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Home My WebLink AboutAPPLICATION - 17-00084 - 36 N Center St - Cell Tower1 Office Hours: Monday-Friday 8:00am-4:00pm Commercial/Multi Family Pre-Construction Checklist Seismic Design Category – D Roof Snow Load – 35 lbs. per sq. ft. (unless soil evaluation confirms category C) Wind Load – 90 MPH Ground Snow – 50 lbs. per sq. ft. Frost Depth – 36” The following items should be completed before you submit your building permit application. INCOMPLETE APPLICATIONS WILL NOT BE ACCEPTED. Completion of a Building Permit Application: You may print this application from our website www.rexburg.org or pick up a copy at the City Annex Building (address above). Commercial Permits: (the following must be submitted with the Application) 4 sets of site plans and 3 sets of building plans stamped by a licensed professional Site plans and building plans in PDF format must be submitted after plans have been approved. Structural Calculations stamped by a licensed Engineer Energy Compliance Report: As per the 2012 IECC, a Compliance check must be completed and submitted (the comcheck is available online at www.energycodes.gov). Page 2 of the Application must include the Idaho Contractor’s Registration Number or the exemption form must be completed and signed, see Page 10. Page 5 of the Application must be completed and signed by your Plumber. Page 6 of the Application must be completed by signed by your Mechanical Contractor. Page 7 of the Application must be completed and signed by your Electrician. Electrical panel layout and calculations must be included with the building plans. Plans will be reviewed by the electrical inspector prior to issuance of the building permit. Emergency Services Construction Permit-for fire related equipment only; to be filled out by the contractor performing the work. Exterior Lighting Plan including photometric layout. The lighting standards are included in this packet. Property Line form needs to be signed by the builder, see Page 4. Electrical Permits are now issued through the City of Rexburg. See Page 6 of the application. Remodels: If you are considering a remodel, a copy of the bid or estimate for the remodel must be submitted with the Permit Application. • 3 set of plans (may need IECC Review) •Additions – Same as new construction 35 N 1st E Rexburg, ID 83440 Phone: 208.359.3020 Fax: 208.359.3022 Hotline: 208.372.2344 or Text: inspections@rexburg.org www.rexburg.org Building Safety Department City of Rexburg 2 COMMERCIAL & MULTI FAMILY BUILDING PERMIT APPLICATION 35 N 1st E, REXBURG, ID 83440 208-359-3020 PARCEL NUMBER:___________________________( We will provide this for you) SUBDIVISION:______________________________UNIT#_________BLOCK#________LOT#______ (Addressing is based on the information - must be accurate) OWNER NAME:__________________________________CONTACT PHONE #______________________ PROPERTY ADDRESS:________________________________________________________________ PHONE #: Home ______________ Work ______________ Cell ___________________ OWNER MAILING ADDRESS:____________________CITY:____________STATE:____ZIP:______ EMAIL_____________________FAX___________________ APPLICANT : (If other than owner)________________________________________________________ (Applicant if other than owner, a statement authorizing applicant to act as agent for owner must accompany this application.) APPLICANT INFORMATION: ADDRESS__________________________CITY:_____________ STATE;________________ZIP_________ EMAIL_____________________FAX___________________ PHONE #: Home ______________ Work ______________ Cell ___________________ CONTRACTOR: __________________________________________________________________________ MAILING ADDRESS: ____________________________CITY_______________STATE______ZIP________ PHONE: Cell#___________________ Work#_______________________ Fax#________________________ EMAIL__________________IDAHO REGISTRATION # & EXP. DATE___________________________ How many buildings are located on this property? __________________________________________________ Did you recently purchase this property? NO YES (If yes, list previous owner’s name) __________________ Is this a lot split? NO YES (Please bring copy of new legal description of property) PROPOSED USE: _________________________________________________________________________ (i.e., Single Family Residence, Multi Family, Apartments, Remodel, Garage, Commercial, Addition, Etc.) – CIRCLE ONE 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 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 2003 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. _________________________________________________________________________________ ___________________ Signature of Owner/Applicant DATE Do you prefer to be contacted by fax, email or phone? Circle One WARNING – BUILDING PERMIT MUST BE POSTED ON CONSTRUCTION SITE! Plan fees are non-refundable and are paid in full at the time of application beginning January 1, 2005. City of Rexburg’s Acceptance of the plan review fee does not constitute plan approval Please Complete the Entire Application! If the question does not apply fill in NA for non applicable 3 **Building Permit Fees are due at time of application** **Building Permits are void if your check does not clear** Affidavit of Legal Interest State of Idaho County of Madison I, __________________________________, ____________________________________ Name Address ____________________________________, ____________________________________ City State 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: _____________________ 35 N 1st E Rexburg, ID 83440 www.rexburg.org Building Safety Department City of Rexburg Phone: 208.359.3020 Fax: 208.359.3022 Hotline: 208.372.2344 or Text: inspections@rexburg.org 4 Property Lines Each site plan that is submitted to the City of Rexburg for the Building Permit process requires that property lines are shown accurately. It is the Developer’s responsibility to correctly identify on the site plan the location of these lines in reference to the public right-of-way, other adjoining property lines, the street, other structures and all 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 Date ______________________________________ Printed Name 35 N 1st E Rexburg, ID 83440 www.rexburg.org Building Safety Department City of Rexburg Phone: 208.359.3020 Fax: 208.359.3022 Hotline: 208.372.2344 or Text: inspections@rexburg.org 5 Please take the time to answer all questions so that we can further assist you and your facility Thank You. What type of business will be performed ____________________________________________________ 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 any maintenance or mechanical work in the building? Yes No Will there be sumps or floor drains in the facility? Yes No Will the business require more parking? Yes No Will the business have any chemicals on site ? Yes No 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? Yes No Is this business planned to be the same with different ownership? Yes No Will there be a change of occupancy? Yes No ___________________________________________ ___________________ ____________ Applicants Signature Phone Date I Certify that The information that I have provided above is to the best of my knowledge accurate and true. Business Application Phone: 208.359.3020 Fax: 208.359.3022 Hotline: 208.372.2344 or Text: inspections@rexburg.org 35 N 1st E Rexburg, ID 83440 www.rexburg.org 6 OWNER’S NAME ____________________________________ PROPERTY ADDRESS ________________________________ Permit# SUBDIVISION _______________________________________ PHASE ____________ LOT___________ BLOCK___________ Required!!! Plumbing Plumbing Contractor’s Name __________________________Business Name __________________________ Address____________________________________City_________________State___________Zip_______ Cell Phone __________________________Business Phone ______________________________ Fax ___________________________Email________________________________________________ (COMMERCIAL/INDUSTRIAL) Total cost of plumbing system (Contracted Amount) $__________ (Includes the cost of materials installed regardless of the party supplying it. The fees listed under this inspection type shall apply to any and all plumbing installations not specifically mentioned elsewhere on this form). □Up to $10,000 (total cost of system x 0.02) + 60 = $ □Between $10,001 - $100,000 ( (total cost of system – 10,000) x 0.01) + $260 = $ □Over $100,001 ( (total cost of system – 100,000) x 0.005) + $1,160 = $ RESIDENTIAL New: Single Family Dwelling, including all buildings with wiring being constructed on each property. (*Based on living space, see definition below) □Up to 1,500 sq ft - $130 □1,501 to 2,500 sq ft - $195 □2,501 to 3,500 sq ft - $260 □3,501 to 4,500 sq ft - $325 □Over 4,500 sq ft $325 plus $65 for each additional 1,000 sq ft. or portion thereof ($325 + ($65 x # of additional 1,000 sq. ft. or portion thereof)). New: Multi -Family Dwelling (Contractors Only) □Duplex Apartment $260 □Three or more multi-family units: $130 per building plus $65 per unit: ($130 x # of buildings) + ($65 x # of units) □Existing Residence, and Detached Shop: $65 fee plus $10 per fixture up to the maximum of the corresponding sq. ft. of the building ($65 + ($10 x # of fixtures)) □Gray Water Systems: $130 □Lawn Sprinklers/Backflow Device: $65 □Modular, Manufactured or Mobile Homes: $65 for sewer and water stub connections □Multipurpose Fire Sprinkler and Domestic Water Supply System: $65 fee or $4 per sprinkler head, whichever is greater Sewer & Water □$65 Sewer Line □$65 Water Line □$65 Sewer & Water- if inspected at the same time □$65 Sewer turnaround under house (change from septic to city) MISCELLANEOUS □Plan Check: 10% of Plumbing Permit Fee □Technical Service: $65 per hour □Gas Line: $65 □Water Heater Replacement: $65 □Requested Inspection: $65 □Hydronic Heating: $65 + ($10 x # of manifolds/zones) *Living Space – space within a dwelling unit intended for human habitation which may reasonably be utilized for sleeping, eating, cooking, bathing, washing, recreation, and sanitation purposes. An unfinished basement is considered part of the living space. ______________________________________ __________________ Signature of Licensed Contractor License number & Exp. date Date Building Safety Department 35 N 1st E Rexburg, ID 83440 www.rexburg.org City of Rexburg Phone: 208.359.3020 Fax: 208.359.3022 Hotline: 208.372.2344 or Text: inspections@rexburg.org 7 OWNER’S NAME ____________________________________ PROPERTY ADDRESS ________________________________ Permit# SUBDIVISION _______________________________________ PHASE ____________ LOT___________ BLOCK___________ Required!!! Mechanical Mechanical Contractor’s Name __________________________Business Name __________________________ Address____________________________________City_________________State___________Zip_______ Cell Phone __________________________Business Phone ______________________________ Fax ___________________________Email________________________________________________ (COMMERCIAL/INDUSTRIAL) Total cost of plumbing system (Contracted Amount) $__________ (Includes the cost of materials installed regardless of the party supplying it. The fees listed under this inspection type shall apply to any and all mechanical installations not specifically mentioned elsewhere on this form). □Up to $10,000 (total cost of system x 0.02) + 60 = $ □Between $10,001 - $100,000 ( (total cost of system – 10,000) x 0.01) + $260 = $ □Over $100,001 ( (total cost of system – 100,000) x 0.005) + $1,160 = $ RESIDENTIAL New: Single Family Dwelling, including all buildings with wiring being constructed on each property. (*Based on living space, see definition below) □Up to 1,500 sq ft - $130 □1,501 to 2,500 sq ft - $195 □2,501 to 3,500 sq ft - $260 □3,501 to 4,500 sq ft - $325 □Over 4,500 sq ft $325 plus $65 for each additional 1,000 sq ft. or portion thereof ($325 + ($65 x # of additional 1,000 sq. ft. or portion thereof)). New: Multi -Family Dwelling (Contractors Only) □Duplex Apartment $260 □Three or more multi-family units: $130 per building plus $65 per unit: ($130 x # of buildings) + ($65 x # of units) □Existing Residence, Modular, Manufactured or Mobile Homes and Detached Shop: $65 fee plus $10 per **HVAC equipment being installed up to the maximum of the corresponding sq. ft. of the building ($65 + ($10 x # of fixtures)) MISCELLANEOUS □Plan Check: 10% of Mechanical Permit Fee □Technical Service: $65 per hour □Gas Line: $65 □Water Heater Replacement: $65 □Requested Inspection: $65 □Fireplace/Solid Fuel Burning Appliance: $65 per inspection *Living Space – space within a dwelling unit intended for human habitation which may reasonably be utilized for sleeping, eating, cooking, bathing, washing, recreation, and sanitation purposes. An unfinished basement is considered part of the living space. **Examples of HVAC Equipment-furnace replacement, solar, water heater, etc. ____________________________________ __________________ Signature of Licensed Contractor License number & Exp. date Date Building Safety Department City of Rexburg Phone: 208.359.3020 Fax: 208.359.3022 Hotline: 208.372.2344 or Text: inspections@rexburg.org 35 N 1st E Rexburg, ID 83440 www.rexburg.org 8 OWNER’S NAME ____________________________________ PROPERTY ADDRESS ________________________________ Permit# SUBDIVISION _______________________________________ PHASE ____________ LOT___________ BLOCK___________ Required!!! ELECTRICAL Electrical Contractor’s Name __________________________Business Name __________________________ Address____________________________________City_________________State___________Zip_______ Cell Phone __________________________Business Phone ______________________________ Fax ___________________________Email________________________________________________ (COMMERCIAL/INDUSTRIAL) Total cost of electrical system (Contracted Amount) $__________ (Includes the cost of materials installed regardless of the party supplying it. The fees listed under this inspection type shall apply to any and all electrical installations not specifically mentioned elsewhere on this form). □Up to $10,000 (total cost of system x 0.02) + 60 = $ □Between $10,001 - $100,000 ( (total cost of system – 10,000) x 0.01) + $260 = $ □Over $100,001 ( (total cost of system – 100,000) x 0.005) + $1,160 = $ Small Works (Contractors ONLY): $10 fee for work not exceeding $200 in cost and not involving a change in service connections. Does NOT require inspection. RESIDENTIAL New: Single Family Dwelling, including all buildings with wiring being constructed on each property. (*Based on living space, see definition below) □Up to 1,500 sq ft - $130 □1,501 to 2,500 sq ft - $195 □2,501 to 3,500 sq ft - $260 □3,501 to 4,500 sq ft - $325 □Over 4,500 sq ft $325 plus $65 for each additional 1,000 sq ft. or portion thereof ($325 + ($65 x # of additional 1,000 sq. ft. or portion thereof)). New: Multi -Family Dwelling (Contractors Only) □Duplex Apartment $260 □Three or more multi-family units: $130 per building plus $65 per unit: ($130 x # of buildings) + ($65 x # of units) □Existing Residence, Modular, Manufactured of Mobile Homes, and Detached Shop: $65 fee plus $10 per branch circuit, up to the maximum of the corresponding sq. ft. of the building ($65 + ($10 x # branch circuits)) □Central Heating/Cooling Systems: $65 When NOT part of new residential or HVAC permit with no additional Wiring □Spas, Hot Tubs, and Swimming Pools: $65 fee for each trip to inspect Pumps-Water, Irrigation, Sewage (each motor) □$65 up to 25HP □$95 – 26 to 200HP □$130 over 200 HP MISCELLANEOUS □Temporary Construction Services ONLY: 200 amp or less, one location (for a period not to exceed 1 year) - $65 □Temporary Amusement: $65 fee plus $10 per ride, concession or generator □Irrigation Machine: $65 for center pivot plus $10 per tower of drive motor □Technical Service: $65 per hour □Plan Check: 10% of Electrical Permit Fee □Requested Inspection: $65 *Living Space – space within a dwelling unit intended for human habitation which may reasonably be utilized for sleeping, eating, cooking, bathing, washing, recreation, and sanitation purposes. An unfinished basement is considered part of the living space. ______________________________________ __________________ Signature of Licensed Contractor License number & exp. date Date Building Safety Department City of Rexburg 35 N 1st E Rexburg, ID 83440 www.rexburg.org Phone: 208.359.3020 Fax: 208.359.3022 Hotline: 208.372.2344 or Text: inspections@rexburg.org 9 LOCATION OF WORK TO BE DONE: Street Address Where Work Will Be Done: _____________________________________ Business Name Where Work Will Be Done: ____________________________________ Dates for Work to Be Done: _____________________ To _______________________ Contact Person: ___________________________________________________________ Phone Number: ________________________ Cell #:_________________ Required!!! FIRE SPRINKLER Fire Sprinkler Contractor’s Name:__________________________________________________ Business Name ________________________________________________________________ Address___________________________City_________________State__________Zip_______ Cell Phone _____________Business Phone ______________________________ Fax___________________ Email________________________________________________ (COMMERCIAL/INDUSTRIAL) Total cost of fire sprinkler system (Contracted Amount) $__________ (Includes the cost of materials installed regardless of the party supplying it. The fees listed under this inspection type shall apply to any and all fire alarm installations not specifically mentioned elsewhere on this form). □Up to $10,000 (total cost of system x 0.02) + 60 = $ □Between $10,001 - $100,000 ( (total cost of system – 10,000) x 0.01) + $260 = $ □Over $100,001 ( (total cost of system – 100,000) x 0.005) + $1,160 = $ MISCELLANEOUS □Existing Inspection Base: $60 □Re- Inspection: $65 per trip □New construction $1 per sprinkler head ($2,000 maximum)_________number head ______________________________________ Signature of Licensed Contractor License number & exp. date Date Building Safety Department City of Rexburg Phone: 208.359.3020 Fax: 208.359.3022 Hotline: 208.372.2344 or Text: inspections@rexburg.org 35 N 1st E Rexburg, ID 83440 www.rexburg.org 10 LOCATION OF WORK TO BE DONE: Street Address Where Work Will Be Done: _____________________________________ Business Name Where Work Will Be Done: ____________________________________ Dates for Work to Be Done: _____________________ To _______________________ Contact Person: ___________________________________________________________ Phone Number: ________________________ Cell #:_________________ Required!!! FIRE ALARM Fire Alarm Contractor’s Name ____________________________________________________ Business Name ________________________________________________________________ Address___________________________City_________________State__________Zip_______ Cell Phone _____________Business Phone ______________________________ Fax ___________________ Email________________________________________________ (COMMERCIAL/INDUSTRIAL) Total cost of fire alarm system (Contracted Amount) $__________ (Includes the cost of materials installed regardless of the party supplying it. The fees listed under this inspection type shall apply to any and all fire alarm installations not specifically mentioned elsewhere on this form). □Up to $10,000 (total cost of system x 0.02) + 60 = $ □Between $10,001 - $100,000 ( (total cost of system – 10,000) x 0.01) + $260 = $ □Over $100,001 ( (total cost of system – 100,000) x 0.005) + $1,160 = $ MISCELLANEOUS □Plan Review: 10% of Fire Alarm Permit □Re- Inspection: $65 per trip ______________________________________ Signature of Licensed Contractor License number & exp. date Date Building Safety Department City of Rexburg 35 N 1st E Rexburg, ID 83440 www.rexburg.org Phone: 208.359.3020 Fax: 208.359.3022 Hotline: 208.372.2344 or Text: inspections@rexburg.org 11 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:____________________________________________________________________________________ 12 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, 10 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 □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