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Home My WebLink AboutAPPLICATIONS, BP - 05-00162 - 508 Golden Willow Dr - New SFR� r.o�. CITY OF R-EXBU R ANAEKICA'`; IAMILY C:OG9A9UNirY Building Permit INSPECTION CARD BUILDING Date Approved 1. Layout 2. Footing 3. Foundation 4. Framing 5. Insulation —{ 6. Drywall 7. Sidewalk 8. Mechanical 9. Final PLUMBING Date Approved 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 06/17/2005 Issued By __ '� �'' I zllez�� 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, 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. 1. Sewer Service Conn 2. Water Service Conn( 3. Rough -In 4. Ground Rough -In 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 CITY OF REXB URG BUILDING PERMIT APPLICA* 19 E MAIN, REXBURG, ID. 83440 208 - 359 -3020 X326 PARCEL NUMBER: PERMIT # Is Please complete the entire Application! If the question does not apply fill in NA for non applicable SUBDIVISION: 0-,//,,; : - 5 UNIT# IV BLOCK# 1 LOT# OWNER: Air, A CONTACT PHONE # r-7 5`V – CJ Cj7� PROPERTY ADDRESS: '{ 6el )/' LG PHONE #: Home ( ) Work ( ) 7� Cell ( ) OWNER MAILING ADDRESS: kI es CITY: STATE: JkZIP: ! '(0 APPLICANT (If other than owner)_ (If applicant if other than owner, a statement act as agent for owner must accompany this application.) MAILING AD RESS O APPLICANT v CITY: STATE; ZIP PHONE #: Home Work ) Cell ( ) �, ' (D`� 15 CONTRACTOR: V 5 PHONE: Home # lg5011 Work Cell# �) MAILING ADDRESS:_ i C ?i CITY STATE_[k_ZIP -5 ' 1 I- Gt4�— How many buildings are located on this property? Did you recently pur ase this property? No Ye' (If yes give owner's name) Is this a lot split? NO ES (Please bring copy of new legal description of property) PROPOSED USE: (i.e., Single Family Residence, Mu ti Far 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 purposes. NOTE: The building official may revoke a permit on approval issued under the provisions of the 2000 International Code in cases of any false statement or misrepresentation of fact in the application or o 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 �ys. Signature of Owner /Applicant 5 - /71/ 0 5 DATE 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 you check does not clear" � ►vim �e�,��tSC,c�srl.�oM Affidavit of Legal Interest State of Idaho County of Madison I, (- - fJY (A Name Address City I dot(03; 7 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 the attached, and I grant my permission to: NaAie Adbress 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 '7j� day of MAi A 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 Aire Application! � If the question does not apply fill in NA for non applicable NAME rw° PROPERTY AD RESS / � ; t�� Permit# SUBDIVISION j,-, Dwelling Units: SETBACKS Parcel Acres: „ �;-/ .Qz FRONT 4/ SIDE r SIDE 16 BACK _ L2- Front Footage (if applicable) /'/ 7 Storm Water Length a3 - 1 ` Remodeling Your Building/Home (need Estimate) $ 11 SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building) First Floor Area /'�'' c.� Unfinished Basement area �/ Second floor /loft area / VA Finished basement area 3Z6 ' c Third floor /loft area N A Garage area Shed or Barn A/ 4 Carport/Deck (30" above grade)Area - Water Meter Count: Required!!! Water Meter Size: 7� PLUMBING ,p / p Plumbing Contractor's Name: y% 2—q'h4/I e Business Name: If 14z-C Address , 0, 1-3 01( 3 0 C - :Z'P 7 De2 State �t/�, Zip Contact Phone: (209) 709 - 1/ 1 a *l Business Phone: ( ys $ - y/a 7-- FIXTURE COUNT (including roughed fixtures) / Clothes Washing Machine Sprinklers Dishwasher .3 Tub /Showers Floor Drain _ Toilet/Urinal Garbage Disposal Water Heater Hot Tub /Spa Water Softener Sinks (Lavatories, kitchens, bar, mop) Plumbing Estimate $ (Commercial Only) si ature of Licensed Contractor License num er Date The City of Rexburg's permit fee schedule is the same as required by the State of Idaho Please complete the qWire Application! If the question does not apply fill in NA for non applicable NAME L ,-- PROPERTYADDkESS ;.�; /�� i r7 Permit# SUBDIVISION c — Required!!! MECHANICAL Mechanical Contractor's Name: V 4L 2 . W , , 11 ,6tMS Business Name: .V igM.6AJ& ��b �`✓7'c Address W, p u State Zip B3 Contact Phone: (ZOB) 313. 338 8 Business Phone: (Zo&) 3sg 9 4Q- 7 Mechanical Estimate $ 5300 (Commercial/Multi Family Only) FIXTYRES & APPLL4NCES COUNT (Single Family Dwelling Only) 5 �✓ Furnace �. Exhaust or Vent Ducts Furnace /Air Conditioner Combo I Dryer Vents I � Heat Pump Range Hood Vents Air Conditioner Evaporative Cooler Unit Heater Space Heater Decorative gas -fired appliance Incinerator System Boiler Pool Heater Similar fixtures or Appliances Cook Stove Vents Bath Fan Vents a� other similar vents & ducts: Fuel Gas Pipe Outlets including stubbed in or future outlets 1 1�0 Inlet Pressure (Meter Supply) PSI Heat (Circle all that apply) Gas Oil Coal Fireplace Electric Mechanical Sizing Calculations must be submitted with Plans & Application Point of Delivery must be shown on plans. /-:357 5/ /6/ 067 Signature of Licensed 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: Concrete: Masonry: z i% ad ? ►� ^�i� �r Roofing: Insulation: Am C, �, - f Drywall: Painting: 11 Floor Coverings: Plumbing: &ji.,- - Heating: Electrical: Roof Trusses: Special Construction (Manufacturer or Supplier) Floor /Ceiling Joists: �r;�.,,10�✓ Siding/Exterior Trim: Other