HomeMy WebLinkAbout12 00533Building Permit No:
Applicable Edition of Code:
Site Address:
Use and Occupancy:
Type of Construction:
Design Occupant Load:
Sprinkler System Required:
Name and Address of Owner:
Contractor:
Special Conditions:
Occupancy:
G.O lssued by:
12 00533
Internationaf Building Code 2009
182 E. Frenrcnt, Rigby ldaho g3H.4Z
RoyalJourney's, LLC
Type V, non-rated
95
No
Based on existing buirding inspection for rife safety issues onry.
Residential - 2 units or less, permanent in nature
This certificate, issued pursuant to the requiremenfs of sec tion 10g of the lnternational Buitdingcode' certifies that, at the time of issuancg, tlis building or that portion of the buitding that wasinspected on the date tisted was found t9 be in
"oipii""rre with the requirements of the code forthe group and division of occupancy and the use for which the proposed occupancy wasclassified'
/ /
Date C.O. fssued: /l - t, n
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'";v;;i;'iir-"r"or until the Buitding officiat has reviewed andapproved said future changes.
Ptumbins fnspector: Al* I ,rspr*t / ,l,lifr Fire Inspector:
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Rexburg Building Department-
Royaf Journeys is a Developmental Disabilities Agency providing
developrnental therapy. We are not educational and our clients are not
in our custodial care as an l-4 building classification, but should rather
be categorized similar to an Occupational Therapy or Speech Therapy
agency. Our buildings are used exclusively to provide these Medicaid
reimbursed medica I therapies.
At no time will non-ambulatory personal exceed the number of fire
safety trained staff, therefore we believe we qualify as R-3.
Feel free to call me anytime regarding the nature and scope of our
services.
Program Manager
749-0537
Thank
rossman
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RESIDENTIAL BUILDING
35 N 1" E,, REXBURG,ID 83440
208-372-2326
PARCEL NUMBE,R:
PERMIT APPLICATION
SUBDIVISION:
(Addressing is based on the information - must be accurate)
Dwelling Units;Parcel Acres:
\We will provide this for you)
UNIT#-BLOCK# LOT#
PJSse Complet!tre E ntire Application!
If the tluestion does not apply fill in N;\ frrr non applicable
CONTACT pHoNE * 7o1 -O*7
PROPERTY ADDRESS:
PHONE #: Home ( ) ?ti{-orel Work ( )
OIilTNER MAILING ADDRESS
e]1.etr pax
APPLICANT (If other than owner)
(Applicant if other than owner, a statement authorizing nt to act as agent for owner must accompany this application.)
APPLICANT INFORMATION: ADDRE,SS
srATE;-zrP- EMAIL- F.Ax
PHONE #: Home (
CONTRACTOR
FAX IDAHO REGISTRATION #& EXP. DATE
[-Iow many buildings are located otr thi.. properfr
Did you recently purchase this property? No yes (If yes, rist previous owner,s name)
Is this a lot split? NO yES @lease bring copy of new legal description of property)
PROPOSE,D USE:
(i.e.,SingleFamilyResidence,MultiFamily,Apartm.nt',R"-od@
::l:j:*)Tjjj:T1.1Yy?:3lTtt:l]9)-o*" AUTHORIZATIoN: -Under penarty orperjury, I hereby certiry that r have read thisi,il;:'1l1f ij:?:'"?:'jT,:*:::::l:::':.::::i1:t'.Td^',:*:::'hii* '3g;;;J;yliil#';#^,,J:iff'#ffi;fffi:;:i:* ".i];1"itrJ:1"i;;'ff*'":T,T,'::lT;:"'.'::i?":::,:*:T:T:: :iil*:i;'hi;;;ffi#;ilJ:ffi# fl:;JJ'fffi;:%lT:.TfiTJff",,:iffi:H';:';:;il:'*sT,T1f:""::ili:Tt1,*::::i"i.:1.':r::*,::.-l'-.ry:"r"o*: "rp. li'' ,"":;;:o""',['J;:l3,::Ti:::fiil:,1;I::":::*::1":.lij::-)^91t.-IT11.1'liirp;-r-uv,.,,ok.'u;;il;;"d;;il;;ffi;il;:#rl'"ff:ffiffi:,fi:ffiijj:::lcases of any fal
STATE-ZIP
Home ()._-.- Work (Cell (
I or mlsrepresentation of fact in the application or on tlie plans on which th. p.r-it or approval was based. permrt vord if notrmrt void if work stops for 180 days.
/Appticant \t ztq/t?\
DATEWARNING - BUILDING PERMIT MUST BE POSTED ON CONSTRUCTION SITEI
"r"
t .:,::.^lg:::1f"1! ill"* paid in ful at ttre time of applicationLeginnin g ranuaq,l. 2005
MAILING ADDRESS:- CITY
PHONE,
EMAIL
City of Rexburg's Acceptance of the plan review fe. do., r,ot constiruL purr-alprorrli*xBuilding Permit Fees are due at time of applicationx* *'rBuilding Permits are void if your check does not clear*,r