HomeMy WebLinkAboutBP & APPLICATION - 06-00055 - 333 Bare St - RemodelCITY OF • •
REX I^^ 3 ``• U • RG
_ ., Buildin
4 ,.
Americas Family Community 9
Per- m__ it
ISSUED TO:
PERMIT #: 0600055
NAME: Taylor Tim Etux
FOR THE CONSTRUCTION OF: 333 Bare St- Taylor Remodel JOB ADDRESS: 333 Bare St
GENERAL CONTRACTOR: Owner
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 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 sefof 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
O T' E' 2) The permit will become null and void in the event of any deviation from the 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.
INSPECTION CARD
BUILDING
nslta Annrnvati
1. Layout
2. Footing
3. Foundation
4. Framing
5. Insulation
6. Drywall
7. Sidewalk
8. Mechanical
9. Final
PLUMBING
Dana Annrnvad
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
CITY OF REXB URG • PERMIT #
BUILDING PERMIT APPLICATION Please complete the entire Application!
19 E MAIN, REXBURG, ID. 83440 If the questior - '"" '— "T ` r °--
208- 359 -3020 X322
PARCEL NUMBER: �',�� (� (We N 06000
SUBDIVISION: UNIT# 333 Bare St- Taylor Remodel
(Addressing is based on the information - must be accurate)
OWNER NAME: "T ; rt, -- rcA �A 16 r J
I CONTACT PHONE # 3/3—
PROPERTY ADDRESS: 3 3 3 6a r e. 5
PHONE #: Home (5W) 356 - 371/ Work 3/3
OWNER MAILING ADDRESS: CITY: STATE:,T/) 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
STATE; ZIP
PHONE #: Home ( )
EMAIL
Work (
CONTRACTOR
CITY:
FAX
Cell ( )
CITY STATE ZIP
MAILING ADDRESS:
PHONE: Home#
EMAIL
m1k a 1T.0
FAX
Cell#
How many buildings are located on this property?
WA Q usf ai n —
Did you recently purchase this property. No es (If yes give owner's name)
Is this a lot split? NO YES (Please bring copy of new legal description of
PROPOSED USE: � - 1 r m i )N
(i.e., Single Family Residence, Multi Family,
Remodel, Garage, Commercial, Addition,
j AN 2 20 L,
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 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.
Signature of Owner /Applicant DATE
Do you prefer to be contacted by fax, email o ho 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 you check does not clear"
r'
, J
CITY OF
REXBURG
AMERICAS FAMILY COMMUNITY 19 E. Main (PO Box 280) Phone: 208 - 359 -3020 x326
Rexburg, Idaho 83440 Fax: 208 - 359 -3024
www.rexburg.org comdevOrexburg.org
Affidavit of Legal Interest
State of Idaho
County of Madison
I,
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 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 effire Application! 40
If the question does not apply fill in NA for non applicable
NAME ev, 7ra j Z 0 f
PROPERTY ADDRESS 333 e�, a r e Permit#
SUBDIVISION
Dwelling Units: 2-- Parcel Acres:
SETBACKS
FRONT SIDE SIDE
City
Remodeling Your Building/Home ( need Estimate) $ -4 ' t)0
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 119(,
Third floor /loft area Garage area 3 (p
Shed or Barn Carport/Deck (30" above grade)A
Water Meter Quantity:
Required!!!
PLUMBING
Plumbing Contractor's Name:
Address
Contact Phone: ( )
Email
State
Business Phone: ( )
Fax
Zip
FIXTURE COUNT (including roughed fixtures)
Clothes Washing Machine
Dishwasher (
Floor Drain
Garbage Disposal
Hot Tub /Spa
Sinks
(Lavatories, kitchens, bar, mop)
Plumbing Estimate $
(Commercial Only)
Signature of Licensed Contractor
The City of Rexburg's
* * * * * * * * * * * * ** Water Meter Size:
Business Name:
'�– Tub /Showers
Toilet/Urinal —Mt';
Water Heater ,Q
_ Water Softener
License number
e schedule is the same as
0 Sprinklers
Date
by the State of Idaho
•
-Please complete the entire Application! If the question does not apply fill in NA for non
applicable.
NAME
PROPERTY ADDRESS-J 333 Permit#
SUBDIVISION
Required!!!
Mechanical Contractor's Name:
Address
Contact Phone: ( )
Email
Zip
Mechanical Estimate $ (Commercial/Multi Family Only)
( F-VCTURES & APPLL4NCES COUNT
Furnace
t� Furnace /Air Conditioner Combo
Heat Pump
Air Conditioner
6 Evaporative Cooler
_ 0 Unit Heater
Space Heater
Decorative gas -fired appliance
_ n Incinerator System
D Boiler
Cj Pool Heater
Cook Stove Vents
Bath Fan Vents 1�y
other similar vents & ducts:
Similar fixtures or Appliances
Fuel Gas Pipe Outlets including stubbed in or future outlets (��r�� -► �t'LQ�
Inlet Pressure (Meter Supply) PSI
Heat (Circle all that apply) Gas Oil Coal ireplac Electric
Mechanical Sizing Calculations must be submitted with Plans & Application
Point of Delivery must be shown on plans.
Signature of Licensed Contractor
The City of Rexburg's
MECHANICAL
Business Name:
City State
Business Phone: ( )
Fax
(Single Family Dwelling Only)
Exhaust or Vent Ducts
Dryer Vents
Range Hood Vents
License number
fee schedule is the same as
Date
the State of Idaho
0 0
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
0 •
SUBCONTRACTOR LIST
Excavation & Earthwork:
Concrete:
Masonry:
Roofing:
Insulation:
Drywall:
Painting:
Floor
Coverings:
Plumbing:
Heating:
Electrical:
Special Construction
(Manufacturer or Supplier)
Roof Trusses:
Floor /Ceiling Joists:
Siding/Exterior Trim:
Other: