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HomeMy WebLinkAboutAPPLICATIONS - 16-00521 - 220 Ricks Ave - Freddy'sCITY OF Building Safety Department o RMURG spam t sy Eroaif City of Rexburg CW 35 North 1St East America's Family Community - 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: .d 3 sets of site plans (see Site Plan Checklist on page 2) tom• 3 sets of building plans (see box below) - stamped by a licensed professional r oR Electrical panel layout and calculations included with building plans. I -r' .®- Exterior Lighting Plan including photometric layout. �f- I ,® ,®•" Digital Plans (PDF Format - can be submitted by USB, CD, o12M box) 1 a' Structural Calculations (see box below) - stamped by a licensed Engineer I"Energy Compliance Report: As per the 2012 IECC, a COMCheck is required (available online at www.energycodes.goy) l E�Pt'/ L-Jq lir7" ¢ +c1 15444- ( Permit Policies Acknowledgment signed. (see page 3) 16` -S , FT� Building Permit Application signed by a registered General Contractor. (seepage 4) 16'"o r"V100'r.l 5vYP11W rVP- SIM - exemptions from State Registration (seepage 5) N �r, K0 $444A "O'S, .I' Affidavit of Legal Interest signed. (see page 6) Property Line form signed by builder. (see page 7) 'I,110 - ❑ Mechanical Permit Application signed by a registered Mechanical Contractor. (seepage 8) our- 'p 16IJP PFAS WILL M (� 'b Electrical Permit Application signed by a registered Electrical Contractor. (see page 9) 5 013M I?Tro lyov Ipso Plumbing Permit Application signed by a registered Plumbing Contractor. (seepage 10) 5 p -t-> Al Pew' Fire Alarm Permit Application (if applicable) signed by a registered professional. (seepage 11) IVI�r e Fire Sprinkler Permit Application (if applicable) signed by a registered professional. (seepage 12) o Subcontractor list filled out. (seepage 13) • 5 c41A 1 J1W V ph✓ %1P +S�-4!' Id Commercial Projects: Completed Business Use Summary. (see page 14) Permft Technician- (208) 372.2341 Revised March, 2016 4� p4YeVgQ,d CITY OF Building Safety Department � o RMV RG Submit By Email City of Rexburg C, 35 North 1st East Amerim' fhndiyCommuu`ry - - Rexburg, Idaho 83440 SITE PLAN CHECKLIST JtFWd0M�M1 A4'-%� biA?rOUSLT 'hGppomp .om 1 Site plan must be drawn to scale, be legible and also be submitted electronically if possible. e•Q 2. Adjoining streets labeled. p 3. Right-of-way location and width, curb to curb widths and sidewalk location. Ja 4. Building location, sq footage and dimensions, with distance to property lines and distances between buildings. p- 5. Show existing and proposed easements. OG 6. Existing utilities (waterlines, sanitary sewer lines, manholes, storm drains). #13 7. Proposed utilities including tie in location to existing services and new easements. 007 8. Proposed storm drain and sanitary sewer elevations (for pipe inverts at manholes and catch basins). 17 9. Storm drainage plan for parking lot and roof areas, with calculations. +I ,D-10. Fire hydrants and fire suppression lines (including tie to City lines). -�W •g'ISM�4 �) ""Io -f J6 0 Sprinkled Not Sprinkled 11. Indicate Fire apparatus access. p?4VF- hI_c4,r Z712. Parking (including parking lot, drainage arrows, dimension of lot, distance between rows, and total numbers). 1x13. Landscaping (type and total area, including dimensions). OT 14. Trash facilities. -G' 15. North Arrow Included 8-16. Proposed street improvements (curb, gutter, sidewalk, pavement, etc.) - ® M UF- ACZAM 0*4q 117117. Legal description of proposed building site included. A1'rPdb -0 , jd 18. Percent of lot covered by building or paving calculated. 5'10- 6 RrT9. Show 10% snow storage area. v N pA•AW l W'20. Distance of entrances from street corner indicated. 5 �^ 0 13 21. Current Vicinity Map. (81/2 x 11") at 1" = 300' scale, showing location of the property. AT 22. Lighting Plan • C4?-kC 4vL- , SITE PLANS MUST BE COMPLETE AND SUBMITTED FOR REVIEW BEFORE THE PROJECT WILL BE PLACED ON THE PLANNING & ZONING AGENDA. Inspecdon Recline -(208)372.2344 w rexhurg.org Permit Technician -(208)372.2341 Revised March, 2016 CITY OF REXBURG tn, America's Family Community Building Safety Department Submit ey Email 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. as 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 In@iais 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. As 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. As 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 inRiaia 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. as 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. Inhials 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. The above policies will be enforced to all, regardless if you pass this information on to them or not. Applicant's Name (print): Arthur Stevens Signature: / Date: 08-18-16 Inspections must he called in before 8 AM on the day the inspection is requested. Inspection requests called in after AM will be scheduled for the next business day. Inspection Hotline -(208)372.2344 w rexlorg.org Permit Technician -(208)372.2341 Revised March, 2016 Qasxaoxc,Building Safety Department CITY OF F, �x REX-BURG ey Eman City of Rexburg 35 North 1 East America's Family Community Rexburg, Idaho 83440 BUILDING APPLICATION Commercial/Multi-family Residence For Office Use Digital Plans Included: D CD D USB D Dropbox D Not Included' Permit Number: Permit Type: ❑ New ❑ Remodel El Addition Deposit Amount: O $1000 New Const O $250 Addition D $100 Other Deposit Included with Application: D Yes []No 1. Property Owner Name: Northwest Developmentcompmies,LLC Address: 42 N 2nd E City: State: ID Zip Code: 83646 Phone&Type: 206.577.5810 0Offfce13Mobile Email: Travis@nwdevcoxom Under Idaho Building Code, a contractor must do the work for a Commercial Building. 2. Applicant Name: RRC contractors Role: (Owner, Tenant, Contractor, etc.) Contractor Address: 21812th Aves City: Nampa State: ID Zip Code: 83651 Phone&Type: 208.465.8887 O+ OfficeOMobile Email: Art@RRCcontractors.com Contact/Rep. Name: Artstevens Phone: 697.2004 Email: Art@RRccontractors.comn 3. General Contractor Name: RID: contractors LLC Registration #: RCE 195 Exp.: Address: 21812th Aves City: Nampa State: ID Zip Code: 83651 Phone&Type: 208.465.8887 O+ OfficeC3Mobile Email: Art@RRCcontractors.com Contact/Rep. Name: Phone: Email: General Contractor Authorized Signatare� Nw�-C Date: 08-18-16 4. Project Description Address: 42 N 2nd E -OR- Lot #: _ Block #: _ Subdivision: Type of work: Check one: 0New Construction ORemodel* OAddition* Check all that apply: O Framing © Mechanical O Plumbing 0 Electrical NOTE: Any sub -contractors involved will need to submit theirown signed applications. Description of work: Newrestaraunt *Total cost of project - materials and labor: $ 960,000 (used to calculate permit fees) # Of Buildings: 1 Building 1:? Units 3,450 sq. ft Building 2: Nn Units NA sq. It. Building 3: NA Units NA sq. ft Additional Buildings: NA Utility, Misc, Private Garage: NA sq. it Storage: NA sq. ft APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Underpenaltyofpedury, I herebycertify that l have read this application and some that the information herein is correct and I swearthat any information which mayhereafterbe given byme in hearings before the Planning and Zoning Commission orthe City Council for the Cityof Rexburg shaRbe truthful and correct I agree to comply with all City regulations and state laws relating to the subjectmatter of this application and hereby authorized representatives ofthe City to enterupon the above-mentioned property for inspections purposes. NOTE: The building ofOcialmay revoke a permiton approval ssued underthe provisions of the 2012 International Code in cases of any false statement or misrepresentation offact in the application or on the plans on which the permit or approval was based. Pennitvoidifnot started within 180 days. Permit mid ifworkstops harlot) days. Applicant's Name (print): Arthur Stevens Signature: C b � Date: 0848-16 Inspectionsmustbe called in before 8 AM on the daythe inspection is requested. Inspection requests called in after 8 AM will be scheduled for the next business day. Inspection Hotline -(208)372.2344 wwwrexbutg.mg Permit Technician -(208)372.2341 Revised March, 2016 CITY Of Building Safety Department G Submit By Email City of Rexburg PXXBUR35 North 1st East cw— America' Family Community Rexburg, Idaho 83440 EXEMPTIONS FROM STATE REGISTRATION ^ 14A-. 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 goy/cont htm) ❑ Currently State licensed pursuant to Title 54 Idaho Code, Chapters: 3 Architects, 10 Electrical Contractors/Journeyman, 1U 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 Print Name \. Inspection Hotline- (208) 372.2344 w nvrexburg.org Date permit Technician -(208)372.2341 Revised March, 2016 µ\X1111/, g ciry OF Building Safety Department artment a n EXBTG mSu6mit By Email City of Rexburg --.-,L—SOW 1` 35 North Isl East America.'0imllyComunify Rexburg, Idaho 83440 Affidavit of Legal Interest State of Idaho County of Madison lll�l,�rMAl���r"� Name Address City Being first duly sworn upon oath, depose and say: (If Applicant is also Owner of Record, skip to B) 1 li C) '2) State A. That I am the record owner of the property described on the attached, and I grant my permission to: IVO CL^•- <Ct'�C�Cj 1 k;, �*' ` iN�kre-C te Name Address to submit the accompanying application pertaining to that property. B. 1 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 "A," a 20a__ Signature Subscribed and sworn to before me the day and year first above written. a.' ptOTga@ lP�a�pC%ff LIG 9�F ®F 19 1S►O Residing at: )L�n CA ( My commission expires: --( 1(l Inxpeclinn Hotline -(208)372.2344 w v.rexhurg.org Perm` t Technician -(208)372.2341 Revised March, 2016 ,o as°"sd CITY OF Building Safety Department REY-BURG Submit By Emall City of Rexburg C 35 North 1st East Amaicu3 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. Itis 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. tom.. Signature Arthur Stevens Printed Name 917/16 Date Inspection Hotline -(208)372.2344 w .rexhurg.org Permit Technician -(208)372.2341 Revised March, 2016 g4%nUq h4o4 qd clzx OF 0 0 RMURG n America's Family community Building Safety Department City of Rexburg Submit By Email 35 North 15C East Rexburg, Idaho 83440 BUILDING APPLICATION Mechanical k or-Office=Use w_ �?eYInACIIUfITlter w Perml> Type L],NRW [ R2 node.(,_ ❑ ddlt<« f �lBaSefReptFirlish. Fees.PaYd .43 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 awn 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 no submittheir 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 ❑ $10,0014100,000 = ((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 # ofunits))$_ 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: Underpenalty ofperjury, l hereby certify that l have read this application and state thatthe 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 shallbe truthful and correct. I agree to comply with all City regulations and State laws relating to the subjectmatter of this application and herebyamhodzed representatives ofthe 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 rases 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 ifnot started within 180 days. Pern ltvoid ifworkstops for 180 days. Applicants Name (print): Signature: Date: Inspectionsmusthe called In before 8 AM on the daythe inspection is requested. Inspection requests called in after 8 AM will be scheduled forthe nextbuslness day. Inspection Hotline -(208)372.2344 www.rexburg.org. Permit Technician -(208)372.2341 Revised March, 2016 CITY OF XBURG c>m America's Family Community Building Safety Department City of Rexburg submit sy Email 35 North 1st East Rexburg, Idaho 83440 BUILDING APPLICATION Electrical Eor fSffice 17se "Mit T,................. C].Ne'uv-,,GLS . moc el � I`1t#ddX#un L"7 >#asernphtRmiskl`.. Cies Baldy, be T7 X14 ........:....... �.. ..... :... '° ....�.... ....... .��.... -:_.. a .... ..... ....: 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/subcontractors 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 ❑ $10,0014100,000 = ((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, HotTubs, and Swimming Pools = $65 . ❑ Requested Inspection = $65 ❑ Pumps - Water, Irrigation, Sewage (per motor) = ❑ $65 up to 25HP1 ❑ $95 26 200HP ❑ $130 over 200HP ❑ Irrigation Machine = $65 for center pivot + $10 per tower of drive motor $ D Technical Service = $65/hour ❑ Temporary Amusement = $65 + $10 per ride, concession, or generator $ ` ❑ Plan Check =10% of Contracted Amoun Temporary Construction Services ONLY = $65 200 amp or less. One location for less than year.1 APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Underpenalty ofperjury, I hereby certifythat l have read this application and state that the information herein is carrectand I swear thatanyinformation which mayhereafter be givenbyme in hearings before the Planningand Zoning Commission orthe City Council ferthe CityofRexburg 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 ofthe 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 ofanyfalse statement ormisrepresentation of fact in the application or onthe plans onwhichthe permitorapproval was based. Permitvoidifnot started within 180 days. Permit void ifworkstops for 180 days. Applicant's Name (print): Signature: Date Inspections mustbe called in before 8 AM an the daythe inspection is requested. Inspection requests called in after8 AM will be scheduled for the nextbusiness day. Inspection Hotline -(208)372.2344 www.rexburg.org Permit Technician -(208)372.2341 Revised March,2016 v�yexnuac ��jCITY YI T�.YTO�P '•,,a a Amcrkas Family Cmmmunfty Submit By Email BUILDING APPLICATION Plumbing Building Safety Department City of Rexburg 35 North 1st East Rexburg, Idaho 83440 . Lor Off ae Us'e , � lsermlt;ISumlrr„ v: PertmtT )1AYY,lReznQdeLiCiAddlrion i3lasemen7tntsh os Patd _,❑ 1{ea O 4 .. a,... . ;; _ _. . 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 43 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 contractms/sub-cmrtractots involved will need to submit their arum 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 13 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: Underpenaltyofperjury, I herebycertifythat l have read this application and state thatthe information herein is correct and I swear that anyinformation which may hereafter be given byme in hearings before the Planning and Zoning Commission orthe City Council for the CityofRexburg 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 enterupon the above-mentioned property forinspections purposes. NOTE: The building official may revoke a permiton approval Issued underthe provisions ofthe 2012 International Code In rases ofany false smtement or misrepresentation of fact in the application oron the plans onwhich the permit orapproval was based. Permitvoldifnot started within 180 days. Permit void ifworkstops for 180 days. Applicants Name (print): Signature: Date Inspections must be plied 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 -(206)372.2344 www.rexburg.org Permit Technician -(208)372.2341 Revised March, 2016 M1yo pF.ltatrgOro CITY OF Building Safety Department ?t o it r.XB mG Submit By Email City of Rexburg CW 35 North 1St East America; Family Community Rexburg, Idaho 83440 BUILDING APPLICATION �� Fire Alarm APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Underpenalty, correct and I swearthat anyinformation which may hereafterbe givenbyme in he be truthful and correct. I agree to comply with all City regulations and State laws A to enter upon the above-mentioned property for inspections purposes. NOTE: The International Code in cases ofanyfalse statement or misrepresentation offact in th started within 180 days. Permitvmid Ifworkstops for 180 days. Applicants Name (print): y, I hereby cerdfythat I have read this application and state that the information herein Fore the Planning and Zoning Commission or the City Council for the City of Rexburg shall the subject matter of this application and hereby authorized representatives of the City official a permit on approval issued under the provisions of the 2012 [ion or on the plans on which the permit or approval was based. Permit void if not Signature: Date: Inspections most be called in before 8 AM on the day the inspection is requested. Inspection requests called In after AM will be scheduled for the next business day. Inspection Hotline -(208)372.2344 wwwrexburg.mg Penult Technician - (208) 372.2341 Revised March, 2016 P@,'tUllUN utnier- -rte :� x '® pnylt approve �'S= ;FeefPafd"DYe 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: 0 Office O Cell Phone Email: Dates for work to be done: From to 3. New Construction Contracted Amount: $ Calculated Fee (See Below): $ 0 Up to $10,000 = (total cost of system x.02) + $60 0 $10,0014100,000 = ((total cost of system -10,000) x.01) + $260 0 Over $100,001= ((total cost of system -100,000) x.005) + $1,160 4. Miscellaneous 0 Plan Review =10% of Contracted Amount 0 Re -Inspection = $65` APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Underpenalty, correct and I swearthat anyinformation which may hereafterbe givenbyme in he be truthful and correct. I agree to comply with all City regulations and State laws A to enter upon the above-mentioned property for inspections purposes. NOTE: The International Code in cases ofanyfalse statement or misrepresentation offact in th started within 180 days. Permitvmid Ifworkstops for 180 days. Applicants Name (print): y, I hereby cerdfythat I have read this application and state that the information herein Fore the Planning and Zoning Commission or the City Council for the City of Rexburg shall the subject matter of this application and hereby authorized representatives of the City official a permit on approval issued under the provisions of the 2012 [ion or on the plans on which the permit or approval was based. Permit void if not Signature: Date: Inspections most be called in before 8 AM on the day the inspection is requested. Inspection requests called In after AM will be scheduled for the next business day. Inspection Hotline -(208)372.2344 wwwrexburg.mg Penult Technician - (208) 372.2341 Revised March, 2016 �oFRtx.BURoIo CITY OF Building Safety Department o REXBURG Submit B Email City of Rexburg D ro, 35 North 1st East Amefioas FamilyCommunily - - Rexburg, Idaho 83440 BUILDING APPLICATION Fire Sprinkler , NA n "�P�rin -`-1. Applicant Business Name: Office Address: City: State: Office Phone: Contact Person: Cell Phone: Contractor's Authorized Signature: Date: License/Registration # Expiration: 2. Location of Work to be Done StreetAddress: 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 ❑ $10,0014100,000 = ((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 APPLICANTS SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, I hereby certify that l have read this application andstate thatthe information herein correct and I 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 City of Rexburg shall be truthful and correct. 1 agree to comply with all City regulations and State lava 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 buildingoffidal may revoke a Permian approval Issuedunderthe provisions ofthe 2012 International Cade in cases of any false statement or misrepreseniaUon of fact in the application or on the plans on which the permit or approval was based. Permitvoidifnot started within 180 days. Permit void if work stops for 180 days. Applicant's Name (print): Signature: Date: Inspections mustbe calledin before 8 AM on the daythe inspection is requested. Inspection requests called in after 8 AM will he scheduled forthe nextbusiness day. Inspection Hotline -(208)372.2344 www.rexburg.org Permit Technician -(208)372.2341 Revised March, 2016 Fo xnvR�re CITY o F Building Safety Department a RMURG, Submit By Emall City of Rexburg CW 35 North 1st East Americasfamily community 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: Inspection Hotline -(208)372.2344 vmv.rexhurg.crg Permit Technician -(208)372.2341 Revised March, 2016 CITY OF Building Safety Department EXE R n G Submit By Email City of Rexburg 1��,(Jj� 35 North 1st East Amerltaa Family Community. 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 wo Will the business be doing any structural/or remodeling changes to the building? []Yes VNo Any changes to the electrical? []Yes ((No Any changes to the plumbing? []Yes [)No Any changes to the mechanical system? []Yes VNo Is the business type changing? []Yes, it will change to U��� �� ❑ No Is this business changing ownership? ❑Yes E�(o Is the business registered with the City of Rexburg? ❑Yes, License #: *If No, please apply for a business license with the Customer Service Dept. Will the business have food preparations? Ves ❑ No Will there be any cooking of foods? Wyes ❑ No Will there be any deep fat frying? Vyes ❑ No Will you have food disposal on site? es /Ves No Will there be sumps or floor drains in the facility? []No Will the business have any chemicals on site? []Yes P(No 00--- ArpK6aikrSig69Gre Phone Date I certify that the information that I have provided above is to the best of my knowledge accurate and true. Inspection. Hotline -(208)372.2344 w .rexburg.org Permit Technician -(208)372.2341. Revised March, 2016