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Home My WebLink AboutAPPLICATION - 17-00282 - 470 Physical Plant Way - BYUI McKay Library - Teaching Stationof p�xaup� CITY OF Building Safety Department oQ REXBURG City of Rexburg : CW 35 North 1st East America's Family Community Rexburg, Idaho 83440 COMMERCIAL TENANT IMPROVEMENT APPLICATION CHECKLIST The following items should be completed before you submit your building permit application. *Reasonable accommodations will be made upon request. Submit the Following Documents: ❑ 3 sets of building plans - stamped by a licensed professional. Include the following as applicable ❑ Foundation Plan, FloorJoist 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. ❑ Electrical panel layout and calculations included with building plans. ❑ Exterior Lighting Plan including photometric layout ❑ Structural Calculations (if applicable) - stamped by a licensed Engineer ❑ Digital Plans (PDF Format- can be submitted by USB, CD, or Dropbox) ❑ **Copies of any Contractors' State License if not on file already. Complete the Following Forms ❑ Permit Policies Acknowledgment signed ❑ Building Permit Application signed by a registered General Contractor ❑ Mechanical Permit Application signed by a registered Mechanical Contractor ❑ Electrical Permit Application signed by a licensed Electrical Contractor ❑ Plumbing Permit Application signed by a licensed Plumbing Contractor ❑ Fire Alarm Permit Application (if applicable) signed by a registered professional ❑ Fire Sprinkler Permit Application (if applicable) signed by a registered professional ❑ Subcontractor list filled out ❑ Affidavit of Legal Interest signed by owner ❑ Notifications Distribution List ❑ Business Use Summary Completed 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 athttp•/ lrexburg.org/pages/develol)tnent- code. Inspection Hodine - (208) 372.2344 w .rexburg.org Permit Technician -(208)372.2341 Revised 10/2016 C I TY OF REXBURG America's Family Community PERMIT POLICIES ACKNOWLEDGMENT Building Safety Department City of Rexburg 35 North 151 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 rials Official may remove the red tag. If the red tag is removed by anyone but a City Official, citations may be issued. No building may be occupied without receiving a signed Certificate of Occupancy. o If a building is occupied without receiving a signed Certificate of Occupancy, citations may be issued and the occupants may be evicted. I t' Is Scheduling inspections is the responsibility of the applicant and their contractor. Inspections need to be called into the hotline and not to the inspector. Inspections called in later than 8 AM will be scheduled for the following business day. o If an inspection is not done, the inspector may require any measures to be taken to allow him to correctly perform the inspection. (Example: If the electrical rough in inspection is not done and the sheetrock has been mals put up, the inspector may require the sheetrock to be removed in order to perform the electrical rough in inspection.) Construction on any project can begin ONLY when you have received a Pink Building Permit from the Building Department. Occupancy of any structure can begin ONLY when you have received an official Certificate of Occupancy from the Building Department. These documents must be signed by the appropriate authorities from the City of Rexburg. Any approvals can be verified by calling (208) 372-2341. o Even if you hear from an inspector that'you're good to go', ultimately if you do not have a Building Permit or Certificate of Occupancy, the above policies will be enforced. rials It is your responsibility to inform anyone on your project of the above policies. All sub -contractors will be held to this standard with no exceptions. o The above policies will be enforced to all, regardless if this information is passed on to them or not. IdSW Applicant's Name (print): VES WAL*f - Signature: Date: 61 Inspections must be called in before SAM on the day the inspection is requested. Inspection requests called In aftm 8 AM will be scheduled for the next business day. Inspection Hotline -(208)372.2344 www.rexbuxorg Permit Technician -(208)372.2341 Revised 10/2016 CITY OF REXBURG BUILDING PERMIT FORM 202 ow UpdautdlO/2016 America's R: mify Community BUILDING APPLICATION Commercial Tenant Improvement Building Safety Department City of Rexburg 35 North 1St East Rexburg, Idaho 83440 For Office Use Permit Number: Application Fee: Cl $100 1. Property Owner Name: BYV —40 Address: W S: &&&ft ILA.Vr AY City: A"WOX State: /0, Zip Code: 83ye4a Phone: 408 Y% 24 43 Email' "41c-gA 2. Applicant �1 Name: tTEAp A. AA4to�L, /,6Yf/'/OANG Role: (Owner, Tenant, Contractor, etc.) OWAMX a ?ZeP Address: V;iD J PNY*449- aAAM AVAY City: ?4X*4tA& State: JP. Zip Code: 83'/GO Phone: 2024 3 Email: �4L9_t -e—Ai-em BYd/."tl Contact/Rep. Name: eAa� R4tlf"A— 3. General Contractor Under Idaho Building Code, a registered contractor must do the work for a Commercial Building. Name: 8Y1V-10*/d Registration#: Exp.: Address' tit70 X ji Ve.04 /9akNr /yY City Arxatlx& State: Zb Zip Code: iff3V& C Phone: Log Y74 "fag Email: W4AA4AaTe M� O_Lfiba Contact/Rep. Name: a --NN AM Phone:2d6 '/9G 29 Email: R4'V470& 8YdI "V General Contractor Authorized Signature: Date: A copy ofyour state registration/license is required to be on file. If this is the first timeyou have done work in the City of Rexburg, please provide a photocopy ofyour license. Ifyou are unsure ifyour license is on file, please check with the Permit Technician by calling (208) 372-2341. 4. Project Description Address: Dw✓Iv O A14&41Y BdR oW&. • ZTV Sot/7N 4r 4*7- Description of Work: /Mfrft4 41 7601CNAY6- SEAWAY Ae,04 CF 7W 4.t%h7d Project Description: • Total cost of project - materials and labor: $ 10, 4/057 • Check all that apply: L9"'Mechanical: Cost $ /0 . B Electrical: Cost $ . M - ❑ Plumbing: Cost $ ❑ Fire Alarm: Cost $ ❑ Fire Sprinkler: Cost $ Note: Any contractors invo ved will need to fill out their respective application. • Change of Occupancy? No Cl Yes: New occupancy: Building Permitfees for commercial construction are charged based on square footage and the City's estimated valuation. The application fee applies toward the fee total. For details on how fees are calculated, contact the Building Department There will also be a plan review fee totaling 10% of the building permitfee. APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, l hereby certify that l have read this application and state that the Information herein Is correct and I swear that any information which may hereafter be given by me In hearings before the Planning and Zoning Commission or the City Council for the City of Rexburg shall be truthful and correct I agree to comply with all City regulations and State laws relating to the subject matter of this application and hereby authorized representatives of the City to enter upon the above-mentioned property for Inspections purposes. NOTE: The building official may revoke a permit on approval Issued under the provisions of the 2012 International Code In cases of any false statement or misrepresentation of fact in the application or on the plans on which the permit or approval was based. Permit void if not started within 180 days. Permit void if work stops for 180 days. Applicant's Name (print): 66o A. rF Signature: 0- TN Date: s /4 � Inspections must be called in before 8 AM on the day the Inspection is requested. Inspec 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 C I TY OF IREX1B1/1\\7 BUILDING PERMIT FORM Z 1O CW UpdaW10/2016 Amedca!; Family Community BUILDING APPLICATION Commercial Mechanical Building Safety Department City of Rexburg 35 North 1st East Rexburg, Idaho 83440 For Office Use Permit Number: Mechanical Fees Paid ❑ 1. Property Owner Name: AYd'/PA/!D __ Address: _V?V Xo&;; Y &rs/Calc As~A4Y City: /2BKBdA& State: ,,/0 Zip Code: 83'1&0 Phone: 208 2463 Email: WA4*o:J.J1r6 6Yd/ EDU 2. Mechanical Contractor Under ldaho Building Code, a registered contractor must do the work for a Commercial Building. Business: /�i/y/M+110 • X4M 44%4/40 State License#:00!•//5 Exp.: /O Address: y70 .%mill Am'4414 &04r /�tYCity: RG)ceJ,¢6 State: /0 Zip Code: Et, j fto Phone: Z4*8 Vitt 7-5;0 Email: M&-JKIC r tIIj 6Yt//• aft/ Contact/Rep. Name: SMa 140^w .fl Phone:206 V¢G 26 70 Email: AV*PA1dXJM Or Wt. 6D9/ Mechanical Contractor Authorized Signature: Date: A copy ofyour state registration/license is required to be on file. If this is the first time you have done work in the City of Rexburg, please provide a photo copy ofyour license. Ifyou are unsure ifyour license is on file, please check with the Permit Technician by calling (208) 372-2341. 3. Project Description Address: At✓/p O. /YCt�ilrj� B✓/4WN(a aie% fa✓lJy /.r �•jti Description of work: /40✓F 341,0Wr Alfa¢ *4JWJ7FhS ❑ Project Cost: $ 101, 74 • Fees for commercial projects are charged by cost: 0 First $10,000 = 2% + $60. From $10,000 to $100,000 = 1% + $260. Above $100,000 = .5% +$1,160. i.e. Work costing $15,000 will be charged $260 for the first $10,000 and 1% of the remaining $5,000 = $260 + $50 = $310 total fee • There will also be a plan review fee totaling 10% of the above fee. APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty ofperjury,l hereby certify that l have read this application and state that he Information herein Is correct and 1 swear that any information which may hereafter be given by me in hearings before the Planning and Zoning Commission or the City Council for the City of Rexburg shall be truthful and correcL Iagree to comply with all City regulations and State laws relating to the subject matter of this application and hereby authorized representatives ofthe City to enter upon the above-mentioned property for inspections purposes. NOTE: The building official may revoke a permit on approval Issued under the provisions of the 2012 International Code in cases of any false statement or misrepresentation of fact in the application or on the plans on which the permit or approval was based. Permit void if not started within 180 days. Permit void if work stops for 180 days. Applicant's Name (print): OFDp A• % *4LO*- fes- Signature: A Q nli // Date: /V Inspections must be called In before 8 AM on the day the Inspection Is requested. Inspection requests called in after 8 AM will be scheduled for the next business day. Inspection Hotline - (208) 372.2344 www.rexburg.org Permit Technician - (208) 372.2341 °Q!E%eugc u; b� CITY OF t REXB\BUILDING PERMIT FORM 220 C, uraa,m 10/2016 Ameritak rnmily Community BUILDING APPLICATION Commercial Electrical Building Safety Department City of Rexburg 35 North 1St East Rexburg, Idaho 83440 For Office Use Permit Number: Electrical Fees Paid ❑ 1. Property Owner Name: B 11 1AWO Address: X*4iff Ars"am A",- A•Y City: �citBtlRb State: —Zip Code: 83N(aQ Phone: 2-08�/?G 2.4 G 3 Email: "LA;9Bc7d'&), L/ 2. Electrical Contractor Under Idaho Building Code, a registered contractor must do the work for a Commercial Building. Business: IMI—fA WO • X?WW Al ICA State License #: &ZI—/—/0$/0 Exp.: Address: V70 JA4W pi/&C,#L PLA"r AAY city: Qe%"Ac State: I&AH0 Zip Code: 83f4LO Phone: LOS 'f94p LS`/O Email: PNCE d Iiy✓I bA✓ Contact/Rep. Name: rSr7rVC Jai2K6 Phoope:208 Y14 AM Email: P~Xg!!5 &Y01.6 -pa Electrical Contractor Authorized Signature: 4�� Dater, n file. If this is the first time you have done work in the City of Rexburg, please provide A copy ofyourstate registration/license is required to be o a photo copy ofyour license. Ifyou are unsure ifyour license is on file, please check with the Permit Technician by calling (208) 372-2341. 3. Project Description Address: DA✓tA o, Me-t4Y 2--ty x -fa y /sr n4r- Description of work: lW40a * ?&MCHAY& .rj*7?oN hN0 ¢trTtrgt;C 7riE u6WIS ❑ Project Cost: $ 00 of • Fees for commercial projects are charged by cost: o First $10,000=245+$60.From $10,000 to $100,000 = 1 % + $260. Above $100,000 =.5% +$1,160. i.e. Work costing $15,000 will be charged $260 for the first $10,000 and 145 of the remaining $5,000 = $260 + $50 = $310 total f� • There will also be a plan review fee totaling 10% of the above fee. APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, I 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 me in hearings before the Planning and Zoning Commission or the City Council for the City of Rexburg shall be truthful and correct I agree to comply with all City regulations and Stare laws relating to the subject matter of this application and hereby authorized representatives of the City to enter upon the above-mentioned property for Inspections purposes. NOTE: The building official may revoke a permit on approval issued under the provisions ofthe 2012 International Code in cases of any false statement or misrepresentation of fact In the application or on the plans on which the permit or approval was based. Permitvoid ifnot started within 180 days. Permit void if work stops for 180 days. Applicant's Name (print): LT aw A. N/A4re7Z- Signature: 2�544 Date:3� U Inspections must be called In before 8 AM on the day the inspection is requested. Inspection requests called In after 8 AM will be scheduled for the next business day. Inspection Hotline - (208) 372.2344 www.rexburg.org Permit Technician - (208) 372.2341 CITY OF REXBURG fly America's Family Community BUILDING PERMIT FORM 230 upatM re/tots BUILDING APPLICATION Commercial Plumbing Building Safety Department City of Rexburg 35 North 1st East Rexburg, Idaho 83440 For Office Use Permit Number: Plumbing Fees Paid 0 1. Property Owner Nor- App 1c-,tBL.E' Name: Address: City: State: Zip Code: Phone: Email: 2. Plumbing Contractor Under Idaho Building Code, a registered contractor must do the work for a Commercial Building. Business: State License #: Exp.: Address: City: State: Zip Code: Phone: Email: Contact/Rep. Name: Phone: Email: Plumbing Contractor Authorized Signature: Date: A copy ofyour state registration/license is required to be on file. If this is the first timeyou have done work in the City of Rexburg, please provide a photo copy ofyour license. Ifyou are unsure ifyour license is on file, please check with the Permit Technician by calling (208) 372-2341. 3. Project Description Address: Description of work: 0 Project Cost: $ • Fees for commercial projects are charged by cost: o First $10,000 = 296 + $60. From $10,000 to $100,000 = 1 % + $260. Above $100,000 =.5% +$1,160. i.e. Work costing $15,000 will be charged $260 for the first $10,000 and 1 % of the remaining $5,000 = $260 + $50 = $310 total • There will also be a plan review fee totaling 10% of the above fee. APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, I hereby certify that 1 have read this applicatlon and state that the Information herein Is correct and I swear that any Information which may hereafter be given by me in hearings before the Planning and Zoning Commission or the City Council for the City of Rexburg shall be truthful and correct I agree to comply with all City regulations and State laws relating to the subject matter of this application and hereby authorized representatives of the City to enter upon the above-mentioned property for Inspections purposes. NOTE: The building official may revoke a permit on approval Issued under the provisions 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. Permitvoldifnot started within 180 days. Permit void If work stops for 180 days. Applicant's Name (print): 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 CITY OF REX-BG BUILDING PERMIT FORM=401 Updot 1a/Ea16 CW America? Family Community BUILDING APPLICATION Pire Alarm Building Safety Department City of Rexburg 35 North 1St East Rexburg, Idaho 83440 For Office Use Permit Number: Fire Alarm Fees Paid ❑ 1. Property Owner Alor Ar.PL/6h/fGE Name: Address: City: State: Zip Code: Phone: Email: 2. Contractor Business: State License #: Exp.: Address: City: State: Zip Code: Phone: Email: Contact/Rep. Name: Phone: Email: Contractor Authorized Signature: Date: A copy ofyourstate registration/license is required to be on file. If this is the first tlmeyou have done work in the City of Rexburg, please provide a photo copy ofyour license. Ifyou are unsure ifyour license is on file, please check with the Permit Technician by calling (208) 372-2341. 3. Project Description Address: Description of work: ❑ Fire Alarm System Cost: $ • Fees forffre alarm systems are charge by cost: 0 First $10,000 = 2% + $60. From $10,000 to $100,000 =1 °% + $260. Above $100,000 =.5% +$1,160. i.e. Work costing $15,000 will be charged $260 for the first $10,000 and 1 % of the remaining $5,000 = $260 + $50 = $310 total ffe • There will also be a plan review fee totaling 10% of the above fee. .APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, I hereby certify that l have read this application and state that the information herein 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 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 of any false statement or misrepresentation of fact In the application or on the plans on which the permit or approval was based. Permlt void Ifnot started within 180 days. Permit void If work stops for 180 days. Applicant's Name (print): Signature: Date: Inspections must be called in before B AM on the day the Inspection is requested. inspection requests called in after SAM will be scheduled for the next business day. Inspection Hotline - (208) 372.2344 www.rexburg.org Permit Technician - (208) 372.2341 CITY OF REXBURG tw America's Family Community BUILDING PERMIT FORM4OZ upaaud 101201e BUILDING APPLICATION Fire Sprinkler Building Safety Department City of Rexburg 35 North 1St East Rexburg, Idaho 83440 For Office Use Permit Number: Fire Sprinkler Fees Paid ❑ 1. Property Owner Nor A•P.P"&ei-war Name: Address: City: State: Zip Code: Phone: Email: 2. Contractor Business: State License #: Exp.: Address: City: State: Zip Code: Phone: Email: Contact/Rep. Name: Phone: Email: Contractor Authorized Signature: Date: A copy ofyourstate registration/license is required to be on file. If this is the first timeyou have done work in the Cityof Rexburg, please provide a photo copy ofyour license. Ifyou are unsure ifyour license is on file, please check with the Permit Technician by calling (208) 372.2341. 3. Project Description Address: Description of work: Number of Heads: ❑ Fire Sprinkler System Cost: $ • Fees for fire alarm systems are charge by cost: o First$10,000 = 2% + $60. From $10,000 to $100,000 = 1% + $260. Above $100,000 =,5% +$1,160. i.e. Work costing $15,000 will be charged $260 for the first $10,000 and 1% of the remaining $5,000 = $260 + $50 =S310 total • There will also be a plan review fee totaling 10% of the above fee. APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, I hereby certify that l have read this application and state thatthe information herein correct and I swear that any information which may hereafter be given by me in hearings before the Planning and Zoning Commission or the City Council for the City of Rexburg shall be truthful and correct I agree to comply with all City regulations and State laws relating to the subject matter ofthis 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 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 startedwithin 180 days. Permit void if work stops for 180 days. Applicant's Name (print): 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 DF µaxaogc CITY OF REXBURG Americas Family Community SUBCONTRACTOR LIST Excavation & Earthwork: Concrete Building Safety Department City of Rexburg 35 North 1St East Rexburg, Idaho 83440 Masonry: Roofing: Insulation: Drywall: BY(J' �DANO Painting: Bill —Ab HD Floor Coverings: Plumbing: Heating: Electrical: Special Construction (Manufacturer or Supplier) Roof Trusses: Floor/Ceiling Joists: Siding/Exterior Trim: Other: Inspection Hotline -(208)372.2344 w .rexburg.org Permit Technician -(208)372.2341 Revised 10/2016 AFFIDAVIT OF LEGAL INTEREST State of Idaho ) ss. County of Madison The undersigned, being first duly sworn, deposes and says: A. that he is the authorized representative of Brigham Young University — Idaho (the "University") for the purpose of submitting the attached application (the "Application") including the making of this Affidavit; B. that the University is the record owner of the property described in the Application; and, C. that the University agrees 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 in this Affidavit or as to the ownership of the Property which is the subject of the Application. Dated: Tuesday, May 16, 2017 Subscribed and sworn to before me the day and year first above written. ��a I I Notary Public Residing at:-�r My commission expires:T" C I TY OF REXBURG Americas Family Gonmmnity DISTRIBUTION LIST Building Safety Department City of Rexburg 35 North 1st East Rexburg, Idaho 83440 Please provide the names and emails of anyone who should begetting automated updates for this project: Review Notes Name: )EDA A {n/myc z— Name: Name: Name: Name: Inspection Tickets Name: ( Tem A W �' Name: (TCWNReuz Name: YAM Name: 57WV4r AX'— Name: Email: IA14*& e (!`j Bid/. EPI) Email: Email: Email: Email: Email: 44/49K-E�LJ6' P) 9 eOl. 4b c/ Email: Rtrb7b e-) .6 1(()/- EDti Email: /% WAtcKS'U ANA Epd Email: EAt! Email: Inspection Hotline -(208)372.2344 www.rexburg.org Permit Technician -(208)372.2341 Revised 10/2016 C IT Y OF REXBURG AinericA Family Ce nununity BUSINESS USE SUMMARY Building Safety Department City of Rexburg 35 North 1St East Rexburg, Idaho 83440 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? aI Yes ❑No Will the business be doing any structural/or remodeling changes to the building? ElYes Ef 'No Any changes to the electrical? tgYes ❑ No Any changes to the plumbing? ❑ Yes Ef No Any changes to the mechanical system? $&I6HT- N'%s ❑ No Is the business type changing? ❑ Yes, it will change to Ef O Is this business changing ownership? ❑ Yes a o I HOF so Is the business registered with the City of Rexburg? ❑ Yes, License #: ❑ No *If No, please apply for a business license with the Customer Service Dept. Will the business have food preparations? ❑ Yes L6No Will there be any cooking of foods? ❑ Yes eNo Will there be any deep fat frying? ❑ Yes 15/No Will you have food disposal on site? ❑ Yes N' o Will there be sumps or floor drains in the facility? ❑ Yes E& Will the business have any chemicals on site? ❑ Yes nlo Q. zoa y9& 24&3 5-11,, / ApoWrants Signature Phone ate 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 www.rexburg.org Perin It Tech nicia n-(208)372.2341 Revised March, 2016