HomeMy WebLinkAboutAPPLICATION - 17-00088-00093 - 565 Pioneer Rd - Rockcreek Townhomes #191-196of pexa UgC
CITY OF
�A� o l7 XB m!"� Submit By Email
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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.
cs 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.
cs 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 snot to the inspector. Inspections called in later than 8 Aide 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
cs perform the inspection. (Example: If the electrical rough in inspection is not done and the sheetrock has been
mitlala 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 Saeed to receive all relevant
documentation from the Permit Technician before you are truly good to go.
cs
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 an anyone who this would be applicable to for your project.
All sub -contractors will be held to this standard with no exceptions.
a 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): Chad Shirley Signature: Chad Shirley Date: 05/26/2016
Inspections must be called in before SAM 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 -(208)372.2341 Revised March, 2016
C P Ty OF
REXBURG
Amenwa Family Community
Building Safety Department
submit ey email City of Rexburg
35 North 1ST East
Rexburg, Idaho 83440
BUILDING APPLICATION
Commercial/Multi-family Residence
For Office Use Digital Plans Included: ❑ CD ❑ USB ❑ Dropbox ❑ Not Included
Permit Number: 1-7-00099-13 Permit Type: ❑ New ❑ Remodel ❑ Addition
Deposit Amount: ❑ $1000 New Const ❑ $250 Addition O $100 Other Deposit Included with Application: ❑ Yes ❑ No
1. Property Owner
Name: Greg Nelson
Address: S65 Pioneer Rd. City; Rexburg. Stater ID Zip Code: 83440
Phone &Type: 208-754-9385 ❑ Office ❑Mobile Email: greg@nelson-electricllc.com'
Under Idaho Building Code, a contractor must do the work for aCommercial Building.
2. Applicant
Name: Chad Shirley Role: (Owner, Tenant, Contractor, etc.) contractor
Address 565 Pioneer Rd.#112 — City; Rexburg State: ID Zip Code: 83440
Phone&Type: 208403-7763 ❑ Office ❑Mobile Email: chadiames88@aol.com
Contact/Rep. Name: Chad Phone: 208-403-7763 Email:
3. General Contractor
Name: Northern States Development Registration #: RCE -78770 Exp.:
Address: P.D. box 142 �jij; Menan State: ID Zip Code: 83434
Phone&Type: 208-754-5389 ❑ Office 13Mobile Email: Chadlames88@aol.com
Contact/Rep. Name: Chad > Phone: 208-754-5385 Email:
General Contractor Authorized Signature: Chad Shirley Date: 05/29/2016
4. Project Description
Address: 565 Pioneer Rd IqL -OR- Lot #: 2 Block #: 14 Subdivision: Rockcreek Hollow
Type of work: .
Check one: El New Construction ❑ Remodel* []Addition*
Check all that apply: O Framing ❑ Mechanical 0 Plumbing O Electrical
NOTE: Any sub contractors involved will need to submit their mini signed applications.
Description of work: New Construction
*Total cost of project - materials and labor: $ (used to calculate permit fees) # Of Buildings:
Building 1: la• i Units sq. ft Building 2: _Units sq. ft Building 3; _Units sq. ft.
Additional Buildings:
Utility, Misc, Private Garage: sq. ft. Storage: —sq. 1
APPLICANT'S SIGNATURE CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, I hereby certify that l have read this application and state that the information herein
- is correct and I swear that any information which may hereafter he given by mein hearings before: the Planning and Zoning Commission or the City Council for the City of Rexburg
shall he 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 permitor approval was based. Permitvoldifnot
started within 180 days. Permit void if work stops for 180 days.'.
Applicants Name (print): Chad Shirley Signature: Chad Shirley Date; 05/26/2016
Inspections must be called in before 8 AM an 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 .1 exbug.org Permit Technician -(208)372.2341 Revised March, 2016.
Building Safe Department
a cnr of g tY P
REXB�� City of Rexburg
' Su6mit By Email
-- �� 35 North 1st East
Americas Family Convineir)• Rexburg, Idaho 83440
BUILDING APPLICATION
Mechanical
For Office Use
Permit Number: Permit Type: ❑ New ❑ Remodel ❑ Addition ❑ Basement Finish
Fees Paid: ❑ Yes ❑ No
1. Property Owner
Name:
Address: ` City: Rexburg 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)
O 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 to submit their own signed applications.
2. Mecham of tra tor, ''ll
Name: 1 Regy�tra 'on #:V Exp.:
Address: r e, City; KB.1 1 V rState:,i4 Zip CQ e:
Phone & Type: r 10 r� ❑ Office 51. Mobile Email:') P hSFl + k4/ffi,Q WIG l • cwh
Contact/Rep. Name: Nu.l"w Phone: 6LA.� _ Email: J 77
Mechanical Contractor Authorized Signature: Date: J
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 ❑ $10,001-$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 -Cannily Residential: ❑ Duplex= $260 ❑ Three or more units= $((130 x # of buildings)+(65 x # of units))$_
New work on anv other residence and Detached Shops: = $(65 + (10x# of HVAC fixtures)) $
N'liscella.:eous: ❑ 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
APPLICANTS SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, I hot eby certify that I have read this application and state that the information herein
is correct and l swear that any information which may hereafter he given by mein hearings before the Planning and Zoning Commission or the city Council for the City of Rexburg,
shall he truthful and correct Iagree to comply with all City regulations and State laws relating tothe subject matter of this applicatimn 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 fake statementor misrepresentation of fact in the application or on the plause hich he permit or approval was based. Permitvoidhfnot
started within 180 days. Permit void ifwork stops for 180 days \ -
Applicant's Name (print): 8L)- St"Idtg, Signature: Date:
Inspections must be called in before SAM 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.rexburgorg : permit Technician (208)372.2341 Revised March, 2016
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Amerrca's Fa ..1�. Co/nnnt,+/!y
Building Safety Department
City of Rexburg
suborn ey small 35 North 1st East
Rexburg, Idaho 83440
BUILDING APPLICATION
Electrical
For Office Use
Permit Number: Permit Type: ❑ New ❑ Remodel ❑ Addition ❑Basement Finish
Fees Paid: O Yes ❑ No
1. Property Owner
Name:
Address: City: menan State: Zip Code:
Phone & Type: - 0 Office ❑ Mobile Email:
Under Idaho Building Code, a homeowner is allowed to do work on their own home.
Are you homeowner doing work on your own home? [3 Yes (Skip to #3 and complete the Homeowner's Exemption page)
❑ No: I am a contractor working for the homeowner El No: This property is a Multi -family Residence or Commercial Property.
NOTE: Any contractors/sub-contractors involved will need to submittheir own signed applications:
2. Electrical c tractor
Name �U
,tlReistr #. �(7
Exp.: e
bs46OUCity: a�Address; ll
State:. Zip Code.
Phone & T e: ��- 7xV-93,
Yp C9•ffffice Mobile Email: dee LL- L- Lb+.�.
Contact/Rep: Name: G_rr illv./ hone: Email:
Electrical Contractor Authorized Signature: Date: Z—/7
3. Project Description
Address: =OR- Lot #: _Block #: — Subdivision:
Check one: ❑ Single-family Residence ❑ Multi -family Residence 0 Commercial
Check one: ❑ New Construction* ❑ Remodel ❑ Addition ;❑ 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 ❑ $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 01,501-2,500 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= $((130 x# of buildings)+(65 x # of units))$
1Vew.work on anyother residence and Detached Shops;= $765 + (10x #of branch circuits))$
Miscellaneous: ❑ Small Works (work costing less than $200 with no change in service connections)=$ 10 (needs no inspection.
Central Heating/Cooling Systems $65 ❑ Spas, Hot Tubs, and Swimming Pools= $65 ❑ Requested Inspection= $65
❑ Pumps -Water, Irrigation, Sewage (per motor) = ❑ $65 up to 25HP 0 $95 26- 200HP 0'$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
OTempor2ry Construction Services ONLY= $65 200 am or less. One location for less than l ear.
peuduy u: perjury, i nereoy cernrytnan nave read t is appuration and state that the information herein
is correct and 1 swear that any information which may hereafter be given by mein hearings before the Plan 'ng and zoning Commission or the City Council for the City of Rexburg
shall be truthful and. correct l agree to comply with all City regulations and State laws relating tothes )act atter of this application and hereby authorized representatives ofthe
City to: enter upon the above-mentioned property for inspections purposes NOTE: The building offic Imay. evoke 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 thepl ns on which the permit or approval. was based. Permitvoid/fnot'.. -
started within 180 days. Permit void if worlmqms for �rg0days/
Applicant's Name (print): I M d i✓�. Signature: Date:.,3- -2 -(,7
Inspections most be called in before 8 AM on the day the inspection is requested Inspection requests called in after 8 AMwill be scheduled forthe next business day.
Inspection Hotline -(208)3722344 www.rexburgorg Permit Technician: -(208)372.2341 Revised March, 2016
;C�RiStq.'P�G
CITYi)F
' REXB V RG Submit By.Email
Americas Coe,ly Community
BUILDING APPLICATION
Plumbing
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: O 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 contractor working for the homeowner ❑ 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. Plumbing Contractor
Name: NV_P nezy P1_V !;J 1y6 Re stratioTI M EZa--G-10655 , Exp.:
Address: A1703 F_' ? j1) v Ci State: Zip i� ZipCode:_26_ �
Phone &Type: LfzGL &r POA(A-1( 1:1 Office' Mobile Email:e,rd`LVolt."'liy(, rrn�i4•f-)�^
Contact/Rep. Name: hone: 5A-',¢ Email: ✓"r
Plumbing Contractor Authorized Si nature:S cz.., '%Z r
Date: Z6--//
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 cast 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)) $
NewMulh-Fancily Residential: ❑ Duplex = $260 ❑ 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 cn any o her residence and Detached Shops: _ $65 for sewer and water stub connections ❑
Miscellaneous: ❑ Sewer Line = $65 ❑ Water Line = $65 ❑ Sewer and Water Line= $BS ❑Requested mspectton - $65
❑ Sewer Turnaround (septic to city) = $65 [J Hydronic Heating ,= $65 + ($10 x# of manifolds/zodes)
❑ Technical Service - $65/hour ❑Plan Check=10% of Contracted Amount
APPLICANTS SIGNATURE, CERTIFICATION AND AUTHORIZATION: Under penalty of perjury, Ihereby certify that 1. have read: this application and state that the information herein
is correct and 1 swear that any information which may hereafter be given by mein hearings before the Planning and Zoning. Commission or the City Council for the City of Rexburg
shall be truthful and correct I agree to comply withal] 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 incases of any false statement or misrepresentation of fact 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): 4/66mr/ Signature: Ski u__ 7Date: 3/067
r<
Inspections must he called in before SAM on the day the inspection is requestaclAnspection requests called m after 8 AM will be scheduled for the next business day.
Inspection Hotline -(208)372.2344. wwwrexburgorg Permit Technician (208)372.2341 Revised March, 2016-
AF6` a4 C i TY OF Building Safety Department
4 j Z l V BURG
�•V 1\G1\c�).
Submit By E nail
City of Rexburg
> —
35 North lstEast
-4mcr@n5rnmilycommvn8y
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 ❑No
Will the business be doing any structural/or remodeling changes to the building?
[]Yes [:]No
Any changes to the electrical?
❑Yes []No
Any changes to the plumbing?
El Yes ❑No
Any changes to the mechanical system?
❑ Yes ❑ No
Is the business type changing? Yes, it will change to
❑ No
Is this business changing ownership?
❑Yes [:]No
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 []No
Will there be any cooking of foods?
❑Yes❑No
Will there be any deep fat frying?
[]Yes ❑ No
Will you have food disposal on site?
[]Yes ❑No
Will there be sumps or floor drains in the facility?
[]Yes ❑No
I
Will the business have any chemicals on site?
❑Yes ❑No
208-403-7763 05/26/2016
Applicants Signature Phone Date
I certify that the information that I have provided above is to the best of my knowledge accurate and true.
Inspection Hothne 6 (208) 372 2344 yr .rexburg.org Permit Technician (208) 372.2341
Revised March, 2016