HomeMy WebLinkAboutAPPLICATIONS, CO, MULT DOCS - 07-00214 - 782 Griffin St - New SFRZ
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Fro 4exsugGr' CITY o Certificate of Occupancy
REX City of Rexburg
��►► `
Ameriut's Fam il y Community Department of Community Development
Fam
19 E. Main St. / Rexburg, ID. 83440
Building Permit No:
Applicable Edition of Code:
Site Address:
Use and Occupancy:
Type of Construction:
Design Occupant Load:
Sprinkler System Required:
0700214
International Residential Code 2003
782 Griffin St
Residential
Type V, non -rated
Single Family Residence
No
Name and Address of Owner: Mccombie Ward Etux
-:374 Mariah Ave
Rexburg, ID 83440
Contractor: Owner /Lessee
Special Conditions: Unfinished Basement.
Occupancy: Residential - less than 2 units, permanent in nature
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
ws inspected on the date listed vees found to be in compliance with the requirements of the code
for the group and division of occupancy and the use for %hich the proposed occupancy v►es
classified.
Date C.O. Issued: December 19, 2007 PM
C.O Issued by: Uhl
Building Official
There shall be no further change in the e)asting 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: A 14
Electrical Inspector: P&ZAdministrator: ��
CITY OF KEXB UKG
PERMIT # •
BUILDING PERMIT APPLICATION Please con
19 E MAIN, REXBURG, ID. 83440 If the question 4 0700214
208 - 359 -3020 X326
PARCEL NUMBER: - 1' "o`1 0 We will 782 Griffin- McCombie
SUBDIVISION: UNIT # " 0 LOT #�
(Addressing is based on the information - must be accurate)
N.CONTACT PHONE
PROPERTY ADDRESS: - TaL _GA%_ V-FIP ST.
PHONE #: Home ( ) Work ( ) Cell ( )
OWNER MAILING ADDRESS: Mega i(wn CITY: F-ex STATE:M>ZIp: 2a4
EMAIL �TOnt JO Dy I OM n Q ma. i I C o N 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
PHONE #: Home (
EMAIL FAX
Work (
Cell (
CONTRACTOR
MAILING ADDRESS: CITY STATE ZIP
PHONE #: Home ( ) Work ( ) Cell ( )
EMAIL FAX IDAHO REGISTRATION # & EXP. DATE
How many buildings are located on this property?
Did you recently purchase this property? No Yes (If yes give owner's name) f uj�
Is this a lot split? � YES (Please bring copy of new legal description of property)
PROPOSED USE: 1
(i.e., Single Family Residence, Multi y , Apartme , Remodel, Garage, Commercial, Addition t .
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: n pern pc' ju}y, &7b
that I have read this application and state that the information herein is correct and I swear that any inform. h may hereafter be given by
hearings before the Planning and Zoning Commission or the City Council for the City of Rexburg shall be tri thful md correct. I agree to compli
City regulations and State laws relating to the subject matter of this application and hereby authorized represe tati e
n e
mentioned property for inspections purposes. NOTE: The building official may revoke a permit on approv is u r r oX
InternationA Code in cases of any false statement or misrepresentation of fact in the application or on the pl
based. Per qt void if not started within 1V days. Permit void if work stops for 180 days.
a ) 6A�l� � Zl _ /� /�
Signature of Owner /Applicant DATE
Do you prefer to be contacted by fax, "� "`ry"r 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 TanuarE 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 your check does not clear**
Bull
g Safety Department
City of Rexburg
19 E. Main
Rexburg, ID 83440
joneiih@rexburg.org Phone: 208.359.3020
www.rexburg.org Fax: 208.359.3024
Y pEXBUR C � O
U �
C I T Y O F
REXBURG
Americas Family Community
Affidavit of Legal Interest
State of Idaho
County of Madison
I, (K ) tA-dzyll� k 7 �f Mar tA
Name Address
City
Being first duly sworn upon oath, depose and say:
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 herein or as to the
ownership of the property which is the subject of the application.
Dated this day of Kay .20 0
1-
Subscribed and sworn to before me the day and year first above written.
LYNDF�NjERRILL Notary P'' c of Idaho
NOTARY PUBLIC
STATE OF IDAHO
Residing at:
My commission expires:
0
Please complete the entire Application!
NAME w I ` I tY �AC 61bb
PROPERTY ADDRE S ASS• 6i ffin
SUBDIVISION Y . W %11 til 3
Dwelling Units:
Parcel Acres: 0 . C� 3
•
Permit#
SETBACKS , ; 1 f
FRONT Q SIDE' I (� SIDE I - BACK
Remodeling Your Building /Home (need Estimate $ tJJ A Igo on
SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building)
First Floor Area ' I Unfinished Basement area
Second floor /loft area N Finished basement area
Third floor /loft area Garage area
Shed or Barn Carport /Deck (30" above grade)Area
Water Meter Quantity: * * * * * * * * * * * ** *Water Meter Size:
Requiredffl
PLUMBING
Plumbing Contractor's Name:
Address
Contact Phone: - 35 - 1 - 3 7 V c� Business Phone: (�o�j ` -3 f D a 5� 7 VO
Email
FIXTURE COUNT CmcludWg toy ghed fixtures
Clothes Washing Machine
Dishwasher
I Floor Drain
I Garbage Disposal
Hot Tub /Spa
S Sinks (Lavatories, kitchens, bar, mop)
Sprinklers
� Tub /Showers
" Toilet / Urinal
I Water Heater
I Water Softener
Plumbing Estimate $ if A 1 0.- co O (COMMERCIAL /MULTI - FAMILY ONLY)
-3 �
Signature of Licensed rontractor License Number& Expiration Date Date
The City of Rexburg's permit fee schedule is the same as required by the State of Idaho
Please complete the entire App lication!
NAME �P 20ronq o VI v
PROPERTY ADD SS Permit#
SUBDIVISION r -S 0 n
Requiredffl MECHANICAL
Mechanical Contractor's Name l— Business Nam / t a z ,
Address -3 2Z0 9 n 3000 Z✓ , City VY State Zip f � L(
Cell Phone pA ✓?' /, t) a 2) k, Business Phone 06 _U
77 p�
Fax V� Email b h
Mechanical Estimate $ (Commercial /Multi Family Only)
FIXTURES & APPLIANCES COUNT (Single Family Dwelling Only)
Furnace
T — Furnace /Air Conditioner Combo
Heat Pump
Air Conditioner
Evaporative Cooler
Unit Heater
/ Exhaust or Vent Ducts
Dryer Vents
Range Hood Vents
Cook Stove Vents
Bath Fan Vents
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
other similar vents & ducts:
Heat (Circle all that app Gas )Oil Coal Fireplace Electric Hydronic
Mechanical Sizing Calculations must be submitted with Plans & Aptilication
Point of Delivery must be shown on plans.
z �/J. z? 1j S /4?S7
Signature of Licensed Contractor Incense number Date
The 00 of Rexburg's permit fee schedule is the same as required by the State
•
SUBCONTRACTOR LIST
Excavation & Earthwork:
re
Masonry: V teS /•f"1 / _
Roofing: C"i, W l/
Insulation: B C V�
Drywall: V'?.syA 6ALSbIu6ms
Painting: F. DMP, 4b�
Floor
Coverings:
Plumbing: MailS
Heating: s er, V'1"
Electrical: &U - 1
Special Construction
(Manufacturer or Supplier)
Roof Trusses V mm1 F" Tr l z
Floor /Ceiling Joists: - 9 tAC,
Siding /Exterior Trim: PmIfi; PAZ,
. . 9 9
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.
(I'his 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.ibol.idaho.gov /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.
Signatures mc)
Print Name
Date