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Home My WebLink AboutBP & DOCS - 08-00148 & 08-00149 - Dormitory Housing - Remodel Z • • � x) c oO ° D z ImIl ma) 5' m� m C p �_ (71,N E. n "1 � 7 00 00 • ca o a. .* n p 0 006 • m Z..... _, . E i- g n o 3 co n Dii 1300C 0 -1 0 0 n x ° ' a c TJ rg o Ft 0 • Z &D)° m m O m •,,0 I o a. a -• 3 - W•p p ''* p °30 � g g * y CO 7 CO - Z. m V n 0 d� o N ° O � -1�(o m a p � N O Q n � o � T1 .D'a <D r ..0".'m <-8 -DC 13 ILL al IV O.• Q C 0 20 Z N d 0 ro RI n° ci 'G X o P N C rt N r, CD bZij m F• "< C 0 - 7 Q . CO 1111111111111tili 7 CD S "'I pl O fD m C c C. N .a a. 0 CD til%4 •� W° a �o m -s a m Z p fD O fD 7 0 ° 0 11414t ' m 0 (ro •m m s' 0z D = ° og m n = i8 0O= oE . C IC m N W° cn Xi 11111::411111 1 . 0 0 Q m 01 ... ID Iv CL m y x 0 .." m (111111:11:? 7• Ti y m - O� Z t�D O = =ma3 a'.cc3 m m 0 - m O S. C NJ (10 - 3 0 R. = n O N O 0 0 hu1 Z A W N --s W N A W N m -n T d S m y m m n N c m ° c 5 xi o m n c ,u S n ID — o z-a a ?Ro m n T m v p 0' co 0 C 0 m r- 0 13" ° 0 F? v aD O d _n Z v zzT ? 0 3 71 _ Z'S W m n o 1 oe Z Z Z 0 to u2' c -aa ID G 0 Ol C z -u W -a " �n N — to 0 '+• fD O-i l xi O a C V `Y N N O nZ N O.O. • 04gEXBUpC," • • CITY O F r ' =-7 0, REXI3URG 08 00148 & 08 00149 ��.'4,1Z 9 ,,. America's FarnilyCommunity 168 S 2nd E- COMMERCIAL & MULTI FAMILY BUILDING PER? 19 E MAIN,REXBURG, ID 83440 Dormitory Housing 208-359-3020 X326 PARCEL NUMBER:c'W O)?OO\ 1 I (We will provide this for you) SUBDIVISION: UNIT# BLOCK# LOT# (Addressing is based on the info s'ation st be accurate) O W N E R N A M E: 1 (.- i i ,-*", CONTACT PHONE # ?'2 — ();) —f S 4--35 PROPERTY ADDRESS: 2 � 1 �. PHONE #: Home ( ) �)5 i- I,.`»i Work, ( ) Cell ( ) �� ll OWNER INS DRESS: �/ - �' .- / CITY: `� '�� r .x77 , 'z`' STATEN ZIP: C _ EMAIL V�=i�i�`i'�jl C: �,.t %/��,f��A 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: Cell# Work# Fax# EMAIL IDAHO REGISTRATION# & EXP. DATE How many buildings are located on this property? Did you recently purchase this property? Yes (If yes,list previous owner's name) Is this a lot split. NO YES (Ple se bring copy of new legal description of property) PROPOSED USE 5� /l� )-7''',f�/ T l L r/L (i.e.,Single Family Residence,Multi Fa ,Apartments,Remode�Gara e Co ercial A �Y Garage, Addition,Etc.)—CIRCLE ONE APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury,I hereby certify that I have read this application •sta e 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 .mmiss.. .r e 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 matt, of this..pli a'.n and hereby authorized representatives of the City to enter upon the above-mentioned property for inspections purposes. NOTE: The building of ial evoke a.ermit on approval issued under the provisions of the 2003 International Code in cases of any false statement or misrepresentation of fact in the applies •n‘o .n,the.1.•.on which the permit or approval was based. Permit void if not started within 180 days. Permit void if work stops for 180 days. /7/1•4/L �� -5 / // / }K' Signature of 0 er/A..licant DAI.'E Do you prefe to b 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 Januay J.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 O�vEX9URC ♦� C I T Y O F City of Rexburg 7� '' '" ° REXBURG 19 E.Main janellh@rexburg.org Phone:208.359.3020 ext 326 America's Family Community Rexburg,ID 83440 www.rexburg.org Fax:208.359.3024 Affidavit of Legal Interest State of Idaho County of Madison I, / G1 7/ I`- / / r, — if eel Z Name Address geze-h-e frly fr// 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 herin or as to the ownership of the property which is the subject of the application. Dated this /7 11 day of &f 20 c ' g „W" Signature Subscribed and sworn to before me the day and year first above written. 1yoTitRp.% Notary Public of Idaho • ...-r f ••. +'UB 1,1G i Residing at: �cli 4 a K +�- f/ ********** • .• My commission expires: il5C)/() .•��F OFID r", Y p 3 • City of Rexburg NAME Please Complete the Entire Application! PROPERTY ADDRESS If the question does not apply fill in NA for non applicable SUBDIVISION Dwelling Units: Parcel Acres: SETBACKS FRONT SIDE SIDE BACK Remodeling Your Building/Home (need Estimate) $ SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building) First Floor Area d Unfinished Basement area A%4' Second floor/loft area Finished basement area Third floor/loft area ,2'4 Garage area A/7-r' Shed or Barn 4 `:4 Carport/Deck (30"above grade)Area Water Meter Quantity: I Water Meter Size: RequiredM PLUMBING Plumbing Contractor's Name: „l ` g � 1 ` � �1 it):. Business Name: �` �y.��. Address City State Zip Contact Phone: ( ) Business Phone: ( ) Email Fax FIXTURE COUNT(including roughed fixtures) Clothes Washing Machine Sprinklers s Dishwasher i Tub/Showers I Floor Drain Toilet/Urinal Garbage Disposal Water Heater Hot Tub/Spa Water Softener Sinks (Lavatories,kitchens, bar,mop) (� j-r'1 Plumbing Estimate $ 1; ;L i (Commercial Only) / `�� .� � o � ' 3 I7 I 1 •rcn' Sign�tur erased Contractor License number Date 4 The Ci ty�xbu permit fee schedule s g p f chedule rs the same as required by hate of Idaho Please Complete the Entire Application! If the question does not apply fill in NA for non applicable NAME PROPERTY ADDRESS SUBDIVISION Permit# Required!!! MECHANICAL Mechanical Contractor's Name: //11'' Business Name: Address City State Zip Contact Phone: ( ) Business Phone: ( ) Email Fax Mechanical Estimate $ (Commercial/Multi Family Only) FIXTURES&APPLIANCES COUNT (Single Family Dwelling Only) Furnace Exhaust or Vent Ducts Furnace/Air Conditioner Combo 2,7 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 Mechanical Sizing Calculations must be submitted with Plans & Application Point of Delivery must be shown on plans. . ..Lr�E .. . ._ /✓ /7//40e' Required! Signatur o'� 'censed C ctor License number Da The City of Rexburg's permit fee schedule is the same as required by the State of Idaho 5 i I Building Safety Department pv.uR c of � CITY OF City of Rexburg 140101 9y j� R EXBU RG 19 E Main janellh @rexburg.org Phone:208.359.3020 x326 • ,, Family Rexburg,ID 83440 www.rexburg.org America's il Community 9• 9 Fax:208.359.3024 OWNER'S NAME PROPERTY ADDRESS SUBDIVISION Permit #08 00149 PHASE LOT BLOCK 168 S 2nd E Required!! ELECTRICAL, Electrical Contractor's Name Diq,e.0£7( (..e.)e{ Business Name Address g7/i 7006 S City 6-iry ev2 State Zip a3'/Yd Cell Phone (doh) Business Phone (.266") 354-6&C(7 Fax (ilor) 36 --G5Y7 Email be(it l`Y ,� N4S4.) rC'o yt Electrical Estimate (cost of wiring&labor) $ (COMMERCIAL ONLY) (Includes the cost of materials installed regardless of the party supp#ing it). TYPES OF INSTALLATION (New Residential includes everything contained within the resit ' ge at the same time) RESIDEN` s ma c Q ❑ *Up to 1,500 sq ft- $72 -- v4,01-1- - $120 ❑ *2,501 to 3,500 sq ft- $168 ,_ ^ wk.( 0 011 :_ $216 ❑ **Over 4,500 sq ft-$216 plus $.04/sq ft: 1'v'� (J ❑ Existing Residential(# of Branch Circuits) -$40 ph... _ #of circuits ❑ Multi-Family Only: #of units per building- $120/bldg+ v-jurac ❑ 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 ❑ 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 $10 per circuit ❑ Other Installations: Wiring not specifically covered by any of the above: Cost of Wiring&Libor.$ (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 ❑ 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. J /9 /— _o 7 Signature of Licensed Contractor License number Date Signature of Licensed Contracto• License number • Date The City of Rexburg's permit fee schedule is the same as required by the State of Idaho Building Safety Department ot0.XB/R0, r CITY OF City of Rexburg c``;3��'m REXBLTRG -- - N 19 E.Main janellh@rexburg.org Phone:208.359.3020 , America's Family Community Rexburg,ID 83440 www.rexburg.org Fax:208.359.3024 APPLICATION: "CONSTRUCTION PERMIT" CONSTRUCTION PERMIT #: PERMIT APPROVED: YES/NO $50.00 FEE PAID: YES/NO APPROVED BY: -APPLICANT INFORMA ON: Business Name: ' �� Office Address: _/ b i, `? (7,4 V State Zip Office Phone Number: ( `t�? ) , gv -- ,c j, / Contractor Performir. th WQ 0k: Contact Person: ( yr- c -� � Cell Phone # (2l )_ 3 -611e-.)-"3 -LOCATION OF WORK TO BE DONE: Street Address Where Work Will Be Done: Business Name Where Work Will Be Done: Dates For Work To Be Done: To Contact Person: Phone Number: ( ) Cell # ( ) PLEASE CHECK THE TYPE OF PERMIT(S) YOU ARE APPLYING FOR: Cl AUTOMATIC FIRE-EXTINGUISHING SYSTEMS ❑ COMPRESSED GASES ❑ FIRE ALARM AND DETECTION SYSTEMS AND RELATED EQUIPMENT ❑ FIRE PUMPS AND RELATED EQUIPMENT ❑ FLAMMABLE AND COMMBUSTIBLE LIQUIDS ❑ HAZARDOUS MATERIALS ❑ INDUSTRIAL OVENS ❑ LP-GAS ❑ PRIVATE FIRE HYDRANTS ❑ SPRAYING OR DIPPING ❑ STANDPIPE SYSTEMS ❑ TEMPORARY MEMBRANE STRUCTURES, TENTS, AND CANOPIES Applicant's Signature Date 7 • • SUBCONTRACTOR LIST Excavation&Earthwork: -FCC/°y,G u Concrete: 11 Masonry: /V. Roofing: 41 Insulation: ( )/: ',..4. - 4 :A977L Drywall: Painting: Floor Coverings: ' - L/(GtL4 /` C ) :// Plumbing: //,u i' /`.• '' Zt , J Heating: Electrical: d'4(4 6/4.4Zi-1/ Special Construction (Manufacturer or Supplier) Roof Trusses: Floor/Ceiling Joists: , ✓`l Siding/Exterior Trim: Other: /'V'i- 8 EXEMPTICS FROM STATE REGTRATION 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.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 KOwner 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 a.. e information is true and correct to the best of my knowledge. ,t,v'�i 7 ' E// Oaf Signature Da e Print Name 9