HomeMy WebLinkAboutCO, APP & PLAN - 04-00425 - Liquid Barters - RemodelCITY OF
R.EXBURG
AM[RK A5 FAMILY C_QMMUNiry
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:
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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
0400425
40 College Ave
Noc �Cor��cr�t��2� 'Re- r��c -��
Owner
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 vtos found to be in compliance vuth the requirements of the code
for the group and division of occupancy and the use for ttihich the proposed occupancy Ines
classified.
Date C.O. Issued: May 03, 2005 (10:16AM)
C.O Issued by:
Building Official
There shall be no further change in the existing 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 Department 1 Fire D
State of Idaho Electrical Department (208- 356 - 4830):
CITY OF REXBURG
BUILDING PERMIT APPLICATION
19 E MAIN, REXBURG, ID. 83440
208 - 359 -3020 X326
PARCEL NUMBER:
PERMIT #
Please complete the entire Application!
If the question does not apply fill in NA for non applicable
SUBDIVISION: UNIT# BLOCK# LOT#
OWNER: / • �� u CONTACT PHONE # a yo 3- S�2 C3
PROPERTY ADDRESS: �l O Col / t
PHONE #: Home ( Work V99 q2 /vel a- Cell 3 y aa y
OWNER MAILING ADDRESS: a•S I c � l k S. CITY: t 4v� STATE T ZIP:
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
a CITY: STATE; ZIP
PHONE #: Home ( ) Work ( ) Cell ( )
CONTRACTOR:
PHONE: Home#
MAILING ADDRESS:
CITY
Work# Cell#
STATE ZIP
How many houses are located on this property?
Did you recently purchase this property Yes (If yes give owner's name) _kJ
Is this a lot split ?( N( YES (Please bring copy of new legal description of property)
PROPOSED USE: S r ''� S 5
(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 v!!thays.ityod jf w for 180 days.
Applicant
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"
t
J
NAME
PROPERTY ADDRESS
SUBDIVISION
Dwelling Units:_
Front Footage (if applicable)
Parcel Acres:
Permit#
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
Remodel (Need Estimate) $
Unfinished Basement area
Finished basement area
Garage area
Carport/Deck (30" above grade)Area
PLUMBING II
PLUMBERS NAME 5 4 -- r- V e (10 ty ADDRESS_
CITY � e x Io � STATE T � ZIP SS 3 , -i z-! aPHONE (
FIXTURE COUNT
) - �.5(- C/ / / I
CLOTHES WASHING MACHINE SPRINKLERS _
DISHWASHER TUB /SHOWERS _
FLOOR DRAIN TOILETIURINAL
GARBAGE DISPOSAL WATER HEATER
HOT TUB /SPA WATER SOFTENER _
SINKS
(Lavatories, kitchens, bar, mop)
WATER METER COUNT
WATER METER SIZE
HEAT (Circle all that apply) Gas Oil Coal Fireplace Electric
with 3 or
BUILDING ESTIMATE $
PLUMBING ESTIMATE $
STORM WATER LENGTH
FRONT FOOTAGE
STRUCTURES
DESCRIPTION
USE
BEDROOMS
UNITS
NON CENSUS
OCCUPANCY LOAD
EXITS
SETBACKS
FRONT SIDE SIDE
CONSTRUCTION
ROOF
SANITATIONMETHOD
HEAT
FLOOD ZONE
FENCE TYPE
OCCUPANCY /
BACK
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