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Home My WebLink AboutAPPLICATION - 16-00443 - 668 E 7th N - SFRCITY OF REXBURG America's Family Community 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. Complete the Following: ❑ 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 ❑ 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.) ❑ Structural Calculations (see box below) -stamped by a licensed Engineer ❑ Energy Compliance Report: Asper the 2012 IECC, a RESCheck is required (available online at www.energycodes.gov) ❑ Homeowner's Exemption signed, if Homeowner is doing work on their own home. (see page 4) ❑ 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. (see page 6) ❑ Plumbing Permit Application signed by a registered Plumbing Contractor. (see page 7) ❑ Property Line form signed by builder. (see page 8) ❑ Affidavit of Legal Interest signed by owner. (see page 9) ❑ Subcontractor list filled out. (see page 10) 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 hoz//rexburg.org/1ages/development-code. Seismic Design Category - D Ground Snow - 50 lbs. per sq. ft Roof Snow Load - 35 lbs. per sq. ft. Wind Load - 90 MPH Frost Depth - 36" hapend on Hotline -(208)372.2344 w .rexburg.org Permit Technician -(208)372.2341 Revised March, 2016 W CITY OF REXBURG tn� Americas Family Community Permit Policies Acknowledgement 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 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 may be occupied without receiving a signed Certificate of Occupancy. o If a building is occupied without receiving a signed Certificate of Occupancy, citations will be issued and the occupants will be evicted. 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. 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 be removed in order to perform the electrical rough in inspection.) Any approval for Certificate of Occupancies and Building Permits is only verified through the Permit Technician. If an inspector says something like "You're good to go", understand that you still need to receive all relevant documentation from the Permit Technician before you are truly good to go. o Even if you hear from an inspector that'you're good to go', ultimately if you do not have a Building Permit or Certificate of Occupancy, the above policies will be enforced. Initi It is your responsibility to relay this information on to anyone who this would be applicable to for your project. All sub -contractors will be held to this standard with no exceptions. o The above policies will be enforced to all, regardless if you pass this information on to them or not. Initials Applicant's Name (print): Js r-ol e5 1,e Sie Lure: / Date: t Inspections must be called in before 8 AM on the day the inspection is requested. Inspecdon requests calle inafterl) AM will be sch edforthe nextbusiness day. Inspection Hotline -(208)372.2344 www.rexburg.org Permit Technian-(208)372.2341 Revised March, 2016 CITY OF REXBURG nv Americas Family Community 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. ❑ 5. Show existing and proposed easements. ❑ 6. Existing utilities (waterlines, sanitary sewer lines, manholes, storm drains). ❑ 7. Proposed utilities including tie in location to existing services and new easements. ❑ 8. Proposed storm drain and sanitary sewer elevations (for pipe inverts at manholes and catch basins). ❑ 9. Storm drainage plan for parking lot and roof areas, with calculations. ❑ 10. Fire hydrants and fire suppression lines (including tie to City lines). 13 Sprinkled a 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 t/2 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 w rexburg.org Permit Technician -(208)372.2341 Revised March, 2016 CITY OF REXBURG AmeNca3 Family Community BUILDING APPLICATION Single Family Residence Building Safety Department City of Rexburg 35 North 1st East Rexburg, Idaho 83440 For Office Use Digital Plans Included: ❑ CD < ❑ USB ❑ Dropbox ❑ Not Included Permit Number: JhrWgtl; Permit Type: ❑ New ❑ Remodel ❑ Addition ❑ Basement Finish DepositAmount:,V $500 New Const. O $100 Other than New Const. Deposit Included with Application: ISYes ❑ No 1. Property Owner Name: f1� _A&,5,6,0 Address: q65 /t.) 4+h State�� Zip Code:fi'3t%C/d Phone &Type:_f26'2r—h_itl—&67 ❑ Office 01lobile 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 #4 and complete the Homeowner's Exemption) ❑ No, I am a contractor working for the homeowner NOTE: Any contractors/sub-contractors involved will need to submit their own signed applications. 2. Applicant pQ I I Name: Lo -N f2e�hlev �Bee+�-�e.v�3rrrcli��Ro e: (Owner, Tenant, Contractor, etc.) CS rn.+r_c,_Ad Address: J�Z 1L ). S, n'. 'f- C''r��i c City: b1or State: LL22.1 Zip Code: 1,59c/6_ Phone&Type: 9M---3(--3 ❑Officefc-Mobile Email: bre-sot �ansf. itn„Ci�vn�tl,��n Contact/Rep. Name: e. r le. - Phone: Email: 3. General Contractor Name: (OLISAid; Wer &6)Registration#: Address: SEW 4&nr e -f G elm City: �P, J•ae.�4 State:jt:cjZipCode: g32Mn Phone&Type:3I"3—e5:221 ❑ Office "obile Email:,�rr��u�,�n�i-irr�;,, l �ce;).rmr✓I Contact/Rep. Name: Phone: 3)3 3-`..731 E il: ;General Contractor Authorized Signa _ Date: d; -95- /e-' 4. Project Descriptio Address: /o(o9 C',IeY 71” /)o rfk -OR- Lot #: Block #: Subdivision: Type of work: Check one: r iew Construction ❑ Remodel* ❑ Addition* ❑ Basement Finish* *Check all that apply: 121` raming EI -Mechanical 121'Flumbing 9 -Electrical NOTE: Any sub -contractors involved will need to submit their own signed applications. II p ,9 *Description of work: -W n )_moi l- 4 me 1<S"�h bah f—gym r'`34 NJ' *Total cost of project - materials and labor: $ used to calculate permit fees) ✓1=; n;.�a,-a� I aJY� BuildingTotaL390Y sq. ft. Main: &LJ_sq. ft. Basement: �nish�dl D -Unfinished sq. ft. (; ft Garage / / sq. . Additional Floors: -P"", / sq. ft. APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, I hereby certify that I have read this application and state that the information herein is correct and I swear that any information which may hereafter be given by mein hearings before the Planning and Zoning Commission or the City Council for the City of Rexburg shall be truthful and corrert. 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 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 approval was based. Permitvoidif not startedwithin 180 days. Permit void if work stops for 180 days. � Applicanfs Name (print): L Signatu e: A Date: / -23//o Inspections most be called in before 8 AM on the day the inspection is requested. Inspection requests called in after 8 AM will zrla,luled for the nextbusiness day. Inspection Hotline -(208)372.2344 www.rexburg.org Permit Technician -(208)372.2341 Revised March, 2016 CITY OF REXBURG Americas Family Com,nanity Building Safety Department City of Rexburg 35 North 1st East Rexburg, Idaho 83440 EXEMPTIONS FROM STATE REGISTRATION As of January 1, 2006, the City of Rexburg can no longer sell permits without having a copy of your State registration number or your exemption from the State registration. Please send a copy of your state registration or fill out this form showing your exemption and send it with your license renewal or your next permit application. (This list is a summarization of Idaho Code Title 54 Chapter 5205, for full definitions of these exemptions please see the State's website at www.ibol.idaho.gov/cont.htm) ❑ Currently State licensed pursuant to Title 54 Idaho Code, Chapters: 3 Architects, 0 Electrical Contractors/Journeyman, 12 Engineers/Surveyors, 19 Public Works Contractors (exempt from fee only registration required), 26 Plumbing/Plumbers, 45 Public Works Construction Management Licensing Act (exempt from fee only registration required), or 50 Installation of heating, ventilation and air conditioning systems ❑ Employee or volunteer of a licensed contractor or part of an educational curriculum or nonprofit charitable activity with no wages or salary ❑ Employee of a US Government agency (State, City, County, or other municipality) ❑ Public Utility doing construction, maintenance, or development to its own business ❑ Involved with gas, oil or mineral operations Cl Supplier doing no installation or fabricating ❑ Contracting a project or projects with a total cost less than $2000 ❑ Operation of a farm or ranch or construction of agriculture buildings exempt from Idaho Building Code ❑ Any type of water district operations ❑ Work in rural districts for fire prevention purposes ❑ Owner who performs work on own property or contracts with a registered contractor to do work as long as the property is not for resale within 12 months ❑ Owner or lessee of commercial property performing maintenance, repair, alteration or construction on that property ❑ Real estate licensee/property manager acting within Idaho Code ❑ Engaging in the logging industry ❑ Renter working on the property where they live with the property owners approval ❑ Construction of a building used for industrial chemical processing per Idaho Code ❑ Construction of a modular building (defined by Idaho Code) to be moved out of state I hereby certify that the above information is true and correct to the best of my knowledge. Signature Date Print Name Inspection Hotline -(208)372.2344 w .rexburg.org Permit Technician -(208)372.2341 Revised March, 2016 }E%B pg Uy°4 � oq CITY OF ° REXBURG Ow- Amerioab Family Community State of Idaho County of Madison I, Name City Affidavit of Legal Interest Address State Building Safety Department City of Rexburg 35 North 1st 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 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 w .rexhurg.org Permit Technician -(288)372.2341 F.emed March, 2016 CITY OF REXBURG Americas 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. If you want to request a copy of your lot, see the front counter at the Community Development Department. I have read and understand the above requirements. Signature L,57 r -r ge--,af Printed Nam Date Inspection Hotline -(206)372.2344 w .rexburg.org Permit Technician -(208)372.2341 Revised March, 2016 pF.XBUR CITY OF REXBURG „ Americas Family Community BUILDING APPLICATION Mechanical Building Safety Department City of Rexburg 35 North 1st East Rexburg, Idaho 83440 For Office Use Permit Number: Permit Type: ❑New ❑Remodel ❑Addition ❑Basement Finish Fees Paid: ❑ Yes []No 1. Property Owner Name: Lcraerr 4 a> e-, 14 Address: -1;7;- hl). State: 7—A Zip Code: I—S403 Phone &Type:x(39--:313-5�210Office CNfbile Email:bra- L,a ei4 ,,,, 1,,,n 0 t Under Idaho Building Code, a homeowner is allowed to do work on theiAwn home. Are you a homeowner doing work on your own home? ❑ Yes (Skip to #3 and complete the Homeowner's Exemption page) &KO: I am a contractor working for the homeowner O No: This property is a Multi -family Residence or Commercial Property. NOTE: Any contractors/sub-contractors involved will need to submit their own signed applications. 2. Mechanic I Contractor Name: �J72ih/ ,:)er {/✓5'O/✓ R gistration #: U6IC `C- l4 /f Exp.: � - 20 � �u '� CiTy: Zip Code:.9-'`f%G Address: O . n �jc"r State:.)• �� Phone & Type: Ze Q-3 -' . 776� Office O Mobile Email: i Jt'n lu /a f•� c) o< Fe 4q, ' ce < �i r� Contact/Rep. Name: Phone: T'Ema Mechanical Contractor Authorized Signature, Date: Zj?- /C 3. Project Description �. Ea Address: 2.V %44t Oafrf� -OR- Lot #: _ Block #: _ Subdivision: Check one: Single-family Residence ❑ Multi -family Residence ❑ Commercial Check one: eNew Construction* ❑ Remodel ❑ Addition ❑ Basement Finish Description of work: o 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: 11s9(o Sq. Ft. ❑ Up to 1,500 Sq. Ft. = $130 ❑ 1,501-2,500 Sq. Ft. = $195 ❑ 2,501-3,500 Sq. Ft. = $260 ❑ 3,501-4,500 Sq. Ft. = $325 ❑ Over 4,500 Sq. Ft = $325+(65 x # of additional 1,000 Sq. Ft. (or portion thereof)) $ New Multi -Family Residential: ❑ Duplex= $260 ❑ Three or more units= $((130 x # of buildings)+(65 x # of units))$_ New work on any other residence and Detached Shops: = $(65 + (10 x # of HVAC fixtures)) $ Miscellaneous: ❑ Gas Pressure = $65 ❑ Furnace or A/C = $65 ❑ Water Heater = $65 El 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 of perjury, I hereby certify that I have read this application and state that the information herein is correct and I swear that any information which may hereafter be given by 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 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 if not started within 180 days. Permit void if work stops for 180 days. Applicant's Name (print): L. F=_ Signa;u're: Date: Inspections must be called in before 8 AM on the day the inspection is requested. Inspection requests ca ed in after 8 AM will be sche /led for the next business day. Inspection Hotline -(208)372.2344 www.rexburg.org Permit Technician -(208)372.2341 Revised March, 2016 CITY OF REXBURG ns+ America's Family Community BUILDING APPLICATION Electrical Building Safety Department City of Rexburg 35 North lxt East Rexburg, Idaho 83440 For Office Use Permit Number: Permit Type: ❑ New ❑ Remodel ❑ Addition ❑ Basement Finish Fees Paid: ❑ Yes ❑ No 1. Property Owner Name: Address: City: State: _ Zip Code: Phone & Type: ❑ Office ❑ Mobile Email: Under Idaho Building Code, a homeowner is allowed to do work on their own home. Are you a homeowner doing work on your own home? ❑ Yes (Skip to #3 and complete the Homeowner's Exemption page) ❑ No: I am a contractor working for the homeowner O No: This property is a Multi -family Residence or Commercial Property. NOTE: Any contractors/sub-contractors involved will need to submit their own signed applications. 2. Electrical Vntractor - Name: V i .Cil t L 1 -CC 7LiC_ �.,)E f>\iL`j) Re istration #: L. - 77 7 Exp.: 6 Address: 11l N0. C k- WLl (2 City: EXBU%Ci State: IJ , Zip Code: f'3 `1`l0 Phone& Type: (20Q351—Ig70 ❑ Office M -Mobile Email: Jerz1.I c-t.V`�tr�:rt. Contact/Rep. Name: 'J GIOL l Vt RFi I,J Phone: S 1 nL: EmatO .� _ Electrical Contractor Authorized _Signature_;-----� — �� Date: 3. Project Description Address: F 7 ti+ ✓1 -OR- Lot #: _ Block #: _ Subdivision: Check one: ❑ Single-family Residence ❑ Multi -family Residence ❑ Commercial Check one: ❑ New Construction*r ❑Remodel Cl Addition El Basement Finish Description of work: C'.sw. }r�-�-�1'n d-� tie ze5 �tnrrl 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: /HkQi Sq. Ft. ❑ Up to1,500 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 # ofadditional 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: 17 Small Works (work costing less than $200 with no change in service connections) =$I 0 (needs no inspection. ❑ Central Heating/Cooling Systems= $65 ❑ Spas, Hot Tubs, and Swimming Pools= $65 ❑ Requested Inspection= $65 ❑ Pumps -Water, Irrigation, Sewage (per motor) = ❑ $65 up to 25HP ❑ $95 26- 200HP ❑ $130 over 200HP ❑ Irrigation Machine= $65 for center pivot+ $10 per tower of drive motor $ ❑ Technical Service= $65/hour ❑ Temporary Amusement= $65 + $10 per ride, concession, or generator $ ❑ Plan Check =10% of Contracted Amoun ❑ Temporary Construction Services ONLY= $65 200 amp or less. One location for less than 1 ear. APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, I hereby certify that I have read this application and state that the information herein is correct and I swear that any information which may hereafter be given by mein hearings before the Planning and Zoning Commission or the City CoundI 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 ofany false statement or misrepresentation of fact in the application or on the plans vhichthepermitorappro alwas based. Permitvoid if not starred within 180 days. Permit void ifwork stops for 18 lays. Applicant's Name (print): 2. v E Signature: _ _ Date: Inspections most be called in before 8 AM on the day the inspection is requested inspection requ sts called matters AM will a scheduled rarthe nextbusiness day. Inspection Hotline -(208)372.2344 wwwsexburg.org Permit Technician -(208)372.2341 Revised March, 2016 oQ pPX9UgC CITY OF 9� RMURG Amerira3 Family Community BUILDING APPLICATION Plumbing Building Safety Department City of Rexburg 35 North 1st East Rexburg, Idaho 83440 For Office Use � Permit Number: Permit Type: ET -New ❑Remodel ElAddition ❑.Basement Finish Fees Paid: 0 Yes 0 No 1. Property Owner Name: Address: City: State: Zip Code: Phone & Type: 0 Office 0 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? 0 Yes (Skip to #3 and complete the Homeowner's Exemption page) B o: I am a contractor working for the homeowner 0 No: This property is a Multi -family Residence or Commercial Property. NOTE: Any contractors/sub-contractors involved will needle submit their own signed applications. 2. Plumbing �ontracto r�} Name: �Pl Registration #: �f$ -- Exp.: Address: City:Sta� Zip Code: Phone & Type: 7!�7 7c' JCOffice 0 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: 0 Single-family Residence 0 Multi -family Residence 0 Commercial Check one: 0 New Construction* 0 Remodel 0 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 $1010014100,000 = ((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: /GG9 Sq. Ft. 0 Up to 1,500 Sq. Ft. = $130 0 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. Ft. = $325+(65 x # of additional 1,000 Sq. Ft. (or portion thereof)) $ New Multi -Family Residential: 0 Duplex= $260 0 Three or more units= $((130 x # of buildings)+(65 x # of units))$_ 0 Gray Water Systems= $130 0 Lawn Sprinklers/Backflow device= $65 0 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: 0 Sewer Line = $65 0 Water Line = $65 0 Sewer and Water Line= $65 ❑Requested inspection= $65 0 Sewer Turnaround (septic to city) = $65 0 Hydronic Heating= $65 + ($10 x# of manifolds/zones) 0 Technical Service= $65/hour 0 Plan Check =10% of Contracted Amount APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, i hereby certify that 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. 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 ofthe 2012 International Code in cases of any falsestate ent or misrepresentation ffact in the application oronthe pla99s on whichthe permit orappmvalwas based. Permitvoidif not startedApplicant's cant's ]Nadays. Permit void if wort stopsf 1805\ys. Applicants Name (print): f 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 business day. Inspection Hotline -(208)372.2344 www.rexburg.org Permit Technician -(208)372.2341 Revised March, 2016 ��pQ pEXBVRCfQ o CITY OF REXBURG CW- America's Family Community Subcontractor List Excavation & Earthwork: Concrete: Masonry: �cSl�yn YAn,r-Sr=, Roofing: �nis ✓�s +� i{a�.� F �i'r <t Insulation: V-�> Drywall: Painting: Floor Coverings: Plumbing Heating: Electrical: q ° ,n h) Building Safety Department City of Rexburg 35 North 1st East Rexburg, Idaho 83440 Special Construction (Manufacturer or Supplier) Roof Trusses: 'E? MC Floor/Ceiling Joists: 5 yo Siding/Exterior Trim: limy �Y- S i�.r� Vje- l.,a�je rn" Other: inspection Hotline -(208)372.2344 w .rexburg.org Permit Technidan-(288)372.2341 Revised March, 2016