The URL can be used to link to this page

Home My WebLink AboutALL DOCS - 11-00292 - 61 N 1st E - Utility Shedc\, *-* A me ri mls Family C ommuni ty COMMERCIAL & MULTI FAMILY BUILDING PERMIT APPLICATION 35 N 1" E,, RE,XBURG,ID 83440 208-372-2326 Please Co Entire Application! lf the question do€s not apply fill in NA for non applicable ( S7e will provide this for you) UNIT# BLOCK# LOT# PARCEL NUMBER: SUBDIVISION: ine is based on the information - must be accurate CONTACT PHONE # PRoPERrYaoonpis,, 6 / N /re! F '- ZS* Sz at PHONE #: Home ( ) 5 t C'r 7;1/ Work (. ) osTNERMArLrNGaoonpss, 3 6 E'€// crry:/,', /,V 7 sr^rtr{/4 zrp: V*L// P APPLICANT (If othet than owner (Applicant if other than owner, a statement authorizing applicant to act as agent for owner must accompany this application.) AppLrcANT TNFORMATTON: ADDRESS / Lt I ; "l Ctry' /1, €{h/v srnrB'%zrp f9/' 0) EMAIL-FAx- PHONE#:Home ( ) Work( ) Cell( ) MATLTNGADDRESS, /4a E /@ ly crcy4eglqz/E-Sr1\rFn/, zrpt2 pHoNE: c.r# 1j -/ //F wo'u# jiq / O / 7 /p^x# EMAIT IDAHO REGISTRATION # & EXP. DATE Did you tecently putchase this proper ry?& Yes (If yes, Is this " lot .plit? @ YES (Please O)a*.on, of new How many buildings ate located on this property? list ptevious owner's name) legal description of properry) PROPOSE,D USE,: (i.e., Single Family Residence, Multi , Apartments, Remodel, Garage,Addition, Etc.) - CIRCLE ONE APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: under penalty orperjury,I hereby certif, that I have read this application and state that the infomation herein is correct and I swer that any infomation which may hereafter be given by me in hearings before the Plaming and Zoning Comission or the City Comcil for the City of Rexburg shall be truthful and correct. I agree to comply with all City regulations md State laws relating to the subject matter of this application md hereby authorized representatives of the City to enter upon the above-mentioned properry for inspections purposes. NOTE: The building offrcial may revoke a permit on approval issued under the provisions of the 2003 Intemational Code in cases of any false statement or misrepresentation of fact in the application or on the plans on which the pemit or approval was based. Pemit void if not started within 180 days. Permit void if work stops for 180 days. {r /r DATE // ature o f Owner/Ap-plicant WARNING - BUILDING PERMIT MUST BE POSTED ON CONSTRUCTION SITE! Plan fees are non-refundable and are paid in full at the tine of application beginningfua_ugJ,2@5 City ofRexburg's Acceptance ofthe plan rcview fee does not constitute plan apprcval#BuildingPemitFeesarcdueattimeofapplication** *BuildingPemitsarevoidifyourcheckdoesnotclear** 2 Do you prefer to be contacted by fax, email or phone? Circle One oo oo Building Sofely Deporlmenl Phone: 208.372.2326 Fox: 208.359.3022 Affidavit of Legal Interest State of Idaho Countv of Madison I, Name Address City State Being ftst duly sworn upon oath, depose and say: (If Applicant is also Owner of Record, skip to B) A. That I am the tecotd owner of the property described on the attached, and I grant my pefm$slon to: Name Addtess to submit the accompanyrngapplication pertaining to that property. B. I agree to indemniff, defend and hold Rexburg City and its employees hatmless from any claim ot liability resulting ftom 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 day of Signature Subscribed and sworn to before me the dav and year frst above written. Notary Public of Idaho Residing at: 20 My commission expires: REXBURG Properfy lines Each site plan that is submitted to the City of Rexburg fot the Building Permit process requires that property lines are shown accurately. It is the Developer's responsibility to corectly identi!' on the site plan the location of these lines in teference to the public right-of-way, other adjoining property lines, the street, other structures and all utility lines. The Developet should find propetry pins that are still available at the lot in question. If these pins do not exist ot 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 descdptions should be checked. The best way to identiSr property line location is with aland survey. The City of Rexburg has aeizl photos and a parcel line layer that can be checked, but they are only a tool and are not guaranteed fot accuracy. If you u/ant to request a copy of your lot, see the front counter at the Community Development Deparffnent. I have read and understand the above requirements. Signature Date Printed Name Deporlm Phone: 208.372.2326 Fox: 208.359.3022 oo oo Building Sofely Deportmenl 35N l.tE tD 83440 Remodeling Yout Buildingr/Ilome (need Estimate) $ City of Rexburg Phone: 208.372.2326 Fox:208.359.3022www.rexburg.org SARFACE SQaARE FOOTAGE: (Shall include the exterior wall measurements of the building) First Floor Area_ Unfinished Basement area Second floor/lofta Finished basement area Thfud floot/loftarca Garage atea Shed ot Barn Carport/Deck (30" above Sade)Area_ Water Meter Quantity:Water Meter Size: Required!!! PLUMBING Plumbing Conttactor's Name: Business Name: city _state-zip Contact Phone: ( )Business Phone: ( ) Email Fa* FIXTURE COUNT (including rcughed lixtutes) Clothes Washing Machine Dishwashet Floot Drain Garbage Disposal Hot Tub/Spa Sinks Sprinklers Tub/Showers Toilet/Urinal Water Heatet 'Watet Softenet (I-avator{es, kitchens, bar, mop) Plumbing Estimate $_ (Commercial Only) Requiredl Signatwe of Licensed Conftactor License numbet Date Building Sofety Depqrlmenl City of Rexburg Phone: 208.372.2326 Fox: 208.359.3022 Permit# LOT-BLOCK CITY OF 35N l.rE Rexburg, lD 83440 REXBURG c\, - ---'--" Am ei c ab Family Communitywww.rexburg.org OlX,\]ER'S NAME PROPERTYADDRESS SUBDIVISION PFIASE Required!!!MECruENICET Mechanical Conttactor's Name: Business Name: Address City State Zip Contact Phone: ( )Business Phone: ( ) ax Mechanical Estimate $_ (Commercial/Multi Family Ody) FIXTURES & APPLIAI{CES COUNT (Single Family Dwelting OnIy) Futnace Furnace/Air Conditioner Combo Heat Pump Air Conditioner Evaporative Coolet Unit Heater Space Heatet Decorative gas-fued appliance Incinerator System Boiler PooI Heatet Exhaust or Vent Ducts Dryer Vents Range Hood Vents Cook Stove Vents Bath Fan Vents other similar vents & ducts: Fuel Gas Pipe Outlets including stubbed in ot future outlets Inlet Pressure (Vleter Supply) PSI Heat (circle all that apply) Gas oil coal Ffueplace Electric Hydronic Requircdl Signatue of Licensed Contractot License number Date Building Sofely Depqrtmenl City of Rexburg Phone: 208.372.2326 Fox: 208.359.3022 Petmit# LOT BLOCK CITY OT 35N l"E Rexburg, lD 83440 REXBURG Ameri cak Family Communitywww.rexDUrg.org O!yNE,R'S NAME PROPERTY ADDRE,SS SUBDTVISION PHASE Requircd!!!ELECTRICAL Electrical Contractor's Address Name Business Name State ZipI Cell Phone (Business Phone ( Fax ( Electdcal Estimate (cost of wiring & labot) g (COMMERCTAL ONLY) Qnclades the co$ of mateialt installed regardbss of the patl suppfiing it). TWES OF INSTAITATION (l'{ew Residential inclades evetything contained within the tesidential sttuctute and attached gange at the same time) Clty tr n ! tr ! xUp to 1,500 sq ft - fi72x2,501. to 3,500 sq ft - $168 RESIDENTIAL ONLY tr x1,501 n x3.501 to 2,500 sq ft - $120 to 4,500 sq ft - $216 # of circuits *xOver 4,500 sq ft - $216 plus 9.04/sq fr _sq ft total Existing Residential (# of Branch Circuits) - 940 plus 910 per circuit: Multi-Familv Onlv: # of units per building - $120lbldg + 960/unit Services: Alterations/Repairs that require utility disconnection. @,stimate applicable for commercial). Temporary Construction Service, 200 amp or less, one location (for a period not to exceed 1 year) - $40 Spa, Hot Tub, Svzimming Pool - $40 plus $40 grounding gnd where applicable Electdc Centml Systems Heating andf or Cooling (when notpaft of a new residential coutruction pernit and no additiorual wiring) - $40 Modular, Manufactured or Mobile Home - $50 plus $10 per circuit Other Installations: Wiring not specifically covered by any of the above: Cwt of lViring dy Iabor $.(ncludes the co$ of mateiab in$alled regardler of the pa@ suppbingit). Pumps (Domestic Water, Irrigation, Sewage): orse povrer tr Requested Inspections (of existing $/iring) - $40/fu (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.x* Includes a maximum of 4 inspections. Additional inspections charged at requested inspection rate of $40 per hour. Si of Licensed Contractor License number Date ! tr D tr ! n Building Sofefy Depqrlmenl City of Rexburg Phone: 208.372.2326 Fox: 208.359.3022 APPLICATION: "CONSTRUCTION PERMIT, CONSTRUCTION PERMIT #: PERMIT APPROVED: yES/ NO $50.00 FEE pArD: yES/NO APPROVED BY: CITY OF 35N I.rE Rexburg, lD 83440 www.rexDurg.org REXBURG Am e ri ca's Family Co mmu nity Business Name: Office Address: zipCityStateOffice Phone Number: ( )Contractor Performing the Work: Contact Person:Cell Phone # (_) Street Address Where Work Will Be Done: Business Name Where Work Will Be Done: Dates For Work To Be Done: Contact Person: To Phone Number: (_)Cell # (_) PLEASE CHECKTHE TYPE OF PERMIT(S) YOU ARE APPLYING FOR: N AUTOMATIC FIRE-EXTINGUISHING SYSTEMS T COMPRESSED GASES T FIRE ALARM AND DETECTION SYSTEMS AND RELATED EQUIPMENTr FIRE PUMPS AND REI.ATED EQUIPMENT T FI.AMMABLE AND COMMBUSTIBLE LIQUIDS T HAZARDOUS MATERIALS ! INDUSTRIAL OVENS ! LP.GAS T PRIVATE FIRE HYDRANTS T SPRAYING OR DIPPING T STANDPIPE SYSTEMS N TEMPORARY MEMBRANE STRUCTURES, TENTS, AND CANOPIES l_pp_{c?nrs Jrgnature DateItllltrt'ltrrrirlllrlllllltlllltrtlttllltrtrrrrrrrrarrtrrrlrrrarltrrrrrarrarrtrtrrrrtrrlrrr oo Excavation & Eathwork: Concrete: Masonry: RoofinE:U [nsu OO SUBCONTRACTOR LIST Drywall: Parnting: Floor Coverings: Plumbing: Heating: Special Construction (Manufacturer or Supplier) Roof Trusses: Floot/CeilingJoi Siding/Extedor Tri Other: EXtr,M oNSFROM STATE, As ofJanuary 7'2006, the City of Rexburg can no longer sell permits without having a copy of your Stateregistration number or yoril exemption from the State registration. Please send a copy of yoo. state registration orfill out this form showing yorrt exemption and send it with your license renewal or yorrr next permit application. (fhis list is a summarization of Idaho Code Title 54 Chapter 5205, for firll definitions of these exemptions pleasesee the State's website at www.ibol.idaho.gov/cont.htm) tr cwtently State licensed pursuant to Title 54 Idaho code, chapters: 3 Architects, 1 0 Electrical Contractors/Joumeyman, 1 2 Engineers/Suweyors, 19 Public W"$: Contmctots (exempt from fee only registration required), 26 Plumbing/Plumbers, 45 Public \Works Construction Management Licensing Act (exempt from fee only registration required), or50 Installation of heating, ventilation and ur conditioning systems^ tr Employee ot volunteet of a licensed contract or or p^rt oi an educational curriculum or nonprofit charitableactivity with no wages or salary tr Employee of a US Government agency (State, City, County, or other municipaliry) tr Public Utility doing construction, maintenance, or development to its own businesstr Involved with gas, oil or mineral operations tr Supplier doing no installation or fabricating tr contracting a project or projects with a total cost less than $2000 D Opetation of a fatm or tanch or construction of agdculture buildings exempt from Idaho Building CodeD Any type of water district operations tr \Work in rural districts for fre prevention purposes tr Ownet who petforms wotk on own property or contracts with a registered contractor to do work as long asthe property is not for resale within 12 months tr Owner or lessee of commetcial property pedorming maintenanc e, repair,alteration or construction on thatpfopefty tr Real estate licensee/property manager acting within Idaho code D Engaging in the logging industry tr Renter working_on the ptopetty wherc they live with the property owners approvaltr Construction of a building used for industrial chemical pro..ssing per Idaho Codetr Construction of a modulat building (defined by Idaho Code) to b-e moved out of state I hereby certi$r that the above information is true and corect to the best of my knowledge. Signatue Date Print Name o PTIO ooRE,GISTRATION F design 6,16^ 1lb Car Garage With Storage lf oll you need is o one cor goroge plus some \l .-sforoge spoce this 14,x22, gctroge is iusf whot vouhove been looking for, The overheoj door is off_ set io ollow exfro storoge ond workbench spoce onihe one side. a.*.,aj: a\- if,, )l)OhcrYl*}'ll sr:){' + F\. "lr.r--) \> 2 .>-It,<#lkmt'j' 1:\>;sd,ir). Y f----- I L _ __-__l ,r, i : u,,),,,,iilftifl$ilWl I design 647 2 Car Garage This oftroctive coloniol design wiih ponel doors ondhigh pitch roof moke fhis on ideol iwo cor gorogeto odd fo ony coloniol or froditionol home. ;i I ,,rll\xo tl '-t l 24'- 0" 5I0 ge ondWI Incn 0re0