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Home My WebLink AboutAPPLICATION - 16-00279 - The Cottages Bldg 1Inspection Hotline – (208) 372.2344 www.rexburg.org Permit Technician – (208) 372.2341 Revised March, 2016 Building Safety Department City of Rexburg 35 North 1st East Rexburg, Idaho 83440 COMMERCIAL/MULTI-FAMILY APPLICATION CHECKLIST The following items should be completed before you submit your building permit application. *Reasonable accommodations will be made upon request. Complete the Following: ྅ 3 sets of site plans (see Site Plan Checklist on page 2) ྅ 3 sets of building plans (see box below) – stamped by a licensed professional ྅ Electrical panel layout and calculations included with building plans. ྅ Exterior Lighting Plan including photometric layout. ྅ Digital Plans (PDF Format – can be submitted by USB, CD, or Dropbox) ྅ Structural Calculations (see box below) – stamped by a licensed Engineer ྅ Energy Compliance Report: As per the 2012 IECC, a COMCheck is required (available online at www.energycodes.gov) ྅ Permit Policies Acknowledgment signed. (see page 3) ྅ Building Permit Application signed by a registered General Contractor. (see page 4) ྅ Exemptions from State Registration (see page 5) ྅ Affidavit of Legal Interest signed. (see page 6) ྅ Property Line form signed by builder. (see page 7) ྅ Mechanical Permit Application signed by a registered Mechanical Contractor. (see page 8) ྅ Electrical Permit Application signed by a registered Electrical Contractor. (see page 9) ྅ Plumbing Permit Application signed by a registered Plumbing Contractor. (see page 10) ྅ Fire Alarm Permit Application (if applicable) signed by a registered professional. (see page 11) ྅ Fire Sprinkler Permit Application (if applicable) signed by a registered professional. (see page 12) ྅ Subcontractor list filled out. (see page 13) ྅ Commercial Projects: Completed Business Use Summary. (see page 14) Seismic Design Category – D (unless soil evaluation confirms category C) Ground Snow – 50 lbs. per sq. ft. Roof Snow Load – 35 lbs. per sq. ft. Wind Load – 90 MPH Frost Depth – 36” ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ Submit By Email Inspection Hotline – (208) 372.2344 www.rexburg.org Permit Technician – (208) 372.2341 Revised March, 2016 Building Safety Department City of Rexburg 35 North 1st East Rexburg, Idaho 83440 SITE PLAN CHECKLIST ྅ 1 Site plan must be drawn to scale, be legible and also be submitted electronically if possible. ྅ 2. Adjoining streets labeled. ྅ 3. Right-of-way location and width, curb to curb widths and sidewalk location. ྅ 4. Building location, sq footage and dimensions, with distance to property lines and distances between buildings. ྅ 5. Show existing and proposed easements. ྅ 6. Existing utilities (waterlines, sanitary sewer lines, manholes, storm drains). ྅ 7. Proposed utilities including tie in location to existing services and new easements. ྅ 8. Proposed storm drain and sanitary sewer elevations (for pipe inverts at manholes and catch basins). ྅ 9. Storm drainage plan for parking lot and roof areas, with calculations. ྅ 10. Fire hydrants and fire suppression lines (including tie to City lines). ྅ Sprinkled ྅ Not Sprinkled ྅ 11. Indicate Fire apparatus access. ྅ 12. Parking (including parking lot, drainage arrows, dimension of lot, distance between rows, and total numbers). ྅ 13. Landscaping (type and total area, including dimensions). ྅ 14. Trash facilities. ྅ 15. North Arrow ྅ 1͸. Proposed street improvements (curb, gutter, sidewalk, pavement, etc.) ྅ 1͹. Legal description of proposed building site included. ྅ 1ͺ. Percent of lot covered by building or paving calculated. ྅ ͳͻ. Show 10% snow storage area. ྅ 2Ͳ. Distance of entrances from street corner indicated. ྅ 2ͳ. Current Vicinity Map. (81/2 x 11”) at 1” = 300’ scale, showing location of the property. ྅ 2ʹ. Lighting Plan SITE PLANS MUST BE COMPLETE AND SUBMITTED FOR REVIEW BEFORE THE PROJECT WILL BE PLACED ON THE PLANNING & ZONING AGENDA. ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ ✔ Submit By Email Inspections must be called in before 8 AM on the day the inspection is requested. Inspection requests 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 Initials Initials Initials Initials Initials Building Safety Department City of Rexburg 35 North 1st East Rexburg, Idaho 83440 Permit Policies Acknowledgement 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 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. o If a building is occupied without receiving a signed Certificate of Occupancy, citations will be issued and the occupants will be evicted. 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 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. 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. Applicant’s Name (print): ___________________________________ Signature: _____________________________________________ Date: ______________ BC BC BC BC BC Brandon Cooper 4/6/16 Submit By Email Inspections must be called in before 8 AM on the day the inspection is requested. Inspection requests 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 Building Safety Department City of Rexburg 35 North 1st East Rexburg, Idaho 83440 BUILDING APPLICATION Commercial/Multi-family Residence For Office Use Digital Plans Included: ྅ CD ྅ USB ྅ Dropbox ྅ Not Included 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: ___________________________________________________________ Address: ___________________________________________________ City: __________________________ State: ____________ Zip Code: _________________ Phone & Type: _______________________ ྅ Office ྅ Mobile Email: _____________________________________________________________ Under Idaho Building Code, a contractor must do the work for a Commercial Building. 2. Applicant Name: __________________________________________________________ Role: (Owner, Tenant, Contractor, etc.) _______________________________ Address: ___________________________________________________ City: __________________________ State: ____________ Zip Code: _________________ Phone & Type: _______________________ ྅ Office ྅ Mobile Email: _____________________________________________________________ Contact/Rep. Name: _________________________________ Phone: _____________________ Email: _______________________________________________ 3. General Contractor Name: _____________________________________________________________ Registration #: _________________________ Exp.: _______________________ Address: ___________________________________________________ City: __________________________ State: ____________ Zip Code: _________________ Phone & Type: _______________________ ྅ Office ྅ Mobile Email: _____________________________________________________________ Contact/Rep. Name: ______________________________________ Phone: _________________ Email: ______________________________________________ General Contractor Authorized Signature: ____________________________________________________________________ Date: __________________ 4. Project Description Address: _______________________________________ -OR- Lot #: ____ Block #: ____ Subdivision: _________________________________ Type of work: Check one: ྅ New Construction ྅ Remodel* ྅ Addition* Check all that apply: ྅ Framing ྅ Mechanical ྅ Plumbing ྅ Electrical NOTE: Any sub-contractors involved will need to submit their own signed applications. Description of work: _____________________________________________________________________________________________________________________ *Total cost of project - materials and labor: $____________ (used to calculate permit fees) # Of Buildings: ______________________ Building 1: _______Units ____________ sq. ft. Building 2: _______Units ____________ sq. ft. Building 3: _______Units ____________ sq. ft. Additional Buildings: ______________________________________________________________________________________________________________________ Utility, Misc, Private Garage: __________________________________sq. ft. Storage: ____________________________________________________sq. ft. 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 t his application and hereby authorized representatives of the City to enter upon the above-mentioned property for inspections purposes. NOTE: The building official may revoke a permit on approval issued under the provisions of the 2012 International Code in cases of any false statement or misrepresentation of fact in the application or on the plans on which the permit or approval was based. Permit void if not started within 180 days. Permit void if work stops for 180 days. Applicant’s Name (print): ___________________________________ Signature: _____________________________________________ Date: _____________ DJT & Company Rexburg Idaho 83440 208.351.8359 djthueson@yahoo.com Mountian Valley Construction, Inc.Contractor Rexburg Idaho 83440 208.522.8449 Brandon Cooper mountainvalleyconstruction@hotmail.com Mountian Valley Construction, Inc.RCE-2456 12/2/16 Rexburg Idaho 83440 208-522-8449 mvconstruction@hotmail.com Brandon Cooper 208.709.4012 mountainvalleyconstruction@hotmail.com 4/6/16 419 W 1st N; 447 W 1st N; 451 W 1st N Remove 3 existing houses and construct 3 buildings with a total of 13 units. Each unit will have 2 beds, bath, and kitchen. 1,500,000 3 4 3,269.67 4 3,269.67 5 4,309.67 n/a 3,187 Brandon Cooper 4/6/16 419 W 1st N; 447 W 1st N; 451 W 1st N PO Box 311 374 Eagle Summit St. ✔ ✔ ✔ ✔ Submit By Email Inspection Hotline – (208) 372.2344 www.rexburg.org Permit Technician – (208) 372.2341 Revised March, 2016 Building Safety Department 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.htm) ྅ 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 ྅ 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. Signature Date Print Name N/A Submit By Email Inspection Hotline – (208) 372.2344 www.rexburg.org Permit Technician – (208) 372.2341 Revised March, 2016 Building Safety Department City of Rexburg 35 North 1st East Rexburg, Idaho 83440 Affidavit of Legal Interest State of Idaho County of Madison I, _____________________________________________________, ___________________________________________________________________ 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 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 ___________________________ day of ____________________________, 20_________ ____________________________________________________________________ Signature Subscribed and sworn to before me the day and year first above written. _______________________________________________________________________________ Notary Public of Idaho Residing at: ________________________________________________________ My commission expires: __________________________________________ Rexburg Submit By Email Inspection Hotline – (208) 372.2344 www.rexburg.org Permit Technician – (208) 372.2341 Revised March, 2016 Building Safety Department City of Rexburg 35 North 1st East Rexburg, Idaho 83440 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. ______________________________________________________________ __________________ Signature Date ______________________________________________________________ Printed Name Brandon Cooper 4/6/16 Submit By Email Inspections must be called in before 8 AM on the day the inspection is requested. Inspection requests 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 Building Safety Department City of Rexburg 35 North 1st East Rexburg, Idaho 83440 BUILDING APPLICATION Mechanical For Office Use Permit Number: ____________________ Permit Type: ྅ New ྅ Remodel ྅ Addition ྅ Basement Finish Fees Paid: ྅ Yes ྅ No 1. Property Owner Name: ___________________________________________________________ Address: ___________________________________________________ City: __________________________ State: ____________ Zip Code: _________________ Phone & Type: _______________________ ྅ Office ྅ Mobile Email: _____________________________________________________________________ Under Idaho Building Code, a homeowner is allowed to do work on their own home. Are you a homeowner doing work on your own home? ྅ Yes (Skip to #3 and complete the Homeowner’s Exemption page) ྅ No: I am a contractor working for the homeowner ྅ No: This property is a Multi-family Residence or Commercial Property. NOTE: Any contractors/sub-contractors involved will need to submit their own signed applications. 2. Mechanical Contractor Name: _____________________________________________________________ Registration #: _________________________ Exp.: _______________________ Address: ___________________________________________________ City: __________________________ State: ____________ Zip Code: _________________ Phone & Type: ___________________________________ ྅ Office ྅ Mobile Email: __________________________________________________________ Contact/Rep. Name: ______________________________________ Phone: _____________________ Email: __________________________________________ Mechanical Contractor Authorized Signature: ____________________________________________________________________ Date:________________ 3. Project Description Address: _______________________________________ -OR- Lot #: ____ Block #: ____ Subdivision: _________________________________ Check one: ྅ Single-family Residence ྅ Multi-family Residence ྅ Commercial Check one: ྅ New Construction* ྅ Remodel ྅ Addition ྅ Basement Finish Description of work: _____________________________________________________________________________________________________________________ New Commercial Work: Contracted amount: $________________________________ Calculated Fee (See Below): $__________________ ྅ Up to $10,000 = (total cost of system x .02) + $60 ྅ $10,001-$100,000 = ((total cost of system -10,000) x .01) + $260 ྅ Over $100,001 = ((total cost of system -100,000) x .005) + $1,160 New Single-Family Residential Work: _________ Sq. Ft. ྅ Up to 1,500 Sq. Ft. = $130 ྅ 1,501-2,500 Sq. Ft. = $195 ྅ 2,501-3,500 Sq. Ft. = $260 ྅ 3,501-4,500 Sq. Ft. = $325 ྅ Over 4,500 Sq. Ft. = $325+(65 x # of additional 1,000 Sq. Ft. (or portion thereof)) $_________________ New Multi-Family Residential: ྅ Duplex = $260 ྅ Three or more units = $((130 x # of buildings)+(65 x # of units))$_____ New work on any other residence and Detached Shops: = $(65 + (10 x # of HVAC fixtures)) $__________________ Miscellaneous: ྅ Gas Pressure = $65 ྅ Furnace or A/C = $65 ྅ Water Heater = $65 ྅ Requested Inspection = $65 ྅ Gas Line = $65 ྅ Fireplace/Solid Fuel Burning Unit = $65 ྅ Technical Service = $65/hour ྅ Plan Check =10% of Contracted Amount 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 t his application and hereby authorized representatives of the City to enter upon the above-mentioned property for inspections purposes. NOTE: The building official may revoke a permit on approval issued under the provisions of the 2012 International Code in cases of any false statement or misrepresentation of fact in the application or on the plans on which the permit or approval was based. Permit void if not started within 180 days. Permit void if work stops for 180 days. Applicant’s Name (print): ___________________________________ Signature: _____________________________________________ Date: _______________ Rexburg Submit By Email Inspections must be called in before 8 AM on the day the inspection is requested. Inspection requests 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 Building Safety Department City of Rexburg 35 North 1st East Rexburg, Idaho 83440 BUILDING APPLICATION Electrical For Office Use Permit Number: ____________________ Permit Type: ྅ New ྅ Remodel ྅ Addition ྅ Basement Finish Fees Paid: ྅ Yes ྅ No 1. Property Owner Name: ___________________________________________________________ Address: ___________________________________________________ City: __________________________ State: ____________ Zip Code: _________________ Phone & Type: _______________________ ྅ Office ྅ Mobile Email: _____________________________________________________________________ Under Idaho Building Code, a homeowner is allowed to do work on their own home. Are you a homeowner doing work on your own home? ྅ Yes (Skip to #3 and complete the Homeowner’s Exemption page) ྅ No: I am a contractor working for the homeowner ྅ No: This property is a Multi-family Residence or Commercial Property. NOTE: Any contractors/sub-contractors involved will need to submit their own signed applications. 2. Electrical Contractor Name: _____________________________________________________________ Registration #: _________________________ Exp.: _______________________ Address: ___________________________________________________ City: __________________________ State: ____________ Zip Code: _________________ Phone & Type: ___________________________________ ྅ Office ྅ Mobile Email: __________________________________________________________ Contact/Rep. Name: ______________________________________ Phone: _________________ Email: ______________________________________________ Electrical Contractor Authorized Signature: ____________________________________________________________________ Date:_________________ 3. Project Description Address: _______________________________________ -OR- Lot #: ____ Block #: ____ Subdivision: _________________________________ Check one: ྅ Single-family Residence ྅ Multi-family Residence ྅ Commercial Check one: ྅ New Construction* ྅ Remodel ྅ Addition ྅ Basement Finish Description of work: _____________________________________________________________________________________________________________________ New Commercial Work: Contracted amount: $________________________________ Calculated Fee (See Below): $___________________ ྅ Up to $10,000 = (total cost of system x .02) + $60 ྅ $10,001-$100,000 = ((total cost of system -10,000) x .01) + $260 ྅ Over $100,001 = ((total cost of system -100,000) x .005) + $1,160 New Single-Family Residential Work: _________ Sq. Ft. ྅ Up to 1,500 Sq. Ft. = $130 ྅ 1,501-2,500 Sq. Ft. = $195 ྅ 2,501-3,500 Sq. Ft. = $260 ྅ 3,501-4,500 Sq. Ft. = $325 ྅ Over 4,500 Sq. Ft. = $325+(65 x # of additional 1,000 Sq. Ft. (or portion thereof)) $_________________ New Multi-Family Residential: ྅ Duplex = $260 ྅ Three or more units = $((130 x # of buildings)+(65 x # of units))$_________ New work on any other residence and Detached Shops: = $(65 + (10 x # of branch circuits)) $__________________ Miscellaneous: ྅ Small Works (work costing less than $200 with no change in service connections)=$10(needs no inspection.) ྅ Central Heating/Cooling Systems = $65 ྅ Spas, Hot Tubs, and Swimming Pools = $65 ྅ Requested Inspection = $65 ྅ Pumps - Water, Irrigation, Sewage (per motor) = ྅ $65 up to 25HP ྅ $95 26- 200HP ྅ $130 over 200HP ྅ Irrigation Machine = $65 for center pivot + $10 per tower of drive motor $_____________ ྅ Technical Service = $65/hour ྅ Temporary Amusement = $65 + $10 per ride, concession, or generator $__________ ྅ Plan Check =10% of Contracted Amount ྅ Temporary Construction Services ONLY = $65 (200 amp or less. One location, for less than 1 year.) 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: The building official may revoke a permit on approval issued under the provisions of the 2012 International Code in cases of any false statement or misrepresentation of fact in the application or on the plans on which the permit or approval was based. Permit void if not started within 180 days. Permit void if work stops for 180 days. Applicant’s Name (print): ___________________________________ Signature: _____________________________________________ Date: _______________ Rexburg Rexburg Submit By Email Inspections must be called in before 8 AM on the day the inspection is requested. Inspection requests 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 Building Safety Department City of Rexburg 35 North 1st East Rexburg, Idaho 83440 BUILDING APPLICATION Plumbing For Office Use Permit Number: ____________________ Permit Type: ྅ New ྅ Remodel ྅ Addition ྅ Basement Finish Fees Paid: ྅ Yes ྅ No 1. Property Owner Name: ___________________________________________________________ Address: ___________________________________________________ City: __________________________ State: ____________ Zip Code: _________________ Phone & Type: _______________________ ྅ Office ྅ Mobile Email: _____________________________________________________________________ Under Idaho Building Code, a homeowner is allowed to do work on their own home. Are you a homeowner doing work on your own home? ྅ Yes (Skip to #3 and complete the Homeowner’s Exemption page) ྅ No: I am a contractor working for the homeowner ྅ No: This property is a Multi-family Residence or Commercial Property. NOTE: Any contractors/sub-contractors involved will need to submit their own signed applications. 2. Plumbing Contractor Name: _____________________________________________________________ Registration #: _________________________ Exp.: _______________________ Address: ___________________________________________________ City: __________________________ State: ____________ Zip Code: _________________ Phone & Type: ___________________________________ ྅ Office ྅ Mobile Email: __________________________________________________________ Contact/Rep. Name: ______________________________________ Phone: _________________ Email: ______________________________________________ Plumbing Contractor Authorized Signature: ____________________________________________________________________ Date:________________ 3. Project Description Water Meter Quantity: ____________________________________ Water Meter Size: ______________________________ Address: _______________________________________ -OR- Lot #: ____ Block #: ____ Subdivision: _________________________________ Check one: ྅ Single-family Residence ྅ Multi-family Residence ྅ Commercial Check one: ྅ New Construction* ྅ Remodel ྅ Addition ྅ Basement Finish Description of work: _____________________________________________________________________________________________________________________ New Commercial Work: Contracted amount: $________________________________ Calculated Fee (See Below): $__________________ ྅ Up to $10,000 = (total cost of system x .02) + $60 ྅ $10,001-$100,000 = ((total cost of system -10,000) x .01) + $260 ྅ Over $100,001 = ((total cost of system -100,000) x .005) + $1,160 New Single-Family Residential Work: _________ Sq. Ft. ྅ Up to 1,500 Sq. Ft. = $130 ྅ 1,501-2,500 Sq. Ft. = $195 ྅ 2,501-3,500 Sq. Ft. = $260 ྅ 3,501-4,500 Sq. Ft. = $325 ྅ Over 4,500 Sq. Ft. = $325+(65 x # of additional 1,000 Sq. Ft. (or portion thereof)) $_________________ New Multi-Family Residential: ྅ Duplex = $260 ྅ Three or more units = $((130 x # of buildings)+(65 x # of units))$_____ ྅ Gray Water Systems = $130 ྅ Lawn Sprinklers/Backflow device = $65 ྅ Multipurpose Fire Sprinkler & Domestic Water Supply System = $65 or $4 per sprinkler head (whichever is greater) New work on any other residence and Detached Shops: = $65 for sewer and water stub connections Miscellaneous: ྅ Sewer Line = $65 ྅ Water Line = $65 ྅ Sewer and Water Line = $65 ྅Requested inspection = $65 ྅ Sewer Turnaround (septic to city) = $65 ྅ Hydronic Heating = $65 + ($10 x # of manifolds/zones) ྅ Technical Service = $65/hour ྅ Plan Check =10% of Contracted Amount 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 t his application and hereby authorized representatives of the City to enter upon the above-mentioned property for inspections purposes. NOTE: The building official may revoke a permit on approval issued under the provisions of the 2012 International Code in cases of any false statement or misrepresentation of fact in the application or on the plans on which the permit or approval was based. Permit void if not started within 180 days. Permit void if work stops for 180 days. Applicant’s Name (print): ___________________________________ Signature: _____________________________________________ Date: _______________ ✔ ✔ ✔✔ ✔✔ ✔ Submit By Email Inspections must be called in before 8 AM on the day the inspection is requested. Inspection requests 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 Building Safety Department City of Rexburg 35 North 1st East Rexburg, Idaho 83440 BUILDING APPLICATION Fire Alarm For Office Use Permit Number: ____________________ Permit approved: ྅ Yes ྅ No Fees Paid: ྅ Yes ྅ No 1. Applicant Business Name: ___________________________________________________________ Office Address: ___________________________________________________ City: __________________________ State: ____________ Zip Code: ____________ Office Phone: _______________________ Contact Person: _______________________________________ Cell Phone: ______________________________ Contractor’s Authorized Signature: ____________________________________________________________________ Date: ________________ License/Registration #_________________________ Expiration: ____________________________ 2. Location of Work to be Done Street Address: ___________________________________________________ City: __________________________ State: ____________ Zip Code: ____________ Business Name: ______________________________________________________________________________________________________________________________ Contact/Rep. Name: ________________________________________ Phone: _______________________________________________྅ Office ྅ Cell Phone Email: _________________________________________________________________________________________________________________________________________ Dates for work to be done: From ______________________ to ______________________ 3. New Construction Contracted Amount: $_____________________________ Calculated Fee (See Below): $___________________________ ྅ Up to $10,000 = (total cost of system x .02) + $60 ྅ $10,001-$100,000 = ((total cost of system -10,000) x .01) + $260 ྅ Over $100,001 = ((total cost of system -100,000) x .005) + $1,160 4. Miscellaneous ྅ Plan Review = 10% of Contracted Amount ྅ Re-Inspection = $65 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 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: The building official may revoke a permit on approval issued under the provisions of the 2012 International Code in cases of any false statement or misrepresentation of fact in the application or on the plans on which the permit or approval was based. Permit void if not started within 180 days. Permit void if work stops for 180 days. Applicant’s Name (print): ___________________________________ Signature: _____________________________________________ Date: _______________ Rexburg Idaho 83440 4/6/16 Brandon Cooper 208.709.4012 mountainvalleyconstruction@hotmail.com Brandon Cooper 4/6/16 Submit By Email Inspections must be called in before 8 AM on the day the inspection is requested. Inspection requests 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 Building Safety Department City of Rexburg 35 North 1st East Rexburg, Idaho 83440 BUILDING APPLICATION Fire Sprinkler For Office Use Permit Number: ____________________ Permit approved: ྅ Yes ྅ No Fees Paid: ྅ Yes ྅ No 1. Applicant Business Name: ___________________________________________________________ Office Address: ___________________________________________________ City: __________________________ State: ____________ Zip Code: ____________ Office Phone: _______________________ Contact Person: _______________________________________ Cell Phone: ______________________________ Contractor’s Authorized Signature: ____________________________________________________________________ Date: ________________ License/Registration #_________________________ Expiration: ____________________________ 2. Location of Work to be Done Street Address: ___________________________________________________ City: __________________________ State: ____________ Zip Code: ____________ Business Name: ______________________________________________________________________________________________________________________________ Contact/Rep. Name: ________________________________________ Phone: _______________________________________________྅ Office ྅ Cell Phone Email: _________________________________________________________________________________________________________________________________________ Dates for work to be done: From ______________________ to ______________________ 3. New Construction Contracted Amount: $_____________________________ Calculated Fee (See Below): $___________________________ ྅ Up to $10,000 = (total cost of system x .02) + $60 ྅ $10,001-$100,000 = ((total cost of system -10,000) x .01) + $260 ྅ Over $100,001 = ((total cost of system -100,000) x .005) + $1,160 4. Miscellaneous ྅ New Construction = $1 per sprinkler head ($2,000 max) # of heads: ____________________ ྅ Existing Inspection Base = $65 ྅ Plan Review = 10% of Contracted Amount ྅ Re-Inspection = $65 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 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: The building official may revoke a permit on approval issued under the provisions of the 2012 International Code in cases of any false statement or misrepresentation of fact in the application or on the plans on which the permit or approval was based. Permit void if not started within 180 days. Permit void if work stops for 180 days. Applicant’s Name (print): ___________________________________ Signature: _____________________________________________ Date: _______________ Rexburg Idaho 83440 4/6/16 Brandon Cooper 208.709.4012 mountainvalleyconstruction@hotmail.com Brandon Cooper 4/6/16 Submit By Email Inspection Hotline – (208) 372.2344 www.rexburg.org Permit Technician – (208) 372.2341 Revised March, 2016 Building Safety Department City of Rexburg 35 North 1st East Rexburg, Idaho 83440 Subcontractor List Excavation & Earthwork: ______________________________________________________________________________________________________ Concrete: ________________________________________________________________________________________________________________________ Masonry: ________________________________________________________________________________________________________________________ Roofing: _________________________________________________________________________________________________________________________ Insulation: _______________________________________________________________________________________________________________________ Drywall: __________________________________________________________________________________________________________________________ Painting: _________________________________________________________________________________________________________________________ Floor Coverings: ________________________________________________________________________________________________________________ Plumbing: ________________________________________________________________________________________________________________________ Heating: __________________________________________________________________________________________________________________________ Electrical: ________________________________________________________________________________________________________________________ Special Construction (Manufacturer or Supplier) Roof Trusses: ___________________________________________________________________________________________________________________ Floor/Ceiling Joists: ____________________________________________________________________________________________________________ Siding/Exterior Trim: __________________________________________________________________________________________________________ Other: ____________________________________________________________________________________________________________________________ Mountain Valley Construction, Inc. Submit By Email Inspection Hotline – (208) 372.2344 www.rexburg.org Permit Technician – (208) 372.2341 Revised March, 2016 Building Safety Department 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 ྅ No Will the business be doing any structural/or remodeling changes to the building? ྅ Yes ྅ No Any changes to the electrical? ྅ Yes ྅ No 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 ____________________________________________________ ྅ No Is this business changing ownership? ྅ Yes ྅ No Is the business registered with the City of Rexburg? ྅ Yes, License #: __________________________________ ྅ No *If No, please apply for a business license with the Customer Service Dept. Will the business have food preparations? ྅ Yes ྅ No Will there be any cooking of foods? ྅ Yes ྅ No 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? ྅ Yes ྅ No ___________________________________________ _________________________________ ____________________ Applicants Signature Phone Date I certify that the information that I have provided above is to the best of my knowledge accurate and true. 4/6/16 ✔ ✔✔ ✔✔ ✔ ✔ N/A Submit By Email