HomeMy WebLinkAboutAPPLICATIONS, CO, BP - 07-00582 - 745 Johnson St - New SFR04 S?XBUR C
�� f o
U 90
N�
9B a�
��SHen ,e
CITY O F
REX
America's Family Community
Building
Permit
INSPECTION CARD
BUILDING
Data onnmunel
1. Mechanical Rough In
2. Mechanical Pressure
3. Mechanical Final Ins
4. Layout
5. Footing
6. Foundation
7. Framing
8. Insulation
9. Drywall
10. Sidewalk
11. Final
ELECTRICAL
FOR THE CONSTRUCTION OF: 745 Johnson -Heart B JOB ADDRESS: 334 Mariah Ave
GENERAL CONTRACTOR: Heart B Company
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
11/29/2007
1 ed By
Building Inspector 617�
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. the building beyond the point indicated
2) The permit will become null and void in the event of any deviation from the in each successive inspection without
NOTICE!
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 roved
1. Rough -In
2. Rough -In
PLUMBING
Date roved
1. Sewer Service Conn
2. Water Service Connf
3. Rough -In
4. Ground Rough -In
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
Q � EXe URC
CITY OF
REX BURG
04 - - --
~'., E, America's Family Community
kE0
Certificate of Occ* upancy
City of Rexburg
Department of Community Development
19 E. Main St. / Rexburg, ID. 83440
Fax
Building Permit No: 0700582
Applicable Edition of Code: International Residential Code 2006
Site Address: 74 J ohnson Ave
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: Heart B Company
Po Box 308
Rexburg, ID 83440
Contractor: Heart B Company
Special Conditions:
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
Kos inspected on the date listed vies found to be in compliance vvth 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: October 15, 2008 :02PM)
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 ns ector• N
g p Fire Inspector:
P &Z Administrator:
Electrical Inspector" — �'
CITY OF REXB URG
BUILDING PERMIT APPLICATION Please c 0700582
19 E MAIN, REXBURG, ID. 83440 If the questi 745 Johnson-Heart B
208 - 359 - 3020 X326
PARCEL NUMBER: �j (�(�� (�. (We wm proviae ttus for you)
SUBDIVISION: �W p PvV\ UNIT #_ BLOCK# ,LOT#
(Addressing is based on the information - must be accurate)
PROPERTY ADDRESS:
PHONE #: Home
OWNER MAILING ADDRESS: F, o r U
V1
CONTACT PHONE #
YI
Work ( ) t 56 Lo 1- 7 8) Cell ( )
C � CITY: c&A STATE:_DLZIP:
AX hS6 1 13
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 5 ". V - P - I±P I held
MAILING ADDRESS: -GA )q CITY STATE ZIP,
PHONE #: Home ( )
Work (
Cell (
EMAIL FAX IDAHO REGISTRATION # & EXP. DATE
How many buildings are located on this property? 1
Did you recently purchase this property? No � m
(If yes give owner's nae)
Is this a lot split? PTO) YES c (Please bring copy of new legal description of property)
PROPOSED USE: - / 1 � Q VA I �V K{' (J (n-J W
(i.e., Single Family Residence, Multi Family, Apartments, RemFidel, Garage, Commercial, Addition, Etc.)
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalt of perjur 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 in ca of any false statement or misrepresentation of fact.in the application or on the plans on which the permit or approval was
based. Pe t v d n started within 180 days. Permit void if work stops for 180 days.
3
Signature of er /app ' a DATE
Do you pr fer o be c tacted by fax, email or phoned Circle One
ARNING — BUILDING PERMIT MUST BE POSTED ON CONSTRUCTION SITE!
Plan fees are non - refundable and are paid in full at the time of application beginning anuary 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**
Build g Safety Department F ; fu$cf9 C I T Y OF
City of Rexburg U
REX
19 E. Main jonellh@rexburg.org Phone: 208.359.3020
Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3024 Americas Family Community
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
20
Signature
Notary Public of Idaho
Residing at:
Subscribed and sworn to before me the day and year first above written.
My commission expires:
Please complete the entire Application!
NAME - 6VQ 1 SID'
PROPERTY ADD SS Permit#
SUBDIVISION � V-6 a y` o �7 _ 6jitK $
Dwelling Units: Parcel Acres: +�
SETBACKS
FRONT 3 r SIDE S a- SIDE BACK
Remodeling Your Building /Home (need Estimate) $
SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building)
First Floor Area ( 31 �^ Unfinished Basement area f �_
Second floor /loft area IC' D 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 bl!
PLUMBING
jj�� /� t
Plumbing Contractor's Nam , //n e: p e N Business Name:
Address /'. Q , -�`
C?y Z C7 City j& & State Zip
Contact Phone: ( ) J 76 Business Phone: ( )
Email Fax 7 :�V" 9 7 2-C
FIX TURF COUNT (including rourlied fixtures
1 Clothes Washing Machine Spri
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)
C' /0 9 ll -1�.a7
Signature of Licensed Contractor License Number& Expiration Date Date
The City of Rexburg'x permit fee schedule is the same as required by the Sta of Idaho
Please complete the entire Application!
NAME rk
PROPERTY ADDRESS Permit#
SUBDIVISION up
Required.!!
MECHANICAL
Mechanical Contractor's , Name ymfA � Business Name
Address City State Zip
Cell Phone Business Phone ( ) 10 1 �1p 1
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
other similar vents & ducts:
Heat (Circle all that apply Ga Oil Coal Fireplace Electric Hydronic
Mechanical Sizing Calculations must be submitted with Plans & Application
Point of Delivery must be shown on plans.
lavv
Signature of LiceLed Contract 4r License number
The
Exhaust or Vent Ducts
Dryer Vents
6 Range Hood Vents
Cook Stove Vents
Bath Fan Vents
schedule is the same as
I l I b off,
Date
the State
•
Building Safety Department
,� r CITY OF
City of Rexburg
� REX America's Family Community
19 E Main jonellh@rexburg.org Phone: 208.359.3020 x326 n�
Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3024 ' "E° ���
OWNER'S NAME
PROPERTYADD SS -I-F2 Permit #07 00582
SUBDNISION _ LOT BLOCK
--- PHASE 745 Johnson - Heart B
_
Requu'ed!fl ELECTRICAL
Electrical Contractor's Name C �' � 1 tl .i--L 4 1 4 tusiness Name �z; f
Address - -S / fi% _� - �� City ��-k�) .h State � zip 3Y z 1 c
Cell Phone (30j) _ `{ �= - `% (.rte % q Business Phone (?ty) 4� a �� °G (-( b
Fax (7- y) - �' _C) L ( W y 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
"� p to 200 amp Service*
201 to 400 amp Service*
Over 400 amp Service*
I / 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 " pections. Additional inspections charged at requested inspection rate of $40 per hour.
]"Fs ovL,-
Signature f Licensed Contractor License number
Date
Th Ci ty of Rexburg'spermit fee schedule is the ,came as required by the State
Building Safety Department
City of Rexburg
+� o
19 E Main ionellh@rexburg.org Phone: 208.359.3020 x326 =kED
Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3024
CITY OF
i XB LTRG
Americas Family Community
OWNER'S NAME 5 V0Q'v-t C'
PROPERTY ADDRES Permit#
SUBDIVISION crsav�
PHASE 3 LOT BLOCK
HOME OWNER'S ELECTRICAL PERMIT
Home Owner's Name
Address City.
Cell Phone
Fax ( )
Home Phone (
State Zip
TYPES OF INSTALLATION
(New Residential includes everything contained within the residential structure and attached garage at the same time)
For power supplier requirements visit www.rockymtnpower.net
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 Home Owner
The
Date
schedule is the same as required by the State
SUBCONTRACTOR LIST
Excavation & Earthwork:
Masonry:
Roofing:
Insulation:
Drywall:
Painting:
Floor
Coverings:
Plumbing:
Heating:
Electrical:
Special Construction
(Manufacturer or Supplier)
Roof Trusses: v L y
Floor /Ceiling Joists: V y \ c w'e 5 (
Siding /Exterior Trim: wUUd 5 tl 'k f 1
•
•
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.ibo1.idaho.Lov/cont.h
❑ 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
Date
Print Name
SUBCONTRACTOR LIST
Excavation & Earthwork:
Concrete:
Masonry: wCk Vk J ,,t Lr�, M
� r
Roofing: S— � V-
Insula
4�
Floor
Coverings: 4aW (AS& 1 kw �
Heating: 1 1�kcl)
6 �. f
Special Construction
(Manufacturer or Supplier)
Roof Trusses: (A m Vhf [ s
Floor /Ceiling Joists: Y W\- L
Siding /Exterior Trim: 6 r�