HomeMy WebLinkAboutAPPLICATION - 17-00379 - 2166 Summerfield Ln - New Kartchner SFRn
CITY OF
REXBURG
Building Safety Department
City of Rexburg
35 North 1st East
Rexburg, Idaho 83440
SINGLE FAMILY RESIDENTIAL 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:
❑ 2 sets of site plans (see Site Plan Checklist)
❑ 2 sets of building plans drawn to scale (see box to right)
❑ Foundation Plan, Floor Joist Layout Floor Plan, Roof Layout Truss Details, Sectional Views, Front, Back, and Side
Elevations, Mechanical Layout, Stair Details, and any details required to illustrate special construction.
Note: All Plans and Construction must conform to IRC2012 standards.
❑ Structural Calculations (see box to right) - stamped by a licensed Engineer Seismic Design Category - D
t.
❑ Energy Compliance Report: As per the 2012 IECC, a RESCheck is required Ground Snow - 50 lbs. per sq.
Roof Snow Load - 35 lbs. per sq.
ft
(available online at www.energycodes.gov) Wind Load - 90 MPH
❑ Digital Plans (PDF Format - can be submitted by USB, CD, or Dropbox) Frost Depth - 36"
❑ **Copies of any Contractors' State License if not on file already.
Complete the Following Forms:
❑ Site Plan Checklist completed.
❑ Permit Policies Acknowledgment signed.
❑ Property Line form signed by builder.
❑ Building Permit Application signed by a registered General Contractor.
❑ Mechanical Permit Application signed by a registered Mechanical Contractor.
❑ Electrical Permit Application signed by a registered Electrical Contractor.
❑ Plumbing Permit Application signed by a registered Plumbing Contractor.
❑ Subcontractor list completed.
❑ Homeowner's Exemption signed, if Homeowner is doing work on their own home.
❑ Affidavit of Legal Interest signed by owner, if applicant is not working directly with owner.
❑ Notifications Distribution List.
Note: Please check the Rexburg Development Code for any requirements such as property setbacks,
design board approval, etc.
This information is available at http://rexburg.org/ages/development-code.
Inspection Hotline -(208)372.2344 www.rexburg.org Permit Technician -(200)372.2341 Revised 2/2017
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CITY OF
° REXBURG
r
America's Family Community
PERMIT POLICIES ACKNOWLEDGMENT
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
a roved ermit.
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
Initials tag. If the red tag is removed by anyone but a City Official, citations may be issued.
No buildin may be occupied without receiving a signed Certificate of Occupancy.
o If a building is occupied without receiving a signed Certificate of Occupancy, citations may be issued and the occupants
may be evicted.
Initia s
A Certificate of Occupancy will not be issued without digital copies of the As -Built Plans.
It is the Applicant's responsibility to turn in digital copies of the As -Built Plans when the project is completed. No
Certificate of Occupancy will be issued without these plans.
Inki
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
da .
o Required inspections can he found on the inspection sequence page in this packet 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
Initials 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 ONLY when you have received an official Certificate of Occupancy
from the Building Department.
o A verbal approval does not constitute approval of these documents. Ultimately if you do not have a Building Permit or
Certificate of Occupancy, the above policies will be enforced. These documents must be signed by the appropriate
Inst. I� authorities from the City of Rexburg. Any approvals can be verified by calling (208) 372-2341.
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.
F�;7 o The above policies will be enforced to all, regardless if this information is passed on to them or not.
Applicant's Name (print):T�iVL EVO� Signature: rzDate:�77
Inspections must be called in before B 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 2/2017
C I TY OF
REXBURG
America's Family Community
PROPERTY LINES
Building Safety Department
City of Rexburg
35 North 1st East
Rexburg, Idaho 83440
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. This information is available at madison.rexbura.org. If you want to request a copy of
your lot information, contact the Community Development Department.
I have read and understand the above requirements.
Signature
I `� �ve-nsap -
Printed Name
-JAV1ice
Date
Inspection Retire -(208)372.2344 w .rexburgarg Permit Technidan-(208)372.2341 Revised 10/2016
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F; a iQ CITY OF
a
1EXBURGBUILDING PERMIT FORM 100
cw Update] 10/2016
Americai Family Community
BUILDING PERMIT APPLICATION
New Single Family Residence
Building Safety Department
City of Rexburg
35 North 1St East
Rexburg, Idaho 83440
For Office Use
Permit Number: Zoning: Application Fee Paid: ❑ $500
1. Property ner,
Name: f'�'Lhas4!--AP
Address: 's" f. 7rAVeust�s.� �t IW City: gyji of4 State: SID Lip Code: V3&14J
Phone: Sk►-Zil4 Email:oL ISD kav4vhA.t,hik .t
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?
Cl Yes (Skip to #4 and complete the Homeowner's Exemption)
17Wo,1 am working with the homeowner
2. Applicant
Name: 541Mt fd cbwc Role: (Owner, Tenant, Contractor, etc.)
Address: City: State: Zip Code:
Phone: Email:
Contact/Rep. Name:
3. General Contractor
Name: y1:Y`sL -W S b O.rL Registration #: Exp.:
Address: City: State: Zip Code:
Phone: Email:
Contact/Rep. Name: Phone: Email:
General Contractor Authorized Signature: TR -•tel( £ A — Date:
A copy ofyour state registration/license is required to be on file. If this is the first time you have done work in the City of Rexburg, p ide
o photo copy ofyour license. Ifyou are unsure ifyour license is on file, please check with the Permit Technician by calling (208) 372-2341.
4. Project Description C R
Address: -OR- Lot#: -Block#: 1 Subdivision: 50MMatnCU
Project Description:
• Square Feet: Building Total: PJ:LO sq. ft. • # of Water Meters: Water Meter Size:
o Main Floor: 170sq. ft. • Fireplace(s) Being Installed?[] Yesga No
o Additional Floors: 11 112 sq. ft. Hydropic Heating Being Installed? O Ye No
o Basement: l
Finished sq. ft. Building Pertiitfeesfor newhomesare chargedbasedon square
Unfinished sq. ft. footage and the City's estimated valuation. For details on howfees
o Garage :1 VO sq. ft. are calculated, contact the Building Department There will also be
• Estimated Total Cost: $ ZLoHi Soo. VZO a plan reviewfee totaling 10% of the building permitfee.
APPLICANTS SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty ofperjury, l hereby otnify that I have read this application and state that the Information herein is correct and 1 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 ofthis 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 ofany false statement or misrepresentation of fact In the application or an the plans on
which the permit or approval was based. Permit void if not started within 180 days. Permit void ifwork shops for 180 days.
Applicant's Name (print):1gfm&-jenLe-W, Signature: OrOL—i-y — Date: 10/
Inspections must be called In before 8 AM on the day the inspection Is requested. Inspection requests called in after SAM will be scheduled for the next business day.
Inspection Hotline- (208) 372.2344 www.rexburg.org Permit Technician - (208) 372.2341
CITY of
REXBURG
cw
Nnrrka4 poetry Cennmuolly
BUILDING PERMIT FORM Z
uaa.uampess
BUILDING APPLICATION
New SFR Electrical
Building Safety Department
City of Rexburg
35 North let East
Rexburg, Idaho 83440
For Office Use
Permit Number: - .. ❑ Electrical fee Paid
1. Properly 0 mer
Name.. arkGh,(yje.ro
Acidness: City: State: Zip Code:
Phone: Small:
Under Idaho Building Code, a homeowner is allowed to do ivopkoil their own home.
Are you a homeowner doing work on your own home?
❑ Yes (Skip to 83 and complete the lionleowner's Exemption)
%No, I ant working with the homeowner
2. Electrical Contractor
Business: Silt Ache. nz t-14- State License N: Bxp,:
Address:Y--0' My, Iii City: j2 i /`I' C State:1j- ZipCode: f33yy3
Phone: �- Email: 4�Cs�`,• ^=SGJ+Y �4'�dNfael. �i]Yi1
Contact/Aep.Name: Picone: Email:
,
Electrical CoifrticForlluthoi•lied Signature:, Date:
Acopy ofyoNrstatereilfstratlon/Iicensefsrequire be mlflle, rfirdslrtheJlrstNmeyouhavedmtewa•lclntheCityofRexbur0,pleaseprovfde
a photo copy ofyourlicense. fyouare Uastfref our license ison/tle,pleasecheckwlthtirePermitTeclunklanbyrnjlhlq(208)372.2341.
3. Project Description
Address: OR- Lot #:Dlock H: IL Stlbtlivlston: S`ichtt �+r�
Description of work: {V'eyi �—�,n7
13 New SFR Construction: X%ka sq. ft.
• peesfornewconstructfon are charged bysquarefootage: Up to 1,500sq.f.=$130+$65foreach additfonal1,0005q.ft. or
portion thereof.
o Up to 1,500sq.f.=$130. Up to2,500sq.ft.=$195. Up to3,500sq.ft. = $Z6a Up to 4,500sq.ft.=$325, etc .(i.e.a
home with $675 sq. ft: tvlll be charged $325)
❑ Spas/Pools/Generators: O Yes 9 No
• Notethatspns/pools/generators are not Included lit squarefootagecosts and N111becharged $65per Inspection.
APPLICANTS SIONATUHH CNIVI'IFICATION AND AUTHORIZATION: Under penally of perjury, l hereby certify that l love read this application and slate trial lite Information herein
Is correct and I sweartimt any Information which may hereafter be given by lite hr hearings before the Planning and •LotbngCouunlsslon or the City council for the City of Rexburg
shall be truthhit and correct. I agree M comply with all city rcgnlnllonsnud Slntelaws relating to the subject inatterotllilsnpplfcatlon unit hereby authorized representatives of the
city to enter upon tile ubuvrmentioned properly fur Imsprctimns purposes. NOTE: The bulldhngofadxl may revoke a pernituu approval Issued under the provisions ache 2012
lliter itatletter Code In cases of any false at itenlent or mistepresenIatIon offset In lhcuplike I inn neon No to plans on which the per It or npp royal wos based. Ile rot ll Vold lfaot
started will On 100 days. Permit Vold If work slops for 100 days.
Applicant'sName(print): 1 aYt ��Ma,� Signahue:� a'� —�� Date:.- -7AWI-7
Inspections must be called In before 0 A on the day lila Inspection Is regnestad. lnapectlun requests called In after 0 AM will be sdwdulasl tot the tient business day.
Inspection Illocu e- (200):172.2344 1Vww re%burg.org Permit Tcclnddan - (200) 372.2341
ea""°mR CITY O F Building Safety Department
1EG BUILDING PERMIT FORM 110 City of Rexburg
°° 'anal
ry 35 North tat East
Arnerkn3 lhmlfy Comnumly Rexburg, Idaho 83440
BUILDING APPLICATION
New SFR Mechanical
For Office Use
Permit Number: ❑ Mechanical Fee Paid
1. Property Owner
Name: KA (k-�A&{ ?r nnt)
Address: City: State: Zip Code: _
Phone: Email:
Under Idaho Rullding 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)
V No, I am working with the homeowner
2. Mechanical Contractor 4 W,Business: Lim (+ State License M Of 5S' Z Exp.: S 5( $
Address: City: Stat : 'Lip Code: : VYz.
Phone: `l. 2- Em 11: D �fL des! iAll s--
ContactfRep.Name; I Phone:Iq Sr- 24 13mail:.V ' ++
Mechanical Contractor Authorized Signature: Date._7 a
Acopy ofyourstate registration/ifcenseIs required tobeonffle.lfthtsist flrsttlmeyouhavedoneworkintheCityofReatburg,pleaseprovide
a photo copy ofyour license. Ifyou are unsure (fyotir license is on file, please check with the Permit Technician by calling (208) 372.2341.
3. Project Description
Address:Lot #: �_ Block #: Subdivision:.5 u Mme( ice✓
Description of work: HJCw R0VOR•
❑ SFR Construction: '4�'» sia sq. ft.
• Fees for new construction are charged by square footage: Up to 1,500 sq. ft. =$130 4 $65for each additional 1,000 sq. f . or
portion thereof.
o Up to 1,500sq.1t=$130. Up to2,500sq.ft=$195. Up to3,500sq.ft.=$260. Up to 4,500sq.ft=$325, etc. (i.e.a
home with 3,675 sqm ft. will be charged $325)
0 Number of Fireplaces;
• Note thatfireploces are not Included fn squarefootage costs and will be charged $65 per Inspection.
❑ Hydronic Heating: N/i%
• Note that hydrontc heating is not Included in square footage costs and will be charged and additional $65 a ($10 x # of
manifolds/zones)
APPLICANTS SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, l hereby certify that l have read this application and state that the Information
herein Is correct and i swear that any inroi motion 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 mrd correct. I agree to comply with all City reguleliuus and Stale laws relating to the subject matter of thfs"appllcation 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 tine 2012 International Code In cases orally 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 Nance (print): Signature:—rk t `y --Ph Date:. / /17
Inspections must be called In before SAM on the day the inspection Is requested. Inspection requests called in after SAM will be scheduled for the next business day,
Inspection Ifotline- (208)372.2344 www.rexburgorg Permit Technician - (200) 372.2341
Oa03*B
1 �,S CITY OF
d ° REXBURG
•4,,,a o ,p' Anrer(cnt Fmnily Cornrnanly
BUILDING PERMIT FORM 13
uO.naepse
BUILDING APPLICATION
New SFR Plumbing
Building Safety Department
City of Rexburg
35 North 1A1, East
Rexburg, Idaho 8344.0
Por Ofnce.Use.
Pete nil! Number; 13 Islumbing Fee Paid
1. Property Oydyh hw
Name:
Address: City: State: Zip Cade:
Phone: Email:
Under• Idaho Building Code, a homeowner Is allowed to llo war* on their own home,
Are you a homeowner doing work on your own home?
O Yes (Skip to 03 and complete the Honeowner s Exemption)
VINCI, I am working with the homeowner
2. Plumbing e. tt to ] n
Business: f�ole,5 f l'"�tihNGc^5 {�Gt Sta�tneLicensell; / �� ���/S/�xp.:
Address: `� t., , 5e'c Gln: / ir9 a'*o/ r �StAte: -s Zip Code; VIV
Phone:°� 5 35 /' O Emalt: ' o/B '.o yry d r r? �yao. ec.«,
Contact 'Rep. Name; Ned or -di Phone: Eme 1L —67
Plumbing ConiractorAutlioi'lzed Signaiure: 'Lc Date: .3
A copy ofyour state registration/license is required to becaptor: tfthlsk /list tinrlyou have done wart ht the City of Rexburg, please provide
a photo copy ofyour license. lfyou ore unsure Ifyour license is on file, pleose dhedir with the Permit Technician by calling (200) 372.2341.
3. Project Description
Address: OR. Lot M-3 Block If: •1, -,Subdivision: SJAhrn fq!9U
Description of work:
O New SPR Construction: sq. R•
+ Poesforne,construction afectiarpedbyequmefootage: Up to 1,500sq.f.=$130+$65fbr each add(tlorm11,000sq.f. arportlon
thereof
o lip to 1,500sq.f.=$130. Up in 2,500nift.=$195. Up to3,500sq.ft.=$260. Up to 4,500sq.f,-$325, etc, (i.e.(I
homeivlll13,675sq. ft. tvfll becharged$325)
❑ Hydronlc (In -noon) Heating: 0 Yes W No
I Note that hydronkheatfngIsnot included Insquarefoologecosts and will bechapead$6:5+($10xllafmnntfolds/zones).
APPLICANT'S SICNATIInC, CERTIFICATION AND AUTHOn2ATION: Underyenaltyofporjury, i hereby codify that i have road this Application And&Into that lbeinformatlon hureln
Is correelnnd I swear door tiny Information watch mayhoteaner be given by Ina In hearingsbefom the Plannlugaod Zooln iComialsslon or Ito City Conndi for the Cllyef Iloxburg
shAll he tnnhfnl and tiered I agree to comply with nil City regulations unit Sime laws mlothigm Wu subject matter of Itis nplillcallou And hereby mAlmrized representatives of the
City to outer upon file Above•menllmod pralmny for Inspections porpoises. NOTIA The bulldmgomctil may revoke permit at, approval Posted underlie provisions of Ito 1012
International Code In cases orally false statement or misrepresentation afflict In Ilia Application myon the plans on which Ihoperndt or Approval was teased. Permit void If not
smiled wilbb, 1110 days. Pennll veld If work stops far f 00 days.
Applicant'sName(print)I__Signature: '" ` — Date:_/W��%
Inspect long mttvt Its called In before 0 AM untie day Ito Inspection Is requested. inspection regnesty colied In after U AM will be scheduled for the next business day.
htspettlaii Ilolllno- (200) 3723374 wwwro tburg.mg Permll Tcliuthlan- (200) 3723341
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� oa CITY OF
REXBURG
CIV
America} Family Connaunity
SUBCONTRACTOR LIST
Excavation & Earthwork:
Concrete: Q L\/,\Rvld Cot\UrekL � 0 (,
Building Safety Departinent
City of Rexburg
35 North 1st East
Rexburg, Idaho 83440
�V)
Insulation:
Drywall:
Painting:
Floor Coverings: Ce 't; &— Q1(ec-A
Plumbing:
Heating:
Electrical:
Special Construction
(Manufacturer or Supplier)
Roof Trusses: QV) Gorer-ks,,,—,
Floor/Ceiling Joists: 1SW)(- West CoC'tDaJ��L�_
Siding/Exterior Trim:
Other:
Inspection Notiine-(208)372.2344 wmv.rexhur&org pennit'rec)nician-(208)372.2341 Revised 10/2016
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Insulation:
Drywall:
Painting:
Floor Coverings: Ce 't; &— Q1(ec-A
Plumbing:
Heating:
Electrical:
Special Construction
(Manufacturer or Supplier)
Roof Trusses: QV) Gorer-ks,,,—,
Floor/Ceiling Joists: 1SW)(- West CoC'tDaJ��L�_
Siding/Exterior Trim:
Other:
Inspection Notiine-(208)372.2344 wmv.rexhur&org pennit'rec)nician-(208)372.2341 Revised 10/2016
C I TY OF
REXBURG
CW -
America's Family Community
Affidavit of Legal Interest
State of Idaho
County of Madison
I, 'roCYa fJeA se- — 800 a
Name
Address
City State
Being first duly sworn upon oath, depose and say:
(If Applicant is also Owner of Record, skip to B)
Building Safety Department
City of Rexburg
35 North 1St East
Rexburg, Idaho 83440
RZ
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 O day of J11 Q- 20_1 -1
Signature
Subscribed and sworn to before me the day and year first above written.
JAW BINGHAM
NOTARY PUBLIC
STATE OF IDAHO
k11 --J
Public of Idaho
Residingat: l>-bq �r��1
My commission expires:
Inspection Hotline -(208)372.2344 w .rexlmrg.org Permit Technician -(208)372.2341 Revised 10, 2016