HomeMy WebLinkAboutAPPLICATIONS, CO, MULT DOCS - 08-00440 - Boice Building #2 - New BuildingC i T Y 0 F_ Certificate of Occupancy
X City of Rexburg
AmerirasFami Department of Community Development
19 E. Main St. / Rexburg, ID. 83440
Phone 208 359 -3020 / Fax 208 359 -3024
Building Permit No: 0800440
Applicable Edition of Code: International Building Code 2006
Site Address: 1087 Summers Dr
Use and Occupancy: Premier Therapy Tenant Finish
Type of Construction: Type V, non -rated
Design Occupant Load: 51
Sprinkler System Required: No
Name and Address of Owner: Dry Fly Properties Llc
P O Box 336
Rexburg, ID 83440
Contractor: Fillmore Construction
Special Conditions:
Occupancy: Business - office, professional or service transactions
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
was inspected on the date listed was found to be in compliance with the requirements of the
code for the group and division of occupancy and the use for which the proposed occupancy
was classified.
Date C.O. Issued: October 05 2010 (03:50PM)
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.
Plumbing Inspector: Fire Inspector
Electrical Inspector: P &Z Administrator
4t
Building Safety Department
aF gexeupc
City of Rexburg �° °,� c t Ty o
19 E Main janellhCa?rexburg.org REXB
Phone: 2 08.359.3020 x326 E
URG
Rexburg, ID 83440 www.rexburg.org ____.�_ Ow
g g Fox: 208.359.3024 o America's Family Community
OWNER'S NAME
PROPERTY ADDRESS 0800440
SUBDIVISION 1087 Summers Dr.
PHASE LOT ► �_ BLOCK
Service
Requlre&q ELECTRICAL
Electrical Contractor's Name C
R l fz'' Business Name Address
' � / 77 City i �p
State. Zi zC ��.�
Cell Phone Z 1 i � ' 3/ 3 �oL 3 - Business Phone Phone 7% -300-31 Fax 7 ! 7T 7 Z
Electrical Estimate ( cost of wiring &labor) $
(Includes the cost (r�nM MERCIAL MULTI - FAMILY ONL
of materials installed regardless of the party supplying it). O_-= Y)
TYPES OFINST TION
(New Residential includes everything contained within the residential structure and attached garage at the same time)
❑ *Up to 1,500 sq ft - $72 RESIDENTIAL ONLY
❑ *2,501 to 3,500 sq ft - $168 ❑ *1,501 to 2,500 sq ft - $120
❑ * *Over 4,500 sq ft - $216 plus $-04 ft: ❑ *3 ,501 to 4,500 sq ft - $216
❑ Existing Residential (# of Branch Circuits sq ft total
- $40 plus $10 per circuit: # of circuits
Temporary Construction Service, 200 amp or less, one location (for a period not to exceed
0,
1 Yew) - $40
❑ Spa Hot Tub
wimmmg Pool - $'+v plus $40 grounding grid where
Electric Central Systems Heating and /or Cooling (when notpart ofa new r
and no additional wiri S) - $4.0
Modular, Manufactured or Mobile Home - $50 plus $10 per circuit
Other Installations: Wiring not ecifically covered by any of the ab
Cost of illiring dam' Labor.
Pumps ps (Domestic Water, Irrigation, Sewage): (Includes the cost ofmater
g) horse p _
• Requested Inspections (of existing wiring) - $4.0/h (1 hr tninitnum) plus $40 /hr thereafter
• Temporary Amusement /Industry - $40 plus $10 per ride, concession or generator
Includes a maximum of 3 inspections. Additional inspections charged at requested inspection rate of $40 per hour.
* Includes a maximum of 4 inspection, Additional inspections charged at requested inspection rate of $40 per hour.
— i1 /
of Licensed Contractor
L icense number
A
�' C IT Y OF _
RE 6 Please CompAete the Entire Application!
.Americas Fbmily t;t >mntuniry
COMMERCIAL & MULTI FAMILY BUILDING I
19 E MAIN, REXBURG, ID 83440
208 - 359 -3020 X326
08 0043 9 & 08 00440
Boice Bldg #2
1087 Summers Dr
PARCEL NUMBER: N ( 14 (We will provide this for you)
SUBDIVISION: — ® G UNIT# BLOCK# LOT#
(Addressing is b ased on the inform' ation - must be accurntP)
— CONTAC T
HONE # /�- -
PROPERTY ADDRESS: Me � �C ,�� S
PHONE #: Home ( ) ��C/ _ �jork Cell ( )
OWNER MAILING 4` �,�fJX � CI7 Y; c STATE ZIP:�Z�
EMAIL e C' 67 l /�Q'.rde FAX r�.���
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 Lf // y,,
MAILING ADDRESS: 3 /l/ CITY STATE ZIP s 3tl
PHONE: Cell# 39 " � S'I Work# G `� .. Fax# 1'
yS
EMAI i lJ t�c�o (2 > ,L. DAHO REGISTRATION # & EXP. DATE
How many buildings are located on this property?
Did you recently purchase this property? No Yes (If yes, list previous owner
Is this a lot split. NO ) YES (Please bring copy of new legal description of
PROPOSED USE:
(i.e., Single Family Residence, Multi Family, Apartments, Remodel
) SEP — �v
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATIO gle " " ereby have read this application and state that the information herein is correct and I swear that any information which may hereafter e given by me in hearings before tthe that I
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 a was based. Pemiit void if not started within 180 days. Permit void if work stops for 180 days.
Signature of ner /�lpplica "'' !�A
Do you prefer to be tacted by fax, email or o ? Circle One
WARNING — BUILDING P T MUST BE POSTED ON CONSTRUCTION SITE!
Plan fees are non - refundable and are paid in full at the time of application beginning ja-uaOL 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**
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Building Safety Department s XeU��
4 i CITY OF
City of Rexburg
REXBURG
^„ ..._....._..._._.__. OW _.......__._.....,...._
19 E. Main ionellh@rexburg.org Phone: 208.359.3020 ext 326 Americas Family Community
Rexburg, ID 83440 www.rexburg.org Fax. 208.359.3024
Affidavit of Legal Interest
State of Idaho
County of Madison
I,
Name
City
Being first duly sworn upon oath, depose and say:
l ye) z)e,
Address
State
(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 w 'ch is the subject of the application.
Dated this day of /4 't , 20 t9 Q�
Signature
Subscribed and sworn to before me the day and year first above written.
\ ......
P
............ �IDT
Notary Pughc of
My commission expires: 6 / I / J
Z
FROM FAX NO. :2087854905 . .Sep. 02 2008 10:42RM PI
Sep 02 00 08:238
P.1
Building Safety Department
CHY of Rexburg
19 E M;y(: iu-'&v1QvteAbv, of g
10 A.14AC. a -
Ptiona 7QB SS4. v X320
)lox! 2flk wv>�
RemodeRag YoutiffulldioWlHoorne (nc L
.Exet
/y 7s C I T V 0 1:
REmu RG
SURFACV, SQUAREFOMAGE. • indude the rxrc6r m
easurt.-nems of the builel
nig
First Floor Area
Second floor /left Atvu Firtishtd bawment ore.
Third fioat/!oft sizeft Ga uge azca-- C)
Shed or Barr—__ Ca--Port[Deck Ws abm g=de)AIC . a
Water Meter Quantity. WgLter Meter size:
J�e
Req rifff
UITC....
P T, T IMB IA rG
Piun*irig Conustctoes 1%;ame
Address
Contact Phone; Business Phove:,'
T 7—V CO
sprinma"
Dishwasher
TLII/Showers
9 , Plf.-^x Dwain
I Ga! Dagc uisposat
A Hwel
Hot Tuh/sju wa!e-- Softener
(1-vatories, kitchens, bar, mop\,
Plumbing Estimate A (CommnevcW Only)
7
C1 - 0z'- jj
Sep utf utf 1 l ,U /a
(208) 524 -0801 p.1
Building Safety Department
City of Rexburg
19 E Moin ione#h@rexburg. org Phone: 208.359.3020 x326
Rexburg, 083440 www.rexburg.org Fox: 208.359.3024
of pExaa,�e,
CITY OF
REXBURG
Ameriea; fami)y Con:n:uriitc
OWNER'S TAME
PROPER'T'Y ADDRESS
SUBDnzSION
PH, -kSE LOT BLOCK
MECHANICAL
Requiredr!!
Mechanical Contractor's Name: .a ICS t4nlws) Y` Business Name: I.), 5 L�� 1 �„r ZV1
Address t J, ;�'
Lrn,� ,� City XJ -0— E . (L S Srate -- Z - , A . Zip , ) 1 a
Contact Phone: ( ) - U ISI Business Phone:
Email bs btu J c j rO . V 1 Fax
Mechanical Estimate $ 24 00 (Commercial /Multi Family Only)
FIXTURES & APPLIANCES COUNT" (Single Family Dwelling Only)
Furnace c�_ Exhaust or Vent Ducts
c�. Fumace /Air Conditioner Combo Dry Vents
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
it
J l Inlet Pressure (Meter Supply) PSI
other similar vents & ducts:
Heat (Circle all that apply) Gas Oil Coal Fireplace Electric Hydronic
R uir Signature of Licensed Contractor License number
1 7 l o
Date
Permit#
Range Hood Vents
Cook Store Vents
Bath Fan Vents
a
SUBCONTRACTOR LIST
Excavation is Earthwork:
Gt U -eL^ ccv ),
Concrete: k� C 1� C t` t'
Masonry: 'w L'(✓ C-�
Roofing: 4�/`
Insulation: J �_ W
0
9
Floor
Coverings:
Hea
LC/C
Roof Trusses:_
Floor /Ceiling Joi
Siding /Exterior 7
Other:
Special Construction
(Manufacturer or S ppli
k CCU
Sow I
/I & f
R