HomeMy WebLinkAboutAPPLICATIONS, CO, BP - 08-00370 - 133 E 1st S - Duplex Conversionoe gaxs vRC,
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CITY OF'
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Americas Family Community
B uilding
Permit
ISSUED TO:
PERMIT #: 0800369
NAME: Peterson William Roger
FOR THE CONSTRUCTION OF: 133 1/2 E 1st S- Peterson JOB ADDRESS: 133 E 1st S
GENERAL CONTRACTOR: Paul Davis Restoration
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 Appro ed Issued By
Bu Iding 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.
NOTICE! 2), The permit will become null and void in the event of any deviation from the
the building beyond the point indicated
in each successive inspection without
3. Drywall
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 aooroval.
5. Mechanical
INSPECTION CARD
BUILDING
Date Approved
1. Framing
2. Insulation
3. Drywall
4. Sidewalk
5. Mechanical
6. Final
ELECTRICAL
Date Auoroved
1. Rough -In
2. Rough -In
3. Electrical Service
4. Final
PLUMBING
Date Approved
1. Sewer Service Conn
2. Water Service Conn(
3. Rough -In
4. 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
QEXB VF
CITY OF Certificate of accupancy
U 0
REX 13URG City of Rexburg
Q% Department of Community Development
'., Americas Family Community
NFO •,
19 E. Main St. / Rexburg, ID. 83440
Phone (208) 359 -3020 / Fax (208) 359 -3024
Building Permit No: 0800369
Applicable Edition of Code: International Residential Code 2006
Site Address: 133E 1st S (P,?Ap,- aPa0WVr\-+
Use and Occupancy: Duplex
Type of Construction: Type V, non -rated
Design Occupant Load: Residential
Sprinkler System Required: No
Name and Address of Owner: Peterson William Roger
133 E 1 S
Rexburg, ID 83440
Contractor: Paul Davis Restoration
Special Conditions: No rough mechanical inspection requested
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 vtiith the requirements of the code
for the group and division of occupancy and the use for vihich the proposed occupancy Kos
classified.
Date C.O. Issued: January 15, 20 (02:55 )
C.O Issued by
Building Official
There shall be no further change in the ebsting 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 Inspecto : Fire Inspector:
Electrical Inspector: P&Z Administrator:
.. o ��exsug c
y f C I T Y
70 Please CompfflF the Entire Application!
REXBURG the question does not annly All i- u a C_-
T cW
America's Family Community
• a�E °`' 0800369
RESIDENTIAL BUILDING PERMIT AP]
19 E MAIN, REXBURG, ID 83440 1331/2 E 1 st S - Peterson
208 - 359 - 3020 X326
PARCEL NUMBER: qL ( QCD (We will provide this for you)
SUBDIVISION: UNIT# BLOCK# LOT#
(Addressing is based on the information - must be accurate)
t 71 s JCJ CONTACT PHONE # Zn�S - 3rJ - C_ S—s1/
PROPERTY ADDRESS: Z Zz. o t s r O� --r� -� �' ti��.�z� l s��ri� -�a s-3 &H 1--.
PHONE #: Home ( ) Work ( ) Cell (L=� 3S1
OWNER MAILING ADDRESS: 13 tc . I s CITY: STATE
APPLICANT (If other than owner) J s4 As6Grcl �p�vi, p,o s �rc„z� -rya
(Applicant if other than owner, a statement authorizing applicant to act as agent for owner must accompany this application.)
APPLICANT INFORMATION: ADDRESS ;E • CITY: s »N`s-
STATE; z3n�_ ZIP
PHONE #: Home ( ) Work (z,Q S Cell (pi, -)
CONTRACTOR
MAILING ADDRESS: CITY ;;P_-w= i -o STATE ZIP S
PHONE #: Home ( ) Work Cell
EMAIL FAX - - 7s�Q/ IDAHO REGISTRATION # & EXP. DATE
Did you recently purchase this propert Yes (If yes, list previous owner's name)_
Is this a lot sph 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.)
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, I hereby certify
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 purpo . NOTE: The building official may revoke a permit on approval issued under the provisions of the 2003
„
International Code in c ses of any fals tement or misrepresentation of fact in the application or on the plans on which the permit or approval was
based. Permit void i not starte ith/ 180 days. Permit void if work stops for 180 days.
Signature 4 Owner /Applicant DATE
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 January 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**
Builffhg Safety DepartmenW Ya RSXHV ,o CITY O F
City of Rexburg n rVnT mG
REXB lJ It
19 E. Main ionellh@rexburg.org Phone: 208.359.3020 N a Americo Family Community
Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3024
Affidavit of Legal Interest
State of Idaho
County of Madison
r
Ix
Jif
01 a�" ,
Name
A" - 7
�ry
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: S--" A—kF I F 03tio i - sN cc t (N iZ
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.
't
Dated this `/ day of ,20
Subscribed and sworn to before me the day and year first above written.
Notary ublic of Idaho
Not" Pub9c Residing at:
L State of Ideho ,
My commission expires: 1,;2-11 /61
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
Ok pEXBUgC
U o
C I T Y OF
REXBURG
1111-1111 CW -- _.___ --
Americas Family Community
Remodeling Your Building /Home (need Estimate $ 4/-S.
SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building)
First Floor Area Unfinished Basement area r4 /,*--
Second floor /loft area N1^ Finished basement area _-'53 fi q �
Third floor /loft area N Garage area
Shed or Barn N f i�1 Carport /Deck (0" above grade)Area "Z ( �
Water Meter Quantity:
* * * * * * * * * * * ** *Water Meter Size:
Required Y
PLUMBING (/ / /� /�
Plumbing Contractor's Name: 1 r/`C t''cr d�'At LI Business Name: 1 � k A 1 2 /
Address �o � `t) II Q 4 s4 City S 11 E State ' —Zip,
Contact Phone: 7j (o GdZ ID Business Phone: ) 716-0c' `1
Email
FIXTURE COUNT tincludin_rou _ fixtures
7 Clothes Washing Machine
Dishwasher
Floor Drain
Garbage Disposal
Hot Tub /Spa
Z Sinks (Lavatories, kitchens, bar, mop)
Plumbing Estimate $.
Sprinklers
Tub /Showers
Toilet /Urinal
Water Heater
Water Softener
(COMMERCIAL /MULTI - FAMILY ONLY)
Signature of Licenso6d Contractor
The
/a � y $ /( / - 3 � / /c, 7 7 -0?V- C ) a: License Number& Expir oats n 13'ate Date
schedule is the same as required by the State of Idaho
Building Safety Department
City of Rexburg
19 E. Main ionellh@rexburg.org Phone: 208.359.3020
Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3024
O� 4 @XBLap4.
u c
zQ
C I T Y OF
REXB_MG
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America's Family Community
NAME
PROPERTY ADDRESS
SUBDIVISION
PHASE LOT BLOCK
Exhaust or Vent Ducts ( i ► uAude�
�/
( /`� Dryer Vents
Require&Y MECHANICAL
Mechanical Contractor's Name (2 Business Name ��� A/
Address • A &..J G sy G City �� State � Zip d
Cell Phone ( ?`7 -,37 Q J Business Phone (20� 5
Fax( ) .! ZS 4 t 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
Z'- 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 Oil Coal Fireplace Electric Hydronic
of Licensed Contra r License number Date
The City of Rexburg s permit fee schedule is the same as required by the State of Idaho
Permit#
Range Hood Vents
Cook Stove Vents
X Bath Fan Vents
Ns
Building Safety Department 4tiXB�R
is c'O CITY OF
City of Rexburg 7� i —
REXBURG
19 E Main janellh @rexburg.org Phone: 208.359.3020 x326 America's Family Community
Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3024 °
OWNER'S NAME
PROPERTY ADDRESS Permit#
SUBDIVISION
PHASE LOT BLOCK
HOME OWNER'S ELECTRICAL PERMIT
Home Owner's Name
Address
Cell Phone ( )
City State Zip
Home Phone ( )
Fax ( )
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.
a
Si a Home Owner Date
The City of Kexburg'r permit fee schedule is the same as required by the State of Idaho
0
Building Safety Department i pFpkXAUR c t .r Y o F
City of Rexburg � 7y n rvnT mG
1�1�1� V 1\
Cy ,__ _T
19 E Main jonellh @rexburg.org Phone: 208.359.3020 x326 n Americas Family Community
Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3024
OWNER'S NAME
PROPERTY ADDRESS
SUBDIVISION
PHASE
LOT BLOCK
Permit#
Requited ►!l E
k� , VYCort-
Electrical Contractor's Name Business Name COinv-_:o �.Cect
Address S75" 3Gcn�l� City Lp�,�_� Svc fiz Stat Zip
Cell Phone :7(�q Business Phone
Fax ( ) Email @ 07 . C—
Electrical Estimate (cost of wiring & labor) $ 5OX) eo (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, 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
*In s a ma imum of 3 inspections. Additional inspections charged at requested inspection rate of $40 per hour.
Signature of Li a ontrac� for - License number
The
schedule is the same as
:Z-;?9 -0
Date
the State of Idabo
SUBCONTRACTOR LIST
Excavation & Earthwork:
Concrete: (q /A
Masonry: N
Roofing: 0
Insulation: N Et.J A-qf -
Drywall: i s w E N M.. -r N
Painting: � —"--, V ,= -Q CJ
Floor
Coverings:
Plumbing: r - - L l - 1 t �►:��,�1 �r
Heating: - v6 -- —...4r -A vN.-.
Electrical:
Special Construction
(Manufacturer or Supplier)
Roof Trusses: N
Floor /Ceiling Joists: N /n�t
Siding /Exterior Trim: f /�
Other: N L"::.-
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.ibcl.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
Cl 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
THE IDAHO CONTRACTORS BOARD
Certifies That
g Vauil Tayis r XesLorafiOn
Registration No: RCE -626
Subject to Annual Renewal
0
STATE
OF
IDAHO
A�N i ` t't ' t � fVi
Q
10�
having fulfilled all the requirements of the Laws of Idaho and possessing the prescribed
qualifications, is hereby authorized to practice as a
CONTRACTING BUSINESS
within the State of Idaho
Bureau of Occupational Licenses
Department of Self Governing Agencies
The person named has met the requirements for licensure and is entitled
under the laws and rules of the State of Idaho to operate as a(n)
CONTRACTING BUSINESS
STATE OF IDAHO CONTRACTORS BOARD
PAUL DAVIS RESTORATION
JACK MEIKLE. ET AL
1022 LINCOLN RD
IDAHO FALLS ID 83401
Tana Cory RCE -626 11/09/2008
Chief, B.O.L. Number Expires
IN TESTIMONY WHEREOF, I have here unto put my
hand and affixed the Official Seal of the Bureau of
Occupational Licenses at Boise, Idaho, this 9th day of
November A.D. 2005
F, U U OF
OCC A N LICENSES