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HomeMy WebLinkAboutAPPLICATIONS, BP, MULT DOCUMENTS - 07-00256 - Mom's Kandy Kitchen - Exterior RemodelCITY OF REX CW Americas Family Community B uilding Z Per- m-- it • O ISSUED TO: PERMIT #: v7 00 NAME: Ambercor Llc FOR THE CONSTRUCTION OF: Mom's Kandy Kitchen - Exterio JOB ADDRESS: GENERAL CONTRACTOR: Classic Foam Design This permit is issued subject to the regulations contained in Building Code and Zoning Regulations of the City of Rexbug. It is specifically understood that this Permit does not allow any Variance to the regulations of the City of Rexburg or Zoning Codes unless specifically approved by the City Council and explained on • the Building Permit Application as approved by the Building Inspector. Date Approved 06/29/2007 Issued Building Inspector THIS PERMIT MUST BE PROMINANTLY DISPLAYED AT THE BUILDING SITE THE BUILDING MAY NOT BE OCCUPIED OR USED WITHOUT FIRST OBTAINING ACERTIFICATE OF OCCUPANCY 1) A complete set of approved drawings along with the permit must be kept No work shall be done on any part of on the premises during construction. 2) The permit will become null and void in the event of any deviation from the NOTICE! the building beyond the point indicated in each successive inspection without 1. Framing accepted drawings. approval. No structural framework of 3) No foundation, structural, electrical, nor plumbing work shall be concealed any underground work shall be covered without approval. Date Approved INSPECTION CARD BUILDING Date Approved 1. Framing 2. Final ELECTRICAL Date Approved 1. Rough -In 2. Final 24 Hour Notice and Permit Number required to make inspection appointments For Inspections Call 359 -3020 option 2 ACERTIFICATE OF OCCUPANCY CAN NOT BE ISSUED PRIOR TO FINAL ELECTRICAL A PI IIMRIWf: IIJCDC(`TInW CITY OF REXB URG # 0 PERMIT # BUILDING PERMIT APPLICATION Pleas 07 00256 19 E MAIN, REXBURG, ID. 83440 208 - 359 -3020 X326 Moms Kandy Kitchen PARCEL NUMBER: �� %X ; L%� L� Exterior Remodel SUBDIVISION: UINIl+r LL%--I Is based on the information - must be OWNER NAME. f M &r co r JAI& C., CONTACT PHONE # PROPERTY ADDRESS: zps PHONE #: Home ( ) Work ( ) ,3�, - -?60 , Cell( ) OWNER MAILING ADDRESS: - 1 e CITY: STATE: ZIP: EMAIL FAX 36 30�t� 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 PHONE #: Home ( ) EMAIL FAX Work ( Cell ( CONTRACTOR C i 1 MAILING ADDRESS: 72 LL, /Y Imo' 4r -i-teq CITY STATE rD ZIP 99 � PHONE: Cell# 1- / Work# S I�y Fax# S 3 � 7 7 `I EMAIL IDAHO REGISTRATION # & EXP. DATE tl�C�', "iVI G' C 'PI A I Cg Hnw mnnv hnilrlinac nrP lnra nn thic nrnnnrty� Did you recently purchase this property? Uo Yes (If yes give owner's name) Is this a lot split. YES (Please bring copy of new legal description of property) PROPOSED USE: (i.e., Single Family Residence, Multi Family, Apartments, Remodel, Garage, Commercial, Addition, Etc.) APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalt of perjury, I hereb 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 pernut on approval issued under the provisions of the 2003 International Code in cases of any false statement or misrepresentation of fact in the cation or Qn -tkie on which the permit or approval was based. Permit void if not started within 180 days. Permit void if work stops for 180 days. • : \..,_ 5 /7 / tgnature of caner /Applicant DATE Do you prefer to be contacted by fax, email o hone Circle One WARNING — BUILDING PE UST BE POSTED ON CONSTRUCTION SITE! Plan fees are non - refundable and are paid in full at the time of application beginning TarnyAW 1, 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 ** 2 Please complete the eltre Application! If the question does not apply fill in NA for non applicable NAME PROPERTY ADDRESS SUBDIVISION Dwelling Units: Parcel Acres: State Zip. SETBACKS FRONT SIDE SIDE BACK Remodeling Your Building /Home (need Estimate) $ ' 4 ' " &X - SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building) First Floor Area 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: " 4 4 , ` . ,` Water Meter Size: Requiredffl PLUMBING Plumbing Contractor's Name: Contact Phone: ( Business Name: I City Business Phone: ( F FIXTURE COUNT (mcluding toughed fixtures Clothes Washing Machine Dishwasher Floor Drain Garbage Disposal Hot Tub /Spa Sinks (Lavatories, kitchens, bar, mop) Plumbing Estimate $. (Commercial Only) Required! Signature of Licensed Contractor The City of& Sprinklers Tub /Showers Toilet /Urinal Water Heater Water Softener Permit# License number Date schedule is the same as required by the State of Idaho 4 Please complete the entir9pplication! If the question does 10apply fill in NA for non applicable NAME PROPERTY ADDRESS Permit# SUBDIVISION Required f!l MECHANICAL Mechanical Contractor's Name: Business Name: Address City State Zip, Contact Phone: ( ) Business Phone: ( ) Mechanical Estimate $ (Commercial /Multi Family Only) FIXTURES & APPLIANCES COUNT (Single Family Dwelling Only) Furnace Exhaust or Vent Ducts 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 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 vl ane. Required! Signature of Licensed Contractor License number The City of Rexburg'permit fee schedule is the same as Date the State of Idaho 5 Building Safety Department City of Rexburg 19 E Main jonellh@rexburg.org Phone: 208.359.3020 x326 Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3024 O4 4tiXBUR C U � � CITY OF RE XBU R G Ow _ America's Family Community OWNER'S NAME L4M. 6 ^ (.A-�' PROPERTY ADDRESS Z-S -so, C L. iti Permit# SUBDIVISION PHASE LOT BLOCK Required!fl ELECTRICAL Electrical Contractor's Name A C, 4 Business Name �' r Address City t i State T Zip Cell Phone ( ) U4 - (D q0 li Business Phone 009) Fax ( ) 5qo Gl ��' 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 same time) Number of meters being installed 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 Other Installations: Wiring not specifically covered by any of the above Cost of Wiring & Labor: $ ,2nC) L c? 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. Ljll J4� - 67 Siinature of Licensed Contractor License number Date The City of Bexburg's permit fee schedule is the same as required by the State of Idaho 0 • SUBCONTRACTOR LIST Excavation & Earthwork: Concrete: Masonry: Painting: Floor Coverings: Plumbing: Heating: Electrical: Special Construction (Manufacturer or Supplier) Roof Trusses: Floor /Ceiling Joists: Siding /Exterior Trim: Other: EXEMPTIONS FROM STATE REGPTRATION 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 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 hereby certify that the above information is true and correct to the best of my knowledge. Signature Print Name Date 9 May 29 2007 11:39AM HP LASERJET FAX 0 WORKERS COMPENSATION INFORMATION PAGE • p.3 FARMERS INSURANCE EXCRARGE 0 Ansipned Risk 17744 t� rnbr irrasrarese taxd+e�pe rnrelrs�r iarerilMr�ea RMerred Ts+ Its Llagne� Members of the Farmers Insurance Group of Companies Home Office: 4M Wilshire Bind., Los Angeles, Cal€famia 90010 .2007 A0609 -31 -70 00 Pe" Year Pantry Na of Co. WESTERN -WCC np cy I. Named . CUSTOM FOAM DESIGN & SUPPLY, JJ43238 Insured - Z379 W. HEYREND issuing ice ekiweNumber Mailing 75 -47 -330 Adder' IDAHO FALLS ID 83402 Ajinllc. IM denuricawn 1E. rderAlfmatiat Na Legal Entity. 0Ind€vidual L7 Partnersh €p O Corpmt€on ON FILg M Other Federal Ward r Mim ft aflarriployment 1=0 NIF Federal lden0cation Ala Other workplaces riot show n abovew ID E66 1" 10 83402 2. Policy Period: From 04/06/07 to 04/06/08 12:01 a.m. Staculard Time at the insured's malkrg address. 3. A. Workem Compensation Iromance: Part One of this policy applies to the Workers Compensation taw of the states listed here: B. Employers Liability Insurance. Part Two of the pol applies to work in each state listed in item 3A. The limits of iiabiiit}r under Part Two are: Bodily Injury by Accident $ 100, 000 each accident Soft injury by {tease $ 100,000 each employee Bodily Injury by Msease S 500,000 pdloy limit Other States insurance. Pact Three of the policy applies to the states, If any, lishod here: 'All stator except No. Dakota, Ohio, C. WasMngtan, West Virginla, Wyoming, states designated in hem 3A of the information Page and 4. The= premium lbr this policy will be determined by our Manuals of Rides. CiaasiBcations. Rates and Rating Plans. The information required below is subject to verification and change by audit. $ 0.00 Total Deposit Premium S SEE INVOICE Cash Reoeived $ ...SEE SEE INVOICE O&w CndNw $ INVOICE BALANCE DUE Thal Annual Classification of Operations Cork No. Premium Basis Rates Estimated Estimated Per $1 t10 Annual Thal Annual of Remu- Premium Remuneration neration SEE CLASSIFICATION OF OPERATIONS SCHEDULE THIS N NOT INVOICE Minimum Premium $ 300.00 Total Estimated Annual Premium $ 3,063.00 Expense Constant $ 0.00 If indicated. interim adjustmlertts of premium shall be made: _ 13 NuidhlY This policy incbades these endorsements and schedules: VC000000A 56- 528SED3 VC000+419 WCOOOI13 E5O00 -ED2 E5022B VC000414 NC000422 E5203 -ED3 WC000421A 4ft CM 00 00 Ot a Eta. sas) WSINE ft EbtMM 6-00 tnNWas mMw%l of NMkNW Cauocil an Conwnwdon lnwraneo. Copyright iSV, wod «d* eta p4ffto lam Anent 131111A WIXON INS AA TWr_ 2007 -05 -29 14,03 FARMERS MIMI PAGE i OF 1 Page 3 Matj 29 2007 11:38AM HP LASERJET FAX p.2 FRAM .GIw WIXOM INSLRANCE *FAX NO. :1-208-7135-2206 DA3 2OW 05-57PM P2 Commercial Certificate of Insurance Al"cy Gins L. Wixom Insivance Agency, lvw. Nam to Box 1009 1k Blackfoot, 10 $3221 Address SL 75 _ T)( 47 Agent 330 Inwfed 0910712007 " Classic Fum & Dmip Nma - 2379 HeyreM Way & - Idaho Fans, ID 9342 AArlms I 4ftFARM Eits lvw, Date MWDDrM =12/13/ftO6 Dam nwallute k twahl as a mover of kX*nu#Wn only and awfi" no rlshtt apace the ca0we kokler, TW c*Ttft*e dm r* wwwW. oteved ur alter the cmffW affat*4 by the poke* shuwn blow. 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R 9 GiNwal 11"Ity commenjil cat ill LUNIfty - OLuffence Ventan rxM"KtPI - TACWMtAl Only owners & OxwKton PfDL Amwbk liability Alt 0wjwdCmwnrxr.Ix1 Auto$ ScW Avics Hked Afitnt Non-Owned Atom GuW tiatility Polky Nuthber 035118971 Umbrella Usibifity -1 08/07/206 erld Iff4kyn Lwany of OpemtWS/Vehicies/Rfiit.tirOom/SpeciaI fleyns; Rcy roomion ate NWOWV) 0910712007 rAw",[ 2,0KOW Pm&;ctx-CampK)NS Ar"te S pe"CM11 & AdvwU*% ItOwy I tfuh(kauumt $ 1,000,000 I've Dm age (Any ow. fire) S medw (Any one = t Cwd*wd Single Limit NMNW) Propeny T*"w I Gonp Ao!tpk Limit I Each Acd&m Disease • NO rMolow I Dimm • Poky Limit I Wcate HOW CamMistion ADD11:10NAL INS1.71RED: Swmd any of the twm &Miw po**% he cAnmarA b&rr. t1w 04kattan date Nam" ookknLook ArrEN:Jiiu Mcw&nPC.M thered. On Witing enmpm will tndrAvur W NW 30 1140 W"ttfft 40 "m In the 3401 Hot= Anderson Rd. ratift9te hader "Noid to tlw kft, but faime to me such to Awl Imew no Add"" fAdess. TX. 76040 a obt4jr of er)Ubtky %#V kind Vm the amrilwy. Its 890MO of 'rM-v a . f - 2007-05-29 14:03 Page 2 Oct 09 2007 11:28PM C1 *ic Foam Design & Sup 208 - 523 -3779 p.1 • 0700256 Mom's Kandy Kitchen - Exterior Remodel rAX MEMO Classic Foam Design & 5u LLC 2379 W. He e-nd Way, Waho Falls, ID 83402 Fax # 208. -523 -5779 rkone: 2-0-6-52-5-5352- TO: V w4 - a t TTGN StN FROM: jmkVF DATE: 101410-( RE: FA4T e,111 j A)e- -SYs -rnp -pjFCj r-d,_ OCT 102007 10 01 CITY OF REXBURG P- 2 0 0 0700256 Morn's Kandy Kitchen Exterior Remodel T Cobblestone around M Window 10 15 2025 30 35 40 =5 50 55 60 65 7075 80 85 9095