HomeMy WebLinkAboutAPPLICATION - 16-00635 - 811 Park St - Basement finishCITY OF
REXBURG
America's Family Community
BUILDING APPLICATION
Single Family Residence
Building Safety Department
City of Rexburg
35 North 151 East
Rexburg, Idaho 83440
For Office Use 4Digital Plans Included:: ❑ CD ❑USB ❑ Dropbox ❑ Not Included.
Permit Number: PermitT et ❑ New'- ❑ Remodel ❑Addition ❑Basement Finish
Deposit Amount: 0 $500 New Const ❑ $100 Other than New Const Deposit Included with Application: ❑ Yes ❑ No
1. Property Owner
Name: Bradlay Lawrance
Address: 811 Park St city: Rexbura State: Idaho Zip Code: 83440
Phone &Type: 208-313-0122 13 Office O Mobile Email: brad.lawrence@gmail.com
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?
El Yes (Skip to #4 and complete the Homeowner's Exemption) ❑ No, I am a contractor working for the homeowner
NOTE: Any cunt actors/sub-contm¢msinvolved will need to submit their own signed applications.
2. Applicant
Name: Role: (Owner, Tenant, Contractor, etc.)
Address: City: State: Zip Code:
Phone & Type: ❑ Office ❑ Mobile Email:
Contact/Rep. Name: Phone: Email:
3. General Contractor
Name: Registration #: Exp.:
Address: City: State: Zip Code:
Phone & Type: ❑ Office O Mobile Email:
Contact/Rep. Name: Phone: Email:
General Contractor Authorized Signature:!, Date:
4. Project Description
Address: WI Pak at -OR- Lot #: _ Block #: _ Subdivision:
Type of work:
Check one: ❑ New Construction d Remodel* [3Addition* O Basement Finish*
*Check all that apply: M Framing O Mechanical O Plumbing O Electrical
NOTE: Any sub -contractors involved will need to submit their own signed applications.
*Description of work: Finishing basement: Living room, laundry room, and bathroom
*Total cost of project - materials and labor: $ (used to calculate permit fees)
Building Total: 1875 sq. ft Main: 1263 sq. ft Basement: O Finished O Unfinished 612 sq. ft
Garage 480 sq. It. Additional Floors: sq. ft
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION; Under penalty ofperlury, I hereby cerHfythat l have read this application and state thatthe information herein
is correct and I swearthat any information which may hereafterbe given byme in hearings before the Planning and Zoning Commission orthe City Council for the City ofRexhurg
shallbetruthful and correct I agree to comply wldi all City regulations and State laws relatingto the subjectmatter ofthis application and hereby authorized representatives ofthe
City to enterupon the above-mentionedproperty fcrinspecdons purposes. NOTE: Thebuilding official may revoke a remotion approval issued underthe provisions afthe 2012
International Code in cases of any false statement or misrepresentation of fact in the application or an the plans on which the permit or approval was based. PermitvoidAnot
started within 180 days. Permit void if work stops for 180 days.
Applicant's Name (print): Bradley Lawrence Signature: Bradley Lawreneeg '=-=- - Date: 0/17/2016
Inspections mustbe called inbefore 8 AM on the day the inspect an is requested. Inspection requests caged inafter8 AM will be scheduled forthe nextbusiness day.
Inspection Hasine-(208)372.2344 wwwrexburg.org Permit Technician -(208)372.2341 Revised March, 2016
CITY OF Building Safety Department
Fy0 �Q
REYBiURG City of Rexburg
C„ 35 North 1st East
Americas Family Community 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,
10 Electrical Contractors/Journeyman,
12 Engineers/Surveyors,
12 Public Works Contractors (exempt from fee only registration required),
26 Plumbing/Plumbers,
41 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 projector 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
O 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.
�VM+w aMe a% o-u�,ea.al..n.�¢memom
Bradley Lawrence 9/17/2016
tl�.glMA.tildl➢9
Signature Date
Bradley Lawrence
Print Name
Inspection Hotline -(208)378.2344 www.rexlmrg.org Permit Technician -(208)372.2341 Revised March, 2016
paXnURC �
a
CITY OF
REXBURG
Awcrimr Pamily Cmnnnmit,
Rexburg, Idaho 83440
Building Safety Department
City of Rexburg
35 North 1St East
BUILDING APPLICATION
Mechanical
For Office Use
Permit Number: Permit Type: ❑ Newr ❑ Remodel ❑ Addition ❑ Basement Finish
Fees Pai i []Yes ❑ No
1. Property Owner
Name: Bradley Lawrence
Address: 8t1 Park st City: Rexburg State: Idaho Zip Code: 83440
Phone &Type: 208-313-0122 ❑ Office O Mobile Email: bmd.lawrence@gmail.com
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)
❑ No: I am a contractor working for the homeowner ❑ No: This property is a Multi -family Residence or Commercial Property.
NOTE: Any cmrtracmrs/subcontractors involvedwill need to submit their own signed applications.
2. Mechanical Contractor
Name: Registration #: Exp.:
Address: City: State; Zip Code:
Phone & Type: ❑ Office ❑ Mobile Email:
Contact/Rep. Name: Phone: Email:
Mechanical Contractor Authorized Signature:,
Date:
3. Project Description
Address: 811 Putst -OR- Lot #: _ Block #: _ Subdivision:
Check one: El Single-family Residence ❑ Multi -family Residence ❑ Commercial
Check one: ❑ New Construction* ❑ Remodel ❑ Addition M Basement Finish
Description of work: AC? Fireplace?, tie in HVAC to living room laundry room and bathroom.
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: 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 ormore units= $((130x#of buildings)+(65x#of units))$_
New work on any other residence and Detached Shops: _ (65 + (10 x # of HVAC fixtures))
Miscellaneous: ❑ Gas Pressuree; $65' Furnace or A/C = $65 ❑ Water Heater = $65equested Inspection = $65
'Gas Line = $65' El Fireplace/Solid Fuel Burning Unit= $65 ❑Tec nical Service = $65/hour
❑ Plan Check =10% of Contracted Amount
APPLICANT'S SIGNATURE, CERTIFICATION AND AUTHORIZATION: Underpenalty ofperjury, I hereby certify that l have read this application and statethatthe 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 orthe City Council for the City of Rexburg
shallbe truthful and correct. I agree to complywith211 City regulations and State laws relating to the subject matter ofthis application and hereby authorized representatives ofthe
Cityto enterupon the above-mentionedproperty, for Inspections purposes. NOTE: The building official may revoke a permiton approval issued under the provisions of the 2012
International Code in cases of any false statement or misrepresentation offact in the application or on the plans on which the permit or approval was based. Permitvoid ifnot
started within 180 days. Permitvoid ifwarkstops for 180 days.
Applicant's Name (print): Bradley Lawrence Signature:
Inspections mustbe called in before 8 AM on the day the inspection is requested. Inspection requests called in after 8 AM will he scheduled for the next business day.
Inspection Hotline -(2081372.2344 www.rexburg,org Permit Technician -(208)372.2341 Revised March, 2016
pF%NUq
CITY OF
REXBURG
,r
Anmricas Family Cotmnunity
BUILDING APPLICATION
Electrical
Building Safety Department
City of Rexburg
35 North 1st East
Rexburg, Idaho 83440
For Office Use
Permit Number: Permit Type: ❑ Newf ❑ Remodel ❑ Addition ❑ Basement Finish
.ees at : DYes D ' o
1. Property Owner
Name: Bradley Lawrence
Address: eft Park at City: Rexburg State: Idaho Zip Code: 83440
Phone &Type: 208-313-0122 ❑ Office El Mobile Email: brad.lawrence@gmail.com
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? EJYes (Skip to #3 and complete the Homeowner's Exemption page)
❑ No: I am a contractor working for the homeowner ❑ No: This property is a Multi -family Residence or Commercial Property.
NOTE: Any contracmrs/sub-cautmctors involved will need to submit their own signed applications.
2. Electrical Contractor
Name: Registration #: Exp.:
Address: 811 Park ST City: Rexburg State: Zip Code:
Phone & Type: ❑ Office ❑ Mobile Email:
Contact/Rep. Name: Phone: Email:
Electrical Contractor Authorized Signatures Date:
3. Project Description
Address: 811 Parks -OR- Lot #: _ Block #: _ Subdivision:
Check one: p Single-family Residence ❑ Multi -family Residence ❑ Commercial
Check one: ❑ New Construction* ❑ Remodel ❑ Addition O 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 0 $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: 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= $((130 x # of buildings)+(6S x #.of units))$.'
New work on any other residence and Detached Shops:_ (65 + (10 x # 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 ElRequested Inspection= $65
❑ Pumps- Water, Irrigation, Sewage (per motor) = [J$65 up to 25HP ❑ $95x26- 200HP ❑ $130 over 20oHP
❑ 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%m of Contracted Amoun
Temvorary Construction Services ONLY= $65 200 amp or less. One location for less than 1 year.1
APPLICAN'T'S SIGNATURE, GERTTPIGATION AND AUTHORIZATION: Underpenalty ofperjury, Ihereby certify that l have read this application and state thatthe information herein
is carrectand I swear that any Infarmationwhich may hereafterbe given byme in hearings before the Planning and Zoning Commission orthe City Coundiforthe City of Rexburg
shallbe 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 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 Cade In cases manyfalse statement ormisrepresentation offact inthe application or on the plans on which the permit or approval was hosed. Permitvoid ifnot
started within 180 days. Permit void ifworkstups for 180 days.
Applicanfs Name (print): Bradley Lawrence Signature: Bradley Lawrence
'-- Date: 9117i2016
Inspections mustbe called in before 8 A on the day the inspection is requested. Inspection requests called in after 8 AM will be scheduled far the next business day.
Inspection Hotline -(208)372.2344 www.rexbmg.org Permit Technician -(208)372.2341 Revised March, 2016
O`pFX11Uge CITY OF Building Safety Department
City of Rexburg
Qu 35 North 1st East
Aulericas Family Community Rexburg, Idaho 83440
BUILDING APPLICATION
Plumbing
For Office Use
Permit Number: Permit Type: 13New ❑ Remodel ❑ Addition ❑ Basement Finish
FeesPaid: Yes ❑ NO
1. Property Owner
Name: Bradley Lawrence
Address: 811 Park s City: Rexburg State: Idaho Zip Code: 83440
Phone &Type: 208.313-0122 ❑ Office ID Mobile Email: bmd.iawrenee®gmaltcom
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? El Yes (Skip to #3 and complete the Homeowner's Exemption page)
❑ No: I am a contractor working for the homeowner ❑ No: This property is a Multi -family Residence or Commercial Property.
NOTE: Any contractors/sub-contactors involved will need to submit their own signed applications.
2. Plumbing Contractor
Name: Registration #: Exp.:
Address: City: State: Zip Code:
Phone & Type: ❑ Office ❑ Mobile Email:
Contact/Rep. Name: Phone: Email:
Plumbing Contractor Authorized Signature-, Date:
3. Project Description Water Meter Quantity: Water Meter Size:
Address: 811 Palk 81 OR- Lot #: _ Block #: Subdivision:
Check one: O Single-family Residence ❑ Multi -family Residence ❑ Commercial
Check one: ❑ New Construction* []Remodel ❑ Addition El Basement Finish
Description of work: Bethmom: sink, toilet, shower. Home already has a water mater.
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: 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))$_
❑ Gray Water Systems= $130 ❑ Lawn Sprinklers/Backflow device= $65 ❑ Multipurpose Fire Sprinkler & Domestic Water
Su Iy S stem - $65 br $4 pets rinkler head whichever is greater)
Ne1v work on any other residence and Detached Shops: = 65 for sewer and water stub connections ❑
Miscellaneous: ❑Sewer Line = 65 ❑ Water Line = $65 Mewer and Water Line= $65 a Requested inspection $65
❑ Sewer Turnaround (septic to city) = $65 ❑ HydronicHeating ='$65 + ($10x# of manifolds/zones)
❑ Technical Service = $65/hour ❑ Plan Check =10% of Contracted Amount
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 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
sha8be truthful and carred. I agree to comply with all City regulations and State laws relating to the subject matter of this application and hereby authodzed representatives ofthe
City to enterupon the above-mentioned property for inspections purposes. NOTE: The building official may revoke a ponniton approval Issued under the provisions of the 2012
International Code in cases of anyfatse statement mrmisrepresentation of fact in the application or on the plans on which the permit or approvalwag based. Permitvold ifnot
started within 180 days. Permkvold Ifworkstops for 180 days.
Applicants Name (Print): Bradley Signature: Bradley Lawrence _I•'-_=e—
'"Date: 911712016
Inspections most he 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 wwwrexhurg.org Permit Technician -(208)372.2341 Revised March, 2016
V
nFaExa°°� CITY OF Building Safety Department
ti4 d
c REXBURGCity of Rexburg
" Submit By Email
0 35 North 1st East
Amerlws Family Community Rexburg, Idaho 83440
SINGLE FAMILY RESIDENTIAL APPLICATION CHECKLIST
The following items should be completed before you submit your building permit application.
*Reasonable accommodations will a made upon request
Complete the Following:
17 2 sets of site plans (see Site Plan Checklist on page 2)
13 2 sets of building plans drawn to scale (see box below) - stamped by a licensed professional
13 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.)
D Structural Calculations (see box below) -stamped by a licensed Engineer
13 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)
0 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)
G Property Line form signed by builder. (see page 8)
o Affidavit of Legal Interest signed by owner. (seepage 9)
O Subcontractor list filled out (seepage 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 htt_li//`rexburg.org/12ages/develoi2merit-code
Seismic Design Category - D
Ground Snow- 50lbs. per sq. ft
Roof Snow Load - 35 lbs. per sq. ft
Wind Load -90 MPH
Frost Depth -36"
Inspection Hotline-(208)372.2344—rexburg.org PermitTechnician- (208) 372.2341 Revised March, 2016
oe pexangC CITY OF Building Safety Department
o REXBURG City of Rexburg
cn 35 North 1st East
America's Family Community
Rexburg, Idaho 83440
Permit Policies Acknowledgement
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.
BL 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.
[3L 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.
BL o If an inspection is not done, the inspector may require any measures to betaken 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.
BL 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 on to anyone who this would be applicable to for your project.
All sub -contractors will be held to this standard with no exceptions.
BL o The above policies will be enforced to all, regardless if you pass this information onto them or not
Intials
Applicants Name (print): Bradley Lawrence Signature: Bradley Lawrence pate: 9/17/2016
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