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Home My WebLink AboutAPPLICATION - 17-00370 - BYUI - Snow Building Teaching Studios.•••vol clry OF Building Safety Department G City of Rexburg REY,BUR35 North In East "'"a'm' mxI7connnwq Rexburg, Idaho 83440 COMMERCIAL REMODEL/TENANT IMPROVEMENT APPLICATION CHECKLIST The following items should be completed before you submit your building permit application. *Reasonable accommodations will be made upon request. Submit the Following Documents: m 3 sets of building plans- stamped by a licensed professional. Include the following as applicable ❑ Foundation Plan, Floor Joist Layout, Floor Plan, Rooflayouk Truss Details, Sectional Views, Front Back and Side Elevations, Mechanical Layout, SwirDetaiLg and any details required to illustrate special construction. ❑ Electrical panel layout and calculations included with building plans. ❑ Exterior Lighting Plan including photometric layout ❑ Structural Calculations (if applicable) -stamped by a licensed Engineer ❑ Digital Plans (PDF Format- can be submitted by USB, CD, or Dropbox) ❑ "Copies of any Contractors' State License if not on file already. Complete the Following Forms ❑ Permit Policies Acknowledgment signed ❑ Building Permit Application signed by a registered General Contractor ❑ Mechanical Permit Application signed by a registered Mechanical Contractor ❑ Electrical Permit Application signed by a licensed Electrical Contractor O Plumbing Permit Application signed by a licensed Plumbing Contractor ❑ Fire Alarm Permit Application (if applicable) signed by a registered professional ❑ Fire Sprinkler Permit Application (if applicable) signed by a registered professional ❑ Subcontractor list filled out C3 Affidavit of Legal Interest signed by owner ❑ Notifications Distribution List ❑ Business Use Summary Completed 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 at htW //rexbure ora/pages/development-code. hvspection Hotline -[208]372.2344 vrvaw b.,a, Pemnttechnlnan-[208]372.2341 Reared 10/2016 p ,.x.b4� a to CITY OF o !CEX-BURG N Amenmi randy Community PERMIT POLICIES ACKNOWLEDGMENT Building Safety Department City of Rexburg 35 North 150 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 in be assessed and the project to be red tagged. If your project is red tagged, halting all construction, only a City is Official may remove the red tag. If the red tag is removed by anyone but a City Official, citations may be issued. No building may be occupied without receiving a signed Certificate of Occupancy. o If a building is occupied without receiving a signed Certificate of Occupancy, citations maybe issued and the occupants may be evicted. b Scheduling 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 put up, the inspector may require the sheetrock to be removed in order to perform the electrical rough in inspection.) Construction on any project can begin ONLY when you have received a Pink Building Permit from the Building Department Occupancy of any structure can begin ON EY when you have received an official Certificate of Occupancy from the Building Department These documents must be signed by the appropriate authorities from }the, City of Rexburg. Any approvals can be verified by calling (208) 372-2341. `kms Jo 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 W] m It is your responsibility to inform anyone on your project of the above policies. All sub -contractors will be held to this standard with no exceptions. U o The above policies will be enforced wall, regardless if this information is passed on to them or not is Applicant's Name (print)- dedd A. Walker Signature Date: 06/28/2017 Inspations mustbe allctl in before 8 AM on the day the inspection Is requested Inspectionreques4 sidled In after 8 AM wJl be uheduled for Ne next business day. Inspection Hodine-(208)372.2344 www.rexbu,g.org Permit Technician -(208)372.2341 RM ed 10/2016 .�"•nag Building Safety Departrnent CITY OF REGURG z�1 City Of Rexburg BUILDING PERMIT FORM ti nra.mr•ram« 35 North In East A• arvas B,muy cnmmmary Rexburg, Idaho 83440 BUILDING APPLICATION Commercial Remodel For Office Use Permit Number: Application Fee: ❑ $100 1. Property Owner Name: BYU-Idaho Address: 470 South Physical Plant Way City: R b rg State: Idaho Zip Code: 83460 Phone: (208) 496-2663 Email: walkerieQbyui.edu Z. Applicant Name: BYU-Idaho Role: (Owner, Tenant, Contractor, etc) Owner/Contractor Address: 470 South Phys ml Plant Way City: Rezburo State: Idaho Zip Code: 83460 Phone: (208) 496-2663 Email: walkerie(cibyui edu Contact/Rep. Name: Jedd A Walker 3. General Contractor Under Idaho Building Code, a registered contractor must do the work for a Commercial Building. Name: BYU-Idaho Registration#:n/a Exp.: Address: 470 South Physical Plant WaV City: Rexburg State: Idaho Zip Code: 83460 Phone: (208)496-25`13 Email: reedio0bylli.edu Contact/Rep. Name: John Reed one:(208) 496-251 Email: reedit a trym edu General Contractor Authorized Signature tt ` Date: 06/282017 Atopy ofYoursmte regisb'aHon/license is gaited 6e on file lf[his is thefirstdmeyou havedoneworkin the ChyafRexburg, pleaseprovide a photo copy ofyourlicense lfyou are unsure' our icense is on file, please check with the Permit Technician by calling (208) 372-2341. 4. Project Description Address: University Operations Building - 470 South Physical Plant Way, Rexburg, Idhao 83460 Description of Work: SNO 233 Teaching Studios - Convert from piano lab into four separate faculty offices Project Description: • Total cost of project- materials and labor: $ • Check all that apply: 0 Mechanical: Cost $ 0 Electrical: Cost $ 0 Plumbing: Cost $ 0 Fire Alarm: Cost $ 0 Fire Sprinkler: Cost $ Note: Any contractors involved will need to fill out their respective application. • Change of Occupancy70 No 9 Yes: New occupancy: Building Peratichusefor commercial construction are charged based on square footage and the City's estimated valuation. The application fee applies toward the fee malt For details on how fees are calculated contact the Building Depar"ATIL There will also be a plan reviewfee totaling 10% ofthe building permit fee. APPLICANTS SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under pewlty ofpequty.[hereby artfy Mail have reve this application and slate Union inf•rmadon herein is tett wea and lsr de any Information vemch may hereaner be given by me In bearings before Me Planning and Tuning Commission or Me Guy 0mr.1 for Me City of Rexburg ll sharbetruMfulandmrrev, I agree ro comply wiM all City regulations and Stare laws mining to Me subject matter sleds applinoon and hereby aummued repreaxndtivu ofthe City to error upon Me above-mentioned property for empeemans purposes. NOTE: The building oRtlal may revoke a permit on approval issued orderthe pmviorms ofthe 2012 InernaUmed Code In rases ofany arm statement or miampreandation of Dart In Ne appbmbon or on Me plans on which the permR or approval was based PereaitemidJwt Scan elWMm 190 days. Fmcnivold if.iA tops lir 100 drys. Applicant's Name (print): Jedd A. Walker Signature. a Date: 06/28/2017 IrrspeMon tbeailedinbefore8AMon Medaytheinspectionisrequeaed.lnspec queshwlledlnaner8AMmllbescheduledmr Men busi•eaday. Inspection Hotline Sus(209)M.2344 www-burgorg Perrot Technican—(208)372.2341 A d CITY OF = REXBURG BUILDING PERMIT FORM 214 far upanmmnms Ammrk4: wmoy commodity BUILDING APPLICATION Commercial Mechanical Building Safety Department City of Rexburg 35 North In East Rexburg Idaho 83440 For Office Use Permit Number: Mechanical Fees Paid ❑ 1. Property Owner Name: BYU-Idaho Address: 470 South Physical Plant Wav city: Rexburq state: Idaho zip code: 83460 Phone: (208) 496-2663 Email: walkerie(aftui edu 2. Mechanical Contractor Under Idaho Building Code, a registered contractor most do the work for a Commercial Building. Business:BYU-Idaho - Sam Merrick State License#:006115 Exp.: 10/31/2018 Address: 470 South Physical Plant Way city: Rexburq State: Idaho zip Code: 83460 Phone: (208) 496-2570 Email: merricks(ftyui.edu Contact/Rep. Name: Sam Merrick /Phone: 496-2570 Email: merdeksna.byui.edu Mechanical Contractor Authorized Signature: �s .-✓%� Date: 06/28/2(19 A copy ofyourstate registrationl%cense is required arbe;nffl vrfdas is theffrst timeyou have done work in the City of Rexburg, please provide a photo copy ofyuur license. Ifyou are unsure fyour license is on file please check with the Permit Technician by calling (208) 372-2341. 3. Project Description Address: Snow Building #233 Description otcvork: Convert from piano lab into four separate faculty offices. ❑ Project Cost $ • Feesforcommercial projects are charged bycost: o Fust$10,000=2%6 $60. From $10,000 to$100,000=196+$260.Above$100,000=.5%+$1,160. ie. Work costing $15,000 will be charged $260 for fhb first$m000 and 1% ofthe rertainigq $5,000 = $260+$50= $310 tataljee • There will also be o plan review fee totaling 1046 of [he above fee. APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penatyofper ay, I hereby ceetiy Chair have read M6 application and state Matthe information herein shairettand I swear Mntany information which may City regube given d to In te eabr elath, to the Plaeainganr Zoning na arehe Ci1.y ufferil for Me City of Rexburg CRYtoetmM upon them¢IagreemcomplywdM all1Cieamb purposes. NOTE: ebodngroMcialb y matter a mania onapplicationraMhued under the pr representatives Ufthe Citymenmrupon inabove-mentionedproperry or misrepresentation of. NOTE: ThebWdingr on yrevon aich the onmitor altssaed under Chep Permitoodirnot 2 International Code In aces ofany Permit vhlsesdrk steps for 180 days. dtion of bet Me application oron Me plans on wM1ICM1 Me permltorapproval wss Eased. Perml[vold Ifnot tutted wiMm 180 days. Perml[void Ifworksmps far 180 days. Applicant's Name (print): Jedd A. Walker Signature Date: 06/28/2017 Inspections must be called in before 8 AM on the day the map rtmn m requested. Inspection requesm celled In after 8 AM war be scheduled for the amid business day. Inspecpon Hotline -(208) 372 2344 webv rexleamorg Penult TecM1mtlan-(288) 3722341 CITY OF Building Safety Department 7�T�� City of Rexburg l�L'.1�DG BUILDING PERMIT FORM ZZO nom^=panic 35 North In East "maks; Nnmurwn Rexburg, Idaho 83440 BUILDING APPLICATION Commercial Electrical For Office Use Permit Number: Electrical Fees Paid ❑ 1. Property Owner Name: BYU-Idaho Address: 470 South Phvsical Plant Wav city: Rexburq State: Idaho zip Code: 83460 Phone: (208) 496-2663 Email: walkerie(ftvui,edu 2. Electrical Contractor Under Idaho Building Code, a registered contractor most do the work for a Commercial Building. Business: BYU-Idaho -Steve Price State License n: ELE-1-10510 Exp.: Address: 470 South Physical Plant Way city: Rexburg State: Idaho zip code: 83460 Phone: (208) 496-2540 Email: oricesftyuLedu Contact/Rep. Name: Steve Price Phone: 96-2540 Email DriGes(7byul.edu Electrical Contractor Authorized Signature: Date: 06/25/2017 A copy ofyourstnte registrthrollicense is required m be on file. Ifthis is the fust dmeyou have done work in the City offtezburg, please provide a photo copy ofyour license. Ifyou are unsure ifyour license is on file, please check with the Permit Technician bycalling (208) 37Z-2341. 3. Project Description Address: Snow Building #233 Description ofwork: Convert from piano lab into four separate faculty offices. ❑ Project Cost: $ • Feesforcommercielprojects are charged by cost o First$10,000-296+$60. From$10,000 W$100,000= 1% $260.Aboee$100,000=.5%+$1,160. i.e. Workcosting $15,000 will be charged $260 for the first$10,000 and 196 ofthe remaining $5,000= $Z60+$50= $310 total feg • There will also be a plan review fee totaling 1046 of the abovefee. APPLICANTS SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty ofperjury,Ihereby orifytbat l have traders application and sm[e tba[tfie information herein is rrect and I swear that any information whitb may hereafter be given by mein hearings before the Planning and Zoning Commission or the City Conrail for the City of Rexburg dull be truthful and correct l agree to comply with all City regulations and State laws relating to the subject matter ofthis appliation and hereby authorised represenmOves addre Citymenmrupon Meabove-mentionMpmperty rinspectionspurposes NOTE. Me building omdal may revoke a permit on approval issued under are prevkiom. afore 2012 Inimmatinnal Code in rases Diaryhke ndtementcar misrepres notlnn or torr in the applirmlon or an the plans on which the permit or approval was based. PermitvoidJmt siar4d witbin iBO days. Permit said ifwork stops for 180 days. Applicant's Name (print): Jedd A. Walker Signature(��, Date: 06/28/2017 Inspections mustbe calldlnbefore BAM on the any she inspection is requested Inemetaquess called In after%AM will be5cheduled far Nenertbusiues day. Inspection Hotlme-(2om) 372.2344 sa w.reffiuryprg PermltTechnlclan-(2081372.2341 F.vt•a.� CITY OF Building Safety Department e' 1�G BUILDING PERMIT FORM 230 City of Rexburg o„ nit 35 North 1n East Aninmz Fini'Irc mousurry Rexburg, Idaho 83440 BUILDING APPLICATION Commercial Plumbing For Office Use Permit Number: Plumbing Fees Paid ❑ 1. Property Owner Name: BYU-Idaho Address: 470 South Phvsieal Plant Wav city: Rexburg State: Idaho zip code: 83460 Phone: (208) 496-2663 Email: walkerie(aftui.edu 2. Plumbing Contractor Under Idaho Building Code, a registered contractor must do the work for a Commercial Building. Business: BYU- Idaho - Craig Forbush State License#: PLB-J-12382 Exp.: 6/30/2019 Address: 470 South Physical Plant Way city: Rexburg state: Idaho zip Code: 83460 Phone: (208) 496-2590 Ernst& forbushc(bvui.edu Contact/Rep. Name: Craig Forbush Phone: 496-2590 Email. forbushc(citayui.edu Plumbing Contractor Authorized Signature: Date: 06/28/2017 A copy ofyour state registration/license is required to be onfile. this is thefirst timeyou have done work in the City of Rexburg, pleaseprovide a photo copyafyour license. Ifyou are unsure ifyourlicense is on file, please check with the Permit Technician bycalling (Z08) 37Z-2341. 3. Project Description Address: Snow Building #233 Description of work: Convert from piano lab into four separate faculty offices. ❑ Project Cost: $ • Feesforcommercial projects are charged by cost: o First$10,000=296+$60. Front$10,000 to$100,000=196+$260. Above$100,000-.596 +$1,160. i.e. Work costing $15,000 will be charged $260 far the frrat$10,000 and 1% of the remaining $5,000= $260+$50 =$.310 tato/!_ There will also be a plan review fee totaling 1096 of the above fee. APPLICANTS SIGNATURE CERTIFICATION AND AUTHORIZATION: Under penalty of proury, l hereby mo fytlut l bave mad Now application and state Mar the laformatian hemm is rved and 1 swear distant Information which may hereaRnr be given by mein hearings before are planning and Tuning Commission or the City Counen for Ne City of Rexbetg shill be tivMPol and correct I agree to comply vin all City regulations and sbce laws reUtingW Me subject matter of MB specimen and hereby authorized representatives of Me City W enter upon the above-menaoeed property for inspections purposes. NOTE: The buddies official may revoke apermit on approval ksued under the previsions ofthe 2012 International Code in cases ofany false tolsomnt or misrepresennition affect in Me application or on the plans on which the permit or approval was based. Permit void Rnnt smrtedwithin 180day5. Permit void ifwork stops for IRO days. Applicanrs Name (print): Jedd A. Walker Signature: Date:06/28/2017 Inspections mustbe called in before 8 AM on Me day Me inspection 0 requested. Inspection requests called in after8 AM will be scheduled for the nextbusiness day. Inspection Hotline -(208) 372.2344 werwowbmgorg PermQ Technician -(208) 372.2341 Q=BeaS CITY OF Building Safety Department F e MOURG BOILDING PERMIT FORM 4,01 City of Rexburg a.r °°a""'°"°" 35 North liA East Aneian, tend, ConvenWr Rexburg, Idaho 83440 BUILDING APPLICATION Fire Alarm For Office Use Permit Number: Fire Alarm Fees Paid ❑ 1. Property Owner Name: BYU-Idaho Address: 470 South Physical Plant Way City: Rexburg State: Idaho Zip Code: 83460 Phone: (209) 496-2663 Email: walkerje(a)byui.edu 2. Contractor Business: BYU-Idaho - Thomas Moore State License #: Exp.: Address: 470 South Physical Plant Way City: Rexburg State: Idaho Zip Code: 83460 Phone: (208) 496-3058 Email: mooret(aft edu Contact/Rep. Name: Thomas Moore Phone: 496-3058 Email: mooretOWui.edu Contractor Authorized Signature: Date: 0 6128 /2 01 7 A copy ofyourstate registeation/license /s required to be on file. If this it thefirstdmeyou have done work in the CityofRexburg, please provide a photo copy ofyourlicense. Ifyou are uremre ifyour license is on file, please check with the Permit Technician by calling (208) 372-2341. 3. Project Description Address: Snow Building #233 Description ofwork: Convert from piano lab into four separate faculty offices ❑ Fire Alarm System Cost: $ • Feesforfire alarm systems are charge by cost o First $10,000=296+$60. Flom$10,000 to$100,000=I%6 $260. Above $I00,000=.5%%$1,160. i.e. Work costing $15,000 will be charged $260for thefina$10,000 and 1 %ofthe remaining $5,000= $260 t $50= 5310 weal fee • There will also be a plan review fee totaling 1096 ofthe above fee .APPWCANr551GNATURE CERTIFIGTION AND AmHORKAT10N: 1—d I swear dol,on lnrormadon whlth may hereaflerbegiv b , t,uthfi d and wrre2 I agree to wm ply with all Cityregulations ar. W enter upon the above-mentioned property for hopecdom pu,,ei International Cade in msec ofany false sonement or m6repi—inaf started within 180 days. Permitvold Ifwork stops for 180 days. 1 have read Nk appllmdon and stare that the i nfarmation M1erei n waebased Permitvoid ifnm Applicant's Name (print): Jedd A. Walker Signature. Date: 06/28/2017 Inspections mustbemlledlnbefmOAMon Medaythcimpedon lsrequested, fiope requemmlledinaherBAMwlll 1n,chednledf,rduni,dbusin—day. Inspection Hoch a-(200) 372.2344 www.rexburg.ory PenuiftTerbaciin-(201) 372.2341 VFe33aVYC e ctrr or RE?�URG m Amm&=kAem Cnmmnmry BUILDING PERMIT FORM 4,QZ u�,ar:ma BUILDING APPLICATION Fire Sprinkler Building Safety Department City of Rexburg 35 North In East Rexburg, Idaho 83440 For Office Use Permit Number: Fire Sprinkler Fees Paid ❑ 1. Property Owner Name: BYU-Idaho Address: 470 South Physical Plant Way City: Rexburg State: Idaho Zip Code: 83460 Phone: (208) 496-2663 Email: walkerie(aftui.edu 2. Contractor Business: 3-D Fire Protection State License #: Exp.: Add ress:6312 South Burggmf Way City: Idaho Falls State4daho Zip Cade: 83402 Phone: (208) 525-8377 Email: lamar@3dfire.com Contact/Rep. Name: Lamar Hayward Phone: (208) 525-8377 Email:lamar@3d1ke.com Contractor Authorized Signature: Date: 0612812017 A copy ofyourstate migistrafion/license is required to be on fi/e. lfthis is the first dmeyou have doneworkin the City of8ezburg, please provide a photo Copy ofyour license. lfyou are unsure ifyour license B on file, please check with the Permit Technician by calling (208) 372-2341. 3. Project Description Address: Snow Building #233 Description of work: Convert from piano lab into four separate faculty offices. Number of Heads: ❑ Fire Sprinkler System Cost: $ • Feesforfire alarm systems are charge by cost' o F7rst$10,000=296+$60. From $10,000 to $100,000 = 1 % + $260. Allow $100,000=.5%+$1,160. i.e. Work costing $15,000 will be charged $260 for N,eFrst$10,000 and 196 ofthe remaining $5,000= $260+$50= $310 mmlire • There will also be a plan reviewfee Doling 1096 ofthe abovefee. APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under Penalty mpmjurg l hereby reality net l have read Misappbamon and underbid Me information herein cournect and l swear Dietary information which may hemmer be given bymein hearings before no Planning and Zoning Commission or are City Councd for the City allexbmg shall ame beenter upend coaa2 1 agree to comply with all Cityedons Part and Rate laws related On Nerea] Cot malNrofNu apphappr and hereby under need owilmontffives 0fthe City Inememinon Code in cases ndoned lalsesproperty eniorintimpreiarado. NOTE: the apdmatim mrlmthre Janson tic the peranitovalorsuedund wNepval. PesofNe2012 hafted ithinudelnasesrmit void stres for resenatlon stories Ue appllatior rare Me Plans on which Me permimrapproval was bash. Permi[wid ifnot started wiMin 180 days. Permi[void ifwork 4nps for 180 days. Applicants Name (print): Jedd A. Walker Signature: 06/28/2017 laspro ions must be called in before 8 AM on Ne day Ne inspectirn is requested, Release requests called in nor AM will be schMWed for the next business day. @specdrn Hotline -(208) 372.2344 www oude rgorg Permit Technician -(208) 372.2341 04 P�nAC CITY O F 6 o REXB RG 11P A1��V1�17 xmc,r�,x�mRy�m.,muy LIST Excavation & Earthwork: N/A Concrete: N/A Masonry: N/A Roofing: N/A Insulation: BYU-Idaho -Carpentry Services Drywall: BYU-Idaho - Carpentry Services Painting: BYU-Idaho- Auxiliary Maintenance Services Floor Coverings: BYU-Idaho - Maintenance Services Plumbing: BYU-Idaho - Mechanical Operations Services Heating: BYU-Idaho - HVAC Services BYU-Idaho - Electrical Services Special Construction (Manufacturer or Supplier) Roof Trusses: N/A Siding/Exterior Trim: N/A Building Safety Department City of Rexburg 3S North V East Rexburg, Idaho 83440 Other: Fire Alarm - BYU-Idaho - University Security S Safety; Fire Sprinklers - 3-D Fire Protection lmpcc nxomne-(208)372.2344 www.rexb .M Permit Tec nfcun-(2oe) 372.2341 Revised 10/2016 AFFIDAVIT OF LEGAL INTEREST State of Idaho ) ss. County of Madison ) The undersigned, being first duly sworn, deposes and says: A. that he is the authorized representative of Brigham Young University —Idaho (the "University") for the purpose of submitting the attached application (the "Application") including the making of this Affidavit; B. that the University is the record owner of the property described in the Application; and, C. that the University agrees 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 in this Affidavit or as to the ownership of the Property which is the subject of the Application. Dated: Wednesday, June 28, 2017 Subscribed and sworn to before me the day and year fust above written. NOTARY.,. PUBLIC;' * = Notary Public pI g Residing at: tsoYl lsoC76 ooi�ir�iEomuo�000`� My commission expires: Xls' P CITY OP TO TRG nd amort rnmilyGmmuntry DISTRIBUTION LIST Building Safety Department City of Rexburg 35 North 1st East Rexburg, Idaho 83440 Please provide the names and emails of anyone who should begetting automated updates for this project; Review Notes Name: Jedd A. Walker Name: e -Builder Name: Name: Name: Inspection Tickets Name: John Reed Name: e -Builder Name: Name: Name: Email: walkeoe@byui.edu Email: SNO_233_Teaching SWdim.A - lnbox@dam.e-builder.net Email: Email: reedjo@byui.edu Email: SNO_233_Teachingstud sA_-_Inbox@tlom.e-buildecnet Email: Email: Email: I-P..N .Hotline-(zoe)372.23" www.rexW,., Permit T.6.,.an-(206)M] Tl1 Re d10/2a16 OF PG9VFC Q CCTYOF REXBURG Amer�'s fmnily ranmmFily BUSINESS. USE SUMMARY Building Safety Department City of Rexburg 3S North In East Rexburg, Idaho 83440 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? 0Yes DNo Will the business be doing any structural/or remodeling changes to the building? 0 Yes 13 No Any changes to the electrical? 0 Yes 0 No Any changes to the plumbing? 0 Yes 0 No Any changes to the mechanical system? 0 Yes 0 No Is the business type changing? 0 Yes, it will change to ONO Is this business changing ownership? 0 Yes ONO Is the business registered with the City of Rexburg? 0 Yes, License #: LI No *If No, please apply for a business license with the Customer Service Dept. Will the business have food preparations? ElYes ONO Will there be any cooling of foods? p Yes 0 No Will there be any deep fat frying? 0 Yes ONO Will you have food disposal on site? O Yes ONO Will there be sumps or Floor drains in the facility? p Yes ONO Will the business have any chemicals on site? l] Yes 0 No Q (208)496-2663 06/28/2017 licants Signature Phone Date I certify that the information that I have provided above is to the best of my knowledge accurate and true, Inspection Hotline, -(288)372.2344 wwwr !Fuc,.oM Permit Tech nican - (208) 3722341 2e—ed March, 2816