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Home My WebLink AboutAPPLICATION 2 - 16-00654 - 127 W 4th N, Rigby - Shop AdditionBuilding Safety Department City of Rexburg 35 N 1 �f E Phone: 208.372.2326 Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3022 C I T Y O F ------------- REXBURG America's Fannily Community Office Hours: Monday -Friday 8:00am-4:00pm Single Family Residential Pre -Construction Checklist Seismic Design Category — D Roof Snow Load — 35 lbs. per sq. ft. Ground Snow — 50 lbs. per sq. ft. Wind Load — 90 MPH Frost Depth — 36" The following items should be completed be oreyou submityour building permit application. Completion of Building Pem*Applieatlon: You may print this application from our website www.reexburg.ore or pick up a copy at the City Hall Annex Building (address above). For Residential Permits: (the following is required to be submitted before the Application can be approved) ❑ 2 sets of site plans and 2 sets of building plans (must be drawn to scale) -Plans must include foundation plan, floor joist layout, floor plan, roof layout, sectional views, front, back, and side elevations, mechanical layout, stair details and any details required to illustrate special construction. ❑ Energy Compliance Report: The State of Idaho has adopted the International Energy Conservation Code (IECC). A Compliance Review must be completed and submitted (the rescheck software 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 and signed by your Mechanical Contractor. ❑ Page 8 of the Application must be completed and signed by your Electrician. ❑ Home owners: please complete page 6 of the application if you will be doing your own electrical work. ❑ Truss details including engineered floor joists are required. ❑ Property Line form needs to be signed by the builder or owner, see Page 4. 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 from the Planning & Zoning Department at the Annex Building located at 19 East Main. New Residential Homes: If your building permit is for a new home, you will need the parcel number (a parcel number is the coundy's pmperiy identification Which recogni.Zes a plot of land) and a new physical address will be issued. If you do not know the parcel number and cannot find a record of it, please bring the name of the subdivision, phase, and the lot and block numbers. The correct location is vital to assure correct addressin . Remodels: If you are considering a remodel, a copy of the bid or estimate for the remodel must be submitted with the Permit Application. • 2 sets of Plans are required (may need IECC Review). • Additions are the same requirements as new construction. `x ll1:Si� t rkG CI"1'Y O F REXBURG America's Family Contniumly Please Complete the Entire Application! If the question does not apply fill in NA for non applicable RESIDENTIAL BUILDING PERMIT APPLICATION 35 N 1' E, REXBURG, ID 83440 208-372-2326 PARCEL NUMBER: (We will provide this for you) SUBDIVISION: UNIT# BLOCK# LOT# (Addressing is based on the information - must be accurate) Dwelling Units: Parcel Acres: PHONE # PROPERTY PHONE #: Home (Z04)1N5 -5gk,1 Work ( OWNER MAILING ADDRESS: 15 Ginn.k, CITY: STATE:_ZIP: F'iT,fd TT 1, 1 1 A 1-A A w AGn.. 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: (,� a c r 51!)q 10 _ MAILING ADDRESS: 33 DO Q e -s+ 1000 1 . CITY 5�Q { Aur\ STATF2 ZA3 tf PHONE #: Home {ZDIZ 15 Work ( ) cell ( ) EMAIL FAX IDAHO REGISTRATION # & EXP. DATF f 1'_F.)_! U many buildings we located on this Did you recently purchase this property? (Lo Yes (If yes, fist previous owner's Is this a lot split? NO YES (Please bring copy of new legal description of property) PROPOSED USE: Z (ie., Single Family Residence, Remodel, Garage, Commercial, Addition, Etc.) 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. Pe ork-stops for 180 days. /// Si a e of 0&/Applicant J DATE WARANG — BUILDING PERMIT MUST BE POSTED ON CONSTRUCTION SITEI Plan fees are non-refundable and are paid in full at the time of application beginning January 1. 2005 City of Rexbwgls Acceptance of the plan review fee does not constitute plan approval "Building Permit Fees are due at time of application** **Building Permits are void if your check does not clear** 2 Building Safety Department City of Rexburg 35 N I+t E Phone: 208.372.2326 Rexburg, ID 83440 www.rexburg.org Fox: 208.359.3022 Affidavit of Legal Interest C4�CCB�R�,. State of Idaho County of Madison L 47 NameAddress U city Being first duly sworn upon oath, depose and say: Td . State (If Applicant is also Owner of Record, skip to B) C I T Y O F REXBURG 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 t5 t k day of Subscribed and sworn to before me the day and year first above written. Notary Public of Idaho Residing at: My commission expires: Building Safety Department City of Rexburg 35 N N E Phone: 208.372.2326 Rexburg, ID 83440 www.rexburg.org Fox: 206.359.3022 Property lines C I r y OF REXBURG OW. America's Fnmi(y Cmnniunilp 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 +Ckvner or ❑ Builder Printed Name N Building Safety Department;,:k„ City of Rexburg U. RET mG v It _-CW 35 N N E Phone: 208.372.2326 America§ Family Conmrlumiq Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3022 Shag RomodeKmg-3 BuildinglF�qRw (need total constructions estimate, excluding fire, electrical, plumbing, and Mechanical valuations) . o 0 Residential SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building) V (I 500 5-0 VC, -First Floor Areaa 6X LpD X I3—Unfinished Basement area Second floor/loft area Finished basement area C4 Third floor/loft area Garage area ` Shed or Barn_aX i?(i�Carport/Deck (30" above grade)Area -rwo q y3 iomows one qX'5 door CNS Commercial Construction Type: Occupancy SURFACE SQUARE FOOTAGE: (Shall include the exterior wall measurements of the building) New Construction sq. ft. Commercial Remodel sq. Commercial Addition sq. ft. Utility, Misc. Private Garage sq. ft. Storage sq. ft. Multi-Family/Single Student Housing sq. ft. per unit Manager Unit sq. ft. 35 N. ISI E., Rexburg, Id 83440 nt,, - — ton gra cnon t v,.a. OWNER'S NAME PROPERTY ADDRESS Water Meter Quantity: Building Safety Department City of Rexburg Permit# **************Water Meter Size: Requiredhff Plumbing Plumbing Contractor's Name Business Name Cell Phone ( ) Business Phone ( CITY os REXBURG -.- - _- CW _... __ __. Amerlm's Family Co mmaJly Fax ( ) Email (COMMERCIAL/INDUSTRIAL) Total cost of plumbing system (Contracted Amount) $ (Includes the cost ofmaterials installed regardless of the party in it. The fees lined under this inspection type shall apply to any and a!1 plumbing installationsnot spedfrcaly 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 Fanvly Dwelling, including all buildings with wiring being constructed on each property. (*Based on living space, see deimidon 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 ❑ $38 Sewer Line ❑$38 Water Line ❑$65 Sewer & Water- if inspected at the same time ❑ $65 Sewer turnaround under house (change from septic to city) MISCELLANEOUS ❑ Plan Check- $65 per hour ❑ 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. of Licensed Contractor License number & Exp. date Date Building Safety Department 35 N. 1st E., Rexburg, Id 83440 OWNER'S NAME PROPERTY ADDRESS SUBDIVISION PHASE LOT BLOCK Requiredffl Mechanical Contractor's Name Cell Phone ( Fax ( ) _ City of Rexburg Mechanical Phone ( Permit# Name C 1 I T n F REXBURG Amencni Fanidy Cone;wdf • (COMMERCIAL/INDUSTRIAL) Total cost of plumbing system (Contracted Amount) $ (Includes the cost ofmatenals installed regardless of the party supplying it. The fees listed under this inspection type shall apply to any and all mechanical installations not specifscaly mentioned elsewhere on this farm). ❑ Up to $10,000 (total cost of system x 0.02) + 60 = $ ❑ Between $10,001- $100,000 ( (totalc_ ost 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 FatudyDwelling, including aft 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-FamrlyDwelling (Contractors Only) ❑ Duplex Apartment $260 ❑ Three or more muld-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: $65 per hour ❑ 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 35 N. 1s" E., Rexburg, Id 83440 City of Rexburg Phone — (208)359-3020 / Hotline — (208)372-2344 / Fax — (208)359-3022 OWNER'S NAME { PROPERTY ADDRESS 9� ! ) Permit# SUBDIVISION PHASE Requiredffl LOT BLOCK ELECTRICAL Electrical Contractor's Name RE(o f X S Business Name Cell Phone ( Fax( )— Phone ( C l I Y OF REXBURG Anu-rims F.Wly Cnmmwrity U )e w� Coq- - (COMMERCIAL/INDUSTRIAL) Total cost of electrical system (Contracted Amount) $ (Includes the cart of materials installed regardless of the party supplying it. The fees luted under this inspection type shall apply to any and all electrical installatioru not spedficaly mentioned elsewhere on this fomr). ❑ 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 aII 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)). Never 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: $65 per hour ❑ Requested Inspection: $65 *Living Space — space within a dwelling unit intended for human habitation which may seasonably 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 ld E Phone: 208.372.2326 Rexburg, ID 83440 www.rexburg.org Fox: 208.359.3022 SUBCONTRACTOR LIST Excavation & Floor Special Construction (Manufacturer or Supplier) Floor/Ceiling Siding/Exterior C f T Y OF i Wi BUR Amencak Family Conununity O 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 Print Name Date 10