HomeMy WebLinkAboutAPPLICATION & BP - 08-00288 - 605 Terra Vista Dr - New SFRO44EXI3URC • •
u� r� CITY OF
REXBURG
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" Americas Family Community
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Perm. it
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ISSUED TO:
PERMIT #: 0800288
NAME: Cazier Gail Allan Etux Trs
FOR THE CONSTRUCTION OF: 582 Gemini Dr- Covered Porc JOB ADDRESS: 582 Gemini Dr
GENERAL CONTRACTOR. Leishman, Terry
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 by the Building Inspector.
Date Approved
Issued 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
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
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.
4. Framing
INSPECTION CARD
BUILDING
Date Annroved
1. Layout
2. Footing
3. Foundation
4. Framing
5. 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
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0800288
RESIDENTIAL BUILDING PERMIT APPL
19 E MAIN, REXBURG, ID 83440
208 - 359 -3020 X326
582 Gemini Dr- Covered Porch
PARCEL NUMBER: (�T o� 7 J G (We will provide this for you)
SUBDIVISION: UNIT# BLOCK# LOT#
(Addressing is based on the information - must be accurate)
ONTACT PHONE #
PROPERTY ADDRESS:
PHONE #: Home ( ) 36i Work ( ) Cell( )
OWNER MAILING ADDRESS: CITY: SIC STATFr ZIP :`Sw
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 ADD
PHONE #: Home (
) 3�9 -3/9l Work
CITY
Cell (
AT E = 7Z) ZIP
EMAIL FAX IDAHO REGISTRATION # & EXP. DATE 2CCr—;51, �' Z4
How many buildings are located on this pro ?
Did you recentlV e this pro perty N Yes (If yes, list previous owner's name) -
Is this a lot split YES (Pl brin copy of new legal description of property)
PROPOSED USE: Il/SZGI
(i.e., Single Family Residence, Multi Family, Apartments, 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 r ng to the subject matter of this application and hereby authorized representatives of the City to enter upon the above -
mentioned property for insp ons purposes. NOTE: The building official may revoke a permit on approval issued under the provisions of the 2003
International Code in case • f any fall statement or sre sentation of fact in the application or on the plans on which the permit or approval was
based. Permit void started n days. e void Tf work stops for 180 days.
G
DATE
Do y�6u 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 JanuarX 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**
Buil
19 E. Main
Rexburg, ID 83440
g Safety Department
City of Rexburg
janellh @rexburg.org Phone: 208.359.3020
www.rexburg.org Fax: 208.359.3024
r CITY OF
U O REXBUR
A
Americas Family Community
Affidavit of Legal Interest
State of Idaho
County of Madison
I,
Name
City
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 5 20
Signature
Subscribed and sworn to before me the day and year first above written.
Notary Public of Idaho
Residing at:
Address
State
My commission expires:
Building Safety Department
City of Rexburg
19 E. Main jonellh@rexburg.org Phone: 208.359.3020
Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3024
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C I T Y OF
RE XBL T RG 1-1-1-11111111 - - - - --
America's Family Community
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:
RequiredLY
PLUMBING
Plumbing Contractor's Name: Business Name:
Address City State Zip.
Contact Phone: ( ) Business Phone: ( )
FIXTURE COUNT (including roughed fixtures
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)
* * * * * * * * * * * ** *Water Meter Size:
Plumbing Estimate $ (COMMERCIAL /MULTI - FAMILY ONLY)
License Number& Expiration Date
Signature of Licensed Contractor
The
Date
schedule is the same as required by the State of Idaho