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HomeMy WebLinkAboutAPPLICATION - 16-00644 - 1121 Adams Ct - SFRCITY o P Building Safety Department r REXBURG City of Rexburg N, 35 North tat East Awertmi Famffy Cbnumodif .Rexburg, Idaho 83440 SINGLE FAMILYRESIDENTIAL APPLICATION CHECKLIST The following items should be completed before you submityour building permit application. *Reasonable accommodations will be made upon'reauest. Complete the Following: i9 2 sets of site plans (see Site Plan Checklist on page 2) 2 sets of building plans drawn to scale (see box below) - stamped by a licensed professional 0 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.) a/ Structural Calculations (see box below) - stamped by a licensed Engineer m/ Energy Compliance Report: As per the 2012 IECC, a RESCheck is required (available online at www energycodes,goy) Homeowner's Exemption signed, if Homeowner is doing work on their own home. (see page 4) B/ Building Permit Application signed by a registered General Contractor. (see page 3). / Mechanical Permit Application signed by a registered Mechanical Contractor. (see page 5) Electrical Permit Application signed by a registered Electrical Contractor. (seepage 6) tl Plumbing Permit Application signed by a registered Plumbing Contractor. (see page 7) 6// Property Line form signed by builder. (see page 8) 15 Affidavit of Legal Interest signed by owner. (see page 9) S Subcontractor list filled out. (see page 10) Subdivisions: If you plan to build in a subdivision please check the Rexburg Development Code for any reyuirementssuch as, property setbacks, architecture board approval, etc. This information is available at htto•//rexburg org���es/develo/development-code; Seismic Design Category- D Ground Snow - 50 Ills. per sq. fL Roof Snow Load - 35 lbs. per sq. it. Wind Load - 90 MPH Frost Depth - 36" Inspection Hotline -(208)372.2344 www.rexlmrg.org Permit Technicion-(208)372.2341 Revised March, 2016 M1�O xexuvq�,4 C I TY OF Building Safety Department J REXBURG City of Rexburg a N 35 North 1st East AnterimItFondly Conm,unity 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 permitshall not begin until an approved permit is obtained. If you do not haven pink building permit signed by Building inspector, then you do not have an approved permit. o Building without the pink building permit signed by the Building Inspector will result in double fees to be assessed and the project to be red tagged. If your project is red tagged, halting all construction, only a City Initials Official may remove the red tag. If the red tag is removed by anyone but a City Official, citations will be issued. No building maybe 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. Initials Calling in inspections is the responsibility of the applicant and their contractor. Inspections need to be called into the hotline and not to the inspector. Inspections called in later than 8 AM will be scheduled for the following business day. S o If an inspection Is notdone, 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 nitials 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. �q o Even if you hear from an inspector that you're good to go', ultimately if you do not have a Building Permit or Certificate of Occupancy, the above policies will be enforced. Initials It is your responsibility to relay this information on to anyone who this would be applicable to for your project: All sub -contractors will be held to this standard with no exceptions. �g. o The above policies will be enforced to all, regardless if you pass this information onto them or not. Initials Applicant's Name (print)• Signature: "AJS6 ST"t't••�1- Date _ Inspections must he called in before 8 A on the day the inspection Is requested. Inspection requests called in after AM MR he scheduled for the next business day. Inspection Hotline -(208)372.2344 w v.rexburg:org Permit Technician—(208)372.2341 Revised March, 2016 CITY OF REXBURG 04 A,nerfea's Fnmily Cmemwitly SITE PLAN CHECKLIST Building Safety Department City of Rexburg 35 North 1st East Rexburg, Idaho 83440 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. S. 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). 0Sprinkled ❑ 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 16. Drawing to Scale, including a graphic scale (11 Y2 x 17" paper if possible). 17. Proposed street improvements (curb, gutter, sidewalk, pavement, etc.) 18. Legal description of proposed building site included. 19. Percent of lot covered by building or paving calculated. 20. Show 10% snow storage area. 21. Distance of entrances from street corner indicated. 22. Current Vicinity Map. (81/2 x 11") at 1" = 300' scale, showing location of the property. 23. Lighting Plan SITE PLANS MUST BE COMPLETE AND SUBMITTED FOR REVIEW BEFORE THE PROJECT WILL BE PLACED ON THE PLANNING & ZONING AGENDA. Inspection Hotline—(208)372.2344 %mmrexburg.crg Permit Teehnkian—(208)372.2341 Revised March, 2016 Ve p4.%nUgq CITY OF Building Safety Department r REXBURG City of Rexburg l 0 35 North IsC East Amerkni Finally Community Rexburg, Idaho 83440 BUILDING APPLICATION Single Family Residence For Office Use Digital Plans Included: 0 CD 0 USB 0 Dropbox 0 Not Included Permit Number:.Jlo-boogq Permit Type: DNew ORemodel DAddition DBasement Finish DepositAmount: $500 New Const. ❑ $100 Other than New Const. Deposit Included with Application: D Yes D No 1. Property0wner Name: fps►}c4�ner }Iovv+es Address: 5 S• PIIUWs'fr City: Q2Xhl4r! State: ld Zip Code: g�� O Phone&Tyne: 20W92.9-2-1115 IElOffice13Mobile Ema]l:-etl Kas-fol-tnerkonaeS-C" 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? 0 Yes (Skip to #4 and complete the. Homeowner's Exemption) 0 No, I am a contractor working for the homeowner NOTE: Any contractars/sub-contractors Involved will need to submit their own signed applications. 2. Applicant Name: SA h^ 2 a 9' Co bo'r-iz Role: (Owner, Tenant, Contractor, etc.) Address:- City: State: Zip Code: Phone & Type: D Office 0 Mobile Email: Contact/Rep. Name: Phone: Email: 3. General Contractor Name: J?0tAy% OL- -c- 01104y -e Registration Address: SAIM0_ " 0j2"e— City: State:. Zip Code: Phone & Type: []Office a Mobile Email: Contact/Rep. Name: P e: .Email: Genesi CantraGtor AuthoriZed Sigiraturej Date: 4. Project De5scrition Address: 11"pamr. CA- -DR- Lot #: 'L Block #t a Subdivision: -Jy ' k7 d e r S cq V^ Type of work:. Check one: XNew Construction 0 Remodel* D Addition* 0 Basement Finish* *Check all that apply: V Framing 0 Mechanical [/Plumbing 0 Electrical NOTO Anysub-contractorsInvolved will need to submit tbeii o.nt siapphcatians. *Description of work: slhOo—-Focrv�lI gned *Total cost of project - materials and labor: $29Jy250•t(Qsed to calculate permit fees) Building Total: 2 Slot sq. ft. Main:1 a f 4 %3 sq. ft. Basement: 0 Finished lig Unfinished 11 d ° sq. ft. Garage ���-- sq. ft. Additional Floors:- 11431 sq. ft. APPLICANT'S SIGNATURE, CERTIFICATION ANDAUTHORIZATION:: Underpenaltyofperjury, l herebyee Is correctand I swear that any information which may hereafter e given by me in hearings before the Pla shallbe truthful and correct. I agree to complywith all City regulations and State laws relating to the sub] City to enter upon the above-mentioned property for Inspections purposes. NOTE: The building official n International Code in cases ofany false statement or misrepresentation offset in the application or on the started within 180 days, Permit void ifworkstops for 180 days. and state that the information herein on approval issued under the provisions of the 2012 permitorapproval was based. Permitvoidifnot Applicant's Name (print):74o-ft �Itg1. Signature: Date: Inspections must he called in before 8 AM on the day the inspection Is requested. Inspection requests ailed in after SAM will be scheduled for the next business day.. Inspection Hotline -(208)3722344 www.nexburg.org Permit Technician -(200)372.2341 Revised MarcIL2016 r] �o ¢.exvvgv+d CITY o a Building Safety Department REXBURG City of Rexburg to 35 North 1st East America's Family Cornimmity 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 seethe State's website at www.ibol.idabo.gov/cont.htm) ❑ Currently State licensed pursuant to Title 54 Idaho Code, Chapters:. 3 Architects, 1R Electrical Contractors/journeyman; 1 Engineers/Surveyors, 12 Public Works Contractors (exempt from fee only registration required); y¢ 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 13 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 13 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 �(yLab.f4S S 7 lwcG�y Print Name Inspection Hotline—(288)372.2344 www.rexlmrgorg Permit Technician—(288)372.2341 Revised Mmrh, 2016 Og p4X8UgC may' r`dCITY OF 3i REXBURG Anierfear Family Cemmunity State of Idaho County of Madison I, Name city Affidavit of Legal Interest Address State Building Safety Department City of Rexburg 35 North 1xt East Rexburg, Idaho 83440 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 0(,/� j2 Signature Subscribed and sworn to before me the day and year first above written. IV ovary runic or ivano V KA V ANClEIL Residing at: Notary Public State of Idaho i My commission expires: Inspection Hotline -(208)372.2344 w .rexburg.org Permit Technician -(208)372.2341 Revised March, 2016 {aF µexnuq�la C IT Y OF - Building Safety Department U REXBURG City of Rexburg CW— 35 North 1st East An,Hcek family Community 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 utilitylines. The Developer should find property pins that are still available at the lot in question. If these pins do not exist or have become unrecognizable then anew 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. Signa ure Date Printed Name Inspection Hotline -(208)372.2344 mvv✓.rexburg.org Permit Technician -(208)372.2341 Revised March, 2016 �;na Pe.%nug56 CITY OF �z ` REXIiURG 1 Anterim3 Fandly:Community BUILDING APPLICATION Mechanical Building Safety Department City of Rexburg 35 North 1st East Rexburg, Idaho 83440 For Office Use Permit Number: Permit Type: 0 New M Remodel 0 Addition 0 Basement Finish Fees Paid: ❑ YER ONO .. . 1. Property Owner Name:h o mP S Address 0GI-9 011O ' 11'eik✓�s-hz.lc+City:_ReybuY'_ State:. I �) Zip Code: 83t-¢yt7 Phone &Type(2p 5a� "LI I� (� Office O Mobile Email: 0.l•t'at� Kati -1 clnnu-(norv.cr;�S. gym. 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? 0 Yes (Skip to #3 and complete the Homeowner's Exemption page) 0 No: t am a contractor working for the homeowner 13 No: This property is a Multi -family Residence or Commercial Property. NOTE: Any contractors/sub contractors involved willneed to submit their: own signed applications, 2. Mechanical Con actor Name: �G Y n U a itSero Registration #: 01 G(Q l 2 Exp.: Address: :?01'i E, ?500C City: Prec+State: tD Zip Code:i'13ZG3 Phone & Type; (=df)i)?d36-g!?gY3 0 Office P Mobile Email: tviICS-014abIq(2llc0"h"1-+ 1•coin, Contact/Rep. Name: .26, � Ct; mbw-. Phone: Email: mochan tal�ontraCt_orAutj"ei I aturei �,yq tz+K&I'l d -&rVy) Dater 3. Project Description Address: -OR- Lot #:— Block III: _Subdivision: Check one: 0 Single-family Residence 0 Multi -family Residence 0 Commercial Check one: 0 New Construction* 0 Remodel ❑ Addition 0 Basement Finish Description of work: New Commercial Work: Contracted amount: $ Calculated Fee (See Below): $ 0 Up to $10,000 = (total cost of system x.02) + $60 0 $10,001-$100,000 = ((total cost of system -10,000) x,01) + $260 0 Over $100,001 ((total cost of system -.100,000)x.005)+$1,160. New Single -Family Residential Work: Sq. Ft. I3Up to 1,500 Sq. Ft = $130 ❑ 1,501-2,500 Sq. Ft = $195 0 2,501-3,500 Sq. Ft. = $260 0 3,501.4,500 Sq. Ft. = $325 0 Over 4,500 Sq. FL _ $325+(65 x # of additional 1,000.. Sq. Ft. (or portion thereon) New Multi -Family Residential: 0 Duplex= $260 0 Three or more unitst: $((130 x# of buildings)+(65 x # of units))$_ New work on any other residence and Detached Shops; _ (65 + (10 x # of HVAC fixtures)) $ Miscellaneous: 0 Gas Pressure ze $65 ' 17 Furnace or A/C = $65 13 Water Heaterz: $6S 0 Requested Inspection= $65 0 Gas Line ze $65 0 Fireplace/Solid Fuel Burning Unit= $65 ❑ Technical Service= $65/hour 0 Plan Check =10% of Contracted Amount APPLICANTS SIGNATURE, CERTIFICATION ANDAUTHORIZATION: Underpenalty of perjury, I herebycertify 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 mein hearings before the Planning and Zoning Commission or the City Council for the City of Rexburg shall betruthful and correct. I agree to comply with all City reguladons and State laws relating to the subject matter ofdds application and herebyzuthodzed representatives afthe City to enter upon the above-mentioned property for Inspections purposes. NOTE: The building official may revoke a permlton approval Issued under the provisions ofthe 2012 International Code Incases ofany false statement or misrepresentation offact in the application or on the plans on which the permit or approval was based. Permitvoid if not started within 180 days. Permit void lfwork sto rl ays. Applicant's Name (print): Signature: :TgAS nyTW_V4 Date: Inspections must be called In before 8 AM on the day the inspection is requested. Inspection requests called In after AM will be scheduled forthe next business day. Inspection Hotline -(208)372.2344 www.rexburg.org Permit Technician -(208)372.2341 Revised March,2016 Building Safety Department 35 N. lir E., Rexburg, Id 83440 Cify of Rexburg OWNEWS NAME _ PROPERTY ADDRESS PHASE Reguitedlll Permit# BLOCK Mechanical CITY OF MXBURG Cw— Mrerim}i'nntlly Con '1017 Mechanical Contractor's Name BrcUr�Ct LA V( � Business Name I\A r-. Cco VQ A;tl nol c(� 0-+r 11 Address 3sj2 I S. t7i0 City 1 iyS1 QyState S. `1 `7 ZiP_�j CellPh�ry one hJ) Vifi 'N't Business Phone — s Fax ...Email /"1vC0'ollrlr-I-i� CA) V\A,Iv-1A fors' J (COMMERCIAL/INDUSTRIAL) Total cost of plumbing system (Contracted Amount) $ (Inchides the eott ofstalejkis instated tFgmdlets ofihe pmy stop.riug it. The fees listed under this inspeedon tope sindl apply to mgr and all mediasiwl installation not speeifical.r nientimed elsemhelz on thisfarn). ❑ Up to $10,000 (total cost of #stem x 0.02) + 60 =. $ ❑ Between $10,001- $100,000 ( (total cost of i4sstem —10,000) x 0.01) + $260 = $ ❑ Over $100,001 ( (total cost of systetn — 100 000) x 0.005) + $1,160 = $ RESIDENTIAL Nem.• Single PamilyDwvMng, including all buildings With wlcingg being constructed on each pmpetty. (*Based on Ilviag space, see dednidon below) ❑ Up to 1,500 sq ft- $130 ❑ 1,501 to 2,500 sq ft- $195 ❑ 2,501 to 3,500 sq ft - $260 ❑ 3,501 to 4,500 sq ft- $325 ❑ Over 4,500 sq ft $325 plus $65 for each additional 1,000 sq ft, or portion thereof ($325 + ($65 x # of additional 1,000 sq, ft. or portion thereof.): New.,Nu1d FamilyDwelGng (Contractors Only) ❑ Duplex Apartment $260 ❑ Three or more muld-fatnily units: $130 per building plus $65 per unit: x130 x # of buildingso + ($65 x # of units) ❑ Existing Residence, Modular, Manufactured or Mobile Homes and Detached Shop: $65 fee plus $10 per **HVAC equipment being installed up to the maxi num of d}e corresponding sq. ft. of the building ($65 + ($10 x # of fixtures)) MISCELLANEOUS ❑ Plan Check: $65 per hour ❑ Technical Service: $65 per hour ❑ Gas Line: $65 ❑ Water Heater Replacement: $65 ❑ Requested Inspection: $65 ❑ Fireplace/Solid Fuel Burning Appliance: $65 pet inspection *Living Space — space within a dwelling unit intended for human habitation which may reasonably be utilized for sleeping, eating, cooldng, bathing, washing, recreation, and sanitation purposes. An unfinished basement is considered part of the living space.. **Examples of HVAC Equipment-famace replacement, solar, water heater, etc. Ol560- U I Signature of Licensed Contractor License number & Exp. date Date o°"fxanR� CITY OF Building Safety Department r, r e REXBURG City of Rexburg ro, 35 North 1st East Amcrhwb Family Community Rexburg, Idaho 83440 BUILDING APPLICATION Electrical For Office Use _. . Permit Number: Permit Type: 0 New 0 Remodel0 Addition 0 Basement Finish Fees paid: 0 Yes 0 No - 1. Property Owner Name: i 13 n 6v- tI ooila:S Address: 4 5' t l oWshnY s City: Reebu� State: kC Zip Code: 83`l't0 Phone &Type:2oA-52q-2itbLk10 iceOMobile Email: CL1i`740..-ka.r-i-ChfurkYr- Cin 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? 0 Yes (Skip to #3 and complete the Homeowner's Exemption page) 0 No: I am a contractor working for the homeowner 0 No: This property is a Multi -family Residence or Commercial Property. NOTE: Any contractors/suh.mntractom Involved will need to submit their own signed applications. 2. Electrical Contractor Name: N oL -4irAn G u I1 u t' Registration #: oIS 4F o Exp.: Address: Po jt oX L 5-1 City: P --I �3b_t�4 State: t 0 Zip Code: Phone & Type: t2o5 69010-gS93 ❑ Office ©Mobile Email: in, tiIIkAf2 eInC(S ex -II oC/K't Contact/Rep. Name: Ctxvri as a(ovve phone: Email: B[ectrical Contractor Aathoriaet} Signature; Sae c { (Lt�(� ecf F m Date: 3, Project Description Address: -OR- Lot #: _ Block #: _ Subdivision: Check one: ❑ Single-family Residence 0 Multi -family Residence ❑ Commercial Check one: 0 New Construction* ❑ Remodel 0 Addition ❑ Basement Finish Description of work: New Commercial Work: Contracted amount: $ Calculated Fee (See Below): $ O Up to $10,000 = (total cost of system x.02) + $60 0 $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. 11 Up to 1,500 Sq.'FL _ $130 01,501-2,500 Sq. Ft. = $195 0 2,501-3,500 Sq. Ft. = $260 0 3,501.4,500 Sq. Ft. = $325 0 Over 4,500 Sq. Ft = $325+(65 x # of additional 1,000 Sq. Ft. (or portion thereof)) $ NewMulti-Fainlly Residential; 0 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: 0 Small Works (work costing less than $200 with no change in service connections)=$10(needs no inspection. 0 Central Heating/Cooling Systems $65 0 Spas, Hot Tubs, and Swimming Pools= $65 0 Requested Inspection= $65 0 Pumps -Water, Irrigation, Sewage (per motor) = O $65 up to 25HP 0 $95 26- 200HP 0 $130 aver 200HP Irrigation Machine= $65 for pivot+ $10 per tower of drive motor $ ❑ Technical Servicez; $65/hour 0 Temporary Amusement= $65 + $10 per ride, concession, or generator $ ' El Plan Check =10% of Contracted Amount ❑ Temporary orar Construction Services ONLY= $65 200 aniv or less. One location for less than 1 year. APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penaltyofperjury, l hereby certify that I have read this application and state that the Information herein Is correct and 1 swearthat any information which may hereafter be given bymein hearings before the Planning and Zoning Commission or the City Council for the City of Rexburg shall be truthful and correctl agree to comply with all City regulations and State laws relating to the subject matter of this application and hereby authorized representatives ofthe City to enter upon the above-mentioned property for inspections purposes. NOTE: The building official may revoke a petmiton approval issued under the provisions of the 2012 International Code in cases ofany false Statement or misrepresentation effect in the application or on the plans on winch the permit or approval was based. Permit void ifnot startedwidd 180days. Permitvoid'fworks YOIltlays. Applicant's Name (print): Signature: '� S-L++n U .. Date: Inspections nest be called in before 8 AM on the day the inspection is requested. Inspection requests called inafter SAM will be scheduled for the next business day. Inspection Hotline -(208)372.2344 www.rexburgorg Permit 'technician - (208) 372.2341 Revised March; 2016 Building Safety Department *'N�" Clly of RexburgRhX13lTR.G35 N. 1!�E, llexburg, Id83AAU Phone - (208)3593020 / Idodine - (208)372-2344 / rax - (208)359-3022 OWNER'S NAME PROPERTYADDRESS Permit#. SUBDIVISION PHASE :LOT BLOCK Required'!!! E'LECTRTCAL r p Electrical Contw,,//clLttoo_es Name T1(>.iln AVI Business NamesA fAlm ol.t+ly(l+ Address QO Yl* Z..s'L City vs 1') Srarc 1'� ip Qs3'`�, r• -u ns....,. % Orl� �%�G10, q CS'3 R,,.���:c. m,n.,n (L �. ' (p �0 Fax Ema ''e' RV I k, I"V.set. I VI U.1 I' lAn' V I (COMMERCIAL/INDUSTRIAL) Total cost of electrical system (Contracted Amount) S (InrGiArrl/rrrouo/nmlednlrfn+mlfafrltr+nl/rhq(IGepor(y+r©plybuit Ttrefedl8rofnnAm/bfiimpatlon4Ps)4allapply to mymidnllrlrmirnlln+tnlludom alt rprdfsmllyaaatiwadrl+ti+MY on lbfif mij, o Up 10$10,000 octal cost ofagstemx0.02)460=5 ❑ Between$10,001-$100,000 ((anal cost ormpom-10.000)x0.01)+$260=$. ❑ Over$100,001 ((tnralcase 0rxig.m.n-100.000)x0.005)451,160=5 Small Worlcs (Contractors ONLY): $10 fee for work not exceeding $200 In cost and not Involving a change in service connections: Does NOT require inspection, l RESIDENTIAL Now, SiaglalramllyDn!efA'ng, lodudlagalttiutldicgs nyds wldogbdogeonsmetedooeaabpmpeap, (Varedn0lfvfagapaeg . seedeaaldoabelow) o Up ro 1,500 sq ft - 5130 0 1,501 to 2,500 sq ft - $195 0 2,501 to 3,500 sq IT - $260 0 3,501 to 4,5d0 sq ft -5325 j ❑ Over 4,500 sq ft $325 plus $65 for each addidonal1,000 sq ft. or portion thereof (5325 + ($65 x # of additional I 'ci DopiexApmmrent$260 o 'three or mom muld•fam0y units: $130 is a Existing Residence, Modulus, Masala branch circuit, op to The maximum of the o Central Hanting/CoolingSystems: .$6! o Spas, Hot Tubs, and Swimming Pools: $65 lee for each Trip to inspect ,Pemps-Water , IadBadon,Setvago (eaeb motof) ❑ $65upto251•IP ❑595-26m=14P 13$130over2o0HP I MISCELLANEOUS o Temporary Construction Services ONLYt 200 amp or less, one location (for a periodnot to exceed 1 year) - S65 o Temporary Amusement: V65 fee plus $10per ride, concession or generator p Irrigation Machine: $65 for center pivot plus 310 per tower of drive motor • Technical Service: $65 per Lour ❑ lion Checks $65 per hour ci Requested Inspection; $65 Hiving Space -space within A dwelling unit Intended for human habitation which may reasonably be uUacd for sleeping, eating, cooking, bmhing,washing, recreation, and nitation purposes. An unfinished basement is considered. panioftbe uYingspace. r Signa u' odtcensed Contractor license lumber &esp. d.m Oarc 1 8 o3 pAxuup� CITY OF Building Safety Department REXBURG City of Rexburg N 35 North 1st East Anrerfcn} Fimdly Counnnnity Rexburg, Idaho 83440 BUILDING APPLICATION Plumbing For Office Use PermitNumber: PermitType: ❑New ❑Remodel ❑Addition ❑Basement Finish Fees leafd: ❑ Yes ❑ No - 1. Property Owner Name: = K6f r -}c r e—r- humps Address: 236g5 tLvl� Sia:-2oi City: Rexburr) State:GJ � ZipCodei 9.34W0 Phone&Type2?��2q-211b1'$rOfficeOMoble Email: cti'!"zt.tt?'crr<f-6hrr2f'Grr-,-,.,c.c.a�rn 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 O No: This property is a Multi -family Residence or Commercial Property. NOTE: Any contractors/sub-mntractom Involved will need tosubmittheirown signedapplications. 2. Plumbing Contractor Name: or,d Registration#: LB-C-hG1 Exp: Address:A�tocjj E•S%�.nri,�Sfc1it rc{•'`+.( City; rmm�n State: 1 ZipCode:`0440.1� Phone &Type: 2C>Pi' �3s 3w ❑ Officer-Mob(Ie Emajl: �f ales kcrf hl C n bi rg P_ we, hoo c Contact/Rep. Name: Sawte. AS UO"C Phone: Email: I'iu'mbin ContractorAUthori2ed suhaturo, Se;e m+V�c :-ci _e Date: 3. Project Description Water Meter Quantity: WaterMeter Size: Address: -OR- Lot #:— Block #i—Subdivision: Check one: © Single-family Residence ❑ Multi -family Residence ❑ Commercial Check one: _❑ New Construction* ❑ Remodel ❑ Addition ❑ Basement Finish Description of work: New CommercialWork: 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=((totalcostof system -..100,000)x.005)+$1,160 New Single -Family: Residential Work: Sq. Ft ❑ Up to 1,500 Sq, Ft. =.$130 M 1,501.2,500 Sq. Ft.=.$195 O 2,501.3,500 Sq. Ft. =. $260 ❑ 3,501-4,500 Sq..Ft. = $325 ❑ Over 4,500 Sq. Ft. = $325+(65 x# ofadditional 1,000 Sq. Ft. (or portion thereof)) $ New Multi -Family' Residential: p Duplex= $260 ❑ Three or more units= $((130 x # of buildings)+(65 x # of units))$_ D Gray Water Systems= $130 ❑ Lawn Sprinklers/Backflow device= $6S ❑ Multipurpose Fire Sprinkler & Domestic Water Supply System= $65 or $4 per sprinkler headwhichever is rester New work on any other residence and Detached -Shaps: _ $65 for sewerand water stub connections Miscellaneous: ❑ Sewer Line = $65 ❑ Water Line $65 ❑ Sewer and Water Line = $65 ORequested 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 l have read this application and mate that the information herein Is correct and 1 swear that any Information which may hereafter he given by me in hearings before the Planning and Zoning Commission or the City Council for the Cityof 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 ofthe City to enter upon the above-mentioned property for inspections purposes. NOTE: The buildingoffielai may revoke a permit on approval issued under the provisions of the 2012 InternatimtalCode in cases ofanyfalse statement or misrepresentation of fact in the application or on the plans on which the permltor approval was based. Permitvuid if not started within 180 days. Permitvoidif It ultp. Applicant's Name (print): Signature: fir -140%b S?tw.A., 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 business day. Inspection Hotline -(208)3722344 www.rexburg.org Permit Technician—(296)372.2341 Revlsed March,2016 Building Safety Department 35 N, is' R, Rexhurg, Id 03440 City of Rexburg OWNER'S NAME PROPERTY ADDRESS Pettnit# Watet Meter Quantity: **************Water Metet Size: Required!# Plumbing c; rx or REXBURG MvIdO Madly C4,m,, ny Plumbing Contractor's Name Business Name 00� e.SYio* Dlamb,na, Address 35103 E Sonm,,d , t2oact'sl City 4.4mrnon State lo;cNnn Zip 0 Cell Phone (20-F) r-35-Xin Business Phone( ) Fax (. ) Email �,nle_¢`nn�:1o_mb�G� V +nrto L•om (COMMERCIAL/INDUSTRIAL) Total cast of plumbing system (rontmoted Amount) $ (lnrh+des the raft elealedal+itu/a/Jrd••iegmdlen oftbepmryn0plybgn Tbefeu lidednndn /blrbuprclrou(yp. flrnllaj1 to.o, andallfhnnbieg Lu/cl/n/Joni net.rpe+!flfally)nes/laved dfo0111M on thirfomi). ❑ 'Up to $10,000 (total cost of system x 0.02) + 60 = $ ❑ Between $10,001-$100,000 ((total cost of system -10.000)x0.01)+$260=$ ❑ Over $IOO,ODi ( (total cost of s)ostem_ 100.0001 x 0.005) + $1,160 = $ RESIDENTIAL Nene Single nidi witngbeing eonstructedon each properos (aBoaedon Bving apace, see definition below) ❑ Up to 1,500 sq ft - $130 0 1,501 to 2,500 sq £t - $195 ❑ 2,501 to 3,500 sq ft - $260 ❑ 3,501 to 4,500 sq it - $325 ❑ Over 4,500 sq R $325 plus $65 for each additional 1,000 sq ft. or portion dmmof ($325 + ($65 x # of additional 1 000 sq ftorporrdun thereof)), Now, Mu1d-)7 milyDmeLfng (Contrscront On$) ❑ DupImApatuneut$260 ❑ Three or more muld-family units: $130 per building plus $65 per unit: ,(8130 x # of buildinoss + (S65 x # of milts) ❑ Existing Residence, and Detached Shop: $65 fee plus $10 per fixture up to the maximum of the corresponding sq. ft of the building,(8G5 + (S10 x # of furores)) ❑ Gray Watet Systems: $130 ❑ Lamm Sptinklets/liackilow Device: 565 ❑ Modular, Manufactured of Mobile Homes; $65 for sewer and water stub connections ❑ Multipurpose Fire Sptlnider and Domestic Water Supply System: $65 fee or $4 per sprialder head, whichever Is greater Sewer ek Water ❑ $38 Sewer Line 13$38 Water Line ❑$6S Sewer & Water- if inspected at the same time ❑ $65 Sewer turnaround under house (change from septic to city) MISCELLANEOUS ❑ Plan Chech: $65 per hour ❑ Technical SoMcc: $65 per hour ❑ Gas Line: $65 ❑ Water Heater Replacement: $65 ❑ Requested )Inspection: $65 ❑ Hydeonle Heating: $65 + ($10 x # of manifolds/zones) *Living Space --space within a dwelling unit intended for human habitation which may reasonably hn udlized for sleeping, eating, cooking, bathing,wSaaMpg, recreation, and sanitation putposes, An unfinished basement is considered pact of the living space. License number & Bxo. date Dnte CITY OF Building Safety Department RXBURG City of Rexburg OW 35 North 1st East ,w o Amenralls Fandl Cnnnnunity Rexburg, Idaho 83440 Subcontractor List Excavation & Earthwork: rY i P 12 Cl C K CC( V 4t, h,C) I Vi C Concrete: 9 ie G K ( C4 V1 Cl C rm 6v e t-? inc- Masonry: ne-Masonry: 9W l p f -LI --e-c( S"iur Q Roofing: RM C— l v e- $ f Cc'r�DcA<-rx Ti N-) Insulation: B M C ) n Sul CA h Drywall: _ v V, Cl rt,( w m i I vN r - Painting: 0eV1Qn ce-&14r, Int Floor Coverings: RAS -e -S O S "F ( UT t- i1!�j LLC . Plumbing: p I Orn b I tl y Heating: A r • CUD{'1QA-11) yi !� a of j i- Electrical: 19�ji h �''r07 Li .P� Ctyl c I n C. Special Construction (Manufacturer or Supplier) Floor/Ceiling Joists: Siding/Exterior Trim: Other; Inspection Hotline -(208)3722344 www.re%burg.org Permit Technician—(208)372.2341 Revised March, 2016