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MULT DOCS & CO - 11-00202 - 582 Woodbridge St - New SFR
1110 Certificate of Occupancy , ` -) REXBURG City of Rexburg Community Development Department of p Y ment p 35 N. 1st E. / Rexburg, ID. 83440 Phone (208) 359-3020/ Fax (208) 359-3022 Building Permit No: 11 00202 Applicable Edition of Code: International Building Code 2009 Site Address: 582 Woodbridge Street 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: Contractor: Ashir Construction 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: f 2,73/7__ < J, C.0 Issued by: �� - Llly 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: - Fire Inspector: F` Electrical Inspector; P&Z Administrator ist Z • GI 11 z 0 ... , ..j,,,.C.N.6,...CO MOM 1.1q X < ''' 9.1 p m " C .. . .0 m v o o.a -� c o z 0 rn z o r ,m zup - z (n a"m > —4 r a 3 a " _ �' p -< 7; c -070 C ' � !3� al0 W= Y.i ,r man � 0 rn o � y 0 A n a N ? o 0 O m z o 2< R CD in 0 ca w li o Q d m r N # < 0 CCJ CC2 CD CD = cx X) � < S O pr Cl) 0 Q R 0 CD 0 O.n 07 fn Z Q. eD 0 CD C3. O 3 o ; — eD a, ? CAD 3 m t° p r c� ri w °' Cl)> a 5 0. Q aoc 0 coo (:tr ta411:7:40/ p m 11. . —� co 1111 1111t �C. Q m 3 ao 8 cQ . ' co < W a c.. 8 0 a z ...< g O ,00„� 0 (::::) ICIII killillita 0 • s< a,. n -6 5 .3.. ....., ow' irJ (\(\c:, ro CD E7 (::::) 10.104111111% m -1 ,�,c a cnn UH Z°C — e�D —I Q.p o Q•01 0 ^ ; g o = a C 5- 0 2 <-g T 0 — co St Er FIT (::::) kill** asc4 m C N m 3 O v ,-��v � '0 •m y omm2.o a. cn e. C 0 C2 IN)A ,.r - ow y a m m cn i W N I 0 CQ I O� �I C7f al as ( (a N� Fa'1 � o ado. X * !' cnI I ?! Cn : 0 ; 5 I 'T1 71 Mir1KIM M c-i (n 3 �. m • o c n11 * 5 a " � v, ! n1 0 0I ° minim Crn7 CO m CD CD Cu m c I "Vaci �� a � vi _ Iv �• n � 1cl. � v —I ry - CD (p � ; CO O (L) m a Q • a c;um o o X1 7 m , 0 ac I o j ∎ 0 Wpm o n v1 c ?. R -U 3 n1 I m ' m _ _ Z Z�-n m w 0 z CA ro r' , I I ?? I � ' C) -0rn< ' c !g I I am ^-4 y j Z p Q n o CD f I I , 1 I b 1v I<r a • INSPECTION TICKETS /1/r. 0 Bldg. ❑ Plumb. ❑ Elect. 0 Mech. ❑ Fire Inspection ' n uest: Rec'd By Date 7 /2 -12-- P II Req. By i(/ , Ci Iu1.1 eJ Phone No. f g I-2 Project SFg Permit No. I ( 66 2G Z Address 5€2, 4100 bite ei Inspection Type FI/JAL_ jJ Day/Time Req. /-f2'/Z L1 z P.m• ai1 k ek tPai) Inspector's Report 6 Res. ❑ Comm. St!--*16 '5 /nib 5/et != f exit /feeds /444A..ty____ !tili . ,Sirs (edk f-tn. c'-k For- f-ein _Covtd I{-ice 4-6r ■vv c r'etb,1( spaces i • / !..•/ !.: re / e'- A. , - Pam, GO odeA. of>14+5 iiIle. jeep in g--- roarvLs _ INSPECTED ITEMS CONFORM TO APPROVED DWGS V 0 D N ❑N/A INSPECTOR'S ACTION 0 APPROVED APPROVED 0 FINAL ❑C.O.(FINAL) ❑NOT APPLICABLE ❑DID NOT INSPECT ACTION REQUIRED: 7 r U : ka4ra.;I 3y'`-38 t`j pai-j-11 ho Ie-s; Fore- S - - rl . G r-own s - 4-s iiL - ,e< i Signed 4_/L. t/ .4r-tS Inspector Rec't Acknowledged While•ONiee Copy Yellow-Job Copy Pink•Inspector's Copy F-FIR-0003 • INSPECTION TICKE7110 LI Bldg. Plumb. ❑ Elect. ❑ Mech. ❑ Fire Inspection Request: Rec'd By ? yt,,tn -�e.� Date (1 I 12-- Req. By n L.i .A.A,r'hilloL9`.,Phone No.____$.19..31—__ Project 5$ oa U.)0d Permit No. 1 ( 0 0 0 L Address 5 W 00 cth?`I ct-'J Inspection Type tI ru/rn at Day/Time Req. to/1 , 4 p Inspector's Report ic i ❑ Res. ❑ Comm. INSPECTED ITEMS CONFORM TO APPROVED DWGS ❑Y ❑N []N/A INSPECTOR'S ACTION 1 APPROVED ❑DISAPPROVED (]FINAL 4'4 C.O.(FINAL) ❑NOT APPLICABLE ❑DID NOT INSPECT ACTION REQUIRED: Signed �Z=/ Inspector Rec't A nowledged F �Cavr White- e Copy Yellow•Job Copy F-FIR•C003 • INSPECTION TICKET', ❑ Bldg. Aj Plumb. ❑ Elect. ❑ Mech. ❑ Fire Inspection Request: Rec'd By Jr4J , Date z- Q Req. By ji,1 G 2z t S/,iyu Phone No. S,X/ Project Permit No. 1 / 6'e10 6�? Address L`vJG,64✓!d y Inspection Type Pi/Vi4-L Day!Time Req. f,-(y/ Z 13d p=vit Inspector's Report pa Res. ❑ Comm. I ri c�, �t f r= .4 (a j d 16 INSPECTED ITEMS CONFORM TO APPROVED DWGS ❑Y ❑N [J N/A INSPECTOR'S ACTION ❑APPROVED ktP SAPPROVED 0 FINAL ❑C.O.(FINAL) ❑NOT APPLICABLE ❑DID NOT INSPECT ACTION REQUIRED: Signed -���-`---- Inspector Rec't Acknowled: +, White-Office Copy Yellow-Job Copy Pink-Inspectors Copy F-FIR.0003 • INSPECTION TICKED ❑ Bldg. 2t. Plumb. ❑ Elect. ❑ Mech. ❑ Fire Inspection Request: Rec'd By 99 Date Req. By - .c) Phone No.gis 1 -21 Project Permit No. /1 ZDZ Address �J a2 Inspection Type +,.L.1 4 / Day/Time Req. 1o/5 Inspector's Report Res. ❑ Comm. 1/4.3LA 1 z3 L . 4 4YeA C;(/‘<._ �.a�L P+1)-4-\* 17) C C 1 '. _ I � ■ ' kg. 4, INSPECTED ITEMS CONFORM I APPROVED DWGS ❑Y ❑N ❑N/A INSPECTOR'S ACTION ❑APPROVED COISAPPROVED ❑FINAL ❑C.O. (FINAL) ❑NOT APPLICABLE ❑DID NOT INSPECT ACTION REQUIRED: --- Signed \ Inspector • cknowledged WNW-OQice Copy Yellow•Job Copy Pink-Inspectors Copy F-FIR•C003 • INSPECTION TICKET• ❑ Bldg. ❑ Plumb. 0 Elect. ❑ Mech. ❑ Fire Inspection Request: Rec'd By -�(\ (k\ ) Date t y Req. By 00\Ye\M \1\f\l-1L `e)Phone No r? -1 - 2CI?i Project Qs. Permit No. \ \ LULLIL Address )1.[, ' C. -'., -ii' \(AC\C Inspection Type -C\y \c,..\ ` -;-� (1 \\, j . - a)y-1 Day/Time Req. 6 \:XL N ,1 T C L, 00 I`r-l Inspector's Report Res. ❑ Comm. • 1 .._�c�.:'s- .t_�.'�. � \-ter. _.r._\�.1� ii �.—Jri, r0i � ,k�° 1 ■ % • i • -tom ' 42Z8j " ``�� vt.J , •-L.. -_ ,—I k] ♦ .1 -.... I INSPECTED ITEMS CONFORM TO APPROVED DWGS DY O N NSA INSPECTOR'S ACTION � ❑APPROVED EI 'DISAPPROVED ❑FINAL ❑C.O.(FINAL) ❑ I APPLI • BLE ❑DID NOT INSPECT ACTION REQUIRED_!' /`1. • ■_ mom_ . Sign-' /_ . I 1 Inspector Rec't Acknowledged Whde-Olfice Copy YYeMow-Job Coq PiWi- rmwdah Coq F-FIR•C003 O INSPECTION TICKET • ❑ Bldg. (.1 Plumb. 0 Elect. ❑ Mech. ❑ Fire Inspection equest: Rec'd By , cc�-Lc.LE Date (0-(C—1 Z Req. By Li ) 4 /141 Phone No. g J/- % Project .c 2 Permit No. f A D O 2e)2. Address 5 r2 te_)66,d k r/c19.0 Inspection Type F//`/,,4---- Day/Time Req. 4.0 --ti"--/ 14;c,) p-r Inspector's Report Res. ❑ Comm. 10.70)_.o .' 0+ 0, __'...:Ill A(..:1 _tat lb . INSPECTED ITEMS CONFORM TO APPROVED DWGS DY ❑N N/A INSPE OR'S ACTION AP ROVED ❑DISAPPROVED ❑FINAL 11W.O.(FINAL) ❑NOT APPLICABLE ❑DID NOT INSPECT ACTION REQUIRED Ow . Signe Inspector Rec't Acknowledged INN,-Once Copy Yellow-Job Copy Pink-Inspector's Copy F-FIR-0003 • Builag Safety Department• o v e..u R G o C I T Y O F City of Rexburg ;''o REXBT m G '�� 1t1.�lJ 1\ jj 5)) — civ 35 N 1st E Phone:208.372.2326 ' =DES America's Family Community Rexburg,ID 83440 www.rexburg.org Fax:208.359.3022 Office Hours: Monday-Friday 8:OOam-4:OOpm Single Family Residential Pre-Construction Checklist Seismic Design Category-D Roof Snow Load-35 lbs. per sq. ft. Ground Snow-50 lbs. per sq. ft. Wind Load-90 MPH Frost Depth-36" The following items should be completed before you submit your building permit application. Completion ofa Building Permit Application: You may print this application from our website www.rexburg.org or pick up a copy at the City Hall Annex Building (address above). For Residential Permits: (the following is required to be submitted before the Application can be approved) O- 2 sets of site plans and 2 sets of building plans (must be drawn to scale) -Plans must include foundation plan, floor joist layout, floor plan,roof layout, sectional views, front,back, and side elevations,mechanical layout, stair details and any details required to illustrate special construction. 5-- Energy Compliance Report: The State of Idaho has adopted the International Energy Conservation Code (IECC). A Compliance Review must be completed and submitted (the rescheck software is available online at www.energycodes.gov). ka- Page 2 of the Application must include the Idaho Contractor's Registration Number or the exemption form must be completed and signed, see Page 10. tif Page 5 of the Application must be completed and signed by your Plumber. .. Page 6 of the Application must be completed and signed by your Mechanical Contractor. • Page 8 of the Application must be completed and signed by your Electrician. Home owners: please complete page 6 of the application if you will be doing your own electrical work. ❑ Truss details including engineered floor joists are required. ❑ Property Line form needs to be signed by the builder or owner, see Page 4. Subdivisions: If you plan to build in a subdivision please check the Rexburg Development Code for any requirements such as,property setbacks, architecture board approval, etc. This information is available from the Planning&Zoning Department at the Annex Building located at 19 East Main. New Residential Homes: If your building permit is for a new home,you will need the parcel number (a parcel number is the county's property identification which recognizes a plot of land) and a new physical address will be issued. If you do not know the parcel number and cannot find a record of it,please bring the name of the subdivision,phase, and the lot and block numbers. The correct location is vital to assure correct addressing. Remodels: If you are considering a remodel, a copy of the bid or estimate for the remodel must be submitted with the Permit Application. • 2 sets of Plans are required (may need IECC Review). •Additions are the same requirements as new construction. t ! iptiXB(Lk IP • 0 - . CITY OF ...1�+�+'o Please Complete the Entire Application! ' �;/� REXBURG If the question does not apply fill in NA for non applicable �/ V — -_cam---- ' Eo America's Family Community RESIDENTIAL BUILDING PERMIT APPLICATION 35 N 1St E,REXBURG,ID 83440 208-372-2326 PARCEL NUMBER: (We will provide this for you) SUBDIVISION: ` -rc∎-3 c i3-A al:,E- UNIT# BLOCK# Li LOT# 3' (Addressing is based on the information-must be accurate) Dwelling Units: ( Parcel Acres: OWNER NAME: aI-4 I>zE"t A1r4 1,,...›4-6. CONTACT PHONE#(Zej ) 415.7,i - z• %1 PROPERTY ADDRESS: crr *z-IDt(i� s C _ 1 ;L cz G. i t 3"sc-iya PHONE#: Home ( ) Work ( ) Cell PI ' 1 - 2-7 ci OWNER MAILING ADDRESS: Ua"S See,,,-, A.v CITY: F.‹.)criAiz&-. STATE: 1 D ZIP: Sf3yLi 6 EMAIL ac. e S I ,..,c, C (z w"A i I. Co+-^-,.. 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: 1Q c...:N-,..7L.,,._7s0, 3 LLL MAILING ADDRESS: 54' t-'c°"c's n ,z.t (-,c. CITY ' -si7.,.a i.. STATE tip ZIP 334/cies PHONE #: Home ( ) Work ( ) Cell 1 Zti - ( 1-S 1 EMAIL FAX IDAHO REGISTRATION #&EXP. DATE i--z.tF - 7e;t-l- How many buildings are located on this property? I Did you recently purchase this property? Nc(YYs{if yes,list previous owner's name) >_-- . _-7-‘ (-c t PL-L-r-- Is this a lot split? 0 YES (Please bring copy of new legal description of property) PROPOSED USE: 5 t rJ ie i_C "t"....11.4 i Z.s%PG.-) t-C (i.e.,Single Family Residence,Multi Family,Apartments,Remodel,Garage,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: Th,buildngg official may revoke a permit on approval issued under the provisions of the 2003 International Code in cases of an false sta ment or misr resent "on of fact in the application or on the plans on which the permit or approval was based. Permit void if not started wi 180 ys. Permit vo. if wo stops for 180 days. L11 ' 5 /'4! / 7v1 ( Signa re f Owner/Applica 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 beginningJanuary 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 aE a� X u R� o CITY OF City of Rexburg ` °� ° REXBURG 'r., 35 N 1st 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 A A:4 I, p 'D(1--t--1/-3 t a 1-\ vVw a-F- , 2„.61,3 .5%C�i ' (\:,4 Name Address . ',.it.(t I I� 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 1 day of AA A-1 ,20 ) Signa re Subscribed and sworn to before me the day and year first above written. Notary Public of Idaho Residing at: My commission expires: 3 • • Building Safety Department ,y°�X B`,a C I T Y O F City of Rexburg REX BRG U 35 N 1st E 208.372.2326 » ;�; Phone:208.372.232 America's Family Community Rexburg,ID 83440 www.rexburg.org Fax:208.359.3022 � '`"E° 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. - - -St -- _z Si tare Date 4`.t A•-,;Avvw tit Owner or ❑ Builder Printed Name 4 Building Safety Department OM) q r e C I T Y O F City of Rexburg REXBURG 35 N 1st E Phone:208.372.2326 , America's Family Community Rexburg,ID 83440 www.rexburg.org Fax:208.359.3022 NAME Nr-li, w..c. i PROPERTY ADDRESS C;gi rtz < '7 Permit# SUBDIVISION 520 N E 2.4 v PHASE LOT Sf BLOCK Remodeling Your Building/Home (need Estimate) $ SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building) First Floor Area r 1 (P Unfinished Basement area NI s-! Second floor/loft area ;3.14 Finished basement area Npc Third floor/loft area ;4/;t Garage area akK Shed or Barn N/A Carport/Deck (30"above grade)Area t--1h L Water Meter Quantity: **************Water Meter Size: Required!! PLUMBING Plumbing Contractor's Name: G1 L v.3 Cam*= Business Name: Address City State Zip Contact Phone: ( ) Business Phone: ( ) Email Fax FIXTURE COUNT(including roughed&ztures) Clothes Washing Machine Sprinklers Dishwasher 7 Tub/Showers Floor Drain Toilet/Urinal f Garbage Disposal I 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 5 • • Building Safety Department ;o4aExa°RC, C I T Y O F City of Rexburg 17". REXBURG 35 N 1st E Phone:208.372.2326 Rexburg,ID 83440 www.rexburg.org Fax:208.359.3022 America's Family Community NAME v(--\v-,. ct c,--= PROPERTY ADDRESS S k z- i.v U c s> c3 n 1 i:) S1• Permit# SUBDIVISION PHASE LOT BLOCK Required!!! MECHANICAL Mechanical Contractor's Name '1 O etZ- 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 I Exhaust or Vent Ducts (water heater) Furnace/Air Conditioner Combo ' Dryer Vents Heat Pump Range Hood Vents Air Conditioner Cook Stove Vents Evaporative Cooler 2 Bath Fan Vents Unit Heater other similar vents &ducts: Space Heater Decorative gas-fired appliance Incinerator System Boiler Pool Heater I Fuel Gas Pipe Outlets including stubbed in or future outlets Inlet Pressure (Meter Supply) PSI Heat (Circle all that apply)c asp Oil Coal Fireplace Electric Hydronic Signature of Licensed Contractor License number Date 6 Building Safety Department 04 URC C I T Y O F City of Rexburg s R EXBURG 35 N 1st E Phone:208.372.2326 *e America's Family Community Rexburg,ID 83440 www.rexburg.org Fax:208.359.3022 OWNER'S NAME S p,z- ����� PROPERTY ADDRESS 6 s w C o r3c�-t t. -c . Permit# 11 SUBDIVISION pie sz.-1 582 Woodbridge St PHASE LOT St BLOCK Y Permanent Power HOME OWNER 'S ELECTRICAL PERMIT Home Owner's Name /c'S h1 v�c�ZC Address '2-6'S S'7 E,tJ L4 Pc•t L City '1 x15. g z. State i n Zip 3 Li'-a 0 Cell Phone - Z 1051 Home Phone ( ) Fax ( ) Email e [z vs-•„1 a L Lc' 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 ❑ 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 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. Sign, e of Home Owner Date 7 Building Safety Department o� — CITY OF QExB VR City of Rexburg i'r jI'o REXBURG 35 N 1st E Phone:208.372.2326 �.o America's Family Community Rexburg,ID 83440 www.rexburg.org Fax:208.359.3022 OWNER'S NAME iNc:3 PROPERTY ADDRESS ‘5S-1_. ti Permit# SUBDIVISION cz-1 v L c PHASE LOT BLOCK `1 Required!!! ELECTRICAL Electrical Contractor's Name 1 1 Ott N = 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 supping 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 lja *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 $10 per circuit ❑ Other Installations: Wiring not specifically covered by any of the above: Cost of firing&Labor:$ (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 SUBCONTRACTOR LIST • Excavation&Earthwork: -jay OVQ;.>�(L - ►�;v :, ��r{ , Concrete: y C.)L'∎i,., v Masonry: 1iS Roofing: V ( 0,3 e- Insulation: / tom% Drywall: n1 E-41— Painting: _I C)-:v,v Floor Coverings: f c e.)r'i Plumbing: 1 N ell-- Heating: ere Electrical: Y ett- Special Construction (Manufacturer or Supplier) Roof Trusses: '7,...,r4 Floor/Ceiling Joists: ` (-- Siding/Exterior Trim: S tti C C. Other: 9 ■ • EXEMPTIONS FROM STATE REGISTRATION As of January 1,2006,the City of Rexburg can no longer sell permits without having a copy of your State registration number or your exemption from the State registration. Please send a copy of your state registration or fill out this form showing your exemption and send it with your license renewal or your next permit application. (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.httn) ❑ 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 I; 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 her f cer 'fy that the ve i formation is true and correct to the best of my knowledge. Si e Date Print Name 10 , , , C.;i- 2-1_,,) _ ' , , • .,,,; , , .,. , ', ,P,` .., ,:y-r- , , _., , , , , , , , , , : , , ' , ,A^•-.. ,' ' 1 :-'-'2.,'"- - - „A,Y,L9.- , . , , -- , , . , i , , . , , , , , , , , , , ,._, , , , ,...,._ , , ' .,,,,.! , , , ' , .''''.. , 7 , , „ , - ' , , , 1 , , I , . : 1 :, - , , 1 : , , , . , , , , , -7, . : - -- , --- ' ,, ,,,,,,,......,:'_- I. :, _____,. ,,,,,„,,_ 7, . __ ,, ":_.,_,_ , ,71''-_. ', ,-- ' ' -Z: , ,,..3:, , , , , --: .._-; .,- '''.,:-■I 7 7,3 -,;" , •,,,-, , , , S ; , ' ' •.= -' - ' , 1 -'3 ' , r � a --•. ft_M. .,... „ Compliance Certificate Energy Code: 2007 IECC Location: Rexburg,Idaho Construction Type: Single Family Building Orientation: Bldg.faces 0 deg.from North Conditioned Floor Area: 1962 ft2 Glazing Area Percentage: 10% Heating Degree Days: 8693 Climate Zone: 6 Construction Site: Owner/Agent: Designer/Contractor: Compliance:19.7%Better Than Code Maximum UA:371 Your UA:298 The%Better or Worse Than Code index reflects how dose to compliance the house is based on code trade-off rules. It DOES NOT provide an estimate of energy use or cost relative to a minimum-code home. M* �`:i',��;�� =^-�.,x�u,, ,., Wall:Wood Frame,16in.o.c. 560 19.0 0.0 28 Orientation:Front Window:Vinyl Frame,2 Pane w/Low-E 80 0.034 3 SHGC:0.31 Orientation:Front Door.Solid 20 0.034 1 Orientation:Front Wall:Wood Frame,16in.o.c. 480 19.0 0.0 28 Orientation:Right Side Window:Vinyl Frame,2 Pane w/Low-E 9 0.034 0 SHGC:0.31 Orientation:Right Side Wall:Wood Frame,16in.o.c. 560 19.0 0.0 27 Orientation:Back Window:Vinyl Frame,2 Pane w/Low-E 92 0.034 3 SHGC:0.31 Orientation:Back Door.Solid 20 0.034 1 Orientation:Back Wall:Wood Frame,16in.o.c. 408 19.0 0.0 22 Orientation:Left Side Window:Vinyl Frame,2 Pane w/Low-E 18 0.034 1 SHGC:0.31 Orientation:Left Side Door:Solid 20 0.034 1 Orientation:Left Side Ceiling:Flat or Scissor Truss 2588 50.0 0.0 67 Crawl:Insulated Concrete Forms 896 30.0 24 Wall height:4.0' Depth below grade:3.0' Insulation depth:4.0' Inside below-grade depth:1.0' Floor:All-Wood Joist/Truss Over Uncond.Space 1962 19.0 0.0 92 Furnace:Forced Hot Air 90 AFUE 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 2007 IECC requirements in REScheck-Web and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. Project Title: Report date: 05/31/11 Data filename: Page 1 of 5 RESIDENTIAL PLAN CHECKLIST (2003 International Residential Code) Date: ` , /C Building Permit Number: 1/ — �p Project: AS Job Address: Zoning: '&0 Z, Number of Stories: Basement: Yes No/Fin. Unfin. Fixtures: (Note unfinished basements as special condition on permit) Floor Area (sf): finished, unfinished, garage Mechanical Fee: The following comments based on the 2003 edition of the International Residential Code should be resolved before a building permit is issued. This correction list is not a building permit. The approval of plans and specifications does not permit the violation of any section of the International Residential Code or any federal, state or local regulations. PLAN CHECK A. Plans A/©To Scale Legible / Plot Plan YaFlood Plain Floor/Foundation Plan ✓Section showing construction details All Building Elevations ✓ esign Criteria(shall be identified on plans as Wind- 85 m.p.h., Snow-35 lb. Per sq ft.) ti' "Truss Calculation Sheets & Floor Joist Details t echanical Design t.. ;nergy Calculations (R320 & Ch 11) B. Zoning(circle one—new zoning designations adopted in 2005) L ' 1 12,000 sf min. (width 80 ft. min) LDR2 8,000 sf min. (width 60 ft. min); Duplex 10,000 sq. ft.min. with C.U.P. 4' 21,780 sf min. (width 150 ft min)Duplex allowed with C.U.P. Other (Verify zoning requirements) T '-'Floor Sheathing(3/4"min for joists 24"oc & 5/8"for joists 1 " � 6 oc)R503.2.2 /Wall (bearing and nonbearing) stud sizes,height& spacing per Table 602.3(5)R602.3 Headers in Bearing Wall shall be designed as per Tables 502.5(1&2)R602.7 (/oof Trusses(designed according to R802.10.1) 35 # Snow and 90 m h winds p (Local Conditions) Rafter and Truss tie-downs. (R802.10.5) /Attic Access 22" x 30"min. opening (R807) Hxterior Covering Masonry and stucco shall have weather resistive barrier over exterior sheathing R703.2 & 703.9.1 I. R Covering and Ventilation Roof Ventilation as per R806 Asphalt Shingles (slope>2:12)w/ice protection. (Other type: to comply w/R905. J. ) walls Garage/House drywall separation(protect ext. walls & beams supporting habitable space)R309.2 i°lloor from Garage to House(1 3/8" solid wood or steel door, or 20 min. fire-rated door)R309.1 ng Separation(1 hr fire separation) Supporting structure also rated. R317.1 n oni wnhouses(2 hr separation& 4' overburn protection or parapet)R317.2 lel to and within 3 ft of property line w/NO openings. R302 revious 3 items to comply with R317.3 K. 9.eneral Requirements House Numbers R321 Half Openable 3sf window or Mech. Ventilation in bathrooms, water closets, and similar rooms. R303.3 Intcripr a a -xterior stair illumination shall comply with R303.6. Bathroom Fixture clearances comply with Figure R307.2 v One room at least 120 s£; Other habitable rooms 70 s£ min w/a min. dimension of 7 ft. R304 *areas w/sloped ceilings less than 5 ft in height&furred ceilings less than 7 ft DO NOT comply *50%or more of the required area must be at least 7ft high in rooms w/sloped ceiling • • • • ,. _' _` :- r __ [I [ Compliance 1 om p e Certificate Energy Code: 2007 IECC Location: Rexburg,Idaho Construction Type: Single Family Building Orientation: Bldg.faces 0 deg.from North Conditioned Floor Area: 1962 ft2 Glazing Area Percentage: 10% Heating Degree Days: 8693 Climate Zone: 6 Construction Site: Owner/Agent: Designer/Contractor: Compliance:19.7%Better Than Code Maximum UA:371 Your UA:298 The%Better or Worse Than Code index reflects how close to compliance the house is based on code trade-off rules. It DOES NOT provide an estimate of energy use or cost relative to a minimum-code home. E c . e a t > i " l MtP, fi x a - i. z f 4 x ' .tie. � t. r �` . e � " P;i �4t� y t �t3 i 4. � � T a a fit � -c wt i, i at1 4� a x µ Wall:Wood Frame, 16in.o.c. 560 19.0 . 0.0` 28 Orientation:Front Window:Vinyl Frame,2 Pane w/Low-E 80 0.034 3 SHGC:0.31 Orientation:Front Door.Solid 20 0.034 1 Orientation:Front Wall:Wood Frame,16in.o.c. 480 19.0 0.0 28 Orientation:Right Side Window:Vinyl Frame,2 Pane w/Low-E 9 0.034 0 SHGC:0.31 Orientation:Right Side Wall:Wood Frame,16in.o.c. 560 19.0 0.0 27 Orientation:Back Window:Vinyl Frame,2 Pane w/Low-E 92 0.034 3 SHGC:0.31 Orientation:Back Door:Solid 20 0.034 1 Orientation:Back Wall:Wood Frame, 16in.o.c. 408 19.0 0.0 22 Orientation:Left Side Window:Vinyl Frame,2 Pane w/Low-E 18 0.034 1 SHGC:0.31 Orientation:Left Side Door.Solid 20 0.034 1 Orientation:Left Side Ceiling:Flat or Scissor Truss 2588 50.0 0.0 67 Crawl:Insulated Concrete Forms 896 30.0 24 Wall height:4.0' Depth below grade:3.0' Insulation depth:4.0' Inside below-grade depth:1.0' Floor:All-Wood Joistffruss Over Uncond.Space 1962 19.0 0.0 92 Furnace:Forced Hot Air 90 AFUE 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 2007 IECC requirements in REScheck-Web and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. Project Title: Report date: 05/31/11 Data filename: Page 1 of 5 ti `'� i 1 j t p����C�— i�SNvv�:: —, �� ( - j'1 --c=i Name-Title 4giature 1 Date Project Title: Report date: 05/31/11 Data filename: Page 2 of 5 Inspection Checklist Ceilings: ❑ Ceiling:Flat or Scissor Truss,R-50.0 cavity insulation Comments: Above-Grade Walls: ❑ Wall:Wood Frame, 16in.o.c.,R-19.0 cavity insulation Comments: LI Wall:Wood Frame, 16in.o.c.,R-19.0 cavity insulation Comments: ❑ Wall:Wood Frame,16in.o.c.,R-19.0 cavity insulation Comments: ❑ Wall:Wood Frame,16in.o.c.,R-19.0 cavity insulation Comments: Windows: ❑ Window:Vinyl Frame,2 Pane w/Low-E,U-factor.0.034 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ Window:Vinyl Frame,2 Pane w/Low-E,U-factor:0.034 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ Window:Vinyl Frame,2 Pane wl Low-E,U-factor:0.034 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ Window:Vinyl Frame,2 Pane w/Low-E,U-factor.0.034 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.Solid,U-factor:0.034 Comments: ❑ Door:Solid,U-factor:0.034 Comments: ❑ Door.Solid,U-factor:0.034 Comments: Floors: ❑ Floor All-Wood Joist/Truss Over Uncond.Space,R-19.0 cavity insulation Comments: Project Title: Report date: 05/31/11 Data filename: Page 3 of 5 Floor insulation is installed in permanent contact with the underside of the subfloor decking. Crawl Space Walls: LI Crawl:Insulated Concrete Forms,4.0'ht/3.0'bg/4.0'ext.insul/1.0'inside bg depth,R-30.0 assembly R-value Comments: Exposed earth in unvented crawl space foundations is covered with a continuous vapor retarder(less than or equal to 0.1 perm).All joints of the vapor retarder are overlapped by 6 inches and are sealed or taped with edges extending at least 6 inches up the stem wall and securely attached. Heating and Cooling Equipment: ❑ Furnace:Forced Hot Air:90 AFUE or higher Make and Model Number: Air Leakage: ❑ Joints,attic access openings,and all other such openings in the building envelope that are sources of air leakage are sealed. ❑ Recessed lights in the building thermal envelope are 1)type IC rated and ASTM E283 labeled and 2)sealed with a gasket or caulk between the housing and the interior wall or ceiling covering. ❑ Access doors separating conditioned from unconditioned space are weather-stripped and insulated(without insulation compression or damage)to at least the level of insulation on the surrounding surfaces.Where loose fill insulation exists,a baffle or retainer is installed to maintain insulation application. ❑ Wood-burning fireplaces have gasketed doors and outdoor combustion air. Sunrooms: ❑ Sunrooms that are thermally isolated from the building envelope have a maximum fenestration U-factor of 0.50 and the maximum skylight U-factor of 0.75.New windows and doors separating the sunroom from conditioned space meet the building thermal envelope requirements. Vapor Retarder: ❑ A minimum of Class II(1.0 perm)vapor retarder is installed on the interior side of above-grade framed walls or it has been determined that moisture or its freezing will not damage the materials. Exceptions: Class Ill(10 perm or less)vapor retarder is permitted for vented cladding over fiberboard,gypsum,or for sheathing over 2x4 framing having insulation of R-7.5 or better,or for sheathing over 2x6 framing having insulation of R-11.25 or better. Materials Identification and Installation: ❑ Materials and equipment are installed in accordance with the manufacturer's installation instructions. • Insulation is installed in substantial contact with the surface being insulated and in a manner that achieves the rated R-value. ❑ Materials and equipment are identified so that compliance can be determined. ❑ Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment have been provided. ❑ Insulation R-values,glazing U-factors,and heating equipment efficiency are clearly marked on the building plans or specifications. Duct Insulation: ❑ Supply ducts in attics are insulated to a minimum of R-8.All other ducts in unconditioned spaces or outside the building envelope are insulated to at least R-6. Duct Construction: ❑ 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. • 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: 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. Heating and Cooling Equipment Sizing: ❑ Additional requirements for equipment sizing are included by an inspection for compliance with the International Residential Code. ❑ For systems serving multiple dwelling units documentation has been submitted demonstrating compliance with 2006 IECC Commercial Building Mechanical and/or Service Water Heating(Sections 503 and 504). Project Title: Report date: 05/31/11 Data filename: Page 4 of 5 Circulating Service Hot Water Systems: Circulating service hot water pipes are insulated to R-2. u Circulating service hot water systems include an automatic or accessible manual switch to turn off the circulating pump when the system is not in use. Heating and Cooling Piping Insulation: HVAC piping conveying fluids above 105 degrees F or chilled fluids below 55 degrees F are insulated to R-2. 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.The certificate does not cover or obstruct the visibility of the circuit directory label,service disconnect label or other required labels. NOTES TO FIELD:(Building Department Use Only) Project Title: Report date:05/31/11 Data filename: Page 5 of 5 s t� 4 , Ceiling/Roof 50.00 Wall 19.00 Floor/Foundation 19.00 Ductwork(unconditioned spaces): Window 0.03 0.31 Door 0.03 NA yk 6y f Forced Hot Air Furnace 90 AFUE Water Heater: Name: Date: Comments: Pr'�C�& 1\SNvv C G ,,/c.z -7-3i -z,c,: 7I Name-Title •i• ature Date I Project Title: Report date: 05/31/11 Data filename: Page 2 of 5 Inspection Checklist Ceilings: ❑ Ceiling:Flat or Scissor Truss,R-50.0 cavity insulation Comments: Above-Grade Walls: ❑ Wall:Wood Frame,16in.o.c.,R-19.0 cavity insulation Comments: ❑ Wall:Wood Frame, 16in.o.c.,R-19.0 cavity insulation Comments: LI Wall:Wood Frame,16in.o.c.,R-19.0 cavity insulation Comments: ❑ Wall:Wood Frame,16in.o.c.,R-19.0 cavity insulation Comments: Windows: ❑ Window:Vinyl Frame,2 Pane w/Low-E,U-factor:0.034 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ Window:Vinyl Frame,2 Pane w/Low-E,U-factor:0.034 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ Window:Vinyl Frame,2 Pane w/Low-E,U-factor:0.034 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ Window:Vinyl Frame,2 Pane w/Low-E,U-factor:0.034 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:Solid,U-factor:0.034 Comments: ❑ Door Solid,U-factor:0.034 Comments: ❑ Door:Solid,U-factor:0.034 Comments: Floors: ❑ Floor.All-Wood Joist/Truss Over Uncond.Space,R-19.0 cavity insulation Comments: Project Title: Report date: 05/31/11 Data filename: Page 3 of 5 Floor insulation is installed in permanent contact with the underside of the subfloor decking. Crawl Space Wails: ❑ Crawl:Insulated Concrete Forms,4.0'ht/3.0'bg/4.0'ext.insul/1.0'inside bg depth,R-30.0 assembly R-value Comments: Exposed earth in unvented crawl space foundations is covered with a continuous vapor retarder(less than or equal to 0.1 perm).All joints of the vapor retarder are overlapped by 6 inches and are sealed or taped with edges extending at least 6 inches up the stem wall and securely attached. Heating and Cooling Equipment: ❑ Furnace:Forced Hot Air:90 AFUE or higher Make and Model Number: Air Leakage: ❑ Joints,attic access openings,and all other such openings in the building envelope that are sources of air leakage are sealed. ❑ Recessed lights in the building thermal envelope are 1)type IC rated and ASTM E283 labeled and 2)sealed with a gasket or caulk between the housing and the interior wall or ceiling covering. ❑ Access doors separating conditioned from unconditioned space are weather-stripped and insulated(without insulation compression or damage)to at least the level of insulation on the surrounding surfaces.Where loose fill insulation exists,a baffle or retainer is installed to maintain insulation application. ❑ Wood-burning fireplaces have gasketed doors and outdoor combustion air. Sunrooms: ❑ Sunrooms that are thermally isolated from the building envelope have a maximum fenestration U-factor of 0.50 and the maximum skylight U-factor of 0.75.New windows and doors separating the sunroom from conditioned space meet the building thermal envelope requirements. Vapor Retarder: ❑ A minimum of Class it(1.0 perm)vapor retarder is installed on the interior side of above-grade framed walls or it has been determined that moisture or its freezing will not damage the materials. Exceptions: Class III(10 perm or less)vapor retarder is permitted for vented cladding over fiberboard,gypsum,or for sheathing over 2x4 framing having insulation of R-7.5 or better,or for sheathing over 2x6 framing having insulation of R-11.25 or better. Materials Identification and Installation: ❑ Materials and equipment are installed in accordance with the manufacturer's installation instructions. ❑ Insulation is installed in substantial contact with the surface being insulated and in a manner that achieves the rated R-value. ❑ Materials and equipment are identified so that compliance can be determined. ❑ Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment have been provided. ❑ Insulation R-values,glazing U-factors,and heating equipment efficiency are clearly marked on the building plans or specifications. Duct Insulation: ❑ Supply ducts in attics are insulated to a minimum of R-8.All other ducts in unconditioned spaces or outside the building envelope are insulated to at least R-6. Duct Construction: ❑ 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 181 B. ❑ Building framing cavities are not used as supply ducts. ❑ 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: ❑ 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. Heating and Cooling Equipment Sizing: ❑ Additional requirements for equipment sizing are included by an inspection for compliance with the International Residential Code. ❑ For systems serving multiple dwelling units documentation has been submitted demonstrating compliance with 2006 IECC Commercial Building Mechanical and/or Service Water Heating(Sections 503 and 504). Project Title: Report date: 05/31/11 Data filename: Page 4 of 5 Circulating Service Hot Water Systems: • Circulating service hot water pipes are insulated to R-2. • Circulating service hot water systems include an automatic or accessible manual switch to turn off the circulating pump when the system is not in use. Heating and Cooling Piping Insulation: • HVAC piping conveying fluids above 105 degrees F or chilled fluids below 55 degrees F are insulated to R-2. 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.The certificate does not cover or obstruct the visibility of the circuit directory label,service disconnect label or other required labels. NOTES TO FIELD:(Building Department Use Only) Project Title: Report date: 05/31/11 Data filename: Page 5 of 5 Ceiling/Roof r. 50.00 Wall 19.00 Floor/Foundation 19.00 Ductwork(unconditioned spaces): Window 0.03 0.31 Door 0.03 NA � K Forced Hot Air Furnace 90 AFUE Water Heater: Name: Date:.. .t Comments: