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Home My WebLink AboutAPPLICATIONS & CO - 10-00138 - 289 Polo Dr - Basement Finish • a ,. -: Certificate of Occupancy 0 r f REXBURG City of Rexburg ''`� Department of Community Development 35 N. 1st E. /Rexburg, ID. 83440 Phone (208) 359-3020/ Fax (208) 359-3022 Building Permit No: 10 00138 Applicable Edition of Code: International Building Code 2006 Site Address: 289 Polo Dr Use and Occupancy: Single Family Residential Basement Finish Type of Construction: Type V, non-rated Design Occupant Load: NA Sprinkler System Required: No Name and Address of Owner: Contractor: Owner/Lessee Special Conditions: Basement finish of 1,694 sq. ft. 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: /4/5---/2.-- C.O Issued by: Gam` �- 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: n/ A Fire Inspector: t\) A Electrical Inspector: � .4_1 P8Z Administrator N A Al- - _a �' m E. n � .�'A e •C CO • 1'U °- _► tb r' c� .: v I . .o tR . :O z -I o ..•E i 'fit t�D .... y:. ... Z ,(A Z ...ow • ?.a �`my n I { '•Zh �� D 2 a y —I i i .�o ° .8 O C O. 'O c 0. ro �. ..{ P ZS .5• t m a"n a.o m rt 0 �'1.� . . "••ao�. § N� .0 a -n �7 _ � ca. % •O CO tc �,C ••,: •. . • .: �. i <... g. m • —0.2 tr o : .G H C .�• �,•� •C 0.w ...a . of a•Q •eD .;� "r 1•3 ��p •rfl "./� .a.tD tD tD•ZD- co �..ca C. A" 3. O = a• r. a c.m a.tR t1 O p• N:. Z. to ,r . 'D g 7. ••_ • 1. . .".:W:A' y' y (it ...�-o "C"' 3 CD I. •q R CD m .: S C C' m CD cu ..o : i • 1• -O m.. " to. 13 ...a W 0�:_i . �.. Ifl' - a: c�• o ciPSo• ... .. ..'11104 0 . • . ...:In to•:► s 4. ^* n M • 0 m . .n.: . = O a • o 0 � D w • :.M M•c 5.N no om • : Q" r QC�. CD 5 ••... :•.)■.' • ..4 •■I i,. \ . ... • • .0 Li) .11) '. . • rT1 CD ...H 1111111111 Z)11111111111111i ' • • Cr:C:14 . .• -13 • 3'2...0: • CX)....... . a N N ,•0 LuLl " to W N • •D•• W IV o •OD�.o :••K..y • .o.., .0. �- _ o0. 0.- a c. .� o G 'z ,.n p•w �.3 0 O•• m� Nw 1111 d . 0 - v.J1. . • .• a I . , f <1 _ •a _ • INSPECTION TICKET a Bldg. a Plumb. IA Elect. a Mech. a Fire Inspection Request: Rec'd By _: AI #/LI i. Date cI—L%—1 Z Req. By ga1/ /u -t csli Phone No. `fctLP-70al' Project 5CXYI ertf - (I'11Sh Permit No. I O OD L3?) Address 289 ro to C•, Inspection Type Finn) RtAispect Day/Time Req. l Irt,rs 9—to—12— x-(.:'36 p •M . Inspector's Report IA Res. a Comm, r-....!.� . . —.� • INSPECTED ITEMS CONFORM TO APPROVED DWGS DY ON 4N/A INSPE OR'S ACTION '»ROVED [J DISAPPROVED Q FINAL Li C.O.(FINAL) NOT APPLICABLE ❑DID NOT INSPECT ACTION REQUIRED: r\ 'Y • Signed ��ii� , Aik Inspeclor Rec't Acknowledged Moo Oft*Copy *Pao.Job Copy Pink.kMry+daY Copy F FIR C003 BUSINE110 OCCUPANCY INSPECT. TICKE17 Bldg. ❑ Plumb. ❑ Elect. ❑ Mech. ❑ Fire Inspection Request: Rec'd By Date $11—ii—a- Req. By ;1/0 A/4 L Phone No. 7$y-73T Project iSage '` "1( Permit No. 16 VO/3$ Address Ze? Polo br Inspection Type rl1Vit- Day/Time Req. $-11 /0 g '✓h ' Inspector's Report yl Res. ❑ Comm. INSPECTED ITEMS CONFORM TO APPROVED DWGS ❑Y ❑N ❑N/A INSPECTOR'S ACTION APPROVED ❑DISAPPROVED ❑FINAL ❑C.O. (FINAL) ❑NOT APPLICABLE ❑DID NOT INSPECT ACTION REQUIRED: Signed Z141144'7tInspector Rec't Acknowledged CITY OF REXBURG, 12 North Center, Rexburg,Idaho 83440 White-Office Copy Yellow-Job Copy Pink-Inspector's Copy tea° ---ire CITY OF ,,,7x Please Complet e Entire Application! `" /�,�,° REXBURG If the question does not apply fill in NA for non applicable Americas Family Community t NFO RESIDENTIAL BUILDING PERMIT APPLICATION 35 N 1st E, REXBURG, ID 83440 208-372-2326 PARCEL NUMBER: (We will provide this for you) SUBDIVISION: UNIT# BLOCK# LOT# (Addressing is based on the information-must be accurate) Dwelling Units: Parcel Acres: O ER NAME: I .,•; Yl CONTACT PHONE # c kJ 1 -"13 PROPERTY ADDRESS: oisoi ?d Ca Etc, PHONE #: Home (247) 7 S(-/-73 91 Work (245) 116' Cell ( ) OWNER MAILING ADDRESS: a 89 Poo CITY: ke>c6c-tr, STATE:—V ZIP: R3L-64o EMAIL ✓lRS(Qi51af- r� hokri.�rf-CD' 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 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 Off yes,list previous owner's name) Is this a lot split? 0 YES (Please bring copy of new legal description of property) PROPOSED USE: (i.e.,Single Family Residence,Multi Family,Apartment Remodel arage,Commercial,Addition,Etc.) APPLICANTS 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 misrepresentation of fact in the application or on 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. / / 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 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** r Builcig Safety Departments o�RExavR�i C I T Y O F City of Rexburg U, 07� 1 ° REXBURG • 35 N 1 sr E Phone:208.372.2326 America's Family Community Rexburg,ID 83440 www.rexburg.org Fax:208.359.3022 '"`° ' Affidavit of Legal Interest State of Idaho County of Madison I, 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: r .a oXBuR�Bui�in Safety De artm et CITY OF REXBURG c City of Rexburg y; fmo, 35 N 1st E Phone:208.372.2326 �, America's Family Community Rexburg,ID 83440 www.rexburg.org Fax:208.359.3022 ""f° 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. Signature Date ❑ Owner or ❑ Builder Printed Name Building Safety Department gaxe °4 14 0,r CITY OF City of Rexburg C.7� �1, 'x —• ° REXBURG 35 N 1st E Phone:208.372.2326 � � �� ' Rexburg,ID 83440 www.rexburg.org °<'=H E o America's Family Community 9 9• 9 Fax:208.359.3022 NAME PROPERTY ADDRESS ,,2 8 C PO Jo pr, Permit# SUBDIVISION PHASE LOT BLOCK Remodeling Your Building/Home (need Estimate) $ 1 ,433 r 3 2 SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building) First Floor Area Unfinished Basement area f(09 t" 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: RequiredlIl PLUMBING Plumbing Contractor's Name: Business Name: Address City State Zip Contact Phone: ( ) Business Phone: ( ) Email Fax 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 Estimate $ (COMMERCIAL/MULTI-FAMILY ONLY) Signature of Licensed Contractor License Number&Expiration Date Date • • Building Safety Department °°'-EXBURC C I T Y OF 6 City of Rexburg • R EXB mG 1� lJ It 35 N 1st E Phone:208.372.2326 ;^ ,iJ\ America `� www.rexburg.org 's Family Community Rexburg,ID 83440 g•ar9 Fax:208.359.3022 NAME PROPERTY ADDRESS Permit# SUBDIVISION PHASE LOT BLOCK Required!!! MECHANICAL Mechanical Contractor's Name Business Name Address City State Zip Cell Phone ( ) Business Phone ( ) Fax ( ) Email Mechanical Estimate $ (Commercial/Multi Family Only) FIXTURES&APPLIANCES COUNT (Single Family Dwelling Only) Furnace Exhaust or Vent Ducts (water heater) Furnace/Air Conditioner Combo Dryer Vents Heat Pump Range Hood Vents Air Conditioner Cook Stove Vents Evaporative Cooler Bath Fan Vents Unit Heater other similar vents &ducts: 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 Heat (Circle all that apply) Gas Oil Coal Fireplace Electric Hydronic Signature of Licensed Contractor License number Date 6 Building Safety Department o4REXB„RG City of Rexburg 4). CITY OF ° REXBURG 35 N 1 E j sr Phone:208.372.2326 \ • -_ �, '• E p America's Family Community Rexburg,ID 83440 www.rexburg.org Fax:208.359.3022 OWNER'S NAME PROPERTY ADDRESS Permit# SUBDIVISION PHASE LOT BLOCK HOME OWNER 'S ELECTRICAL PERMIT Home Owner's Name Address City State Zip Cell Phone ( ) Home Phone ( ) Fax ( ) Email TYPES OF INSTALLATION (New Residential includes everything contained within the residential structure and attached garage at the same time) 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 91 Existing Residential (# of Branch Circuits) - $40 plus $10 per circuit: CO # 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 parry 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. Signature of Home Owner Date Build% Safety Department S ,,,vs-Bui N� C I T Y O F City of Rexburg 'x �i.ro► ° REXBURG ,a%%�►1 • 35 N 15t E Phone:208.372.2326 America's Family Community Rexburg,ID 83440 www.rexburg.org Fax:208.359.3022 , E0 OWNER'S NAME PROPERTY ADDRESS Permit# SUBDIVISION PHASE LOT BLOCK Required!!! ELECTRICAL Electrical Contractor's Name Business Name Address City State Zip 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 ❑ *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 par),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 • SUBCONTRACTOR LIST • Excavation&Earthwork: Concrete: Masonry: Roofing: Insulation: Drywall: Painting: Floor Coverings: Plumbing: Heating: Electrical: Special Construction (Manufacturer or Supplier) Roof Trusses: Floor/Ceiling Joists: Siding/Exterior Trim: Other: EXEMPTIATS FROM STATE RECIISTRATION 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.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. Signature Date Print Name