HomeMy WebLinkAboutAPPLICATION, CO, BP - 07-00170 - 772 Yost St - New SFRZ
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��Q CMG CITY OF
REX
Americas Family Community
Certificate of Occupancy
City of Rexburg
Department of Community Development
19 E. Main St. / Rexburg, ID. 83440
Fax
Building Permit No: 0700170
Applicable Edition of Code: International Residential Code 2003
Site Address: - 7 - 7 2 Y o A .S+
Use and Occupancy: Single Family Residence
Type of Construction: Type V, non -rated
Design Occupant Load: Residential
Sprinkler System Required: No
Name and Address of Owner: Sainsbury C Thomas Etal
4697 N Haroldsen Dr
Idaho Falls, ID 83401
Contractor: Muir Construction Co
Special Conditions:, Basement rough in electrical and mechanical was not inspected.
Occupancy: Residential - less than 2 units, permanent in nature
This Certificate, issued pursuant to the requirements of Section 109 of the Intemational Building
Code, certifies that, at the time time of issuance, this building or that portion of the building that
%es,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 t4hich the proposed occupancy v►es
classified.
Date C.O. Issued: February 12, 2
C.O Issued by: -; � �. 4
Building Official
There shall be no further change in the ebsting 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.
I NA
Fire Inspector: / / a-
P&Z Administrator
CT7Y OF KEXB UKG 0 PERMIT #
BUILDING PERMIT APPLICATION Please t
19 E MAIN, REXBURG, ID. 83440 If the quest 0700170
208 - 359 -3020 X326
PARCEL NUMBE -4j N ,() D�I U (W 772 Yost -Muir
SUBDIVISION: bVi
(Addressing is based on the information - must be accurate)
QVVIVER NAME 71�N! �"Pl- !,�lS(�Ul�M CONTACT PHONE # ZC t
PROPERTY ADDRESS: 3 wC-K
i COT 2-1 , HSO L 5 *01
PHONE #: Home (" 515 7 - `iS 1 C Work
OWNER MAILING ADDRESS: 3 W"
0
APPLICANT (If other than owner) Myfn. (Pius - TYW 7-102 - ?2smr.•oc Mu res
(Applicant if other than owner, a statement authorizing applicant to act as agent for owner must accompany this application)
APPLICANT INFORMATION: ADDRESS 7-41 S ` "/ - W 3 U ! CITY: fzr4e (3 u
STATE; 1 ZIP SAID EMAIL myi&cy� i&;no^' ° c' FAX 't _S'' - 9 ' 952
PHONE #: Home (act;) 3510 '3l °i9 Work 0*) 364 ^� 9 70 Cell µ ZZO V S)
CONTRACTOR
MAILING ADDRESS: 3 1 A h"� c*J CITY 1 STATE 1 "0 ZIP `� or
PHONE #: Home " '52ri - 45 1 C' Work (? )_
EMAIL FAX 5S - S - 745 IDAHO
How many buildings are located on this property ?.
Did you recently purchase this property? No (g�l (If yes give
Is this a lot split? ( YES (Please bring copy of new legal
PROPOSED USE: 91 . I LA4 V f ®VJ
(i.e., Single Family Residence, Multi Family, Apartments, Remodel, Garage,
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHi
that I have read this application and state that the information herein is correct and I swe
hearings before the Planning and Zoning Commission or the City Council for the City of
City regulations and State laws relating to the subject matter of this application and beret
mentioned property for inspections purposes. NOTE: The building official may revoke
International Code in casyl of any false statement or misrepresentation of fact in the app
based. PeoniAd i f neffstarted within 180 days. Permit void if work stops for 180 day,
name) ro" S'A hl r g R M
ion of urouerty)
Addition,
RIZATION: uM&rk
that any information 'ch
Cexburg shall be truth and
authorized represent_ vet
permit on approval is e
:ation or on the plans
9 RurJ 13.e Jerb
hereafter be given by me
.ct. I aeree to comply wi
I/ // / 0
DATE
Signature f Owner /Applicant
Do you prefer to be contacted by fax, email or phone? Circle On,
WARNING - BUILDING PERMIT MUST BE P097
Plan fees are non - refundable and are paid in full at the time
City of Rexbures Acceptance of the plan review fee
**Building Permit Fees are due at time of application** **Buildin;
TY: 1, f STATE: I A ' ZIP:
AX Sze - S - ?95
TION # & EXP. DATE l0'%-DS -^ °I 3
- Q510 Cell (264 2 5 - 7
4$1 Cell" '7S - '7 -0
D ON CONSTRUCTION SITE!
application beginning uW1.2005.
es not constitute plan approval
'ermits are void if your check does not clear**
all
0J
Safety Departi
City of
19 E. Main janellh@rexburg.org Phone: 20 .359.3020
Rexburg, ID 83440 www.rexburg.org Fax: 20P .359.3024
4 �
w r-
C 1 T Y C F
REXBURG
__ - __
Americas FatrPitx
Affidavit of Leg
State of Idaho
County of Madison
I, '-U rA 5^ ris 3 v �►
Name
I 9" l' f i��LS
City
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 describe I on the attached, and I grant my
permission to: 3Rg�r,)otJ Mu l2 2q ! S' S w mull -4 1 - 0
Name Address
to submit the accompanying application pertaining to that p>operty.
B. I agree to indemnify, defend and hold Rexburg City
claim or liability resulting from any dispute as to the
ownership of the property which is the subject of th
Dated this
11 4 - 11 day,,Af
Subscribed and sworn to before
Notary Public of Idaho
Residing at:
id its employees harmless from any
tatements contained herein or as to the
application.
written.
My commission expires:
20 0 - )
3
Please complete the Mire Application!
NAME '51%hi S 9L" l oad t`. Co
PROPERTY ADDRESS k w G' S , L.07` 2.t Permit#
SUBDIVISION #19!;j 5"aj
Dwelling Units: Parcel Acres: C> . 2 Z
SETBACKS
FRONT 22 SIDE A- SIDE - ZO / BACK /
Remodeling Your Building /Home ( need Estimate $
SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building)
First Floor Area 1 Unfinished Baserr ent area 1- b - 7
Second floor /loft area Finished basemer t area
Third floor /loft area -' Garage area
Shed or Barn — Carport/Deck (30 above erade)Area —
Water Meter Quantity: i * * * * * * * * * * * ** *Water Meter Size: 314 ,"
Requi red rat -
PLUMBING
Plumbing Contractor's Name: ,n h O Bus ess Name: /7 PW M q�.v
Address City ` State tp zip - T-N/ - 0:
Contact Phone: o4 Business Phon .?
�
Email Fax
FIXTI7RE COU1V7" (including roughed & tuLcs
: Clothes Washing Machine Sprinklers
Dishwasher Tub /Showers
Floor Drain Toilet /Urinal
Garbage Disposal S Water Heater
Hot Tub /Spa
Sinks (Lavatories, kitchens, bar, mop)
Pl" Estimate $ - (COMMERCI)4,L /MUU
of Licensed Contractor
The
License
Water Softener
AMILY ONLY)
L (�
in Date Date
schedule is the same as 4gAdred by the State
It"
,Plea complete the entire Application! If the qu� soon do t apply fill in NA for non
es no
Applicable
NAME _ 3 % - `{ Co & -
PROPERTY ADDRESS LO T ZI
SUBDIVISION _
Requlredffl
MECHANI
Mechanical Contractor's Name :: OtC-V-
Address e b • �O ?C 1 70 Y� City
Contact Phone: Vu q — *50 Business
Mechanical Estimate $ - (Commercial /Multi
FIXTURES & APPLIANCES COUNT (Single Family
S Furnace
I Furnace /Air Conditioner Combo 3
Heat Pump
Air Conditioner
Evaporative Cooler
Unit Heater -
Space Heater
_ Decorative gas -fired appliance l
Incinerator System
Boiler
Pool Heater
`Y- 'r✓' 1 tom,�Q
Fuel Gas Pipe Ou ets inc stubbed in or tore o
Inlet Pressure (Meter Supply) PSI
Heat (Circle all that apply) Ga Oil Coal Fireplace Electric
Contractor `7 icense number
The City of Aexbw'r permit fee schedmk it the came ar
Permit#
Name: 11 K
Only)
Only)
Exhaust or Vent Ducts
Dryer Vents
Range Hood Vents
Cook Stove Vents
Bath Fan Vents
other similar vents & ducts:
w r 9 V
pit
r�
? -,,.a
Date
the State ofldaho
Z
5
BuilcMg Safety Department
City o Rexburg
19 E Main jonellh@rexburg.org Phone: 208.35R. x326
Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3024
OWNER'S NAME S%QWX CONS V—j C-71&J Cam -
PROPERTY ADDRESS
SUBDIVISION [14y00LSc-J
PHASE LOT BLOCK
'g- XII(
C i T yy O F
REX
1vrerirw.€ Franz riy C ommr nhy
Permit #07 00170
772 Yost -Muir
RequiredLY
ELECTRI
Electrical Contractor's Name rJEt-Scr4
Address P - D . go X k4 2 _ City _. !:.
Cell Phone (U4;) O - 31 2.4 Business
Fax ( )
Electrical Estimate (cost of wiring & labor) $
TYPES OF INSTALLA TION
(New Residential includes everything contained within the residential
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
Existing Residential (# of Branch Circuits)
Spa, Hot Tub, Swimming Pool
Electric Central Systems Heating and /or Cooling
and no additional wiring)
Modular, Manufactured or Mobile Home
Name 1 FL-G&M
193.1
( X 1. ) -,-" 9 (' - "Z4
TI - FAMILY ONLY)
and attached garage at the same time)
one location (for a period not to exceed 1 year)
not part of a new residential construction permit
Other Installations: Wiring not specifically covere I by any of the above
Cost of Wiring & Labor: $
Pumps (Domestic Water, Irrigation, Sewage)
3 Requested Inspections (of existing wiring)
Temporary Amusement /Industry
*Includes a maximum of 3 inspections. Additional inspections charged at reques d inspection rate of $40 per hour.
3575 i t� b
Signature of Licensed Contractor License number I Date
The GO of Rexburg'. pa mt fee tcheduk u the same as tegrdred by the State
mannnnannnummunnnmnnnonnoommononammennnessuennonsennnonoweennnnnowassannnnounn
SUBCONTRACTOR LIST
Excavation & Earthwork: SL#rU
Co ti's rt-v on ara
Masonry: � N µ �3 C-k XN
Roofing:
V X-(L
Insulation:
Pro ✓ 0,.s t'0
Drywall: I1J
A FW 94-J
Painting:
Floor
Coverings:
Plumbing:
Heating.
1®It(a �vN°' 1°tlN
Electrical:
OF44W Wit.^+ (°
Special Construction
(Manufacturer or Suppli er)
Roof Trusses: 544PM t T
Floor /Ceiling Joists: M C
Siding /Exterior Trim: Nom j Fie P—,
Other:
• •
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 Nxnvw.ibol.idaho.goF/cant.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 4repy e that the above information is true and correct to the best of my knowledge.
gawk M V
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