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HomeMy WebLinkAboutAPPLICATION - 16-00703 - 255 W 2nd N - 4 Plex 1CITY OF REXBURG America's Family Community Submit By Email Permit Policies Acknowledgement Building Safety Department City of Rexburg 35 North 1st East Rexburg, Idaho 83440 The City of Rexburg Building Safety Department is determined to provide excellent customer service. In an effort to help you understand the City of Rexburg Permit Policies, listed below are several policies which you are required to know prior to proceeding with your project. Any construction within the City of Rexburg which requires a permit shall not begin until an approved permit is obtained. If you do not have a pink building permit signed by the Building Inspector, then you do not have an approved permit. o Building without the pink building permit signed by the Building Inspector will result in double fees to be assessed and the project to be red tagged. If your project is red tagged, halting all construction, only a City Initials Official may remove the red tag. If the red tag is removed by anyone but a City Official, citations will be issued. No building may be occupied without receiving a signed Certificate of Occupancy. U �y o If a building is occupied without receiving a signed Certificate of Occupancy, citations will be issued and the occupants will be evicted. initials Calling in inspections is the responsibility of the applicant and their contractor. Inspections need to be called into the hotline and not to the inspector. Inspections called in later than 8 AM will be scheduled for the following business day. o If an inspection is not done, the inspector may require any measures to be taken to allow him to correctly perform the inspection. (Example: If the electrical rough in inspection is not done and the sheetrock has been Initials put up, the inspector may require the sheetrock be removed in order to perform the electrical rough in inspection.) Any approval for Certificate of Occupancies and Building Permits is only verified through the Permit Technician. If an inspector says something like "You're good to go", understand that you still need to receive all relevant documentation from the Permit Technician before you are truly good to go. o Even if you hear from an inspector that `you're good to go', ultimately if you do not have a Building Permit or Certificate of Occupancy, the above policies will be enforced. Initials It is your responsibility to relay this information on to anyone who this would be applicable to for your project. All sub -contractors will be held to this standard with no exceptions. o The above policies will be enforced to all, regardless if you pass this information on to them or not. Initials Applicant's Name (print): Signature:2� Date: to ^ 1 % " Inspections must be called in before 8 AM on the day the inspection is requested. Inspection re/q sts called in after 8 AM will be scheduled for the next business day. Inspecdon Hotline -(208)372.2344 w ..rexburg.org Permit Technician -(208)372.2341 Revised March, 2016 R�OQ pp,XBUpQb CITY OF v o EXB R T Submit By Email ,> 1�jlj5Ult m AmericdsFamily Community BUILDING APPLICATION Commercial/Multi-family Residence Building Safety Department City of Rexburg 35 North 1St East Rexburg, Idaho 83440 For Office Use z 1 Digital Plans Included: El CD ❑USB ElDropbox 11 Not Included 1 Permit Number: _ Permit Type: ❑ New ❑ Remodel ❑ Addition Deposit Amount: $1000 New Const. ❑ $250 Addition ❑ $100 Other Deposit Included with Application: []Yes ❑ No 1. Property Owner Name:i.//yf )'i j � t t rs /4k.°�S Address: State:_ Zip Code: Phone & Type: 2 f "SA4G�E❑Office❑Mobile Email: z9AL14hz Under Idaho Building Code, a contractor must do the work fora Commercial Building. 2. Applicant Name: LA)kS j e,,` Role: (Owner, Tenant, Contractor, etc.) (jw/✓e12 _ Address: 136 T, 0. C2 0 S City: ia<x6m>z4 State: ;; O Zip Code: ;!�3V Phone &Type: 'ms`s 55;7-,Z3s1❑Office'dMobile Email: kfs /-VV. , �n Contact/Rep. Name:='?Sae x,A Phone:'z-os' -5S7..y35/ Email:_ 3. General Contractor Name: c -_f7 Registration_ 7 AddresjGj✓ 4 iS�'C S City: Kau ,%G State: -_IO _ Z p Code: Phone & Type: Lo`a L "10 _k'W ❑ Office•&IMobile Email' jetA/ tP YNIAF�a Contact/Rep. Name: _Wee lr 0011v`� Phone: Email: r.✓e S Not -., A, a �.ci57 "g`35� General Contractor Authorized Signatures "''� _ Date: /r2 - 7` lb 4. Project Description ,y Address: 2 55 Al -OR- Lot #: _ Block #: _ Subdivision: Type of work: Check one: %NewConstruction ❑Remodel* ❑Addition* Check all that apply: X Framing ❑ Mechanical ❑ Plumbing ❑ Electrical NOTE: Any sub -contractors involved will need to submit their own signed applications. Description of work: �' `�1Pf, _s/'o'"✓lTi.-e-✓7�5 __ *Total cost of project - materials and labor: $33&0 00qused to calculate permit fees) # Of Buildings: 2- Building 1: _Units sq. ft. Building 2: Units 7_ Z5_ sq. ft. Building-&•"_ Units _ sq. ft. Additional BuilLzs•�-� — Utility, Misc, Private Garage: sq. ft. Storage: APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty ofperjury, I hereby certify that I have read this application and state that the information herein is correct and I swear that anyinformatian which may hereafter be given by mein hearings before the Planning and Zoning Commission or the City Council for the City of Rexburg shall be truthful and correct. 1 agree to comply with all City regulations and State laws relating to the subject matter ofthis application and hereby authorized representatives of the City to enter upon the above -mend oned property for inspections purposes. NOTE: The building official may revoke a permit on approval issued under the provisions of the 2012 International Code in rases crony false statement or misrepresentation of fact in the application or on the plans on which the permit or approval was based. Permit void ifnot started within 180 days. Permit void if work stops for 180 days. Applicant's Name (print): 4a*'0 Si r"jj Pj ' Signature: -�"_ Date: Inspections must be called in beforee AM�y the inspection is requested. Inspection called in after 8 AM will be scheduled for the next business day. Inspection Hotline -(208)372.2344 www.rexburg.org Permit Technician -(208)372.2341 Revised March, 2016 CITY OF REXBURG AmerW Family Community Building Safety Department Submit By Email City of Rexburg 35 North 1st East Rexburg, Idaho 83440 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.html ❑ 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 JR 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. �✓ /®--17-16, Sigm furg, Date �✓�;1 T)/ ¢]la s Print Name Inspection Hotline -(208)372.2344 vnvvrexburg.org Permit Technician -(208)372.2341 Revised March, 2016 CITY OF REXBURG America's Family Comm unity Building Safety Department Submit 8y Email City of Rexburg 35 North 1st East Rexburg, Idaho 83440 Affidavit of Legal Interest State of Idaho County of Madison I 1�X /& 1&/ a C 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 I7am cord 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 I -/ k— day of ' 2016 Signa e n Subscribed and sworn to before me the day and year first above written. N pT ota ubli of Idaho gat: zv� !iCz u My commission expires:/�!/ W//J;�NN0111111 Inspection Hotline -(208)372.2344 vnvvvrexhurg.org Permit Technician -(208)372.2341 Revised March, 2016 °�yE%BUpC, CITY OF ° REXBURG Amenwr Family Community Submit By Email Property Lines Building Safety Department City of Rexburg 35 North 1st East Rexburg, Idaho 53440 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 utilitylines. 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. Signatae-,� Printed Name X0'/7- A Date Inspection Hotline -(208)372.2344 w .rexhurg.org Permit Technician -(208)372.2341 Revised March, 2016 (W CITY OF REXBURG America's Family Community Building Safety Department Submit By Email City of Rexburg 35 North 1st East Rexburg, Idaho 83440 Subcontractor List Excavation & Earthwork: Hill tat i'Ft�/ Concrete: N/l 1�^P.S GO. ✓SiV'�Via✓ Masonry: �) 11l Ids e0'<; Y -k e -T I � Roofing: Am -1tt'4 loc"r'to.✓ Insulation: N/!/ io e<,e NS7Y-"&ci t0A✓ Drywall: — d -W) i odP?' G� %� t! �✓ Painting: N//! :M cam 'J Floor Coverings: cul f©�:� �!ta�S/ -ice✓ Plumbing: _ Heating: Electrical: Special Construction inufacturer or Supplier) Roof Trusses: Floor/Ceiling Joists: Siding/Exterior Trim: Other: Inspection Hotline -(208)372.2344 www.rexhurg.org Permit Technician -(208)372.2341 Revised March, 2016 CITY OF REXBURG CW - Americas Family Community Building Safety Department sunmu sy ema i City of Rexburg 35 North 1st East Rexburg, Idaho 83440 BUSINESS USE SUMMARY The following questions will help speed the review process along. Please take the time to answer all of them. Is this business occupying an existing building? ❑ Yes XNo Will the business be doing any structural/or remodeling changes to the building? []Yes ANo Any changes to the electrical? []Yes Po Any changes to the plumbing? ❑Yes No Any changes to the mechanical system? ❑Yes No Is the business type changing? ❑Yes, it will change to r-RNo Is this business changing ownership? []Yes tNo Is the business registered with the City of Rexburg? ❑Yes, License #: *If No, please apply for a business license with the Customer Service Dept. Will the business have food preparations? []Yes JXNo Will there be any cooking of foods? []Yes JS5No Will there be any deep fat frying? []Yes No Will you have food disposal on site? []Yes ) No Will there be sumps or floor drains in the facility? []Yes ] No Will the business have any chemicals on site? ❑YesA No Applicant lgnature Phone Date I certify that the information that I have provided above is to the best of my knowledge accurate and true. Inspection Hotline -(208)372.2344 w .rexburg.org Permit Technician -(208)372.2341 Revised March, 2016