HomeMy WebLinkAboutAPPLICATIONS, CO, BP - 06-00452 - 140 E 2nd N - Addition•
C1 Ty OF - -- Certificate of Occ
: xB v upancy
Americo} Family Community City of Rexburg
Department of Community Development
19 E. Main St. / Rexburg, ID. 83440
Phone 208 359 -3020 / Fax 208 359 ,3024
Building Permit No:
0600452
Applicable Edition of Code: International Building Code
Site Address: 2006
Use and Occupancy: 140 E 2nd N
Type of Construction: Single Family Residential Addition
Design Occupant Load: Type V, non -rated
N/A
Sprinkler System Required: No
Name and Address of Owner: Bell Sheryl
140E 2N
Rexburg, ID 83440
Contractor:
Garon Bell
Special Conditions: Single Family Residential Addition of 52
and 520 sq. ft. of unfinished basement. 0 sq' ft. first floor area,
Occupancy:
Residential - 2 units or less, permanent in nature
This Certificate, issued pursuant to the requirements of S
Code, certifies that, at the time time of issuance, this building or that o
was inspected on the date listed was found to be >09 of the International Building
code for the group and division of occupancy and the use in comp /lance with the requirements of the
Portion of the building that
was classified. for which the proposed occupancy
Date C.O. Issued: July 08,3
(02:17P
C.O Issued by:
,
There shall be no further change in the existing occupancy classification of the building nor shall a
modifications or additions be made to the building or any portion thereof until the Building Official has revie
approved said future changes. any structural changes,
wed and
Plumbing Inspec
Fire Inspector: /1/�
Electrical Inspector-
P&Z Administrator _�
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0 INSPECTION TICKET
❑ Bldg. ❑ Plumb. 0 Elect. ❑ Mech. ❑ Fire
Inspection Request: Rec'd By GIGO' Date q411
Req. By Phone No. 7' %3 -
Project Permit No. aa riny
Address _�(� �, ;�,( N -
Inspection Type > -- 1 11/9',/
Day !rime Req. �,LCIL?� zLeZo
Inspector's Report Res. ❑ Comm.
INSPECTED ITEMS CONFORM TO APPROVED DWGS ❑Y ❑ N 9NIA
INSPE TOR'S ACTION
APPROVED El DISAPPROVED E] FINAL
C.O. (FINAL) ❑ NOT APPLICABLE ❑ DID NOT INSPECT
ACTION REQUIRED:
Sign
Rec't Acknowledged
WhOe - 01ke Copy
F- FIR -CO03
*Now - Job Copy Pink . Ir F r IS Copp
0 INSPECTION TICKET*
,� Bldg. ❑ Plumb. ❑ Elect. ❑ Mech. ❑ Fide
Inspection Request: Rec'd By Date
Req. By ! Phone No. 3 ,1611 J�
Project Permit No. t`0 r0y5 Z
Address —� G% C: UL211L1
Inspection Type ?A
Day /Time Req. tz/o
Inspector's Report Res. ❑ Comm.
INSPECTED ZN TION CONFORM TO APPROVED DWGS
INSPECTO
P OVED O DISAPPROVED
C.O. (FINAL) ❑NOTAPPLICABLE
ACTION REQUIRED:
❑ N ❑ N/A
Ej FINAL
❑ DID NOT INSPECT
White - Office Copy Me4ow - Job Coq PirA - Inspecim s Copy
F- FIR -CO03
Building Safety Department o4 AEXB UkC,
City of Rexburg �` s
s� o
19 E Main ionellh@rexburg.org Phone: 208.359.3020 x326
Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3024
CITY O F
REXBURG
Americas Family Community
OWNER'S NAME C- jCWQ V1 i Permit #06 00497
PROPERTY ADDRESS 1 4U
SUBDIVISION 140 E 2nd North
PHASE LOT BLOCK
HOME OWNER'S ELECTRICAL PERMIT
Home Owner's Name
Address �"" City tate _Zi
Z p
Cell Phone Home Phone, G�)
a
Fax ( ) Email
TYPES OFINSTALLATION(RESIDENTIAL)
(New Residential includes everything contained within the residential structure and attached garage at the same time)
Up to 200 amp Service*
201 to 400 amp Service*
Over 400 amp Service*
Temporary Construction Service, 200 amp or less, one location (for a period not to exceed 1 year)
Existing Residential (# of Branch Circuits)
Spa, Hot Tub, Swimming Pool
Electric Central Systems Heating and /or Cooling (when not part of a new residential construction permit
and no additional wiring)
Modular, Manufactured or Mobile Home
Other Installations: Wiring not specifically covered by any of tb.-� 6L acD rnp•
Cost of Wiring & Labor: $ ` 1
Pumps (Domestic Water, Irrigation, Sewage)
Requested Inspections (of existing wiring)
Temporary Amusement /Industry
*Includes a maximum of 3 inspections. Additional inspections charged at requested inspection rate of $40 per hour.
Se " "��. d am ' <'`: /`/ / � ✓ �� . %`"� f
Signatur6'orHome Owner
The
schedule is the same as
Date
the State of Idaho
G
CITY .OF KEXB UAG • S
BUILDING PERMIT APPLICATION Pll 0600452 ion!
19 E MAIN, REXBURG, ID. 83440 If c 140 E 2nd N -Bel I Addition icable
208 - 359 -3020 X326
PARCEL NUMBER: � X 1o?1 1 N (We will provide this for you)
SUBDIVISION: UNIT# BLOCK# LOT#
(Addressing is based on the information - must be accurate)
UW-NEW NAME. d` v 1 -' CONTACT PHONE # 1-/
PROPERTY ADDRESS: // 1
PHONE #: Home
Work ( ) ., � dl/' y� J � � Cell ( )
OWNER MAILING ADDRESS: f �I G` V CITY: A
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
CITY:
STATE; ZIP EMAIL FAX
PHONE #: Home ( ) Work ( ) Cell( )
CONTRACTOR
MAILING ADDRESS: CITY d < / STATE ZIP. L
PHONE #: Home Work( ) ��� Cell ( ) /rZZ
T
AX IDAHO REGISTRATION # & EXP. DA
piny buildings are located on this property? �_3
Did you recently purchase this property? Yes (If yes give owner's
Is this a lot split? YES (Please bring copy of new legal descripi
PROPOSED USE:
(i.e., Single Family Residence, Multi
mily, Apartments, Vmodel, Garage, Commercial, Ac
EP 15 2006
RURG
APPLICANTS SIGNATURE, CERTIFICATION AND AUTHORIZATI I� Vkdlr xe y 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 2003
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 withi 1180 days. Permit void if work stops for 180 days.
Signature of Owner /Applicant 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 fanuarvl. 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 your check does not clear**
2
Buildit Safety DepartmentV aEXaUR�
y o`` CITY OF
City of Rexburg 7�
° REX
0
19 E. Main janellh@rexburg.org Phone: 208 Americas Family Community
Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3024
Affidavit of Legal Interest
State of Idaho
County of Madison
I, 2
N me
City
Address f f
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 ap lication.
A
Dated this j /% 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:
3
Please complete the Atire A ! 40
p A
If the question does not apply fill in NA for non applicable
NAME ` L ,
PROPERTY ADD SS L l _-'
SUBDIVISION Z
Dwelling Units: Parcel Acres:
SETBACKS
FRONT
SIDE SIDE
Permit#
CK
Remodeling Your Building /Home (need Estimate $ "' IX�
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
Third floor /loft area Garage area
Shed or Barn Carport /Deck (30" above grade)Area
Water Meter Quantity:
* * * * * * * * * * * ** *Water Meter Size: ��.i'Gt`f t
RequiredLY
PLUMBING f
Plumbing Contractor's Name: Business Name:
Address City State Zip
Contact Phone: ( ) Business Phone: ( )
Email Fax
FIXTURE COUNT (including roughed fixtures
V Clothes Washing Machine Sprinklers
Dishwasher Tub /Showers
Floor Drain Toilet /Urinal
Garbage Disposal Water Heater
Hot Tub /Spa Water Softener
Sinks (Lavatories, kitchens, bar, mop)
Plumbing Estimate $ (Commercial Only)
Signature of Licensed Contractor License Number& Expiration Date 15ate
The City of Rexburg's permit fee schedule is the same as r equired by the State of Idaho
El
Please; complete the entire Application! If the question does not apply fill in NA for non
applicable
NAME
PROPERTY ADD S _; Permit#
SUBDIVISION G
Required!!! MECHANICAL
Mechanical Contractor's Name: Business Name:
Address
Contact Phone: (
_City State Zip
Business Phone: ( )
Email F
Mechanical Estimate $ (Commercial /Multi Family Only)
FIXTURES & APPLIANCES COUNT (Single Family Dwelling Only)
Furnace Exhaust or Vent Ducts
Furnace /Air Conditioner Combo
Heat Pump
Air Conditioner
Evaporative Cooler
Unit Heater
Space Heater
Decorative gas -fired appliance
Incinerator System
Boiler
Pool Heater
Fuel Gas Pipe Outlets including stubbed in or future outlets
Inlet Pressure (Meter Supply) PSI
Dryer Vents
Range Hood Vents
Cook Stove Vents
Bath Fan Vents
other similar vents & ducts:
Heat (Circle all that apply) Gas Oil Coal Fireplace Electric Hydronic
Mechanical Sizing Calculations must be submitted with Plans & Ayahcation
Point of Delivery must be shown on plans.
Signature of Licensed Contractor
The City of Rexburg s
License number
schedule is the same as
Date
the State
5
• •
SUBCONTRACTOR LIST
Excavation & Earthwork:
Masonry:
Roofing:
Insula
Floor
Heating:
Special Construction
(Manufacturer or Supplier)
Roof Trusses:
Floor /Ceiling J
Siding /Exterior
-lr 1-
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.iboLidaho.gQy /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
02)