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HomeMy WebLinkAboutAPPLICATION, CO - 07-00147 - 257 Marianne Dr - AdditionRo ¢fiXBUR�,� CITY O F Certificate .of Occupancy REX 13URG City of Rexburg America's Family Communi ' Department of Community Development .co 19 E. Main St. / Rexburg, ID. 83440 Phone (2081359020 / Fax (2081359 'An2d Building Permit No: 0700147 Applicable Edition of Code: International Residential Code 2006 Site Address: 257 Marianne 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: Dickey Debbie 257 Marianne Dr Rexburg, ID 83440 Contractor: Fransen Homes Special Conditions: 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 Wth the requirements of the code for the group and division of occupancy and the use for vthich the proposed occupancy vies classified. Date C.O. Issued: April 27, C.O Issued by: 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 Electrical Inspecto Fire Inspector: 11 P &Z Administrator: 11 �Gt CIFFf OF AEXB URG BUILDING PERMIT APPLICATION 19 E MAIN, REXBURG, ID. 83440 208 - 359 -3020 X326 Please c If the queen 257 Marianne Dr- Dickey Addition PARCEL NUMBER: N) W O� \ _, W ✓(- J - 0 (We will provide this for you) SUBDIVISION: R r CtCS -- WL &d L UNIT# BLOCK # a— LOT# (Addressing is based on the information - must be accurate) CONTACT PHONE # PROPERTY ADDRESS: D. !�; 7 M a r-t CLYNA P, Re x6%,L!n , JYA . S 3 Y V D PHONE #: Home ( ) ( (o ' 9 (c, l Z Work ( ) ?j5'q _ a I Cell( OWNER MAILING ADDRESS: )5 VVV- 6 a.wl o e Di • CITY: � STATE: -UZIP: 8 3 y b EMAIL FAX 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 ( CITY: EMAIL FAX Work ( Cell ( CONTRACTOR ,o S MAILING ADDRESS: 2a VV i'0A ne, D r. CITY 9!q_ u �STATE - ZIP 3 V PHONE #: Home ( ) 35 -1 0 - (000f, Work Cell (z -� ZI - &S 3 S AX IDAHO REGISTRATION # & EXP. DATE Q CT- 3lv How manv huildinas nre lncnted nn this nrnnPrtvP Did you recently purchase this property? No Yes (If yes give owner's name) Is this a lot split? 1 0) YES (Please bring copy of new legal description of property) A PROPOSED USE: _ a J 1 f 4yl (i.e., Single Family Residence, Multi Family, Apartments, Remodel, Garage, Commercial, Addition, Etc.) APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjur I hereby certif 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 th.,.�_20W_ International Code in cases of any false statement or misrepresentation of fact in the application or on the leas: on which the permit or approvP b Permit void f not,sta_ ed within 180 s. Permit void if work stops for 180 days. �' � Signature of Owner /Applicant - f D37 Do you prefer to be contacted by fax, email o hone? Circle One WARNING - BUILDING PE ST BE POSTED ON CONSTI LUCT ON SITE! Plan fees are non - refundable and are paid in full at the time of application beg 'nn' 2 X LJ U R G City of Rexburg's Acceptance of the plan review fee does not constitut pl p ov * *Building Permit Fees are due at time of application ** **Building Permits are void ' oes not c ear** P) BullcNg Safety Department City of Rexburg 19 E. Main jonellh@rexburg.org Phone: 208.359.3020 Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3024 Of pEXB(1RC CITY OF v REXBURG E o Americas Family Community Affidavit of Legal Interest City State of Idaho County of Madison I, Name 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 herein 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: 3 Please complete the etire A p p lication! NAME bbG c b o c Ac."A PROPERTY ADDRESS �LS"l "W;uv►hc Oc SUBDIVISION R. CtS Dwelling Units: Parcel Acres: 0 Permit# SETBACKS r o , t � FRONT a6i SIDE 71 SIDE ' BACK :S4o (�uvL �3 Remodeling Your Building /Home ( need Estimate $ I n ©n SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building) First Floor Area — a ( Unfinished Basement area Second floor /loft area Finished basement area Third floor /loft area Garage area Shed or Barn Carport /Deck (30" above grade)Area Water Meter Quantity: * * * * * * * * * * * ** *Water Meter Size: Requ.iredMI PLUMBING Plumbing Contractor's Name: _bc4LA A r Business Name: City State Zip Contact Phone: ( ) 8 " t-I yea Business Phone: ( ) � '1� 4 ° 99 (a a Email Fax FIXTURE COUNT (including rou --hed fixtures Clothes Washing Machine Sprinklers Dishwasher Tub /Showers Floor Drain Toilet /Urinal Garbage Disposal Water Heater Hot Tub /Spa Water Softener Sinks (Lavatories, kitchens, bar, mop) Plumbing Estimate $ (COMMERCIAL /MULTI - FAMILY ONLY) Signature of Licensed Contractor The License Number& Expiration Date schedule is the same as required by the State of Idaho Date 4 Please complete the entire Application! NAME PROPERTY ADDRESS SUBDIVISION Permit# RequlredW MECHANICAL Mechanical Contractor's Name Business Name Address City 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 State Zip Exhaust or Vent Ducts Dryer Vents Range Hood Vents / Cook Stove Vents Evaporative Cooler V Bath Fan Vents _ Unit Heater other similar vents & ducts: Space Heater 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) 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 schedule is the same as • the State Date 5 Bull 19 E Main Rexburg, ID 83440 Safety Department City of Rexburg janellh @rexburg.org Phone: 208.359.3020 x326 www.rexburg.org Fax: 208.359.3024 O4 REXB URC �� lO � 0 CITY OF REMB V RG America's Family Community OWNER'S NAME CJ C PROPERTY ADDRESS C SUBDIVISION PHASE LOT BLOCK Permit #07 00147 257 Marianne Dr- Dicke Addition Required!!! ELECTRICAL Electrical Contractor's Name " 1 Business Name 12a6* putl H rrec IC- Address f kaki 14 3 City l , "'d State LAI V Zip k) Cell Phone Or) pi n 5�i � Business Phone Fax ( ) Email Electrical Estimate (cost of wiring & labor) $ _ (COMMERCIAL /MULTI - FAMILY ONLY) TYPES OF INSTALLATION (New Residential includes everything contained within the residential structure and attached garage at the sometime) Number of meters being installed 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 Cost of Wiring & Labor: $__ Pumps (Domestic Water, Irrigation, Sew +.ge) Requested Inspections (of existing wiring) Temporary Amusement /Industry *Includes a m um of 3 inspections. Additional inspections charged at requested inspection rate o �. Signature of Licens d Contractor License nunber bate The schedule is the same as required by the State of Idaho 7 tixgt7 Building Safety Department City of Rexburg o 19 E Main janellh@rexburg.org Phone: 208.359.3020 x326 Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3024 CITY O F REXBURG Americas Family Community OWNER'S NAME L� J PROPERTY ADDRESS Permtt# SUBDIVISION PHASE LOT BLOCK t5 HOME OWNER'S ELECTRICAL PERMIT Home Owner's Name)..1C4�, \ \)��t l�� ),tJZ- - Address . (1YY\ arvy--- city_ "�2A y Stat Zi �`t 41 6 Cell Phone Phone U, Fax 4 1 _ Email Gk a --e- A � e V 11 %7 2 lea W V XQ 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* 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 pern and no additional wiring) M 2 Modular, Manufactured or Mobile Home D E E V E �r`4d 2�4 4 bther Installations: Wiring not spe i fo ally covered by any of ove Cost of Wiring & Labor: $ / R g? r- MAGI 3 0 2007 Pumps (Domestic Water, Irrigation, Sewage) Requested Inspections (of existing wirin CITY OF R EXB U R G Temporary Amusement /Industry *Includes a maximum of 3 inspections. Additional inspections charged at requested inspection rate of $40 per hour. O � � Signature H ome Owner The schedule is the same as Date the State of Idaho 0 • 0 SUBCONTRACTOR LIST Excavation & -OFsI Concrete: clan yl ` l2 .c, �i„ C el.� - 341.3 Masonry: Roofing: • fa - R � .', v� C _ T� 't t S QQ 16 - Z 31,3 Insulation: is S •7 S - 1 � . � =► . - Painting: yku mot. O - Floor Coverings: a ©w g LAA LteAM f SAS 3 S(p - SSs 3 1 Plumbing: �.e,. t Heating: k Electrical: Special Construction (Manufacturer or Supplier) Roof Trusses: 5)b(AC, , Lwe W ca q1 Floor /Ceiling Joists: Sk-bG1L Siding /Exterior Trim: tv +Y y, U'+ y CIL ' it ) s : k Other: 0 [Jj,,� ^,4 - Sly'} 1�e ✓ 1 a,� �c� (�� �,�..� - Sr n�j 3S (. — 3 1W EXEMPTIONS FROM STATE REGISTRATION 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.gpv /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 Cl 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) Cl Public Utility doing construction, maintenance, or development to its own business ❑ Involved with gas, oil or mineral operations ❑ Supplier doing no installation or fabricating Cl 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 Z6,L: �, bra hAS UA Print Name Date 9�