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HomeMy WebLinkAboutALL DOCS & CO - 10-00305 - Henderson Apartments - Bldg #1, 20 Units4" µEX6UR G , lO C i I }.. -F. Certificate of Occupancy U REXBURG City of Rexburg Amc"!«a; llmul,v communit, Department of Community Development 35 N. 1st E. / Rexburg, ID. 83440 Phone (208) 359 -3020 / Fax (208) 359-3022 Building Permit No: 1000305 Applicable Edition of Code: International Building Code 2006 Site Address: ** No Situs Address Information On File ** Use and Occupancy: Henderson Apartment Building #1 Type of Construction: Type V, non -rated Design Occupant Load: N/A Sprinkler System Required: No Name and Address of Owner: Henderson W R Etux P O Box 190 Rexburg, ID 83440 Contractor: Headwaters Construction Company Special Conditions: Occupancy: Residential - 3 or more units primarily permanent in nature (apts) 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 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: 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 Inspect4 Fire Ins P ector: Electrical Inspe x P &Z Administrator Y-- 10 6-C, rz�v' � .e-'1. d e JM c eA' � �4LQ v:F c tE33a.3 um11111 013S9S3 s. s't R P /E6 Ng Address Assignment- Form City of Rexburg ❑ City of Sugar City ❑ Madison County Name: 4,,A1A�r�6Y1 A ssigned by: ❑ Current Address Address:_ Subdivision: City Block: , Date: J-1/p El Parcel No. Parcel No. R�� Sote(a O Block: Lot: Block: Lot: New Address: eta �.�-ps m oo p Additional Information: ❑ Legal Description 4 �G S B 1, �o r� C 1 1 Y 0 RE 3 tom, Please Co to the Entire Application! n If the question does apply fill in NA for non applicable �� rlr9rer Far�aily C;cs�i��at!'rtid�' COMMERCIAL & MULTI FAMILY BUILDING PERMIT APPLICATION 35 N V E, REXBURG, ID 83440 208 - 372 -2326 PARCEL NUMBER: (We will provide this for you) SUBDIVISION: UNIT# BLOCK# LOT# is based on the intormation - must be accurate OWNERN"E. BVH I, LLC (W. R. Henderson) CONTACTPHONE # _ (208) 356 -0764 PROPERTY ADD PHONE #: Home ( Northeast Corner of 7th South and 2nd West N/A Work (208) 356 -0764 Cell PO 351 -2674 OWNER MAILING ADDRESS: P.O. Box 51298 CITY: Idaho Fall STATE: ID ZIP: 83405 EMAIL kelly@wrhcon.com FAX (208) 356 -9972 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 .( ) - s Cell ( ) CONTRACTOR Headwaters Construction Company - — -- MAILING ADDRESS: _ 175 So 2nd West CITY Rexburg STATE ID ZIP 83440 PHONE: Cell# (208) 313 -1058 Work# (208) 787 -8040 Fax# (208) 787 -8017 lbingham @headwater o EMAIL fbw( wn REGlS'TRATION # & EXP. DATE RCE2339 12/14/2010 How many buildings are located on this property? Five Did you recently purchase this property? No Yes (If yes, list previous owner's name) No Is this a lot split. NO YES (Please bring copy of new legal description of property) PROPOSED USE: Henderson BYU -I Approved Student Housing (i.e., Single Family Residence, Multi Family, Apartments Remodel, Garage, Commercial, Addition, Etc.) - CIRCLE ONE APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: under penalt of perjur I hereb 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 ay 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 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. / , ` k 4 ss�� 08 12 / 2010 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 anmm 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** 2 Building Safety Department City of Rexburg 35 N 1st E Phone: 208.372.2326 Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3022 C I T Y O P REXBURG OW Ameriau Family Community f U s Affidavit of Legal Interest State of Idaho County of Madison I, W. R. Henderson P.O. Box 376 Name Address City Rexbur Id State Being first duly sworn upon oath, depose and say: (If Applicant is also Owner of Record, strap 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 which is the subject of the application. Dated this 13th day of August , 20 10 q�A e--.,N CN Signature Subscribed and sworn to before me the day and year first above written. . A Notary Public of Idaho ° Residing at: Rexburg, ID e My commission expires: 02/28/2012 3 Builaing Safety Department City of Rexburg 35N WE Phone: 208.372.2326 Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3022 i CITY OF J.� REXBURG A Family Community Property Lines Each site plan that is submitted to the City of Rexburg for the Building Permit process requires that property lines are shown accurately. It is the Developer's responsibility to correctly identify on the site plan the location of these lines in reference to the public right -of -way, other adjoining property lines, the street, other structures and all utility lines. The Developer should find property pins that are still available at the lot in question. If these pins do not exist or have become unrecognizable then a new survey should be performed. Accurate property line information is a must for a timely review. In addition to finding existing property pins, legal descriptions should be checked. The best way to identify property line location is with a land survey. The City of Rexburg has aerial photos and a parcel line layer that can be checked, but they are only a tool and are not guaranteed for accuracy. If you want to request a copy of your lot, see the front counter at the Community Development Department. I have read and understand the above requirements. ISE I August 13, 2010 Signature Date W. R. Henderson Printed Name 4 Heather Dowd 435 -563 -1414 (2/7) 12/16/2010 13:52:49 -0700 Building Safety Depadment City of Rexburg 35N Isr E Phone: 208.372.2326 Rexburg, 1D 83440 www.rexburg.org Fax: 208.359.3022 oY pY,xu !; n V G s{ C I T Y O F REXB -- -- CW Amerkan Fmuib Conimurrity NAME PROPERTY ADDRESS 2c w - 'lam S . Permit# 1 SUBDIVISION -AA Require ! MECHANICAL Mechanical Contractor's Name: ��_ "usiness Name. Address 31`15 1,'S. (J3. City �460_ l-- State UT zip sVr - - l "t 9 Cell Phone: ( ) Business Phone: ( S(O3 -LQQta Fax. HL S) Sto Email Mechanical Estimate $11 �'� (Co Family Only) FIXTURES & APPLIANCES COUNT (Single Family Dwelling Only) Furnace 5 Exhaust or Vent Ducts Furnace /Air Conditioner Combo _Q Heat Pump Air Conditioner Evaporative Cooler Unit Heater Space_Heater Decorative gas -fired appliance Incinerator System Boiler Pool Heater Dryer Vents Range Hood Vents Cook Stove Vents Bath Fan Vents other similar vents & ducts: Fuel Gas Pipe Outlets including stubbed in or future outlets Heat (Circle all that apply) Gas Oil Coal Fireplace Electric Hydronic Mechanical Sizinz Calculations must be submitted with Plans & application Point of Delivery must be shown on plans. 0, " 1_1(cn 4 C -C.: 4Q 4 tDl 1 C� Signature of Licensed Contractor License number Date The City ofRexburr; s permit fee schedule is the same as required by the State ofldalw VI N & Building Safety Department City of Rexburg 35N ISrE ID 83440 WWW' Nor -E AEA -34 C rrw Phone: 208.372.2326 Fox: 208.359.3022 a �® U y _ , Fu C I T 4' O t' RFMUR Anwrica Farm() (gnrrraunrfy Remodeling Your Building /Home ( need Estimate $ SURFACE SQUARE FOOTAGE.- (Shall include the exterior wall measurements of the building) First Floor Area - 9 . 49 Unfinished Basement area Second floor /loft are 9L) I Finished basement area Third floor /loft area g , 4Lp 9 Garage area Shed or Barn Carport /Deck T (30" above grade)Area � -P lo(Sr- Water Meter Quantity: Size: 2 Contact Phone: 3 Email A L T )\I -P— 1 T),A- s FIXTURE COUNT (includingroWhed fixtures� Za Clothes Washing Machine 2 0 Dishwasher Z 0 Floor Drain 0 Garbage Disposal Hot Tub /Spa 0 Sinks (Lavatories, kitchens, bar, mop) Plumbing Estimate $ 56 ),000. (Commercial Only) Sprinklers �d Tub /Showers Toilet /Urinal Water Heater Water Softener e - 6 - -/n Re ed! Signa a of •censed Contractor License number Date Susiness Phone: (4) 367 6 13 Fax 2-06 =35 7 3g�! 5 35NNE Rexburg, ID 83440 www.rexburg.org City of Rexburg Phone: 208.372.2326 Fox: 208.359.3022 ,,,� 0. •: B t ri t 4 OJ t, g :intrrt,�I: F:,t,.n, t.naur,u�t�h OWNER'S NAME �je.ncl��a� PROPERTY ADD RESS 2– �? ? t � SUBDIVISION Permit# 1000305 Henderson Bldg #1, 20 Units PHASE. _ LOT BLOCK 654 S. 2nd W. Permanent - t ' ir_ ed X ELECTRICAL I?lectrical Contractor's Name Cy c*-� -P Business Name cA(' k' aj`c Address_ L;, , 1 � X z ;; Z City R" !- i r State "�,� Zip 2 c t Cell Phone per) Business Phone Email /' a-��- c�,.t6e= 21,E -,t"'I .1 .K6trt/1 Electrical Estimate (cost of wiring & tabor) $ Z— (COMMERCIAL ONLY) (Lrc /odes the cost o/ nwterialr installed regardless of the party .supplying it). TYPES OF INSTALLATION (Nen Residential includes everything contained within the residential structure and attached garage at the same time) RESIDENTIAL ONLY ❑ *Up to 1,500 sq ft - $72 ❑ *1,501 to 2,500 sq ft - $120 ❑ *2,501 to 3,500 sq ft - $168 ❑ *3,501 to 4,500 sq ft - $216 ❑ * *Over 4,500 sq ft - $216 plus $.04 /sq ft: sq ft total ❑ Existing Residential (# of Branch Circuits) - $40 plus $10 per circuit: # of circuits ❑ Multi- Family Only: # of units ( per building - $120 /bldg + $60 /unit • Services: Alterations /Repairs that require utility disconnection. (Estimate applicable for commercial). • Temporary Construction Service, 200 amp or less, one location (for a period not to exceed 1 year) - $40 �I ❑ Spa, Hot Tub, Swimming Pool - $40 plus $40 grounding grid where applicable ti n l "lectric Central Systems Heating and /or Cooling (when not part of a new residential construction permit and no additional suiting) - $40 ❑ Modular, Manufactured or Mobile Home - $50 plus $10 per circuit ❑ Other Installations: Wiring not specifically covered by any of the above: Cost o f Viring Labor. $ ( Includes the cost of materials installed regardless of the party supplyins it). ❑ Pumps (Domestic Water, Irrigation, Sewage): — horse power * Requested Inspections (of existing wiring) - $40 /hr (1 hr minimum) plus $40 /hr thereafter I I I "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 inspections. :additional inspections charged at requested inspection rate of $40 per hour. Y X A Signature of Licensed Contractor License number Date ' Building Safety Department � CITY OF City of Rexburg - - - - —� - -- REXB�RG 35 N lu E ---- - - - - -- cw - - -- - _....._ Phone: 208.372.2326 America's Family Corrn *t <iri�y Rexburg, ID 83440 www.rexburg.org Fox: 208.359.3022 OWNER'S NAME cif t PROPERTY ADD IS r u Permit# 1000305 SUBDIVISION /ffVU cr�� -c / o .s,�� -� 654 S. 2nd W. - 6 Pedestals PHASE LOT BLOCK Temporary Power Requlredlll ELECTRICAL Electrical Contractor's Name > Fj l- -► _ Business Name 'S T6_LA k"` Address Pot 'L>_ �C_ h . ,P!S State 71D — zip - 0 4 yk Cell Phone (_Z�5) -3 Business Phone Fax go©; 7�v _ 05 S 3 Email Electrical Estimate (cost of wiring & labor $ (COMMERCIAL ONLY) (Includes the cost of materzalr installed regardless of the party .supplying it). TYPES OFINSTALLATION (New Residentialiacludes everything contained within the residential structure and attachedgarage atthe same time) RESIDENTIAL ONLY ❑ *Up to 1,500 sq ft - $72 ❑ *1,501 to 2,500 sq ft - $120 ❑ *2,501 to 3,500 sq ft - $168 ❑ *3501 to 4,500 sq ft - $216 ❑ * *Over 4,500 sq ft - $216 plus $.04 /sq ft: sq ft total ❑ Existing Residential (# of Branch Circuits) - $40 plus $10 per circuit: # of circuits ❑ Multi - Family Only: # of units per building - $120 /bldg + $60 /unit ❑ Services: Alterations /Repairs that require utility disconnection. (Estimate applicable for commercial). 1 Temporary Construction Service, 200 amp or less, one location (for a period not to exceed 1 year) - $40 ❑ Spa, Hot Tub, Swimming Pool - $40 plus $40 grounding grid where applicable to Pte+` ❑ Electric Central Systems Heating and /or Cooling (when not part of a new residential construction permit and no additional wiring) - $40 ❑ Modular, Manufactured or Mobile Home - $50 plus $10 per circuit ❑ Other Installations: Wiring not specifically covered by any of the above: Cost of Wiring & Labor ,_ (Includes the cost of materials installed regardless of the party supplyi; ❑ Pumps (Domestic Water, Irrigation, Sewage): horse power • Requested Inspections (of existing wiring) - $40 /hr (1 hr minim 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 inspections. Additional inspections charged at requested inspection rate of $40 per hour. of U License number Date Contractor Apr 13 2011 10:51RM TETON MICROBIOLOGY LAS 2085223797 S M M I I v C MI o a� a O �h m p.3 F � GS Ea G] s Q , 1 3 E U p.3 F � GS Ea G] IAS EnviroChem 3314 Pole Line Rd.. Pocatello, ID 83201 Phone: (208) 237 -3300 . Fax: (208) 237 -3336 email: iasec3308@iasenvirochem.com • www.iasenvirochem.com EPA Laboratory Number: ID00952 Microbiological Analysis Report Ed Strom Construction Angie 534 Trejo Suite 200 Rexburg, ID 83440 Lab Sample ID: MO10177 -01 Jurisdiction: Collection Date: 10/28/10 11:47 Date Received by Lab: 10/28/10 16:00 Water System: - Ed Strom Construction Sample ID /Location: North Tire Hydrant Henderson Apts Collector Name: Collector Phone: (208) 356 -3577 Method Desc: SM9223 B P/A Colilert Cmp Name Result Analysis Daterrime Analyst Total Coliforms Absent /100 ml 10/28/10 17:00 GRP F soli Absent /100 ml 10/28/10 17:00 GRP Aux. Data Sample Type Code: C - Construction /Special Residual Chlorine: PWS Date of Original Positive: PWS Repeat Sample Location: Tag II/ Facility ID: A ;4 t' V V po; ��/ 10/29/2010 Signature of Laboratory Supervisor Date Page 1 of 2 Friday, October 29, 20 10 IAS EnviroChem 3314 Pole Line Rd.. Pocatello, ID 83201 Phone: (208) 237 -3300 . Fax: (208) 237 -3336 email: iasec3308@?iasenvirochem.com • www.iasenvirochem.com EPA Laboratory Number: ID00952 Microbiological Analysis Report Ed Strom Construction Angie 534 Trejo Suite 200 Rexburg, ID 83440 Lab Sample ID: MO10177 -02 Jurisdiction: Collection Date: 10/28/10 11:50 Date Received by Lab: 10/28/10 16:00 Water System: - Ed Strom Construction Sample ID /Location: South Fire I lydrant Hendersen Apts Collector Name: Collector Phone: (208) 356 -3577 Method Dese: SM9223 I3 P/A Colilert Cmp Name Result Analysis Date/Time Analyst Total Colilorms Absent /100 ml 10/28/10 17:00 GRP E. coli Absent /100 ml 10/28/10 17:00 GRP Aux. Data Sample Type Code: C - Construction /Special Residual Chlorine: PWS Date of Original Positive: PWS Repeat Sample Location: Tag #/ Facility ID: 10/29/2010 / 2010 Signature of Laboratory Supervisor Date Page 2 of 2 Friday, October 29, 2010 Procedure Upon completion of work, inspection and tests shall be made by the contractor's representative and witnessed by an owner's representative. All defects shall be corrected and system left in service before contractor's personnel finally leave the job. A certificate shall be filled out and signed by both representatives. Copies shall be prepared for approving authorities, owners, and contractor. It is understood the owner's representative's signature in no way prejudices any claim against contractor or faulty material, poor workmanship, or failure to com k!Bu!ildfin ving authority's requirements or local ordinances. Property name: Henderson Apartmen g I Date: Property address: NE corner 2 n d West 7 South Rexburg, ID 83440 Accepted by approving authorities (names): City of Rexburg, Idaho Address: 35 North I East, Rexburg, Idaho 83440 Installation conforms to accepted plans ® Yes ❑ No Equipment used is approved ® Yes ❑ No � If no, expla ucvla tioils: Has person in charge of fire equipment been instructed as to location of control valves and care and maintenance of this new equipment? ® Yes ❑ No If no, explain? Make Model Year of Manufacture Orifice Size Quantity Temperature Rating Globe GL -5610 Residential SSP— GL5610 0 h" 352 155° Tyco Tyco — TY -FRB HSW — TY3331 Air pressure /z" 5 155° Minutes I Seconds psi psi psi Minutes Seconds YES NO Without Q.O.D. With Q.O.D. ❑ ❑ ❑ ❑ If no, explain PIPE, AND FITTING Type of pipe: NFPA 13 Type of fitti ^gs: NFP A '. ? Ai A ID X4 VA7 Vri nv 'VT' nW 1111 YVATf117 Alarm Device Maximum time to operate through test connection Type Make Model Minutes Seconds FLOW POTTER VSF -R 0 30 Time to trip through test connection Water pressure Dry Valve Q.O.D. Make Model Serial No. Make Model Serial No. Time to trip through test connection Water pressure Air pressure Trip point air pressure Time water reached test outlet Alarm operated properl Minutes I Seconds psi psi psi Minutes Seconds YES NO Without Q.O.D. With Q.O.D. ❑ ❑ ❑ ❑ If no, explain J, Operation ❑ Pneumatic ❑ Electric ❑ Hydraulics Static Pressure Piping supervised ❑ Yes ❑ No Detecting media supervised ❑ Yes ❑ No Does valve operate from the manual trip, remote, or both ❑ Yes ❑ No Control stations? Inlet (psi) I Outlet (psi) Inlet (psi) Outlet( psi) Is there an accessible facility in each circuit If no, explain For testing? ❑ Yes ❑ No Make Model Does each circuit operate Does each circuit Maximum time to Supervision loss alarm? operate valve Operate release release? Minutes I Seconds ❑ Yes ❑ No I ❑Yes ❑ No Location Make And floor and Model Setting Static Pressure Residual pressure (flowing) Flow rate Inlet (psi) I Outlet (psi) Inlet (psi) Outlet( psi) Flow (gpm) Hydrostatic: Hydrostatic tests shall be made at not less than 200 psi (13.6 bar) for 2 hours or 50 psi (3.4 bar) above static pressure in excess of 150 psi (10.2 bar) for 2 hours. Differential dry -pipe valve clappers shall be left open during the test to prevent damage. All aboveground piping leakage shall be stopped. Pneumatic: Establish 40 psi (2.7 bar) air pressure and measure drop, which shall not exceed 1 ' /2 psi (0.1 bar) in 24 hours. Test pressure tanks at normal water level and air pressure and measure air pressure drop, which shall not exceed 1 ' /2 psi (0.1 bar) in 24 hours. All piping hydrostatically tested at 200 psi ( bar) for 2 hours If no, state reason Dry piping pneumatically tested ❑ Yes ❑ No Equipment operates properly ® Yes ❑ No Do you certify as the sprinkler contractor that additives and corrosive chemicals, sodium silicate or derivatives of sodium silicate, brine, or other corrosive chemicals were not used for testing systems or stopping leaks? ® Yes ❑ No Drain Test Reading of gauge located near water Residual pressure with valve in test Supply tcsi (A)MICcii�il. psi Contieciiun vpcia �Nide: psi ( bar) ( bar) Underground mains and lead in connections to system risers flushed before Other Connection made to sprinkler piping Explain: Verified by copy of the U Form No. 85B ® Yes ❑ No Flushed by installer of underground Sprinkler piping ® Yes ❑ No If power- driven fasteners are used in concrete, has If no, explain Representative sample testing been satisfactorily completed? Yes I I No Number used: I Locations: I Number removed: LDIN Welded Piping ® Yes n No IF' YES ..... Do you certify as the sprinkler contractor that welding procedures comply With the requirements of at least AWS B2.1? ® Yes ❑ No Do you certify that the welding was performed by welders qualified in Compliance with the requirements of at least AWS B2.1? ® Yes ❑ No Do you certify that the welding was carried out in compliance with a documented Quality control procedure to ensure that all discs are retrieved , that openings in piping are smooth, that slag and other welding residue are removed, and that the internal diameters of piping are not penetrated? ® Yes ❑ No Do you certify that you have a control feature to ensure that All cutouts (discs) are retrieved? ❑ Yes ❑ No YDRALLTC DATA NAMEPLAT Nameplate provided? ® Yes [:]No If no, explain: Date left in service with all control valves open: Name of sprinkler contractor: Phoenix Fire Protection (208) 468 -9115 fax: (208)461 -9117 TESTS WITNESSED BY For Inspector (signed) Title Date For sprinkler contractor (signed) Title Date Additional explanations and notes: 1 Receipt Number: 11 -0023 velopment 440 18) 359 -3024 REF NO: 34682 ;:F HEM PERMIT UNDER 2, A`iMEN %HiN 4:=. rUlK 4Oi5 00 Tt Y :" HAV A NTCE DAY imbing Permit Fee N if ;sidential Fixtures $405.00 $405.00 imbing Permit Fee Total: $405.00 40 e 00 11/01/2010 Deposit Applied $1,000.00 4yl -t t' uu Payment. 11/22/2010 Fire Impact $1,388.60 e'�esCrii�tion A�Ttt UFA Paid ' �. @ItTli� Hookup Fee /Sewer Fee $13,332.15 10 00305 1112212010 Hookup Fee[Water $957 87 10 00305 Tt Y :" HAV A NTCE DAY imbing Permit Fee N if imbing Permit Fee $1,176.13 1000305 10 -0547 11/01/2010 Deposit Applied $1,000.00 1000305 10 -0579 11/22/2010 Fire Impact $1,388.60 1000305 10 -0579 11/22/2010 Hookup Fee /Sewer $25,908.00 1000305 10 -0579 1112212010 Hookup Fee[Water $8,090.40 1000305 10 -0579 11/22/2010 Park Impact Fee $22,344.20 1000305 10 -0605 12/15/2010 Permit - Electrical $40.00 1000305 10 -0451 09/13/2010 Permit - Electrical $1,320.00 1000305 10 -0579 11122/2010 Permit Fee Deposit - $1,000.00 1000305 10 -0451 09113/2010 Plan Check Fee $1,333.22 1000305 10 -0579 11/22/2010 Police Impact Fee $1,105.20 1000305 10 -0579 11122/2010 Street Impact Fee $13,833.20 1000305 10 -0451 09/13/2010 Water Meter & Parts $1,518.20 1000305 Payment Check! Payment Method'. Number Amount CHECK 34682 $ 405.uu Total: $405.00 JAN 2 1 2011 CITY Q RE XBIlRG $0.00 Page 1 of 1 genpmtrreceipts is T'i "i O PEXB FKG PAID D'I': NATHAN GALLUP P DAZE. 12%15x'10 BBB 'i21 /1.N T R RECEIPT NO: i66,73j° 52 BP ELECT. PERMIT 2 MI 40.00 CREDIT CART' AMOUNT" 4 0, :,0 0 PAYMENT 401.;.0+ CHANGE ii,GO ELECTRICAL. PERMIT #10 00305 Receipt Number: relopment 440 8)359 -3024 $13,332.15 $957.87 $1,176.13 $1,000.00 $1,388.60 $25,908.00 $8,090.40 $22,344.20 $1,320.00 - $1,000.00 $1,333.22 $1,105.20 $13,833.20 $1,518.20 DEC 15 2010 1000305 1000305 1000305 1000305 1000305 1000305 1000305 1000305 1000305 1000305 1000305 1000305 1000305 1000305 Page 1 of 1 genpmtrreceipts rical $40.00 _ $40.00 $O.OU Total: $40.00 t Fee THANK YOU ANU HAVE A NICE DAY umbing Permit Fee umbing Permit Fee 10 -0547 11/01/2010 Deposit Applied 10 -0579 11/22/2010 Fire Impact 10 -0579 11/2212010 Hookup Fee /Sewer 10 -0579 11/22/2010 Hookup Fee/Water 10 -0579 11/22/2010 Park Impact Fee 10 -0451 0911312010 Permit - Electrical 10 -0579 11/2212010 Permit Fee Deposit 10 -0451 09113/2010 Plan Check Fee 10 -0579 1112212010 Police Impact Fee 10 -0579 11/22/2010 Street Impact Fee 10 -0451 09/13/2010 Water Meter & Parts $ 40.00 CREDIT CARD NIA _ _____ Total: $40.00 $13,332.15 $957.87 $1,176.13 $1,000.00 $1,388.60 $25,908.00 $8,090.40 $22,344.20 $1,320.00 - $1,000.00 $1,333.22 $1,105.20 $13,833.20 $1,518.20 DEC 15 2010 1000305 1000305 1000305 1000305 1000305 1000305 1000305 1000305 1000305 1000305 1000305 1000305 1000305 1000305 Page 1 of 1 genpmtrreceipts rical $40.00 _ $40.00 $O.OU Total: $40.00 PAID BY' HEADWATERS C DATE: 11/23/1O BLB /1123/CNTR TIME: 09:49:46 RECEIPT NO: 164060 REF NO: 16866 13 8P PLUMB. PERMIT OVER 2 14 FIRE DEV. IMPACT BB 15 WATER CAPITAL CONNECT To 16 SEWER CAPITAL CONNECTIO 17 PARKS DEV, IMPACT FEES 18 POLICE-DEVELOPMENT IMPA 19 BUILDING PERMIT DEPOSIT 20 STREET DEV. IMPACT FEES 1 176.13 1,388.6U 8,O9O.4O 25,9O8,OO 2 9 - ,34 4,2"0 1,105.20 1,OOO.00 13,833.2O CHECK AMOUNT 72,845. 3 PAYMENT 72,845.73 CHANGE 0.00 FOR PERMIT #10 00305 '|umhinQPmrnit Fee ;ewer Water mw Fee 'pmau Fee $2,134.00 *1.38B.6O $25 $8,090.40 $22.344'20 $1.105.20 '$1.0O0'Q0 $13 $1,176.13 $1.380.60 ��908.00 $8,090.40 *22.344.20 $1.1O5'2$ '*i.000.D0 $13.833.20 $72,845.73 tFee $ $13,332.15 1 1000305 THANK YOU AND HAVE A NICE DAY xmbhngPermit Fee * *957.87 1 1000305 0tir.~'..+,...J $ $1 1 1000305 10'0451 09/13/2010 Permit 'Electrical $ $1.320.00 1 1800305 10'0481 09N13/2010 Plan Check Fee $ $1.333.22 1 1000305 10'0481 09/13/2010 Water Meter &Parts * *1.510.20 1 1008305 � "vw, 2 2 2010 � ' / genpmtrreceipts $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Page 1o[1 0 RFX13URG City of Rexburg Receipt Number: 10 - 050 Department of Commu Developm 19 E. Main St. / Rexburg, ID. 83440 Phone (208) 359 -3020 / Fax (208) 359 -3024 genpmtrreceipts Page 1 of 1 Receipt Date 410 as t Ir AAWAS [ IygF /Pgyeo awe: HEADWA'1 ER&Coi1$iTRUG OIN! ,11/Q4/ q0 A . / "vi unt al Permit �. s P �tc±9 ' °' Fee'i esc pti0 ' " .�kmrnt am- 10 �. ali �. a 1000305 RPRXBCA03( Deposit Applied $1,000.00 $1,000.00 $0.00 Total: $1,000.00 v us Payment fflt dlry k ` Room 1pt # ry sl �eof�t [later" .. Fee "De$crip lan- fir; Amgulnt Pala X' R E�'L 10 -0451 09113/2010 Building Permit Fee $13,332.15 1000305 10 -0451 09/13/2010 Commercial Plumbing Permit Fee $957.87 1000305 10 -0451 09/13/2010 Permit - Electrical $1,320.00 1000305 10 -0451 09/13/2010 Plan Check Fee $1,333.22 1000305 10 -0451 09/13/2010 Water Meter & Parts $1,518.20 1000305 ayme"t r eCfi cle ' Pi ym�ent Method 1(umlar w At>iiount CHECK 16131 $ 1,000.00 Total: $1,000.00 genpmtrreceipts Page 1 of 1 n/ppmwm *» CITY u� ``^'— >xoo'noz4 CITY OF REXBURG By HEADWATERS CONSTUCTIO0 COhR - PAID BY: KARTCHNER HOMES OF IDAHO PAID /13/1O BL u �� o° ''`'54O76 DATE: O8/18/1O MS /O818/CNTR DATE; u« 2q REC��r' "". � TlME: 14.13:15 TIH£: 16:32: REF MO: 16� � � RECEIPT NO: 1546O2 REF NO: 1004 33 BUILD1MG pERMIT DEPOSIT 1'OOO`UO 6 BP BUlL^ PERMITS UNDER 2OO,OOO,OO $1,000 1 OOO.0 ' To CHECK AM3UNT 1,3O0 CHECK AMOUNT 200 OOO OO O.00 PAYMENT ' ^ PAYME0T CHANGE 200,000.00 CHANGE O.00 F PERMIT #1O 003O5 pOSIT | cns ^_ REVERSAL OR /« FOR HE0DE«�vn 10. �EAN� � E� Permit Fee 1o~ 1 MR 10-C ...".v Plan Check Fee 10'0451 09/13/2010 VVoter Meter &Pa�s no , in� M r CHECK 16131 $ 1,000.0u Tota $1,000.00 ."^ nux/nu*/F THANK 'YOU AND HAVE A NICE DAY $1,518.20 1000305 genpmtrreceipts pvno 1 m1 CITY OF REXBURG PAID BY; HEADWATERS CONSTRUCTION DATE: 09/13/10 MG /0913/CNTR TIME: 16:17:44 RECEIPT NO: 156836 REF NO: 16328 25 BP ELEC. PERMIT OVER 2 26 BP PLUMB. PERMIT OVER 2 28 WATER METERS & PARTS SA 29 BP BUILD. PERMITS OVER 27 BP BUIL DEP PLANCHECKFE 1,32O.00 957.67 1,518.20 13,332.15 1,333.22 CHECK AMOUNT 18,461.44 PAYMENT 18,461.44 CHANGE 13. DO PERMIT # 10 00305 THANK YOU AND HAVE A NICE DAY Receipt Number: iempment ical $112100 $1,320.00 $0.00 |umbing Permit Fee $2.134.00 $957.87 $1.176.13 e $1.333.23 $1,333.22 $0.00 Pads $111820 $111&2U $OAO itFee $1313115 $1313115 $010 Total: $18,461-44 two on Tip Ex SEP 13 CITY OF REXBURG Page I of I 04 gEX K U2�, 4 > o November 19, 2010 To Kelly McCandless, CI "rY O r RE X B URG Cw- America; Fmnily Cnnvnundy Permission from the Rexburg Building Official has been granted to WR Henderson to use Fire Facts Guide Design TJ /FCA 45 -01 and End Wall designs 1A and 1B. Please find the details attached to this letter Sincerely, Val Christensen Community Development Director City of Rexburg Val Christensen, Community Development Director City of Rexburg 35 North 1st East Rexburg, ID 83440 Phone: 208.359.3020 One -Hour Assembly Assembly E CAN /ULC -5101 and ASTM E119; ICC ES reports ESR -1153 and ESR -1774. See reports for additional construction information. One -Hour Assembly Assembly F CAN /ULC -S101 and ASTM E119; ICC ES report ESR -1153. See reports for additional construction information. Typical detail for butt joints perpendicular to framing members Two -Hour Assembly Assembly G CAN /ULC -5101 and ASTM E119; ICC ES reports ESR -1153 and ESR -1174. See reports for additional construction information. Assembly his typically used for garageAiving unit separation FLOOR /CEILING ASSEMBLY 1. 48/24 tongue- and - groove, span -rated sheathing (Exposure 1) 2. TJI® joist or open -web truss, 24" on- center maximum 3. Optional glass fiber insulation, unlaced batts, 3W thick in plenum, supported by stay wires 12" on- center and centered on joist bottom flanges 4. Three layers of s/a" thick Type C gypsum board 5. Resilient channels at 16" on- center located between first and second layers of gypsum board 45- Minute Assembly Design TJ/FCA 45 -01 CAN /ULC -S101 and ASTM E119. As evaluated by Intertek Testing Services in their Directory of Listed Products. A 45- minute floor /ceiling system is not currently used in the United States 1. Double wood floor or single layer of 48/24 tongue- and -groove span -rated sheathing (Exposure 1) 2. TAM joist or open -web truss 3. An approved ceiling system that will provide a 40- minute finish rating 1. 48/24 tongue- and - groove, span -rated sheathing (Exposure 1) 2. W thick Type C gypsum board 3. TAID joist (with flange size minimum of 1W thickx 3W wide) 4. Resilient channel at 16" on- center 5. Minimum Bi" thick (2.5 pcf minimum) mineral wool batts 1. 48/24 tongue- and - groove, span -rated sheathing (Exposure 1). 40/20 tongue- and - groove, span -rated sheathing (Exposure 1) is permitted with proprietary gypsum as listed in TJ /FCA 45 -06. 2. TJI ®joist 3. Single layer Vs" thick Type X gypsum board 4. Resilient channels at 16" on- center (optional) 5. Optional when used with resilient channels: Minimum 3W thick glass fiber insulation or non - combustible insulation that is rated R -30 or less Note: For concrete topping applications, a single layer of 40/20 span -rated sheathing (Exposure 1) over joists at 24" on- center with 1W lightweight concrete or 1" of gypsum concrete is an allowed deck alternative. If the joists are spaced no more than 20" on- center, a 3;" thick gypsum concrete topping is permitted. Lightweight concrete or approved gypsum concrete topping with appropriate sheathing can be substituted for the decking material shown in any of these assemblies. r M�_ 191 6 il-evel Trus Joist' Fire Facts Guide 1500 July 2008 Typical resilient channel and gypsum board attachment 5 4 ITER -WALL ASSEMBLIES Multi -Story Application: Single bearing wall with full design load on rim board. Staggered 2x4 studs attached to 2x6 plates in bearing wall is also acceptable. TJI® joists are either perpendicular or parallel to the wall. Blocking as required for stability. One -Hour Assembly Center -Wall Design 6A CAWULC -S101 and ASTM El 19. As evaluated by Intertek Testing Services. 1. 2x6 minimum studs 2. One- hour -rated wall construction 3. Non - continuous TAO joist at 24" on- center maximum, abutting to continuous rim board along the wall 4. iLevel®1>/s" rim board for depths of 16' or less lr/" TimberStrand® LSL rim board for depths of 18" and 20" 5. 45- minute- or one - hour -rated floor /ceiling One -Hour Assembly Center -Wall Design 7A CAN /ULC -S101 and ASTM El 19. As evaluated by Intertek Testing Services. 1. 2x4 or 2x6 minimum studs 2. One- hour -rated wall construction 3. Continuous TJI® joist at 24' on- center maximum across the wall 4. Rim board cut to fit snug between joist flanges, toenail to keep in position. Ievel®1 rim board for depths of 16' or less; 1 r/a" TimberStrand® LSL rim board for depths of 18" and 20 ". 5. 45- minute- or one - hour -rated floor /ceiling 6. Web stiffeners each side of TJI® joists and attached to web at rim board. See iLevel literature for placement. 7. Gap: 1 h6' maximum between joist flange and web stiffener. END -WALL ASSEMBLIES Multi -Story Application: Single bearing wall with full design load on rim board. T11® joists are either perpendicular or parallel to wall with continuous rim. Bracing orb I ocking as required for stability. This design can also be used for interior walls if 5 W Type Xgypsum is installed on the opposite side (not shown). One -Hour Assembly From occupant side End -Wall Designs 1A and 113 CAN /ULC -5101 and ASTM Ell 9. As evaluated by Intertek Testing Services. (1B) Joists Parallel to Wall 1. 2x4 minimum studs 2. 2x6 minimum studs 3. TJI ®joists 4. Continuous iLevel®1W rim board for depths of 16" or less; Continuous IN' TimberStrand® LSL rim board for depths of 18" and 20" 5. Continuous Va' Type X gypsum board applied to rim board on occupancy side and fastened with I Type W screws at 12" on- center (gypsum board may be eliminated if a one - hour -rated floor /ceiling assembly exists) 6. One- hour -rated floor /ceiling system (if required) 7. One- hour -rated wall construction Not shown: Specific details for gypsum board and cladding on exterior side of the vertical studs. iLevel Trus Joist' Fire Facts Guide 1500 July 2008 9 (1A) Joists Perpendicular to Wall INSPECTION TICKET ❑ Bldg. ❑ Plumb. Elcct. ❑ Mech. ❑ F'im Date inspection Request: Rec'd B 3�U — CIES3 A _ Phone No. Req. BY Permit No. Project - Address Inspection Type Day Time Req. a n Inspector's Report ❑ Res. � Comm. ' APPROVFD DWGS ❑Y ❑ N L�'1 NIA INSPECTED ITEMS CONFORM INSP' TOR'S ACTION 1] FINAL APPROVED ❑ DISAPPROVED APPLICABLE [I DID NOT INSPECT' C.O. (FINAL) �� C ACTION REQUIRED: - Rec'i Acknowledged pb* _ kmedm*s copy wtwe - once Copy vesow •Job Copy F- Fip -0003 INSPECTION TICKET Bldg. ❑ Plumb. ❑ Elect. Mech. ❑ Fire inspection Request: Rec'd By �,� Date 11 Re 1 � q . By VI?hone No. t , Project Y >1�'�" N` \ Permit No. Address La Inspection Type r- Day rFime Req. _ Inspector's Report / Res. 4 Comm. INSPECTED ITEMS CONFORM TO APPROVED DWGS INSPECTOR'S ACTION ❑ APPROVED DISAPP ❑ C.O. (FINAL) ❑ NOT APPLICABLE ACTION REQUIRED: Signedy Rec't Ackr While - oniee F- FIR.0003 F] y [] N El N/A ❑ FINAL O DID NOT INSPECT Pi* - hMedor's Copt INSPECTION TICKET ❑ Bldg. ❑ Plumb. Elect. ❑ Mech. ❑ Fim Inspection Request: Rec'd By Date 'Rhshi Req. By Phone No. - gSS3 Project Pennit No. 10'306 Address VT Inspection Type Day /Time Req. ►? Inspector's Report ❑ Res. a Comm. INSPECTED ITEMS CONFORM TO APPROVED DWGS El ❑ N N/A INSPECTOR'S ACTION ❑ APPROVED DISAPPROVED El FINAL ❑ C.O. (FINAL) FlNOTAPPLICABLE ❑ DID NOT INSPECT ACTION REQUIRED. �• Signed Inspector Rec't Acknowledged while - office Copy Yel ow • Job Coq Pink - Irlap rao *$ Coq F- FIR•0003 INSPECTION TICKET ❑ Bldg. �L plumb. ❑ Elect. ❑ Mech. L1 Fire Inspection Request: Rec d B y Date C,'r o►� No. Req. By Project �,�Iv -- Peri it No. Address Inspection Type Day /Time Req. Inspector's Report ❑ Res. ❑ Comm. INSPECTED ITEMS CONFORM TO APPROVED DWGS El E] N ❑ N/A INSPECTOR'S ACTION ❑APP ROVED El DISAPPROVED E] FINAL n APP (FINAL) El NOT APPLICABLE El DID NOT INSPECT ACTION REQUIRED: ReCt Acknowledged While - Mice Copy F- FIR-CO03 YeNow - Job Copy Pink - I nsp.cW5 Copy NSPECTION TICKET ❑ Bldg. ❑ Plumb. ❑ Elect. ❑ mech. ff Fire Inspection Request: Rec'd By Date Req. By Phone No. .3 1• A- 0. rc __ 1„1 �1.� Permit No. �• '�S - Address inspection Type t .PA ' DayffimeReq. 3(7—G inspector's Report ❑ Res. "U' Comm. / G INSPECTED ITEMS CONFORM TO APPROVED DWGSU ❑Y ❑ N C] NIA INSPE OR'S ACTION PROVED (I DISAPPROVED p FINAL 7 .0. (FINAL) El NOT APPLICABLE [j DID NOT INSPECT ACTION REQUIRED 4\_ T ' Rec't Acknowledged VeNow • fob Copy Pink - Npaor S d Capp Who@ . Ofte Copy F- FIR•CO03 INSPECTION&CKET ❑ Bldg. ❑ Plumb. ❑ Elect. ❑ Mech. lYJ Fire Inspection Request. Recd By Date Req. By Phone No 1 Project Pennit No. 0 ' - �Q� Address Inspection Type Day /Time Req. � INSPECTED ITEMS CONFORM TO APPROVED DW ❑Y ❑ N U N/A INSPECTOR'S ACTION F1 APPROVED DISAPPROVED ❑FINAL ❑ C.O. (FINAL) NOT APPLICABLE ❑ DID NOT INSPECT ACTION REQUIRED: Signed Rec't Acknowledged wade - oike Copy F- FIR -CO03 *ftw - Job Copy F'iMc Y COPY .:. r n_.. IH rnmm U E. �'•' �® SECURITY SYSTEMS INC. NF pp MEMBER "• FIRE ALARM INSPECTION AND TESTING REPORT Testing performed in accordance with applicable NFPA 72 Standards / By NICET Certified Technicians :,' Address of Building Building occupied as �+""+ t I a Owner /Manager: Nat0e &Number Date of In tion °` Name of Tester ' 'd / .:., , �' Notification of Testing Y Type of Inspection r° r Control Panel Manufacturer & Model "' a FCPS. Total NAC's: -L - — # of Zones SLC Loops: __Z_____ —. NAC's - FACP:__ — 'System should be tested on Standby (battery power) for 30 min. prior to Battery Test. Battery Inspection FCPS 2 FCPS 3 Battery Voltage FACP FCPS 1 Voltage Amp Hour ~ ` Date on Battery _ FACP Inspection Yes No N/A Yes No N/A All circuits checked tor Key to Panel Available electrical supervision peratmg Instructions at Pane Al unctions and buttons Newest Record posted at Pane work properly circuit Breaker marKeo Red Does A arm system meet circuit Bre er Panel: # audibility standards" Trouble Signa with A Power o Contro Panel chec s ma a per System operates satisfactory on manufacturer's instruction standby power at max load A 1 mte ace equipment operates All signals operate on AC power (Elevators, Fans, Dampers) All LED s Illuminate Account # Name of Monitoring Company: Communication Verified: V Tested Yes No Controls l Prima ` l Sec ll Shunt Access Control Door Auto Kelease Door Holders in Bldg. Corrections Made: This is to certify that this Fire Alarm has been properly Tested and Inspected for liability to cover the items listed in this report, according to Manufacturers Recommendation: Date: ' Signature of Fire Marshall: Date: __--- Signature of Owner or representate: ; tr Date:' `�F — ignature of Certified Tester: .'Rigby, ID 83442 Office 208 - 745 -1020 Fax: 208 - 745 -15 X ency: Omni Security Systems, Inc. P. O. Box 309 Problems rounu INSPECTION TICKET KET ixt Bldg. (3 Plumb. ❑ Elect. LI Mech. ❑ Fire Inspection Request: Rec'd By . Date 1:31. Req. By &k-cr.„ Phone No. 2-0/ - 3517 Project 1-1-eAr,A Permit No. 10 Ad Address Inspection Type r t 1 4-1 12e, AAA.A.f Day /Time Req. 9 1 t to 30 Inspector's Report Res. Comm. Gaildi' !'er.&Spee-h'd71 INSPECTED ITEMS CONFORM TO APPROVED DWGS ❑Y ❑ N ❑ N/A INSPECTOR'S ACTION APPROVED ❑ DISAPPROVED D FINAL C.O. (FINAL) ❑ NOT APPLICABLE ❑ DID NOT INSPECT ACTION REQUIRED: /�� �/ Signed i�./� 1 rtro Vhe , . Inspector Rec't Acknowledged May - (nee Copy Yellow • Job Copy Pia - Inspodoes Copy F- F1R-0003 INSPECTION TICKET X, Bldg. ❑ Plumb. ❑ Elect. ❑ Mech. ❑ Fire Inspection Request: Rec'd By Date 21/ Req. By _ � kE Phone No. Project `kou E,e5o,J Permit No. / — /b0kj Address Inspection Type - 5/n/7 fr "14 / 2_ Day /Time Req. 24. Inspector's Report kr Res. a Comm. IF CIE cu- - ✓ z� (mLi4 .w_____Cp_,e/zir,_ Merl C •____.n • ., .... - 6A� a . /1106- A- IftA m � - i • r... I. ; a. AO CI.' alt. INSPECTED ITEMS CONFORM TO APPROV _D ► WGS ❑Y ❑ N N/A INSPECTOR'S ACTION Li APPROVED I6ISAPPROVED ❑ FINAL ❑ C.O. (FINAL) ✓ ❑ NOT APPLICABLE ❑ D(D J V NSP CT ACTION REQUIRED: .. 23 0 3 <1w J 1 - �CC Q•G2.w' _ • e /VO'r /A 1 / A• II g 1 Signed- ...-..■ Inspector Rec't Ack owled ed while. ON Copy YeNow . Job C Pink - Inspector's Copy F- FIR -0003