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HomeMy WebLinkAboutAPPLICATIONS, CO, BP - 07-00416 - 109 S Center St - RemodelO � VLEXB UR , 7� v o �'e e (SHED \0 CITY O F REX Americas Family Community Building Permit ISSUED TO: PERMIT #: 0700416 NAME: Andersen Mark Etux FOR THE CONSTRUCTION OF: 109 S Center - Andersen JOB ADDRESS: 109 S Center St GENERAL CONTRACTOR: Owner 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 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 bythe Building Inspector. Date Approved Issued By d 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 NOTICE! on the premises during construction. 2) The permit will become null and void in the event of any deviation from the the building beyond the point indicated accepted drawings. in each successive inspection without 3) No foundation, structural, electrical, nor plumbing work shall be concealed approval. No structural framework of any underground work shall be covered without approval. 6. Drywall INSPECTION CARD BUILDING Data Annrnverl 1. Footing 3. Foundation 4. Framing 5. Insulation 6. Drywall 7. Sidewalk 8. Mechanical 9. Final PLUMBING Date Annrnvprl 1. Sewer Service Conn 2. Water Service Conn( 3. Rough -In 4. 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 & PLUMBING INSPECTION ,A CITY O F Certificate of Occupancy y yo -.— REX BURG City of Rexburg ` — — America's Family Community Department of Community Development 19 E. Main St. / Rexburg, ID. 83440 Phone (2081359 -3020 / Fax (208) 359 -3024 Building Permit No: Applicable Edition of Code: Site Address: Use and Occupancy: Type of Construction: Design Occupant Load: Sprinkler System Required: 0700416 International Residential Code 2006 109 S Center St Single Family Residential Type V, non -rated Residential No Name and Address of Owner: Andersen Mark Etux 2140 Dar Es Salaam PI Dulles, VA 20189 Contractor: Owner /Lessee Special Conditions: Residential Only. Also covers permit 08 00068 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 was inspected on the date listed ties found to be in compliance with the requirements of the code for the group and division of occupancy and the use for which the proposed occupancy wes classified. Date C.O. Issued C.O Issued by: ounuu,y v„w,a, There shall be no further change in the existing 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: Electrical Inspector P&Z Administrator: h- CITY OF REXB UKG BUILDING PERMIT APPLICATION Pleas 19 E MAIN, REXBURG, ID. 83440 If the q 208 - 359 -3020 X326 PARCEL NUMBER: SUBDIVISION: UNIT# BLOCK# :LOT# (Addressing is based on the information - must be accurate) CONTACT PHONE # PROPERTY ADD PHONE #: Home O? y Work OWNER MAILING ADDRESS: /07 S. (ZjZ&&r CITY STATEID ZIP: Z) EMAIL Iacr lot) 197g/ ya op I cpoq� 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.) PERMIT # 0 d 0700416 le 109 S Center - Andersen Cell ( APPLICANT INFORMATION: ADDRESS CITY: STATE; ZIP EMAIL FAX PHONE #: Home ( Work ( Cell ( ) CONTRACTOR MAILING ADDRESS: G! �4P�1" CITY - STATE / ZIP PHONE #: Home Work ( ) Cell ( ) IDAHO REGISTRATION # & EXP. DA How manv buildings are located on this nronerty? Did you recently purchase this property? Poes (If yes give owner's name) Is this a lot split? N YE (Please bring copy of new legal description of property) PROPOSED US : �>7a6 F&",t GU -iG� (i.e., Single Family Residence, Mi'Ilti Family, Apaltments, 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 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 based. Permit void if not started within 180 days. Permit void if work stops for 180 days. Signature of Owner /Applicant DATE Do you prefer to be contacted by fax, email or phone? cle 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 Ianuary 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** State of Idaho County of Madison Bull 19 E. Main Rexburg, ID 83440 I Safety Department City of Rexburg janellh @rexburg.org Phone: 208.359.3020 www.rexburg.org Fax: 208.359.3024 O� QEXB(1RC -; r CITY O F REXBU Americas Family Community MEO I, Name City Affidavit of Legal Interest 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: Please complete the entire Application! NAME & U-< 9rjd L/4cy hf'?G��P�L,`�i PROPERTY ADDRESS Mel S e . " Permit# SUBDIVISION Dwelling Units: SETBACKS FRONT Remodeling Parcel Acres: SIDE SIDE BA Your Building /Home (need Estimate) $ t?q QM 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: * * * * * * * * * * * ** *Water Meter Size: Required!fl PL I�MBING �i Plumbing Contractor's Name:. C --X ' Business Name: Ha m Address 124 I � ✓T ° K [z Df " City - State Zi �1 Contact Phone: ( ) [7 L P 0 , - 3 2- 0 , - 3 2- - 2- Business Phone: (" } >� b� a ZL Email 0dodu mb e do / C t Fax FIXTURE COUNT (including roughed fixtures, Clothes Washing Machine Dishwasher Floor Drain Garbage Disposal j Hot Tub /Spa Sinks (Lavatories, kitchens, bar, mop) Sprinklers Tub /Showers I Toilet /Urinal Water Heater Water Softener Plumbing Estimate $ (COMMERCIAL /MULTI - FAMILY ONLY) Signature of Licensed Contractor License Number& Expiration Date D to The City of Rexburf's permit fee schedule is the same as required by the State • Building Safety Department ;o �EXB�R� a C I T Y OF City of Rexburg 'y REXBURG 19 E Main jonellh@rexburg.org Phone: 208.359.3020 x326 Americas Family Community Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3024 OWNER'S NAME Q z&l r 6dA J PROPERTY ADDRESS J©J Se fro"4 -M 5l-- Permit# SUBDIVISION PHASE LOT BLOCK Requlredffl ELECTRICAL Electrical Contractor's Name I� , �'� "� �l G � r t ( Business Name C Address N (' ,� �Y P� Cit c y� 4f'�L�' c State Zip Cell Phone f.#i�) 5 5/ — X 7666 Business Phone Fax ( ) Email Electrical Estimate (cost of wiring & labor) $ D Q (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 m u c f 3 inspections. Additional inspections charged at requested inspection rate of $40 per hour. 277 -�� Signatu Licensed Contractor License number Date The schedule is the same as required by the State of Idaho ' • Please complete the entire Application! NAME PROPERTY ADDRESS SUBDIVISION Exhaust or Vent Ducts Dryer Vents Range Hood Vents Cook Stove Vents Bath Fan Vents other similar vents & ducts: Requiredffl MECHANICAL Mechanical Contractor's Name A1 Business Name Address City State _Zip Cell Phone ( ) Business Phone ( ) Fax ( ) 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 Heat (Circle all that apply) Gas Oil Coal Fireplace Electric Hydronic Signature of Licensed Contractor The License number Rexburg's permit fee schedule is the same as Permit# Date the State of Idabo SUBCONTRACTOR LIST Excavation & Earthwork: Masonry: 3 ZZ, i-t cI 4 - L-) 7 0 4 7 09 33 3S'6 7o 8U 7e6 Special Construction (Manufacturer or Supplier) Roof Trusses: Floor /Ceiling Joists: Siding /Exterior Trig Painting. �-- Floor