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HomeMy WebLinkAboutAPPLICATIONS, CO, BP - 07-00223 - 1053 Widdison Ln - BarnZ W v � CT �P O N -n v w N m � � y N nc—i v j z CA m m N c � m t7 O ,_ _ o spa m' o D S ° "� ' V/ = v o m 3 ° v Z m n a ° v ° m m O -4 to 0 CD — N Q y° m m C o y o c p m a c 3 v 0 o X `0 <Cp Romer_+ m 0a 0 _' Q C = m v M. CL O Z o o .'D 7 fl ? N c TOO 0 m .0 ° o m Zq CD v r 7 7 3 v o CD c to N N D �. y y o CD o m v 3 v CD CD Z a= m w m S s Z ° 3os�o X 0 m Z n C ° v 0 ° co C r * m 'n. ° ° m o c O Z Q N w n Q. = 0) O n 3 = Cr m 0 n co) ooh. s m mo D m n Z CL n v CD 0 CD �< CL N YI Z i y s 3 C12, — 0 , ma 0-4 m p S W =y Z y h M -i m m x c 0 !Z ;a 2 C o �, I c m m - 3`<K 0 O voi to o ss = n p 3 � oK cQ Z N —1 tr -yc D c o to -C to 0 W. �� � a A �• C a p H o n m o '�q o O p 01 = m N 0 S _ n ic CD x ►�i / to O o. CD p CL � r W y to CD C ° < =o CO c. (o C. - m Q `< W S N O rt to n c. o 3 3 to d X CL N v' tD 6 N Q, t. a to W • �M g rt t t v X3 m l< l< t: CO) nw V n `° W Ul 3 O tD < • (D S C a O: x �o °r vi - 0 0 2 to 3 rt 3 H W a „ W v � CT �P W N -n v w N m � � y N nc—i v j z CA o o W N t7 O 3 3 � N c N Romer_+ m 0a — a m 0 TOO 0 m .0 � to c '0 • j 7 O N N p z W 0 0 �* -n m 0 m C z z C G) � � o � r (A - M Z z z v � N Q v v 3 t7 c ttlm r-.< <D <D Z m �■ z� R F) g o 7 y N �0 CD a CO W v � CT �P W N -n v w N m � � y N nc—i v j o c �� � o o v o c Fio4 gEXBpAG ♦' 4 � SNE6 CITY 0 Certificate of Occupancy REX America's Family Community City of Rexburg Department of Community Development 19 E. Main St. / Rexburg, ID. 83440 Phone (2081359 -3020 / Fax (2081359 - 3024 Building Permit No: Applicable Edition of Code: Site Address: Use and Occupancy: Type of Construction: Design Occupant Load: Sprinkler System Required: Name and Address of Owner: Contractor: Special Conditions: Occupancy: 0700223 International Residential Code 2003 1053 Widdison Ln Shed Type V, non -rated Residential Z2 Thompson Douglas C Etux 1053 Widdison Ln Rexburg, ID 83440 Owner /Lessee General Utility 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 Mich the proposed occupancy vies classified. Date C.O. Issued: January 10, 2008 (02 :46P C.O Issued by: Building Official There shall be no further change in the e)dsting 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 Inspect Fire Inspector: lam_ ICA Electrical Inspector: c PBZAdministrator: )a IC� CITY OF REXB UKG i BUILDING PERMIT APPLICATION Please 4 0700223 19 E MAIN, REXBURG, ID. 83440 If the ques 208- 359 -3020 X326 1053 Widdison- Thompson Barn PARCEL NUMBER: P -NU� �Z2 I (w SUBDIVISION: ttt dot t &(\ UNIT# BLOCK# LOT# 6 (Addressing is based on the information - must be accurate) CONTACT PHONE # PROPERTY ADDRESS: v J/213 �L) PHONE #: Home ( ) (;, - (off `/ Q Work ( ) yq 1, - ,28/ 0 4v ' - Cell( - ,5 OWNER MAILING ADDRESS: S/-mr CITY: STATE: -£D ZIP: P3 ` gyp EMAIL '� Q �Sor) 5/0 1 , ac a FAX APPLICANT (If other than owner) et: (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 F Work ( Cell ( ) CONTRACTOR MAILING ADDRESS: CITY STATE ZIP PHONE #: Home ( EMAIL F Work ( ) Cell ( ) IDAHO REGISTRATION # & EXP. DA How many buildings are located on this property? Did you recently purchase this property ?DYes (If yes give owner's name). Is this a lot spli NO YES (Please bring copy of new legal description of PROPOSED USE: f Z) (i.e., Single Family Residence, Multi Family, Remodel, Garage, Commercial, Addition, M AY 1 5 2007 III R EXBURG APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: u J = ClY fO F R 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 base rmit void if not started within 180 days. Permit void if work stops for 180 days. Signa e Owner /Ap 'cant 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 January L 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** Buil 19 E. Main Rexburg, ID 83440 Safety Department City of Rexburg janellh@rexburg.org Phone: 208.359.3020 www.rexburg.org Fax: 208.359.3024 Of REXB URC CITY OF U � ° REXB Americas Family Community Eo Affidavit of Legal Interest State of Idaho County of Madison I, Name 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 herein or as to the ownership of the property which is the subject of the application. Dated this day of 5 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 the entire Application! p PP NAME ULA.p PROPERTY ADI?ESS JO SUBDIVISION Dwelling Units: Parcel Acres: SETBACKS FRONT 0 Permit# SIDE SIDE /U 1 BACK /D t Remodeling Your Building /Home (need Estimate) $ S1 WO SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building) First Floor Area Unfinished Basement are-, Second floor /loft area Finished basement area Third floor loft area Garage area Shed o Carport /Deck (30" above Water Meter Quantity: 1 - ) 4 * * * * * * * * * * * ** * Water Meter Size: 11 .1 11 ' Requiredffl PLUMBING Plumbing Contractor's Name: Business Name: Address —City Contact Phone: ( ) Business Phone: Email Fax FIXTURE COUNT (including roughed fixtures1 Clothes Washing Machine Dishwasher Floor Drain Garbage Disposal Hot Tub /Spa Sinks (Lavatories, kitchens, bar, mop) Plumbing Estimate $ State Zip Sprinklers Tub /Showers Toilet /Urinal Water Heater Water Softener (COMMERCIAL /MULTI - FAMILY ONLY) Signature of Licensed Contractor The License Number& Expiration Date Date 's permit fee schedule is the same as required by the State of Idaho Please complete the entir A p p lication! lication! NAME PROPERTY AIW)R SS r` I.e�►rk �.5 c � .. ; , SUBDIVISION 4-9 • Permit# RequiredN MECHANICAL Mechanical Contractor's Name 01 �� Business Name 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 Fuel Gas Pipe Outlets including stubbed in or future outlets Inlet Pressure (Meter Supply) PSI Exhaust or Vent Ducts Dryer Vents Range Hood Vents Cook Stove Vents Bath Fan Vents other similar vents & ducts: 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 License number The City of Rexburg's permit fee schedule is the same as the State of Idaho Date Building Safety Department City of Rexburg 19 E Main lanellh@rexburg.org Phone: 208.359.3020 x326 Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3024 o f ptixa u v o CITY OF REXBURG America's Family Community OWNER'S NAME bou — T kc w _k PROPERTY ADD " I DS 3 44 Permit# SUBDIVISION PHASE LOT # BLOCK HOME OWNER -S ELECTRICAL PERMIT Home Owner's Name A �.1 c Addres t'�5 3 �� Mo 1\1 City r State = D Zip f tY Cell Phone ( ) 1 3 .. .S.3,y,7 ! Home Phone ( ) Fax ( Email jLng S zir4 6D b biz t i, c� TYPES OF INSTALLATION (New Residential includes everything contained within the residential structure and attached garage at the same time) Number of meters being installed X 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, Sw immin g 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. Si ature of Home Owner Date The City of Rexburg's permit fee schedule is the same as required by the State of Idaho 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 of Q' XB °Bc .� 7 U � CITY OF REX America's Family Community OWNER'S NAME PROPERTY ADDRESS SUBDIVISION PHASE LOT BLOCK Permit# Requiredffl ELECTRICAL Electrical Contractor's Name Business Name Address City State Zip Cell Phone ( ) Business Phone ( ) Fax ( ) 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 same time) 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 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 The License number '.r permit fee schedule is the same as re, Date the State • ............................................................ ............................... SUBCONTRACTOR LIST Excavation & Masonry: Floor Plumbing: Electrical: Special Construction (Manufacturer or Supplier) Roof Trusses: Floor /Ceiling J Siding /Exterior 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.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 ' 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 0 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. ,5 // - or V I Date Tk 10 Print N e