HomeMy WebLinkAboutBP & APPLICATION - 06-00061 - Utah Power - Remodeloe gexg aR�. � �
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Permit
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ISSUED TO:
PERMIT #: 0600061
NAME: Falls Cleaning & Painting
FOR THE CONSTRUCTION OF: Utah Power - Firewall JOB ADDRESS:
GENERAL CONTRACTOR: Falls Cleaning & Painting
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 Approv Issued By
2 Z ; /,,/,
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.
N O T I C E 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
■ 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
Date Appr oved
1. Layout
2. Footing
3. Foundation
4. Framing
5. Insulation
6. Drywall
7. Sidewalk
8. Final
9. Mechanical
OTHER
Date Approved
1. Fire Department Fina
PLUMBING
1. Sewer Service Conn
2. Water Service Conne
3. Rough -In
4. Ground Rough -In
5. Final
Date proved
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
CITI' OFREXBURG , F •
BUILDING PERMIT APPLICATION Please co 0600061
19 E MAIN, REXBURG, ID. 83440 If the questio
208 - 359 -3020 X322 Utah Power Remodel
PARCEL NUMBER: � � 1 0�, We Will ttruvtuc uns iur you)
SUBDIVISION: UNIT# BLOCK# LOT#
(Addressing is based on the information - must be accurate)
/❑
PROPERTY ADDRESS:
PHONE #: Home (
OWNER MAILING ADDRESS:
EMAIL
CONTACT PHO E #
CITY:
FAX
STATE: ZIP:
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: ADDRES 6 CITY: " /,
STATE; .� ZIP - � -- EMAIL FAX
PHONE #: Home ) G- ( r - � f S r Cell (moo # ' , �
Work .�,� .5 � �°
CONTRACTOR PgtW5
MAILING ADDRESS: 5
t
/L ��
CITY STATE -4) ZIP
PHONE: Home # S�y - 014e , Work# ;,---; - } - J�5; Cell#
EMAIL
FAX 5 -�-' 9 `` c> Op h)
ituw tttatty uuuutngs are I ocatea on finis property!
Did you recently purchase this property ?& Yes (If yes give owner's name)
Is this a lot split? YES (Please bring copy of new legal description of property)
PROPOSED USE: /" 12
(i.e., Single Family Residence, Multi Family,
Garage, Commercial, Addition, Etc.)
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: under penalt of perjur 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 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 1 days.
of
Work ( )
:Z K, 1 -- q - 6
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
3
Affidavit of Legal Interest
State of Idaho
County of Madison
I,
Name
City
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:
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 herin 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:
2
"Building Permit Fees are d yye�,, time of application — "Building Permits are v �f you check does not clear"
Please complete the elt'ire Application!
NAME If the question does not apply fill in NA for non applicable
PROPERTY ADDRESS Permit#
SUBDIVISION
Dwelling Units:
SETBACKS
FRONT_ SIDE
SIDE
BACK
Remodeling Your Building/Home (need Estimate) $ 7ep�.. Jv
SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building)
First Floor Area
Second floor /loft area
Third floor /loft area_
Shed or Barn
Unfinished Basement area
Finished basement area_
Garage area
0" above grade)Area
Water Meter Count:
Parcel Acres:
Water Meter Size:
Required!!!
PLUMBING
Plumbing Contractor's Name:
Address
Contact Phone: ( )
Email
FIXTURE COUNT (including roughed fixtures)
Clothes Washing Machine
Dishwasher
Floor Drain
Garbage Disposal
Hot Tub /Spa
Sinks
(Lavatories, kitchens, bar, mop)
Plumbing Estimate $
Business Name:
City
Business Phone:
Fax
1
State Zip
Sprinklers
Tub /Showers
Toilet/Urinal
Water Heater
Water Softener
(Commercial Only)
Required! Signature of Licensed Contractor
The City of Rexburg's permit
License number
schedule is the same as
Date
by the State of Idaho
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