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Home My WebLink AboutAPPLICATIONS, CO, BP - 07-00620 - 520 Woodbridge St - Basement FinishSV XB UR Al r CITY OF • • Us REX Bul in .' Americas Family Community Permit EE SHED `° 9 ISSUED TO: PERMIT #: .07 00 620 NAME: Jacobson Donald E FOR THE CONSTRUCTION OF: 520 Woodbridge- Jacobson JOB ADDRESS: 520 Woodbridge St GENERAL CONTRACTOR: Owner /Lessee 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 bythe City Council and explained on the Building Permit Application as approved bythe Building Inspector.. Date Approved A d By 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! 2. Insulation 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 in accepted drawings. 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 aooroval. INSPECTION CARD BUILDING Date OnnrnughA ;1. :F:raming 2. Insulation 3. Drywall 4. Final r ELECTRICAL Date proved 1. Rough -In 2. Final PLUMBING Date roved 1. Water Service Conn( 2. Rough -In 3. 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 • 0 �yo�Rexs�q�r' CITY o F Certificate of Occupancy ° RE City of Rexburg America's Fam Communi ` t Department of Community Development 19 E. Main St. / Rexburg, ID. 83440 Phone (208) 359 -3020 / Fax (208) 359 -30 Building Permit No: Applicable Edition of Code: Site Address: Use and Occupancy: Type of Construction: Design Occupant Load: Sprinkler System Required: 0700620 International Residential Code 2003 520 Woodbridge St Residential Basement Finish Type V, non -rated Single Family Residence No Name and Address of Owner: Jacobson Donald E 520 Woodbridge Rexburg, ID 83440 Contractor: Owner /Lessee Special Conditions: 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 vies inspected on the date listed vies 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 vies classified. Date C.O. Issued: April 08, (01:35 M 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. 0 Plumbing Inspector: Electrical Inspector: Fire Inspector: D P &Z Administrator: 'NA_ CITY OF KEXB UKG 0 BUILDING PERMIT APPLICATION 19 E MAIN, REXBURG, ID. 83440 208 - 359 -3020 X326 070620 Ply 520 Woodbridge- Jacobson If d PARCEL NUMBER *?RY��_�)O (We will provide this for SUBDIVISION: UNIT #_ BLOC (Addressing is based on the information - ust be accurate) Basement Finish t I fil DEC 12 207 OWNER NAME: Lldda // D CONTACT PHONE # 2 �3 PROPERTY ADDRESS: �> PHONE #: Home Work ( ) Cell OWNER MAILING ADDRESS: CITY: STATE:LZIRI EMAIL JW7" P, [/ i G. e 6 :ors 1*S /1/ 61-17 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.) APPLICANT INFORMATION: ADDRESS CITY: STATE; ZIP EMAIL FAX PHONE #: Home ( Work ( Cell ( CONTRACTOR MAILING ADD 1 CITY STATE- ZIP43 PHONE #: Home 5"Z Z94 Work ( ) Cell (Z4 3�a Z— / 5 EMAIL FAX IDAHO REGISTRATION # & EXP. DATE How many buildings are located on this property? Did you recently purchase this property? No �(If yes, list previous owner's name) Is this a lot split? NO YES (Please bring copy of new legal description of PROPOSED USE: J1 r (i.e., Single Family Residence, Mufti Family, blelle- Remodel, Garage, Commercial, Addition, Etc.) APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjur I hereby 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 Inte on de in cases of any false statement or misrepresentation of fact in the application or on the plans on which the permit or approval was e ased_ . Permit v d if not started ithi d s. Permit void if work stops for 180 days. Signature of Owner /Applicant DATE Do you prefer to be contacted by fax, email o phone? ircle 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 lanuary 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** tf,p ■ Bull 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 04 RexaU,pG CITY OF REXBURG Americas Family Community State of Idaho County of Madison I, Name Affidavit of Legal Interest Address City State Being first duly sworn upon oath, depose and sa)k: (If Applicant is also Owner of Record, kkip to B) A. That I am the record owner of the property`describedon the attached, and I grant my permission to: k Name Address to submit the accompanying application pertaining to . at property. B. I agree to indemnify, defend and hold Rexburg C and its employees harmless from any claim or liability resulting from any dispute as to statements contained herein or as to the ownership of the property which is the of e application. Dated this / day of 3 20 Signature r Subscribed and sworn to before me the day and year first above Notary Public of Idaho Residing at: My commission expires: complete he entir Please e A p pphcation. NAME C PROPERTY ADDRESS Ga Permit# SUBDIVISION fjrSalsP Dwelling Units: Parcel Acres: SETBACKS I , FRONT SID SIDE BACK Remodeling Your Building /Home ( need Estimate $ el, � SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building) First Floor Area / �� Unfinished Basement area Z4756� 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!!! PLUMBING Plumbing Contractor's Nat Address d%1i Contact Phone: Email Fax FIXTURE COUNT (rnclud=toWhed fixtures) Clothes Washing Machine Dishwasher Floor Drain Garbage Disposal Hot Tub /Spa _ Sinks (Lavatories, kitchens, bar, mop) j Q _Business Name: _ City State Zip ss Phone: Sprinklers Tub /Showers Toilet /Urinal Water Heater Water Softener Plumbing Estimate $ (COMMERCIAL /MULTI - FAMILY ONLY) Signature of Licen ontractor License Number& Expiration Date The City of Rexburg's permit fee schedule is the same as required by the State of Idaho Date Please complete the entire Application! NAME PROPERTY AD DRE S `— Permit# SUBDIVISION RequiredLY � VIECICAL Mechanical Contractor's Nam l �T � ' Business Name Address S �� City _State , / o/y� Zip �/ b � Cell Phone �) ✓�� l _Business Phone ( ) Fax ( ) Email �' • Gb�'Y 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 Exhaust or Vent Ducts Dryer Vents Range Hood Vents Cook Stove Vents Bath Fan Vents other similar vents & ducts: 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 Mechanical Sizing Calculations must be submitted with Plans & Application Point of Delivery must be shown on pla sign a re of Wnsed Contractor License number Date OUJ1�!" The City of Rexburg's permit fee schedul is the same as required by the State of Idaho Building Safety Department o��tiXBUR� i City of Rexburg �� o :7 19 E Main janellh @rexburg.org Phone: 208.359.3020 x326 Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3024 CITY OF REXBURG _ ___ -_ � _.____..._ -. Americas Family Community OWNER'S NAME PROPERTY ADDRESS Permit# SUBDIVISION �► PHASE 1 52 LOT BLOCK_ HOME 0 W7VER'S ELECTRICAL PERMIT Home Owner's Name Addres F" City Cell Phone J�J t' �' / �/� ` Home Phone (w) Fax ( ) Email �dl'Lb2t11 C$�t�71$f2 h t�J N - � �1 V TYPES OF INSTALLATION (New Residential includes everything contained within the residential structure and attached garage at the same time) 0' 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) �3 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. C Home Owner i - ,2-- - / /-- ,, 7 Date 0 • Building Safety Department City of Rexburg 19 E Main ioneiih@rexburg.org Phone: 208.359.3020 x326 Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3024 O� pEXH V *q o cITY OF REXBURG _. ___ 010 1 ------ .____.._. Americas Family Community OWNER'S NAME PROPERTY ADDRESS SUBDIVISION PHASE Requlredffl ELECTRICAL Electrical Contractor's Name Business Permit# Address City State Zip Cell Phone ( ) Business Phore ( ) Fax ( ) Email Electrical Estimate (cost of w4{ing & labor $ (COMMERCIAL /MULTI - FAMILY ONLY) TYPES OF INSTALLATION (New Residential includes everything co \ tad esidential structure and attached garage at the same time) Number of meters Up to 200 amp Ser 201 to 400 amp Ser Over 400 amp Sery Temporary Constru am or less, one location (for a period not to exceed 1 year) Exi sting 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 Airing & Labor: $ Pump /I 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 LOT BLOCK License number Date The City of Rexburg's permit fee schedule is the same as required by the State SUBCONTRACTOR LIST Excavation & Earthwork: Masonry: Drywall: r- Painting: a,z Floor Coverings: Plumbing: 4�);tl Ne, Y' Heating. / 1/ Electrical: r' Special Construction (Manufacturer or Supplier) Roof Trus 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 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 X 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 is true and correct to the best of my knowledge. 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