HomeMy WebLinkAboutALL DOCS - 08-00208 - Garth Wilcox Accounting Firm - Remodel�� agxsuR� °v
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CITY OF
REX
CW
Americas Family Community
Building
Per- it
ISSUED TO:
PERMIT #: 0800208
NAME: Wilcox Garth
FOR THE CONSTRUCTION OF: Garth Wilcox Accounting Firrn JOB ADDRESS: 70 N Center St
GENERAL CONTRACTOR: Beattie Construction
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 Issue B
�- a I lo':&
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
3. Drywall
accepted drawings.
I approval. No structural framework of
3) No foundation, structural, electrical, nor plumbing work shall be concealed
any underground work shall be covered
without aDDroval.
5. Final
INSPECTION CARD
BUILDING
Date Anoroved
1. Framing
2. Insulation
3. Drywall
4. Mechanical
5. Final
ELECTRICAL
Date Approved
1. Rough -In
2. Final
OTHER
Date Approved
1. Fire Department Fina
PLUMBING
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
& PLUMBING INSPECTION
� C I7'Y
F. 7
REXBUR�
cv- " 0 Americas Family Conununity
f, F
COMMERCIAL & MULTI FAMILY BUILDING P]
19 E MAIN, REXBURG, ID 83440
208 - 359 -3020 X326
Please Co l plete the Entire Application!
Garth Wilcox Accounting Firm
70 N Center
PARCEL NUMBER: a g �X2' L . 1 t (We will provide this for you)
SUBDIVISION: UNIT# BLOCK# LOT#
(Addressing is based on the information - must be accurate)
CONTACT PHONE # 7) 7 '
PROPERTY ADDRESS: _7U l� , ' f�� S'
PHONE #: Home ( ) 2 J5� ' ? �> �� work( Cell(
)
OWNER MAILING ADDRESS: A , 11't v �� CITY: �� r STATE: r ZIP: 2
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 , f a
MAILING ADDRESS:
5 S
S, v & o ,_?
CITY 'r -.X i t
t G
STATE
i f1
ZIP
PHONE: Cell#
Work # 5(c
- UG6. 5
Fax#
35
EMAIL IDAHO REGISTRATION # & EXP. DAT
How many buildings are located on this property? —
Did you recently purchase this property ? /` 9 Yes (If yes, list previous owner's name) _
Is this a lot split? NO 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. — CIRCLE ONE
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.
of Owner /Applicant
i / 2 V /
DATE
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 jamugixL 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
0 0
Building Safety Department �4��X�ucrQ CITY o
City of Rexburg �= r� REXBURG
19 E. Main jonellh @rexburg.org Phone: 208.359.3020 ext 326 Americas Amity Communit}
Rexburg, ID 83440 www.rexburg.org Fax. 208.359.3024
Affidavit of Legal Interest
State of Idaho
County of Madison
Name Address
City 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 rant my
permission to: j 6a r4k 01' 1C.o a! O
Name Address eXbu►
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 herin or as to the
ownership of the property which is the subject of the application.
Dated this .2 7 day of 4,,,
—20
,A% -h�
Subscribed and sworn to before me the day and year first above written.
• N C T . Notary Pu c? Idaho
7
aip_
( ? .4 Residing at:
9 .10
$ F '�••••N' 0 M commission e
1D Y p
0 • City of Rexburg
NAME
PROPERTY ADDRESS
SUBDIVISION
Dwelling Units: Parcel Acres:
Please Complete the Entire Application!
If the question does not apply fill in NA for non applicable
SETBACKS
FRONT SIDE SIDE BACK
Remodeling Your Building /Home ( need Estimate) $7
SURFACE SQUARE FOOTAGE. • (Shall include the exterior wall measurements of the building)
First Floor Area Unfinished Basement are:
Second floor /loft area Finished basement area_
Third floor /loft area Garage area
Shed or Barn Carport /Deck (30" above
Water Meter Quantity:
Water Meter Size:
Requlre&Y
PLUMBING s Ye, e- )9, Alf
Plumbing Contractor's Name: _ e ' F ' ! ` b L
Business Name:
Address City State Zip,
Contact Phone: ( ) Business Phone: (
Email Fax ae`B - ;, -
FIXTURE COUNT (includingroughed Aytures)
_ Clothes Washing Machine
Dishwasher
Floor Drain
Garbage Disposal
Hot Tub /Spa
Sinks
(Lavatories, kitchens, bar, mop)
Plumbing Estimate $ �c�' (Commercial Only)
Sprinklers
Tub /Showers
_ Toilet /Urinal
Water Heater
Water Softener
Signature of Licensed Contractor License number
Date
4
The �P Z xburg s permit fee schedule is the same as required hate of Idaho
NAME
PROPERTY ADDRESS
SUBDIVISION
M
Please Complete the Entire Application!
If the question does not apply fill in NA for non applicable
Permit#
,v_.. 1Y lv el
Required!fl
MECHANICAL
Mechanical Contractor's Name: .,OVA' & Business Name:
Address City State Zip
Contact Phone: ( ) Business Phone: ( )
Email F
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
Dryer Vents
Range Hood Vents
Cook Stove Vents
Bath Fan Vents
other similar vents & ducts:
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
Required! Signature of Licensed Contractor License number
The City of Kexburg's permit fee schedule is the same as
Date
the State of Idaho
Mechanical Sizing Calculations must be submitted with Plans & Application
Point of Delivery must be shown on plans
5
0
Building Safety Department
City of Rexburg
19 E Main joneiih @rexburg.org Phone: 208.359.3020 x326
Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3024
O � g4XBV"
�Y r °
' o
CITY OF
R
Americas Family Community
OWNER'S NAME
PROPERTY ADDRESS
SUBDIVISION
PHASE LOT BLOCK
Permit#
I � Required.!!
ELECTRICAL
Electrical Contractor's Name I ,( C
� ) or f
Business Name
ty l 0 0 S
Address
City
State
Zip
Cell Phone ( ) Business Phone ( )
Fax ( )
Electrical Estimate (cost of wiring & labor) $ (COMMERCIAL /MULTI - FAMILY ONLY)
TYPES OFINSTALLATION 6?. - o v,,` I
(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: $
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.
6
Signature of Licensed
The
License number Date
Y permit fee sc hedule is the same as required by the State of Tdahn
Building Safety Department ik
City of Rexburg 19 E. Main janeiih@rexburg.org Phone: 208.359.3020
Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3024
C I T Y OF
R
-1._ .- Cw -- - -- ---
America's Family Community
APPLICATION: "CONSTRUCTION PERMIT"
CONSTRUCTION PERMIT #:
PERMIT APPROVED: YES/ NO $50.00 FEE PAID: YES /NO
- APPLICANT INFORMATION:
Business Name:
Office Address:
APPROVED BY:
Office Phone Number: ( )
Contractor Performing the Work:
Contact Person:
- LOCATION OF WORK TO BE DONE:
Street Address Where Work Will Be Done:
Business Name Where Work Will Be Done:
Dates For Work To Be Done:
Contact Person:
Phone Number: ( )
To
Cell # ( )
PLEASE CHECK THE TYPE OF PERMITS) YOU ARE APPLYING FOR:
❑ AUTOMATIC FIRE- EXTINGUISHING SYSTEMS
❑ COMPRESSED GASES
❑ FIRE ALARM AND DETECTION SYSTEMS AND RELATED EQUIPMENT
❑ FIRE PUMPS AND RELATED EQUIPMENT
❑ FLAMMABLE AND COMMBUSTIBLE LIQUIDS
❑ HAZARDOUS MATERIALS
❑ INDUSTRIAL OVENS
❑ LP -GAS
❑ PRIVATE FIRE HYDRANTS
❑ SPRAYING OR DIPPING
❑ STANDPIPE SYSTEMS
❑ TEMPORARY MEMBRANE STRUCTURES, TENTS, AND CANOPIES
Applicant's Signature Date
............................................................ ..............................,
Cell Phone # ( )
City
State Zip
7
r �
SUBCONTRACTOR LIST
Excavation & Earthwork:
Masonry:
Insula
�5e" HA
Painting: VG y tv e �-
Floor
Coverings:
Plumbing:
Special Construction
(Manufacturer or Supplier)
Roof Trusses: —
Floor /Ceiling Joists:=
Siding /Exterior Trim:_
Other:
8
EXEMS FROM STATE STRATION
i
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.
(Phis 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.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
Print Name
Date
0