HomeMy WebLinkAboutCO & APPLICATION - 04-00344 - 602 Cook St - New SFRa
CITY OF
REXBURG
AMERICA'S FAMILY COMMUNfrY
Building Permit No:
Applicable Edition of Code:
Site Address:
Use and Occupancy:
Type of Construction:
Design Occupant Load:
Sprinkler System Required:
Name and Address of Owner:
Contractor:
Special Conditions:
Occupancy:
CERTIFICATE OF OCCUPANCY
City of Rexburg
Department of Community Development
19 E. Main St. / Rexburg, ID. 83440
Phone (208) 359 -3020 / Fax (208) 359 -3022
0400344
602 Cook Ave
Henderson W R
P O Box 190
Rexburg, ID 83440
Hams, Trent
This Certificate, issued pursuant to the requirements of Section 909 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 inith the requirements of the code
for the group and division of occupancy and the use for vihich the proposed occupancy vies
classified.
Date C.O. Issued: February 18, 2005 21
C.O Issued by:
Building Official
There shall be no further change in the eAsting 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.
Water Dfipartment-�R Fire
State of Idaho Electrical Department
CITY OF REXB URG PERMIT #
BUILDING PERMIT APPLICATION
19 E MAIN, REXBURG, ID. 83440p
208 - 359 -3020 X326
PARCEL NUMBER: R ANI%onfbao
SUBDIVISION: 0 N UNIT # BLOCK# LOT# I�
OWNER: ^ �n1� — l�l�l� �-IJ CONTACT PHONE #
PROPERTY ADDRESS: br)q
PHONE #: Home ( ) 93''j Work (
Cell ( ) 357- 7 $
OWNER MAILING ADDRESS: 3S ?S 6, CITY: STATE: S1> ZIP t?1V V o
APPLICANT (If other than owner)
(If applicant if other than owner, a statement authorizing applicant to act as agent for owner must accompany this application.)
MAILING ADDRESS OF APPLICANT
PHONE #: Home (
CITY:
Work ( )
CONTRACTOR: _rAr,/ r— 49*_R 0 PHONE: Home#
MAILING ADDRESS:
How many houses are located on this property ?
Did you recently purchase this property? No (Yes (If yes give owner's name
Is this a lot split? NO 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 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
Work# Cell#
CITY STATE ZIP
M
STATE; ZIP
Cell ( )
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"
NAME -�� *942elS
PROPERTY ADDRESS Mock I C dTLo
SUBDIVISION /�X&oN
Dwelling Units:
Front Footage (if applicable)
Parcel Acres:
Permit#
SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building)
First Floor Area i '�1.� Unfinished Basement area
Second floor /loft area Finished basement area - 7 3 Z
Third floor /loft area Garage area 7 ;L
Shed or Barn Carport/Deck (36" above grade)Area
Remodel (Need Estimate) $
PLUMBING
PLUMBERS NAME �, �'! �'� lJry� i,�/Z� ADDRESS
O , (� ► J Z
CITY ST STATE X-D ZIP 9 PHONE ( ) 3 9 - - e , ?
�Z
FIXTURE COUNT
CLOTHES WASHING MACHINE X
SPRINKLERS
- �-
DISHWASHER x
TUB /SHOWERS
FLOOR DRAIN x
TOILET/URINAL
s V� Z
GARBAGE DISPOSAL
WATER HEATER
X
HOT TUB /SPA
WATER SOFTENER
X
SINKS 3
(Lavatories, kitchens, bar, mop)
WATER METER COUNT / WATER METER SIZE �
HEAT (Circle all that apply Oil Coal Fireplace Electric
Commercial Buildings & ADariments with 3 or more units Only
BUILDING ESTIMATE $
PLUMBING ESTIMATE $
STORM WATER LENGTH
FRONT FOOTAGE
STRUCTURES
DESCRIPTION
USE _
BEDROOMS
UNITS
NON CENSUS
OCCUPANCY LOAD,
EXITS
SETBACKS
FRONT SIDE
CONSTRUCTION
ROOF
SANITATIONMETHOD_
HEAT
FLOOD ZONE
FENCE TYPE
OCCUPANCY l
SIDE BACK
2