City of Rexburg 19 E. Main Rexburg, ID 83440 jonellh @rexburg.org Phone: 208.359.3020 www.rexburg.org Fax: 208.359.3024 gEx 8 vp� CI TY O F REXBURG - -- Ow -------- ____ America4 Family Community APPLICATION: "CONSTRUCTION PERMIT" CONSTRUCTION PERMIT #: PERMIT APPROVED: YES/ NO $50.00 FEE PAID: YES /NO - APPLICANT INFORMATION: Business Name: 8Y1 - /vi-to APPROVED BY: Office Address: _Office #z13 ocPLT An6ay- , /a "Y&O — Szo Office Phone Number: ( 2°S ) 4 /4 ` - 2 - Y Y9 City State Zip Contractor Performing the Work: R5"0 /o,wfse V 3n FiAW Pao root/ Contact Person: cTEno WA44ir� Cell Phone # ( ) - LOCATION OF WORK TO BE DONE: Street Address Where Work Will Be Done: GEoac,� ,Pc,vt�- 8cx�c✓.v� - Qeo�.s ZSS7 .s, zw, L Business Name Where Work Will Be Done: BY1/ Dates For Work To Be Done: _ APwz_ 3 200 To 2-00 -7 Contact Person: Ttz» W.#4*,e7e_ Phone Number: ( ) "t. - 2 yy 9 Cell # ( ) PLEASE CHECK THE TYPE OF PERMIT(S) YOU ARE APPLYING FOR: *( AUTOMATIC FIRE- EXTINGUISHING SYSTEMS 6; - frxe *amtw ❑ COMPRESSED GASES °�/ FIRE ALARM AND DETECTION SYSTEMS AND RELATED EQUIPMENT ❑ FIRE PUMPS AND RELATED EQUIPMENT �6YU - lcgh►o ❑ FLAMMABLE AND COMMBUSTIBLE LIQUIDS ❑ HAZARDOUS MATERIALS ❑ INDUSTRIAL OVENS ❑ LP -GAS ❑ PRIVATE FIRE HYDRANTS ❑ SPRAYING OR DIPPING ❑ STANDPIPE SYSTEMS ❑ TEMPORARY MEMBRANE STRUCTURES, TENTS, AND CANOPIES Applic ht's Signature Date 7 0 0 SUBCONTRACTOR LIST Excavation & Earthwork: Concrete: Masonry: Roofing: Insulation: 8 Y U - /^*Vo Drywall: ,&YU - /,04W o Painting: BYv - 1,04H Floor Coverings: Q YU - /te Plumbing: BYU - /beef -C Fi rW T�Z?l Heating: e Yu - ID*#O Electrical: BY0 - /pip Special Construction (Manufacturer or Supplier) Roof Trusse Floor /Ceiling Joists: Siding /Exterior EXEMP'I'ANS FROM STATE RE MkTRATION 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 filt 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 Cl 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. 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S iION DREES CHECKED BY; I EDD ALAN WALKER REVISIONS DATF DESCRIPTION PRELIMIN C) CD CP -3 n to 4- W I\) F11 mi T' U) c > > + T rn C 0 o n O 9 U% (A c " o 0 0 M LA 0 .4 0 m max 1A 0 om ° z lli if 0 13 1 iT, "D li U) 1j O :L r kj) 1-7A UJ ti 73 1 rn 0 0 rn J) > n M.1 ul O 0 YRO NO, 2006.25508 CAD FILE: ROMNEY 255, 257, 261, 277 - N FIN -. S iION DREES CHECKED BY; I EDD ALAN WALKER REVISIONS DATF DESCRIPTION PRELIMIN C) CD CP -3 n to 4- W I\) F11 mi T' U) c > > + T rn C 0 o n O 9 U% (A c " o 0 0 M LA 0 .4 0 m max 1A 0 om ° z lli if 0 13 1 iT, "D li U) 1j O :L r kj) 1-7A UJ ti