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Home My WebLink AboutAPPLICATION - 17-00192 - 780 Yost St - Basement Finishc I .I. Y 0 t Building Safety Department - - - City of Rexburg REXBURG 35 North 1st East CW --- Amcr 4Ev..inyComn,p,iry Rexburg, Idaho 83440 SINGLE FAMILY RESIDENTIAL BASEMENT FINISH 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 building plans drawn to scale ❑ Floor Plan, Sectional Views, Mechanical Layout, Stair Details, and any details required to illustrate special construction. [V Digital Plans (PDF Format- can be submitted by USB, CD, or Dropbox) 13 KV "Copies of any Contractors' State License if not on file already. Complete the Following Forms: R( Permit Policies Acknowledgment signed. [� Building Permit Application signed by a registered General Contractor. Mechanical Permit Application signed by a registered Mechanical Contractor. C7 Electrical Permit Application signed by a registered Electrical Contractor. Plumbing Permit Application signed by a registered Plumbing Contractor. 51/ Subcontractor list completed. WHomeowner's Exemption signed, if Homeowner is doing work on their own home. ❑ Affidavit of Legal Interest signed by owner, if ap licant is not working directly with owner. 5� Notifications Distribution List. 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 http://rexburg.org/pages/development-code. I nspection H oNine-(208)372.2344 www.reburg.org Permit Technician -(208)372.2341 Revised 10/2016 C I I Y O F REXBURG .._ tw ........._ Amens rnnnly Cnuvnuniq, PERMIT POLICIES ACKNOWLEDGMENT Building Safety Department City of Rexburg 35 North 11t 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. 1 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 Initlals 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. �J� o If a building is occupied without receiving a signed Certificate of Occupancy, citations may be issued and the occupants may be evicted. nitials 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 Initials 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 ONLY 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. 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 inform anyone on your project of the above policies. All sub -contractors will be held to this standard with no exceptions. o The above policies will be enforced to all, regardless if this information is passed on to them or not. Initials Applicant's Name (print): I' n&f0. (?A, Signature: Date: 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 businessday. Inspection Hotline -(208)372.2344 www.rexburg.org Permit Technician -(208)372.2341 Revised 10/2016 C IT Y OF lEXBURG BUILDING PERMIT FORM 104 0 nytlauJ 10/0016 dnu umi huudi Community BUILDING APPLICATION Single Family Residence Basement Finish Building Safety Department City of Rexburg 35 North 151 East Rexburg, Idaho 83440 For Office Use Permit Number: Application Fee Paid: 0 $100 .1.PropertvOwner. Name: Address: -City: 9� State: � Zi oder Phone: l f)R)��D1—�D�o1� Email a^,W1Lr�.tP _5Cr, _ ('-Dm. 9 Under Idaho Building Code, a homeowner is allowed to do work on their wome. Are you a homeowner doing work on your own home? XYes (Skip to #4 and complete the Homeowner's Exemption) 0 No, I am working with the homeowner 2. Applicant Name: Role: (Owner, Tenant, Contractor, etc.) Address: City: State: Zip Code: Phone: Email: Contact/Rep. Name: 3. General Contractor Name: Registration #: Exp.: Address: City: State: Zip Code: Phone: Email: Contact/Rep. Name: Phone: Email: General Contractor Authorized Signature: Date: A copy of your state registration/license is required to be on file. If this is the first time you have done work in the City of Rexburg, please provide a photo copy ofyour license. Ifyou are unsure if your license is on file, please check with the Permit Technician by calling (208) 372-2341. 4. Project Description :' "l Address:/� St �a Project Description: 7_A&t'Y1fL�'_4;- Ft✓�iS�h.. • Square Footage being Finished: 11fflO sq. ft. • Check All Included in Scope of Work: QKMechanical Work X Electrical Work IXPlumbing Work Note: Any contractors involved will need to fill out their respective application. • Fireplace(s) Being Installed? ❑ Yes A No Building Permit fees for new homes are charged based on square footage and the City's estimated valuation. Fordetails on how feet are calculated, contact the Building Department There will also be a plan review fee totaling 10% of the building permit fee. APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, I hereby certify that l have read this application and state that the information herein is correct and 1 swear that any information 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. 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 Inter national 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. e Applicant's Name (print): LAW _ 42N Signature: /�lY6K. f 5 , Date: .O o Inspections must be called in before 8 AM on the day the inspection is requested. Inspection Wquests 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 C I T Y OF REXBURG Amedc4 Pully C'ornmumly BUILDING PERMIT FORM113 ondm,o m/zits BUILDING APPLICATION Basement Finish SFR Mechanical Building Safety Department City of Rexburg 35 North 1S1 East Rexburg, Idaho 83440 For Office Use Permit Number: ❑ Mechanical Fee Paid 1. Prooerry Owner Name: �/�s��1 �� Address: City: tWHY9t.l,t-C/v State: -I Coder Phone: (W!6)201-(a31Email: Tl�Q3'L�Q�v\ 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) n No, I am working with the homeowner 2. Mechanical Contractor Business: iut7nso i4eenNo uL State License #: WVL-c- I3z7 Exp.: 9- 2017 Address: 6q& w; lla.a b- Y- c; ecl s City: F-x-bur-�;, State: a'i-'> Zip Code: 63" 'VD Phone: 7oS-39o'O�7-5— Email: -]lo1-50-,J 14 6 6—;' Contact/Rep. Name: n1A.. '3oyr Phone:Zv ' 90'o5'Zs—Email: Mechanical Contractor Authorized Signatur Date:/0 m19'r Z°l7 A copy ofyour state registration/license is required to be on file. If this the first timeyou have done work in the City of Rexburg, please provide a photo copy ofyour license. Ifyou are unsure ifyour license is on file, please check with Che Permit Technician by calling (20B)372-2341. 3. Project Description Address: 14Rju Yos-t r Description of work: �L12(.yv�fl.n�F' +tV\iSAA, �P SFR Construction: sq. ft. • Feesforbasementfinishes are charged bysquarefootage: Up to 1,500sq.ft=$130+$65foreach additional 1,000sq.ft or portion thereof. o Up to 1,500 sq. ft = $130. Up to 2,500 sq. ft. = $195. Up to 3,500 sq. ft. = $230. Up to 4,500 sq. ft = $295, etc. (i.e. a home with 3,675sq. ft. will be charged$295) ❑NumberofFireplaces: n • Note that fireplaces are not included in square footage costs and will be charged $65 per inspection. APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty ofperjury, l hereby certify that l 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): 74ddn JP01gAJe29f Signature: // 44AA a a Q2ni Date: ��x f�v� 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 wvvw.rrxbrrg.org Permit Technician -(208) 372.2341 �� µexoopc y��rVC Y O F 1 c G BUILDING PERMIT FORM 12 3 r upaam to/zors . O Americo la Ji Cmn,vunity BUILDING APPLICATION SFR Basement Finish Electrical Building Safety Department City of Rexburg 35 North 1st East Rexburg, Idaho 83440 For Office Use Permit Number: ❑ Electrical Fee Paid 1. ProperOwner Name: Address: fl +. city: State �Zi Code:93� Phone: 2t� 1 _ VAi'3 Email: -t�-t.r o_,a ,i6aV eJ1 :IINVi'i..O. N Poew Under Idaho Building Code, a homeowner is allowed to do work on thei wr b n home. Are you a homeowner doing work on your own home? ❑ Yes (Skip to #3 and complete the Homeowner's Exemption) XI No,1 am working with the homeowner 2. Electrical Contractor Business: L✓esty RnrYa LLC State License #: 00760(, Exp.: f/31/19 Address: Py ax 2 s'8' City: Vc/s State: Z.0 Zip Code: 83c/SS- Phone: IS -C- 573 • 5-Sca Email: Contact/Rep. Name:_-V-.YV %//aT.c- Phone("22r•lef3zEmail: ,Fca, ..re1`,4WM.L/.Caen o__� Electrical Contractor Authorized Signature: Date: ! /� A copy ofyour state rc9istration/license is requiredto be on file. If is is thefirst timeyou have done work in the City of Rexburg, please provide a photocopy ofyour license. Ifyou are unsure ifyour license is on file, please check with the Permit Technician by calling (208) 372-2341. 3. Project Description Address:U Description of work: _RA%geO t'1v T'y66_�_ ❑ SFR Construction: I i on sq. ft. • Feesforbasementfinishes are charged by squarefootage• Up to 1,500sq.ft. = $130 + $65for each additional 1,000sq.ft or portion thereof. o Up to 1,500 sq.ft. t. = $130. Up to 2,500 sq. f . = $195. Up to 3,500 sq. ft. = $230. Up to 4,500 sq. ft = $295, etc. (i.e. a home with 3,675 sq. ft. will be charged $295) APPLICANTS SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, I hereby certify that l have read this application and state that the information herein is correct and I swear that any information 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 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 incases 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 ifwork stops for 180 days. Applicant's Name (print): An�CIrPQ Signature: PAalt, Date:'fir j'1 U 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 Hall i me - (208) 37 2.2 344 www.rexbnrg.org Permit Technician - (208) 3 72.2 341 (4 ( I 1 Y O F ............. 7�r��rr� L EXBURG BUILDING PERMIT FORM 13 3 ueaa�a m/zars Arno cn_ 1 droll, C, nunouhy BUILDING APPLICATION SFR Basement Finish Plumbing Building Safety Department City of Rexburg 35 North 15t East Rexburg, Idaho 83440 For Office Use Permit Number: ❑ Plumbing Fee Paid 1. Pro er Owner Name: Address:`' City:State: � Zip Code: Phone: Email=.ltPll�''� Ot✓Mm;. . �3Vln Under Idaho Building Code, a homeowner is allowed to do work on theiroown home. Are you a homeowner doing work on your own home? ❑ Yes (Skip to 43 and complete the Homeowner's Exemption) JONo, 1 am working with the homeowner 2. Plumbing -Sr Business: I ^ C State License #: Olfgf l Exp.: &3� Address: VtT �.tlnoti�c�vn �(' City: -ILO OTail State: Zip Code: Phone: og- 21^ 'IN" Email: -�alcst7lt....�.bi�aMa�l rCbM Contact/Rep. Name: Phone: S"2-1'�2q Email: l: `t-�� r— Plumbing Contractor Authorized Signature: Date: fi A copy ofyour state registration/license is required t Ir%le. If thniiis thefirst timeyou have done work in the City of Rexburg, please provide a photo copy ofyour license. Ifyou are unsure ifyour license is on file, please check with the Permit Technician by calling (208) 372-2341. 3. ProjectDescription Address: Q -k - Description of work: ` &V_ n 0 N -1-"r N1iSG�A ❑ SFR Construction: I ( M) sq. ft. • Fees for basement finishes are charged by square footage: Up to 1,500 sq. ft. = $130 + $65 for each additional 1,000 sq. ft or portion thereof. o Up to 1,500 sq. ft. = $130. Up to 2,500 sq.ft = $195. Up to 3,500 sq. ft. = $230. Up to 4,500 sq. It = $295, etc. (i.e. a home with 3,675 sq.ft. t. will be charged $295) APPLICANT'S 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 information 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 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 ofthe 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 ap prove[was based. Permit void if not started within 180 days, Permit void if work stops for 1B0 days. Applicant's Name (print): rVGtl'\_"d gi& _Signature: i' Date:742,07 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 - (2 08) 372.2344 www.rexburg.org Permit Technician - (208) 372.2341 ,F µt x BURG RBX0BURG Americws hnnd) Cmnrnuuity SUBCONTRACTOR LIST Excavation & Earthwork: Concrete: Masonry: N A - Roofing: Insulation: Drywall: Painting: Floor Coverings: Plumbing: Heating: _ Electrical: Special Construction (Manufacturer or Supplier) Roof Trusses: Floor/Ceiling Joists: _ Siding/Exterior Trim: Other: Building Safety Department City of Rexburg 35 North 161 East Rexburg, Idaho 83440 Inspection Hotline -(208)372.2344 www.rexburg.org Permit Technician -(208)372.2341 Revised 10/2016 "a'R Building Safety Department ,F r.;� clTv or g Y P per= REXBURG City of Rexburg N 35 North V East Amerl,ws Fnnull Canunwtity Rexburg, Idaho 83440 j State of Idaho County of Madison I, Name Affidavit of Legal Interest Address City State Being first duly sworn upon oath, depose and say: (If Applicant is also Owner of Record, skip to B) A. That 1 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: Inspection Hotline -(208)372.2344 www.rexburg.org Permit Technician -(208)372.2341 Revised 10, 2016 %era Building Safe ciiY oP g tY Department p� REXBURG City of Rexburg �i N 35 North 1st East Amema Fnr.ily( nunity Rexburg, Idaho 83440 HOMEOWNER'S EXEMPTION 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 fill out this form showing your exemption and send it with your permit application. Idaho State Statute allows a homeowner to do work on their own residence; An owner performing construction on the owner's personal residential real property, whether or not occupied by the owner, provided however, this exemption shall not apply to an owner who is otherwise regulated by this chapter who constructs a building, residence or other improvement on the owner's property with the intention and for the purpose of promptly selling the improved property, unless the owner has continuously occupied the property as the owner's primary residence for not less than twelve (12) months prior to the sale of such property; Title 54, Chapter 52, Subsection (2) 1 hereby certify that the above information is true and correct to the best of my knowledge. Sigrature / An(- 2yq Date ' Permit Tech Nd.a,-(200)372.2341 w .rexburg.org Revised 10/2016 e x"xa°a; Building Safety Department .� cllroP g Y P 's 7� r��G City of Rexburg 1�-- C, ---- 35 North 151 East '•,, ,o Americas Fondly (.mo,mmlly Rexburg, Idaho 83440 DISTRIBUTION LIST Please provide the names and emails of anyone who should he getting automated updates for this project. Review Notes Name: N &41 �V �.•�� r N .. a Name Name: Name: Inspection Tickets Name: g4arl%dvid, P� Name: Name: Name: Name: Inspection Hotline -(208)372.2344 www.rexburg.org Email: Email: Email: Email:V �4�(�2ECnl�U Y-�Qa[°¢�vulQaCdiwr Email: E�.tPQJnakP��LNByIA Email: Email: Email: Permit Technician -(208)372.2341 Revised 10/2016