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ALL DOCS & CO - 10-00376 - 315 Millhollow Rd - SFR/Garage
. 0 t,t.XR Certificate of Occupancy (2 „`wt" l 3 j �' � N '�F mow.v ( ' REXBURG City of Rexburg Ir�t,r Ica,1��rrz�t,� unworn} Department of Community Development 35 N. 1st E. /Rexburg, ID. 83440 Phone (208) 359-3020/ Fax (208) 359-3022 Building Permit No: 10 00376 Applicable Edition of Code: International Building Code 2009 Site Address: 307 S. Mill Hollow Rd Use and Occupancy: Single Family Residential Type of Construction: Type V, non-rated Design Occupant Load: N/A Sprinkler System Required: No Name and Address of Owner: Price Vaughn 315 Millhollow Rd Rexburg, ID 83440 Contractor: Owner/Lessee Special Conditions: Occupancy: Residential - 2 units or less, permanent in nature This Certificate, issued pursuant to the requirements of Section 109 of the International Building Code, certifies that, at the 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: /* ; /2 C.O Issued by: !ii' 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: a ,;) _ --- Fire Inspector: N'a Electrical Inspector: ~i P&Z Administrator N A Z 0 c) rn .. Z 0 Ili .0)Z -. �r• CD •• Z ` , ] nom � _• 7 41) rn p X � . m �� Q 1.,''',.1 s a r m 11 -13 C3 .'a d' .i 0 O (D . tG O _ Mill F z S D Z •p O N —1 w aa3' m m. = n• C1 •"Q a o v §.s. 0. � 3 O 171: 0 :'T1 xi. F ;p ��Qwo C: N 7C W ''li w O �. es " f E N o c w " 2. 3 o a v X " .rO 3 r' c cQ m � •t N N CD 7 O C- r_ (fl _3 0... -c p p N O m-N a W m Z Q. QO.. D.a �� : N 3 N 0 •f m y� 3 n°' n�� O Y rt.N I Un I t:I/Zi . /11111.1 ::j aa 3. '� ..:r. 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By 'Vat 1 it.i.t Piet C E Phone No. 3 C/—/7 g 7 Project Oa�-2aTe, Permit No. }i Oc3'7(r Address . - _ r M, . '-fiit, �4 4 Inspection Type F7 NA'L__ Day/lime Req. g-(c- / a /A : ( (-? Ck rn - Inspector's Report 14 Res. ❑ Comm. ;s4e* Ziaard r'au f alt. ba 6k 0- dr i ;e I f Gil lore- elev. _,3(!r`.6d#1,, ouk- 44- 30" k i k INSPECTED ITEMS CONFORM TO APPROVED DWGS D ❑N ❑N/A INSPECTOR'S ACTION p APPROVED g DISAPPROVED D FINAL ❑C.O.(FINAL) ❑NOT APPLICABLE ❑DID NOT INSPECT ACTION REQUIRED: Signed 4.e,; OW S Inspector Rec't Acknowledged WAN.-Office Copy Mellow•Job Copy Pink-Inspectors Copy F-FIR-0003 • INSPECTION TICKE• ❑ Bldg. ❑ Plumb. ❑ Elect. Mech. ❑ Fire Inspection Request: Rec'd By ... M` Ylfi' Date s '3/ -/ Req. By ' (uee t--P/U Phone No. 3s/ ��/9 Project S /6a47-a e_ Permit No. It) dU 3 Address 567 J• int:%/hG'l&.Jo 'ci Inspection Type F/A/ t Day/Time Req. SIC/ 6U1"q- Inspector's Report Res. ❑ Comm. rY ea . INSPECTED ITEMS CONFORM TO APPROVED DWGS ❑Y 0 N 0 N/A INSPECT R'S ACTION AP ROVED 0 DISAPPROVED 0 FINAL C.O.(FINAL) 0 NOT APPLICABLE 0 DID NOT INSPECT ACTION REQUIRED: Signed It ,v ./Wit 4 • Inspector Rec't Acknowledged Whole-OHica Copy Yellow•Job Copy Pick-NapedoeS Copy F-FIR•C003 • INSPECTION TICKET• ❑ Bldg. ❑ Plumb. Elect. ❑ Mech. ❑ Fire inspection Request: Recd By 2d4 C Date 73/-/ Req. By. 1/4/.24.0 h-/ Iii c Q� Phone No. 30•-/'7 y9 Project FP /624-6-1j Permit No. /G &9 Address L'-7(7 /12(0/2 de;c/0 Pc( inspection Type FM/AL- Day/Time Req. 3/6/12_ /6 ', c')(1, '✓'7 inspector's Report Res. ❑ Comm. J e.A:. . "(ter ���:��rt��`1I►.�tI�1J L,=JCieL<.�-Lt���� �l •� I . 1IPtI ire* i. &fir ma / A� . I 1 t:h Mb. ♦: �e .g . i& 1r..��0�2�.r. ��A��„�ri j�� -tea _— _d O LK7 . 1 V %t e.2e' iu u INSPECTED ITEMS CONFORM TO APPROVED DWGS 0 ❑N N/A INSPECTOR'S ACTION ❑APPROVED It IISAPPROVED ❑FINAL ❑C.O.(FINAL) ❑ APPLICAABBLLEE ❑DID NOT INSPECT ACTION REQUIRED: j� . 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N Y 0 D gN OO mD Tr,XN T eN-DD D m rr, -o =A6 mF ZOzo?0 FF Vo NNN ii D F3 Eh E N 00 In o Zr OS t4m "O O Sz�Ie W•P N N w r c E A N n T r n V D r 0 poo m D D r =D •D D O D D A r g � '� 6r F rA • � � '” pp 8vD D oa ion sN- von !-o 6i F 2A o �n Rye Remo 5.5.s. ��tryI {p�q9 to D D V W Dz - • -L�DFi DDD m m UI m0, 7�UII> ANZ (IM(Pil Di RI r { ym AO A oi.- N n 8 8 r N A w �n , z rXX- pZ, c t� D D �` 88 EO A ti py OE N w° o D m F F q S � a Poo 8 PP ill fa 16 d0 Building Safety Department "�Fxo��c . •� CITY or City of Rexburg -- — ---_.- -: '.° EXI URG 35 N 1 E Phone:208.372.2326 _ America's Tan ilv Community •Rexburg,ID 83440 www.rexburg.org Fax:208.359.3022 Remodeling Your Building/Home (need Estimate) $ SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building) First Floor Area Unfinished Basement area 1 Second floor/loft area Finished basement area Third floor/loft area Garage area iShed or Barn Carport/Deck (30" above grade)Area L .- - - -- - J. Water Meter Quantity: Water Meter Size: Required!!! { PLUMBING Plumbing Contractor's Name: 7. i .Pt-' Bus' ess Name: Address f i' ( ;i'C 0--i - City State -a Zir-3'1'�'-�C� Contact Phone: rl')s ' ' e( e_' ( 7 Business Phone: (ikeir') 3 5 i-- /19? Email Fax 1 J FIXTURE COUNT(including roughed fixtures) 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 Estimates (Commercial Only) Required! Signature of-Licensed Contractor License number Date 5 10 00376 315 Millhollow Rd - SFR/Garage REScheck Software Version 4.2.0 Compliance Certificate Project Title: Price Residence Energy Code: 2006 IRC Location: Rexburg, Idaho Construction Type: Single Family Glazing Area Percentage: 17% Heating Degree Days: 8693 Climate Zone: 6 Construction Site: Owner/Agent: Designer/Contractor: Rexburg, ID Design Intelligence Rexburg, ID u.. Compliance:1.3%Better Than Code Maximum UA:393 Your UA:388 ' Gross Cavity Cont. Glazing UA Assembly Area or R-Value R-Value or Door Perimeter U-Factor Ceiling 1:Flat Ceiling or Scissor Truss 1013 38.0 0.0 30 Wall 1:Wood Frame, 16"o.c. 2570 23.0 0.0 119 Window 1:Vinyl Frame:Double Pane with Low-E 230 0.340 78 Door 1:Solid 40 0.340 14 Door 2:Glass 140 0.340 48 Floor 1:All-Wood Joist/Truss:Over Unconditioned Space 308 19.0 0.0 14 Basement Wall 1:Solid Concrete or Masonry 992 13.0 0.0 58 Wall height:8.0' Depth below grade:6.0' Insulation depth:8.0' Window 2:Vinyl Frame:Double Pane with Low-E 48 0.340 16 Door 3:Glass 33 0.340 11 Compliance Statement: The proposed building design described here is consistent with the building plans,specifications,and other calculations submitted with the permit application.The proposed building has been designed to meet the 2006 IRC requirements in REScheck Version 4.2.0 and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. Name-Title Signature Date Project Title: Price Residence Report date: 10/04/10 Data filename: S:\Scott\Year 2010\2008-140 Vaughn Price\Price Energy.rck Page 1 of 3 REScheck Software Version 4.2.0 Inspection Checklist Ceilings: LI Ceiling 1:Flat Ceiling or Scissor Truss,R-38.0 cavity insulation Comments: Above-Grade Walls: ❑ Wall 1:Wood Frame, 16"o.c.,R-23.0 cavity insulation Comments: Basement Walls: ❑ Basement Wall 1:Solid Concrete or Masonry,8.0'ht/6.0'bg/8.0'insul,R-13.0 cavity insulation Comments: Windows: ❑ Window 1:Vinyl Frame:Double Pane with Low-E,U-factor:0.340 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: LI Window 2:Vinyl Frame:Double Pane with Low-E,U-factor:0.340 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: Note:Up to 15 sq.ft.of glazed fenestration per dwelling is exempt from U-factor and SHGC requirements. Doors: ❑ Door 1:Solid,U-factor:0.340 Comments: LI Door 2:Glass,U-factor:0.340 Comments: ❑ Door 3:Glass,U-factor:0.340 Comments: Floors: ❑ Floor 1:All-Wood Joist/Truss:Over Unconditioned Space,R-19.0 cavity insulation Comments: Floor insulation is installed in permanent contact with the underside of the subfloor decking. Air Leakage: ❑ Joints,penetrations,and all other such openings in the building envelope that are sources of air leakage are sealed. ❑ Recessed lights are either 1)Type IC rated with enclosures sealed/gasketed against leaks to the ceiling,or 2)Type IC rated and ASTM E283 labeled,or 3)installed inside an air-tight assembly with a 0.5"clearance from combustible materials and a 3"clearance from insulation. Vapor Retarder: ❑ Vapor retarder is installed on the warm-in-winter side of all non-vented framed ceilings,walls,and floors;or it has been determined that moisture or its freezing will not damage the materials;or other approved means to avoid condensation are provided. Comments: Materials Identification: Project Title: Price Residence Report date: 10/04/10 Data filename: S:\Scott\Year 2010\2008-140 Vaughn Price\Price Energy.rck Page 2 of 3 Materials and equipment are identified so that compliance can be determined. LI Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment have been provided. Insulation R-values and glazing U-factors are clearly marked on the building plans or specifications. Insulation is installed according to manufacturer's instructions,in substantial contact with the surface being insulated,and in a manner that achieves the rated R-value without compressing the insulation. Duct Insulation: o Ducts in unconditioned spaces or outside the building are insulated to at least R-8. o Ducts in floor trusses above unconditioned spaces or above the outdoors are insulated to at least R-6. Duct Construction: LI Air handlers,filter boxes,and duct connections to flanges of air distribution system equipment or sheet metal fittings are sealed and mechanically fastened. • All joints,seams,and connections are made substantially airtight with tapes,gasketing,mastics(adhesives)or other approved closure systems.Tapes and mastics are rated UL 181A or UL 181B. • Building framing cavities are not used as supply ducts. o Automatic or gravity dampers are installed on all outdoor air intakes and exhausts. Additional requirements for tape sealing and metal duct crimping are included by an inspection for compliance with the International Mechanical Code. Temperature Controls: Li Thermostats exist for each separate HVAC system.A manual or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor is provided. Certificate: A permanent certificate is provided on or in the electrical distribution panel listing the predominant insulation R-values;window U-factors;type and efficiency of space-conditioning and water heating equipment. NOTES TO FIELD:(Building Department Use Only) Project Title: Price Residence ot_.d., Data filename: S:\Scott\Year 2010\2008-140 Vaughn Price\Price Energy.rck Report date: 10/04/10 gy.rck Page 3 of 3 I (.... IRC Energy,,, t 2006 i may " Cer+ifirate Insulation Rating Ceiling/Roof 38.00 Wall 23.00 Floor/Foundation 13.00 Ductwork(unconditioned spaces): Window 0.34 Door 0.34 NA Heating&Cooling Equipment Effimeney Heating System: Cooling System: Water Heater: Name: Date: Comments: Madison County/City of Reyrg GIS Page 1 of 1 •rt Am 0 w 5 1 4 .04100"r ■ WW ^ a » F 1 4 lk—..- t". a 4g s ter' a A -, N fir i on :Aw' 4 ,r r .■ i z 1111.1 DISCLAIMER: This map is intended for display purposes only and is not intended for any legal representations. http://gis/intranet/arcims/printable.aspx?MapURL=http://agentsmith/output/arclMS_agents... 11/9/2010 Madison County/City of Rex,�urg GIS Page 1 of 1 . . '' _.°- 4 - i. ` l'L g' , - i rf m i s �, s "}� i'4 42 ,'z, t 'i, i I wa4 ; f �m k 'F. F -a c . a' r z DISCLAIMER: This map is intended for display purposes only and is not intended for any legal representations. http://gis/intranet/arcims/printable.aspx?MapURL=http://agentsmith/output/arcIMS_agents... 11/9/2010 010104 • • h . ___ C f 'F V C) 1' 1° �? Please Complete the Entire Application! ' ° 1 t1d - If the question does not apply fill in NA for non applicable 'B - Arnemra'si-anntly Community RESIDENTIAL BUILDING PERMIT APPLICATION 35 N 15t E,REXBURG, ID 83440 208-372-2326 PARCEL NUMBER: (We will provide this for you) SUBDIVISION: in It I ke,l is ) UNIT# BLOCK# LOT# / • (Addressing is based on the information-must be accurate) Dwelling Units: Parcel Acres: OWNER NAME: /P-Li (°IM) 4,6t-' CONTACT PHONE # ( - / I-57—%' `r PROPERTY ADDRESS: C` ez PHONE #: Home ( 'Si:, `�%/ Work - S '1"--37 Cell ( S( —/-7`� OWNER MAILING ADDRESS: 3/5 /4.I l L(I CITY: ( ((I--) STATE: ZIP: V? Y"f U EMAIL FAX (-vim c'c.,A.1 FAX ;)--c C1' 3S — f'f ' ''' 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: 1, A-tx6,,1-," rc MAILING ADDRESS: 3(5 AA II I L 1(0 --' CITY (Lo ✓7■;--1 STATE ZIP '`� PHONE#: Home ( ) Work ( ) Cell,(k,S)- 35.1—/ 7 t EMAIL S. 6. .s.xe FAX IDAHO REGISTRATION # &EXP. DATE IC 17.16 6 j( I ,I hi How many buildings are located on this property? Did you recently purchase this property? No Yes(If yes,list previous owner's name) Is this a lot split?CN�O/ YES (Please bring copy of new legal description of property PROPOSED USE: C�.N ,^'G '� / y'�d-f-e�t.,' 7)t, u�I LASI (i.e.,Single Family Residence,Multi Family,Apartments,Remodel,Gage,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 2003 International Code in cases of any false statement or isrepresentation of fact in the application or on the plans on which the permit or approval was based. Permit void if not started within 0 days. Peri oid if work stops for 180 days. j CC lu / / /0 Signature of Owner 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 b 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 City of Rexburg ' I B URG <" rlmrrtr.�ts ... 35 N 1st E Phone:208.372.2326 • Family Community Rexburg,ID 83440 www.rexburg.org Fax:208.359.3022 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. CAA-1 LA, /...) Signature Date M Owner or ❑ Builder Printed Name 4 A Building Safety Department �, XX_�R, r C 1 Y OF City of Rexburg - ►..-- ----.� 35 N I"E Phone:208.372.2326 f,� c, ' Rexburg,ID 83440 www.rexburg.org Americua Fcr,rrrly Community \ 9• 9 Fax:208.359.3022 NAME V4-a r,i1 P"'k< PROPERTY ADDRE Lo•t) (.> 1A+((L4o 5'... �j Permit# SUBDIVISION i S di ha It i°" PHASE LOT id— BLOCK Remodeling Your Building/Home (need Estimate) $ SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building) First Floor Area 14g Unfinished Basement area Second floor/loft area 2 5 3 Finished basement area 7 9 Third floor/loft area Garage area I*if a Shed or Barn Carport/Deck (30" above grade)Area .24O -f-1 I(p Water Meter Quantity: 1 **************Water Meter Size: 5/y Required.!!/ PLUMBING Plumbing Contractor's Name:: (,r,.., Y Busi ess Name: ./-,,z o' p`'- . Address P' 4)-- 6 x 7J-3 City r "* State Zip �..S''7:3F— Contact y Contact Phone: ( ) Business Phone: ( . 3/7 —f 9745 Email Fax FIXTURE COUNT(including roughed fixtures) I Clothes Washing Machine Sprinklers 1 Dishwasher 3 Tub/Showers 1 Floor Drain 3 Toilet/Urinal Garbage Disposal I Water Heater I Hot Tub/Spa ‘ Water Softener 5 Sinks (Lavatories, kitchens,bar,mop) Plumbing Estimate $ (COMMERCIAL/MULTI-FAMILY ONLY) 4 G- 9 'I 5 G1,t,,,� I.0 Signature of Lice se Contract r License Number&Expiration Date Date 5 • • Building Safety Department ,XI§08c C< 1 1 l Q F City of Rexburg v* "�` �"j ~+ 9 �> i� °I REXBURG 35 N 1st E Phone:208.372.2326 � �� ._ __ ._` ut Rexburg,ID 83440 www.rexburg.org Fax 208.359.3022 �tr'vencusE?rmriyCrrr,rnurr;dy NAME 4,46_,t er-tu2. PROPERTY ADDRESS f 4,1 j14,"'/i(../ 51. 4 Permit# SUBDIVISION /111 Gk.;//a-' PHASE LOT BLOCK v _ -.. _ -. - . ..._ . _. . .._ _.. _ .Required/fir MECHANICAL Mechanical Contractor's Name 6 ''`e- //,,-..:�..c�, Business Name e:,,,,, �L- �lu,...�j7 Address P. 0 604: /)3 City ( -c1 ,', State --P Zip jcf Cell Phone ( ) Business Phone (,)4) 3 r 7-N6 r Fax ( ) Email Mechanical Estimate$ (Commercial/Multi Family Only) FIXTURES&APPLIANCES COUNT (Single Family D•-elling Only) h Furnace Exhaust or Vent Ducts (water heater) Furnace/Air Conditioner Combo D Dryer Vents Heat Pump Range Hood Vents Air Conditioner O Cook Stove Vents Evaporative Cooler 3 Bath Fan Vents Unit Heater other similar vents &ducts: Space Heater Decorative gas-fired appliance f \i .. Incinerator System IL Boiler Pool Heater Fuel Gas Pipe Outlets including stubbed in or future outlets Inlet Pressure (Meter Supply) PSI Heat(Circle all that apply) 10 Oil Coal Fireplace Electri Hydronic � a5� ./i (.7...„... 2 ? , Signature of Lic nse Contracto License number Date 6 • • Building Safety Department 4 ti V4,0. OE City of Rexburg u gair st 35 N 1 E Phone:208.372.2326 lmeru hunily E;c mnuntly Rexburg,ID 83440 www.rexburg.org Fax:208.359.3022 OWNER'S NAME Vr }uGitJ Pc,'ce PROPERTY ADDRESS Permit# 10 00376 SUBDIVISION Yitil i0 315 Mill Hollow Rd - SFR/Garage PHASE LOT l 2.. BLOCK Permanent Power HOME OWNER 'S ELECTRICAL PERMIT Home Owner's Name 4 A‘46( *Address 3 i Lk%��t lid— City IC`z-t L State .11-6 Zip 31`tro Cell Phone (DO& 3 51 /7 41 Home one ( /� 3 S /� (1 Fax ( ) Email V I itc W� . �J �� C TYPES OF INSTALLATION (New Residential includes everything contained within the residential structure and attachedgarage at the same tune) For power supplier requirements visit www.rockymtnpower.net ❑ *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 ❑ 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 ❑ 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 part'supplying it). ❑ Pumps (Domestic Water,Irrigation,Sewage): horse power ❑ Requested Inspections (of existing wiring) - $40/hr(1 hour minimum) plus $40/hr thereafter *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. CAAJI ALL (..)--(//3 ti Signature of Home Owner Date 7 • • Building Safety Department ,,,.k..r.,„4j c I T} <, 1, City of Rexburg ^� G 4144"11 '8 35 N 1st E Phone:208.372.2326* ' ' WWW.rexbur America's Yamily Commurfy Rexburg,ID 8344? / g• f Fax:208.359.3022 OWNER'S NAME V A 1.4)(4 ri`te PROPERTY ADDRESS Permit# SUBDIVISION A A dl L o t(a S h 4 J s, PHASE LOT BLOCK Required/I! ELECTRICAL Electrical Contractor's Name VU6( Business Name �--- Address 36 AA�� �,.,,�l - City ( L .1/4 State ---Ly Zip ? � ,Th Cell Phone ( ) Business Phone ( ) Fax ( ) Email Electrical Estimate (cost of wiring&labor) $ (COMMERCIAL/MULTI-FAMILY ONLY) (Includes the cost of materials installed regardless of the party supplying it). TYPES OF INSTALLATION (New 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 X. *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 ❑ 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 ❑ 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 supplying it). ❑ Pumps (Domestic Water,Irrigation,Sewage): horse power ❑ Requested Inspections (of existing wiring) - $40/hr (1 hr minimum) plus $40/hr thereafter *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. Signature of Licensed Contractor License number Date 8 • I SUBCONTRACTOR LIST Excavation&Earthwork: Le3"--"I V J Concrete: E L C c, C w7._ Masonry: N A Roofing: V Ail_ aT ^1(k) Insulation: VA- P.,-,'ct' Drywall:: S Lr- Painting: \/A,--,-ti 'C-t Floor Coverings: V 4-L tt„,,_ -t ck. Plumbing: l >_° -`l K-c j I Heating: � v�� ke vt;n.Z41 Electrical: V NIA(c�(ti+% Special Construction (Manufacturer or Supplier) Roof Trusses: ),) C - .(-.t.k- Floor/Ceiling Joists: I J )-kc Siding/Exterior Trim: _ ( h,& 00-s S 7=S F'f Other: 9 • Bureau of Occupational Licenses Department of Self Governing Agencies The person named has met the requirements for licensure and is entitled under the laws and rules of the State of Idaho to operate as a(n) REGISTERED CONTRACTOR VAUGHN PRICE 315 MILLHOLLOW ROAD • REXBURG ID 83440 Tana Cory RCT-16036 01/01/2011 Chief,B.O.L. Number Expires 09 164 • 1 • r S Building Safety Department X6 UR, City of Rexburg h� `-= G 35 N 1' E Phone:208.372.2326 Am rie chomey Cornmunay Rexburg,ID 83440 www.rexburg.org Fox:208.359.3022 Affidavit of Legal Interest State of Idaho County of Madison Name Address City 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 application. Dated this 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 21227 1/ ass p Address Assignment Form City of Rexburg 0 City of Sugar City 0 Madison County Marne: /a l��h '� Prce Date: 017-3 j 1 Assigned by: Current Address ❑ Legal Description ❑ Parcel No. Address: „%1/17 Parcel No. Kf' po( o !'`44 Subdivision: Block: Lot: City Block: Block: Lot: New Address: 1 Care S Si olares 76 -7 i2so prce ! _ 1,-2 Additional Information: • • M- t �ir5 t - r' -`. ° .,e•f' � 'i •'r-t,'v. r •'i ,i 4't I� ti ■. .'Srorl•1. st -C c" ag. 7..•.•1 k.•_ 1', r . r•" 'i Yet- „' h . .�+ - A,• ',{ 'k .'t•,`'a �^^ f ±A`.• ♦ '_•J $f -t. ' a^ ■ �' -i}`i'i>m.` °,` �7tj . ?. 'h. 'S' 1S:r `:'A. Y Y-:.S' . yx • c`Y ri -.z Ate.rA t t a� � T:+T..�, �Y 4.-.3,-. 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