HomeMy WebLinkAboutALL DOCS - 08-00192 - 118 N 1st E - New RoofOe �BXB UA
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CITY OF
REX
Americas Family Community
Building
Permit
ISSUED TO:
PERMIT #: 08001 92
NAME: Bell Garon
FOR THE CONSTRUCTION OF: 118 N 1st E -New Roof JOB ADDRESS: 118 N 1st E
GENERAL CONTRACTOR. Garon Bell
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 Lied By
( Building lnspecto
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.
INSPECTION CARD
BUILDING
Date Approved
1. Framing
2. Insulation
3. Drywall
4. Final
ELECTRICAL
Date P
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
o � 4EXB UR •
CITY O F
R P.
America's Family Community
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RESIDENTIAL BUILDING PERMIT APPLI(
•
0800192
118 N IA E -New Roof
19 E MAIN, REXBURG, ID 83440
208 - 359 -3020 X326
PARCEL NUMBER: PA ffi ic-a I� (We will provide this for you)
SUBDIVISION: UNIT# BLOCK# LOT#
(Addressing is based on the information - must be accurate)
a
OWNER NAME CONTACT PHONE #
PROPERTY ADDRESS: 1 l N
PHONE #: Home ( ) Work ( ) Cell ( )
OWNER MAILING ADDRESS: CITY: STATE: ZIP:
EMAIL 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 ADDRESS:
PHONE #: Home (
Work (
STATE ZIP
Cell ( )
EMAIL FAX IDAHO REGISTRATION # & EXP. DATE
How many buildings are located on this property ?
Did you recently purchase this property? No Yes (If yes, list previous owner's
Is this a lot split? NO \ nYEQS (Please bring copy of new legal description of p
y
PROPOSED USE: t ,bJ () (;E f ew's -es
(i.e., Single Family Residence, Multi Family, Apartments, Remodel, Garage, Commercial, Additi
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATIO Wn eb certi
that I have read this application and state that the information herein is correct and I swear that any info i e
hearings before the Planning and Zoning Commission or the City Council for the City of Rexburg shall be truthful an cor t � vit all
City regulations and State laws relating to the subject matter of this application and hereby authorized representatives of the City to enter upon t e a ve-
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. Pe it void if not started within 180 days. Permit void if work stops for 180 days.
Signature of Owner /App cant DA
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 fanuatX 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**
0 .EXBU R4;
Bull^ Safety Department S
City of Rexburg 7
19 E. Main janellh @rexburg.org Phone: 208.359.3020
Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3024 �• ' "`°
CITY O F
R EX B URG
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
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 A p p lication!
•
p pp
NAME
PROPERTY ADDRESS
SUBDIVISION
Dwelling Units: Parcel Acres:
SETBACKS
FRONT
Permit#
SIDE SIDE BACK
Remodeling Your Building /Home (need Estimate $ 'J � 1 00 R
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:
Requlred.
PLUMBING
Plumbing Contractor's Name: Business Name:
Address City State Zip
Contact Phone: ( ) Business Phone: ( )
Email Fax
FIXTURE COUNT (including roughed fixtutes�
Clothes Washing Machine
Sprinklers
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)
Signature of Licensed Contractor
The
License Number& Expiration Date
'r permit fee schedule is the same as required by the State of Idabo
Date
Please complete the entire Application!
P PP
NAME
PROPERTY ADDRESS
SUBDIVISION
Permit#
Required.►►
MECHANICAL
Mechanical Contractor's Name 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 -fated 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
P o i nt o De be I i on 1 ans
Signature of Licensed Contractor License number
Date
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
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CITY OF
REXBURG
___.__
Americas Family Community
OWNER'S NAME
PROPERTY ADDRESS
SUBDIVISION
PHASE LOT BLOCK
Permit#
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)
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)
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
the State of Idabo
0 0
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
04 pEX B URC
CITY OF
REXBU
- -Ow-
Americas Family Community
OWNER'S NAME j l(XA, j
PROPERTY ADDRESS
SUBDIVISION
PHASE
LOT BLOCK
0800192
118 N 1st E -New Roof
Requiredffl ELECTRICAL
Electrical Contractor's Name i i� - try
y � ' Business Name EI R'- I 12.1L..
Address 1 N C` CE City State Zip 6)
0
Cell Phone (2 cf) 35 ► - 1 7 7 U Business Phone (` :�? — 7 7 3 '
Fax ( ) 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*
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.
777 - 61
gignatu of Llcen+ ed Contractor License number Date
The City of Rexburg's permit fee schedule is the same as required by the State of Idaho
SUBCONTRACTOR LIST
Excavation & Earthwork: YJ
Concrete:
Masonry: -na.�-nr FD V—
Roofing:
Insulation: � L� vr c
Q I Ifi -
mmm
Floor / 6
Coverings: R A J �
Plumbing: ! v I
Heating: N �T
Special Construction
(Manufacturer or Supplier)
Roof Trusses: ) m
Floor /Ceiling Joi
Siding /Exterior Trim:
Other:
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
❑ 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